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Sample records for pulse oximetry trial

  1. Pulse oximetry for perioperative monitoring

    DEFF Research Database (Denmark)

    Pedersen, Tom; Nicholson, Amanda; Hovhannisyan, Karen

    2014-01-01

    or infectious complications were detected in the two groups. The duration of hospital stay was a median of five days in both groups, and equal numbers of in-hospital deaths were reported in the two groups. Continuous pulse oximetry has the potential to increase vigilance and decrease pulmonary complications...

  2. Photonic textiles for pulse oximetry.

    Science.gov (United States)

    Rothmaier, Markus; Selm, Bärbel; Spichtig, Sonja; Haensse, Daniel; Wolf, Martin

    2008-08-18

    Biomedical sensors, integrated into textiles would enable monitoring of many vitally important physiological parameters during our daily life. In this paper we demonstrate the design and performance of a textile based pulse oximeter, operating on the forefinger tip in transmission mode. The sensors consisted of plastic optical fibers integrated into common fabrics. To emit light to the human tissue and to collect transmitted light the fibers were either integrated into a textile substrate by embroidery (producing microbends with a nominal diameter of 0.5 to 2 mm) or the fibers inside woven patterns have been altered mechanically after fabric production. In our experiments we used a two-wavelength approach (690 and 830 nm) for pulse wave acquisition and arterial oxygen saturation calculation. We have fabricated different specimens to study signal yield and quality, and a cotton glove, equipped with textile based light emitter and detector, has been used to examine movement artifacts. Our results show that textile-based oximetry is feasible with sufficient data quality and its potential as a wearable health monitoring device is promising.

  3. Pulse oximetry: fundamentals and technology update

    Directory of Open Access Journals (Sweden)

    Nitzan M

    2014-07-01

    Full Text Available Meir Nitzan,1 Ayal Romem,2 Robert Koppel31Department of Physics/Electro-Optics, Jerusalem College of Technology, Jerusalem, Israel; 2Pulmonary Institute, Shaare Zedek Medical Center, Jerusalem, Israel; 3Neonatal/Perinatal Medicine, Cohen Children's Medical Center of New York/North Shore-LIJ Health System, New Hyde Park, NY, United StatesAbstract: Oxygen saturation in the arterial blood (SaO2 provides information on the adequacy of respiratory function. SaO2 can be assessed noninvasively by pulse oximetry, which is based on photoplethysmographic pulses in two wavelengths, generally in the red and infrared regions. The calibration of the measured photoplethysmographic signals is performed empirically for each type of commercial pulse-oximeter sensor, utilizing in vitro measurement of SaO2 in extracted arterial blood by means of co-oximetry. Due to the discrepancy between the measurement of SaO2 by pulse oximetry and the invasive technique, the former is denoted as SpO2. Manufacturers of pulse oximeters generally claim an accuracy of 2%, evaluated by the standard deviation (SD of the differences between SpO2 and SaO2, measured simultaneously in healthy subjects. However, an SD of 2% reflects an expected error of 4% (two SDs or more in 5% of the examinations, which is in accordance with an error of 3%–4%, reported in clinical studies. This level of accuracy is sufficient for the detection of a significant decline in respiratory function in patients, and pulse oximetry has been accepted as a reliable technique for that purpose. The accuracy of SpO2 measurement is insufficient in several situations, such as critically ill patients receiving supplemental oxygen, and can be hazardous if it leads to elevated values of oxygen partial pressure in blood. In particular, preterm newborns are vulnerable to retinopathy of prematurity induced by high oxygen concentration in the blood. The low accuracy of SpO2 measurement in critically ill patients and newborns

  4. Pulse oximetry in bronchiolitis: is it needed?

    Directory of Open Access Journals (Sweden)

    Hendaus MA

    2015-10-01

    Full Text Available Mohamed A Hendaus,1,2 Fatima A Jomha,3 Ahmed H Alhammadi,1,2 1Department of Pediatrics, General Pediatrics Division, Hamad Medical Corporation, 2Weill-Cornell Medical College, Doha, Qatar; 3School of Pharmacy, Lebanese International University, Khiara, Lebanon Abstract: Infants admitted to health-care centers with acute bronchiolitis are frequently monitored with a pulse oximeter, a noninvasive method commonly used for measuring oxygen saturation. The decision to hospitalize children with bronchiolitis has been largely influenced by pulse oximetry, despite its questionable diagnostic value in delineating the severity of the illness. Many health-care providers lack the appropriate clinical fundamentals and limitations of pulse oximetry. This deficiency in knowledge might have been linked to changes in the management of bronchiolitis. The aim of this paper is to provide the current evidence on the role of pulse oximetry in bronchiolitis. We discuss the history, fundamentals of operation, and limitations of the apparatus. A search of the Google Scholar, Embase, Medline, and PubMed databases was carried out for published articles covering the use of pulse oximetry in bronchiolitis. Keywords: bronchiolitis, children, monitor, oxygen

  5. Optimal filter bandwidth for pulse oximetry

    Science.gov (United States)

    Stuban, Norbert; Niwayama, Masatsugu

    2012-10-01

    Pulse oximeters contain one or more signal filtering stages between the photodiode and microcontroller. These filters are responsible for removing the noise while retaining the useful frequency components of the signal, thus improving the signal-to-noise ratio. The corner frequencies of these filters affect not only the noise level, but also the shape of the pulse signal. Narrow filter bandwidth effectively suppresses the noise; however, at the same time, it distorts the useful signal components by decreasing the harmonic content. In this paper, we investigated the influence of the filter bandwidth on the accuracy of pulse oximeters. We used a pulse oximeter tester device to produce stable, repetitive pulse waves with digitally adjustable R ratio and heart rate. We built a pulse oximeter and attached it to the tester device. The pulse oximeter digitized the current of its photodiode directly, without any analog signal conditioning. We varied the corner frequency of the low-pass filter in the pulse oximeter in the range of 0.66-15 Hz by software. For the tester device, the R ratio was set to R = 1.00, and the R ratio deviation measured by the pulse oximeter was monitored as a function of the corner frequency of the low-pass filter. The results revealed that lowering the corner frequency of the low-pass filter did not decrease the accuracy of the oxygen level measurements. The lowest possible value of the corner frequency of the low-pass filter is the fundamental frequency of the pulse signal. We concluded that the harmonics of the pulse signal do not contribute to the accuracy of pulse oximetry. The results achieved by the pulse oximeter tester were verified by human experiments, performed on five healthy subjects. The results of the human measurements confirmed that filtering out the harmonics of the pulse signal does not degrade the accuracy of pulse oximetry.

  6. Pulse oximetry: a potential aid in endodontic diagnosis?

    Science.gov (United States)

    Caplan, Dan

    2010-06-01

    Pulse oximetry: review of a potential aid in endodontic diagnosis. Jafarzadeh H, Rosenberg PA. J Endod 2009;35(3):329-33. Dan Caplan, DDS, PhD. This article provided a description of pulse oximetry, its use in patient care settings, and its potential for use in endodontic diagnosis. Information not available. Comprehensive literature review. Level 3: Other evidence. Not applicable.

  7. Advanced Pulse Oximetry System for Remote Monitoring and Management

    Science.gov (United States)

    Pak, Ju Geon; Park, Kee Hyun

    2012-01-01

    Pulse oximetry data such as saturation of peripheral oxygen (SpO2) and pulse rate are vital signals for early diagnosis of heart disease. Therefore, various pulse oximeters have been developed continuously. However, some of the existing pulse oximeters are not equipped with communication capabilities, and consequently, the continuous monitoring of patient health is restricted. Moreover, even though certain oximeters have been built as network models, they focus on exchanging only pulse oximetry data, and they do not provide sufficient device management functions. In this paper, we propose an advanced pulse oximetry system for remote monitoring and management. The system consists of a networked pulse oximeter and a personal monitoring server. The proposed pulse oximeter measures a patient's pulse oximetry data and transmits the data to the personal monitoring server. The personal monitoring server then analyzes the received data and displays the results to the patient. Furthermore, for device management purposes, operational errors that occur in the pulse oximeter are reported to the personal monitoring server, and the system configurations of the pulse oximeter, such as thresholds and measurement targets, are modified by the server. We verify that the proposed pulse oximetry system operates efficiently and that it is appropriate for monitoring and managing a pulse oximeter in real time. PMID:22933841

  8. Feasibility of Pulse Oximetry Pre-discharge Screening ...

    African Journals Online (AJOL)

    Feasibility of Pulse Oximetry Pre-discharge Screening Implementation for detecting Critical Congenital heart Lesions in newborns in a secondary-level maternity hospital in the Western Cape, South Africa: The 'POPSICLe' study.

  9. Vessel calibre and haemoglobin effects on pulse oximetry

    International Nuclear Information System (INIS)

    McEwen, M P; Reynolds, K J; Bull, G P

    2009-01-01

    Despite its success as a clinical monitoring tool, pulse oximetry may be improved with respect to the need for empirical calibration and the reports of biases in readings associated with peripheral vasoconstriction and haemoglobin concentration. To effect this improvement, this work aims to improve the understanding of the photoplethysmography signal—as used by pulse oximeters—and investigates the effect of vessel calibre and haemoglobin concentration on pulse oximetry. The digital temperature and the transmission of a wide spectrum of light through the fingers of 57 people with known haemoglobin concentrations were measured and simulations of the transmission of that spectrum of light through finger models were performed. Ratios of pulsatile attenuations of light as used in pulse oximetry were dependent upon peripheral temperature and on blood haemoglobin concentration. In addition, both the simulation and in vivo results showed that the pulsatile attenuation of light through fingers was approximately proportional to the absorption coefficients of blood, only when the absorption coefficients were small. These findings were explained in terms of discrete blood vessels acting as barriers to light transmission through tissue. Due to the influence of discrete blood vessels on light transmission, pulse oximeter outputs tend to be dependent upon haemoglobin concentration and on the calibre of pulsing blood vessels—which are affected by vasoconstriction/vasodilation. The effects of discrete blood vessels may account for part of the difference between the Beer–Lambert pulse oximetry model and empirical calibration

  10. Quantitative evaluation of photoplethysmographic artifact reduction for pulse oximetry

    Science.gov (United States)

    Hayes, Matthew J.; Smith, Peter R.

    1999-01-01

    Motion artefact corruption of pulse oximeter output, causing both measurement inaccuracies and false alarm conditions, is a primary restriction in the current clinical practice and future applications of this useful technique. Artefact reduction in photoplethysmography (PPG), and therefore by application in pulse oximetry, is demonstrated using a novel non-linear methodology recently proposed by the authors. The significance of these processed PPG signals for pulse oximetry measurement is discussed, with particular attention to the normalization inherent in the artefact reduction process. Quantitative experimental investigation of the performance of PPG artefact reduction is then utilized to evaluate this technology for application to pulse oximetry. While the successfully demonstrated reduction of severe artefacts may widen the applicability of all PPG technologies and decrease the occurrence of pulse oximeter false alarms, the observed reduction of slight artefacts suggests that many such effects may go unnoticed in clinical practice. The signal processing and output averaging used in most commercial oximeters can incorporate these artefact errors into the output, while masking the true PPG signal corruption. It is therefore suggested that PPG artefact reduction should be incorporated into conventional pulse oximetry measurement, even in the absence of end-user artefact problems.

  11. Pulse oximetry : technology to reduce child mortality in developing countries

    NARCIS (Netherlands)

    Duke, T.; Subhi, R.; Peel, D.; Frey, B.

    The causes of hypoxaemia in children include the commonest causes of childhood illness: pneumonia and other acute respiratory infections, and neonatal illness, particularly sepsis, low birthweight, birth asphyxia and aspiration syndromes. The systematic use of pulse oximetry to monitor and treat

  12. Finger blood content, light transmission, and pulse oximetry errors.

    Science.gov (United States)

    Craft, T M; Lawson, R A; Young, J D

    1992-01-01

    The changes in light emitting diode current necessary to maintain a constant level of light incident upon a photodetector were measured in 20 volunteers at the two wavelengths employed by pulse oximeters. Three states of finger blood content were assessed; exsanguinated, hyperaemic, and normal. The changes in light emitting diode current with changes in finger blood content were small and are not thought to represent a significant source of error in saturation as measured by pulse oximetry.

  13. Determination of blood volume by pulse CO-oximetry

    International Nuclear Information System (INIS)

    Lalande, S; Kelsey, J W; Joyner, M J; Johnson, B D

    2012-01-01

    The objective of this study was to determine whether changes in carboxyhaemoglobin (COHb) saturation following carbon monoxide (CO) rebreathing can be accurately detected by pulse CO-oximetry in order to determine blood volume. Noninvasive measurements of carboxyhaemoglobin saturation (SpCO) were continuously monitored by pulse CO-oximetry before, during and following 2 min of CO rebreathing. Reproducibility and accuracy of noninvasive blood volume measurements were determined in 16 healthy non-smoking individuals (15 males, age: 28 ± 2 years, body mass index: 25.4 ± 0.6 kg m −2 ) through comparison with blood volume measurements calculated from invasive measurements of COHb saturation. The coefficient of variation for noninvasive blood volume measurements performed on separate days was 15.1% which decreases to 9.1% when measurements were performed on the same day. Changes in COHb saturation and SpCO following CO rebreathing were strongly correlated (r = 0.90, p < 0.01), resulting in a significant correlation between invasive and noninvasive blood volume measurements (r = 0.83, p = 0.02). Changes in SpCO following CO rebreathing can be accurately detected by pulse CO-oximetry, which could potentially provide a simplified, convenient and reproducible method to rapidly determine blood volume in healthy individuals

  14. Accuracy of pulse oximetry in pigmented patients

    African Journals Online (AJOL)

    Trempel'" KK. Barker SJ. PuI$e pulse OJlim€try. Anestilesiology 1992; 76: 1018-1038.

  15. EVALUATION OF CONDITION OF THE PULP BY PULSE OXIMETRY.

    Directory of Open Access Journals (Sweden)

    Dimitar Kosturkov

    2015-12-01

    Full Text Available Purpose: To conduct pulse oximetry (PO and electric pulp test (EPT on intact frontal teeth in clinically healthy patients aged between 18 and 25 years who do not have periodontal disease. Material/Methods: To achieve the aim 1058 teeth of 31 patients were studied. The following inclusion criteria for the study were set: 1. Age – 18-25 years. 2. Clinically healthy patient, who does not have any systemic diseases, do not take any medicine systematically. 3. Intact frontal teeth – without carious lesions, restorations or root canal treatment. 4. Lack of periodontal disease. Research was conducted with a pulse oximeter Contec™ - CMS60D and a custom made probe holder. Results: Average values obtained by pulse oximetry in upper jaw vary between 83% and 85%. In lower jaw – between 82% and 85%. 99% is the maximum and 48% is the minimum registered value. The average value of the measurement of all the teeth is 84%. The average saturation measured on the small finger of the right hand of the patient is 98%. The average value of EPT for all teeth is 4 μA. The maximum measured value is 20 μA, and the minimum - 1 μA. Conclusions: 1. Adequate study of the pulp includes two complementary methods – electric pulp test (evaluation of innervation and pulse oximetry (assessment of pulp microcirculation. 2. Teeth that are larger in size have larger values of PO and EPT, which is in direct relation to the size of their pulp chamber. 3. The total saturation, measured in the little finger of the right hand is greater than the one of the teeth.

  16. Pulse carboxyhemoglobin-oximetry and cigarette smoking.

    Science.gov (United States)

    Sokolova-Djokić, L; Milosević, S; Skrbić, R; Salabat, R; Voronov, G; Igić, R

    2011-01-01

    We used a pulse carbon monoxide (CO)-oximeter to measure the levels of carboxyhemoglobin (COHb) in smokers and non-smokers. Our goal was to determine if this device could not only define smoking status, but also to increase accuracy of self-reported data at various surveys on smoking. Thirty-four healthy volunteers participated in this study. Twenty-two of them were current daily smokers; 12 participants were non-smokers who lived alone or with a nonsmoker, and who worked in non-smoking environment. Nicotine dependency level was determined by the modified Fagerstrom questionnaire. Blood COHb levels were measured with a pulse CO-oximeter (Masimo, Radical 7). The COHb levels in both moderate/heavy smokers and light smokers increased significantly after they smoked a single cigarette. This increase persisted for more than 6 h in the moderate/heavy smokers, while in the light smokers COHb levels returned to the baseline level after one hour. The pulse rate of all smokers increased significantly 20 min after smoking. We conclude that the CO-oximeter can detect smoking by moderate/heavy smokers and light smokers if they smoked 6 h or 20 min earlier, respectively. We concluded that it could be used as a validation test for smoking at the time of admission to the surgical facility and to increase smoking abstinence during preoperative and postoperative periods. This noninvasive, simple and inexpensive test may also be used at various surveys to increase accuracy of self-reports on smoking.

  17. New laser system for highly sensitive clinical pulse oximetry

    Science.gov (United States)

    Hamza, Mostafa; Hamza, Mohammad

    1996-04-01

    This paper describes the theory and design of a new pulse oximeter in which laser diodes and other compact laser sources are used for the measurement of oxygen saturation in patients who are at risk of developing hypoxemia. The technique depends upon illuminating special sites of the skin of the patient with radiation from modulated laser sources at selected wavelengths. The specific laser wavelengths are chosen based on the absorption characteristics of oxyhemoglobin, reduced hemoglobin and other interfering sources for obtaining more accurate measurements. The laser radiation transmitted through the tissue is detected and signal processing based on differential absorption laser spectroscopy is done in such a way to overcome the primary performance limitations of the conventionally used pulse oximetry. The new laser pulse oximeter can detect weak signals and is not affected by other light sources such as surgical lamps, phototherapy units, etc. The detailed description and operating characteristics of this system are presented.

  18. Pulse oximetry in family practice: indications and clinical observations in patients with COPD.

    NARCIS (Netherlands)

    Schermer, T.R.J.; Leenders, J.L.H.; Veen, H. in 't; Bosch, W.J.H.M. van den; Wissink, A.; Smeele, I.J.M.; Chavannes, N.H.

    2009-01-01

    PURPOSE: To establish situations in which family physicians (FPs) consider pulse oximetry a valuable addition to their clinical patient assessment; to explore pulse oximetry results (SpO(2)) when used by FPs in patients with chronic obstructive pulmonary disease (COPD); to explore associations

  19. In-vitro model for evaluation of pulse oximetry

    Science.gov (United States)

    Vegfors, Magnus; Lindberg, Lars-Goeran; Lennmarken, Claes; Oberg, P. Ake

    1991-06-01

    An in vitro model with blood circulating in a silicon tubing system and including an artificial arterial bed is an important tool for evaluation of the pulse oximetry technique. The oxygen saturation was measured on an artificial finger using a pulse oximeter (SpO2) and on blood samples using a hemoximeter (SaO2). Measurements were performed at different blood flows and at different blood hematocrits. An increase in steady as well as in pulsatile blood flow was followed by an increase in pulse oximeter readings and a better agreement between SpO2 and SaO2 readings. After diluting the blood with normal saline (decreased hematocrit) the agreement was further improved. These results indicate that the pulse oximeter signal is related to blood hematocrit and the velocity of blood. The flow-related dependance of SpO2 was also evaluated in a human model. These results provided evidence that the pulse oximeter signal is dependent on vascular changes.

  20. [The source and factors that influence tracheal pulse oximetry signal].

    Science.gov (United States)

    Fan, Xiao-hua; Wei, Wei; Wang, Jian; Mu, Ling; Wang, Li

    2010-03-01

    To investigate the source and factors that influence tracheal pulse oximetry signal. The adult mongrel dog was intubated after anesthesia. The tracheal tube was modified by attaching a disposable pediatric pulse oximeter to the cuff. The chest of the dog was cut open and a red light from the tracheal oximeter was aligned with the deeper artery. The changes in tracheal pulse oxygen saturation (SptO2) signal were observed after the deeper artery was blocked temporarily. The photoplethysmography (PPG) and readings were recorded at different intracuff pressures. The influence of mechanical ventilation on the signal was also tested and compared with pulse oxygen saturation (SpO2). The SptO2 signal disappeared after deeper artery was blocked. The SptO2 signal changed with different intracuff pressures (P signal appeared under 20-60 cm H2O of intracuff pressure than under 0-10 cm H2O of intracuff pressure(P signal under a condition with mechanical ventilation differed from that without mechanical ventilation (P signal is primarily derived from deeper arteries around the trachea, not from the tracheal wall. Both intracuff pressures and mechanical ventilation can influence SptO2 signal. The SptO2 signal under 20-60 cm H2O of intracuff pressure is stronger than that under 0-10 em H2O of intracuff pressure. Mechanical ventilation mainly changes PPG.

  1. Intrauterine Methylene Blue Injection Influences the Accuracy of Pulse Oximetry Readings

    Directory of Open Access Journals (Sweden)

    Fuh-Cheng Yeh

    2005-12-01

    Conclusions: Intraoperative administration of methylene blue may induce false low readings on pulse oximetry. The patient was not hypoxemic. If there is any doubt, arterial blood gas analysis should be done to ensure that the patient is well oxygenated.

  2. Reliability of pulse oximetry during cardiopulmonary resuscitation in a piglet model of neonatal cardiac arrest.

    Science.gov (United States)

    Hassan, Mohammad Ahmad; Mendler, Marc; Maurer, Miriam; Waitz, Markus; Huang, Li; Hummler, Helmut D

    2015-01-01

    Pulse oximetry is widely used in intensive care and emergency conditions to monitor arterial oxygenation and to guide oxygen therapy. To study the reliability of pulse oximetry in comparison with CO-oximetry in newborn piglets during cardiopulmonary resuscitation (CPR). In a prospective cohort study in 30 healthy newborn piglets, cardiac arrest was induced, and thereafter each piglet received CPR for 20 min. Arterial oxygen saturation was monitored continuously by pulse oximetry (SpO2). Arterial blood was analyzed for functional oxygenation (SaO2) every 2 min. SpO2 was compared with coinciding SaO2 values and bias considered whenever the difference (SpO2 - SaO2) was beyond ±5%. Bias values were decreased at the baseline measurements (mean: 2.5 ± 4.6%) with higher precision and accuracy compared with values across the experiment. Two minutes after cardiac arrest, there was a marked decrease in precision and accuracy as well as an increase in bias up to 13 ± 34%, reaching a maximum of 45.6 ± 28.3% after 10 min over a mean SaO2 range of 29-58%. Pulse oximetry showed increased bias and decreased accuracy and precision during CPR in a model of neonatal cardiac arrest. We recommend further studies to clarify the exact mechanisms of these false readings to improve reliability of pulse oximetry during the marked desaturation and hypoperfusion found during CPR. © 2014 S. Karger AG, Basel.

  3. Development and initial testing of a pulse oximetry prototype for measuring dental pulp vitality

    Science.gov (United States)

    Cerqueira, M.; Ferreira, M.; Caramelo, F.

    2015-05-01

    The guiding principle of endodontic treatment is to preserve teeth while maintaining its aesthetic and functional roles. To accomplish this goal the assessment of teeth pulp vitality is very important since it will determine the procedures that should be adopted and define the therapy strategy. Currently, the most commonly tests for determining dental pulp state are the thermal and the electrical tests, which are based on nerve response and, because of that, have a relatively high rate of false positives and false negatives cases. In this work we present a simple test to be used in the clinical setting for evaluating noninvasively the existence of blood perfusion in dental pulp. This test is based on pulse oximetry principle that was devised to indirectly measure the amount of oxygen in blood. Although pulse oximetry has already demonstrated its usefulness in clinical environment its usage for the determination of dental pulp vitality has been frustrated by several factors, notably the absence of a suitable sensor to the complex shape of the various coronary teeth. We developed a suitable sensor and present the first trials with promising results, regarding the ability for distinguish teeth with and without blood perfusion.

  4. Wavelength selection method with standard deviation: application to pulse oximetry.

    Science.gov (United States)

    Vazquez-Jaccaud, Camille; Paez, Gonzalo; Strojnik, Marija

    2011-07-01

    Near-infrared spectroscopy provides useful biological information after the radiation has penetrated through the tissue, within the therapeutic window. One of the significant shortcomings of the current applications of spectroscopic techniques to a live subject is that the subject may be uncooperative and the sample undergoes significant temporal variations, due to his health status that, from radiometric point of view, introduce measurement noise. We describe a novel wavelength selection method for monitoring, based on a standard deviation map, that allows low-noise sensitivity. It may be used with spectral transillumination, transmission, or reflection signals, including those corrupted by noise and unavoidable temporal effects. We apply it to the selection of two wavelengths for the case of pulse oximetry. Using spectroscopic data, we generate a map of standard deviation that we propose as a figure-of-merit in the presence of the noise introduced by the living subject. Even in the presence of diverse sources of noise, we identify four wavelength domains with standard deviation, minimally sensitive to temporal noise, and two wavelengths domains with low sensitivity to temporal noise.

  5. Parental preference and perspectives on continuous pulse oximetry in infants and children with bronchiolitis

    Directory of Open Access Journals (Sweden)

    Hendaus MA

    2018-04-01

    Full Text Available Mohamed A Hendaus,1,2 Suzan Nassar,3 Bassil A Leghrouz,3 Ahmed H Alhammadi,1,2 Mohammed Alamri4 1Department of Pediatrics, Section of Academic General Pediatrics, Sidra Medicine, Doha, Qatar; 2Department of Clinical Pediatrics, Weill Cornell Medicine, Doha, Qatar; 3Department of Pediatrics, Hamad General Corporation, Doha, Qatar; 4Pediatric Emergency Center, Hamad General Corporation, Doha, Qatar Objective: The purpose of the study was to investigate parental preference of continuous pulse oximetry in infants and children with bronchiolitis. Materials and methods: A cross-sectional prospective study was conducted at Hamad Medical Corporation in Qatar. Parents of infants and children <24 months old and hospitalized with bronchiolitis were offered an interview survey. Results: A total of 132 questionnaires were completed (response rate 100%. Approximately 90% of participants were 20–40 years of age, and 85% were females. The mean age of children was 7.2±5.8 months. Approximately eight in ten parents supported the idea of continuous pulse oximetry in children with bronchiolitis. Almost 43% of parents believed that continuous pulse-oximetry monitoring would delay their children’s hospital discharge. Interestingly, approximately 85% of caregivers agreed that continuous pulse oximetry had a good impact on their children’s health. In addition, around one in two of the participants stated that good bedside examinations can obviate the need for continuous pulse oximetry. Furthermore, 80% of parents believed that continuous pulse-oximetry monitoring would give the health-care provider a good sense of security regarding the child’s health. Finally, being a male parent was associated with significantly increased risk of reporting unnecessary fatigue, attributed to the sound of continuous pulse oximetry (P=0.031. Conclusion: Continuous pulse-oximetry monitoring in children with bronchiolitis was perceived as reassuring for parents. Involving parents

  6. Design of pulse oximetry signal based on personal computer for detection oxygen saturation

    International Nuclear Information System (INIS)

    Umi Salamah; Margi Sasono

    2015-01-01

    The lack or excess of oxygen in the blood will cause healthy and body system disorder. At certain level, the disease can lead to death. For that reason, the information about oxygen saturation in blood becomes important to be identified. One of the devices used to monitor the blood oxygen saturation is pulse oximetry. This research attempt to designed Pulse Oximetry based on personal computer using red LED and infrared as its light source, while the light sensor using photodiode. The designed Pulse Oximetry is a non-invasive instrumentation which LED drivers is placed on the fingertips. The LED light goes through the finger will be a signal that is fed to the photodiode and will be converted into digital signals by ADC (Analog to Digital Converter) and will be processed further by a personal computer to display the pulse oximetry graphics. This study uses Delphi 7, Microsoft Excel, and Mt Lab as its software.This designed pulse oximetry has been tested in two peoples: sample A, male 38 years; and sample B, a woman 23 years old. Oxygen saturation of sample A is 80.75, while the sample B is 90.75. (author)

  7. A Meta-Analysis about the Screening Role of Pulse Oximetry for Congenital Heart Disease

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    Caiju Du

    2017-01-01

    Full Text Available Objective. The opinions about the application of pulse oximetry in diagnosis of congenital heart disease (CHD were debatable. We performed this meta-analysis to confirm the diagnostic role of pulse oximetry screening for CHD. Methods. Relevant articles were searched in the databases of Pubmed, Embase, Google Scholar, and Chinese National Knowledge Infrastructure (CNKI up to April 2017. Data was processed in the MetaDiSc 1.4 software. Pooled sensitivity and specificity with 95% confidence interval (95% CI were calculated to explain the diagnostic role of pulse oximetry screening for CHD. I2⩾50% or p<0.05 indicated significant heterogeneity. Area under curve (AUC of summary receiver operating characteristics (SROC was calculated to assess its diagnostic accuracy. The robustness of overall results was evaluated by sensitivity analysis. Publication bias was evaluated by Deek’s funnel plot. Results. 22 eligible articles were selected. Pooled sensitivity and specificity were 0.69 (0.67–0.72 and 0.99 (0.99-0.99, respectively. The corresponding AUC was 0.9407, suggesting high diagnostic accuracy of pulse oximetry screening for CHD. Sensitivity analysis demonstrated that the pooled results were robust. Deek’s funnel plot seemed to be symmetrical. Conclusions. Pulse oximetry screening could be used to diagnose CHD. It shows high diagnosis specificity and accuracy.

  8. RANCANG BANGUN PULSE OXIMETRY MENGGUNAKAN ARDUINO SEBAGAI DETEKSI KEJENUHAN OKSIGEN DALAM DARAH

    Directory of Open Access Journals (Sweden)

    Umi Salamah

    2016-12-01

    Full Text Available Kekurangan atau kelebihan oksigen dalam darah akan menimbulkan penyakit dan gangguan kerja tubuh. Pada tingkat tertentu, penyakit tersebut dapat meninbulkan resiko kematian. Oleh karena itu, informasi tentang kejenuhan oksigen dalam darah menjadi hal yang penting untuk dideteksi. Salah satu insturmentasi yang digunakan untuk memantau kejenuhan oksigen dalam darah adalah dengan pulse oximetry. Dalam penelitian ini dirancang bangun pulse oximetry berbasis personal computer menggunakan LED merah dan inframerah sebagai sumber cahaya sedang sensor cahaya yang digunakan adalah fotodioda. Pulse oximetry yang dirancang adalah instrumentasi non invasive yang mana driver LED diletakkan pada ujung jari. Cahaya LED yang terserap jari akan menjadi sinyal yang diumpankan ke fotodioda yang selanjutnya sinyal tersebut akan diubah menjadi sinyal digital oleh Arduino dan diproses lebih lanjut oleh personal computer untuk menampilkan grafik pulse oximetry tersebut. Perangkat lunak untuk mengolah data keluaran Arduino menggunakan Delphi 7, Microsoft Exel dan Mat Lab sebagai perangkat lunaknya. Hasil penelitian ini diperoleh sinyal Photopletysmography (PPG Ujung Jari yang representatif  dengan sinyal PPG referensi. Pengujian pulse oximetry yang telah dirancang adalah 16 dengan sampel uji random. Dari sampel tersebut, diperoleh 13 sampel uji berada pada prosentase kejenuhan oksigen normal dan 3 sampel uji berada pada prosentase kejenuhan oksigen tidak normal.

  9. Pulse Oximetry and Auscultation for Congenital Heart Disease Detection.

    Science.gov (United States)

    Hu, Xiao-Jing; Ma, Xiao-Jing; Zhao, Qu-Ming; Yan, Wei-Li; Ge, Xiao-Ling; Jia, Bing; Liu, Fang; Wu, Lin; Ye, Ming; Liang, Xue-Cun; Zhang, Jing; Gao, Yan; Zhai, Xiao-Wen; Huang, Guo-Ying

    2017-10-01

    Pulse oximetry (POX) has been confirmed as a specific screening modality for critical congenital heart disease (CCHD), with moderate sensitivity. However, POX is not able to detect most serious and critical cardiac lesions (major congenital heart disease [CHD]) without hypoxemia. In this study, we investigated the accuracy and feasibility of the addition of cardiac auscultation to POX as a screening method for asymptomatic major CHD. A multicenter prospective observational screening study was conducted at 15 hospitals in Shanghai between July 1, 2012, and December 31, 2014. Newborns with either an abnormal POX or cardiac auscultation were defined as screen positive. All screen-positive newborns underwent further echocardiography. False-negative results were identified by clinical follow-up, parents' feedback, and telephone review. We assessed the accuracy of POX plus cardiac auscultation for the detection of major CHD. CHD screening was completed in all 15 hospitals, with a screening rate of 94.0% to 99.8%. In total, 167 190 consecutive asymptomatic newborn infants were screened, of which 203 had major CHD (44 critical and 159 serious). The sensitivity of POX plus cardiac auscultation was 95.5% (95% confidence interval 84.9%-98.7%) for CCHD and 92.1% (95% confidence interval 87.7%-95.1%) for major CHD. The false-positive rate was 1.2% for detecting CCHD and 1.1% for detecting major CHD. In our current study, we show that using POX plus cardiac auscultation significantly improved the detection rate of major CHD in the early neonatal stage, with high sensitivity and a reasonable false-positive rate. It provides strong evidence and a reliable method for neonatal CHD screening. Copyright © 2017 by the American Academy of Pediatrics.

  10. Evaluation of Masimo signal extraction technology pulse oximetry in anaesthetized pregnant sheep.

    Science.gov (United States)

    Quinn, Christopher T; Raisis, Anthea L; Musk, Gabrielle C

    2013-03-01

    Evaluation of the accuracy of Masimo signal extraction technology (SET) pulse oximetry in anaesthetized late gestational pregnant sheep. Prospective experimental study. Seventeen pregnant Merino ewes. Animals included in study were late gestation ewes undergoing general anaesthesia for Caesarean delivery or foetal surgery in a medical research laboratory. Masimo Radical-7 pulse oximetry (SpO(2) ) measurements were compared to co-oximetry (SaO(2) ) measurements from arterial blood gas analyses. The failure rate of the pulse oximeter was calculated. Accuracy was assessed by Bland & Altman's (2007) limits of agreement method. The effect of mean arterial blood pressure (MAP), perfusion index (PI) and haemoglobin (Hb) concentration on accuracy were assessed by regression analysis. Forty arterial blood samples paired with SpO(2) and blood pressure measurements were obtained. SpO(2) ranged from 42 to 99% and SaO(2) from 43.7 to 99.9%. MAP ranged from 24 to 82 mmHg, PI from 0.1 to 1.56 and Hb concentration from 71 to 114 g L(-1) . Masimo pulse oximetry measurements tended to underestimate oxyhaemoglobin saturation compared to co-oximetry with a bias (mean difference) of -2% and precision (standard deviation of the differences) of 6%. Accuracy appeared to decrease when SpO(2) was oximeter function during extreme hypotension and hypoxaemia. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

  11. Simultaneous use of intrapartum fetal pulse oximetry and amnioinfusion in meconium stained amniotic fluid.

    Science.gov (United States)

    Halvax, László; Szabó, István; Vizer, Miklós; Csermely, Tamás; Ertl, Tibor

    2002-09-10

    Fetal pulse oximetry is a minimally invasive, simple technique which continuously helps to reflect in utero well-being. The presence of meconium in the amniotic fluid may be a clinical sign of fetal hypoxaemia. Amnioinfusion has a beneficial effect on the incidence of meconium aspiration syndrome (MAS), and the presence of meconium below the level of the vocal cords. We studied the impact of amnioinfusion combined with fetal pulse oximetry on the incidence of meconium aspiration syndrome and operative delivery. The retrospective analysis revealed that the presence of meconium below the level of vocal cords was significantly reduced. The frequency of cesarean section is decreased, however, it did not reach statistical significance. Fetal pulse oximetry may be used in combination with amnioinfusion and cardiotocography (CTG) to reduce the risk of meconium aspiration syndrome and the number of instrumental deliveries and improve perinatal outcome. Copyright 2002 Elsevier Science Ireland Ltd.

  12. Predicting blood transfusion using automated analysis of pulse oximetry signals and laboratory values.

    Science.gov (United States)

    Shackelford, Stacy; Yang, Shiming; Hu, Peter; Miller, Catriona; Anazodo, Amechi; Galvagno, Samuel; Wang, Yulei; Hartsky, Lauren; Fang, Raymond; Mackenzie, Colin

    2015-10-01

    Identification of hemorrhaging trauma patients and prediction of blood transfusion needs in near real time will expedite care of the critically injured. We hypothesized that automated analysis of pulse oximetry signals in combination with laboratory values and vital signs obtained at the time of triage would predict the need for blood transfusion with accuracy greater than that of triage vital signs or pulse oximetry analysis alone. Continuous pulse oximetry signals were recorded for directly admitted trauma patients with abnormal prehospital shock index (heart rate [HR] / systolic blood pressure) of 0.62 or greater. Predictions of blood transfusion within 24 hours were compared using Delong's method for area under the receiver operating characteristic (AUROC) curves to determine the optimal combination of triage vital signs (prehospital HR + systolic blood pressure), pulse oximetry features (40 waveform features, O2 saturation, HR), and laboratory values (hematocrit, electrolytes, bicarbonate, prothrombin time, international normalization ratio, lactate) in multivariate logistic regression models. We enrolled 1,191 patients; 339 were excluded because of incomplete data; 40 received blood within 3 hours; and 14 received massive transfusion. Triage vital signs predicted need for transfusion within 3 hours (AUROC, 0.59) and massive transfusion (AUROC, 0.70). Pulse oximetry for 15 minutes predicted transfusion more accurately than triage vital signs for both time frames (3-hour AUROC, 0.74; p = 0.004) (massive transfusion AUROC, 0.88; p transfusion prediction (3-hour AUROC, 0.84; p transfusion AUROC, 0.91; p blood transfusion during trauma resuscitation more accurately than triage vital signs or pulse oximetry analysis alone. Results suggest automated calculations from a noninvasive vital sign monitor interfaced with a point-of-care laboratory device may support clinical decisions by recognizing patients with hemorrhage sufficient to need transfusion. Epidemiologic

  13. Texas Pulse Oximetry Project: A Multicenter Educational and Quality Improvement Project for Implementation of Critical Congenital Heart Disease Screening Using Pulse Oximetry.

    Science.gov (United States)

    Guillory, Charleta; Gong, Alice; Livingston, Judith; Creel, Liza; Ocampo, Elena; McKee-Garrett, Tiffany

    2017-07-01

    Objective  Critical congenital heart disease (CCHD) is a leading cause of death in infants. Newborn screening (NBS) by pulse oximetry allows early identification of CCHD in asymptomatic newborns. To improve readiness of hospital neonatal birthing facilities for mandatory screening in Texas, an educational and quality improvement (QI) project was piloted to identify an implementation strategy for CCHD NBS in a range of birthing hospitals. Study Design  Thirteen Texas hospitals implemented standardized CCHD screening by pulse oximetry. An educational program was devised and a tool kit was created to facilitate education and implementation. Newborn nursery nurses' knowledge was assessed using a pre- and posttest instrument. Results  The nurses' knowledge assessment improved from 71 to 92.5% ( p  educational program, including a tool kit, QI processes, and standardized pulse oximetry CCHD NBS, is applicable for a range of hospital birthing facilities and may facilitate wide-scale implementation, thereby improving newborn health. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Prognostic value of nocturnal pulse oximetry in patients with heart failure.

    Science.gov (United States)

    Rivera-López, Ricardo; Jordán-Martínez, Laura; López-Fernández, Silvia; Rivera-Fernandez, Ricardo; Tercedor, Luis; Sáez-Roca, Germán

    2018-05-23

    To analyze the prognostic value of nocturnal hypoxemia measured with portable nocturnal pulse-oximetry in patients hospitalized due to heart failure and its relation to mortality and hospital readmission. We included 38 patients who were admitted consecutively to our unit with the diagnosis of decompensated heart failure. Pulse-oximetry was considered positive for hypoxemia when more than 10 desaturations per hour were recorded during sleep. Follow-up was performed for 30.3 (standard deviation [SD] 14.2) months, the main objective being a combined endpoint of all-cause mortality and hospital readmission due to heart failure. The average age was 70.7 (SD 10.7) years, 63.3% were males. Pulse-oximetry was considered positive for hypoxemia in 27 (71%) patients. Patients with positive pulse-oximetry had the most frequent endpoint (9.1% [1] vs. 61.5% [16], P = 0.003). After multivariate analysis, continuous nocturnal hypoxemia was related to the combined endpoint (HR = 8.37, 1.19-68.4, P = 0.03). Patients hospitalized for heart failure and nocturnal hypoxemia measured with portable pulse-oximeter have an increased risk of hospital readmission and death. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  15. Feasibility of pulse oximetry for assessment of infants born in community based midwifery care

    NARCIS (Netherlands)

    Smit, M.; Ganzeboom, A.; Dawson, J.A.; Walther, F.J.; Bustraan, J.; van Roosmalen, Jos; te Pas, A.B.

    2014-01-01

    To evaluate the feasibility of using pulse oximetry (PO) for evaluating infants born in community-based midwifery care. Design: a prospective, observational study of infants born after midwifery supervised (home) births. Setting: 27 midwives from seven practices providing primary care in (home)

  16. High quantum efficiency annular backside silicon photodiodes for reflectance pulse oximetry in wearable wireless body sensors

    DEFF Research Database (Denmark)

    Duun, Sune Bro; Haahr, Rasmus Grønbek; Hansen, Ole

    2010-01-01

    The development of annular photodiodes for use in a reflectance pulse oximetry sensor is presented. Wearable and wireless body sensor systems for long-term monitoring require sensors that minimize power consumption. We have fabricated large area 2D ring-shaped silicon photodiodes optimized...

  17. An Electronic Patch for Wearable Health Monitoring by Reflectance Pulse Oximetry

    DEFF Research Database (Denmark)

    Haahr, Rasmus Grønbek; Duun, Sune Bro; Toft, Mette H.

    2012-01-01

    photodiode to enable low power consumption by the light emitting components. The Electronic Patch has a disposable part of soft adhesive hydrocolloid polymer and a reusable part of hard polylaurinlactam. The disposable part contains the battery. The reusable part contains the reflectance pulse oximetry...

  18. REFLECTANCE PULSE OXIMETRY AT THE FOREHEAD IMPROVES BY PRESSURE ON THE PROBE

    NARCIS (Netherlands)

    DASSEL, ACM; GRAAFF, R; SIKKEMA, M; ZIJLSTRA, WG; AARNOUDSE, JG

    In this study, we investigated the possibility of improving reflectance (back-scatter) pulse oximetry measurements by pressure applied to the probe. Optimal signal detection, with the probe applied to an easily accessible location, is important to prevent erroneous oxygen saturation readouts. At the

  19. Identifying individual sleep apnea/hypoapnea epochs using smartphone-based pulse oximetry.

    Science.gov (United States)

    Garde, Ainara; Dekhordi, Parastoo; Ansermino, J Mark; Dumont, Guy A

    2016-08-01

    Sleep apnea, characterized by frequent pauses in breathing during sleep, poses a serious threat to the healthy growth and development of children. Polysomnography (PSG), the gold standard for sleep apnea diagnosis, is resource intensive and confined to sleep laboratories, thus reducing its accessibility. Pulse oximetry alone, providing blood oxygen saturation (SpO2) and blood volume changes in tissue (PPG), has the potential to identify children with sleep apnea. Thus, we aim to develop a tool for at-home sleep apnea screening that provides a detailed and automated 30 sec epoch-by-epoch sleep apnea analysis. We propose to extract features characterizing pulse oximetry (SpO2 and pulse rate variability [PRV], a surrogate measure of heart rate variability) to create a multivariate logistic regression model that identifies epochs containing apnea/hypoapnea events. Overnight pulse oximetry was collected using a smartphone-based pulse oximeter, simultaneously with standard PSG from 160 children at the British Columbia Children's hospital. The sleep technician manually scored all apnea/hypoapnea events during the PSG study. Based on these scores we labeled each epoch as containing or not containing apnea/hypoapnea. We randomly divided the subjects into training data (40%), used to develop the model applying the LASSO method, and testing data (60%), used to validate the model. The developed model was assessed epoch-by-epoch for each subject. The test dataset had a median area under the receiver operating characteristic (ROC) curve of 81%; the model provided a median accuracy of 74% sensitivity of 75%, and specificity of 73% when using a risk threshold similar to the percentage of apnea/hypopnea epochs. Thus, providing a detailed epoch-by-epoch analysis with at-home pulse oximetry alone is feasible with accuracy, sensitivity and specificity values above 73% However, the performance might decrease when analyzing subjects with a low number of apnea/hypoapnea events.

  20. Optimal spacing between transmitting and receiving optical fibres in reflectance pulse oximetry

    International Nuclear Information System (INIS)

    Hickey, M; Kyriacou, P A

    2007-01-01

    Splanchnic ischaemia can ultimately lead to cellular hypoxia and necrosis, and may well contribute to the development of multiple organ failures and increased mortality. Therefore, it is of utmost importance to monitor abdominal organ blood oxygen saturation (SpO 2 ). Pulse oximetry has been widely accepted as a reliable method for monitoring oxygen saturation of arterial blood. Animal studies have also shown it to be effective in the monitoring of blood oxygen saturation in the splanchnic region. However, commercially available pulse oximeter probes are not suitable for the continuous assessment of SpO 2 in the splanchnic region. Therefore, there is a need for a new sensor technology that will allow the continuous measurement of SpO 2 in the splanchnic area pre-operatively, operatively and post-operatively. For this purpose, a new fibre optic sensor and processing system utilising the principle of reflectance pulse oximetry has been developed. The accuracy in the estimation of SpO 2 in pulse oximetry depends on the quality and amplitude of the photoplethysmographic (PPG) signal and for this reason an experimental procedure was carried out to examine the effect of the source-detector separation distance on the acquired PPG signals, and to ultimately select an optimal separation for the final design of the fibre-optic probe. PPG signals were obtained from the finger for different separation distances between the emitting and detecting fibres. Good quality PPG signals with large amplitudes and high signal-to-noise ratio were detected in the range of 3mm to 6mm. At separation distances between 1mm and 2mm, PPG signals were erratic with no resemblance to a conventional PPG signal. At separation distances greater than 6mm, the amplitudes of PPG signals were very small and not appropriate for processing. This investigation indicates the suitability of optical fibres as a new pulse oximetry sensor for estimating blood oxygen saturation (SpO 2 ) in the splanchnic region

  1. Optimal spacing between transmitting and receiving optical fibres in reflectance pulse oximetry

    Science.gov (United States)

    Hickey, M.; Kyriacou, P. A.

    2007-10-01

    Splanchnic ischaemia can ultimately lead to cellular hypoxia and necrosis, and may well contribute to the development of multiple organ failures and increased mortality. Therefore, it is of utmost importance to monitor abdominal organ blood oxygen saturation (SpO2). Pulse oximetry has been widely accepted as a reliable method for monitoring oxygen saturation of arterial blood. Animal studies have also shown it to be effective in the monitoring of blood oxygen saturation in the splanchnic region. However, commercially available pulse oximeter probes are not suitable for the continuous assessment of SpO2 in the splanchnic region. Therefore, there is a need for a new sensor technology that will allow the continuous measurement of SpO2 in the splanchnic area pre-operatively, operatively and post-operatively. For this purpose, a new fibre optic sensor and processing system utilising the principle of reflectance pulse oximetry has been developed. The accuracy in the estimation of SpO2 in pulse oximetry depends on the quality and amplitude of the photoplethysmographic (PPG) signal and for this reason an experimental procedure was carried out to examine the effect of the source-detector separation distance on the acquired PPG signals, and to ultimately select an optimal separation for the final design of the fibre-optic probe. PPG signals were obtained from the finger for different separation distances between the emitting and detecting fibres. Good quality PPG signals with large amplitudes and high signal-to-noise ratio were detected in the range of 3mm to 6mm. At separation distances between 1mm and 2mm, PPG signals were erratic with no resemblance to a conventional PPG signal. At separation distances greater than 6mm, the amplitudes of PPG signals were very small and not appropriate for processing. This investigation indicates the suitability of optical fibres as a new pulse oximetry sensor for estimating blood oxygen saturation (SpO2) in the splanchnic region.

  2. Lung cancer symptoms and pulse oximetry in the prognostic assessment of patients with lung cancer

    Directory of Open Access Journals (Sweden)

    Harada Cecilia M

    2005-07-01

    Full Text Available Abstract Background Medical oncologists continue to use performance status as a proxy for quality of life (QOL measures, as completion of QOL instruments is perceived as time consuming, may measure aspects of QOL not affected by cancer therapy, and interpretation may be unclear. The pulse oximeter is widely used in clinical practice to predict cardiopulmonary morbidity after lung resection in cancer patients, but little is known on its role outside the surgical setting. We evaluated whether the Lung Cancer Symptom Scale and pulse oximetry may contribute to the evaluation of lung cancer patients who received standard anticancer therapy. Methods We enrolled forty-one consecutive, newly diagnosed, patients with locally advanced or metastatic lung cancer in this study. We developed a survival model with the variables gender, age, histology, clinical stage, Karnofsky performance status, wasting, LCSS symptom scores, average symptom burden index, and pulse oximetry (SpO2. Results Patient and observer-rated scores were correlated, except for the fatigue subscale. The median SpO2 was 95% (range: 86 to 98, was unrelated to symptom scores, and was weakly correlated with observer cough scores. In a multivariate survival model, SpO2 > 90% and patient scores on the LCSS appetite and fatigue subscales were independent predictors of survival. Conclusion LCSS fatigue and appetite rating, and pulse oximetry should be studied further as prognostic factors in lung cancer patients.

  3. An Electronic Patch for wearable health monitoring by reflectance pulse oximetry.

    Science.gov (United States)

    Haahr, Rasmus G; Duun, Sune B; Toft, Mette H; Belhage, Bo; Larsen, Jan; Birkelund, Karen; Thomsen, Erik V

    2012-02-01

    We report the development of an Electronic Patch for wearable health monitoring. The Electronic Patch is a new health monitoring system incorporating biomedical sensors, microelectronics, radio frequency (RF) communication, and a battery embedded in a 3-dimensional hydrocolloid polymer. In this paper the Electronic Patch is demonstrated with a new optical biomedical sensor for reflectance pulse oximetry so that the Electronic Patch in this case can measure the pulse and the oxygen saturation. The reflectance pulse oximetry solution is based on a recently developed annular backside silicon photodiode to enable low power consumption by the light emitting components. The Electronic Patch has a disposable part of soft adhesive hydrocolloid polymer and a reusable part of hard polylaurinlactam. The disposable part contains the battery. The reusable part contains the reflectance pulse oximetry sensor and microelectronics. The reusable part is 'clicked' into the disposable part when the patch is prepared for use. The patch has a size of 88 mm by 60 mm and a thickness of 5 mm.

  4. Principle study on the signal connection at transabdominal fetal pulse oximetry

    Directory of Open Access Journals (Sweden)

    Böttrich Marcel

    2016-09-01

    Full Text Available Transabdominal fetal pulse oximetry is an approach to measure oxygen saturation of the unborn child non-invasively. The principle of pulse oximetry is applied to the abdomen of a pregnant woman, such that the measured signal includes both, the maternal and the fetal pulse curve. One of the major challenges is to extract the shape of the fetal pulse curve from the mixed signal for computation of the oxygen saturation. In this paper we analyze the principle kind of connection of the fetal and maternal pulse curves in the measured signal. A time varying finite element model is used to rebuild the basic measurement environment, including a bulk tissue and two independently pulsing arteries to model the fetal and maternal blood circuit. The distribution of the light fluence rate in the model is computed by applying diffusion equation. From the detectors we extracted the time dependent fluence rate and analyzed the signal regarding its components. The frequency spectra of the signals show peaks at the fetal and maternal basic frequencies. Additional signal components are visible in the spectra, indicating multiplicative coupling of the fetal and maternal pulse curves. We conclude that the underlying signal model of algorithms for robust extraction of the shape of the fetal pulse curve, have to consider additive and multiplicative signal coupling.

  5. Comparison of NIRS, laser Doppler flowmetry, photoplethysmography, and pulse oximetry during vascular occlusion challenges

    OpenAIRE

    Abay, T. Y.; Kyriacou, P. A.

    2016-01-01

    © 2016 Institute of Physics and Engineering in Medicine. Monitoring changes in blood volume, blood flow, and oxygenation in tissues is of vital importance in fields such as reconstructive surgery and trauma medicine. Near infrared spectroscopy (NIRS), laser Doppler (LDF) flowmetry, photoplethysmography (PPG), and pulse oximetry (PO) contribute to such fields due to their safe and noninvasive nature. However, the techniques have been rarely investigated simultaneously or altogether. The aim of...

  6. Effectiveness of Pulse Oximetry Versus Doppler for Tourniquet Monitoring.

    Science.gov (United States)

    Wall, Piper L; Buising, Charisse M; Grulke, Lisa; Troester, Alexander; Bianchina, Nicholas; White, Shannon; Freymark, Rosemarie; Hassan, Ali; Hopkins, James W; Renner, Catherine Hackett; Sahr, Sheryl M

    Pulse oximeters are common and include arterial pulse detection as part of their methodology. The authors investigated the possible usefulness of pulse oximeters for monitoring extremity tourniquet arterial occlusion. Tactical Ratcheting Medical Tourniquets were tightened to the least Doppler-determined occluding pressure at mid-thigh or mid-arm locations on one limb at a time on all four limbs of 15 volunteers. A randomized block design was used to determine the placement locations of three pulse oximeter sensors on the relevant digits. The times and pressures of pulsatile signal absences and returns were recorded for 200 seconds, with the tourniquet being tightened only when the Doppler ultrasound and all three pulse oximeters had pulsatile signals present (pulsatile waveform traces for the pulse oximeters). From the first Doppler signal absence to tourniquet release, toe-located pulse oximeters missed Doppler signal presence 41% to 50% of the times (discrete 1-second intervals) and missed 39% to 49% of the pressure points (discrete 1mmHg intervals); fingerlocated pulse oximeters had miss rates of 11% to 15% of the times and 13% to 19% of the pressure points. On toes, the pulse oximeter ranges of sensitivity and specificity for Doppler pulse detection were 71% to 90% and 44% to 51%, and on fingers, the respective ranges were 65% to 77% and 78% to 83%. Use of a pulse oximeter to monitor limb tourniquet effectiveness will result in some instances of an undetected weak arterial pulse being present. If a pulse oximeter waveform is obtained from a location distal to a tourniquet, the tourniquet should be tightened. If a pulsatile waveform is not detected, vigilance should be maintained. 2017.

  7. High quantum efficiency annular backside silicon photodiodes for reflectance pulse oximetry in wearable wireless body sensors

    International Nuclear Information System (INIS)

    Duun, Sune; Haahr, Rasmus G; Hansen, Ole; Birkelund, Karen; Thomsen, Erik V

    2010-01-01

    The development of annular photodiodes for use in a reflectance pulse oximetry sensor is presented. Wearable and wireless body sensor systems for long-term monitoring require sensors that minimize power consumption. We have fabricated large area 2D ring-shaped silicon photodiodes optimized for minimizing the optical power needed in reflectance pulse oximetry. To simplify packaging, backside photodiodes are made which are compatible with assembly using surface mounting technology without pre-packaging. Quantum efficiencies up to 95% and area-specific noise equivalent powers down to 30 fW Hz -1/2 cm -1 are achieved. The photodiodes are incorporated into a wireless pulse oximetry sensor system embedded in an adhesive patch presented elsewhere as 'The Electronic Patch'. The annular photodiodes are fabricated using two masked diffusions of first boron and subsequently phosphor. The surface is passivated with a layer of silicon nitride also serving as an optical filter. As the final process, after metallization, a hole in the center of the photodiode is etched using deep reactive ion etch.

  8. First day of life pulse oximetry screening to detect congenital heart defects.

    Science.gov (United States)

    Meberg, Alf; Brügmann-Pieper, Sabine; Due, Reidar; Eskedal, Leif; Fagerli, Ingebjørg; Farstad, Teresa; Frøisland, Dag Helge; Sannes, Catharina Hovland; Johansen, Ole Jakob; Keljalic, Jasmina; Markestad, Trond; Nygaard, Egil Andre; Røsvik, Alet; Silberg, Inger Elisabeth

    2008-06-01

    To evaluate the efficacy of first day of life pulse oximetry screening to detect congenital heart defects (CHDs). We performed a population-based prospective multicenter study of postductal (foot) arterial oxygen saturation (SpO(2)) in apparently healthy newborns after transfer from the delivery suite to the nursery. SpO(2) < 95% led to further diagnostic evaluations. Of 57,959 live births, 50,008 (86%) were screened. In the screened population, 35 CHDs were [corrected] classified as critical (ductus dependent, cyanotic). CHDs were prospectively registered and diagnosed in 658/57,959 (1.1%) [corrected] Of the infants screened, 324 (0.6%) failed the test. Of these, 43 (13%) had CHDs (27 critical), and 134 (41%) had pulmonary diseases or other disorders. The remaining 147 infants (45%) were healthy with transitional circulation. The median age for babies with CHDs at failing the test was 6 hours (range, 1-21 hours). For identifying critical CHDs, the pulse oximetry screening had a sensitivity rate of 77.1% (95% CI, 59.4-89.0), specificity rate of 99.4% (95% CI, 99.3-99.5), and a false-positive rate of 0.6% (95% CI, 0.5-0.7). Early pulse oximetry screening promotes early detection of critical CHDs and other potentially severe diseases. The sensitivity rate for detecting critical CHDs is high, and the false-positive rate is low.

  9. Assessment of Arterial Oxygen Saturation by Pulse Oximetry Before, During and After Electroconvulsive Therapy

    Directory of Open Access Journals (Sweden)

    SH Tarig

    2006-07-01

    Full Text Available Introduction & Objective: Electroconvulsive therapy (ECT is used widely in psychiatric practice. The goal of anesthesia for ECT is the prevention of complications such as discomfort, fractures, aspiration of gastric contents and hypoxia. However, general anesthesia can cause some adverse effects as hypoxia. Prevention and treatment of hypoxia is important due to its undesirable effects on seizure duration and cardiovascular system. This study was designed to detect the incidence and probable times of desaturation in patients receiving ECT. Materials & Methods: This prospective randomized clinical trial was carried out on 100 patients (18-50 y/o with ASA I or II who were scheduled for ECT. After pre-oxygenation and similar anesthesia induction the patients received ECT. The patients were ventilated by oxygen and face masked until the return of their spontaneous respiration with adequate tidal volume and respiratory rate. Then they were transferred to recovery room where there was no oxygen supplementation. Oxygen saturation was measured by a Nell core pulse oximeter and was recorded at six stages: before and after anesthesia induction, during ECT, after ECT, 5 minutes after entering recovery room and before leaving there. The data were analyzed by standard statistical tests using SPSS software Results: Data analysis revealed that desaturation was not noticed at any stage except for the 5th stage (5 minutes after entering recovery room, when 13% of patients developed Sao2% less than 90%. Also there was a significant difference between Sao2% of patients between this stage (5th and other stages (p<0.001. Conclusion: According to our findings, appropriate oxygen supplementation and pulse oximetry monitoring during recovery period after ECT can be recommend

  10. Assessment of anastomotic reliability with pulse oximetry in graded intestinal ischemia: an experimental study in dogs.

    Science.gov (United States)

    Türkyilmaz, Z; Sönmez, K; Başaklar, A C; Demiroğullari, B; Numanoğlu, V; Ekingen, G; Dursun, A; Altin, M A; Kale, N

    1997-12-01

    Pulse oximetry has been proposed as an appropriate and feasible technique in the assessment of intestinal ischemia in recent years. In this study the authors aimed to assess the reliability of anastomoses in the dog small intestine in which there is graded irreversible ischemia as measured by pulse oxymeter. In a control group of four dogs, without any devascularization, three small bowel anastomoses were formed in each dog. The study group consisted of 12 dogs. In each animal three intestinal segments with different levels of ischemia were created by ligating the marginal vessels proximally and distally in sequence beginning from the midpoint of the segmental vascular arcade. Preanastomotic pulse oximeter readings between 80% and 90% were assigned to mild ischemia, 70% and 80% to moderate, and 60% and 70% to severe ischemia group. Pulse oximetry measurements were obtained from probes applied to the antimesenteric serosal surfaces at the midpoint of small intestinal segments. A total of 48 intestinal segments (12 nonischemic in the control group and 36 with three different levels of ischemia in the study group) were transected in the midpoint and anastomosed in double layers. Postanastomotic SaO2 values were also noted. The anastomoses were evaluated 48 hours later macroscopically if there was any leakage, and biopsy specimens were obtained for histopathologic ischemic gradings. All results were studied statistically. Histopathologic grades between each group were statistically different (P .05), worsening as the level of ischemia increased. Pre- and postanastomotic pulse oximetry measurements correlated very well with the histological gradings (r = -0.90, P anastomoses) in severe ischemia groups. In the moderate ischemia group with an average preanastomotic pulse reading of 76.75%, each of the leaking anastomoses had a postanastomotic pulse measurement of lower than 70%. The finding that the difference between histopathologic grades of control and mild ischemia

  11. The use of overnight pulse oximetry and phoniatrics parameters in the screening protocol of obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Yassin Soliman Bahgat

    2012-10-01

    Conclusions: Polysomnography is the current golden standard test for diagnosis and evaluation of degree of OSA. Overnight pulse oximetry offers an inexpensive method of screening for and diagnosing OSAHS. Oximetry alone allowed confident recognition of moderate and severe cases of OSAHS. Acoustic analysis of snoring sounds and voice in patients with snoring and/or OSAHS is useful as a screening or supportive method with other investigations to diagnose the site of upper airway obstruction during sleep.

  12. Reliable monitoring of oxygen saturation via pulse oximetry: Which ...

    African Journals Online (AJOL)

    This study focuses on identifying the best site for placement of pulse oximeter probe accurate measuring of oxygen saturation. Twenty-three healthy male volunteers aged 20 to 40 years old were recruited in this study. Cold pressor test was done to stim 460 measurements of SpO2level were obtained throughout the study.

