Variables associated with feeding tube placement in head and neck cancer.

PubMed

Cheng, Sara S; Terrell, Jeffrey E; Bradford, Carol R; Ronis, David L; Fowler, Karen E; Prince, Mark E; Teknos, Theodoros N; Wolf, Gregory T; Duffy, Sonia A

2006-06-01

To identify clinical factors associated with enteral feeding tube placement in a head and neck cancer population. A self-administered survey was given to patients being treated for head and neck cancer while they were waiting to be seen in 1 of 4 otolaryngology clinics. The post hoc analysis presented here combines survey and chart review data to determine clinical and demographic variables associated with feeding tube placement. Four otolaryngology clinics. Otolaryngology clinic patients being treated for head and neck cancer. Enteral feeding tube placement. Of the 724 patients eligible for this study, 14% (n = 98) required enteral feeding tube placement. Multivariate analysis found the following variables to be independently associated with feeding tube placement: oropharynx/hypopharynx tumor site (odds ratio [OR], 2.4; P = .01), tumor stage III/IV (OR, 2.1; P = .03), flap reconstruction (OR, 2.2; P = .004), current tracheotomy (OR, 8.0; P<.001), chemotherapy (OR, 2.6; P<.001), and increased age (OR, 1.3; P = .02). In addition, there was a curvilinear relationship between time since treatment and feeding tube placement, with about 30% having a feeding tube at 1 month posttreatment, tapering down during the first 3 years to about 8% and leveling off thereafter. Identification of factors associated with an increased risk of feeding tube placement may allow physicians to better counsel patients regarding the possibility of feeding tube placement during treatment. Since feeding tube placement has been linked to decreased quality of life in head and neck cancer, such counseling is an integral part of the clinical management of these patients.

Survival times with and without tube feeding in patients with dementia or psychiatric diseases in Japan.

PubMed

Takayama, Keiko; Hirayama, Keisuke; Hirao, Akihiko; Kondo, Keiko; Hayashi, Hideki; Kadota, Koichi; Asaba, Hiroyuki; Ishizu, Hideki; Nakata, Kenji; Kurisu, Kairi; Oshima, Etsuko; Yokota, Osamu; Yamada, Norihito; Terada, Seishi

2017-11-01

It is widely supposed that there has been no evidence of increased survival in patients with advanced dementia receiving enteral tube feeding. However, more than a few studies have reported no harmful outcome from tube feeding in dementia patients compared to in patients without dementia. This was a retrospective study. Nine psychiatric hospitals in Okayama Prefecture participated in this survey. All inpatients fulfilling the entry criteria were evaluated. All subjects suffered from difficulty with oral intake. Attending physicians thought that the patients could not live without long-term artificial nutrition. The physicians decided whether to make use of long-term artificial nutrition between January 2012 and December 2014. We evaluated 185 patients. Their mean age was 76.6 ± 11.4 years. Of all subjects, patients with probable Alzheimer's disease (n = 78) formed the biggest group, schizophrenia patients (n = 44) the second, and those with vascular dementia (n = 30) the third. The median survival times were 711 days for patients with tube feeding and 61 days for patients without tube feeding. In a comparison different types of tube feeding, median survival times were 611 days for patients with a nasogastric tube and more than 1000 days for those with a percutaneous endoscopic gastrostomy tube. Patients with tube feeding survived longer than those without tube feeding, even among dementia patients. This study suggests that enteral nutrition for patients with dementia prolongs survival. Additionally, percutaneous endoscopic gastrostomy tube feeding may be safer than nasogastric tube feeding among patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

Medication administration through enteral feeding tubes.

PubMed

Williams, Nancy Toedter

2008-12-15

An overview of enteral feeding tubes, drug administration techniques, considerations for dosage form selection, common drug interactions with enteral formulas, and methods to minimize tube occlusion is given. Enteral nutrition through a feeding tube is the preferred method of nutrition support in patients who have a functioning gastrointestinal tract but who are unable to be fed orally. This method of delivering nutrition is also commonly used for administering medications when patients cannot swallow safely. However, several issues must be considered with concurrent administration of oral medications and enteral formulas. Incorrect administration methods may result in clogged feeding tubes, decreased drug efficacy, increased adverse effects, or drug-formula incompatibilities. Various enteral feeding tubes are available and are typically classified by site of insertion and location of the distal tip of the feeding tube. Liquid medications, particularly elixirs and suspensions, are preferred for enteral administration; however, these formulations may be hypertonic or contain large amounts of sorbitol, and these properties increase the potential for adverse effects. Before solid dosage forms are administered through the feeding tube, it should be determined if the medications are suitable for manipulation, such as crushing a tablet or opening a capsule. Medications should not be added directly to the enteral formula, and feeding tubes should be properly flushed with water before and after each medication is administered. To minimize drug-nutrient interactions, special considerations should be taken when administering phenytoin, carbamazepine, warfarin, fluoroquinolones, and proton pump inhibitors via feeding tubes. Precautions should be implemented to prevent tube occlusions, and immediate intervention is required when blockages occur. Successful drug delivery through enteral feeding tubes requires consideration of the tube size and placement as well as careful selection and appropriate administration of drug dosage forms.

Laparoscopic insertion of the Moss feeding tube.

PubMed

Albrink, M H; Hagan, K; Rosemurgy, A S

1993-12-01

Placement of enteral feeding tubes is an important part of a surgeon's skill base. Surgical insertion of feeding tubes has been performed safely for many years with very few modifications. With the recent surge in interest and applicability of other laparoscopic procedures, it is well within the skills of the average laparoscopic surgeon to insert feeding tubes. We describe herein a simple technique for the insertion of the Moss feeding tube. The procedure described has a minimum of invasion, along with simplicity, safety, and accuracy.

Development, prevention, and treatment of feeding tube dependency.

PubMed

Krom, Hilde; de Winter, J Peter; Kindermann, Angelika

2017-06-01

Enteral nutrition is effective in ensuring nutritional requirements and growth. However, when tube feeding lasts for a longer period, it can lead to tube dependency in the absence of medical reasons for continuation of tube feeding. Tube-dependent children are unable or refuse to start oral activities and they lack oral skills. Tube dependency has health-, psychosocial-, and economy-related consequences. Therefore, the transition to oral feeding is of great importance. However, this transition can be very difficult and needs a multidisciplinary approach. Most studies for treatment of tube dependency are based on behavioral interventions, such as family therapy, individual behavior therapy, neuro-linguistic programming, and parental anxiety reduction. Furthermore, oral motor therapy and nutritional adjustments can be helpful in tube weaning. The use of medication has been described in the literature. Although mostly chosen as the last resort, hunger-inducing methods, such as the Graz-model and the Dutch clinical hunger provocation program, are also successful in weaning children off tube feeding. The transition from tube to oral feeding is important in tube-dependent children but can be difficult. We present an overview for the prevention and treatment of tube dependency. What is known: • Longer periods of tube feeding can lead to tube dependency. • Tube weaning can be very difficult. What is new: • Weaning as soon as possible and therefore referral to a multidisciplinary team are recommended. • An overview of treatment options for tube dependency is presented in this article.

Performance test of different 3.5 mm drill bits and consequences for orthopaedic surgery.

PubMed

Clement, Hans; Zopf, Christoph; Brandner, Markus; Tesch, Norbert P; Vallant, Rudolf; Puchwein, Paul

2015-12-01

Drilling of bones in orthopaedic and trauma surgery is a common procedure. There are yet no recommendations about which drill bits/coating should be preferred and when to change a used drill bit. In preliminary studies typical "drilling patterns" of surgeons concerning used spindle speed and feeding force were recorded. Different feeding forces were tested and abrasion was analysed using magnification and a scanning electron microscope (SEM). Acquired data were used for programming a friction stir welding machine (FSWM). Four drill bits (a default AISI 440A, a HSS, an AISI 440B and a Zirconium-oxide drill bit) were analysed for abrasive wear after 20/40/60 machine-guided and hand-driven drilled holes. Additionally different drill coatings [diamond-like carbon/grafitic (DLC), titanium nitride/carbide (Ti-N)] were tested. The mean applied feeding force by surgeons was 45 ± 15.6 Newton (N). HSS bits were still usable after 51 drill holes. Both coated AISI 440A bits showed considerable breakouts of the main cutting edge after 20 hand-driven drilled holes. The coated HSS bit showed very low abrasive wear. The non-coated AISI 440B bit had a similar durability to the HSS bits. The ZrO2 dental drill bit excelled its competitors (no considerable abrasive wear at >100 holes). If the default AISI 440A drill bit cannot be checked by 20-30× magnification after surgery, it should be replaced after 20 hand-driven drilled holes. Low price coated HSS bits could be a powerful alternative.

Do financial incentives of introducing case mix reimbursement increase feeding tube use in nursing home residents?

PubMed

Teno, Joan M; Feng, Zhanlian; Mitchell, Susan L; Kuo, Sylvia; Intrator, Orna; Mor, Vincent

2008-05-01

To determine whether adoption of Medicaid case mix reimbursement is associated with greater prevalence of feeding tube use in nursing home (NH) residents. Secondary analysis of longitudinal administrative data about the prevalence of feeding tube insertion and surveys of states' adoption of case mix reimbursement. NHs in the United States. NH residents at the time of NH inspection between 1993 and 2004. Facility prevalence of feeding tubes reported at the state inspection of NHs reported in the Online Survey, Certification and Reporting database and interviews with state policy makers regarding the adoption of case mix reimbursement. Between 1993 and 2004, 16 states adopted Resource Utilization Group case mix reimbursement. States varied in the prevalence of feeding tubes in their NHs. Although the use of feeding tube increased substantially over the years of the study, once temporal trends and facility fixed effects were accounted for, case mix reimbursement was not associated with greater prevalence of feeding tube use. The adoption of Medicaid case mix reimbursement was not associated with an increase in the prevalence of feeding tube use.

Release of carbon nanotubes from an epoxy-based nanocomposite during an abrasion process.

PubMed

Schlagenhauf, Lukas; Chu, Bryan T T; Buha, Jelena; Nüesch, Frank; Wang, Jing

2012-07-03

The abrasion behavior of an epoxy/carbon nanotube (CNT) nanocomposite was investigated. An experimental setup has been established to perform abrasion, particle measurement, and collection all in one. The abraded particles were characterized by particle size distribution and by electron microscopy. The abrasion process was carried out with a Taber Abraser, and the released particles were collected by a tube for further investigation. The particle size distributions were measured with a scanning mobility particle sizer (SMPS) and an aerodynamic particle sizer (APS) and revealed four size modes for all measured samples. The mode corresponding to the smallest particle sizes of 300-400 nm was measured with the SMPS and showed a trend of increasing size with increasing nanofiller content. The three measured modes with particle sizes from 0.6 to 2.5 μm, measured with the APS, were similar for all samples. The measured particle concentrations were between 8000 and 20,000 particles/cm(3) for measurements with the SMPS and between 1000 and 3000 particles/cm(3) for measurements with the APS. Imaging by transmission electron microscopy (TEM) revealed that free-standing individual CNTs and agglomerates were emitted during abrasion.

Is tube feeding futile in advanced dementia?

PubMed Central

Lynch, Matthew C.

2016-01-01

It is controversial whether tube feeding in people with dementia improves nutritional status or prolongs survival. Guidelines published by several professional societies cite observational studies that have shown no benefit and conclude that tube feeding in patients with advanced dementia should be avoided. However, all studies on tube feeding in dementia have major methodological flaws that invalidate their findings. The present evidence is not sufficient to justify general guidelines. Patients with advanced dementia represent a very heterogeneous group, and evidence demonstrates that some patients with dementia benefit from tube feeding. However, presently available guidelines make a single recommendation against tube feeding for all patients. Clinicians, patients, and surrogates should be aware that the guidelines and prior commentary on this topic tend both to overestimate the strength of evidence for futility and to exaggerate the burdens of tube feeding. Shared decision making requires accurate information tailored to the individual patient's particular situation, not blanket guidelines based on flawed data. Lay Summary: Many doctors believe that tube feeding does not help people with advanced dementia. Scientific studies suggest that people with dementia who have feeding tubes do not live longer or gain weight compared with those who are carefully hand fed. However, these studies are not very helpful because of flaws in design, which are discussed in this article. Guidelines from professional societies make a blanket recommendation against feeding tubes for anyone with dementia, but an individual approach that takes each person's situation into account seems more appropriate. Patients and surrogates should be aware that the guidelines on this topic tend both to underestimate the benefit and exaggerate the burdens of tube feeding. PMID:27833208

Development of a two-body wet abrasion test method with attention to the effects of reused abradant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blau, Peter Julian; Dehoff, Ryan R

2012-01-01

Abrasive wear is among the most common and costliest causes for material wastage, and it occurs in many forms. A simple method has been developed to quantify the response of metals and alloys to two-body wet abrasion. A metallographic polishing machine was modified to create a disk-on-flat sliding test rig. Adhesive-backed SiC grinding papers were used under fixed load and speed to rank the abrasive wear of seven alloy steels, some of which are candidates for drill cones for geothermal drilling. Standardized two-body abrasion tests, like those described in ASTM G132, feed unused abrasive into the contact; however, the currentmore » work investigated whether useful rankings could still be obtained with a simpler testing configuration in which specimens repeatedly slide on the same wear path under water-lubricated conditions. Tests using abrasive grit sizes of 120 and 180 resulted in the same relative ranking of the alloys although the coarser grit produced more total wear. Wear decreased when the same abrasive disk was re-used for up to five runs, but the relative rankings of the steels remained the same. This procedure was presented to ASTM Committee G2 on Wear and Erosion as a potential standard test for wet two-body abrasive wear.« less

Verifying placement of small-bore feeding tubes: electromagnetic device images versus abdominal radiographs.

PubMed

Bryant, Vera; Phang, Jean; Abrams, Kevin

2015-11-01

Clinicians are unsure if radiography is needed to confirm correct positioning of feeding tubes inserted with assistance from an electromagnetic system. To compare radiographic reports of feeding tube placement with images generated by an electromagnetic feeding tube placement device. The medical records of 200 consecutive patients who had feeding tubes inserted with assistance from an electromagnetic feeding tube placement device were reviewed retrospectively. Radiographic reports of tube site were compared with images generated by the device. Radiographic evidence of tube sites was available in 188 cases: 184 tubes were located in portions of the gastrointestinal tract. Ninety of the 188 tubes were situated in the optimal site (distal duodenum or jejunum) radiographically. Images generated by the electromagnetic device were available in 176 cases; of these, 52 tubes appeared to end in the expected left lower quadrant. Tubes shown on radiographs to be in other sites also occasionally appeared to end in the left lower quadrant. Nurses using the device did not recognize 4 of the 188 tubes (2.1%) that were inadvertently placed in the lung. No consistent pattern of quadrant distribution was found for tubes positioned in the stomach or proximal duodenum. Images generated by the electromagnetic tube placement device provided inconsistent results regarding tube location. A small percentage of seriously malpositioned tubes were not detected by using the electromagnetic device. These findings do not support eliminating radiographs to confirm correct tube placement following use of an electromagnetic tube placement device. ©2015 American Association of Critical-Care Nurses.

Nasoenteral feeding tube placement by nurses using an electromagnetic guidance system (with video).

PubMed

Mathus-Vliegen, Elisabeth M H; Duflou, Ann; Spanier, Marcel B W; Fockens, Paul

2010-04-01

The early institution of feeding in patients who need postpyloric feeding tubes is often hampered by a limited availability of endoscopists experienced in safe tube positioning. To test the feasibility of having nurses place postpyloric feeding tubes by using a universal path finding system device. Prospective study. Academic hospital. The success rate and learning curve of a senior nurse placing postpyloric feeding tubes in 50 patients was studied, followed by a study in 160 patients on the success rates and learning curves of 4 inexperienced nurses instructed by the senior nurse. Finally, the success rate of postpyloric feeding tube placement by the senior nurse in 50 critically ill patients was investigated. Postpyloric feeding tube positioning by nurses using an electromagnetic universal path-finding system device enabling them to follow the path of the tip of the feeding tube on a monitor screen. Success was defined by postpyloric positioning of the feeding tube. The ultimate aim was to reach at least the duodenojejunal flexure. In the first part, the senior nurse was successful in 72% of cases. There was a clear learning curve. In the second part, the 4 newly instructed nurses had a success rate of 89.4% without an evident learning curve. In the third part, successful feeding tube positioning was achieved in 78% of critically ill patients. Of the 217 successfully positioned tubes, 74% reached at least the duodenojejunal flexure. In half of the unsuccessful cases, an explanation for the failure was found at endoscopy. No complications were seen. The generalization to less-specialized hospitals should be investigated. Postpyloric positioning of feeding tubes by nurses at the bedside without endoscopy is feasible and safe. Nurses may take over some of the tasks of doctors in a time of high endoscopic needs. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Do Financial Incentives of Introducing Case Mix Reimbursement Increase Feeding Tube Use in Nursing Home Residents?

PubMed Central

Teno, Joan M.; Feng, Zhanlian; Mitchell, Susan L.; Kuo, Sylvia; Intrator, Orna; Mor, Vincent

2013-01-01

OBJECTIVES To determine whether adoption of Medicaid case mix reimbursement is associated with greater prevalence of feeding tube use in nursing home (NH) residents. DESIGN Secondary analysis of longitudinal administrative data about the prevalence of feeding tube insertion and surveys of states’ adoption of case mix reimbursement. SETTING NHs in the United States. PARTICIPANTS NH residents at the time of NH inspection between 1993 and 2004. MEASUREMENTS Facility prevalence of feeding tubes reported at the state inspection of NHs reported in the Online Survey, Certification and Reporting database and interviews with state policy makers regarding the adoption of case mix reimbursement. RESULTS Between 1993 and 2004, 16 states adopted Resource Utilization Group case mix reimbursement. States varied in the prevalence of feeding tubes in their NHs. Although the use of feeding tube increased substantially over the years of the study, once temporal trends and facility fixed effects were accounted for, case mix reimbursement was not associated with greater prevalence of feeding tube use. CONCLUSION The adoption of Medicaid case mix reimbursement was not associated with an increase in the prevalence of feeding tube use. PMID:18331293

Social Ecological Perspectives of Tube-Feeding Older Adults with Advanced Dementia: A Systematic Literature Review.

PubMed

Douglas, Joy W; Lawrence, Jeannine C; Turner, Lori W

2017-01-01

Dementia is a progressive, debilitating disease that often results in weight loss, malnutrition, and dehydration. Feeding tubes are often prescribed; however, this practice can lead to complications. The purpose of this systematic review was to examine the use of feeding tubes in elderly demented patients from a social ecological perspective. Results indicated that family members often receive inadequate decision-making education. Many health care professionals lack knowledge of evidence-based guidelines pertaining to feeding tube use. Organizational and financial reimbursement structures influence feeding tube use. Feeding practices for patients with advanced dementia is a complex issue, warranting approaches that target each level of the Social Ecological Model.

Oral Feeding Outcome after Analgesic and Sedative Exposure in VLBW Preterm Infant.

PubMed

Astoria, Mark T; Thacker, Leroy; Hendricks-Muñoz, Karen D

2018-06-08

 The objective of this study was to assess the association of analgesics and sedatives on oral feeding function and need for feeding tube at discharge in the very low birth weight (VLBW) (<1,500 g) preterm infant.  A retrospective review of surviving inborn infants < 1,500 g and < 32 weeks' gestation ( n  = 209), discharged between January 1, 2012, and December 31, 2014, from the neonatal intensive care unit identified exposure to analgesic and sedative medications, demographics, medical course, and nasogastric or gastrostomy tube (GT) feeding at discharge. Predictive modeling with logistic regression to identify independent factors associated with discharge on tube feedings.  Out of 209, 45 (21.5%) infants received an analgesic/sedative with 23 out of 45 (51.1%) discharged with tube feedings. Infants discharged with tube feedings were born smaller, of younger gestation, with greater SNAPPE-II scores, periventricular leukomalacia, chronic lung disease, postnatal glucocorticoids, lansoprazole, and longer time intubated. After adjusting for covariates, exposure to analgesic/sedatives (fentanyl, midazolam, or morphine) was independently predictive of discharge on tube feedings.  Analgesic and sedative exposure in VLBW infants is highly associated with poor oral feeding and need for tube feedings at discharge. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Enteral Tube Feeding and Pneumonia

ERIC Educational Resources Information Center

Gray, David Sheridan; Kimmel, David

2006-01-01

To determine the effects of enteral tube feeding on the incidence of pneumonia, we performed a retrospective review of all clients at our institution who had gastrostomy or jejunostomy tubes placed over a 10-year period. Ninety-three subjects had a history of pneumonia before feeding tube insertion. Eighty had gastrostomy and 13, jejunostomy…

Fluoroscopically guided nose tube drainage of mediastinal abscesses in post-operative gastro-oesophageal anastomotic leakage.

PubMed

Xu, Q Y; Yin, G W; Chen, S X; Jiang, F; Bai, X J; Wu, J D

2012-11-01

The aim of this study was to retrospectively evaluate the technical success rates and clinical effectiveness of fluoroscopically guided nose tube drainage of mediastinal abscesses and a nasojejunum feeding tube in post-operative gastro-oesophageal anastomotic leakage (GEAL). From January 2006 to June 2011, 18 cases of post-operative GEAL with mediastinal abscesses after oesophagectomy with intrathoracic oesophagogastric anastomotic procedures for oesophageal and cardiac carcinoma were treated by insertion of a nose drainage tube and nasojejunum feeding tube under fluoroscopic guidance. We evaluated the feasibility of two-tube insertion to facilitate leakage site closure and complete resolution of the abscess, and the patients' nutritional benefit was also evaluated by checking the serum albumin level between pre- and post-enteral feeding via the feeding tube. The two tubes were placed successfully under fluoroscopic guidance in 18 patients (100%). The procedure time for two-tube insertion ranged from 20 to 40 min (mean 30 min). 17 patients (94%) achieved leakage site closure after two-tube insertion and had a good tolerance of two tubes in the nasal cavity. The serum albumin level was significant, increased from pre-enteral feeding (2.49 ± 0.42 g dl(-1)) to the post-enteral feeding (3.58 ± 0.47 g dl(-1)) via the feeding tube (p<0.001). The duration of follow-up ranged from 1 to 49 months (mean 19 months). The insertion of nose tube drainage and a nasojejunum feeding tube under fluoroscopic guidance is safe, and it provides effective relief from mediastinal abscesses in GEAL after oesophagectomy. Moreover, our findings indicate that two-tube insertion may be used as a selective procedure to treat mediastinal abscesses in post-operative GEAL. Advances in knowledge Directive drainage of mediastinal abscesses in post-operative GEAL may be an effective treatment.

Air feed tube support system for a solid oxide fuel cell generator

DOEpatents

Doshi, Vinod B.; Ruka, Roswell J.; Hager, Charles A.

2002-01-01

A solid oxide fuel cell generator (12), containing tubular fuel cells (36) with interior air electrodes (18), where a supporting member (82) containing a plurality of holes (26) supports oxidant feed tubes (51), which pass from an oxidant plenum (52") into the center of the fuel cells, through the holes (26) in the supporting member (82), where a compliant gasket (86) around the top of the oxidant feed tubes and on top (28) of the supporting member (82) helps support the oxidant feed tubes and center them within the fuel cells, and loosen the tolerance for centering the air feed tubes.

Pretreatment risk stratification of feeding tube use in patients treated with intensity-modulated radiotherapy for head and neck cancer.

PubMed

Anderson, Nigel J; Jackson, James E; Smith, Jennifer G; Wada, Morikatsu; Schneider, Michal; Poulsen, Michael; Rolfo, Maureen; Fahandej, Maziar; Gan, Hui; Joon, Daryl Lim; Khoo, Vincent

2018-05-13

The purpose of this study was to establish a risk stratification model for feeding tube use in patients who undergo intensity-modulated radiotherapy (IMRT) for head and neck cancers. One hundred thirty-nine patients treated with definitive IMRT (+/- concurrent chemotherapy) for head and neck mucosal cancers were included in this study. Patients were recommended a prophylactic feeding tube and followed up by a dietician for at least 8 weeks postradiotherapy (post-RT). Potential prognostic factors were analyzed for risk and duration of feeding tube use for at least 25% of dietary requirements. Many variables had significant effects on risk and/or duration of feeding tube use in univariate analyses. Subsequent multivariable analysis showed that T classification ≥3 and level 2 lymphadenopathy were the best independent significant predictors of higher risk and duration of feeding tube use, respectively, in oral cavity, pharyngeal, and supraglottic primaries. In patients treated with definitive IMRT, T classification ≥3 and level 2 lymphadenopathy can potentially stratify patients into 4 risk groups for developing severe dysphagia requiring feeding tube use. © 2018 Wiley Periodicals, Inc.

Colorimetric carbon dioxide detector to determine accidental tracheal feeding tube placement.

PubMed

Howes, Daniel W; Shelley, Eric S; Pickett, William

2005-04-01

To determine the accuracy of colorimetric CO2 detection compared to the reference standard two-step radiological confirmation of feeding tube position. A prospective study was conducted with patients presenting to a 21-bed medical-surgical intensive care unit. An adapter was developed using an endotracheal tube adapter to connect a colorimetric CO2 detector to a feeding tube in an airtight manner. In part I of the study a feeding tube connected to the colorimeter was inserted into the endotracheal tubes of ten ventilated patients to test the device's ability to detect tracheal placement. In part II patients undergoing feeding tube insertion had tube position confirmed with the colorimeter as well as the reference standard two-step x-ray. In phase I the colorimeter correctly identified tracheal placement in all ten patients. In phase II 93/100 procedures ultimately were eligible; the colorimeter had a sensitivity of 0.88 (95% confidence interval: 0.65-1.00) and specificity of 0.99 (0.97-1.00). The device missed one of the eight tracheal placements. Agreement between the colorimeter and two-step x-ray interpretations was excellent (Kappa 0.86; standard error 0.10). We describe a novel, convenient method to confirm esophageal feeding tube placement. The device is easily assembled and inexpensive, but should not be reused. Colorimetric determination of tracheal feeding tube placement with this device has excellent agreement with the reference standard two-step radiological technique.

Pleurectomy versus pleural abrasion for primary spontaneous pneumothorax in children.

PubMed

Joharifard, Shahrzad; Coakley, Brian A; Butterworth, Sonia A

2017-05-01

Primary spontaneous pneumothorax (PSP) represents a common indication for urgent surgical intervention in children. First episodes are often managed with thoracostomy tube, whereas recurrent episodes typically prompt surgery involving apical bleb resection and pleurodesis, either via pleurectomy or pleural abrasion. The purpose of this study was to assess whether pleurectomy or pleural abrasion was associated with lower postoperative recurrence. The records of patients undergoing surgery for PSP between February 2005 and December 2015 were retrospectively reviewed. Recurrence was defined as an ipsilateral pneumothorax requiring surgical intervention. Bivariate logistic regressions were used to identify factors associated with recurrence. Fifty-two patients underwent 64 index operations for PSP (12 patients had surgery for contralateral pneumothorax, and each instance was analyzed separately). The mean age was 15.7±1.2years, and 79.7% (n=51) of patients were male. In addition to apical wedge resection, 53.1% (n=34) of patients underwent pleurectomy, 39.1% (n=25) underwent pleural abrasion, and 7.8% (n=5) had no pleural treatment. The overall recurrence rate was 23.4% (n=15). Recurrence was significantly lower in patients who underwent pleurectomy rather than pleural abrasion (8.8% vs. 40%, p<0.01). In patients who underwent pleural abrasion without pleurectomy, the relative risk of recurrence was 2.36 [1.41-3.92, p<0.01]. Recurrence of PSP is significantly reduced in patients undergoing pleurectomy compared to pleural abrasion. Level III, retrospective comparative therapeutic study. Copyright © 2017 Elsevier Inc. All rights reserved.

Lunar Regolith Simulant Feed System for a Hydrogen Reduction Reactor System

NASA Technical Reports Server (NTRS)

Mueller, R. P.; Townsend, Ivan I., III

2009-01-01

One of the goals of In-Situ Resource Utilization (ISRU) on the moon is to produce oxygen from the lunar regolith which is present in the form of Ilmenite (FeTi03) and other compounds. A reliable and attainable method of extracting some of the oxygen from the lunar regolith is to use the hydrogen reduction process in a hot reactor to create water vapor which is then condensed and electrolyzed to obtain oxygen for use as a consumable. One challenge for a production system is to reliably acquire the regolith with an excavator hauler mobility platform and then introduce it into the reactor inlet tube which is raised from the surface and above the reactor itself. After the reaction, the hot regolith (-1000 C) must be expelled from the reactor for disposal by the excavator hauler mobility system. In addition, the reactor regolith inlet and outlet tubes must be sealed by valves during the reaction in order to allow collection of the water vapor by the chemical processing sub-system. These valves must be able to handle abrasive regolith passing through them as well as the heat conduction from the hot reactor. In 2008, NASA has designed and field tested a hydrogen reduction system called ROxygen in order to demonstrate the feasibility of extracting oxygen from lunar regolith. The field test was performed with volcanic ash known as Tephra on Mauna Kea volcano on the Big Island of Hawai'i. The tephra has similar properties to lunar regolith, so that it is regarded as a good simulant for the hydrogen reduction process. This paper will discuss the design, fabrication, operation, test results and lessons learned with the ROxygen regolith feed system as tested on Mauna Kea in November 2008.

Efficacy of a Creon delayed-release pancreatic enzyme protocol for clearing occluded enteral feeding tubes.

PubMed

Stumpf, Janice L; Kurian, Rebecca M; Vuong, Jennifer; Dang, Kimberlyn; Kraft, Michael D

2014-04-01

Alkalinized Viokase pancreatic enzyme tablets restored patency to 71.9% of occluded Dobhoff tubes in a prospective study. After removal of Viokase tablets from the US market, the hospital protocol for unclogging enteral feeding tubes was adapted to use Creon pancreatic enzyme delayed-release capsules, despite the lack of published data. To evaluate the effectiveness of a Creon-based protocol to clear occluded enteral feeding tubes. This retrospective study included all adult and pediatric patients seen in the emergency department or in an inpatient setting who received Creon 12 000 units lipase delayed-release capsule dissolved in a solution of sodium bicarbonate 650 mg and sterile water for clearing occluded enteral feeding tubes between May 1 and November 30, 2010. The Creon protocol was deemed effective if tube clearance was documented in the medical record or if enteral feedings were resumed with no note regarding tube replacement. Alkalinized Creon delayed-release capsules were administered to 83 patients with a total of 118 clogged tubes. Three poorly documented cases and 5 tubes with mechanical clogs were excluded from data analysis. Patency was restored to 53 of 110 (48.2%) occluded tubes. More than 1 treatment course was attempted in 5 cases, with success in 3. An alkalinized Creon pancreatic enzyme protocol was effective in clearing approximately half of the occluded enteral feeding tubes in this retrospective study, an efficacy rate much less than that previously reported in the literature with a Viokase-based protocol.

Feeding tubes and health costs postinsertion in nursing home residents with advanced dementia.

PubMed

Hwang, Deborah; Teno, Joan M; Gozalo, Pedro; Mitchell, Susan

2014-06-01

The best evidence suggests that feeding tubes are ineffective in persons with advanced dementia. Little is known about their health care costs. To estimate Medicare costs attributable to inpatient care among nursing home (NH) residents with advanced dementia during the year following the placement of a percutaneous endoscopic gastrostomy (PEG) tube during an index hospitalization. Medicare claims (1999-2009) and Minimum Data Set data (1999-2009) were used to estimate Medicare costs attributable to inpatient care among NH residents with advanced dementia during the year following the placement of a PEG tube and compared with those who did not get a PEG tube. The study used a 3:1 propensity-matched cohort design. Matched residents with (n=1924, 68.9% female, 28.8% African American, average age 83.1 years) and without (weighted n=1924, unique n=4337) PEG insertion showed comparable sociodemographic characteristics, similar rates of feeding tube risk factors, and similar mortality (51.9% 180 day mortality among those with a feeding tube vs. 49.8% among those without a feeding tube, P=0.11). One year hospital costs were $2224 higher in NH residents with a feeding tube ($10,191 vs. $7967, 95% CI of difference=$1514, $2933), with those with a feeding tube likely to spend more time in an intensive care unit (1.92 vs. 1.29 days, 95% CI of difference=0.34, 0.92 days). In an analysis controlling for selection bias, PEG tube insertion is associated with a small but significant increase in annual inpatient health care costs, as well as in hospital and intensive care unit days, postinsertion. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Comparison of complication rates in dogs with nasoesophageal versus nasogastric feeding tubes.

PubMed

Yu, Melissa K; Freeman, Lisa M; Heinze, Cailin R; Parker, Valerie J; Linder, Deborah E

2013-01-01

To compare complication rates between nasoesophageal (NE) and nasogastric (NG) feeding tubes in dogs. Retrospective study. University referral veterinary hospital. A total of 46 dogs that were fed through a NE (n = 28) or NG (n = 18) tube between January 2007 and December 2011 and that also had either thoracic radiography or computed tomography performed so that location of the distal tip of the tube in either the esophagus or stomach could be confirmed. None. The medical record of each eligible case was reviewed and data recorded included signalment, underlying disease, body weight, body condition score, medications, duration of feeding, diet used, and complications observed (ie, vomiting, regurgitation, diarrhea, early tube removal, clogged tube, epistaxis, pulmonary aspiration, hyperglycemia, and refeeding syndrome). Dogs with NE tubes were significantly younger than dogs with NG tubes (P = 0.03) but there were no other significant differences in signalment, underlying disease, medications, duration of anorexia, percent of resting energy requirement achieved, or change in weight during tube feeding. There also was no significant difference between the NE and NG groups for any of the recorded complications. Significantly fewer dogs in the NE group died or were euthanized (3/28) compared to the NG group (7/18; P = 0.02) but outcome was not associated with age, underlying disease, or any of the recorded tube complications. This study did not identify a difference in complication rate between NE and NG feeding tubes in dogs. Additional studies are required to determine the optimal terminal location of feeding tubes in dogs. © Veterinary Emergency and Critical Care Society 2013.

Transition from tube feeding to oral feeding: experience in a tertiary care paediatric cardiology unit.

PubMed

Shine, Anne Marie; Finn, Daragh Gerard; Allen, Noeleen; McMahon, Colin J

2018-05-02

Home enteral tube feeding (HETF) is imperative for many infants and children with congenital heart disease (CHD). Tube weaning (TW) facilitates the progression from tube feeding to oral diet. There is limited literature on TW practices, protocols and success for children with CHD that have been tube fed. The objective of this study is to assess the process of weaning HETF in a tertiary referral centre for paediatric CHD. Specifically, we aimed to assess the duration of HETF, duration of TW and the interventions involved. We retrospectively reviewed the medical and dietetic records of all infants and children that were successfully weaned off HETF over a 12-month period from January 2015 to December 2015. There were 30 children included in the study, 9 boys and 21 girls. The diagnoses included 15 septal defects, 8 univentricular diagnosis and other diagnoses in 7 children. The median age at initiation of enteral tube feeding was 45 days (range 2-169). The median duration to wean from enteral tube feeding was 52 days (range 2-359). Number of dietetic consults required for successful TW varied among patients, median 5 (range 2-23). The number of days required for successful TW was associated with age and duration on HETF. Dietetic interventions included discontinuation of nutrient dense feeds, altering feed schedule and reduction of feed volume. Weaning HETF is possible in the outpatient setting. Early and frequent dietetic intervention is recommended to ensure prompt discontinuation of HETF when appropriate.

The feeding tube of cyst nematodes: characterisation of protein exclusion.

PubMed

Eves-van den Akker, Sebastian; Lilley, Catherine J; Ault, James R; Ashcroft, Alison E; Jones, John T; Urwin, Peter E

2014-01-01

Plant parasitic nematodes comprise several groups; the most economically damaging of these are the sedentary endoparasites. Sedentary endoparasitic nematodes are obligate biotrophs and modify host root tissue, using a suite of effector proteins, to create a feeding site that is their sole source of nutrition. They feed by withdrawing host cell assimilate from the feeding site though a structure known as the feeding tube. The function, composition and molecular characteristics of feeding tubes are poorly characterised. It is hypothesised that the feeding tube facilitates uptake of host cell assimilate by acting as a molecular sieve. Several studies, using molecular mass as the sole indicator of protein size, have given contradictory results about the exclusion limits of the cyst nematode feeding tube. In this study we propose a method to predict protein size, based on protein database coordinates in silico. We tested the validity of these predictions using travelling wave ion mobility spectrometry--mass spectrometry, where predictions and measured values were within approximately 6%. We used the predictions, coupled with mass spectrometry, analytical ultracentrifugation and protein electrophoresis, to resolve previous conflicts and define the exclusion characteristics of the cyst nematode feeding tube. Heterogeneity was tested in the liquid, solid and gas phase to provide a comprehensive evaluation of three proteins of particular interest to feeding tube size exclusion, GFP, mRFP and Dual PI. The data and procedures described here could be applied to the design of plant expressed defence compounds intended for uptake into cyst nematodes. We also highlight the need to assess protein heterogeneity when creating novel fusion proteins.

The Feeding Tube of Cyst Nematodes: Characterisation of Protein Exclusion

PubMed Central

Eves-van den Akker, Sebastian; Lilley, Catherine J.; Ault, James R.; Ashcroft, Alison E.; Jones, John T.; Urwin, Peter E.

2014-01-01

Plant parasitic nematodes comprise several groups; the most economically damaging of these are the sedentary endoparasites. Sedentary endoparasitic nematodes are obligate biotrophs and modify host root tissue, using a suite of effector proteins, to create a feeding site that is their sole source of nutrition. They feed by withdrawing host cell assimilate from the feeding site though a structure known as the feeding tube. The function, composition and molecular characteristics of feeding tubes are poorly characterised. It is hypothesised that the feeding tube facilitates uptake of host cell assimilate by acting as a molecular sieve. Several studies, using molecular mass as the sole indicator of protein size, have given contradictory results about the exclusion limits of the cyst nematode feeding tube. In this study we propose a method to predict protein size, based on protein database coordinates in silico. We tested the validity of these predictions using travelling wave ion mobility spectrometry – mass spectrometry, where predictions and measured values were within approximately 6%. We used the predictions, coupled with mass spectrometry, analytical ultracentrifugation and protein electrophoresis, to resolve previous conflicts and define the exclusion characteristics of the cyst nematode feeding tube. Heterogeneity was tested in the liquid, solid and gas phase to provide a comprehensive evaluation of three proteins of particular interest to feeding tube size exclusion, GFP, mRFP and Dual PI. The data and procedures described here could be applied to the design of plant expressed defence compounds intended for uptake into cyst nematodes. We also highlight the need to assess protein heterogeneity when creating novel fusion proteins. PMID:24489891

An anthology of advances in enteral tube feeding formulations.

PubMed

Campbell, Sheila M

2006-08-01

This article summarizes several major advances in tube feeding formulas marketed in the United States. It traces the progress in tube feeding formulas, starting with blenderized formulas to commercially available intact-nutrient formulas and culminating in the introduction of the concept of immunonutrition. The impact of packaging is also described.

Continuous nasogastric milk feeding versus intermittent bolus milk feeding for premature infants less than 1500 grams.

PubMed

Premji, Shahirose S; Chessell, Lorraine

2011-11-09

Milk feedings can be given via nasogastric tube either intermittently, typically over 10 to 20 minutes every two or three hours, or continuously, using an infusion pump. Although theoretical benefits and risks of each method have been proposed, effects on clinically important outcomes remain uncertain. To examine the evidence regarding the effectiveness of continuous versus intermittent bolus nasogastric milk feeding in premature infants less than 1500 grams. Searches were performed of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 3, 2011), MEDLINE, CINAHL and HealthSTAR up to July 2011. Randomised and quasi-randomised clinical trials comparing continuous versus intermittent bolus nasogastric milk feeding in premature infants less than 1500 grams. Two review authors independently assessed all trials for relevance and methodologic quality. The standard methods of the Cochrane Neonatal Review Group were used to extract data. Overall, the seven included trials, involving 511 infants, found no differences in time to achieve full enteral feeds between feeding methods (weighted mean difference (WMD) 2 days; 95% CI -0.3 to 3.9) . In the subgroup analysis of those studies comparing continuous nasogastric versus intermittent bolus nasogastric milk feedings the findings remained unchanged (WMD 2 days, 95% CI -0.4 to 4.1). There was no significant difference in somatic growth and incidence of NEC between feeding methods irrespective of tube placement. One study noted a trend toward more apneas during the study period in infants fed by the continuous tube feeding method compared to those fed by intermittent feedings delivered predominantly by orogastric tube placements [mean difference (MD) 14.0 apneas during study period; 95% CI -0.2 to 28.2]. In subgroup analysis based on weight groups, one study suggested that infants less than 1000 grams and 1000 to 1250 grams birth weight gained weight faster when fed by the continuous nasogastric tube feeding method compared to intermittent nasogastric tube feeding method (MD 2.0 g/day; 95% CI 0.5 to 3.5; MD 2.0 g/day; 95% CI 0.2 to 3.8, respectively). A trend toward earlier discharge for infants less than 1000 grams birth weight fed by the continuous tube feeding method compared to intermittent nasogastric tube feeding method (MD -11 days; 95% CI -21.8 to -0.2). Small sample sizes, methodologic limitations, inconsistencies in controlling variables that may affect outcomes, and conflicting results of the studies to date make it difficult to make universal recommendations regarding the best tube feeding method for premature infants less than 1500 grams. The clinical benefits and risks of continuous versus intermittent nasogastric tube milk feeding cannot be reliably discerned from the limited information available from randomised trials to date.

American Association of Nurse Anesthetists

MedlinePlus

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[Head and neck cancer patients included at home enteral nutrition by tube].

PubMed

Cots Seignot, I; Cárdenas Lagranja, G; Puiggròs Llop, C; Chicharro Serrano, L; Pérez-Portabella Maristany, C; Planas Vilà, M

2009-01-01

To know characteristics and the patients' evolution with head and neck cancer who received radiotherapy treatment and they were included at a home enteral nutrition (HEN) by feeding tube programme. To analyse the weight evolution according to the start of HEN before or after radiotherapy. Observational study of tube feeding patients with head and neck cancer who were included in HEN programme in our hospital for two years. Variables analysed: gender, age, Body Mass Index (BMI), Karnofsky Index (KI), reason for nutritional support, type of feeding tube, formula used and prescribed caloric contribution, necessity to change access device and HEN days. 62 patients were studied (77.4% men; 22.6% women). Age 64 +/- 10.1 years (rang: 39-90). The dysphagia was the main cause to begin enteral nutrition by feeding tube in these patients. Naso-gastric tube was prevalence (67.7%). The most used formula was polymeric hypercaloric diet with a mean of caloric contribution of 1,629 +/- 267.09 kcal/day. Overall, there was a weight loss in all patients during the study period time. However, patients who began the HEN by feeding tube before the radiotherapy treatment, the BMI did not decrease. All patients who began feeding tube before oncological treatment didn't lose weight for the period of study.

Prevalence of Tracheotomy and Percutaneous Endoscopic Gastrostomy in Patients with Guillain-Barré Syndrome.

PubMed

Yoshida, Mitsuyoshi; Ikeda, Junko; Urikane, Yukiko; Kashiwada, Takashi; Kaseda, Yumiko; Kohriyama, Tatsuo

2017-04-01

Some patients with Guillain-Barré syndrome require respiratory management by tracheotomy and/or nutritional management by tube feeding; however, few studies have reported the follow-up course in these patients. The objective of this study was to investigate the follow-up course of tracheotomy and gastrostomy in patients with Guillain-Barré syndrome. The study subjects were 50 patients with Guillain-Barré syndrome (25 males, 25 females; mean age, 51.1 ± 18.7 years) who were admitted to the Hiroshima City Rehabilitation Hospital during the period from April 2008 to December 2015. We retrospectively reviewed the medical records to determine the presence or absence of tracheotomy and/or feeding tube, and the timing of withdrawal from these treatments. During the acute phase, 15 patients underwent tracheotomy and 14 underwent tube feeding management. A tracheotomy tube was inserted for 110 days or longer in five patients, and four of these five patients also had a gastrostomy tube inserted. Among the 14 patients in the tube feeding group, seven underwent nasal feeding and seven underwent percutaneous endoscopic gastrostomy. All patients had the nasal tube removed (mean duration of nasal tube placement, 62.1 ± 46.5 days); however, the gastrostomy tube could not be removed in two patients. Our findings indicate that patients in the acute phase of Guillain-Barré syndrome carry a relevant risk of long-term tube feeding and prolonged need of an artificial airway.

Reduced Feeding Tube Duration with IMRT for Head and Neck Cancer: A SEER-Medicare Analysis

PubMed Central

Beadle, Beth M.; Liao, Kai-Ping; Giordano, Sharon H.; Garden, Adam S.; Hutcheson, Katherine A.; Lai, Stephen Y.; Guadagnolo, B. Ashleigh

2016-01-01

Background Intensity-modulated radiation therapy (IMRT) is a technologically advanced and resource-intensive method of delivering radiation therapy (RT) used to minimize toxicity for patients with head and neck cancers (HNC). Dependence on feeding tubes is a significant marker of toxicity of RT. The goal of this analysis was to compare the placement and duration of feeding tube use for patients with HNC from 1999-2011. Methods The cohort, demographics, and cancer-related variables were determined using the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database and analyzed regarding treatment details using claims data. Results A total of 2993 patients were identified. With a median follow-up of 47 months, 54.4% of patients had a feeding tube placed. The median duration from feeding tube placement to removal was 277 days. On zero-inflated negative binomial regression, patients treated with IMRT and 3DRT (non-IMRT) had similar rates of feeding tube placement (odds ratio (OR) 1.10; p=.35); however, patients treated with 3DRT had the feeding tube in place 1.18 times longer than those treated with IMRT (p=.03). The difference was only seen amongst patients treated with definitive radiation; patients treated with surgery and adjuvant radiation had no statistically significant difference in placement or duration. Conclusions Patients with HNC treated with definitive IMRT had significantly shorter duration of feeding tubes in place than those treated with 3DRT. These data suggest that there may be significant quality of life benefits to IMRT with respect to long-term swallowing function for patients. PMID:27662641

High-flexibility, noncollapsing lightweight hose

DOEpatents

Williams, David A.

1993-01-01

A high-flexibility, noncollapsing, lightweight, large-bore, wire-reinforced hose is inside fiber-reinforced PVC tubing that is flexible, lightweight, and abrasion resistant. It provides a strong, kink- and collapse-free conduit for moving large quantities of dangerous fluids, e.g., removing radioactive waste water or processing chemicals.

High-flexibility, noncollapsing lightweight hose

DOEpatents

Williams, D.A.

1993-04-20

A high-flexibility, noncollapsing, lightweight, large-bore, wire-reinforced hose is inside fiber-reinforced PVC tubing that is flexible, lightweight, and abrasion resistant. It provides a strong, kink- and collapse-free conduit for moving large quantities of dangerous fluids, e.g., removing radioactive waste water or processing chemicals.

Bridge-in-a-Backpack(TM). Task 3 : investigation of durability enhancements relative to abrasion from ice and other sources.

DOT National Transportation Integrated Search

2013-02-01

The arch-shaped concrete filled fiber reinforced polymer tube bridges are being constructed throughout New : England and elsewhere. The composite system durability and maintenance requirements need to be evaluated. For : this study, an asymmetric hyb...

Feeding tube replacement: not always that simple!

PubMed Central

Lederman, Alex; Coelho da Rocha, Ricardo Frank; Lourenção, Rodrigo Montenegro

2015-01-01

Although surgical gastrostomy is not a technically troublesome surgery, the procedure may be accompanied by unfavorable outcomes. Most complications occur early in the post-operative period and include feeding tube dislodgment, stomal infection, peritonitis, and pneumonia. The authors report the case of an 83-year-old man who underwent a surgical gastrostomy because of a swallowing disorder after an ischemic stroke. Nine months after the procedure, the feeding tube dislodged and a new tube was inserted with a certain delay and with some difficulty, causing a false path and consequently an intrabdominal abscess after diet infusion. The outcome was fatal. The authors call attention for meticulous care with the insertion of feeding tubes and advise the performance of imaging control to assure its precise positioning. PMID:26484325

[Enteral nutrition: drug administration via feeding tube].

PubMed

Behnken, I; Gaschott, T; Stein, J

2005-11-01

Enteral nutrition support via a feeding tube is a preferred and broadly applied way of artificial nutrition in patients who cannot take up orally an adequate amount of nutrients. These patients often need simultaneous drug therapy as well. Thus, there is a high risk of drug-nutrient interactions. Although enteral nutrition is commonly used there is a lack of awareness and knowledge about the appropriate handling and drug administration via the feeding tube. On the one hand, drug-nutrient interactions can lead to clogging of the tube, on the other hand, the change in bioavailability of the drug can have a direct effect on the therapeutic effort. To optimise safety and efficacy of drug therapy in patients with feeding tubes, some basic rules have been set up.

Litmus tests for verification of feeding tube location in infants: evaluation of their clinical use.

PubMed

Nyqvist, Kerstin Hedberg; Sorell, Annette; Ewald, Uwe

2005-04-01

To examine the clinical use of litmus paper tests for the assessment of aspirates in infants. In connection with establishing a programme for home care of infants with requirement of tube feeding with parents as the infants' carers, the need for a research-based method for verification of feeding tube position was identified by nurses as a complement to other methods. In adult care the litmus paper test is commonly used when visual inspection is not sufficient for assessment of aspirates obtained from feeding tubes. Observational study. Nurses performed litmus tests for verification of feeding tube location in a convenience sample of 60 infants born at a gestational age (GA) of 24-42 weeks. Presence/absence and volumes of aspirates were recorded as well as positive/negative litmus test reactions. Analyses on the association between test results and the infants' GA and postmenstrual and postnatal age at the time of the tests were conducted. Data were obtained from 2970 tube feeds. Aspirates were present on 1840 occasions (62%). A higher proportion of infants with absence of aspirates were born at a GA below 32 weeks. A positive reaction occurred in 97% of the tests in volumes between 0.01 and 22 ml. Birth at a GA below 32 weeks and respiratory problems were associated with negative tests. The high ratio of positive litmus reactions at all maturational levels supports the bedside use of analysis of pH in gastric aspirates for verification of feeding tube location. Application of pH indicator paper is recommended as a complementary method for assessment of aspirates from feeding tubes.

Impact of a decision aid on surrogate decision-makers' perceptions of feeding options for patients with dementia.

PubMed

Snyder, E Amanda; Caprio, Anthony J; Wessell, Kathryn; Lin, Feng Chang; Hanson, Laura C

2013-02-01

In advanced dementia, feeding problems are nearly universal, and families face difficult decisions about feeding options. Initial interviews for a randomized trial were used to describe surrogates' perceptions of feeding options, and to determine whether a decision aid on feeding options in advanced dementia would improve knowledge, reduce expectation of benefit from tube feeding, and reduce conflict over treatment choices for persons with advanced dementia. Semistructured interview with prestudy and poststudy design for surrogates in the intervention group. Twenty-four skilled nursing facilities across North Carolina participating in a cluster randomized trial. Two hundred and fifty-five surrogate decision makers for nursing home residents with advanced dementia and feeding problems, in control (n = 129) and intervention (n = 126) groups. For intervention surrogates only, an audiovisual-print decision aid provided information on dementia, feeding problems in dementia, advantages and disadvantages of feeding tubes or assisted oral feeding options, and the role of surrogates in making these decisions. The interview included open-ended items asking surrogates to report advantages and disadvantages of tube feeding and assisted oral feeding. Knowledge of feeding options was measured with 19 true/false items and items measuring expectation of benefit from tube feeding. Surrogates reported which of these two feeding options they preferred for the person with dementia, and how confident they were in this choice; their level of conflict about the choice was measured using the decisional conflict scale. Before the decision aid, surrogates described advantages and disadvantages of assisted oral feeding and tube feeding in practical, ethical, and medical terms. After review of the decision aid, intervention surrogates had improved knowledge scores (15.5 vs 16.8; P < .001), decreased expectation of benefits from tube feeding (2.73 vs 2.32; P = .001), and reduced decisional conflict (2.24 vs 1.91; P < .001). Surrogates preferred assisted oral feeding initially and reported more certainty about this choice after the decision aid. A structured decision aid can be used to improve decision making about feeding options in dementia care. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Impact of a Decision Aid on Surrogate Decision-makers’ Perceptions of Feeding Options for Patients with Dementia

PubMed Central

Snyder, E. Amanda; Caprio, Anthony J.; Wessell, Kathryn; Lin, Feng Chang; Hanson, Laura C.

2012-01-01

Objective In advanced dementia, feeding problems are nearly universal, and families face difficult decisions about feeding options. Initial interviews for a randomized trial were used to describe surrogates’ perceptions feeding options, and to determine if a decision aid on feeding options in advanced dementia would improve knowledge, reduce expectation of benefit from tube feeding, and reduce conflict over treatment choices for persons with advanced dementia. Design Semi-structured interview with pre-post study design for surrogates in the intervention group. Setting Twenty-four skilled nursing facilities across North Carolina participating in a cluster randomized trial. Participants Two hundred fifty-five surrogate decision-makers for nursing home residents with advanced dementia and feeding problems, in control (n=129) and intervention (n=126) groups. Intervention For intervention surrogates only, an audiovisual-print decision aid provided information on dementia, feeding problems in dementia, advantages and disadvantages of feeding tubes or assisted oral feeding options and the role of surrogates in making these decisions. Measurements The interview included open-ended items asking surrogates to report advantages and disadvantages of tube feeding and assisted oral feeding. Knowledge of feeding options was measured with 19 true-false items, and items measuring expectation of benefit from tube feeding. Surrogates reported which of these two feeding options they preferred for the person with dementia, and how confident they were in this choice; their level of conflict about the choice was measured using the Decisional Conflict Scale. Results Prior to the decision aid, surrogates described advantages and disadvantages of assisted oral feeding and tube feeding in practical, ethical and medical terms. After review of the decision aid, intervention surrogates had improved knowledge scores (15.5 vs. 16.8; p<0.001), decreased expectation of benefits from tube feeding (2.73 vs. 2.32; p = 0.001) and reduced decisional conflict (2.24 vs. 1.91, p<0.001). Surrogates preferred assisted oral feeding initially, and reported more certainty about this choice after the decision aid. Conclusion A structured decision aid can be used to improve decision-making about feeding options in dementia care. PMID:23273855

Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD): a multicentre randomised controlled trial.

PubMed

Dennis, M S; Lewis, S C; Warlow, C

Undernutrition is common in patients admitted with stroke. We aimed to establish whether the timing and route of enteral tube feeding after stroke affected patients' outcomes at 6 months. The FOOD trials consist of three pragmatic multicentre randomised controlled trials, two of which included dysphagic stroke patients. In one trial, patients enrolled within 7 days of admission were randomly allocated to early enteral tube feeding or no tube feeding for more than 7 days (early versus avoid). In the other, patients were allocated percutaneous endoscopic gastrostomy (PEG) or nasogastric feeding. The primary outcome was death or poor outcome at 6 months. Analysis was by intention to treat. Between Nov 1, 1996, and July 31, 2003, 859 patients were enrolled by 83 hospitals in 15 countries into the early versus avoid trial. Early tube feeding was associated with an absolute reduction in risk of death of 5.8% (95% CI -0.8 to 12.5, p=0.09) and a reduction in death or poor outcome of 1.2% (-4.2 to 6.6, p=0.7). In the PEG versus nasogastric tube trial, 321 patients were enrolled by 47 hospitals in 11 countries. PEG feeding was associated with an absolute increase in risk of death of 1.0% (-10.0 to 11.9, p=0.9) and an increased risk of death or poor outcome of 7.8% (0.0 to 15.5, p=0.05). Early tube feeding might reduce case fatality, but at the expense of increasing the proportion surviving with poor outcome. Our data do not support a policy of early initiation of PEG feeding in dysphagic stroke patients.

Enteral tube feeding for cystic fibrosis.

PubMed

Conway, S P; Morton, A; Wolfe, S

2008-04-16

Enteral tube feeding is routinely used in many cystic fibrosis centres when weight for height percentage is less than 85%, when there has been weight loss for longer than a two-month period or when there has been no weight gain for two to three months (under five years old) or for six months (over five years old). To examine the evidence that in people with cystic fibrosis supplemental enteral tube feeding improves nutritional status, respiratory function, and quality of life without significant adverse effects. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We also contacted the companies that market enteral feeds and reviewed their databases. Date of the most recent search of the Group's Cystic Fibrosis Trials Register: November 2007. All randomised controlled trials comparing supplemental enteral tube feeding for one month or longer with no specific intervention in people with cystic fibrosis. Thirteen trials were identified by the search; however, none were eligible for inclusion in this review. There are no trials included in this review. Supplemental enteral tube feeding is widely used throughout the world to improve nutritional status in people with cystic fibrosis. The methods mostly used, nasogastric or gastrostomy feeding, are invasive, expensive, and may have a negative effect on self-esteem and body image. Reported use of enteral tube feeding suggests that it results in nutritional and respiratory improvement and it is disappointing that their efficacy has not been fully assessed by randomised controlled trials. With the more frequent recommendations to use enteral tube feeding as an early rather than a late intervention, this systematic review identifies the need for a multicentre, randomised controlled trial assessing both efficacy and possible adverse effects of enteral tube feeding in cystic fibrosis. There are no trials included in the review and we have not identified any relevant trials up to November 2007. We therefore do not plan to update this review until new trials are published.

Incidence of Tube Feeding in 7174 Newly Admitted Nursing Home Residents With and Without Dementia.

PubMed

Schulze, Jana; Mazzola, Rosa; Hoffmann, Falk

2016-02-01

Tube feeding is a common form of long-term nutritional support, especially for nursing home residents, of whom many have dementia. Estimating the incidence of feeding tube placement in nursing home residents with and without dementia. Using claims data, we studied a cohort of newly admitted nursing home residents aged 65 years and older between 2004 and 2009. Analyses were stratified by dementia. We estimated incidence rates and performed multivariate Cox regression analyses. The study cohort included 7174 nursing home residents. Over a mean follow-up of 1.3 years, 273 people received a feeding tube. The incidence per 1000 person-years was 28.4, with higher estimates for patients with dementia. When adjusting for age, sex, and level of care as a time-dependent covariate, influence of dementia decreased to a nonsignificant hazard ratio. It seems that not dementia itself but the overall clinical condition might be a predictor of tube feeding placement. © The Author(s) 2015.

