Background: Accurate determination of the optimal insertion depth of a pediatric endotracheal tube (ETT) is quite important. The aim of this study was to create an easily available formula that can be used to determin...Background: Accurate determination of the optimal insertion depth of a pediatric endotracheal tube (ETT) is quite important. The aim of this study was to create an easily available formula that can be used to determine the optimal insertion depth for a cuffed ETT even without depth marking with clear definitions of the upper and lower limits for the tip of ETT in the trachea in clinical practice. Methods: Eighty children under 12 years of age were enrolled. The depth marking of the cuffed ETT was placed at the vocal cords and both lungs were then auscultated using a stethoscope. The upper limit was radiographically defined as the position of the tip of the cuffed ETT being between the clavicles. The lower limit was defined as a distance of 5 mm above the carina. The relationship between the insertion depth and patient characteristics was analyzed to create a formula for optimal ETT insertion depth. Results: Sixty-nine ETTs were optimally placed in the trachea. There were good correlations between the optimal insertion depth of ETTs and patients characteristics (height (R = 0.92);BSA (R = 0.92);weight (R = 0.91);age (R = 0.88)). Using these patient characteristics, we created the following three formulas for calculation of the optimal insertion depth for pediatric cuffed ETTs: insertion depth (cm) = height (cm)/11 + 5.5, weight (kg)/3 + 9.5 or 11 + 3/4 × age (years). The rates of appropriate tube placement of both pediatric cuffed ETTs were 87.5% (Hi-Contour) and 85.0% (Microcuff). Conclusions: Our formula and graphs may be easy to determine the optimal insertion depth of cuffed ETT even without depth marking in clinical practice.展开更多
用0、50、100、150和200 m M Na Cl溶液处理不同秋眠等级紫花苜蓿标准品种Maverick、Archer和CUF101,观察形态特征和盐害级别,测定叶片净光合速率(Pn)、细胞间隙CO2浓度(Ci)和气孔导度(Gs),分析盐胁迫对不同秋眠等级紫花苜蓿光合特性的...用0、50、100、150和200 m M Na Cl溶液处理不同秋眠等级紫花苜蓿标准品种Maverick、Archer和CUF101,观察形态特征和盐害级别,测定叶片净光合速率(Pn)、细胞间隙CO2浓度(Ci)和气孔导度(Gs),分析盐胁迫对不同秋眠等级紫花苜蓿光合特性的影响.不同秋眠等级紫花苜蓿植株叶片盐害级别随品种和处理浓度不同而不同,但均随Na Cl浓度的增加和胁迫时间的延长而加大.在较低Na Cl浓度下Maverick、Archer和CUF101光合响应存在着预警阶段-恢复阶段-耗尽阶段,在高Na Cl浓度下,所有的供试品种光合响应直接进入耗尽阶段.展开更多
Background: Surveys of pediatric endotracheal tube (ETT) management previously reported that specialists in pediatric anesthesia and intensive care medicine preferred to use uncuffed ETTs for children younger than 8 t...Background: Surveys of pediatric endotracheal tube (ETT) management previously reported that specialists in pediatric anesthesia and intensive care medicine preferred to use uncuffed ETTs for children younger than 8 to 10 years of age. The aim of this study was to reveal the most recent attitudes and clinical practices of pediatric ETT management in Japan. Methods: The attitudes and clinical practices of pediatric ETT management were investigated using the data sheets of each institution and each patient. The data sheets contained information on patient characteristics and type of hospital, surgical procedures, devices used for intubation, and ETT information including types, size, depth, intracuff pressure (ICP), interval of ICP measurement, laryngeal packing, ETT exchange, airway complications, and reintubations. Results: The response rate of this survey was 66.7%. More than half of children older than 2 years of age were intubated with cuffed ETTs;83.5% of cuffed ETTs were used with the cuffs inflated, and ICP was measured in 80.7% of cuffed ETTs. More than half of ICP measurements were only taken at the time of intubation. Post-extubation stridor was rarely observed in cuffed (0.4%) or uncuffed ETTs (1.2%). The pediatric ETT management questionnaire revealed age-based size selection, differences in pressure of air leakage between cuffed (15 - 20 cmH2O) and uncuffed ETTs (20 - 30 cmH2O) of different sizes, the depthmarking method of insertion length. Continuous measurement of ICP was not common. Conclusion: This study revealed widespread use of cuffed ETTs in children older than 2 years of age, rarely occurrence of post-extubation stridor, inflation of cuffs, and practice of ICP measurement.展开更多