  13. Multiwavelength pulse oximetry in the measurement of hemoglobin fractions

    Science.gov (United States)

    Manzke, Bernd; Schwider, Johannes; Lutter, Norbert O.; Engelhardt, Kai; Stork, Wilhelm

    1996-04-01

    The two wavelength design of the majority of pulse oximeters assumes only two absorbing hemoglobin fractions, oxyhemoglobin (O2Hb), and reduced hemoglobin (HHb) irrespective of the presence of methemoglobin (MetHb) and carboxyhemoglobin (COHb). If MetHb or COHb is present, it contributes to the pulse-added absorbance signal and will be interpreted as either HHb or O2Hb or some combination of the two. In this paper we describe a noninvasive multi-wavelength pulse oximeter measuring O2Hb, HHb, MetHb, and COHb at a specified accuracy of 1.0%. The system was designed with respect to the results of numerical simulations. It consists of 9 laserdiodes (LDs) and 7 light emitting diodes (LEDs), a 16-bit analog-digital converter (ADC) and has a sampling rate of 16 kHz. The laser didoes and LEDs were coupled into multi-mode fibers and led with a liquid lightguide to the finger clip and then the photodiode. It also presents the results of a clinical study, including a setup with a quartz tungsten halogen lamp (with fiber output) and a diode array spectrometer, a standard pulse oximeter and two in-vitro oximeters (radiometer OSM3 and radiometer ABL 520) as references.

  14. Inaccurate pulse CO-oximetry of carboxyhemoglobin due to digital clubbing: case report.

    Science.gov (United States)

    Harlan, Nicole; Weaver, Lindell K; Deru, Kayla

    2016-01-01

    Newer pulse CO-oximeters provide a non-invasive and quick means of measuring oxyhemoglobin, carboxyhemoglobin and methemoglobin. Clubbing has been reported to cause inaccuracy in pulse oximeters. We present a case of inaccurate carboxy-hemoglobin measurement by pulse CO-oximetry due to digital clubbing. An 18-year-old man with a history of cystic fibrosis presented after a suicide attempt by inhalation of exhaust. At the initial emergency department evaluation, his blood carboxyhemoglobin was 33%. He was intubated, placed on 100% oxygen and transferred to our facility. Upon arrival, we placed three different pulse CO-oximeters on different fingers and toes. Carboxyhemoglobin levels measured by these meters ranged from 9%-11%. A venous blood gas drawn on arrival showed a carboxyhemoglobin level of 2.3% after four hours on 100% oxygen by endotracheal tube. Thirty minutes later, we checked arterial blood gas, which revealed a COHb level of 0.9%. Again, non-invasive carboxyhemoglobin measurements read 10%. The patient was treated with hyperbaric oxygen for carbon monoxide poisoning. This case suggests that non-invasive measurements of carboxyhemoglobin should be correlated with the clinic history and with an arterial or venous blood gas oximetry analysis.

  15. Optimal spacing between transmitting and receiving optical fibres in reflectance pulse oximetry

    Energy Technology Data Exchange (ETDEWEB)

    Hickey, M; Kyriacou, P A [School of Engineering and Mathematical Sciences, City University, Northampton Square, London, EC1V 0HB (United Kingdom)

    2007-10-15

    Splanchnic ischaemia can ultimately lead to cellular hypoxia and necrosis, and may well contribute to the development of multiple organ failures and increased mortality. Therefore, it is of utmost importance to monitor abdominal organ blood oxygen saturation (SpO{sub 2}). Pulse oximetry has been widely accepted as a reliable method for monitoring oxygen saturation of arterial blood. Animal studies have also shown it to be effective in the monitoring of blood oxygen saturation in the splanchnic region. However, commercially available pulse oximeter probes are not suitable for the continuous assessment of SpO{sub 2} in the splanchnic region. Therefore, there is a need for a new sensor technology that will allow the continuous measurement of SpO{sub 2} in the splanchnic area pre-operatively, operatively and post-operatively. For this purpose, a new fibre optic sensor and processing system utilising the principle of reflectance pulse oximetry has been developed. The accuracy in the estimation of SpO{sub 2} in pulse oximetry depends on the quality and amplitude of the photoplethysmographic (PPG) signal and for this reason an experimental procedure was carried out to examine the effect of the source-detector separation distance on the acquired PPG signals, and to ultimately select an optimal separation for the final design of the fibre-optic probe. PPG signals were obtained from the finger for different separation distances between the emitting and detecting fibres. Good quality PPG signals with large amplitudes and high signal-to-noise ratio were detected in the range of 3mm to 6mm. At separation distances between 1mm and 2mm, PPG signals were erratic with no resemblance to a conventional PPG signal. At separation distances greater than 6mm, the amplitudes of PPG signals were very small and not appropriate for processing. This investigation indicates the suitability of optical fibres as a new pulse oximetry sensor for estimating blood oxygen saturation (SpO{sub 2}) in

  16. Improving pulse oximetry accuracy by removing motion artifacts from photoplethysmograms using relative sensor motion: a preliminary study

    NARCIS (Netherlands)

    Wijshoff, R.W.C.G.R.; Mischi, M.; Woerlee, P.H.; Aarts, R.M.; Van Huffel, S.; Naelaers, G.; Caicedo, A.; Bruley, D.F.; Harrison, D.K.

    2013-01-01

    To expand applicability of pulse oximetry in low-acuity ambulatory settings, the impact of motion on extracted parameters as saturation (SpO2) and pulse rate (PR) needs to be reduced. We hypothesized that sensor motion relative to the skin can be used as an artifact reference in a correlation

  17. Intraoperative colonic pulse oximetry in left-sided colorectal surgery: can it predict anastomotic leak?

    Science.gov (United States)

    Salusjärvi, Johannes M; Carpelan-Holmström, Monika A; Louhimo, Johanna M; Kruuna, Olli; Scheinin, Tom M

    2018-03-01

    An anastomotic leak is a fairly common and a potentially lethal complication in colorectal surgery. Objective methods to assess the viability and blood circulation of the anastomosis could help in preventing leaks. Intraoperative pulse oximetry is a cheap, easy to use, fast, and readily available method to assess tissue viability. Our aim was to study whether intraoperative pulse oximetry can predict the development of an anastomotic leak. The study was a prospective single-arm study conducted between the years 2005 and 2011 in Helsinki University Hospital. Patient material consisted of 422 patients undergoing elective left-sided colorectal surgery. The patients were operated by one of the three surgeons. All of the operations were partial or total resections of the left side of the colon with a colorectal anastomosis. The intraoperative colonic oxygen saturation was measured with pulse oximetry from the colonic wall, and the values were analyzed with respect to post-operative complications. 2.3 times more operated anastomotic leaks occurred when the colonic StO 2 was ≤ 90% (11/129 vs 11/293). The mean colonic StO 2 was 91.1 in patients who developed an operated anastomotic leak and 93.0 in patients who did not. With logistic regression analysis, the risk of operated anastomotic leak was 4.2 times higher with StO 2 values ≤ 90%. Low intraoperative colonic StO 2 values are associated with the occurrence of anastomotic leak. Despite its handicaps, the method seems to be useful in assessing anastomotic viability.

  18. Noncontact simultaneous dual wavelength photoplethysmography: A further step toward noncontact pulse oximetry

    International Nuclear Information System (INIS)

    Humphreys, Kenneth; Ward, Tomas; Markham, Charles

    2007-01-01

    We present a camera-based device capable of capturing two photoplethysmographic (PPG) signals at two different wavelengths simultaneously, in a remote noncontact manner. The system comprises a complementary metal-oxide semiconductor camera and dual wavelength array of light emitting diodes (760 and 880 nm). By alternately illuminating a region of tissue with each wavelength of light, and detecting the backscattered photons with the camera at a rate of 16 frames/wavelength s, two multiplexed PPG wave forms are simultaneously captured. This process is the basis of pulse oximetry, and we describe how, with the inclusion of a calibration procedure, this system could be used as a noncontact pulse oximeter to measure arterial oxygen saturation (S p O 2 ) remotely. Results from an experiment on ten subjects, exhibiting normal S p O 2 readings, that demonstrate the instrument's ability to capture signals from a range of subjects under realistic lighting and environmental conditions are presented. We compare the signals captured by the noncontact system to a conventional PPG signal captured concurrently from a finger, and show by means of a J. Bland and D. Altman [Lancet 327, 307 (1986); Statistician 32, 307 (1983)] test, the noncontact device to be comparable to a contact device as a monitor of heart rate. We highlight some considerations that should be made when using camera-based ''integrative'' sampling methods and demonstrate through simulation, the suitability of the captured PPG signals for application of existing pulse oximetry calibration procedures

  19. Noncontact simultaneous dual wavelength photoplethysmography: A further step toward noncontact pulse oximetry

    Science.gov (United States)

    Humphreys, Kenneth; Ward, Tomas; Markham, Charles

    2007-04-01

    We present a camera-based device capable of capturing two photoplethysmographic (PPG) signals at two different wavelengths simultaneously, in a remote noncontact manner. The system comprises a complementary metal-oxide semiconductor camera and dual wavelength array of light emitting diodes (760 and 880nm). By alternately illuminating a region of tissue with each wavelength of light, and detecting the backscattered photons with the camera at a rate of 16frames/wavelengths, two multiplexed PPG wave forms are simultaneously captured. This process is the basis of pulse oximetry, and we describe how, with the inclusion of a calibration procedure, this system could be used as a noncontact pulse oximeter to measure arterial oxygen saturation (SpO2) remotely. Results from an experiment on ten subjects, exhibiting normal SpO2 readings, that demonstrate the instrument's ability to capture signals from a range of subjects under realistic lighting and environmental conditions are presented. We compare the signals captured by the noncontact system to a conventional PPG signal captured concurrently from a finger, and show by means of a J. Bland and D. Altman [Lancet 327, 307 (1986); Statistician 32, 307 (1983)] test, the noncontact device to be comparable to a contact device as a monitor of heart rate. We highlight some considerations that should be made when using camera-based "integrative" sampling methods and demonstrate through simulation, the suitability of the captured PPG signals for application of existing pulse oximetry calibration procedures.

  20. Early Detection with Pulse Oximetry of Hypoxemic Neonatal Conditions. Development of the IX Clinical Consensus Statement of the Ibero-American Society of Neonatology (SIBEN

    Directory of Open Access Journals (Sweden)

    Augusto Sola

    2018-03-01

    Full Text Available This article reviews the development of the Ninth Clinical Consensus Statement by SIBEN (the Ibero-American of Neonatology on “Early Detection with Pulse Oximetry (SpO2 of Hypoxemic Neonatal Conditions”. It describes the process of the consensus, and the conclusions and recommendations for screening newborns with pulse oximetry.

  1. Cerebral near infrared spectroscopy oximetry in extremely preterm infants : Phase II randomised clinical trial

    NARCIS (Netherlands)

    Hyttel-Sorensen, Simon; Pellicer, Adelina; Alderliesten, Thomas; Austin, Topun; Van Bel, Frank; Benders, Manon; Claris, Olivier; Dempsey, Eugene; Franz, Axel R.; Fumagalli, Monica; Gluud, Christian; Grevstad, Berit; Hagmann, Cornelia; Lemmers, Petra; Van Oeveren, Wim; Pichler, Gerhard; Plomgaard, Anne Mette; Riera, Joan; Sanchez, Laura; Winkel, Per; Wolf, Martin; Greisen, Gorm

    2015-01-01

    Objective: To determine if it is possible to stabilise the cerebral oxygenation of extremely preterm infants monitored by cerebral near infrared spectroscopy (NIRS) oximetry. Design: Phase II randomised, single blinded, parallel clinical trial. Setting Eight tertiary neonatal intensive care units in

  2. Simulation based investigation of source-detector configurations for non-invasive fetal pulse oximetry

    Directory of Open Access Journals (Sweden)

    Böttrich Marcel

    2015-09-01

    Full Text Available Transabdominal fetal pulse oximetry is a method to monitor the oxygen supply of the unborn child non-invasively. Due to the measurement setup, the received signal of the detector is composed of photons coding purely maternal and photons coding mixed fetal-maternal information. To analyze the wellbeing of the fetus, the fetal signal is extracted from the mixed component. In this paper we assess source-detector configurations, such that the mixed fetal-maternal components of the acquired signals are maximized. Monte-Carlo method is used to simulate light propagation and photon distribution in tissue. We use a plane layer and a spherical layer geometry to model the abdomen of a pregnant woman. From the simulations we extracted the fluence at the detector side for several source-detector distances and analyzed the ratio of the mixed fluence component to total fluence. Our simulations showed that the power of the mixed component depends on the source-detector distance as expected. Further we were able to visualize hot spot areas in the spherical layer model where the mixed fluence ratio reaches the highest level. The results are of high importance for sensor design considering signal composition and quality for non-invasive fetal pulse oximetry.

  3. The Feasibility and Validity of a Remote Pulse Oximetry System for Pulmonary Rehabilitation: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Jonathan Tang

    2012-01-01

    Full Text Available Pulmonary rehabilitation is an effective treatment for people with chronic obstructive pulmonary disease. However, access to these services is limited especially in rural and remote areas. Telerehabilitation has the potential to deliver pulmonary rehabilitation programs to these communities. The aim of this study was threefold: to establish the technical feasibility of transmitting real-time pulse oximetry data, determine the validity of remote measurements compared to conventional face-to-face measures, and evaluate the participants’ perception of the usability of the technology. Thirty-seven healthy individuals participated in a single remote pulmonary rehabilitation exercise session, conducted using the eHAB telerehabilitation system. Validity was assessed by comparing the participant's oxygen saturation and heart rate with the data set received at the therapist’s remote location. There was an 80% exact agreement between participant and therapist data sets. The mean absolute difference and Bland and Altman’s limits of agreement fell within the minimum clinically important difference for both oxygen saturation and heart rate values. Participants found the system easy to use and felt confident that they would be able to use it at home. Remote measurement of pulse oximetry data for a pulmonary rehabilitation exercise session was feasible and valid when compared to conventional face-to-face methods.

  4. Pulse Oximetry

    Science.gov (United States)

    ... This is important to know because when your oxygen level is low, the cells in your body can have a hard time ... level of at least 89% to keep their cells healthy. Having an oxygen level lower than this for a short time is ...

  5. Pulse Oximetry Screening Adapted to a System with Home Births: The Dutch Experience

    Directory of Open Access Journals (Sweden)

    Ilona C. Narayen

    2018-03-01

    Full Text Available Neonatal screening for critical congenital heart defects is proven to be safe, accurate, and cost-effective. The screening has been implemented in many countries across all continents in the world. However, screening for critical congenital heart defects after home births had not been studied widely yet. The Netherlands is known for its unique perinatal care system with a high rate of home births (18% and early discharge after an uncomplicated delivery in hospital. We report a feasibility, accuracy, and acceptability study performed in the Dutch perinatal care system. Screening newborns for critical congenital heart defects using pulse oximetry is feasible after home births and early discharge, and acceptable to mothers. The accuracy of the test is comparable to other early-screening settings, with a moderate sensitivity and high specificity.

  6. Reduction of motion artifact in pulse oximetry by smoothed pseudo Wigner-Ville distribution

    Directory of Open Access Journals (Sweden)

    Zhang Yuan-ting

    2005-03-01

    Full Text Available Abstract Background The pulse oximeter, a medical device capable of measuring blood oxygen saturation (SpO2, has been shown to be a valuable device for monitoring patients in critical conditions. In order to incorporate the technique into a wearable device which can be used in ambulatory settings, the influence of motion artifacts on the estimated SpO2 must be reduced. This study investigates the use of the smoothed psuedo Wigner-Ville distribution (SPWVD for the reduction of motion artifacts affecting pulse oximetry. Methods The SPWVD approach is compared with two techniques currently used in this field, i.e. the weighted moving average (WMA and the fast Fourier transform (FFT approaches. SpO2 and pulse rate were estimated from a photoplethysmographic (PPG signal recorded when subject is in a resting position as well as in the act of performing four types of motions: horizontal and vertical movements of the hand, and bending and pressing motions of the finger. For each condition, 24 sets of PPG signals collected from 6 subjects, each of 30 seconds, were studied with reference to the PPG signal recorded simultaneously from the subject's other hand, which was stationary at all times. Results and Discussion The SPWVD approach shows significant improvement (p Conclusion The results suggested that the SPWVD approach could potentially be used to reduce motion artifact on wearable pulse oximeters.

  7. Pulse oximetry findings in newborns with antenatally diagnosed congenital heart disease.

    Science.gov (United States)

    Mawson, Isabel E; Babu, Pratusha L; Simpson, John M; Fox, Grenville F

    2018-05-01

    A retrospective review of admission preductal oxygen saturations of neonates with antenatally diagnosed critical congenital heart disease (CCHD) was performed to investigate the differences in newborn pulse oximetry (Pulsox) by specific CCHD diagnosis. Saturations were recorded at median of  34 weeks and birth weight > 1.8 kg. A statistically significant increase in the proportion with low admission saturations was seen using ≤ 95% saturation threshold (72% (95% CI 66-78)) compared to ≤ 92% (52% (95% CI 46-59)) and ≤ 90% (46% (95% CI 39-52)). Sub-group analysis found the proportion of neonates with low saturations varied according to the specific CCHD diagnosis with only 20-42% of neonates with aortic stenosis, coarctation of the aorta and pulmonary stenosis having saturations ≤ 95%. The proportion of neonates with low admission oxygen saturation varied by CCHD diagnosis with those without critically reduced pulmonary blood flow not having low admission saturations, in general, even using the ≤ 95% threshold which had the highest proportions of abnormal saturations. This data may assist developing Pulsox screening policies. What is Known: • The addition of pulse oximetry (Pulsox) screening to the routine newborn examination increases the sensitivity of CCHD detection. Pulsox screening is also highly specific for CCHD in asymptomatic neonates, with low false-positive rates. • Early diagnosis of CCHD improves patient outcomes in relation to both morbidity and mortality. What is New: • The proportion of affected infants with an abnormal Pulsox result varies by CCHD diagnosis and screening threshold. In our study using the ≤ 95% threshold gave the highest proportion of neonates with abnormal saturations at admission. • In general, Pulsox yield of abnormal results is low for CCHD diagnoses not associated with critically reduced pulmonary blood flow; however, increasing the Pulsox threshold increased the proportion of infants with an

  8. Reliability of Pulse Oximetry during Progressive Hypoxia, Cardiopulmonary Resuscitation, and Recovery in a Piglet Model of Neonatal Hypoxic Cardiac Arrest.

    Science.gov (United States)

    Hassan, Mohammad Ahmad; Weber, Claudia; Waitz, Markus; Huang, Li; Hummler, Helmut D; Mendler, Marc Robin

    2017-01-01

    Pulse oximetry is widely used in intensive care and emergency conditions to monitor arterial oxygenation and to guide oxygen therapy. To study the reliability of pulse oximetry in comparison with CO-oximetry in newborn piglets during progressive hypoxia, cardiac arrest, cardiopulmonary resuscitation (CPR), and after return of spontaneous circulation (ROSC). Thirty-three newborn piglets were exposed to hypoxia until asystole occurred and then resuscitated until ROSC. Arterial oxygen saturation was monitored continuously by pulse oximetry (SpO2) with one sensor applied to the wrist of the right forelimb (FL) and another to the thigh of the left hind limb (HL). Arterial functional oxygen saturation (SaO2) was measured at baseline and at predefined intervals during each phase of the experiment. SpO2 was compared with coinciding SaO2 values and bias considered whenever the difference (SpO2 - SaO2) was beyond ±5%. Bias values were lower at the baseline measurements (-3.7 ± 2.3% in FL and -4.1 ± 3.4% in HL) as well as after ROSC (1.5 ± 4.2% in FL and 0.2 ± 4.6% in HL) with higher precision and accuracy than during other experiment phases. During hypoxia induction, cardiac arrest, and CPR, there was a marked decrease in precision and accuracy as well as an increase in bias up to 43 ± 26 and 56 ± 27% in FL and HL, respectively, over a range of SaO2 from 13 to 51%. Pulse oximetry showed increased bias and decreased accuracy and precision during marked hypoxemia in a model of neonatal hypoxic cardiac arrest. © 2017 S. Karger AG, Basel.

  9. Use of pulse co-oximetry as a screening and monitoring tool in mass carbon monoxide poisoning.

    Science.gov (United States)

    Bledsoe, Bryan E; Nowicki, Kevin; Creel, James H; Carrison, Dale; Severance, Harry W

    2010-01-01

    Carbon monoxide (CO) poisoning remains a common cause of poisoning in the United States. We describe a case where responding fire department personnel encountered a sick employee with a headache at an automotive brake manufacturing plant. Using both atmospheric CO monitoring and pulse CO-oximetry technology, fire department personnel were able to diagnose the cause of the patient's illness and later identify the source of CO in the plant.

  10. Examination of Pulse Oximetry Tracings to Detect Obstructive Sleep Apnea in Patients with Advanced Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Adrienne S Scott

    2014-01-01

    Full Text Available Nocturnal hypoxemia and obstructive sleep apnea (OSA are common comorbidities in patients with chronic obstructive pulmonary disease (COPD. The authors sought to develop a strategy to interpret nocturnal pulse oximetry and assess its capacity for detection of OSA in patients with stage 3 to stage 4 COPD. A review of consecutive patients with COPD who were clinically prescribed oximetry and polysomnography was conducted. OSA was diagnosed if the polysomnographic apnea-hypopnea index was >15 events/h. Comprehensive criteria were developed for interpretation of pulse oximetry tracings through iterative validation and interscorer concordance of ≥80%. Criteria consisted of visually identified desaturation ‘events’ (sustained desaturation ≥4%, 1 h time scale, ‘patterns’ (≥3 similar desaturation/saturation cycles, 15 min time scale and the automated oxygen desaturation index. The area under the curve (AUC, sensitivity, specificity and accuracy were calculated. Of 59 patients (27 male, 31 had OSA (53%. The mean forced expiratory volume in 1 s was 46% of predicted (range 21% to 74% of predicted and 52% of patients were on long-term oxygen therapy. Among 59 patients, 35 were correctly identified as having OSA or not having OSA, corresponding to an accuracy of 59%, with a sensitivity and specificity of 59% and 60%, respectively. The AUC was 0.57 (95% CI 0.55 to 0.59. Using software-computed desaturation events (hypoxemia ≥4% for ≥10 s indexed at ≥15 events/h of sleep as diagnostic criteria, sensitivity was 60%, specificity was 63% and the AUC was 0.64 (95%CI 0.62 to 0.66. No single criterion demonstrated important diagnostic utility. Pulse oximetry tracing interpretation had a modest diagnostic value in identifying OSA in patients with moderate to severe COPD.

  11. Using pulse oximetry to account for high and low frequency physiological artifacts in the BOLD signal.

    Science.gov (United States)

    Verstynen, Timothy D; Deshpande, Vibhas

    2011-04-15

    The BOLD signal not only reflects changes in local neural activity, but also exhibits variability from physiological processes like cardiac rhythms and breathing. We investigated how both of these physiological sources are reflected in the pulse oximetry (PO) signal, a direct measure of blood oxygenation, and how this information can be used to account for different types of noise in the BOLD response. Measures of heart rate, respiration and PO were simultaneously recorded while neurologically healthy participants performed an eye-movement task in a 3T MRI. PO exhibited power in frequencies that matched those found in the independently recorded cardiac and respiration signals. Using the phasic and aphasic properties of these signals as nuisance regressors, we found that the different frequency components of the PO signal could be used to identify different types of physiological artifacts in the BOLD response. A comparison of different physiological noise models found that a simple, down-sampled version of the PO signal improves the estimation of task-relevant statistics nearly as well as more established noise models that may run the risk of over-parameterization. These findings suggest that the PO signal captures multiple sources of physiological noise in the BOLD response and provides a simple and efficient way of modeling these noise sources in subsequent analysis. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Evaluation of pulse-oximetry oxygen saturation taken through skin protective covering

    Science.gov (United States)

    James, Jyotsna; Tiwari, Lokesh; Upadhyay, Pramod; Sreenivas, Vishnubhatla; Bhambhani, Vikas; Puliyel, Jacob M

    2006-01-01

    Background The hard edges of adult finger clip probes of the pulse oximetry oxygen saturation (POOS) monitor can cause skin damage if used for prolonged periods in a neonate. Covering the skin under the probe with Micropore surgical tape or a gauze piece might prevent such injury. The study was done to see if the protective covering would affect the accuracy of the readings. Methods POOS was studied in 50 full-term neonates in the first week of life. After obtaining consent from their parents the neonates had POOS readings taken directly (standard technique) and through the protective covering. Bland-Altman plots were used to compare the new method with the standard technique. A test of repeatability for each method was also performed. Results The Bland-Altman plots suggest that there is no significant loss of accuracy when readings are taken through the protective covering. The mean difference was 0.06 (SD of 1.39) and 0.04 (SD 1.3) with Micropore and gauze respectively compared to the standard method. The mean difference was 0.22 (SD 0.23) on testing repeatability with the standard method. Conclusion Interposing Micropore or gauze does not significantly affect the accuracy of the POOS reading. The difference between the standard method and the new method was less than the difference seen on testing repeatability of the standard method. PMID:16677394

  13. Comparison of NIRS, laser Doppler flowmetry, photoplethysmography, and pulse oximetry during vascular occlusion challenges

    International Nuclear Information System (INIS)

    Abay, T Y; Kyriacou, P A

    2016-01-01

    Monitoring changes in blood volume, blood flow, and oxygenation in tissues is of vital importance in fields such as reconstructive surgery and trauma medicine. Near infrared spectroscopy (NIRS), laser Doppler (LDF) flowmetry, photoplethysmography (PPG), and pulse oximetry (PO) contribute to such fields due to their safe and noninvasive nature. However, the techniques have been rarely investigated simultaneously or altogether. The aim of this study was to investigate all the techniques simultaneously on healthy subjects during vascular occlusion challenges. Sensors were attached on the forearm (NIRS and LDF) and fingers (PPG and PO) of 19 healthy volunteers. Different degrees of vascular occlusion were induced by inflating a pressure cuff on the upper arm. The responses of tissue oxygenation index (NIRS), tissue haemoglobin index (NIRS), flux (LDF), perfusion index (PPG), and arterial oxygen saturation (PO) have been recorded and analyzed. Moreover, the optical densities were calculated from slow varying dc PPG, in order to distinguish changes in venous blood volumes. The indexes showed significant changes (p  <  0.05) in almost all occlusions, either venous or over-systolic occlusions. However, differentiation between venous and arterial occlusion by LDF may be challenging and the perfusion index (PI) may not be adequate to indicate venous occlusions. Optical densities may be an additional tool to detect venous occlusions by PPG. (paper)

  14. Neural networks and wavelet analysis in the computer interpretation of pulse oximetry data

    Energy Technology Data Exchange (ETDEWEB)

    Dowla, F.U.; Skokowski, P.G.; Leach, R.R. Jr.

    1996-03-01

    Pulse oximeters determine the oxygen saturation level of blood by measuring the light absorption of arterial blood. The sensor consists of red and infrared light sources and photodetectors. A method based on neural networks and wavelet analysis is developed for improved saturation estimation in the presence of sensor motion. Spectral and correlation functions of the dual channel oximetry data are used by a backpropagation neural network to characterize the type of motion. Amplitude ratios of red to infrared signals as a function of time scale are obtained from the multiresolution wavelet decomposition of the two-channel data. Motion class and amplitude ratios are then combined to obtain a short-time estimate of the oxygen saturation level. A final estimate of oxygen saturation is obtained by applying a 15 s smoothing filter on the short-time measurements based on 3.5 s windows sampled every 1.75 s. The design employs two backpropagation neural networks. The first neural network determines the motion characteristics and the second network determines the saturation estimate. Our approach utilizes waveform analysis in contrast to the standard algorithms that are based on the successful detection of peaks and troughs in the signal. The proposed algorithm is numerically efficient and has stable characteristics with a reduced false alarm rate with a small loss in detection. The method can be rapidly developed on a digital signal processing platform.

  15. Accuracy of pulse oximetry in detection of oxygen saturation in patients admitted to the intensive care unit of heart surgery: comparison of finger, toe, forehead and earlobe probes.

    Science.gov (United States)

    Seifi, Sohila; Khatony, Alireza; Moradi, Gholamreza; Abdi, Alireza; Najafi, Farid

    2018-01-01

    Heart surgery patients are more at risk of poor peripheral perfusion, and peripheral capillary oxygen saturation (SpO2) measurement is regular care for continuous analysis of blood oxygen saturation in these patients. With regard to controversial studies on accuracy of the current pulse oximetry probes and lack of data related to patients undergoing heart surgery, the present study was conducted to determine accuracy of pulse oximetry probes of finger, toe, forehead and earlobe in detection of oxygen saturation in patients admitted to intensive care units for coronary artery bypass surgery. In this clinical trial, 67 patients were recruited based on convenience sampling method among those admitted to intensive care units for coronary artery bypass surgery. The SpO2 value was measured using finger, toe, forehead and earlobe probes and then compared with the standard value of arterial oxygen saturation (SaO2). Data were entered into STATA-11 software and analyzed using descriptive, inferential and Bland-Altman statistical analyses. Highest and lowest correlational mean values of SpO2 and SaO2 were related to finger and earlobe probes, respectively. The highest and lowest agreement of SpO2 and SaO2 were related to forehead and earlobe probes. The SpO2 of earlobe probes due to lesser mean difference, more limited confidence level and higher agreement ration with SaO2 resulted by arterial blood gas (ABG) analysis had higher accuracy. Thus, it is suggested to use earlobe probes in patients admitted to the intensive care unit for coronary artery bypass surgery. Registration of this trial protocol has been approved in Iranian Registry of Clinical Trials at 2018-03-19 with reference IRCT20100913004736N22. "Retrospectively registered."

  16. The influence of stellate ganglion transcutaneous electrical nerve stimulation on signal quality of pulse oximetry in prehospital trauma care.

    Science.gov (United States)

    Barker, Renate; Lang, Thomas; Hager, Helmut; Steinlechner, Barbara; Hoerauf, Klaus; Zimpfer, Michael; Kober, Alexander

    2007-05-01

    Accurate monitoring of the peripheral arterial oxygen saturation has become an important tool in the prehospital emergency medicine. This monitoring requires an adequate plethysmographic pulsation. Signal quality is diminished by cold ambient temperature due to vasoconstriction. Blockade of the stellate ganglion can improve peripheral vascular perfusion and can be achieved by direct injection or transcutaneous electrical nerve stimulation (TENS) stimulation. We evaluated whether TENS on the stellate ganglion would reduce vasoconstriction and thereby improve signal detection quality of peripheral pulse oximetry. In our study, 53 patients with minor trauma who required transport to the hospital were enrolled. We recorded vital signs, including core and skin temperature before and after transport to the hospital. Pulse oximetry sensors were attached to the patient's second finger on both hands. TENS of the stellate ganglion was started on one side after the beginning of the transport. Pulse oximeter alerts, due to poor signal detection, were recorded for each side separately. On the hand treated with TENS we detected a significant reduction of alerts compared to the other side (mean alerts TENS 3.1 [1-15] versus control side 8.8 [1-28] P signal quality of pulse oximeters in the prehospital setting.

  17. An in vivo investigation of photoplethysmographic signals and preliminary pulse oximetry estimation from the bowel using a new fiberoptic sensor.

    Science.gov (United States)

    Hickey, Michelle; Samuels, Neal; Randive, Nilesh; Langford, Richard M; Kyriacou, Panayiotis A

    2011-05-01

    The continuous monitoring of splanchnic organ oxygen saturation could make the early detection of inadequate tissue oxygenation feasible, reducing the risk of hypoperfusion, severe ischemia, multiple organ failure, and, ultimately, death. Current methods for assessing splanchnic perfusion have not been widely accepted for use in the clinical care environment. In an attempt to overcome the limitations of the current techniques, a new fiberoptic photoplethysmographic (PPG)/pulse oximetry sensor was developed as a means of assessing splanchnic organ perfusion during surgery in humans. A new fiberoptic splanchnic pulse oximeter and an optically identical fiberoptic finger pulse oximeter have been developed. Simultaneous PPG signals and preliminary estimates of arterial oxygen saturation from the bowel (small and large) and finger were obtained in 17 patients (3 men and 14 women) undergoing open laparotomy. Good quality PPG signals were obtained from the small and large bowel and from the finger in all patients (lower 95% confidence limit for the proportion was 0.64). Comparisons of blood oxygen saturation values acquired when using the splanchnic and the finger fiberoptic sensors and a commercial finger pulse oximeter indicated that there was no statistically significant difference between them (all P>0.454). A Bland and Altman plot of the difference between blood oxygen saturation values from the bowel fiberoptic pulse oximeter and the fiberoptic finger pulse oximeter against their mean showed that the limits of agreement between the 2 pulse oximeters were -3.8% and 4.2% for small bowel measurements, and -3.4% and 4.3% for large bowel measurements. The 95% prediction interval for the difference between the 2 devices was between -4.2% and 4.7%. This study demonstrated that good quality PPG signals can be obtained from the bowel using a new fiberoptic sensor. Further evaluation is required to determine whether fiberoptic pulse oximetry of the bowel may provide a

  18. Rejection of Erroneous Saturation Data in Optical Pulse Oximetry in Newborn Patients

    Science.gov (United States)

    Scalise, L.; Marchionni, Paolo; Carnielli, Virgilio P.

    2011-08-01

    Pulse oximetry (PO) is extensively used in intensive care unit (ICU); this is mainly due to the fact that it is a non-invasive and real-time monitoring method. PO allows to measure arterial oxygen saturation (SaO2) and in particular hemoglobin oxygenation. Optical PO is typically realized by the use of a clip (to be applied on the ear or on the finger top) containing a couple of monochromatic LED sources and a photodiode. The main drawback with the use of PO is the presence of movement artifacts or disturbance due to optical sources and skin, causing erroneous saturation data. The aim of this work is to present the measurement procedure based on a specially developed algorithm able to reject erroneous oxygen saturation data during long lasting monitoring of patients in ICU and to compare measurement data with reference data provided by EGA. We have collected SaO2 data from a standard PO and used an intensive care unit monitor to collect data. This device was connected to our acquisition system and heart rate (HR) and SaO2 data were acquired and processed by our specially developed algorithm and directly reproduced on the PC screen for use by the clinicians. The algorithm here used for the individuation and rejection of erroneous saturation data is based on the assessment of the difference between the Heart Rate (HR) measured by respectively by the ECG and PO. We have used an emogasanalyzer (EGA) for comparison of the measured data. The study was carried out in a neonatal intensive care unit (NICU), using 817 data coming from 24 patients and the observation time was of about 10000 hours. Results show a reduction in the maximum difference between the SaO2 data measured, simultaneously, on the same patient by the EGA and by the proposed method of 14.20% and of the 4.76% in average over the 817 samples. The measurement method proposed is therefore able to individuate and eliminate the erroneous saturation data due to motion artifacts and reported by the pulse oxymeter

  19. Comparison of oxygen saturation values and measurement times by pulse oximetry in various parts of the body.

    Science.gov (United States)

    Yönt, Gülendam Hakverdioğlu; Korhan, Esra Akin; Khorshid, Leyla

    2011-11-01

    The aim of this study, which included 40 patients, was to compare the values pulse oximetry and the measurement times in various regions of the body. Data were analyzed using intraclass correlation coefficient test and paired-sample test. The confidence power value was found to be .81 for the comparison of oxygen saturation values by arterial blood gas analysis and measurement by the forehead probe. It was found that the time for oxygen saturation measurement using the forehead probe was shorter than those using the finger and toe probes. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Can we Replace Arterial Blood Gas Analysis by Pulse Oximetry in Neonates with Respiratory Distress Syndrome, who are Treated According to INSURE Protocol?

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    Pedram Niknafs

    2015-05-01

    Full Text Available Neonates with respiratory distress syndrome (RDS, who are treated according to INSURE protocol; require arterial blood gas (ABG analysis to decide on appropriate management. We conducted this study to investigate the validity of pulse oximetry instead of frequent ABG analysis in the evaluation of these patients. From a total of 193 blood samples obtained from 30 neonates <1500 grams with RDS, 7.2% were found to have one or more of the followings: acidosis, hypercapnia, or hypoxemia. We found that pulse oximetry in the detection of hyperoxemia had a good validity to appropriately manage patients without blood gas analysis. However, the validity of pulse oximetry was not good enough to detect acidosis, hypercapnia, and hypoxemia.

  1. Accuracy of noninvasive multiwave pulse oximetry compared with carboxyhemoglobin from blood gas analysis in unselected emergency department patients.

    Science.gov (United States)

    Roth, Dominik; Herkner, Harald; Schreiber, Wolfgang; Hubmann, Nina; Gamper, Gunnar; Laggner, Anton N; Havel, Christof

    2011-07-01

    Accurate and timely diagnosis of carbon monoxide (CO) poisoning is difficult because of nonspecific symptoms. Multiwave pulse oximetry might facilitate the screening for occult poisoning by noninvasive measurement of carboxyhemoglobin (COHb), but its reliability is still unknown. We assess bias and precision of COHb oximetry compared with the criterion standard blood gas analysis. This was a prospective diagnostic accuracy study according to STARD (Standards for the Reporting of Diagnostic accuracy studies) criteria, performed at a tertiary care hospital emergency department. We included all patients for whom both invasive and noninvasive measurement within 60 minutes was available, regardless of their complaints, during a 1-year period. One thousand five hundred seventy-eight subjects were studied, of whom 17 (1.1%) received a diagnosis of CO poisoning. In accordance with this limited patient cohort, we found a bias of 2.99% COHb (1.50% for smokers, 4.33% for nonsmokers) and a precision of 3.27% COHb (2.90% for smokers, 2.98% for nonsmokers), limits of agreement from -3.55% to 9.53% COHb (-4.30% to 7.30% for smokers, -1.63% to 10.29% for nonsmokers). Upper limit of normal cutoff of 6.6% COHb had the highest sensitivity in screening for CO poisoning. Smoking status and COHb level had the most influence on the deviation between measurements. Multiwave pulse oximetry was found to measure COHb with an acceptable bias and precision. These results suggest it can be used to screen large numbers of patients for occult CO poisoning. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  2. PULSE OXIMETRY AS A POTENTIAL SCREENING TOOL FOR LOWER EXTREMITY ARTERIAL DISEASE IN ASYMPTOMATIC PATIENTS WITH DIABETES MELLITUS

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    Sankaran Nair Kailasanadhan

    2018-02-01

    Full Text Available BACKGROUND India, with a population greater than 1.1 billion, has the dubious distinction of having a larger number of people with diabetes than any other country in the world. It was estimated in the year. 2000 that there are 32 million diabetes patients. Diabetic foot ulcers will complicate the disease in more than 15% of these people during their life time. Foot ulcers precede more than 80% of non-traumatic lower limb amputation. Individuals with diabetes had a tenfold higher overall amputation prevalence than did people without diabetes, 2.8% versus 0.29%. MATERIALS AND METHODS A Cross sectional study was done in the department of general surgery, Government Medical College Kottayam and Diabetic Clinic, Kottayam Medical College, from April 1, 2013 to October 1, 2013. RESULTS Out of 150 patients studied 83 were males and 67 were females and 95 patients (63.3% had POVD Statically significant association was found between POVD and age, history of hypertension, hyperlipidaemia, smoking, alcoholism, duration of diabetes mellitus and family history of hypertension/diabetes and hyperlipidaemia. Sensitivity and specificity of Pulse Oximetry in diagnosing POVD is 80% and 92.7% respectively. Sensitivity and specificity of ABPI in diagnosing POVD is 77.9% and 89.1% respectively. CONCLUSION Pulse Oximetry is an accurate and efficient screening tool for POVD in patients with diabetes mellitus. It can be incorporated to regular outpatient visits of Diabetes patients for early detection of POVD.

  3. Beyond Critical Congenital Heart Disease: Newborn Screening Using Pulse Oximetry for Neonatal Sepsis and Respiratory Diseases in a Middle-Income Country.

    Science.gov (United States)

    Jawin, Vida; Ang, Hak-Lee; Omar, Asma; Thong, Meow-Keong

    2015-01-01

    Studies on pulse oximetry screening for neonatal sepsis and respiratory disease in a middle-income country are lacking. Newborn screening for critical congenital heart disease (CCHD) using pulse oximetry is an effective and life-saving strategy in developed countries. While most studies have reported false-positive results during CCHD screening, they have not elaborated on the detected disease types. We studied the effectiveness and outcomes of pulse oximetry newborn screening for non-cardiac hypoxemic diseases such as neonatal sepsis, respiratory diseases, and CCHD in a middle-income country. In a pilot study performed at the University Malaya Medical Centre (UMMC), Malaysia, all apparently healthy term newborns, delivered at UMMC were screened pre-discharge using pulse oximetry. Echocardiography was performed for newborns that had positive screening results on two separate occasions, 1-h apart. Newborns with normal echocardiograms were evaluated and treated for other non-cardiac diseases. Fifteen of 5247 term newborns had positive screening results. The median age at screening was 20 h. Thirteen newborns (0.24%) had significant non-cardiac diseases: sepsis (n = 2) and respiratory diseases (n = 11) that required hospitalization and treatment. The remaining two newborns with normal antenatal ultrasonograms had positive screening test and confirmed to have CCHD. Another 18 newborns with negative screening test were later admitted for treatment of sepsis (n = 16) and penumonia (n = 2). All newborns were treated and alive at the end of the study. The sensitivity and specificity of pulse oximetry screening for non-cardiac diseases were 42% and 99.9% respectively, and 100% and 99.7% for CCHD, respectively. Routine pulse oximetry screening test was effective in identifying newborns with CCHD and other hypoxemia illnesses, which may led to potential life-threatening condition. This study showed that the expanded use of pulse oximetry has immediate implications for low

  4. Utility of the Pediatric Sleep Questionnaire and Pulse Oximetry as Screening Tools in Pediatric Patients with Suspected Obstructive Sleep Apnea Syndrome

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    Jose A. Peña-Zarza

    2012-01-01

    Full Text Available Objective. To assess the screening tools in snoring patients. Material and Methods. A retrospective review of data was conducted from children between 2 and 15 years old who were referred on suspicion of obstructive sleep apnea-hypopnea (OSAH between June 2008 and June 2011. We excluded patients with significant comorbidities. Pediatric Sleep Questionnaire (PSQ, physical exam (PE, and pulse-oximetry data were collected and correlated with the results of the nightly polygraph at home. Results. We selected 98 patients. The 22-item version of the PSQ had sensitivity of 96% and specificity of 36.8%. The overall value of the clinic predictor of OSAH (PSQ and PE together exhibited an increased specificity 57.6% with 94.6% of sensitivity. The nocturnal home oximetry method used alone was very specific, 92.1%, but had a lower sensitivity, 77.1%. The set of clinical assessment tools used together with pulse-oximetry screening provided excellent specificity 98.1% and a positive predictive value 94.1% globally. The performance of this screening tool is related with the severity of OSAH and accuracy is better in moderate and severe cases. Conclusion. The combination of clinical assessment and pulse-oximetry screening can provide a sufficient diagnostic approach for pediatric patients with suspected OSAH at least in moderate and severe cases.

  5. The OXIMAPA Study: Hypertension Control by ABPM and Association with Sleep Apnea Syndrome by Pulse Oximetry.

    Science.gov (United States)

    Maricoto, Tiago; Silva, Eurico Alves Rodrigues; Damião, Pedro; Bastos, José Mesquita

    2017-02-27

    Ambulatory blood pressure monitoring by automatic device is the best blood pressure evaluation method and sleep apnea syndrome is the leading cause of poor control. Oximetry allows screening these individuals but its usefulness has been poorly explored in Primary Health Care. The aim was to evaluate the blood pressure control at the office and with ambulatory blood pressure monitoring by automatic device and to relate it to sleep apnea syndrome. We selected a sample of 50 participants, representative of 3036 hypertensive patients. The variables were: blood pressure value at the office and blood pressure with ambulatory blood pressure monitoring by automatic device; presence of criteria of sleep apnea syndrome in oximetry. The prevalence of uncontrolled blood pressure was 56% on office evaluation and 68% on ambulatory blood pressure monitoring by automatic device. It was found: 36% of daytime hypertension, 52% nocturnal hypertension, 40% non-dipper profile, 16% of white coat hypertension and 28% masked hypertension. The prevalence of sleep apnea syndrome was 16%. Blood pressure in ambulatory blood pressure monitoring by automatic device and blood pressure in office showed no statistically significant association (p = 0.761). We found a statistically significant association between sleep apnea syndrome and daytime hypertension (p = 0.019) and non-dipper profile (p = 0.005). Ambulatory blood pressure monitoring by automatic device detected more 12% of uncontrolled hypertension than office blood pressure. Sleep apnea syndrome is strongly associated with uncontrolled hypertension and oximetry may be a good screening method, but should be studied further.

  6. Pulse Oximetry: A Non-Invasive, Novel Marker for the Quality of Chest Compressions in Porcine Models of Cardiac Arrest.

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    Jun Xu

    Full Text Available Pulse oximetry, which noninvasively detects the blood flow of peripheral tissue, has achieved widespread clinical use. We have noticed that the better the quality of cardiopulmonary resuscitation (CPR, the better the appearance of pulse oximetry plethysmographic waveform (POP. We investigated whether the area under the curve (AUC and/or the amplitude (Amp of POP could be used to monitor the quality of CPR.Prospective, randomized controlled study.Animal experimental center in Peking Union Medical Collage Hospital, Beijing, China.Healthy 3-month-old male domestic swine.34 local pigs were enrolled in this study. After 4 minutes of untreated ventricular fibrillation, animals were randomly assigned into two resuscitation groups: a "low quality" group (with a compression depth of 3cm and a "high quality" group (with a depth of 5cm. All treatments between the two groups were identical except for the depth of chest compressions. Hemodynamic parameters [coronary perfusion pressure (CPP, partial pressure of end-tidal carbon dioxide (PETCO2] as well as AUC and Amp of POP were all collected and analyzed.There were statistical differences between the "high quality" group and the "low quality" group in AUC, Amp, CPP and PETCO2 during CPR (P<0.05. AUC, Amp and CPP were positively correlated with PETCO2, respectively (P<0.01. There was no statistical difference between the heart rate calculated according to the POP (FCPR and the frequency of mechanical CPR at the 3rd minute of CPR. The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.Both the AUC and Amp of POP correlated well with CPP and PETCO2 in animal models. The frequency of POP closely matched the CPR heart rate. AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

  7. Measuring arterial oxygenation in a high altitude field environment: comparing portable pulse oximetry with blood gas analysis.

    Science.gov (United States)

    Ross, Elliot M; Matteucci, Michael J; Shepherd, Matthew; Barker, Matthew; Orr, Lance

    2013-06-01

    High altitude environments present unique medical treatment challenges. Medical providers often use small portable pulse oximetry devices to help guide their clinical decision making. A significant body of high altitude research is based on the use of these devices to monitor hypoxia, yet there is a paucity of evidence that these devices are accurate in these environments. We studied whether these devices perform accurately and reliably under true mountain conditions. Healthy unacclimatized active-duty military volunteers participating in mountain warfare training at 2100 m (6900 feet) above sea level were evaluated with several different pulse oximetry devices while in a cold weather, high altitude field environment and then had arterial blood gases (ABG) drawn using an i-STAT for comparison. The pulse oximeter readings were compared with the gold standard ABG readings. A total of 49 individuals completed the study. There was no statistically significant difference between any of the devices and the gold standard of ABG. The best performing device was the PalmSAT (PS) 8000SM finger probe with a mean difference of 2.17% and SD of 2.56 (95% CI, 1.42% to 2.92%). In decreasing order of performance were the PS 8000AA finger probe (mean ± SD, 2.54% ± 2.68%; 95% CI, 1.76% to 3.32%), the PS 8000Q ear probe (2.47% ± 4.36%; 95% CI, 1.21% to 3.75%), the Nonin Onyx 9500 (3.29% ± 3.12%; 95% CI, 2.39% to 4.20%), and finally the PS 8000R forehead reflectance sensor (5.15% ± 2.97%; 95% CI, 4.28% to 6.01%). Based on the results of this study, results of the newer portable pulse oximeters appear to be closely correlated to that of the ABG measurements when tested in true mountain conditions. Copyright © 2013 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  8. Melodic algorithms for pulse oximetry to allow audible discrimination of abnormal systolic blood pressures.

    Science.gov (United States)

    Chima, Ranjit S; Ortega, Rafael; Connor, Christopher W

    2014-12-01

    An anesthesiologist must remain vigilant of the patient's clinical status, incorporating many independent physiological measurements. Oxygen saturation and heart rate are represented by continuous audible tones generated by the pulse oximeter, a mandated monitoring device. Other important clinical parameters--notably blood pressure--lack any audible representation beyond arbitrarily-configured threshold alarms. Attempts to introduce further continuous audible tones have apparently foundered; the complexity and interaction of these tones have exceeded the ability of clinicians to interpret them. Instead, we manipulate the tonal and rhythmic structure of the accepted pulse oximeter tone pattern melodically. Three melodic algorithms were developed to apply tonal and rhythmic variations to the continuous pulse oximeter tone, dependent on the systolic blood pressure. The algorithms distort the original audible pattern minimally, to facilitate comprehension of both the underlying pattern and the applied variations. A panel of anesthesia practitioners (attending anesthesiologists, residents and nurse anesthetists) assessed these algorithms in characterizing perturbations in cardiopulmonary status. Twelve scenarios, incorporating combinations of oxygen desaturation, bradycardia, tachycardia, hypotension and hypertension, were tested. A rhythmic variation in which additional auditory information was conveyed only at halftime intervals, with every other "beat" of the pulse oximeter, was strongly favored. The respondents also strongly favored the use of musical chords over single tones. Given three algorithms of tones embedded in the pulse oximeter signal, anesthesiologists preferred a melodic tone to signal a significant change in blood pressure.

  9. Measurement of carboxyhemoglobin and methemoglobin by pulse oximetry: a human volunteer study.

    Science.gov (United States)

    Barker, Steven J; Curry, Jeremy; Redford, Daniel; Morgan, Scott

    2006-11-01

    A new eight-wavelength pulse oximeter is designed to measure methemoglobin and carboxyhemoglobin, in addition to the usual measurements of hemoglobin oxygen saturation and pulse rate. This study examines this device's ability to measure dyshemoglobins in human volunteers in whom controlled levels of methemoglobin and carboxyhemoglobin are induced. Ten volunteers breathed 500 ppm carbon monoxide until their carboxyhemoglobin levels reached 15%, and 10 different volunteers received intravenous sodium nitrite, 300 mg, to induce methemoglobin. All were instrumented with arterial cannulas and six Masimo Rad-57 (Masimo Inc., Irvine, CA) pulse oximeter sensors. Arterial blood was analyzed by three laboratory CO-oximeters, and the resulting carboxyhemoglobin and methemoglobin measurements were compared with the corresponding pulse oximeter readings. The Rad-57 measured carboxyhemoglobin with an uncertainty of +/-2% within the range of 0-15%, and it measured methemoglobin with an uncertainty of 0.5% within the range of 0-12%. The Masimo Rad-57 is the first commercially available pulse oximeter that can measure methemoglobin and carboxyhemoglobin, and it therefore represents an expansion of our oxygenation monitoring capability.

  10. Continuous pulse oximetry in the general surgical ward: Nellcor N-200 versus Nellcor N-3000

    DEFF Research Database (Denmark)

    Christensen, M; Lie, C; Rosenberg, J

    1999-01-01

    of drop-outs (loss of signal) was 13 (range 1-46) with the N-200 compared with nine (2-41) with the N-3000 (p = 0.06). The N-200 registered saturation values of 85% or below for 23% of the observation time compared with 6% of the observation time with the N-3000 pulse oximeter (p ... Symphony N-3000 with the Nellcor N-200 pulse oximeter, when monitoring patients in the general surgical ward. Twenty-two patients were monitored during unrestricted ward activities for a total of 275 h with a N-3000 and a N-200 pulse oximeter simultaneously. Data were analysed for lack of concordance...... between the two pulse oximeters with respect to frequency of registered hypoxaemic episodes and thus the amount of time spent in the alarm state. The median number of desaturation episodes with the N-200 was 18 (range 0-511) compared with four (range 0-476) with the N-3000 (p

  11. Notes on the apparent discordance of pulse oximetry and multi-wavelength haemoglobin photometry

    NARCIS (Netherlands)

    Nijland, R.; Jongsma, H.W.; Nijhuis, J.G.; Oeseburg, Berend; Zijlstra, Willem

    1995-01-01

    Multi-wavelength photometers, blood gas analysers and pulse oximeters are widely used to measure various oxygen-related quantities. The definitions of these quantities are not always correct. This paper gives insight in the various definitions for oxygen quantities. Furthermore, the possible

  12. Accuracy of carboxyhemoglobin detection by pulse CO-oximetry during hypoxemia.

    Science.gov (United States)

    Feiner, John R; Rollins, Mark D; Sall, Jeffrey W; Eilers, Helge; Au, Paul; Bickler, Philip E

    2013-10-01

    Carbon monoxide poisoning is a significant problem in most countries, and a reliable method of quick diagnosis would greatly improve patient care. Until the recent introduction of a multiwavelength "pulse CO-oximeter" (Masimo Rainbow SET(®) Radical-7), obtaining carboxyhemoglobin (COHb) levels in blood required blood sampling and laboratory analysis. In this study, we sought to determine whether hypoxemia, which can accompany carbon monoxide poisoning, interferes with the accurate detection of COHb. Twelve healthy, nonsmoking, adult volunteers were fitted with 2 standard pulse-oximeter finger probes and 2 Rainbow probes for COHb detection. A radial arterial catheter was placed for blood sampling during 3 interventions: (1) increasing hypoxemia in incremental steps with arterial oxygen saturations (SaO2) of 100% to 80%; (2) normoxia with incremental increases in %COHb to 12%; and (3) elevated COHb combined with hypoxemia with SaO2 of 100% to 80%. Pulse-oximeter (SpCO) readings were compared with simultaneous arterial blood values at the various increments of hypoxemia and carboxyhemoglobinemia (≈25 samples per subject). Pulse CO-oximeter performance was analyzed by calculating the mean bias (SpCO - %COHb), standard deviation of the bias (precision), and the root-mean-square error (A(rms)). The Radical-7 accurately detected hypoxemia with both normal and elevated levels of COHb (bias mean ± SD: 0.44% ± 1.69% at %COHb <4%, and -0.29% ± 1.64% at %COHb ≥4%, P < 0.0001, and A(rms) 1.74% vs 1.67%). COHb was accurately detected during normoxia and moderate hypoxia (bias mean ± SD: -0.98 ± 2.6 at SaO2 ≥95%, and -0.7 ± 4.0 at SaO2 <95%, P = 0.60, and A(rms) 2.8% vs 4.0%), but when SaO2 decreased below approximately 85%, the pulse CO-oximeter always gave low signal quality errors and did not report SpCO values. In healthy volunteers, the Radical-7 pulse CO-oximeter accurately detects hypoxemia with both low and elevated COHb levels, and accurately detects COHb

  13. Pulse oximetry recorded from the Phone Oximeter for detection of obstructive sleep apnea events with and without oxygen desaturation in children.

    Science.gov (United States)

    Garde, Ainara; Dehkordi, Parastoo; Wensley, David; Ansermino, J Mark; Dumont, Guy A

    2015-01-01

    Obstructive sleep apnea (OSA) disrupts normal ventilation during sleep and can lead to serious health problems in children if left untreated. Polysomnography, the gold standard for OSA diagnosis, is resource intensive and requires a specialized laboratory. Thus, we proposed to use the Phone Oximeter™, a portable device integrating pulse oximetry with a smartphone, to detect OSA events. As a proportion of OSA events occur without oxygen desaturation (defined as SpO2 decreases ≥ 3%), we suggest combining SpO2 and pulse rate variability (PRV) analysis to identify all OSA events and provide a more detailed sleep analysis. We recruited 160 children and recorded pulse oximetry consisting of SpO2 and plethysmography (PPG) using the Phone Oximeter™, alongside standard polysomnography. A sleep technician visually scored all OSA events with and without oxygen desaturation from polysomnography. We divided pulse oximetry signals into 1-min signal segments and extracted several features from SpO2 and PPG analysis in the time and frequency domain. Segments with OSA, especially the ones with oxygen desaturation, presented greater SpO2 variability and modulation reflected in the spectral domain than segments without OSA. Segments with OSA also showed higher heart rate and sympathetic activity through the PRV analysis relative to segments without OSA. PRV analysis was more sensitive than SpO2 analysis for identification of OSA events without oxygen desaturation. Combining SpO2 and PRV analysis enhanced OSA event detection through a multiple logistic regression model. The area under the ROC curve increased from 81% to 87%. Thus, the Phone Oximeter™ might be useful to monitor sleep and identify OSA events with and without oxygen desaturation at home.

  14. 3-lead electrocardiogram is more reliable than pulse oximetry to detect bradycardia during stabilisation at birth of very preterm infants.

    Science.gov (United States)

    Iglesias, Beatriz; Rodrí Guez, Marí A José; Aleo, Esther; Criado, Enrique; Martí Nez-Orgado, Jose; Arruza, Luis

    2018-05-01

    Current neonatal resuscitation guidelines suggest the use of ECG in the delivery room (DR) to assess heart rate (HR). However, reliability of ECG compared with pulse oximetry (PO) in a situation of bradycardia has not been specifically investigated. The objective of the present study was to compare HR monitoring using ECG or PO in a situation of bradycardia (HR <100 beats per minute (bpm)) during preterm stabilisation in the DR. Video recordings of resuscitations of infants <32 weeks of gestation were reviewed. HR readings in a situation of bradycardia (<100 bpm) at any moment during stabilisation were registered with both devices every 5 s from birth. A total of 29 episodes of bradycardia registered by the ECG in 39 video recordings were included in the analysis (n=29). PO did not detect the start of these events in 20 cases (69%). PO detected the start and the end of bradycardia later than the ECG (median (IQR): 5 s (0-10) and 5 s (0-7.5), respectively). A decline in PO accuracy was observed as bradycardia progressed so that by the end of the episode PO offered significantly lower HR readings than ECG. PO detects the start and recovery of bradycardia events slower and less accurately than ECG during stabilisation at birth of very preterm infants. ECG use in this scenario may contribute to an earlier initiation of resuscitation manoeuvres and to avoid unnecessary prolongation of resuscitation efforts after recovery. © 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.

  15. A History of Mild Traumatic Brain Injury affects Peripheral Pulse Oximetry during Normobaric Hypoxia

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    Leonard Temme

    2016-09-01

    Full Text Available Introduction: Physiological and emotional stressors increase symptoms of concussion in recently injured individuals and both forms of stress induce symptoms in people recovering from mild traumatic brain injury (mTBI but who are asymptomatic when not stressed or are at rest. Methods: Healthy asymptomatic adults (25.0 ± 5.1 years with a history of mTBI (n = 36 and matched healthy controls (n = 36 with no mTBI history were exposed to three levels of normobaric hypoxic stress generated with the Reduced Oxygen Breathing Device (ROBD (Environics, Inc., Tollande, CT, which reduced the percent oxygen by mixing sea level air with nitrogen. The ROBD reduced the percent oxygen in the breathable air from the normal 21% to 15.5% O2, 14% O2, and 13% O2. Under these conditions: (a a standard pulse oximeter recorded peripheral oxygen saturation (SpO2 and pulse rate (beats per minute, and (b the FIT (PMI, Inc., Rockville, MD recorded saccadic velocity and pupillary response dynamics to a brief light flash. Results: For all three hypoxic stress conditions the mTBI group had significantly higher SpO2 during the final minute of exposure than did the controls F(2.17,151.8 = 5.29, p < .001, η2 = .852 and the rate of SpO2 change over time was significantly shallower for the mTBI than for the controls F(2.3,161.3 = 2.863, p < .001, η2 = .569, Greenhouse-Geisser corrected. Overall, mTBI had lower pulse rate but the difference was only significant for the 14% O2 condition. FIT oculomotor measures were not sensitive to group differences. When exposed to mild or moderate normobaric hypoxic stress (15% O2: (1 SpO2 differences emerged between the mTBI and matched healthy controls, (2 heart rate trended lower in the mTBI group, and (3 FIT measures were not sensitive to group differences. Conclusion: A relatively minor hypoxic challenge can reveal measurable differences in SpO2 and heart rate in otherwise asymptomatic individuals with a history of mTBI.

  16. Evaluating cost and resource use associated with pulse oximetry screening for critical congenital heart disease: Empiric estimates and sources of variation.

    Science.gov (United States)

    Reeder, Matthew R; Kim, Jaewhan; Nance, Amy; Krikov, Sergey; Feldkamp, Marcia L; Randall, Harper; Botto, Lorenzo D

    2015-11-01

    Newborn screening for critical congenital heart disease (CCHD) using pulse oximetry is being implemented in the United States and internationally; however, few data are available on the associated in-hospital costs and use of resources. Time and motion study in well-baby nurseries at two large urban hospitals in Utah using different approaches to pulse oximetry screening. Two observers recorded the time for each screening step together with provider and equipment characteristics. Structured questionnaire provided additional information on labor and equipment costs. Fifty-three CCHD screens were observed. At site A (n = 22), screening was mostly done by medical assistants (95%) using disposable probes (100%); at site B (n = 31), screening was mostly performed by certified nursing assistants (90%) using reusable probes (90%). Considering only first screens (n = 53), the median screen time was 8.6 min (range: 3.2-23.2), with no significant difference between sites. The overall cost ($ in 2014) of screening per baby was $24.52 at site A and $2.60 at site B. Nearly all the variation in cost (90%) was due to the cost of disposable probes; labor costs were similar between sites. CCHD screening by means of pulse oximetry is reasonably fast for most babies, leading to relative small labor costs with little variation by provider type. The main driver of costs is equipment: in a high throughput setting, reusable probes are currently associated with considerable cost saving compared with disposable probes. As programs expand to universal screening, improved and cheaper technologies could lead to considerable economies of scale. © 2015 Wiley Periodicals, Inc.