Clinical tube weaning supported by hunger provocation in fully-tube-fed children.

PubMed

Hartdorff, Caroline M; Kneepkens, C M Frank; Stok-Akerboom, Anita M; van Dijk-Lokkart, Elisabeth M; Engels, Michelle A H; Kindermann, Angelika

2015-04-01

Children with congenital malformations, mental retardation, and complex early medical history frequently have feeding problems. Although tube feeding is effective in providing the necessary energy and nutrients, it decreases the child's motivation to eat and may lead to oral aversion. In this study, we sought to confirm our previous results, showing that a multidisciplinary clinical hunger provocation program may lead to quick resumption of oral feeding. In a crossover study, 22 children of 9 to 24 months of age who were fully dependent on tube feeding were randomly assigned to one of two groups: group A, intervention group (2-week multidisciplinary clinical hunger provocation program); and group B, control group (4-week outpatient treatment by the same multidisciplinary team). Patients failing one treatment were reassigned to the other treatment group. Primary outcome measures were at least 75% orally fed at the conclusion of the intervention and fully orally fed and gaining weight 6 months after the intervention. In group A, 9/11 patients were successfully weaned from tube feeding (2 failures: 1 developed ulcerative colitis, 1 drop-out). In group B, only 1 patient was weaned successfully; 10/11 were reassigned to the clinical hunger provocation program, all being weaned successfully. Six months after the intervention, 1 patient had to resume tube feeding. In total, in the control group, 1/11 (9%) was weaned successfully as compared with 18/21 (86%) in the hunger provocation group (P < 0.001). Multidisciplinary clinical hunger provocation is an effective short-term intervention for weaning young children from tube feeding.

Jejunal feeding tubes can be efficiently and independently placed by intensive care unit teams.

PubMed

Welpe, Pascal; Frutiger, Adrian; Vanek, Patrik; Kleger, Gian-Reto

2010-01-01

Nutrition support is an important therapeutic measure in critically ill patients. Several studies have shown that the enteral route is preferable to the parenteral route. Insertion of a feeding tube beyond the ligament of Treitz combined with continuous gastric drainage will reduce regurgitation and probably also the rate of nosocomial pneumonia. This study was conducted to assess the safety, success rate, and time required to establish jejunal nutrition by the fluoroscopy-guided technique in intensive care unit (ICU) patients. This was a prospective observational study in the ICUs of a 300-bed and a 600-bed community hospital. Indications were large gastric residuals during attempted gastric feeding, severe acute pancreatitis, or recurrent aspiration. Feeding tubes were introduced by the ICU staff at bedside under fluoroscopic guidance (a senior ICU physician and a resident or a registered ICU nurse). The correct jejunal position was documented by the application of a radiopaque contrast medium through the tube. After confirmation of the correct position, jejunal tube feeding was immediately started. The insertion procedure in 38 patients lasted a median of 17 minutes. The median time from decision to place the tube until start of enteral feeding was 141 minutes. The success rate was 84.2%. No adverse events were observed. Fluoroscopic placement of a jejunal feeding tube at the bedside is fast, is safe, and has a high success rate when performed by well-trained ICU staff. Using this method makes the ICU team more self-sufficient when critically ill patients require enteral nutrition and no gastroenterologist is available.

Pre-radiotherapy feeding tube identifies a poor prognostic subset of postoperative p16 positive oropharyngeal carcinoma patients.

PubMed

Verma, Vivek; Liu, Jingxia; Eschen, Laura; Danieley, Jonathan; Spencer, Christopher; Lewis, James S; Diaz, Jason; Piccirillo, Jay F; Adkins, Douglas R; Nussenbaum, Brian; Thorstad, Wade L; Gay, Hiram A

2015-01-09

This study explores variables associated with poor prognosis in postoperative p16 positive oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing adjuvant radiotherapy or chemoradiotherapy. Specifically, analysis was done related to timing of feeding tube insertion relative to radiotherapy. From 1997-2009, of 376 consecutive patients with OPSCC, 220 received adjuvant IMRT, and 97 were p16 positive and eligible. Of these, 23 had feeding tube placement before IMRT (B-FT), 32 during/after IMRT (DA-FT), and 42 had no feeding tube (NO-FT). Feeding tubes were not placed prophylactically. These three groups were analyzed for differential tumor, patient, treatment, and feeding tube characteristics, as well as differences in overall survival (OS), disease free survival (DFS), and distant metastasis free survival (DMFS). Pre-RT FT insertion was associated with higher tumor size and depth, T (but not N) and overall stage, comorbidities, presence of chemotherapy, and less use of transoral laser microsurgery/transoral bovie. Additionally, time from surgery to IMRT completion was also statistically longer in the B-FT group. The feeding tube was permanent in 52% of patients in the B-FT group versus 16% in the DA-FT group (p = 0.0075). The 5-year OS for the NO-FT, DA-FT, and B-FT groups was 90%, 86%, and 50%, respectively. The 5-year DFS for the NO-FT, DA-FT, and B-FT groups was 87.6%, 83.6%, and 42.7%, respectively. Multivariate analysis showed that for OS and DFS, feeding tube placement timing and smoking history were statistically significant. Due to the poor prognosis of early FT insertion, the presence of FTs at time of radiotherapy consultation can be used as an alternate marker to identify a subset of p16 positive OPSCC patients that have a poor prognosis.

Rock Cutting Depth Model Based on Kinetic Energy of Abrasive Waterjet

NASA Astrophysics Data System (ADS)

Oh, Tae-Min; Cho, Gye-Chun

2016-03-01

Abrasive waterjets are widely used in the fields of civil and mechanical engineering for cutting a great variety of hard materials including rocks, metals, and other materials. Cutting depth is an important index to estimate operating time and cost, but it is very difficult to predict because there are a number of influential variables (e.g., energy, geometry, material, and nozzle system parameters). In this study, the cutting depth is correlated to the maximum kinetic energy expressed in terms of energy (i.e., water pressure, water flow rate, abrasive feed rate, and traverse speed), geometry (i.e., standoff distance), material (i.e., α and β), and nozzle system parameters (i.e., nozzle size, shape, and jet diffusion level). The maximum kinetic energy cutting depth model is verified with experimental test data that are obtained using one type of hard granite specimen for various parameters. The results show a unique curve for a specific rock type in a power function between cutting depth and maximum kinetic energy. The cutting depth model developed here can be very useful for estimating the process time when cutting rock using an abrasive waterjet.

Tires

DTIC Science & Technology

2015-12-15

during shipment, protect the threads of the valve stem, and shield the folded tube against abrasion by the threads . A metal valve cap contains a...Test types include force and moment, rolling resistance , steer frequency response, load-deflection curves, characteristics, endurance, and...several on-vehicle tests. 15. SUBJECT TERMS tire test rig force and moment rolling resistance steer frequency response

Inflatable partition for fighting mine fires

DOEpatents

Conti, Ronald S.; Lazzara, Charles P.

1995-01-01

The seal is a lightweight, inflatable, bag which may be inflated by a portable air generator and is used to seal a burning mine passage. A collapsible tube-like aperture extends through the seal and allows passage of high expansion foam through the seal in a feed tube. The foam fills the passageway and extinguishes the fire. In other embodiments, the feed tubes incorporate means to prevent collapse of the aperture. In these embodiments a shroud connects the feed tube to a foam generator. This seal allows creation of a high expansion foam fire fighting barrier even in upward sloping passages.

Safety and Efficacy of Electromagnetic-Guided Bedside Placement of Nasoenteral Feeding Tubes versus Standard Placement.

PubMed

Shadid, Husam; Keckeisen, Maureen; Zarrinpar, Ali

2017-10-01

Although enteral feeding in critically ill patients has been shown to be beneficial, reliable postpyloric placement of feeding tubes remains a challenge. The standard of care involves blind placement, frequently requiring multiple attempts, and radiographs. To evaluate the effect of electromagnetic-guided bedside placement in reducing time to establishment of feeding, lung placement, use of radiography, and cost, we initiated a prospective trial using electromagnetic-guided bedside placement and compared them to a retrospective cohort. Fifty-three consecutive placements of nasoenteral feeding tubes were made using electromagnetic-guidance on patients requiring enteral nutrition in a surgical intensive care unit at a tertiary care center. Sixty-three placement attempts in the preceding seven months served as controls. There were no significant differences between the two groups in terms of age, sex, weight, body mass index, hiatal or ventral hernias, or previous esophageal/gastric operations. The number of radiographs needed per patient, need for fluoroscopy, radiology charge per patient for the tube placement, and time from first attempt at placement to confirmation of postpyloric location were lower for the electromagnetic-guided group. Use of electromagnetic guidance allows reliable and cost-effective postpyloric enteral feeding tube placement compared with blind insertion.

Using a nasogastric tube.

PubMed

Candy, C

1986-09-01

This discussion of the use of a nasogastric tube covers the equipment needed, the method, rehydration and feeding, prolonged nasogastric feeding, and stopping nasogastric feeding. A nasogastric tube is useful when children are unable to drink safely and in sufficient amounts for any of the following reasons: severe dehydration; if intravenous (IV) therapy is unavailable; low birth weight infants; or the child is drowsy or vomiting. Severely malnourished children may be fed initially in this way if they are too weak or anorexic to eat or drink normally. The following equipment is needed: nasogastric tube; lubricating fluid; a syringe; blue litmus paper, if available; adhesive tape; stethoscope if available; and fluid to be given. Explain to the child's parents and the child, if old enough to understand, what will be done; lie infants flat; measure the approximate length from the child's nostril to the ear lobe and then to the top of the abdomen with the tube and mark the position; clean the nostrils to remove the mucus, and lubricate the tip of the tube and gently insert into the nostril; give the child a drink of water if he or she is conscious; continue to pass the tube down until the position marked reaches the nostril; use the syringe to suck up some fluid and test with blue litmus paper to check that the tube is in the stomach; and inject 5-10 ml of fluid (saline or oral rehydration solution, not milk formula) by syringe if satisfied the tube is in the correct position. Where possible, give a continuous drip of fluid. If this is not possible, give frequent small amounts using the syringe as a funnel. If feeding continues for more than 24 hours, clean the nostrils daily with warm water and change the tube to the other nostril every few days. Also keep the mouth very clean with a dilute solution of 8% sodium bicarbonate, if available, or citrus fruit juice. To remove the tube, remove the adhesive tape, take the tube out gently and smoothly, and offer the child a drink and gently cleanse the nostrils. After prolonged nasogastric feeding, a child may experience feeding problems or loss of appetite. Patient and encouragement are needed to establish feeding by mouth again.

Consideration of alternative designs for a Percutaneous Endoscopic Gastrostomy feeding tube

NASA Astrophysics Data System (ADS)

Yerrabolu, Santosh Rohit

The inability of some people to chew or swallow foods (but can digest foods) due to problems associated with various diseases and complications leads them to insufficient nutritional intake and loss of quality of life. These individuals are generally provided with nutritional support by means of injecting or infusing food directly into their stomachs or small intestines via feeding tubes. Gastrostomy feeding tubes (G-tubes) are used when such nutritional support is required for over 3-6 weeks. Percutaneous Endoscopic Gastrostomy (PEG) tubes are one of the most widely used G- Tubes and devices which are inserted via an incision through the abdominal wall either through a pull or push method. This investigation proposes conceptual alternative Percutaneous Endoscopy Gastrostomy (PEG) feeding tube designs with optimized materials selection to be used for their construction. The candidate materials were chosen from 18 commercial catheters, 2 reference grade polymers and a commercial polymer; using tissue-catheter-friction testing and surface chemistry characterization (Infrared spectroscopy and Critical Surface Tension approximation). The main objectives considered were to minimize slipping/dislodgement of gastrostomy tube/seal, to reduce peristomal leakage, and to attain size variability of PEG tubes while maintaining a low profile. Scanning Electron Microscope- Energy Dispersive X-ray Spectroscopy was employed to further determine the filler materials used in the samples. Nylon coated with fatty ester and filled with Barium sulphate was determined as the optimum material for the construction of the tube part of the feeding tubes to reduce slipping/dislodgment of gastrostomy tube/seal and to minimize peristomal leakage. Nylon coated with fatty ester and filled with Silica is the suggested as a candidate material for construction of the bumper/mushroom sections of the feeding tubes to avoid the Buried Bumper Syndrome. Fused Deposition Modeling, Selective Laser Sintering and/or 3-D printing are proposed for manufacturing of the product. Radio Frequency Glow Discharge Treatment is proposed as a sterilizing technique. Further investigations suggested are pilot Finite Element Analysis of the biomechanics involved and the subsequent validation and optimization of the conceptual designs apart from pursuing materials performance evaluation with stomach tissue-skin composites and long-term placement of tubes/ catheters at variable surface roughness profiles, filler materials, modulus of rigidities, tube-pull-through speeds and tissue stretch ratios.

Pancreatitis - discharge

MedlinePlus

... Diet - clear liquid Diet - full liquid Enteral nutrition - child - managing problems Gallstones - discharge Gastrostomy feeding tube - bolus Jejunostomy feeding tube Review Date 12/1/2016 Updated by: Subodh K. Lal, MD, Gastroenterologist ...

Contamination risk of stable isotope samples during milling.

PubMed

Isaac-Renton, M; Schneider, L; Treydte, K

2016-07-15

Isotope analysis of wood is an important tool in dendrochronology and ecophysiology. Prior to mass spectrometry analysis, wood must be homogenized, and a convenient method involves a ball mill capable of milling samples directly in sample tubes. However, sample-tube plastic can contaminate wood during milling, which could lead to biological misinterpretations. We tested possible contamination of whole wood and cellulose samples during ball-mill homogenization for carbon and oxygen isotope measurements. We used a multi-factorial design with two/three steel milling balls, two sample amounts (10 mg, 40 mg), and two milling times (5 min, 10 min). We further analyzed abrasion by milling empty tubes, and measured the isotope ratios of pure contaminants. A strong risk exists for carbon isotope bias through plastic contamination: the δ(13) C value of polypropylene deviated from the control by -6.77‰. Small fibers from PTFE filter bags used during cellulose extraction also present a risk as the δ(13) C value of this plastic deviated by -5.02‰. Low sample amounts (10 mg) showed highest contamination due to increased abrasion during milling (-1.34‰), which is further concentrated by cellulose extraction (-3.38‰). Oxygen isotope measurements were unaffected. A ball mill can be used to homogenize samples within test tubes prior to oxygen isotope analysis, but not prior to carbon or radiocarbon isotope analysis. There is still a need for a fast, simple and contamination-free sample preparation procedure. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Protective coatings for composite tubes in space applications

NASA Technical Reports Server (NTRS)

Dursch, Harry W.; Hendricks, Carl L.

1987-01-01

Protective coatings for graphite/epoxy (Gr/Ep) tubular structures for a manned Space Station truss structure were evaluated. The success of the composite tube truss structure depends on its stability to long-term exposure to the low earth orbit (LEO) environment, with particular emphasis placed on atomic oxygen. Concepts for protectively coating Gr/Ep tubes include use of inorganic coated metal foils and electroplating. These coatings were applied to Gr/Ep tubes and then subjected to simulated LEO environment to evaluate survivability of coatings and coated tubes. Evaluation included: atomic oxygen resistance, changes in optical properties and adhesion, abrasion resistance, surface preparation required, coating uniformity, and formation of microcracks in the Gr/Ep tubes caused by thermal cycling. Program results demonstrated that both phosphoric and chromic acid anodized Al foil provided excellent adhesion to Gr/Ep tubes and exhibited stable optical properties when subjected to simulated LEO environment. The SiO2/Al coatings sputtered onto Al foils also resulted in an excellent protective coating. Electroplated Ni exhibited unacceptable adhesion loss to Gr/Ep tubes during atomic oxygen exposure.

Protective coatings for composite tubes in space applications

NASA Technical Reports Server (NTRS)

Dursch, Harry W.; Hendricks, Carl L.

1987-01-01

Protective coatings for graphite/epoxy (Gr/Ep) tubular structures for a Manned Space Station truss structure were evaluated. The success of the composite tube truss structure depends on its stability to long-term exposure to the Low Earth Orbit (LEO) environment with particular emphasis placed on atomic oxygen. Concepts for protectively coating Gr/Ep tubes include use of inorganic coated metal foils and electroplating. These coatings were applied to Gr/Ep tubes and then subjected to simulated LEO environmnet to evaluate survivability of coatings and coated tubes. Evaluation included: atomic oxygen resistance, changes in optical properties and adhesion, abrasion resistancem surface preparation required, coating uniformity, and formation of microcracks in the Gr/Ep tubes caused by thermal cycling. Program results demonstrated that both phosphoric and chromic acid anodized Al foil provided excellent adhesion to Gr/Ep tubes and exhibited stable optical properties when subjected to simulated LEO environment. The SiO2/Al coatings speuttered onto Al foils also resulted in an excellent protective coating. Electroplated Ni exhibited unaccepatble adhesion loss to Gr/Ep tubes during atomic oxygen exposure.

Refining low protein modular feeds for children on low protein tube feeds with organic acidaemias.

PubMed

Daly, A; Evans, S; Ashmore, C; Chahal, S; Santra, S; MacDonald, A

2017-12-01

Children with inherited metabolic disorders (IMD) who are dependent on tube feeding and require a protein restriction are commonly fed by 'modular tube feeds' consisting of several ingredients. A longitudinal, prospective two-phase study, conducted over 18 months assessed the long-term efficacy of a pre-measured protein-free composite feed. This was specifically designed to meet the non-protein nutritional requirements of children (aged over 1 year) with organic acidaemias on low protein enteral feeds and to be used as a supplement with an enteral feeding protein source. All non-protein individual feed ingredients were replaced with one protein-free composite feed supplying fat, carbohydrate, and micronutrients. Thirteen subjects, median age 7.4y (3-15.5y), all nutritionally tube dependent (supplying nutritional intake: ≥ 90%, n = 12; 75%, n = 1), and diagnosed with organic acidaemias (Propionic acidaemia, n = 6; Vitamin B 12 non-responsive methyl malonic acidaemia, n = 4; Isovaleric acidaemia, n = 2; Glutaric aciduria type1, n = 1); were studied. Nutritional intake, biochemistry and anthropometry were monitored at week - 8, 0, 12, 26 and 79. Energy intake remained unchanged, providing 76% of estimated energy requirements. Dietary intakes of vitamins, minerals and essential fatty acids significantly increased from week 0 to week 79, but sodium, potassium, magnesium, decosahexanoic acid and fibre did not meet suggested requirements. Plasma zinc, selenium, haemoglobin and MCV significantly improved, and growth remained satisfactory. Natural protein intake met WHO/FAO/UNU 2007 recommendations. A protein-free composite feed formulated to meet the non-protein nutritional requirements of children aged over 1 year improved nutritional intake, biochemical nutritional status, and simplified enteral tube feeding regimens in children with organic acidaemias.

In Vitro Evaluation of Eslicarbazepine Delivery via Enteral Feeding Tubes.

PubMed

Reindel, Kristin; Zhao, Fang; Hughes, Susan; Dave, Vivek S

2017-12-01

Purpose: The feasibility of preparing an eslicarbazepine acetate suspension using Aptiom tablets for administration via enteral feeding tubes was evaluated. Methods: Eslicarbazepine acetate suspension (40 mg/mL) was prepared using Aptiom tablets after optimizing the tablet crushing methods and the vehicle composition. A stability-indicating high-performance liquid chromatography (HPLC) method was developed to monitor the eslicarbazepine stability in the prepared suspension. Three enteric feeding tubes of various composition and dimensions were evaluated for the delivery of the suspensions. The suspension was evaluated for the physical and chemical stability for 48 hours. Results: The reproducibility and consistency of particle size reduction was found to be best with standard mortar/pestle. The viscosity analysis and physical stability studies showed that ORA-Plus:water (50:50 v/v) was optimal for suspending ability and flowability of suspension through the tubes. The developed HPLC method was found to be stability indicating and suitable for the assay of eslicarbazepine acetate in the prepared suspension. The eslicarbazepine concentrations in separately prepared suspensions were within acceptable range (±3%), indicating accuracy and reproducibility of the procedure. The eslicarbazepine concentrations in suspensions before and after delivery through the enteric feeding tubes were within acceptable range (±4%), indicating absence of any physical/chemical interactions of eslicarbazepine with the tubes and a successful delivery of eslicarbazepine dosage via enteric feeding tubes. The stability study results showed that eslicarbazepine concentration in the suspension remained unchanged when stored at room temperature for 48 hours. Conclusion: The study presents a convenient procedure for the preparation of a stable suspension of eslicarbazepine acetate (40 mg/mL) using Aptiom tablets, for administration via enteral feeding tubes.

The impact of HPV status on weight loss and feeding tube use in oropharyngeal carcinoma.

PubMed

Vangelov, Belinda; Kotevski, Damian P; Williams, Janet R; Smee, Robert I

2018-04-01

It has been well established that patients with oropharyngeal carcinoma are at high nutritional risk, with significant weight loss and tube feeding common. Human papillomavirus (HPV)-associated disease has led to a change in the "typical" presentation and nutritional profile of this population. The aim of our study was to determine whether the need for a feeding tube, and weight loss during radiotherapy (RT) in patients with oropharyngeal carcinoma differed with HPV status. Patients who received curative RT ± chemotherapy from January 2011 to January 2016 were included (n = 100). We retrospectively evaluated feeding tube use and timing of insertion (prophylactic vs reactive), percentage weight loss during RT and the prevalence of critical weight loss (CWL) ≥5%. HPV-positive patients had significantly higher weight loss during RT compared to the rest of the cohort (8.4% vs 6.1%, 95%CI 0.8-3.9, p = 0.003). CWL was observed in 86% and in a higher proportion with HPV-positive disease (93%, p = 0.011). Conditional probability modelling analysis revealed, with 74% accuracy, concurrent chemoradiotherapy and HPV-positive status were predictors of CWL when comparing HPV-positive patients to HPV-negative (96%, p = 0.001 and 98%, p = 0.012 respectively). More HPV-positive patients required feeding tubes (n = 43, 63%, p = 0.05), most being reactive (n = 27, 63%). All patients with reactive tubes experienced CWL. The high incidence of CWL in patients with HPV-positive oropharyngeal carcinoma is of concern. Tube feeding continues to be a necessary nutritional intervention in this population and predicting who will require a tube is challenging. Larger, prospective cohort studies are required. Copyright © 2018 Elsevier Ltd. All rights reserved.

Tube Feeding Transition Plateaus

ERIC Educational Resources Information Center

Klein, Marsha Dunn

2007-01-01

The journey children make from tube feeding to oral feeding is personal for each child and family. There is a sequence of predictable plateaus that children climb as they move toward orally eating. By better understanding this sequence, parents and children can maximize the development, learning, enjoyment and confidence at each plateau. The…

Casing window milling with abrasive fluid jet

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vestavik, O.M.; Fidtje, T.H.; Faure, A.M.

1995-12-31

Methods for through tubing re-entry drilling of multilateral wells has a large potential for increasing hydrocarbon production and total recovery. One of the bottle-necks of this technology is initiation of the side-track by milling a window in the casing downhole. A new approach to this problem has been investigated in a joint industry project. An experimental set-up has been built for milling a 4 inch window in a 7 inch steel casing at surface in the laboratory. A specially designed bit developed at RIF using abrasive jet cutting technology has been used for the window milling. The bit has anmore » abrasive jet beam which is always directed in the desired side-track direction, even if the bit is rotating uniformly. The bit performs the milling with a combined mechanical and hydraulic jet action. The method has been successfully demonstrated. The experiments has shown that the window milling can be performed with very low WOB and torque, and that only small side forces are required to perform the operation. Casing milling has been performed without a whipstock, a cement plug has been the only support for the tool. The tests indicate that milling operations can be performed more efficiently with less time and costs than what is required with conventional techniques. However, the method still needs some development of the downhole motor for coiled tubing applications. The method can be used both for milling and drilling giving the advantage of improved rate of penetration, improved bit life and increased horizontal reach. The method is planned to be demonstrated downhole in the near future.« less

[Intraoperative placement of transnasal small intestinal feeding tube during the surgery in 5 cases with high position intestinal obstruction and postoperative feeding].

PubMed

Duan, Guang-qi; Zhang, Min; Guan, Xiao-hao; Yin, Zhi-qing

2012-09-01

To explore the value of employing the small intestinal feeding tube in treating high position intestinal obstruction of newborn infant. Five newborn infants (3 males and 2 females; 1 premature infant and 4 fully-mature infants; 2 had membranous atresia of duodenum, 1 had annular pancreas, and 2 had proximal small intestine atresia; 1 infant had malrotation). The duodenal membrane-like atresia and the blind-end of small intestine were removed and intestinal anastomosis was performed, which was combined with intestinal malrotation removal. Before the intestinal anastomosis surgery, the anesthetist inserted via nose a 6Fr small intestinal ED tube, made by CREATE MEDIC CO LTD of Japan[ the State Food and Drug Administration-instrument (Im.) 2007-NO.2661620]. Twenty-four hours after surgery, abdominal X-ray plain film was taken and patients were fed with syrup; 48 hours later, formula milk was pumped or lactose-free milk amino acids were given by intravenous injection pump through the feeding tube. The amount of milk and fluids was gradually increased to normal amount according to the condition. In initial 3 days the intravenous nutrition was given and one week after operation, the infants were fed through mouth in addition to pumping milk through the tube and stopped infusion. Ten to 22 days after operation, the tube was removed and the infant patients were discharged. All the five infants showed that the feeding through the nutrition tube was accomplished and the time of venous nutrition was reduced and fistula operation was avoided. None of the infants on question was off the tube and no jaundice exacerbation was found and the liver function was also found normal. At the very beginning, the tube was occasionally blocked by milk vale in one infant and after 0.9% sodium chloride solution flushing patency restored. After that, the feeding tube was washed once with warm water after feeding. In one infant vomiting occurred due to enough oral milk. The photograph of upper gastrointestine did not show anastomomotic stricture or fistula, or intestinal obstruction. After pulling out the tube, the symptoms disappeared and then the patient was discharged. One child was found to have diarrhea with no lactose nutrition liquid and given compound lactic bacteria preparations for oral administration, the symptom disappeared. In the 5 cases, the shortest hospital stay was 10 days and the longest was 22 days, the average stay was 16 days. Three to 5 days after operation the weight restored to birth weight, the weight had increased, when discharged, to an average of 5.5 g (kg·d). The small intestinal feeding tube was very effective for the postoperative nutrition maintenance of high position intestinal obstruction in newborn infants.

Tooth wear in captive giraffes (Giraffa camelopardalis): mesowear analysis classifies free-ranging specimens as browsers but captive ones as grazers.

PubMed

Clauss, Marcus; Franz-Odendaal, Tamara A; Brasch, Juliane; Castell, Johanna C; Kaiser, Thomas

2007-09-01

Captive giraffe (Giraffa camelopardalis) mostly do not attain the longevity possible for this species and frequently have problems associated with low energy intake and fat storage mobilization. Abnormal tooth wear has been among the causes suggested as an underlying problem. This study utilizes a tooth wear scoring method ("mesowear") primarily used in paleobiology. This scoring method was applied to museum specimens of free-ranging (n=20) and captive (n=41) giraffes. The scoring system allows for the differentiation between attrition--(typical for browsers, as browse contains little abrasive silica) and abrasion--(typical for grazers, as grass contains abrasive silica) dominated tooth wear. The dental wear pattern of the free-ranging population is dominated by attrition, resembles that previously published for free-ranging giraffe, and clusters within browsing herbivores in comparative analysis. In contrast, the wear pattern of the captive population is dominated by abrasion and clusters among grazing herbivores in comparative analyses. A potential explanation for this difference in tooth wear is likely related to the content of abrasive elements in zoo diets. Silica content (measured as acid insoluble ash) is low in browse and alfalfa. However, grass hay and the majority of pelleted compound feeds contain higher amounts of silica. It can be speculated that the abnormal wear pattern in captivity compromises tooth function in captive giraffe, with deleterious long-term consequences.

Successful use of a bulk laxative to control the diarrhea of tube feeding.

PubMed

Frank, H A; Green, L C

1979-01-01

The greatly increased nutritional demands of the severely burned patient frequently require the use of tube feeding for enternal hyperalimentation. At a time when general patient morale is low and motivation needs to be maximally maintained, there is nothing so dispiriting as the distress of a painful perianal region and uncontrollable liquid stools. Attempts to control the diarrhea which frequently accompanies tube feeding by changing the formula or the method of administration or a wide variety of constipating drugs have all met with very limited success. Based on the clinical observation of a noted gastroenterologist (Bockus), we have administered a mucilagenous hydrophilic colloid bulk laxative (Metamucil) to patients on tube feeding formulae. The dosage and frequency are adjusted to individual patient needs, but average 7 g per liter of liquid formula. The results have been dramatic; namely, the virtual elimination of the diarrhea problem in our burn patients on enteral hyperalimentation by gastric tube feeding. Colonic transit time increases. The stools become formed but soft, cohesive but not adhesive. Perianal irritation does not occur. Neither does soilage of wound, dressings, or bed. No rebound constipation or obstructive symptoms have been encountered. We attribute this response to the same water binding mechanism that allows these colloids to prevent chronic constipation. Our patients may be given as much as 5,000 to 6,000 calories of tube feeding per day. Our patients are not distressed by diarrhea. Our nursing staff is relieved of the burden that entails.

Extemporaneous procedures for dissolving risedronate tablets for oral administration and for feeding tubes.

PubMed

Dansereau, Richard J; Crail, Debbie J

2005-01-01

Risedronate (Actonel, Procter & Gamble Pharmaceuticals) is commercially available only as film-coated tablets. Extemporaneous procedures for dissolving tablets for feeding tubes and for preparation of an oral liquid have not previously been evaluated. To evaluate procedures for dissolving risedronate sodium tablets for administration in liquid form and drug recovery following dissolution in cups and following passage through different types of feeding tubes. Tablets (5 and 35 mg) were individually dispersed in 2 oz of water. After 2 minutes, the solution was stirred for 30 seconds, dispensed, and rinsed with an additional 4 oz of water. The sample was filtered and analyzed by HPLC. Ten replicates were performed using the various cups. Gastrostomy and nasoenteric tubes were flushed with 1 oz of water. Individual tablets were dispersed in 2 oz of water; after 2 minutes, the solution was stirred for 30 seconds and poured through the tube and flushed with 1 oz of water. Samples were filtered and analyzed by HPLC. Ten replicates were performed for each type of feeding tube. For cups, the mean amount of drug recovered ranged from 95.7% to 100.5% of the label claim, with a relative standard deviation (RSD) range of 1.1-6.3%. For gastrostomy and nasoenteric tubes, the mean amount of drug recovered ranged from 98.3% to 101.9% of label claim, with an RSD range of 0.9-3.3%. A simple and accurate procedure was developed for dissolving risedronate tablets in water to prepare a liquid formulation for administration orally or through feeding tubes.

Comparison of laparoscopic jejunostomy tube to percutaneous endoscopic gastrostomy tube with jejunal extension: long-term durability and nutritional outcomes.

PubMed

Haskins, Ivy N; Strong, Andrew T; Baginsky, Mary; Sharma, Gautam; Karafa, Matthew; Ponsky, Jeffrey L; Rodriguez, John H; Kroh, Matthew D

2018-05-01

Enteral access through the jejunum is indicated when patients cannot tolerate oral intake or gastric feeding. While multiple approaches for feeding jejunal access exist, few studies have compared the efficacy of these techniques. The purpose of this study was to investigate the long-term durability, re-intervention rates, and nutritional outcomes following percutaneous endoscopic gastrostomy tubes with jejunal extension tubes (PEG-JET) versus laparoscopic jejunostomy tubes (j-tubes). Retrospective chart review was performed on all patients who underwent PEG-JET or laparoscopic jejunostomy tube placement from January 2005 through December 2015 at our institution. Thirty-day and long-term outcomes were compared between the two groups. A total of 105 patients underwent PEG-JET and 307 patients underwent laparoscopic j-tube placement during the defined study period. In terms of 30-day outcomes, patients who underwent PEG-JET placement were significantly more likely to experience a tube dislodgement event (p = 0.005) and undergo a re-intervention (p < 0.001). Patients who had a laparoscopic j-tube placed were significantly more likely to meet their enteral feeding goals (p = 0.002) and less likely to require nutritional supplementation with total parenteral nutrition (TPN) (p < 0.001). With regard to long-term outcomes, patients who underwent PEG-JET placement were significantly more likely to experience tube occlusion (p < 0.001) and require an endoscopic or surgical tube re-intervention (p < 0.001). Patients who underwent laparoscopic j-tube placement were significantly more likely to experience a tube site leak (p = 0.015) but were less likely to require nutritional supplementation with TPN (p = 0.001). Laparoscopic jejunostomy tubes provide more durable long-term enteral access compared to PEG-JET. Consideration should be given to laparoscopic jejunostomy tube placement in eligible patients who cannot tolerate oral intake or gastric enteral feeding.

Travels with Mullen

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Early discharge with tube feeding at home for preterm infants is associated with longer duration of breast feeding.

PubMed

Meerlo-Habing, Z E; Kosters-Boes, E A; Klip, H; Brand, P L P

2009-07-01

Mothers of preterm infants are more likely to discontinue breast feeding early than mothers of term infants. We evaluated the effect of early discharge with tube feeding of preterm infants under close supervision by paediatric nurse specialists on the duration of breast feeding. Case-control study. Medium/high-care neonatal unit of a large district general hospital. Preterm infants (<37 weeks' gestational age). Early discharge with tube feeding under close supervision by paediatric nurse specialists or regular follow-up of preterm infants discharged with oral feeding. Duration of breast feeding assessed by telephone interview 6 months after birth. There were 50 preterm infants in the early discharge group and 78 in the control group. Mothers in the early discharge group continued to breast feed longer than mothers in the control group (log rank test, p = 0.028). Four months after discharge, 63% of preterm infants in the control group were fed formula compared to 36% in the early discharge group (95% CI for difference 9% to 43%, p = 0.04). The relative risk of breast feeding cessation 6 months after birth in the early discharge group compared to the control group was 0.63 (95% CI 0.41 to 0.96). After adjustment for smoking, gestational age and birth weight, this relative risk was 0.67 (95% CI 0.43 to 1.05). Close supervision and follow-up by paediatric nurse specialists of preterm infants discharged early with tube feeding appears to increase duration of breast feeding. A randomised controlled trial to confirm these findings is warranted.

A Numerical Process Control Method for Circular-Tube Hydroforming Prediction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, Kenneth I.; Nguyen, Ba Nghiep; Davies, Richard W.

2004-03-01

This paper describes the development of a solution control method that tracks the stresses, strains and mechanical behavior of a tube during hydroforming to estimate the proper axial feed (end-feed) and internal pressure loads through time. The analysis uses the deformation theory of plasticity and Hill?s criterion to describe the plastic flow. Before yielding, the pressure and end-feed increments are estimated based on the initial tube geometry, elastic properties and yield stress. After yielding, the pressure increment is calculated based on the tube geometry at the previous solution increment and the current hoop stress increment. The end-feed increment is computedmore » from the increment of the axial plastic strain. Limiting conditions such as column buckling (of long tubes), local axi-symmetric wrinkling of shorter tubes, and bursting due to localized wall thinning are considered. The process control method has been implemented in the Marc finite element code. Hydroforming simulations using this process control method were conducted to predict the load histories for controlled expansion of 6061-T4 aluminum tubes within a conical die shape and under free hydroforming conditions. The predicted loading paths were transferred to the hydroforming equipment to form the conical and free-formed tube shapes. The model predictions and experimental results are compared for deformed shape, strains and the extent of forming at rupture.« less

Double copper sheath multiconductor instrumentation cable is durable and easily installed in high thermal or nuclear radiation area

NASA Technical Reports Server (NTRS)

Mc Crae, A. W., Jr.

1967-01-01

Multiconductor instrumentation cable in which the conducting wires are routed through two concentric copper tube sheaths, employing a compressed insulator between the conductors and between the inner and outer sheaths, is durable and easily installed in high thermal or nuclear radiation area. The double sheath is a barrier against moisture, abrasion, and vibration.

Investigation of the strength of shielded and unshielded underwater electrical cables

NASA Astrophysics Data System (ADS)

Glowe, D. E.; Arnett, S. L.

1981-09-01

The mechanical properties of shielded and unshielded submarine cables (MIL-C-915/8E) were investigated to determine the effect of shielding on cable life, performance, and reliability. Ten cables (five shielded and five unshielded) were selected for laboratory evaluation. A mission profile was developed to establish the mechanical stress limits that cables must endure in service and a test sequence designed to measure tensile strength, flexural abrasion endurance, crush resistance, creep under static tension, and performance in a hull-stuffing tube. The results of this program showed that: (1) DSS-2 cable does not have adequate tensile strength and should have a strength member added. DSS-3 and larger cables have adequate tensile strength with or without the shield; (2) Unshielded DSS-3 type cable does not perform satisfactorily in hull-stuffing tubes; (3) Shielding is not required to meet mission profile specifications for cable crush or flexural abrasion resistance; (4) Construction parameters other than shielding can significantly affect mechanical performance of cable; (5) Unshielded cable construction can result in increased reliability since it permits a thicker single-jacket construction; and (6) Unshielded cable construction can reduce the cost of cable by 8 to 20 percent.

Crashworthiness of Aluminium Tubes; Part 1: Hydroforming at Different Corner-Fill Radii and End Feeding Levels

NASA Astrophysics Data System (ADS)

D'Amours, Guillaume; Rahem, Ahmed; Williams, Bruce; Worswick, Michael; Mayer, Robert

2007-05-01

The automotive industry, with an increasing demand to reduce vehicle weight through the adoption of lightweight materials, requires a search of efficient methods that suit these materials. One attractive concept is to use hydroforming of aluminium tubes. By using FE simulations, the process can be optimized to reduce the risk for failure while maintaining energy absorption and component integrity under crash conditions. It is important to capture the level of residual ductility after forming to allow proper design for crashworthiness. This paper presents numerical and experimental studies that have been carried out for high pressure hydroforming operations to study the influence of the tube corner radius, end feeding, material thinning, and work hardening in 76.2 mm diameter, 3 mm wall thickness AA5754 aluminium alloy tube. End feeding was used to increase the formability of the tubes. The influence of the end feed displacement versus tube forming pressure schedule was studied to optimize the forming process operation to reduce thinning. Validation of the numerical simulations was performed by comparison of the predicted strain distributions and thinning, with measured quantities. The effect of element formulation (thin shell versus solid elements) was also considered in the models.

Percutaneous transesophageal gastro-tubing (PTEG) as an alternative long-term tube feeding procedure when gastrostomy is not feasible

PubMed Central

Toh Yoon, Ezekiel Wong; Nishihara, Kazuki

2017-01-01

Background: Percutaneous transesophageal gastro-tubing (PTEG) is a minimally invasive technique to access the gut via an esophagostomy. However, this procedure is not well known and the literature available is still fairly limited. This observational study was conducted to evaluate our experience using this method as an alternative long-term tube feeding procedure when gastrostomy is not suitable. Methods: A total of 15 patients (10 males and 5 females) who underwent PTEG at our institution from 2012 to 2016 were observed and analyzed in this study. Results: The average age was 80.1 (71–93) years. Underlying conditions that required PTEG were previous gastric resection in 11 patients, left diaphragm disorder in 2 patients, interposing transverse colon between the abdominal wall and anterior gastric wall in 1 patient, and severe gastrostomy site leakage in 1 patient. Tube placement was successful in all patients by approaching the left side of the neck, using a 15 Fr size tube. The mean postoperative length of stay was 22 (8–48) days. Postoperative adverse events included accidental tube dislodgement in three patients, tracheoesophageal fistula in one patient, inferior thyroid artery injury in one patient and thyroid gland mispuncture in one patient. There was no procedure-related mortality nor mortality at 30 days. Eight patients were discharged with some oral intake. Conclusions: PTEG is feasible in patients requiring long-term tube feeding for whom gastrostomy is unsuitable. It is an effective long-term tube feeding procedure and should be offered as a more comfortable alternative to nasogastric tubing. PMID:29204186

Percutaneous transesophageal gastro-tubing (PTEG) as an alternative long-term tube feeding procedure when gastrostomy is not feasible.

PubMed

Toh Yoon, Ezekiel Wong; Nishihara, Kazuki

2017-12-01

Percutaneous transesophageal gastro-tubing (PTEG) is a minimally invasive technique to access the gut via an esophagostomy. However, this procedure is not well known and the literature available is still fairly limited. This observational study was conducted to evaluate our experience using this method as an alternative long-term tube feeding procedure when gastrostomy is not suitable. A total of 15 patients (10 males and 5 females) who underwent PTEG at our institution from 2012 to 2016 were observed and analyzed in this study. The average age was 80.1 (71-93) years. Underlying conditions that required PTEG were previous gastric resection in 11 patients, left diaphragm disorder in 2 patients, interposing transverse colon between the abdominal wall and anterior gastric wall in 1 patient, and severe gastrostomy site leakage in 1 patient. Tube placement was successful in all patients by approaching the left side of the neck, using a 15 Fr size tube. The mean postoperative length of stay was 22 (8-48) days. Postoperative adverse events included accidental tube dislodgement in three patients, tracheoesophageal fistula in one patient, inferior thyroid artery injury in one patient and thyroid gland mispuncture in one patient. There was no procedure-related mortality nor mortality at 30 days. Eight patients were discharged with some oral intake. PTEG is feasible in patients requiring long-term tube feeding for whom gastrostomy is unsuitable. It is an effective long-term tube feeding procedure and should be offered as a more comfortable alternative to nasogastric tubing.

Particle shedding from peristaltic pump tubing in biopharmaceutical drug product manufacturing.

PubMed

Saller, Verena; Matilainen, Julia; Grauschopf, Ulla; Bechtold-Peters, Karoline; Mahler, Hanns-Christian; Friess, Wolfgang

2015-04-01

In a typical manufacturing setup for biopharmaceutical drug products, the fill and dosing pump is placed after the final sterile filtration unit in order to ensure adequate dispensing accuracy and avoid backpressure peaks. Given the sensitivity of protein molecules, peristaltic pumps are often preferred over piston pumps. However, particles may be shed from the silicone tubing employed. In this study, particle shedding and a potential turbidity increase during peristaltic pumping of water and buffer were investigated using three types of commercially available silicone tubing. In the recirculates, mainly particles of around 200 nm next to a very small fraction of particles in the lower micrometer range were found. Using 3D laser scanning microscopy, surface roughness of the inner tubing surface was found to be a determining factor for particle shedding from silicone tubing. As the propensity toward particle shedding varied between tubing types and also cannot be concluded from manufacturer's specifications, individual testing with the presented methods is recommended during tubing qualification. Choosing low abrasive tubing can help to further minimize the very low particle counts to be expected in pharmaceutical drug products. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

Feeding Tubes

MedlinePlus

... of placement carefully with your physician and surgeon. Methods of Feeding Enteral feeding means the gastrointestinal (digestive) ... unable to absorb nutrients from enteral feeds. This method of feeding requires a central intravenous line. A ...

Defense.gov Special Report: Travels with Winnefeld: USO Tour

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Defense.gov Special Report: Travels with Lynn - June 2011

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Compounded Apixaban Suspensions for Enteral Feeding Tubes.

PubMed

Caraballo, Maria L; Donmez, Seda; Nathan, Kobi; Zhao, Fang

2017-07-01

Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of 7 days. Methods: Apixaban suspensions were prepared from commercially available 5-mg Eliquis tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride, with varying lengths and diameters, were included in the study. They were mounted on a peg board during evaluation to mimic the patient body position. A 7-day stability study of the selected formulation was also conducted. Results: Vehicles containing 40% to 60% Ora-Plus in water all exhibited satisfactory flowability through the tubes. The mortar/pestle compounding method was found to produce more accurate and consistent apixaban suspensions than the pill crusher or crushing syringe method. The selected formulation, 0.25 mg/mL apixaban in 50:50 Ora-Plus:water, was compatible with both tubing types, retaining >98% drug in posttube samples. The stability study also confirmed that this formulation was stable physically and chemically over 7 days of storage at room temperature. Conclusions: A suitable apixaban suspension formulation was identified for administration via enteral feeding tubes. The formulation consisted of 0.25 mg/mL apixaban in 50:50 Ora-Plus:water. The stability study results supported a beyond-use date of 7 days at room temperature.

En Route Nutrition for Severely Injured: Battlefield to CONUS

DTIC Science & Technology

2008-07-01

Overview at LRMC and CCATT • Early stages of conflict • Development of feeding protocol • Initiation of enteral feeds • Immune enhancing formula...to war with the Army you have, not the Army you want" Donald Rumsfeld US Secretary of Defense 9 December 2004 LRMC Feeding Protocol • Placement of... feeding tube within 24 hours of admission • NJ or OJ rather than PEG or surgical tube • GI with endoscopy • Surgery with open abdomens • OG vs NG to

Crashworthiness of Aluminium Tubes; Part 1: Hydroforming at Different Corner-Fill Radii and End Feeding Levels

DOE Office of Scientific and Technical Information (OSTI.GOV)

D'Amours, Guillaume; Rahem, Ahmed; Williams, Bruce

2007-05-17

The automotive industry, with an increasing demand to reduce vehicle weight through the adoption of lightweight materials, requires a search of efficient methods that suit these materials. One attractive concept is to use hydroforming of aluminium tubes. By using FE simulations, the process can be optimized to reduce the risk for failure while maintaining energy absorption and component integrity under crash conditions. It is important to capture the level of residual ductility after forming to allow proper design for crashworthiness. This paper presents numerical and experimental studies that have been carried out for high pressure hydroforming operations to study themore » influence of the tube corner radius, end feeding, material thinning, and work hardening in 76.2 mm diameter, 3 mm wall thickness AA5754 aluminium alloy tube. End feeding was used to increase the formability of the tubes. The influence of the end feed displacement versus tube forming pressure schedule was studied to optimize the forming process operation to reduce thinning. Validation of the numerical simulations was performed by comparison of the predicted strain distributions and thinning, with measured quantities. The effect of element formulation (thin shell versus solid elements) was also considered in the models.« less

Enteral nutrition tube placement assisted by ultrasonography in patients with severe acute pancreatitis

PubMed Central

Li, Gang; Pan, Yiyuan; Zhou, Jing; Tong, Zhihui; Ke, Lu; Li, Weiqin

2017-01-01

Abstract To evaluate the effect of a novel procedure using real-time ultrasonography to assist nasojejunal tube placement at bedside in patients with severe acute pancreatitis (SAP). Single center, prospective descriptive study in a 15-bed surgery intensive care unit of a university hospital. Thirty SAP patients were enrolled. The whole procedure of placing nasojejunal tube was performed by a single physician, who places nasojejunal tube at the bedside and performs ultrasonography to guide the tube positioning. The final nasojejunal tube position was confirmed by abdominal radiograph. The successful rate of the procedure as well as the time it took, the time from the decision of enteral feeding to commencement of feeding, and complications were recorded. Thirty-six intubations were performed in 30 patients by using ultrasonography-assisted method at bedside. Nasojejunal tubes were successful placed in 28 of 30 patients (93.3%). The average time of successful placement was 22.07 ± 5.78 minutes. The median time between physician's decision for tube placement and feeding initiation was 5.5 (2, 24) hours. No adverse events occurred in all of patients. This novel method of nasojejunal tube placement under ultrasound guidance is practical, less time consuming and reliable. PMID:29137035

Continuous versus bolus intragastric tube feeding for preterm and low birth weight infants with gastro-oesophageal reflux disease.

PubMed

Richards, Robyn; Foster, Jann P; Psaila, Kim

2014-07-17

Gastro-oesophageal reflux disease is a particularly common condition in preterm and low birth weight infants. These infants are also more likely to have excessive regurgitation, as they do not have a fully developed antireflux mechanism. Preterm and low birth weight infants who are unable to suck oral feeds are required to be fed via an intragastric tube for varying lengths of time. Intragastric tube feeding can be delivered by the intermittent bolus or continuous feeding method. Use of continuous or intermittent bolus intragastric feeding may have a positive or negative effect on the incidence or severity of gastro-oesophageal reflux disease. To determine whether continuous or intermittent bolus intragastric tube feeding reduces the number of episodes and the duration of gastro-oesophageal reflux disease (GORD) in preterm and low birth weight infants.We intended to perform subgroup analyses for gestational age; birth weight; age in days from birth at full enteral feeding via intragastric tube (breast vs bottle); frequency of intermittent bolus feed; and type of medication for treatment of GORD (only if medication prescribed and given similarly to both intervention groups). We used the standard search strategy of the Cochrane Neonatal Group as described in The Cochrane Library (www.thecochranelibrary.com) to search for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 9), MEDLINE (1966 to September 2013), EMBASE (1980 to September 2013) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to September 2013). We also searched previous reviews, including cross-references, abstracts and conference and symposia proceedings of the Perinatal Society of Australia and New Zealand and the Pediatric Academic Societies (American Pediatric Society/Society for Pediatric Research and European Society for Paediatric Research) from 1990 to 2012. Published and unpublished RCTs and quasi-RCTs were eligible for inclusion in this review, as were cluster-randomised and cross-over randomised trials that compared the effects of continuous versus intermittent bolus intragastric tube feeding on gastro-oesophageal reflux disease in preterm and low birth weight infants. Two review authors independently assessed study eligibility and quality. We found no trials that met the inclusion criteria for this review. We did not identify any randomised trials that evaluated the effects of continuous versus intermittent bolus intragastric tube feeding on gastro-oesophageal reflux disease in preterm and low birth weight infants. Well-designed and adequately powered trials are needed.

On modelling the interaction between two rotating bodies with statistically distributed features: an application to dressing of grinding wheels

NASA Astrophysics Data System (ADS)

Spampinato, A.; Axinte, D. A.

2017-12-01

The mechanisms of interaction between bodies with statistically arranged features present characteristics common to different abrasive processes, such as dressing of abrasive tools. In contrast with the current empirical approach used to estimate the results of operations based on attritive interactions, the method we present in this paper allows us to predict the output forces and the topography of a simulated grinding wheel for a set of specific operational parameters (speed ratio and radial feed-rate), providing a thorough understanding of the complex mechanisms regulating these processes. In modelling the dressing mechanisms, the abrasive characteristics of both bodies (grain size, geometry, inter-space and protrusion) are first simulated; thus, their interaction is simulated in terms of grain collisions. Exploiting a specifically designed contact/impact evaluation algorithm, the model simulates the collisional effects of the dresser abrasives on the grinding wheel topography (grain fracture/break-out). The method has been tested for the case of a diamond rotary dresser, predicting output forces within less than 10% error and obtaining experimentally validated grinding wheel topographies. The study provides a fundamental understanding of the dressing operation, enabling the improvement of its performance in an industrial scenario, while being of general interest in modelling collision-based processes involving statistically distributed elements.

Push versus gravity for intermittent bolus gavage tube feeding of premature and low birth weight infants.

PubMed

Dawson, Jennifer A; Summan, Ravinder; Badawi, Nadia; Foster, Jann P

2012-11-14

Many small, sick and premature infants are unable to coordinate sucking, swallowing and breathing, and therefore, require gavage feeding. In gavage feeding, milk feeds are delivered through a tube passed via the nose or mouth into the stomach. Intermittent bolus milk feeds may be administered using a syringe to gently push milk into the infant's stomach (push feed). Alternatively, milk can be poured into a syringe attached to the tube and allowed to drip in by gravity (gravity feed). To determine whether the use of push compared with gravity gavage feeding results in a more rapid establishment of full gavage feeds without increasing adverse events in preterm or low birth weight, infants who require intermittent bolus gavage feeding. We searched the following electronic databases to locate randomised controlled or quasi-randomised trials: Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, 2012, Issue 5), MEDLINE (from 1966 to May 2012), EMBASE (from 1980 to May 2012), and CINAHL (from 1982 to May 2012). We used the standard search strategy of the Cochrane Neonatal Review Group. Randomised or quasi-randomised controlled trials comparing push versus gravity intermittent gavage tube feeding in premature or low birth weight, or both, infants. We assessed the methodology of trials regarding blinding of randomisation and outcome measurement. We evaluated treatment effect with a fixed-effect model using risk ratio (RR), relative risk reduction, risk difference (RD) and number needed to treat (NNT) for categorical data; and using mean, standard deviation and weighted mean difference (WMD) for continuous data. We analysed outcomes measured as count data, for example frequency of apnoea, bradycardia and episodes of pulse oximeter oxygen (SpO(2)) desaturation, by comparing rates of events and the rate ratio. We evaluated heterogeneity to help determine the suitability of pooling results. Only one small cross-over trial met the criteria for inclusion in this review and therefore meta-analysis for any of the treatment outcomes was not performed. Symon 1994 reported a trend towards a higher respiratory rate at 10 to 30 minutes following push gavage feeding and no statistical difference in the time taken to give the feeds regardless of the method used. There was one small cross-over study that was included in this review. There is insufficient evidence to recommend either method of gavage feeding. A randomised trial is needed to evaluate the benefits and harms of push versus gravity bolus tube feeding in preterm infants. Infants should be stratified by gestational age at birth (above and below 32 weeks) or birth weight (above and below 1500 grams) and respiratory support (ventilated versus non-ventilated) and the sample size should be of sufficient size to evaluate the primary outcomes outlined in this review (time to establish full tube feeds and feeding intolerance).

Laparoscopic feeding jejunostomy: also a simple technique.

PubMed

Albrink, M H; Foster, J; Rosemurgy, A S; Carey, L C

1992-01-01

Placement of feeding tubes is a common procedure for general surgeons. While the advent of percutaneous endoscopic gastrostomy has changed and improved surgical practice, this technique is contraindicated in many circumstances. In some patients placement of feeding tubes in the stomach may be contraindicated due to the risks of aspiration, gastric paresis, or gastric dysmotility. We describe a technique of laparoscopic jejunostomy tube placement which is easy and effective. It is noteworthy that this method may be used in patients who have had previous abdominal operations, and it has the added advantage of a direct peritoneal view of the viscera. We suggest that qualified laparoscopic surgeons learn the technique of laparoscopic jejunostomy.

Strangulation by Feeding Tube in a 23-Month-Old With Down Syndrome: Case Report and Review of Literature.

PubMed

Woodham, Paige C; Fulcher, James W; Ward, Michael E

2016-12-01

Ligature strangulation, although typically homicidal in nature, has been reported as accidental in both the pediatric and adult populations. The unique mode of accidental strangulation with a gastric feeding tube in a 23-month-old with Down syndrome is currently unreported in the literature and has prompted us to report this case and look into safety modifications that can be made to these common medical devices. Given the number of children with gastric feeding tubes and concern over this exact scenario brought up by parents, it is unusual that a similar case has not been reported.

Tube Feedings.

ERIC Educational Resources Information Center

Plummer, Nancy

This module on tube feedings is intended for use in inservice or continuing education programs for persons who work in long-term care. Instructor information, including teaching suggestions and a listing of recommended audiovisual materials and their sources appear first. The module goal and objectives are then provided. A brief discussion follows…

Head and neck cancer patients' experiences of percutaneous endoscopic gastrostomy feeding: a Q-methodology study.

PubMed

Merrick, S; Farrell, D

2012-07-01

Head and neck cancer patients are at high risk of malnutrition and its complications and therefore often undergo non-oral nasogastric or percutaneous endoscopic gastrostomy (PEG) nutrition support. However, there is little evidence that either approach is effective in this group. While one possible explanation for these findings relates to the relationship between artificial tube feeding and poor quality of life, there is little research that examines the patient's subjective experience of nutrition support. This study investigated the experiences of PEG tube feeding in head and neck cancer patients undergoing radical treatment. Conventional Q-methodology was used with 15 head and neck cancer patients, who rank-ordered 36 statements according to the extent to which these reflected their experiences of PEG tube feeding. The sorted statements were factor-analysed case-wise to provide clusters of similar experiences. Three perspectives emerged. Factor 1, labelled 'Constructive cognitive appraisal', focused around positive adaptation to, and acceptance of, PEG feeding. Factor 2, labelled 'Cognitive-affective dissonance', reflected ambivalence between cognitive acceptance and affective rejection of the PEG tube. Factor 3, labelled 'Emotion-focused appraisal', was characterised by tube-focused anxiety and fear. The findings broadly confirm Levanthal et al.'s Self-Regulatory Model of coping and support the need for genuine and individualised patient-centred nutritional care. © 2012 Blackwell Publishing Ltd.

Extraction of the plasticizers diethylhexylphthalate and polyadipate from polyvinylchloride nasogastric tubes through gastric juice and feeding solution.

PubMed

Subotic, Ulrike; Hannmann, Torsten; Kiss, Matthias; Brade, Joachim; Breitkopf, Katja; Loff, Steffan

2007-01-01

Except for polyadipate, which is used as an alternative in polyvinylchloride (PVC) feeding tubes, diethylhexylphthalate (DEHP) is the plasticizer used almost exclusively in PVC medical products. A clear response to the chronic intake of DEHP has been shown in several organ systems from different species. In the present study, we compared the extraction of DEHP and polyadipate from PVC gastric tubes. An in vivo setting was simulated. We used 5 cm of PVC nasogastric tubes containing DEHP or polyadipate, which were incubated with gastric juice for 1 week and a feeding solution for 4 weeks. The leakage of these plasticizers was measured daily in the gastric juice group and weekly in the feeding solution group. The amount of plasticizer extracted was compared between groups and days. In the feeding solution group, the extraction of DEHP ranged from 200 to 542 microg after 1 week and from 660 to 1700 microg after 4 weeks. The extraction of polyadipate was 10 times lower than that of DEHP. In the gastric juice group, extracted DEHP ranged from 635 to 1043 microg, whereas the extraction of polyadipate was 100 times lower. Within 1 week, the extraction of DEHP from a 5-cm PVC tube reaches up to 1 mg. Extrapolated, this represents an in vivo load of up to 4 mg. The load accumulated by a newborn in an intensive care unit can therefore easily reach several milligrams of DEHP per day. Polyadipate nasogastric tubes may therefore be an alternative and help to reduce the daily load of DEHP.