Background: Comparison of the tracheal tube depth over the same body height of men and women based upon intubation depth markings. Methods: Kashan University of Medical Sciences ethics committee approved the study and...Background: Comparison of the tracheal tube depth over the same body height of men and women based upon intubation depth markings. Methods: Kashan University of Medical Sciences ethics committee approved the study and written informed consent was taken for each patient. Patients undergoing surgery requiring general anesthesia with oro-tracheal intubation were included in a prospective observational study. After induction of general anesthesia, the endotracheal tube was secured at the point at which the cuff was just below the vocal cord on laryngoscopy. Results: In a statistical study of 682 intubated patients which consisted of 499 women and 183 men, 28 cases of laryngoscopic view grade III and IV were excluded from the study. The measurement markings on the ETT at the level of right corner of the mouth were 20.65 ± 0.13 and 18.52 ± 0.08 for men and women respectively (CI 95%). Patient’s height has a meaningful correlation with the measurement of the fixation point of the ETT. Pearson correlation coefficient between the securing point of the tube and height was 0.2 and 0.357 for men and women respectively. In most cases of men and women of the same height, Mann-Whitney U test rejected the hypothesis that the tube can be fixed in the particular point. Conclusions: In general, men are taller than women. Comparing the fixation depth of the tube, even when man and woman have the same body height, the endotracheal tube might be placed in a deeper level for men rather than women.展开更多
Panel flutter phenomena can be strongly affected by thermal loads,and so a refined aeroelastic model is presented.Higher-order shell theories are used as structural models.The aerodynamic forces are described using th...Panel flutter phenomena can be strongly affected by thermal loads,and so a refined aeroelastic model is presented.Higher-order shell theories are used as structural models.The aerodynamic forces are described using the Piston theory.The temperature is considered uniform over the thickness of the panel.The aero-thermo-elastic model is derived in the framework of the Carrera unified formulation(CUF),therefore the matrices are expressed in a compact form using the″fundamental nuclei″.Composite and sandwich structures are considered and different boundary conditions are taken into account.The effects of the thermal load on the aeroelastic behavior are investigated.展开更多
Immune cell accumulation and white matter anomaly are common features of HIV(human immunodeficiency virus)-infected patients in combination antiretroviral therapy(cART) era.Neuroimaging tests on cART treated patients ...Immune cell accumulation and white matter anomaly are common features of HIV(human immunodeficiency virus)-infected patients in combination antiretroviral therapy(cART) era.Neuroimaging tests on cART treated patients displayed prominent diffuse white matter lesions.Notably,immune cell nodular lesion(NL) was a conspicuous type of pathological change in HIV/SIV(simian immunodeficiency virus) infected brain before cART.Therefore,we used SIV infected brain to investigate the distribution of those NLs in gray and white matters.We found a significant higher number of NLs in white matter than that in gray matter.However,virus infection correlated with macrophage NLs but not with microglia NLs,especially in white matter.In addition,NLs interrupted white matter integrity more severely,since even tiny nodules could disconnect nerve fibers in white matter tracts.In the gray matter with dense myelinated axons,NLs obviously encroached those fibers;in the area of few myelinated axons,small nodules well co-localized with extracellular matrix between neurons.展开更多