  17. False positive rate of carbon monoxide saturation by pulse oximetry of emergency department patients.

    Science.gov (United States)

    Weaver, Lindell K; Churchill, Susan K; Deru, Kayla; Cooney, Darryl

    2013-02-01

    Symptoms of carbon monoxide (CO) poisoning are non-specific. Diagnosis requires suspicion of exposure, confirmed by measuring ambient CO levels or carboxyhemoglobin (COHb). An FDA-approved pulse oximeter (Rad-57) can measure CO saturation (S(pCO)). The device accuracy has implications for clinical decision-making. From April 1 to August 15, 2008, study personnel measured S(pCO) and documented demographic factors at time of clinical blood draw, in a convenience sample of 1,363 subjects presenting to the emergency department at Intermountain Medical Center, Murray, Utah. The technician then assayed COHb. COHb and S(pCO) values were compared by subject; false positive or negative values were defined as S(pCO) at least 3 percentage points greater or less than COHb level, reported by the manufacturer to be ± 1 SD in performance. In 1,363 subjects, 613 (45%) were male, 1,141 (84%) were light-skinned, 14 in shock, 4 with CO poisoning, and 122 (9%) met the criteria for a false positive value (range 3-19 percentage points), while 247 (18%) met the criteria for a false negative value (-13 to -3 percentage points). Risks for a false positive S(pCO) reading included being female and having a lower perfusion index. Methemoglobin, body temperature, and blood pressure also appear to influence the S(pCO) accuracy. There was variability among monitors, possibly related to technician technique, as rotation of monitors among technicians was not enforced. While the Rad-57 pulse oximeter functioned within the manufacturer's specifications, clinicians using the Rad-57 should expect some S(pCO) readings to be significantly higher or lower than COHb measurements, and should not use S(pCO) to direct triage or patient management. An elevated S(pCO) could broaden the diagnosis of CO poisoning in patients with non-specific symptoms. However, a negative S(pCO) level in patients suspected of having CO poisoning should never rule out CO poisoning, and should always be confirmed by COHb. © 2013

  18. Capnography is superior to pulse oximetry for the detection of respiratory depression during colonoscopy La capnografía es superior a la pulsioximetría en la detección de depresión respiratoria durante las colonoscopias

    Directory of Open Access Journals (Sweden)

    G. Cacho

    2010-02-01

    Full Text Available Background: pulse oximetry is a widely accepted procedure for ventilatory monitoring during gastrointestinal endoscopy, but this method provides an indirect measurement of the respiratory function. In addition, detection of abnormal ventilatory activity can be delayed, especially if supplemental oxygen is provided. Capnography offers continuous real-time measurement of expiratory carbon dioxide. Objective: we aimed at prospectively examining the advantages of capnography over the standard pulse oximetry monitoring during sedated colonoscopies. Patients and methods:fifty patients undergoing colonoscopy were simultaneously monitored with pulse oximetry and capnography by using two different devices in each patient. Several sedation regimens were administered. Episodes of apnea or hypoventilation detected by capnography were compared with the occurrence of hypoxemia. Results: twenty-nine episodes of disordered respiration occurred in 16 patients (mean duration 54.4 seconds. Only 38% of apnea or hypoventilation episodes were detected by pulse oximetry. A mean delay of 38.6 seconds was observed in the events detected by pulse oximetry (two episodes of disturbed ventilation were simultaneously detected by capnography and pulse oximetry. Conclusions: apnea or hypoventilation commonly occurs during colonoscopy with sedation. Capnography is more reliable than pulse oximetry in early detection of respiratory depression in this setting.

  19. Oximetry using multispectral imaging: theory and application

    Science.gov (United States)

    MacKenzie, Lewis E.; Harvey, Andrew R.

    2018-06-01

    Multispectral imaging (MSI) is a technique for measurement of blood oxygen saturation in vivo that can be applied using various imaging modalities to provide new insights into physiology and disease development. This tutorial aims to provide a thorough introduction to the theory and application of MSI oximetry for researchers new to the field, whilst also providing detailed information for more experienced researchers. The optical theory underlying two-wavelength oximetry, three-wavelength oximetry, pulse oximetry, and multispectral oximetry algorithms are described in detail. The varied challenges of applying MSI oximetry to in vivo applications are outlined and discussed, covering: the optical properties of blood and tissue, optical paths in blood vessels, tissue auto-fluorescence, oxygen diffusion, and common oximetry artefacts. Essential image processing techniques for MSI are discussed, in particular, image acquisition, image registration strategies, and blood vessel line profile fitting. Calibration and validation strategies for MSI are discussed, including comparison techniques, physiological interventions, and phantoms. The optical principles and unique imaging capabilities of various cutting-edge MSI oximetry techniques are discussed, including photoacoustic imaging, spectroscopic optical coherence tomography, and snapshot MSI.

  20. Cerebral oximetry in preterm infants

    DEFF Research Database (Denmark)

    Greisen, Gorm; Andresen, Bjørn; Plomgaard, Anne Mette

    2016-01-01

    Preterm birth constitutes a major cause of death before 5 years of age and it is a major cause of neurodevelopmental impairment across the world. Preterm infants are most unstable during the transition between fetal and newborn life during the first days of life and most brain damage occurs...... in this period. The brain of the preterm infant is accessible for tissue oximetry by near-infrared spectroscopy. Cerebral oximetry has the potential to improve the long-term outcome by helping to tailor the support of respiration and circulation to the individual infant's needs, but the evidence is still lacking....... The goals for research include testing the benefit and harms of cerebral oximetry in large-scale randomized trials, improved definition of the hypoxic threshold, better understanding the effects of intensive care on cerebral oxygenation, as well as improved precision of oximeters and calibration among...

  1. New hybrid reflectance optical pulse oximetry sensor for lower oxygen saturation measurement and for broader clinical application

    Science.gov (United States)

    Nogawa, Masamichi; Ching, Chong Thong; Ida, Takeyuki; Itakura, Keiko; Takatani, Setsuo

    1997-06-01

    A new reflectance pulse oximeter sensor for lower arterial oxygen saturation (Sa)2) measurement has been designed and evaluated in animals prior to clinical trials. The new sensor incorporates ten light emitting diode chips for each wavelength of 730 and 880 nm mounted symmetrically and at the radial separation distance of 7 mm around a photodiode chip. The separation distance of 7 mm was chosen to maximize the ratio of the pulsatile to the average plethysmographic signal level at each wavelength. The 730 and 880 wavelength combination was determined to obtain a linear relationship between the reflectance ratio of the 730 and 880 nm wavelengths and Sa)2. In addition to these features of the sensor, the Fast Fourier Transform method was employed to compute the pulsatile and average signal level at each wavelength. The performance of the new reflectance pulse oximeter sensor was evaluated in dogs in comparison to the 665/910 nm sensor. As predicted by the theoretical simulation based on a 3D photon diffusion theory, the 730/880 nm sensor demonstrated an excellent linearity over the SaO2 range from 100 to 30 percent. For the SaO2 range between 100 and 70 percent, the 665/910 and 730/880 sensors showed the standard error of around 3.5 percent and 2.1 percent, respectively, in comparison to the blood samples. For the range between 70 and 30 percent, the standard error of the 730/880 nm sensor was only 2.7 percent, while that of the 665/910 nm sensor was 9.5 percent. The 730/880 sensor showed improved accuracy for a wide range of SaO2 particularly over the range between 70 and 30 percent. This new reflectance sensor can provide noninvasive measurement of SaO2 accurately over the wide saturation range from 100 to 30 percent.

  2. Respiratory Outcomes of the Surfactant Positive Pressure and Oximetry Randomized Trial

    Science.gov (United States)

    Stevens, Timothy P.; Finer, Neil N.; Carlo, Waldemar A.; Szilagyi, Peter G.; Phelps, Dale L.; Walsh, Michele C.; Gantz, Marie G.; Laptook, Abbot R.; Yoder, Bradley A.; Faix, Roger G.; Newman, Jamie E.; Das, Abhik; Do, Barbara T.; Schibler, Kurt; Rich, Wade; Newman, Nancy S.; Ehrenkranz, Richard A.; Peralta-Carcelen, Myriam; Vohr, Betty R.; Wilson-Costello, Deanne E.; Yolton, Kimberly; Heyne, Roy J.; Evans, Patricia W.; Vaucher, Yvonne E.; Adams-Chapman, Ira; McGowan, Elisabeth C.; Bodnar, Anna; Pappas, Athina; Hintz, Susan R.; Acarregui, Michael J.; Fuller, Janell; Goldstein, Ricki F.; Bauer, Charles R.; O’Shea, T. Michael; Myers, Gary J.; Higgins, Rosemary D.

    2014-01-01

    Objective To explore the early childhood pulmonary outcomes of infants who participated in the NICHD SUPPORT Trial, using a factorial design that randomized extremely preterm infants to lower vs. higher oxygen saturation targets and delivery room CPAP vs. intubation/surfactant, found no significant difference in the primary composite outcome of death or BPD. Study design The Breathing Outcomes Study, a prospective secondary to SUPPORT, assessed respiratory morbidity at 6 month intervals from hospital discharge to 18–22 months corrected age (CA). Two pre-specified primary outcomes, wheezing more than twice per week during the worst 2 week period and cough longer than 3 days without a cold were compared between each randomized intervention. Results One or more interviews were completed for 918 of 922 eligible infants. The incidence of wheezing and cough were 47.9% and 31.0%, respectively, and did not differ between study arms of either randomized intervention. Infants randomized to lower vs. higher oxygen saturation targets had similar risks of death or respiratory morbidities (except for croup, treatment with oxygen or diuretics at home). Infants randomized to CPAP vs. intubation/surfactant had fewer episodes of wheezing without a cold (28.9% vs. 36.5%, pCPAP rather than intubation/surfactant is associated with less respiratory morbidity by 18–22 months CA. Longitudinal assessment of pulmonary morbidity is necessary to fully evaluate the potential benefits of respiratory interventions for neonates. PMID:24725582

  3. Neonatal screening for life-threatening conditions persistent – pulmonary hypertension in newborns and critical congenital heart disease – by the method of pulse oximetry

    Directory of Open Access Journals (Sweden)

    D. I. Sadykova

    2017-01-01

    Full Text Available Research objective: to assess the diagnostic significance of the pulse oximetry performed by the newborn for the 3rd hour of life to identify critical conditions and to justify the expediency of further introduction of this technology in the work of obstetric institutions.Results. In 5 maternity hospitals of the Republic of Tatarstan, from April 2016 to February 2017, 8358 88.4% of newborns were pulsometrically screened. Positive results were obtained in 95 (1.14% patients. Because of screening, 13 newborns were diagnosed with congenital heart defects, not diagnosed in utero, in the first hours of life, five of them were critical. All newborns with critical congenital heart defects were successfully operated. Besides, 20 patients had persistent pulmonary hypertension, 30 had intrauterine pneumonia.Conclusions. The measurement of saturation at the 3rd hour of life of a newborn allows avoiding life-threatening complications in children with critical congenital heart defects and persistent pulmonary hypertension and in a stable state to transfer them to a further treatment stage.

  4. Detection of Hb Rothschild HBB: c.[112T>A or 112T>C], Through High Index of Suspicion on Abnormal Pulse Oximetry.

    Science.gov (United States)

    Alli, Nazeer A; Wessels, Piet; Rampersad, Narisha; Clark, Barnaby E; Thein, Swee Lay

    2017-03-01

    We describe a case with a low oxygen affinity hemoglobin (Hb) variant who presented with cyanosis in the absence of cardiopulmonary disease. The patient, a 27-year-old pregnant female (P1G2), complained of a productive cough and bluish discoloration of the lips that started 3 days prior to seeking attention. She had no previous episodes and has generally been in good health. A positive family history of cyanosis was obtained in one sibling. Systematic examination, notably the cardiorespiratory system, revealed no abnormalities. The arterial Hb oxygen saturation (SpO 2 ) on pulse oximetry was 81.0% and Hb separation studies revealed an Hb variant identified as Hb Rothschild [β37(C3)Trp→Arg] (HBB: c.[112 T>A or 112 T>C]) by gene sequencing. The amino acid substitution (Trp→Arg) is an important contact point at the α1β2 interface and favors a T-quaternary state of the Hb tetramer. This leads to a low oxygen affinity state, which results in premature release of oxygen and drop in oxygen saturation. In the absence of cardiopulmonary disease, a decreased oxygen saturation reading, with or without cyanosis, should arouse suspicion for a possible dysHb.

  5. A Ring-shaped photodiode designed for use in a reflectance pulse oximetry sensor in wireless health monitoring applications

    DEFF Research Database (Denmark)

    Duun, Sune; Haahr, Rasmus Grønbek; Birkelund, Karen

    2010-01-01

    We report a photodiode for use in a reflectance pulse oximeter for use in autonomous and low-power homecare applications. The novelty of the reflectance pulse oximeter is a large ring shaped backside silicon pn photodiode. The ring-shaped photodiode gives optimal gathering of light and thereby...... enable very low light-emitting diode (LED) driving currents for the pulse oximeter. The photodiode also have a two layer SiO2/SiN interference filter yielding 98% transmission at the measuring wavelengths, 660 nm and 940 nm, and suppressing other wavelengths down to 50% transmission. The photodiode has...

  6. Cerebral near infrared spectroscopy oximetry in extremely preterm infants

    DEFF Research Database (Denmark)

    Hyttel-Sorensen, Simon; Pellicer, Adelina; Alderliesten, Thomas

    2015-01-01

    OBJECTIVE: To determine if it is possible to stabilise the cerebral oxygenation of extremely preterm infants monitored by cerebral near infrared spectroscopy (NIRS) oximetry. DESIGN: Phase II randomised, single blinded, parallel clinical trial. SETTING: Eight tertiary neonatal intensive care unit...

  7. Pulse Oximetry for the Detection of Obstructive Sleep Apnea Syndrome: Can the Memory Capacity of Oxygen Saturation Influence Their Diagnostic Accuracy?

    Directory of Open Access Journals (Sweden)

    Carlos A. Nigro

    2011-01-01

    Full Text Available Objective. To assess the diagnostic ability of WristOx 3100 using its three different recording settings in patients with suspected obstructive sleep apnea syndrome (OSAS. Methods. All participants (135 performed the oximetry (three oximeters WristOx 3100 and polysomnography (PSG simultaneously in the sleep laboratory. Both recordings were interpreted blindly. Each oximeter was set to one of three different recording settings (memory capabilities 0.25, 0.5, and 1 Hz. The software (nVision 5.1 calculated the adjusted O2 desaturation index-mean number of O2 desaturation per hour of analyzed recording ≥2, 3, and 4% (ADI2, 3, and 4. The ADI2, 3, and 4 cutoff points that better discriminated between subjects with or without OSAS arose from the receiver-operator characteristics (ROCs curve analysis. OSAS was defined as a respiratory disturbance index (RDI ≥ 5. Results. 101 patients were included (77 men, mean age 52, median RDI 22.6, median BMI 27.4 kg/m2. The area under the ROCs curves (AUC-ROCs of ADI2, 3, and 4 with different data storage rates were similar (AUC-ROCs with data storage rates of 0.25/0.5/1 Hz: ADI2: 0.958/0.948/0.965, ADI3: 0.961/0.95/0.966, and ADI4: 0.957/0.949/0.963, P NS. Conclusions. The ability of WristOx 3100 to detect patients with OSAS was not affected by the data storage rate of the oxygen saturation signal. Both memory capacity of 0.25, 0.5, or 1 Hz showed a similar performance for the diagnosis of OSAS.

  8. Spectrophotometric retinal oximetry in pigs

    DEFF Research Database (Denmark)

    Traustason, Sindri; Kiilgaard, Jens Folke; Karlsson, Robert

    2013-01-01

    PURPOSE: To assess the validity of spectrophotometric retinal oximetry, by comparison to blood gas analysis and intra-vitreal measurements of partial pressure of oxygen (pO2). METHODS: Female domestic pigs were used for all experiments (n=8). Oxygen fraction in inspired air was changed using...... a mixture of room air, pure oxygen and pure nitrogen, ranging from 5% to 100% oxygen. Femoral arterial blood gas analysis and retinal oximetry was performed at each level of inspiratory oxygen fraction. Retinal oximetry was performed using a commercial instrument, the Oxymap Retinal Oximeter T1 (Oxymap ehf...... arterial oxygen saturation and the optical density ratio over retinal arteries revealed an approximately linear relationship (R(2) = 0.74, p = 3.4 x 10(-9)). In order to test the validity of applying the arterial calibration to veins, we compared non-invasive oximetry measurements to invasive pO2...

  9. Cerebral Oximetry in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    A. N. Shepelyuk

    2012-01-01

    Full Text Available Based on the data of numerous current references, the review describes different neuromonitoring methods during cardiac surgery under extracorporeal circulation. It shows that it is important and necessary to make neuromonitoring for the early diagnosis and prevention of neurological complications after cardiac surgery. Particular attention is given to cerebral oximetry; the possibilities and advantages of this technique are described. Correction of cerebral oximetric values is shown to improve survival rates and to reduce the incidence of postoperative complications. Lack of cerebral oximetry monitoring denudes a clinician of important information and possibilities to optimize patient status and to prevent potentially menacing complications, which allows one to conclude that it is necessary to use cerebral oximetry procedures within neu-romonitoring in cardiac surgery. Key words: extracorporeal circulation, cerebral oximetry, neurological dysfunction, cerebral oxygenation.

  10. Independent component analysis applied to pulse oximetry in the estimation of the arterial oxygen saturation (SpO2) - a comparative study

    DEFF Research Database (Denmark)

    Jensen, Thomas; Duun, Sune Bro; Larsen, Jan

    2009-01-01

    We examine various independent component analysis (ICA) digital signal processing algorithms for estimating the arterial oxygen saturation (SpO2) as measured by a reflective pulse oximeter. The ICA algorithms examined are FastICA, Maximum Likelihood ICA (ICAML), Molgedey and Schuster ICA (ICAMS......), and Mean Field ICA (ICAMF). The signal processing includes pre-processing bandpass filtering to eliminate noise, and post-processing by calculating the SpO2. The algorithms are compared to the commercial state-of-the-art algorithm Discrete Saturation Transform (DST) by Masimo Corporation...

  11. Feasibility of Pulse Oximetry Pre-discharge Screening Implementation for detecting Critical Congenital heart Lesions in newborns in a secondary level maternity hospital in the Western Cape, South Africa: The 'POPSICLe' study.

    Science.gov (United States)

    Van Niekerk, A M; Cullis, R M; Linley, L L; Zühlke, L

    2016-07-07

    Early detection of critical congenital heart disease (CCHD) through newborn pulse oximetry (POx) screening is an effective strategy for reducing paediatric morbidity and mortality rates and has been adopted by much of the developed world. To document the feasibility of implementing pre-discharge POx screening in well babies born at Mowbray Maternity Hospital, a busy government hospital in Cape Town, South Africa. Parent and staff acceptance was assessed. We conducted a prospective study of predischarge POx screening in one postnatal ward, following informed parental consent. During the 4-month study period, 1 017 of 2 256 babies discharged (45.1%) were offered POx screening and 1 001 were screened; 94.0% of tests took <3 minutes to perform, 4.3% 3 - 5 minutes and 1.7% >5 minutes. Eighteen patients needed second screens and three required third screens. Only 3.1% protocol errors were made, all without consequence. The vast majority (91.6%) of nursing staff reported insufficient time to perform the study screening in addition to their daily tasks, but ~75% felt that with a full nursing staff complement and if done routinely (not part of a study), pre-discharge POx screening could be successfully instituted at our facility. Over 98% of the mothers had positive comments. Two babies failed screening and required echocardiograms; one was diagnosed with CCHD and the other with neonatal sepsis. The sensitivity and specificity were 50% (95% confidence interval (CI) 1.3 - 98.7%) and 99.9% (95% CI 99.4 - 100%), respectively, with a percentage correct of 99.8%. POx screening was supported and accepted by staff and parents. If there are no nursing staff shortages and if it is done routinely before discharge, not as part of a study, we conclude that POx screening could be implemented successfully without excessive false positives or errors, or any additional burden to cardiology services.

  12. Interferência da coloração de esmaltes de unha e do tempo na oximetria de pulso em voluntários sadios Interference of nail polish colors and time on pulse oximetry in healthy volunteers

    Directory of Open Access Journals (Sweden)

    Mara Harumi Miyake

    2003-12-01

    Full Text Available INTRODUÇÃO: A oximetria de pulso é um método não invasivo de mensuração da saturação periférica da oxiemoglobina (SpO2. É freqüentemente utilizado em unidades de emergência, de terapia intensiva e em centro cirúrgico. A leitura da oximetria de pulso tem acurácia limitada na presença de metaemoglobina, carboxiemoglobina, anemia, vasoconstrição periférica, esmalte de unha, luz fluorescente e movimentação. OBJETIVO: Avaliar a interferência da coloração de esmalte de unha e do tempo sobre a SpO2 em indivíduos sadios. MÉTODO: Participaram do estudo 61 voluntárias sadias, com idades entre 18 e 32 anos. Foi avaliada SpO2 nas seguintes colorações de esmaltes: base (dedo mínimo, rosa claro (dedo anular, rosa claro com cintilante (dedo médio e vermelha (polegar. O indicador não recebeu esmalte. Foi analisado o tempo para cada coloração de esmalte, a cada minuto até completar cinco minutos. RESULTADOS: Quando comparadas as medidas da SpO2 com o controle, as colorações base (p = 0,56, rosa claro (p = 0,56 e rosa claro com cintilante (p = 0,37 não apresentaram diferença estatisticamente significante. A SpO2 apresentou variação significante na cor vermelha (p BACKGROUND: Pulse oximetry is a noninvasive method to measure the saturation of peripheral oxyhaemoglobin (SpO2. It's usually used in emergency, intensive care and operating room units. Pulse oximeter readings have limited accuracy in the presence of methemoglobin, carboxyhemoglobin, anaemia, peripheral vasoconstriction, nail polish, fluorescent light, and motion. OBJECTIVES: To evaluate the interferences of the color of nail polishes and time on SpO2 in healthy individuals. METHODS: Sixty-one healthy female volunteers, ages ranging from 18 to 32 years. The nail polish colors used to evaluate SpO2 were: base coat on the little finger, light pink on the ring finger, sparkling light pink on the medium finger and red on the thumb. The index finger was used as control

  13. Synchronizing the transcranial magnetic pulse with electroencephalographic recordings effectively reduces inter-trial variability of the pulse artefact

    DEFF Research Database (Denmark)

    Tomasevic, Leo; Takemi, Mitsuaki; Siebner, Hartwig Roman

    2017-01-01

    delivered monophasic and biphasic TMS to a melon as head phantom and to four healthy participants and recorded the pulse artefact at 5 kHz with a TMS-compatible EEG system. Pulse delivery was either synchronized or non-synchronized to the clock of the EEG recording system. The effects of synchronization...... were tested at 10 and 20 kHz using the head phantom. We also tested the effect of a soft sheet placed between the stimulation coil and recording electrodes in both human and melon. RESULTS & CONCLUSION: Synchronizing TMS and data acquisition markedly reduced trial-to-trial variability of the pulse...

  14. Clinical use of cerebral oximetry in extremely preterm infants is feasible

    DEFF Research Database (Denmark)

    Hyttel-Sørensen, Simon; Austin, Topun; van Bel, Frank

    2013-01-01

    The research programme Safeguarding the Brains of our smallest Children (SafeBoosC) aims to test the benefits and harms of cerebral near-infrared spectroscopy (NIRS) oximetry in infants born before 28 weeks of gestation. In a phase II trial, infants will be randomised to visible cerebral NIRS...

  15. Clinical use of cerebral oximetry in extremely preterm infants is feasible

    DEFF Research Database (Denmark)

    Hyttel-Sørensen, Simon; Austin, Topun; van Bel, Frank

    2013-01-01

    The research programme Safeguarding the Brains of our smallest Children (SafeBoosC) aims to test the benefits and harms of cerebral near-infrared spectroscopy (NIRS) oximetry in infants born before 28 weeks of gestation. In a phase II trial, infants will be randomised to visible cerebral NIRS oxi...

  16. Pulse oximeter as a sensor of fluid responsiveness: do we have our finger on the best solution?

    Science.gov (United States)

    Monnet, Xavier; Lamia, Bouchra; Teboul, Jean-Louis

    2005-10-05

    The pulse oximetry plethysmographic signal resembles the peripheral arterial pressure waveform, and the degree of respiratory variation in the pulse oximetry wave is close to the degree of respiratory arterial pulse pressure variation. Thus, it is tempting to speculate that pulse oximetry can be used to assess preload responsiveness in mechanically ventilated patients. In this commentary we briefly review the complex meaning of the pulse oximetry plethysmographic signal and highlight the advantages, limitations and pitfalls of the pulse oximetry method. Future studies including volume challenge must be performed to test whether the pulse oximetry waveform can really serve as a nonivasive tool for the guidance of fluid therapy in patients receiving mechanical ventilation in intensive care units and in operating rooms.

  17. Saturação de oxigênio fetal medida pela oximetria de pulso durante o trabalho de parto: relações com o ph da artéria umbilical Fetal oxygen saturation measured by pulse oximetry during labor: relation to umbilical artery pH

    Directory of Open Access Journals (Sweden)

    Edson Nunes de Morais

    1999-04-01

    Full Text Available Objetivos: estudar os níveis de saturação de oxigênio fetal (SpO2 durante o trabalho de parto pela técnica da oximetria de pulso e sua relação com o pH da artéria umbilical (AU. Pacientes e Métodos: a SpO2 fetal foi medida durante o parto por meio da técnica da oximetria de pulso em 50 casos. Comparou-se a média dos valores de SpO2 entre os dois períodos do trabalho de parto, sendo o primeiro subdividido em fases, segundo a dilatação cervical ( ou = 7,20 e ou = 30,0%. Resultados: as médias da SpO2 fetal no primeiro período do parto foram de 53,0 ± 7,3% e 44,2 ± 6,8%, e no segundo 46,8 ± 7,7% e 38,4 ± 7,1% (pH da AU > ou = 7,20 e ou = 7,20 foram de 55,1 ± 5,1% (Purpose: to study fetal oxygen saturation (SpO2 levels during labor by continuous pulse oximetry tecnique, and its relation to umbilical artery (UA pH. Patients and Methods: fetal SpO2 levels were measured during labor by the pulse oximetry technique in 50 subjects. Average values of SpO2 were compared between the first and second stage of labor, with the first stage further subdivided into phases, according to cervical dilatation of ( or = 7.20 and or = 30.0% was considered normal. Results: fetal SpO2 averages during the first stage were 53.0 ± 7.3% and 44.2 ± 6.8% (UA pH > or = 7.20 and or = 7.20 were 55.1 ± 5.1% (<=4 cm, 52.3 ± 4.6% (5-7 cm and 51.5 ± 7.2% (8-9 cm; for UA pH <7.20, the fetal SpO2 averages were 46.3 ± 5.1% (<=4 cm, 43.6 ± 6.7% (5-7 cm and 42.8 ± 5.8% (8-9 cm. Considering the UA pH, these differences were statistically significant (p<0.01. Conclusion: a significant decrease of oxygen saturation values was observed during labor when fetal pulse oximetry was used.

  18. A flexible infrared sensor for tissue oximetry

    DEFF Research Database (Denmark)

    Petersen, Søren Dahl; Thyssen, Anders; Engholm, Mathias

    2013-01-01

    We present a flexible infrared sensor for use in tissue oximetry with the aim of treating prematurely born infants. The sensor will detect the oxygen saturation in brain tissue through near infrared spectroscopy. The sensor itself consists of several individual silicon photo detectors fully...

  19. Baseline cerebral oximetry values depend on non-modifiable patient characteristics.

    Science.gov (United States)

    Valencia, Lucía; Rodríguez-Pérez, Aurelio; Ojeda, Nazario; Santana, Romen Yone; Morales, Laura; Padrón, Oto

    2015-12-01

    The aim of the present study was to evaluate baseline regional cerebral oxygen saturation (rSO2) values and identify factors influencing preoperative rSO2 in elective minor surgery. Observational analysis post-hoc. Observational post-hoc analysis of data for the patient sample (n=50) of a previously conducted clinical trial in patients undergoing tumourectomy for breast cancer or inguinal hernia repair. Exclusion criteria included pre-existing cerebrovascular diseases, anaemia, baseline pulse oximetry values were recorded while the patient breathed room air, using the INVOS 5100C monitor™ (Covidien, Dublin, Ireland). Thirty-seven women (72%) and 13 men (28%) 48 ± 13 years of age were enrolled in this study. Baseline rSO2 was 62.01 ± 10.38%. Baseline rSO2 was significantly different between men (67.6 ± 11.2%) and women (60 ± 9.4%), (P=0.023). There were also differences between baseline rSO2 and ASA physical status (ASA I: 67.6 ± 10.7%, ASA II: 61.6 ± 8.4%, ASA III: 55.8 ± 13.9%, P=0.045). Baseline rSO2 had a positive correlation with body weight (r=0.347, P=0.014) and height (r=0.345, P=0.014). We also found significant differences in baseline rSO2 among patients with and without chronic renal failure (P=0.005). No differences were found in any other studied variables. Non-modifiable patient characteristics (ASA physical status, sex, chronic renal failure, body weight and height) influence baseline rSO2. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  20. Field trial of a pulsed limestone diversion well

    Science.gov (United States)

    Sibrell, Philip L.; Denholm, C.; Dunn, Margaret

    2013-01-01

    The use of limestone diversion wells to treat acid mine drainage (AMD) is well-known, but in many cases, acid neutralization is not as complete as would be desired. Reasons for this include channeling of the water through the limestone bed, and the slow reaction rate of the limestone gravel. A new approach to improve the performance of the diversion well was tested in the field at the Jennings Environmental Education Center, near Slippery Rock, PA. In this approach, a finer size distribution of limestone was used so as to allow fluidization of the limestone bed, thus eliminating channeling and increasing particle surface area for faster reaction rates. Also, water flow was regulated through the use of a dosing siphon, so that consistent fluidization of the limestone sand could be achieved. Testing began late in the summer of 2010, and continued through November of 2011. Initial system performance during the 2010 field season was good, with the production of net alkaline water, but hydraulic problems involving air release and limestone sand retention were observed. In the summer of 2011, a finer size of limestone sand was procured for use in the system. This material fluidized more readily, but acid neutralization tapered off after several days. Subsequent observations indicated that the hydraulics of the system was compromised by the formation of iron oxides in the pipe leading to the limestone bed, which affected water distribution and flow through the bed. Although results from the field trial were mixed, it is believed that without the formation of iron oxides and plugging of the pipe, better acid neutralization and treatment would have occurred. Further tests are being considered using a different hydraulic configuration for the limestone sand fluidized bed.

  1. Feasibility of Pulse Oximetry Pre-discharge Screening ...

    African Journals Online (AJOL)

    1 Division of Neonatal Medicine, School of Child and Adolescent Health, Faculty of Health Sciences, University of Cape Town; Mowbray ... perform the study screening in addition to their daily tasks, but ~75% felt that with a full nursing staff complement and if done routinely (not part .... calm, asleep or breastfeeding.

  2. 36 PULSE OXIMETRY DUROG TYLENO TAVANI DRAGE ICUMA

    African Journals Online (AJOL)

    The text is clearly written and is accompanied by frequent, well drawn .line diagrams. Important points are highlighted in text boxes. It is comprehensively referenced. This book will be especially useful for staff involved in anaesthesia, intensive care medicine and neonatology, and for registrars in training in these disciplines.

  3. Pulse versus daily oral Alfacalcidol treatment of secondary hyperparathyroidism in hemodialysis patients: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Sawalmeh O

    2018-01-01

    Full Text Available Osama Sawalmeh,1 Shaheed Moala,1 Zakaria Hamdan,2 Huda Masri,3 Khubaib Ayoub,4 Emad Khazneh,2 Mujahed Shraim5 1Medicine Department, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine; 2Nephrology Department, 3Pharmacy Department, 4Internal Medicine Department, An-Najah National University Hospital, Nablus, Palestine; 5Public Health Department, College of Health Sciences, Qatar University, Doha, Qatar Background: Secondary hyperparathyroidism is a common complication of chronic kidney disease and is managed using vitamin D replacement therapy. Very few studies have examined the effectiveness of pulse alfacalcidol therapy in comparison to daily oral alfacalcidol therapy in suppressing serum parathyroid hormone (PTH levels in hemodialysis patients. The aim of this randomized controlled trial was to replicate the findings of prior studies comparing effectiveness of pulse oral alfacalcidol therapy versus daily oral alfacalcidol therapy in suppressing PTH after 13 weeks of therapy using a Palestinian sample of hemodialysis patients, and to identify demographic and biomedical characteristics of patients that are independently associated with PTH levels.Methods: One hundred and sixty-seven patients completed the study, 88 in the daily group and 79 in the pulse group. The pulse group had more clinically significant reduction in mean PTH level by 75 pg/dL at 13 weeks than the daily group, but this was not statistically significant.Results: The effect of alfacalcidol therapy on metabolism of phosphate and corrected calcium levels was comparable in both groups, and pulse therapy was not associated with increased risk of hypercalcemia and hyperphosphatemia. Serum PTH levels were independently and inversely associated with older age and diabetes.Conclusion: Switching daily alfacalcidol therapy to thrice-weekly alfacalcidol pulse therapy seems safe and convenient, especially for hemodialysis patients with poor compliance

  4. [transcutaneous oximetry--between theory and practice].

    Science.gov (United States)

    Zulec, Mirna

    2014-10-01

    Transcutaneous oximetry is a procedure used to measure the pressure of oxygen in tissue and to determine oxygenation level. It is essential to determine the state of microcirculation and is used to assess the necessity and level of amputation and the effect of revascularization procedures, as a predictor of wound healing and hyperbaric oxygen therapy (HBOT) effectiveness tool. The measurement is done by the application electrode measuring point and the result is measured in mm Hg. Tissue with adequate oxygen level has a value greater than 50 mm Hg. Values between 20 and 40 mm Hg are considered hypoxic, while those below 20 mm Hg indicate extreme hypoxia. In Croatia, TcPO2 is commonly used for HBOT assessment but there is the need of broader application to objectify and facilitate procedures in the care of persons with impaired microcirculation.

  5. Multisite EPR oximetry from multiple quadrature harmonics.

    Science.gov (United States)

    Ahmad, R; Som, S; Johnson, D H; Zweier, J L; Kuppusamy, P; Potter, L C

    2012-01-01

    Multisite continuous wave (CW) electron paramagnetic resonance (EPR) oximetry using multiple quadrature field modulation harmonics is presented. First, a recently developed digital receiver is used to extract multiple harmonics of field modulated projection data. Second, a forward model is presented that relates the projection data to unknown parameters, including linewidth at each site. Third, a maximum likelihood estimator of unknown parameters is reported using an iterative algorithm capable of jointly processing multiple quadrature harmonics. The data modeling and processing are applicable for parametric lineshapes under nonsaturating conditions. Joint processing of multiple harmonics leads to 2-3-fold acceleration of EPR data acquisition. For demonstration in two spatial dimensions, both simulations and phantom studies on an L-band system are reported. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Randomized, controlled clinical trial evaluating the efficacy of pulsed signal therapy in dogs with osteoarthritis.

    Science.gov (United States)

    Sullivan, Meghan O; Gordon-Evans, Wanda J; Knap, Kim E; Evans, Richard B

    2013-04-01

    To evaluate the efficacy of pulsed signal therapy (PST) in reducing pain and increasing function in dogs with osteoarthritis (OA) using a randomized, blinded, controlled clinical trial. Randomized, controlled, blinded clinical trial. Adult dogs (n = 60) with moderate-to-severe clinical signs of OA. Dogs were randomized by age into 2 groups: dogs ≥ 9 years and dogs Goniometry and gait analysis were performed, and the Canine Brief Pain Inventory (CBPI) questionnaire was given to the owners to fill out without supervision. Outcome measures were repeated at the end of treatment (Day 11) and 6 weeks after beginning treatment (Day 42). The PST group performed significantly better than the control group as measured by the CBPI Severity and Interference scores (P Veterinary Surgeons.

  7. Sensibilidade e especificidade da oximetria fetal de pulso e da cardiotocografia durante o parto: comparação entre os métodos no prognóstico de recém-nascidos Acidóticos Sensitivity and specificity of fetal pulse oximetry and cardiotocography during labor: comparison of both methods regarding prognosis of acidotic newborns

    Directory of Open Access Journals (Sweden)

    Edson Nunes de Morais

    1999-07-01

    Full Text Available Objetivo: estudar a sensibilidade e a especificidade dos valores de saturação de oxigênio fetal (SpO2 e padrões da freqüência cardíaca fetal (FCF durante o parto, no prognóstico de fetos acidóticos ao nascimento. Pacientes e Métodos: os valores fetais de SpO2 foram obtidos pela técnica da oximetria de pulso. Um valor de SpO2 > ou = 30% foi considerado normal, e 10 minutos no intervalo entre contrações, foi considerado anormal. A SpO2 fetal e os traçados de FCF foram obtidos continuamente no primeiro e segundo períodos do parto. A classificação utilizada para a FCF foi a do NICHD19. Resultados: um total de 72 casos foram estudados. A sensibilidade e especificidade com base na SpO2 fetal foram respectivamente de 61,5% e 96,6%, ao passo que a sensibilidade e especificidade baseadas nos padrões de FCF foram respectivamente 69,2% e 66,1%. Os valores preditivos positivo e negativo em função da SpO2 fetal foram respectivamente 80% e 91,9%; em função dos padrões de FCF foram respectivamente 31% e 90,7%. Conclusões: uma boa especificidade da SpO2 para o prognóstico de recém-nascidos acidóticos foi encontrada, se comparada com a especificidade dos padrões de FCF, ao passo que a sensibilidade foi relativamente baixa para os dois métodos. Entretanto, o número de fetos acidóticos é muito pequeno para conclusões.Purpose: to study the sensitivity and specificity based on fetal oxygen saturation (SpO2 values and fetal heart rate (FHR patterns during labor, for the prognosis of acidotic fetuses at birth. Patients and Methods: SpO2 values were obtained by fetal pulse oximetry technique. A fetal SpO2 value > or = 30% was considered normal, and an SpO2 which remained <30.0% for more than 10 min between contractions was considered abnormal. Fetal SpO2 and FHR tracings were obtained during the first and second stage of labor. FHR classification used in the study has been derived from the National Institute of Child Health and Human

  8. Avaliação das medidas de oximetria de pulso em indivíduos sadios com esmalte de unha Evaluación de las medidas de oximetría de pulso en individuos sanos con esmalte de uña Evaluation of pulse oximetry measurements in healthy subjects with nail polish

    Directory of Open Access Journals (Sweden)

    Solange Diccini

    2011-01-01

    Full Text Available OBJETIVO: Avaliar as alterações nas medidas da oximetria de pulso em indivíduos sadios com esmaltes de unha. MÉTODOS: Estudo transversal com 80 voluntárias sadias. As cores de esmalte utilizadas para avaliar a saturação periférica de oxigênio (SpO2 foram: café com leite, café, chocolate, vermelho e ameixa. Estas cores foram distribuídas entre as unhas dos dedos da mão esquerda. Os dedos da mão direita foram os controles. RESULTADOS: As cores vermelha (p=0,047 e café (p=0,024 mostraram valores menores na SpO2 quando comparados ao controle. As outras cores não alteraram a medida da SpO2. CONCLUSÃO: As cores vermelha e café causaram redução na medida da SpO2, porém a relevância clínica deste achado é questionável, pois os valores estavam dentro do intervalo de normalidade.OBJETIVO: Evaluar las alteraciones en las medidas de la oximetría de pulso en individuos sanos con esmalte de uña. MÉTODOS: Estudio transversal realizado con 80 voluntarias sanas. Los colores de esmalte utilizados para evaluar la saturación periférica de oxígeno (SpO2 fueron: café con leche, café, chocolate, rojo y ciruela. Estos colores fueron distribuidos entre las uñas de los dedos de la mano izquierda. Los dedos de la mano derecha fueron los controles. RESULTADOS: Los colores rojo (p=0,047 y café (p=0,024 mostraron valores menores en la SpO2 cuando fueron comparados al control. Los otros colores no alteraron la medida del SpO2. CONCLUSIÓN: Los colores rojo y café causaron reducción en la medida del SpO2, sin embargo la relevancia clínica de este hallazgo es cuestionable, pues los valores estaban dentro del intervalo de normalidad.OBJECTIVE: To evaluate the changes in measurements of pulse oximetry in healthy individuals with nail polish. METHODS: Cross sectional study with 80 healthy volunteers. The colors of enamel used to assess oxygen saturation (SpO2 were: coffee with milk, coffee, chocolate, red and plum. These colors were

  9. Long-pulsed dye laser versus intense pulsed light for photodamaged skin: A randomized split-face trial with blinded response evaluation

    DEFF Research Database (Denmark)

    Jorgensen, G.F.; Hedelund, L.; Haedersdal, M.

    2008-01-01

    Objective: In a randomized controlled split-face trial to evaluate efficacy and adverse effects from rejuvenation with long-pulsed dye laser (LPDL) versus intense pulsed light (IPL). Materials and Methods: Twenty female volunteers with Fitzpatrick skin types I-III, classes I-II rhytids......, and symmetrical split-face photodamage were included in the study. Subjects received a series of three treatments at 3-week intervals with half-face LPDL (V-beam Perfecta, 595 nm, Candela Laser Corporation) and half-face IPL (Ellipse Flex, Danish Dermatologic Development); the interventions being randomly...... assigned to left and right sides. Primary end-points were telangiectasias, irregular pigmentation and preferred treatment. Secondary end-points were skin texture, rhytids, pain, and adverse effects. Efficacy was evaluated by patient self-assessments and by blinded clinical on-site and photographic...

  10. Results of the ANSWER Trial Using the PulseRider for the Treatment of Broad-Necked, Bifurcation Aneurysms.

    Science.gov (United States)

    Spiotta, Alejandro M; Derdeyn, Colin P; Tateshima, Satoshi; Mocco, Jay; Crowley, R Webster; Liu, Kenneth C; Jensen, Lee; Ebersole, Koji; Reeves, Alan; Lopes, Demetrius K; Hanel, Ricardo A; Sauvageau, Eric; Duckwiler, Gary; Siddiqui, Adnan; Levy, Elad; Puri, Ajit; Pride, Lee; Novakovic, Roberta; Chaudry, M Imran; Turner, Raymond D; Turk, Aquilla S

    2017-07-01

    The safety and probable benefit of the PulseRider (Pulsar Vascular, Los Gatos, California) for the treatment of broad-necked, bifurcation aneurysms was studied in the context of the prospective, nonrandomized, single arm clinical trial-the Adjunctive Neurovascular Support of Wide-neck aneurysm Embolization and Reconstruction (ANSWER) Trial. To present the results of the United States cases employing the PulseRider device as part of the ANSWER clinical trial. Aneurysms treated with the PulseRider device among sites enrolling in the ANSWER trial were prospectively studied and the results are summarized. Aneurysms arising at either the carotid terminus or basilar apex that were relatively broad necked were considered candidates for inclusion into the ANSWER study. Thirty-four patients were enrolled (29 female and 5 male) with a mean age of 60.9 years (27 basilar apex and 7 carotid terminus). Mean aneurysm height ranged from 2.4 to 15.9 mm with a mean neck size of 5.2 mm (range 2.3-11.6 mm). In all patients, the device was delivered and deployed. Immediate Raymond I or II occlusion was achieved in 82.4% and progressed to 87.9% at 6-month follow-up. A modified Rankin Score of 2 or less was seen in 94% of patients at 6 months. The results from the ANSWER trial demonstrate that the PulseRider device is safe and offers probable benefit as for the treatment of bifurcation aneurysms arising at the basilar apex or carotid terminus. As such, it represents a useful addition to the armamentarium of the neuroendovascular specialist. Copyright © 2017 by the Congress of Neurological Surgeons

  11. Lung deflation and oxygen pulse in COPD: results from the NETT randomized trial.

    Science.gov (United States)

    Come, Carolyn E; Divo, Miguel J; San José Estépar, Raúl; Sciurba, Frank C; Criner, Gerard J; Marchetti, Nathaniel; Scharf, Steven M; Mosenifar, Zab; Make, Barry J; Keller, Cesar A; Minai, Omar A; Martinez, Fernando J; Han, MeiLan K; Reilly, John J; Celli, Bartolome R; Washko, George R

    2012-01-01

    In COPD patients, hyperinflation impairs cardiac function. We examined whether lung deflation improves oxygen pulse, a surrogate marker of stroke volume. In 129 NETT patients with cardiopulmonary exercise testing (CPET) and arterial blood gases (ABG substudy), hyperinflation was assessed with residual volume to total lung capacity ratio (RV/TLC), and cardiac function with oxygen pulse (O(2) pulse=VO(2)/HR) at baseline and 6 months. Medical and surgical patients were divided into "deflators" and "non-deflators" based on change in RV/TLC from baseline (∆RV/TLC). We defined deflation as the ∆RV/TLC experienced by 75% of surgical patients. We examined changes in O(2) pulse at peak and similar (iso-work) exercise. Findings were validated in 718 patients who underwent CPET without ABGs. In the ABG substudy, surgical and medical deflators improved their RV/TLC and peak O(2) pulse (median ∆RV/TLC -18.0% vs. -9.3%, p=0.0003; median ∆O(2) pulse 13.6% vs. 1.8%, p=0.12). Surgical deflators also improved iso-work O(2) pulse (0.53 mL/beat, p=0.04 at 20 W). In the validation cohort, surgical deflators experienced a greater improvement in peak O(2) pulse than medical deflators (mean 18.9% vs. 1.1%). In surgical deflators improvements in O(2) pulse at rest and during unloaded pedaling (0.32 mL/beat, pdeflators were 88% more likely than non-deflators to have an improvement in O(2) pulse (OR 1.88, 95% CI 1.30-2.72, p=0.0008). In COPD, decreased hyperinflation through lung volume reduction is associated with improved O(2) pulse. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Advances in Probes and Methods for Clinical EPR Oximetry

    Science.gov (United States)

    Hou, Huagang; Khan, Nadeem; Jarvis, Lesley A.; Chen, Eunice Y.; Williams, Benjamin B.; Kuppusamy, Periannan

    2015-01-01

    EPR oximetry, which enables reliable, accurate, and repeated measurements of the partial pressure of oxygen in tissues, provides a unique opportunity to investigate the role of oxygen in the pathogenesis and treatment of several diseases including cancer, stroke, and heart failure. Building on significant advances in the in vivo application of EPR oximetry for small animal models of disease, we are developing suitable probes and instrumentation required for use in human subjects. Our laboratory has established the feasibility of clinical EPR oximetry in cancer patients using India ink, the only material presently approved for clinical use. We now are developing the next generation of probes, which are both superior in terms of oxygen sensitivity and biocompatibility including an excellent safety profile for use in humans. Further advances include the development of implantable oxygen sensors linked to an external coupling loop for measurements of deep-tissue oxygenations at any depth, overcoming the current limitation of 10 mm. This paper presents an overview of recent developments in our ability to make meaningful measurements of oxygen partial pressures in human subjects under clinical settings. PMID:24729217

  13. A trial of ignition innovation of gasoline engine by nanosecond pulsed low temperature plasma ignition

    International Nuclear Information System (INIS)

    Shiraishi, Taisuke; Urushihara, Tomonori; Gundersen, Martin

    2009-01-01

    Application of nanosecond pulsed low temperature plasma as an ignition technique for automotive gasoline engines, which require a discharge under conditions of high back pressure, has been studied experimentally using a single-cylinder engine. The nanosecond pulsed plasma refers to the transient (non-equilibrated) phase of a plasma before the formation of an arc discharge; it was obtained by applying a high voltage with a nanosecond pulse (FWHM of approximately 80 or 25 ns) between coaxial cylindrical electrodes. It was confirmed that nanosecond pulsed plasma can form a volumetric multi-channel streamer discharge at an energy consumption of 60 mJ cycle -1 under a high back pressure of 1400 kPa. It was found that the initial combustion period was shortened compared with the conventional spark ignition. The initial flame visualization suggested that the nanosecond pulsed plasma ignition results in the formation of a spatially dispersed initial flame kernel at a position of high electric field strength around the central electrode. It was observed that the electric field strength in the air gap between the coaxial cylindrical electrodes was increased further by applying a shorter pulse. It was also clarified that the shorter pulse improved ignitability even further.

  14. A trial of ignition innovation of gasoline engine by nanosecond pulsed low temperature plasma ignition

    Science.gov (United States)

    Shiraishi, Taisuke; Urushihara, Tomonori; Gundersen, Martin

    2009-07-01

    Application of nanosecond pulsed low temperature plasma as an ignition technique for automotive gasoline engines, which require a discharge under conditions of high back pressure, has been studied experimentally using a single-cylinder engine. The nanosecond pulsed plasma refers to the transient (non-equilibrated) phase of a plasma before the formation of an arc discharge; it was obtained by applying a high voltage with a nanosecond pulse (FWHM of approximately 80 or 25 ns) between coaxial cylindrical electrodes. It was confirmed that nanosecond pulsed plasma can form a volumetric multi-channel streamer discharge at an energy consumption of 60 mJ cycle-1 under a high back pressure of 1400 kPa. It was found that the initial combustion period was shortened compared with the conventional spark ignition. The initial flame visualization suggested that the nanosecond pulsed plasma ignition results in the formation of a spatially dispersed initial flame kernel at a position of high electric field strength around the central electrode. It was observed that the electric field strength in the air gap between the coaxial cylindrical electrodes was increased further by applying a shorter pulse. It was also clarified that the shorter pulse improved ignitability even further.

  15. Retinal Oximetry with Scanning Laser Ophthalmoscope in Infants.

    Directory of Open Access Journals (Sweden)

    Wouter B Vehmeijer

    Full Text Available Dual wavelength retinal oximetry has been developed for adults, but is not available for infants. Retinal oximetry may provide insight into the pathophysiology of oxygen-mediated diseases like retinopathy of prematurity. More insight in the oxygen metabolism of the retina in infants may provide valuable clues for better understanding and subsequent prevention or treatment of the disease. The measurements of oxygen saturation are obtained with two fundus images simultaneously captured in two different wavelengths of light. The comparison in light absorption of oxygenated and deoxygenated hemoglobin can be used to estimate the oxygen saturation within the retinal vessels by means of a software algorithm. This study aims to make retinal oximetry available for neonates. The first step towards estimating retinal oxygen saturation is determining the optical density ratio. Therefore, the purpose of this study is to image healthy newborn infants with a scanning laser ophthalmoscope and determine the optical density ratio for retinal oximetry analysis.Images of the retina of full-term healthy infants were obtained with an SLO, Optomap 200Tx (Optos, with two laser wavelengths (532nm and 633nm. The infant lay face down on the lower arm of the parent, while the parent supported the chest and chin with one hand, and stabilized the back with the other hand. No mydriatics or eyelid specula were used during this study. The images were analyzed with modified Oxymap Analyzer software for calculation of the Optical Density Ratio (ODR and vessel width. The ODR is inversely and approximately linearly related to the oxygen saturation. Measurements were included from the superotemporal vessel pair. A paired t-test was used for statistical analysis.Fifty-nine infants, (58% female, were included with mean gestational age of 40 ± 1.3 weeks (mean ± SD and mean post-natal age of 16 ± 4.8 days. A total of 28 images were selected for retinal oximetry analysis. The ODR was

  16. Test-retest reliability of pulse amplitude tonometry measures of vascular endothelial function: implications for clinical trial design.

    Science.gov (United States)

    McCrea, Cindy E; Skulas-Ray, Ann C; Chow, Mosuk; West, Sheila G

    2012-02-01

    Endothelial dysfunction is an important outcome for assessing vascular health in intervention studies. However, reliability of the standard non-invasive method (flow-mediated dilation) is a significant challenge for clinical applications and multicenter trials. We evaluated the repeatability of pulse amplitude tonometry (PAT) to measure change in pulse wave amplitude during reactive hyperemia (Itamar Medical Ltd, Caesarea, Israel). Twenty healthy adults completed two PAT tests (mean interval = 19.5 days) under standardized conditions. PAT-derived measures of endothelial function (reactive hyperemia index, RHI) and arterial stiffness (augmentation index, AI) showed strong repeatability (intra-class correlations = 0.74 and 0.83, respectively). To guide future research, we also analyzed sample size requirements for a range of effect sizes. A crossover design powered at 0.90 requires 28 participants to detect a 15% change in RHI. Our study is the first to show that PAT measurements are repeatable in adults over an interval greater than 1 week.

  17. Pulsed magnetic field versus ultrasound in the treatment of postnatal carpal tunnel syndrome: A randomized controlled trial in the women of an Egyptian population

    Directory of Open Access Journals (Sweden)

    Dalia M. Kamel

    2017-01-01

    Full Text Available The aim of this study was to compare the effects of pulsed electromagnetic field versus pulsed ultrasound in treating patients with postnatal carpal tunnel syndrome. The study was a randomized, double-blinded trial. Forty postnatal female patients with idiopathic carpal tunnel syndrome were divided randomly into two equal groups. One group received pulsed electromagnetic field, with nerve and tendon gliding exercises for the wrist, three times per week for four weeks. The other group received pulsed ultrasound and the same wrist exercises. Pain level, sensory and motor distal latencies and conduction velocities of the median nerve, functional status scale and hand grip strength were assessed pre- and post-treatment. There was a significant decrease (P  0.05. In conclusion, while the symptoms were alleviated in both groups, pulsed electromagnetic field was more effective than pulsed ultrasound in treating postnatal carpal tunnel syndrome.

  18. Trial Application of Pulse-Field Magnetization to Magnetically Levitated Conveyor System

    Directory of Open Access Journals (Sweden)

    Yoshihito Miyatake

    2012-01-01

    Full Text Available Magnetically levitated conveyor system using superconductors is discussed. The system is composed of a levitated conveyor, magnetic rails, a linear induction motor, and some power supplies. In the paper, pulse-field magnetization is applied to the system. Then, the levitation height and the dynamics of the conveyor are controlled. The static and dynamic characteristics of the levitated conveyor are discussed.

  19. Physical activity and resting pulse rate in older adults: findings from a randomized controlled trial

    Science.gov (United States)

    Background: Elevated resting pulse rate (RPR) is a well-recognized risk factor for adverse outcomes. Epidemiological evidence supports the beneficial effects of regular exercise for lowering RPR, but studies are mainly confined to persons younger than 65 years. We set out to evaluate the utility of ...

  20. Assessing diabetic foot ulcer development risk with hyperspectral tissue oximetry

    Science.gov (United States)

    Yudovsky, Dmitry; Nouvong, Aksone; Schomacker, Kevin; Pilon, Laurent

    2011-02-01

    Foot ulceration remains a serious health concern for diabetic patients and has a major impact on the cost of diabetes treatment. Early detection and preventive care, such as offloading or improved hygiene, can greatly reduce the risk of further complications. We aim to assess the use of hyperspectral tissue oximetry in predicting the risk of diabetic foot ulcer formation. Tissue oximetry measurements are performed during several visits with hyperspectral imaging of the feet in type 1 and 2 diabetes mellitus subjects that are at risk for foot ulceration. The data are retrospectively analyzed at 21 sites that ulcerated during the course of our study and an ulceration prediction index is developed. Then, an image processing algorithm based on this index is implemented. This algorithm is able to predict tissue at risk of ulceration with a sensitivity and specificity of 95 and 80%, respectively, for images taken, on average, 58 days before tissue damage is apparent to the naked eye. Receiver operating characteristic analysis is also performed to give a range of sensitivity/specificity values resulting in a Q-value of 89%.

  1. Optical surgical navigation system causes pulse oximeter malfunction.

    Science.gov (United States)

    Satoh, Masaaki; Hara, Tetsuhito; Tamai, Kenji; Shiba, Juntaro; Hotta, Kunihisa; Takeuchi, Mamoru; Watanabe, Eiju

    2015-01-01

    An optical surgical navigation system is used as a navigator to facilitate surgical approaches, and pulse oximeters provide valuable information for anesthetic management. However, saw-tooth waves on the monitor of a pulse oximeter and the inability of the pulse oximeter to accurately record the saturation of a percutaneous artery were observed when a surgeon started an optical navigation system. The current case is thought to be the first report of this navigation system interfering with pulse oximetry. The causes of pulse jamming and how to manage an optical navigation system are discussed.

  2. A finger-free wrist-worn pulse oximeter for the monitoring of chronic obstructive pulmonary disease

    Science.gov (United States)

    Chu, Chang-Sheng; Chuang, Shuang-Chao; Lee, Yeh Wen; Fan, Chih-Hsun; Chung, Lung Pin; Li, Yu-Tang; Chen, Jyh-Chern

    2016-03-01

    Herein, a finger-free wrist-worn pulse oximeter is presented. This device allows patients to measure blood oxygen level and pulse rate without hindering their normal finger movement. This wrist-worn pulse oximeter is built with a reflectance oximetry sensor, which consists of light emitting diodes and photodiode light detectors located side by side. This reflectance oximetry sensor is covered with an optical element with micro structured surface. This micro structured optical element is designed to modulate photon propagation beneath the skin tissue so that the photoplethysmogram signals of reflected lights or backscattered lights detected by the photodetector are therefore enhanced.

  3. Rearfoot Transcutaneous Oximetry is a Useful Tool to Highlight Ischemia of the Heel

    Energy Technology Data Exchange (ETDEWEB)

    Izzo, Valentina, E-mail: valentina-izzo@virgilio.it; Meloni, Marco, E-mail: meloni.marco@libero.it [University of Tor Vergata, Department of Systems Medicine (Italy); Fabiano, Sebastiano, E-mail: sebas575@yahoo.it; Morosetti, Daniele, E-mail: danielemorosetti@hotmail.com [University of Tor Vergata, Department of Diagnostic Imaging and Interventional Radiology (Italy); Giurato, Laura, E-mail: lauragiurato@yahoo.it [University of Tor Vergata, Department of Systems Medicine (Italy); Chiaravalloti, Antonio, E-mail: antoniochiaravalloti@hotmail.it [University of Tor Vergata, Department of Diagnostic Imaging and Interventional Radiology (Italy); Ruotolo, Valeria, E-mail: valeriaruotolo@virgilio.it [University of Tor Vergata, Department of Systems Medicine (Italy); Gandini, Roberto, E-mail: roberto.gandini@fastwebnet.it [University of Tor Vergata, Department of Diagnostic Imaging and Interventional Radiology (Italy); Uccioli, Luigi, E-mail: luccioli@yahoo.com [University of Tor Vergata, Department of Systems Medicine (Italy)

    2017-01-15

    PurposeTo demonstrate the usefulness of rearfoot transcutaneous oximetry to assess the peripheral arterial disease in diabetic patients with heel ulcer.MethodsFrom our database of 550 critical limb ischemia diabetic patients followed after a percutaneous transluminal angioplasty, we have selected patients with below the knee arterial disease. Patients were grouped according to the dorsal transcutaneous oximetry value (Group A < 30 mmHg; Group B ≥ 30 mmHg). Patients of Group B had a second oximetry performed at the rearfoot, close to the lesion localized in all cases at the heel. Finally, the analysis of the arterial pattern disease has been done.ResultsWe selected 191 patients: Group A (151 patients), dorsal transcutaneous oximetry of 11.8 ± 0.7 mmHg; Group B (40 patients), dorsal transcutaneous oximetry of 44.2 ± 10.1 mmHg. In Group B, rearfoot oximetry was 20.5 ± 5 mmHg, significantly lower than dorsal oximetry (p = 0.0179). The anterior tibial artery was involved in all patients of Group A. In Group B, the anterior tibial artery was involved in 15 subjects and never alone; the posterior tibial artery was involved in 20 subjects and in 11 cases alone. The peroneal artery was affected in 20 subjects and in 14 patients alone.ConclusionWhen a heel lesion is present and the transcutaneous oximetry recorded on the dorsum of the foot does not confirm the presence of critical limb ischemia (not ≤30 mmHg), a second oximetry recorded on the rearfoot is useful to point out ischemia of the peroneal artery and/or of the posterior tibial artery.

  4. Rearfoot Transcutaneous Oximetry is a Useful Tool to Highlight Ischemia of the Heel

    International Nuclear Information System (INIS)

    Izzo, Valentina; Meloni, Marco; Fabiano, Sebastiano; Morosetti, Daniele; Giurato, Laura; Chiaravalloti, Antonio; Ruotolo, Valeria; Gandini, Roberto; Uccioli, Luigi

    2017-01-01

    PurposeTo demonstrate the usefulness of rearfoot transcutaneous oximetry to assess the peripheral arterial disease in diabetic patients with heel ulcer.MethodsFrom our database of 550 critical limb ischemia diabetic patients followed after a percutaneous transluminal angioplasty, we have selected patients with below the knee arterial disease. Patients were grouped according to the dorsal transcutaneous oximetry value (Group A < 30 mmHg; Group B ≥ 30 mmHg). Patients of Group B had a second oximetry performed at the rearfoot, close to the lesion localized in all cases at the heel. Finally, the analysis of the arterial pattern disease has been done.ResultsWe selected 191 patients: Group A (151 patients), dorsal transcutaneous oximetry of 11.8 ± 0.7 mmHg; Group B (40 patients), dorsal transcutaneous oximetry of 44.2 ± 10.1 mmHg. In Group B, rearfoot oximetry was 20.5 ± 5 mmHg, significantly lower than dorsal oximetry (p = 0.0179). The anterior tibial artery was involved in all patients of Group A. In Group B, the anterior tibial artery was involved in 15 subjects and never alone; the posterior tibial artery was involved in 20 subjects and in 11 cases alone. The peroneal artery was affected in 20 subjects and in 14 patients alone.ConclusionWhen a heel lesion is present and the transcutaneous oximetry recorded on the dorsum of the foot does not confirm the presence of critical limb ischemia (not ≤30 mmHg), a second oximetry recorded on the rearfoot is useful to point out ischemia of the peroneal artery and/or of the posterior tibial artery.