Osmolality, pH, and compatibility of selected oral liquid medications with an enteral nutrition product.

PubMed

Klang, Mark; McLymont, Veronica; Ng, Nicole

2013-09-01

When selecting medication for feeding tube administration, the liquid formulation is selected, so as to avoid obstructions that may occur from incompletely crushing a solid dosage form. Liquid medications can present issues of intolerance and compatibility when administered via a feeding tube. A predictor of intolerance is the liquid's osmolarity, and a predicator of compatibility is the liquid's pH value. This study examines 62 liquid formulations for their osmolality, pH, and physical compatibility with enteral nutrition (EN) formulas. These medications were selected as being the most commonly dispensed liquid medications from our outpatient pharmacy department. This study measures osmolality using freezing point depression. Depending on the dose, the osmotic load of a liquid medication may cause cramping and diarrhea. The pH value is predictive of potential interactions with the EN formula. Many drugs are weak bases and require acidic vehicles for optimal stability. The acidic liquids are especially reactive with enteral formulas that contain intact proteins. The result of this interaction can result in an occlusion of the feeding tube as the proteins form a gel-like clog. This study combined the liquid medication directly with the EN formula to determine the potential for feeding tube occlusion. Some drugs formed a solid mass in the test tube immediately, whereas others only presented granules, which may later contribute to obstructing the feeding tube. The prescriber should be aware of the potential impact of their choice in formulation, both in terms of the gastrointestinal tolerance and potential for interaction with coadministered nutrition.

Enteral tube feeding alters the oral indigenous microbiota in elderly adults.

PubMed

Takeshita, Toru; Yasui, Masaki; Tomioka, Mikiko; Nakano, Yoshio; Shimazaki, Yoshihiro; Yamashita, Yoshihisa

2011-10-01

Enteral tube feeding is widely used to maintain nutrition for elderly adults with eating difficulties, but its long-term use alters the environment of the oral ecosystem. This study characterized the tongue microbiota of tube-fed elderly adults by analyzing the 16S rRNA gene. The terminal restriction fragment length polymorphism (T-RFLP) profiles of 44 tube-fed subjects were compared with those of 54 subjects fed orally (average age, 86.4 ± 6.9 years). Bar-coded pyrosequencing data were also obtained for a subset of the subjects from each group (15 tube-fed subjects and 16 subjects fed orally). The T-RFLP profiles demonstrated that the microbiota of the tube-fed subjects was distinct from that of the subjects fed orally (permutational multivariate analysis of variance [perMANOVA], P < 0.001). The pyrosequencing data revealed that 22 bacterial genera, including Corynebacterium, Peptostreptococcus, and Fusobacterium, were significantly more predominant in tube-fed subjects, whereas the dominant genera in the subjects fed orally, such as Streptococcus and Veillonella, were present in much lower proportions. Opportunistic pathogens rarely detected in the normal oral microbiota, such as Corynebacterium striatum and Streptococcus agalactiae, were often found in high proportions in tube-fed subjects. The oral indigenous microbiota is disrupted by the use of enteral feeding, allowing health-threatening bacteria to thrive.

Established enteral nutrition pathway in a severe acute pancreatitis patient with duodenum fistula: a case report.

PubMed

Li, G; Shen, X; Ke, L; Tong, Z; Li, W

2015-10-01

Enteral feeding is the preferred way to provide nutritional support in patients with high nutritional risk but relatively normal gastrointestinal function; thus, establishing a safe and a reliable pathway of enteral nutrition (EN) is of great importance. There are many techniques for placing the feeding tube, such as blind placement at bedside, assisting by fluoroscopy and endoscopy, surgical and so on. Despite these variable techniques, it is still difficult to obtain the pathway for EN in some specific patients. Here, we present a recent case of infected pancreatic/peripancreatic necrosis complicated by a duodenal enteric fistula in whom we establish the feeding pathway extraordinarily. Briefly, after several failed attempts of placing the nasojejunal feeding tube, a jejunal feeding tube was placed percutaneously guided by computed tomography, and EN was successfully applied thereafter. With the implementation of EN, duodenal fistula healed without surgical intervention. As EN is pivotal for the recovery of duodenal fistula, this novel approach could be beneficial in selected patients.

Pool boiling of nanofluids on rough and porous coated tubes: experimental and correlation

NASA Astrophysics Data System (ADS)

Cieśliński, Janusz T.; Kaczmarczyk, Tomasz Z.

2014-06-01

The paper deals with pool boiling of water-Al2O3 and water- Cu nanofluids on rough and porous coated horizontal tubes. Commercially available stainless steel tubes having 10 mm outside diameter and 0.6 mm wall thickness were used to fabricate the test heater. The tube surface was roughed with emery paper 360 or polished with abrasive compound. Aluminium porous coatings of 0.15 mm thick with porosity of about 40% were produced by plasma spraying. The experiments were conducted under different absolute operating pressures, i.e., 200, 100, and 10 kPa. Nanoparticles were tested at the concentration of 0.01, 0.1, and 1% by weight. Ultrasonic vibration was used in order to stabilize the dispersion of the nanoparticles. It was observed that independent of operating pressure and roughness of the stainless steel tubes addition of even small amount of nanoparticles augments heat transfer in comparison to boiling of distilled water. Contrary to rough tubes boiling heat transfer coefficient of tested nanofluids on porous coated tubes was lower compared to that for distilled water while boiling on porous coated tubes. A correlation equation for prediction of the average heat transfer coefficient during boiling of nanofluids on smooth, rough and porous coated tubes is proposed. The correlation includes all tested variables in dimensionless form and is valid for low heat flux, i.e., below 100 kW/m2.

Transition from Tube to Oral Feeding in the School Setting

ERIC Educational Resources Information Center

McKirdy, Laura S.; Sheppard, Justine J.; Osborne, Mary L.; Payne, Pamela

2008-01-01

Purpose: A school-based treatment program for tube-fed children with medically complex conditions and food refusal was implemented to facilitate the children's transition to oral feeding and advance their eating skills. Method: The program combined educational and therapeutic goals. It was implemented in a regional public school for children with…

How phloem-feeding insects face the challenge of phloem-located defenses

PubMed Central

Will, Torsten; Furch, Alexandra C. U.; Zimmermann, Matthias R.

2013-01-01

Due to the high content of nutrient, sieve tubes are a primary target for pests, e.g., most phytophagous hemipteran. To protect the integrity of the sieve tubes as well as their content, plants possess diverse chemical and physical defense mechanisms. The latter mechanisms are important because they can potentially interfere with the food source accession of phloem-feeding insects. Physical defense mechanisms are based on callose as well as on proteins and often plug the sieve tube. Insects that feed from sieve tubes are potentially able to overwhelm these defense mechanisms using their saliva. Gel saliva forms a sheath in the apoplast around the stylet and is suggested to seal the stylet penetration site in the cell plasma membrane. In addition, watery saliva is secreted into penetrated cells including sieve elements; the presence of specific enzymes/effectors in this saliva is thought to interfere with plant defense responses. Here we detail several aspects of plant defense and discuss the interaction of plants and phloem-feeding insects. Recent agro-biotechnological phloem-located aphid control strategies are presented. PMID:24009620

Evaluation and Management of Neonatal Dysphagia: Impact of Pharyngoesophageal Motility Studies and Multidisciplinary Feeding Strategy

PubMed Central

Jadcherla, Sudarshan R.; Stoner, Erin; Gupta, Alankar; Bates, D. Gregory; Fernandez, Soledad; Di Lorenzo, Carlo; Linscheid, Thomas

2013-01-01

Background and objectives Abnormal swallowing (dysphagia) among neonates is commonly evaluated using the videofluoroscopic swallow study (VSS). Radiological findings considered high risk for administration of oral feeding include nasopharyngeal reflux, laryngeal penetration, aspiration, or pooling. Our aims were to determine pharyngoesophageal motility correlates in neonates with dysphagia and the impact of multidisciplinary feeding strategy. Methods Twenty dysphagic neonates (mean gestation ± standard deviation [SD] = 30.9 ± 4.9 weeks; median 31.1 weeks; range = 23.7–38.6 weeks) with abnormal VSS results were evaluated at 49.9 ± 16.5 weeks (median 41.36 weeks) postmenstrual age. The subjects underwent a swallow-integrated pharyngoesophageal motility assessment of basal and adaptive swallowing reflexes using a micromanometry catheter and pneumohydraulic water perfusion system. Based on observations during the motility study, multidisciplinary feeding strategies were applied and included postural adaptation, sensory modification, hunger manipulation, and operant conditioning methods. To discriminate pharyngoesophageal manometry correlates between oral feeders and tube feeders, data were stratified based on the primary feeding method at discharge, oral feeding versus tube feeding. Results At discharge, 15 of 20 dysphagic neonates achieved oral feeding success, and the rest required chronic tube feeding. Pharyngoesophageal manometry correlates were significantly different (P <0.05) between the primary oral feeders versus the chronic tube feeders for swallow frequency, swallow propagation, presence of adaptive peristaltic reflexes, oral feeding challenge test results, and upper esophageal sphincter tone. VSS results or disease characteristics had little effect on the feeding outcomes (P = NS). Conclusions Swallow-integrated esophageal motility studies permit prolonged evaluation of swallowing reflexes and responses to stimuli under controlled conditions at cribside. The dysfunctional neuromotor mechanisms may be responsible for neonatal dysphagia or its consequences. Manometry may be a better predictor than VSS in identifying patients who are likely to succeed in vigorous intervention programs. PMID:19179881

Technical activities report: Heat, water, and mechanical studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alexander, W.K.

1951-10-04

Topics in the heat studies section include: front and rear face reflector shields at the C-pile; process tube channel thermocouples; water temperature limits for horizontal rods; slug temperature and thermal conductivity calculations; maximum slug-end cap temperature; boiling consideration studies; scram time limit for Panellit alarm; heat transfer test; slug stresses; thermal insulation of bottom tube row at C-pile; flow tests; present pile enrichment; electric analog; and measurement of thermal contact resistance. Topics in the water studies section include: 100-D flow laboratory; process water studies; fundamental studies on film formation; coatings on tip-offs; can difference tests; slug jacket abrasion at highmore » flow rates; corrosion studies; front tube dummy slugs; metallographic examination of tubes from H-pile; fifty-tube mock-up; induction heating facility; operational procedures and standards; vertical safety rod dropping time tests; recirculation; and power recovery. Mechanical development studies include: effect of Sphincter seal and lubricant VSR drop time; slug damage; slug bubble tester; P-13 removal; chemical slug stripper; effect of process tube rib spacing and width; ink facility installation; charging and discharging machines; process tube creep; flapper nozzle assembly test; test of single gun barrel assembly; pigtail fixture test; horizontal rod gland seal test; function test of C-pile; and intermediate test of Ball 3-X and VSR systems.« less

A Comparison of Two Patient Classification Systems in Determining Nursing Care Hour Requirements

DTIC Science & Technology

1985-07-01

checks q2h or x 12 (3) Neuro checks q4h or x 6 6) Neuro checks q2h or x 12- (2) CVP or rCp (manual) q2h or x 12 ( 6) Cardiac/apnea/temp/pressure...turn q2h) - ( 8) Peds recreation/observation - 5 yearS (exclude NBN) (4) - Isolation (Mask and Gown) I FEEDING ( 5) Tube feed adult/child/ neonate g4h or...x 6 (10) Tube feed adult/child/ neonate q2h or x 12 6) Adult meals > 5 years (spoon feed x 3) (10) Child meals < 5 years (spoon feed x 3) (2) Infant

Enteral Tube Feeding Alters the Oral Indigenous Microbiota in Elderly Adults ▿ †

PubMed Central

Takeshita, Toru; Yasui, Masaki; Tomioka, Mikiko; Nakano, Yoshio; Shimazaki, Yoshihiro; Yamashita, Yoshihisa

2011-01-01

Enteral tube feeding is widely used to maintain nutrition for elderly adults with eating difficulties, but its long-term use alters the environment of the oral ecosystem. This study characterized the tongue microbiota of tube-fed elderly adults by analyzing the 16S rRNA gene. The terminal restriction fragment length polymorphism (T-RFLP) profiles of 44 tube-fed subjects were compared with those of 54 subjects fed orally (average age, 86.4 ± 6.9 years). Bar-coded pyrosequencing data were also obtained for a subset of the subjects from each group (15 tube-fed subjects and 16 subjects fed orally). The T-RFLP profiles demonstrated that the microbiota of the tube-fed subjects was distinct from that of the subjects fed orally (permutational multivariate analysis of variance [perMANOVA], P < 0.001). The pyrosequencing data revealed that 22 bacterial genera, including Corynebacterium, Peptostreptococcus, and Fusobacterium, were significantly more predominant in tube-fed subjects, whereas the dominant genera in the subjects fed orally, such as Streptococcus and Veillonella, were present in much lower proportions. Opportunistic pathogens rarely detected in the normal oral microbiota, such as Corynebacterium striatum and Streptococcus agalactiae, were often found in high proportions in tube-fed subjects. The oral indigenous microbiota is disrupted by the use of enteral feeding, allowing health-threatening bacteria to thrive. PMID:21821752

Drug Administration via Enteral Feeding Tube in Residential Care Facilities for Individuals with Intellectual Disability: A Focus Group Study on Guideline Implementation

ERIC Educational Resources Information Center

Joos, Elke; Van Tongelen, Inge; Wijnants, Karen; Mehuys, Els; Van Bocxlaer, Jan; Remon, Jean Paul; Grypdonck, Maria; Van Winckel, Myriam; Boussery, Koen

2016-01-01

People with profound intellectual disabilities often receive medication through enteral feeding tube (EFT). In a previous study, we found that current guidelines concerning medication preparation and administration through EFT are often not followed in residential care facilities (RCFs) for individuals with intellectual disabilities. The present…

Performance analysis of cutting graphite-epoxy composite using a 90,000psi abrasive waterjet

NASA Astrophysics Data System (ADS)

Choppali, Aiswarya

Graphite-epoxy composites are being widely used in many aerospace and structural applications because of their properties: which include lighter weight, higher strength to weight ratio and a greater flexibility in design. However, the inherent anisotropy of these composites makes it difficult to machine them using conventional methods. To overcome the major issues that develop with conventional machining such as fiber pull out, delamination, heat generation and high tooling costs, an effort is herein made to study abrasive waterjet machining of composites. An abrasive waterjet is used to cut 1" thick graphite epoxy composites based on baseline data obtained from the cutting of ¼" thick material. The objective of this project is to study the surface roughness of the cut surface with a focus on demonstrating the benefits of using higher pressures for cutting composites. The effects of major cutting parameters: jet pressure, traverse speed, abrasive feed rate and cutting head size are studied at different levels. Statistical analysis of the experimental data provides an understanding of the effect of the process parameters on surface roughness. Additionally, the effect of these parameters on the taper angle of the cut is studied. The data is analyzed to obtain a set of process parameters that optimize the cutting of 1" thick graphite-epoxy composite. The statistical analysis is used to validate the experimental data. Costs involved in the cutting process are investigated in term of abrasive consumed to better understand and illustrate the practical benefits of using higher pressures. It is demonstrated that, as pressure increased, ultra-high pressure waterjets produced a better surface quality at a faster traverse rate with lower costs.

Gastrostomy feeding tube - bolus

MedlinePlus

... jaw muscles. Feeding Your Child With the Gravity Method Your provider will show you the best way ... the button. Feeding Your Child With the Syringe Method Your provider will teach you the best way ...

The prevalence and effects of aspiration among neonates at the time of discharge.

PubMed

Karsch, Emily; Irving, Sharon Y; Aylward, Brandon S; Mahle, William T

2017-09-01

Neonates undergoing heart surgery for CHD are at risk for postoperative gastrointestinal complications and aspiration events. There are limited data regarding the prevalence of aspiration after neonatal cardiothoracic surgery; thus, the effects of aspiration events on this patient population are not well understood. This retrospective chart review examined the prevalence and effects of aspiration among neonates who had undergone cardiac surgery at the time of their discharge. Introduction This study examined the prevalence of aspiration among neonates who had undergone cardiac surgery. Demographic data regarding these patients were analysed in order to determine risk factors for postoperative aspiration. Post-discharge feeding routes and therapeutic interventions were extracted to examine the time spent using alternate feeding routes because of aspiration risk or poor caloric intake. Modified barium swallow study results were used to evaluate the effectiveness of the test as a diagnostic tool. Materials and methods A retrospective study was undertaken of neonates who had undergone heart surgery from July, 2013 to January, 2014. Data describing patient demographics, feeding methods, and follow-up visits were recorded and compared using a χ2 test for goodness of fit and a Kaplan-Meier graph. The patient population included 62 infants - 36 of whom were male, and 10 who were born with single-ventricle circulation. The median age at surgery was 6 days (interquartile range=4 to 10 days). Modified barium swallow study results showed that 46% of patients (n=29) aspirated or were at risk for aspiration, as indicated by laryngeal penetration. In addition, 48% (n=10) of subjects with a negative barium swallow or no swallow study demonstrated clinical aspiration events. Tube feedings were required by 66% (n=41) of the participants. The median time spent on tube feeds, whether in combination with oral feeds or exclusive use of a nasogastric or gastric tube, was 54 days; 44% (n=27) of patients received tube feedings for more than 120 days. Premature infants were significantly more likely to have aspiration events than infants delivered at full gestational age (OR p=0.002). Infants with single-ventricle circulation spent a longer time on tube feeds (median=95 days) than infants with two-ventricle defects (median=44 days); the type of cardiac defect was independent of prevalence of an aspiration event. Aspiration is common following neonatal cardiac surgery. The modified barium swallow study is often used to identify aspiration events and to determine an infant's risk for aspirating. This leads to a high proportion of infants who require tube feedings following neonatal cardiac surgery.

Use of propofol for anesthesia in cats with primary hepatic lipidosis: 44 cases (1995-2004).

PubMed

Posner, Lysa P; Asakawa, Makoto; Erb, Hollis N

2008-06-15

OBJECTIVE-To determine morbidity and fatalities in cats with hepatic lipidosis that received propofol to facilitate placement of a feeding tube. STUDY DESIGN-Retrospective case series. ANIMALS-44 Cats with presumed primary hepatic lipidosis anesthetized for placement of a feeding tube. PROCEDURES-Medical records from January 1995 through December 2004 were reviewed to identify cats that matched the inclusion criteria (histologic confirmation of hepatic lipidosis, anesthetized for placement of feeding tube, complete intensive care unit [ICU] records, and recorded outcome). Data extracted included age, body weight, sex, anesthetic drugs, drug dosages, type of feeding tube, duration of anesthesia, number of hours in ICU, administration of blood products, and survival until discharge from ICU. RESULTS-44 Cats (21 females and 23 males) were included in the analysis. Age range was 3 to 15 years (median, 8 years), and body weight ranged from 1.8 to 9.0 kg (4.0 to 19.8 lb), with a median of 4.8 kg (10.6 lb). Twenty-seven cats were administered propofol. There was no significant association between the use of propofol or the dosage of propofol and any risk factor, need for blood products, number of hours in the ICU, or survival. There was no significant difference between cats that received propofol and cats that did not receive propofol with regard to interval until discharge from the ICU. CONCLUSIONS AND CLINICAL RELEVANCE-The use of propofol did not increase morbidity or fatalities in cats with primary hepatic lipidosis. Thus, propofol can be used in these cats for placement of a feeding tube.

Pettis v. Smith.

PubMed

2004-01-01

Court Decision: 880 Southern Reporter, 2d Series 145; 2004 Aug 13 (date of decision). The Court of Appeal of Louisiana's Second Circuit held that a living will gave informed consent to the withdrawal of artificial nutrition and hydration even though the living will did not specifically identify such treatment as a life-sustaining procedure. Mrs. Doris suffered a stroke that left her in a semi-coma. According to two physicians, Mrs. Doris's condition was not likely to improve and her condition was characterized as a persistent vegetative state. Mrs. Doris received nourishment by way of a gastric feeding tube without which she would live for at most a week. Two of Mrs. Doris's children petitioned for the removal of her feeding tube. One of the children, Oris Pettis, opposed removing the feeding tube on the grounds that Mrs. Doris's living will was not properly witnessed and that Mrs. Doris did not give informed consent to remove a feeding tube. The Court of Appeal dispensed with Pettis's first argument by holding that the will was properly witnessed. Considering Pettis's second argument, the court held that a gastric feeding tube is not considered "comfort care" and is, instead, a "life-sustaining procedure." In 1991, the Louisiana legislature amended its laws to include "invasive administration of nutrition and hydration" within the definition of "life-sustaining procedure." Moreover, the court concluded that it was not necessary for a person writing a living will to specifically list the types of "life-sustaining procedures" he or she wished to withdraw. The Court affirmed a lower court decision denying Pettis' claims and upholding Mrs. Doris's living will.

Enteral Feeding Tube Clogging: What Are the Causes and What Are the Answers? A Bench Top Analysis.

PubMed

Garrison, Christopher M

2018-02-01

Clogged enteral feeding tubes remain a significant barrier to the delivery of nutrition, hydration, and medications to patients who cannot tolerate oral intake. There is limited research that compares the relative efficacy of different methods used to clear a clogged feeding tube. The objectives of this study were to better understand the factors that contribute to enteral feeding tube clogging and to test the efficacy of 3 methods for clearing clogged feeding tubes. Three formulations of clogs were artificially created and tested in vitro and composed of various quantities of crushed medication (ie, aspirin) and 0.15 g coagulated protein (ie, tofu). The following 3 clog clearing strategies were tested on all clog types (n = 5 clogs/formulation/treatment): warm water flushes, an enzyme treatment, and an actuated mechanical occlusion clearing device. The variable among the clog types that appears most responsible for decreased clearing success is the state of the coagulated protein. Dried-out protein appears to makes a greater difference than increasing the medication quantity. The actuated mechanical occlusion clearing device was significantly more successful (93%) when compared with warm water flushes (20%) and the commercially available enzyme treatment (33%; P < .005) at clearing the clogs. The actuated device required significantly less total procedure time (P < .005) and total nursing time (P < .005) when compared with the other 2 clearing methods. When clogs occur, they can be quickly and effectively resolved by the actuated device, but other methodologies such as water and enzyme treatments may be of assistance. © 2018 American Society for Parenteral and Enteral Nutrition.

Artificial feeding--solid ground, not a slippery slope.

PubMed

Steinbrook, R; Lo, B

1988-02-04

Decisions about artificial feeding arouse more controversy than those involving any other life-sustaining treatment. Because food and water are generally considered basic elements of humane care, representing love and concern for the helpless, it is often thought that they must always be provided. In a landmark decision, the Supreme Judicial Court of Massachusetts ruled that a feeding tube could be removed from a patient in a persistent vegetative state if this was consistent with his previously expressed wishes. The case of Paul E. Brophy, Sr., is part of an emerging medical and legal consensus on the withholding of artificial feeding from adult patients. The view is growing that tube and intravenous feeding should be likened to other medical interventions and not to the routine provision of nursing care or comfort. Competent patients have the right to refuse such feeding. Feeding can also be stopped incompetent patients who have earlier stated such a wish.

Test Results of Heat Exchanger Cleaning in Support of Ocean Thermal Energy Conversion.

DTIC Science & Technology

1980-12-01

tests evaluated the performance of three in-situ cleaning techniques in two potential heat exchanger materials ...1-6. 41Mann, M. J., 1979, "Possible Cu-Ni-Clad Steel Material and Abrasive Slurry Cleaning System for Plate-Fin-Type OTEC Heat Exchangers ," in...of a Shell-less Folded Aluminum Tube, OTEC Heat Exchanger ," Proceedings of the Sixth OTEC Conference, Washington, DC, June 19-22, 1978, pp 12.8-1

Quality of Life Issues for Families Who Make the Decision to Use a Feeding Tube for Their Child with Disabilities.

ERIC Educational Resources Information Center

Brotherson, Mary Jane; And Others

1995-01-01

Eight families deciding to use a feeding tube to meet the nutrition needs of their children with disabilities were interviewed over a two-year period. Family decision making in the context of quality of life was examined using a theoretical family systems model. Implications for future interventions are addressed. (Author/SW)

Swallowing performance and tube feeding status in patients treated with parotid-sparing intensity-modulated radiotherapy for head and neck cancer.

PubMed

Roe, Justin W G; Carding, Paul N; Drinnan, Michael J; Harrington, Kevin J; Nutting, Christopher M

2016-04-01

The purpose of this prospective study was to evaluate the swallowing performance of patients with head and neck cancer treated with parotid-sparing intensity-modulated radiotherapy (IMRT). Sixty-two patients were recruited. Data were collected before and up to 12 months after treatment. Measures included the Performance Status Scale for head and neck cancer (PSS-HN Normalcy of Diet and Eating in Public subscales), tube feeding status, and 100 mL water swallow test (WST) volume and capacity scores. There was a significant reduction in PSS-HN and WST scores from baseline to 3 months (p < .001). Significant improvements were observed up to 12 months on the PSS-HN. Swallowing volume and capacity scores recovered but did not reach statistical significance. Tube feeding was not required in 47% of the patients. IMRT significantly impacts on swallowing performance, although there is a trend for improvement up to 12 months after treatment. Our data support a case-by-case approach to tube feeding. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1436-E1444, 2016. © 2015 Wiley Periodicals, Inc.

Exposure to cyclic anhydrides in welding: a new allergen-chlorendic anhydride.

PubMed

Pfäffli, Pirkko; Hämeilä, Mervi; Keskinen, Helena; Wirmoila, Ritva

2002-11-01

Respiratory effects associated with welding fumes have been manifested in welders as occupational asthma. Previous studies have concerned mainly the effects of metal fume exposure, although it has also been suggested that asthma may develop as a result of exposure to contaminants generated from painted metals. To determine whether welding fumes contain irritating and sensitizing anhydrides, air samples were collected during the repair welding of forest harvesters, which were painted with chlorinated polyester paint. Samples were collected with an assembly of a spiral glass trap inserted between a filter holder with a Teflon filter and a Tenax sampling tube. Sample analyses were with GC-MS and GC-ECD. Sensitizing anhydrides released from the paint into the air were primarily chlorendic anhydride (<2-44 microg/m(3)) and phthalic anhydride (11-21 microg/m(3)). Hydrogen chloride (HCl) and hexachlorocyclopentadiene were also found. Airborne HCl was measured with Dräger tubes. Since paint films are electrical insulators, the film around the welding seam was removed before arc welding. Removal of paint with an abrasive wheel caused the least exposure to HCl (<0.5 ppm) in contrast to burning with a gas fuel torch, (HCl approximately 5 ppm). HCl exposure was the highest (<0.5-20 ppm) during welding. It is recommended that dry paint coating be removed from an area around the seam with an abrasive wheel, not by burning, before welding.

Debris trap in a turbine cooling system

DOEpatents

Wilson, Ian David

2002-01-01

In a turbine having a rotor and a plurality of stages, each stage comprising a row of buckets mounted on the rotor for rotation therewith; and wherein the buckets of at least one of the stages are cooled by steam, the improvement comprising at least one axially extending cooling steam supply conduit communicating with an at least partially annular steam supply manifold; one or more axially extending cooling steam feed tubes connected to the manifold at a location radially outwardly of the cooling steam supply conduit, the feed tubes arranged to supply cooling steam to the buckets of at least one of the plurality of stages; the manifold extending radially beyond the feed tubes to thereby create a debris trap region for collecting debris under centrifugal loading caused by rotation of the rotor.

Analysis of Tube Hydroforming by means of an Inverse Approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nguyen, Ba Nghiep; Johnson, Kenneth I.; Khaleel, Mohammad A.

2003-05-01

This paper presents a computational tool for the analysis of freely hydroformed tubes by means of an inverse approach. The formulation of the inverse method developed by Guo et al. is adopted and extended to the tube hydrofoming problems in which the initial geometry is a round tube submitted to hydraulic pressure and axial feed at the tube ends (end-feed). A simple criterion based on a forming limit diagram is used to predict the necking regions in the deformed workpiece. Although the developed computational tool is a stand-alone code, it has been linked to the Marc finite element code formore » meshing and visualization of results. The application of the inverse approach to tube hydroforming is illustrated through the analyses of the aluminum alloy AA6061-T4 seamless tubes under free hydroforming conditions. The results obtained are in good agreement with those issued from a direct incremental approach. However, the computational time in the inverse procedure is much less than that in the incremental method.« less

Decreasing Use of Percutaneous Endoscopic Gastrostomy Tube Feeding in Japan.

PubMed

Komiya, Kosaku; Usagawa, Yuko; Kadota, Jun-Ichi; Ikegami, Naoki

2018-05-25

To identify trends in percutaneous endoscopic gastrostomy (PEG) tube placement and intravenous hyperalimentation (IVH) in nonhospital settings (as a potential alternative to tube feeding for nutrition) and to summarize published reports concerning the decision-making process for PEG placement. National survey and systematic review. Japan. All Japanese people. Data on numbers of individuals with a PEG tube and IVH were obtained from the website of the Japanese Ministry of Health, Labour, and Welfare and published reports concerning the decision-making process for PEG placement in Japan were summarized. The number of PEG tube placements peaked in 2007 and has been decreasing since Japan experienced the Great East Japan Earthquake in 2011. A further decline was seen in 2015 after the Japanese Ministry of Health, Labour and Welfare revised the fee schedule in 2014. More than half of individuals who had tubes were aged 80 and older during the years observed. In contrast, the number of individuals receiving IVH was lowest in the same year as PEG tube placement peaked and has been increasing ever since. Four studies reported that the decision-making process included consideration of not only the underlying disease, but also the individual's age and social barriers and the physician's personal philosophy. The number of PEG tube placements has been decreasing since its peak in 2007, and the number of individuals receiving IVH has been increasing. Many factors influence the decision-making process for PEG tube placement. Physicians in Japan may be realizing that there is little evidence to support the use of tube feeding in frail elderly adults. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Apparatus and method for treating a cathode material provided on a thin-film substrate

DOEpatents

Hanson, Eric J.; Kooyer, Richard L.

2001-01-01

An apparatus and method for treating a cathode material provided on a surface of a continuous thin-film substrate and a treated thin-film cathode having increased smoothness are disclosed. A web of untreated cathode material is moved between a feed mechanism and a take-up mechanism, and passed through a treatment station. The web of cathode material typically includes areas having surface defects, such as prominences extending from the surface of the cathode material. The surface of the cathode material is treated with an abrasive material to reduce the height of the prominences so as to increase an 85 degree gloss value of the cathode material surface by at least approximately 10. The web of cathode material may be subjected to a subsequent abrasive treatment at the same or other treatment station. Burnishing or lapping film is employed at a treatment station to process the cathode material. An abrasive roller may alternatively be used to process the web of cathode material. The apparatus and method of the present invention may also be employed to treat the surface of a lithium anode foil so as to cleanse and reduce the roughness of the anode foil surface.

Apparatus and method for treating a cathode material provided on a thin-film substrate

DOEpatents

Hanson, Eric J.; Kooyer, Richard L.

2003-01-01

An apparatus and method for treating a cathode material provided on a surface of a continuous thin-film substrate and a treated thin-film cathode having increased smoothness are disclosed. A web of untreated cathode material is moved between a feed mechanism and a take-up mechanism, and passed through a treatment station. The web of cathode material typically includes areas having surface defects, such as prominences extending from the surface of the cathode material. The surface of the cathode material is treated with an abrasive material to reduce the height of the prominences so as to increase an 85 degree gloss value of the cathode material surface by at least approximately 10. The web of cathode material may be subjected to a subsequent abrasive treatment at the same or other treatment station. Burnishing or lapping film is employed at a treatment station to process the cathode material. An abrasive roller may alternatively be used to process the web of cathode material. The apparatus and method of the present invention may also be employed to treat the surface of a lithium anode foil so as to cleanse and reduce the roughness of the anode foil surface.

Treatment of idiopathic hepatic lipidosis in cats: 11 cases (1986-1987).

PubMed

Jacobs, G; Cornelius, L; Allen, S; Greene, C

1989-09-01

Idiopathic hepatic lipidosis was diagnosed in 11 cats. Cats were treated by delivery of balanced nutrients supplemented with L-carnitine via a surgically placed gastrostomy tube. Feeding through the gastrostomy tube was initiated in the hospital and was continued at home in all cats. The mean duration of gastrostomy tube feeding was 48 days (range, 22 to 98 days). Vomiting associated with feeding (3 cats) and localized cellulitis at the gastrostomy site (2 cats) were the most frequent complications. Vomiting was controlled by reducing the volume of food administered at each feeding or by administration of metoclopramide. Cellulitis was treated successfully by parenteral administration of antibiotics and local wound cleansing. Seven of 11 cats (65%) survived and have remained clinically healthy for 15 to 29 months (mean, 20 months) since diagnosis. The other 4 cats died of peritonitis (n = 1), pneumonia (n = 1), hepatic encephalopathy (n = 1), or cardiopulmonary arrest (n = 1) between 0 and 10 days after surgery.

The effect of a natural food based tube feeding in minimizing diarrhea in critically ill neurological patients.

PubMed

Schmidt, Simone B; Kulig, Willibald; Winter, Ralph; Vasold, Antje S; Knoll, Anette E; Rollnik, Jens D

2018-01-09

Diarrhea has negative consequences for patients, health care staff and health care costs when neurological patients are fed enterally over long periods. We examined the effect of tube feeding with natural foods in reducing the number of fluid stool evacuations and diarrhea in critically ill neurological patients. A multicenter, prospective, open-label and randomized controlled trial (RCT) was conducted at facilities in Germany specializing in early rehabilitation after neurological damage. Patients of the INTERVENTION group were fed by tube using a commercially available product based on real foods such as milk, meat, carrots, whereas CONTROL patients received a standard tube-feed made of powdered raw materials. All received enteral nutrition over a maximum of 30 days. The number of defecations and the consistency of each stool according to the Bristol Stool Chart (BSC) were monitored. In addition, daily calories, liquids and antibiotic-use were recorded. 118 Patients who had suffered ischemic stroke, intracerebral hemorrhage, traumatic brain injury or hypoxic brain damage and requiring enteral nutrition were enrolled; 59 were randomized to receive the intervention and 59 control feed. There were no significant differences in clinical screening data, age, sex, observation period or days under enteral nutrition between the groups. Patients in both groups received equivalent amount of calories and fluids. In both groups antibiotics were frequently prescribed (69.5% in the INTERVENTION group and 75.7% in the CONTROL group) for 10-11 days on average. In comparison to the CONTROL group, patients in the INTERVENTION group had a significant reduction of the number of watery stool evacuations (type 7 BSC) (minus 61%, IRR = 0.39, p < 0.001). Further statistical evaluations using the following corrections: major diarrhea-associated confounders (number and duration of antibiotics); shorter observation period of 15 days; excluding patients with Clostridiumdifficile associated diarrhea (CDAD) and the Per Protocol Population, confirmed the primary hypothesis. The number of days with diarrhea was significantly lower in the INTERVENTION group (0.8 ± 1.60 days versus 2.0 ± 3.46 days). Tube feeding with natural based food was effective in reducing the number of watery defecations and diarrhea in long term tube-fed critically ill neurological patients, compared to those fed with standard tube feeding. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

The effect of an intervention aimed at reducing errors when administering medication through enteral feeding tubes in an institution for individuals with intellectual disability.

PubMed

Idzinga, J C; de Jong, A L; van den Bemt, P M L A

2009-11-01

Previous studies, both in hospitals and in institutions for clients with an intellectual disability (ID), have shown that medication errors at the administration stage are frequent, especially when medication has to be administered through an enteral feeding tube. In hospitals a specially designed intervention programme has proven to be effective in reducing these feeding tube-related medication errors, but the effect of such a programme within an institution for clients with an ID is unknown. Therefore, a study was designed to measure the influence of such an intervention programme on the number of medication administration errors in clients with an ID who also have enteral feeding tubes. A before-after study design with disguised observation to document administration errors was used. The study was conducted from February to June 2008 within an institution for individuals with an ID in the Western part of The Netherlands. Included were clients with enteral feeding tubes. The intervention consisted of advice on medication administration through enteral feeding tubes by the pharmacist, a training programme and introduction of a 'medication through tube' box containing proper materials for crushing and suspending tablets. The outcome measure was the frequency of medication administration errors, comparing the pre-intervention period with the post-intervention period. A total of 245 medication administrations in six clients (by 23 nurse attendants) have been observed in the pre-intervention measurement period and 229 medication administrations in five clients (by 20 nurse attendants) have been observed in the post-intervention period. Before the intervention, 158 (64.5%) medication administration errors were observed, and after the intervention, this decreased to 69 (30.1%). Of all potential confounders and effect modifiers, only 'medication dispensed in automated dispensing system ("robot") packaging' contributed to the multivariate model; effect modification was shown for this determinant. Multilevel analysis using this multivariate model resulted in an odds ratio of 0.33 (95% confidence interval 0.13-0.71) for the error percentage in the post-intervention period compared with the pre-intervention period. The intervention was found to be effective in an institution for clients with an ID. However, additional efforts are needed to reduce the proportion of administration errors which is still high after the intervention.

The Effect of an Intervention Aimed at Reducing Errors when Administering Medication through Enteral Feeding Tubes in an Institution for Individuals with Intellectual Disability

ERIC Educational Resources Information Center

Idzinga, J. C.; de Jong, A. L.; van den Bemt, P. M. L. A.

2009-01-01

Background: Previous studies, both in hospitals and in institutions for clients with an intellectual disability (ID), have shown that medication errors at the administration stage are frequent, especially when medication has to be administered through an enteral feeding tube. In hospitals a specially designed intervention programme has proven to…

Knowledge of Staff Members of Residential Care Facilities for Individuals with Intellectual Disability on Medication Administration via Enteral Feeding Tube

ERIC Educational Resources Information Center

Joos, E.; Mehuys, E.; Van Bocxlaer, J.; Remon, J. P.; Van Winckel, M.; Boussery, K.

2016-01-01

Background: Guidelines for the safe administration of drugs through enteral feeding tube (EFT) are an important tool to minimise the risk of errors. This study aimed to investigate knowledge of these guidelines among staff of residential care facilities (RCF) for people with ID. Method: Knowledge was assessed using a 13-item self-administered…

Effect of different flooring systems on weight and pressure distribution on claws of dairy cows.

PubMed

Telezhenko, E; Bergsten, C; Magnusson, M; Ventorp, M; Nilsson, C

2008-05-01

Weight and pressure distribution on the claw were studied in Swedish Holsteins housed in different flooring systems. A total of 127 cows housed in different sections of the experimental barn were used. Each section had different flooring in the walking and standing areas. There were rubber mats or abrasive mastic asphalt flooring on the alleys or a low-abrasive slatted concrete floor. Some sections had feed-stalls equipped with rubber mats; other sections did not. The vertical ground reaction force, contact area, and average contact pressure were determined on the left hind foot using the I-Scan system and analyzed with the F-scan system. These determinations were made in each of the following 3 zones of the claw: bulb, wall, and sole. Most of the weight on claws exposed to concrete floors was carried by the bulb (37.4 +/- 3.5 and 18.3 +/- 2.9% of weight exerted on the foot in the lateral and medial claw, respectively) and the wall zone (20.0 +/- 2.6 and 13.4 +/- 2.4% on lateral and medial claw, respectively). The weight and pressure distribution in cows kept on sections with rubber covered alleys but passing daily over the asphalt floor on their way to the milking parlor did not differ in any zones, except for lateral bulbs, compared with those exposed to slatted concrete alone. Still, the weight bearing of the sole zone in cows kept on rubber mats without access to asphalt was less than that of cows kept on concrete slatted floors (5.1 +/- 0.7 vs. 12.7 +/- 1.1% and 1.1 +/- 0.5 vs. 8.7 +/- 0.7% in lateral and medial claws, respectively). In cows kept on asphalt flooring without feed-stalls, most weight was exerted to the sole zone (36.2 +/- 2.9 and 22.2 +/- 1.8% in lateral and medial claws, respectively). Feed-stalls in combination with asphalt flooring yielded a decreased total contact area (30.1 +/- 1.2 cm(2)) compared with asphalt floors without feed-stalls (35.7 +/- 1.2 cm(2)). The largest total contact area was obtained on the asphalt floor without feed-stalls, resulting in a lower contact pressure (39.8 +/- 2.3 N/cm(2)) than in claws exposed to concrete (66.0 +/- 2.7 N/ cm(2)) or rubber mats (56.7 +/- 1.7 N/cm(2)). In conclusion, housing with abrasive floors resulted in claws with increased contact area at the sole surface and therefore, decreased contact pressure, but reduced the weight-bearing role of the strongest part of the claw capsule, the claw wall.

Process optimization for ultrasonic vibration assisted polishing of micro-structured surfaces on super hard material

NASA Astrophysics Data System (ADS)

Sun, Zhiyuan; Guo, Bing; Rao, Zhimin; Zhao, Qingliang

2014-08-01

In consideration of the excellent property of SiC, the ground micro-structured surface quality is hard to meet the requirement - consequently the ultrasonic vibration assisted polishing (UVAP) of micro-structures of molds is proposed in this paper. Through the orthogonal experiment, the parameters of UVAP of micro-structures were optimized. The experimental results show that, abrasive polishing process, the effect of the workpiece feed rate on the surface roughness (Ra), groove tip radius (R) and material removal rate (MRR) of micro-structures is significant. While, the UVAP, the most significant effect factor for Ra, R and MRR is the ultrasonic amplitude of the ultrasonic vibration. In addition, within the scope of the polishing process parameters selected by preliminary experiments, ultrasonic amplitude of 2.5μm, polishing force of 0.5N, workpiece feed rate of 5 mm·min-1, polishing wheel rotational speed of 50rpm, polishing time of 35min, abrasive size of 100nm and the polishing liquid concentration of 15% is the best technology of UVAP of micro-structures. Under the optimal parameters, the ground traces on the micro-structured surface were removed efficiently and the integrity of the edges of the micro-structure after grinding was maintained efficiently.

Tube feeding and quality of life in children with severe neurological impairment.

PubMed

Mahant, S; Friedman, J N; Connolly, B; Goia, C; Macarthur, C

2009-09-01

To assess the quality of life (QOL) of neurologically impaired children before and after gastrostomy (G) and gastrojejunostomy (GJ) tube insertion. This was a prospective longitudinal study of children with severe neurological impairment who underwent G or GJ tube insertion. At baseline, and at 6 and 12 months after tube insertion, parents rated (1) global QOL and health-related quality of life (HRQOL) using 10 cm visual analogue scales, with 10 representing maximal QOL and (2) HR-QOL using a questionnaire-based measure. Fifty patients, 45 and five of whom underwent G and GJ tube insertion, respectively, were enrolled with a median age of 591 days. Forty-two had a static neurological disorder, and eight had a progressive neurological disorder. The mean weight for age z score increased significantly over time: -2.8 at baseline and -1.8 at 12 months. The mean QOL and HR-QOL scores at baseline were 5.5 and 5.6 out of 10, respectively. There was no significant change in these scores at 6 and 12 months post-tube insertion. Children with a progressive versus a static neurological disorder had a significantly lower QOL over time. Ease of medication administration as well as feeding showed a significant improvement in scores from baseline to 12 months. Parents felt that the G and GJ tube had a positive impact on their child's health at 6 months (86%) and 12 months (84%). QOL as rated by parents did not increase following insertion of a G or GJ tube in neurologically impaired children. However, parents felt that the tube had a positive impact on their child's health, particularly with regards to feeding and administration of medications.

Leucine pulses enhance skeletal muscle protein synthesis during continuous feeding in neonatal pigs

USDA-ARS?s Scientific Manuscript database

Infants unable to maintain oral feeding can be nourished by orogastric tube. We have shown that orogastric continuous feeding restricts muscle protein synthesis compared with intermittent bolus feeding in neonatal pigs. To determine whether leucine leu infusion can be used to enhance protein synthes...

Comparison of various solutions to dissolve critical care diet clots.

PubMed

Parker, Valerie J; Freeman, Lisa M

2013-01-01

Enteral feeding tubes are frequently placed in animals to provide assisted nutritional support; however, one major reported complication is clogging of the tubes. The goal of this study was to determine which solution is most effective at dissolving in vitro clots made using a veterinary canned critical care diet. Various solutions were tested for their ability to dissolve enteral feed clots, including water, meat tenderizers in water, predetermined amounts of pancreatic enzymes (with and without sodium bicarbonate) in water, carbonated beverages, and cranberry juice. The solution that resulted in the greatest dissolution was ¼ teaspoon pancreatic enzymes and 325 mg sodium bicarbonate in 5 mL water, which was significantly better than all other solutions (water: P = 0.03; ¼ teaspoon pancreatic enzymes in water: P = 0.002; all others: P < 0.001). Water was significantly better than all carbonated beverages and cranberry juice (P < 0.001). The least successful solution was ½ teaspoon pancreatic enzymes and sodium bicarbonate in water. Despite anecdotal reports of using carbonated beverages, cranberry juice, and ½ teaspoon pancreatic enzymes to unclog feeding tubes, all were significantly less effective than water. In vivo studies to evaluate the effectiveness of methods to unclog feeding tubes are warranted to further investigate these findings. © Veterinary Emergency and Critical Care Society 2013.

Feeding the gut after revisional bariatric surgery: The fate of 126 enteral access tubes.

PubMed

Strong, Andrew T; Fayazzadeh, Hana; Sharma, Gautam; El-Hayek, Kevin; Kroh, Matthew; Rodriguez, John

2018-03-09

Revisional bariatric surgery (RBS) is associated with higher complication rates compared with primary bariatric surgery. Feeding tubes (FTs), including gastrostomy and jejunostomy tubes placed during RBS, may serve as a safety net to provide nutrition when oral intake is contraindicated or limited; however, FTs in this setting have not been well investigated. This study aims to determine complications, use, and duration of FTs placed during RBS. A high-volume academic medical center in the United States. Included patients underwent RBS between January 2008 and December 2016 with FTs placed at the time of RBS. There were 126 patients identified (84.9% female, 76.2% Caucasian, mean age 53.4-±10.9 yr). Patients had previously undergone Roux-en-Y gastric bypass (34.1%), vertical banded gastroplasty (27.8%), and adjustable gastric band (14.3%). Indications for RBS included correction of complication of prior bariatric surgeries (50%), weight regain/failure to lose weight (32.3%), or both (17.3%). Most FTs were placed in the excluded stomach (89.7%), and median tube size was 18 F. FTs were used for feeding in 68.2% of patients, with feeding initiated in a median of 2 days. Leakage around the tube (32.5%) and pain (26.8%) were common complaints. Significant tube-related complications included infection (9.1%), dislodgement (5.9%), reintervention (5.8%), and reoperation (2.8%); 16.7% experienced at least 1 significant complication. FTs were removed at a median of 36 days. FTs may aid in prevention of perioperative dehydration and malnutrition after RBS, but should not be considered a benign intervention. FT use should be balanced against institutional outcomes and care goals. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

TJC: plan and prepare for the transition to new tubing connectors to minimize the risk of dangerous misconnections, clinician frustration.

PubMed

2014-12-01

To reduce the risk of dangerous tubing misconnections, the ISO is rolling out new tubing connector standards that will eventually make it nearly impossible for tubing associated with one delivery system to be connected to a delivery system that serves a different purpose. Experts welcome the change, noting that tubing misconnections that cause injury and even death have been happening for years. However, TJC has issued a Sentinel Event Alert, warning that health care organizations need to be vigilant in managing the risk posed by these misconnections during the phased-in transition to the new connectors. Experts explain that tubing misconnections occur because many different types of tubing utilize the same Leur connector, making it possible for a clinician to mistakenly connect a tube to the wrong delivery system. The most common type of tubing misconnection reported to the ISMP is when a clinician wants to administer something to a patient through a feeding tube, but accidently administers the substance through an IV tube instead. The first new connector, called the ENFit, is going to be for enteral feeding tubes. It will not connect to IV tubing, making that type of misconnection unlikely. The new connector should be available early next year. Since hospitals will continue to use older tubing until their supplies are exhausted, manufacturers will temporarily provide adapters capable of making new administration sets compatible with older tubing.

Multi-tube thermal fuse for nozzle protection from a flame holding or flashback event

DOEpatents

Lacy, Benjamin Paul; Davis, Jr., Lewis Berkley; Johnson, Thomas Edward; York, William David

2012-07-03

A protection system for a pre-mixing apparatus for a turbine engine, includes: a main body having an inlet portion, an outlet portion and an exterior wall that collectively establish a fuel delivery plenum; and a plurality of fuel mixing tubes that extend through at least a portion of the fuel delivery plenum, each of the plurality of fuel mixing tubes including at least one fuel feed opening fluidly connected to the fuel delivery plenum; at least one thermal fuse disposed on an exterior surface of at least one tube, the at least one thermal fuse including a material that will melt upon ignition of fuel within the at least one tube and cause a diversion of fuel from the fuel feed opening to at least one bypass opening. A method and a turbine engine in accordance with the protection system are also provided.

Brain Lesions among Orally Fed and Gastrostomy-Fed Dysphagic Preterm Infants: Can Routine Qualitative or Volumetric Quantitative Magnetic Resonance Imaging Predict Feeding Outcomes?

PubMed

Kashou, Nasser H; Dar, Irfaan A; El-Mahdy, Mohamed A; Pluto, Charles; Smith, Mark; Gulati, Ish K; Lo, Warren; Jadcherla, Sudarshan R

2017-01-01

The usefulness of qualitative or quantitative volumetric magnetic resonance imaging (MRI) in early detection of brain structural changes and prediction of adverse outcomes in neonatal illnesses warrants further investigation. Our aim was to correlate certain brain injuries and the brain volume of feeding-related cortical and subcortical regions with feeding method at discharge among preterm dysphagic infants. Using a retrospective observational study design, we examined MRI data among 43 (22 male; born at 31.5 ± 0.8 week gestation) infants who went home on oral feeding or gastrostomy feeding (G-tube). MRI scans were segmented, and volumes of brainstem, cerebellum, cerebrum, basal ganglia, thalamus, and vermis were quantified, and correlations were made with discharge feeding outcomes. Chi-squared tests were used to evaluate MRI findings vs. feeding outcomes. ANCOVA was performed on the regression model to measure the association of maturity and brain volume between groups. Out of 43 infants, 44% were oral-fed and 56% were G-tube fed at hospital discharge (but not at time of the study). There was no relationship between qualitative brain lesions and feeding outcomes. Volumetric analysis revealed that cerebellum was greater ( p  < 0.05) in G-tube fed infants, whereas cerebrum volume was greater ( p  < 0.05) in oral-fed infants. Other brain regions did not show volumetric differences between groups. This study concludes that neither qualitative nor quantitative volumetric MRI findings correlate with feeding outcomes. Understanding the complexity of swallowing and feeding difficulties in infants warrants a comprehensive and in-depth functional neurological assessment.

Immediate Tube Feeding after Percutaneous Endoscopic Gastrostomy: Early Return to Goal Tube Feeds without Added Complications.

PubMed

Lamb, Laura C; Jayaraman, Vijay; Montgomery, Stephanie C; Umer, Affan; Shapiro, David S; Feeney, James M

2017-02-01

Percutaneous endoscopic gastrostomy (PEG) is frequently performed for delivery of nonoral enteral nutrition (EN) in critically ill patients. Tube-based supplement initiation is often delayed for a variety of reasons despite evidence that EN interruption results in worse outcomes. To determine if early initiation of EN after PEG placement is safe and well-tolerated in critically ill patients and if early initiation of EN results in more goal-accomplished days of EN. A retrospective chart review of patients who underwent PEG and at least 24 hours of EN. Patients were stratified according to time to tube- feed initiation: immediate (< one hour), early (one to four hours), and late (four to 24 hours). 'Ihe three groups were similar with respect to demographics, comorbidities, and 30-day mortality. Sixty-one percent of patients in the immediate group were advanced to the previously-met goal EN rates compared to 24% and 18% in the early and delayed groups, respectively (P < .0001). Immediate reinitiation of nonoral EN after PEG procedure is safe and is associated with reaching goal nutrition faster.

Development of a clinical practice guideline for testing nasogastric tube placement.

PubMed

Peter, Sue; Gill, Fenella

2009-01-01

A Perth metropolitan hospital group standardized changes to nasogastric tube placement, including removal of the "whoosh test" and litmus paper, and introduction of pH testing. Two audits were conducted: bedside data collection at a pediatric hospital and a point-prevalence audit across seven hospitals. Aspirate was obtained for 97% of all tests and pH was < or = 5.5 for 84%, validating the practice changes. However, patients on continuous feeds and/or receiving acid-inhibiting medications had multiple pH testing fails. Nasogastric tube placement continues to present a challenge for those high-risk patients on continuous feeds and/or receiving acid-inhibiting medications.

Optimization of a Tube Hydroforming Process

NASA Astrophysics Data System (ADS)

Abedrabbo, Nader; Zafar, Naeem; Averill, Ron; Pourboghrat, Farhang; Sidhu, Ranny

2004-06-01

An approach is presented to optimize a tube hydroforming process using a Genetic Algorithm (GA) search method. The goal of the study is to maximize formability by identifying the optimal internal hydraulic pressure and feed rate while satisfying the forming limit diagram (FLD). The optimization software HEEDS is used in combination with the nonlinear structural finite element code LS-DYNA to carry out the investigation. In particular, a sub-region of a circular tube blank is formed into a square die. Compared to the best results of a manual optimization procedure, a 55% increase in expansion was achieved when using the pressure and feed profiles identified by the automated optimization procedure.

[Evaluation of serum total carnitine values in persons with severe motor and intellectual disabilities with enteral (tube) feeding].

PubMed

Ohtaki, Ushio; Ozawa, Hiroshi; Ishizuka, Takehiro; Kamiishi, Akiko; Sasaki, Kyoko; Nakajima, Suemi; Katayama, Ayako; Arimoto, Kiyoshi; Yagihashi, Tatsuhiko; Kimiya, Satoshi

2012-09-01

The nutritive evaluation and the serum carnitine values were measured for persons with severe motor and intellectual disabilities with enteral (tube) feeding. In Shimada Rehabilitation Center, twenty one people who had serum albumin levels of 3.4 g/dl or less, and were taking nutrition with enteral (tube) feeding, were tested. Body weight, blood samples, and serum carnitine levels were measured. The total carnitine value was less than the standard value in 19 patients. The total carnitine value decreased in the group taking valporate sodium (VPA), compared to the values from the group non-taking VPA. From our evaluation, we think that daily carnitine supplements is essential for persons with sever motor and intellectual disabilities taking VPA to maintain carnitine levels in the blood, and regular urine test should be done for earlier detection secondary lack complications from the secondary lack of carnitine.

Continuous feedings of fortified human milk lead to nutrient losses of fat, calcium, and phosphorous

USDA-ARS?s Scientific Manuscript database

Substantial losses of nutrients may occur during tube (gavage) feeding of fortified human milk. Our objective was to compare the losses of key macronutrients and minerals based on method of fortification, and gavage feeding method. We used clinically available gavage feeding systems and measured pre...

Generator module architecture for a large solid oxide fuel cell power plant

DOEpatents

Gillett, James E.; Zafred, Paolo R.; Riggle, Matthew W.; Litzinger, Kevin P.

2013-06-11

A solid oxide fuel cell module contains a plurality of integral bundle assemblies, the module containing a top portion with an inlet fuel plenum and a bottom portion receiving air inlet feed and containing a base support, the base supports dense, ceramic exhaust manifolds which are below and connect to air feed tubes located in a recuperator zone, the air feed tubes passing into the center of inverted, tubular, elongated, hollow electrically connected solid oxide fuel cells having an open end above a combustion zone into which the air feed tubes pass and a closed end near the inlet fuel plenum, where the fuel cells comprise a fuel cell stack bundle all surrounded within an outer module enclosure having top power leads to provide electrical output from the stack bundle, where the fuel cells operate in the fuel cell mode and where the base support and bottom ceramic air exhaust manifolds carry from 85% to all 100% of the weight of the stack, and each bundle assembly has its own control for vertical and horizontal thermal expansion control.

Development of hybrid fluid jet/float polishing process

NASA Astrophysics Data System (ADS)

Beaucamp, Anthony T. H.; Namba, Yoshiharu; Freeman, Richard R.

2013-09-01

On one hand, the "float polishing" process consists of a tin lap having many concentric grooves, cut from a flat by single point diamond turning. This lap is rotated above a hydrostatic bearing spindle of high rigidity, damping and rotational accuracy. The optical surface thus floats above a thin layer of abrasive particles. But whilst surface texture can be smoothed to ~0.1nm rms (as measured by atomic force microscopy), this process can only be used on flat surfaces. On the other hand, the CNC "fluid jet polishing" process consists of pumping a mixture of water and abrasive particles to a converging nozzle, thus generating a polishing spot that can be moved along a tool path with tight track spacing. But whilst tool path feed can be moderated to ultra-precisely correct form error on freeform optical surfaces, surface finish improvement is generally limited to ~1.5nm rms (with fine abrasives). This paper reports on the development of a novel finishing method, that combines the advantages of "fluid jet polishing" (i.e. freeform corrective capability) with "float polishing" (i.e. super-smooth surface finish of 0.1nm rms or less). To come up with this new "hybrid" method, computational fluid dynamic modeling of both processes in COMSOL is being used to characterize abrasion conditions and adapt the process parameters of experimental fluid jet polishing equipment, including: (1) geometrical shape of nozzle, (2) position relative to the surface, (3) control of inlet pressure. This new process is aimed at finishing of next generation X-Ray / Gamma Ray focusing optics.

The Effects of Glucose Therapy Agents-Apple Juice, Orange Juice, and Cola-on Enteral Tube Flow and Patency.