Commercially available wind-turbines are optimized to operate at certain wind velocity, known as rated wind velocity. For other values of wind velocity, it has different output which is lower than the rated output of ...Commercially available wind-turbines are optimized to operate at certain wind velocity, known as rated wind velocity. For other values of wind velocity, it has different output which is lower than the rated output of the wind plant. Wind mill can be designed to provide maximum power output at different wind velocities through modification of swept area to match with the wind speed available at the moment. This can result in higher power output at all the velocities except that at rated wind speed because of limitation of generator. This results in increased utilization of generation capacity of wind mill compared to its commercially designed counterpart. A theoretical simulation has been done to prove a new concept about swept area of wind turbine blade which results in a significant increase in the power output through the year. Simulation results of power extracted through normal wind blade design and new concept are studied and compared. The findings of the study are presented in graphical and tabular form. Study establishes that there can be a significant gain in the power output with the new concept.展开更多
文摘Background: Accurate determination of the optimal insertion depth of a pediatric endotracheal tube (ETT) is quite important. The aim of this study was to create an easily available formula that can be used to determine the optimal insertion depth for a cuffed ETT even without depth marking with clear definitions of the upper and lower limits for the tip of ETT in the trachea in clinical practice. Methods: Eighty children under 12 years of age were enrolled. The depth marking of the cuffed ETT was placed at the vocal cords and both lungs were then auscultated using a stethoscope. The upper limit was radiographically defined as the position of the tip of the cuffed ETT being between the clavicles. The lower limit was defined as a distance of 5 mm above the carina. The relationship between the insertion depth and patient characteristics was analyzed to create a formula for optimal ETT insertion depth. Results: Sixty-nine ETTs were optimally placed in the trachea. There were good correlations between the optimal insertion depth of ETTs and patients characteristics (height (R = 0.92);BSA (R = 0.92);weight (R = 0.91);age (R = 0.88)). Using these patient characteristics, we created the following three formulas for calculation of the optimal insertion depth for pediatric cuffed ETTs: insertion depth (cm) = height (cm)/11 + 5.5, weight (kg)/3 + 9.5 or 11 + 3/4 × age (years). The rates of appropriate tube placement of both pediatric cuffed ETTs were 87.5% (Hi-Contour) and 85.0% (Microcuff). Conclusions: Our formula and graphs may be easy to determine the optimal insertion depth of cuffed ETT even without depth marking in clinical practice.
文摘用0、50、100、150和200 m M Na Cl溶液处理不同秋眠等级紫花苜蓿标准品种Maverick、Archer和CUF101,观察形态特征和盐害级别,测定叶片净光合速率(Pn)、细胞间隙CO2浓度(Ci)和气孔导度(Gs),分析盐胁迫对不同秋眠等级紫花苜蓿光合特性的影响.不同秋眠等级紫花苜蓿植株叶片盐害级别随品种和处理浓度不同而不同,但均随Na Cl浓度的增加和胁迫时间的延长而加大.在较低Na Cl浓度下Maverick、Archer和CUF101光合响应存在着预警阶段-恢复阶段-耗尽阶段,在高Na Cl浓度下,所有的供试品种光合响应直接进入耗尽阶段.
文摘Background: Surveys of pediatric endotracheal tube (ETT) management previously reported that specialists in pediatric anesthesia and intensive care medicine preferred to use uncuffed ETTs for children younger than 8 to 10 years of age. The aim of this study was to reveal the most recent attitudes and clinical practices of pediatric ETT management in Japan. Methods: The attitudes and clinical practices of pediatric ETT management were investigated using the data sheets of each institution and each patient. The data sheets contained information on patient characteristics and type of hospital, surgical procedures, devices used for intubation, and ETT information including types, size, depth, intracuff pressure (ICP), interval of ICP measurement, laryngeal packing, ETT exchange, airway complications, and reintubations. Results: The response rate of this survey was 66.7%. More than half of children older than 2 years of age were intubated with cuffed ETTs;83.5% of cuffed ETTs were used with the cuffs inflated, and ICP was measured in 80.7% of cuffed ETTs. More than half of ICP measurements were only taken at the time of intubation. Post-extubation stridor was rarely observed in cuffed (0.4%) or uncuffed ETTs (1.2%). The pediatric ETT management questionnaire revealed age-based size selection, differences in pressure of air leakage between cuffed (15 - 20 cmH2O) and uncuffed ETTs (20 - 30 cmH2O) of different sizes, the depthmarking method of insertion length. Continuous measurement of ICP was not common. Conclusion: This study revealed widespread use of cuffed ETTs in children older than 2 years of age, rarely occurrence of post-extubation stridor, inflation of cuffs, and practice of ICP measurement.