  5. Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Ha, Vanessa; Sievenpiper, John L; de Souza, Russell J; Jayalath, Viranda H; Mirrahimi, Arash; Agarwal, Arnav; Chiavaroli, Laura; Mejia, Sonia Blanco; Sacks, Frank M; Di Buono, Marco; Bernstein, Adam M; Leiter, Lawrence A; Kris-Etherton, Penny M; Vuksan, Vladimir; Bazinet, Richard P; Josse, Robert G; Beyene, Joseph; Kendall, Cyril W C; Jenkins, David J A

    2014-05-13

    Evidence from controlled trials encourages the intake of dietary pulses (beans, chickpeas, lentils and peas) as a method of improving dyslipidemia, but heart health guidelines have stopped short of ascribing specific benefits to this type of intervention or have graded the beneficial evidence as low. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction. We searched electronic databases and bibliographies of selected trials for relevant articles published through Feb. 5, 2014. We included RCTs of at least 3 weeks' duration that compared a diet emphasizing dietary pulse intake with an isocaloric diet that did not include dietary pulses. The lipid targets investigated were low-density lipoprotein (LDL) cholesterol, apolipoprotein B and non-high-density lipoprotein (non-HDL) cholesterol. We pooled data using a random-effects model. We identified 26 RCTs (n = 1037) that satisfied the inclusion criteria. Diets emphasizing dietary pulse intake at a median dose of 130 g/d (about 1 serving daily) significantly lowered LDL cholesterol levels compared with the control diets (mean difference -0.17 mmol/L, 95% confidence interval -0.25 to -0.09 mmol/L). Treatment effects on apolipoprotein B and non-HDL cholesterol were not observed. Our findings suggest that dietary pulse intake significantly reduces LDL cholesterol levels. Trials of longer duration and higher quality are needed to verify these results. ClinicalTrials.gov, no. NCT01594567.

  6. Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody-associated vasculitis: a randomized trial

    DEFF Research Database (Denmark)

    de Groot, Kirsten; Harper, Lorraine; Jayne, David R W

    2009-01-01

    BACKGROUND: Current therapies for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis are limited by toxicity. OBJECTIVE: To compare pulse cyclophosphamide with daily oral cyclophosphamide for induction of remission. DESIGN: Randomized, controlled trial. Random assignments were...... outcome); change in renal function, adverse events, and cumulative dose of cyclophosphamide (secondary outcomes). RESULTS: Groups did not differ in time to remission (hazard ratio, 1.098 [95% CI, 0.78 to 1.55]; P = 0.59) or proportion of patients who achieved remission at 9 months (88.1% vs. 87...... regimen induced remission of ANCA-associated vasculitis as well as the daily oral regimen at a reduced cumulative cyclophosphamide dose and caused fewer cases of leukopenia. PRIMARY FUNDING SOURCE: The European Union....

  7. Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter, prospective, double blind, placebo controlled, randomized trial

    Directory of Open Access Journals (Sweden)

    Poeze Martijn

    2011-05-01

    Full Text Available Abstract Background The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%, non-union (5-21% and early osteo-arthritis (up to 32% which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences. Initially Pulsed Electromagnetic Fields was used in the treatment of tibial pseudoarthrosis and non-union. More recently there is evidence that physical forces can also be used in the treatment of fresh fractures, showing accelerated healing by 30% and 71% reduction in nonunion within 12 weeks after initiation of therapy. Until now no double blind randomized, placebo controlled trial has been conducted to investigate the effect of this treatment on the healing of fresh fractures of the scaphoid. Methods/Design This is a multi center, prospective, double blind, placebo controlled, randomized trial. Study population consists of all patients with unilateral acute scaphoid fracture. Pregnant women, patients having a life supporting implanted electronic device, patients with additional fractures of wrist, carpal or metacarpal bones and pre-existing impairment in wrist function are excluded. The scaphoid fracture is diagnosed by a combination of physical and radiographic examination (CT-scanning. Proven scaphoid fractures are treated with cast immobilization and a small Pulsed Electromagnetic Fields bone growth stimulating device placed on the cast. Half of the devices will be disabled at random in the factory. Study parameters are clinical consolidation

  8. Detecting obstructive sleep apnea in children by self-affine visualization of oximetry.

    Science.gov (United States)

    Garde, Ainara; Dekhordi, Parastoo; Petersen, Christian L; Ansermino, J Mark; Dumont, Guy A

    2017-07-01

    Obstructive sleep apnea (OSA), characterized by cessations of breathing during sleep due to upper airway collapse, can affect the healthy growth and development of children. The gold standard for OSA diagnosis, polysomnography(PSG), is expensive and resource intensive, resulting in long waiting lists to perform a PSG. Previously, we investigated the time-frequency analysis of blood oxygen saturation (SpO 2 ) to screen for OSA. We used overnight pulse oximetry from 146 children, collected using a smartphone-based pulse oximeter (Phone Oximeter), simultaneously with standard PSG. Sleep technicians manually scored PSG and provided the average of apnea/hypoapnea events per hour (AHI). In this study, we proposed an alternative method for analyzing SpO 2 , in which a set of contracting transformations form a self-affine set with a 2D attractor, previously developed for qualitative visualization of the photoplethysmogram and electroencephalogram. We applied this technique to the overnight SpO 2 signal from individual patients and extracted features based on the distribution of points (radius and angle) in the visualization. The cloud of points in children without OSA (NonOSA) was more confined than in children with OSA, which was reflected by more empty pixels (radius and angles). The maximum value, skewness and standard deviation of the distribution of points located at different radius and angles were significantly (Bonferroni corrected) higher in NonOSA compared to OSA children. To detect OSA defined at different levels (AHI≥5, AHI≥10 and AHI≥15), three multivariate logistic regression models were implemented using a stepwise feature selection and internally validated through bootstrapping. The models (AHI≥5, AHI≥10, AHI≥15), consisting of 3, 4 and 1 features respectively, provided a bootstrap-corrected AUC of 73%, 81%, 73%. Thus, applying this visualization to nocturnal SpO 2 could yield both visual and quantitative information that might be useful for

  9. Randomized controlled trial of pulse methyl prednisolone × placebo in treatment of pulmonary involvement associated with severe leptospirosis. [ISRCTN74625030

    Directory of Open Access Journals (Sweden)

    Leite Alfredo

    2011-06-01

    Full Text Available Abstract Background The lungs are involved in up to 70% of cases of leptospirosis. In the more severe forms-bleeding from the lungs and acute respiratory distress syndrome-the lethality is high. The treatment proposed for leptospirotic pneumonitis includes just care for patients in critical condition. Clinical and experimental studies point to the involvement of immunological mechanisms in the physiopathology of lung damage caused by leptospirosis. The aim of this study is to evaluate pulse treatment with methylprednisolone × placebo for leptospirotic pneumonitis. Study design This is a randomized double-blind clinical trial to test the efficacy of pulse treatment with methylprednisolone in patients with leptospirotic pneumonitis, compared with a placebo. The patients are recruited from three hospitals in the city of Recife, in the Brazilian State of Pernambuco. The exclusion criteria include patients aged under 15 years, a history of hypersensitivity to the use of corticosteroids, the presence of active infection of fungal, tuberculous or bacterial origin apart from the infection by leptospira itself, the presence of hemoconcentration or atypical lymphocyte count on admission to hospital, the presence of co-morbidities that could be responsible for the radiological and gasometric alterations used to diagnose leptospirotic pneumonitis, evidence of recent cranial trauma, neurosurgery, peptic ulcer, and participation in another clinical trial. The patients are followed until they are discharged from hospital or die. The intervention consists of endovenous pulse treatment with 1 g methylprednisolone for three consecutive days in the study group and a placebo in the control group. The primary end-point is mortality from leptospirotic pneumonitis. The secondary end-points are: evolution of lung disease; the occurrence of nosocomial respiratory infection; duration of mechanical ventilation; duration of intensive care unit (ICU stay; duration of

  10. Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter, prospective, double blind, placebo controlled, randomized trial.

    Science.gov (United States)

    Hannemann, Pascal; Göttgens, Kevin W A; van Wely, Bob J; Kolkman, Karel A; Werre, Andries J; Poeze, Martijn; Brink, Peter R G

    2011-05-06

    The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%), non-union (5-21%) and early osteo-arthritis (up to 32%) which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences.Initially Pulsed Electromagnetic Fields was used in the treatment of tibial pseudoarthrosis and non-union. More recently there is evidence that physical forces can also be used in the treatment of fresh fractures, showing accelerated healing by 30% and 71% reduction in nonunion within 12 weeks after initiation of therapy. Until now no double blind randomized, placebo controlled trial has been conducted to investigate the effect of this treatment on the healing of fresh fractures of the scaphoid. This is a multi center, prospective, double blind, placebo controlled, randomized trial. Study population consists of all patients with unilateral acute scaphoid fracture. Pregnant women, patients having a life supporting implanted electronic device, patients with additional fractures of wrist, carpal or metacarpal bones and pre-existing impairment in wrist function are excluded. The scaphoid fracture is diagnosed by a combination of physical and radiographic examination (CT-scanning).Proven scaphoid fractures are treated with cast immobilization and a small Pulsed Electromagnetic Fields bone growth stimulating device placed on the cast. Half of the devices will be disabled at random in the factory.Study parameters are clinical consolidation, radiological consolidation evaluated by CT-scanning, functional

  11. Autologous hematopoietic stem cell transplantation vs intravenous pulse cyclophosphamide in diffuse cutaneous systemic sclerosis: a randomized clinical trial.

    Science.gov (United States)

    van Laar, Jacob M; Farge, Dominique; Sont, Jacob K; Naraghi, Kamran; Marjanovic, Zora; Larghero, Jérôme; Schuerwegh, Annemie J; Marijt, Erik W A; Vonk, Madelon C; Schattenberg, Anton V; Matucci-Cerinic, Marco; Voskuyl, Alexandre E; van de Loosdrecht, Arjan A; Daikeler, Thomas; Kötter, Ina; Schmalzing, Marc; Martin, Thierry; Lioure, Bruno; Weiner, Stefan M; Kreuter, Alexander; Deligny, Christophe; Durand, Jean-Marc; Emery, Paul; Machold, Klaus P; Sarrot-Reynauld, Francoise; Warnatz, Klaus; Adoue, Daniel F P; Constans, Joël; Tony, Hans-Peter; Del Papa, Nicoletta; Fassas, Athanasios; Himsel, Andrea; Launay, David; Lo Monaco, Andrea; Philippe, Pierre; Quéré, Isabelle; Rich, Éric; Westhovens, Rene; Griffiths, Bridget; Saccardi, Riccardo; van den Hoogen, Frank H; Fibbe, Willem E; Socié, Gérard; Gratwohl, Alois; Tyndall, Alan

    2014-06-25

    High-dose immunosuppressive therapy and autologous hematopoietic stem cell transplantation (HSCT) have shown efficacy in systemic sclerosis in phase 1 and small phase 2 trials. To compare efficacy and safety of HSCT vs 12 successive monthly intravenous pulses of cyclophosphamide. The Autologous Stem Cell Transplantation International Scleroderma (ASTIS) trial, a phase 3, multicenter, randomized (1:1), open-label, parallel-group, clinical trial conducted in 10 countries at 29 centers with access to a European Group for Blood and Marrow Transplantation-registered transplant facility. From March 2001 to October 2009, 156 patients with early diffuse cutaneous systemic sclerosis were recruited and followed up until October 31, 2013. HSCT vs intravenous pulse cyclophosphamide. The primary end point was event-free survival, defined as time from randomization until the occurrence of death or persistent major organ failure. A total of 156 patients were randomly assigned to receive HSCT (n = 79) or cyclophosphamide (n = 77). During a median follow-up of 5.8 years, 53 events occurred: 22 in the HSCT group (19 deaths and 3 irreversible organ failures) and 31 in the control group (23 deaths and 8 irreversible organ failures). During the first year, there were more events in the HSCT group (13 events [16.5%], including 8 treatment-related deaths) than in the control group (8 events [10.4%], with no treatment-related deaths). At 2 years, 14 events (17.7%) had occurred cumulatively in the HSCT group vs 14 events (18.2%) in the control group; at 4 years, 15 events (19%) had occurred cumulatively in the HSCT group vs 20 events (26%) in the control group. Time-varying hazard ratios (modeled with treatment × time interaction) for event-free survival were 0.35 (95% CI, 0.16-0.74) at 2 years and 0.34 (95% CI, 0.16-0.74) at 4 years. Among patients with early diffuse cutaneous systemic sclerosis, HSCT was associated with increased treatment-related mortality in the first year

  12. Mannan-MUC1-pulsed dendritic cell immunotherapy: a phase I trial in patients with adenocarcinoma.

    Science.gov (United States)

    Loveland, Bruce E; Zhao, Anne; White, Shane; Gan, Hui; Hamilton, Kate; Xing, Pei-Xiang; Pietersz, Geoffrey A; Apostolopoulos, Vasso; Vaughan, Hilary; Karanikas, Vaios; Kyriakou, Peter; McKenzie, Ian F C; Mitchell, Paul L R

    2006-02-01

    Tumor antigen-loaded dendritic cells show promise for cancer immunotherapy. This phase I study evaluated immunization with autologous dendritic cells pulsed with mannan-MUC1 fusion protein (MFP) to treat patients with advanced malignancy. Eligible patients had adenocarcinoma expressing MUC1, were of performance status 0 to 1, with no autoimmune disease. Patients underwent leukapheresis to generate dendritic cells by culture ex vivo with granulocyte macrophage colony-stimulating factor and interleukin 4 for 5 days. Dendritic cells were then pulsed overnight with MFP and harvested for reinjection. Patients underwent three cycles of leukapheresis and reinjection at monthly intervals. Patients with clinical benefit were able to continue with dendritic cell-MFP immunotherapy. Ten patients with a range of tumor types were enrolled, with median age of 60 years (range, 33-70 years); eight patients were of performance status 0 and two of performance status 1. Dendritic cell-MFP therapy led to strong T-cell IFNgamma Elispot responses to the vaccine and delayed-type hypersensitivity responses at injection sites in nine patients who completed treatments. Immune responses were sustained at 1 year in monitored patients. Antibody responses were seen in three patients only and were of low titer. Side effects were grade 1 only. Two patients with clearly progressive disease (ovarian and renal carcinoma) at entry were stable after initial therapy and went on to further leukapheresis and dendritic cell-MFP immunotherapy. These two patients have now each completed over 3 years of treatment. Immunization produced T-cell responses in all patients with evidence of tumor stabilization in 2 of the 10 advanced cancer patients treated. These data support further clinical evaluation of this dendritic cell-MFP immunotherapy.

  13. Pulse oximeter sensor application during neonatal resuscitation: a randomized controlled trial.

    Science.gov (United States)

    Louis, Deepak; Sundaram, Venkataseshan; Kumar, Praveen

    2014-03-01

    This study was done to compare 2 techniques of pulse oximeter sensor application during neonatal resuscitation for faster signal detection. Sensor to infant first (STIF) and then to oximeter was compared with sensor to oximeter first (STOF) and then to infant in ≥28 weeks gestations. The primary outcome was time from completion of sensor application to reliable signal, defined as stable display of heart rate and saturation. Time from birth to sensor application, time taken for sensor application, time from birth to reliable signal, and need to reapply sensor were secondary outcomes. An intention-to-treat analysis was done, and subgroup analysis was done for gestation and need for resuscitation. One hundred fifty neonates were randomized with 75 to each technique. The median (IQR) time from sensor application to detection of reliable signal was longer in STIF group compared with STOF group (16 [15-17] vs. 10 [6-18] seconds; P signal did not differ between the 2 methods (STIF: 61 [52-76] seconds; STOF: 58 [47-73] seconds [P = .09]). Time taken for signal acquisition was longer with STIF than with STOF in both subgroups. In the delivery room setting, the STOF method recognized saturation and heart rate faster than the STIF method. The time from birth to reliable signal was similar with the 2 methods.

  14. Process Evaluation of the Type 2 Diabetes Mellitus PULSE Program Randomized Controlled Trial: Recruitment, Engagement, and Overall Satisfaction.

    Science.gov (United States)

    Aguiar, Elroy J; Morgan, Philip J; Collins, Clare E; Plotnikoff, Ronald C; Young, Myles D; Callister, Robin

    2017-07-01

    Men are underrepresented in weight loss and type 2 diabetes mellitus (T2DM) prevention studies. To determine the effectiveness of recruitment, and acceptability of the T2DM Prevention Using LifeStyle Education (PULSE) Program-a gender-targeted, self-administered intervention for men. Men (18-65 years, high risk for T2DM) were randomized to intervention ( n = 53) or wait-list control groups ( n = 48). The 6-month PULSE Program intervention focused on weight loss, diet, and exercise for T2DM prevention. A process evaluation questionnaire was administered at 6 months to examine recruitment and selection processes, and acceptability of the intervention's delivery and content. Associations between self-monitoring and selected outcomes were assessed using Spearman's rank correlation. A pragmatic recruitment and online screening process was effective in identifying men at high risk of T2DM (prediabetes prevalence 70%). Men reported the trial was appealing because it targeted weight loss, T2DM prevention, and getting fit, and because it was perceived as "doable" and tailored for men. The intervention was considered acceptable, with men reporting high overall satisfaction (83%) and engagement with the various components. Adherence to self-monitoring was poor, with only 13% meeting requisite criteria. However, significant associations were observed between weekly self-monitoring of weight and change in weight ( r s = -.47, p = .004) and waist circumference ( r s = -.38, p = .026). Men reported they would have preferred more intervention contact, for example, by phone or email. Gender-targeted, self-administered lifestyle interventions are feasible, appealing, and satisfying for men. Future studies should explore the effects of additional non-face-to-face contact on motivation, accountability, self-monitoring adherence, and program efficacy.

  15. Transcutaneous oximetry compared to ankle-brachial-index measurement in the evaluation of percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    Wildgruber, Moritz; Wolf, Oliver; Weiss, Wolfgang; Berger, Hermann; Lutzenberger, Werner; Eckstein, Hans-Henning; Heider, Peter

    2007-01-01

    Objective: To investigate transcutaneous oximetry as parameter of the microcirculation is correlated to ankle-brachial-index as parameter of the macrocirculation after peripheral angioplasty procedures. Design: Prospective study. Materials and methods: 60 patients suffering from intermittent claudication were scheduled for angioplasty treatment. 45 patients were considered as eligible for angioplasty after angiographic evaluation, 15 patients underwent angiography only. Transcutaneous oximetry measurements were performed before the procedure, at the end of intervention, 24 h as well as 2 and 4 weeks after percutaneous transluminal angioplasty. Ankle-brachial-indices were obtained before intervention, 24 h as well as 2 and 4 weeks later. Results: Ankle-brachial-indices increased significantly at 24 h after angioplasty in patients being treated with angioplasty. Transcutaneous oximetry values dropped significantly at the end of the procedure and returned close to the baseline levels at 2 and 4 weeks after angioplasty. Ankle-brachial-indices and transcutaneous oximetry were positively correlated before (r = 0.3833, p = 0.009) as well as 4 weeks after angioplasty (r = 0.4596, p = 0.001). Immediately after radiological interventions, ankle-brachial-indices and transcutaneous oximetry are not positively correlated. In patients undergoing angiography only, transcutaneous oximetry levels drop significantly immediately after angiography and remain at decreased levels even at 4 weeks after intervention. Conclusion: Transcutaneous oximetry as parameter of the microcirculation is positively correlated with ankle-brachial-index as parameter of the macrocirculation before and at 4 weeks after angioplasty. Intraarterial angiography leads to a sudden decrease in skin microcirculation without affecting macrocirculation. As indicated by a lack of recovery in transcutaneous oximetry levels after 4 weeks, angiography alone results in a prolonged impaired microcirculation which may

  16. Amlodipine+benazepril is superior to hydrochlorothiazide+benazepril irrespective of baseline pulse pressure: subanalysis of the ACCOMPLISH trial.

    Science.gov (United States)

    Skoglund, Per H; Svensson, Per; Asp, Joline; Dahlöf, Björn; Kjeldsen, Sverre E; Jamerson, Kenneth A; Weber, Michael A; Jia, Yan; Zappe, Dion H; Östergren, Jan

    2015-02-01

    Pulse pressure (PP) is an independent risk factor for cardiovascular (CV) disease and death but few studies have investigated the effect of antihypertensive treatments in relation to PP levels before treatment. The Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH) trial showed that the combination of benazepril+amlodipine (B+A) is superior to benazepril+hydrochlorothiazide (B+H) in reducing CV events. We aimed to investigate whether the treatment effects in the ACCOMPLISH trial were dependent on baseline PP. High-risk hypertensive patients (n=11,499) were randomized to double-blinded treatment with single-pill combinations of either B+A or B+H and followed for 36 months. Patients were divided into tertiles according to their baseline PP and events (CV mortality/myocardial infarction or stroke) were compared. Hazard ratios (HRs) for the treatment effect (B+A over B+H) were calculated in a Cox regression model with age, coronary artery disease, and diabetes mellitus as covariates and were compared across the tertiles. The event rate was increased in the high tertile of PP compared with the low tertile (7.2% vs 4.4% P<.01). In the high and medium PP tertiles, HRs were 0.75 (95% confidence interval [CI], 0.60-0.95; P=.018) and 0.74 (CI, 0.56-0.98, P=.034), respectively, in favor of B+A. There was no significant difference between the treatments in the low tertile and no significant differences in treatment effect when comparing the HRs between tertiles of PP. B+A has superior CV protection over B+H in high-risk hypertensive patients independent of baseline PP although the absolute treatment effect is enhanced in the higher tertiles of PP where event rates are higher. © 2014 Wiley Periodicals, Inc.

  17. Oximetry and indications for tracheotomy for amyotrophic lateral sclerosis.

    Science.gov (United States)

    Bach, John Robert; Bianchi, Carlo; Aufiero, Elaine

    2004-11-01

    To explore the use of oximetry as a guide for using respiratory aids and tracheotomy in the treatment of patients with amyotrophic lateral sclerosis (ALS). A retrospective review of all ALS patients presenting to a neuromuscular disease clinic since 1996. Patients who were symptomatic for nocturnal hypoventilation were prescribed noninvasive ventilation (NIV). Patients with assisted cough peak flows of NIV and MAC and the duration of normalization were recorded. When the baseline was not or could not be normalized, the time to acute respiratory failure and tracheotomy or death were recorded. Twenty-five patients became dependent on NIV, including 13 patients who received NIV continuously for a mean (+/- SD) period of 19.7 +/- 16.9 months, without desaturation (group 1). For another 76 patients, the daytime baseline Spo(2) level decreased to NIV/MAC (group 2) for a mean duration of 11.1 +/- 8.7 months before desaturation reoccurred for 27 patients. Of the latter patients, 11 underwent tracheotomy, 14 died in NIV or MAC. The long-term use of NIV and MAC, and the avoidance of tracheotomy is dependent on glottic function rather than on inspiratory or expiratory muscle failure.

  18. Oximetry: a reflective tool for the detection of physiological expression of emotions in a science education classroom

    Science.gov (United States)

    Calderón, Olga

    2016-09-01

    The pulse oximeter is a device that measures the oxygen concentration (or oxygen saturation—SpO2); heart rate, and heartbeat of a person at any given time. This instrument is commonly used in medical and aerospace fields to monitor physiological outputs of a patient according to health conditions or physiological yields of a flying pilot according to changes in altitude and oxygen availability in the atmosphere. Nonetheless, the uses for pulse oximetry may expand to other fields where there is human interaction and where physiological outputs reflect fluctuations mediated by arising emotions. A classroom, for instance is filled with a plethora of emotions, but very often participants in this space are unaware of others' or their own sentiments as these arise as a result of interactions and responses to class discussions. In this paper I describe part of a larger study-taking place at Brooklyn College of the City University of New York. The focus is on the exploration of emotions and mindfulness in the science classroom. The oximeter is used in this study as a reflexive tool to detect emotions emerging among participants of a graduate History and Philosophy of Science Education course offered in the spring of 2012. Important physiological information of class participants provided by the oximeter is used to analyze the role of emotions in the classroom as sensitive and controversial topics in science education are discussed every week.

  19. Intense pulsed light vs. long-pulsed dye laser treatment of telangiectasia after radiotherapy for breast cancer: a randomized split-lesion trial of two different treatments

    DEFF Research Database (Denmark)

    Nymann, P.; Hedelund, L.; Hædersdal, Merete

    2009-01-01

    Background Chronic radiodermatitis is a common sequela of treatment for breast cancer and potentially a psychologically distressing factor for the affected women. Objectives To evaluate the efficacy and adverse effects of treatments with a long-pulsed dye laser (LPDL) vs. intense pulsed light (IPL......); the interventions were randomly assigned to left/right or upper/lower halves. Primary end-points were reduction in telangiectasia, patient satisfaction and preferred treatment. Secondary end-points were pain and adverse effects. Efficacy was registered by blinded photographic evaluations 3 months after the final...

  20. Comparing Two Methods of Cryotherapy and Intense Pulsed Light with Triamcinolone Injection in the Treatment of Keloid and Hypertrophic Scars: A Clinical Trial

    OpenAIRE

    Meymandi, Simin Shamsi; Moosazadeh, Mahmood; Rezazadeh, Azadeh

    2016-01-01

    Objectives Keloid and hypertrophic scars are abnormal manifestations of wounds that occur following skin injuries in the form of local proliferation of fibroblasts and increased production of collagen. There are several ways to cure these scars; treatment must be selected based on the nature of the scars. In this clinical trial, two methods?cryotherapy and intense pulsed light (IPL)?are compared in the treatment of scars, and the results are presented in terms of improvement level, complicati...

  1. In vivo electron paramagnetic resonance oximetry and applications in the brain

    Directory of Open Access Journals (Sweden)

    John M Weaver

    2017-01-01

    Full Text Available Molecular oxygen (O2 is essential to brain function and mechanisms necessary to regulate variations in delivery or utilization of O2 are crucial to support normal brain homeostasis, physiology and energy metabolism. Any imbalance in cerebral tissue partial pressure of O2 (pO2 levels may lead to pathophysiological complications including increased reactive O2 species generation leading to oxidative stress when tissue O2 level is too high or too low. Accordingly, the need for oximetry methods, which assess cerebral pO2 in vivo and in real time, is imperative to understand the role of O2 in various metabolic and disease states, including the effects of treatment and therapy options. In this review, we provide a brief overview of the common in vivo oximetry methodologies for measuring cerebral pO2 . We discuss the advantages and limitations of oximetry methodologies to measure cerebral pO2 in vivo followed by a more in-depth review of electron paramagnetic resonance oximetry spectroscopy and imaging using several examples of current electron paramagnetic resonance oximetry applications in the brain.

  2. Long-pulsed Nd:YAG laser vs. intense pulsed light for hair removal in dark skin: a randomized controlled trial.

    Science.gov (United States)

    Ismail, S A

    2012-02-01

    Although several lasers meet the wavelength criteria for selective follicular destruction, the treatment of darker skin phototypes is particularly challenging because absorption of laser energy by the targeted hairs is compromised by an increased concentration of epidermal melanin. To compare satisfaction level, safety and effectiveness of a long-pulsed Nd:YAG laser and intense pulsed light (IPL) in axillary hair reduction in subjects with dark skin. The study design was a within-patient, right-left, assessor-blinded, comparison of long-pulsed Nd:YAG laser and IPL. Fifty women (skin phototypes IV-VI) volunteered for removal of axillary hair. Five sessions at 4- to 6-week intervals were performed. Hair counts at both sides were compared at baseline and 6months after the last session. Final overall evaluations were performed by subjects and clinician at the end of the study. Satisfaction was scored for both devices. Thirty-nine women completed the study. At 6months, the decrease in hair counts on the laser side (79·4%, Pvs. pretreatment) was significantly (Pvs. pretreatment). Only temporary adverse effects were reported at both sides. Higher pain scores and more inflammation were reported with Nd:YAG laser; however, it was preferred by 29 volunteers (74%). Volunteers reported higher satisfaction score with Nd:YAG laser (PDark skin can be treated by both systems safely and effectively; however, long-pulsed (1064 nm) Nd:YAG laser is more effective as reported by both subjects and clinician. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

  3. Design and implementation of a sigma delta technology based pulse oximeter's acquisition stage

    Science.gov (United States)

    Rossi, E. E.; Peñalva, A.; Schaumburg, F.

    2011-12-01

    Pulse oximetry is a widely used tool in medical practice for estimating patient's fraction of hemoglobin bonded to oxygen. Conventional oximetry presents limitations when changes in the baseline, or low amplitude of signals involved occur. The aim of this paper is to simultaneously solve these constraints and to simplify the circuitry needed, by using ΣΔ technology. For this purpose, a board for the acquisition of the needed signals was developed, together with a PC managed software which controls it, and displays and processes in real time the information acquired. Also laboratory and field tests where designed and executed to verify the performance of this equipment in adverse situations. A simple, robust and economic instrument was achieved, capable of obtaining signals even in situations where conventional oximetry fails.

  4. Design and implementation of a sigma delta technology based pulse oximeter's acquisition stage

    International Nuclear Information System (INIS)

    Rossi, E E; Peñalva, A; Schaumburg, F

    2011-01-01

    Pulse oximetry is a widely used tool in medical practice for estimating patient's fraction of hemoglobin bonded to oxygen. Conventional oximetry presents limitations when changes in the baseline, or low amplitude of signals involved occur. The aim of this paper is to simultaneously solve these constraints and to simplify the circuitry needed, by using ΣΔ technology. For this purpose, a board for the acquisition of the needed signals was developed, together with a PC managed software which controls it, and displays and processes in real time the information acquired. Also laboratory and field tests where designed and executed to verify the performance of this equipment in adverse situations. A simple, robust and economic instrument was achieved, capable of obtaining signals even in situations where conventional oximetry fails.

  5. Where do pulse oximeter probes break?

    Science.gov (United States)

    Crede, S; Van der Merwe, G; Hutchinson, J; Woods, D; Karlen, W; Lawn, J

    2014-06-01

    Pulse oximetry, a non-invasive method for accurate assessment of blood oxygen saturation (SPO2), is an important monitoring tool in health care facilities. However, it is often not available in many low-resource settings, due to expense, overly sophisticated design, a lack of organised procurement systems and inadequate medical device management and maintenance structures. Furthermore medical devices are often fragile and not designed to withstand the conditions of low-resource settings. In order to design a probe, better suited to the needs of health care facilities in low-resource settings this study aimed to document the site and nature of pulse oximeter probe breakages in a range of different probe designs in a low to middle income country. A retrospective review of job cards relating to the assessment and repair of damaged or faulty pulse oximeter probes was conducted at a medical device repair company based in Cape Town, South Africa, specializing in pulse oximeter probe repairs. 1,840 job cards relating to the assessment and repair of pulse oximeter probes were reviewed. 60.2 % of probes sent for assessment were finger-clip probes. For all probes, excluding the neonatal wrap probes, the most common point of failure was the probe wiring (>50 %). The neonatal wrap most commonly failed at the strap (51.5 %). The total cost for quoting on the broken pulse oximeter probes and for the subsequent repair of devices, excluding replacement components, amounted to an estimated ZAR 738,810 (USD $98,508). Improving the probe wiring would increase the life span of pulse oximeter probes. Increasing the life span of probes will make pulse oximetry more affordable and accessible. This is of high priority in low-resource settings where frequent repair or replacement of probes is unaffordable or impossible.

  6. A Novel Ring Shaped Photodiode for Reflectance Pulse Oximetry in Wireless Applications

    DEFF Research Database (Denmark)

    Duun, Sune; Haahr, Rasmus Grønbek; Birkelund, Karen

    2007-01-01

    gives optimal gathering of light and thereby enabling lower LED drive currents and lower power consumption. To further optimize the photodiode a two layer SiO2/SiN interference filter is employed yielding 98% transmission at the wavelengths of the LED and damping of other wavelengths. The presented...

  7. How Noninvasive Haemoglobin Measurement with Pulse CO-Oximetry Can Change Your Practice: An Expert Review

    Directory of Open Access Journals (Sweden)

    Gregor Lindner

    2013-01-01

    Full Text Available Trauma related haemorrhagic anaemia is rarely diagnosed by physical examination alone but typically includes measurement of blood haemoglobin, one of the most frequently ordered laboratory tests. Recently, noninvasive technologies have been developed that allow haemoglobin to be measured immediately without the need for intravenous access or having to take venous, arterial, or capillary blood. Moreover, with these technologies haemoglobin can be continuously measured in patients with active bleeding, to guide the start and stop of blood transfusions and to detect occult bleeding. Recent studies on the accuracy of the devices showed promising results in terms of accuracy of hemoglobin measurement compared to laboratory determination. The present review gives an overview on the technology itself and reviews the current literature on the subject.

  8. Critical Congenital Heart Disease Screening by Pulse Oximetry in a Neonatal Intensive Care Unit

    Science.gov (United States)

    Manja, Veena; Mathew, Bobby; Carrion, Vivien; Lakshminrusimha, Satyan

    2014-01-01

    Critical congenital heart disease (CCHD) screening is effective in asymptomatic late preterm and term newborn infants with a low false positive rate (0.035%). Objective (1) To compare 2817 NICU discharges before and after implementation of CCHD screening; and (2) to evaluate CCHD screening at < 35 weeks gestation. Methods collection of results of CCHD screening including preductal and postductal SpO2 values. Results During the pre-CCHD screen period, 1247 infants were discharged from the NICU and one case of CCHD was missed. After 3/1/12, 1508 CCHD screens were performed among 1570 discharges and no CCHDs were missed. The preductal and postductal SpO2 values were 98.8±1.4% and 99±1.3% respectively in preterm and 98.9±1.3% and 98.9±1.4% in term infants. Ten infants had false positive screens (10/1508=0.66%). Conclusions Performing universal screening in the NICU is feasible but is associated with a higher false positive rate compared to asymptomatic newborn infants. PMID:25058746

  9. Pulse oximetry and supplemental oxygen during gastrointestinal endoscopy: a critical review

    DEFF Research Database (Denmark)

    Holm, C; Rosenberg, J

    1996-01-01

    A high proportion of the mortality and morbidity associated with endoscopic procedures may be of cardiopulmonary origin. For this reason, the appropriate degree of monitoring and prophylactic measures to be used in the sedated patient undergoing endoscopy has become a topic of discussion during r...

  10. A Single-Chip CMOS Pulse Oximeter with On-Chip Lock-In Detection

    OpenAIRE

    Diwei He; Stephen P. Morgan; Dimitrios Trachanis; Jan van Hese; Dimitris Drogoudis; Franco Fummi; Francesco Stefanni; Valerio Guarnieri; Barrie R. Hayes-Gill

    2015-01-01

    Pulse oximetry is a noninvasive and continuous method for monitoring the blood oxygen saturation level. This paper presents the design and testing of a single-chip pulse oximeter fabricated in a 0.35 ?m CMOS process. The chip includes photodiode, transimpedance amplifier, analogue band-pass filters, analogue-to-digital converters, digital signal processor and LED timing control. The experimentally measured AC and DC characteristics of individual circuits including the DC output voltage of the...

  11. Evaluating the Use of Tissue Oximetry to Decrease Intensive Unit Monitoring for Free Flap Breast Reconstruction.

    Science.gov (United States)

    Ricci, Joseph A; Vargas, Christina R; Ho, Olivia A; Lin, Samuel J; Tobias, Adam M; Lee, Bernard T

    2017-07-01

    Postoperative free flap care has historically required intensive monitoring for 24 hours in an intensive care unit. Continuous monitoring with tissue oximetry has allowed earlier detection of vascular compromise, decreasing flap loss and improving salvage. This study aims to identify whether a fast-track postoperative paradigm can be safely used with tissue oximetry to decrease intensive monitoring and costs. All consecutive microsurgical breast reconstructions performed at a single institution were reviewed (2008-2014) and cases requiring return to the operating room were identified. Data evaluated included patient demographics, the take back time course, and complications of flap loss and salvage. A cost-benefit analysis was performed to analyse the utility of a postoperative intensive monitoring setting. There were 900 flaps performed and 32 required an unplanned return to the operating room. There were 16 flaps that required a reexploration within the first 24 hours; the standard length of intensive unit monitoring. After 4 hours, there were 7 flaps (44%) detected by tissue oximetry for reexploration. After 15 hours of intensive monitoring postoperatively, cost analysis revealed that the majority (15/16; 94%) of failing flaps had been identified and the cost of identifying each subsequent failing flap exceeded the cost of another hour of intensive monitoring. The postoperative paradigm for microsurgical flaps has historically required intensive unit monitoring. Using tissue oximetry, a fast-track pathway can reduce time spent in an intensive monitoring setting from 24 to 15 hours with significant cost savings and minimal risk of missing a failing free flap.

  12. Electron paramagnetic resonance and dynamic nuclear polarization of char suspensions: surface science and oximetry

    DEFF Research Database (Denmark)

    Clarkson, R B; Odintsov, B M; Ceroke, P J

    1998-01-01

    ; they can be calibrated and used for oximetry. Biological stability and low toxicity make chars good sensors for in vivo measurements. Scalar and dipolar interactions of water protons at the surfaces of chars may be utilized to produce dynamic nuclear polarization (DNP) of the nuclear spin population...

  13. Long-pulsed dye laser versus long-pulsed dye laser-assisted photodynamic therapy for acne vulgaris: A randomized controlled trial

    DEFF Research Database (Denmark)

    Haedersdal, M.; Togsverd, K.; Wiegell, S.R.

    2008-01-01

    Background: Long-pulsed dye laser (LPDL)-assisted photodynamic therapy has been suggested to be superior to laser alone for acne vulgaris but no evidence is available. Objective: To evaluate the efficacy and safety of LPDL alone versus LPDL in photodynamic therapy with methylaminolevulinic acid...... (MAL-LPDL) for acne vulgaris. Methods: Fifteen patients received a series of 3 full-face LPDL treatments and half-face prelaser MAL treatments; the latter being randomly assigned to the left or right side. Results: Inflammatory lesions were reduced more on MAL-LPDL-treated than on LPDL-treated sides...... to draw conclusions about the efficacy of the LPDL, only about the efficacy of MAL-LPDL compared with LPDL alone. Conclusions: MAL-LPDL is slightly superior to LPDL for the treatment of inflammatory acne Udgivelsesdato: 2008/3...

  14. Pulsed dye laser vs. intense pulsed light for port-wine stains: a randomized side-by-side trial with blinded response evaluation

    DEFF Research Database (Denmark)

    Faurschou, A; Togsverd-Bo, K; Zachariae, C

    2009-01-01

    Corporation, Wayland, MA, U.S.A.) and IPL (StarLux, Lux G prototype handpiece, 500-670 and 870-1400 nm, 5-10 ms; Palomar Medical Technologies, Burlington, MA, U.S.A.). Settings depended on the preoperative lesional colour. Treatment outcome was evaluated by blinded, clinical evaluations and by skin......: To compare efficacy and adverse events of PDL and IPL in an intraindividual randomized clinical trial. METHODS: Twenty patients with PWS (face, trunk, extremities; pink, red and purple colours; skin types I-III) received one side-by-side treatment with PDL (V-beam Perfecta, 595 nm, 0.45-1.5 ms; Candela Laser...

  15. The effectiveness of pulsed electrical stimulation (E-PES in the management of osteoarthritis of the knee: a protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Gupta Ritu

    2008-02-01

    Full Text Available Abstract Background Osteoarthritis (OA of the knee is one of the main causes of musculoskeletal disability in the western world. Current available management options provide symptomatic relief (exercise and self-management, medication and surgery but do not, in general, address the disease process itself. Moreover, adverse effects and complications with some of these interventions (medication and surgery and the presence of co-morbidities commonly restrict their use. There is clearly a need to investigate treatments that are more widely applicable for symptom management and which may also directly address the disease process itself. In two randomised controlled trials of four and 12 weeks duration, pulsed electrical stimulation was shown to be effective in managing the symptoms of OA of the knee. Laboratory and animal studies demonstrate the capacity of externally applied electric and electromagnetic fields to positively affect chondrocyte proliferation and extracellular matrix protein production. This latter evidence provides strong theoretical support for the use of electrical stimulation to maintain and repair cartilage in the clinical setting and highlights its potential as a disease-modifying modality. Methods/Design A double-blind, randomised, placebo-controlled, repeated measures trial to examine the effectiveness of pulsed electrical stimulation in providing symptomatic relief for people with OA of the knee over 26 weeks. Seventy people will be recruited and information regarding age, gender, body mass index and medication use will be recorded. The population will be stratified for age, gender and baseline pain levels. Outcome measures will include pain (100 mm VAS and WOMAC 3.1, function (WOMAC 3.1, stiffness (WOMAC 3.1, patient global assessment (100 mm VAS and quality of life (SF-36. These outcomes will be measured at baseline, four, 16 and 26 weeks. Activity levels will be measured at baseline and 16 weeks using accelerometers and

  16. Assessing the effectiveness of ‘pulse radiofrequency treatment of dorsal root ganglion’ in patients with chronic lumbar radicular pain: study protocol for a randomized control trial

    Directory of Open Access Journals (Sweden)

    Shanthanna Harsha

    2012-04-01

    Full Text Available Abstract Background Chronic lumbar radicular pain can be described as neuropathic pain along the distribution of a particular nerve root. The dorsal root ganglion has been implicated in its pathogenesis by giving rise to abnormal impulse generation as a result of irritation, direct compression and sensitization. Chronic lumbar radicular pain is commonly treated with medications, physiotherapy and epidural steroid injections. Epidural steroid injections are associated with several common and rarer side effects such as spinal cord infarction and death. It is essential and advantageous to look for alternate interventions which could be effective with fewer side effects. Pulse radio frequency is a relatively new technique and is less destructive then conventional radiofrequency. Safety and effectiveness of pulse radio frequency in neuropathic pain has been demonstrated in animal and humans studies. Although its effects on dorsal root ganglion have been studied in animals there is only one randomized control trial in literature demonstrating its effectiveness in cervical radicular pain and none in lumbar radicular pain. Our primary objective is to study the feasibility of a larger trial in terms of recruitment and methodology. Secondary objectives are to compare the treatment effects and side effects. Methods/designs This is a single-center, parallel, placebo-controlled, triple-blinded (patients, care-givers, and outcome assessors, randomized control trial. Participants will have a history of chronic lumbar radicular pain for at least 4 months in duration. Once randomized, all patients will have an intervention involving fluoroscopy guided needle placement to appropriate dorsal root ganglion. After test stimulation in both groups; the study group will have a pulse radio frequency treatment at 42°C for 120 s to the dorsal root ganglion, with the control group having only low intensity test stimulation for the same duration. Primary outcome is to

  17. Evaluation of pulsing magnetic field effects on paresthesia in multiple sclerosis patients, a randomized, double-blind, parallel-group clinical trial.

    Science.gov (United States)

    Afshari, Daryoush; Moradian, Nasrin; Khalili, Majid; Razazian, Nazanin; Bostani, Arash; Hoseini, Jamal; Moradian, Mohamad; Ghiasian, Masoud

    2016-10-01

    Evidence is mounting that magnet therapy could alleviate the symptoms of multiple sclerosis (MS). This study was performed to test the effects of the pulsing magnetic fields on the paresthesia in MS patients. This study has been conducted as a randomized, double-blind, parallel-group clinical trial during the April 2012 to October 2013. The subjects were selected among patients referred to MS clinic of Imam Reza Hospital; affiliated to Kermanshah University of Medical Sciences, Iran. Sixty three patients with MS were included in the study and randomly were divided into two groups, 35 patients were exposed to a magnetic pulsing field of 4mT intensity and 15-Hz frequency sinusoidal wave for 20min per session 2 times per week over a period of 2 months involving 16 sessions and 28 patients was exposed to a magnetically inactive field (placebo) for 20min per session 2 times per week over a period of 2 months involving 16 sessions. The severity of paresthesia was measured by the numerical rating scale (NRS) at 30, 60days. The study primary end point was NRS change between baseline and 60days. The secondary outcome was NRS change between baseline and 30days. Patients exposing to magnetic field showed significant paresthesia improvement compared with the group of patients exposing to placebo. According to our results pulsed magnetic therapy could alleviate paresthesia in MS patients .But trials with more patients and longer duration are mandatory to describe long-term effects. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Comparative efficacy of continuous and pulse dose terbinafine regimes in toenail dermatophytosis: A randomized double-blind trial.

    Science.gov (United States)

    Yadav, Pravesh; Singal, Archana; Pandhi, Deepika; Das, Shukla

    2015-01-01

    Dermatophytes are the most frequently implicated agents in toenail onychomycosis and oral terbinafine has shown the best cure rates in this condition. The pharmacokinetics of terbinafine favors its efficacy in pulse dosing. To compare the efficacy of terbinafine in continuous and pulse dosing schedules in the treatment of toenail dermatophytosis. Seventy-six patients of potassium hydroxide (KOH) and culture positive dermatophyte toenail onychomycosis were randomly allocated to two treatment groups receiving either continuous terbinafine 250 mg daily for 12 weeks or 3 pulses of terbinafine (each of 500 mg daily for a week) repeated every 4 weeks. Patients were followed up at 4, 8 and 12 weeks during treatment and post-treatment at 24 weeks. At each visit, a KOH mount and culture were performed. In each patient, improvement in a target nail was assessed using a clinical score; total scores for all nails and global assessments by physician and patient were also recorded. Mycological, clinical and complete cure rates, clinical effectivity and treatment failure rates were then compared. The declines in target nail and total scores from baseline were significant at each follow-up visit in both the treatment groups. However, the inter-group difference was statistically insignificant. The same was true for global assessment indices, clinical effectivity as well as clinical, mycological, and complete cure rates. The short follow-up in our study may have led to lower cure rates being recorded. Terbinafine in pulse dosing is as effective as continuous dosing in the treatment of dermatophyte toenail onychomycosis.

  19. Electron paramagnetic resonance and dynamic nuclear polarization of char suspensions: surface science and oximetry

    International Nuclear Information System (INIS)

    Clarkson, R.B.; Odintsov, B.M.; Ceroke, P.J.; Ardenkjaer-Larsen, J.H.; Fruianu, M.; Belford, R.L.

    1998-01-01

    Carbon chars have been synthesized in our laboratory from a variety of starting materials, by means of a highly controlled pyrolysis technique. These chars exhibit electron paramagnetic resonance (EPR) line shapes which change with the local oxygen concentration in a reproducible and stable fashion; they can be calibrated and used for oximetry. Biological stability and low toxicity make chars good sensors for in vivo measurements. Scalar and dipolar interactions of water protons at the surfaces of chars may be utilized to produce dynamic nuclear polarization (DNP) of the 1 H nuclear spin population in conjunction with electron Zeeman pumping. Low-frequency EPR, DNP and DNP-enhanced MRI all show promise as oximetry methods when used with carbon chars. (author)

  20. A unique case of pulmonary artery catheter bleeding from the oximetry connection port

    Directory of Open Access Journals (Sweden)

    Suman Rajagopalan

    2014-12-01

    Full Text Available Pulmonary artery catheter is an invasive monitor usually placed in high-risk cardiac surgical patients to optimize the cardiac functions. We present this case of blood oozing from the oximetry connection port of the pulmonary artery catheter that resulted in the inability to monitor continuous cardiac output requiring replacement of the catheter. The cause of this abnormal bleeding was later confirmed to be due to a manufacturing defect.

  1. Effects of placebo-controlled continuous and pulsed ultrasound treatments on carpal tunnel syndrome: a randomized trial

    Directory of Open Access Journals (Sweden)

    Onur Armagan

    2014-08-01

    Full Text Available OBJECTIVE: The aim of this placebo-controlled study was to evaluate the effects of pulsed and continuous ultrasound treatments combined with splint therapy on patients with mild and moderate idiopathic carpal tunnel syndrome. METHODS: The study included 46 carpal tunnel syndrome patients who were randomly divided into 3 groups. The first group (n = 15 received a 0 W/cm2 ultrasound treatment (placebo; the second group (n = 16 received a 1.0 W/cm2 continuous ultrasound treatment and the third group (n = 15 received a 1.0 W/cm2 1:4 pulsed ultrasound treatment 5 days a week for a total of 15 sessions. All patients also wore night splints during treatment period. Pre-treatment and post-treatment Visual Analogue Scale, Symptom Severity Scale and Functional Status Scale scores, median nerve motor conduction velocity and distal latency and sensory conduction velocities of the median nerve in the 2nd finger and palm were compared. Clinicaltrials.gov: NCT02054247. RESULTS: There were significant improvements in all groups in terms of the post-treatment Functional Status Scale score (p<0.05 for all groups, Symptom Severity Scale score (first group: p<0.05, second group: p<0.01, third group: p<0.001 and Visual Analogue Scale score (first and third groups: p<0.01, second group: p<0.001. Sensory conduction velocities improved in the second and third groups (p<0.01. Distal latency in the 2nd finger showed improvement only in the third group (p<0.01 and action potential latency in the palm improved only in the second group (p<0.05. CONCLUSION: The results of this study suggest that splinting therapy combined with placebo and pulsed or continuous ultrasound have similar effects on clinical improvement. Patients treated with continuous and pulsed ultrasound showed electrophysiological improvement; however, the results were not superior to those of the placebo.

  2. Transcranial pulsed electromagnetic fields for multiple chemical sensitivity: Study protocol for a randomized, double-blind, placebo-controlled trial

    DEFF Research Database (Denmark)

    Tran, Marie Thi Dao; Skovbjerg, Sine; Arendt-Nielsen, Lars

    2013-01-01

    . The symptoms may have severe impact on patients' lives, but an evidence-based treatment for the condition is nonexisting. The pathophysiology is unclarified, but several indicators point towards abnormal processing of sensory signals in the central nervous system. Pulsed electromagnetic fields (PEMF) offer...... follow-up according to a predefined timetable. The primary outcome will be a measurement of the impact of MCS on everyday life. The secondary outcomes will be measurements of MCS symptoms, psychological distress (stress, anxiety or depressive symptoms), capsaicin-induced secondary punctate hyperalgesia...

  3. Comparing Two Methods of Cryotherapy and Intense Pulsed Light with Triamcinolone Injection in the Treatment of Keloid and Hypertrophic Scars: A Clinical Trial.

    Science.gov (United States)

    Meymandi, Simin Shamsi; Moosazadeh, Mahmood; Rezazadeh, Azadeh

    2016-10-01

    Keloid and hypertrophic scars are abnormal manifestations of wounds that occur following skin injuries in the form of local proliferation of fibroblasts and increased production of collagen. There are several ways to cure these scars; treatment must be selected based on the nature of the scars. In this clinical trial, two methods-cryotherapy and intense pulsed light (IPL)-are compared in the treatment of scars, and the results are presented in terms of improvement level, complications, and patient satisfaction. This clinical trial was conducted in southeastern Iran. The intervention group included scars that underwent the IPL method and the control group, which consisted of scars that were subjected to cryotherapy. In both methods, intralesional corticosteroid injection was administered. To select samples, the easy sampling method was used. To determine the expected outcomes, the criteria determined in the Vancouver scar scale were used. Data were analyzed using the Mix Model, chi-square test, and t test. In this study, 166 samples of keloid and hypertrophic scars were cured using two methods (Cryotherapy, 83; IPL, 83). The recovery rate was higher in the Cryotherapy group than in the IPL group ( p  > 0.05), and the incidence of complications was also higher in the Cryotherapy group (14.5% vs. 12%). Moreover, patients were more satisfied, although not significantly so, with the cryotherapy method ( p  = 0.09). Both methods were highly successful in curing scars; participants were totally satisfied with both methods.

  4. Regional tumor oximetry: 19F NMR spectroscopy of hexafluorobenzene

    International Nuclear Information System (INIS)

    Hunjan, Sandeep; Mason, Ralph P.; Constantinescu, Anca; Peschke, Peter; Hahn, Eric W.; Antich, Peter P.

    1998-01-01

    Purpose: An accurate method for monitoring oxygen tension (pO 2 ) of individual tumors could be valuable for optimizing treatment plans. We have recently shown that 19 F nuclear magnetic resonance (NMR) spin-lattice relaxometry of hexafluorobenzene (HFB) provides a highly sensitive indicator of tumor oxygenation. We have now refined the methodology to provide enhanced precision, and applied the method to investigate dynamic changes in tumor oxygenation. Methods and Materials: Dunning prostate adenocarcinoma R3327-AT1 was grown in the form of pedicles on the foreback of male Copenhagen rats. When the tumors reached ≅1 cm diameter, HFB (20 μl) was administered, either centrally or peripherally, by direct intratumoral (IT) injection. Local pO 2 was determined using pulse-burst saturation recovery (PBSR) 19 F NMR spectroscopy on the basis of the spin-lattice relaxation rate, R1. Results: Interrogation of the central region of tumors provided typical values in the range pO 2 = 1.4-6.4 mmHg, with a typical stability of ±2 mmHg over a period of 20 min, when rats breathed 33% O 2 . Altering the inhaled gas to oxygen or carbogen (95% O 2 /5% CO 2 ) produced no significant change. In contrast, interrogation of tumor periphery indicated baseline pO 2 in the range 7.9-78.9 mmHg. Altering inspired gas produced significant changes (p 2 or carbogen, although the change was generally greater with carbogen. In each case, pO 2 returned to baseline within 16 min of returning the inhaled gas to baseline. Conclusion: We believe this method provides a valuable new approach with the requisite precision and accuracy to investigate tumor pO 2

  5. A confocal scanning laser ophthalmoscope for retinal vessel oximetry

    Science.gov (United States)

    Lompado, Arthur

    Measurement of a person's blood oxygen saturation has long been recognized as a useful metric for the characterizing ailments ranging from chronic respiratory disorders to acute, potentially life threatening, traumas. The ubiquity of oxygen saturation monitors in the medical field, including portable pulse oximeters and laboratory based CO-oximeters, is a testament to the importance of this technique. The work presented here documents the design, fabrication and development of a unique type of oxygen saturation monitor, a confocal scanning retinal vessel oximeter, with the potential to expand the usefulness of the present devices. A large part of the knowledge base required to construct the instrument comes from the consideration of light scattering by red blood cells in a blood vessel. Therefore, a substantial portion of this work is devoted to the process of light scattering by whole human blood and its effects on the development of a more accurate oximeter. This light scattering effect has been both measured and modeled stochastically to determine its contribution to the measured oximeter signal. It is shown that, although well accepted in the published literature, the model only correlates marginally to the measurements due to inherent limitations imposed by the model assumptions. Nonetheless, enough material has been learned about the scattering to allow development of a mathematical model for the interaction of light with blood in a vessel, and this knowledge has been applied to the data reduction of the present oximeter. This data reduction technique has been tested in a controlled experiment employing a model eye with a blood filled mock retinal vessel. It will be shown that the presently developed technique exhibited strong correlation between the known blood oxygen saturation and that calculated by the new system.

  6. Improved healing response in delayed unions of the tibia with low-intensity pulsed ultrasound: results of a randomized sham-controlled trial

    Directory of Open Access Journals (Sweden)

    Aigner Julia

    2010-10-01

    Full Text Available Abstract Background We compared the healing response of tibial delayed unions between subjects treated with low-intensity pulsed ultrasound (LIPUS (n = 51 and subjects treated with a sham device (n = 50. Fracture age was ≥ 4 months in all cases. Study personnel and participants were blinded to random treatment assignment throughout the study. Methods This multi-center randomized sham-controlled trial was undertaken at six hospitals in Germany. Adult patients who had sustained a tibial shaft fracture that subsequently showed inadequate progress toward healing (i.e., delayed union were enrolled and randomized to receive either LIPUS (Exogen 2000/2000+, Smith & Nephew GmbH, Schenefeld, Germany or an identical nonoperative sham device. The daily treatment duration was 20 minutes, for a period of 16 weeks. Subjects randomly assigned to active treatment had the ultrasound pressure wave signal set at the following parameters: 1.5 MHz frequency, 1 kHz repetition rate, 200 μs pulse duration, 30 mW/cm2 spatial intensity. Progress toward healing was estimated from changes in bone mineral density (BMD and gap area as determined from computed tomography scans. Intention-to-treat analysis was conducted using a multiple imputation methodology. Results Based on log-transformed data, mean improvement in BMD was 1.34 (90% confidence interval (CI 1.14 to 1.57 times greater for LIPUS-treated subjects compared to sham (p = 0.002. A mean reduction in bone gap area also favored LIPUS treatment (p = 0.014. Conclusions These findings demonstrate significantly greater progress toward bone healing after LIPUS treatment compared to no LIPUS treatment in subjects with established delayed unions of the tibia.

  7. Improvement of Infrared Detectors for Tissue Oximetry using Black Silicon Nanostructures

    DEFF Research Database (Denmark)

    Petersen, Søren Dahl; Davidsen, Rasmus Schmidt; Alcala, Lucia R.

    2014-01-01

    We present a nanostructured surface, made of dry etched black silicon, which lowers the reflectance for light incident at all angles. This surface is fabricated on infrared detectors used for tissue oximetry, where the detection of weak diffuse light signals is important. Monte Carlo simulations...... performed on a model of a neonatal head shows that approximately 60% of the injected light will be diffuse reflected. However, the change in diffuse reflected light due to the change in cerebral oxygenation is very low and the light will be completely isotropic scattered. The reflectance of the black...... in quantum efficiency for both normal incident light and light incident at 38°....

  8. Effects of Pulsed Electromagnetic Fields on Return to Sports After Arthroscopic Debridement and Microfracture of Osteochondral Talar Defects: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial.

    Science.gov (United States)

    Reilingh, Mikel L; van Bergen, Christiaan J A; Gerards, Rogier M; van Eekeren, Inge C; de Haan, Rob J; Sierevelt, Inger N; Kerkhoffs, Gino M M J; Krips, Rover; Meuffels, Duncan E; van Dijk, C N; Blankevoort, Leendert

    2016-05-01

    Osteochondral defects (OCDs) of the talus usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracture. Various possibilities have been suggested to improve the recovery process after debridement and microfracture. A potential solution to obtain this goal is the application of pulsed electromagnetic fields (PEMFs), which stimulate the repair process of bone and cartilage. The use of PEMFs after arthroscopic debridement and microfracture of an OCD of the talus leads to earlier resumption of sports and an increased number of patients that resume sports. Randomized controlled trial; Level of evidence, 1. A total of 68 patients were randomized to receive either PEMFs (n = 36) or placebo (n = 32) after arthroscopic treatment of an OCD of the talus. The primary outcomes (ie, the number of patients who resumed sports and time to resumption of sports) were analyzed with Kaplan-Meier curves as well as Mann-Whitney U, chi-square, and log-rank tests. Secondary functional outcomes were assessed with questionnaires (American Orthopaedic Foot and Ankle Society ankle-hindfoot score, Foot and Ankle Outcome Score, EuroQol, and numeric rating scales for pain and satisfaction) at multiple time points up to 1-year follow-up. To assess bone repair, computed tomography scans were obtained at 2 weeks and 1 year postoperatively. Almost all outcome measures improved significantly in both groups. The percentage of sport resumption (PEMF, 79%; placebo, 80%; P = .95) and median time to sport resumption (PEMF, 17 weeks; placebo, 16 weeks; P = .69) did not differ significantly between the treatment groups. Likewise, there were no significant between-group differences with regard to the secondary functional outcomes and the computed tomography results. PEMF does not lead to a higher percentage of patients who resume sports or to earlier resumption of sports after arthroscopic debridement and microfracture of talar OCDs. Furthermore, no

  9. Retrievable micro-inserts containing oxygen sensors for monitoring tissue oxygenation using EPR oximetry

    International Nuclear Information System (INIS)

    Dinguizli, M; Beghein, N; Gallez, B

    2008-01-01

    Tissue oxygenation is a crucial parameter in various physiopathological situations and can influence the therapeutic response of tumours. EPR oximetry is a reliable method for assessing and monitoring oxygen levels in vivo over long periods of time. Among the different paramagnetic oxygen sensors available for EPR oximetry, lithium phthalocyanine (LiPc) is a serious candidate for in vivo applications because of its narrow linewidth and its high signal-to-noise ratio. To enhance the biocompatibility of the sensors, fluoropolymer Teflon AF2400 was used to make cylindrical micro-inserts containing LiPc crystals. This new micro-pellet design has several advantages for in vivo studies, including the possibility of being able to choose the implant size, a high sensor content, the facility of in vivo insertion and complete protection with preservation of the oxygen sensor's characteristics. The response to oxygen and the kinetics of this response were tested using in vivo EPR: no differences were observed between micro-inserts and uncoated LiPc crystals. Pellets implanted in vivo in muscles conserved their responsiveness over a long period of time (∼two months), which is much longer than the few days of stability observed using LiPc crystals without protection by the implant. Finally, evaluation of the biocompatibility of the implants revealed no inflammatory reaction around the implantation area

  10. Efficacy of Intense-pulsed Light Therapy with Topical Benzoyl Peroxide 5% versus Benzoyl Peroxide 5% Alone in Mild-to-moderate Acne Vulgaris: A Randomized Controlled Trial.