PubMed

Steinberg, Daphna J; Montreuil, Jasmine; Santoro, Andrea L; Zettas, Antonia; Lowe, Julia

2016-06-01

To develop evidence-based hypoglycemia treatment protocols in patients receiving total enteral nutrition, this study determined the effect on enteral tube flow of glucose therapy agents: apple juice, orange juice, and cola, and it also examined the effects of tube type and feed type with these glucose therapy agents. For this study, 12 gastrostomy tubes (6 polyethylene and 6 silicone) were set at 50 mL/h. Each feeding set was filled with Isosource HN with fibre or Novasource Renal. Each tube was irrigated with 1 glucose therapy agent, providing approximately 20 g of carbohydrate every 4 h. Flow-rate measurements were collected at 2 h intervals. The results showed that the glucose therapy agent choice affected flow rates: apple juice and cola had higher average flow rates than orange juice (P = 0.01). A significant difference was found between tube type and enteral formula: polyethylene tubes had higher average flow rates than silicone tubes (P < 0.0001), and Isosource HN with fibre had higher flow rates than Novasource Renal (P = 0.01). We concluded that apple juice and cola have less tube clogging potential than orange juice, and thus may be considered as primary treatment options for hypoglycemia in enterally fed patients. Polyethylene tubes and Isosource HN with fibre were less likely to clog than silicone tubes and Novasource Renal.

Prolonged Barium-Impaction Ileus in Two Lung Transplant Recipients With Systemic Sclerosis: Case Report.

PubMed

Tokman, S; Hays, S R; Leard, L E; Bush, E L; Kukreja, J; Kleinhenz, M E; Golden, J A; Singer, J P

2015-12-01

Lung transplantation can be a life-saving measure for people with end-stage lung disease from systemic sclerosis. However, outcomes of lung transplantation may be compromised by gastrointestinal manifestations of systemic sclerosis, which can involve any part of the gastrointestinal tract. Esophageal and gastric disease can be managed by enteral feeding with the use of a gastrojejunal feeding tube. In this report, we describe the clinical courses of 2 lung transplant recipients with systemic sclerosis who experienced severe and prolonged barium-impaction ileus after insertion of a percutaneous gastrojejunal feeding tube. Copyright © 2015 Elsevier Inc. All rights reserved.

Association of a Proactive Swallowing Rehabilitation Program With Feeding Tube Placement in Patients Treated for Pharyngeal Cancer.

PubMed

Ajmani, Gaurav S; Nocon, Cheryl C; Brockstein, Bruce E; Campbell, Nicholas P; Kelly, Amy B; Allison, Jamie; Bhayani, Mihir K

2018-04-19

A proactive speech and language pathology (SLP) program is an important component of the multidisciplinary care of patients with head and neck squamous cell carcinoma (HNSCC). Swallowing rehabilitation can reduce the rate of feeding tube placement, thereby significantly improving quality of life. To evaluate the initiation of a proactive SLP rehabilitation program at a single institution and its association with rates of feeding tube placement and dietary intake in patients with HNSCC. Cohort study at a tertiary care and referral center for patients with HNSCC serving the northern Chicago region. Patients were treated for squamous cell carcinomas of the hypopharynx, oropharynx, and nasopharynx from 2004 to 2015 with radiation or chemoradiation therapy in the definitive or adjuvant setting. Patients who received less than 5000 cGy radiation or underwent reirradiation were excluded. A proactive SLP program for patients with HNSCC was initiated in 2011. Study cohorts were divided into 2 groups: 2004 through 2010 and 2011 through 2015. Primary outcome variables were SLP referral placement and timing of the referral. Secondary outcomes were feeding tube placement and ability to tolerate any oral intake. A total of 254 patients met inclusion criteria (135 before and 119 after implementation of SLP program; median age, 60 years [range, 14-94 years]; 77% male). With the initiation of a proactive SLP program, pretreatment evaluations increased from 29 (21.5%) to 70 (58.8%; risk ratio [RR], 2.74; 95% CI, 1.92-3.91), and rate of referral overall at any time increased from 60.0% to 79.8% (RR, 1.33; 95% CI, 1.13-1.57). Feeding tube placement rates decreased from 45.9% (n = 62) to 29.4% (n = 35; RR, 0.64; 95% CI, 0.46-0.89). Among patients receiving a swallow evaluation, feeding tube requirements were less frequent for those receiving a pretreatment evaluation (31 of 99 [31%]) than for those referred during (11 of 18 [61%]) or after (38 of 59 [64%]) treatment. The rate of tolerating any oral intake at the end of treatment improved from 71.1% (n = 96) in the preimplementation period to 82.4% (n = 98; RR, 1.16; 95% CI, 1.01-1.33). A proactive SLP program can be successfully established as part of the multidisciplinary care of patients with HNSCC and improve patient quality of life.

Detecting Inter-Cusp and Inter-Tooth Wear Patterns in Rhinocerotids

PubMed Central

Taylor, Lucy A.; Kaiser, Thomas M.; Schwitzer, Christoph; Müller, Dennis W. H.; Codron, Daryl; Clauss, Marcus; Schulz, Ellen

2013-01-01

Extant rhinos are the largest extant herbivores exhibiting dietary specialisations for both browse and grass. However, the adaptive value of the wear-induced tooth morphology in rhinos has not been widely studied, and data on individual cusp and tooth positions have rarely been published. We evaluated upper cheek dentition of browsing Diceros bicornis and Rhinoceros sondaicus, mixed-feeding R. unicornis and grazing Ceratotherium simum using an extended mesowear method adapted for rhinos. We included single cusp scoring (EM(R)-S) to investigate inter-cusp and inter-tooth wear patterns. In accordance with previous reports, general mesowear patterns in D. bicornis and R. sondaicus were attrition-dominated and C. simum abrasion-dominated, reflecting their respective diets. Mesowear patterns for R. unicornis were more attrition-dominated than anticipated by the grass-dominated diet, which may indicate a low intake of environmental abrasives. EM(R)-S increased differentiation power compared to classical mesowear, with significant inter-cusp and inter-tooth differences detected. In D. bicornis, the anterior cusp was consistently more abrasion-dominated than the posterior. Wear differences in cusp position may relate to morphological adaptations to dietary regimes. Heterogeneous occlusal surfaces may facilitate the comminution of heterogeneous browse, whereas uniform, broad grinding surfaces may enhance the comminution of physically more homogeneous grass. A negative tooth wear gradient was found in D. bicornis, R. sondaicus and R. unicornis, with wear patterns becoming less abrasion-dominated from premolars to molars. No such gradients were evident in C. simum which displayed a uniform wear pattern. In browsers, premolars may be exposed to higher relative grit loads, which may result in the development of wear gradients. The second premolar may also have a role in food cropping. In grazers, high absolute amounts of ingested abrasives may override other signals, leading to a uniform wear pattern and dental function along the tooth row, which could relate to the observed evolution towards homodonty. PMID:24312507

Detecting inter-cusp and inter-tooth wear patterns in rhinocerotids.

PubMed

Taylor, Lucy A; Kaiser, Thomas M; Schwitzer, Christoph; Müller, Dennis W H; Codron, Daryl; Clauss, Marcus; Schulz, Ellen

2013-01-01

Extant rhinos are the largest extant herbivores exhibiting dietary specialisations for both browse and grass. However, the adaptive value of the wear-induced tooth morphology in rhinos has not been widely studied, and data on individual cusp and tooth positions have rarely been published. We evaluated upper cheek dentition of browsing Diceros bicornis and Rhinoceros sondaicus, mixed-feeding R. unicornis and grazing Ceratotherium simum using an extended mesowear method adapted for rhinos. We included single cusp scoring (EM(R)-S) to investigate inter-cusp and inter-tooth wear patterns. In accordance with previous reports, general mesowear patterns in D. bicornis and R. sondaicus were attrition-dominated and C. simum abrasion-dominated, reflecting their respective diets. Mesowear patterns for R. unicornis were more attrition-dominated than anticipated by the grass-dominated diet, which may indicate a low intake of environmental abrasives. EM(R)-S increased differentiation power compared to classical mesowear, with significant inter-cusp and inter-tooth differences detected. In D. bicornis, the anterior cusp was consistently more abrasion-dominated than the posterior. Wear differences in cusp position may relate to morphological adaptations to dietary regimes. Heterogeneous occlusal surfaces may facilitate the comminution of heterogeneous browse, whereas uniform, broad grinding surfaces may enhance the comminution of physically more homogeneous grass. A negative tooth wear gradient was found in D. bicornis, R. sondaicus and R. unicornis, with wear patterns becoming less abrasion-dominated from premolars to molars. No such gradients were evident in C. simum which displayed a uniform wear pattern. In browsers, premolars may be exposed to higher relative grit loads, which may result in the development of wear gradients. The second premolar may also have a role in food cropping. In grazers, high absolute amounts of ingested abrasives may override other signals, leading to a uniform wear pattern and dental function along the tooth row, which could relate to the observed evolution towards homodonty.

APPARATUS FOR VACUUM DEPOSITION OF METALS

DOEpatents

Milleron, N.

1962-03-13

An apparatus and a method are described for continuous vacuum deposition of metals for metallic coatings, for ultra-high vacuum work, for purification of metals, for maintaining high-density electron currents, and for other uses. The apparatus comprises an externally cooled feeder tube extending into a container and adapted to feed metal wire or strip so that it emerges in a generally vertical position therein. The tube also provides shielding from the heat produced by an electron beam therein focused to impinge from a vertical direction upon the tip of the emerging wire. By proper control of the wire feed, coolant feed, and electron beam intensity, a molten ball of metal forms upon the emerging tip and remains self-supported thereon by the interaction of various forces. The metal is vaporized and travels in a line of sight direction, while additional wire is fed from the tube, so that the size of the molten ball remains constant. In the preferred embodiments, the wire is selected from a number of gettering metals and is degassed by electrical resistance in an adjacent chamber which is also partially evacuated. The wire is then fed through the feed tube into the electron beam and vaporizes and adsorbs gases to provide pumping action while being continuously deposited upon surfaces within the chamber. Ion pump electrodes may also be provided within line of sight of the vaporizing metal source to enhance the pumping action. (AEC)

Avoidance of bottles during the establishment of breast feeds in preterm infants.

PubMed

Collins, Carmel T; Gillis, Jennifer; McPhee, Andrew J; Suganuma, Hiroki; Makrides, Maria

2016-10-19

Preterm infants start milk feeds by gavage tube. As they mature, sucking feeds are gradually introduced. Women who choose to breast feed their preterm infant are not always able to be in hospital with their baby and need an alternative approach to feeding. Most commonly, milk (expressed breast milk or formula) is given by bottle. Whether using bottles during establishment of breast feeds is detrimental to breast feeding success is a topic of ongoing debate. To identify the effects of avoidance of bottle feeds during establishment of breast feeding on the likelihood of successful breast feeding, and to assess the safety of alternatives to bottle feeds. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 2), MEDLINE via PubMed (1966 to July 2016), Embase (1980 to July 2016) and CINAHL (1982 to July 2016). We also searched databases of clinical trials and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised and quasi-randomised controlled trials comparing avoidance of bottles with use of bottles in women who have chosen to breast feed their preterm infant. Two review authors independently assessed trial quality and extracted data. When appropriate, we contacted study authors for additional information. Review authors used standard methods of The Cochrane Collaboration and the Cochrane Neonatal Review Group. We included seven trials with 1152 preterm infants. Five studies used a cup feeding strategy, one used a tube feeding strategy and one used a novel teat when supplements to breast feeds were needed. We included the novel teat study in this review, as the teat was designed to more closely mimic the sucking action of breast feeding. The trials were of small to moderate size, and two had high risk of attrition bias. Adherence with cup feeding was poor in one of the studies, indicating dissatisfaction with this method by staff and/or parents; the remaining four cup feeding studies provided no such reports of dissatisfaction or low adherence. Meta-analyses provided evidence of low to moderate quality indicating that avoiding bottles increases the extent of breast feeding on discharge home (full breast feeding typical risk ratio (RR) 1.47, 95% confidence interval (CI) 1.19 to 1.80; any breast feeding RR 1.11, 95% CI 1.06 to 1.16). Limited available evidence for three months and six months post discharge shows that avoiding bottles increases the occurrence of full breast feeding and any breast feeding at discharge and at six months post discharge, and of full (but not any) breast feeding at three months post discharge. This effect was evident at all time points for the tube alone strategy and for all except any breast feeding at three months post discharge for cup feeding. Investigators reported no clear benefit when the novel teat was used. No other benefits or harms were evident, including, in contrast to the previous (2008) review, length of hospital stay. Evidence of low to moderate quality suggests that supplementing breast feeds by cup increases the extent and duration of breast feeding. Current insufficient evidence provides no basis for recommendations for a tube alone approach to supplementing breast feeds.

Asymptomatic hepatic portal venous gas with gastric emphysema as a chronic complication of gastrostomy tube placement: a case report.

PubMed

Sawano, Toyoaki; Nemoto, Tsuyoshi; Tsubokura, Masaharu; Leppold, Claire; Ozaki, Akihiko; Kato, Shigeaki; Kanazawa, Yukio

2016-08-24

Percutaneous endoscopic gastrostomy feeding is widely used as a route for enteral feeding for patients with impaired swallowing ability, particularly in older patients. Hepatic portal venous gas is a condition that may arise from several causes. Hepatic portal venous gas that develops after an endoscopic procedure is generally reported to be nonfatal, yet there is little information available concerning the characteristics of hepatic portal venous gas as a chronic complication of percutaneous endoscopic gastrostomy feeding. We experienced a case of hepatic portal venous gas that happened to be detected in an 81-year-old Japanese man with long-term percutaneous endoscopic gastrostomy use who was admitted to our hospital with aspiration pneumonia. While aspiration pneumonia was treated with antibiotics and suspension of tube feedings, he recovered from hepatic portal venous gas without any treatment. The presence of a percutaneous endoscopic gastrostomy tube may have induced hepatic portal venous gas through a mechanism in which vomiting led to increased abdominal pressure and eventually gastric emphysema. This case suggests that hepatic portal venous gas without any signs of bowel ischemia or emphysematous gastritis can resolve without treatment, which is a finding that could be helpful for clinicians who deal with those supported by percutaneous endoscopic gastrostomy feeding.

Diet and eating after esophagectomy

MedlinePlus

... a special diet when you first get home. Self-care If you have a feeding tube (PEG tube) ... sit upright for 1 hour after eating or drinking because gravity helps food and liquid move downward. ...

Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for patients with head and neck cancer: a systematic review

PubMed Central

Wang, Jinfeng; Liu, Minjie; Liu, Chao; Ye, Yun; Huang, Guanhong

2014-01-01

There are two main enteral feeding strategies—namely nasogastric (NG) tube feeding and percutaneous gastrostomy—used to improve the nutritional status of patients with head and neck cancer (HNC). But up till now there has been no consistent evidence about which method of enteral feeding is the optimal method for this patient group. To compare the effectiveness of percutaneous gastrostomy and NGT feeding in patients with HNC, relevant literature was identified through Medline, Embase, Pubmed, Cochrane, Wiley and manual searches. We included randomized controlled trials (RCTs) and non-experimental studies comparing percutaneous gastrostomy—including percutaneous endoscopic gastrostomy (PEG) and percutaneous fluoroscopic gastrostomy (PFG) —with NG for HNC patients. Data extraction recorded characteristics of intervention, type of study and factors that contributed to the methodological quality of the individual studies. Data were then compared with respect to nutritional status, duration of feeding, complications, radiotherapy delays, disease-free survival and overall survival. Methodological quality of RCTs and non-experimental studies were assessed with separate standard grading scales. It became apparent from our studies that both feeding strategies have advantages and disadvantages. PMID:24453356

Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for patients with head and neck cancer: a systematic review.

PubMed

Wang, Jinfeng; Liu, Minjie; Liu, Chao; Ye, Yun; Huang, Guanhong

2014-05-01

There are two main enteral feeding strategies-namely nasogastric (NG) tube feeding and percutaneous gastrostomy-used to improve the nutritional status of patients with head and neck cancer (HNC). But up till now there has been no consistent evidence about which method of enteral feeding is the optimal method for this patient group. To compare the effectiveness of percutaneous gastrostomy and NGT feeding in patients with HNC, relevant literature was identified through Medline, Embase, Pubmed, Cochrane, Wiley and manual searches. We included randomized controlled trials (RCTs) and non-experimental studies comparing percutaneous gastrostomy-including percutaneous endoscopic gastrostomy (PEG) and percutaneous fluoroscopic gastrostomy (PFG) -with NG for HNC patients. Data extraction recorded characteristics of intervention, type of study and factors that contributed to the methodological quality of the individual studies. Data were then compared with respect to nutritional status, duration of feeding, complications, radiotherapy delays, disease-free survival and overall survival. Methodological quality of RCTs and non-experimental studies were assessed with separate standard grading scales. It became apparent from our studies that both feeding strategies have advantages and disadvantages.

Pneumonia Frequencies with Different Enteral Tube Feeding Access Sites.

ERIC Educational Resources Information Center

Taylor, Henry M.

2002-01-01

Over a 24-month period, 25 adults with mental retardation being fed via a gastrostomy tube experienced 40 cases of pneumonia during 508 person-months of observations, whereas 5 individuals being fed via a jejunostromy tube did not experience any pneumonia during 96 person-months of observation. (Contains references.) (Author/CR)

Evaluation of the benefits of gastric tube feeding in an elderly population.

PubMed

Weaver, J P; Odell, P; Nelson, C

1993-09-01

To assess the benefits of gastric tube feeding in an elderly community hospital population. One hundred consecutive patients who required feeding gastrostomies from July 1984 through June 1987. Durham (NC) Regional Hospital, a 380-bed community hospital. Patients were evaluated using a quality of life scale (QL scale) adapted from Spitzer's QL Index. The evaluation was based on hospital records at the time of tube placement and interviews with patients or family members at follow-up between June 1991 and March 1992. Subjective evaluation of the benefits of gastric tube feeding were obtained in interviews with patients or their families at follow-up. Overall there was no significant change in the objective evaluation of quality of life at follow-up. Men, patients over 76 years of age, and patients with chronic illnesses such as multiple strokes or dementia showed the poorest response on the QL scale. Subjective evaluation by patients or their family members was positively correlated with objective evaluation on the QL scale. Family members of patients who showed the poorest response on the QL scale were more likely than other family members to respond no to the question, "Would you want this done to you if you were in his/her situation?" Our QL scale provides a good indication of patients' and family members' subjective evaluation of the benefits of gastrostomy tube feeding after 4 to 8 years. Thus, the scale should be helpful to physicians who must consult with patients and their families and make decisions about the use of this procedure. The significant discrepancy between family members' evaluations of the benefit of the procedure to the patient and their refusal of the procedure for themselves if they were in the patient's situation confirms the need for advance directives and the importance of conscientious implementation of the Patient Self Determination Act of 1990.

Replacement of Mushroom Cage Gastrostomy Tube Using a Modified Technique to Allow Percutaneous Replacement with an Endoscopic Tube in Patients with Amyotrophic Lateral Sclerosis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ammar, Thoraya; Rio, Alan; Ampong, Mary Ann

2010-06-15

Radiologic inserted gastrostomy (RIG) is the preferred method in our institution for enteral feeding in amyotrophic lateral sclerosis (ALS). Skin-level primary-placed mushroom cage gastrostomy tubes become tight with weight gain. We describe a minimally invasive radiologic technique for replacing mushroom gastrostomy tubes with endoscopic mushroom cage tubes in ALS. All patients with ALS who underwent replacement of a RIG tube were included. Patients were selected for a modified replacement when the tube length of the primary placed RIG tube was insufficient to allow like-for-like replacement. Replacement was performed under local anesthetic and fluoroscopic guidance according to a preset technique, withmore » modification of an endoscopic mushroom cage gastrostomy tube to allow percutaneous placement. Assessment of the success, safety, and durability of the modified technique was undertaken. Over a 60-month period, 104 primary placement mushroom cage tubes in ALS were performed. A total of 20 (19.2%) of 104 patients had a replacement tube positioned, 10 (9.6%) of 104 with the modified technique (male n = 4, female n = 6, mean age 65.5 years, range 48-85 years). All tubes were successfully replaced using this modified technique, with two minor complications (superficial wound infection and minor hemorrhage). The mean length of time of tube durability was 158.5 days (range 6-471 days), with all but one patient dying with a functional tube in place. We have devised a modification to allow percutaneous replacement of mushroom cage gastrostomy feeding tubes with minimal compromise to ALS patients. This technique allows tube replacement under local anesthetic, without the need for sedation, an important consideration in ALS.« less

Wear Mechanism of Chemical Vapor Deposition (CVD) Carbide Insert in Orthogonal Cutting Ti-6Al-4V ELI at High Cutting Speed

NASA Astrophysics Data System (ADS)

Gusri, A. I.; Che Hassan, C. H.; Jaharah, A. G.

2011-01-01

The performance of Chemical Vapor Deposition (CVD) carbide insert with ISO designation of CCMT 12 04 04 LF, when turning titanium alloys was investigated. There were four layers of coating materials for this insert i.e.TiN-Al2O3-TiCN-TiN. The insert performance was evaluated based on the insert's edge resistant towards the machining parameters used at high cutting speed range of machining Ti-6Al-4V ELI. Detailed study on the wear mechanism at the cutting edge of CVD carbide tools was carried out at cutting speed of 55-95 m/min, feed rate of 0.15-0.35 mm/rev and depth of cut of 0.10-0.20 mm. Wear mechanisms such as abrasive and adhesive were observed on the flank face. Crater wear due to diffusion was also observed on the rake race. The abrasive wear occurred more at nose radius and the fracture on tool were found at the feed rate of 0.35 mm/rev and the depth of cut of 0.20 mm. The adhesion wear takes place after the removal of the coating or coating delaminating. Therefore, adhesion or welding of titanium alloy onto the flank and rake faces demonstrates a strong bond at the workpiece-tool interface.

Loss of feed flow, steam generator tube rupture and steam line break thermohydraulic experiments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mendler, O J; Takeuchi, K; Young, M Y

1986-10-01

The Westinghouse Model Boiler No. 2 (MB-2) steam generator test model at the Engineering Test Facility in Tampa, Florida, was reinstrumented and modified for performing a series of tests simulating steam generator accident transients. The transients simulated were: loss of feed flow, steam generator tube rupture, and steam line break events. This document presents a description of (1) the model boiler and the associated test facility, (2) the tests performed, and (3) the analyses of the test results.

A Broadband High-Gain Bi-Layer Log-Periodic Dipole Array (LPDA) for Ultra High Frequency (UHF) Conformal Load Bearing Antenna Structures (CLAS) Applications

DTIC Science & Technology

2014-08-01

AFRL-RQ-WP-TR-2014-0212 University of South Carolina Department of Electrical Engineering Columbia, SC 29208 Structures Technology Branch...S2603-04-C01. Cleared for Public Release - Case Number: . Nicholas Bishop and M. Ali are with the Department of Electrical Engineering, University of...Lower substrate Upper substrate Foam core Coax Feed tube LPDA traces Coax inner conductor Feed tube Copper plate Input 88ABW-2014-3668, 8

Retortable Laminate/Polymeric Food Tubes for Specialized Feeding

DTIC Science & Technology

2012-06-01

on commercial off-the-shelf materials and not military unique. A market survey of commercially available laminated tubes revealed that they are all...on commercial off-the-shelf materials and not military unique. A market survey of commercially available laminated tubes revealed that they are...available materials and not be uniquely military. We surveyed the market for laminated retortable tubes and were not able to find any application

Modeling and Tool Wear in Routing of CFRP

DOE Office of Scientific and Technical Information (OSTI.GOV)

Iliescu, D.; Fernandez, A.; Gutierrez-Orrantia, M. E.

2011-01-17

This paper presents the prediction and evaluation of feed force in routing of carbon composite material. In order to extend tool life and improve quality of the machined surface, a better understanding of uncoated and coated tool behaviors is required. This work describes (1) the optimization of the geometry of multiple teeth tools minimizing the tool wear and the feed force, (2) the optimization of tool coating and (3) the development of a phenomenological model between the feed force, the routing parameters and the tool wear. The experimental results indicate that the feed rate, the cutting speed and the toolmore » wear are the most significant factors affecting the feed force. In the case of multiple teeth tools, a particular geometry with 14 teeth right helix right cut and 11 teeth left helix right cut gives the best results. A thick AlTiN coating or a diamond coating can dramatically improve the tool life while minimizing the axial force, roughness and delamination. A wear model has then been developed based on an abrasive behavior of the tool. The model links the feed rate to the tool geometry parameters (tool diameter), to the process parameters (feed rate, cutting speed and depth of cut) and to the wear. The model presented has been verified by experimental tests.« less

Automatic feed system for ultrasonic machining

DOEpatents

Calkins, Noel C.

1994-01-01

Method and apparatus for ultrasonic machining in which feeding of a tool assembly holding a machining tool toward a workpiece is accomplished automatically. In ultrasonic machining, a tool located just above a workpiece and vibrating in a vertical direction imparts vertical movement to particles of abrasive material which then remove material from the workpiece. The tool does not contact the workpiece. Apparatus for moving the tool assembly vertically is provided such that it operates with a relatively small amount of friction. Adjustable counterbalance means is provided which allows the tool to be immobilized in its vertical travel. A downward force, termed overbalance force, is applied to the tool assembly. The overbalance force causes the tool to move toward the workpiece as material is removed from the workpiece.

Fundoplication

MedlinePlus

... with feeds. It is also harder for the child to burp after fundoplication, and if a gastrosomy feeding tube is in place, parents learn to open it to relieve the pressure. These problems may be temporary and respond to ...

Shaping oral feeding in a gastronomy tube-dependent child in natural settings.

PubMed

Gutentag, S; Hammer, D

2000-07-01

A 3-year-old medically fragile girl who refused to eat after prolonged and frequent hospitalizations was started on a feeding program in the home and school settings. She exhibited food aversions and received all nourishment via a gastronomy tube. Preevaluation observations of her feeding behavior revealed that she refused all presented drinks and foods. Treatment was two-fold. First, food acceptance was followed by social praise and access to preferred toy play, and second, food refusal and disruptive behaviors were ignored. Gagging, vomiting, and crying occurred periodically during initial feedings. In addition, there were medical complications during the course of treatment necessitating continuous modifications of the program. Results of a multiple-phase design showed marked increases in the amount of food consumed at home, which then generalized to the school setting.

Fundoplication and gastrostomy versus image-guided gastrojejunal tube for enteral feeding in neurologically impaired children with gastroesophageal reflux.

PubMed

Wales, Paul W; Diamond, Ivan R; Dutta, Sanjeev; Muraca, Sergio; Chait, Peter; Connolly, Bairbre; Langer, Jacob C

2002-03-01

Neurologically impaired children with gastroesophageal reflux (GER) usually are treated with a fundoplication and gastrostomy (FG); however, this approach is associated with a high rate of complications and morbidity. The authors evaluated the image-guided gastrojejunal tube (GJ) as an alternative approach for this group of patients. A retrospective review of 111 neurologically impaired patients with gastroesophageal reflux was performed. Patients underwent either FG (n = 63) or GJ (n = 48). All FGs were performed using an open technique by a pediatric surgeon, and all GJ tubes were placed by an interventional radiologist. The 2 groups were similar with respect to diagnosis, age, sex and indication for feeding tube. Patients in the GJ group were followed up for an average of 3.11 years, and those in the FG group for 5.71 years. The groups did not differ statistically with respect to most complications (bleeding, peritonitis, aspiration pneumonia, recurrent gastroesophageal reflux [GER], wound infection, failure to thrive, and death), subsequent GER related admissions, or cost. Children in the GJ group were more likely to continue taking antireflux medication after the procedure (P <.05). Also, there was a trend for GJ patients to have an increased incidence of bowel obstruction or intussusception (20.8% v 7.9%). Of the FG patients 36.5% experienced retching, and 12.7% experienced dysphagia. Eighty-five percent of patients in the GJ group experienced GJ tube-specific complications (breakage, blockage, dislodgment), and GJ tube manipulations were required an average of 1.68 times per year follow-up. Nine patients (14.3%) in the FG group had wrap failure, with 7 (11.1%) of these children requiring repeat fundoplication. In the GJ group, 8.3% of patients went on to require a fundoplication for persistent problems. A total of 14.5% of GJ patients had their tube removed by the end of the follow-up period because they no longer needed the tube for feeding. Image-guided gastrojejunal tubes are a reasonable alternative to fundoplication and gastrostomy for neurologically impaired children with GER. The majority can be inserted without general anesthesia. This technique failed in only 8.3% patients, and they subsequently required fundoplication. A total of 14.5% of GJ patients showed some spontaneous improvement and had their feeding tube removed. Each approach, however, still is associated with a significant complication rate. A randomized prospective study comparing these 2 approaches is needed. Copyright 2002 by W.B. Saunders Company.

The effect of gastrostomy tube feeding on body protein and bone mineralization in children with quadriplegic cerebral palsy.

PubMed

Arrowsmith, Fiona; Allen, Jane; Gaskin, Kevin; Somerville, Helen; Clarke, Samantha; O'Loughlin, Edward

2010-11-01

The aim of this study was to investigate the effect of gastrostomy tube feeding on body protein and bone mineralization in malnourished children with cerebral palsy (CP). Children aged between 4 and 18 years with spastic quadriplegic CP (Gross Motor Function Classification System level V) were recruited from the Children's Hospital at Westmead to participate in this prospective cohort study. The children had measurements of anthropometry (weight, height, and skinfold), bone mineral content (BMC) by dual-energy X-ray absorptiometry, and total body protein (TBP) by neutron activation analysis before and after gastrostomy tube feeding. Comparison data were collected prospectively from age-matched healthy children and extracted from databases for this study. A total of 21 children (nine females, 12 males) participated in the study (median age 8 y 5 mo; interquartile range [IQR] 6 y 9 mo-11 y 10 mo). The median length of time of gastrostomy feeding was 19.4 months (IQR 7.7-29.9 mo). Significant (p<0.05) improvements were found in the median values for weight (15.4-23.3 kg), weight standard deviation scores (SDS; -4.8 to -3.0), height (105.4-118.3 cm), per cent body fat (10.7-16.3), TBP (2.4-3.4 kg), TBP per cent predicted for height (83.4-99.0), and BMC (469-626 g). No significant increases were found in height SDS, TBP per cent predicted for age, or BMC SDS for age or height. Malnourished children with quadriplegic CP showed significant increases in body fat and protein with gastrostomy tube feeding. No significant change in bone mineralization predicted for age or height was observed. © The Authors. Journal compilation © Mac Keith Press 2010.

A preliminary study of the tolerance of healthy foals to a low residue enteral feeding solution.

PubMed

Kohn, C W; Knight, D A; Yvorchyk-St Jean, K E; Scaman, P A; Ruey, P R

1991-09-01

After a three day acclimatization period, six healthy, young (aged 4 to 20 days) orphan foals of mixed breeding were fed 100 per cent of their caloric needs (estimated at 523 kjoules/kg bodyweight [bwt] or 125 kcal/kg bwt/day) as a low residue isotonic feeding solution (LRF) for seven days. The solution provided 4.18 kjoules (1 kcal/ml) and was fortified with minerals and protein to meet estimated foal requirements. The solution was fed through an indwelling 12 French feeding tube. Five of the six foals completed the study; the loss of the sixth foal apparently was unrelated to the feeding protocol. The foals tolerated LRF well. Signs of intolerance were noted in two foals and were limited to flatulence, mild bloat and very mild abdominal pain associated with a decreased interval between two feedings during the first 48 h on 100 per cent LRF. Complete recovery without therapy occurred within 6 h and feedings were resumed. Growth in height and weight were comparable to published data for healthy foals raised with their dams. Feeding tubes were easily maintained with no apparent dysphagia, regurgitation or discomfort to foals. This low residue, calorically dense, isotonic feeding solution may be useful for enteral feeding of selected foals aged at least seven days.

Carnitine deficiency presenting with a decreased mental state in a patient with amyotrophic lateral sclerosis receiving long-term tube feeding: a case report.

PubMed

Isse, Naohi; Miura, Yoh; Obata, Toshiyuki; Takahara, Noriko

2013-12-30

L-carnitine is an important metabolic mediator involved in fatty acid transport. It is obtained from the diet, particularly from animal products, such as red meat. Previous reports have revealed that long-term tube feeding with a commercial product containing no or low levels of carnitine can lead to an altered mental state caused by hyperammonemia. A 72-year-old Japanese man had a 12-year history of amyotrophic lateral sclerosis. He was bedridden and had required mechanical ventilation and enteral tube feeding for 10 years at home. His main enteral solution was a commercial product that contained low carnitine levels, and he sometimes received coffee and homemade products such as miso soup. Our patient's ability to communicate gradually deteriorated over a period of one year. His serum total carnitine level was abnormally low, at 26.7μmol/L (normal range, 45 to 91μmol/L), but his ammonium level was normal. His mental state improved dramatically after starting L-carnitine supplementation (600mg twice daily). This case highlights the importance of avoiding carnitine deficiency in patients with amyotrophic lateral sclerosis undergoing long-term tube feeding. These patients experience progressive muscle atrophy that might cause impaired carnitine storage and might manifest as communication difficulties. Carnitine deficiency can be misdiagnosed as a progression of systemic muscle atrophy. Clinicians should be aware of this disorder and should consider periodically measuring carnitine levels, regardless of the patient's serum ammonium levels.

Failure to feed patients with anorexia nervosa and other perils and perplexities in the medical care of eating disorder patients.

PubMed

Powers, Pauline S; Cloak, Nancy L

2013-01-01

A 28 year old woman with anorexia nervosa was sent to an emergency room by her gastroenterologist for weakness and nausea following placement of a percutaneous endoscopic gastrostomy (PEG) tube, with a plan for admission to the hospital. She spent 2 days in the emergency room without receiving any nutrition, and was discharged home after being told that her laboratory tests and x-rays were normal. The following day, her gastroenterologist reviewed the x-rays and determined that she had a bowel obstruction, at which point she was admitted to the hospital, weighing 2 kg less than on her initial visit. A 26 year old woman with anorexia nervosa was prematurely discharged from a residential facility with a Dobhoff feeding tube in her small intestine. She developed dizziness and weakness and was admitted to the hospital, but did not receive any feeding during the 6 days she was there, despite documented blood sugars in the 30s. Apparently an early order for tube feeding was cancelled, for unclear reasons. Two days after discharge, she again developed weakness and returned to the emergency room with a letter from her physician stating that she required medical supervision for the initiation of feeding. However, she was discharged from the emergency room within hours, only to be re-admitted to the hospital the next day.

46 CFR 56.50-30 - Boiler feed piping.

Code of Federal Regulations, 2010 CFR

2010-10-01

... least two separate means of supplying feed water for the boilers. All feed pumps shall be fitted with... allowable stress for design purposes shall be selected as described in § 56.07-10(e) at a temperature not... for water tube boilers shall have fresh water connections only. Care shall be taken to prevent the...

46 CFR 56.50-30 - Boiler feed piping.

Code of Federal Regulations, 2011 CFR

2011-10-01

... least two separate means of supplying feed water for the boilers. All feed pumps shall be fitted with... allowable stress for design purposes shall be selected as described in § 56.07-10(e) at a temperature not... for water tube boilers shall have fresh water connections only. Care shall be taken to prevent the...

Predation mechanisms of Rapana venosa (Gastropoda: Muricidae) in different biotopes along the Black Sea coast.

PubMed

Kosyan, Alisa

2016-01-30

Mechanisms of feeding by the invasive gastropod Rapana venosa from different biotopes of 11 sites along the Black Sea coast are discussed. Two methods--edge-drilling and suffocation--are used, but the prevailing method in a particular biotope depends on the type of bivalve prey. Drill signs were present on almost all shells of Chamelea gallina, captured by rapa whelks in field conditions, while in a field experiment, only 11% of all empty Mytilus galloprovincialis had drilling signatures. The degree of radula abrasion was also dependent on the available bivalves: it was the highest in biotopes with C. gallina and juvenile mussels, and the lowest in biotopes with large mussels. Intermediate degrees of abrasion were observed in biotopes with mixed prey: C. gallina and Anadara kagoshimensis, C. gallina and mussels, or small and large mussels. Since we observed only initial signs of drilling, simultaneous application of boring and suffocation could take place. Copyright © 2015 Elsevier Ltd. All rights reserved.

HIGH-POWER TURBODRILL AND DRILL BIT FOR DRILLING WITH COILED TUBING

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robert Radtke; David Glowka; Man Mohan Rai

2008-03-31

Commercial introduction of Microhole Technology to the gas and oil drilling industry requires an effective downhole drive mechanism which operates efficiently at relatively high RPM and low bit weight for delivering efficient power to the special high RPM drill bit for ensuring both high penetration rate and long bit life. This project entails developing and testing a more efficient 2-7/8 in. diameter Turbodrill and a novel 4-1/8 in. diameter drill bit for drilling with coiled tubing. The high-power Turbodrill were developed to deliver efficient power, and the more durable drill bit employed high-temperature cutters that can more effectively drill hardmore » and abrasive rock. This project teams Schlumberger Smith Neyrfor and Smith Bits, and NASA AMES Research Center with Technology International, Inc (TII), to deliver a downhole, hydraulically-driven power unit, matched with a custom drill bit designed to drill 4-1/8 in. boreholes with a purpose-built coiled tubing rig. The U.S. Department of Energy National Energy Technology Laboratory has funded Technology International Inc. Houston, Texas to develop a higher power Turbodrill and drill bit for use in drilling with a coiled tubing unit. This project entails developing and testing an effective downhole drive mechanism and a novel drill bit for drilling 'microholes' with coiled tubing. The new higher power Turbodrill is shorter, delivers power more efficiently, operates at relatively high revolutions per minute, and requires low weight on bit. The more durable thermally stable diamond drill bit employs high-temperature TSP (thermally stable) diamond cutters that can more effectively drill hard and abrasive rock. Expectations are that widespread adoption of microhole technology could spawn a wave of 'infill development' drilling of wells spaced between existing wells, which could tap potentially billions of barrels of bypassed oil at shallow depths in mature producing areas. At the same time, microhole coiled tube drilling offers the opportunity to dramatically cut producers' exploration risk to a level comparable to that of drilling development wells. Together, such efforts hold great promise for economically recovering a sizeable portion of the estimated remaining shallow (less than 5,000 feet subsurface) oil resource in the United States. The DOE estimates this U.S. targeted shallow resource at 218 billion barrels. Furthermore, the smaller 'footprint' of the lightweight rigs utilized for microhole drilling and the accompanying reduced drilling waste disposal volumes offer the bonus of added environmental benefits. DOE analysis shows that microhole technology has the potential to cut exploratory drilling costs by at least a third and to slash development drilling costs in half.« less

Empirically supported treatments for feeding difficulties in young children.

PubMed

Davis, Ann McGrath; Bruce, Amanda; Cocjin, Jose; Mousa, Hayat; Hyman, Paul

2010-06-01

Pediatric feeding problems are common among children and present severe issues for families. Unfortunately, treatment outcome studies with this population are sparse. The current study reviews the literature regarding treatment studies of children with severe feeding issues, provides an overview of empirically supported treatments for children who do eat orally, and finally summarizes interventions that attempt to reintroduce oral feeding to children who have been fed by gastrostomy tube or other non-oral feeding route.

Enteral feeding and its impact on family mealtime routines for caregivers of children with cerebral palsy: A mixed method study.

PubMed

Russell, Marion; Jewell, Vanessa; Poskey, Gail A; Russell, Asa

2018-02-01

Enteral feedings are part of the daily mealtime experience for many caregivers of children with cerebral palsy. The scope of occupational therapy practice incorporates multiple aspects of the enteral feeding process. Yet, the research in this area is very limited. The purpose of this study was to provide practitioners with better understanding of the impact enteral feedings of children with cerebral palsy have on family mealtime routines. Using a complimentary mixed method approach, data were obtained through an online survey containing the Satisfaction Questionnaire with Gastrostomy Feeding (SAGA-8) and supplementary questions, and qualitative semi-structured phone interviews. Participants were caregivers of children with cerebral palsy who receive their primary nutrition through a gastrostomy tube. This study's cohort consisted of n = 36, SAGA-8, and n = 6 in-depth interviews. The mean age of children of was 9.4 (6.94 SD) with a mean age of 3.4 (5.35 SD) when enteral feeding was introduced. While families' overall situations positively changed after the gastronomy tube placement, environmental barriers and length of feeding time continued to present a challenge to mealtime routines. The mixed methods data analysis revealed that successful adjustment to having a child with a gastronomy tube and problem solving are closely linked and a consistent part of mealtime experience. Findings highlighted the necessity of comprehensive support from health professionals in achieving positive mealtime experience. Themes in this study indicated that caregivers would benefit from a professional with knowledge in the development and integration of rituals and routines to support positive outcomes. © 2017 Occupational Therapy Australia.

In re Visbeck.

PubMed

1986-02-04

The Superior Court of New Jersey ordered the appointment of a guardian to consent to implantation of a feeding tube for a 90-year-old patient who had suffered a severely disabling stroke, though her son had not agreed to the proposed procedure. The court reasoned that a patient who becomes incompetent does not lose the right to accept or refuse medical treatment; instead, a substitute or surrogate decision maker exercises the patient's right of consent. Without the surgical implantation of a feeding tube in the patient's stomach, she would have suffered death from dehydration and starvation.

Influence of particle shedding from silicone tubing on antibody stability.

PubMed

Saller, Verena; Hediger, Constanze; Matilainen, Julia; Grauschopf, Ulla; Bechtold-Peters, Karoline; Mahler, Hanns-Christian; Friess, Wolfgang

2018-05-01

Peristaltic pumps are increasingly employed during fill & finish operations of a biopharmaceutical drug, due to sensitivity of many biological products to rotary piston pump-related stresses. Yet, possibly also unit operations using peristaltic pumps may shed particulates into the final product due to abrasion from the employed tubing. It was the aim of this study to elucidate the potential influence of particles shed from peristaltic pump tubing on the stability of a drug product. Spiking solutions containing shed silicone particles were prepared via peristaltic pumping of placebo under recirculating conditions and subsequently characterized. Two formulated antibodies were spiked with two realistic, but worst-case levels of particles and a 6-month accelerated stability study with storage at 2-8, 25 and 40°C were conducted. Regarding the formation of aggregates and fragments, both mAbs degraded at their typically expected rates and no additional impact of spiked particles was observed. No changes were discerned however in turbidity, subvisible and visible particle assessments. Flow imaging data for one of the mAb formulations with spiked particles suggested limited colloidal stability of shed particles as indicated by a similar increase in spiked placebo. Shed silicone particles from peristaltic pump tubing are assumed to not impair drug product stability. © 2016 Royal Pharmaceutical Society.

Intermittent At-Home Suctioning of Esophageal Content for Prevention of Recurrent Aspiration Pneumonia in 4 Dogs with Megaesophagus.

PubMed

Manning, K; Birkenheuer, A J; Briley, J; Montgomery, S A; Harris, J; Vanone, S L; Gookin, J L

2016-09-01

Megaesophagus carries a poor to guarded prognosis due to death from aspiration pneumonia. Options for medical management of regurgitation are limited to strategic oral or gastrostomy tube feeding. To describe the use and efficacy of intermittent esophageal suctioning to prevent regurgitation and associated episodes of aspiration pneumonia in dogs with megaesophagus. Four dogs with acquired idiopathic megaesophagus and recurrent aspiration pneumonia. Retrospective review of medical records of dogs with megaesophagus in which intermittent suctioning of esophageal content was employed for management of recurrent aspiration pneumonia. Intermittent suctioning of the esophagus was initiated in 4 dogs after failure of strict gastrostomy tube feeding failed to prevent regurgitation and repeated episodes of aspiration pneumonia. Suctioning was accomplished by esophagostomy tube in 3 dogs and per os in 1 dog. After initiation of esophageal suctioning, dogs survived for a median of 13.5 additional months (range, 10-30 months) during which time 2 dogs had no additional episodes of aspiration pneumonia and 2 dogs had infrequent episodes of pneumonia, but aspiration was suspected to be a contributing factor in their death. Complications included clogging of the esophagostomy tube, esophagostomy site infections, and esophagitis. Use of intermittent esophageal suctioning in dogs with megaesophagus that continue to regurgitate despite gastrostomy tube feedings can reduce or abolish clinical episodes of aspiration pneumonia. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Pulsatile delivery of a leucine supplement during long-term continuous enteral feeding enhances lean growth in term neonatal pigs

USDA-ARS?s Scientific Manuscript database

Neonatal pigs are used as a model to study and optimize the clinical treatment of infants who are unable to maintain oral feeding. Using this model, we have previously shown that pulsatile administration of leucine during continuous feeding over 24 h via orogastric tube enhanced protein synthesis in...

Chronic subclinical perforation of a duodenal ulcer presenting with an abdominal abscess in a patient with seronegative rheumatoid arthritis.

PubMed

Ashfaq, Awais; Chapital, Alyssa B

2015-07-06

Peptic ulcer disease has been a major problem since the turn of this century with high morbidity and mortality. Perforation is less common, with an estimated incidence of 7-10 per 100 000. We present a young woman with rheumatoid arthritis presenting with anaemia. On work up, she was found to have a chronic abdominal abscess secondary to subclinical perforation of a duodenal ulcer. After undergoing percutaneous drainage, she became haemodynamically unstable and was taken for surgical washout and jejunostomy tube placement. A week later she had a decrease in the size of the abscess and was discharged home with drain and tube feeds. At her follow-up a few weeks later, she was tolerating goal tube feeds. 2015 BMJ Publishing Group Ltd.

Propellant Feed System for Swirl-Coaxial Injection

NASA Technical Reports Server (NTRS)

Reynolds, David Christopher (Inventor)

2015-01-01

A propellant feed system for swirl-coaxial injection of a liquid propellant includes a reservoir having a bottom plate and at least one tube originating in the bottom plate and extending therefrom. The tube has rectangular slits defined in and distributed tangentially and evenly about a portion of the tube that is disposed in the bottom plate. Drain holes are provided in the bottom plate and tunnels are defined in the bottom plate. Each tunnel fluidly couples one of the drain holes to a corresponding one of the rectangular slits. Each tunnel includes (i) a bend of at least 90.degree., and (ii) a straight portion leading to its corresponding rectangular slit wherein the straight portion is at least five times as long as a hydraulic diameter of the corresponding rectangular slit.

Family Experiences With Feeding Tubes in Neurologic Impairment: A Systematic Review.

PubMed

Nelson, Katherine E; Lacombe-Duncan, Ashley; Cohen, Eyal; Nicholas, David B; Rosella, Laura C; Guttmann, Astrid; Mahant, Sanjay

2015-07-01

Gastrostomy tubes (G-tubes) are frequently used to provide enteral nutrition for children who have neurologic impairment. Understanding the impact of G-tubes from the family's perspective will inform decision-making and improve support from health care providers. This study explored the experiences of families after G-tube placement in children with neurologic impairment. We conducted a systematic review of English-language qualitative primary research studies describing family experiences after G-tube placement. Six electronic databases were searched from inception to June 2014. Two authors independently screened and identified relevant studies, evaluated quality of reporting by using the Consolidated Criteria for Reporting Qualitative Research tool, and extracted data. Overarching concepts were developed by using thematic analysis. From 2674 screened abstracts, 84 texts were reviewed, and 13 studies met the inclusion criteria. G-tubes affect the lives of children, parents, and the family unit in many ways, both positive and negative. Improvements and challenges were described for children's health and happiness, for parental caregiving and stress, and for logistics and bonding within the family. G-tube feeding also changed relationships within the family, between the family and the medical system, and between the family and the outside world. Furthermore, experiences varied, with different families framing similar concepts as positive and negative. G-tube placement has diverse effects on daily life for children with neurologic impairment and their families. Clinicians may use the themes identified in this study to guide conversations with families about their values, experiences, and expectations before and after G-tube placement. Copyright © 2015 by the American Academy of Pediatrics.

Comparison of three methods of feeding colostrum to dairy calves.

PubMed

Besser, T E; Gay, C C; Pritchett, L

1991-02-01

Absorption of colostral immunoglobulins by Holstein calves was studied in 3 herds in which 3 methods of colostrum feeding were used. Failure of passive transfer, as determined by calf serum immunoglobulin G1 (IgG1) concentration less than 10 mg/ml at 48 hours of age, was diagnosed in 61.4% of calves from a dairy in which calves were nursed by their dams, 19.3% of calves from a dairy using nipple-bottle feeding, and 10.8% of calves from a dairy using tube feeding. The management factor determined to have the greatest influence on the probability of failure of passive transfer in the herds using artificial methods of colostrum feeding (bottle feeding or tube feeding) was the volume of colostrum fed as it affected the amount of IgG1 received by the calf. In dairies that used artificial feeding methods, failure of passive transfer was infrequent in calves fed greater than or equal to 100 g IgG1 in the first colostrum feeding. In the dairy that allowed calves to suckle, prevalence of failure of passive transfer was greater than 50% even among calves nursed by cows with above-average colostral IgG1 concentration. Analysis of the effect of other management factors on calf immunoglobulin absorption revealed small negative effects associated with the use of previously frozen colostrum and the use of colostrum from cows with long nonlactating intervals.

Development and evaluation of an algorithm to facilitate drug prescription for inpatients with feeding tubes.

PubMed

Lohmann, Kristina; Freigofas, Julia; Leichsenring, Julian; Wallenwein, Chantal Marie; Haefeli, Walter Emil; Seidling, Hanna Marita

2015-04-01

We aimed to develop and evaluate an algorithm to facilitate drug switching between primary and tertiary care for patients with feeding tubes. An expert consortium developed an algorithm and applied it manually to 267 preadmission drugs of 46 patients admitted to a surgical ward of a tertiary care university hospital between June 12 and December 2, 2013, and requiring a feeding tube during their inpatient stay. The new algorithm considered the following principles: Drugs should be ideally listed on the hospital drug formulary (HDF). Additionally, drugs should include the same ingredient instead of a therapeutic equivalent. Preferred dosage forms were appropriate liquids, followed by solid drugs with liquid administration form, and solid drugs that could be crushed and/or suspended. Of all evaluated drugs, 83.5% could be switched to suitable drugs listed on the HDF and another 6.0% to drugs available on the German drug market. Additionally, for 4.1% of the drugs, the integration of individual switching rules allowed the switch from enteric-coated to immediate-release drugs. Consequently, 6.4% of the drugs could not be automatically switched and required case-to-case decision by a clinical professional (e.g., from sustained-release to immediate-release). The predefined principles were successfully integrated in the new algorithm. Thus, the algorithm switched more than 90% of the evaluated preadmission drugs to suitable drugs for inpatients with feeding tubes. This finding suggests that the algorithm can readily be transferred to an electronic format and integrated into a clinical decision support system.

Treatment of spontaneous esophageal rupture with transnasal thoracic drainage and temporary esophageal stent and jejunal feeding tube placement.

PubMed

Wu, Gang; Zhao, Yan Shi; Fang, Yi; Qi, Yu; Li, Xiangnan; Jiao, Dechao; Ren, Kewei; Han, Xinwei

2017-01-01

Spontaneous rupture of the esophagus is a rare but life-threatening thoracic emergency, with high rates of clinical misdiagnosis and mortality. This article summarizes our experience in the treatment of spontaneous esophageal rupture with transnasal thoracic drainage and temporary esophageal stent and jejunal feeding tube placement. We retrospectively assessed the medical records of 19 patients with spontaneous esophageal rupture treated using our intervention protocol. Patients received local anesthesia and sedation prior to undergoing transnasal drainage catheter placement into the thoracic abscess cavity, followed by temporary esophageal stent and jejunal feeding tube placement. After the operation, abscess lavage, nutritional support, and anti-inflammatory treatment were given. The transnasal thoracic drainage catheter, esophageal stent, and feeding tube were removed after the healing of the abscess cavity. In all, 19 covered esophageal stents were placed in 19 patients with spontaneous esophageal rupture. All operations were technically successful. After an average of 84.06 days, the stents were successfully removed from 17 patients. No cases of massive hemorrhage, esophageal rupture, or other complications occurred during stent removal. An 82-year-old patient died of heart failure 2 months after the operation. One patient died of sudden massive hematemesis and hematochezia 55 days after the operation. In one patient, the esophageal injury failed to heal completely. Our treatment protocol is simple, minimally invasive, and efficacious and may be an alternative for patients who are not candidates for surgery, have a high risk of postoperative complications, or wish to undergo minimally invasive surgery. Therapeutic study, level V.

A protocol of early aggressive acceleration of tube feeding increases ileus without perceptible benefit in severely burned patients.

PubMed

Kesey, Jennifer; Dissanaike, Sharmila

2013-01-01

Optimal nutrition is essential to the recovery of burned patients. The authors evaluated the efficacy of an aggressive nutrition delivery protocol. The following protocol was implemented: initiation of tube feeds within 4 hours, acceleration to goal rate within 8 hours, and tolerance of gastric residual volumes of 400 ml. Patients on the protocol formed the study group whereas patients admitted immediately before implementation served as controls for a study period of 7 days after admission. Outcome variables included ileus, prokinetic medication use, intensive care unit and overall length of stay, ventilator days and mortality. Variables were compared using bivariate analysis. The 42 study subjects and 34 controls were similar at baseline. Time to initiation was similar (6.8 vs 9.4 hours; P = .226), however, goal rate was achieved much sooner in the study group (11.2 vs 20.9 hours; P < .001). Number of hours spent at goal was different on days 1 and 2 (6.62 vs 2.74, P = .003 and 17.24 vs 13.18, P = .032) with no difference thereafter. Residual volumes in the study group were higher from day 2 onward, and remained increased throughout the study period (401 vs 234 ml average; P = .449). Clinical ileus was much more common in the study group (8 cases vs 1, P = .037). There was no difference in length of stay or mortality. The protocol was successfully implemented and resulted in early achievement of goal tube feed rates. However, this resulted in tube feed intolerance as manifested by more cases of clinical ileus.

Enteral Feeding During Chemoradiotherapy for Advanced Head-and-Neck Cancer: A Single-Institution Experience Using a Reactive Approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clavel, Sebastien, E-mail: sebastien.clavel@umontreal.c; Fortin, Bernard; Despres, Philippe

Purpose: The optimal method for providing enteral nutrition to patients with head-and-neck cancer is unclear. The purpose of the present study was to evaluate the safety and efficacy of our reactive policy, which consists of the installation of a nasogastric (NG) feeding tube only when required by the patient's nutritional status. Methods and Materials: The records of all patients with Stage III and IV head-and-neck cancer treated with concomitant chemotherapy and radiotherapy between January 2003 and December 2006 were reviewed. The overall and disease-free survival rates were estimated using the Kaplan-Meier method and compared with the log-rank test. Results: Themore » present study included 253 patients, and the median follow-up was 33 months. At 3 years, the estimated overall survival and disease-free survival rate was 82.8% and 77.8%, respectively, for the whole population. No survival difference was observed when the patients were compared according to the presence and absence of a NG tube or stratified by weight loss quartile. The mean weight loss during treatment for all patients was 10.4%. The proportion of patients requiring a NG tube was 49.8%, and the NG tube remained in place for a median duration of 40 days. No major complications were associated with NG tube installation. Only 3% of the patients were still dependent on enteral feeding at 6 months. Conclusion: These results suggest that the use of a reactive NG tube with an interdisciplinary team approach is a safe and effective method to manage malnutrition in patients treated with concomitant chemotherapy and radiotherapy for head-and-neck cancer.« less

Electromagnetic-guided placement of nasoduodenal feeding tubes versus endoscopic placement: a randomized, multicenter trial.

PubMed

Kappelle, Wouter F W; Walter, Daisy; Stadhouders, Paul H; Jebbink, Hendrik J A; Vleggaar, Frank P; van der Schaar, Peter J; Kappelle, Jan Willem; van der Tweel, Ingeborg; Van den Broek, Medard F M; Wessels, Frank J; Siersema, Peter D; Monkelbaan, Jan F

2018-01-01

Electromagnetic-guided placement (EMP) of a nasoduodenal feeding tube by trained nurses is an attractive alternative to EGD-guided placement (EGDP). We aimed to compare EMP and EGDP in outpatients, ward patients, and critically ill patients with normal upper GI anatomy. In 3 centers with no prior experience in EMP, patients were randomized to placement of a single-lumen nasoduodenal feeding tube either with EGDP or EMP. The primary endpoint was post-pyloric position of the tube on abdominal radiography. Patients were followed for 10 days to assess patency and adverse events. The analyses were performed according to the intention-to-treat principle. In total, 160 patients were randomized to EGDP (N = 76) or EMP (N = 84). Three patients withdrew informed consent, and no abdominal radiography was performed in 2 patients. Thus, 155 patients (59 intensive care unit, 38%) were included in the analyses. Rates of post-pyloric tube position between EGDP and EMP were comparable (79% vs 82%, odds ratio 1.16; 90% confidence interval, 0.58-2.38; P = .72). Adverse events were observed in 4 patients after EMP (hypoxia, GI blood loss, atrial fibrillation, abdominal pain) and in 4 after EGDP (epistaxis N = 2, GI blood loss, hypoxia). Costs of tube placements were lower for EMP compared with EGDP: $519.09 versus $622.49, respectively (P = .04). Success rates and safety of EMP and EGDP in patients with normal upper GI anatomy were comparable. Lower costs and potential logistic advantages may drive centers to adopt EMP as their new standard of care. (Clinical trial registration number: NTR4286.). Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Implementation of the evidence review on best practice for confirming the correct placement of nasogastric tube in patients in an acute care hospital.

PubMed

Tho, Poh Chi; Mordiffi, Siti; Ang, Emily; Chen, Helen

2011-03-01

Nasogastric (NG) tube is a device passed through the gastrointestinal tract of patients for the purpose of feeding, gastric decompression and medication administration. However, a small risk involved in the process is that the tube may be misplaced into the trachea during insertion or may get displaced at a later stage, leading to disastrous results. Recent adverse incidences arising out of the misplacement of NG tube raised concerns among the nursing and medical community and the Patient Safety Officer of the hospital. The Evidence Based Nursing Unit, in collaboration with some of the key nursing leaders in nursing administration, was tasked to explore and institute the current best practice in confirming the correct placement of NG tube. The aim of this project was to institute the best practice to confirm the correct placement of NG tube in patients in an acute care hospital setting. The project comprised of a few stages. The first stage involved reviewing the existing recommendations and guidelines on the methods for checking correct NG tube placement. The second stage involved incorporation of the change of practice into the clinical setting. The final stage was to monitor and evaluate the impact of the new practice on the patients, nurses and other healthcare professionals. Evidence search from guidelines and journals supported the test that used pH indicator instead of the litmus test. There is no evidence that supports the method of auscultation and bubbling to confirm correct NG tube placement in the absence of aspirate. Radiology remains the 'gold standard' for checking correct NG tube placement. The revised method of NG tube placement and workflow was incorporated in the revised Standard Operating Procedures. A total of 17 roadshows were conducted to create awareness regarding the new method amongst the nurses, and the implementation of the revised method and workflow was commenced on 3 November 2008. The initial audit conducted 1 month after the practice change was implemented reported 26 (50%) observations of NG tube feeding in 26 audit wards. The key areas of practice change in feeding when tube placement was confirmed (84.6%) and proper testing of aspirate (76.9%) showed good compliance. The implementation of the change in the practice of confirming the correct placement of the NG tube in patients requires good coordination and a multidisciplinary team approach. © 2011 The Authors. International Journal of Evidence-Based Healthcare © 2011 The Joanna Briggs Institute.