文摘Background: Comparison of the tracheal tube depth over the same body height of men and women based upon intubation depth markings. Methods: Kashan University of Medical Sciences ethics committee approved the study and written informed consent was taken for each patient. Patients undergoing surgery requiring general anesthesia with oro-tracheal intubation were included in a prospective observational study. After induction of general anesthesia, the endotracheal tube was secured at the point at which the cuff was just below the vocal cord on laryngoscopy. Results: In a statistical study of 682 intubated patients which consisted of 499 women and 183 men, 28 cases of laryngoscopic view grade III and IV were excluded from the study. The measurement markings on the ETT at the level of right corner of the mouth were 20.65 ± 0.13 and 18.52 ± 0.08 for men and women respectively (CI 95%). Patient’s height has a meaningful correlation with the measurement of the fixation point of the ETT. Pearson correlation coefficient between the securing point of the tube and height was 0.2 and 0.357 for men and women respectively. In most cases of men and women of the same height, Mann-Whitney U test rejected the hypothesis that the tube can be fixed in the particular point. Conclusions: In general, men are taller than women. Comparing the fixation depth of the tube, even when man and woman have the same body height, the endotracheal tube might be placed in a deeper level for men rather than women.
文摘Panel flutter phenomena can be strongly affected by thermal loads,and so a refined aeroelastic model is presented.Higher-order shell theories are used as structural models.The aerodynamic forces are described using the Piston theory.The temperature is considered uniform over the thickness of the panel.The aero-thermo-elastic model is derived in the framework of the Carrera unified formulation(CUF),therefore the matrices are expressed in a compact form using the″fundamental nuclei″.Composite and sandwich structures are considered and different boundary conditions are taken into account.The effects of the thermal load on the aeroelastic behavior are investigated.
基金supported by R01 NS063878,R01 NS077873 and P30 MH062261(to H.X.and H.S.F.)。
文摘Immune cell accumulation and white matter anomaly are common features of HIV(human immunodeficiency virus)-infected patients in combination antiretroviral therapy(cART) era.Neuroimaging tests on cART treated patients displayed prominent diffuse white matter lesions.Notably,immune cell nodular lesion(NL) was a conspicuous type of pathological change in HIV/SIV(simian immunodeficiency virus) infected brain before cART.Therefore,we used SIV infected brain to investigate the distribution of those NLs in gray and white matters.We found a significant higher number of NLs in white matter than that in gray matter.However,virus infection correlated with macrophage NLs but not with microglia NLs,especially in white matter.In addition,NLs interrupted white matter integrity more severely,since even tiny nodules could disconnect nerve fibers in white matter tracts.In the gray matter with dense myelinated axons,NLs obviously encroached those fibers;in the area of few myelinated axons,small nodules well co-localized with extracellular matrix between neurons.
文摘Commercially available wind-turbines are optimized to operate at certain wind velocity, known as rated wind velocity. For other values of wind velocity, it has different output which is lower than the rated output of the wind plant. Wind mill can be designed to provide maximum power output at different wind velocities through modification of swept area to match with the wind speed available at the moment. This can result in higher power output at all the velocities except that at rated wind speed because of limitation of generator. This results in increased utilization of generation capacity of wind mill compared to its commercially designed counterpart. A theoretical simulation has been done to prove a new concept about swept area of wind turbine blade which results in a significant increase in the power output through the year. Simulation results of power extracted through normal wind blade design and new concept are studied and compared. The findings of the study are presented in graphical and tabular form. Study establishes that there can be a significant gain in the power output with the new concept.