    Science.gov (United States)

    Mokhtari, Fatemeh; Gholami, Maryam; Siadat, Amir Hossein; Jafari-Koshki, Tohid; Faghihi, Gita; Nilforoushzadeh, Mohammad Ali; Hosseini, Sayed Mohsen; Abtahi-Naeini, Bahareh

    2017-01-01

    Acne vulgaris is a disease of pilosebaceous unit with multifactorial pathogenesis and threats patients' social functioning. There is a growing research to find faster, more effective, and easy to use treatments. The aim of this study is to evaluate the efficacy of benzoyl peroxide 5% (BP) with and without concomitant intense-pulsed light (IPL) therapy in mild-to-moderate acne vulgaris. In this controlled trial, 58 eligible patients with mild-to-moderate acne and Fitzpatrick skin phototype III and IV were randomly allocated to two groups. All patients were asked to use a thin layer of BP every night. The IPL therapy was administered at the end of first, 2 nd , and 3 rd months. Acne Global Severity Scale (AGSS), Acne Severity Index (ASI), and total lesion counting (TLC) along with patient satisfaction were recorded. Patients were also examined 1 month after the final therapeutic visit. The IPL group showed greater reduction in AGSS ( P < 0.001) and TLC ( P = 0.005) than the control group. However, the difference in ASI was not significant ( P = 0.12). Patients in IPL groups were more satisfied than control group ( P < 0.001). Adding IPL to BP can result better response to BP alone. In acne treatment, combination therapy such as IPL and other topical agents should be kept in mind.

  11. Longevity of Masimo and Nellcor pulse oximeter sensors in the care of infants.

    Science.gov (United States)

    Erler, Thomas; Avenarius, Stefan; Wischniewski, Esther; Schmidt, Katerina; Kläber, Hans-Georg

    2003-03-01

    Pulse oximetry is a standard of care for monitoring oxygenation in neonates. Associated with the use of pulse oximetry is the cost of patient sensors, especially if the sensor is designed for single-patient use. Pulse oximetry monitoring of sick newborns is routine and often lengthy and, if the pulse oximeter sensor is short-lived, can result in a significant portion in the cost of intensive care. We evaluated, in the NICUs of two hospitals and one step-down nursery, the useful life of disposable neonatal pulse oximeter sensors from two manufacturers: Masimo and Nellcor. The only requisites were ethics committee approval and need for monitoring. The timed of PO sensor placement and replacement were noted along with the reason for changing the sensor. The standard care practices for PO and sensor use in the respective institutions were followed. A total of 835.5 patient days of monitoring were accumulated with 65 infants in the Masimo group and 56 using Nellcor. The Masimo Neo sensors had over twice (2.33) the useful life of the Nellcor N-25 (9.05+/-4.4 versus 3.9+/-2.3 days (range of 7.2-11.8 and 2.5-5.8 days, respectively, psignal (six Masimo and four Nellcor). We found a more than two-fold increase in the life of Masimo versus Nellcor sensors. This difference was consistent between various caregivers in multiple settings and corroborates the experience of another, more limited study. A cost savings should result from the use of Masimo versus Nellcor disposable pulse oximeter sensors in neonatal routine care

  12. Pulse Generator

    Science.gov (United States)

    Greer, Lawrence (Inventor)

    2017-01-01

    An apparatus and a computer-implemented method for generating pulses synchronized to a rising edge of a tachometer signal from rotating machinery are disclosed. For example, in one embodiment, a pulse state machine may be configured to generate a plurality of pulses, and a period state machine may be configured to determine a period for each of the plurality of pulses.

  13. Performance evaluation of photoacoustic oximetry imaging systems using a dynamic blood flow phantom with tunable oxygen saturation

    Science.gov (United States)

    Vogt, William C.; Zhou, Xuewen; Andriani, Rudy; Wear, Keith A.; Garra, Brian S.; Pfefer, Joshua

    2018-02-01

    Photoacoustic Imaging (PAI) is an emerging technology with strong potential for broad clinical applications from breast cancer detection to cerebral monitoring due to its ability to compute maps of blood oxygen saturation (SO2) distribution in deep tissues using multispectral imaging. However, no well-validated consensus test methods currently exist for evaluating oximetry-specific performance characteristics of PAI devices. We have developed a phantombased flow system capable of rapid SO2 adjustment to serve as a test bed for elucidation of factors impacting SO2 measurement and quantitative characterization of device performance. The flow system is comprised of a peristaltic pump, membrane oxygenator, oxygen and nitrogen gas, and in-line oxygen, pH, and temperature sensors that enable real-time estimation of SO2 reference values. Bovine blood was delivered through breast-relevant tissue phantoms containing vessel-mimicking fluid channels, which were imaged using a custom multispectral PAI system. Blood was periodically drawn for SO2 measurement in a clinical-grade CO-oximeter. We used this flow phantom system to evaluate the impact of device parameters (e.g.,wavelength-dependent fluence corrections) and tissue parameters (e.g. fluid channel depth, blood SO2, spectral coloring artifacts) on oximetry measurement accuracy. Results elucidated key challenges in PAI oximetry and device design trade-offs, which subsequently allowed for optimization of system performance. This approach provides a robust benchtop test platform that can support PAI oximetry device optimization, performance validation, and clinical translation, and may inform future development of consensus test methods for performance assessment of photoacoustic oximetry imaging systems.

  14. Classification methods to detect sleep apnea in adults based on respiratory and oximetry signals: a systematic review.

    Science.gov (United States)

    Uddin, M B; Chow, C M; Su, S W

    2018-03-26

    Sleep apnea (SA), a common sleep disorder, can significantly decrease the quality of life, and is closely associated with major health risks such as cardiovascular disease, sudden death, depression, and hypertension. The normal diagnostic process of SA using polysomnography is costly and time consuming. In addition, the accuracy of different classification methods to detect SA varies with the use of different physiological signals. If an effective, reliable, and accurate classification method is developed, then the diagnosis of SA and its associated treatment will be time-efficient and economical. This study aims to systematically review the literature and present an overview of classification methods to detect SA using respiratory and oximetry signals and address the automated detection approach. Sixty-two included studies revealed the application of single and multiple signals (respiratory and oximetry) for the diagnosis of SA. Both airflow and oxygen saturation signals alone were effective in detecting SA in the case of binary decision-making, whereas multiple signals were good for multi-class detection. In addition, some machine learning methods were superior to the other classification methods for SA detection using respiratory and oximetry signals. To deal with the respiratory and oximetry signals, a good choice of classification method as well as the consideration of associated factors would result in high accuracy in the detection of SA. An accurate classification method should provide a high detection rate with an automated (independent of human action) analysis of respiratory and oximetry signals. Future high-quality automated studies using large samples of data from multiple patient groups or record batches are recommended.

  15. A multicenter randomized controlled fellow eye trial of pulse-dosed difluprednate 0.05% versus prednisolone acetate 1% in cataract surgery.

    Science.gov (United States)

    Donnenfeld, Eric D; Holland, Edward J; Solomon, Kerry D; Fiore, Jay; Gobbo, Anthony; Prince, Jessica; Sandoval, Helga P; Shull, Emily R; Perry, Henry D

    2011-10-01

    To compare the effects of 2 corticosteroids on corneal thickness and visual acuity after cataract surgery. Multicenter, randomized, contralateral-eye, double-masked trial. Fifty-two patients (104 eyes) underwent bilateral phacoemulsification. The first eye randomly received difluprednate 0.05% or prednisolone acetate 1%; the fellow eye received the alternative. Before surgery, 7 doses were administered over 2 hours; 3 additional doses were given after surgery, before discharge. For the remainder of the day, corticosteroids were administered every 2 hours, then 4 times daily during week 1 and twice daily during week 2. Corneal pachymetry, visual acuity, and corneal edema were evaluated before surgery and at days 1, 15, and 30 after surgery. Endothelial cell counts were evaluated before surgery and at 30 days after surgery. Retinal thickness was evaluated before surgery and at 15 and 30 days after surgery. Corneal thickness at day 1 was 33 μm less in difluprednate-treated eyes (P = .026). More eyes were without corneal edema in the difluprednate group than in the prednisolone group at day 1 (62% vs 38%, respectively; P = .019). Uncorrected and best-corrected visual acuity at day 1 were significantly better with difluprednate than prednisolone by 0.093 logMAR lines (P = .041) and 0.134 logMAR lines (P eyes at day 30 (P eyes (P = .011). In this high-dose pulsed-therapy regimen, difluprednate reduced inflammation more effectively than prednisolone acetate, resulting in more rapid return of vision. Difluprednate was superior at protecting the cornea and reducing macular thickening after cataract surgery. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Nano-emulsions of fluorinated trityl radicals as sensors for EPR oximetry

    Science.gov (United States)

    Charlier, N.; Driesschaert, B.; Wauthoz, N.; Beghein, N.; Préat, V.; Amighi, K.; Marchand-Brynaert, J.; Gallez, B.

    2009-04-01

    This article reports the development and evaluation of two nano-emulsions (F45T-03/HFB and F15T-03/PFOB) containing fluorinated trityl radicals dissolved in perfluorocarbons. Preparation with a high-pressure homogenizer conferred sub-micronic size to both nano-emulsions. In vitro and in vivo EPR spectroscopy showed that the nano-emulsions had much greater oxygen sensitivity than the hydrophilic trityl, CT-03. In vivo experiments in rodents confirmed the ability of the nano-emulsions to follow the changes in oxygen concentration after induced ischemia. Histological evaluation of the tissue injected with the nano-emulsions revealed some acute toxicity for the F45T-03/HFB nano-emulsion but none for the F15T-03/PFOB nano-emulsion. These new formulations should be considered for further EPR oximetry experiments in pathophysiological situations where subtle changes in tissue oxygenation are expected.

  17. Carbogen Enhanced Femto Oximetry Breast Cancer Diagnosis Method with High Specificity

    Science.gov (United States)

    Maglich, Bogdan C.; Shultis, J. K.; Solomon, C. J.

    2011-03-01

    As large malignant tumors are oxygen deficient (hypoxic), cancer could be diagnosed in vivo and online, by non-invasive measurement of oxygen difference between tumor and adjacent tissue. Computer simulations of noninvasive diagnosis by Femto Oximetry (FO) of hypoxia in 1 cm tumor in 10 cm breast shows that background γ 's from non hypoxic tissue will mask hypoxia. To amplify the hypoxic-to-normal O difference, air breathing will be replaced with carbogen (O2 95 % , CO2 5 %) using vasco-constrictive property whereby carbogen breathing increases O in normal tissue, while not in malignant hypoxic tumors. 90% hypoxia will be detectable by FO with specificity 99%. Our method will be tested on R3230 tumors in Fischer rats at UCI.

  18. Pre-clinical evaluation of OxyChip for long-term EPR oximetry.

    Science.gov (United States)

    Hou, Huagang; Khan, Nadeem; Gohain, Sangeeta; Kuppusamy, M Lakshmi; Kuppusamy, Periannan

    2018-03-16

    Tissue oxygenation is a critical parameter in various pathophysiological situations including cardiovascular disease and cancer. Hypoxia can significantly influence the prognosis of solid malignancies and the efficacy of their treatment by radiation or chemotherapy. Electron paramagnetic resonance (EPR) oximetry is a reliable method for repeatedly assessing and monitoring oxygen levels in tissues. Lithium octa-n-butoxynaphthalocyanine (LiNc-BuO) has been developed as a probe for biological EPR oximetry, especially for clinical use. However, clinical applicability of LiNc-BuO crystals is hampered by potential limitations associated with biocompatibility, biodegradation, or migration of individual bare crystals in tissue. To overcome these limitations, we have embedded LiNc-BuO crystals in polydimethylsiloxane (PDMS), an oxygen-permeable biocompatible polymer and developed an implantable/retrievable form of chip, called OxyChip. The chip was optimized for maximum spin density (40% w/w of LiNc-BuO in PDMS) and fabricated in a form suitable for implantation using an 18-G syringe needle. In vitro evaluation of the OxyChip showed that it is robust and highly oxygen sensitive. The dependence of its EPR linewidth to oxygen was linear and highly reproducible. In vivo efficacy of the OxyChip was evaluated by implanting it in rat femoris muscle and following its response to tissue oxygenation for up to 12 months. The results revealed preservation of the integrity (size and shape) and calibration (oxygen sensitivity) of the OxyChip throughout the implantation period. Further, no inflammatory or adverse reaction around the implantation area was observed thereby establishing its biocompatibility and safety. Overall, the results demonstrated that the newly-fabricated high-sensitive OxyChip is capable of providing long-term measurements of oxygen concentration in a reliable and repeated manner under clinical conditions.

  19. Hyperspectral imaging with near-infrared-enabled mobile phones for tissue oximetry

    Science.gov (United States)

    Lin, Jonathan L.; Ghassemi, Pejhman; Chen, Yu; Pfefer, Joshua

    2018-02-01

    Hyperspectral reflectance imaging (HRI) is an emerging clinical tool for characterizing spatial and temporal variations in blood perfusion and oxygenation for applications such as burn assessment, wound healing, retinal exams and intraoperative tissue viability assessment. Since clinical HRI-based oximeters often use near-infrared (NIR) light, NIR-enabled mobile phones may provide a useful platform for future point-of-care devices. Furthermore, quantitative NIR imaging on mobile phones may dramatically increase the availability and accessibility of medical diagnostics for low-resource settings. We have evaluated the potential for phone-based NIR oximetry imaging and elucidated factors affecting performance using devices from two different manufacturers, as well as a scientific CCD. A broadband light source and liquid crystal tunable filter were used for imaging at 10 nm bands from 650 to 1000 nm. Spectral sensitivity measurements indicated that mobile phones with standard NIR blocking filters had minimal response beyond 700 nm, whereas one modified phone showed sensitivity to 800 nm and another to 1000 nm. Red pixel channels showed the greatest sensitivity up to 800 nm, whereas all channels provided essentially equivalent sensitivity at longer wavelengths. Referencing of blood oxygenation levels was performed with a CO-oximeter. HRI measurements were performed using cuvettes filled with hemoglobin solutions of different oxygen saturation levels. Good agreement between absorbance spectra measured with mobile phone and a CCD cameras were seen for wavelengths below 900 nm. Saturation estimates showed root-mean-squared-errors of 5.2% and 4.5% for the CCD and phone, respectively. Overall, this work provides strong evidence of the potential for mobile phones to provide quantitative spectral imaging in the NIR for applications such as oximetry, and generates practical insights into factors that impact performance as well as test methods for performance assessment.

  20. The evaluation of cerebral oxygenation by oximetry in patients with ischaemic stroke.

    Directory of Open Access Journals (Sweden)

    Demet G

    2000-04-01

    Full Text Available AIMS: To evaluate the clinical significance of estimation of the regional cerebral oxygen saturation (rSO2 in the patients with ischaemic stroke by the cerebral oximetry during acute, sub-acute and chronic phases. SUBJECTS AND METHODS: In this prospective study, 24 patients with ischaemic stroke in the middle cerebral artery territory were included. A detailed clinical examination and appropriate laboratory investigations were carried out. The rSO2 was determined by oximetery (INVOS 3100-SD bilaterally on the first, third, seventh, and fifteenth days. The blood pressure, the peripheral capillary oxygen saturation and the arterial blood gas values were noted too. the changes were evaluated along with Glasgow coma scale (GCS using unpaired student t-test and one way ANOVA test. RESULTS: There were significant differences between the rSO2 values in acute, subacute and chronic phases on the side of the lesion (p value < 0.05. The values of oxygen saturation gradually increased throughout the chronic phase. These values showed a positive correlation with GCS, but the results were not significant statistically. The rSO2 values were also significantly higher on the non-lesional side than those on the lesion side in the acute phase (p= 0.0034, the discrepancy disappeared during the sub-acute and chronic phases. CONCLUSION: Cerebral oximetry can be used as a measure to evaluate the cerebral oxygenation during the various phases of ischaemic stroke. It has a potential to serve as a useful marker for detection of cerebral oxygenation imbalances, to judge the effectiveness of the management and for the follow-up of patients with ischaemic stroke.

  1. Trials

    Directory of Open Access Journals (Sweden)

    Michele Fornaro

    2010-01-01

    Full Text Available Mental Retardation (MR is a developmental disability characterized by impairments in adaptive daily life skills and difficulties in social and interpersonal functioning. Since multiple causes may contribute to MR, associated clinical pictures may vary accordingly. Nevertheless, when psychiatric disorders as Treatment Resistant Depression (TRD and/or alcohol abuse co-exist, their proper detection and management is often troublesome, essentially due to a limited vocabulary MR people could use to describe their symptoms, feelings and concerns, and the lack of reliable screening tools. Furthermore, MR people are among the most medicated subjects, with (over prescription of antidepressants and/or typical antipsychotics being the rule rather than exception. Thus, treatment resistance or even worsening of depression, constitute frequent occurrences. This report describes the case of a person with MR who failed to respond to repetitive trials of antidepressant monotherapies, finally recovering using aripiprazole to fluvoxamine augmentation upon consideration of a putative bipolar diathesis for “agitated” TRD. Although further controlled investigations are needed to assess a putative bipolar diathesis in some cases of MR associated to TRD, prudence is advised in the long-term prescription of antidepressant monotherapies in such conditions.

  2. Quantitative impact of small angle forward scatter on whole blood oximetry using a Beer-Lambert absorbance model.

    Science.gov (United States)

    LeBlanc, Serge Emile; Atanya, Monica; Burns, Kevin; Munger, Rejean

    2011-04-21

    It is well known that red blood cell scattering has an impact on whole blood oximetry as well as in vivo retinal oxygen saturation measurements. The goal of this study was to quantify the impact of small angle forward scatter on whole blood oximetry for scattering angles found in retinal oximetry light paths. Transmittance spectra of whole blood were measured in two different experimental setups: one that included small angle scatter in the transmitted signal and one that measured the transmitted signal only, at absorbance path lengths of 25, 50, 100, 250 and 500 µm. Oxygen saturation was determined by multiple linear regression in the 520-600 nm wavelength range and compared between path lengths and experimental setups. Mean calculated oxygen saturation differences between setups were greater than 10% at every absorbance path length. The deviations to the Beer-Lambert absorbance model had different spectral dependences between experimental setups, with the highest deviations found in the 520-540 nm range when scatter was added to the transmitted signal. These results are consistent with other models of forward scatter that predict different spectral dependences of the red blood cell scattering cross-section and haemoglobin extinction coefficients in this wavelength range.

  3. EPR Oximetry for Investigation of Hyperbaric O2 Pre-treatment for Tumor Radiosensitization.

    Science.gov (United States)

    Williams, Benjamin B; Hou, Huagang; Coombs, Rachel; Swartz, Harold M

    A number of studies have reported benefits associated with the application of hyperbaric oxygen treatment (HBO) delivered immediately prior to radiation therapy. While these studies provide evidence that pre-treatment with HBO may be beneficial, no measurements of intratumoral pO2 were carried out and they do not directly link the apparent benefits to decreased hypoxic fractions at the time of radiation therapy. While there is empirical evidence and some theoretical basis for HBO to enhance radiation therapy, without direct and repeated measurements of its effects on pO2, it is unlikely that the use of HBO can be understood and optimized for clinical applications. In vivo EPR oximetry is a technique uniquely capable of providing repeated direct measurements of pO2 through a non-invasive procedure in both animal models and human patients. In order to evaluate the ability of pretreatment with HBO to elevate tumor pO2, a novel small animal hyperbaric chamber system was constructed that allows simultaneous in vivo EPR oximetry. This chamber can be placed within the EPR magnet and is equipped with a variety of ports for multiplace gas delivery, thermoregulation, delivery of anesthesia, physiologic monitoring, and EPR detection. Initial measurements were performed in a subcutaneous RIF-1 tumor model in C3H/HeJ mice. The mean baseline pO2 value was 6.0 ± 1.2 mmHg (N = 7) and responses to two atmospheres absolute pressure HBO varied considerably across subjects, within tumors, and over time. When an increase in pO2 was observed, the effect was transient in all but one case, with durations lasting from 5 min to over 20 min, and returned to baseline levels during HBO administration. These results indicate that without direct measurements of pO2 in the tissue of interest, it is likely to be difficult to know the effects of HBO on actual tissue pO2.

  4. In vivo evidence of methamphetamine induced attenuation of brain tissue oxygenation as measured by EPR oximetry

    International Nuclear Information System (INIS)

    Weaver, John; Yang, Yirong; Purvis, Rebecca; Weatherwax, Theodore; Rosen, Gerald M.; Liu, Ke Jian

    2014-01-01

    Abuse of methamphetamine (METH) is a major and significant societal problem in the US, as a number of studies have suggested that METH is associated with increased cerebrovascular events, hemorrhage or vasospasm. Although cellular and molecular mechanisms involved in METH-induced toxicity are not completely understood, changes in brain O 2 may play an important role and contribute to METH-induced neurotoxicity including dopaminergic receptor degradation. Given that O 2 is the terminal electron acceptor for many enzymes that are important in brain function, the impact of METH on brain tissue pO 2 in vivo remains largely uncharacterized. This study investigated striatal tissue pO 2 changes in male C57BL/6 mice (16–20 g) following METH administration using EPR oximetry, a highly sensitive modality to measure pO 2 in vivo, in situ and in real time. We demonstrate that 20 min after a single injection of METH (8 mg/kg i.v.), the striatal pO 2 was reduced to 81% of the pretreatment level and exposure to METH for 3 consecutive days further attenuated striatal pO 2 to 64%. More importantly, pO 2 did not recover fully to control levels even 24 h after administration of a single dose of METH and continual exposure to METH exacerbates the condition. We also show a reduction in cerebral blood flow associated with a decreased brain pO 2 indicating an ischemic condition. Our findings suggests that administration of METH can attenuate brain tissue pO 2 , which may lead to hypoxic insult, thus a risk factor for METH-induced brain injury and the development of stroke in young adults. - Highlights: • Explored striatal tissue pO 2 in vivo after METH administration by EPR oximetry. • pO 2 was reduced by 81% after a single dose and 64% after 3 consecutive daily doses. • pO 2 did not recover fully to control levels even 24 h after a single dose. • Decrease in brain tissue pO 2 may be associated with a decrease in CBF. • Administration of methamphetamine may lead to hypoxic

  5. In vivo evidence of methamphetamine induced attenuation of brain tissue oxygenation as measured by EPR oximetry

    Energy Technology Data Exchange (ETDEWEB)

    Weaver, John, E-mail: jmweaver@salud.unm.edu [Center of Biomedical Research Excellence, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Yang, Yirong [Center of Biomedical Research Excellence, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Purvis, Rebecca [Center of Biomedical Research Excellence, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Weatherwax, Theodore [Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Rosen, Gerald M. [Center for Biomedical Engineering and Technology, University of Maryland, Baltimore, MD 21201 (United States); Center for EPR Imaging In Vivo Physiology, University of Maryland, Baltimore, MD 21201 (United States); Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD 21201 (United States); Liu, Ke Jian [Center of Biomedical Research Excellence, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States); Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131 (United States)

    2014-03-01

    Abuse of methamphetamine (METH) is a major and significant societal problem in the US, as a number of studies have suggested that METH is associated with increased cerebrovascular events, hemorrhage or vasospasm. Although cellular and molecular mechanisms involved in METH-induced toxicity are not completely understood, changes in brain O{sub 2} may play an important role and contribute to METH-induced neurotoxicity including dopaminergic receptor degradation. Given that O{sub 2} is the terminal electron acceptor for many enzymes that are important in brain function, the impact of METH on brain tissue pO{sub 2}in vivo remains largely uncharacterized. This study investigated striatal tissue pO{sub 2} changes in male C57BL/6 mice (16–20 g) following METH administration using EPR oximetry, a highly sensitive modality to measure pO{sub 2}in vivo, in situ and in real time. We demonstrate that 20 min after a single injection of METH (8 mg/kg i.v.), the striatal pO{sub 2} was reduced to 81% of the pretreatment level and exposure to METH for 3 consecutive days further attenuated striatal pO{sub 2} to 64%. More importantly, pO{sub 2} did not recover fully to control levels even 24 h after administration of a single dose of METH and continual exposure to METH exacerbates the condition. We also show a reduction in cerebral blood flow associated with a decreased brain pO{sub 2} indicating an ischemic condition. Our findings suggests that administration of METH can attenuate brain tissue pO{sub 2}, which may lead to hypoxic insult, thus a risk factor for METH-induced brain injury and the development of stroke in young adults. - Highlights: • Explored striatal tissue pO{sub 2}in vivo after METH administration by EPR oximetry. • pO{sub 2} was reduced by 81% after a single dose and 64% after 3 consecutive daily doses. • pO{sub 2} did not recover fully to control levels even 24 h after a single dose. • Decrease in brain tissue pO{sub 2} may be associated with a decrease in

  6. Effect of bupivacaine and adjuvant drugs for regional anesthesia on nerve tissue oximetry and nerve blood flow

    Directory of Open Access Journals (Sweden)

    Wiesmann T

    2018-01-01

    Full Text Available Thomas Wiesmann,1 Stefan Müller,1,2 Hans-Helge Müller,3 Hinnerk Wulf,1 Thorsten Steinfeldt1,4 1Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, University Hospital Marburg, Philipps University, Marburg, 2Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen, Justus-Liebig-University, Giessen, 3Institute of Medical Biometry and Epidemiology, Philipps University, Marburg, 4Department of Anesthesiology and Intensive Care Medicine, Diakoniekrankenhaus Schwäbisch Hall, Schwäbisch Hall, Germany Background: Nerve blood flow has a critical role in acute and chronic pathologies in peripheral nerves. Influences of local anesthetics and adjuvants on tissue perfusion and oxygenation are deemed as relevant factors for nerve damage after peripheral regional anesthesia. The link between low tissue perfusion due to local anesthetics and resulting tissue oxygenation is unclear.Methods: Combined tissue spectrophotometry and laser-Doppler flowmetry were used to assess nerve blood flow in 40 surgically exposed median nerves in pigs, as well as nerve tissue oximetry for 60 min. After baseline measurements, test solutions saline (S, bupivacaine (Bupi, bupivacaine with epinephrine (BupiEpi, and bupivacaine with clonidine (BupiCloni were applied topically.Results: Bupivacaine resulted in significant decrease in nerve blood flow, as well as tissue oximetry values, compared with saline control. Addition of epinephrine resulted in a rapid, but nonsignificant, reduction of nerve blood flow and extensive lowering of tissue oximetry levels. The use of clonidine resulted in a reduction of nerve blood flow, comparable to bupivacaine alone (relative blood flow at T60 min compared with baseline, S: 0.86 (0.67–1.18, median (25th–75th percentile; Bupi: 0.33 (0.25–0.60; BupiCloni: 0.43 (0.38–0.63; and BupiEpi: 0.41(0.30–0.54. The use of adjuvants did not result in any relevant impairment of tissue oximetry

  7. The evaluation of new and isotopically labeled isoindoline nitroxides and an azaphenalene nitroxide for EPR oximetry

    Science.gov (United States)

    Khan, Nadeem; Blinco, James P.; Bottle, Steven E.; Hosokawa, Kazuyuki; Swartz, Harold M.; Micallef, Aaron S.

    2011-01-01

    Isoindoline nitroxides are potentially useful probes for viable biological systems, exhibiting low cytotoxicity, moderate rates of biological reduction and favorable Electron Paramagnetic Resonance (EPR) characteristics. We have evaluated the anionic (5-carboxy-1,1,3,3-tetramethylisoindolin-2-yloxyl; CTMIO), cationic (5-(N,N,N-trimethylammonio)-1,1,3,3-tetramethylisoindolin-2-yloxyl iodide, QATMIO) and neutral (1,1,3,3-tetramethylisoindolin-2-yloxyl; TMIO) nitroxides and their isotopically labeled analogues (2H12- and/or 2H12-15N-labeled) as potential EPR oximetry probes. An active ester analogue of CTMIO, designed to localize intracellularly, and the azaphenalene nitroxide 1,1,3,3-tetramethyl-2,3-dihydro-2-azaphenalen-2-yloxyl (TMAO) were also studied. While the EPR spectra of the unlabeled nitroxides exhibit high sensitivity to O2 concentration, deuteration resulted in a loss of superhyperfine features and a subsequent reduction in O2 sensitivity. Labeling the nitroxides with 15N increased the signal intensity and this may be useful in decreasing the detection limits for in vivo measurements. The active ester nitroxide showed approximately 6% intracellular localization and low cytotoxicity. The EPR spectra of TMAO nitroxide indicated an increased rigidity in the nitroxide ring, due to dibenzo-annulation. PMID:21665499

  8. Effect of regional cerebral oximetry to estimate neurologic prognostic outcomes in patients administered targeted temperature management.

    Science.gov (United States)

    Sarıtaş, Aykut; Çinleti, Burcu Acar; Zincircioğlu, Çiler; Uzun, Uğur; Köse, Işıl; Şenoğlu, Nimet

    2018-04-09

    The aim of our study is to research the role and efficacy of cerebral oximetry in predicting neurologic prognosis when applied during TTM to patients experiencing coma after CA. This study was performed on surviving adult comatose patients after CA treated with TTM. The average scores of rSO 2 was measured at 6h intervals for the first 2days and once a day for the following 3days with a NIRS device during TTM. The CPC scale was used to define the neurologic outcomes of patients. We compared the correlations of rSO 2 values between good (CPC 1-2) and poor (CPC 3-5) neurologic outcomes in CA patients. There was no statistically significant difference identified between the prognosis groups in terms of rSO 2 , CPR durations, hemoglobin values and admission body temperature (p>0.05). When the variation in rSO 2 values over time is investigated, though there was no significant difference between the good and poor prognosis groups, it appeared to fall in the first 6h in both prognosis groups. The median NT-proBNP and lactate values were observed to be higher in the poor prognosis group. There is no significant correlation between rSO 2 values and neurologic outcomes. Multimodal monitoring methods may be useful and further studies with a larger patient population are necessary in this area. Copyright © 2018. Published by Elsevier Inc.

  9. Laser Doppler Flowmetry and Transcutaneous Oximetry in Chronic Skin Ulcers: A Comparative Evaluation.

    Science.gov (United States)

    Raposio, Edoardo; Bertozzi, Nicolò; Moretti, Rebecca; Grignaffini, Eugenio; Grieco, Michele P

    2017-07-01

    Laser Doppler Flowmetry (LDF) and transcutaneous oximetry (TcpO2) are established methods for investigating cutaneous perfusion. To date, no study previously performed has compared data obtained from these 2 methodologies in cases of chronic cutaneous ulcers. Laser Doppler Flowmetry and TcpO2 were performed in 25 consecutive outpatients with chronic lower limb ulcers (group A, experimental; 9 women and 16 men; mean age 67 years [range, 52-81 years]) and 25 age- and sex-matched healthy control subjects (group B, control) enrolled for the study. Ulcer aetiologies included 12 peripheral arterial occlusive disease, 9 chronic venous insufficiencies, and 4 pressure ulcers. Data were analyzed with Shapiro-Wilk and Wilcoxon-Mann-Whitney tests. A statistically significant difference (P < .05) was found between LDF values of the 2 groups. No statistically significant differences were found between the 2 groups regarding the TcpO2 measurements. The data confirmed the soundness of LDF while investigating local perfusion in patients with chronic cutaneous ulcers. The same diagnostic accuracy was not obtained by means of TcpO2.

  10. In-vivo studies of reflectance pulse oximeter sensor

    Science.gov (United States)

    Ling, Jian; Takatani, Setsuo; Noon, George P.; Nose, Yukihiko

    1993-08-01

    Reflectance oximetry can offer an advantage of being applicable to any portion of the body. However, the major problem of reflectance oximetry is low pulsatile signal level which prevents prolonged clinical application during extreme situations, such as hypothermia and vasoconstriction. In order to improve the pulsatile signal level of reflectance pulse oximeter and thus its accuracy, three different sensors, with the separation distances (SPD) between light emitting diode (LED) and photodiode being 3, 5, and 7 mm respectively, were studied on nine healthy volunteers. With the increase of the SPD, it was found that both the red (660 nm) and near-infrared (830 nm) pulsatile to average signal ratio (AC/DC) increased, and the standard deviations of (AC/DC)red/(AC/DC)infrared ratio decreased, in spite of the decrease of the absolute signal level. Further clinical studies of 3 mm and 7 mm SPD sensors on seven patients also showed that the (AC/DC)red/(AC/DC)infrared ratio measured by the 7 mm sensor were less disturbed than the 3 mm sensor during the surgery. A theoretical study based on the three-dimensional photon diffusion theory supports the experimental and clinical results. As a conclusion, the 7 mm sensor has the highest signal-to- noise ratio among three different sensors. A new 7 mm SPD reflectance sensor, with the increased number of LEDs around the photodiode, was designed to increase the AC/DC ratio, as well as to increase the absolute signal level.

  11. Design of a randomized controlled trial on the effect on return to work with coaching plus light therapy and pulsed electromagnetic field therapy for workers with work-related chronic stress

    Directory of Open Access Journals (Sweden)

    Antonius M. C. Schoutens

    2016-07-01

    Full Text Available Abstract Background Work-related chronic stress is a common problem among workers. The core complaint is that the employee feels exhausted, which has an effect on the well-being and functioning of the employee, and an impact on the employer and society. The employee’s absence is costly due to lost productivity and medical expenses. The usual form of care for work-related chronic stress is coaching, using a cognitive-behavioural approach whose primary aim is to reduce symptoms and improve functioning. Light therapy and pulsed electromagnetic field therapy are used for the treatment of several mental and physical disorders. The objective of this study is to determine whether coaching combined with light therapy plus pulsed electromagnetic field therapy is an effective treatment for reducing absenteeism, fatigue and stress, and improving quality of life compared to coaching alone. Methods/design The randomized placebo-controlled trial consists of three arms. The population consists of 90 participants with work-related chronic stress complaints. The research groups are: (i intervention group; (ii placebo group; and (iii control group. Participants in the intervention group will be treated with light therapy/pulsed electromagnetic field therapy for 12 weeks, twice a week for 40 min, and coaching (once a fortnight for 50 min. The placebo group receives the same treatment but with the light and pulsed electromagnetic field switched to placebo settings. The control group receives only coaching for 12 weeks, a course of six sessions, once a fortnight for 50 min. The primary outcome is the level of return to work. Secondary outcomes are fatigue, stress and quality of life. Outcomes will be measured at baseline, 6 weeks, 12 and 24 weeks after start of treatment. Discussion This study will provide information about the effectiveness of coaching and light therapy plus pulsed electromagnetic field therapy on return to work, and secondly on fatigue

  12. Safety of mechanical chest compression devices AutoPulse and LUCAS in cardiac arrest: a randomized clinical trial for non-inferiority

    NARCIS (Netherlands)

    Koster, Rudolph W.; Beenen, Ludo F.; van der Boom, Esther B.; Spijkerboer, Anje M.; Tepaske, Robert; van der Wal, Allart C.; Beesems, Stefanie G.; Tijssen, Jan G.

    2017-01-01

    Aims Mechanical chest compression (CC) during cardiopulmonary resuscitation (CPR) with AutoPulse or LUCAS devices has not improved survival from cardiac arrest. Cohort studies suggest risk of excess damage. We studied safety of mechanical CC and determined possible excess damage compared with manual

  13. Comparison of photobiomodulation therapy and suprascapular nerve-pulsed radiofrequency in chronic shoulder pain: a randomized controlled, single-blind, clinical trial.

    Science.gov (United States)

    Ökmen, Burcu Metin; Ökmen, Korgün

    2017-11-01

    Shoulder pain can be difficult to treat due to its complex anatomic structure, and different treatment methods can be used. We aimed to examine the efficacy of photobiomodulation therapy (PBMT) and suprascapular nerve (SSN)-pulsed radiofrequency (RF) therapy. In this prospective, randomized, controlled, single-blind study, 59 patients with chronic shoulder pain due to impingement syndrome received PBMT (group H) or SSN-pulsed RF therapy (group P) in addition to exercise therapy for 14 sessions over 2 weeks. Records were taken using visual analog scale (VAS), Shoulder Pain and Disability Index (SPADI), and Nottingham Health Profile (NHP) scoring systems for pretreatment (PRT), posttreatment (PST), and PST follow-up at months 1, 3, and 6. There was no statistically significant difference in initial VAS score, SPADI, and NHP values between group H and group P (p > 0.05). Compared to the values of PRT, PST, and PST at months 1, 3, and 6, VAS, SPADI, and NHP values were statistically significantly lower in both groups (p measurement times in VAS, SPADI, and NHP between the two groups. We established that PBMT and SSN-pulsed RF therapy are effective methods, in addition to exercise therapy, in patients with chronic shoulder pain. PBMT seems to be advantageous compared to SSN-pulsed RF therapy, as it is a noninvasive method.

  14. A Single-Chip CMOS Pulse Oximeter with On-Chip Lock-In Detection

    Directory of Open Access Journals (Sweden)

    Diwei He

    2015-07-01

    Full Text Available Pulse oximetry is a noninvasive and continuous method for monitoring the blood oxygen saturation level. This paper presents the design and testing of a single-chip pulse oximeter fabricated in a 0.35 µm CMOS process. The chip includes photodiode, transimpedance amplifier, analogue band-pass filters, analogue-to-digital converters, digital signal processor and LED timing control. The experimentally measured AC and DC characteristics of individual circuits including the DC output voltage of the transimpedance amplifier, transimpedance gain of the transimpedance amplifier, and the central frequency and bandwidth of the analogue band-pass filters, show a good match (within 1% with the circuit simulations. With modulated light source and integrated lock-in detection the sensor effectively suppresses the interference from ambient light and 1/f noise. In a breath hold and release experiment the single chip sensor demonstrates consistent and comparable performance to commercial pulse oximetry devices with a mean of 1.2% difference. The single-chip sensor enables a compact and robust design solution that offers a route towards wearable devices for health monitoring.

  15. A Single-Chip CMOS Pulse Oximeter with On-Chip Lock-In Detection.

    Science.gov (United States)

    He, Diwei; Morgan, Stephen P; Trachanis, Dimitrios; van Hese, Jan; Drogoudis, Dimitris; Fummi, Franco; Stefanni, Francesco; Guarnieri, Valerio; Hayes-Gill, Barrie R

    2015-07-14

    Pulse oximetry is a noninvasive and continuous method for monitoring the blood oxygen saturation level. This paper presents the design and testing of a single-chip pulse oximeter fabricated in a 0.35 µm CMOS process. The chip includes photodiode, transimpedance amplifier, analogue band-pass filters, analogue-to-digital converters, digital signal processor and LED timing control. The experimentally measured AC and DC characteristics of individual circuits including the DC output voltage of the transimpedance amplifier, transimpedance gain of the transimpedance amplifier, and the central frequency and bandwidth of the analogue band-pass filters, show a good match (within 1%) with the circuit simulations. With modulated light source and integrated lock-in detection the sensor effectively suppresses the interference from ambient light and 1/f noise. In a breath hold and release experiment the single chip sensor demonstrates consistent and comparable performance to commercial pulse oximetry devices with a mean of 1.2% difference. The single-chip sensor enables a compact and robust design solution that offers a route towards wearable devices for health monitoring.

  16. Evaluation of peripheral microcirculation improvement of foot after tarsal tunnel release in diabetic patients by transcutaneous oximetry.

    Science.gov (United States)

    Trignano, Emilio; Fallico, Nefer; Chen, Hung-Chi; Faenza, Mario; Bolognini, Alfonso; Armenti, Andrea; Santanelli Di Pompeo, Fabio; Rubino, Corrado; Campus, Gian Vittorio

    2016-01-01

    According to recent studies, peripheral nerve decompression in diabetic patients seems to not only improve nerve function, but also to increase microcirculation; thus decreasing the incidence of diabetic foot wounds and amputations. However, while the postoperative improvement of nerve function is demonstrated, the changes in peripheral microcirculation have not been demonstrated yet. The aim of this study is to assess the degree of microcirculation improvement of foot after the tarsal tunnel release in the diabetic patients by using transcutaneous oximetry. Twenty diabetic male patients aged between 43 and 72 years old (mean age 61.2 years old) suffering from diabetic peripheral neuropathy with superimposed nerve compression underwent transcutaneous oximetry (PtcO2) before and after tarsal tunnel release by placing an electrode on the skin at the level of the dorsum of the foot. Eight lower extremities presented diabetic foot wound preoperatively. Thirty-six lower extremities underwent surgical release of the tibialis posterior nerve only, whereas four lower extremities underwent the combined release of common peroneal nerve, anterior tibialis nerve, and posterior tibialis nerve. Preoperative values of transcutaneous oximetry were below the critical threshold, that is, lower than 40 mmHg (29.1 ± 5.4 mmHg). PtcO2 values at one month after surgery (45.8 ± 6.4 mmHg) were significantly higher than the preoperative ones (P = 0.01). The results of postoperative increase in PtcO2 values demonstrate that the release of the tarsal tunnel determines a relevant increase in microcirculation in the feet of diabetic patients. © 2015 Wiley Periodicals, Inc.

  17. In vivo evidence of methamphetamine induced attenuation of brain tissue oxygenation as measured by EPR oximetry

    Science.gov (United States)

    Weaver, John; Yang, Yirong; Purvis, Rebecca; Weatherwax, Theodore; Rosen, Gerald M.; Liu, Ke Jian

    2014-01-01

    Abuse of methamphetamine (METH) is a major and significant societal problem in the US, as a number of studies have suggested that METH is associated with increased cerebrovascular events, hemorrhage or vasospasm. Although cellular and molecular mechanisms involved in METH-induced toxicity are not completely understood, changes in brain O2 may play an important role and contribute to METH-induced neurotoxicity including dopaminergic receptor degradation. Given that O2 is the terminal electron acceptor for many enzymes that are important in brain function, the impact of METH on brain tissue pO2 in vivo remains largely uncharacterized. This study investigated striatal tissue pO2 changes in male C57BL/6 mice (16–20g) following METH administration using EPR oximetry, a highly sensitive modality to measure pO2 in vivo, in situ and in real time. We demonstrate that 20 min after a single injection of METH (8 mg/kg i.v.), the striatal pO2 was reduced to 81% of the pretreatment level and exposure to METH for 3 consecutive days further attenuated striatal pO2 to 64%. More importantly, pO2 did not recover fully to control levels even 24 hrs after administration of a single dose of METH. and continual exposure to METH exacerbates the condition. We also show a reduction in cerebral blood flow associated with a decreased brain pO2 indicating an ischemic condition. Our findings suggests that administration of METH can attenuate brain tissue pO2, which may lead to hypoxic insult, thus a risk factor for METH-induced brain injury and the development of stroke in young adults. PMID:24412707

  18. Design of a randomized controlled trial on the effect on return to work with coaching plus light therapy and pulsed electromagnetic field therapy for workers with work-related chronic stress.

    Science.gov (United States)

    Schoutens, Antonius M C; Frings-Dresen, Monique H W; Sluiter, Judith K

    2016-07-19

    Work-related chronic stress is a common problem among workers. The core complaint is that the employee feels exhausted, which has an effect on the well-being and functioning of the employee, and an impact on the employer and society. The employee's absence is costly due to lost productivity and medical expenses. The usual form of care for work-related chronic stress is coaching, using a cognitive-behavioural approach whose primary aim is to reduce symptoms and improve functioning. Light therapy and pulsed electromagnetic field therapy are used for the treatment of several mental and physical disorders. The objective of this study is to determine whether coaching combined with light therapy plus pulsed electromagnetic field therapy is an effective treatment for reducing absenteeism, fatigue and stress, and improving quality of life compared to coaching alone. The randomized placebo-controlled trial consists of three arms. The population consists of 90 participants with work-related chronic stress complaints. The research groups are: (i) intervention group; (ii) placebo group; and (iii) control group. Participants in the intervention group will be treated with light therapy/pulsed electromagnetic field therapy for 12 weeks, twice a week for 40 min, and coaching (once a fortnight for 50 min). The placebo group receives the same treatment but with the light and pulsed electromagnetic field switched to placebo settings. The control group receives only coaching for 12 weeks, a course of six sessions, once a fortnight for 50 min. The primary outcome is the level of return to work. Secondary outcomes are fatigue, stress and quality of life. Outcomes will be measured at baseline, 6 weeks, 12 and 24 weeks after start of treatment. This study will provide information about the effectiveness of coaching and light therapy plus pulsed electromagnetic field therapy on return to work, and secondly on fatigue, stress and quality of life in people with work-related chronic

  19. Pulse plating

    CERN Document Server

    Hansal, Wolfgang E G; Green, Todd; Leisner, Peter; Reichenbach, Andreas

    2012-01-01

    The electrodeposition of metals using pulsed current has achieved practical importance in recent years. Although it has long been known that changes in potential, with or without polarity reversal, can significantly affect the deposition process, the practical application of this has been slow to be adopted. This can largely be explained in terms of the complex relationship between the current regime and its effect on the electrodeposition process. In order to harness these effects, an understanding of the anodic and cathodic electrochemical processes is necessary, together with the effects of polarity reversal and the rate of such reversals. In this new monograph, the basics of metal electrodeposition from solution are laid out in great detail in seven distinct chapters. With this knowledge, the reader is able to predict how a given pulse train profile can be adopted to achieve a desired outcome. Equally important is the choice of a suitable rectifier and the ancillary control circuits to enable pulse platin...

  20. Evaluation of a randomized controlled trial on the effect on return to work with coaching combined with light therapy and pulsed electromagnetic field therapy for workers with work-related chronic stress

    Directory of Open Access Journals (Sweden)

    Karen Nieuwenhuijsen

    2017-10-01

    Full Text Available Abstract Background Chronic work-related stress is quite prevalent in the working population and is in some cases accompanied by long-term sick leave. These stress complaints highly impact employees and are costly due to lost productivity and medical expenses. A new treatment platform with light therapy plus Pulsed Electro Magnetic Fields (PEMF in combination with coaching was used to assess whether more positive effects on return to work, stress, work-related fatigue, and quality of life could be induced compared to coaching alone. Methods A placebo-controlled trial was executed after inclusion of 96 workers, aged 18–65 with work-related chronic stress complaints and who were on sick leave (either part-time or full-time. Participants were divided into three arms at random. Group 1 (n = 28 received the treatment and coaching (Intervention group, group 2 (n = 28 received the treatment with the device turned off and coaching (Placebo group and group 3 (n = 28 received coaching only (Control group. The data were collected at baseline, and after 6, 12 and 24 weeks. The primary outcome was % return to work, and secondary outcomes were work-related fatigue (emotional exhaustion and need for recovery after work, stress (distress and hair cortisol, and quality of life (SF-36 dimensions: vitality, emotional role limitation, and social functioning. Results Eighty-four workers completed all measurements, 28 in each group. All groups improved significantly over time in the level of return to work, as well as on all secondary outcomes. No statistical differences between the three groups were found either on the primary outcome or on any of the secondary outcomes. Conclusions Light therapy with Pulsed Electro Magnetic Fields PEMF therapy has no additional effect on return to work, stress, fatigue, and quality of live compared to coaching alone. Trial registration NTR4794 , registration date: 18-sep-2014

  1. Synergistic combination of hyperoxygenation and radiotherapy by repeated assessments of tumor pO2 with EPR oximetry

    International Nuclear Information System (INIS)

    Hou, H.; Dong, R.; Lariviere, J.P.; Mupparaju, S.P.; Swartz, H.M.; Khan, N.

    2011-01-01

    The effect of hyperoxygenation with carbogen (95% O 2 +5% CO 2 ) inhalation on radiation-induced fibrosarcoma (RIF-1) tumor pO 2 and its consequence on growth inhibition with fractionated radiotherapy is reported. The temporal changes in the tumor pO 2 were assessed by in vivo Electron Paramagnetic Resonance (EPR) oximetry in mice breathing 30% O 2 or carbogen and the tumors were irradiated with 4 Gy/day for 5 consecutive days; a protocol that emulates the clinical application of carbogen. The RIF-1 tumors were hypoxic with a tissue pO 2 of 5-9 mmHg. Carbogen (CB) breathing significantly increased tumor pO 2 , with a maximum increase at 22.9-31.2 min on days 1-5, however, the magnitude of increase in pO 2 declined on day 5. Radiotherapy during carbogen inhalation (CB/RT) resulted in a significant tumor growth inhibition from day 3 to day 6 as compared to 30%O 2 /RT and carbogen (CB/Sham RT) groups. The results provide unambiguous quantitative information on the effect of carbogen inhalation on tumor pO 2 over the course of 5 days. Tumor growth inhibition in the CB/RT group confirms that the tumor oxygenation with carbogen was radiobiologically significant. Repeated tumor pO 2 measurements by EPR oximetry can provide temporal information that could be used to improve therapeutic outcomes by scheduling doses at times of improved tumor oxygenation. (author)

  2. Synergistic combination of hyperoxygenation and radiotherapy by repeated assessments of tumor pO2 with EPR oximetry

    Science.gov (United States)

    HOU, Huagang; DONG, Ruhong; LARIVIERE, Jean P.; MUPPARAJU, Sriram P.; SWARTZ, Harold M.; KHAN, Nadeem

    2013-01-01

    The effect of hyperoxygenation with carbogen (95% O2 + 5% CO2) inhalation on RIF-1 tumor pO2 and its consequence on growth inhibition with fractionated radiotherapy is reported. The temporal changes in the tumor pO2 were assessed by in vivo Electron Paramagnetic Resonance (EPR) oximetry in mice breathing 30% O2 or carbogen and the tumors were irradiated with 4 Gy/day for 5 consecutive days; a protocol that emulates the clinical application of carbogen. The RIF-1 tumors were hypoxic with a tissue pO2 of 5 – 9 mm Hg. Carbogen (CB) breathing significantly increased tumor pO2, with a maximum increase at 22.9 – 31.2 min on days 1 – 5, however, the magnitude of increase in pO2 declined on day 5. Radiotherapy during carbogen inhalation (CB/RT) resulted in a significant tumor growth inhibition from day 3 to day 6 as compared to 30%O2/RT and carbogen (CB/Sham RT) groups. The results provide unambiguous quantitative information on the effect of carbogen inhalation on tumor pO2 over the course of 5 days. Tumor growth inhibition in the CB/RT group confirms that the tumor oxygenation with carbogen was radiobiologically significant. Repeated tumor pO2 measurements by EPR oximetry can provide temporal information that could be used to improve therapeutic outcomes by scheduling doses at times of improved tumor oxygenation. PMID:21799293

  3. Theoretical model for optical oximetry at the capillary level: exploring hemoglobin oxygen saturation through backscattering of single red blood cells

    Science.gov (United States)

    Liu, Rongrong; Spicer, Graham; Chen, Siyu; Zhang, Hao F.; Yi, Ji; Backman, Vadim

    2017-02-01

    Oxygen saturation (sO2) of red blood cells (RBCs) in capillaries can indirectly assess local tissue oxygenation and metabolic function. For example, the altered retinal oxygenation in diabetic retinopathy and local hypoxia during tumor development in cancer are reflected by abnormal sO2 of local capillary networks. However, it is far from clear whether accurate label-free optical oximetry (i.e., measuring hemoglobin sO2) is feasible from dispersed RBCs at the single capillary level. The sO2-dependent hemoglobin absorption contrast present in optical scattering signal is complicated by geometry-dependent scattering from RBCs. We present a numerical study of backscattering spectra from single RBCs based on the first-order Born approximation, considering practical factors: RBC orientations, size variation, and deformations. We show that the oscillatory spectral behavior of RBC geometries is smoothed by variations in cell size and orientation, resulting in clear sO2-dependent spectral contrast. In addition, this spectral contrast persists with different mean cellular hemoglobin content and different deformations of RBCs. This study shows for the first time the feasibility of, and provides a theoretical model for, label-free optical oximetry at the single capillary level using backscattering-based imaging modalities, challenging the popular view that such measurements are impossible at the single capillary level.

  4. Direct Measurements of Oxygen Gradients in Spheroid Culture System Using Electron Parametric Resonance Oximetry.

    Directory of Open Access Journals (Sweden)

    Laura M Langan

    Full Text Available Advanced in vitro culture from tissues of different origin includes three-dimensional (3D organoid micro structures that may mimic conditions in vivo. One example of simple 3D culture is spheroids; ball shaped structures typically used as liver and tumour models. Oxygen is critically important in physiological processes, but is difficult to quantify in 3D culture: and the question arises, how small does a spheroid have to be to have minimal micro-environment formation? This question is of particular importance in the growing field of 3D based models for toxicological assessment. Here, we describe a simple non-invasive approach modified for the quantitative measurement and subsequent evaluation of oxygen gradients in spheroids developed from a non-malignant fish cell line (i.e. RTG-2 cells using Electron Paramagnetic Resonance (EPR oximetry. Sonication of the paramagnetic probe Lithium phthalocyanine (LiPc allows for incorporation of probe particulates into spheroid during its formation. Spectra signal strength after incorporation of probe into spheroid indicated that a volume of 20 μl of probe (stock solution: 0.10 mg/mL is sufficient to provide a strong spectra across a range of spheroid sizes. The addition of non-toxic probes (that do not produce or consume oxygen report on oxygen diffusion throughout the spheroid as a function of size. We provide evidence supporting the use of this model over a range of initial cell seeding densities and spheroid sizes with the production of oxygen distribution as a function of these parameters. In our spheroid model, lower cell seeding densities (∼2,500 cells/spheroid and absolute size (118±32 μm allow control of factors such as pre-existing stresses (e.g. ∼ 2% normoxic/hypoxic interface for more accurate measurement of treatment response. The applied methodology provides an elegant, widely applicable approach to directly characterize spheroid (and other organoid cultures in biomedical and

  5. Evaluation of a new pulse oximeter sensor.

    Science.gov (United States)

    Fernandez, Marco; Burns, Kathy; Calhoun, Beverly; George, Saramma; Martin, Beverly; Weaver, Chris

    2007-03-01

    A new forehead noninvasive oxygen saturation sensor may improve signal quality in patients with low cardiac index. To examine agreement between oxygen saturation values obtained by using digit-based and forehead pulse oximeters with arterial oxygen saturation in patients with low cardiac index. A method-comparison study was used to examine the agreement between 2 different pulse oximeters and arterial oxygen saturation in patients with low cardiac index. Readings were obtained from a finger and a forehead sensor and by analysis of a blood sample. Bias, precision, and root mean square differences were calculated for the digit and forehead sensors. Differences in bias and precision between the 2 noninvasive devices were evaluated with a t test (level of significance P<.05). Nineteen patients with low cardiac index (calculated as cardiac output in liters per minute divided by body surface area in square meters; mean 1.98, SD 0.34) were studied for a total of 54 sampling periods. Mean (SD) oxygen saturations were 97% (2.4) for blood samples, 96% (3.2) for the finger sensor, and 97% (2.8) for the forehead sensor. By Bland Altman analysis, bias +/- precision was -1.16 +/- 1.62% for the digit sensor and -0.36 +/- 1.74% for the forehead sensor; root mean square differences were 1.93% and 1.70%, respectively. Bias and precision differed significantly between the 2 devices; the forehead sensor differed less from the blood sample. In patients with low cardiac index, the forehead sensor was better than the digit sensor for pulse oximetry.

  6. Randomized, controlled trial split-faced study of 595-nm pulsed dye laser in the treatment of acne vulgaris and acne erythema in adolescents and early adulthood.

    Science.gov (United States)

    Lekwuttikarn, Ramrada; Tempark, Therdpong; Chatproedprai, Susheera; Wananukul, Siriwan

    2017-08-01

    The high prevalence of acne vulgaris in teenagers has increased comorbidities. Lasers offer alternative options for acne treatment because they have rapid action, low systemic adverse effects, and do not require everyday treatment. To study the efficacy and patients' satisfaction of 595-nm pulse dye laser (PDL) treatment of acne vulgaris and acne erythema in adolescents and early adulthood, we designed a blocked-randomized, split-faced 595-nm PDL (fluence 8 J/cm 3 pulse duration 10 ms, spot size 7 mm, 2 session every 2 weeks) study in patients with mild to moderate acne by comparing the laser-treated and non-treated side. The acne lesion counts, acne erythema grading, and acne severity grading were evaluated at baseline and 2, 4, and 8 weeks. Thirty patients were recruited. The results showed no statistically significant difference except the papule count at week 4 which was -1.828 on the treated side and 0.103 on the non-treated side of the face, P-value 0.0018. There was no statistically significant difference of acne severity grading and acne erythema grading between both sides of the face. The mean scores of patients' satisfaction on the laser-treated side were 75, 81, and 81%, respectively. The PDL treatment in this study reveals no significant improvement in acne therapy; however, the patients were satisfied with this laser treatment. © 2017 The International Society of Dermatology.

  7. Improved Pulse Wave Velocity and Renal Function in Individualized Calcineurin Inhibitor Treatment by Immunomonitoring: The Randomized Controlled Calcineurin Inhibitor-Sparing Trial.

    Science.gov (United States)

    Sommerer, Claudia; Brocke, Janina; Bruckner, Thomas; Schaier, Matthias; Morath, Christian; Meuer, Stefan; Zeier, Martin; Giese, Thomas

    2018-03-01

    A new immune monitoring tool which assesses the expression of nuclear factor of activated T cells (NFAT)-regulated genes measures the functional effects of cyclosporine A. This is the first prospective randomized controlled study to compare standard pharmacokinetic monitoring by cyclosporine trough levels to NFAT-regulated gene expression (NFAT-RE). Expression of the NFAT-regulated genes was determined by qRT-PCR at cyclosporine trough and peak level. Cardiovascular risk was assessed by change of pulse wave velocity from baseline to month 6. Clinical follow-up was 12 months. In total, 55 stable kidney allograft recipients were enrolled. Mean baseline residual NFAT-RE was 13.1 ± 9.1%. Patients in the NFAT-RE group showed a significant decline in pulse wave velocity from baseline to month 6 versus the standard group (-1.7 ± 2.0 m/s vs 0.4 ± 1.4 m/s, P function was significantly better with NFAT-RE versus standard monitoring (Nankivell glomerular filtration rate: 68.5 ± 17.4 mL/min vs 57.2 ± 19.0 mL/min; P = 0.009). NFAT-RE as translational immune monitoring tool proved efficacious and safe in individualizing cyclosporine therapy, with the opportunity to reduce the cardiovascular risk and improve long-term renal allograft function.

  8. A Comparative Evaluation of EPR and OxyLite Oximetry Using a Random Sampling of pO2 in a Murine Tumor

    Science.gov (United States)

    Vikram, Deepti S.; Bratasz, Anna; Ahmad, Rizwan; Kuppusamy, Periannan

    2015-01-01

    Methods currently available for the measurement of oxygen concentrations (oximetry) in viable tissues differ widely from each other in their methodological basis and applicability. The goal of this study was to compare two novel methods, particulate-based electron paramagnetic resonance (EPR) and OxyLite oximetry, in an experimental tumor model. EPR oximetry uses implantable paramagnetic particulates, whereas OxyLite uses fluorescent probes affixed on a fiber-optic cable. C3H mice were transplanted with radiation-induced fibrosarcoma (RIF-1) tumors in their hind limbs. Lithium phthalocyanine (LiPc) microcrystals were used as EPR probes. The pO2 measurements were taken from random locations at a depth of ~3 mm within the tumor either immediately or 48 h after implantation of LiPc. Both methods revealed significant hypoxia in the tumor. However, there were striking differences between the EPR and OxyLite readings. The differences were attributed to the volume of tissue under examination and the effect of needle invasion at the site of measurement. This study recognizes the unique benefits of EPR oximetry in terms of robustness, repeatability and minimal invasiveness. PMID:17705635

  9. Assessment of automated analysis of portable oximetry as a screening test for moderate-to-severe sleep apnea in patients with chronic obstructive pulmonary disease.