Electric controlled air incinerator for radioactive wastes

DOEpatents

Warren, Jeffery H.; Hootman, Harry E.

1981-01-01

A two-stage incinerator is provided which includes a primary combustion chamber and an afterburner chamber for off-gases. The latter is formed by a plurality of vertical tubes in combination with associated manifolds which connect the tubes together to form a continuous tortuous path. Electrically-controlled heaters surround the tubes while electrically-controlled plate heaters heat the manifolds. A gravity-type ash removal system is located at the bottom of the first afterburner tube while an air mixer is disposed in that same tube just above the outlet from the primary chamber. A ram injector in combination with rotary magazine feeds waste to a horizontal tube forming the primary combustion chamber.

Fuel cell integral bundle assembly including ceramic open end seal and vertical and horizontal thermal expansion control

DOEpatents

Zafred, Paolo R [Murrysville, PA; Gillett, James E [Greensburg, PA

2012-04-24

A plurality of integral bundle assemblies contain a top portion with an inlet fuel plenum and a bottom portion containing a base support, the base supports a dense, ceramic air exhaust manifold having four supporting legs, the manifold is below and connects to air feed tubes located in a recuperator zone, the air feed tubes passing into the center of inverted, tubular, elongated, hollow electrically connected solid oxide fuel cells having an open end above a combustion zone into which the air feed tubes pass and a closed end near the inlet fuel plenum, where the open end of the fuel cells rest upon and within a separate combination ceramic seal and bundle support contained in a ceramic support casting, where at least one flexible cushion ceramic band seal located between the recuperator and fuel cells protects and controls horizontal thermal expansion, and where the fuel cells operate in the fuel cell mode and where the base support and bottom ceramic air exhaust manifolds carry from 85% to all of the weight of the generator.

Morphological specializations of the buccal cavity in relation to the food and feeding habit of a carp Cirrhinus mrigala: a scanning electron microscopic investigation.

PubMed

Yashpal, Madhu; Kumari, Usha; Mittal, Swati; Mittal, Ajay Kumar

2009-06-01

The buccal cavity of an herbivorous fish, Cirrhinus mrigala, was investigated by scanning electron microscopy to determine its surface ultrastructure. The buccal cavity shows significant adaptive modifications in relation to food and feeding ecology of the fish. The buccal cavity of the fish is of modest size and limited capacity, which is considered an adaptation with respect to the small-sized food items primarily consumed by the fish that could be accommodated in a small space. Modification of surface epithelial cells, on the upper jaw, into characteristic structures-the unculi-is considered an adaptation to browse or scrap, to grasp food materials, e.g., algal felts, and to protect the epithelial surface against abrasions, likely to occur during their characteristic feeding behavior. Differentiation of the highly specialized lamellar organ on the anterior region of the palate could be an adaptation playing a significant role in the selection, retention, and sorting out of palatable food particles from the unpalatable items ingested by the fish. The filamentous epithelial projections and the lingulate epithelial projections on the palatal organ in the posterior region of the palate are considered to serve a critical function in final selection, handling, maneuvering, and propelling the food particles toward the esophagus. The abundance of different categories of taste buds in the buccal cavity suggests that gustation is well developed and the fish is highly responsive in the evaluation and the selection of the preferred palatable food items. The secretions of mucous cells in the buccal cavity are associated with multiple functions-particle entrapment, lubrication of the buccal epithelium and food particles to assist smooth passage of food, and to protect the epithelium from possible abrasion. These morphological characteristics ensure efficient working of the buccal cavity in the assessment of the quality and palatability of ingested food, their retention and transport toward the esophagus. Such an adaptation may be essential in conducting the function most basic to the survival of the individuals and species-feeding.

A Novel Approach to Improving Fat Delivery in Neonatal Enteral Feeding

PubMed Central

Jarjour, Jane; Juarez, Alexa M.; Kocak, Denizen K.; Liu, Nathan J.; Tabata, Mika M.; Hawthorne, Keli M.; Ramos, Renata F.; Abrams, Steven A.

2015-01-01

Continuous infusion systems used for enteral nutrition support in the neonatal intensive care unit deliver as little as 60% of the fat in human milk to the neonate. This study determined the effect of mixing common feedings for preterm infants in the feeding bag and tubing on fat losses during enteral feeding. Laboratory models were developed to assess the contribution of various mixing techniques to delivered fat content. Fat content was measured periodically during feeding and compared to baseline measurements. A multistage approach incorporating a feeding bag inverter and a tubing circulation loop delivered >90% of milk fat when used in conjunction with a commercial continuous infusion system. With unfortified human milk, this approach delivered 91.9% ± 1.5% of fat content over a one hour feed, significantly greater (p < 0.01) than 77.5% ± 2.2% delivered by continuous infusion controls (Mean ± SEM). With fortified human milk, this approach delivered 92.1% ± 2.4% of fat content, significantly greater (p < 0.01) than 79.4% ± 1.0% delivered by a non-adapted infusion system (Mean ± SEM). Mixing human milk during continuous infusion improves fat delivery, which may improve nutrition and growth outcomes in low birth weight neonates. PMID:26110253

Bidirectional, Automatic Coal-Mining Machine

NASA Technical Reports Server (NTRS)

Collins, Earl R., Jr.

1986-01-01

Proposed coal-mining machine operates in both forward and reverse directions along mine face. New design increases efficiency and productivity, because does not stop cutting as it retreats to starting position after completing pass along face. To further increase efficiency, automatic miner carries its own machinery for crushing coal and feeding it to slurry-transport tube. Dual-drum mining machine cuts coal in two layers, crushes, mixes with water, and feeds it as slurry to haulage tube. At end of pass, foward drum raised so it becomes rear drum, and rear drum lowered, becoming forward drum for return pass.

The grain-size distribution of pyroclasts: Primary fragmentation, conduit sorting or abrasion?

NASA Astrophysics Data System (ADS)

Kueppers, U.; Schauroth, J.; Taddeucci, J.

2013-12-01

Explosive volcanic eruptions expel a mixture of pyroclasts and lithics. Pyroclasts, fragments of the juvenile magma, record the state of the magma at fragmentation in terms of porosity and crystallinity. The grain size distribution of pyroclasts is generally considered to be a direct consequence of the conditions at magma fragmentation that is mainly driven by gas overpressure in bubbles, high shear rates, contact with external water or a combination of these factors. Stress exerted by any of these processes will lead to brittle fragmentation by overcoming the magma's relaxation timescale. As a consequence, most pyroclasts exhibit angular shapes. Upon magma fragmentation, the gas pyroclast mixture is accelerated upwards and eventually ejected from the vent. The total grain size distribution deposited is a function of fragmentation conditions and transport related sorting. Porous pyroclasts are very susceptible to abrasion by particle-particle or particle-conduit wall interaction. Accordingly, pyroclastic fall deposits with angular clasts should proof a low particle abrasion upon contact to other surfaces. In an attempt to constrain the degree of particle interaction during conduit flow, monomodal batches of washed pyroclasts have been accelerated upwards by rapid decompression and subsequently investigated for their grain size distribution. In our set-up, we used a vertical cylindrical tube without surface roughness as conduit. We varied grain size (0.125-0.25; 0.5-1; 1-2 mm), porosity (0; 10; 30 %), gas-particle ratio (10 and 40%), conduit length (10 and 28 cm) and conduit diameter (2.5 and 6 cm). All ejected particles were collected after settling at the base of a 3.3 m high tank and sieved at one sieve size below starting size (half-Φ). Grain size reduction showed a positive correlation with starting grain size, porosity and overpressure at the vent. Although milling in a volcanic conduit may take place, porous pyroclasts are very likely to be a primary product of magma fragmentation at or close to the fragmentation level. Given the high abrasiveness of pumice, hemispherical clasts should be observed if clast break-up followed efficient clast abrasion. As a consequence, finer grained pyroclastic fall deposits do not necessarily proof efficient secondary fragmentation in the conduit but may rather reveal the influence of conduit length on 'What size of pyroclasts can be erupted'?

Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: a systematic review.

PubMed

Langius, Jacqueline A E; Zandbergen, Myrna C; Eerenstein, Simone E J; van Tulder, Maurits W; Leemans, C René; Kramer, Mark H H; Weijs, Peter J M

2013-10-01

We performed a systematic review to examine the effect of nutritional interventions on nutritional status, quality of life (QoL) and mortality in patients with head and neck squamous cell cancer (HNSCC) receiving radiotherapy or chemoradiotherapy. We searched Pubmed, EMBASE, CENTRAL and Cinahl from inception through January 3rd, 2012 to identify randomized controlled trials (RCTs) from a broad range of nutritional interventions in patients with HNSCC during (chemo)radiotherapy. Two reviewers independently assessed study eligibility and risk of bias, and extracted data. Of 1141 titles identified, 12 study reports were finally included, describing 10 different studies with 11 interventions. Four out of 10 studies examined the effects of individualized dietary counseling, and showed significant benefits on nutritional status and QOL compared to no counseling or general nutritional advice by a nurse (p < 0.05). Three studies on oral nutritional supplements (ONS) were inconsistent about the effect on nutritional status compared with no supplementation. One study showed that nasogastric tube feeding had beneficial effects on nutritional status compared to ONS, but not in all patient groups (p < 0.04). One study showed benefits of percutaneous endoscopic gastronomy (PEG) feeding on nutritional status shortly after RT compared with nasogastric feeding (p = 0.001). Two studies showed that prophylactic PEG feeding was not superior over tube feeding if required. This review shows beneficial effects of individualized dietary counseling on nutritional status and QoL, compared to no counseling or standard nutritional advice. Effects of ONS and tube feeding were inconsistent. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Clinical utility of topiramate extended-release capsules (USL255): Bioequivalence of USL255 sprinkled and intact capsule in healthy adults and an in vitro evaluation of sprinkle delivery via enteral feeding tubes.

PubMed

Clark, Annie M; Pellock, John M; Holmay, Mary; Anders, Bob; Cloyd, James

2016-04-01

The objectives of these two studies were to determine if beads from extended-release topiramate capsules sprinkled onto soft food are bioequivalent to the intact capsule and if beads from the capsule can be passed through enteral gastrostomy (G-) and jejunostomy (J-) feeding tubes. Bioequivalence of 200-mg USL255 (Qudexy XR [topiramate] extended-release capsules) sprinkled onto soft food (applesauce) versus the intact capsule was evaluated in a phase 1, randomized, single-dose, crossover study (N=36). Pharmacokinetic evaluations included area under the curve (AUC), maximum plasma concentration (Cmax), time to Cmax (Tmax), and terminal elimination half-life (t1/2). If 90% confidence intervals (CI) of the ratio of geometric least-squares means were between 0.80 and 1.25, AUC and Cmax were considered bioequivalent. In separate in vitro experiments, 100-mg USL255 beads were passed through feeding tubes using gentle syringe pressure to develop a clog-free bead-delivery method. Multiple tube sizes (14- to 18-French [Fr] tubes), dilutions (5 mg/15 mL-25 mg/15 mL), and diluents (deionized water, apple juice, Ketocal, sparkling water) were tested. Area under the curve and Cmax for USL255 beads sprinkled onto applesauce were bioequivalent to the intact capsule (GLSM [90% CI]: AUC0-t 1.01 [0.97-1.04], AUC0-∞ 1.02 [0.98-1.05]; Cmax 1.09 [1.03-1.14]). Median Tmax was 4h earlier for USL255 sprinkled versus the intact capsule (10 vs 14 h; p=0.0018), and t1/2 was similar (84 vs 82 h, respectively). In 14-Fr G-tubes, USL255 beads diluted in Ketocal minimized bead clogging versus deionized water. Recovery of USL255 beads diluted in deionized water was nearly 100% in 16-Fr G-, 18-Fr G-, and 18-Fr J-tubes. For patients with difficulty swallowing pills, USL255 sprinkled onto applesauce offers a useful once-daily option for taking topiramate. USL255 beads were also successfully delivered in vitro through ≥14-Fr G- or J-tubes, with tube clogging minimized by portioning the dose and using glidant diluents for smaller tubes. Copyright © 2016 Upsher-Smith Laboratories, Inc. Published by Elsevier Inc. All rights reserved.

Influence of contamination on bonding to zirconia ceramic.

PubMed

Yang, Bin; Scharnberg, Michael; Wolfart, Stefan; Quaas, Anne C; Ludwig, Klaus; Adelung, Rainer; Kern, Matthias

2007-05-01

The purpose of this study was to investigate the influences of contaminations and cleaning methods on bonding to dental zirconia ceramic. After saliva immersion and using silicone disclosing agent, airborne-particle abraded ceramic specimens were cleaned with isopropanol (AL), acetone (AC), 37% phosphoric acid (PA), additional airborne-particle abrasion (AA), or only with water rinsing (SS). Airborne-particle abraded specimens without contaminations (CL) were used as control group. For chemical analysis specimens of all groups were examined with X-ray photoelectron spectroscopy (XPS). Plexiglas tubes filled with composite resin were bonded to ceramic specimens using a phosphate-monomer containing composite luting resin. After 3-day water storage, tensile bond strengths (TBS) were tested. XPS analysis of group SS showed the presence of saliva and silicone (Si) contamination on the surface. The ratios of carbon/zirconium and oxygen/zirconium for groups PA and AA were comparable to those ratios obtained for group CL, indicating the removal of the organic saliva contamination. Airborne-particle abrasion and acetone completely removed Si contamination from ceramic surfaces. Isopropanol had little cleaning effect on the two contaminants. TBS (median +/- standard deviation) in MPa of the groups SS (11.6 +/- 3.1), AL (10.0 +/- 2.9), and AC (13.0 +/- 2.8) were statistically lower than those of groups PA (33.6 +/- 5.5), AA (40.1 +/- 3.6), and CL (47.0 +/- 8.1) (p < 0.001), while no differences were found in TBS between groups AA and CL (p > 0.5). Contamination significantly reduced bond strengths to zirconia ceramic. Airborne-particle abrasion was the most effective cleaning method.

The molecular characterisation of Escherichia coli K1 isolated from neonatal nasogastric feeding tubes.

PubMed

Alkeskas, Aldukali; Ogrodzki, Pauline; Saad, Mohamed; Masood, Naqash; Rhoma, Nasreddin R; Moore, Karen; Farbos, Audrey; Paszkiewicz, Konrad; Forsythe, Stephen

2015-10-26

The most common cause of Gram-negative bacterial neonatal meningitis is E. coli K1. It has a mortality rate of 10-15 %, and neurological sequelae in 30-50 % of cases. Infections can be attributable to nosocomial sources, however the pre-colonisation of enteral feeding tubes has not been considered as a specific risk factor. Thirty E. coli strains, which had been isolated in an earlier study, from the residual lumen liquid and biofilms of neonatal nasogastric feeding tubes were genotyped using pulsed-field gel electrophoresis, and 7-loci multilocus sequence typing. Potential pathogenicity and biofilm associated traits were determined using specific PCR probes, genome analysis, and in vitro tissue culture assays. The E. coli strains clustered into five pulsotypes, which were genotyped as sequence types (ST) 95, 73, 127, 394 and 2076 (Achman scheme). The extra-intestinal pathogenic E. coli (ExPEC) phylogenetic group B2 ST95 serotype O1:K1:NM strains had been isolated over a 2 week period from 11 neonates who were on different feeding regimes. The E. coli K1 ST95 strains encoded for various virulence traits associated with neonatal meningitis and extracellular matrix formation. These strains attached and invaded intestinal, and both human and rat brain cell lines, and persisted for 48 h in U937 macrophages. E. coli STs 73, 394 and 2076 also persisted in macrophages and invaded Caco-2 and human brain cells, but only ST394 invaded rat brain cells. E. coli ST127 was notable as it did not invade any cell lines. Routes by which E. coli K1 can be disseminated within a neonatal intensive care unit are uncertain, however the colonisation of neonatal enteral feeding tubes may be one reservoir source which could constitute a serious health risk to neonates following ingestion.

Attempted mechanical transfer of Ehrlichia risticii by tabanids (Diptera: Tabanidae).

PubMed

Levine, J F; Levy, M G; Nicholson, W L; Irby, W S; Gager, R; Apperson, C S

1992-09-01

The ability of tabanid mouthparts to retain and to transfer mechanically Ehrlichia risticii Holland, Weiss, Burgdorfer, Cole & Kakoma was evaluated by feeding flies on infected and noninfected mice and on capillary tubes containing infected cells and cell-free medium. Flies representing two genera and 29 species were collected at equine boarding stables, farms, and along riding trails in Wake, Johnston, and Duplin counties in North Carolina for the feeding trials. Two species, Tabanus fulvulus Wiedemann and T. pallidescens Philip, fed on mice but failed to transfer the pathogen from infected to susceptible mice. Chrysops vittatus Wiedemann, Tabanus americanus Forster, and T. sulcifrons Macquart transferred E. risticii-infected cells from capillary tubes containing infected cells in medium to tubes containing medium. These studies document that E. risticii-infected cells can be retained on mouthparts and potentially transferred by tabanids.

Use of proton pump inhibitors is associated with increased mortality due to nosocomial pneumonia in bedridden patients receiving tube feeding.

PubMed

Hamai, Kosuke; Iwamoto, Hiroshi; Ohshimo, Shinichiro; Wakabayashi, Yu; Ihara, Daisuke; Fujitaka, Kazunori; Hamada, Hironobu; Ono, Koichi; Hattori, Noboru

2018-05-22

To investigate the association between the use of proton pump inhibitors (PPI) and nosocomial pneumonia and gastrointestinal bleeding in bedridden patients receiving tube feeding. A total of 116 bedridden hospitalized patients receiving tube feeding, of which 80 were supported by percutaneous endoscopic gastrostomy and 36 by nasogastric tube, were included in the present study. The patients were divided into two groups: 62 patients treated with PPI (PPI group) and 54 patients without PPI (non-PPI group). Mortality due to nosocomial pneumonia was evaluated using the Kaplan-Meier approach and the log-rank test. A total of 36 patients (31%) died of nosocomial pneumonia during the observation period; the mortality rate due to nosocomial pneumonia was significantly higher in the PPI group than in the non-PPI group (P = 0.0395). Cox proportional hazard analysis showed that the use of PPI and lower levels of serum albumin were independent predictors of 2-year mortality due to nosocomial pneumonia. Gastrointestinal bleeding was observed in four patients in the non-PPI group (7.7%) and in one patient in the PPI group (1.6%); there was no significant difference between the two groups. The use of PPI in bedridden tube-fed patients was independently associated with mortality due to nosocomial pneumonia, and the PPI group had a non-significant lower incidence of gastrointestinal bleeding than the non-PPI group. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

Simple blood-feeding method for live imaging of gut tube remodeling in regenerating planarians.

PubMed

Hosoda, Kazutaka; Morimoto, Mizuki; Motoishi, Minako; Nishimura, Osamu; Agata, Kiyokazu; Umesono, Yoshihiko

2016-04-01

Live cell imaging is a powerful technique to study cellular dynamics in vivo during animal development and regeneration. However, few live imaging methods have been reported for studying planarian regeneration. Here, we developed a simple method for steady visualization of gut tube remodeling during regeneration of a living freshwater planarian, Dugesia japonica. When planarians were fed blood several times, gut branches were well-visualized in living intact animals under normal bright-field illumination. Interestingly, tail fragments derived from these colored planarians enabled successive observation of the processes of the formation of a single anterior gut branch in the prepharyngeal region from the preexisting two posterior gut branches in the same living animals during head regeneration. Furthermore, we combined this method and RNA interference (RNAi) and thereby showed that a D. japonica raf-related gene (DjrafA) and mek-related gene (DjmekA) we identified both play a major role in the activation of extracellular signal-regulated kinase (ERK) signaling during planarian regeneration, as indicated by their RNAi-induced defects on gut tube remodeling in a time-saving initial screening using blood-feeding without immunohistochemical detection of the gut. Thus, this blood-feeding method is useful for live imaging of gut tube remodeling, and provides an advance for the field of regeneration study in planarians. © 2016 Japanese Society of Developmental Biologists.

Sample Containerization and Sealing Techniques for Contamination Prevention and Preservation of Science Value for Mars Sample Return

NASA Astrophysics Data System (ADS)

Younse, Paulo

Four sealing methods for encapsulating samples in 1 cm diameter thin-walled sample tubes were designed, along with a set of tests for characterization and evaluation of contamination prevention and sample preservation capability for the proposed Mars Sample Return (MSR) campaign. The sealing methods include a finned shape memory alloy (SMA) plug, expanding torque plug, contracting SMA ring cap, and expanding SMA ring plug. Mechanical strength and hermeticity of the seal were measured using a helium leak detector. Robustness of the seal to Mars simulant dust, surface abrasion, and pressure differentials were tested. Survivability tests were run to simulate thermal cycles on Mars, vibration from a Mars Ascent Vehicle (MAV), and shock from Earth Entry Vehicle (EEV) landing. Material compatibility with potential sample minerals and organic molecules were studied to select proper tube and seal materials that would not lead to adverse reactions nor contaminate the sample. Cleaning and sterilization techniques were executed on coupons made from the seal materials to assess compliance with planetary protection and contamination control. Finally, a method to cut a sealed tube for sample removal was designed and tested.

Feeding method and health outcomes of children with cerebral palsy.

PubMed

Rogers, Brian

2004-08-01

Disorders of feeding and swallowing are common in children with cerebral palsy. Feeding and swallowing disorders have significant implications for development, growth and nutrition, respiratory health, gastrointestinal function, parent-child interaction, and overall family life. Assessments need to be comprehensive in scope and centered around the medical home. Oral feeding interventions for children with cerebral palsy may be effective in promoting oral motor function, but have not been shown to be effective in promoting feeding efficiency or weight gain. Feeding gastrostomy tubes are a reasonable alternative for children with severe feeding and swallowing problems who have had poor weight gain. Copyright 2004 Elsevier Inc.

Crashworthiness of Aluminium Tubes; Part 2: Improvement of Hydroforming Operation to Increase Absorption Energy

DOE Office of Scientific and Technical Information (OSTI.GOV)

D'Amours, Guillaume; Rahem, Ahmed; Mayer, Robert

2007-05-17

The motivation to reduce overall vehicle weight within the automotive sector drives the substitution of lightweight materials such as aluminium alloys for structural components. Such a substitution requires a significant amount of development to manufacture structurally parts such that the energy absorption characteristics are not sacrificed in the event of crash. The effects of the manufacturing processes on the crash performance of automotive structural components must be better understood to ensure improved crashworthiness. This paper presents results of an experimental and numerical investigation of the crash response and energy absorption properties of impacted hydroformed aluminium alloy tubes. Crash experiments onmore » hydroformed tubes were performed using a deceleration sled test at the General Motors Technical Center. Results from axial crush testing showed that an important parameter that influences the energy absorption characteristics during crash was the thickness reduction caused by circumferential expansion of the tube during hydroforming. It was found that that the energy absorption decreased as the corner radius decreased, which results because of increased thinning. Sensitivity studies of end feeding parameters, such as end feed level and profile, were carried out to evaluate their impact on the energy absorption of the aluminium tubes.« less

Reversible and irreversible wrinkling in tube hydroforming process

NASA Astrophysics Data System (ADS)

El-Aty, Ali Abd; Ahmed, Tauseef; Farooq, Ahmed

2017-07-01

The aim of this research is to analyzeandoptimize the hydroforming process parameters in order to achieve a sound bulged tube without failure. Theoretical constitutive model is formulated to develop a working diagram including process window, which represents the optimize region to carry out the hydroforming process and predict the type of tube failure during the process accurately. The model is applied into different bulging ratios for low carbon steel (C1010). From this study, it is concluded that the tubes with bulging ratios up to 50% and 70% are successfully formed without defects. The tubes with bulging ratio of 90% are successfully formed by hydroforming with optimized the loading path (axial feed versus internal pressure) within the process window. The working diagram is modified due to different types of formation of wrinkling during the hydroforming process. The formation of wrinkles with increasing axial feed can be useful in terms of the achievement of higher bulging ratio and/or less thinning and this type of wrinkles can be overcome through the internal pressure in the later stage of the hydroforming process. On the other hand, the formation of wrinkles may be harmful, if it cannot be reversed.

Crashworthiness of Aluminium Tubes; Part 2: Improvement of Hydroforming Operation to Increase Absorption Energy

NASA Astrophysics Data System (ADS)

D'Amours, Guillaume; Rahem, Ahmed; Mayer, Robert; Williams, Bruce; Worswick, Michael

2007-05-01

The motivation to reduce overall vehicle weight within the automotive sector drives the substitution of lightweight materials such as aluminium alloys for structural components. Such a substitution requires a significant amount of development to manufacture structurally parts such that the energy absorption characteristics are not sacrificed in the event of crash. The effects of the manufacturing processes on the crash performance of automotive structural components must be better understood to ensure improved crashworthiness. This paper presents results of an experimental and numerical investigation of the crash response and energy absorption properties of impacted hydroformed aluminium alloy tubes. Crash experiments on hydroformed tubes were performed using a deceleration sled test at the General Motors Technical Center. Results from axial crush testing showed that an important parameter that influences the energy absorption characteristics during crash was the thickness reduction caused by circumferential expansion of the tube during hydroforming. It was found that that the energy absorption decreased as the corner radius decreased, which results because of increased thinning. Sensitivity studies of end feeding parameters, such as end feed level and profile, were carried out to evaluate their impact on the energy absorption of the aluminium tubes.

A Behavior Analysis Approach toward Chronic Food Refusal in Children with Gastrostomy-Tube Dependency.

ERIC Educational Resources Information Center

Luiselli, James K.; Luiselli, Tracy Evans

1995-01-01

This report describes a behavior analysis treatment approach to establishing oral feeding in children with multiple developmental disabilities and gastrostomy-tube dependency. Pretreatment screening, functional assessment, and treatment are reported as implemented within a behavioral consultation model. A case study illustrates the sequence and…

Hannah's Feeding Journey: A Multidisciplinary Treatment Approach to Establishing Oral Acceptance for a Toddler with a Complex Medical History

ERIC Educational Resources Information Center

Dunn, Dena M.; Galbally, Sandra Lynn; Markowitz, Goldie; Pucci, Kristy N.; Brochi, Ligia; Cohen, Sherri Shubin

2017-01-01

This article presents the importance of multidisciplinary, family-centered care, and a developmental bio-psycho-social approach to treating feeding difficulties in a child with a complex medical history. Hannah spent the first 9 months of her life in the hospital and was discharged dependent on nasogastric tube feeding. Her journey to recovery…

Improving post-stroke dysphagia outcomes through a standardized and multidisciplinary protocol: an exploratory cohort study.

PubMed

Gandolfi, Marialuisa; Smania, Nicola; Bisoffi, Giulia; Squaquara, Teresa; Zuccher, Paola; Mazzucco, Sara

2014-12-01

Stroke is a major cause of dysphagia. Few studies to date have reported on standardized multidisciplinary protocolized approaches to the management of post-stroke dysphagia. The aim of this retrospective cohort study was to evaluate the impact of a standardized multidisciplinary protocol on clinical outcomes in patients with post-stroke dysphagia. We performed retrospective chart reviews of patients with post-stroke dysphagia admitted to the neurological ward of Verona University Hospital from 2004 to 2008. Outcomes after usual treatment for dysphagia (T- group) were compared versus outcomes after treatment under a standardized diagnostic and rehabilitative multidisciplinary protocol (T+ group). Outcome measures were death, pneumonia on X-ray, need for respiratory support, and proportion of patients on tube feeding at discharge. Of the 378 patients admitted with stroke, 84 had dysphagia and were enrolled in the study. A significantly lower risk of in-hospital death (odds ratio [OR] 0.20 [0.53-0.78]), pneumonia (OR 0.33 [0.10-1.03]), need for respiratory support (OR 0.48 [0.14-1.66]), and tube feeding at discharge (OR 0.30 [0.09-0.91]) was recorded for the T+ group (N = 39) as compared to the T- group (N = 45). The adjusted OR showed no difference between the two groups for in-hospital death and tube feeding at discharge. Use of a standardized multidisciplinary protocolized approach to the management of post-stroke dysphagia may significantly reduce rates of aspiration pneumonia, in-hospital mortality, and tube feeding in dysphagic stroke survivors. Consistent with the study's exploratory purposes, our findings suggest that the multidisciplinary protocol applied in this study offers an effective model of management of post-stroke dysphagia.

Attachment of and biofilm formation by Enterobacter sakazakii on stainless steel and enteral feeding tubes.

PubMed

Kim, Hoikyung; Ryu, Jee-Hoon; Beuchat, Larry R

2006-09-01

Enterobacter sakazakii has been reported to form biofilms, but environmental conditions affecting attachment to and biofilm formation on abiotic surfaces have not been described. We did a study to determine the effects of temperature and nutrient availability on attachment and biofilm formation by E. sakazakii on stainless steel and enteral feeding tubes. Five strains grown to stationary phase in tryptic soy broth (TSB), infant formula broth (IFB), or lettuce juice broth (LJB) at 12 and 25 degrees C were examined for the extent to which they attach to these materials. Higher populations attached at 25 degrees C than at 12 degrees C. Stainless steel coupons and enteral feeding tubes were immersed for 24 h at 4 degrees C in phosphate-buffered saline suspensions (7 log CFU/ml) to facilitate the attachment of 5.33 to 5.51 and 5.03 to 5.12 log CFU/cm(2), respectively, before they were immersed in TSB, IFB, or LJB, followed by incubation at 12 or 25 degrees C for up to 10 days. Biofilms were not produced at 12 degrees C. The number of cells of test strains increased by 1.42 to 1.67 log CFU/cm(2) and 1.16 to 1.31 log CFU/cm(2) in biofilms formed on stainless steel and feeding tubes, respectively, immersed in IFB at 25 degrees C; biofilms were not formed on TSB and LJB at 25 degrees C, indicating that nutrient availability plays a major role in processes leading to biofilm formation on the surfaces of these inert materials. These observations emphasize the importance of temperature control in reconstituted infant formula preparation and storage areas in preventing attachment and biofilm formation by E. sakazakii.

Use and efficacy of a nutrition protocol for patients with burns in intensive care.

PubMed

Lown, D

1991-01-01

The University of Michigan Burn Center uses a protocol to standardize the assessment, initiation, and monitoring of nutritional support for patients with burns of greater than 30% total body surface area (TBSA). Six patients with 20% to 80% TBSA burns were followed for 3 weeks to determine the effect of the protocol on the assessment, initiation, monitoring, and adequacy of nutritional support. The protocol calls for resting energy expenditure (REE) measurement within 24 hours of injury, to be repeated 3 times per week, for assessment of caloric requirements. Patients experienced an average delay before first REE measurement of 3 days after burn injury because measurements were unavailable on weekends and surgical days. REE measurements were used to determine caloric requirements and to tailor nutritional support to fluctuating metabolic needs. In four of the six patients a Dobhoff feeding tube (Biosearch Medical Products, Inc., Somerville, N.J.) was placed in the small bowel and enteral nutrition was initiated within 24 hours of admission, as outlined in the protocol. Two patients received concurrent parenteral nutrition because of difficulty in placing the Dobhoff feeding tube when fluoroscopy was not available. The three patients receiving nutrition solely through enteral feeding had achieved 100% of their caloric requirements by day 2, 4, and greater than 7 days after injury, respectively. Overall, the six patients received enterally an average of 75% of their caloric requirements. The major reason for inadequate enteral support was interruption of tube feedings because of tube dislodgment or multiple surgical procedures. The protocol used weekly measurements of total iron-binding capacity and prealbumin level s parameters of nutritional support.(ABSTRACT TRUNCATED AT 250 WORDS)

Opportunistic Feeding Strategy for the Earliest Old World Hypsodont Equids: Evidence from Stable Isotope and Dental Wear Proxies

PubMed Central

Tütken, Thomas; Kaiser, Thomas M.; Vennemann, Torsten; Merceron, Gildas

2013-01-01

Background The equid Hippotherium primigenium, with moderately hypsodont cheek teeth, rapidly dispersed through Eurasia in the early late Miocene. This dispersal of hipparions into the Old World represents a major faunal event during the Neogene. The reasons for this fast dispersal of H. primigenium within Europe are still unclear. Based on its hypsodonty, a high specialization in grazing is assumed although the feeding ecology of the earliest European hipparionines within a pure C3 plant ecosystem remains to be investigated. Methodology/Principal Findings A multi-proxy approach, combining carbon and oxygen isotopes from enamel as well as dental meso- and microwear analyses of cheek teeth, was used to characterize the diet of the earliest European H. primigenium populations from four early Late Miocene localities in Germany (Eppelsheim, Höwenegg), Switzerland (Charmoille), and France (Soblay). Enamel δ13C values indicate a pure C3 plant diet with small (<1.4‰) seasonal variations for all four H. primigenium populations. Dental wear and carbon isotope compositions are compatible with dietary differences. Except for the Höwenegg hipparionines, dental microwear data indicate a browse-dominated diet. By contrast, the tooth mesowear patterns of all populations range from low to high abrasion suggesting a wide spectrum of food resources. Conclusions/Significance Combined dental wear and stable isotope analysis enables refined palaeodietary reconstructions in C3 ecosystems. Different H. primigenium populations in Europe had a large spectrum of feeding habits with a high browsing component. The combination of specialized phenotypes such as hypsodont cheek teeth with a wide spectrum of diet illustrates a new example of the Liem’s paradox. This dietary flexibility associated with the capability to exploit abrasive food such as grasses probably contributed to the rapid dispersal of hipparionines from North America into Eurasia and the fast replacement of the brachydont equid Anchitherium by the hypsodont H. primigenium in Europe. PMID:24040254

What Is the Evidence for Use of a Supplemental Feeding Tube Device as an Alternative Supplemental Feeding Method for Breastfed Infants?

PubMed

Penny, Frances; Judge, Michelle; Brownell, Elizabeth; McGrath, Jacqueline M

2018-02-01

According to the Healthy People 2020 goals, the sustainability of breastfeeding duration rates within the United States has not been achieved. To increase these rates, it is important that women with breastfeeding difficulties receive the support needed to continue breastfeeding. When supplementation occurs, it is essential that the breastfeeding relationship be preserved. Various methods of supplementation are often recommended including use of the supplemental feeding tube device (SFTD). The question guiding this brief is "What evidence exists to support the use of an SFTD as a method of supplementation for breastfed infants?" The PubMed and CINAHL databases were queried for original research published in English from 1990 through July 2016. Search terms included "supplemental feeding tube," "breastfeeding," "term infants," "premature infants," "Supplemental Nursing System," "Lact-aid," and "supply line." Very limited research exists on the use of SFTDs as a method of supplementation for breastfed infants; however, existing research suggests that an SFTD may be useful as a supplementation method for breastfed infants. High-quality research is needed to evaluate the efficacy of using an SFTD for supporting exclusive and all breastfeeding rates. Nurses and providers need to be educated and trained in the use of SFTDs as well as all supplemental feeding methods. Information on efficacy and SFTD use should also be included in policies related to breastfeeding and human milk use. Further research should determine best methods of supplementation for breastfed infants and should examine differences in breastfeeding rates when using the SFTD for supplementation.

Weight-for-height values and limb anthropometric composition of tube-fed children with quadriplegic cerebral palsy.

PubMed

Kong, Chi-Keung; Wong, Heung-Sang Stephen

2005-12-01

Research has shown that growth retardation among children with quadriplegic cerebral palsy (CP) is often attributed to feeding dysfunction and malnutrition. The study compared weight-for-height values and limb anthropometric composition of nasogastric and gastrostomy tube-fed children with quadriplegic CP with those of orally fed children with quadriplegic CP and normal children, to examine the plausible effects of tube feeding on weight-for-height, fat, and muscle values for children with quadriplegic CP. Triceps, anterior mid-thigh, and medial calf skinfold thicknesses and the corresponding circumferences of the right or less affected side were measured. The subjects consisted of 119 normal children and 62 orally fed and 48 tube-fed children with quadriplegic CP. Body weight and height were recorded. For children with CP whose height could not be measured, height was estimated from the ulna length. Weight-for-height z scores, limb skinfold thicknesses, fat areas, skinfold-corrected muscle girths, and muscle areas of the children were compared. Tube-fed children with CP had normal mean weight-for-height z scores. Weight-for-height z scores of the orally fed children with CP were significantly below those of normal children and tube-fed children with CP. For children with CP, whereas triceps skinfold thickness seemed to predict the mid-upper arm fat area correctly, leg skinfold thicknesses seemed to overestimate the corresponding fat areas. Stepwise multiple regression analysis showed that triceps skinfold thicknesses had good correlation (r = 0.86) and the presence of CP had nonsignificant correlation with mid-upper arm fat areas. Multiple regression analysis of fat areas with skinfold thicknesses and the presence of CP, however, showed that CP was correlated negatively (partial correlation of CP: thigh, -0.45; calf, -0.53) with thigh and calf fat areas. Although skinfold-corrected mid-upper arm muscle girths of children with CP were quite similar to those of normal children, leg muscle girths were much reduced for both orally fed and tube-fed children with CP. The apparent thickening of leg skinfold thicknesses among children with CP probably was attributable to disproportional leg muscle wasting, with resulting reduced internal circumference of the subcutaneous fat layer. For tube-fed children with CP, skinfold thicknesses and fat areas were increased significantly, although their leg skinfold-corrected muscle girths and areas remained reduced. Skinfold thickness may overestimate the fat area in the affected limb with significant muscle wasting for children with CP. The condition was particularly obvious in the leg, where muscle wasting was prominent. Because leg muscles represent approximately one quarter of the normal body weight, low weight-for-height values among children with CP can be caused by leg muscle wasting attributable to disuse atrophy, which is unlikely to be correctable with tube feeding. Tube feeding may improve body weight mainly through fat deposition.

FLUID MECHANICS AND TANKAGE DESIGN FOR LOW GRAVITY ENVIRONMENT

DTIC Science & Technology

tankage delivers only single-phase propellants. The requirements for feed systems of electric engines are described briefly. Also, the 1.85-second drop...direction of mass transfer in tapered tubes and liquid-vapor interface shapes in an annular space between concentric cylinders. Possible feed systems

Feed-through connector couples RF power into vacuum chamber

NASA Technical Reports Server (NTRS)

Grandy, G. L.

1967-01-01

Feed-through device connects RF power to an RF coil in a vacuum chamber. The coil and leads are water cooled and vacuum tight seals are provided at the junctions. The device incorporates silver soldered copper tubes, polytetrafluoroethylene electrical insulators, and O-ring vacuum seals.

Quality factors, antioxidant activity, and sensory properties of jet-tube dried rabbiteye blueberries.

PubMed

Pallas, Laura A; Pegg, Ronald B; Kerr, William L

2013-06-01

Rabbiteye blueberries are an excellent source of nutrients and phytochemicals. They are often dried, which can degrade health-promoting compounds. Means of shortening exposure to high-temperature drying air are desirable. Five cultivars of rabbiteye blueberries ('Premier', 'Tifblue', 'Brightwell', 'Alapaha', and 'Powderblue') were dried in a jet-tube fluidized bed air dryer with varying pretreatments including mechanical abrasion and osmotic dehydration. Drying time ranged from 66 to 95 min at 107 °C, achieving a final water activity of 0.347-0.605. Prior osmotic dehydration significantly reduced the drying time. Vacuum osmotic dehydration for 70 min achieved similar moisture contents to soaking blueberries for 24 h. Jet-tube dried blueberries exhibited greater color saturation than commercially available blueberries. While drying reduced the total monomeric anthocyanin (TMA) content, this occurred to a lesser extent than by other processing methods. The total phenolics content (TPC) and antioxidant capacity (H-ORACFL values) increased after drying. 'Premier' was the most preferred vacuum-infused dried blueberry, with a water activity (aw) of 0.53 and 157 g H2O kg(-1). 'Tifblue' was most preferred amongst the overnight-infused and also unsweetened dried blueberries. Jet-tube drying can substantially reduce drying times while yielding blueberries with good color, sensory properties, TMA, TPC, and H-ORACFL values. Furthermore, some cultivars produce better-quality dried blueberries than others. © 2012 Society of Chemical Industry.

Devise of an exhaust gas heat exchanger for a thermal oil heater in a palm oil refinery plant

NASA Astrophysics Data System (ADS)

Chucherd, Panom; Kittisupakorn, Paisan

2017-08-01

This paper presents the devise of an exhaust gas heat exchanger for waste heat recovery of the exhausted flue gas of palm oil refinery plant. This waste heat can be recovered by installing an economizer to heat the feed water which can save the fuel consumption of the coal fired steam boiler and the outlet temperature of flue gas will be controlled in order to avoid the acid dew point temperature and protect the filter bag. The decrease of energy used leads to the reduction of CO2 emission. Two designed economizer studied in this paper are gas in tube and water in tube. The gas in tube exchanger refers to the shell and tube heat exchanger which the flue gas flows in tube; this designed exchanger is used in the existing unit. The new designed water in tube refers to the shell and tube heat exchanger which the water flows in the tube; this designed exchanger is proposed for new implementation. New economizer has the overall coefficient of heat transfer of 19.03 W/m2.K and the surface heat transfer area of 122 m2 in the optimized case. Experimental results show that it is feasible to install economizer in the exhaust flue gas system between the air preheater and the bag filter, which has slightly disadvantage effect in the system. The system can raise the feed water temperature from 40 to 104°C and flow rate 3.31 m3/h, the outlet temperature of flue gas is maintained about 130 °C.

[Study of bacterial flora in the oral cavity and stomach of elderly patients receiving nasogastric tube feeding].

PubMed

Matsuura, T; Suzuki, K; Yamakoshi, M; Yamamoto, T; Yamamoto, T; Yoshitomo, K; Tonegawa, K; Ariga, K; Odawara, F

1997-05-01

To investigate the significance of oropharyngeal flora and gastric flora in elderly patients receiving nasogastric tube feeding, throat secretions and gastric aspirates were cultured and the pH of the latter was measured. Of 116 bacterial isolates from throat secretions of 27 elderly patients, 30 were beta-streptococci and 28 were Pseudomonas aeruginosa. Bacteria isolated from gastric aspirates numbered 86 and 24 (27.9%) of them were the same species as those found in the throat secretions. Patients with gastric pH were below 3.5 had significantly lower concentrations of gram-negative bacili in gastric aspirates. We also studied oropharyngeal flora in 33 elderly patients who were admitted to Nagoyashi Koseiin Geriatric Hospital. The major bacterial isolates from throat swabs of bedridden patients were gram-negative bacilli and beta-streptococci, especially group B streptococci (GBS). We measured the level of antibody to GBS in these patients. Those from whom GBS were isolated had high titers. These results suggest that in elderly patients receiving enteral nasogastric) tube feeding, large numbers of bacteria colonize the oral cavity and stomach. The measurement of type-specific antibody to GBS may be useful in managing such patients.

Use of scanning electron microscopy to monitor nanofibre/cell interaction in digestive epithelial cells.

PubMed

Millaku, Agron; Drobne, Damjana; Torkar, Matjaz; Novak, Sara; Remškar, Maja; Pipan-Tkalec, Živa

2013-09-15

We provide data obtained by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) on the interaction of ingested tungsten nanofibers with epithelial cells of the digestive tubes of a test organism Porcellio scaber. Conventional toxicity endpoints including feeding behaviour, weight loss and mortality were also measured in each investigated animal. No toxicity was detected in any of exposed animals after 14 days of feeding on tungsten nanofiber dosed food, but when nanofibers enter the digestive system they can react with epithelial cells of the digestive tubes, becoming physically inserted into the cells. In this way, nanofibers can injure the epithelial cells of digestive gland tubes when they are ingested with food. Our SEM data suggest that peristaltic forces may have an important role, not predicted by in vitro experiments, in the interactions of nanomaterials with digestive intestinal cells. Copyright © 2013 Elsevier B.V. All rights reserved.

Predictors for gut colonization of carbapenem-resistant Enterobacteriaceae in neonates in a neonatal intensive care unit.

PubMed

Singh, Narendra Pal; Choudhury, Debapriya Das; Gupta, Kavita; Rai, Sumit; Batra, Prerna; Manchanda, Vikas; Saha, Rituparna; Kaur, I R

2018-06-01

With the emergence of carbapenem-resistant isolates, the therapeutic alternatives have become limited. Various factors are responsible for carbapenem-resistant Enterobacteriaceae (CRE) gut colonization. This study was conducted to determine predictors for CRE gut colonization in neonates who were hospital delivered and admitted in a neonatal intensive care unit (NICU). Three rectal swabs were collected from 300 hospital-delivered and NICU-admitted neonates (likely to stay for >3 days). The data collected for the possible risk factors for CRE gut colonization were namely mode of delivery, prolonged rupture of membrane >18 hours, period of gestation, birth weight, meconium-stained liquor, ventilation, intravenous catheter, nasogastric (NG) tube, NG feeding, breastfeeding, katori spoon feeding, top feeding, expressed breastmilk, antibiotics administration, and duration of hospitalization. P < .05 was considered as statistically significant. A total of 26 cases of CRE were isolated from 300 neonates. Statistically significant risk factors were found to be NG tube, breastfeeding, NG feeding, top feeding, expressed breastmilk, ventilation, antibiotic administration, and duration of hospitalization. Top feeding and antibiotics administration were identified as 2 independent risk factors by multiple logistic regression. Active surveillance of cultures from hospitalized patients and implementation of preventive efforts can reduce the risk of CRE. Copyright © 2018. Published by Elsevier Inc.

Feeding outcomes in infants after supraglottoplasty.

PubMed

Eustaquio, Marcia; Lee, Erika Nevin; Digoy, G Paul

2011-11-01

Review the impact of bilateral supraglottoplasty on feeding and compare the risk of postoperative feeding difficulties between infants with and without additional comorbidities. Case series with chart review. Children's hospital. The medical records of all patients between birth and 12 months of age treated for laryngomalacia with bilateral supraglottoplasty by a single surgeon (GPD) between December 2005 and September 2009 and followed for a minimum of 1 month were reviewed. Infants with significant comorbidities were evaluated separately. Nutritional intake before and after surgery, as well as speech and language pathology reports, was reviewed to qualify any feeding difficulties. Age at the time of surgery, additional surgical interventions, medical comorbidities, and length of follow-up were also noted during chart review. Of 81 infants who underwent bilateral supraglottoplasty, 75 were eligible for this review. In the cohort of infants without comorbidities, 46 of 48 (96%) had no change or an improvement in their oral intake after surgery. Of the 2 patients with initial worsening of feeding, all resumed oral intake within 2 months. In the group of patients with additional medical comorbidities, 22% required further interventions such as nasogastric tube, dietary modification, or gastrostomy tube placement. Supraglottoplasty in infants has a low incidence of persistent postoperative dysphagia. Infants with additional comorbidities are at a higher risk of feeding difficulty than otherwise healthy infants.

Implementation of an electromagnetic imaging system to facilitate nasogastric and post-pyloric feeding tube placement in patients with and without critical illness.

PubMed

Windle, E M; Beddow, D; Hall, E; Wright, J; Sundar, N

2010-02-01

Artificial nutrition support is required to optimise nutritional status in many patients. Traditional methods of placing feeding tubes may incur clinical risk and financial costs. A technique facilitating placement of nasogastric and post-pyloric tubes via electromagnetic visual guidance may reduce the need for X-ray exposure, endoscopy time and the use of parenteral nutrition. The present study aimed to audit use of such a system at initial implementation in patients within an acute NHS Trust. A retrospective review was undertaken of dietetic and medical records for the first 14 months of using the Cortrak system. Data were collected on referral origin, preparation of the patient prior to insertion, placement success rates and need for X-ray. Cost analysis was also performed. Referrals were received from primary consultants or consultant intensivists, often on the advice of the dietitian. Fifty-nine percent of patients received prokinetic therapy at the time of placement. Thirty-nine tube placements were attempted. Sixty-nine percent of referrals for post-pyloric tube placement resulted in successful placement. X-ray films were requested for 22% of all attempted post-pyloric placements. Less than half of nasogastric tubes were successfully passed, although none of these required X-ray confirmation. The mean cost per tube insertion attempt was 111 pounds. This system confers advantages, particularly in terms of post-pyloric tube placement, even at this early stage of implementation. A reduction in clinical risk and cost avoidance related to X-ray exposure, the need for endoscopic tube placement and parenteral nutrition have been achieved. The implementation of this system should be considered in other centres.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koyfman, Shlomo A., E-mail: koyfmas@ccf.org; Adelstein, David J.

Definitive chemoradiation therapy has evolved as the preferred organ preservation strategy in the treatment of locally advanced head-and-neck cancer (LA-HNC). Dry mouth and dysphagia are among the most common and most debilitating treatment-related toxicities that frequently necessitate the placement of enteral feeding tubes (FT) in these patients to help them meet their nutritional requirements. The use of either a percutaneous endoscopic gastrostomy tube or a nasogastric tube, the choice of using a prophylactic vs a reactive approach, and the effects of FTs on weight loss, hospitalization, quality of life, and long-term functional outcomes are areas of continued controversy. Considerable variationsmore » in practice patterns exist in the United States and abroad. This critical review synthesizes the current data for the use of enteral FTs in this patient population and clarifies the relative advantages of different types of FTs and the timing of their use. Recent developments in the biologic understanding and treatment approaches for LA-HNC appear to be favorably impacting the frequency and severity of treatment-related dysphagia and may reduce the need for enteral tube feeding in the future.« less

Effect of the collector tube profile on Pitot pump performances

NASA Astrophysics Data System (ADS)

Komaki, K.; Kanemoto, T.; Sagara, K.; Umekage, T.

2013-12-01

The pitot pump is composed of the rotating casing with the impeller channel and the pitot tube type collector as the discharge line. The radial impeller feeds water to the rotating casing. The water rotating together with the casing is caught by the stationary pitot tube type collector, and then discharges to the outside. This type pump, as the extra high head pump, is provided mainly for boiler feed systems, and has been designed by trial and error. To optimize the pump profiles, it is desirable to investigate not only performances but also internal flow conditions. This paper discusses experimentally and numerically the relation between the pump performances and the flow conditions in the rotating casing. The moderately larger dimensions of the collector make the pump head and the discharge high with the higher hydraulic efficiency. The flow in the casing is almost the forced vortex type whose velocity is in proportion to the radius but the core velocity is affected with the drag force of the stationary collector. Based upon the above results, the profile of the pitot tube type collector was optimized with the numerical simulation.

Schlieren Imaging of a Single-Ejector, Multi-Tube Pulsed Detonation Engine (Postprint)

DTIC Science & Technology

2009-01-01

studies have shown the potential of an ejector to almost double the thrust of a pulsed detonation engine ( PDE ) tube [1-3]. Axial misalignment of the... Detonation Research Facility in the Air Force Research Laboratory were used for this study. The PDE utilizes automotive valving to feed up to four... detonation tubes. The damped thrust stand was setup to measure PDE thrust alone for baseline tests or total thrust from ejector and PDE . This

Use of an esophagostomy tube as a method of nutritional management in raptors: a case series.

PubMed

Huynh, Minh; Sabater, Mikel; Brandão, João; Forbes, Neil A

2014-03-01

We determined if esophagostomy tube placement is feasible for nutritional support in raptors. The clinical data were reviewed from 18 raptors admitted between 2006 and 2012, and in which esophagostomy tubes were placed. Indications for tube placement, complications associated with its placement and management, duration of treatment, and changes in patient body weight were evaluated. The most common indication was nutritional and medical support in stressed hospitalized animals, and intensive care cases. Complications were regurgitation, unexpected removal, and misplacement of the tube. The esophagostomy tube was well tolerated in all but 2 cases. A tube was replaced once in 2 patients. Five birds died during the treatment course. Mortality was not associated with the placement of the tube. Average duration of tube placement was 6.1 +/- 3.7 days. Most birds did not gain any weight with use of the feeding tubes. Esophagostomy tubes are well tolerated in raptors, but further studies are needed to demonstrate their efficiency.

Enteral feeding: drug/nutrient interaction.

PubMed

Lourenço, R

2001-04-01

Enteral nutrition support via a feeding tube is the first choice for artificial nutrition. Most patients also require simultaneous drug therapy, with the potential risk for drug-nutrient interactions which may become relevant in clinical practice. During enteral nutrition, drug-nutrient interactions are more likely to occur than in patients fed orally. However, there is a lack of awareness about its clinical significance, which should be recognised and prevented in order to optimise nutritional and pharmacological therapeutic goals of safety and efficacy. To raise the awareness of potential drug-nutrient interactions and influence on clinical outcomes. To identify factors that can promote drug-nutrient interactions and contribute to nutrition and/or therapeutic failure. To be aware of different types of drug-nutrient interactions. To understand complex underlying mechanisms responsible for drug-nutrient interactions. To learn basic rules for the administration of medications during tube-feeding. Copyright 2001 Harcourt Publishers Ltd.

PEG tubes: dealing with complications.

PubMed

Malhi, Hardip; Thompson, Rosie

A percutaneous endoscopic gastronomy tube can be used to deliver nutrition, hydration and medicines directly into the patient's stomach. Patients will require a tube if they are unable to swallow safely, putting them at risk of aspiration of food, drink and medicines into their lungs. It is vital that nurses are aware of the complications that may arise when caring for a patient with a PEG tube. It is equally important that nurses know how to deal with these complications or from where tc seek advice. This article provides a quick troubleshooting guide to help nurses deal with complications that can arise with PEG feeding.

Comparison of a RELAP5/MOD2 posttest calculation to the data during the recovery portion of a semiscale single-tube steam generator tube rupture experiment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chapman, J.C.

This report discusses the comparisons of a RELAP5 posttest calculation of the recovery portion of the Semiscale Mod-2B test S-SG-1 to the test data. The posttest calculation was performed with the RELAP5/MOD2 cycle 36.02 code without updates. The recovery procedure that was calculated mainly consisted of secondary feed and steam using auxiliary feedwater injection and the atmospheric dump valve of the unaffected steam generator (the steam generator without the tube rupture). A second procedure was initiated after the trends of the secondary feed and steam procedure had been established, and this was to stop the safety injection that had beenmore » provided by two trains of both the charging and high pressure injection systems. The Semiscale Mod-2B configuration is a small scale (1/1705), nonnuclear, instrumented, model of a Westinghouse four-loop pressurized water reactor power plant. S-SG-1 was a single-tube, cold-side, steam generator tube rupture experiment. The comparison of the posttest calculation and data included comparing the general trends and the driving mechanisms of the responses, the phenomena, and the individual responses of the main parameters.« less

BOILING WATER REACTOR WITH FEED WATER INJECTION NOZZLES

DOEpatents

Treshow, M.

1963-04-30

This patent covers the use of injection nozzles for pumping water into the lower ends of reactor fuel tubes in which water is converted directly to steam. Pumping water through fuel tubes of this type of boiling water reactor increases its power. The injection nozzles decrease the size of pump needed, because the pump handles only the water going through the nozzles, additional water being sucked into the tubes by the nozzles independently of the pump from the exterior body of water in which the fuel tubes are immersed. The resulting movement of exterior water along the tubes holds down steam formation, and thus maintains the moderator effectiveness, of the exterior body of water. (AEC)

Palliative treatment of inoperable patients with carcinoma of the cardia region.

PubMed

Seifert, E; Reinhard, A; Lütke, A; Gail, K

1983-02-01

Endoscopic palliative treatment of inoperable patients with carcinoma of the cardia region is superior to surgical procedures that allow the feeding of patients. After dilating the malignant stenosis with an Eder-Puestow dilator, a Celestin or Atkinson tube is inserted endoscopically by means of the Nottingham introducer. In 25 of 26 patients the inserted tube functioned well until the death of the patient for an average of 109 days. Six patients are still alive and one patient has had the tube for almost 3 years. Of the 19 patients who died, 18 retained the tube until they died. The complication rate of the procedure was 11.5% with a 3.8% mortality related to tube insertion.

Abrasive rolling effects on material removal and surface finish in chemical mechanical polishing analyzed by molecular dynamics simulation

NASA Astrophysics Data System (ADS)

Si, Lina; Guo, Dan; Luo, Jianbin; Lu, Xinchun; Xie, Guoxin

2011-04-01

In an abrasive chemical mechanical polishing (CMP) process, materials were considered to be removed by abrasive sliding and rolling. Abrasive sliding has been investigated by many molecular dynamics (MD) studies; while abrasive rolling was usually considered to be negligible and therefore was rarely investigated. In this paper, an MD simulation was used to study the effects of abrasive rolling on material removal and surface finish in the CMP process. As the silica particle rolled across the silicon substrate, some atoms of the substrate were dragged out from their original positions and adhered to the silica particle, leaving some atomic vacancies on the substrate surface. Meanwhile, a high quality surface could be obtained. During the abrasive rolling process, the influencing factors of material removal, e.g., external down force and driving force, were also discussed. Finally, MD simulations were carried out to examine the effects of abrasive sliding on material removal under the same external down force as abrasive rolling. The results showed that the ability of abrasive rolling to remove material on the atomic scale was not notably inferior to that of abrasive sliding. Therefore, it can be proposed that both abrasive sliding and rolling play important roles in material removal in the abrasive CMP of the silicon substrate.

Study on design of light-weight super-abrasive wheel

NASA Astrophysics Data System (ADS)

Nohara, K.; Yanagihara, K.; Ogawa, M.