    Directory of Open Access Journals (Sweden)

    Ana M Andrés-Blanco

    Full Text Available The coexistence of obstructive sleep apnea syndrome (OSAS and chronic obstructive pulmonary disease (COPD leads to increased morbidity and mortality. The development of home-based screening tests is essential to expedite diagnosis. Nevertheless, there is still very limited evidence on the effectiveness of portable monitoring to diagnose OSAS in patients with pulmonary comorbidities.To assess the influence of suffering from COPD in the performance of an oximetry-based screening test for moderate-to-severe OSAS, both in the hospital and at home.A total of 407 patients showing moderate-to-high clinical suspicion of OSAS were involved in the study. All subjects underwent (i supervised portable oximetry simultaneously to in-hospital polysomnography (PSG and (ii unsupervised portable oximetry at home. A regression-based multilayer perceptron (MLP artificial neural network (ANN was trained to estimate the apnea-hypopnea index (AHI from portable oximetry recordings. Two independent validation datasets were analyzed: COPD versus non-COPD.The portable oximetry-based MLP ANN reached similar intra-class correlation coefficient (ICC values between the estimated AHI and the actual AHI for the non-COPD and the COPD groups either in the hospital (non-COPD: 0.937, 0.909-0.956 CI95%; COPD: 0.936, 0.899-0.960 CI95% and at home (non-COPD: 0.731, 0.631-0.808 CI95%; COPD: 0.788, 0.678-0.864 CI95%. Regarding the area under the receiver operating characteristics curve (AUC, no statistically significant differences (p >0.01 between COPD and non-COPD groups were found in both settings, particularly for severe OSAS (AHI ≥30 events/h: 0.97 (0.92-0.99 CI95% non-COPD vs. 0.98 (0.92-1.0 CI95% COPD in the hospital, and 0.87 (0.79-0.92 CI95% non-COPD vs. 0.86 (0.75-0.93 CI95% COPD at home.The agreement and the diagnostic performance of the estimated AHI from automated analysis of portable oximetry were similar regardless of the presence of COPD both in-lab and at

  10. The role of nocturnal oximetry in obstructive sleep apnoea-hypopnoea syndrome screening

    Directory of Open Access Journals (Sweden)

    Celestina Ventura

    2007-07-01

    Full Text Available Aim: The aim of our study was to evaluate the sensitivity and specificity of Nocturnal Oximetry (NO as a diagnostic screening tool for obstructive sleep apnoea hypopnoea syndrome (OSAHS, compared with polysomnography (PSG as the gold standard. Methodology: 63 patients with clinical suspicion of OSAHS and exclusion of respiratory disease underwent PSG and NO. We then determined NO sensitivity, specificity, positive (PPV and negative predictive values (NPV. Results: OSAHS was diagnosed in 47 patients with a mean age of 54 years. In the evaluation of the percentage of Total Sleep Time (TST with oxygen desaturation below 90%, we found significant differences between patients with OSAHS (25.4 ± 29.7% and without OSAHS (1 ± 1.5%, p<0,001. We used two cutoff points to evaluate sensitivity, specificity, positive (PPV and negative predictive values (NPV, based on the severity of O2 desaturation (StO2<90%. Using the first cutoff point we diagnosed with NO as positive all the patients with TST desaturation values ≥1% of the TST. Under these circumstances we found a sensitivity of 76.6%, a specificity of 75%, a PPV of 90% and an NPV value of 52.2% for our screening test (NO. Using the second cutoff point, we diagnosed with NO as positive all the patients with TST desaturation values ≥5% of the TST. With this method we found a sensitivity of 65.9%, a specificity of 100%, a PPV of 100% and an NPV of 50%. Conclusion: NO is a useful screening test for the diagnosis of OSAHS in patients without respiratory disease. Resumo: Objectivo: Foi objectivo deste estudo determinar a sensibilidade e a especificidade da oximetria nocturna (ON como método de screening diagnóstico para a síndroma de apneia-hipopneia obstrutiva do sono (SAHOS, utilizando como método de referência a polissonografia (PSG. Metodologia: Foram incluídos 63 doentes com suspeita clínica de SAHOS e exclusão de doença respiratória, sendo

  11. Long term results of a prospective dose escalation phase-II trial: Interstitial pulsed-dose-rate brachytherapy as boost for intermediate- and high-risk prostate cancer

    International Nuclear Information System (INIS)

    Lettmaier, Sebastian; Lotter, Michael; Kreppner, Stephan; Strnad, Annedore; Fietkau, Rainer; Strnad, Vratislav

    2012-01-01

    Purpose: We reviewed our seven year single institution experience with pulsed dose rate brachytherapy dose escalation study in patients with intermediate and high risk prostate cancer. Materials and methods: We treated a total of 130 patients for intermediate and high risk prostate cancer at our institution between 2000 and 2007 using PDR-brachytherapy as a boost after conformal external beam radiation therapy to 50.4 Gy. The majority of patients had T2 disease (T1c 6%, T2 75%, T3 19%). Seventy three patients had intermediate-risk and 53 patients had high-risk disease according to the D’Amico classification. The dose of the brachytherapy boost was escalated from 25 to 35 Gy – 33 pts. received 25 Gy (total dose 75 Gy), 63 pts. 30 Gy (total dose 80 Gy) and 34 pts. 35 Gy, (total dose 85 Gy) given in one session (dose per pulse was 0.60 Gy or 0.70 Gy/h, 24 h per day, night and day, with a time interval of 1 h between two pulses). PSA-recurrence-free survival according to Kaplan–Meier using the Phoenix definition of biochemical failure was calculated and also late toxicities according to Common Toxicity Criteria scale were assessed. Results: At the time of analysis with a median follow-up of 60 months biochemical control was achieved by 88% of patients – only 16/130 patients (12.3%) developed a biochemical relapse. Biochemical relapse free survival calculated according to Kaplan–Meier for all patients at 5 years was 85.6% (83.9% for intermediate-risk patients and 84.2% for high-risk patients) and at 9 years’ follow up it was 79.0%. Analysing biochemical relapse free survival separately for different boost dose levels, at 5 years it was 97% for the 35 Gy boost dose and 82% for the 25 and 30 Gy dose levels. The side effects of therapy were negligible: There were 18 cases (15%) of grade 1/2 rectal proctitis, one case (0.8%) of grade 3 proctitis, 18 cases (15%) of grade 1/2 cystitis, and no cases (0%) with dysuria grade 3. No patient had a bulbourethral

  12. Pulsed power

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    The key element of our pulsed power program is concentration of power in time and space by suppression of breakdown in dielectrics and in vacuum. Magnetically insulated vacuum transmission lines and magnetic suppression of insulator flashover have continued as the main reserch directions. Vacuum insulated line studies at Physics International have been expanded and a test bed at Sandia, called MITE (Magnetically Insulated Transmission Experiment), is under development. The choice for the baseline EBFA design will depend on the outcome of these studies and should be made in July 1977. The slow and intermediate speed pulsed power approaches to EBFA will be based on Proto I and Proto II results and several of the projected EBFA subsystems are presently being tested in Proto II. A further stage of power concentration, within the vacuum diode itself, would considerably ease the burden on dielectrics; methods of power multiplication involving magnetically imploded plasmas are being considered and tests have begun using the Ripple III apparatus

  13. Aromatherapy with Rosa Damascenes in Apnea, Bradycardia and Spo2 of Preterm Infants; a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Saeideh Aghagoli

    2016-06-01

    Full Text Available Background  Apnea is one of the most common problems in preterm neonates. This study aimed to evaluate the effectiveness of aromatherapy on the reduction of apnea, bradycardia, and Pulse Oximetry (SPO2 in premature infants. Materials and Methods In a clinical trial study, 60 preterm neonates randomly divided in two groups and exposed to aromatherapy with Rosa damascenes distillate or distilled water beside the routine treatment. In experimental group, two drops of 10% Rosa damascenes distillate was dropped on the pad eye in second day of birth at 6 Am. The intervention was repeated in 9 AM, 12 Am, 15 PM and 18 PM hours. A same condition applied for control group and distilled water was dropped on the pad eye. The number of apnea attacks, bradycardia and decrease in SpO2 compared between two groups using chi-square test, independent t-test and repeated measure test. Results The overall apnea attacks, bradycardia, and SPO2 in tree studied days were lower in intervention group than control group (0.47±0.13 vs. 2.6±0.41, 0.47±0.13 vs. 2.56±0.41 and 0.70±0.17 vs. 2.77±0.21, respectively. In addition, the repeated measurement test showed that the mean number of apnea attacks, decrease in heart pulse rate, and decrease in SpO2 was statistically lower in intervention group with aromatherapy than controls in first, second, third and sum of three days (P< 0.05. Conclusion Aromatherapy with Rosa damascenes distillate can reduce more and speedy the occurrence of apnea attacks, bradycardia and SPO2 in premature infants, along with other routine treatment.

  14. Effects of high-intensity pulse irradiation with linear polarized near-infrared rays and stretching on muscle tone in patients with cerebrovascular disease: a randomized controlled trial.

    Science.gov (United States)

    Takeuchi, Nobuyuki; Takezako, Nobuhiro; Shimonishi, Yuko; Usuda, Shigeru

    2017-08-01

    [Purpose] The purpose of this study was to clarify the influence of high-intensity pulse irradiation with linear polarized near-infrared rays (HI-LPNR) and stretching on hypertonia in cerebrovascular disease patients. [Subjects and Methods] The subjects were 40 cerebrovascular disease patients with hypertonia of the ankle joint plantar flexor muscle. The subjects were randomly allocated to groups undergoing treatment with HI-LPNR irradiation (HI-LPNR group), stretching (stretching group), HI-LPNR irradiation followed by stretching (combination group), and control group (10 subjects each). In all groups, the passive range of motion of ankle dorsiflexion and passive resistive joint torque of ankle dorsiflexion were measured before and after the specified intervention. [Results] The changes in passive range of motion, significant increase in the stretching and combination groups compared with that in the control group. The changes in passive resistive joint torque, significant decrease in HI-LPNR, stretching, and combination groups compared with that in the control group. [Conclusion] HI-LPNR irradiation and stretching has effect of decrease muscle tone. However, combination of HI-LPNR irradiation and stretching has no multiplier effect.

  15. Evaluation of a randomized controlled trial on the effect on return to work with coaching combined with light therapy and pulsed electromagnetic field therapy for workers with work-related chronic stress.

    Science.gov (United States)

    Nieuwenhuijsen, Karen; Schoutens, Antonius M C; Frings-Dresen, Monique H W; Sluiter, Judith K

    2017-10-02

    Chronic work-related stress is quite prevalent in the working population and is in some cases accompanied by long-term sick leave. These stress complaints highly impact employees and are costly due to lost productivity and medical expenses. A new treatment platform with light therapy plus Pulsed Electro Magnetic Fields (PEMF) in combination with coaching was used to assess whether more positive effects on return to work, stress, work-related fatigue, and quality of life could be induced compared to coaching alone. A placebo-controlled trial was executed after inclusion of 96 workers, aged 18-65 with work-related chronic stress complaints and who were on sick leave (either part-time or full-time). Participants were divided into three arms at random. Group 1 (n = 28) received the treatment and coaching (Intervention group), group 2 (n = 28) received the treatment with the device turned off and coaching (Placebo group) and group 3 (n = 28) received coaching only (Control group). The data were collected at baseline, and after 6, 12 and 24 weeks. The primary outcome was % return to work, and secondary outcomes were work-related fatigue (emotional exhaustion and need for recovery after work), stress (distress and hair cortisol), and quality of life (SF-36 dimensions: vitality, emotional role limitation, and social functioning). Eighty-four workers completed all measurements, 28 in each group. All groups improved significantly over time in the level of return to work, as well as on all secondary outcomes. No statistical differences between the three groups were found either on the primary outcome or on any of the secondary outcomes. Light therapy with Pulsed Electro Magnetic Fields PEMF therapy has no additional effect on return to work, stress, fatigue, and quality of live compared to coaching alone. NTR4794 , registration date: 18-sep-2014.

  16. Monitoring Oxygen Levels in Orthotopic Human Glioma Xenograft Following Carbogen Inhalation and Chemotherapy by Implantable Resonator Based Oximetry

    Science.gov (United States)

    Hou, Huagang; Nemani, Venkata Krishnamurthy; Du, Gaixin; Montano, Ryan; Song, Rui; Gimi, Barjor; Swartz, Harold M.; Eastman, Alan; Khan, Nadeem

    2014-01-01

    Hypoxia is a critical hallmark of glioma, and significantly compromises treatment efficacy. Unfortunately, techniques for monitoring glioma pO2 to facilitate translational research are lacking. Furthermore, poor prognoses of patients with malignant glioma, in particular glioblastoma multiforme, warrant effective strategies that can inhibit hypoxia and improve treatment outcome. EPR oximetry using implantable resonators was implemented for monitoring pO2 in normal cerebral tissue and U251 glioma in mice. Breathing carbogen (95% O2 + 5% CO2) was tested for hyperoxia in the normal brain and glioma xenografts. A new strategy to inhibit glioma growth by rationally combining gemcitabine and MK-8776, a cell cycle checkpoint inhibitor, was also investigated. The mean pO2 of left and right hemisphere were approximately 56 – 69 mmHg in the normal cerebral tissue of mice. The mean baseline pO2 of U251 glioma on the first and fifth day of measurement was 21.9 ± 3.7 and 14.1 ± 2.4 mmHg, respectively. The mean brain pO2 including glioma increased by at least 100% on carbogen inhalation, although the response varied between the animals over days. Treatment with gemcitabine + MK-8776 significantly increased pO2 and inhibited glioma growth assessed by MRI. In conclusion, EPR oximetry with implantable resonators can be used to monitor the efficacy of carbogen inhalation and chemotherapy on orthotopic glioma in mice. The increase in glioma pO2 of mice breathing carbogen can be used to improve treatment outcome. The treatment with gemcitabine + MK-8776 is a promising strategy that warrants further investigation. PMID:25111969

  17. In vivo colocalization of 2-nitroimidazole EF5 fluorescence intensity and electron paramagnetic resonance oximetry in mouse tumors

    International Nuclear Information System (INIS)

    Mahy, Pierre; Bast, Marc de; Gallez, Bernard; Gueulette, John; Koch, Cameron J.; Scalliet, Pierre; Gregoire, Vincent

    2003-01-01

    Background and purpose: The primary objective of this study was to establish in vivo the relationship between 2-2-nitro-1H-imidazol-1yl-N-(2,2,3,3,3-pentafluoropropyl)-acetamide (EF5) adduct formation and intratumoral oxygen concentrations measured by electron paramagnetic resonance (EPR) in a tumor model mimicking a clinical situation. The secondary objective was an attempt to calibrate in situ the immunofluorescence (IF) signal with EPR oximetry. Materials and methods: IM syngeneic fibrosarcoma (NFSA) bearing C3H mice were used. Three days after injection of a paramagnetic charcoal into the tumor, the mice were anesthetized, injected with the hypoxic marker EF5, and monitored every 20 min for 3 h with a low-frequency EPR spectrometer. Animals were allowed to breath either under 21 or 100% O 2 . Tumors were then harvested, frozen, cut into sections including the charcoal and processed for EF5 adducts detection using monoclonal antibodies. Slices were viewed with a fluorescence microscope and 190x140 μm areas surrounding the charcoal were digitized and analyzed with the NIH-Image and Adobe Photoshop TM software. The fluorescence intensity (FI) was measured in the whole pictures and in strips of 10 μm around the charcoal. Results: EF5 binding increased with decreasing pO 2 , most substantially at pO 2 below 5 mm Hg. Baseline (ambient air) pO 2 reached 3.2±2.1 mm Hg in NFSA tumors. It increased to 9.8±3.2 mm Hg under 100% O 2 . A statistically significant correlation was observed on an individual tumor basis between the FI in the first 10 μm strip around the charcoal and the pO 2 determined by EPR oximetry (Wilcoxon signed rank test: P 2 in an in vivo environment under biologically-relevant pO 2 values of less than 10 mm Hg

  18. Monitoring oxygen levels in orthotopic human glioma xenograft following carbogen inhalation and chemotherapy by implantable resonator-based oximetry.

    Science.gov (United States)

    Hou, Huagang; Krishnamurthy Nemani, Venkata; Du, Gaixin; Montano, Ryan; Song, Rui; Gimi, Barjor; Swartz, Harold M; Eastman, Alan; Khan, Nadeem

    2015-04-01

    Hypoxia is a critical hallmark of glioma, and significantly compromises treatment efficacy. Unfortunately, techniques for monitoring glioma pO2 to facilitate translational research are lacking. Furthermore, poor prognosis of patients with malignant glioma, in particular glioblastoma multiforme, warrant effective strategies that can inhibit hypoxia and improve treatment outcome. EPR oximetry using implantable resonators was implemented for monitoring pO2 in normal cerebral tissue and U251 glioma in mice. Breathing carbogen (95% O2 + 5% CO2 ) was tested for hyperoxia in the normal brain and glioma xenografts. A new strategy to inhibit glioma growth by rationally combining gemcitabine and MK-8776, a cell cycle checkpoint inhibitor, was also investigated. The mean pO2 of left and right hemisphere were ∼56-69 mmHg in the normal cerebral tissue of mice. The mean baseline pO2 of U251 glioma on the first and fifth day of measurement was 21.9 ± 3.7 and 14.1 ± 2.4 mmHg, respectively. The mean brain pO2 including glioma increased by at least 100% on carbogen inhalation, although the response varied between the animals over days. Treatment with gemcitabine + MK-8776 significantly increased pO2 and inhibited glioma growth assessed by MRI. In conclusion, EPR oximetry with implantable resonators can be used to monitor the efficacy of carbogen inhalation and chemotherapy on orthotopic glioma in mice. The increase in glioma pO2 of mice breathing carbogen can be used to improve treatment outcome. The treatment with gemcitabine + MK-8776 is a promising strategy that warrants further investigation. © 2014 UICC.

  19. PULSE COLUMN

    Science.gov (United States)

    Grimmett, E.S.

    1964-01-01

    This patent covers a continuous countercurrent liquidsolids contactor column having a number of contactor states each comprising a perforated plate, a layer of balls, and a downcomer tube; a liquid-pulsing piston; and a solids discharger formed of a conical section at the bottom of the column, and a tubular extension on the lowest downcomer terminating in the conical section. Between the conical section and the downcomer extension is formed a small annular opening, through which solids fall coming through the perforated plate of the lowest contactor stage. This annular opening is small enough that the pressure drop thereacross is greater than the pressure drop upward through the lowest contactor stage. (AEC)

  20. Pulse radiolysis

    International Nuclear Information System (INIS)

    Greenshields, H.; Seddon, W.A.

    1982-03-01

    This supplement to two bibliographies published in 1970 and 1972 lists 734 references to the literature of pulse radiolysis, arranged under eight broad subject headings. The references were compiled by searching Biological Abstracts, Chemical Abstracts, Nuclear Science Abstracts and the Weekly List of Papers in Radiation Chemistry issued by the Radiation Chemistry Data Center of Notre Dame University. Full bibliographic data is given for papers published in the period 1971 to 1974. A personal author index listing more than 600 authors and a similar number of co-authors is included

  1. Pulse pile-up. I: Short pulses

    International Nuclear Information System (INIS)

    Wilkinson, D.H.

    1990-07-01

    The search for rare large pulses against an intense background of smaller ones involves consideration of pulse pile-up. Approximate methods are presented, based on ruin theory, by which the probability of such pile-up may be estimated for pulses of arbitrary form and of arbitrary pulse-height distribution. These methods are checked against cases for which exact solutions are available. The present paper is concerned chiefly with short pulses of finite total duration. (Author) (5 refs., 24 figs.)

  2. Association of Implementation of Practice Standards for Electrocardiographic Monitoring with Nurses’ Knowledge, Quality of Care, and Patient Outcomes: Findings from the Practical Use of the Latest Standards of Electrocardiography (PULSE) Trial

    Science.gov (United States)

    Funk, Marjorie; Fennie, Kristopher P.; Stephens, Kimberly E.; May, Jeanine L.; Winkler, Catherine G.; Drew, Barbara J.

    2017-01-01

    Background Although continuous electrocardiographic (ECG) monitoring is ubiquitous in hospitals, monitoring practices are inconsistent. We evaluated implementation of American Heart Association practice standards for ECG monitoring on nurses’ knowledge, quality of care, and patient outcomes. Methods and Results The PULSE Trial was a 6-year multi-site randomized clinical trial with crossover that took place in 65 cardiac units in 17 hospitals. We measured outcomes at baseline, Time 2 after Group 1 hospitals received the intervention, and Time 3 after Group 2 hospitals received the intervention. Measurement periods were 15 months apart. The 2-part intervention consisted of an online ECG monitoring education program and strategies to implement and sustain change in practice. Nurses’ knowledge (N=3,013 nurses) was measured by a validated 20-item online test, quality of care related to ECG monitoring (N=4,587 patients) by on-site observation, and patient outcomes (mortality, in-hospital myocardial infarction, and not surviving a cardiac arrest) (N=95,884 hospital admissions) by review of administrative, laboratory, and medical record data. Nurses’ knowledge improved significantly immediately following the intervention in both groups, but was not sustained 15 months later. For most measures of quality of care (accurate electrode placement, accurate rhythm interpretation, appropriate monitoring, and ST-segment monitoring when indicated), the intervention was associated with significant improvement, which was sustained 15 months later. Of the 3 patient outcomes, only in-hospital myocardial infarction declined significantly after the intervention, and was sustained. Conclusions Online ECG monitoring education and strategies to change practice can lead to improved nurses’ knowledge, quality of care, and patient outcomes. PMID:28174175

  3. Hypoxia triggers high-altitude headache with migraine features: A prospective trial.

    Science.gov (United States)

    Broessner, Gregor; Rohregger, Johanna; Wille, Maria; Lackner, Peter; Ndayisaba, Jean-Pierre; Burtscher, Martin

    2016-07-01

    Given the high prevalence and clinical impact of high-altitude headache (HAH), a better understanding of risk factors and headache characteristics may give new insights into the understanding of hypoxia being a trigger for HAH or even migraine attacks. In this prospective trial, we simulated high altitude (4500 m) by controlled normobaric hypoxia (FiO2 = 12.6%) to investigate acute mountain sickness (AMS) and headache characteristics. Clinical symptoms of AMS according to the Lake Louise Scoring system (LLS) were recorded before and after six and 12 hours in hypoxia. O2 saturation was measured using pulse oximetry at the respective time points. History of primary headache, especially episodic or chronic migraine, was a strict exclusion criterion. In total 77 volunteers (43 (55.8%) males, 34 (44.2%) females) were enrolled in this study. Sixty-three (81.18%) and 40 (71.4%) participants developed headache at six or 12 hours, respectively, with height and SpO2 being significantly different between headache groups at six hours (p headache development (p headache according to the International Classification of Headache Disorders (ICHD-3 beta) in n = 5 (8%) or n = 6 (15%), at six and 12 hours, respectively. Normobaric hypoxia is a trigger for HAH and migraine-like headache attacks even in healthy volunteers without any history of migraine. Our study confirms the pivotal role of hypoxia in the development of AMS and beyond that suggests hypoxia may be involved in migraine pathophysiology. © International Headache Society 2015.

  4. Ability of the Masimo pulse CO-Oximeter to detect changes in hemoglobin.

    Science.gov (United States)

    Colquhoun, Douglas A; Forkin, Katherine T; Durieux, Marcel E; Thiele, Robert H

    2012-04-01

    The decision to administer blood products is complex and multifactorial. Accurate assessment of the concentration of hemoglobin [Hgb] is a key component of this evaluation. Recently a noninvasive method of continuously measuring hemoglobin (SpHb) has become available with multi-wavelength Pulse CO-Oximetry. The accuracy of this device is well documented, but the trending ability of this monitor has not been previously described. Twenty patients undergoing major thoracic and lumbar spine surgery were recruited. All patients received radial arterial lines. On the contralateral index finger, a R1 25 sensor (Rev E) was applied and connected to a Radical-7 Pulse CO-Oximeter (both Masimo Corp, Irvine, CA). Blood samples were drawn intermittently at the anesthesia provider's discretion and were analyzed by the operating room satellite laboratory CO-Oximeter. The value of Hgb and SpHb at that time point was compared. Trend analysis was performed by the four quadrant plot technique, testing directionality of change, and Critchley's polar plot method testing both directionality and magnitude of the change in values. Eighty-eight samples recorded at times of sufficient signal quality were available for analysis. Four quadrant plot analysis revealed 94% of data within the quadrants associated with the correct direction change, and 90% of data points lay within the analysis bounds proposed by Critchley. Pulse CO-Oximetry offers an acceptable trend monitor in patients undergoing major spine surgery. Future work should explore the ability of this device to detect large changes in hemoglobin, as well as its applicability in additional surgical and non-surgical patient populations.

  5. Improving oxygen therapy for children and neonates in secondary hospitals in Nigeria: study protocol for a stepped-wedge cluster randomised trial.

    Science.gov (United States)

    Graham, Hamish R; Ayede, Adejumoke I; Bakare, Ayobami A; Oyewole, Oladapo B; Peel, David; Gray, Amy; McPake, Barbara; Neal, Eleanor; Qazi, Shamim; Izadnegahdar, Rasa; Falade, Adegoke G; Duke, Trevor

    2017-10-27

    Oxygen is a life-saving, essential medicine that is important for the treatment of many common childhood conditions. Improved oxygen systems can reduce childhood pneumonia mortality substantially. However, providing oxygen to children is challenging, especially in small hospitals with weak infrastructure and low human resource capacity. This trial will evaluate the implementation of improved oxygen systems at secondary-level hospitals in southwest Nigeria. The improved oxygen system includes: a standardised equipment package; training of clinical and technical staff; infrastructure support (including improved power supply); and quality improvement activities such as supportive supervision. Phase 1 will involve the introduction of pulse oximetry alone; phase 2 will involve the introduction of the full, improved oxygen system package. We have based the intervention design on a theory-based analysis of previous oxygen projects, and used quality improvement principles, evidence-based teaching methods, and behaviour-change strategies. We are using a stepped-wedge cluster randomised design with participating hospitals randomised to receive an improved oxygen system at 4-month steps (three hospitals per step). Our mixed-methods evaluation will evaluate effectiveness, impact, sustainability, process and fidelity. Our primary outcome measures are childhood pneumonia case fatality rate and inpatient neonatal mortality rate. Secondary outcome measures include a range of clinical, quality of care, technical, and health systems outcomes. The planned study duration is from 2015 to 2018. Our study will provide quality evidence on the effectiveness of improved oxygen systems, and how to better implement and scale-up oxygen systems in resource-limited settings. Our results should have important implications for policy-makers, hospital administrators, and child health organisations in Africa and globally. Australian New Zealand Clinical Trials Registry: ACTRN12617000341325

  6. Comparison between fluorimetry and oximetry techniques to measure photosynthesis in the diatom Skeletonema costatum cultivated under simulated seasonal conditions.

    Science.gov (United States)

    Lefebvre, Sébastien; Mouget, Jean-Luc; Loret, Pascale; Rosa, Philippe; Tremblin, Gérard

    2007-02-01

    This study reports comparison of two techniques measuring photosynthesis in the ubiquitous diatom Skeletonema costatum, i.e., the classical oximetry and the recent modulated fluorimetry. Microalgae in semi-continuous cultures were exposed to five different environmental conditions simulating a seasonal effect with co-varying temperature, photoperiod and incident light. Photosynthesis was assessed by gross rate of oxygen evolution (P(B)) and the electron transport rate (ETR) measurements. The two techniques were linearly related within seasonal treatments along the course of the P/E curves. The light saturation intensity parameters (Ek and Ek(ETR)), and the maximum electron transport rate increased significantly with the progression of the season while the maximum light utilization efficiency for ETR (alpha(ETR)) was constant. By contrast, the maximum gross oxygen photosynthetic capacity (Pmax(B)) and the maximum light utilization efficiency for P(B) (alpha(B)) increased from December to May treatment but decreased from May to July treatment. Both techniques showed clear photoacclimation in microalgae with the progression of the season, as illustrated by changes in photosynthetic parameters. The relationship between the two techniques changed when high temperature, photoperiod and incident light were combined, possibly due to an overestimation of the PAR--averaged chlorophyll-specific absorption cross-section. Despite this change, our results illustrate the strong suitability of in vivo chlorophyll fluorimetry to estimate primary production in the field.

  7. Cerebral blood flow and oximetry response to blood transfusion in relation to chronological age in preterm infants.

    Science.gov (United States)

    Banerjee, J; Leung, T S; Aladangady, N

    2016-06-01

    Preterm infants frequently receive blood transfusion (BT) and the aim of this study was to measure the effect of BT on cerebral blood flow and oxygenation in preterm infants in relation to chronological age. Preterm infants undergoing intensive care recruited to three chronological age groups: 1 to 7 (Group 1; n=20), 8 to 28 (Group 2; n=21) & ≥29days of life (Group 3; n=18). Pre and post-BT anterior cerebral artery (ACA) time averaged mean velocity (TAMV) and superior vena cava (SVC) flow were measured. Cerebral Tissue Haemoglobin Index (cTHI) and Oxygenation Index (cTOI) were measured from 15-20min before to 15-20min post-BT using NIRS. Vital parameters and blood pressure were measured continuously. Mean BP increased significantly, and there was no significant change in vital parameters following BT. Pre-BT ACA TAMV was higher in Group 2 and 3 compared to Group 1 (pBlood transfusion increased cTOI and cTHI and decreased ACA TAMV in all groups. PDA had no impact on the baseline cerebral oximetry and blood flow as well as changes following blood transfusion. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Random pulse generator

    International Nuclear Information System (INIS)

    Guo Ya'nan; Jin Dapeng; Zhao Dixin; Liu Zhen'an; Qiao Qiao; Chinese Academy of Sciences, Beijing

    2007-01-01

    Due to the randomness of radioactive decay and nuclear reaction, the signals from detectors are random in time. But normal pulse generator generates periodical pulses. To measure the performances of nuclear electronic devices under random inputs, a random generator is necessary. Types of random pulse generator are reviewed, 2 digital random pulse generators are introduced. (authors)

  9. Programmable pulse generator

    International Nuclear Information System (INIS)

    Xue Zhihua; Lou Binqiao; Duan Xiaohui

    2002-01-01

    The author introduces the design of programmable pulse generator that is based on a micro-controller and controlled by RS232 interface of personal computer. The whole system has good stability. The pulse generator can produce TTL pulse and analog pulse. The pulse frequency can be selected by EPLD. The voltage amplitude and pulse width of analog pulse can be adjusted by analog switches and digitally-controlled potentiometers. The software development tools of computer is National Instruments LabView5.1. The front panel of this virtual instrumentation is intuitive and easy-to-use. Parameters can be selected and changed conveniently by knob and slide

  10. [Improved detection of the pulse oximeter signal with a digital nerve block in patients in poor health status].

    Science.gov (United States)

    Cordoví de Armas, L; Espinaco Valdés, J; Jiménez Paneque, R E; Costa Hidalgo, T; Vallongo Menéndez, M B

    2008-10-01

    To demonstrate the efficacy of a digital nerve block for improving pulse oximetry in conditions of low tissue perfusion. A randomized single-blind study of adult patients undergoing surgery under general anesthesia for conditions characterized by hypoperfusion. Patients were assigned to a control group or an experimental group. The experimental group received a digital nerve block in the middle finger of the left hand; a sensor was then placed on the finger for between 120 and 300 minutes. Age, sex, diagnosis, total observation time (TOT), percentage of time with no pulse oximeter signal (NoPO), and percentage of time with an unstable pulse oximeter signal (UnstPO) were recorded. Each patient was questioned between 16 and 24 hours after surgery and was examined for flushing, paresthesia, hypoesthesia, pain, and ecchymosis. The chi2 test was used to compare dichotomized or nominal variables and the t test was used to compare age, TOT, NoPO, and UnstPO. Values of P<.05 were considered statistically significant in both cases. Fifty patients were randomized to each group. A total of 82 patients remained in the study (control group=42, experimental group=40). There were no significant between-group differences in diagnoses or TOT. The mean values for NoPO and UnstPO were higher in the control group than in the experimental group (11.1% vs 4.4% and 35.9% vs 15.7%, respectively; P<.001). A digital nerve block can be used to prevent pulse oximetry failures in conditions of low peripheral perfusion.

  11. Novel 1H NMR approach to quantitative tissue oximetry using hexamethyldisiloxane.

    Science.gov (United States)

    Kodibagkar, Vikram D; Cui, Weina; Merritt, Matthew E; Mason, Ralph P

    2006-04-01

    19F NMR spin-lattice relaxometry of hexafluorobenzene (HFB) has been shown to be a highly sensitive indicator of tumor oxygenation. In this study hexamethyldisiloxane (HMDSO) was identified as a proton NMR analog, and its potential as a probe for investigating dynamic changes in tissue oxygen tension (pO2) was evaluated. HMDSO has a single proton resonance (delta= -0.3 ppm) and the spin-lattice relaxation rate, Rl (= 1/T1) exhibits a linear dependence on pO2: R1 (s(-1)) = 0.1126 + 0.0013* pO2 (torr) at 37 degrees C. To demonstrate application in vivo, HMDSO was administered into healthy rat thigh muscle (100 microl) and tumors (50 microl). Local pO2 was determined by using pulse-burst saturation recovery (PBSR) 1H NMR spectroscopy to assess R1. Water and fat signals were effectively suppressed by frequency-selective excitation of the HMDSO resonance. Rat thigh muscle had a mean baseline pO2 of 35 +/- 11 torr, with a typical stability of +/-3 torr over 20 min, when the rats breathed air. Altering the inhaled gas to oxygen produced a significant increase in pO2 to 100-200 torr. In tumors, altering the inspired gas also produced significant (albeit generally smaller) changes. This new pO2 reporter molecule offers a potentially valuable new tool for investigating pO2 in vivo. (c) 2006 Wiley-Liss, Inc.

  12. Pulsed water jet generated by pulse multiplication

    Czech Academy of Sciences Publication Activity Database

    Dvorský, R.; Sitek, Libor; Sochor, T.

    2016-01-01

    Roč. 23, č. 4 (2016), s. 959-967 ISSN 1330-3651 R&D Projects: GA MŠk(CZ) LO1406; GA MŠk ED2.1.00/03.0082 Institutional support: RVO:68145535 Keywords : high- pressure pulses * pulse intensifier * pulsed water jet * water hammer effect Subject RIV: JQ - Machines ; Tools Impact factor: 0.723, year: 2016 http://hrcak.srce.hr/163752?lang=en

  13. Normobaric Hypoxia as a Cognitive Stress Test for Mild Traumatic Brain Injury: Oculometrics, Pulse Oximetry, and the Self Report of Symptom Severity

    Science.gov (United States)

    2011-06-20

    fitness for duty of personnel. Hypoxia and Mild Traumatic Brain Injury The present research was motivated in part by a serendipitous observation made...athletic departments, bicycle shops, fitness and health centers as well as such clubs and organizations as roller derby teams, rodeo clubs, rugby teams

  14. Comparability of pulse oximeters used in sleep medicine for the screening of OSA

    International Nuclear Information System (INIS)

    Böhning, N; Schultheiß, B; Eilers, S; Schmittendorf, E; Penzel, T; Böhning, W

    2010-01-01

    Obstructive sleep apnea syndrome (OSA) is a frequent clinical picture. It is characterized by repetitive respiratory arrest with a consecutive decrease in arterial oxygen saturation (SaO 2 ). In clinical practice, the number of desaturations per hour, oxygen desaturation index (ODI), is used as an important diagnostic criterion. Medical literature, however, mentions different threshold values that are defined as pathological. By means of systematic comparative measurements, the study presented here will examine to what extent the diagnosis and the quantification of OSA severity are affected by the device-specific measurement technique, thus impacting the predictive value of nighttime pulse oximetry in outpatient OSA screening. Different pulse oximeters commonly used in clinical practice were analyzed comparatively regarding technical parameters, temporal dynamics and the reproducibility of measuring results. The measurements were executed simultaneously and time synchronized in a reference group of five test subjects (four males, one female, average age 33.0 ± 9.4 years), in a group of five patients (all males, average age 51.8 ± 18.4 years) and using a simulator (pulse oximeter simulator index 2). All devices underestimate the simulator's predetermined oxygen desaturation of 10%. The dispersion of values is high. The device-specific characteristics have a significant influence on the collected data. The fundamental weakness of the systems lies in the reproducibility of measuring results (this only seems adequate at a signal resolution in steps of 0.1%) as well as the differing temporal dynamics. In the synchronous use of different systems on patients for the purpose of a direct comparison of devices, the dispersion of values is serious, reaching a fluctuation range of up to factor 1.42. In measuring dynamic events (apneas), different pulse oximeters do not record identical values. This is due to the different internal signal processing of the devices

  15. Low-intensity pulsed ultrasound: Nonunions

    Directory of Open Access Journals (Sweden)

    Dijkman Bernadette

    2009-01-01

    Full Text Available Nonunions occur in 5-10% of fractures and are characterized by the failure to heal without further intervention. Low intensity pulsed ultrasound therapy has been developed as an alternative to surgery in the treatment of nonunions. We describe a systematic review on trials of low-intensity pulsed ultrasound therapy for healing of nonunions. We searched the electronic databases Medline and the Cochrane library for articles on ultrasound and healing of nonunions published up to 2008. Trials selected for the review met the following criteria: treatment of at least one intervention group with low intensity pulsed ultrasound; inclusion of patients (humans with one or more nonunions (defined as "established" or as a failure to heal for a minimum of eight months after initial injury; and assessment of healing and time to healing, as determined radiographically. The following data were abstracted from the included studies: sample size, ultrasound treatment characteristics, nonunion location, healing rate, time to fracture healing, fracture age, and demographic information. We found 79 potentially eligible publications, of which 14 met our inclusion criteria. Of these, eight studies were used for data abstraction. Healing rates averaged 87%, (range 65.6%-100% among eight trials. Mean time to healing was 146.5 days, (range 56-219 days. There is evidence from trials that low-intensity pulsed ultrasound may be an effective treatment for healing of nonunions. More homogeneous and larger controlled series are needed to further investigate its efficacy.

  16. Laser pulse stacking method

    Science.gov (United States)

    Moses, E.I.

    1992-12-01

    A laser pulse stacking method is disclosed. A problem with the prior art has been the generation of a series of laser beam pulses where the outer and inner regions of the beams are generated so as to form radially non-synchronous pulses. Such pulses thus have a non-uniform cross-sectional area with respect to the outer and inner edges of the pulses. The present invention provides a solution by combining the temporally non-uniform pulses in a stacking effect to thus provide a more uniform temporal synchronism over the beam diameter. 2 figs.

  17. Dynamic changes in oxygenation of intracranial tumor and contralateral brain during tumor growth and carbogen breathing: A multisite EPR oximetry with implantable resonators

    Science.gov (United States)

    Hou, Huagang; Dong, Ruhong; Li, Hongbin; Williams, Benjamin; Lariviere, Jean P.; Hekmatyar, S.K.; Kauppinen, Risto A.; Khan, Nadeem; Swartz, Harold

    2013-01-01

    Introduction Several techniques currently exist for measuring tissue oxygen; however technical difficulties have limited their usefulness and general application. We report a recently developed electron paramagnetic resonance (EPR) oximetry approach with multiple probe implantable resonators (IRs) that allow repeated measurements of oxygen in tissue at depths of greater than 10 mm. Methods The EPR signal to noise (S/N) ratio of two probe IRs was compared with that of LiPc deposits. The feasibility of intracranial tissue pO2 measurements by EPR oximetry using IRs was tested in normal rats and rats bearing intracerebral F98 tumors. The dynamic changes in the tissue pO2 were assessed during repeated hyperoxia with carbogen breathing. Results A 6–10 times increase in the S/N ratio was observed with IRs as compared to LiPc deposits. The mean brain pO2 of normal rats was stable and increased significantly during carbogen inhalation in experiments repeated for 3 months. The pO2 of F98 glioma declined gradually, while the pO2 of contralateral brain essentially remained the same. Although a significant increase in the glioma pO2 was observed during carbogen inhalation, this effect declined in experiments repeated over days. Conclusion EPR oximetry with IRs provides a significant increase in S/N ratio. The ability to repeatedly assess orthotopic glioma pO2 is likely to play a vital role in understanding the dynamics of tissue pO2 during tumor growth and therapies designed to modulate tumor hypoxia. This information could then be used to optimize chemoradiation by scheduling treatments at times of increased glioma oxygenation. PMID:22033225

  18. Cerebral Oxygenation of the Cortex and Striatum following Normobaric Hyperoxia and Mild Hypoxia in Rats by EPR Oximetry using Multi-Probe Implantable Resonators

    Science.gov (United States)

    Hou, Huagang; Li, Hongbin; Dong, Ruhong; Mupparaju, Sriram; Khan, Nadeem; Swartz, Harold

    2013-01-01

    Multi-site electron paramagnetic resonance (EPR) oximetry, using multi-probe implantable resonators, was used to measure the partial pressure of oxygen (pO2) in the brains of rats following normobaric hyperoxia and mild hypoxia. The cerebral tissue pO2 was measured simultaneously in the cerebral cortex and striatum in the same rats before, during, and after normobaric hyperoxia and mild hypoxia challenges. The baseline mean tissue pO2 values (±SE) were not significantly different between the cortex and striatum. During 30 min of 100% O2 inhalation, a statistically significant increase in tissue pO2 of all four sites was observed, however, the tissue pO2 of the striatum area was significantly higher than in the forelimb area of the cortex. Brain pO2 significantly decreased from the baseline value during 15 min of 15% O2 challenge. No differences in the recovery of the cerebral cortex and striatum pO2 were observed when the rats were allowed to breathe 30% O2. It appears that EPR oximetry using implantable resonators can provide information on pO2 under the experimental conditions needed for such a study. The levels of pO2 that occurred in these experiments are readily resolvable by multi-site EPR oximetry with multi-probe resonators. In addition, the ability to simultaneously measure the pO2 in several areas of the brain provides important information that could potentially help differentiate the pO2 changes that can occur due to global or local mechanisms. PMID:21445770

  19. Transcutaneous oximetry measurements of the leg: comparing different measuring equipment and establishing values in healthy young adults.

    Science.gov (United States)

    Trinks, Tobias P; Blake, Denise F; Young, Derelle A; Thistlethwaite, Ken; Vangaveti, Venkat N

    2017-06-01

    Transcutaneous oximetry measurement (TCOM) is a non-invasive method of determining oxygen tension at the skin level using heated electrodes. To compare TCOM values generated by different machines and to establish lower limb TCOM values in a cohort of healthy individuals younger than 40 years of age. Sixteen healthy, non-smoking volunteers aged 18 to 39 years were recruited. TCOM was obtained at six locations on the lower leg and foot using three different Radiometer machines. Measurements were taken with subjects lying supine, breathing air. Except for one sensor site, there were no statistical differences in measurements obtained by the different TCOM machines. There was no statistical difference in measurements comparing left and right legs. Room air TCOM values for the different lower leg sites were (mean (SD) in mmHg): lateral leg 61.5 (9.2); lateral ankle 61.1 (9.7); medial ankle 59.1 (10.8); foot, first and second toe 63.4 (10.6); foot, fifth toe 59.9 (13.2) and plantar foot 74.1 (8.8). The overall mean TCOM value for the lower limb was 61 (10.8; 95% confidence intervals 60.05-62.0) mmHg. Lower-leg TCOM measurements using different Radiometer TCOM machines were comparable. Hypoxia has been defined as lower-leg TCOM values of less than 40 mmHg in non-diabetic patients and this is supported by our measurements. The majority (96.9%) of the lower leg TCOM values in healthy young adults are above the hypoxic threshold.

  20. Pulse to pulse klystron diagnosis system

    International Nuclear Information System (INIS)

    Nowak, J.; Davidson, V.; Genova, L.; Johnson, R.; Reagan, D.

    1981-03-01

    This report describes a system used to study the behavior of SLAC high powered klystrons operating with a twice normal pulse width of 5 μs. At present, up to eight of the klystrons installed along the accelerator can be operated with long pulses and monitored by this system. The report will also discuss some of the recent findings and investigations

  1. Inter-eye comparison of retinal oximetry and vessel caliber between eyes with asymmetrical glaucoma severity in different glaucoma subtypes

    Directory of Open Access Journals (Sweden)

    Cheng CS

    2016-07-01

    differences in oximetric parameters or vessel calibers between the worse and the better eyes in POAG and NTG groups. Conclusion: Eyes with PACG showed increased arteriolar oxygen saturation and increased AV difference. This was not observed in POAG and NTG eyes. Arteriolar diameter in PACG and venular diameter in all three glaucoma groups were reduced. The difference observed in PACG eyes may be due to an increased metabolic demand in the disease process compared to open-angle glaucoma. Keywords: glaucoma, oximetry, retinal vessels, imaging

  2. Masimo Rad-57 Pulse CO-Oximeter for noninvasive carboxyhemoglobin measurement.

    Science.gov (United States)

    Suner, Selim; McMurdy, John

    2009-03-01

    Noninvasive methods of body fluid chemical measurement have been expanding. New technologies are enabling the quantification of different compounds in the blood and interstitial tissues. One example of this is the pulse oximeter, which has facilitated the measurement of oxyhemoglobin rapidly and reliably without the requirement of blood-draws. The Masimo Rad-57 Pulse CO-Oximeter expanded the capabilities of pulse-oximetry to include measurements of carboxyhemoglobin and methemoglobin. This innovation has revolutionized the paradigm for detection of patients with CO poisoning. Previously, clinicians relied on historical information and patient signs and symptoms pointing to the possibility of CO exposure or toxicity. Only then would a blood test be ordered to measure carboxyhemoglobin levels. Since the presentation of CO poisoning is nonspecific and overlaps with many other conditions, and since the presence of environmental CO is often unknown, the detection of this condition was only possible in cases where the presence of CO was obvious or where the symptoms were severe. We now know, from studies conducted using the Rad-57, the only US FDA-approved device for noninvasive measurement of SpCO, that there are a significant number of patients who experience CO exposure but are nonsymptomatic. The Rad-57 provides a clinical justification for screening in the healthcare setting to identify patients with significant CO exposure who would otherwise be undetected.

  3. Repeated assessment of orthotopic glioma pO2 by multi-site EPR oximetry: A technique with the potential to guide therapeutic optimization by repeated measurements of oxygen

    Science.gov (United States)

    Khan, Nadeem; Mupparaju, Sriram; Hou, Huagang; Williams, Benjamin B.; Swartz, Harold

    2011-01-01

    Tumor hypoxia plays a vital role in therapeutic resistance. Consequently, measurements of tumor pO2 could be used to optimize the outcome of oxygen-dependent therapies, such as, chemoradiation. However, the potential optimizations are restricted by the lack of methods to repeatedly and quantitatively assess tumor pO2 during therapies, particularly in gliomas. We describe the procedures for repeated measurements of orthotopic glioma pO2 by multi-site electron paramagnetic resonance (EPR) oximetry. This oximetry approach provides simultaneous measurements of pO2 at more than one site in the glioma and contralateral cerebral tissue. The pO2 of intracerebral 9L, C6, F98 and U251 tumors, as well as contralateral brain, were measured repeatedly for five consecutive days. The 9L glioma was well oxygenated with pO2 of 27 - 36 mm Hg, while C6, F98 and U251 glioma were hypoxic with pO2 of 7 - 12 mm Hg. The potential of multi-site EPR oximetry to assess temporal changes in tissue pO2 was investigated in rats breathing 100% O2. A significant increase in F98 tumor and contralateral brain pO2 was observed on day 1 and day 2, however, glioma oxygenation declined on subsequent days. In conclusion, EPR oximetry provides the capability to repeatedly assess temporal changes in orthotopic glioma pO2. This information could be used to test and optimize the methods being developed to modulate tumor hypoxia. Furthermore, EPR oximetry could be potentially used to enhance the outcome of chemoradiation by scheduling treatments at times of increase in glioma pO2. PMID:22079559

  4. Ultrashort Laser Pulse Phenomena

    CERN Document Server

    Diels, Jean-Claude

    2006-01-01

    Ultrashort Laser Pulse Phenomena, 2e serves as an introduction to the phenomena of ultra short laser pulses and describes how this technology can be used to examine problems in areas such as electromagnetism, optics, and quantum mechanics. Ultrashort Laser Pulse Phenomena combines theoretical backgrounds and experimental techniques and will serve as a manual on designing and constructing femtosecond (""faster than electronics"") systems or experiments from scratch. Beyond the simple optical system, the various sources of ultrashort pulses are presented, again with emphasis on the basic

  5. Clinical Trials

    Medline Plus

    Full Text Available ... Clinical Trials About Clinical Trials Clinical trials are research studies that explore whether a medical strategy, treatment, or ... humans. What Are Clinical Trials? Clinical trials are research studies that explore whether a medical strategy, treatment, or ...

  6. Searching for Single Pulses Using Heimdall

    Science.gov (United States)

    Walsh, Gregory; Lynch, Ryan

    2018-01-01

    In radio pulsar surveys, the interstellar medium causes a frequency dependent dispersive delay of a pulsed signal across the observing band. If not corrected, this delay substantially lowers S/N and makes most pulses undetectable. The delay is proportional to an unknown dispersion measure (DM), which must be searched over with many trial values. A number of new, GPU-accelerated codes are now available to optimize this dedispersion task, and to search for transient pulsed radio emission. We report on the use of Heimdall, one such GPU-accelerated tree dedispersion utility, to search for transient radio sources in a Green Bank Telescope survey of the Cygnus Region and North Galactic Plane. The survey is carried out at central frequency of 820 MHz with a goal of finding Fast Radio Bursts, Rotating Radio Transients, young pulsars, and millisecond pulsars. We describe the the survey, data processing pipeline, and follow-up of candidate sources.

  7. Oximetry: A Reflective Tool for the Detection of Physiological Expression of Emotions in a Science Education Classroom

    Science.gov (United States)

    Calderón, Olga

    2016-01-01

    The pulse oximeter is a device that measures the oxygen concentration (or oxygen saturation--SpO[subscript 2]); heart rate, and heartbeat of a person at any given time. This instrument is commonly used in medical and aerospace fields to monitor physiological outputs of a patient according to health conditions or physiological yields of a flying…

  8. Peripheral tissue oximetry

    DEFF Research Database (Denmark)

    Hyttel-Sorensen, Simon; Hessel, Trine Witzner; Greisen, Gorm

    2014-01-01

    Estimation of regional tissue oxygenation (rStO2) by near infrared spectroscopy enables non-invasive end-organ oxygen balance monitoring and could be a valuable tool in intensive care. However, the diverse absolute values and dynamics of different devices, and overall poor repeatability of measur......Estimation of regional tissue oxygenation (rStO2) by near infrared spectroscopy enables non-invasive end-organ oxygen balance monitoring and could be a valuable tool in intensive care. However, the diverse absolute values and dynamics of different devices, and overall poor repeatability......, and response to changing oxygenation by the down slope of rStO2 during vascular occlusion in the respective arm. 10 healthy adults, 21-29 years old, with double skinfolds on the forearm less than 10 mm participated. The median rStO2 was 70.7% (interquartile range (IQR) 7.7%), 68.4% (IQR 8.4%), and 64.6% (IQR 4...

  9. The Accuracy of Pulse Spectroscopy for Detecting Hypoxemia and Coexisting Methemoglobin or Carboxyhemoglobin.

    Science.gov (United States)

    Kulcke, Axel; Feiner, John; Menn, Ingolf; Holmer, Amadeus; Hayoz, Josef; Bickler, Philip

    2016-06-01

    Pulse spectroscopy is a new noninvasive technology involving hundreds of wavelengths of visible and infrared light, enabling the simultaneous quantitation of multiple types of normal and dysfunctional hemoglobin. We evaluated the accuracy of a first-generation pulse spectroscopy system (V-Spec™ Monitoring System, Senspec, Germany) in measuring oxygen saturation (SpO2) and detecting carboxyhemoglobin (COHb) or methemoglobin (MetHb), alone or simultaneously, with hypoxemia. Nineteen volunteers were fitted with V-Spec probes on the forehead and fingers. A radial arterial catheter was placed for blood sampling during (1) hypoxemia with arterial oxygen saturations (SaO2) of 100% to 58.5%; (2) normoxia with MetHb and COHb increased to approximately 10%; (3) 10% COHb or MetHb combined with hypoxemia with SaO2 of 100% to 80%. Standard measures of pulse-oximetry performance were calculated: bias (pulse spectroscopy measured value - arterial measured value) mean ± SD and root-mean-square error (Arms). The SpO2 bias for SaO2 approximately 60% to 100% was 0.06% ± 1.30% and Arms of 1.30%. COHb bias was 0.45 ± 1.63, with an Arms of 1.69% overall, and did not degrade substantially during moderate hypoxemia. MetHb bias was 0.36 ± 0.80 overall and stayed small with hypoxemia. Arms was 0.88 and was 10%. Pulse spectroscopy accurately detects hypoxemia, MetHb, and COHb. The technology also accurately detects these dysfunctional hemoglobins during hypoxemia. Future releases of this device may have an improved SpO2 algorithm that is more robust with methemoglobinemia.

  10. Gas phase pulse radiolysis

    International Nuclear Information System (INIS)

    Jonah, C.D.; Andong Liu; Mulac, W.A.

    1987-01-01

    Gas phase pulse radiolysis, a technique which can be used to study many different phenomena in chemistry and physics, is discussed. As a source of small radicals, pulse radiolysis is important to the field of chemistry, particularly to combustion and atmospheric kinetics. The reactions of 1,3-butadiene, allene, ethylene and acetylene with OH are presented. 52 refs., 1 fig., 1 tab

  11. Pulse duration discriminator

    International Nuclear Information System (INIS)

    Kosakovskij, L.F.

    1980-01-01

    Basic circuits of a discriminator for discrimination of pulses with the duration greater than the preset one, and of a multifunctional discriminator allowing to discriminate pulses with the duration greater (tsub(p)>tsub(s)) and lesser (tsub(p) tsub(s) and with the duration tsub(p) [ru

  12. Sources of pulsed radiation

    International Nuclear Information System (INIS)

    Sauer, M.C. Jr.

    1981-01-01

    Characteristics of various sources of pulsed radiation are examined from the viewpoint of their importance to the radiation chemist, and some examples of uses of such sources are mentioned. A summary is given of the application of methods of physical dosimetry to pulsed sources, and the calibration of convenient chemical dosimeters by physical dosimetry is outlined. 7 figures, 1 table

  13. Pulsed neutron generator

    International Nuclear Information System (INIS)

    Bespalov, D.F.; Bykovskii, Yu.A.; Vergun, I.I.; Kozlovskii, K.I.; Kozyrev, Yu.P.; Leonov, R.K.; Simagin, B.I.; Tsybin, A.S.; Shikanov, A.Ie.

    1986-03-01

    The paper describes a new device for generating pulsed neutron fields, utilized in nuclear geophysics for carrying out pulsed neutron logging and activation analysis under field conditions. The invention employs a sealed-off neutron tube with a laser ion source which increases neutron yield to the level of 10 neutrons per second or higher. 2 refs., 1 fig

  14. Bipolar pulse generator for intense pulsed ion beam accelerator

    International Nuclear Information System (INIS)

    Ito, H.; Igawa, K.; Kitamura, I.; Masugata, K.

    2007-01-01

    A new type of pulsed ion beam accelerator named ''bipolar pulse accelerator'' (BPA) has been proposed in order to improve the purity of intense pulsed ion beams. To confirm the principle of the BPA, we developed a bipolar pulse generator for the bipolar pulse experiment, which consists of a Marx generator and a pulse forming line (PFL) with a rail gap switch on its end. In this article, we report the first experimental result of the bipolar pulse and evaluate the electrical characteristics of the bipolar pulse generator. When the bipolar pulse generator was operated at 70% of the full charge condition of the PFL, the bipolar pulse with the first (-138 kV, 72 ns) and the second pulse (+130 kV, 70 ns) was successfully obtained. The evaluation of the electrical characteristics indicates that the developed generator can produce the bipolar pulse with fast rise time and sharp reversing time

  15. Assessment of the Changes in 9L and C6 Glioma pO2 by EPR Oximetry as a Prognostic Indicator of Differential Response to Radiotherapy

    Science.gov (United States)

    Hou, Huagang; Mupparaju, Sriram P.; Lariviere, Jean P.; Hodge, Sassan; Gui, Jiang; Swartz, Harold M.; Khan, Nadeem

    2013-01-01

    Tumor hypoxia impedes the outcome of radiotherapy. As the extent of hypoxia in solid tumors varies during the course of radiotherapy, methods that can provide repeated assessment of tumor pO2 such as EPR oximetry may enhance the efficacy of radiotherapy by scheduling irradiations when the tumors are oxygenated. The repeated measurements of tumor pO2 may also identify responders, and thereby facilitate the design of better treatment plans for nonresponding tumors. We have investigated the temporal changes in the ectopic 9L and C6 glioma pO2 irradiated with single radiation doses less than 10 Gy by EPR oximetry. The 9L and C6 tumors were hypoxic with pO2 of approximately 5–9 mmHg. The pO2 of C6 tumors increased significantly with irradiation of 4.8–9.3 Gy. However, no change in the 9L tumor pO2 was observed. The irradiation of the oxygenated C6 tumors with a second dose of 4.8 Gy resulted in a significant delay in growth compared to hypoxic and 2 Gy × 5 treatment groups. The C6 tumors with an increase in pO2 of greater than 50% from the baseline of irradiation with 4.8 Gy (responders) had a significant tumor growth delay compared to nonresponders. These results indicate that the ectopic 9L and C6 tumors responded differently to radiotherapy. We propose that the repeated measurement of the oxygen levels in the tumors during radiotherapy can be used to identify responders and to design tumor oxygen guided treatment plans to improve the outcome. PMID:23391148

  16. Assessment of the changes in 9L and C6 glioma pO2 by EPR oximetry as a prognostic indicator of differential response to radiotherapy.

    Science.gov (United States)

    Hou, Huagang; Mupparaju, Sriram P; Lariviere, Jean P; Hodge, Sassan; Gui, Jiang; Swartz, Harold M; Khan, Nadeem

    2013-03-01

    Tumor hypoxia impedes the outcome of radiotherapy. As the extent of hypoxia in solid tumors varies during the course of radiotherapy, methods that can provide repeated assessment of tumor pO2 such as EPR oximetry may enhance the efficacy of radiotherapy by scheduling irradiations when the tumors are oxygenated. The repeated measurements of tumor pO2 may also identify responders, and thereby facilitate the design of better treatment plans for nonresponding tumors. We have investigated the temporal changes in the ectopic 9L and C6 glioma pO2 irradiated with single radiation doses less than 10 Gy by EPR oximetry. The 9L and C6 tumors were hypoxic with pO2 of approximately 5-9 mmHg. The pO2 of C6 tumors increased significantly with irradiation of 4.8-9.3 Gy. However, no change in the 9L tumor pO2 was observed. The irradiation of the oxygenated C6 tumors with a second dose of 4.8 Gy resulted in a significant delay in growth compared to hypoxic and 2 Gy × 5 treatment groups. The C6 tumors with an increase in pO2 of greater than 50% from the baseline of irradiation with 4.8 Gy (responders) had a significant tumor growth delay compared to nonresponders. These results indicate that the ectopic 9L and C6 tumors responded differently to radiotherapy. We propose that the repeated measurement of the oxygen levels in the tumors during radiotherapy can be used to identify responders and to design tumor oxygen guided treatment plans to improve the outcome.

  17. Pulse induction heating

    Energy Technology Data Exchange (ETDEWEB)

    Vasiliev, A S; Kachanov, B Y; Kogan, B V

    1993-12-31

    Induction heating and three types of pulse processes were studied. It was found that in pulse processes the frequency and pulse duration of heat treatments do not remain constant. High frequency pulse heat treatments can be used on sprayed coatings; such treatments will result in stronger surfaces with no cracks. For induction hardening, the rate of specific power was 1 to 1.5 kW/sq.cm, for forging it was 0.2 to 0.3 kW/sq.cm and for melting it was 0.05 to 0.1 kW/sq.cm. The application of pulse heating will result in higher rates of specific power.

  18. Pulse Distortion in Saturated Fiber Optical Parametric Chirped Pulse Amplification

    DEFF Research Database (Denmark)

    Lali-Dastjerdi, Zohreh; Da Ros, Francesco; Rottwitt, Karsten

    2012-01-01

    Fiber optical parametric chirped pulse amplification is experimentally compared for different chirped pulses in the picosecond regime. The amplified chirped pulses show distortion appearing as pedestals after recompression when the amplifier is operated in saturation.......Fiber optical parametric chirped pulse amplification is experimentally compared for different chirped pulses in the picosecond regime. The amplified chirped pulses show distortion appearing as pedestals after recompression when the amplifier is operated in saturation....

  19. Detection of Respiratory Adverse Events in Pediatric Dental Patients Sedated With 0.75mg/Kg of Midazolam and Oxygen by Continuous Pretracheal Auscultation: A Prospective Randomized Controlled Trial.

    Science.gov (United States)

    Somri, Mostafa; Matter, Ibrahim; Hadjittofi, Christopher; Hoash, Naser; Moaddi, Bian; Kharouba, Johnny; Parisinos, Constantinos A; Peretz, Benjamin

    Sedation is becoming more commonplace for pediatric patients undergoing minor procedures. Fortunately, electronic monitors have contributed to a reduction in the associated respiratory adverse events (RAEs). To test the hypothesis that adding the pretracheal stethoscope (PTS) to standard monitoring methods (SMMs) may improve RAE detection in sedated pediatric dental patients, the frequency of RAEs detected by SMMs (i.e. visual observation, capnography, and pulse oximetry) was compared to that detected by SMMs alongside continuous PTS auscultation. A prospective, randomised, controlled trial was performed with 100 pediatric patient participants of ASA≤2, who were scheduled to receive dental treatment under 0.75 mg/kg and oxygen. Patients were randomised into Groups A (n=50; SMMs) and B (n=50; SMMs+PTS). Inclusion criteria were behavioral management problems and intolerance to dental treatment despite behavioral management techniques or nitrous oxide administration. Exclusion criteria were high-risk conditions for RAEs, altered mental status, gastrointestinal disorders, parental refusal of conscious sedation and failure of previous conscious sedation. An anesthesist was present throughout the dental treatments. RAEs were detected in 10 (20%) and 22(44%) Group A and B patients respectively (p=0.01). The majority of RAEs within Group B were detected by PTS auscultation (n=19). Capnography produced 13 and 15 false-positive results in Groups A and B respectively, whereas the PTS produced 4(8%) false-positive results in Group B (p=0.009). PTS was found to be useful for detecting RAEs during pediatric dental sedation with 0.75mg/kg midazolam and oxygen, in the presence of an anesthesist.

  20. Optical pulse compression

    International Nuclear Information System (INIS)

    Glass, A.J.

    1975-01-01

    The interest in using large lasers to achieve a very short and intense pulse for generating fusion plasma has provided a strong impetus to reexamine the possibilities of optical pulse compression at high energy. Pulse compression allows one to generate pulses of long duration (minimizing damage problems) and subsequently compress optical pulses to achieve the short pulse duration required for specific applications. The ideal device for carrying out this program has not been developed. Of the two approaches considered, the Gires--Tournois approach is limited by the fact that the bandwidth and compression are intimately related, so that the group delay dispersion times the square of the bandwidth is about unity for all simple Gires--Tournois interferometers. The Treacy grating pair does not suffer from this limitation, but is inefficient because diffraction generally occurs in several orders and is limited by the problem of optical damage to the grating surfaces themselves. Nonlinear and parametric processes were explored. Some pulse compression was achieved by these techniques; however, they are generally difficult to control and are not very efficient. (U.S.)

  1. RF Pulsed Heating

    Energy Technology Data Exchange (ETDEWEB)

    Pritzkau, David P.

    2002-01-03

    RF pulsed heating is a process by which a metal is heated from magnetic fields on its surface due to high-power pulsed RF. When the thermal stresses induced are larger than the elastic limit, microcracks and surface roughening will occur due to cyclic fatigue. Pulsed heating limits the maximum magnetic field on the surface and through it the maximum achievable accelerating gradient in a normal conducting accelerator structure. An experiment using circularly cylindrical cavities operating in the TE{sub 011} mode at a resonant frequency of 11.424 GHz is designed to study pulsed heating on OFE copper, a material commonly used in normal conducting accelerator structures. The high-power pulsed RF is supplied by an X-band klystron capable of outputting 50 MW, 1.5 {micro}s pulses. The test pieces of the cavity are designed to be removable to allow testing of different materials with different surface preparations. A diagnostic tool is developed to measure the temperature rise in the cavity utilizing the dynamic Q change of the resonant mode due to heating. The diagnostic consists of simultaneously exciting a TE{sub 012} mode to steady-state in the cavity at 18 GHz and measuring the change in reflected power as the cavity is heated from high-power pulsed RF. Two experimental runs were completed. One run was executed at a calculated temperature rise of 120 K for 56 x 10{sup 6} pulses. The second run was executed at a calculated temperature rise of 82 K for 86 x 10{sup 6} pulses. Scanning electron microscope pictures show extensive damage occurring in the region of maximum temperature rise on the surface of the test pieces.

  2. Dynamic pulse difference circuit

    International Nuclear Information System (INIS)

    Erickson, G.L.

    1978-01-01

    A digital electronic circuit of especial use for subtracting background activity pulses in gamma spectrometry is disclosed which comprises an up-down counter connected to count up with signal-channel pulses and to count down with background-channel pulses. A detector responsive to the count position of the up-down counter provides a signal when the up-down counter has completed one scaling sequence cycle of counts in the up direction. In an alternate embodiment, a detector responsive to the count position of the up-down counter provides a signal upon overflow of the counter

  3. Coaxial pulse matching transformer

    International Nuclear Information System (INIS)

    Ledenev, V.V.; Khimenko, L.T.

    1986-01-01

    This paper describes a coaxial pulse matching transformer with comparatively simple design, increased mechanical strength, and low stray inductance. The transformer design makes it easy to change the turns ratio. The circuit of the device and an expression for the current multiplication factor are presented; experiments confirm the efficiency of the transformer. Apparatus with a coaxial transformer for producing high-power pulsed magnetic fields is designed (current pulses of 1-10 MA into a load and a natural frequency of 100 kHz)

  4. Pulse-width discriminators

    International Nuclear Information System (INIS)

    Budyashov, Yu.G.; Grebenyuk, V.M.; Zinov, V.G.

    1978-01-01

    A pulse duration discriminator is described which is intended for processing signals from multilayer scintillators. The basic elements of the scintillator are: an input gate, a current generator, an integrating capacitor, a Schmidt trigger and an anticoincidence circuit. The basic circuit of the discriminator and its time diagrams explaining its operating are given. The discriminator is based on microcircuits. Pulse duration discrimination threshold changes continuously from 20 to 100 ns, while its amplitude threshold changes within 20 to 100 mV. The temperature instability of discrimination thresholds (both in pulse width and in amplitude) is better than 0.1 per cent/deg C

  5. Multimode pulse counter

    International Nuclear Information System (INIS)

    Natanzon, D.D.

    1982-01-01

    A pulse counter with code conversion is described. The counter is based on the integrated circuits of direct-counting devices of medium integration. The counter ensures various modes of pulse counting depending on the logical control signals: reversible, two-channel summing, one-channel summing binary, summing with ''storage'' signal code fixation without interrupting pulse counting. Arrangement of the suggested structure as a microcircuit of medium integration might contribute to reduction in the counter type nomenclature in digital families of widely used integrated circuits

  6. Pulsed atomic soliton laser

    International Nuclear Information System (INIS)

    Carr, L.D.; Brand, J.

    2004-01-01

    It is shown that simultaneously changing the scattering length of an elongated, harmonically trapped Bose-Einstein condensate from positive to negative and inverting the axial portion of the trap, so that it becomes expulsive, results in a train of self-coherent solitonic pulses. Each pulse is itself a nondispersive attractive Bose-Einstein condensate that rapidly self-cools. The axial trap functions as a waveguide. The solitons can be made robustly stable with the right choice of trap geometry, number of atoms, and interaction strength. Theoretical and numerical evidence suggests that such a pulsed atomic soliton laser can be made in present experiments

  7. DogPulse

    DEFF Research Database (Denmark)

    Skovgaard, Christoffer; Thomsen, Josephine Raun; Verdezoto, Nervo

    2015-01-01

    This paper presents DogPulse, an ambient awareness system to support the coordination of dog walking among family members at home. DogPulse augments a dog collar and leash set to activate an ambient shape-changing lamp and visualize the last time the dog was taken for a walk. The lamp gradually...... changes its form and pulsates its lights in order to keep the family members aware of the dog walking activity. We report the iterative prototyping of DogPulse, its implementation and its preliminary evaluation. Based on our initial findings, we present the limitations and lessons learned as well...

  8. Quantitative determination of arterial wall mechanics with pulse oximetric finger plethysmography.

    Science.gov (United States)

    Kato, R; Sato, J; Iuchi, T; Higuchi, Y

    1999-10-30

    The plethysmographic wave of pulse oximetry reflects arterial pulsation at the fingertip. Since arterial pressure and the pulsatile component of the arterial cross section represent the input and output of the fingertip arterial system, respectively, arterial wall mechanics may be delineated from their relationship. We aimed to construct a mathematical model of the fingertip arterial wall from the relationship between the plethysmographic wave and arterial pressure. The pulse oximetric plethysmographic signal at the forefinger and pressure at the ipsilateral radial artery were measured. Employing the data, simple mathematical models with one to four mechanical elements were tested in terms of the goodness of fit and the physiological implications. The determined model was applied to the data obtained during administration of vasoactive agents in anesthetized patients. The mathematical model suited for describing arterial wall mechanics was a four-element, two-compartment model. The two compartments represent passive mechanical and active contractile properties, respectively. In the application of the model to the anesthetized patients, the vasoactive agents produced changes in the model parameters that implied mechanical alterations in the arterial wall. These findings suggest the benefit of the four-element, two-compartment model in analyzing peripheral vascular wall mechanics influenced by various stimuli in intensive care and anesthesia.

  9. Accuracy of the Masimo SET® LNCS neo peripheral pulse oximeter in cyanotic congenital heart disease.

    Science.gov (United States)

    Griksaitis, Michael J; Scrimgeour, Gemma E; Pappachan, John V; Baldock, Andrew J

    2016-08-01

    Introduction Non-invasive peripheral pulse oximeters are routinely used to measure oxyhaemoglobin saturation (SpO2) in cyanotic congenital heart disease. These probes are calibrated in healthy adult volunteers between arterial saturations of ~75 and 100%, using the gold standard of co-oximetry on arterial blood samples. There are little data to attest their accuracy in cyanotic congenital heart disease. Aims We aimed to assess the accuracy of a commonly used probe in children with cyanotic congenital heart disease. Children with cyanotic congenital heart disease admitted to the Paediatric Intensive Care Unit with an arterial line in situ were included to our study. Prospective simultaneous recordings of SpO2, measured by the Masimo SET® LNCS Neo peripheral probe, and co-oximeter saturations (SaO2) measured by arterial blood gas analysis were recorded. A total of 527 paired measurements of SpO2 and SaO2 (using an ABL800 FLEX analyser) in 25 children were obtained. The mean bias of the pulse oximeter for all SaO2 readings was +4.7±13.8%. The wide standard deviation indicates poor precision. This mean bias increased to +7.0±13.7% at SaO2 recordings congenital heart disease. This may have serious implications for clinical decisions.

  10. Clinical Trials

    Medline Plus

    Full Text Available ... questions and clinical trials. Optimizing our Clinical Trials Enterprise NHLBI has a strong tradition of supporting clinical ... multi-pronged approach to Optimize our Clinical Trials Enterprise that will make our clinical trials enterprise even ...

  11. Clinical Trials

    Medline Plus

    Full Text Available ... to-kol). This plan explains how the trial will work. The trial is led by a principal ... for the clinical trial. The protocol outlines what will be done during the clinical trial and why. ...

  12. Clinical Trials

    Medline Plus

    Full Text Available ... take part in a clinical trial. When researchers think that a trial's potential risks are greater than ... care costs for clinical trials. If you're thinking about taking part in a clinical trial, find ...

  13. Clinical Trials

    Medline Plus

    Full Text Available ... of clinical trials contribute to medical knowledge and practice. Why Clinical Trials Are Important Clinical trials are ... earlier than they would be in general medical practice. This is because late-phase trials have large ...

  14. Clinical Trials

    Medline Plus

    Full Text Available ... clinical trials contribute to medical knowledge and practice. Why Clinical Trials Are Important Clinical trials are a ... will be done during the clinical trial and why. Each medical center that does the study uses ...

  15. Clinical Trials

    Medline Plus

    Full Text Available ... medical strategy, treatment, or device is safe and effective for humans. What Are Clinical Trials? Clinical trials ... and Centers sponsor clinical trials. Many other groups, companies, and organizations also sponsor clinical trials. Examples include ...

  16. Clinical Trials

    Medline Plus

    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... kol). This plan explains how the trial will work. The trial is led by a principal investigator ( ...

  17. Repeated pulsed x-ray emission equipment

    International Nuclear Information System (INIS)

    Terauchi, Hikaru; Iida, Satoshi

    1982-01-01

    X-ray diffraction technique has been applied to determine the spatial positions of atoms which compose a material, and it is needless to say that the technique is a fundamental means regardless of the fields of research. However, the application of X-ray diffraction to the research on physical properties has been so far limited to know the spatial positions of atoms or molecules under thermal equilibrium condition. The addition of time element to the conventional technique, that is, the analysis of material structure including the time-varying processes under non-equilibrium conditions, is considered to approach the elucidation of the essence of materials. The authors call this dynamic structural analysis. The authors have planned to analyze X-ray diffraction intensity which has the resolution of about 10 -8 s in the real time which is conjugate with energy. However, present pulsed X-ray sources are not suitable for diffraction experiment because the pulse width is too long or X-ray wavelength is too short. Accordingly, the authors have made for trial a pulsed X-ray source for diffraction experiment. Its specifications are: diode voltage (X-ray tube voltage) from 200 to 300 kV, diode current from 2 to 5 kA, pulse width of about 30ns, maximum repetition frequency 10 pps, and X-ray focus size of 2 mm diameter. One of the features of this source is the repeated generation of pulsed X-ray. This is the first trial in the world, and is indispensable to the dynamic structural analysis described above. The quality of the emitted X-ray is also written. (Wakatsuki, Y.)

  18. Rapid thermal pulse annealing

    International Nuclear Information System (INIS)

    Miller, M.G.; Koehn, B.W.; Chaplin, R.L.

    1976-01-01

    Characteristics of recovery processes have been investigated for cases of heating a sample to successively higher temperatures by means of isochronal annealing or by using a rapid pulse annealing. A recovery spectra shows the same features independent of which annealing procedure is used. In order to determine which technique provides the best resolution, a study was made of how two independent first-order processes are separated for different heating rates and time increments of the annealing pulses. It is shown that the pulse anneal method offers definite advantages over isochronal annealing when annealing for short time increments. Experimental data by means of the pulse anneal techniques are given for the various substages of stage I of aluminium. (author)

  19. Pulse holographic measurement techniques

    International Nuclear Information System (INIS)

    Kim, Cheol Jung; Baik, Seong Hoon; Hong, Seok Kyung; Kim, Jeong Moog; Kim, Duk Hyun

    1992-01-01

    With the development of laser, remote inspection techniques using laser have been growing on. The inspection and measurement techniques by pulse holography are well-established technique for precise measurement, and widely used in various fields of industry now. In nuclear industry, this technology is practically used because holographic inspection is remote, noncontact, and precise measurement technique. In relation to remote inspection technology in nuclear industry, state-of-the art of pulse HNDT (Holographic non-destructive testing) and holographic measurement techniques are examined. First of all, the fundamental principles as well as practical problems for applications are briefly described. The fields of pulse holography have been divided into the HNDT, flow visualization and distribution study, and other application techniques. Additionally holographic particle study, bubble chamber holography, and applications to other visualization techniques are described. Lastly, the current status for the researches and applications of pulse holography to nuclear industry which are carried out actively in Europe and USA, is described. (Author)

  20. IAE pulsed electrostatic accelerator

    International Nuclear Information System (INIS)

    Afanas'ev, V.P.; Ganzhelyuk, M.L.; Kozlov, L.D.; Koltypin, E.A.; Molchanov, Yu.D.; Otroshchenko, G.A.; Yan'kov, G.B.

    1976-01-01

    The modernized pulse electrostatic accelerator using the klystron ion grouping and the beam interruption system prior to acceleration is described. The accelerator is modernized in order to improve parameters of a current pulse and to decrease the background in the measurement room. The ion beam of needed dimensions is obtained with the help of a high-frequency source and a beam grouping and deflection system. The general view of the beam grouping and deflection system is shown. The ion beam forming process is considered in detail. The modernized electrostatic accelerator permits to obtain a pulse current with a pulse length of 1.5 ns and an amplitude of 1.5 - 2 μA. With the repetition frequency of 2 MHz, the average target current is about 6 μA

  1. International Year of Pulses 2016 | 2016 International Year of Pulses

    Science.gov (United States)

    the Year in collaboration with Governments, relevant organizations, non-governmental organizations and the composition of pulses Image 4 Wrapping up the International Year of Pulses The 5 key messages to food security Infographic Pulses and climate change International Year of Pulses 2016 The 68th UN

  2. Realtime aspects of pulse-to-pulse modulation

    International Nuclear Information System (INIS)

    Steiner, R.; Riedel, C.; Roesch, W.

    1992-01-01

    The pulse-to-pulse modulation of the SIS-ESR control system is described. Fast response to operator interaction and to changes in process conditions is emphasized as well as the essential part played by the timing system in pulse-to-pulse modulation. (author)

  3. Pulsed spallation Neutron Sources

    International Nuclear Information System (INIS)

    Carpenter, J.M.

    1994-01-01

    This paper reviews the early history of pulsed spallation neutron source development at Argonne and provides an overview of existing sources world wide. A number of proposals for machines more powerful than currently exist are under development, which are briefly described. The author reviews the status of the Intense Pulsed Neutron Source, its instrumentation, and its user program, and provides a few examples of applications in fundamental condensed matter physics, materials science and technology

  4. Pulsed spallation neutron sources

    International Nuclear Information System (INIS)

    Carpenter, J.M.

    1996-01-01

    This paper reviews the early history of pulsed spallation neutron source development ar Argonne and provides an overview of existing sources world wide. A number of proposals for machines more powerful than currently exist are under development, which are briefly described. The author reviews the status of the Intense Pulsed Neutron Source, its instrumentation, and its user program, and provide a few examples of applications in fundamental condensed matter physics, materials science and technology

  5. Clinical Trials

    Medline Plus

    Full Text Available ... Trial Protocol Each clinical trial has a master plan called a protocol (PRO-to-kol). This plan explains how the trial will work. The trial ... clinical trial; and detailed information about the treatment plan. Eligibility Criteria A clinical trial's protocol describes what ...

  6. Noninvasive quantification of left-to-right shunt by phase contrast magnetic resonance imaging in secundum atrial septal defect: the effects of breath holding and comparison with invasive oximetry.

    Science.gov (United States)

    Yamasaki, Yuzo; Kawanami, Satoshi; Kamitani, Takeshi; Sagiyama, Koji; Sakamoto, Ichiro; Hiasa, Ken-Ichi; Yabuuchi, Hidetake; Nagao, Michinobu; Honda, Hiroshi

    2018-01-16

    To investigate the effect of breath-holding on left-to-right shunts in patients with a secundum atrial septal defect (ASD). Thirty-five consecutive patients with secundum ASDs underwent right heart catheterization and invasive oximetry. Phase-contrast magnetic resonance imaging (MRI) was performed for the main pulmonary artery and ascending aorta. All measurements were obtained during free breathing (FB) (quiet breathing; no breath-hold), expiratory breath-hold (EBH), and inspiratory breath-hold (IBH). Pulmonary circulation flow (Qp) and systemic circulation flow (Qs) were calculated by multiplying the heart rate by the stroke volume. Measurements during FB, EBH, and IBH were compared, and the differences compared to invasive oximetry were evaluated. There were significant differences among the measurements during FB, EBH, and IBH for Qp (FB, 7.70 ± 2.68; EBH, 7.18 ± 2.34; IBH, 6.88 ± 2.51 l/min); however, no significant difference was found for Qs (FB, 3.44 ± 0.74; EBH, 3.40 ± 0.83; IBH, 3.40 ± 0.86 l/min). There were significant differences among the measurements during FB, EBH, and IBH for Qp/Qs (FB, 2.38 ± 1.12; EBH, 2.24 ± 0.95; IBH, 2.14 ± 0.97). Qp/Qs during FB and EBH correlated better with Qp/Qs measured by invasive oximetry than did IBH. The limit of agreement was smaller for EBH than for FB and IBH. In patients with secundum ASDs, Qp/Qs significantly decreased with breath-holding. The accuracy of the Qp/Qs measurement by MRI compared with invasive oximetry during EBH was higher than during FB and IBH.

  7. A comparative evaluation of adaptive noise cancellation algorithms for minimizing motion artifacts in a forehead-mounted wearable pulse oximeter.

    Science.gov (United States)

    Comtois, Gary; Mendelson, Yitzhak; Ramuka, Piyush

    2007-01-01

    Wearable physiological monitoring using a pulse oximeter would enable field medics to monitor multiple injuries simultaneously, thereby prioritizing medical intervention when resources are limited. However, a primary factor limiting the accuracy of pulse oximetry is poor signal-to-noise ratio since photoplethysmographic (PPG) signals, from which arterial oxygen saturation (SpO2) and heart rate (HR) measurements are derived, are compromised by movement artifacts. This study was undertaken to quantify SpO2 and HR errors induced by certain motion artifacts utilizing accelerometry-based adaptive noise cancellation (ANC). Since the fingers are generally more vulnerable to motion artifacts, measurements were performed using a custom forehead-mounted wearable pulse oximeter developed for real-time remote physiological monitoring and triage applications. This study revealed that processing motion-corrupted PPG signals by least mean squares (LMS) and recursive least squares (RLS) algorithms can be effective to reduce SpO2 and HR errors during jogging, but the degree of improvement depends on filter order. Although both algorithms produced similar improvements, implementing the adaptive LMS algorithm is advantageous since it requires significantly less operations.

  8. Optical noninvasive calculation of hemoglobin components concentrations and fractional oxygen saturation using a ring-scattering pulse oximeter

    Science.gov (United States)

    Abdallah, Omar; Stork, Wilhelm; Muller-Glaser, Klaus

    2004-06-01

    The deficiencies of the currently used pulse oximeter are discussed in diverse literature. A hazardous pitfalls of this method is that the pulse oximeter will not detect carboxyhemoglobin (COHb) and methemoglobin (metHb) concentrations. This leads to incorrect measurement of oxygen saturation by carbon monoxide poisoning and methemoglobinemia. Also the total hemoglobin concentration will not be considered and can only be measured in-vitro up to now. A second pitfall of the standard pulse oximetry is that it will not be able to show a result by low perfusion of tissues. This case is available inter alia when the patient is under shock or has a low blood pressure. The new non-invasive system we designed measures the actual (fractional) oxygen saturation and hemoglobin concentration. It will enable us also to measure COHb and metHb. The measurement can be applied at better perfused body central parts. Four or more light emitting diodes (LEDs) or laser diodes (LDs) and five photodiodes (PDs) are used. The reflected light signal detected by photodiodes is processed using a modified Lambert-Beer law (I=I0×e-α.d ). According to this law, when a non scattering probe is irradiated with light having the incident intensity I0, the intensity of transmitted light I decays exponentially with the absorption coefficient a of that probe and its thickness d. Modifications of this law have been performed following the theoretical developed models in literature, Monte Carlo simulation and experimental measurement.

  9. Particle acceleration by electromagnetic pulses

    International Nuclear Information System (INIS)

    Lai, H.M.

    1982-01-01

    Particle interaction with plane electromagnetic pulses is studied. It is shown that particle acceleration by a wavy pulse, depending on the shape of the pulse, may not be small. Further, a diffusive-type particle acceleration by multiple weak pulses is described and discussed. (author)

  10. Dynamics of traveling reaction pulses

    International Nuclear Information System (INIS)

    Dovzhenko, A. Yu.; Rumanov, E. N.

    2007-01-01

    The growth of activator losses is accompanied by the decay of a traveling reaction pulse. In a ring reactor, this propagation threshold is present simultaneously with a threshold related to the ring diameter. The results of numerical experiments with pulses of an exothermal reaction reveal the transition from pulse propagation to a homogeneous hot regime, established regimes with periodic variations of the pulse velocity, and oscillatory decay of the pulse. When the medium becomes 'bistable' as a result of the variation in parameters, this factor does not prevent the propagation of pulses, but leads to changes in the pulse structure

  11. Pulsed rf excited spectrometer having improved pulse width control

    International Nuclear Information System (INIS)

    1977-01-01

    RF excitation for a spectrometer is obtained by pulse width modulating an RF carrier to produce the desired broadband RF exciting spectrum. The RF excitation includes a train of composite RF pulses, each composite pulse having a primary pulse portion of a first RF phase and a second pulse portion of a second RF phase opposite that of the first. In this manner, the finite rise and fall times of the primary pulse portion are compensated for by the corresponding rise and fall times of the secondary pulse portion. The primary pulse portion is lengthened by an amount equal to the secondary pulse portion so that the secondary pulse portion cancels the added primary pulse portion. In a spectrometer, the compensating second pulse component removes certain undesired side bands of the RF excitation caused by the finite rise and fall times of the applied RF pulses. The compensating second pulse component removes certain undesired side bands associated with each of the resonant lines of the excited resonance spectrum of the sample under analysis, particularly for wide band RF excitation

  12. Herophilus on pulse

    Directory of Open Access Journals (Sweden)

    Afonasin, Eugene

    2015-01-01

    Full Text Available The first detailed study of the pulse (sphygmology is associated in antiquity with Herophilus (the end of the 4th century BCE, an Alexandrian physician, renowned for his anatomical discoveries. The scholars also attribute to him a discovery of a portable and adjustable water-clock, used for measuring ‘natural’ and ‘unnatural’ pulse and, accordingly, temperature of the patient. In the article we translate the principal ancient evidences and comment upon them. We study both the practical aspects of ancient sphygmology and the theoretical speculations associated with it. Ancient theory of proportion and musical harmony allowed to build a classification of the pulses, but the medical experience did not fit well in the Procrustean bed of this rather simple theory.

  13. Current Extensions on PULSE

    Directory of Open Access Journals (Sweden)

    Sanda Dragos

    2010-09-01

    Full Text Available Using a learning management system (LMS is a common practise nowadays. Such instruments are used in educational institutions to enhance and support the teaching act as well as in industry for training purposes. In a computer science department of an university such instrument tends to be a basic requirement. That is because not only it allows a better management of courses and a better communication between students and professors, but can also serve as a perfect instrument for presenting teaching related materials for computer science subjects. During the years I have created and used several such instruments: a System with Interactive ackNowledgement and Evaluation of students work during laboratory sessions (SINE, a Php Utility used in Laboratories for Student Evaluation (PULSE, and PULSE Extended. The aim of this paper is to present the current enhancements of PULSE.

  14. Millimicrosecond pulse techniques

    CERN Document Server

    Lewis, Ian A D

    1959-01-01

    Millimicrosecond Pulse Techniques, Second Edition focuses on millimicrosecond pulse techniques and the development of devices of large bandwidth, extending down to comparatively low frequencies (1 Mc/s). Emphasis is on basic circuit elements and pieces of equipment of universal application. Specific applications, mostly in the field of nuclear physics instrumentation, are considered. This book consists of eight chapters and opens with an introduction to some of the terminology employed by circuit engineers as well as theoretical concepts, including the laws of circuit analysis, Fourier analysi

  15. Pulsed Plasma Electron Sources

    Science.gov (United States)

    Krasik, Yakov

    2008-11-01

    Pulsed (˜10-7 s) electron beams with high current density (>10^2 A/cm^2) are generated in diodes with electric field of E > 10^6 V/cm. The source of electrons in these diodes is explosive emission plasma, which limits pulse duration; in the case E Saveliev, J. Appl. Phys. 98, 093308 (2005). Ya. E. Krasik, A. Dunaevsky, and J. Felsteiner, Phys. Plasmas 8, 2466 (2001). D. Yarmolich, V. Vekselman, V. Tz. Gurovich, and Ya. E. Krasik, Phys. Rev. Lett. 100, 075004 (2008). J. Z. Gleizer, Y. Hadas and Ya. E. Krasik, Europhysics Lett. 82, 55001 (2008).

  16. Spallation neutrons pulsed sources

    International Nuclear Information System (INIS)

    Carpenter, J.

    1996-01-01

    This article describes the range of scientific applications which can use these pulsed neutrons sources: Studies on super fluids, measures to verify the crawling model for the polymers diffusion; these sources are also useful to study the neutron disintegration, the ultra cold neutrons. In certain applications which were not accessible by neutrons diffusion, for example, radiations damages, radionuclides production and activation analysis, the spallation sources find their use and their improvement will bring new possibilities. Among others contributions, one must notice the place at disposal of pulsed muons sources and neutrinos sources. (N.C.). 3 figs

  17. Pulse Doppler radar

    CERN Document Server

    Alabaster, Clive

    2012-01-01

    This book is a practitioner's guide to all aspects of pulse Doppler radar. It concentrates on airborne military radar systems since they are the most used, most complex, and most interesting of the pulse Doppler radars; however, ground-based and non-military systems are also included. It covers the fundamental science, signal processing, hardware issues, systems design and case studies of typical systems. It will be a useful resource for engineers of all types (hardware, software and systems), academics, post-graduate students, scientists in radar and radar electronic warfare sectors and milit

  18. Pulse Synchronization System (PSS)

    International Nuclear Information System (INIS)

    1977-06-01

    This document is intended to serve as an operations manual, as well as a documentation of the backup analyses pertinent to the design as delivered. A history of earlier unsuccessful versions of the Pulse Synchronization System (PSS) is not included. The function of the PSS is to synchronize the time of arrival at the fusion target of laser pulses that are propagated through the 20 amplifier chains of the SHIVA laser. The positional accuracy requirement is +-1.5 mm (+-5 psec), and is obtained by the PSS with a wide margin factor

  19. Physical model of reactor pulse

    International Nuclear Information System (INIS)

    Petrovic, A.; Ravnik, M.

    2004-01-01

    Pulse experiments have been performed at J. Stefan Institute TRIGA reactor since 1991. In total, more than 130 pulses have been performed. Extensive experimental information on the pulse physical characteristics has been accumulated. Fuchs-Hansen adiabatic model has been used for predicting and analysing the pulse parameters. The model is based on point kinetics equation, neglecting the delayed neutrons and assuming constant inserted reactivity in form of step function. Deficiencies of the Fuchs-Hansen model and systematic experimental errors have been observed and analysed. Recently, the pulse model was improved by including the delayed neutrons and time dependence of inserted reactivity. The results explain the observed non-linearity of the pulse energy for high pulses due to finite time of pulse rod withdrawal and the contribution of the delayed neutrons after the prompt part of the pulse. The results of the improved model are in good agreement with experimental results. (author)

  20. Measurement of differences in pO2 in response to perfluorocarbon/carbogen in FSa and NFSa murine fibrosarcomas with low-frequency electron paramagnetic resonance oximetry.

    Science.gov (United States)

    Halpern, H J; Yu, C; Peric, M; Barth, E D; Karczmar, G S; River, J N; Grdina, D J; Teicher, B A

    1996-05-01

    We have used very low-frequency electron paramagnetic resonance (EPR) oximetry to measure the change in oxygen concentration (delta pO2) due to change in breathing atmosphere in FSa and NFSa fibrosarcomas implanted in the legs of C3H mice infused with perfluoro-octylbromine (PFOB). Measurements in each tumor were made before and after the administration of the high-density (47% v/v) perfluorocarbon PFOB, perflubron (Alliance Pharmaceutical Corporation, San Diego, CA). Measurements in each tumor were also made, after the administration of the PFOB, both before (PFOB/air) and after the administration of carbogen (95% O2 + 5% CO2, PFOB/carbogen). Large changes (delta p02) relative to PFOB/air oxygenation were seen with the administration of PFOB/carbogen. No significant difference in oxygen concentration was seen between air-breathing mice with and without PFOB. The mean delta pO2 for FSa tumors was 13 +/- 6 torr, while the mean for NFSa fibrosarcomas was 28 +/- 7 torr. There were such large intertumor differences that the trend toward a smaller change in the more hypoxic FSa tumors was not significant (P = 0.13). This paper describes a novel method of measuring differences in oxygenation in tumor tissues. The results of such measurements indicate large differences in pO2 response to different breathing atmospheres in PFOB-infused tumors of similar histology. The intertumor delta pO2 differences may correlate with differences in radiation response.

  1. Pulse power modulators - an overview

    International Nuclear Information System (INIS)

    Venkatramani, N.

    2006-01-01

    Pulse power modulators are electronic devices to provide, high voltage, high current, power bursts. Ideally, a modulator, with the means to shape and control the pulses, acts as a switch between a high voltage power supply and its load. This article gives an overview of the pulse power modulators: starting with the basics of pulse and modulation, it covers modulation topologies, different types of modulators, major subsystems and pulse measurement techniques. The various applications of pulse power modulators and the recent trends have been included at the end. (author)

  2. Clinical Trials

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    Full Text Available ... protocol affect the trial's results. Comparison Groups In most clinical trials, researchers use comparison groups. This means ... study before you agree to take part. Randomization Most clinical trials that have comparison groups use randomization. ...

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    Full Text Available ... or vulnerable patients (such as children). A DSMB's role is to review data from a clinical trial ... a Clinical Trial If you're interested in learning more about, or taking part in, clinical trials, ...

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    Full Text Available ... Clinical Trials About Clinical Trials Clinical trials are research studies that explore whether a medical strategy, treatment, ... required to have an IRB. Office for Human Research Protections The U.S. Department of Health and Human ...

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    Full Text Available ... Trials About Clinical Trials Clinical trials are research studies that explore whether a medical strategy, treatment, or ... and Clinical Studies Web page. Children and Clinical Studies Learn more about Children and Clinical Studies Importance ...

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    Full Text Available ... any clinical trial before you agree to take part in the trial. Talk with your doctor about specific trials you're interested in. For a list of questions to ask your doctor and the ...

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    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... study? How might this trial affect my daily life? Will I have to be in the hospital? ...

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    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... from a study at any time, for any reason. Also, during the trial, you have the right ...

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    Full Text Available ... or device is safe and effective for humans. What Are Clinical Trials? Clinical trials are research studies ... parents, clinicians, researchers, children, and the general public. What to Expect During a clinical trial, doctors, nurses, ...

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    Full Text Available ... under way. For example, some trials are stopped early if benefits from a strategy or treatment are ... stop a trial, or part of a trial, early if the strategy or treatment is having harmful ...

  15. Proton Pulse Radiolysis

    Energy Technology Data Exchange (ETDEWEB)

    Christensen, H C; Nilsson, G; Reitberger, T; Thuomas, K A

    1973-03-15

    A 5 MeV proton accelerator (Van de Graaff) has been used for pulse radiolysis of a number of organic gases and the transient spectra obtained from the alkanes methane, ethane, propane, n-butane and neopentane have tentatively been assigned to alkyl radicals. Some methodological aspects of this new technique are discussed

  16. Lectures on pulsed NMR

    International Nuclear Information System (INIS)

    Pines, A.

    1988-08-01

    These lectures discuss some recent developments in pulsed NMR, emphasizing fundamental principles with selected illustrative applications. Major topics covered include multiple-quantum spectroscopy, spin decoupling, the interaction of spins with a quantized field, adiabatic rapid passage, spin temperature and statistics of cross-polarization, coherent averaging, and zero field NMR. 32 refs., 56 figs

  17. Lectures on pulsed NMR

    International Nuclear Information System (INIS)

    Pines, A.

    1986-09-01

    These lectures discuss some recent developments in pulsed NMR, emphasizing fundamental principles with selected illustrative applications. Major topics covered include multiple-quantum spectroscopy, spin decoupling, the interaction of spins with a quantized field, adiabatic rapid passage, spin temperature and statistics of cross-polarization, coherent averaging, and zero field NMR. 55 figs

  18. Pulsed electric fields

    Science.gov (United States)

    The concept of pulsed electric fields (PEF) was first proposed in 1967 to change the behavior or microorganisms. The electric field phenomenon was identified as membrane rupture theory in the 1980s. Increasing the membrane permeability led to the application of PEF assisted extraction of cellular co...

  19. Pulsed inductive HF laser

    Energy Technology Data Exchange (ETDEWEB)

    Razhev, A M; Kargapol' tsev, E S [Institute of Laser Physics, Siberian Branch, Russian Academy of Sciences, Novosibirsk (Russian Federation); Churkin, D S; Demchuk, S V [Novosibirsk State University, Novosibirsk (Russian Federation)

    2016-03-31

    We report the results of experimentally investigated dependences of temporal, spectral and spatial characteristics of an inductive HF-laser generation on the pump conditions. Gas mixtures H{sub 2} – F{sub 2}(NF{sub 3} or SF6{sub 6}) and He(Ne) – H{sub 2} – F{sub 2}(NF{sub 3} or SF{sub 6}) were used as active media. The FWHM pulse duration reached 0.42 μs. This value corresponded to a pulsed power of 45 kW. For the first time, the emission spectrum of an inductive HF laser was investigated, which consisted of seven groups of bands with centres around the wavelengths of 2732, 2736, 2739, 2835, 2837, 2893 and 2913 nm. The cross section profile of the laser beam was a ring with a diameter of about 20 mm and width of about 5 mm. Parameters of laser operation in the repetitively pulsed regime were sufficiently stable. The amplitude instability of light pulses was no greater than 5% – 6%. (lasers)

  20. Sequentially pulsed traveling wave accelerator

    Science.gov (United States)

    Caporaso, George J [Livermore, CA; Nelson, Scott D [Patterson, CA; Poole, Brian R [Tracy, CA

    2009-08-18

    A sequentially pulsed traveling wave compact accelerator having two or more pulse forming lines each with a switch for producing a short acceleration pulse along a short length of a beam tube, and a trigger mechanism for sequentially triggering the switches so that a traveling axial electric field is produced along the beam tube in synchronism with an axially traversing pulsed beam of charged particles to serially impart energy to the particle beam.

  1. Pulse pile-up IV

    International Nuclear Information System (INIS)

    Wilkinson, D.H.

    1991-05-01

    The study of pulse pile-up is extended from the case of unipolar pulses, for which ruin theory is an excellent approximation, to the case of bipolar pulses for which ruin theory is not applicable to the effect of the back-kicks in reducing the pile-up: an appropriate solution is presented. (Author) 3 refs., 11 figs

  2. Pulsed electron beam generation with fast repetitive double pulse system

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Surender Kumar; Deb, Pankaj; Shyam, Anurag, E-mail: surender80@gmail.com [Energetics and Electromagnetics Division, Bhabha Atomic Research Centre, Visakhapatnam (India); Sharma, Archana [Accelerator and Pulse Power Division, Bhabha Atomic Research Centre, Mumbai (India)

    2014-07-01

    Longer duration high voltage pulse (∼ 100 kV, 260 ns) is generated and reported using helical pulse forming line in compact geometry. The transmission line characteristics of the helical pulse forming line are also used to develop fast repetition double pulse system with very short inter pulse interval. It overcomes the limitations caused due to circuit parameters, power supplies and load characteristics for fast repetitive high voltage pulse generation. The high voltage double pulse of 100 kV, 100 ns with an inter pulse repetition interval of 30 ns is applied across the vacuum field emission diode for pulsed electron beam generation. The electron beam is generated from cathode material by application of negative high voltage (> 100 kV) across the diode by explosive electron emission process. The vacuum field emission diode is made of 40 mm diameter graphite cathode and SS mesh anode. The anode cathode gap was 6 mm and the drift tube diameter was 10 cm. The initial experimental results of pulsed electron beam generation with fast repetitive double pulse system are reported and discussed. (author)

  3. Clinical Trials

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    Full Text Available ... need to travel or stay in hospitals to take part in clinical trials. For example, the National Institutes of Health Clinical Center in ... Maryland, runs clinical trials. Many other clinical trials take place in medical centers and ... trial can have many benefits. For example, you may gain access to new treatments before ...

  4. Clinical Trials

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    Full Text Available ... of clinical trials contribute to medical knowledge and practice. Why Clinical Trials Are Important Clinical trials are a key ... Enterprise NHLBI has a strong tradition of supporting clinical trials that have not only shaped medical practice around the world, but have improved the health ...

  5. Clinical Trials

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    Full Text Available ... clinical trials. If you're thinking about taking part in a clinical trial, find out ahead of time about costs and coverage. You should learn about the risks and benefits of any clinical trial before you agree to take part in the trial. Talk with your doctor about ...

  6. Pulsed current generator

    International Nuclear Information System (INIS)

    Semenov, V.D.; Furman, Eh.G.

    1974-01-01

    The paper describes a current pulse generator with an auxiliary network consisting of a choke and diode in series designed to enlarge the range of pulse frequency control. One output of the network is connected to an adjustable valve cathode and via antoher auxiliary condenser to the point where the cathode of the main key unit is joined to the start of the magnetizing coil. A second output is connected to the anode of another adjustable valve and via another auxiliary condenser to the point where the anode of the other main key unit is joined to the end of the magnetizing coil. The generator can be used to excite the electromagnets of charged particle accelerators or in devices designed to produce magnetic fields. (author)

  7. Fast pulse amplifier

    International Nuclear Information System (INIS)

    Lepetit, J.; Poussier, E.

    1984-01-01

    This amplifier comprises an inverter transformer, the primary circuit of which receives a pulse and the secondary circuit of which is connected to several amplifying elements in parallel. The inverter transformer is made of coaxial cable segments winded around a magnetic torus; the cable cores connected in series constitute the primary circuit and the braiding of cables, connected in parallel, are the secondary circuit. The transformer comprises, besides, delay lines in series with each braiding of the secondary circuit, these ones are such that pulses issued from each braiding arrive together to the secondary circuit connectors. This invention applies, noticeably in the case of a high voltage amplifier, to the control of deflection blocks of particles used in medicine or in particle accelerators [fr

  8. Linear pulse amplifier

    International Nuclear Information System (INIS)

    Tjutju, R.L.

    1977-01-01

    Pulse amplifier is standard significant part of spectrometer. Apart from other type of amplification, it's a combination of amplification and pulse shaping. Because of its special purpose the device should fulfill the following : High resolution is desired to gain a high yield comparable to its actual state of condition. High signal to noise is desired to nhν resolution. High linearity to facilitate calibration. A good overload recovery, in order to the device will capable of analizing a low energy radiation which appear joinly on the high energy fields. Other expections of the device are its economical and practical use its extentive application. For that reason it's built on a standard NIM principle. Taking also into account the above mentioned considerations. High quality component parts are used throughout, while its availability in the domestic market is secured. (author)

  9. Pulsed fusion reactors

    International Nuclear Information System (INIS)

    1975-01-01

    This summer school specialized in examining specific fusion center systems. Papers on scientific feasibility are first presented: confinement of high-beta plasma, liners, plasma focus, compression and heating and the use of high power electron beams for thermonuclear reactors. As for technological feasibility, lectures were on the theta-pinch toroidal reactors, toroidal diffuse pinch, electrical engineering problems in pulsed magnetically confined reactors, neutral gas layer for heat removal, the conceptual design of a series of laser fusion power plants with ''Saturn'', implosion experiments and the problem of the targets, the high brightness lasers for plasma generation, and topping and bottoming cycles. Some problems common to pulsed reactors were examined: energy storage and transfer, thermomechanical and erosion effects in the first wall and blanket, the problems of tritium production, radiation damage and neutron activation in blankets, and the magnetic and inertial confinement

  10. Short pulse neutron generator

    Science.gov (United States)

    Elizondo-Decanini, Juan M.

    2016-08-02

    Short pulse neutron generators are described herein. In a general embodiment, the short pulse neutron generator includes a Blumlein structure. The Blumlein structure includes a first conductive plate, a second conductive plate, a third conductive plate, at least one of an inductor or a resistor, a switch, and a dielectric material. The first conductive plate is positioned relative to the second conductive plate such that a gap separates these plates. A vacuum chamber is positioned in the gap, and an ion source is positioned to emit ions in the vacuum chamber. The third conductive plate is electrically grounded, and the switch is operable to electrically connect and disconnect the second conductive plate and the third conductive plate. The at least one of the resistor or the inductor is coupled to the first conductive plate and the second conductive plate.

  11. Effects of divided attention and operating room noise on perception of pulse oximeter pitch changes: a laboratory study.

    Science.gov (United States)

    Stevenson, Ryan A; Schlesinger, Joseph J; Wallace, Mark T

    2013-02-01

    Anesthesiology requires performing visually oriented procedures while monitoring auditory information about a patient's vital signs. A concern in operating room environments is the amount of competing information and the effects that divided attention has on patient monitoring, such as detecting auditory changes in arterial oxygen saturation via pulse oximetry. The authors measured the impact of visual attentional load and auditory background noise on the ability of anesthesia residents to monitor the pulse oximeter auditory display in a laboratory setting. Accuracies and response times were recorded reflecting anesthesiologists' abilities to detect changes in oxygen saturation across three levels of visual attention in quiet and with noise. Results show that visual attentional load substantially affects the ability to detect changes in oxygen saturation concentrations conveyed by auditory cues signaling 99 and 98% saturation. These effects are compounded by auditory noise, up to a 17% decline in performance. These deficits are seen in the ability to accurately detect a change in oxygen saturation and in speed of response. Most anesthesia accidents are initiated by small errors that cascade into serious events. Lack of monitor vigilance and inattention are two of the more commonly cited factors. Reducing such errors is thus a priority for improving patient safety. Specifically, efforts to reduce distractors and decrease background noise should be considered during induction and emergence, periods of especially high risk, when anesthesiologists has to attend to many tasks and are thus susceptible to error.

  12. Detection of sleep disordered breathing and its central/obstructive character using nasal cannula and finger pulse oximeter.

    Science.gov (United States)

    Sommermeyer, Dirk; Zou, Ding; Grote, Ludger; Hedner, Jan

    2012-10-15

    To assess the accuracy of novel algorithms using an oximeter-based finger plethysmographic signal in combination with a nasal cannula for the detection and differentiation of central and obstructive apneas. The validity of single pulse oximetry to detect respiratory disturbance events was also studied. Patients recruited from four sleep laboratories underwent an ambulatory overnight cardiorespiratory polygraphy recording. The nasal flow and photoplethysmographic signals of the recording were analyzed by automated algorithms. The apnea hypopnea index (AHI(auto)) was calculated using both signals, and a respiratory disturbance index (RDI(auto)) was calculated from photoplethysmography alone. Apnea events were classified into obstructive and central types using the oximeter derived pulse wave signal and compared with manual scoring. Sixty-six subjects (42 males, age 54 ± 14 yrs, body mass index 28.5 ± 5.9 kg/m(2)) were included in the analysis. AHI(manual) (19.4 ± 18.5 events/h) correlated highly significantly with AHI(auto) (19.9 ± 16.5 events/h) and RDI(auto) (20.4 ± 17.2 events/h); the correlation coefficients were r = 0.94 and 0.95, respectively (p signals with a nasal flow signal provides an accurate distinction between obstructive and central apneic events during sleep.

  13. Effects of divided attention and operating room noise on perception of pulse oximeter pitch changes: A laboratory study

    Science.gov (United States)

    Stevenson, Ryan A.; Fellow, Postdoctoral; Schlesinger, Joseph J.; Physician, Resident; Wallace, Mark T.

    2012-01-01

    Background Anesthesiology requires performing visually-oriented procedures while monitoring auditory information about a patient’s vital signs. A concern in operating rooms environments is the amount of competing information and the effects that divided attention have on patient monitoring, such as detecting auditory changes in arterial oxygen saturation via pulse oximetry. Methods We measured the impact of visual attentional load and auditory background noise on the ability of anesthesia residents to monitor the pulse oximeter auditory display in a laboratory setting. Accuracies and response times were recorded reflecting anesthesiologists’ abilities to detect changes in oxygen saturation across three levels of visual attention in quiet and with noise. Results Results show that visual attentional load substantially impacts the ability to detect changes in oxygen saturation levels conveyed by auditory cues signaling 99 and 98% saturation. These effects are compounded by auditory noise, with up to a 17% decline in performance. These deficits are seen in the ability to accurately detect a change in oxygen saturation and in speed of response. Conclusions Most anesthesia accidents are initiated by small errors that cascade into serious events. Lack of monitor vigilance and inattention are two of the more commonly cited factors. Reducing such errors is thus a priority for improving patient safety. Specifically, efforts to reduce distractors and lower background noise should be considered during induction and emergence, periods of especially high risk, when anesthesiologists must attend to many tasks and are thus susceptible to error. PMID:23263015

  14. Pulsed rf operation analysis

    International Nuclear Information System (INIS)

    Puglisi, M.; Cornacchia, M.

    1981-01-01

    The need for a very low final amplifier output impedance, always associated with class A operation, requires a very large power waste in the final tube. The recently suggested pulsed rf operation, while saving a large amount of power, increases the inherent final amplifier non linearity. A method is presented for avoiding the large signal non linear analysis and it is shown how each component of the beam induced voltage depends upon all the beam harmonics via some coupling coefficients which are evaluated

  15. PULSE Pilot Certification Results

    Directory of Open Access Journals (Sweden)

    Pamela Pape-Lindstrom

    2015-08-01

    Full Text Available The pilot certification process is an ambitious, nationwide endeavor designed to motivate important changes in life sciences education that are in line with the recommendations of the 2011 Vision and Change Report: A Call to Action (American Association for the Advancement of Science [AAAS], 2011.  It is the goal of the certification process to acknowledge departments that have progressed towards full implementation of the tenets of Vision and Change and to motivate departments that have not begun to adopt the recommendations to consider doing so.  More than 70 life science departments applied to be part of the pilot certification process, funded by a National Science Foundation grant, and eight were selected based on initial evidence of transformed and innovative educational practices.  The programs chosen represent a wide variety of schools, including two-year colleges, liberal-arts institutions, regional comprehensive colleges, research universities and minority serving institutions.  Outcomes from this pilot were released June 1, 2015 (www.pulsecommunity.org, with all eight programs being recognized as having progressed along a continuum of change.  Five levels of achievement were defined as PULSE Pilot Progression Levels.  Of the eight departments in the pilot, one achieved “PULSE Progression Level III: Accomplished”.  Six departments achieved “PULSE Progression Level II: Developing” and one pilot department achieved “PULSE Progression Level I: Beginning”.  All of the schools have made significant movement towards the recommendations of Vision and Change relative to a traditional life sciences curriculum.  Overall, the response from the eight pilot schools has been positive. 

  16. STUCTURE OF PULSED BED

    Directory of Open Access Journals (Sweden)

    I. A. Bokun

    2014-01-01

    Full Text Available The structure of pulsed layer is proposed which can be suggested as a state of particulates that is blown by intermittent gas flow with speed which has the force to start material moving. Layer during one cycle is in a suspension, falling down and immobile state resulting in changes of particles arrangement as well as ways of gas flowing through layer. Moreover, it allows carrying out effective interphase heat exchange even adamant real granulation.The process of formation of impact flows is considered aw well as their influence on formation of air bubbles in pulsed layer. At startup of air blast the balance between the force of hydro-dynamic resistance is broken, on one side, and forces of gravity, particles inertia and their links with walls on the other side. The layer is transferred in the state of pulsed pseudo-fluidization, and presents gas-disperse mixture, inside of which impulse of pressure increasing is spreading to all sides as pressure waves (compression. These waves are the sources of impact flows’ formation, the force of which is two times more than during the stationary flow.The waves of pressure are divided into weak and strong ones depending on movement velocity within gas-disperse system. Weak waves are moving with a sound speed and strong ones in active phase of pulsed layer are moving over the speed of sound limit within gas-disperse system. The peculiarity of strong wave is that parameters of system (pressure, density and others are changing in discrete steps.The article describes the regime of layer’s falling down in the passive stage of cycle, which begins after finishing of gas impulse action. And suspension layer of moving up granular material is transferred in the state of falling resulting in change of the layer structure.

  17. Downhole pulse radar

    Science.gov (United States)

    Chang, Hsi-Tien

    1987-09-28

    A borehole logging tool generates a fast rise-time, short duration, high peak-power radar pulse having broad energy distribution between 30 MHz and 300 MHz through a directional transmitting and receiving antennas having barium titanate in the electromagnetically active region to reduce the wavelength to within an order of magnitude of the diameter of the antenna. Radar returns from geological discontinuities are sampled for transmission uphole. 7 figs.

  18. A comparison of linear and logarithmic auditory tones in pulse oximeters.

    Science.gov (United States)

    Brown, Zoe; Edworthy, Judy; Sneyd, J Robert; Schlesinger, Joseph

    2015-11-01

    This study compared the ability of forty anaesthetists to judge absolute levels of oxygen saturation, direction of change, and size of change in saturation using auditory pitch and pitch difference in two laboratory-based studies that compared a linear pitch scale with a logarithmic scale. In the former the differences in saturation become perceptually closer as the oxygenation level becomes higher whereas in the latter the pitch differences are perceptually equivalent across the whole range of values. The results show that anaesthetist participants produce significantly more accurate judgements of both absolute oxygenation values and size of oxygenation level difference when a logarithmic, rather than a linear, scale is used. The line of best fit for the logarithmic function was also closer to x = y than for the linear function. The results of these studies can inform the development and standardisation of pulse oximetry tones in order to improve patient safety. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  19. Evaluation of pulse oximeter derived photoplethysmographic signals for obstructive sleep apnea diagnosis.

    Science.gov (United States)

    Li, Yan; Gao, He; Ma, Yan

    2017-05-01

    High prevalence of obstructive sleep apnea (OSA) has increased the demands for more convenient and accessible diagnostic devices other than standard in-lab polysomnography (PSG). Despite the increasing utility of photoplethysmograph (PPG), it remains understudied in underserved populations. This study aimed to evaluate the reliability of a standard pulse oximeter system with an automated analysis based on the PPG signal for the diagnosis of OSA, as compared with PSG derived measures.Consecutive out-patients with suspect OSA completed a PPG monitoring simultaneous with an overnight in-lab standard PSG. Forty-nine OSA patients (38 males, age 43.5 ± 16.9 years, BMI 26.9 ± 0.5 kg/m) were included in this study. Automated analyses were based on PPG and oximetry signals only. The PPG calculated measures were compared with PSG derived measures for agreement tests.Respiratory events index derived from PPG significantly correlated with PSG-derived apnea-hypopnea index (r = 0.935, P oximeter system with PPG recording can be used for the diagnosis or screening of OSA in high risk population.

  20. Pulse radiolysis of gases

    International Nuclear Information System (INIS)

    Nielsen, O.J.

    1984-04-01

    The pulse radiolysis equipment and technique are described and its relevance to atmospheric chemistry is discussed. Pulse radiolysis of a number of different chemical systems have been used to check the validity of the proposed mechanisms: 1) The hydrogen atom yield in the pulse radiolysis of H 2 was measured by four independent calibration techniques, using reactions of H with O 2 , C1NO, and HI. The H atom yield was compared with O 2 yields in pure O 2 and in O 2 /SF 6 mixtures which lead to a value G(H) = 17.6. The rate constants at room temperature of several reactions were determined. 2) OH radical reactions with tetraalkyllead at room temperature and with ethane, methane, and a series of C1- and F-substituted methanes at 300-400 K were studied. Arrhenius parameters, A and Esub(a), were determined for several reactions. The lifetime of Pb(CH 3 ) 4 and Pb(C 2 H 5 ) 4 in ambient air is estimated. CF 2 C1 2 was found to be a very efficient third body, M, in the reaction OH + OH + M arrow H 2 O 2 + M. 3) In the H 2 S systems the HS extinction coefficient at 3242 AA was determined to 9.5 x 10 2 cm -1 mol -1 . Four rate constants at room temperature were determined. (author)

  1. Petawatt pulsed-power accelerator

    Science.gov (United States)

    Stygar, William A.; Cuneo, Michael E.; Headley, Daniel I.; Ives, Harry C.; Ives, legal representative; Berry Cottrell; Leeper, Ramon J.; Mazarakis, Michael G.; Olson, Craig L.; Porter, John L.; Wagoner; Tim C.

    2010-03-16

    A petawatt pulsed-power accelerator can be driven by various types of electrical-pulse generators, including conventional Marx generators and linear-transformer drivers. The pulsed-power accelerator can be configured to drive an electrical load from one- or two-sides. Various types of loads can be driven; for example, the accelerator can be used to drive a high-current z-pinch load. When driven by slow-pulse generators (e.g., conventional Marx generators), the accelerator comprises an oil section comprising at least one pulse-generator level having a plurality of pulse generators; a water section comprising a pulse-forming circuit for each pulse generator and a level of monolithic triplate radial-transmission-line impedance transformers, that have variable impedance profiles, for each pulse-generator level; and a vacuum section comprising triplate magnetically insulated transmission lines that feed an electrical load. When driven by LTD generators or other fast-pulse generators, the need for the pulse-forming circuits in the water section can be eliminated.

  2. Foundations of pulsed power technology

    CERN Document Server

    Lehr, Janet

    2018-01-01

    Pulsed power technologies could be an answer to many cutting-edge applications. The challenge is in how to develop this high-power/high-energy technology to fit current market demands of low-energy consuming applications. This book provides a comprehensive look at pulsed power technology and shows how it can be improved upon for the world of today and tomorrow. Foundations of Pulsed Power Technology focuses on the design and construction of the building blocks as well as their optimum assembly for synergetic high performance of the overall pulsed power system. Filled with numerous design examples throughout, the book offers chapter coverage on various subjects such as: Marx generators and Marx-like circuits; pulse transformers; pulse-forming lines; closing switches; opening switches; multi-gigawatt to multi-terawatt systems; energy storage in capacitor banks; electrical breakdown in gases; electrical breakdown in solids, liquids and vacuum; pulsed voltage and current measurements; electromagnetic interferen...

  3. Repeated tumor pO2 measurements by multi-site EPR oximetry as a prognostic marker for enhanced therapeutic efficacy of fractionated radiotherapy

    International Nuclear Information System (INIS)

    Hou Huagang; Lariviere, Jean P.; Demidenko, Eugene; Gladstone, David; Swartz, Harold; Khan, Nadeem

    2009-01-01

    Purpose: To investigate the temporal effects of single or fractionated radiotherapy on subcutaneous RIF-1 tumor pO 2 and to determine the therapeutic outcomes when the timing of fractionations is guided by tumor pO 2 . Methods: The time-course of the tumor pO 2 changes was followed by multi-site electron paramagnetic resonance (EPR) oximetry. The tumors were treated with single 10, 20, and 10 Gy x 2 doses, and the tumor pO 2 was measured repeatedly for six consecutive days. In the 10 Gy x 2 group, the second dose of 10 Gy was delivered at a time when the tumors were either relatively oxygenated or hypoxic. The changes in tumor volumes were followed for nine days to determine the therapeutic outcomes. Results: A significant increase in tumor pO 2 was observed at 24 h post 10 Gy, while 20 Gy resulted in a significant increase in tumor pO 2 at 72-120 h post irradiation. The tumors irradiated with a second dose of 10 Gy at 24 h, when the tumors were oxygenated, had a significant increase in tumor doubling times (DTs), as compared to tumors treated at 48 h when they were hypoxic (p 2 repeatedly during fractionated schemes to optimize radiotherapeutic outcome. This technique could also be used to identify responsive and non-responsive tumors, which will facilitate the design of other therapeutic approaches for non-responsive tumors at early time points during the course of therapy.

  4. Nasal continuous positive airway pressure: does bubbling improve gas exchange?

    Science.gov (United States)

    Morley, C J; Lau, R; De Paoli, A; Davis, P G

    2005-07-01

    In a randomised crossover trial, 26 babies, treated with Hudson prong continuous positive airway pressure (CPAP) from a bubbling bottle, received vigorous, high amplitude, or slow bubbling for 30 minutes. Pulse oximetry, transcutaneous carbon dioxide, and respiratory rate were recorded. The bubbling rates had no effect on carbon dioxide, oxygenation, or respiratory rate.

  5. How Are Newborn Screening Tests Done?

    Science.gov (United States)

    ... If the infant has normal hearing, the microphone picks up an echo reflected back into the ear ... hearing problem. Pulse Oximetry In some cases, hospital staff will perform pulse oximetry (pronounced ox-EM-i- ...

  6. Development of the pulse transformer for NLC klystron pulse modulator

    International Nuclear Information System (INIS)

    Akemoto, M.; Gold, S.; Koontz, R.; Krasnykh, A.

    1997-05-01

    We have studied a conventional pulse transformer for the NLC klystron pulse modulator. The transformer has been analyzed using a simplified lumped circuit model. It is found that a fast rise time requires low leakage inductance and low distributed capacitance and can be realized by reducing the number of secondary turns, but it produces larger pulse droop and core size. After making a tradeoff among these parameters carefully, a conventional pulse transformer with a rise time of 250ns and pulse droop of 3.6% has been designed and built. The transmission characteristics and pulse time-response were measured. The data were compared with the model. The agreement with the model was good when the measured values were used in the model simulation. The results of the high voltage tests are also presented

  7. Pulse transformer R and D for NLC klystron pulse modulator

    International Nuclear Information System (INIS)

    Akemoto, M.; Gold, S.; Krasnykh, A.; Koontz, R.

    1997-07-01

    The authors have studied a conventional pulse transformer for the NLC klystron pulse modulator. The transformer has been analyzed using a simplified lumped circuit model. It is found that a fast rise time requires low leakage inductance and low distributed capacitance and can be realized by reducing the number of secondary turns, but it produces larger pulse droop and requires a larger core size. After making a tradeoff among these parameters carefully, a conventional pulse transformer with a rise time of 250ns and a pulse droop of 3.6% has been designed and built. The transmission characteristics and pulse time-response were measured. The data were compared with the model. The agreement with the model was good when the measured values were used in the model simulation. The results of the high voltage tests using a klystron load are also presented

  8. Coiled transmission line pulse generators

    Science.gov (United States)

    McDonald, Kenneth Fox

    2010-11-09

    Methods and apparatus are provided for fabricating and constructing solid dielectric "Coiled Transmission Line" pulse generators in radial or axial coiled geometries. The pour and cure fabrication process enables a wide variety of geometries and form factors. The volume between the conductors is filled with liquid blends of monomers, polymers, oligomers, and/or cross-linkers and dielectric powders; and then cured to form high field strength and high dielectric constant solid dielectric transmission lines that intrinsically produce ideal rectangular high voltage pulses when charged and switched into matched impedance loads. Voltage levels may be increased by Marx and/or Blumlein principles incorporating spark gap or, preferentially, solid state switches (such as optically triggered thyristors) which produce reliable, high repetition rate operation. Moreover, these Marxed pulse generators can be DC charged and do not require additional pulse forming circuitry, pulse forming lines, transformers, or an a high voltage spark gap output switch. The apparatus accommodates a wide range of voltages, impedances, pulse durations, pulse repetition rates, and duty cycles. The resulting mobile or flight platform friendly cylindrical geometric configuration is much more compact, light-weight, and robust than conventional linear geometries, or pulse generators constructed from conventional components. Installing additional circuitry may accommodate optional pulse shape improvements. The Coiled Transmission Lines can also be connected in parallel to decrease the impedance, or in series to increase the pulse length.

  9. High current transistor pulse generator

    International Nuclear Information System (INIS)

    Nesterov, V.; Cassel, R.

    1991-05-01

    A solid state pulse generator capable of delivering high current trapezoidally shaped pulses into an inductive load has been developed at SLAC. Energy stored in the capacitor bank of the pulse generator is switched to the load through a pair of Darlington transistors. A combination of diodes and Darlington transistors is used to obtain trapezoidal or triangular shaped current pulses into an inductive load and to recover the remaining energy in the same capacitor bank without reversing capacitor voltage. The transistors work in the switch mode, and the power losses are low. The rack mounted pulse generators presently used at SLAC contain a 660 microfarad storage capacitor bank and can deliver 400 amps at 800 volts into inductive loads up to 3 mH. The pulse generators are used in several different power systems, including pulse to pulse bipolar power supplies and in application with current pulses distributed into different inductive loads. The current amplitude and discharge time are controlled by the central computer system through a specially developed multichannel controller. Several years of operation with the pulse generators have proven their consistent performance and reliability. 8 figs

  10. Versatile pulse programmer for pulsed nuclear magnetic resonance spectroscopy

    International Nuclear Information System (INIS)

    Adduci, D.J.

    1979-05-01

    A description of the sequence of events and the decisions leading to the design of a versatile pulse programmer for pulsed NMR are presented. Background and application information is discussed in order that the reader might better understand the role of the pulse programmer in a NMR spectrometer. Various other design approaches are presented as a basis for comparison. Specifications for this design are proposed, the hardware implementation of the specifications is discussed, and the software operating system is presented

  11. Versatile pulse programmer for pulsed nuclear magnetic resonance spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Adduci, D.J.

    1979-05-01

    A description of the sequence of events and the decisions leading to the design of a versatile pulse programmer for pulsed NMR are presented. Background and application information is discussed in order that the reader might better understand the role of the pulse programmer in a NMR spectrometer. Various other design approaches are presented as a basis for comparison. Specifications for this design are proposed, the hardware implementation of the specifications is discussed, and the software operating system is presented.

  12. Pulsed power for fusion

    International Nuclear Information System (INIS)

    Martin, T.H.

    1976-01-01

    A review which traces the development of high power pulsed accelerators from the original inception at the Atomic Weapons Research Establishment, Aldermaston, England, for Bremsstrahlung output, through the low impedance accelerators, to the double-sided accelerators for fusion will be given. Proto II is presently being assembled at Sandia and preliminary testing on the Marx has been completed. Examples of various techniques will be shown from Sandia accelerators. Requirements for accelerators capable of achieving fusion levels will be developed and problem areas outlined. The diode insulator flashover problem presently limits the maximum current available from the accelerators

  13. A Pulsed Sphere Tutorial

    Energy Technology Data Exchange (ETDEWEB)

    Cullen, Dermott E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-01-30

    Here I attempt to explain what physically happens when we pulse an object with neutrons, specifically what we expect the time dependent behavior of the neutron population to look like. Emphasis is on the time dependent emission of both prompt and delayed neutrons. I also describe how the TART Monte Carlo transport code models this situation; see the appendix for a complete description of the model used by TART. I will also show that, as we expect, MCNP and MERCURY, produce similar results using the same delayed neutron model (again, see the appendix).