2018-01-01

Fixed-abrasive tool, also called a grinding wheel, is produced by furnacing abrasive compound which contains abrasive grains and binding powder such as vitrified materials or resins. Fixed-abrasive tool is installed on spindle of grinding machine. And it is given 1,800-2,000 min-1 of spindle rotation for the usage. The centrifugal fracture of the compound of fixed- abrasive tool is one of the careful respects in designing. In recent years, however, super-abrasive wheel as a fixed-abrasive tool has been developed and applied widely. One of the most characteristic respects is that metal is applied for the body of grinding-wheel. The strength to hold abrasive grain and the rigidity of wheel become stronger than those of general grinding wheel, also the lifespan of fixed-abrasive tool becomes longer. The weight of fixed-abrasive tool, however, becomes heavier. Therefore, when the super-abrasive wheel is used, the power consumption of spindle motor becomes larger. It also becomes difficult for the grinding-wheel to respond to sudden acceleration or deceleration. Thus, in order to reduce power consumption in grinding and to obtain quicker frequency response of super-abrasive wheel, the new wheel design is proposed. The design accomplishes 46% weight reduction. Acceleration that is one second quicker than that of conventional grinding wheel is obtained.

Effect of cleaning methods after reduced-pressure air abrasion on bonding to zirconia ceramic.

PubMed

Attia, Ahmed; Kern, Matthias

2011-12-01

To evaluate in vitro the influence of different cleaning methods after low-pressure air abrasion on the bond strength of a phosphate monomer-containing luting resin to zirconia ceramic. A total of 112 zirconia ceramic disks were divided into 7 groups (n = 16). In the test groups, disks were air abraded at low pressure (L) 0.05 MPa using 50-μm alumina particles. Prior to bonding, the disks were ultrasonically (U) cleaned either in isopropanol alcohol (AC), hydrofluoric acid (HF), demineralized water (DW), or tap water (TW), or they were used without ultrasonic cleaning. Disks air abraded at a high (H) pressure of 0.25 MPa and cleaned ultrasonically in isopropanol served as positive control; original (O) milled disks used without air abrasion served as the negative control group. Plexiglas tubes filled with composite resin were bonded with the adhesive luting resin Panavia 21 to the ceramic disks. Prior to testing tensile bond strength (TBS), each main group was further subdivided into 2 subgroups (n=8) which were stored in distilled water either at 37°C for 3 days or for 30 days with 7500 thermal cycles. Statistical analyses were conducted with two- and one-way analyses of variance (ANOVA) and Tukey's HSD test. Initial tensile bond strength (TBS) ranged from 32.6 to 42.8 MPa. After 30 days storage in water with thermocycling, TBS ranged from 21.9 to 36.3 MPa. Storage in water and thermocycling significantly decreased the TBS of test groups which were not air abraded (p = 0.05) or which were air abraded but cleaned in tap water (p = 0.002), but not the TBS of the other groups (p > 0.05). Also, the TBS of air-abraded groups were significantly higher than the TBS of the original milled (p < 0.01). Cleaning procedures did not significantly affect TBS either after 3 days or 30 days storage in water and thermocycling (p > 0.05). Air abrasion at 0.05 MPa and ultrasonic cleaning are important factors for improving bonding to zirconia ceramic.

Peristaltic pumping in an elastic tube: feeding the hungry python

NASA Astrophysics Data System (ADS)

Takagi, Daisuke; Balmforth, Neil

2010-11-01

Biological ducts convey contents like food in the digestive system by peristaltic action, propagating waves of muscular contraction and relaxation. The motion is investigated theoretically by considering a radial force of sinusoidal or Gaussian form moving steadily down a fluid-filled axisymmetric tube. Effects of the prescribed force on the resultant fluid flow and elastic deformation of the tube wall are presented. The flow can induce a rigid object suspended in the fluid to propel in different ways, as demonstrated in numerous examples.

Flow rate of nutrient preparations through nasogastric tubes.

PubMed Central

Skidmore, F. D.

1980-01-01

Experiments have been carried out in vitro to determine the relationships between the internal diameter of fine-bore nasogastric tubes, the viscosity of nutrient solutions, and the flow rate that can be achieved in the enteral feeding of surgical patients. It was found that such tubes are capable of delivering 3-5 l of nutrient solution in 24 h without a pump. The findings are discussed in relation to the supply of nitrogen and energy to the patient. PMID:6772081

Bacterial Diversity of the Gastric Content of Preterm Infants during Their First Month of Life at the Hospital.

PubMed

Moles, Laura; Gómez, Marta; Jiménez, Esther; Bustos, Gerardo; de Andrés, Javier; Melgar, Ana; Escuder, Diana; Fernández, Leónides; Del Campo, Rosa; Rodríguez, Juan Miguel

2017-01-01

Studies focused on the stomach microbiota are relatively scarce, and most of them are focused on the adult population. The aim of this work is to describe the bacterial communities inhabiting the gastric content (GC) of preterm neonates. For that purpose, GC samples were collected weekly from a total of 13 preterm neonates during their first month of life within their hospital stay. Samples were analyzed by using both culture-dependent and -independent techniques. The former allowed the isolation of bacteria belonging mainly to the genera Enterococcus, Staphylococcus, Streptococcus, Serratia, Klebsiella , and Escherichia . The cultured dominant species in the GC samples during all the hospitalization period were Enterococcus faecalis and Staphylococcus epidermidis . Multilocus sequence typing (MLST) analysis revealed the presence of high-risk clonal complexes associated with the hospital environment, which may colonize enteral feeding tubes. Similarly, the 16S rRNA sequencing showed that Streptococcus, Staphylococcus, Lactobacillus, Enterococcus, Corynebacterium , and Propionibacterium were the dominant genera present at 75% of the gastric samples. However, the genera Serratia, Klebsiella , and Streptococcus were the most abundant. Own mother's milk (OMM) and donor milk (DM) were collected after their pass through the external feeding tubes to assess their bacterial content. OMM and DM had a similar bacterial pattern to GC. Based on these data, the GC of preterm neonates is dominated by Proteobacteria and Firmicutes and harbors high-risk bacterial clones, which may colonize enteral feeding tubes, and therefore the feeds that pass through them.

Bacterial Diversity of the Gastric Content of Preterm Infants during Their First Month of Life at the Hospital

PubMed Central

Moles, Laura; Gómez, Marta; Jiménez, Esther; Bustos, Gerardo; de Andrés, Javier; Melgar, Ana; Escuder, Diana; Fernández, Leónides; del Campo, Rosa; Rodríguez, Juan Miguel

2017-01-01

Studies focused on the stomach microbiota are relatively scarce, and most of them are focused on the adult population. The aim of this work is to describe the bacterial communities inhabiting the gastric content (GC) of preterm neonates. For that purpose, GC samples were collected weekly from a total of 13 preterm neonates during their first month of life within their hospital stay. Samples were analyzed by using both culture-dependent and -independent techniques. The former allowed the isolation of bacteria belonging mainly to the genera Enterococcus, Staphylococcus, Streptococcus, Serratia, Klebsiella, and Escherichia. The cultured dominant species in the GC samples during all the hospitalization period were Enterococcus faecalis and Staphylococcus epidermidis. Multilocus sequence typing (MLST) analysis revealed the presence of high-risk clonal complexes associated with the hospital environment, which may colonize enteral feeding tubes. Similarly, the 16S rRNA sequencing showed that Streptococcus, Staphylococcus, Lactobacillus, Enterococcus, Corynebacterium, and Propionibacterium were the dominant genera present at 75% of the gastric samples. However, the genera Serratia, Klebsiella, and Streptococcus were the most abundant. Own mother’s milk (OMM) and donor milk (DM) were collected after their pass through the external feeding tubes to assess their bacterial content. OMM and DM had a similar bacterial pattern to GC. Based on these data, the GC of preterm neonates is dominated by Proteobacteria and Firmicutes and harbors high-risk bacterial clones, which may colonize enteral feeding tubes, and therefore the feeds that pass through them. PMID:28459051

Validation of Test Weighing Protocol to Estimate Enteral Feeding Volumes in Preterm Infants.

PubMed

Rankin, Michael W; Jimenez, Elizabeth Yakes; Caraco, Marina; Collinson, Marie; Lostetter, Lisa; DuPont, Tara L

2016-11-01

To evaluate the accuracy of pre- and postfeeding weights to estimate enteral feeding volumes in preterm infants. Single-center prospective cohort study of infants 28-36 weeks' corrected age receiving gavage feedings. For each test weight, 3 pre- and 3 postgavage feeding weights were obtained by study personnel, blinded to feeding volume, via a specific protocol. The correlation between test weight difference and actual volume ingested was assessed by the use of summary statistics, Spearman rho, and graphical analyses. The relationship between categorical predictive variables and a predefined acceptable difference (±5 mL) was assessed with the χ 2 or Fisher exact test. A total of 101 test weights were performed in 68 infants. Estimated and actual feeding volumes were highly correlated (r = 0.94, P < .001), with a mean absolute difference of 2.95 mL (SD: 2.70; range: 0, 12.3 mL; 5th, 95th percentile: 0, 9.3); 85% of test weights were within ±5 mL of actual feeding volume and did not vary significantly by corrected age, feeding tube or respiratory support type, feeding duration or volume, formula vs breast milk, or caloric density. With adherence to study protocol, 89% of test weights (66/74) were within ±5 mL of actual volume, compared with 71% (19/27, P = .04) when concerns about protocol adherence were noted (eg, difficulty securing oxygen tubing). Via the use of a standard protocol, feeding volumes can be estimated accurately by pre- and postfeeding weights. Test weighing could be a valuable tool to support direct breastfeeding in the neonatal intensive care unit. Copyright © 2016 Elsevier Inc. All rights reserved.

Pervaporation process and assembly

DOEpatents

Wynn, Nicholas P.; Huang, Yu; Aldajani, Tiem; Fulton, Donald A.

2010-07-20

The invention is a pervaporation process and pervaporation equipment, using a series of membrane modules, and including inter-module reheating of the feed solution under treatment. The inter-module heating is achieved within the tube or vessel in which the modules are housed, thereby avoiding the need to repeatedly extract the feed solution from the membrane module train.

Pervaporation assembly

DOEpatents

Wynn, Nicholas P [Redwood City, CA; Huang, Yu [Palo Alto, CA; Aldajani, Tiem [San Jose, CA; Fulton, Donald A [Fairfield, CA

2012-02-28

The invention is a pervaporation process and pervaporation equipment, using a series of membrane modules, and including inter-module reheating of the feed solution under treatment. The inter-module heating is achieved within the tube or vessel in which the modules are housed, thereby avoiding the need to repeatedly extract the feed solution from the membrane module train.

Additive, Multi-Component Treatment of Emerging Refusal Topographies in a Pediatric Feeding Disorder

ERIC Educational Resources Information Center

Sharp, William G.; Jaquess, David L.; Bogard, Jennifer D.; Morton, Jane F.

2010-01-01

This case study describes inter-disciplinary treatment of chronic food refusal and tube dependency in a 2-year-old female with a pediatric feeding disorder. Evidence-based behavioral components--including escape extinction (EE), differential reinforcement of alterative mealtime behavior (DRA), and stimulus fading--were introduced sequentially as…

An epidemiologic approach to toothbrushing and dental abrasion.

PubMed

Bergström, J; Lavstedt, S

1979-02-01

Abrasion lesions were recorded in 818 individuals representing the adult population of 430,000 residents of the Stockholm region, Sweden. The subjects were asked about toothbrushing habits, toothbrush quality and dentifrice usage; these factors were related to abrasion criteria. Abrasion was prevalent in 30% and wedge-like or deep depressions were observed in 12%. The relationship between abrasion and toothbrushing was evident, the prevalence and severity of abrasion being correlated to toothbrushing consumption. The importance of the toothbrushing technique for the development of abrasion lesions was elucidated. Horizontal brushing technique was strongly correlated to abrasion. It was demonstrated by treating the data with the statistical AID analysis that toothbrushing factors related to the individual (brushing frequency and brushing technique) exert a greater influence than material-oriented toothbrushing factor such as dentifrice abrasivity and bristle stiffness.

Blind bedside postpyloric placement of spiral tube as rescue therapy in critically ill patients: a prospective, tricentric, observational study.

PubMed

Lv, Bo; Hu, Linhui; Chen, Lifang; Hu, Bei; Zhang, Yanlin; Ye, Heng; Sun, Cheng; Zhang, Xiunong; Lan, Huilan; Chen, Chunbo

2017-09-26

Various special techniques for blind bedside transpyloric tube placement have been introduced into clinical practice. However, transpyloric spiral tube placement facilitated by a blind bedside method has not yet been reported. The objective of this prospective study was to evaluate the safety and efficiency of blind bedside postpyloric placement of a spiral tube as a rescue therapy subsequent to failed spontaneous transpyloric migration in critically ill patients. This prospective, tricentric, observational study was conducted in the intensive care units (ICUs) of three tertiary hospitals. A total of 127 consecutive patients with failed spontaneous transpyloric spiral tube migration despite using prokinetic agents and still required enteral nutrition for more than 3 days were included. The spiral tube was inserted postpylorically using the blind bedside technique. All patients received metoclopramide intravenously prior to tube insertion. The exact tube tip position was determined by radiography. The primary efficacy endpoint was the success rate of postpyloric spiral tube placement. Secondary efficacy endpoints were success rate of a spiral tube placed in the third portion of the duodenum (D3) or beyond, success rate of placement in the proximal jejunum, time to insertion, length of insertion, and number of attempts. Safety endpoints were metoclopramide-related and major adverse tube-associated events. In 81.9% of patients, the spiral feeding tubes were placed postpylorically; of these, 55.1% were placed in D3 or beyond and 33.9% were placed in the proximal jejunum, with a median time to insertion of 14 min and an average number of attempts of 1.4. The mean length of insertion was 95.6 cm. The adverse event incidence was 26.0%, and no serious adverse event was observed. Blind bedside postpyloric placement of a spiral tube, as a rescue therapy subsequent to failed spontaneous transpyloric migration in critically ill patients, is safe and effective. This technique may facilitate the early initiation of postpyloric feeding in the ICU. Chinese Clinical Trial Registry, ChiCTR-OPN-16008206 . Registered on 1 April 2016.

Comparison of lipid and calorie loss from donor human milk among 3 methods of simulated gavage feeding: one-hour, 2-hour, and intermittent gravity feedings.

PubMed

Brooks, Christine; Vickers, Amy Manning; Aryal, Subhash

2013-04-01

The objective of this study was to compare the differences in lipid loss from 24 samples of banked donor human milk (DHM) among 3 feeding methods: DHM given by syringe pump over 1 hour, 2 hours, and by bolus/gravity gavage. Comparative, descriptive. There were no human subjects. Twenty-four samples of 8 oz of DHM were divided into four 60-mL aliquots. Timed feedings were given by Medfusion 2001 syringe pumps with syringes connected to narrow-lumened extension sets designed for enteral feedings and connected to standard silastic enteral feeding tubes. Gravity feedings were given using the identical syringes connected to the same silastic feeding tubes. All aliquots were analyzed with the York Dairy Analyzer. Univariate repeated-measures analyses of variance were used for the omnibus testing for overall differences between the feeding methods. Lipid content expressed as grams per deciliter at the end of each feeding method was compared with the prefed control samples using the Dunnett's test. The Tukey correction was used for other pairwise multiple comparisons. The univariate repeated-measures analysis of variance conducted to test for overall differences between feeding methods showed a significant difference between the methods (F = 58.57, df = 3, 69, P < .0001). Post hoc analysis using the Dunnett's approach revealed that there was a significant difference in fat content between the control sample and the 1-hour and 2-hours feeding methods (P < .0001), but we did not find any significant difference in fat content between the control and the gravity feeding methods (P = .3296). Pairwise comparison using the Tukey correction revealed a significant difference between both gravity and 1-hour feeding methods (P < .0001), and gravity and 2-hour feeding method (P < .0001). There was no significant difference in lipid content between the 1-hour and 2-hour feeding methods (P = .2729). Unlike gravity feedings, the timed feedings resulted in a statistically significant loss of fat as compared with their controls. These findings should raise questions about how those infants in the neonatal intensive care unit are routinely gavage fed.

Factors associated with nosocomial diarrhea in patients with enteral tube feeding.

PubMed

Trabal, J; Leyes, P; Hervás, S; Herrera, M; de Talló Forga, Ma

2008-01-01

Diarrhea is a frequent complication associated to enteral tube feeding (ETF) and it is a frequent cause of reduction or suspension of this type of nutritional support. Our objective was to evaluate the factors associated with nosocomial diarrhea in patients receiving ETF. The only significant factor associated with the appearance of diarrhea was antibiotic consumption, specially those patients receiving the combination of two or more antibiotics. We did not find any association between factors related to ETF, analytical parameters, nor other medications and diarrhea. Our observational data supports the idea that ETF should not be seen as a primary cause of diarrhea, other possible causes should be considered before reducing or discontinuing ETF administration.

Dependence of Non-Prestonian Behavior of Ceria Slurry with Anionic Surfactant on Abrasive Concentration and Size in Shallow Trench Isolation Chemical Mechanical Polishing

NASA Astrophysics Data System (ADS)

Kang, Hyun‑Goo; Kim, Dae‑Hyeong; Katoh, Takeo; Kim, Sung‑Jun; Paik, Ungyu; Park, Jea‑Gun

2006-05-01

The dependencies of the non-Prestonian behavior of ceria slurry with anionic surfactant on the size and concentration of abrasive particles were investigated by performing chemical mechanical polishing (CMP) experiments using blanket wafers. We found that not only the abrasive size but also the abrasive concentration with surfactant addition influences the non-Prestonian behavior. Such behavior is clearly exhibited with small abrasive sizes and a higher concentrations of abrasives with surfactant addition, because the abrasive particles can locally contact the film surface more effectively with applied pressure. We introduce a factor to quantify these relations with the non-Prestonian behavior of a slurry. For ceria slurry, this non-Prestonian factor, βNP, was determined to be almost independent of the abrasive concentration for a larger size and a smaller weight conentration of abrasive particles, but it increased with the surfactant concentration for a smaller size and a higher concentration of abrasives with surfactant addition.

Prevalence, Outcomes, and Management of Enteral Tube Feeding Intolerance: A Retrospective Cohort Study in a Tertiary Center.

PubMed

Wang, Kailun; McIlroy, Kerry; Plank, Lindsay D; Petrov, Max S; Windsor, John A

2017-08-01

Enteral tube feeding (ETF) is the most common form of artificial feeding in hospitalized patients, and the development of intolerance (ETFI) is the most common complication. This study aimed to determine the prevalence of ETFI, the clinical consequences, and the current management approach to ETFI in hospitalized adult patients. Adult patients receiving ETF were identified from a prospective database in the Nutrition Services at Auckland City Hospital. Further information was obtained by the review of clinical records for a 12-month period, up to December 2014. The prevalence of ETFI was 33% among 754 patients. ETFI more frequently occurred in the intensive care unit ( P < .05). Patients with ETFI were less likely to reach their feeding goal rate ( P < .01). Multivariate analysis showed that younger age, certain specialties, and acute mesenteric ischemia were independent predictors of ETFI ( P < .05). The management of ETFI was highly variable. Medication was the most common treatment, while changes in the feeding protocol such as reducing infusion rate and stopping and changing the route of ETF were also frequently attempted. ETFI is a frequent problem in adult hospitalized patients receiving ETF, and it is associated with poor clinical outcomes such as inadequate nutrition and complications of feeding. While the pathophysiology is poorly understood, there also appears to be no standard evidence-based treatment. Studies investigating the mechanisms and optimized management are therefore indicated.

The Environmental Assessment and Management (TEAM) Guide: North Carolina Supplement

DTIC Science & Technology

2010-03-01

for Federal Regulations incorporated by reference. Definitions • Abrasive - any material used in abrasive blasting operations (15A NCAC 2D.0541...Added March 2001]. • Abrasive Blasting - the operation of cleaning or preparing a surface by forcibly propelling a stream of abrasive material against...the surface. Sandblasting is one form of abrasive blasting (15A NCAC 2D.0541) [Added March 2001]. • Abrasive Blasting Equipment - any equipment

Micro-abrasion-corrosion behaviour of a biomedical Ti-25Nb-3Mo-3Zr-2Sn alloy in simulated physiological fluid.

PubMed

Wang, Zhenguo; Li, Yan; Huang, Weijiu; Chen, Xiaoli; He, Haoran

2016-10-01

The micro-abrasion-corrosion behaviour of the biomedical Ti-25Nb-3Mo-3Zr-2Sn alloy in Hank׳s solution with protein has been investigated using electrochemical measurements, tribological tests and scanning electron microscope (SEM) observations. The potentiodynamic polarization tests showed that the corrosion potential (Ecorr) exhibits the maximum value at the abrasive concentration of 0.05gcm(-3) despite of the load level. The tribological results indicated that the total material loss of the Ti-25Nb-3Mo-3Zr-2Sn alloy during micro-abrasion increased with the increasing abrasive concentration at a certain applied load. When the abrasive concentration is no more than 0.15gcm(-3), the total material loss increases with increasing load, while the total material loss exhibits the maximum value at a moderate load in case of higher abrasive concentration levels. This was ascribed to the three-body or two-body micro-abrasion-corrosion at different abrasive concentration levels. The wastage map, abrasion mode map and synergy map associated with the applied load and the abrasive concentration were constructed to evaluate the micro-abrasion-corrosion behaviour of the Ti-25Nb-3Mo-3Zr-2Sn alloy in potential biomedical applications. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Iodine Satellite (iSAT) Propellant Feed System - Design and Development

NASA Technical Reports Server (NTRS)

Polzin, Kurt A.; Seixal, Joao F.; Mauro, Stephanie L.; Burt, Adam O.; Martinez, Armando; Martin, Adam K.

2017-01-01

The development, modeling, and testing of components and subsystems required to feed iodine propellant to a 200-W Hall thruster and cathode are described. This work aims to address design deficiencies and issues associated with the propellant feed system that were revealed by an integrated thruster-cathode-feed system test. The feed system design is modified to use materials that are more resistant to the highly-reactive nature of iodine propellant. Dynamic modeling indicates that the inclusion of additional constraints on feed system tubing will reduce the vibrationally-induced stresses that occur during launch. Full spacecraft thermal modeling show that the feed system heater power levels are sufficient to heat the tank and propellant lines to operating temperatures, where iodine in the tank is sublimed to supply propellant for operation and the tubing is elevated in temperature to keep propellant from redepositing to block the flow. Experiments are conducted to demonstrate that is it possible through the application of heating to clear an iodine deposit blocking the flow. Deposits in the low-pressure portion of the system near the exit to vacuum are shown to be relatively easy to remove in this manner while blockages forming upstream nearer to the higher-pressure propellant tank require significantly more effort to remove. Fluid flow modeling of the feed system is performed, exhibiting some qualitative agreement with experimental data. However, the highly viscous nature of the fluid flow and the dependence of the component flow coefficients on the Reynolds number are likely causes of the generally-poor quantitative agreement between the modeling results and experimentally-measured fluid flow properties.

A simple technique for laparoscopic gastrostomy.

PubMed

Murphy, C; Rosemurgy, A S; Albrink, M H; Carey, L C

1992-05-01

While endoscopically placed gastrostomy tubes are routinely simple, they are not always feasible. Endoscopic technique also does not uniformly secure the tube to the abdominal wall, which presents possible complications, including leakage, accidental early tube removal, intraperitoneal catheter migration and necrosis of the stomach or abdominal wall because of excessive traction. Presented herein is a technique that is rapid, simple and eliminates some of these potential complications. The technique is easily combined with other operative procedures, such as tracheostomy, is done under direct vision, can be performed quickly with intravenous sedation and local anesthetic and is a safe method of tube placement for enteral feeding or gastric decompression.

Improvised external ventricular drain in neurosurgery: A Nigerian tertiary hospital experience.

PubMed

Ojo, O A; Asha, M A; Bankole, O B; Kanu, O O

2015-01-01

The most common type of hydrocephalus in developing countries is post infective hydrocephalus. Infected cerebrospinal fluid (CSF) however cannot be shunted for the reason that it will block the chamber of the ventriculo-peritoneal (VP) shunt due to its high protein content. In centers where standard external ventricular drain (EVD) sets are not available, improvised feeding tube can be used. The main focus of this study is to encourage the use of improvised feeding tube catheters for EVD when standard sets are not available to improve patients' survival. This was a prospective study. Consecutive patients with hydrocephalus that cannot be shunted immediately for high chances of shunt failure or signs of increasing intracranial pressure were recruited into the study. Other inclusion criteria were preoperative brain tumor with possibility of blocked CSF pathway and massive intraventricular hemorrhage necessitating ventricular drainage as a salvage procedure. Standard EVD set is not readily available and too expensive for most of the parents to afford. Improvised feeding tube is used to drain/divert CSF using the standard documented procedure for EVD insertion. Outcome is measured and recorded. A total of 28 patients were recruited into the study over a time frame of 2 years. There were 19 (67.9%) male and 9 (32.1%) females with a ratio of about 2:1. Age ranges varied from as low as 7 days to 66 years. The median age of the study sample was 6.5 months while the mean was 173.8 months. Duration of EVD varied from 2 days to 11 days with a median of 7 while the average was 6 days. Eventual outcome following the procedure of EVD showed that 19 (67.9%) survived and were discharged either to go home or to have VP shunt afterwards while 8 (28.6%) of the patients died. External ventricular drain can and should be done when it is necessary. Potential mortalities could be reduced by the improvised drainage using a standard feeding tube as described.

Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program.

PubMed

Bozec, Alexandre; Benezery, Karen; Chamorey, Emmanuel; Ettaiche, Marc; Vandersteen, Clair; Dassonville, Olivier; Poissonnet, Gilles; Riss, Jean-Christophe; Hannoun-Lévi, Jean-Michel; Chand, Marie-Eve; Leysalle, Axel; Saada, Esma; Sudaka, Anne; Haudebourg, Juliette; Hebert, Christophe; Falewee, Marie-Noelle; Demard, François; Santini, José; Peyrade, Frédéric

2016-09-01

The objective of the study is to evaluate the nutritional status and determine its impact on clinical outcomes in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy (ICT)-based larynx preservation program without prophylactic feeding-tube placement. All patients with locally advanced (T3/4, N0-3, M0) hypopharyngeal squamous cell carcinoma, technically suitable for total pharyngolaryngectomy, treated by docetaxel, cisplatin and 5-fluorouracil (TPF)-ICT for larynx preservation at our institution between 2004 and 2013, were included in this retrospective study. Patients' nutritional status was closely monitored. Enteral nutrition was used if and when a patient was unable to sustain per-oral nutrition and hydration. The impact of nutritional status on clinical outcomes was investigated in univariate and multivariate analysis. A total of 53 patients (42 men and 11 women, mean age = 58.6 ± 8.2 years) were included in this study. Six (11.3 %) patients had lost more than 10 % of their usual body weight before therapy. Compared with patients' usual weight, the mean maximum patient weight loss during therapeutic management was 8.7 ± 4.5 kg. Enteral nutrition was required in 17 patients (32 %). We found no influence of the tested nutritional status-related factors on response to ICT, toxicity of ICT, overall, cause-specific and recurrence-free survival, and on post-therapeutic swallowing outcome. Maximum weight loss was significantly associated with a higher risk of enteral tube feeding during therapy (p = 0.03) and of complications (grade ≥3, p = 0.006) during RT. Without prophylactic feeding-tube placement, approximately one-third of the patients required enteral nutrition. There was no significant impact of nutritional status on oncologic or functional outcomes.

Severe Feeding Problems Secondary to Anatomical Disorders: Effectiveness of Behavioural Treatment in Three School-Aged Children

ERIC Educational Resources Information Center

de Moor, Jan; Didden, Robert; Tolboom, Jules

2005-01-01

In the present study, behavioural treatment is described of three school-aged children with severe feeding problems caused by (surgically corrected) anatomical disorders of the digestive system. Two children showed food refusal and were tube-fed whereas the third child showed extreme food selectivity. During treatment, shaping, (non)verbal…

Tubing misconnections--a systems failure with human factors: lessons for nursing practice.

PubMed

Simmons, Debora; Graves, Krisanne

2008-12-01

In a neonatal unit, an experienced nurse inadvertently connected a feeding tube to an intravenous catheter. An analysis of this error, including the historical perspective, reveals that this threat to safety has been documented since 1972. Implications for nursing practice include the redesign of systems to accommodate human factors science and a change in health care's view of vigilance.

Gallbladder mucocoele and concurrent hepatic lipidosis in a cat.

PubMed

Bennett, S L; Milne, M; Slocombe, R F; Landon, B P

2007-10-01

A 3-year-old Domestic Shorthair cat was presented with weight loss, anorexia and icterus. Feline hepatic lipidosis and gallbladder mucocoele were diagnosed; this is the first report of gallbladder mucocoele in the cat. The case was managed successfully with cholecystojejunostomy, gastrostomy tube placement and tube feeding for 3 months. The cat has survived over the long term with minimal complications.

Effects of surgically and gastrically implanted radio transmitters on growth and feeding behavior of juvenile chinook salmon

USGS Publications Warehouse

Adams, N.S.; Rondorf, D.W.; Evans, S.D.; Kelly, J.E.

1997-01-01

We examined the effects of surgically and gastrically implanted radio transmitters (representing 2.3-5.5% of body weight) on the growth and feeding behavior of 192 juvenile chinook salmon Oncorhynchus tshawytscha (114-159 mm in fork length). Throughout the 54-d study, the 48 fish with transmitters in their stomachs (gastric fish) consistently grew more slowly than fish with surgically implanted transmitters (surgery fish), fish with surgery but no implanted transmitter (sham-surgery fish), or fish exposed only to handling (control fish). Growth rates of surgery fish were also slightly impaired at day 21, but by day 54 they were growing at rates comparable with those of control fish. Despite differences in growth, overall health was similar among all test fish. However, movement of the transmitter antenna caused abrasions at the corner of the mouth in all gastric fish, whereas only 22% of the surgery fish had inflammation around the antenna exit wound. Feeding activity was similar among groups, but gastric fish exhibited a coughing behavior and appeared to have difficulty retaining swallowed food. Because growth and feeding behavior were less affected by the presence of surgically implanted transmitters than by gastric implants, we recommend surgically implanting transmitters for biotelemetry studies of juvenile chinook salmon between 114 and 159 mm fork length.

Closure of a large high-output gastrocutaneous fistula with combined postpyloric feeding and aggressive medical therapy.

PubMed

Vasant, Dipesh Harshvadan; Lal, Simon; Blackett, Brenda D; Paine, Peter A

2012-10-22

Widening of the exit site of a percutaneous gastrostomy tube is a rare but difficult to manage complication, which leads to significant morbidity as a result of caustic material leak and associated cutaneous injury. Such defects fail to close with conservative measures such that invasive (surgical or endoscopic) intervention is often required. The authors present a 49-year-old woman with neurological dysphagia, 2 years after gastrostomy tube insertion with several months' history of leakage and widening of the hole at the exit site. Following gastrostomy tube removal; the patient was left with a large, high-output gastrocutaneous fistula which was treated aggressively with measures to reduce gastric discharge including 'nil-by-mouth', bypassing the stomach with distal feeding, administration of a somatostatin analogue, high-dose proton pump inhibitor and prokinetics with the aim of preoperatively downsizing the wound. This novel approach led to complete closure of the large gastrocutaneous fistula, obviating the need for surgical intervention.

Investigate the complex process in particle-fluid based surface generation technology using reactive molecular dynamics method

NASA Astrophysics Data System (ADS)

Han, Xuesong; Li, Haiyan; Zhao, Fu

2017-07-01

Particle-fluid based surface generation process has already become one of the most important materials processing technology for many advanced materials such as optical crystal, ceramics and so on. Most of the particle-fluid based surface generation technology involves two key process: chemical reaction which is responsible for surface softening; physical behavior which is responsible for materials removal/deformation. Presently, researchers cannot give a reasonable explanation about the complex process in the particle-fluid based surface generation technology because of the small temporal-spatial scale and the concurrent influence of physical-chemical process. Molecular dynamics (MD) method has already been proved to be a promising approach for constructing effective model of atomic scale phenomenon and can serve as a predicting simulation tool in analyzing the complex surface generation mechanism and is employed in this research to study the essence of surface generation. The deformation and piles of water molecule is induced with the feeding of abrasive particle which justifies the property mutation of water at nanometer scale. There are little silica molecule aggregation or materials removal because the water-layer greatly reduce the strength of mechanical interaction between particle and materials surface and minimize the stress concentration. Furthermore, chemical effect is also observed at the interface: stable chemical bond is generated between water and silica which lead to the formation of silconl and the reaction rate changes with the amount of water molecules in the local environment. Novel ring structure is observed in the silica surface and it is justified to be favored of chemical reaction with water molecule. The siloxane bond formation process quickly strengthened across the interface with the feeding of abrasive particle because of the compressive stress resulted by the impacting behavior.

The effect of microstructure on abrasive wear of steel

NASA Astrophysics Data System (ADS)

Kešner, A.; Chotëborský, R.; Linda, M.

2017-09-01

Abrasive wear of agricultural tools is one of the biggest problems in currently being. The amount of abrasive wear, depending on the microstructure, has been investigated in this work. Steels 25CrMo4 and 51CrV4 were used in this work to determine the effect of the microstructure on the abrasive wear. These steels are commonly used for components that have to withstand abrasive wear.SEM analysis was used to detect the microstructure. The standardized ASTM G65 method was used to compare the abrasive wear of steels. The results show that the abrasive wear depends on the microstructure of steels.

A profilometry-based dentifrice abrasion Method for V8 brushing machines. Part I: Introduction to RDA-PE.

PubMed

White, Donald J; Schneiderman, Eva; Colón, Ellen; St John, Samuel

2015-01-01

This paper describes the development and standardization of a profilometry-based method for assessment of dentifrice abrasivity called Radioactive Dentin Abrasivity - Profilometry Equivalent (RDA-PE). Human dentine substrates are mounted in acrylic blocks of precise standardized dimensions, permitting mounting and brushing in V8 brushing machines. Dentin blocks are masked to create an area of "contact brushing." Brushing is carried out in V8 brushing machines and dentifrices are tested as slurries. An abrasive standard is prepared by diluting the ISO 11609 abrasivity reference calcium pyrophosphate abrasive into carboxymethyl cellulose/glycerin, just as in the RDA method. Following brushing, masked areas are removed and profilometric analysis is carried out on treated specimens. Assessments of average abrasion depth (contact or optical profilometry) are made. Inclusion of standard calcium pyrophosphate abrasive permits a direct RDA equivalent assessment of abrasion, which is characterized with profilometry as Depth test/Depth control x 100. Within the test, the maximum abrasivity standard of 250 can be created in situ simply by including a treatment group of standard abrasive with 2.5x number of brushing strokes. RDA-PE is enabled in large part by the availability of easy-to-use and well-standardized modern profilometers, but its use in V8 brushing machines is enabled by the unique specific conditions described herein. RDA-PE permits the evaluation of dentifrice abrasivity to dentin without the requirement of irradiated teeth and infrastructure for handling them. In direct comparisons, the RDA-PE method provides dentifrice abrasivity assessments comparable to the gold industry standard RDA technique.

Abrasion of acrylic veneers by simulated toothbrushing.

PubMed

Xu, H C; Söremark, R; Wiktorsson, G; Wang, T; Liu, W Y

1984-12-01

The abrasion responses were tested on four acrylic veneer materials, K + B Plus, K + B 75, Isosit, and Ivocron. The studies were performed in two independent research laboratories. Two different brushing machines were used with an abrasive slurry. The results were used for comparing the degree of abrasion for the resin materials. Three analytical methods of measuring the degree of abrasive wear were used: surface profile measurement, microscopic evaluation, and measurement of loss of volume. Isosit showed the best abrasion resistance of the four materials tested.

Gastrostomy versus nasogastric tube feeding for chemoradiation patients with head and neck cancer: the TUBE pilot RCT.

PubMed

Paleri, Vinidh; Patterson, Joanne; Rousseau, Nikki; Moloney, Eoin; Craig, Dawn; Tzelis, Dimitrios; Wilkinson, Nina; Franks, Jeremy; Hynes, Ann Marie; Heaven, Ben; Hamilton, David; Guerrero-Urbano, Teresa; Donnelly, Rachael; Barclay, Stewart; Rapley, Tim; Stocken, Deborah

2018-04-01

Approximately 9000 new cases of head and neck squamous cell cancers (HNSCCs) are treated by the NHS each year. Chemoradiation therapy (CRT) is a commonly used treatment for advanced HNSCC. Approximately 90% of patients undergoing CRT require nutritional support via gastrostomy or nasogastric tube feeding. Long-term dysphagia following CRT is a primary concern for patients. The effect of enteral feeding routes on swallowing function is not well understood, and the two feeding methods have, to date (at the time of writing), not been compared. The aim of this pilot randomised controlled trial (RCT) was to compare these two options. This was a mixed-methods multicentre study to establish the feasibility of a RCT comparing oral feeding plus pre-treatment gastrostomy with oral feeding plus as-required nasogastric tube feeding in patients with HNSCC. Patients were recruited from four tertiary centres treating cancer and randomised to the two arms of the study (using a 1 : 1 ratio). The eligibility criteria were patients with advanced-staged HNSCC who were suitable for primary CRT with curative intent and who presented with no swallowing problems. The primary outcome was the willingness to be randomised. A qualitative process evaluation was conducted alongside an economic modelling exercise. The criteria for progression to a Phase III trial were based on a hypothesised recruitment rate of at least 50%, collection of outcome measures in at least 80% of those recruited and an economic value-of-information analysis for cost-effectiveness. Of the 75 patients approached about the trial, only 17 consented to be randomised [0.23, 95% confidence interval (CI) 0.13 to 0.32]. Among those who were randomised, the compliance rate was high (0.94, 95% CI 0.83 to 1.05). Retention rates were high at completion of treatment (0.94, 95% CI 0.83 to 1.05), at the 3-month follow-up (0.88, 95% CI 0.73 to 1.04) and at the 6-month follow-up (0.88, 95% CI 0.73 to 1.04). No serious adverse events were recorded in relation to the trial. The qualitative substudy identified several factors that had an impact on recruitment, many of which are amenable to change. These included organisational factors, changing cancer treatments and patient and clinician preferences. A key reason for the differential recruitment between sites was the degree to which the multidisciplinary team gave a consistent demonstration of equipoise at all patient interactions at which supplementary feeding was discussed. An exploratory economic model generated from published evidence and expert opinion suggests that, over the 6-month model time horizon, pre-treatment gastrostomy tube feeding is not a cost-effective option, although this should be interpreted with caution and we recommend that this should not form the basis for policy. The economic value-of-information analysis indicates that additional research to eliminate uncertainty around model parameters is highly likely to be cost-effective. The recruitment issues identified for this cohort may not be applicable to other populations undergoing CRT. There remains substantial uncertainty in the economic evaluation. The trial did not meet one of the three criteria for progression, as the recruitment rate was lower than hypothesised. Once patients were recruited to the trial, compliance and retention in the trial were both high. The implementation of organisational and operational measures can increase the numbers recruited. The economic analysis suggests that further research in this area is likely to be cost-effective. The implementation of organisational and operational measures can increase recruitment. The appropriate research question and design of a future study needs to be identified. More work is needed to understand the experiences of nasogastric tube feeding in patients undergoing CRT. Current Controlled Trials ISRCTN48569216. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 22, No. 16. See the NIHR Journals Library website for further project information.

Malnutrition in healthcare settings and the role of gastrostomy feeding.

PubMed

Kurien, Matthew; Williams, Jake; Sanders, David S

2017-08-01

Malnutrition can adversely affect physical and psychological function, influencing both morbidity and mortality. Despite the prevalence of malnutrition and its associated health and economic costs, malnutrition remains under-detected and under-treated in differing healthcare settings. For a subgroup of malnourished individuals, a gastrostomy (a feeding tube placed directly into the stomach) may be required to provide long-term nutritional support. In this review we explore the spectrum and consequences of malnutrition in differing healthcare settings. We then specifically review gastrostomies as a method of providing nutritional support. The review highlights the origins of gastrostomies, and discusses how endoscopic and radiological advances have culminated in an increased demand and placement of gastrostomy feeding tubes. Several studies have raised concerns about the benefits derived following this intervention and also about the patients selected to undergo this procedure. These studies are discussed in detail in this review, alongside suggestions for future research to help better delineate those who will benefit most from this intervention, and improve understanding about how gastrostomies influence nutritional outcomes.

Self-cleaning feed distributing delivery device for glass melters

DOEpatents

Mensink, Daniel L.

1992-01-01

A self cleaning, plug resistant, adjustable parameter feed distributing and delivery apparatus for a glass melter comprising a housing with a passage therethrough for a glass slurry, a cold finger within the passage for creating a dispersion pattern of the slurry, a movable slotted tube for controlling the confluence of air propellant and slurry in the passage, and a plurality of ribs that extend through the slots in the slotted tube to urge the slurry forward if it becomes stuck or resists forward movement. Coolant passages in the housing and the cold finger maintain the slurry temperature below that of the melter plenum. The cold finger is axially movable to adjust the dispersion pattern to the desired consistency. Other design features of size can be applied for use in situations requiring different parameters of pattern, particle size, rate, and feed consistencies. The device utilizes air as both a propellant and a surface cleansing mechanism. Other fluids may be used as propellants where process compatibility requires.

Investigation of the effects of process and geometrical parameters on formability in tube hydroforming using a modular hydroforming tool

NASA Astrophysics Data System (ADS)

Joghan, Hamed Dardaei; Staupendahl, Daniel; Hassan, Hamad ul; Henke, Andreas; Keesser, Thorsten; Legat, Francois; Tekkaya, A. Erman

2018-05-01

Tube hydroforming is one of the most important manufacturing processes for the production of exhaust systems. Tube hydroforming allows generating parts with highly complex geometries with the forming accuracies needed in the automotive sector. This is possible due to the form-closed nature of the production process. One of the main cost drivers is tool manufacturing, which is expensive and time consuming, especially when forming large parts. To cope with the design trend of individuality, which is gaining more and more importance and leads to a high number of product variants, a new flexible tool design was developed. The designed tool offers a high flexibility in manufacturing different shapes and geometries of tubes with just local alterations and relocation of tool segments. The tolerancing problems that segmented tools from the state of the art have are overcome by an innovative and flexible die holder design. The break-even point of this initially more expensive tool design is already overcome when forming more than 4 different tube shapes. Together with an additionally designed rotary hydraulic tube feeding system, a highly adaptable forming setup is generated. To investigate the performance of the developed tool setup, a study on geometrical and process parameters during forming of a spherical dome was done. Austenitic stainless steel (grade 1.4301) tube with a diameter of 40 mm and a thickness of 1.5 mm was used for the investigations. The experimental analyses were supported by finite element simulations and statistical analyses. The results show that the flexible tool setup can efficiently be used to analyze the interaction of the inner pressure, friction, and the location of the spherical dome and demonstrate the high influence of the feeding rate on the formed part.

Compounding rifampin suspensions with improved injectability for nasogastric enteral feeding tube administration.

PubMed

de Villiers, Melgardt M; Vogel, Laura; Bogenschutz, Monica C; Fingerhut, Bonnie J; D'Silva, Joseph B; Moore, Anne

2010-01-01

Often medications that have to be administered to patients via a nasogastric enteral feeding tubes are only available as tablets and capsules with no suitable commercial liquid alternatives. In such situations, pharmacists and nurses have to compound the tablets and capsule contents into liquid suspension formulations for dosing. The risk of occlusion of the enteral tubes during administration is reduced by employing liquid suspensions that are composed of small and uniform particles, not subject to rapid rates of settling, resistant to caking, and easily and uniformly re-suspended upon agitation. Present techniques often employ a manual process, such as a mortar and pestle, to accomplish the particle size reduction and subsequent incorporation into a suitable liquid diluent. A new compounding device has been invented that employs an automated wet-milling process in a single-use disposable plastic container to compound the suspensions. The two processes were compared using Rifampin capsules and various liquid diluents. A prototype version of the new device was employed in the experiments. The physical characteristics of the compounded suspensions were evaluated by determining sedimentation rate, sedimentation volume, and particle size and shape using laser light scattering, optical microscopy, and scanning electron microscopy techniques. The use characteristic of the compounded suspensions was evaluated using a nasogastric tube inject ability test. The results indicated that suspensions prepared using the new device were more resistant to sedimentation and caking and were easier to re-disperse into a uniform mixture by gentle shaking. The results were a consequence of the particles generated by the new device which were found to be smaller and more uniform in shape and size. The suspensions prepared using the new device did not cause blockage of the enteral feeding tubes in comparison to those prepared using a mortar and pastle. In conclusion, the results indicate that the wet-milling process employed by the new compounding device produces liquid suspensions that are more suitable for dosing via nasogastric enteral tubes in comparison to the manual mortar and pestle method that is presently employed.

Solid oxide fuel cell systems with hot zones having improved reactant distribution

DOEpatents

Poshusta, Joseph C.; Booten, Charles W.; Martin, Jerry L.

2012-11-06

A Solid Oxide Fuel Cell (SOFC) system having a hot zone with a center cathode air feed tube for improved reactant distribution, a CPOX reactor attached at the anode feed end of the hot zone with a tail gas combustor at the opposing end for more uniform heat distribution, and a counter-flow heat exchanger for efficient heat retention.

Solid oxide fuel cell systems with hot zones having improved reactant distribution

DOEpatents

Poshusta, Joseph C; Booten, Charles W; Martin, Jerry L

2013-12-24

A Solid Oxide Fuel Cell (SOFC) system having a hot zone with a center cathode air feed tube for improved reactant distribution, a CPOX reactor attached at the anode feed end of the hot zone with a tail gas combustor at the opposing end for more uniform heat distribution, and a counter-flow heat exchanger for efficient heat retention.

Solid oxide fuel cell systems with hot zones having improved reactant distribution

DOEpatents

Poshusta, Joseph C.; Booten, Charles W.; Martin, Jerry L.

2016-05-17

A Solid Oxide Fuel Cell (SOFC) system having a hot zone with a center cathode air feed tube for improved reactant distribution, a CPOX reactor attached at the anode feed end of the hot zone with a tail gas combustor at the opposing end for more uniform heat distribution, and a counter-flow heat exchanger for efficient heat retention.

Baking soda as an abrasive in toothpastes: Mechanism of action and safety and effectiveness considerations.

PubMed

Hara, Anderson T; Turssi, Cecilia P

2017-11-01

Toothpastes can be formulated with different abrasive systems, depending on their intended clinical application. This formulation potentially affects their effectiveness and safety and, therefore, requires proper understanding. In this article, the authors focused on abrasive aspects of toothpastes containing sodium bicarbonate (baking soda), which have gained considerable attention because of their low abrasivity and good compatibility, while providing clinical effectiveness (further detailed in the other articles of this special issue). The authors first appraised the role of toothpaste abrasivity on tooth wear, exploring some underlying processes and the existing methods to determine toothpaste abrasivity. The authors reviewed the available data on the abrasivity of toothpastes containing baking soda and reported a summary of findings highlighting the clinical implications. On the basis of the collected evidence, baking soda has an intrinsic low-abrasive nature because of its comparatively lower hardness in relation to enamel and dentin. Baking soda toothpastes also may contain other ingredients, which can increase their stain removal effectiveness and, consequently, abrasivity. Even those formulations have abrasivity well within the safety limit regulatory agencies have established and, therefore, can be considered safe. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

Gastrostomy Tube Feeding in Children With Developmental or Acquired Disorders: A Longitudinal Comparison on Healthcare Provision and Eating Outcomes 4 Years After Gastrostomy.

PubMed

Backman, Ellen; Karlsson, Ann-Kristin; Sjögreen, Lotta

2018-03-30

Studies on long-term feeding and eating outcomes in children requiring gastrostomy tube feeding (GT) are scarce. The aim of this study was to describe children with developmental or acquired disorders receiving GT and to compare longitudinal eating and feeding outcomes. A secondary aim was to explore healthcare provision related to eating and feeding. This retrospective cohort study reviewed medical records of children in 1 administrative region of Sweden with GT placement between 2005 and 2012. Patient demographics, primary diagnoses, age at GT placement, and professional healthcare contacts prior to and after GT placement were recorded and compared. Feeding and eating outcomes were assessed 4 years after GT placement. The medical records of 51 children, 28 boys and 23 girls, were analyzed and grouped according to "acquired" (n = 13) or "developmental" (n = 38) primary diagnoses. At 4 years after GT placement, 67% were still using GT. Only 6 of 37 (16%) children with developmental disorders transferred to eating all orally, as opposed to 10 of 11 (91%) children with acquired disorders. Children with developmental disorders were younger at the time of GT placement and displayed a longer duration of GT activity when compared with children with acquired disorders. This study demonstrates a clear difference between children with developmental or acquired disorders in duration of GT activity and age at GT placement. The study further shows that healthcare provided to children with GT is in some cases multidisciplinary, but primarily focuses on feeding rather than eating. © 2018 American Society for Parenteral and Enteral Nutrition.

Shoe heel abrasion and its possible biomechanical cause: a transversal study with infantry recruits.

PubMed

Baumfeld, Daniel; Raduan, Fernando C; Macedo, Benjamim; Silva, Thiago Alexandre Alves; Baumfeld, Tiago; Favato, Danilo Fabrino; de Andrade, Marco Antonio Percope; Nery, Caio

2015-11-19

Excessive shoe heel abrasion is of concern to patients and shoe manufacturers, but little scientific information is available about this feature and its possible causes. The purpose of this study was to relate this phenomenon with biomechanical factors that could predispose to shoe heel abrasion. Ninety-seven recruits (median age 25) were enrolled in this study. Shoe abrasion was assessed manually with a metric plastic tape on the posterior part of the heel that comes in contact with the ground. The number of sprains, foot alignment, and calf muscle shortening (Silfverskiold test) was also assessed in order to relate it with shoe heel abrasion. After using our exclusion criteria, 86 recruits and 172 were considered for this study. The most common abrasion site was the lateral portion of the heel surface (50 %). Forty-four percent of the participants had neutral hind-foot alignment and 39 % had valgus alignment. Twenty-six (30 %) patients have had previous ankle or foot sprains. Neutral foot was related with less calf muscle shortening. On the other hand, valgus hind-foot alignment was more associated with Achilles shortening (p < 0.05). Patients with neutral alignment were associated with more uniform shoe heel abrasion and varus feet were associated with more central and lateral abrasion (p < 0.05). The pattern of shoe heel abrasion was not statistically related with calf muscle shortening nor with number of sprains. This study was able to correlate shoe heel abrasion with biomechanical causes (neutral alignment-uniform abrasion/varus alignment-central and lateral abrasion). More effort has to be done to continue evaluating outsole abrasion with its possible biomechanical cause in order to predict and treat possible associated injuries.

Effects of Process Parameters on Ultrasonic Micro-Hole Drilling in Glass and Ruby

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schorderet, Alain; Deghilage, Emmanuel; Agbeviade, Kossi

2011-05-04

Brittle materials such as ceramics, glasses and oxide single crystals find increasing applications in advanced micro-engineering products. Machining small features in such materials represents a manufacturing challenge. Ultrasonic drilling constitutes a promising technique for realizing simple micro-holes of high diameter-to-depth ratio. The process involves impacting abrasive particles in suspension in a liquid slurry between tool and work piece. Among the process performance criteria, the drilling time (productivity) is one of the most important quantities to evaluate the suitability of the process for industrial applications.This paper summarizes recent results pertaining to the ultrasonic micro-drilling process obtained with a semi-industrial 3-axis machine.more » The workpiece is vibrated at 40 kHz frequency with an amplitude of several micrometers. A voice-coil actuator and a control loop based on the drilling force impose the tool feed. In addition, the tool is rotated at a prescribed speed to improve the drilling speed as well as the hole geometry. Typically, a WC wire serves as tool to bore 200 {mu}m diameter micro-holes of 300 to 1,000 {mu}m depth in glass and ruby. The abrasive slurry contains B4C particles of 1 {mu}m to 5 {mu}m diameter in various concentrations.This paper discusses, on the basis of the experimental results, the influence of several parameters on the drilling time. First, the results show that the control strategy based on the drilling force allows to reach higher feed rates (avoiding tool breakage). Typically, a 8 um/s feed rate is achieved with glass and 0.9 {mu}m/s with ruby. Tool rotation, even for values as low as 50 rpm, increases productivity and improves holes geometry. Drilling with 1 {mu}m and 5 {mu}m B4C particles yields similar productivity results. Our future research will focus on using the presented results to develop a model that can serve to optimize the process for different applications.« less

Solid Lubrication Fundamentals and Applications. Chapter 5; Abrasion: Plowing and Cutting

NASA Technical Reports Server (NTRS)

Miyoshi, Kazuhisa

2001-01-01

Chapter 5 discusses abrasion, a common wear phenomenon of great economic importance. It has been estimated that 50% of the wear encountered in industry is due to abrasion. Also, it is the mechanism involved in the finishing of many surfaces. Experiments are described to help in understanding the complex abrasion process and in predicting friction and wear behavior in plowing and/or cutting. These experimental modelings and measurements used a single spherical pin (asperity) and a single wedge pin (asperity). Other two-body and three-body abrasion studies used hard abrasive particles.

A Modified Isotropic-Kinematic Hardening Model to Predict the Defects in Tube Hydroforming Process

NASA Astrophysics Data System (ADS)

Jin, Kai; Guo, Qun; Tao, Jie; Guo, Xun-zhong

2017-11-01

Numerical simulations of tube hydroforming process of hollow crankshafts were conducted by using finite element analysis method. Moreover, the modified model involving the integration of isotropic-kinematic hardening model with ductile criteria model was used to more accurately optimize the process parameters such as internal pressure, feed distance and friction coefficient. Subsequently, hydroforming experiments were performed based on the simulation results. The comparison between experimental and simulation results indicated that the prediction of tube deformation, crack and wrinkle was quite accurate for the tube hydroforming process. Finally, hollow crankshafts with high thickness uniformity were obtained and the thickness distribution between numerical and experimental results was well consistent.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sutcliffe, James, E-mail: jasutcliffe@gmail.com; Wigham, Andrew, E-mail: a.wigham@doctors.org.uk; Mceniff, Niall, E-mail: nmceniff@stjames.ie

PurposeSurgical Gastrostomy has been around since the 19th century but in 1980 the first successful percutaneous endoscopic gastrostomy was reported. A year later the first successful percutaneous gastrostomy was performed using fluoroscopic guidance. The technique for percutaneous insertion and the equipment used has been refined since then and it is now considered the gold standard for gastrostomy insertion. Here we present guidelines for image-guided enteral feeding tubes in adults.Material and MethodWe performed a review and analysis of the scientific literature, other national and international guidelines and expert opinion.ResultsStudies have shown fluoroscopic techniques have consistently higher success rates with lower ratesmore » of major complications than endoscopic techniques. However, the Achilles' heel of many fluoroscopic techniques is the requirement for smaller gastrostomy tube sizes resulting in them being more prone to blockages and thus requiring further intervention.ConclusionRadiological feeding tube insertion is a safe and effective procedure. Success rates are higher, and complication rates lower than PEG or surgical gastrostomy tube placement and innovative techniques for gastric and jejunal access mean that there are very few cases in which RIG is not possible. The principal weakness of radiologically inserted gastrostomies is the limitiation on tube size which leads to a higher rate of tube blockage. Per-oral image-guided gastrostomies have to an extent addressed this but have not been popularised. Currently many centres still consider endoscopic gastrostomies as the first line unless patients are too unwell to undergo this procedure or previous attempts have failed, in which case radioloically inserted gastrostomies are the technique of choice.« less

Wire electric-discharge machining and other fabrication techniques

NASA Technical Reports Server (NTRS)

Morgan, W. H.

1983-01-01

Wire electric discharge machining and extrude honing were used to fabricate a two dimensional wing for cryogenic wind tunnel testing. Electric-discharge cutting is done with a moving wire electrode. The cut track is controlled by means of a punched-tape program and the cutting feed is regulated according to the progress of the work. Electric-discharge machining involves no contact with the work piece, and no mechanical force is exerted. Extrude hone is a process for honing finish-machined surfaces by the extrusion of an abrasive material (silly putty), which is forced through a restrictive fixture. The fabrication steps are described and production times are given.

Abrasion Plus Local Fibrin Sealant Instillation Produces Pleurodesis Similar to Pleurectomy in Rabbits.

PubMed

Marchi, Evaldo; de Carvalho, Marcus V H; Ventureli, Tiago R; Fruchi, Andre J; Lazaro, Ariane; do Carmo, Deborah C; Barreto, Thayssa Y A S; Dias, Bruno V B; Acencio, Milena M P; Teixeira, Lisete R; Light, Richard W

2016-09-01

Pleurodesis performed either by pleurectomy or pleural abrasion is recommended in the approach to primary spontaneous pneumothorax to avoid recurrence. However, the efficacy of parietal pleural abrasion in producing pleurodesis is questioned. This study aims to determine the efficacy of apical abrasion alone, abrasion plus fibrin sealant application, and pleurectomy in producing pleurodesis in rabbits. Rabbits were subjected to video-assisted thoracic surgery alone (control) or to video-assisted thoracic surgery with apical gauze abrasion, abrasion plus fibrin sealant instillation, or apical pleurectomy. Blood samples were collected preoperatively and 48 h and 28 days postoperatively to measure total leukocytes (white blood cell count), neutrophil counts, and serum interleukin (IL)-8 levels. After 28 days the animals were sacrificed for macroscopic evaluation of the degree of apical pleurodesis and microscopic evaluation of local pleural fibrosis and collagen deposition. White blood cell and neutrophil counts were similar in all groups, whereas the serum IL-8 level peaked at 48 h in all groups and decreased after 28 days, except in the pleurectomy group. After 28 days the abrasion plus fibrin sealant and pleurectomy groups had significantly more pleural adhesions, pleural fibrosis, and collagen deposition than the abrasion alone group, mainly due to thick mature fibers. Abrasion with local fibrin sealant instillation is as effective as pleurectomy in producing pleurodesis in rabbits. Apical pleurectomy elicits a more persistent elevation of serum IL-8 levels than apical abrasion alone or abrasion plus fibrin adhesive instillation. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Modified tube gastropexy using a mushroom-tipped silicone catheter for management of gastric dilatation-volvulus in dogs.