  14. PULSE SYNTHESIZING GENERATOR

    Science.gov (United States)

    Kerns, Q.A.

    1963-08-01

    >An electronlc circuit for synthesizing electrical current pulses having very fast rise times includes several sinewave generators tuned to progressively higher harmonic frequencies with signal amplitudes and phases selectable according to the Fourier series of the waveform that is to be synthesized. Phase control is provided by periodically triggering the generators at precisely controlled times. The outputs of the generators are combined in a coaxial transmission line. Any frequency-dependent delays that occur in the transmission line can be readily compensated for so that the desired signal wave shape is obtained at the output of the line. (AEC)

  15. Charge pulse preamplifier

    International Nuclear Information System (INIS)

    Libs, Gerard.

    1973-01-01

    A charge pulse preamplifier with very low background noise is described. The inlet stage of that preamplifier comprises a cooled field-effect transistor receiving the signal to be amplified at its gate input. Preferably, the charge resistor of said transistor is a field effect transistor, the source inlet of which is connected to the drain inlet of the former transistor through a self-induction coil and a resistor mounted in series. This can be applied to the treatment of the signals delivered by a particle detector in the form of a semi-conductor [fr

  16. Effect of oxycodone hydrochloride combined with flurbiprofen axetil for intravenous patient-controlled analgesia in lower abdominal patients: A randomized trial.

    Science.gov (United States)

    Xiang, Xiaobing; Yuan, Xiaohong; Lian, Yanhong; Fang, Jun; Wu, Yingli

    2018-02-01

    Problems like postoperative pain are still common phenomena after general anesthesia. Oxycodone hydrochloride is a semisynthetic opioid with a safe and excellent therapeutic effect on visceral pain. Flurbiprofen axetil has the efficacy of targeted analgesia. We hypothesize that different doses of oxycodone hydrochloride combined with flurbiprofen axetil would generate great results on postoperative intravenous analgesia in lower abdominal patients. In the clinical trial, 90 American Society of Anesthesiologists I or II patients scheduled for elective general anesthesia were randomly divided into 3 groups, 30 cases in each group. Group I: oxycodone hydrochloride 0.5 mg/kg + flurbiprofen axetil 150 mg, group II: oxycodone hydrochloride 0.75 mg/kg + flurbiprofen axetil 150 mg, group III: oxycodone hydrochloride 1.0 mg/kg + flurbiprofen axetil 150 mg. Dilute them with 0.9% saline to 150 mL, respectively, with the background dose of 2 mL/h, patient-controlled analgesia 2 mL per time, with an interval of 10 min, and the loading dose of 0.1 mL/kg. Record the preoperative situation, 24 h (T0) before surgery, postoperative situation, 1 h (T1), 4 h (T2), 8 h (T3), 12 h (T4), 24 h (T5), 48 h (T6), 72 h (T7) after the surgery, including the mean arterial pressure, heart rate, saturation of pulse oximetry, static and dynamic pain rating (NRS) and Ramsay sedation score, effective pressing and total pressing ratio (referred to as the pressing ratio), patient satisfaction, and occurrence of adverse reactions. There was no significant statistic difference in mean arterial blood pressure, heart rate, arterial oxygen saturation, and adverse reactions among the 2 groups at each time point (P > .05). Compared with group I, the static NRS rating in group II and group III were significantly lower than that in group I (P  .05). Compared with group III, the Ramsay sedation scores of group I and group II were significantly lower from T1 to T4 (P

  17. Narrowband pulse-enhanced upconversion of chirped broadband pulses

    International Nuclear Information System (INIS)

    Zhao, Kun; Yuan, Peng; Zhong, Haizhe; Zhang, Dongfang; Zhu, Heyuan; Qian, Liejia; Chen, Liezun; Wen, Shuangchun

    2010-01-01

    We propose and demonstrate an efficient sum-frequency mixing scheme based on narrowband and chirped broadband pulses. It combines the advantages of wider spectral acceptance bandwidth and of alleviating the temporal walk-off, which are both beneficial to higher conversion efficiency. Chirped sum-frequency pulses at 455 nm with energy up to 360 µJ, corresponding to a conversion efficiency of ∼ 40%, are obtained and the pulses can be compressed to ∼ 110 fs. The sum-frequency mixing scheme may provide a promising route to the efficient generation of deep-ultraviolet femtosecond pulses

  18. Diagnosis of Obstructive Sleep Apnea Using Pulse Oximeter Derived Photoplethysmographic Signals

    Science.gov (United States)

    Romem, Ayal; Romem, Anat; Koldobskiy, Dafna; Scharf, Steven M.

    2014-01-01

    Objectives: Increasing awareness of the high prevalence of obstructive sleep apnea (OSA) and its impact on health in conjunction with high cost, inconvenience, and short supply of in-lab polysomnography (PSG) has led to the development of more convenient, affordable, and accessible diagnostic devices. We evaluated the reliability and accuracy of a single-channel (finger pulse-oximetry) photoplethysmography (PPG)-based device for detection of OSA (Morpheus Ox). Methods: Among a cohort of 73 patients referred for in-laboratory evaluation of OSA, 65 were simultaneously monitored with the PPG based device while undergoing PSG. Among these, 19 had significant cardiopulmonary comorbidities. Using the PSG as the “gold standard,” the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), as well as the positive likelihood ratio (+LR) for an apnea hypopnea index (AHI)PSG > 5/h and AHIPSG > 15/h were calculated for the PPG. Results: Valid results were available for 65 subjects. Mean age: 52.1 ± 14.2, Male: 52%, and BMI: 36.3 ± 9.7 kg/m2. Positive correlation was found between PPG-derived and PSG-derived AHI (r = 0.81, p 5/h, sensitivity was 80%, specificity 86%, PPV 93%, NPV 68%, and +LR was 5.9. For AHIPSG > 15/h, sensitivity was 70%, specificity 91%, PPV 80%, NPV 85%, and +LR was 7.83. The corresponding areas under the receiver operator curves were 0.91 and 0.9. Conclusions: PPG-derived data compare well with simultaneous in-lab PSG in the diagnosis of suspected OSA among patients with and without cardiopulmonary comorbidities. Citation: Romem A; Romem A; Koldobskiy D; Scharf SM. Diagnosis of obstructive sleep apnea using pulse oximeter derived photoplethysmographic signals. J Clin Sleep Med 2014;10(3):285-290. PMID:24634626

  19. Supercoherent phenomena in pulsed power

    International Nuclear Information System (INIS)

    O'Rourke, R.C.

    1983-01-01

    This chapter proposes the formulation of programs of basic physics research to transform Pulsed Power Technology (PPT) to Pulsed Power Science and Technology (PPS and T) by formulating the laws of the quantized microscopic electromagnetic field; applying the microscopic electromagnetic field theory to the generation, propagation and deposition of pulses in nonlinear networks; learning more about the basic super coherent ''micro-structure'' in space and time of the many-photon states of pulsed laser beams; learning more about the basic super coherent ''micro-structure'' in space and time of the many-electronstates of pulsed electron and ion laser beams; and learning everything about the ''micro-picture'' of so-called ''dielectric breakdown'' and the associated absolute time delays. Promotes the idea that laser, electron and ion beams are similar kinds of pulses in the microscopic electromagnetic field. Presents expression for the microscopic electromagnetic field in order to show the role of supercoherence in PPS and T

  20. Clinical Trials

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    Full Text Available ... groups, companies, and organizations also sponsor clinical trials. Examples include Government Agencies, such as the U.S. Departments ... sponsor trials that test principles or strategies. For example, one NHLBI study explored whether the benefits of ...

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    Full Text Available ... Departments of Defense and Veterans Affairs; private companies; universities; and nonprofit organizations. NIH Institutes and Centers (including ... our campus or trials NIH has sponsored at universities, medical centers, and hospitals. ClinicalTrials.gov View a ...

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    Full Text Available ... trials are research studies that explore whether a medical strategy, treatment, or device is safe and effective ... trials are research studies that explore whether a medical strategy, treatment, or device is safe and effective ...

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    Full Text Available ... trials show what doesn't work or may cause harm. For example, the NHLBI Women's Health Initiative tested whether hormone therapy (HT) reduced the risk of heart disease in postmenopausal women. (When the trial began, HT ...

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    Full Text Available ... risks that outweigh any possible benefits. Clinical Trial Phases Clinical trials of new medicines or medical devices are done in phases. These phases have different purposes and help researchers ...

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    Full Text Available ... the past, clinical trial participants often were White men. Researchers assumed that trial results were valid for ... different ethnic groups sometimes respond differently than White men to the same medical approach. As a result, ...

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    Full Text Available ... or strategies work best for certain illnesses or groups of people. Some clinical trials show a positive result. For example, the National Heart, Lung, and Blood Institute (NHLBI) sponsored a trial of two different ...

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    Full Text Available ... sponsored a trial of two different combinations of asthma treatments. The trial found that one of the ... much better than the other for moderate persistent asthma. The results provided important treatment information for doctors ...

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    Full Text Available ... Sponsors also may stop a trial, or part of a trial, early if the strategy or treatment is having harmful effects. Food and Drug Administration In the United States, the Food and Drug Administration (FDA) provides oversight ...

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  8. Bipolar pulse forming line

    Science.gov (United States)

    Rhodes, Mark A.

    2008-10-21

    A bipolar pulse forming transmission line module for linear induction accelerators having first, second, third, fourth, and fifth planar conductors which form an interleaved stack with dielectric layers between the conductors. Each conductor has a first end, and a second end adjacent an acceleration axis. The first and second planar conductors are connected to each other at the second ends, the fourth and fifth planar conductors are connected to each other at the second ends, and the first and fifth planar conductors are connected to each other at the first ends via a shorting plate adjacent the first ends. The third planar conductor is electrically connectable to a high voltage source, and an internal switch functions to short a high voltage from the first end of the third planar conductor to the first end of the fourth planar conductor to produce a bipolar pulse at the acceleration axis with a zero net time integral. Improved access to the switch is enabled by an aperture through the shorting plate and the proximity of the aperture to the switch.

  9. Heat driven pulse pump

    Science.gov (United States)

    Benner, Steve M (Inventor); Martins, Mario S. (Inventor)

    2000-01-01

    A heat driven pulse pump includes a chamber having an inlet port, an outlet port, two check valves, a wick, and a heater. The chamber may include a plurality of grooves inside wall of the chamber. When heated within the chamber, a liquid to be pumped vaporizes and creates pressure head that expels the liquid through the outlet port. As liquid separating means, the wick, disposed within the chamber, is to allow, when saturated with the liquid, the passage of only liquid being forced by the pressure head in the chamber, preventing the vapor from exiting from the chamber through the outlet port. A plurality of grooves along the inside surface wall of the chamber can sustain the liquid, which is amount enough to produce vapor for the pressure head in the chamber. With only two simple moving parts, two check valves, the heat driven pulse pump can effectively function over the long lifetimes without maintenance or replacement. For continuous flow of the liquid to be pumped a plurality of pumps may be connected in parallel.

  10. Compensated pulsed alternator

    International Nuclear Information System (INIS)

    Weldon, W.F.; Driga, M.D.; Woodson, H.H.

    1980-01-01

    This invention relates to an electromechanical energy converter with inertial energy storage. The device, a single phase, two or multi-pole alternator with stationary field coils, and a rotating armature is provided. The rotor itself may be of laminated steel for slower pulses or for faster pulses should be nonmagnetic and electrically nonconductive in order to allow rapid penetration of the field as the armature coil rotates. The armature coil comprises a plurality of power generating conductors mounted on the rotor. The alternator may also include a stationary or counterrotating compensating coil to increase the output voltage thereof and to reduce the internal impedance of the alternator at the moment of peak output. As the machine voltage rises sinusoidally, an external trigger switch is adapted to be closed at the appropriate time to create the desired output current from said alternator to an external load circuit, and as the output current passes through zero a self-commutating effect is provided to allow the switch to disconnect the generator from the external circuit

  11. Pulsed neutron sources at KAON

    International Nuclear Information System (INIS)

    Thorson, I.M.; Egelstaff, P.A.; Craddock, M.K.

    1991-01-01

    The proposed KAON Factory facility at TRIUMF consists of a number of synchrotrons and storage rings which offer proton beams of energies between 0.45 and 30 GeV with varying pulse amplitudes, widths and repetition rates. Various possibilities for feeding these beams to a pulsed neutron facility and their potential for future development are examined. The incremental cost of such a pulsed neutron facility is estimated approximately. (author)

  12. Assembly delay line pulse generators

    CERN Multimedia

    CERN PhotoLab

    1971-01-01

    Assembly of six of the ten delay line pulse generators that will power the ten kicker magnet modules. One modulator part contains two pulse generators. Capacitors, inductances, and voltage dividers are in the oil tank on the left. Triggered high-pressure spark gap switches are on the platforms on the right. High voltage pulse cables to the kicker magnet emerge under the spark gaps. In the centre background are the assembled master gaps.

  13. Clinical Trials

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    Full Text Available ... resources to the strategies and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, you may get tests or treatments in a hospital, clinic, or doctor's office. In some ways, taking part in a clinical trial is different ...

  14. Clinical Trials

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    Full Text Available ... Health Topics / About Clinical Trials About Clinical Trials Clinical trials are research studies that explore whether a medical strategy, treatment, ... tool for advancing medical knowledge and patient care. Clinical research is done only if doctors don't know ...

  15. Clinical Trials

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    Full Text Available ... about your health or fill out forms about how you feel. Some people will need to travel or stay in hospitals to take part in clinical trials. For example, the National Institutes of Health Clinical Center in Bethesda, Maryland, runs clinical trials. Many other clinical trials take place ...

  16. Clinical Trials

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    Full Text Available ... more screening tests to see which test produces the best results. Some companies and groups sponsor clinical trials that test the ... and Drug Administration (FDA) oversees these clinical trials. The NIH may partner with these companies or groups to help sponsor some trials. All ...

  17. Clinical Trials

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    Full Text Available ... child to enroll. Also, children aged 7 and older often must agree (assent) to take part in clinical trials. Clinical trials for children have the same scientific safeguards as clinical trials for adults. For more information, go to "How Do Clinical ...

  18. Clinical Trials

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    Full Text Available ... give permission for their child to enroll. Also, children aged 7 and older often must agree (assent) to take part in clinical trials. Find a Clinical Trial If you're interested in learning more about, or taking part in, clinical trials, ...

  19. Clinical Trials

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    Full Text Available ... part in a clinical trial is your decision. Talk with your doctor about all of your treatment options. Together, you can make the ... more about, or taking part in, clinical trials, talk with your doctor. He or she may know about ... clinical trials. NIH Clinical Research Studies ...

  20. Powerful nanosecond pulse train generator

    International Nuclear Information System (INIS)

    Isakov, I.F.; Logachev, E.I.; Opekunov, M.S.; Pechenkin, S.A.; Remnev, G.E.; Usov, Yu.P.

    1987-01-01

    A generator permitting to shape on the load pulsed with the repetition frequency of 10 3 -10 6 Hz and more is described. The amplitude of shaped voltage pulses is up to 150 kV at pulse duration equal to 50 ns. The generator comprises connected in-series with the load two shaping and two transmission lines realized on the base of the KVI-300 low-ohmic cable. The shaping lines are supplied from two independently connected pulse voltage generators for obtaining time interval between pulses > 10 -6 s; they may be also supplied from one generator for obtaining time interval -6 s. At the expense of reducing losses in the discharge circuit the amplitude of the second pulse grows with increase of time interval between pulses up to 300 ns, further on the curve flat-topping exists. The described generator is used in high-current accelerators, in which the primary negative pulse results in generation of explosive-emission plasma, and the second positive pulse provides ion beam shaping including ions of heavy metal used for production of a potential electrode. The generator multipulse mode is used for successive ion acceleration in the transport system

  1. Changes in body weight and pulse

    DEFF Research Database (Denmark)

    Seimon, R V; Espinoza, D; Finer, N

    2015-01-01

    BACKGROUND/OBJECTIVES: The Sibutramine Cardiovascular OUTcomes (SCOUT) trial showed a significantly increased relative risk of nonfatal cardiovascular events, but not mortality, in overweight and obese subjects receiving long-term sibutramine treatment with diet and exercise. We examined the rela......BACKGROUND/OBJECTIVES: The Sibutramine Cardiovascular OUTcomes (SCOUT) trial showed a significantly increased relative risk of nonfatal cardiovascular events, but not mortality, in overweight and obese subjects receiving long-term sibutramine treatment with diet and exercise. We examined...... the relationship between early changes (both increases and decreases) in pulse rate, and the impact of these changes on subsequent cardiovascular outcome events in both the placebo and sibutramine groups. SUBJECTS/METHODS: 9804 males and females, aged ⩾55 years, with a body mass index of 27-45 kg m(-)(2) were...... included in this current subanalysis of the SCOUT trial. Subjects were required to have a history of cardiovascular disease and/or type 2 diabetes mellitus with at least one cardiovascular risk factor, to assess cardiovascular outcomes. The primary outcome event (POE) was a composite of nonfatal myocardial...

  2. New MR pulse sequence

    International Nuclear Information System (INIS)

    Harms, S.E.; Flamig, D.P.; Griffey, R.H.

    1990-01-01

    This paper describes a method for fat suppression for three-dimensional MR imaging. The FATS (fat-suppressed acquisition with echo time shortened) sequence employs a pair of opposing adiabatic half-passage RF pulses tuned on fat resonance. The imaging parameters are as follows: TR, 20 msec; TE, 21.7-3.2 msec; 1,024 x 128 x 128 acquired matrix; imaging time, approximately 11 minutes. A series of 54 examinations were performed. Excellent fat suppression with water excitation is achieved in all cases. The orbital images demonstrate superior resolution of small orbital lesions. The high signal-to-noise ratio (SNR) in cranial studies demonstrates excellent petrous bone and internal auditory canal anatomy

  3. Digital pulse shape discrimination

    International Nuclear Information System (INIS)

    Miller, L. F.; Preston, J.; Pozzi, S.; Flaska, M.; Neal, J.

    2007-01-01

    Pulse-shape discrimination (PSD) has been utilised for about 40 years as a method to obtain estimates for dose in mixed neutron and photon fields. Digitizers that operate close to GHz are currently available at a reasonable cost, and they can be used to directly sample signals from photomultiplier tubes. This permits one to perform digital PSD rather than the traditional, and well-established, analogous techniques. One issue that complicates PSD for neutrons in mixed fields is that the light output characteristics of typical scintillators available for PSD, such as BC501A, vary as a function of energy deposited in the detector. This behaviour is more easily accommodated with digital processing of signals than with analogous signal processing. Results illustrate the effectiveness of digital PSD. (authors)

  4. Pulsed Compression Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Roestenberg, T. [University of Twente, Enschede (Netherlands)

    2012-06-07

    The advantages of the Pulsed Compression Reactor (PCR) over the internal combustion engine-type chemical reactors are briefly discussed. Over the last four years a project concerning the fundamentals of the PCR technology has been performed by the University of Twente, Enschede, Netherlands. In order to assess the feasibility of the application of the PCR principle for the conversion methane to syngas, several fundamental questions needed to be answered. Two important questions that relate to the applicability of the PCR for any process are: how large is the heat transfer rate from a rapidly compressed and expanded volume of gas, and how does this heat transfer rate compare to energy contained in the compressed gas? And: can stable operation with a completely free piston as it is intended with the PCR be achieved?.

  5. Pulse-shaping strategies in short-pulse fiber amplifiers

    Energy Technology Data Exchange (ETDEWEB)

    Schimpf, Damian Nikolaus

    2010-02-09

    Ultrashort pulse lasers are an important tool in scientific and industrial applications. However, many applications are demanding higher average powers from these ultrashort pulse sources. This can be achieved by combining direct diode pumping with novel gain media designs. In particular, ultrashort pulse fiber lasers are now delivering average powers in the kW range. However, the design of fiber lasers, producing pulses with high peak-powers, is challenging due to the impact of nonlinear effects. To significantly reduce these detrimental effects in ultrashort pulse fiber amplifers, the combination of chirped pulse amplification (CPA) and large mode area fibers is employed. Using these methods, the pulse energy of fiber lasers has been steadily increasing for the past few years. Recently, a fiber-based CPA-system has been demonstrated which produces pulse energies of around 1 mJ. However, both the stretching and the enlargement of the mode area are limited, and therefore, the impact of nonlinearity is still noticed in systems employing such devices. The aim of this thesis is the analysis of CPA-systems operated beyond the conventional nonlinear limit, which corresponds to accumulated nonlinear phase-shifts around 1 rad. This includes a detailed discussion of the influence of the nonlinear effect self-phase modulation on the output pulse of CPA-systems. An analytical model is presented. Emphasis is placed on the design of novel concepts to control the impact of self-phase modulation. Pulse-shaping is regarded as a powerful tool to accomplish this goal. Novel methods to control the impact of SPM are experimentally demonstrated. The design of these concepts is based on the theoretical findings. Both amplitude- and phase-shaping are studied. Model-based phase-shaping is implemented in a state-of-the-art fiber CPA-system. The influence of the polarization state is also highlighted. Additionally, existing techniques and recent advances are put into context. (orig.)

  6. Pulse-shaping strategies in short-pulse fiber amplifiers

    International Nuclear Information System (INIS)

    Schimpf, Damian Nikolaus

    2010-01-01

    Ultrashort pulse lasers are an important tool in scientific and industrial applications. However, many applications are demanding higher average powers from these ultrashort pulse sources. This can be achieved by combining direct diode pumping with novel gain media designs. In particular, ultrashort pulse fiber lasers are now delivering average powers in the kW range. However, the design of fiber lasers, producing pulses with high peak-powers, is challenging due to the impact of nonlinear effects. To significantly reduce these detrimental effects in ultrashort pulse fiber amplifers, the combination of chirped pulse amplification (CPA) and large mode area fibers is employed. Using these methods, the pulse energy of fiber lasers has been steadily increasing for the past few years. Recently, a fiber-based CPA-system has been demonstrated which produces pulse energies of around 1 mJ. However, both the stretching and the enlargement of the mode area are limited, and therefore, the impact of nonlinearity is still noticed in systems employing such devices. The aim of this thesis is the analysis of CPA-systems operated beyond the conventional nonlinear limit, which corresponds to accumulated nonlinear phase-shifts around 1 rad. This includes a detailed discussion of the influence of the nonlinear effect self-phase modulation on the output pulse of CPA-systems. An analytical model is presented. Emphasis is placed on the design of novel concepts to control the impact of self-phase modulation. Pulse-shaping is regarded as a powerful tool to accomplish this goal. Novel methods to control the impact of SPM are experimentally demonstrated. The design of these concepts is based on the theoretical findings. Both amplitude- and phase-shaping are studied. Model-based phase-shaping is implemented in a state-of-the-art fiber CPA-system. The influence of the polarization state is also highlighted. Additionally, existing techniques and recent advances are put into context. (orig.)

  7. Multiple cutaneous leiomyomas: Pain relief with pulsed hysocine butyl bromide

    Directory of Open Access Journals (Sweden)

    Kaliyadan Feroze

    2009-01-01

    Full Text Available A 35-year-old male patient presented to our outpatient department, complaining of multiple, raised skin lesions on the forehead and back, associated with intermittent pain, especially on exposure to cold. A diagnosis of cutaneous leiomyoma (type 2 segmental was made, which was confirmed by skin biopsy. The patient was started on a trial of pulsed Hyoscine Butyl bromide tablets, following which the patient had significant relief from pain associated with the lesions.

  8. Low-intensity pulsed ultrasound: Fracture healing

    Directory of Open Access Journals (Sweden)

    Mundi Raman

    2009-01-01

    Full Text Available Annually, millions of people across the world are inflicted with bone fracture injuries. Untimely healing is a significant burden in terms of socioeconomic costs, personal costs, and patients′ quality of life. Low-intensity pulsed ultrasound (LIPUS has gained much attention as a potential adjunctive therapy for accelerating fresh fracture healing, but its efficacy remains controversial. This paper is presented in two parts a literature review followed by a systematic review. The literature review highlights the physiology of fracture healing and the influence LIPUS exerts on cells and molecules involved in this healing process. In part two, we present a systematic review of randomized controlled trials (RCTs assessing the clinical effectiveness of LIPUS in accelerating the time to fracture healing. The electronic databases we searched for the systematic review are as follows: MEDLINE (from 1996 to November 2008, EMBASE (from 1996 to November 2008, and Healthstar (from 1966 to October 2008. A two-step screening process was used to assess the eligibility of studies yielded by our search. The first step was a review of titles and abstracts for the selection of studies that met the following criteria: (i inclusion of skeletally mature patients with a fresh fracture, (ii a minimum of two treatment arms with at least one arm receiving LIPUS treatment and another arm receiving placebo, (iii random allocation of patients to the different treatment arms, (iv radiological assessment of time to fracture healing, and (v publication in the English language. In the second step, selected articles were reviewed in full text. Eligible trials were all scored independently by two reviewers for methodological reporting quality using the 15-item CLEAR NPT checklist (Checklist to Evaluate the Report of a Nonpharmacological Trial. We identified a total of seventy seven studies, nine of which met our inclusion criteria after the initial screening. Of these nine

  9. The Vulcan pulse generating system

    International Nuclear Information System (INIS)

    Danson, C.N.; Edwards, C.B.; Wyatt, R.W.W.

    1985-01-01

    During the past two years several changes have been made to the front end system on the VULCAN pulse generating system. These changes give greater flexibility and a wider choice of operating conditions. This note gives an updated description of the system capabilities, and gives users of the facility an idea of the various pulse combinations that are available. (author)

  10. NMR in pulsed magnetic field

    KAUST Repository

    Abou-Hamad, Edy; Bontemps, P.; Rikken, Geert L J A

    2011-01-01

    Nuclear magnetic resonance (NMR) experiments in pulsed magnetic fields up to 30.4 T focused on 1H and 93Nb nuclei are reported. Here we discuss the advantage and limitation of pulsed field NMR and why this technique is able to become a promising research tool. © 2011 Elsevier Inc. All Rights Reserved.

  11. Progress in pulsed power fusion

    Energy Technology Data Exchange (ETDEWEB)

    Quintenz, J P; Adams, R G; Bailey, J E [Sandia Labs., Albuquerque, NM (United States); and others

    1997-12-31

    Pulsed power offers an efficient, high energy, economical source of x-rays for inertial confinement fusion (ICF) research. Two main approaches to ICF driven with pulsed power accelerators are pursued: intense light ion beams and z-pinches. Recent progress in each approach and plans for future development is described. (author). 2 figs., 10 refs.

  12. NMR in pulsed magnetic field

    KAUST Repository

    Abou-Hamad, Edy

    2011-09-01

    Nuclear magnetic resonance (NMR) experiments in pulsed magnetic fields up to 30.4 T focused on 1H and 93Nb nuclei are reported. Here we discuss the advantage and limitation of pulsed field NMR and why this technique is able to become a promising research tool. © 2011 Elsevier Inc. All Rights Reserved.

  13. A Single-Pulse Integrator

    DEFF Research Database (Denmark)

    Miller, Arne

    1974-01-01

    A single-pulse integrator is described. It gives a relative measure of the integral of the output signal from a coil monitor on the Risø 10 MeV linear accelerator, and displays the value on a digital voltmeter. The reproduccibility is found to be better than ±1% for an accelerated pulse charge...

  14. Progress in pulsed power fusion

    International Nuclear Information System (INIS)

    Quintenz, J.P.; Adams, R.G.; Bailey, J.E.

    1996-01-01

    Pulsed power offers an efficient, high energy, economical source of x-rays for inertial confinement fusion (ICF) research. Two main approaches to ICF driven with pulsed power accelerators are pursued: intense light ion beams and z-pinches. Recent progress in each approach and plans for future development is described. (author). 2 figs., 10 refs

  15. Using a pulse oximeter to determine clinical depth of anesthesia-investigation of the utility of the perfusion index.

    Science.gov (United States)

    Krishnamohan, Anirudh; Siriwardana, Viraj; Skowno, Justin J

    2016-11-01

    Peripheral vasodilation is a well-recognized side effect of general anesthesia, and induces changes in the amplitude of the pulse plethysmograph (PPG) waveform. This can be continuously quantitaed using the Perfusion Index (PI), a ratio of the pulsatile to nonpulsatile signal amplitude in the PPG waveform. We hypothesized that the perfusion index would rise with the induction of anesthesia in children, and fall with emergence, and performed a prospective, observational study to test this. Our primary aim was to test whether the different clinical stages of anesthesia were associated with changes in the perfusion index, and the secondary aim was to test the correlation between the normalized perfusion index and the MAC value. Twenty-one patients between the ages of 1 and 18 undergoing minor procedures with no anticipated painful stimuli were recruited. Patients with significant illnesses were excluded. Data collection commenced with a preinduction baseline, and data were collected continuously, with event marking, until completion of the anesthesia and removal of the pulse oximeter. Data collected included perfusion index, heart rate, and anesthetic gas concentration values. A normalized perfusion index was calculated by subtracting the initial baseline perfusion index value from all perfusion index values, allowing changes, from a standardized initial baseline value of zero, to be analyzed. During induction, the mean normalized perfusion index rose from 0.0 to 4.2, and then declined to 0.470 when the patients returned to consciousness. P < 0.001 using repeated measures anova test. The normalized perfusion index was correlated with MAC values (r 2 = 0.33, 95% CI 0.18-0.47, P < 0.01). The perfusion index changed significantly during different stages of anesthesia. There is a significant correlation between the perfusion index, measured by pulse oximetry, and the MAC value, in pediatric patients undergoing minor procedures. © 2016 John Wiley & Sons Ltd.

  16. Electromagnetic pulses, localized and causal

    Science.gov (United States)

    Lekner, John

    2018-01-01

    We show that pulse solutions of the wave equation can be expressed as time Fourier superpositions of scalar monochromatic beam wave functions (solutions of the Helmholtz equation). This formulation is shown to be equivalent to Bateman's integral expression for solutions of the wave equation, for axially symmetric solutions. A closed-form one-parameter solution of the wave equation, containing no backward-propagating parts, is constructed from a beam which is the tight-focus limit of two families of beams. Application is made to transverse electric and transverse magnetic pulses, with evaluation of the energy, momentum and angular momentum for a pulse based on the general localized and causal form. Such pulses can be represented as superpositions of photons. Explicit total energy and total momentum values are given for the one-parameter closed-form pulse.

  17. A digital long pulse integrator

    International Nuclear Information System (INIS)

    Broesch, J.D.; Strait, E.J.; Snider, R.T.

    1996-10-01

    A prototype digital integrator with very long integration capabilities has been developed and field tested on an inductive magnetic sensor on the DIII-D Tokamak. The integrator is being developed for use on ITER with a pulse length of 1000 s, and has direct applications for other long pulse Tokamaks. Inductive magnetic sensors are routinely used on existing Tokamaks, are well understood, and are extremely robust, however, they require integration of the signal to determine the magnetic field strength. The next generation of Tokamaks, will have pulse lengths of 1000 s or longer, require integrators with drift and noise characteristics compatible with the very long pulse lengths. This paper will discuss the architecture, algorithms, and programming of the Long Pulse Integrator (LPI). Of particular interest are the noise control and the built-in offset correction techniques used in this application

  18. Nanosecond pulsed electric field ablation of hepatocellular carcinoma.

    Science.gov (United States)

    Beebe, Stephen J; Chen, Xinhua; Liu, Jie A; Schoenbach, Karl H

    2011-01-01

    Hepatocellular carcinoma often evades effective therapy and recurrences are frequent. Recently, nanosecond pulsed electric field (nsPEF) ablation using pulse power technology has emerged as a local-regional, non-thermal, and non-drug therapy for skin cancers. In the studies reported here we use nsPEFs to ablate murine, rat and human HCCs in vitro and an ectopic murine Hepa 1-6 HCC in vivo. Using pulses with 60 or 300 ns and electric fields as high as 60 kV/cm, murine Hepa 1-6, rat N1S1 and human HepG2 HCC are readily eliminated with changes in caspase-3 activity. Interestingly caspase activities increase in the mouse and human model and decrease in the rat model as electric field strengths are increased. In vivo, while sham treated control mice survived an average of 15 days after injection and before humane euthanasia, Hepa 1-6 tumors were eliminated for longer than 50 days with 3 treatments using one hundred pulses with 100 ns at 55 kV/cm. Survival was 40% in mice treated with 30 ns pulses at 55 kV/cm. This study demonstrates that nsPEF ablation is not limited to effectively treating skin cancers and provides a rationale for treating orthotopic hepatocellular carcinoma in pre-clinical applications and ultimately in clinical trials.

  19. Pulsed neutron generator for use with pulsed neutron activation techniques

    International Nuclear Information System (INIS)

    Rochau, G.E.

    1980-01-01

    A high-output, transportable, pulsed neutron generator has been developed by Sandia National Laboratories for use with Pulsed Neutron Activation (PNA) techniques. The PNA neutron generator generates > 10 10 14 MeV D-T neutrons in a 1.2 millisecond pulse. Each operation of the unit will produce a nominal total neutron output of 1.2 x 10 10 neutrons. The generator has been designed to be easily repaired and modified. The unit requires no additional equipment for operation or measurement of output

  20. Laser ablation comparison by picosecond pulses train and nanosecond pulse

    Science.gov (United States)

    Lednev, V. N.; Filippov, M. N.; Bunkin, A. F.; Pershin, S. M.

    2015-12-01

    A comparison of laser ablation by a train of picosecond pulses and nanosecond pulses revealed a difference in laser craters, ablation thresholds, plasma sizes and spectral line intensities. Laser ablation with a train of picosecond pulses resulted in improved crater quality while ablated mass decreased up to 30%. A reduction in laser plasma dimensions for picosecond train ablation was observed while the intensity of atomic/ionic lines in the plasma spectra was greater by a factor of 2-4 indicating an improved excitation and atomization in the plasma.

  1. Pulse on pulse: modulation and signification in Rafael Lozano-Hemmer's Pulse Room

    Directory of Open Access Journals (Sweden)

    Merete Carlson

    2012-06-01

    Full Text Available This article investigates the relation between signifying processes and non-signifying material dynamism in the installation Pulse Room (2006 by Mexican Canadian artist Rafael Lozano-Hemmer. In Pulse Room the sense of pulse is ambiguous. Biorhythms are transmitted from the pulsing energy of the visitor's beating heart to the flashing of a fragile light bulb, thereby transforming each light bulb into a register of individual life. But at the same time the flashing light bulbs together produce a chaotically flickering light environment composed by various layers of repetitive rhythms, a vibrant and pulsating “room”. Hence, the visitor in Pulse Room is invited into a complex scenario that continuously oscillates between various aspects of signification (the light bulbs representing individual lives; the pulse itself as the symbolic “rhythm of life” and instants of pure material processuality (flickering light bulbs; polyrhythmic layers. Taking our point of departure in a discussion of Gilles Deleuze's concepts of modulation and signaletic material in relation to electronic media, we examine how the complex orchestration of pulsation between signification and material modulation produces a multilayered sense of time and space that is central to the sensory experience of Pulse Room as a whole. Pulse Room is, at the very same time, a relational subject–object intimacy and an all-encompassing immersive environment modulating continuously in real space-time.

  2. Pulse shaping using a spatial light modulator

    CSIR Research Space (South Africa)

    Botha, N

    2009-07-01

    Full Text Available Femtosecond pulse shaping can be done by different kinds of pulse shapers, such as liquid crystal spatial light modulators (LC SLM), acousto optic modulators (AOM) and deformable and movable mirrors. A few applications where pulse shaping...

  3. Clinical Trials

    Medline Plus

    Full Text Available ... part. Randomization Most clinical trials that have comparison groups use randomization. This involves assigning patients to different comparison groups by chance, rather than choice. This ...

  4. Bomb pulse biology

    Energy Technology Data Exchange (ETDEWEB)

    Falso, Miranda J. Sarachine [Center for Accelerator Mass Spectrometry, Mail Stop L-397, Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA 94551 (United States); Buchholz, Bruce A., E-mail: buchholz2@llnl.gov [Center for Accelerator Mass Spectrometry, Mail Stop L-397, Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA 94551 (United States)

    2013-01-15

    The past decade has seen an explosion in use of the {sup 14}C bomb pulse to do fundamental cell biology. Studies in the 1960s used decay counting to measure tissue turnover when the atmospheric {sup 14}C/C concentration was changing rapidly. Today bulk tissue measurements are of marginal interest since most of the carbon in the tissue resides in proteins, lipids and carbohydrates that turn over rapidly. Specific cell types with specialized functions are the focus of cell turnover investigations. Tissue samples need to be fresh or frozen. Fixed or preserved samples contain petroleum-derived carbon that has not been successfully removed. Cell or nuclear surface markers are used to sort specific cell types, typically by fluorescence-activated cell sorting (FACS). Specific biomolecules need to be isolated with high purity and accelerator mass spectrometry (AMS) measurements must accommodate samples that generally contain less than 40 {mu}g of carbon. Furthermore, all separations must not add carbon to the sample. Independent means such as UV absorbance must be used to confirm molecule purity. Approaches for separating specific proteins and DNA and combating contamination of undesired molecules are described.

  5. Pulsed radiation decay logging

    International Nuclear Information System (INIS)

    Mills, W.R. Jr.

    1983-01-01

    There are provided new and improved well logging processes and systems wherein the detection of secondary radiation is accomplished during a plurality of time windows in a manner to accurately characterize the decay rate of the secondary radiation. The system comprises a well logging tool having a primary pulsed radiation source which emits repetitive time-spaced bursts of primary radiation and detector means for detecting secondary radiation resulting from the primary radiation and producing output signals in response to the detected radiation. A plurality of measuring channels are provided, each of which produces a count rate function representative of signals received from the detector means during successive time windows occurring between the primary radiation bursts. The logging system further comprises means responsive to the measuring channels for producing a plurality of functions representative of the ratios of the radiation count rates measured during adjacent pairs of the time windows. Comparator means function to compare the ratio functions and select at least one of the ratio functions to generate a signal representative of the decay rate of the secondary radiation

  6. NEMP (Nuclear Electromagnetic Pulse)

    International Nuclear Information System (INIS)

    Grunow, H.K.

    The variety of measures discussed in this contribution can be used to achieve with minimum effort a damping of 10 6 :1 (120 dB) between the interfering pulses in the networks and lines outside the buildings and the lines leading to the semiconductors. Expert knowledge, experience, and insight into the systems are required to solve this task optimally. The procedure to be adopted for NEMP protection differs only slightly from that used for achieving electromagnetic compatibility and lightning protection. Industry has developed the equipment for overvoltage protection and offers graded protection systems, experienced experts and systems engineers are available. This potential of the industry could be used to sponsor a pilot project, e.g. by public research funds. One of the goals of such a project could be to work out reliable data for cost estimated for large projects. Even if one would not accept the hypothetical probability of a nuclear war as a reason good anough to start such a project, it would not be justified to deny the necessity of additional expenditure for setting up a ''NEMP emergency system'' for protection waterborne traffic on purely financial grounds. (orig./RW) [de

  7. Magnetic Alignment of Pulsed Solenoids Using the Pulsed Wire Method

    International Nuclear Information System (INIS)

    Arbelaez, D.; Madur, A.; Lipton, T.M.; Waldron, W.L.; Kwan, J.W.

    2011-01-01

    A unique application of the pulsed-wire measurement method has been implemented for alignment of 2.5 T pulsed solenoid magnets. The magnetic axis measurement has been shown to have a resolution of better than 25 (micro)m. The accuracy of the technique allows for the identification of inherent field errors due to, for example, the winding layer transitions and the current leads. The alignment system is developed for the induction accelerator NDCX-II under construction at LBNL, an upgraded Neutralized Drift Compression experiment for research on warm dense matter and heavy ion fusion. Precise alignment is essential for NDCX-II, since the ion beam has a large energy spread associated with the rapid pulse compression such that misalignments lead to corkscrew deformation of the beam and reduced intensity at focus. The ability to align the magnetic axis of the pulsed solenoids to within 100 pm of the induction cell axis has been demonstrated.

  8. Repeatability of Pulse Diagnosis and Body Constitution Diagnosis in Traditional Indian Ayurveda Medicine

    Science.gov (United States)

    Waagepetersen, Rasmus; Toft, Egon; Prasad, Ramjee; Raturi, Lokesh

    2012-01-01

    In Ayurveda, pulse diagnosis and body constitution diagnosis have a long historical use; still, there is lack of quantitative measure of the reliability of these diagnostic methods. Reliability means consistency of information. Consistent diagnosis leads to consistent treatment and is important for clinical practice, education, and research. The objective of this study is to study the methodology to evaluate the test-retest reliability (repeatability) of pulse diagnosis and body constitution diagnosis. A double-blinded, controlled, clinical trial was conducted in Copenhagen. The same doctor, an expert in Ayurvedic pulse diagnosis, examined the pulse and body constitution of 17 healthy participants twice, in random order without seeing them. A metric on pulse and body constitution variables was developed. Cohen's weighted kappa statistic was used as a measure of intra-rater reliability. Permutation tests were used to test the hypothesis of homogeneous diagnosis (ie, the doctor's diagnosis does not depend on the subject). The hypothesis of homogeneous classification was rejected on the 5% significance level (P values of .02 and .001, respectively, for pulse and body constitution diagnosis). According to the Landis and Koch scale, values of the weighted kappa for pulse diagnosis (P = .42) and body constitution diagnosis (P = .65) correspond to “moderate” and “substantial” agreement, respectively. There was a reasonable level of consistency between 2 pulse and body constitution diagnoses. Further studies are required to quantify inter-subject and intra-subject agreement for greater understanding of reliability of pulse and body constitution diagnosis. PMID:27257530

  9. LIMITS ON PROMPT, DISPERSED RADIO PULSES FROM GAMMA-RAY BURSTS

    International Nuclear Information System (INIS)

    Bannister, K. W.; Murphy, T.; Gaensler, B. M.; Reynolds, J. E.

    2012-01-01

    We have searched for prompt radio emission from nine gamma-ray bursts (GRBs) with a 12 m telescope at 1.4 GHz, with a time resolution of 64 μs to 1 s. We detected single dispersed radio pulses with significances >6σ in the few minutes following two GRBs. The dispersion measures of both pulses are well in excess of the expected Galactic values, and the implied rate is incompatible with known sources of single dispersed pulses. The arrival times of both pulses also coincide with breaks in the GRB X-ray light curves. A null trial and statistical arguments rule out random fluctuations as the origin of these pulses with >95% and ∼97% confidence, respectively, although a simple population argument supports a GRB origin with confidence of only 2%. We caution that we cannot rule out radio frequency interference (RFI) as the origin of these pulses. If the single pulses are not related to the GRBs, we set an upper limit on the flux density of radio pulses emitted between 200 and 1800 s after a GRB of 1.27w –1/2 Jy, where 6.4 × 10 –5 s –3 s is the pulse width. We set a limit of less than 760 Jy for long timescale (>1 s) variations. These limits are some of the most constraining at high time resolution and GHz frequencies in the early stages of the GRB phenomenon.

  10. Pulsed ultrasonic stir welding method

    Science.gov (United States)

    Ding, R. Jeffrey (Inventor)

    2013-01-01

    A method of performing ultrasonic stir welding uses a welding head assembly to include a plate and a rod passing through the plate. The rod is rotatable about a longitudinal axis thereof. In the method, the rod is rotated about its longitudinal axis during a welding operation. During the welding operation, a series of on-off ultrasonic pulses are applied to the rod such that they propagate parallel to the rod's longitudinal axis. At least a pulse rate associated with the on-off ultrasonic pulses is controlled.

  11. Pulse timing for cataclysmic variables

    International Nuclear Information System (INIS)

    Chester, T.J.

    1979-01-01

    It is shown that present pulse timing measurements of cataclysmic variables can be explained by models of accretion disks in these systems, and thus such measurements can constrain disk models. The model for DQ Her correctly predicts the amplitude variation of the continuum pulsation and can also perhaps explain the asymmetric amplitude of the pulsed lambda4686 emission line. Several other predictions can be made from the model. In particular, if pulse timing measurements that resolve emission lines both in wavelength and in binary phase can be made, the projected orbital radius of the white dwarf could be deduced

  12. Hyper dispersion pulse compressor for chirped pulse amplification systems

    Science.gov (United States)

    Barty, Christopher P. J.

    2011-11-29

    A grating pulse compressor configuration is introduced for increasing the optical dispersion for a given footprint and to make practical the application for chirped pulse amplification (CPA) to quasi-narrow bandwidth materials, such as Nd:YAG. The grating configurations often use cascaded pairs of gratings to increase angular dispersion an order of magnitude or more. Increased angular dispersion allows for decreased grating separation and a smaller compressor footprint.

  13. Treatment of knee osteoarthritis with pulsed electromagnetic fields: a randomized, double-blind, placebo-controlled study

    DEFF Research Database (Denmark)

    Thamsborg, G; Florescu, A; Oturai, P

    2005-01-01

    OBJECTIVE: The investigation aimed at determining the effectiveness of pulsed electromagnetic fields (PEMF) in the treatment of osteoarthritis (OA) of the knee by conducting a randomized, double-blind, placebo-controlled clinical trial. DESIGN: The trial consisted of 2h daily treatment 5 days per...

  14. Assessment of multi-wavelength pulse photometry for non-invasive dose estimation of circulating drugs and nanoparticles

    Science.gov (United States)

    Adhikari, Pratik; Eklund, Wakako; Sherer, Eric A.; O'Neal, D. Patrick

    2016-03-01

    The feasibility of multi-wavelength photoplethysmography for the real-time sensing of absorptive and scattering agents in pulsatile blood is discussed. The use of pulsatile signals extracted from trans-illumination of an accessible section of tissue allows us to calculate the concentration of the optically extinctive species in the pulsatile blood. This technology, initially used for pulse oximetry and dye densitometry, can be applied to monitor in vivo concentration and clearance of various absorptive species. Recently, our prototype has been used monitor the concentration of therapeutic gold nanoparticles, antimalarial quinine, and the antifungal agent amphotericin B. The assessment of the optical properties, device specifications, and signal quality for each compound are presented. We observe that this technology can be used to monitor numerous extinctive drug and nano-materials that present features in the 350-1100 nm range. The rationale for using this technology in a clinical setting would be to improve outcomes by real-time pharmacological feedback and/or control at point of care in addition to the elimination of invasive blood draws for collection of data.

  15. Wearable Oximetry for Harsh Environments

    Science.gov (United States)

    characterize the types and significance of motion artifacts that will need to be mitigated. The forehead was confirmed to be an excellent site with...respect to signal quality, but signal corruption from changes in contact pressure will need to be mitigated. The sternal locations are initially assessed

  16. Wearable oximetry for harsh environments

    Science.gov (United States)

    2017-02-23

    averages were computed using a 2nd- order Kalman filter [26]. The Kalman filter was applied within local 5-minute data windows in both the forward...to produce distributions that are approximately normally distributed [25]. In each iteration, values with absolute deviations from the Kalman filter ...Firefighters, first responders, warfighters, and explorers must often operate in environmental extremes of temperature (hot or cold), humidity

  17. Clinical Trials

    Medline Plus

    Full Text Available ... trial found that one of the combinations worked much better than the other for moderate persistent asthma. The results provided important treatment information for doctors and patients. The results from other clinical trials show what doesn't work or may cause harm. For example, the NHLBI ...

  18. Clinical Trials

    Medline Plus

    Full Text Available ... the clinical trial you take part in, the information gathered can help others and add to scientific knowledge. People who take part in clinical trials are vital to the process of improving medical care. Many people volunteer because ...

  19. Clinical Trials

    Medline Plus

    Full Text Available ... from other clinical trials show what doesn't work or may cause harm. For example, the NHLBI Women's Health Initiative ... safe a treatment is or how well it works. Children (aged 18 and younger) get ... legal consent for their child to take part in a clinical trial. When ...

  20. Clinical Trials

    Medline Plus

    Full Text Available ... other expenses (for example, travel and child care)? Who will be in charge of my care? What will happen after the trial? Taking part in a clinical trial is your decision. Talk with your doctor about all of your treatment ...

  1. Clinical Trials

    Medline Plus

    Full Text Available ... for trials with cutting-edge approaches, such as gene therapy or new biological treatments. Health insurance and health ... trials that involve high-risk procedures (such as gene therapy) or vulnerable patients (such as children). A DSMB's ...

  2. Clinical Trials

    Medline Plus

    Full Text Available ... to Expect During a clinical trial, doctors, nurses, social workers, and other health care providers might be part of your treatment ... clinical trials are vital to the process of improving medical care. Many people ... participants, it may not work for you. A new treatment may have side ...

  3. Clinical Trials

    Medline Plus

    Full Text Available ... Expect During a clinical trial, doctors, nurses, social workers, and other health care providers might be part of your treatment ... phase II clinical trials. The risk of side effects might be even greater for ... treatments. Health insurance and health care providers don't always ...

  4. Clinical Trials

    Medline Plus

    Full Text Available ... a Clinical Trial If you're interested in learning more about, or taking part in, clinical trials, talk with your doctor. He or she may know about studies going on in your area. You can visit the following website to learn more about ...

  5. Clinical Trials

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    Full Text Available ... benefits of lowering high blood pressure in the elderly outweighed the risks. Other examples of clinical trials ... child to enroll. Also, children aged 7 and older often must agree (assent) to ... as clinical trials for adults. For more information, go to "How Do Clinical ...

  6. Clinical Trials

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    Full Text Available ... products, such as medicines, and how well they work. The U.S. Food and Drug Administration (FDA) oversees these clinical trials. ... cancer also increased. As a result, the U.S. Food and Drug Administration now recommends never using HT ... Clinical Trials Work If you take ...

  7. Harmonic generation with a dual frequency pulse.

    Science.gov (United States)

    Keravnou, Christina P; Averkiou, Michalakis A

    2014-05-01

    Nonlinear imaging was implemented in commercial ultrasound systems over the last 15 years offering major advantages in many clinical applications. In this work, pulsing schemes coupled with a dual frequency pulse are presented. The pulsing schemes considered were pulse inversion, power modulation, and power modulated pulse inversion. The pulse contains a fundamental frequency f and a specified amount of its second harmonic 2f. The advantages and limitations of this method were evaluated with both acoustic measurements of harmonic generation and theoretical simulations based on the KZK equation. The use of two frequencies in a pulse results in the generation of the sum and difference frequency components in addition to the other harmonic components. While with single frequency pulses, only power modulation and power modulated pulse inversion contained odd harmonic components, with the dual frequency pulse, pulse inversion now also contains odd harmonic components.

  8. Pulsed Corona for Sustainable Technology

    International Nuclear Information System (INIS)

    Heesch, E.J.M. van; Pemen, A.J.M.; Yan, K.; Blom, P.P.M.; Huijbrechts, P.A.H.J.; Der Laan, P.C.T. van

    2000-01-01

    Highly active coronas with a peak power of up to 25 MW p/m corona wire and kJ/liter energy densities in the streamer channels can be produced by pulsed power. Since the voltage pulses are short, full breakdown does not occur even though the discharge currents are hundreds of Amperes. A matched pulsed power source can deposit up to 80% of its electrical energy into such a controlled discharge. Reliable and efficient sources characterized by 100 kV,150 ns wide pulses at 1000 Hz have passed 400 hours of operation. The area of applications is growing: VOC control, hot gas cleanup, water and air purification and sterilization. (author)

  9. Next generation Chirped Pulse Amplification

    Energy Technology Data Exchange (ETDEWEB)

    Nees, J; Biswal, S; Mourou, G [Univ. Michigan, Center for Ultrafast Optical Science, Ann Arbor, MI (United States); Nishimura, Akihiko; Takuma, Hiroshi

    1998-03-01

    The limiting factors of Chirped Pulse Amplification (CPA) are discussed and experimental results of CPA in Yb:glass regenerative amplifier are given. Scaling of Yb:glass to the petawatt level is briefly discussed. (author)

  10. Pulsed ventilation in mines. II

    Energy Technology Data Exchange (ETDEWEB)

    Krause, D

    1975-06-01

    Using test results, an attempt is made to determine the form of the free jet and to derive design data for pulsed fans. The most suitable placing of these fans for the ventilation of headings is discussed.

  11. Quantitative pulsed eddy current analysis

    International Nuclear Information System (INIS)

    Morris, R.A.

    1975-01-01

    The potential of pulsed eddy current testing for furnishing more information than conventional single-frequency eddy current methods has been known for some time. However, a fundamental problem has been analyzing the pulse shape with sufficient precision to produce accurate quantitative results. Accordingly, the primary goal of this investigation was to: demonstrate ways of digitizing the short pulses encountered in PEC testing, and to develop empirical analysis techniques that would predict some of the parameters (e.g., depth) of simple types of defect. This report describes a digitizing technique using a computer and either a conventional nuclear ADC or a fast transient analyzer; the computer software used to collect and analyze pulses; and some of the results obtained. (U.S.)

  12. Pulsed high-power beams

    International Nuclear Information System (INIS)

    Reginato, L.L.; Birx, D.L.

    1988-01-01

    The marriage of induction linac technology with nonlinear magnetic modulators has produced some unique capabilities. It is now possible to produce short-pulse electron beams with average currents measured in amperes, at gradients approaching 1-MeV/m, and with power efficiencies exceeding 50%. This paper reports on a 70-MeV, 3-kA induction accelerator (ETA II) constructed at the Lawrence Livermore National Laboratory that incorporates the pulse technology concepts that have evolved over the past several years. The ETA II is a linear induction accelerator and provides a test facility for demonstration of the high-average-power components and high-brightness sources used in such accelerators. The pulse drive of the accelerator is based on state-of-the-art magnetic pulse compressors with very high peak-power capability, repetition rates exceeding 1 kHz, and excellent reliability

  13. Pulsed ultrasonic stir welding system

    Science.gov (United States)

    Ding, R. Jeffrey (Inventor)

    2013-01-01

    An ultrasonic stir welding system includes a welding head assembly having a plate and a rod passing through the plate. The rod is rotatable about a longitudinal axis thereof. During a welding operation, ultrasonic pulses are applied to the rod as it rotates about its longitudinal axis. The ultrasonic pulses are applied in such a way that they propagate parallel to the longitudinal axis of the rod.

  14. Pulsed feedback defers cellular differentiation.

    Directory of Open Access Journals (Sweden)

    Joe H Levine

    2012-01-01

    Full Text Available Environmental signals induce diverse cellular differentiation programs. In certain systems, cells defer differentiation for extended time periods after the signal appears, proliferating through multiple rounds of cell division before committing to a new fate. How can cells set a deferral time much longer than the cell cycle? Here we study Bacillus subtilis cells that respond to sudden nutrient limitation with multiple rounds of growth and division before differentiating into spores. A well-characterized genetic circuit controls the concentration and phosphorylation of the master regulator Spo0A, which rises to a critical concentration to initiate sporulation. However, it remains unclear how this circuit enables cells to defer sporulation for multiple cell cycles. Using quantitative time-lapse fluorescence microscopy of Spo0A dynamics in individual cells, we observed pulses of Spo0A phosphorylation at a characteristic cell cycle phase. Pulse amplitudes grew systematically and cell-autonomously over multiple cell cycles leading up to sporulation. This pulse growth required a key positive feedback loop involving the sporulation kinases, without which the deferral of sporulation became ultrasensitive to kinase expression. Thus, deferral is controlled by a pulsed positive feedback loop in which kinase expression is activated by pulses of Spo0A phosphorylation. This pulsed positive feedback architecture provides a more robust mechanism for setting deferral times than constitutive kinase expression. Finally, using mathematical modeling, we show how pulsing and time delays together enable "polyphasic" positive feedback, in which different parts of a feedback loop are active at different times. Polyphasic feedback can enable more accurate tuning of long deferral times. Together, these results suggest that Bacillus subtilis uses a pulsed positive feedback loop to implement a "timer" that operates over timescales much longer than a cell cycle.

  15. Artistic Representation with Pulsed Holography

    International Nuclear Information System (INIS)

    Ishii, S

    2013-01-01

    This thesis describes artistic representation through pulsed holography. One of the prevalent practical problems in making holograms is object movement. Any movement of the object or film, including movement caused by acoustic vibration, has the same fatal results. One way of reducing the chance of movement is by ensuring that the exposure is very quick; using a pulsed laser can fulfill this objective. The attractiveness of using pulsed laser is based on the variety of materials or objects that can be recorded (e.g., liquid material or instantaneous scene of a moving object). One of the most interesting points about pulsed holograms is that some reconstructed images present us with completely different views of the real world. For example, the holographic image of liquid material does not appear fluid; it looks like a piece of hard glass that would produce a sharp sound upon tapping. In everyday life, we are unfamiliar with such an instantaneous scene. On the other hand, soft-textured materials such as a feather or wool differ from liquids when observed through holography. Using a pulsed hologram, we can sense the soft touch of the object or material with the help of realistic three-dimensional (3-D) images. The images allow us to realize the sense of touch in a way that resembles touching real objects. I had the opportunity to use a pulsed ruby laser soon after I started to work in the field of holography in 1979. Since then, I have made pulsed holograms of activities, including pouring water, breaking eggs, blowing soap bubbles, and scattering feathers and popcorn. I have also created holographic art with materials and objects, such as silk fiber, fabric, balloons, glass, flowers, and even the human body. Whenever I create art, I like to present the spectator with a new experience in perception. Therefore, I would like to introduce my experimental artwork through those pulsed holograms.

  16. The Toulouse pulsed magnet facility

    International Nuclear Information System (INIS)

    2006-01-01

    The 'Laboratoire National des Champs Magnetiques Pulses' (LNCMP) is an international user facility providing access to pulsed magnetic fields up to and beyond 60 T. The laboratory disposes of 10 magnet stations equipped with long-pulse magnets operating in the 35-60 T range and a short-pulse system reaching magnetic fields in excess of 70 T. The experimental infrastructure includes various high and low-temperature systems ranging from ordinary flow-type cryostats to dilution refrigerators reaching 50 mK, as well as different types of high-pressure cells. Experimental techniques include magnetization, transport, luminescence, IR-spectroscopy and polarimetry. The LNCMP pursues an extensive in-house research program focussing on all technological and scientific aspects of pulsed magnetic fields. Recent technical developments include the implementation of 60 T rapid-cooling coils, an 80 T prototype, a pulsed dipole magnet for optical investigations of dilute matter and a transportable horizontal access magnet for small angle x-ray scattering experiments. Scientific activities cover a variety of domains, including correlated electron systems, magnetism, semiconductors and nanoscience

  17. Square pulse linear transformer driver

    Directory of Open Access Journals (Sweden)

    A. A. Kim

    2012-04-01

    Full Text Available The linear transformer driver (LTD technological approach can result in relatively compact devices that can deliver fast, high current, and high-voltage pulses straight out of the LTD cavity without any complicated pulse forming and pulse compression network. Through multistage inductively insulated voltage adders, the output pulse, increased in voltage amplitude, can be applied directly to the load. The usual LTD architecture [A. A. Kim, M. G. Mazarakis, V. A. Sinebryukhov, B. M. Kovalchuk, V. A. Vizir, S. N Volkov, F. Bayol, A. N. Bastrikov, V. G. Durakov, S. V. Frolov, V. M. Alexeenko, D. H. McDaniel, W. E. Fowler, K. LeCheen, C. Olson, W. A. Stygar, K. W. Struve, J. Porter, and R. M. Gilgenbach, Phys. Rev. ST Accel. Beams 12, 050402 (2009PRABFM1098-440210.1103/PhysRevSTAB.12.050402; M. G. Mazarakis, W. E. Fowler, A. A. Kim, V. A. Sinebryukhov, S. T. Rogowski, R. A. Sharpe, D. H. McDaniel, C. L. Olson, J. L. Porter, K. W. Struve, W. A. Stygar, and J. R. Woodworth, Phys. Rev. ST Accel. Beams 12, 050401 (2009PRABFM1098-440210.1103/PhysRevSTAB.12.050401] provides sine shaped output pulses that may not be well suited for some applications like z-pinch drivers, flash radiography, high power microwaves, etc. A more suitable power pulse would have a flat or trapezoidal (rising or falling top. In this paper, we present the design and first test results of an LTD cavity that generates such a type of output pulse by including within its circular array a number of third harmonic bricks in addition to the main bricks. A voltage adder made out of a square pulse cavity linear array will produce the same shape output pulses provided that the timing of each cavity is synchronized with the propagation of the electromagnetic pulse.

  18. Long Silver Nanowires Synthesis by Pulsed Electrodeposition

    Directory of Open Access Journals (Sweden)

    M.R. Batevandi

    2015-09-01

    Full Text Available Silver nanowires were pulse electrodeposited into nanopore anodic alumina oxide templates. The effects of continuous and pulse electrodeposition waveform on the microstructure properties of the nanowire arrays were studied. It is seen that the microstructure of nanowire is depend to pulse condition. The off time duration of pulse waveform enables to control the growth direction of Ag nanowires.

  19. System for increasing laser pulse rate

    International Nuclear Information System (INIS)

    1980-01-01

    A technique of static elements is disclosed for combining a plurality of laser beams having time sequenced, pulsed radiation to achieve an augmented pulse rate. The technique may also be applied in a system for combining both time sequenced pulses and frequency distinct pulses for use in a system for isotope enrichment. (author)

  20. Neutron induced current pulses in fission chambers

    International Nuclear Information System (INIS)

    Taboas, A.L.; Buck, W.L.

    1978-01-01

    The mechanism of neutron induced current pulse generation in fission chambers is discussed. By application of the calculated detector transfer function to proposed detector current pulse shapes, and by comparison with actually observed detector output voltage pulses, a credible, semi-empirical, trapezoidal pulse shape of chamber current is obtained