PubMed

Belch, A; Rubinos, C; Barnes, D C; Nelissen, P

2017-02-01

To report the short- and long-term complications and clinical outcomes of a cohort of dogs managed for gastric dilatation-volvulus using a modified right-sided tube gastropexy technique. Retrospective case series. Of 31 dogs treated, 29 (93·5%) had an excellent short-term outcome, and gastric dilatation-volvulus did not recur in any dog. Twenty-six dogs (84%) were initially fed via the gastrostomy tube postoperatively; three (9·7%) suffered a major complication including septic peritonitis (n=1), and premature tube removal (n=2). Fourteen dogs (45·1%) had minor complications including mild, self-limiting discharge from the stoma site in 13. Modified tube gastropexy using a mushroom-tipped silicone catheter is an effective and safe surgical method for the management of gastric dilatation-volvulus. The gastrostomy tube allowed early enteral feeding and easy administration of medications, including gastroprotectants. © 2017 British Small Animal Veterinary Association.

Process Monitoring Evaluation and Implementation for the Wood Abrasive Machining Process

PubMed Central

Saloni, Daniel E.; Lemaster, Richard L.; Jackson, Steven D.

2010-01-01

Wood processing industries have continuously developed and improved technologies and processes to transform wood to obtain better final product quality and thus increase profits. Abrasive machining is one of the most important of these processes and therefore merits special attention and study. The objective of this work was to evaluate and demonstrate a process monitoring system for use in the abrasive machining of wood and wood based products. The system developed increases the life of the belt by detecting (using process monitoring sensors) and removing (by cleaning) the abrasive loading during the machining process. This study focused on abrasive belt machining processes and included substantial background work, which provided a solid base for understanding the behavior of the abrasive, and the different ways that the abrasive machining process can be monitored. In addition, the background research showed that abrasive belts can effectively be cleaned by the appropriate cleaning technique. The process monitoring system developed included acoustic emission sensors which tended to be sensitive to belt wear, as well as platen vibration, but not loading, and optical sensors which were sensitive to abrasive loading. PMID:22163477

Effect of abrasive grit size on wear of manganese-zinc ferrite under three-body abrasion

NASA Technical Reports Server (NTRS)

Miyoshi, Kazuhisa

1987-01-01

Wear experiments were conducted using replication electron microscopy and reflection electron diffraction to study abrasion and deformed layers produced in single-crystal Mn-Zn ferrites under three-body abrasion. The abrasion mechanism of Mn-Zn ferrite changes drastically with the size of abrasive grits. With 15-micron (1000-mesh) SiC grits, abrasion of Mn-Zn ferrite is due principally to brittle fracture; while with 4- and 2-micron (4000- and 6000-mesh) SiC grits, abrasion is due to plastic deformation and fracture. Both microcracking and plastic flow produce polycrystalline states on the wear surfaces of single-crystal Mn-Zn ferrites. Coefficient of wear, total thickness of the deformed layers, and surface roughness of the wear surfaces increase markedly with an increase in abrasive grit size. The total thicknesses of the deformed layers are 3 microns for the ferrite abraded by 15-micron SiC, 0.9 microns for the ferrite abraded by 4-micron SiC, and 0.8 microns for the ferrite abraded by 1-micron SiC.

Solidification/stabilization of spent abrasives and use as nonstructural concrete

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brabrand, D.J.; Loehr, R.C.

1993-01-01

Tons of spent abrasives result each year from the removal of old paint from bridges. Because the spent abrasives contain metals from the paint, some spent abrasives may be considered hazardous by the Toxicity Characteristic (TC) criteria. Incorporation of the spent blasting abrasives in nonstructural concrete (rip-rap, dolphins) offers an opportunity to recycle the spent abrasives while immobilizing potentially leachable metals. This study focused on the Portland Cement Solidification/Stabilization (S/S) of spent blasting abrasives taken from a bridge located in Southeast Texas. The study examined (a) the cadmium, chromium, and lead concentrations in extracts obtained by using the Toxicity Characteristicmore » Leaching Procedure (TCLP) and (b) the compressive strengths of Portland Cement mixes that contained different amounts of the spent abrasives. Performance was measured by meeting the TC criteria as well as the requirements for compressive strength. Study results indicated that considerable quantities of these spent abrasives can be solidified/stabilized while reducing the leachability of cadmium, chromium, and lead and producing compressive strengths over 6,895 kN/m[sup 2] (1,000 psi).« less

Genes determining the severity of cerebral palsy: the role of single nucleotide polymorphisms on the amount and structure of apolipoprotein E

PubMed Central

Lien, Espen; Andersen, Guro; Bao, Yongde; Gordish-Dressman, Heather; Skranes, Jon S.; Blackman, James A.; Vik, Torstein

2015-01-01

Aim ApolipoproteinE (apoE) influences repair and other processes in the brain and the apoE4 variant is a risk factor for Alzheimer's disease and for prolonged recovery following traumatic brain injury. We previously reported that specific single nucleotide polymorphisms in the APOE or TOMM40 genes affecting the structure and production of apoE were associated with epilepsy, more impaired hand function and gastrostomy tube feeding in children with cerebral palsy (CP). This study explored how various combinations of the same polymorphisms may affect these clinical manifestations. Methods Successful DNA analyses of APOE and TOMM40 were carried out on 227 children. The CP Register of Norway provided details of gross and fine motor function, epilepsy and gastrostomy tube feeding. Possible associations between these clinical manifestations and various combinations of the APOEε2, ε3 or ε4 alleles and of the rs59007384 polymorphism in the TOMM40 gene were explored. Results Epilepsy, impaired fine motor function and gastrostomy tube feeding were less common in children carrying the combination of rs59007384 GG and APOEε2 or ε3 than in children with other combinations. Conclusion Our findings suggest that specific combinations of genes influence the structure and production of apoE differently and affect the clinical manifestations of CP. PMID:25703783

The consequence of phototherapy exposure on oxidative stress status of expressed human milk.

PubMed

Unal, Sezin; Demirel, Nihal; Yaprak Sul, Deniz; Ulubas Isik, Dilek; Erol, Sara; Neselioglu, Salim; Erel, Ozcan; Bas, Ahmet Yagmur

2017-09-04

There exists evidence that phototherapy can disturb the oxidant/antioxidant balance in favor of oxidants. If phototherapy is continued during tube feeding in preterms, expressed human milk is subjected to phototherapy lights for about 20 min per feeding. We aimed to investigate the effects of phototherapy lights on oxidative/antioxidative status of expressed human milk. Milk samples of 50 healthy mothers were grouped as control and phototherapy and exposed to 20 min of day-light and phototherapy light, respectively. Total antioxidant capacity (mmol-Trolox equiv/L) and total oxidant status (mmol-H 2 O 2 /L) in expressed human milk samples were measured. Levels of antioxidant capacity of the expressed human milks in the phototherapy group were lower than those of the control group [mmol-Trolox equiv/L; median (interquartile-range): 1.30 (0.89-1.65) and 1.77 (1.51-2.06), p: < .001]. Levels of oxidant status were similar in both groups. We demonstrated that phototherapy decreased antioxidant capacity of expressed human milk without any alteration in oxidative status. We think that this observation is important for the care of very low birth weighted infants who have limited antioxidant capacity and are vulnerable to oxidative stress. It may be advisable either to turn off the phototherapy or cover the tube and syringe to preserve antioxidant capacity of human milk during simultaneous tube feeding and phototherapy treatment.

Early diagnosis and multidisciplinary care reduce the hospitalization time and duration of tube feeding and prevent early obesity in PWS infants.

PubMed

Bacheré, N; Diene, G; Delagnes, V; Molinas, C; Moulin, P; Tauber, M

2008-01-01

To describe and evaluate the impact of very early diagnosis and multidisciplinary care on the evolution and care of infants presenting with Prader-Willi syndrome (PWS). 19 infants diagnosed with PWS before the second month of life were followed by a multidisciplinary team. Median age at the time of analysis was 3.1 years [range 0.4-6.5]. The data were compared with data collected in 1997 from 113 questionnaires filled out by members of the French PWS Association. The patients from this latter data set were 12.0 years [range 4 months to 41 years] at the time of analysis, with a median age of 36 months at diagnosis. The duration of their hospitalization time was significantly reduced from 30.0 [range 0-670] to 21 [range 0-90] days (p = 0.043). The duration of gastric tube feeding was significantly reduced from 30.5 [range 0-427] to 15 [range 0-60] days (p = 0.017). Growth hormone treatment was started at a mean age of 1.9 +/- 0.5 years in 10 infants and L-thyroxine in 6 infants. Only 1 infant became obese at 2.5 years. Early diagnosis combined with multidisciplinary care decreases the hospitalization time, duration of gastric tube feeding and prevents early obesity in PWS infants. (c) 2007 S. Karger AG, Basel.

Herbivore-induced callose deposition on the sieve plates of rice: an important mechanism for host resistance.

PubMed

Hao, Peiying; Liu, Caixiang; Wang, Yuanyuan; Chen, Rongzhi; Tang, Ming; Du, Bo; Zhu, Lili; He, Guangcun

2008-04-01

The brown planthopper (Nilaparvata lugens Stål; BPH) is a specialist herbivore on rice (Oryza sativa) that ingests phloem sap from the plant through its stylet mouthparts. Electronic penetration graphs revealed that BPH insects spent more time wandering over plants carrying the resistance genes Bph14 and Bph15, but less time ingesting phloem than they did on susceptible plants. They also showed that their feeding was frequently interrupted. Tests with [(14)C]sucrose showed that insects ingested much less phloem sap from the resistant than the susceptible plants. BPH feeding up-regulated callose synthase genes and induced callose deposition in the sieve tubes at the point where the stylet was inserted. The compact callose remained intact in the resistant plants, but genes encoding beta-1,3-glucanases were activated, causing unplugging of the sieve tube occlusions in susceptible plants. Continuing ingestion led to a remarkable reduction in the susceptible plants' sucrose content and activation of the RAmy3D gene, leading to starch hydrolysis and ultimately carbohydrate deprivation in the plants. Our results demonstrate that BPH feeding induces the deposition of callose on sieve plates in rice and that this is an important defense mechanism that prevents insects from ingesting phloem sap. In response, however, the BPH can unplug sieve tube occlusions by activating beta-1,3-glucanase genes in rice plants.

Prader-Willi Syndrome: Frequently Asked Questions

MedlinePlus

... techniques or tube feeding for several months after birth, until muscle control improves. Sometime in the following years, usually before school age, children with PWS develop an intense interest ...

Novel Strategy for Temporary Decompression of the Lower Urinary Tract in Neonates Using a Ureteral Stent.

PubMed

Penna, Frank J; Bowlin, Paul; Alyami, Fahad; Bägli, Darius J; Koyle, Martin A; Lorenzo, Armando J

2015-10-01

In children with congenital obstructive uropathy, including posterior urethral valves, lower urinary tract decompression is recommended pending definitive surgical intervention. Current options, which are limited to a feeding tube or Foley catheter, pose unappreciated constraints in luminal diameter and are associated with potential problems. We assess the impact of luminal diameter on the current draining options and present a novel alternative method, repurposing a widely available stent that optimizes drainage. We retrospectively reviewed patients diagnosed with posterior urethral valves between January 2013 and December 2014. In all patients a 6Fr 12 cm Double-J ureteral stent was advanced over a guidewire in a retrograde fashion into the bladder. Luminal flow and cross-sectional areas were also assessed for each of 3 tubes for urinary drainage, ie 6Fr Double-J stent, 5Fr feeding tube and 6Fr Foley catheter. A total of 30 patients underwent uneventful bedside Double-J stent placement. Mean ± SD age at valve ablation was 28.5 ± 16.6 days. Mean ± SD peak serum creatinine was 2.23 ± 0.97 mg/dl after birth and 0.56 ± 0.22 mg/dl at the procedure. Urine output after stent placement was excellent in all patients. The Foley catheter and feeding tube drained approximately 18 and 6 times more slowly, respectively, and exhibited half the calculated cross-sectional luminal area compared to the Double-J stent. Use of Double-J stents in neonates with posterior urethral valves is a safe and effective alternative method for lower urinary tract decompression that optimizes the flow/lumen relationship compared to conventional drainage options. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

A prospective study comparing prophylactic gastrostomy to nutritional counselling with a therapeutic feeding tube if required in head and neck cancer patients undergoing chemoradiotherapy in Thai real-world practice.

PubMed

Pramyothin, P; Manyanont, S; Trakarnsanga, A; Petsuksiri, J; Ithimakin, S

2016-12-01

Concurrent chemoradiotherapy (CRT) is the standard treatment for head and neck (HN) cancer patients. Most patients experience malnutrition and weight loss during treatment because of mucositis and difficulty in swallowing. Prevention of malnutrition may allow more patients to complete their treatment. The present study aimed to examine whether prophylactic gastrostomy tube (PGT) could reduce treatment interruption, prevent malnutrition and maintain quality of life, especially in Thai patients who generally do not accept feeding tubes. A prospective study was performed on HN cancer patients undergoing CRT at a tertiary hospital in Thailand (n = 95). Before starting CRT, all patients received nutritional assessment and were counselled about the risks and benefits of PGT. According to patient discretion, they chose to have a PGT (experimental group) or only nutritional counselling with a therapeutic feeding tube if required (control group). During CRT, weight, degree of mucositis, delayed chemotherapy and/or radiotherapy, and nutritional status were recorded. Quality of life (Functional Assessment of Cancer Therapy - Head and Neck Scale; FACT-H&N) was compared between two groups. There was no significant difference in the rates of delayed treatment. Mean weight loss was 3.1 and 4.8 kg in the experimental and control groups, respectively (P = 0.04). A higher proportion of patients in the control group experienced ≥10% weight loss (24% versus 4%; P = 0.03). In terms of quality of life, no significant difference in FACT-H&N score was found. The results of the present study suggest that PGT provided similar quality of life without a reduction in treatment interruption. However, patients with PGT had significantly less weight loss (P = 0.04) during CRT. © 2016 The British Dietetic Association Ltd.

Real-time image-guided nasogastric feeding tube placement: A case series using Kangaroo with IRIS Technology in an ICU.

PubMed

Mizzi, Anna; Cozzi, Silvano; Beretta, Luigi; Greco, Massimiliano; Braga, Marco

2017-05-01

Pulmonary misplacement during the blind insertion of enteral feeding tubes is frequent, particularly in ventilated and neurologically impaired patients. This is probably the first clinical study using the Kangaroo Feeding Tube with IRIS technology (IRIS) which incorporates a camera designed to provide anatomic landmark visualization during insertion. The study aim was to evaluate IRIS performance during bedside gastric placement. This is the first prospective study to collect data on the use of IRIS. Twenty consecutive unconscious patients requiring enteral nutrition were recruited at a single center. IRIS placement was considered complete when a clear image of the gastric mucosa appeared. Correct placement was confirmed using a contrast-enhanced abdominal X-ray. To evaluate the device performance over time, the camera was activated every other day up to 17 d postplacement. In 7 (35%) patients, the trachea was initially visualized, requiring a second placement attempt with the same tube. The IRIS camera allowed recognition of the gastric mucosa in 18 (90%) patients. The esophagogastric junction was identified in one patient, while in a second patient the quality of visualization was poor. Contrast-enhanced X-ray confirmed the gastric placement of IRIS in all patients. IRIS allowed identification of gastric mucosa in 14 (70%) patients 3 d after placement. Performance progressively declined with time (P = 0.006, chi-square for trend). IRIS placement could have spared X-ray confirmation in almost all patients and prevented misplacement into the airway in about one third. Visualization quality needs to be improved, particularly after the first week. Copyright © 2016 Elsevier Inc. All rights reserved.

Determination of a practical pH cutoff level for reliable confirmation of nasogastric tube placement.

PubMed

Gilbertson, Heather Ruth; Rogers, Elizabeth Jessie; Ukoumunne, Obioha Chukwunyere

2011-07-01

Enteral feeding is a common method of nutrition support when oral intake is inadequate. Confirmation of correct nasogastric (NG) tube placement is essential. Risks of morbidity/mortality associated with misplacement in the lung are well documented. Studies indicate that pH ≤ 4 confirms gastric aspirate, but in pediatrics, a pH of gastric aspirate is often >4. The goal of this study was to determine a reliable and practical pH value to confirm NG tube placement, without increasing the risk of not identifying a misplaced NG tube. Pediatric inpatients older than 4 weeks receiving enteral nutrition (nasogastric or gastrostomy) were recruited over 9 months. Aspirate samples were pH tested at NG tube placement and before feedings. If pH >4, NG tube position was confirmed by chest radiograph or further investigations. In addition, intensive care unit (ICU) patients who required endotracheal suctioning were recruited, and endotracheal aspirate samples were pH tested. A total of 4,330 gastric aspirate samples (96% nasogastric) were collected from 645 patients with a median (interquartile range [IQR]) age of 1.0 years (0.3-5.2 years). The mean (standard deviation [SD]) pH of these gastric samples was 3.6 (1.4) (range, 0-9). pH was >4 in 1,339 (30.9%) gastric aspirate samples, and of these, 244 were radiographed, which identified 10 misplaced tubes (1 with pH 5.5). A total of 65 endotracheal aspirate samples were collected from 19 ICU patients with a median (IQR) age of 0.6 years (0.4-5.2 years). The mean (SD) pH of these samples was 8.4 (0.8) (range, 6-9.5). Given that the lowest pH value of endotracheal aspirate sample was 6, and a misplaced NG tube was identified with pH 5.5, it is proposed that a gastric aspirate pH ≤ 5 is a safer, reliable, and practical cutoff in this population.

NRH Neuroscience Research Center

DTIC Science & Technology

2004-06-01

liii ED ED ED EDPet Therapy: 30. Use or dog 47. Platform (parallel bars Co- Treat : or FWW) No. ofminutes: F IT ] Disciplines: 31. Use of other... s . Pneumonia: examine relationship with feeding tube use , diet types, and swallowing descriptions and interventions from SLP. Examine tube placement...Gassaway J, Dijkers M, Slavin S . Toward a taxonomy of rehabilitation interventions: using an inductive approach to examine the ’black box’ of rehabilitation

The Effect of Pleural Abrasion on the Treatment of Primary Spontaneous Pneumothorax: A Systematic Review of Randomized Controlled Trials

PubMed Central

Ming, Mo-yu; Cai, Shuang-qi; Chen, Yi-Qiang

2015-01-01

Background Pleural abrasion has been widely used to control the recurrence of primary spontaneous pneumothorax (PSP). However, controversy still exists regarding the advantages and disadvantages of pleural abrasion compared with other interventions in preventing the recurrence of PSP. Methods The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched up to December 15, 2014 to identify randomized controlled trials (RCTs) that compared the effects of pleural abrasion with those of other interventions in the treatment of PSP. The study outcomes included the PSP recurrence rate and the occurrence rate of adverse effects. Results Mechanical pleural abrasion and apical pleurectomy after thoracoscopic stapled bullectomy exhibited similarly persistent postoperative air leak occurrence rates (p = 0.978) and 1-year PSP recurrence rates (p = 0.821), whereas pleural abrasion led to reduced residual chest pain and discomfort (p = 0.001) and a smaller rate of hemothorax (p = 0.036) than did apical pleurectomy. However, the addition of minocycline pleurodesis to pleural abrasion did not reduce the pneumothorax recurrence rate compared with apical pleurectomy (3.8% for both procedures) but was associated with fewer complications. There was no statistical difference in the pneumothorax recurrence rate between mechanical pleural abrasion and chemical pleurodesis with minocycline on either an intention-to-treat basis (4 of 42 versus 0 of 42, p = 0.12; Fisher exact test) or after exclusions (2 of 40 versus 0 of 42, p = 0.24; Fisher exact test). Pleural abrasion plus minocycline pleurodesis also did not reduce the pneumothorax recurrence rate compared with pleural abrasion alone (p = 0.055). Moreover, pleural abrasion plus minocycline pleurodesis was associated with more intense acute chest pain. The postoperative overall recurrence rate in patients who underwent staple line coverage with absorbable cellulose mesh and fibrin glue was similar to that with mechanical abrasion after thoracoscopic bullectomy (13.8% vs. 14.2%, respectively; p = 0.555), but staple line coverage resulted in less postoperative residual pain than mechanical abrasion (0.4% vs.3.2%; p<0.0001). Pleural abrasion after thoracoscopic wedge resection did not decrease the recurrence of pneumothorax compared with wedge resection alone (p = 0.791), but the intraoperative bleeding and postoperative pleural drainage rates were higher when pleural abrasion was performed. Conclusions In addition to resulting in the same pneumothorax recurrence rate, thoracoscopic pleural abrasion with or without minocycline pleurodesis is safer than apical pleurectomy in the treatment of PSP. However, minocycline pleurodesis with or without pleural abrasion is not any more effective than pleural abrasion alone. Moreover, additional mechanical abrasion is not safer than additional staple line coverage with absorbable cellulose mesh and fibrin glue after thoracoscopic bullectomy because of increased postoperative pain. Additionally, pleural abrasion after thoracoscopic wedge resection should not be recommended for routine application due to the greater incidence of adverse effects than wedge resection alone. However, further large-scale, well-designed RCTs are needed to confirm the best procedure. PMID:26042737

Catamenial pneumothorax revealing diaphragmatic endometriosis: a case report and revue of literature.

PubMed

Aissa, Sana; Benzarti, Wafa; Alimi, Faouzi; Gargouri, Imen; Salem, Halima Ben; Aissa, Amène; Fathallah, Khadija; Abdelkade, Atef Ben; Alouini, Rafika; Garrouche, Abdelhamid; Hayoun, Abdelaziz; Abdelghani, Ahmed; Benzarti, Mohamed

2017-01-01

Catamenial pneumothorax (CP) is a rare entity of spontaneous, recurring pneumothorax in women. We aim to discuss the etiology, clinical course, and surgical treatment of a 42-year-old woman with CP. This patient had a right-sided spontaneous pneumothoraces occurred one week after menses. She had under-gone video-assisted thoracoscopic surgery (VATS) because of a persistent air leak under chest tube. VATS revealed multiple diaphragmatic fenestrations with an upper right nodule. Defects were removed and a large part of the diaphragm was resected. Pleural abrasion was then performed over the diaphragm. Diaphragmatic endometriosis was confirmed by microscopic examination. Medical treatment with GnRH agonists was prescribed, and after recovery, the patient has been symptoms free for 20 months.

Mitigation of steam generator tube rupture in a pressurized water reactor with passive safety systems

DOEpatents

McDermott, D.J.; Schrader, K.J.; Schulz, T.L.

1994-05-03

The effects of steam generator tube ruptures in a pressurized water reactor are mitigated by reducing the pressure in the primary loop by diverting reactor coolant through the heat exchanger of a passive heat removal system immersed in the in containment refueling water storage tank in response to a high feed water level in the steam generator. Reactor coolant inventory is maintained by also in response to high steam generator level introducing coolant into the primary loop from core make-up tanks at the pressure in the reactor coolant system pressurizer. The high steam generator level is also used to isolate the start-up feed water system and the chemical and volume control system to prevent flooding into the steam header. 2 figures.

Mitigation of steam generator tube rupture in a pressurized water reactor with passive safety systems

DOEpatents

McDermott, Daniel J.; Schrader, Kenneth J.; Schulz, Terry L.

1994-01-01

The effects of steam generator tube ruptures in a pressurized water reactor are mitigated by reducing the pressure in the primary loop by diverting reactor coolant through the heat exchanger of a passive heat removal system immersed in the in containment refueling water storage tank in response to a high feed water level in the steam generator. Reactor coolant inventory is maintained by also in response to high steam generator level introducing coolant into the primary loop from core make-up tanks at the pressure in the reactor coolant system pressurizer. The high steam generator level is also used to isolate the start-up feed water system and the chemical and volume control system to prevent flooding into the steam header. 2 figures.

A novel reverse-osmosis wash water recycle system for manned space stations

NASA Technical Reports Server (NTRS)

Ray, R. J.; Babcock, W. C.; Barss, R. P.; Andrews, T. A.; Lachapelle, E. D.

1984-01-01

The preliminary development of a wash water recycle system utilizing an inside-skinned hollow-fiber membrane is described. This module configuration is based on tube-side feed and is highly resistant to fouling with a minimum of pretreatment. During an ongoing research program for NASA, these modules were operated on actual wash waters with no significant fouling for a period of 40 days. Due to the tube-side-feed flow in these hollow-fiber membranes, the fibers themselves become the pressure vessels, allowing the development of extremely lightweight membrane modules. During the NASA research program, a pre-prototype membrane module capable of processing 6 gallons per day of wash water at 97 percent recovery was developed that can be dry-stored and that weighs 120 g.

Complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology

PubMed Central

Ray, David M; Srinivasan, Indu; Tang, Shou-Jiang; Vilmann, Andreas S; Vilmann, Peter; McCowan, Timothy C; Patel, Akash M

2017-01-01

Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient’s work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions. PMID:28396724

The effect of dental overbite on eustachian tube dysfunction in Iranian children.

PubMed

Azadani, Peyman Nejatbakhsh; Jafarimehr, Elnaz; Shokatbakhsh, Abdorahman; Pourhoseingholi, Mohamad Amin; Ghougeghi, Aman

2007-02-01

To investigate the association between deep dental overbite and eustachian tube dysfunction. It was designed as a case-control study. Among hospitalized patients in otolaryngology department at Taleghani Hospital in Tehran, Iran, from January to December 2005, 132 patients between the ages of 2 and 6 years were recruited. Dental overbite, overjet, and occlusal relationships were measured by one observer. Eustachian tube dysfunction was defined as having ventilation tubes with an abnormal tympanometry. In addition, demographic information, medical and social histories were prospectively recorded. Univariate and multivariate logistic regression model were used. In a multivariate model, children with deep bites were 10.6 times more likely to have eustachian tube dysfunction than those without deep bites (P<0.05). Other independent risk factors for eustachian tube dysfunction identified in this model were family history of otitis media, daycare exposure, and non-breast-feeding. Children with deep dental overbites are at a significantly increased risk for developing eustachian tube dysfunction.

Preliminary Investigation of the Process Capabilities of Hydroforging

PubMed Central

Alzahrani, Bandar; Ngaile, Gracious

2016-01-01

Hydroforging is a hybrid forming operation whereby a thick tube is formed to a desired geometry by combining forging and hydroforming principles. Through this process hollow structures with high strength-to-weight ratio can be produced for applications in power transmission systems and other structural components that demands high strength-to-weight ratio. In this process, a thick tube is deformed by pressurized fluid contained within the tube using a multi-purpose punch assembly, which is also used to feed tube material into the die cavity. Fluid pressure inside the thick tube is developed by volume change governed by the movement of the punch assembly. In contrast to the conventional tube hydroforming (THF), the hydroforging process presented in this study does not require external supply of pressurized fluid to the deforming tube. To investigate the capability of hydroforging process, an experimental setup was developed and used to hydroforge various geometries. These geometries included hollow flanged vessels, hexagonal flanged parts, and hollow bevel and spur gears. PMID:28787840

Macrofaunal involvement in the sublittoral decay of kelp debris: the polychaete Platynereis dumerilii (Audouin and Milne-Edwards) (Annelida: Polychaeta)

NASA Astrophysics Data System (ADS)

Bedford, A. P.; Moore, P. G.

1985-02-01

Platynereis dumerilii is found in large numbers in parchment-like tubes attached to sublittoral accumulations of detached maroalgae (principally Laminaria saccharina) in Kames Bay, Isle of Cumbrae and Lochranza, Isle of Arran. Its rôle in weed decomposition has been examined by comparing its responses (behavioural choice, growth rates, absorption efficiencies of both carbon and protein, gut retention times and rate of faecal output) to fresh and rotting weed. Worms grew significantly on either diet, with older individuals gaining more weight than small individuals. Animals of a standard size (derived from measurements of maximum bite size) feeding on fresh weed, however, grew significantly faster than those feeding on rotting weed. The former had a significantly higher protein absorption efficiency which was linearly related to protein content of ingested weed. This was not so on rotting weed. Organic carbon absorption efficiencies did not differ significantly between the two groups, neither did gut retention times nor rates of faecal output. Given a choice, Platynereis chooses to build its tube, and to feed, on fresh kelp—a strategem which ensures both maximum scope for occupancy before fronds decay and a superabundance of preferred food. Platynereis feeds around its tube entrance, recropping small areas for 2-3 days, prior to switching to another area nearby. Ciliate population densities on Platynereis faeces are much lower than on either homogenized or intact weed, associated with their lower, nutritional value (at first). Platynereis bubes act to bind kelp fronds together stabilizing the faecal input to infaunal detritivores. Platynereis is an example of a detritivore which exploits the detrital substratum directly.

Compliance with nutrition support guidelines in acutely burned patients.

PubMed

Holt, Brennen; Graves, Caran; Faraklas, Iris; Cochran, Amalia

2012-08-01

Adequate and timely provision of nutritional support is a crucial component of care of the critically ill burn patient. The goal of this study was to assess a single center's consistency with Society of Critical Care Medicine/American Society for Parenteral and Enteral Nutrition (SCCM/ASPEN) guidelines for nutritional support in critically ill patients. Acutely burned patients >45kg in weight admitted to a regional burn center during a two-year period and who required 5 or more days of full enteral nutritional support were eligible for inclusion in this retrospective review. Specific outcomes evaluated include time from admission to feeding tube placement and enteral feeding initiation and percent of nutritional goal received within the first week of hospital stay. Descriptive statistics were used for all analyses. IRB approval was obtained. Thirty-seven patients were included in this retrospective review. Median age of patients was 44.9 years (IQR: 24.2-55.1), and median burn injury size was 30% (IQR: 19-47). Median time to feeding tube placement was 31.1h post admission (IQR: 23.6-50.2h), while median time to initiation of EN was 47.9h post admission (IQR: 32.4-59.9h). The median time required for patients to reach 60% of caloric goal was 3 days post-admission (IQR: 3-4.5). The median time for initiation of enteral nutrition was within the SCCM/ASPEN guidelines for initial nutrition in the critically ill patient. This project identified a 16h time lag between placement of enteral access and initiation of enteral nutrition. Development of a protocol for feeding tube placement and enteral nutrition management may optimize early nutritional support in the acutely injured burn patient. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Patterns of prophylactic gastrostomy tube placement in head and neck cancer patients: a consideration of the significance of social support and practice variation.

PubMed

Locher, Julie L; Bonner, James A; Carroll, William R; Caudell, Jimmy J; Allison, Jeroan J; Kilgore, Meredith L; Ritchie, Christine S; Tajeu, Gabriel S; Yuan, Ya; Roth, David L

2013-08-01

The purpose of this study was to examine factors associated with prophylactic placement of feeding tubes in head and neck cancer patients receiving radiation therapy as a part of treatment using multilevel models that account for patient-, physician-, and institution-level sources of variation. A retrospective analysis using binary logistic regression and hierarchical linear models was run to evaluate independent predictors of prophylactic feeding tube placement. Surveillance, Epidemiology, and End Results-Medicare data were used. Head and neck cancer patients diagnosed with locoregionally advanced stage disease from 2000 to 2005 were included in this study (N = 8,306). Across all models, prophylactic gastrostomy tube placement was found to be more likely in patients who had cancer of the larynx or oropharynx compared with those with cancer of the nasopharynx or oral cavity; who had regional instead of local cancer; who did not receive surgery as a part of treatment, but did receive chemotherapy; and who were divorced, separated, or widowed. Additionally, although practice variation was observed to occur, its overall contribution in predicting prophylactic gastrostomy tube placement was minimal. As health care enters an era of patient-centered care, further investigation of the potential role of social support (or lack of social support) in influencing treatment decisions of head and neck cancer patients and providers is warranted. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Aliasing Signal Separation of Superimposed Abrasive Debris Based on Degenerate Unmixing Estimation Technique.

PubMed

Li, Tongyang; Wang, Shaoping; Zio, Enrico; Shi, Jian; Hong, Wei

2018-03-15

Leakage is the most important failure mode in aircraft hydraulic systems caused by wear and tear between friction pairs of components. The accurate detection of abrasive debris can reveal the wear condition and predict a system's lifespan. The radial magnetic field (RMF)-based debris detection method provides an online solution for monitoring the wear condition intuitively, which potentially enables a more accurate diagnosis and prognosis on the aviation hydraulic system's ongoing failures. To address the serious mixing of pipe abrasive debris, this paper focuses on the superimposed abrasive debris separation of an RMF abrasive sensor based on the degenerate unmixing estimation technique. Through accurately separating and calculating the morphology and amount of the abrasive debris, the RMF-based abrasive sensor can provide the system with wear trend and sizes estimation of the wear particles. A well-designed experiment was conducted and the result shows that the proposed method can effectively separate the mixed debris and give an accurate count of the debris based on RMF abrasive sensor detection.

The efficacy of mechanical abrasion and talc slurry as methods of pleurodesis in normal dogs.

PubMed

Jerram, R M; Fossum, T W; Berridge, B R; Steinheimer, D N; Slater, M R

1999-01-01

To determine the efficacy of mechanical abrasion and talc slurry as methods for pleurodesis in normal dogs. Experimental study. Ten normal beagle dogs. Group I dogs had mechanical abrasion (MA) of the pulmonary and costal pleurae performed in one hemithorax with a dry gauze sponge with a median sternotomy approach. Group II dogs had 100 mL of a 1 g talc slurry (TS) administered into one hemithorax through a tube thoracostomy. Administration of the TS was visualized by using video thoracoscopy. All dogs were evaluated at 2, 10, 20, and 30 days postoperatively by means of thoracic radiography and ultrasonographic thoracic wall measurement. The dogs were euthanatized 30 days postoperatively and a gross necropsy was performed. Hemithoraces were assigned a pleurodesis score (0-4) and an obliteration grade (0-6). Tissues were collected for histopathologic examination of pulmonary pleura, costal pleura, and pleural adhesions. Pulmonary and costal pleurae were graded for the degree of fibrosis (0-4). Obliteration grade and costal pleural fibrosis score were significantly higher for the treated sides in the MA dogs compared with the TS dogs. MA Dogs: Mechanical abrasion dogs had pleurodesis, obliteration, and pleural fibrosis scores that were greater on the treated side than the untreated side, however, the differences were not statistically significant. Only two MA dogs had firm adhesion of the pulmonary pleura to the costal pleura in portions of the cranial and middle lung lobes in the treated hemithorax. Thoracic wall surface area covered with adhesions was 15% and 21% in each of these two dogs. The median pulmonary pleural fibrosis score of all MA dogs for the treated hemithorax was 3 compared to 0 on the untreated side. TS Dogs: There was no statistical difference for pleurodesis scores and obliteration grades between the treated and untreated sides. No dogs showed evidence of pulmonary to costal pleural adhesions. Histopathology showed talc crossover into the untreated side in all five dogs. Median pulmonary fibrosis score of the treated hemithorax was 1 compared with 0 on the untreated side. Neither method of pleurodesis produced sufficient pleural adhesions to obliterate the pleural space. It is possible that the degree of pulmonary pleural fibrosis present in MA dogs may be sufficient to limit air leakage from pulmonary blebs and bullae resulting in successful treatment of spontaneous pneumothorax.

Low Temperature Cure Powder Coatings (LTCPC)

DTIC Science & Technology

2010-10-01

17  3.2.2.5  Abrasion Resistance ...criteria • N/A Field Service Evaluation: • Coating Appearance • Adhesion • Fluids Resistance • Humidity Resistance • Abrasion Resistance • Low...Results • Abrasion Resistance • Low Temperature Flexibility humidity • Document occurrences of coating abrasions during

The optimization study on the tool wear of carbide cutting tool during milling Carbon Fibre Reinforced (CFRP) using Response Surface Methodology (RSM)

NASA Astrophysics Data System (ADS)

Nor Khairusshima, M. K.; Hafiz Zakwan, B. Muhammad; Suhaily, M.; Sharifah, I. S. S.; Shaffiar, N. M.; Rashid, M. A. N.

2018-01-01

Carbon Fibre Reinforced Plastic (CFRP) composite has become one of famous materials in industry, such as automotive, aeronautics, aerospace and aircraft. CFRP is attractive due to its properties, which promising better strength and high specification of mechanical properties other than its high resistance to corrosion. Other than being abrasive material due to the carbon nature, CFRP is an anisotropic material, which the knowledge of machining metal and steel cannot be applied during machining CFRP. The improper technique and parameters used to machine CFRP may result in high tool wear. This paper is to study the tool wear of 8 mm diameter carbide cutting tool during milling CFRP. To predict the suitable cutting parameters within range of 3500-6220 (rev/min), 200-245 (mm/min), and 0.4-1.8 (mm) for cutting speed, speed, feed rate and depth of cut respectively, which produce optimized result (less tool wear), Response Surface Methodology (RSM) has been used. Based on the developed mathematical model, feed rate was identified as the primary significant item that influenced tool wear. The optimized cutting parameters are cutting speed, feed and depth of cut of 3500 rev/min, 200 mm/min and 0.5 mm, respectively, with tool wear of 0.0267 mm. It is also can be observed that as the cutting speed and feed rate increased the tool wear is increasing.

Sniffin' Away the Feeding Tube - The Influence of Olfactory Stimulation on Oral Food Intake in Newborns and Premature Infants.

PubMed

Schriever, Valentin A; Gellrich, Janine; Rochor, Nora; Croy, Ilona; Cao-Van, Helene; Rüdiger, Mario; Hummel, Thomas

2018-06-02

Because of their immaturity many premature infants are fed via nasogastric tube. One objective of the neonatal care is to feed infants orally early. The olfactory function of premature infants is developed before birth and odorants have a significant impact on nutrition in infants. The aim of the study was to test whether odor stimulation has a positive effect on the transition from gavage to oral feeding in infants. Participants were premature infants with gestational age of more than 27 weeks, with full or partial gavage feeding, stable vital parameters and without invasive ventilation. Before each feeding procedure an odorant was presented in front of the infant's nose. Infants were randomized into one of three groups and received either rose odor (not food-associated), vanilla odor (food-associated) or placebo (no odor). The primary outcome of the study was defined as the time until complete oral nutrition. 150 children born at a postnatal age of 9.5±7.8 days were included in this study. The duration until complete oral nutrition was reached after 11.8±7.7 (vanilla), 12.2±7.7 (rose) and 12.9±8.8 (control) days. A nearly linear relation between odor presentation frequency and effect size was detectable. For infants that received the intervention for more than 66.7% of the time the length of gavage feeding (8±5.4) and hospitalization (11±6.5) was significantly lower in the vanilla group when compared with control (15±7.3 and 21±13.7 respectively). Odor stimulation with vanilla has an impact on oral feeding in premature infants, however the odor has to be presented on regular basis.

Airway and Feeding Outcomes of Mandibular Distraction, Tongue-Lip Adhesion, and Conservative Management in Pierre Robin Sequence: A Prospective Study.

PubMed

Khansa, Ibrahim; Hall, Courtney; Madhoun, Lauren L; Splaingard, Mark; Baylis, Adriane; Kirschner, Richard E; Pearson, Gregory D

2017-04-01

Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospectively evaluate the airway and feeding outcomes of their comprehensive approach to Pierre Robin sequence, which includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion. A longitudinal study of newborns with Pierre Robin sequence treated at a pediatric academic medical center between 2010 and 2015 was performed. Baseline feeding and respiratory data were collected. Patients underwent conservative management if they demonstrated sustainable weight gain without tube feeds, and if their airway was stable with positioning alone. Patients who required surgery underwent tongue-lip adhesion or mandibular distraction osteogenesis based on family and surgeon preference. Postoperative airway and feeding data were collected. Twenty-eight patients with Pierre Robin sequence were followed prospectively. Thirty-two percent had a syndrome. Ten underwent mandibular distraction osteogenesis, eight underwent tongue-lip adhesion, and 10 were treated conservatively. There were no differences in days to extubation or discharge, change in weight percentile, requirement for gastrostomy tube, or residual obstructive sleep apnea between the three groups. No patients required tracheostomy. The greatest reduction in apnea-hypopnea index occurred with mandibular distraction osteogenesis, followed by tongue-lip adhesion and conservative management. Careful selection of which patients with Pierre Robin sequence need surgery, and of the most appropriate surgical procedure for each patient, can minimize the need for postprocedure tracheostomy. A comprehensive approach to Pierre Robin sequence that includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion can result in excellent airway and feeding outcomes. Therapeutic, II.

Distribution of Calcium and Chitin in the Tardigrade Feeding Apparatus in Relation to its Function and Morphology.

PubMed

Guidetti, Roberto; Bonifacio, Alois; Altiero, Tiziana; Bertolani, Roberto; Rebecchi, Lorena

2015-08-01

The cuticular portion of the tardigrade feeding apparatus is a complex structure that can be schematically divided into four parts: a buccal ring, a buccal tube, a stylet system (formed by two piercing stylets, each within a stylet coat, and two stylet supports), and the lining of a myoepithelial sucking pharynx. To better understand the function and evolution of the feeding apparatus, the morpho-functional traits and chemical composition of the structures forming the feeding apparatuses of eight different species of tardigrades were analyzed. These eight species are representative of almost all main phylogenetic lineages of the phylum. The calcium and chitin in the feeding apparatus were examined by light microscopy, scanning electron microscopy, confocal laser scanning microscopy, energy dispersive X-ray spectroscopy, and Raman microspectroscopy (Raman). In all species, the feeding apparatus had been subjected to biomineralization due to CaCO3 encrustations organized in the crystalline form of aragonite. Aragonite and chitin are present in different concentrations in the feeding apparatus according to the structures and species considered. Generally, where the structures are rigid there is more aragonite than chitin, and vice versa. The buccal tube and piercing stylets are rich in calcium, with the piercing stylets apparently composed exclusively of aragonite. In eutardigrades, chitin is in higher concentration in the structures subject to higher mechanical stresses, such as the crests of the buccal crown and the condyles of the stylet furca. © The Author 2015. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

Benefits of postpyloric enteral access placement by a nutrition support dietitian.

PubMed

Jimenez, L Lee; Ramage, James E

2004-10-01

Although enteral nutrition is considered the preferred strategy for nutrition support, it is often precluded by nasogastric feeding intolerance or the inability to place feeding access into the postpyloric position. In an effort to improve enteral nutrition (EN) outcomes at our institution, the nutrition support dietitian (NSD) began placing postpyloric feeding tubes (PPFT) in intensive care unit patients. Intensive care unit patients who received blind, bedside PPFT placements by the NSD (n = 18) were compared with a concurrent age- and diagnosis-matched control group that received standard nutritional care without NSD intervention (n = 18). Interruption of EN infusion, appropriateness of parenteral nutrition (PN) prescription (based on American Society of Parenteral and Enteral Nutrition guidelines), and incidence of ventilator-associated pneumonia (VAP), as defined by the American College of Chest Physicians practice guidelines, were determined in each group. The NSD was successful in positioning the PPFT at or distal to the third portion of the duodenum in 83% of attempts. The PPFT group demonstrated no interruption of enteral feeding compared with 56% in the control group (p < .01) and required 1 (6%) PN initiation in contrast to 8 (44%) in the control group (p < .01). There was a trend toward reduced VAP in the PPFT group (6% vs 28%, p = .07). Of the PN initiations in the control group, 88% were deemed to be potentially avoidable; 6 of 8 PNs were initiated because of gastric residuals. Enteral nutrition facilitated by NSD placement of postpyloric feeding access is associated with improved tube feeding tolerance and reduced PN use. Further studies are needed to evaluate a possible effect of postpyloric feeding on the incidence of VAP.

Seasonal Affective Disorder

MedlinePlus

... than any non-seasonal depressions. Symptoms of Major Depression Feeling depressed most of the day, nearly every ... Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS Feed NIMH ...

Swallowing problems

MedlinePlus

... Read More Brain aneurysm repair Brain surgery Laryngectomy Multiple sclerosis Oral cancer Parkinson disease Stroke Throat or larynx ... Jejunostomy feeding tube Mouth and neck radiation - discharge Multiple sclerosis - discharge Stroke - discharge Review Date 5/11/2016 ...

Improvised external ventricular drain in neurosurgery: A Nigerian tertiary hospital experience

PubMed Central

Ojo, O. A.; Asha, M. A.; Bankole, O. B.; Kanu, O. O.

2015-01-01

Background: The most common type of hydrocephalus in developing countries is post infective hydrocephalus. Infected cerebrospinal fluid (CSF) however cannot be shunted for the reason that it will block the chamber of the ventriculo-peritoneal (VP) shunt due to its high protein content. In centers where standard external ventricular drain (EVD) sets are not available, improvised feeding tube can be used. Aim: The main focus of this study is to encourage the use of improvised feeding tube catheters for EVD when standard sets are not available to improve patients’ survival. Methodology: This was a prospective study. Consecutive patients with hydrocephalus that cannot be shunted immediately for high chances of shunt failure or signs of increasing intracranial pressure were recruited into the study. Other inclusion criteria were preoperative brain tumor with possibility of blocked CSF pathway and massive intraventricular hemorrhage necessitating ventricular drainage as a salvage procedure. Standard EVD set is not readily available and too expensive for most of the parents to afford. Improvised feeding tube is used to drain/divert CSF using the standard documented procedure for EVD insertion. Outcome is measured and recorded. Results: A total of 28 patients were recruited into the study over a time frame of 2 years. There were 19 (67.9%) male and 9 (32.1%) females with a ratio of about 2:1. Age ranges varied from as low as 7 days to 66 years. The median age of the study sample was 6.5 months while the mean was 173.8 months. Duration of EVD varied from 2 days to 11 days with a median of 7 while the average was 6 days. Eventual outcome following the procedure of EVD showed that 19 (67.9%) survived and were discharged either to go home or to have VP shunt afterwards while 8 (28.6%) of the patients died. Conclusions: External ventricular drain can and should be done when it is necessary. Potential mortalities could be reduced by the improvised drainage using a standard feeding tube as described. PMID:26167009

Growth in Very Young Children Undergoing Chronic Peritoneal Dialysis

PubMed Central

Azocar, Marta; Borzych, Dagmara; Watson, Alan R.; Büscher, Anja; Edefonti, Alberto; Bilge, Ilmay; Askenazi, David; Leozappa, Giovanna; Gonzales, Claudia; van Hoeck, Koen; Secker, Donna; Zurowska, Aleksandra; Rönnholm, Kai; Bouts, Antonia H. M.; Stewart, Heather; Ariceta, Gema; Ranchin, Bruno; Warady, Bradley A.; Schaefer, Franz

2011-01-01

Very young children with chronic kidney disease often have difficulty maintaining adequate nutrition, which contributes to the high prevalence of short stature in this population. Characteristics of the dialysis prescription and supplemental feeding via a nasogastric (NG) tube or gastrostomy may improve growth, but this is not well understood. Here, we analyzed data from 153 children in 18 countries who commenced chronic peritoneal dialysis at <24 months of age. From diagnosis to last observation, 57 patients were fed on demand, 54 by NG tube, and 10 by gastrostomy; 26 switched from NG to gastrostomy; and 6 returned from NG to demand feeding. North American and European centers accounted for nearly all feeding by gastrostomy. Standardized body mass index (BMI) uniformly decreased during periods of demand feeding and increased during NG and gastrostomy feeding. Changes in BMI demonstrated significant regional variation: 26% of North American children were obese and 50% of Turkish children were malnourished at last observation (P < 0.005). Body length decreased sharply during the first 6 to 12 months of life and then tended to stabilize. Time fed by gastrostomy significantly associated with higher lengths over time (P < 0.001), but adjustment for baseline length attenuated this effect. In addition, the use of biocompatible peritoneal dialysate and administration of growth hormone independently associated with improved length, even after adjusting for regional factors. In summary, growth and nutritional status vary regionally in very young children treated with chronic peritoneal dialysis. The use of gastrostomy feeding, biocompatible dialysis fluid, and growth hormone therapy associate with improved linear growth. PMID:22021715

The Fate of Fat: Pre-Exposure Fat Losses during Nasogastric Tube Feeding in Preterm Newborns

PubMed Central

Rayyan, Maissa; Rommel, Nathalie; Allegaert, Karel

2015-01-01

Deficient nutritional support and subsequent postnatal growth failure are major covariates of short- and long-term outcome in preterm neonates. Despite its relevance, extrauterine growth restriction (EUGR) is still prevalent, occurring in an important portion of extremely preterm infants. Lipids provide infants with most of their energy needs, but also cover specific supplies critical to growth, development and health. The use of human milk in preterm neonates results in practices, such as milk storage, pasteurization and administration by an infusion system. All of these pre-exposure manipulations significantly affect the final extent of lipid deposition in the intestinal track available for absorption, but the impact of tube feeding is the most significant. Strategies to shift earlier to oral feeding are available, while adaptations of the infusion systems (inversion, variable flow) have only more recently been shown to be effective in “in vitro”, but not yet in “in vivo” settings. Pre-exposure-related issues for drugs and nutritional compounds show similarities. Therefore, we suggest that the available practices for “in vitro” drug evaluations should also be considered in feeding strategies to further reduce pre-exposure losses as a strategy to improve the nutritional status and outcome of preterm neonates. PMID:26230707

Study of Effect of Impacting Direction on Abrasive Nanometric Cutting Process with Molecular Dynamics

NASA Astrophysics Data System (ADS)

Li, Junye; Meng, Wenqing; Dong, Kun; Zhang, Xinming; Zhao, Weihong

2018-01-01

Abrasive flow polishing plays an important part in modern ultra-precision machining. Ultrafine particles suspended in the medium of abrasive flow removes the material in nanoscale. In this paper, three-dimensional molecular dynamics (MD) simulations are performed to investigate the effect of impacting direction on abrasive cutting process during abrasive flow polishing. The molecular dynamics simulation software Lammps was used to simulate the cutting of single crystal copper with SiC abrasive grains at different cutting angles (0o-45o). At a constant friction coefficient, we found a direct relation between cutting angle and cutting force, which ultimately increases the number of dislocation during abrasive flow machining. Our theoretical study reveal that a small cutting angle is beneficial for improving surface quality and reducing internal defects in the workpiece. However, there is no obvious relationship between cutting angle and friction coefficient.

Control technology for crystalline silica exposures in construction: wet abrasive blasting.

PubMed

Golla, Vijay; Heitbrink, William

2004-03-01

This study was designed to document the effect that wet abrasive blasting has on reducing worker exposure to crystalline silica, which has been associated with silicosis and premature death. In this study, worker exposure to respirable crystalline silica was monitored during wet abrasive blasting on the exterior walls of a parking garage to remove surface concrete and expose the underlying aggregate. In this process a wet sand mix comprised of 80% dry sand and 20% water was used. Sampling and analysis revealed that the geometric mean respirable quartz concentration was 0.2 mg/m(3) for workers conducting abrasive blasting and 0.06 mg/m(3) for helpers. When abrasive blasting was conducted in areas that apparently had reduced natural ventilation, dust exposures appeared to increase. When compared with other published data, this case study suggests that wet abrasive blasting causes less exposure to crystalline silica than dry abrasive blasting.

Study of Effect of Impacting Direction on Abrasive Nanometric Cutting Process with Molecular Dynamics.

PubMed

Li, Junye; Meng, Wenqing; Dong, Kun; Zhang, Xinming; Zhao, Weihong

2018-01-11

Abrasive flow polishing plays an important part in modern ultra-precision machining. Ultrafine particles suspended in the medium of abrasive flow removes the material in nanoscale. In this paper, three-dimensional molecular dynamics (MD) simulations are performed to investigate the effect of impacting direction on abrasive cutting process during abrasive flow polishing. The molecular dynamics simulation software Lammps was used to simulate the cutting of single crystal copper with SiC abrasive grains at different cutting angles (0 o -45 o ). At a constant friction coefficient, we found a direct relation between cutting angle and cutting force, which ultimately increases the number of dislocation during abrasive flow machining. Our theoretical study reveal that a small cutting angle is beneficial for improving surface quality and reducing internal defects in the workpiece. However, there is no obvious relationship between cutting angle and friction coefficient.

Using sounds for making decisions: greater tube-nosed bats prefer antagonistic calls over non-communicative sounds when feeding

PubMed Central

Jiang, Tinglei; Long, Zhenyu; Ran, Xin; Zhao, Xue; Xu, Fei; Qiu, Fuyuan; Kanwal, Jagmeet S.

2016-01-01

ABSTRACT Bats vocalize extensively within different social contexts. The type and extent of information conveyed via their vocalizations and their perceptual significance, however, remains controversial and difficult to assess. Greater tube-nosed bats, Murina leucogaster, emit calls consisting of long rectangular broadband noise burst (rBNBl) syllables during aggression between males. To experimentally test the behavioral impact of these sounds for feeding, we deployed an approach and place-preference paradigm. Two food trays were placed on opposite sides and within different acoustic microenvironments, created by sound playback, within a specially constructed tent. Specifically, we tested whether the presence of rBNBl sounds at a food source effectively deters the approach of male bats in comparison to echolocation sounds and white noise. In each case, contrary to our expectation, males preferred to feed at a location where rBNBl sounds were present. We propose that the species-specific rBNBl provides contextual information, not present within non-communicative sounds, to facilitate approach towards a food source. PMID:27815241

Feeding tube insertion - gastrostomy

MedlinePlus

... and the A.D.A.M. Editorial team. Nutritional Support Read more NIH MedlinePlus Magazine Read more ... any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should ...

Intestinal Failure (Short Bowel Syndrome)

MedlinePlus

... given slowly by a feeding tube and a pump, sometimes just at night. Dripping the formula in ... the intestine more time to absorb nutrients. Portable pumps are available for children who also need drip ...

Aliasing Signal Separation of Superimposed Abrasive Debris Based on Degenerate Unmixing Estimation Technique

PubMed Central

Li, Tongyang; Wang, Shaoping; Zio, Enrico; Shi, Jian; Hong, Wei

2018-01-01

Leakage is the most important failure mode in aircraft hydraulic systems caused by wear and tear between friction pairs of components. The accurate detection of abrasive debris can reveal the wear condition and predict a system’s lifespan. The radial magnetic field (RMF)-based debris detection method provides an online solution for monitoring the wear condition intuitively, which potentially enables a more accurate diagnosis and prognosis on the aviation hydraulic system’s ongoing failures. To address the serious mixing of pipe abrasive debris, this paper focuses on the superimposed abrasive debris separation of an RMF abrasive sensor based on the degenerate unmixing estimation technique. Through accurately separating and calculating the morphology and amount of the abrasive debris, the RMF-based abrasive sensor can provide the system with wear trend and sizes estimation of the wear particles. A well-designed experiment was conducted and the result shows that the proposed method can effectively separate the mixed debris and give an accurate count of the debris based on RMF abrasive sensor detection. PMID:29543733

Study of Abrasive Wear Volume Map for PTFE and PTFE Composites

NASA Astrophysics Data System (ADS)

Unal, H.; Sen, U.; Mimaroglu, A.

2007-11-01

The potential of this work is based on consideration of wear volume map for the evaluation of abrasive wear performance of polytetrafluoroethylene (PTFE) and PTFE composites. The fillers used in the composite are 25% bronze, 35% graphite and 17% glass fibre glass (GFR). The influence of filler materials, abrasion surface roughness and applied load values on abrasive wear performance of PTFE and PTFE composites were studied and evaluated. Experimental abrasive wear tests were carried out at atmospheric condition on pin-on-disc wear tribometer. Tests were performed under 4, 6, 8 and 10 N load values, travelling speed of 1 m/sec and abrasion surface roughness values of 5, 20 and 45 µm. Wear volume maps were obtained and the results showed that the lowest wear volume rate for PTFE is reached using GFR filler. Furthermore, the results also showed that the higher is the applied load and the roughness of the abrasion surface, the higher is the wear rate. Finally it is also concluded that abrasive wear process mechanism include ploughing and cutting mechanisms.

Randomized Controlled Trial to Explore the Effect of Experimental Low Abrasivity Dentifrices on Enamel Gloss and Smoothness, and the Build-up of Extrinsic Tooth Stain.

PubMed

Milleman, Kimberly R; Milleman, Jeffery L; Young, Sarah; Parkinson, Charles

2017-06-01

To evaluate and compare examiner-assessed changes in enamel gloss, extrinsic dental stain, and surface smoothness following one, two, four, and eight weeks of twice-daily use of an experimental low abrasivity desensitizing dentifrice (relative dentin abrasivity [RDA] ~40) containing 5% sodium tripolyphosphate (STP) chemical cleaning agent and 1% aluminum trioxide abrasive. This was compared with an ultra-low abrasivity dentifrice (5% STP only; RDA ~13), a moderate abrasivity fluoride dentifrice (RDA ~80), and a higher abrasivity marketed whitening dentifrice (RDA ~142). This was a single-center, examiner-blind, randomized, controlled, parallel group study in healthy adults stratified by gloss score and age. Following a washout period with a conventional silica abrasive dentifrice, subjects received a dental scale and polish and were randomized to treatment. Subjects brushed their teeth for two minutes, twice daily, with their assigned dentifrice. Enamel gloss was assessed visually by comparing the facial surfaces of the maxillary incisors to the Sturzenberger gloss standards. Extrinsic dental stain was measured on the 12 anterior teeth (facial and lingual) using the Macpherson modification of the Lobene Stain Index (MLSI). Tooth smoothness was assessed using scanning electron microscope (SEM) analysis of a silicone impression of the central incisors. Of 120 screened subjects, 95 were randomized to the study. Subjects using the low abrasivity aluminum trioxide/STP dentifrice demonstrated statistically significant (p < 0.05) and increasing improvements in surface gloss over baseline at all time points, with a significant treatment effect compared to all other study dentifrices from Week 2 (p < 0.05). With respect to dental stain, the low abrasivity dentifrice group had the lowest stain score at each post-treatment time point and demonstrated statistically significantly less stain compared to all study dentifrices at Weeks 2 (p < 0.05) and 8 (p < 0.01). For tooth smoothness, at Week 8, statistically significant increases in surface smoothness were observed for most treatment groups compared to baseline (p < 0.05), except for the moderate abrasivity dentifrice. This study shows the benefit of a low abrasivity dentifrice containing STP and aluminum trioxide in reducing stain build-up and increasing tooth gloss compared to a non-alumina ultra-low abrasivity STP-containing dentifrice, and moderate and high abrasivity dentifrices, over an eight-week period.

Laser Powder Cladding of Ti-6Al-4V α/β Alloy

PubMed Central

Al-Sayed Ali, Samar Reda; Hussein, Abdel Hamid Ahmed; Nofal, Adel Abdel Menam Saleh; Elgazzar, Haytham Abdelrafea; Sabour, Hassan Abdel

2017-01-01

Laser cladding process was performed on a commercial Ti-6Al-4V (α + β) titanium alloy by means of tungsten carbide-nickel based alloy powder blend. Nd:YAG laser with a 2.2-KW continuous wave was used with coaxial jet nozzle coupled with a standard powder feeding system. Four-track deposition of a blended powder consisting of 60 wt % tungsten carbide (WC) and 40 wt % NiCrBSi was successfully made on the alloy. The high content of the hard WC particles is intended to enhance the abrasion resistance of the titanium alloy. The goal was to create a uniform distribution of hard WC particles that is crack-free and nonporous to enhance the wear resistance of such alloy. This was achieved by changing the laser cladding parameters to reach the optimum conditions for favorable mechanical properties. The laser cladding samples were subjected to thorough microstructure examinations, microhardness and abrasion tests. Phase identification was obtained by X-ray diffraction (XRD). The obtained results revealed that the best clad layers were achieved at a specific heat input value of 59.5 J·mm−2. An increase by more than three folds in the microhardness values of the clad layers was achieved and the wear resistance was improved by values reaching 400 times. PMID:29036935

Laser Powder Cladding of Ti-6Al-4V α/β Alloy.

PubMed

Al-Sayed Ali, Samar Reda; Hussein, Abdel Hamid Ahmed; Nofal, Adel Abdel Menam Saleh; Hasseb Elnaby, Salah Elden Ibrahim; Elgazzar, Haytham Abdelrafea; Sabour, Hassan Abdel

2017-10-15

Laser cladding process was performed on a commercial Ti-6Al-4V (α + β) titanium alloy by means of tungsten carbide-nickel based alloy powder blend. Nd:YAG laser with a 2.2-KW continuous wave was used with coaxial jet nozzle coupled with a standard powder feeding system. Four-track deposition of a blended powder consisting of 60 wt % tungsten carbide (WC) and 40 wt % NiCrBSi was successfully made on the alloy. The high content of the hard WC particles is intended to enhance the abrasion resistance of the titanium alloy. The goal was to create a uniform distribution of hard WC particles that is crack-free and nonporous to enhance the wear resistance of such alloy. This was achieved by changing the laser cladding parameters to reach the optimum conditions for favorable mechanical properties. The laser cladding samples were subjected to thorough microstructure examinations, microhardness and abrasion tests. Phase identification was obtained by X-ray diffraction (XRD). The obtained results revealed that the best clad layers were achieved at a specific heat input value of 59.5 J·mm -2 . An increase by more than three folds in the microhardness values of the clad layers was achieved and the wear resistance was improved by values reaching 400 times.

Deoxynivalenol (DON) Contamination of Feed and Grinding Fineness: Are There Interactive Implications on Stomach Integrity and Health of Piglets?

PubMed

Dänicke, Sven; Beineke, Andreas; Berk, Andreas; Kersten, Susanne

2017-01-01

The common feed contaminant deoxynivalenol (DON) was reported to influence the morphology of the pars nonglandularis (PN) of porcine stomach. Moreover, finely ground feed is known to trigger the development of ulcers and other pathologies of PN while coarsely ground feed protects from such lesions. The interactions between grinding fineness and DON contamination of feed were not examined so far. Therefore, both finely and coarsely ground feeds were tested either in the absence or presence of a DON contaminated wheat on growth performance and health of rearing piglets, including stomach integrity. DON contamination significantly reduced feed intake and serum albumin concentration with this effect being more pronounced after feeding the coarsely ground feed. Albeit at a higher level, albumin concentration was also reduced after feeding the finely ground and uncontaminated feed. Finely ground and DON-contaminated feed caused a significantly more pronounced lymphoplasmacytic infiltration both of PN and pars glandularis , partly paralleled by lymph follicle formation and detritus filled foveolae and tubes suggesting a local immune response probably triggered by epithelial lesions. It is concluded that DON contamination of feed exacerbates the adverse effects of finely ground feed on stomach mucosal integrity.

Deoxynivalenol (DON) Contamination of Feed and Grinding Fineness: Are There Interactive Implications on Stomach Integrity and Health of Piglets?

PubMed Central

Dänicke, Sven; Beineke, Andreas; Berk, Andreas; Kersten, Susanne

2017-01-01

The common feed contaminant deoxynivalenol (DON) was reported to influence the morphology of the pars nonglandularis (PN) of porcine stomach. Moreover, finely ground feed is known to trigger the development of ulcers and other pathologies of PN while coarsely ground feed protects from such lesions. The interactions between grinding fineness and DON contamination of feed were not examined so far. Therefore, both finely and coarsely ground feeds were tested either in the absence or presence of a DON contaminated wheat on growth performance and health of rearing piglets, including stomach integrity. DON contamination significantly reduced feed intake and serum albumin concentration with this effect being more pronounced after feeding the coarsely ground feed. Albeit at a higher level, albumin concentration was also reduced after feeding the finely ground and uncontaminated feed. Finely ground and DON-contaminated feed caused a significantly more pronounced lymphoplasmacytic infiltration both of PN and pars glandularis, partly paralleled by lymph follicle formation and detritus filled foveolae and tubes suggesting a local immune response probably triggered by epithelial lesions. It is concluded that DON contamination of feed exacerbates the adverse effects of finely ground feed on stomach mucosal integrity. PMID:28045426

Tube Feeding Troubleshooting Guide

MedlinePlus

... in place. (For example, does it have a balloon, a mushroom bumper, or other internal device, or ... Frequent vomiting. • See “Nausea and Vomiting” page 3. Balloon deflates or bursts. • Be sure the balloon under ...

Nasogastric feeding tube

MedlinePlus

... chap 16. Ziegler TR. Malnutrition, nutritional assessment, and nutritional support in adult hospitalized patients. In: Goldman L, Schafer ... A.M. Editorial team. Related MedlinePlus Health Topics Nutritional Support Browse the Encyclopedia A.D.A.M., Inc. ...

Feeding tube - infants

MedlinePlus

... BP, Ehrenkranz RA. Nutrient requirements and provision of nutritional support in the premature neonate. In: Martin RJ, Fanaroff ... and the A.D.A.M. Editorial team. Nutritional Support Read more NIH MedlinePlus Magazine Read more Health ...

Gastrostomy feeding tube - pump - child

MedlinePlus

... at home. In: O'Keefe SJD, ed. The Principles and Practice of Nutritional Support . New York, NY: Springer; 2015:chap 10. Schattner MA, Grossman EB. Nutritional management. In: Feldman M, Friedman LS, Brandt LJ, eds. ...

Medical Equipment at Home After the NICU

MedlinePlus

... Medical equipment at home after the NICU Medical equipment at home after the NICU E-mail to ... care unit (NICU) don’t need special medical equipment, like monitors or feeding tubes, when they leave ...

Clinics in diagnostic imaging (168).

PubMed

Lai, Yusheng Keefe; Mahmood, Rameysh Danovani

2016-05-01

A 16-year-old Chinese male patient presented with constipation lasting five days, colicky abdominal pain, lethargy, weakness and body aches. He was able to pass flatus. Abdominal radiography showed a distended stomach causing inferior displacement of the transverse colon. Computed tomography revealed a dilated oesophagus, stomach and duodenum up to its third portion, with a short aortomesenteric distance and narrow angle. There was also consolidation in the lungs bilaterally. Based on the constellation of clinical and imaging findings, a diagnosis of superior mesenteric artery syndrome complicated by aspiration pneumonia was made. The patient was subsequently started on intravenous hydration, nasogastric tube aspiration and antibiotics. Following stabilisation of his acute condition, a nasojejunal feeding tube was inserted and a feeding plan was implemented to promote weight gain. The clinical presentation, differentials, diagnosis and treatment of superior mesenteric artery syndrome are discussed. Copyright: © Singapore Medical Association.

Nutritional intervention in patients with Cystic Fibrosis: a systematic review.

PubMed

Woestenenk, J W; Castelijns, S J A M; van der Ent, C K; Houwen, R H J

2013-03-01

To systematically assess the literature published after 1997 describing the effectiveness of nutritional interventions in Cystic Fibrosis patients. An online search in PUBMED, EMBASE and COCHRANE databases was conducted. Original studies with 4 patients or more, describing a nutritional intervention and giving at least weight as an outcome parameter were included. The inclusion criteria were met by 17 articles, focusing on respectively behavioural interventions (n=6), oral supplementation (n=4) or enteral tube feeding (n=7). This latter intervention was universally successful to induce weight gain. One behavioural study and 2 oral supplementation studies also reported significant weight gain. Enteral tube feeding is effective to improve nutritional status, while the described effects of behavioural intervention and oral supplementation are not consistent at present. Copyright © 2012 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

[Nasogastric tube feeding in bulimia. Controlled study with follow-up at 3 months].

PubMed

Rigaud, Daniel; Brayer, Véronique; Biton-Jélic, Violaine; Païs, Vanessa; Pennacchio, Hélène; Brun, Jean-Marcel

2007-10-01

Few effective treatments are available for severe forms of bulimia nervosa, which are accompanied by malnutrition, anxiety, and depressive mood. We previously showed in an open study that nasogastric tube feeding (TF) reduced binges and purging in patients with anorexia nervosa. This prospective randomized trial compared bulimia patients in two treatment groups: one group received TF at home, together with psychotherapy, nutritional counseling and a support group while the control group received only psychotherapy, nutritional counseling, and a support group. Patients in the first group underwent TF for 8 weeks (exclusively for 10 days and associated with meals thereafter). Assessment was based on clinical examination, laboratory results, and a variety of questionnaires (our in-house instrument for measuring binge and vomiting episodes, eating disorder inventory, Beck's depression inventory and the Hamilton rating scale for anxiety), all performed at the onset of treatment and at 8 days, 8 weeks (i.e., the end of TF), and 3 months after treatment began. Binges and vomiting disappeared faster and more frequently in TF patients than in the control group: 65% versus 29% (p<0.01). Three months later, these remained less frequent in the TF group than among controls (52% versus 33%, p=0.064). Nutritional status, depression, and anxiety improved more among the TF than control subjects (p<0.05). Tube feeding was effective in these patients with bulimia nervosa, reducing the number of binge and vomiting episodes and improving nutritional status and mood.

Wear resistance and mechanisms of composite hardfacings at abrasive impact erosion wear

NASA Astrophysics Data System (ADS)

Surzhenkov, A.; Viljus, M.; Simson, T.; Tarbe, R.; Saarna, M.; Casesnoves, F.

2017-05-01

Tungsten carbide based hardmetal containing sprayed and melted composite hardfacings are prospective for protection against abrasive wear. For selection of abrasive wear resistant hardfacings under intensive impact wear conditions, both mechanical properties (hardness, fracture toughness, etc.) and abrasive wear conditions (type of abrasive, impact velocity, etc.) should be considered. This study focuses on the wear (wear rate and mechanisms) of thick metal-matrix composite hardfacings with hardmetal (WC-Co) reinforcement produced by powder metallurgy technology. The influence of the hardmetal reinforcement type on the wear resistance at different abrasive impact erosion wear (AIEW) conditions was studied. An optimal reinforcement for various wear conditions is described. Based on wear mechanism studies, a mathematical model for wear prediction was drafted.

Fuel cell and system for supplying electrolyte thereto with wick feed

DOEpatents

Cohn, J. Gunther; Feigenbaum, Haim; Kaufman, Arthur

1984-01-01

An electrolyte distribution and supply system for use with a fuel cell having a means for drawing electrolyte therein is formed by a set of containers of electrolyte joined to respective fuel cells in a stack of such cells. The electrolyte is separately stored so as to provide for electrical isolation between electrolytes of the individual cells of the stack. Individual storage compartments are coupled by tubes containing wicking fibers, the ends of the respective tubes terminating on the means for drawing electrolyte in each of the respective fuel cells. Each tube is heat shrunk to tightly bind the fibers therein.

Feeding Problems and Their Underlying Mechanisms in the Esophageal Atresia–Tracheoesophageal Fistula Patient

PubMed Central

Mahoney, Lisa; Rosen, Rachel

2017-01-01

Feeding difficulties such as dysphagia, coughing, choking, or vomiting during meals, slow eating, oral aversion, food refusal, and stressful mealtimes are common in children with repaired esophageal atresia (EA) and the reasons for this are often multifactorial. The aim of this review is to describe the possible underlying mechanisms contributing to feeding difficulties in patients with EA and approaches to management. Underlying mechanisms for these feeding difficulties include esophageal dysphagia, oropharyngeal dysphagia and aspiration, and aversions related to prolonged gastrostomy tube feeding. The initial diagnostic evaluation for feeding difficulties in a patient with EA may involve an esophagram, videofluoroscopic imaging or fiberoptic endoscopic evaluation during swallowing, upper endoscopy with biopsies, pH-impedance testing, and/or esophageal motility studies. The main goal of management is to reduce the factors contributing to feeding difficulties and may include reducing esophageal stasis, maximizing reflux therapies, treating underlying lung disease, dilating strictures, and altering feeding methods, routes, or schedules. PMID:28620597

A pulsed neutron generator for in vivo body composition studies

NASA Astrophysics Data System (ADS)

Weinlein, J. H.; O'Neal, M. L.; Bacon, F. M.

1991-05-01

A neutron generator system utilizing two Zetatron neutron tubes has been designed and delivered to the U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University for use in clinical measurements of body carbon by neutron inelastic scattering. Each neutron tube is capable of delivering 10 3-10 4 14-MeV neutrons in a 7-μs pulse at repetition rates of 4 or 8 kHz, and can be operated independently as well as in a master-slave mode. The neutron tubes are gas filled with a mixture of deuterium and tritium; the target of the tube is operated at - 30 to - 60 kV dc and the ion source is operated with a 2.5-kV, 7-μs pulse. The tube gas pressure is monitored and controlled by measuring the total current in the high voltage circuit and feeding it back to the gas-reservoir drive circuit. Neutrons were measured with a plastic scintillator and photomultiplier tube.

A new Fenestrulina (Bryozoa, Cheilostomata) commensal with tube-dwelling anemones (Cnidaria, Ceriantharia) in the tropical southwestern Atlantic.

PubMed

Vieira, Leandro M; Stampar, Sergio N

2014-03-21

A new species of cheilostome bryozoan, Fenestrulina commensalis n. sp., was collected in December 2008 by scuba at 5-10 meters depth at Guaibura Beach, Guarapari, Espírito Santo state, southeastern Brazil. The specimen was found associated with tubes of the cerianthid Pachycerianthus sp., representing the first commensal association between a bryozoan and a tube-dwelling anemone. Fenestrulina commensalis n. sp. is the third species of the genus found in Brazilian waters; it is distinguished from other Atlantic species of Fenestrulina by its small angular orificial condyles, a single oral spine and basal anchoring rhizoids arising from abfrontal pore chambers. Morphological adaptations to encrust the tubes of cerianthids include anchoring rootlets and weakly contiguous zooids. These morphological features allow the colony the flexibility to grow around the tube and feed relatively undisturbed by silt and detritus, being raised well above the soft-sediment substratum in which the tube-anemone grows.

Typing and Subtyping of 83 Clinical Isolates Purified from Surgically Implanted Silicone Feeding Tubes by Random Amplified Polymorphic DNA Amplification

PubMed Central

Dautle, Melanie P.; Ulrich, Ricky L.; Hughes, Thomas A.

2002-01-01

In this study, 83 clinical isolates purified from biofilms colonizing 18 silicone gastrostomy devices (12 “buttons” and six tubes converted to skin level devices) were selected for subtype characterization utilizing genetic analysis. The tubes, previously used for feeding, remained in place for 3 to 47 months (mean, 20.0 months) in children ranging in age from 6 months to 17 years. Classification of specific microbes using random amplified polymorphic DNA (RAPD) analysis revealed genetic similarities and differences among isolates belonging to the same genus. Both gram-positive and -negative bacteria were investigated, including 2 isolates of Bacillus brevis, 4 isolates of Bacillus licheniformis, 2 isolates of Bacillus pumilus, 3 isolates of Enterococcus durans, 19 isolates of Enterococcus faecalis, 8 isolates of Enterococcus faecium, 2 isolates of Enterococcus hirae, 7 isolates of Escherichia coli, 8 isolates of Lactobacillus plantarum, 19 isolates of Staphylococcus aureus, 2 isolates of Staphylococcus epidermidis, and 7 isolates of Staphylococcus saprophyticus. Amplified DNA fragments (amplicons) provided species-specific fingerprints for comparison by agarose gel electrophoresis. A total of 62 distinct RAPD types were categorized from the five genera studied. Typing analysis suggested cross acquisition of E. coli, E. faecalis, and S. aureus in three patient pairs. Genomic polymorphism detection proved efficient and reliable for classifying bacterial subtypes isolated from biofilms adhering to various portions of commonly employed enteral access tubes. PMID:11825951

Transpyloric Feeding Tube Placement Using Electromagnetic Placement Device in Children.

PubMed

Goggans, Margaret; Pickard, Sharon; West, Alina Nico; Shah, Samir; Kimura, Dai

2017-04-01

Transpyloric feeding tubes (TPT) are often recommended in critically ill children. Blind tube placement, however, can be difficult, be time-consuming, and incur multiple radiation exposures. An electromagnetic device (EMD) is available for confirmation of successful placement of TPTs. We conducted a retrospective cohort study to evaluate the efficacy of an EMD for TPT placement in children and determine its impact on placement success, radiation exposure, confirmation time, and cost for tube placement compared with traditional blind TPT placement. Retrospective data were collected in patients receiving a TPT before (pre-EMD group) and after implementation of an EMD (EMD group). Need for radiographic exposure decreased significantly in the EMD group (n = 40) compared with the pre-EMD group (n = 38) (0.6 vs 1.6 x-rays, P < .001). TPTs were placed and confirmed without abdominal x-ray in 21 of 40 patients in the EMD group. There were no serious adverse events such as misplacement into the lung or pneumothorax or perforation injury of the stomach. Successful tube confirmation took a significantly shorter time in the EMD group than in the pre-EMD group (1.45 vs 4.59 hours, P < .0001). There was an estimated cost savings of $245.10 per placement associated with decreased x-ray and fluoroscopy. The use of an EMD in children significantly decreased radiation exposure and confirmation time while maintaining TPT placement success. The use of an EMD can potentially offer large cost savings. Elimination of abdominal x-ray with EMD during TPT placement was achieved without any serious complications in approximately half of the children.

New Rock Abrasivity Test Method for Tool Life Assessments on Hard Rock Tunnel Boring: The Rolling Indentation Abrasion Test (RIAT)

NASA Astrophysics Data System (ADS)

Macias, F. J.; Dahl, F.; Bruland, A.

2016-05-01

The tunnel boring machine (TBM) method has become widely used and is currently an important presence within the tunnelling industry. Large investments and high geological risk are involved using TBMs, and disc cutter consumption has a great influence on performance and cost, especially in hard rock conditions. Furthermore, reliable cutter life assessments facilitate the control of risk as well as avoiding delays and budget overruns. Since abrasive wear is the most common process affecting cutter consumption, good laboratory tests for rock abrasivity assessments are needed. A new abrasivity test method by rolling disc named Rolling Indentation Abrasion Test (RIAT) has been developed. The goal of the new test design and procedure is to reproduce wear behaviour on hard rock tunnel boring in a more realistic way than the traditionally used methods. Wear by rolling contact on intact rock samples is introduced and several rock types, covering a wide rock abrasiveness range, have been tested by RIAT. The RIAT procedure indicates a great ability of the testing method to assess abrasive wear on rolling discs. In addition and to evaluate the newly developed RIAT test method, a comprehensive laboratory testing programme including the most commonly used abrasivity test methods and the mineral composition were carried out. Relationships between the achieved results from conventional testing and RIAT results have been analysed.

Abrasive wear of ceramic wear protection at ambient and high temperatures

NASA Astrophysics Data System (ADS)

Varga, M.; Adam, K.; Tumma, M.; Alessio, K. O.

2017-05-01

Ceramic wear protection is often applied in abrasive conditions due to their excellent wear resistance. This is especially necessary in heavy industries conveying large amounts of raw materials, e.g. in steel industry. Some plants also require material transport at high temperatures and velocities, making the need of temperature stable and abrasion resistant wear protection necessary. Various types and wear behaviour of ceramic protection are known. Hence, the goal of this study is to identify the best suitable ceramic materials for abrasive conditions in harsh environments at temperatures up to 950°C and severe thermal gradients. Chamottes, known for their excellent thermal shock resistance are compared to high abrasion resistant ceramic wear tiles and a cost efficient cement-bounded hard compound. Testing was done under high-stress three-body abrasion regime with a modified ASTM G65 apparatus enabling for investigations up to ~950°C. Thereto heated abrasive is introduced into the wear track and also preheated ceramic samples were used and compared to ambient temperature experiments. Results indicate a significant temperature influence on chamottes and the hard compound. While the chamottes benefit from temperature increase, the cement-bounded hard compound showed its limitation at abrasive temperatures of 950°C. The high abrasion resistant wear tiles represented the materials with the best wear resistance and less temperature influence in the investigated range.

Modeling of Micro Deval abrasion loss based on some rock properties

NASA Astrophysics Data System (ADS)

Capik, Mehmet; Yilmaz, Ali Osman

2017-10-01

Aggregate is one of the most widely used construction material. The quality of the aggregate is determined using some testing methods. Among these methods, the Micro Deval Abrasion Loss (MDAL) test is commonly used for the determination of the quality and the abrasion resistance of aggregate. The main objective of this study is to develop models for the prediction of MDAL from rock properties, including uniaxial compressive strength, Brazilian tensile strength, point load index, Schmidt rebound hardness, apparent porosity, void ratio Cerchar abrasivity index and Bohme abrasion test are examined. Additionally, the MDAL is modeled using simple regression analysis and multiple linear regression analysis based on the rock properties. The study shows that the MDAL decreases with the increase of uniaxial compressive strength, Brazilian tensile strength, point load index, Schmidt rebound hardness and Cerchar abrasivity index. It is also concluded that the MDAL increases with the increase of apparent porosity, void ratio and Bohme abrasion test. The modeling results show that the models based on Bohme abrasion test and L type Schmidt rebound hardness give the better forecasting performances for the MDAL. More models, including the uniaxial compressive strength, the apparent porosity and Cerchar abrasivity index, are developed for the rapid estimation of the MDAL of the rocks. The developed models were verified by statistical tests. Additionally, it can be stated that the proposed models can be used as a forecasting for aggregate quality.

Characterization of fine abrasive particles for optical fabrication

NASA Astrophysics Data System (ADS)

Funkenbusch, Paul D.; Zhou, Y. Y.; Takahashi, Toshio; Quesnel, David J.; Lambropoulos, John C.

1995-08-01

Material removal during fine grinding operations is accomplished primarily by the action of individual abrasive particles on the glass surface. The mechanical properties of the abrasive are therefore important. Unfortunately it is difficult to directly measure the mechanical response of abrasives once they reach the scale of approximately 10 microns. As a result mechanical properties of fine abrasives are sometimes characterized in terms of an empirical `friability', based on the response of the abrasive to crushing by a metal ball in a vial. In this paper we report on modeling/experiments designed to more precisely quantify the mechanical properties of fine abrasives and ultimately to relate them to the conditions experienced by bound particles during grinding. Experiments have been performed on various types and sizes of diamond abrasives. The response of the particles is a strong function of the loading conditions and can be tracked by changing the testing parameters. Diamond size is also found to play a critical role, with finer diamonds less susceptible to fracture. A micromechanical model from the literature is employed estimate the forces likely to be seen during testing. We are also developing dynamic models to better predict the forces experienced during `friability' testing as a function of the testing parameters.

[Implantation of ultra thin naso-duodenal and naso-jejunal tubes for feeding].

PubMed

Manegold, B C; Jung, M; Miceli, F; Schneider, K G

1984-05-01

Enteral nutrition through filiform naso-duodenal or naso-jejunal tubes with homogeneous low molecular nutritional solutions has a rather important place in therapy of different conditions; endoscopy can help to introduce these tubes into the intestinal tract in the following situations: A leak in the upper gastrointestinal tract, which may occur after surgical resections of the esophagus or stomach, or which may occur in rare cases after bouginage or after diagnostic procedures can be passed by with an ultrathin tube until it is healed of. Patients with stenotic lesions of the esophagus or the cardia, which can not be treated by surgery or conservative procedures like pertubation and dilation can be fed enterally if it is possible to move the tube beyond the stenosis. Patients with neurogenic swallowing dysfunction of different origine can be fed during long periods of time through such filiform naso-enteral tubes successfully and reach a perfect nutritional state. In acute treatment of Crohn's disease and other inflammatory intestinal diseases enteral nutrition through tubes is an essential therapeutic procedure.

Caregiver stress and outcomes of children with pediatric feeding disorders treated in an intensive interdisciplinary program.

PubMed

Greer, Ashley J; Gulotta, Charles S; Masler, Elizabeth A; Laud, Rinita B

2008-07-01

This study investigated the impact of an intensive interdisciplinary feeding program on caregiver stress and child outcomes of children with feeding disorders across three categories. Children were categorized into either tube dependent, liquid dependent, or food selective groups. Outcomes for caregiver stress levels, child mealtime behaviors, weight, and calories were examined at admission and discharge for 121 children. Repeated measures ANOVAs were used to examine differences pre- and post-treatment and across feeding categories. Caregiver stress, child mealtime behaviors, weight, and caloric intake improved significantly following treatment in the intensive feeding program, regardless of category placement. Few studies have examined the impact of an intensive interdisciplinary approach on caregiver stress, as well as on child outcome variables with such a diverse population. This study provides support that regardless of a child's medical and feeding history, an intensive interdisciplinary approach significantly improves caregiver stress and child outcomes.

Jejunostomy feeding tube

MedlinePlus

... in adult hospitalized patients. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 217. Read More Cerebral palsy Cystic fibrosis Esophageal cancer Failure to thrive HIV/AIDS Patient Instructions Crohn ...

Advanced Password Tips and Tricks

MedlinePlus

... email Looking for business guidance on privacy and security? Get Email Updates Blog Feed Facebook YouTube Twitter The Federal Trade Commission (FTC) is the nation’s consumer protection agency. The FTC works to prevent fraudulent, deceptive ...

Critical Care Team

MedlinePlus

... to improve the health of the patient who lacks nutrients. The registered dietitian can lead or perform feedings by mouth, tube or vein. Respiratory therapist: A caregiver who has special knowledge and practice in healing patients with breathing problems. ...

Infant-Guided, Co-Regulated Feeding in the Neonatal Intensive Care Unit. Part I: Theoretical Underpinnings for Neuroprotection and Safety.

PubMed

Shaker, Catherine S

2017-04-01

The rapid progress in medical and technical innovations in the neonatal intensive care unit (NICU) has been accompanied by concern for outcomes of NICU graduates. Although advances in neonatal care have led to significant changes in survival rates of very small and extremely preterm neonates, early feeding difficulties with the transition from tube feeding to oral feeding are prominent and often persist beyond discharge to home. Progress in learning to feed in the NICU and continued growth in feeding skills after the NICU may be closely tied to fostering neuroprotection and safety. The experience of learning to feed in the NICU may predispose preterm neonates to feeding problems that persist. Neonatal feeding as an area of specialized clinical practice has grown considerably in the last decade. This article is the first in a two-part series devoted to neonatal feeding. Part 1 explores factors in NICU feeding experiences that may serve to constrain or promote feeding skill development, not only in the NICU but long after discharge to home. Part II describes approaches to intervention that support neuroprotection and safety. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Micro-scale abrasive wear behavior of medical implant material Ti-25Nb-3Mo-3Zr-2Sn alloy on various friction pairs.

PubMed

Wang, Zhenguo; Huang, Weijiu; Ma, Yanlong

2014-09-01

The micro-scale abrasion behaviors of surgical implant materials have often been reported in the literature. However, little work has been reported on the micro-scale abrasive wear behavior of Ti-25Nb-3Mo-3Zr-2Sn (TLM) titanium alloy in simulated body fluids, especially with respect to friction pairs. Therefore, a TE66 Micro-Scale Abrasion Tester was used to study the micro-scale abrasive wear behavior of the TLM alloy. This study covers the friction coefficient and wear loss of the TLM alloy induced by various friction pairs. Different friction pairs comprised of ZrO2, Si3N4 and Al2O3 ceramic balls with 25.4mm diameters were employed. The micro-scale abrasive wear mechanisms and synergistic effect between corrosion and micro-abrasion of the TLM alloy were investigated under various wear-corrosion conditions employing an abrasive, comprised of SiC (3.5 ± 0.5 μm), in two test solutions, Hanks' solution and distilled water. Before the test, the specimens were heat treated at 760°C/1.0/AC+550°C/6.0/AC. It was discovered that the friction coefficient values of the TLM alloy are larger than those in distilled water regardless of friction pairs used, because of the corrosive Hanks' solution. It was also found that the value of the friction coefficient was volatile at the beginning of wear testing, and it became more stable with further experiments. Because the ceramic balls have different properties, especially with respect to the Vickers hardness (Hv), the wear loss of the TLM alloy increased as the ball hardness increased. In addition, the wear loss of the TLM alloy in Hanks' solution was greater than that in distilled water, and this was due to the synergistic effect of micro-abrasion and corrosion, and this micro-abrasion played a leading role in the wear process. The micro-scale abrasive wear mechanism of the TLM alloy gradually changed from two-body to mixed abrasion and then to three-body abrasion as the Vickers hardness of the balls increased. Copyright © 2014 Elsevier B.V. All rights reserved.

21 CFR 872.6030 - Oral cavity abrasive polishing agent.

Code of Federal Regulations, 2013 CFR

2013-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6030 Oral cavity abrasive polishing.... The abrasive polish is applied to the teeth by a handpiece attachment (prophylaxis cup). (b...

21 CFR 872.6030 - Oral cavity abrasive polishing agent.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6030 Oral cavity abrasive polishing.... The abrasive polish is applied to the teeth by a handpiece attachment (prophylaxis cup). (b...

21 CFR 872.6030 - Oral cavity abrasive polishing agent.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6030 Oral cavity abrasive polishing.... The abrasive polish is applied to the teeth by a handpiece attachment (prophylaxis cup). (b...

21 CFR 872.6030 - Oral cavity abrasive polishing agent.

Code of Federal Regulations, 2011 CFR

2011-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6030 Oral cavity abrasive polishing.... The abrasive polish is applied to the teeth by a handpiece attachment (prophylaxis cup). (b...

21 CFR 872.6030 - Oral cavity abrasive polishing agent.

Code of Federal Regulations, 2014 CFR

2014-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6030 Oral cavity abrasive polishing.... The abrasive polish is applied to the teeth by a handpiece attachment (prophylaxis cup). (b...

Electro-Optic Fabrics for the Warrior of the 21st Century - Phase II

DTIC Science & Technology

2010-01-01

46 28. Effect of 1000 cycles of hex- abrasion testing on Fire Wire cable .................................... 46 UNCLASSIFIED vi 29. Close...49 32. Effect of 2000 cycles of hex- abrasion testing on Fire Wire cable .................................... 49 33. Effect of 4000 cycles of...hex- abrasion testing on Fire Wire cable .................................... 50 34. Effect of 2000 cycles of hex- abrasion testing on USB v2 cable

Nutritional status and feeding practices in gastrointestinal surgery patients at Bach Mai Hospital, Hanoi, Vietnam

PubMed Central

Young, Lorraine S; Huong, Pham Thi Thu; Lam, Nguyen Thi; Thu, Nghiem Nguyet; Van, Ha Thi; Hanh, Nguyen Lien; Tuyen, Le Danh; Lien, Dinh Thi Kim; Hoc, Tran Hieu; Tuyet, Chu Thi; Anh, Nguyen Quoc; Henry, Elizabeth G; Lenders, Carine M; Gura, Kathleen M; Bigornia, Sherman J; Apovian, Caroline M; Ziegler, Thomas R

2017-01-01

Background and Objectives The nutritional status and hospital feeding practices of surgical patients in Vietnam are not well documented. Based on a cross-sectional study at Bach Mai Hospital (BMH), the prevalence of malnutrition was found to be 33% in the surgical ward using a body mass index (BMI<18.5 kg/m2. We conducted an observational study over a three month period to evaluate the feeding practices in the gastrointestinal (GI) surgery ward at Bach Mai Hospital (BMH) in Hanoi, Vietnam. Methods and Study Design Investigators from the U.S. and the Vietnamese National Institute of Nutrition (NIN) enrolled 72 subjects admitted for elective GI surgery in an observational study at BMH. Baseline anthropometrics and changes over time, body mass index (BMI), Subjective Global Assessment (SGA) and daily kcal and protein intake from oral diet, tube feeding, and parenteral nutrition (PN) from admission until discharge were documented. Results A total of 50% of subjects scored a B or C on the SGA; 48% of subjects had a BMI<18.5, while mean mid upper arm circumference was in the low-normal range (24±4 cm). Nearly all patients (98%) were given PN postoperatively, with oral feeding starting on an average of postoperative day 4. Only one patient was tube fed. Mean daily total calorie intake was 15 kcal/kg/day and protein intake was 0.61 g/kg/day during hospitalization. Micronutrient supplementation was minimal in subjects receiving PN. Conclusions Hospital malnutrition in surgical patients in Vietnam is a significant problem, peri-operative feeding appears suboptimal and use of early postoperative PN was routine. PMID:27440685

Abrasion of eroded and sound enamel by a dentifrice containing diamond abrasive particles

PubMed

Wegehaupt, Florian J.; Hoegger, Vanessa G. M.; Attin, Thomas

2017-07-24

Eroded enamel is more susceptible to abrasive wear than sound enamel. New toothpastes utilizing diamond particles as abrasives have been developed. The present study investigated the abrasive wear of eroded enamel by three commercially available toothpastes (one containing diamond particles) and compared it to the respective wear of sound enamel caused by these toothpastes. Seventy-two bovine enamel samples were randomly allocated to six groups (S1–S3 and E1–E3; n=12). Samples were submitted to an abrasive (S1–S3) or erosion plus abrasion (E1–E3) cycling. Per cycle, all samples were brushed (abrasion; 20 brushing stokes) with the following toothpastes: S1/E1: Signal WHITE SYSTEM, S2/E2: elmex KARIESSCHUTZ and S3-E3: Candida WHITE DIAMOND (diamond particles). Groups E1–E3 were additionally eroded with HCl (pH 3.0) for 2 min before each brushing procedure. After 30, 60 and 90 cycles enamel wear was measured by surface profilometry. Within the same toothpaste and same number of cycles, enamel wear due to erosion plus abrasion was significantly higher than due to mere abrasion. After 30, 60 and 90 cycles, no significant difference in the wear in groups S1 and S2 was observed while the wear in group E1 was significantly (p<0.05, ANOVA, Scheffecyc) lower than that in group E2. After 90 cycles, wear in group S3 was about 5 times higher than that in group S2, while wear in group E3 was about 1.3 times higher than that in group E2. As compared to the other two investigated toothpastes, the dentifrice containing diamond particles caused slightly higher abrasive wear of eroded enamel and distinctly higher wear of sound enamel compared to the conventional toothpastes under investigation.

Extracorporeal life support for critical enterovirus 71 rhombencephalomyelitis: long-term neurologic follow-up.

PubMed

Lee, Hsiu-Fen; Chi, Ching-Shiang; Jan, Sheng-Ling; Fu, Yun-Ching; Huang, Fang-Liang; Chen, Po-Yen; Wang, Chung-Chi; Wei, Hao-Ji

2012-04-01

Enterovirus 71 rhombencephalomyelitis with cardiopulmonary dysfunction has become an endemic problem in Taiwan since an epidemic outbreak in 1998. Such cases frequently involve significant morbidity and mortality. From October 2000-June 2008, we collected 10 consecutive patients diagnosed with enterovirus 71 rhombencephalomyelitis complicated by left heart failure, with or without pulmonary edema, and surviving more than 3 months after receiving extracorporeal life support. Follow-up neurologic outcomes were analyzed prospectively. The median duration of neurologic follow-up was 7 years and 2 months. Significant morbidities included bulbar dysfunction, respiratory failure, and flaccid quadriparesis. Eight patients exhibited bulbar dysfunction, and feeding tubes could be removed from four patients (median, 15.5 months). Respiratory failure was observed in seven patients. Three patients were gradually withdrawn from their tracheostomy tube (median period, 30 months). Intelligence tests revealed four patients with normal cognitive function, one with borderline cognitive function, and one with mild mental retardation. Four were bedridden survivors. Extracorporeal life support for critical enterovirus 71 rhombencephalomyelitis demonstrated decreased neurologic sequelae during long-term follow-up, allowing for decannulation of feeding and tracheostomy tubes, and resulting in improved cognitive function. Copyright © 2012 Elsevier Inc. All rights reserved.

Hyperfiltration wash water recovery subsystem - Design and test results. [for extended mission spacecraft such as space stations

NASA Technical Reports Server (NTRS)

Reysa, R. P.; Price, D. F.; Olcott, T.; Gaddis, J. L.

1983-01-01

The Hyperfiltration Wash Water Recovery (HWWR) subsystem, designed to offer low-power high-volume wash water purification for extended mission spacecraft, is discussed in terms of preprototype design and configuration. Heated wash water collected from the shower, hand wash, and laundry flows into a temperature-controlled (374 K) waste storage tank. Two parallel 25 micron absolute filters at the tank outlet remove large particles from the feed stream. A positive displacement feed pump delivers wash water to the hyperfiltration module at a constant flow rate of 0.20 lpm with discharge pressure variations from 4181-7239 Kpa. The hyperfiltration membrane module is a single-pass design including 36 porous stainless steel tubes, and is designed to provide an approximate water recovery rate of 90 percent. Permeate and brine water flows are monitored by flow meters, and removal of urea and ammonia is achieved by adding 15 percent NaOCl solution to the permeate fluid stream. An alternate module design using two diameters of tubing (allowing a smaller pressure drop and a larger membrane area) gave a superior predicted performance over the first module with larger tubing throughout.

An interaction between levodopa and enteral nutrition resulting in neuroleptic malignant-like syndrome and prolonged ICU stay.

PubMed

Bonnici, André; Ruiner, Carola-Ellen; St-Laurent, Lyne; Hornstein, David

2010-09-01

To describe a probable interaction between enteral feeds and levodopa leading to neuroleptic malignant-like syndrome (NMLS) in a polytrauma patient with Parkinson's disease (PD). A 63-year-old morbidly obese male polytrauma patient with PD and type 2 diabetes mellitus was admitted to our intensive care unit postoperatively. Enteral feeds were administered per nasogastric tube and provided 0.88 g /kg/day of protein based on ideal body weight (IBW). His PD medications (pramipexole, entacapone, and immediate-release levodopa/carbidopa 100 mg/25 mg, 1.5 tablets 4 times daily) were administered via nasogastric tube. To achieve better glycemic control, his enteral feeds were changed to a formula that provided 1.8 g/kg/day of protein based on IBW. In the following 24 hours, the patient's mental status deteriorated and he was reintubated. He developed a high fever (40.5 degrees C), leukocytosis, elevated serum creatine kinase (CK) (480-1801 units/L), and acute renal impairment. His enteral nutrition was changed to decrease protein intake to 1.0 g/kg/day based on IBW and he was given bromocriptine 5 mg 3 times daily via nasogastric tube. Within 24 hours, the patient's mental status improved, his temperature and CK decreased, and his renal function began to improve; the values returned to baseline levels on the 18th day of admission. Withdrawal or dose reduction of levodopa in patients with PD has been reported to precipitate NMLS, which is potentially fatal. Because dietary protein can decrease the absorp0tion of levodopa, a potential for an interaction between levodopa and enteral feedings exists, although published reports of such an interaction are limited. In this patient, the likelihood that a drug-nutrient interaction occurred between levodopa and enteral feedings is considered to be probable based on the Naranjo probability scale and the Horn Drug Interaction Probability Scale. Health-care professionals should be aware of the interaction between levodopa and protein content of enteral nutrition to avoid the occurrence of NMLS in patients with PD.

21 CFR 872.6010 - Abrasive device and accessories.

Code of Federal Regulations, 2014 CFR

2014-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6010 Abrasive device and accessories... crowns. The device is attached to a shank that is held by a handpiece. The device includes the abrasive...

21 CFR 872.6010 - Abrasive device and accessories.

Code of Federal Regulations, 2013 CFR

2013-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6010 Abrasive device and accessories... crowns. The device is attached to a shank that is held by a handpiece. The device includes the abrasive...

21 CFR 872.6010 - Abrasive device and accessories.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6010 Abrasive device and accessories... crowns. The device is attached to a shank that is held by a handpiece. The device includes the abrasive...

21 CFR 872.6010 - Abrasive device and accessories.

Code of Federal Regulations, 2011 CFR

2011-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6010 Abrasive device and accessories... crowns. The device is attached to a shank that is held by a handpiece. The device includes the abrasive...

21 CFR 872.6010 - Abrasive device and accessories.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6010 Abrasive device and accessories... crowns. The device is attached to a shank that is held by a handpiece. The device includes the abrasive...

78 FR 22213 - Airworthiness Directives; Eurocopter France Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-15

... float assemblies for any cuts, tears, punctures, or abrasion. Replace the cover if the internal... cuts, tears, punctures, or abrasion. If there is a cut, tear, puncture, or any abrasion, repair the...

Electron Microscopy Abrasion Analysis of Candidate Fabrics for Planetary Space Suit Protective Overgarment Application

NASA Technical Reports Server (NTRS)

Hennessy, Mary J.

1992-01-01

The Electron Microscopy Abrasion Analysis of Candidate Fabrics for Planetary Space Suit Protective Overgarment Application is in support of the Abrasion Resistance Materials Screening Test. The fundamental assumption made for the SEM abrasion analysis was that woven fabrics to be used as the outermost layer of the protective overgarment in the design of the future, planetary space suits perform best when new. It is the goal of this study to determine which of the candidate fabrics was abraded the least in the tumble test. The sample that was abraded the least will be identified at the end of the report as the primary candidate fabric for further investigation. In addition, this analysis will determine if the abrasion seen by the laboratory tumbled samples is representative of actual EVA Apollo abrasion.

Fluidized bed injection assembly for coal gasification

DOEpatents

Cherish, Peter; Salvador, Louis A.

1981-01-01

A coaxial feed system for fluidized bed coal gasification processes including an inner tube for injecting particulate combustibles into a transport gas, an inner annulus about the inner tube for injecting an oxidizing gas, and an outer annulus about the inner annulus for transporting a fluidizing and cooling gas. The combustibles and oxidizing gas are discharged vertically upward directly into the combustion jet, and the fluidizing and cooling gas is discharged in a downward radial direction into the bed below the combustion jet.

Advanced Illness: Feeding Tubes and Ventilators

MedlinePlus

... stage Alzheimer's disease. For many, this is a quality of life issue, and they would prefer to not to ... supplements, use of a ventilator is also a quality of life decision. For some people, staying alive under these ...

Apparatus and methods for direct conversion of gaseous hydrocarbons to liquids

DOEpatents

Kong, Peter C.; Lessing, Paul A.

2006-04-25

A chemical reactor for direct conversion of hydrocarbons includes a dielectric barrier discharge plasma cell and a solid oxide electrochemical cell in fluid communication therewith. The discharge plasma cell comprises a pair of electrodes separated by a dielectric material and passageway therebetween. The electrochemical cell comprises a mixed-conducting solid oxide electrolyte membrane tube positioned between a porous cathode and a porous anode, and a gas inlet tube for feeding oxygen containing gas to the porous cathode. An inlet is provided for feeding hydrocarbons to the passageway of the discharge plasma cell, and an outlet is provided for discharging reaction products from the reactor. A packed bed catalyst may optionally be used in the reactor to increase efficiency of conversion. The reactor can be modified to allow use of a light source for directing ultraviolet light into the discharge plasma cell and the electrochemical cell.

Percutaneous endoscopic gastrostomy.

PubMed

Gay, F; el Nawar, A; Van Gossum, A

1992-01-01

From March 87 to March 92, fifty eight patients were referred to our department for percutaneous endoscopic gastrostomy (PEG). The modality of the feeding tube insertion is described. The most common indications for placement were neurologic disorders in 62% of the cases (n = 36) and malignant diseases in 32% (n = 19). The success rate of the technique was 98.3% (n = 57). No procedure-related mortality was observed. A low rate of major complication (1.7%) and minor complication (10.5%) was noted. Feeding tubes were removed in 21% of patients (n = 12); none of them with malignant disease. Survival curve analysis demonstrated that 50% of patients died within 3 months of PEG placement. Such results raise questions about the selection of patients undergoing PEG. Our experience of patients undergoing PEG. Our experience suggests that PEG is easy and safe, even in debilitated patients, having an acceptable life expectancy.

Malnutrition in Patients with Acute Stroke

PubMed Central

Bouziana, Stella D.; Tziomalos, Konstantinos

2011-01-01

Stroke is a devastating event that carries a potential for long-term disability. Malnutrition is frequently observed in patients with stroke, and dysphagia contributes to malnutrition risk. During both the acute phase of stroke and rehabilitation, specific nutritional interventions in the context of a multidisciplinary team effort can enhance the recovery of neurocognitive function. Early identification and management of malnutrition with dietary modifications or specific therapeutic strategies to ensure adequate nutritional intake should receive more attention, since poor nutritional status appears to exacerbate brain damage and to contribute to adverse outcome. The main purpose of nutritional intervention should be the prevention or treatment of complications resulting from energy-protein deficit. This paper reviews the evaluation and management of malnutrition and the use of specialized nutrition support in patients with stroke. Emphasis is given to enteral tube and oral feeding and to strategies to wean from tube feeding. PMID:22254136

Method for direct conversion of gaseous hydrocarbons to liquids

DOEpatents

Kong, Peter C.; Lessing, Paul A.

2006-03-07

A chemical reactor for direct conversion of hydrocarbons includes a dielectric barrier discharge plasma cell and a solid oxide electrochemical cell in fluid communication therewith. The discharge plasma cell comprises a pair of electrodes separated by a dielectric material and passageway therebetween. The electrochemical cell comprises a mixed-conducting solid oxide electrolyte membrane tube positioned between a porous cathode and a porous anode, and a gas inlet tube for feeding oxygen containing gas to the porous cathode. An inlet is provided for feeding hydrocarbons to the passageway of the discharge plasma cell, and an outlet is provided for discharging reaction products from the reactor. A packed bed catalyst may optionally be used in the reactor to increase efficiency of conversion. The reactor can be modified to allow use of a light source for directing ultraviolet light into the discharge plasma cell and the electrochemical cell.

Lapping slurry

DOEpatents

Simandl, Ronald F.; Upchurch, Victor S.; Leitten, Michael E.

1999-01-01

Improved lapping slurries provide for easier and more thorough cleaning of alumina workpieces, as well as inhibit corrosion of the lapping table and provide for easier cleaning of the lapping equipment. The unthickened lapping slurry comprises abrasive grains such as diamond abrasive dispersed in a carrier comprising water, glycerine, and triethanolamine. The thickened lapping slurry comprises abrasive grains such as diamond abrasive dispersed in a carrier comprising water, glycerine, triethanolamine, a water soluble silicate, and acid.

Microhardness evaluation of silorane and methacrylate composites submitted to erosion and abrasion processes

PubMed Central

Gazola, Eloá Aguiar; Rego, Marcos Augusto; Brandt, William Cunha; D’Arce, Maria Beatriz Freitas; Liporoni, Priscila Christiane Suzy

2015-01-01

Abstract Objective: The aim of this study was to evaluate the Knoop hardness number (KHN) of methacrylate (MC) and silorane (SC) composites after being submitted to erosion and abrasion processes. Material and methods: Forty samples were made with each composite: MC and SC. The samples were divided into eight groups (n = 10) according to the type of composite (G1–G4, MC; G5–G8, SC) and the beverages involved in the erosion process (G1 and G5 – Control (C), without erosion, with abrasion; G2 and G6 – Orange Juice (OJ), abrasion; G3 and G7 – Smirnoff Ice® (SI), abrasion; G4 and G8 – Gatorade® (GA), abrasion). The KHN test was performed 24 h after the last cycle of erosion/abrasion. Results: The MC groups showed smaller KHN values for the SI group (p < 0.05) when compared to the Control and OJ groups; however, for the SC groups, no differences were found (p > 0.05). Conclusion: Methacrylate composite when submitted to acidic beverages erosive challenge combined with abrasive process might alter its surface microhardness. However, the beverages used in the present study were not able to interfere in silorane composite surface microhardness. PMID:28642903

Size-dependent enrichment of waste slag aggregate fragments abraded from asphalt concrete.

PubMed

Takahashi, Fumitake; Shimaoka, Takayuki; Gardner, Kevin; Kida, Akiko

2011-10-30

Authors consider the environmental prospects of using melted waste slag as the aggregate for asphalt pavement. In particular, the enrichment of slag-derived fragments in fine abrasion dust particles originated from slag asphalt concrete and its size dependency were concerned. A series of surface abrasion tests for asphalt concrete specimens, containing only natural aggregates as reference or 30 wt% of substituted slag aggregates, were performed. Although two of three slag-asphalt concretes generated 1.5-3.0 times larger amount of abrasion dust than the reference asphalt concrete did, it could not be explained only by abrasion resistance of slag. The enrichment of slag-derived fragments in abrasion dust, estimated on the basis of the peak intensity of quartz and heavy metal concentrations, had size dependency for all slag-asphalt concretes. Slag-derived fragments were enriched in abrasion dust particles with diameters of 150-1000 μm. Enrichment factors were 1.4-2.1. In contrast, there was no enrichment in abrasion dust particles with diameter less than 75 μm. This suggests that prior airborne-size fragmentation of substituted slag aggregates does not need to be considered for tested slag aggregates when environmental risks of abrasion dust of slag-asphalt pavement are assessed. Copyright © 2011 Elsevier B.V. All rights reserved.

Relationships Between Abrasive Wear, Hardness, and Surface Grinding Characteristics of Titanium-Based Metal Matrix Composites

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blau, Peter Julian; Jolly, Brian C

2009-01-01

The objective of this work was to support the development of grinding models for titanium metal-matrix composites (MMCs) by investigating possible relationships between their indentation hardness, low-stress belt abrasion, high-stress belt abrasion, and the surface grinding characteristics. Three Ti-based particulate composites were tested and compared with the popular titanium alloy Ti-6Al-4V. The three composites were a Ti-6Al-4V-based MMC with 5% TiB{sub 2} particles, a Ti-6Al-4V MMC with 10% TiC particles, and a Ti-6Al-4V/Ti-7.5%W binary alloy matrix that contained 7.5% TiC particles. Two types of belt abrasion tests were used: (a) a modified ASTM G164 low-stress loop abrasion test, and (b)more » a higher-stress test developed to quantify the grindability of ceramics. Results were correlated with G-ratios (ratio of stock removed to abrasives consumed) obtained from an instrumented surface grinder. Brinell hardness correlated better with abrasion characteristics than microindentation or scratch hardness. Wear volumes from low-stress and high-stress abrasive belt tests were related by a second-degree polynomial. Grindability numbers correlated with hard particle content but were also matrix-dependent.« less

Investigation into the mechanisms of closed three-body abrasive wear

NASA Astrophysics Data System (ADS)

Dwyer-Joyce, R. S.; Sayles, R. S.; Ioannides, E.

1994-06-01

Contacting components frequently fail by abrasion caused by solid contaminants in the lubricant. This process can be classified as a closed three-body abrasive wear process. The mechanisms by which trapped particles cause material removal are not fully understood. This paper describes tests using model elastohydrodynamic contacts to study these mechanisms. An optical elastohydrodynamic lubrication rig has been used to study the deformation and fracture of ductile and brittle lubricant-borne debris. A ball-on-disk machine was used to study the behavior of the particles in partially sliding contacts. Small diamond particles were used as abrasives since these were thought not to break down in the contact; wear could then be directly related to particles of a known size. The particles were found to embed in the softer surface and to scratch the harder. The mass of material worn from the ball surface was approximately proportional to the particle sliding distance and abrasive concentration. Small particles tumbled through the contact, while larger particles ploughed. Mass loss was found to increase with abrasive particle size. Individual abrasion scratches have been measured and related to the abrading particle. A simple model of the abrasive process has been developed and compared with experimental data. The discrepancies are thought to be the result of the uncertainty about the entrainment of particles into the contact.

Development of feedback-speed-control system of fixed-abrasive tool for mat-surface fabrication

NASA Astrophysics Data System (ADS)

Yanagihara, K.; Kita, R.

2018-01-01

This study deals with the new method to fabricate a mat-surface by using fixed-abrasive tool. Mat-surface is a surface with microscopic irregularities whose dimensions are close to the wavelengths of visible light (400-700 nanometers). In order to develop the new method to fabricate mat-surface without pre-masking and large scale back up facility, utilization of fixed-abrasive tool is discussed. The discussion clarifies that abrasives in shot blasting are given kinetic energy along to only plunge-direction while excluding traverse-direction. If the relative motion between tool and work in fixed-abrasive process can be realized as that in blasting, mat-surface will be accomplished with fixed-abrasive process. To realize the proposed idea, new surface-fabrication system to which is adopted feedback-speed-control of abrasive wheel has been designed. The system consists of micro-computer unit (MPU), work-speed sensor, fixed-abrasive wheel, and wheel driving unit. The system can control relative speed between work and wheel in optimum range to produce mat-surface. Finally experiment to verify the developed system is carried out. The results of experiments show that the developed system is effective and it can produce the surface from grinding to mat-surface seamlessly.

AFCF and clinoptilolite use in reduction of (137)Cs deposition in several days' contaminated broiler chicks.

PubMed

Mitrovic, B; Vitorovic, G; Vitorovic, D; Dakovic, A; Stojanovic, M

2007-01-01

The objective of this study was to investigate the binding efficiency of AFCF and clinoptilolite, mixed to the feed and administered orally using gastric tube to chronically (137)Cs alimentary contaminated broiler chicks. Seventy-five male Hybro broiler chicks, between 35 and 47 days of age were divided into five groups (15 birds per group) reared in cages (five birds in a cage) and fed a standard diet. Every day during 13 days of the experimental period all chicks received orally 1 ml CsCl water solution with activity of 1310 Bq ml(-1)(137)Cs (gastric tube). Group 1 was the control group and received no binders. The experimental groups received the binders. Group 2 received 0.2 g of AFCF in the form of water solution (gastric tube); group 3 received 0.2% AFCF in the feed; group 4 received 2g clinoptilolite in the form of water suspension (gastric tube) and group 5 received 2% clinoptilolite in the feed. Five chicks from each group were sacrificed on days 4, 10 and 13 of the experimental period. Using gamma spectrometric methods specific activity of (137)Cs was determined in the samples of breast meat, liver and gizzard. The results obtained showed that administering binders to the chronically contaminated broiler chicks significantly (p<0.01) reduced (137)Cs transfer and deposition in breast meat, liver and gizzard. Decreasing deposition of (137)Cs in breast meat and internal organs increased with time of contamination and binders' administration. With AFCF as a cesium binder, on day 13 of measuring the (137)Cs activity in breast meat was 80-83% lower than that in the control group, 89% in liver and 83-84% in gizzard. Natural clinoptilolite demonstrated lower binding efficiency. On day 13 of measuring the (137)Cs activity in breast meat was 53-69% lower than that in the control group, 67-60% in liver and 59-71% in gizzard.

Confirmation of nasogastric tube position by pH testing.

PubMed

Taylor, S J; Clemente, R

2005-10-01

In 2004, the Medicines and Healthcare products Regulatory Agency (MHRA) advised that nasogastric (NG) tube position should be confirmed using pH strips or paper. However, gastric pH is raised by the use of H2-blockers and proton-pump inhibitors (PPIs) potentially producing false negative pH tests resulting in delayed feeding. In addition, colorimetric differentiation using pH strips may be more prone to bias and inaccuracy than direct pH measurements largely used to establish the threshold. To quantify this problem a 1 day survey of all the patients requiring NG and nasointestinal (NI) feeding was undertaken, to establish the numbers of patients receiving H2-Blockers or PPIs, with or without a safe swallow and the methods currently being used to confirm tube positioning. A second observational study was performed to establish the accuracy of six pH strips available to NHS trusts against four unlabelled pH solutions. Forty-two per cent of patients receiving NG feeding were on H2-blockers or PPIs, including 13% who had a safe swallow for acidic drinks that could be subsequently aspirated to confirm position. In the second study 'testers' correctly identified pH's 3, 4, 5 and 6 with Mackery-Nagel 0-6, BDH 0-6 and 0-14 strips but overestimated pH 4 as pH 5 with Johnson 0-11 paper, underestimated pH 6 as pH 5 with Pehanon 0-12 paper and with Litmus classified pH 3-5 as acid (all), but half also classified pH 6 as acid. Theoretically 29% of NG tube positions could not be confirmed by pH testing because of the usage of PPIs or H2-blockers and lack of swallow. Some pH strips are either inaccurate or their result misinterpreted by staff. Large surveys and trials of the actual efficacy and accuracy of pH testing are required.

Vibratory high pressure coal feeder having a helical ramp

DOEpatents

Farber, Gerald

1978-01-01

Apparatus and method for feeding powdered coal from a helical ramp into a high pressure, heated, reactor tube containing hydrogen for hydrogenating the coal and/or for producing useful products from coal. To this end, the helical ramp is vibrated to feed the coal cleanly at an accurately controlled rate in a simple reliable and trouble-free manner that eliminates complicated and expensive screw feeders, and/or complicated and expensive seals, bearings and fully rotating parts.

Precision replenishable grinding tool and manufacturing process

DOEpatents

Makowiecki, D.M.; Kerns, J.A.; Blaedel, K.L.; Colella, N.J.; Davis, P.J.; Juntz, R.S.

1998-06-09

A reusable grinding tool consisting of a replaceable single layer of abrasive particles intimately bonded to a precisely configured tool substrate, and a process for manufacturing the grinding tool are disclosed. The tool substrate may be ceramic or metal and the abrasive particles are preferably diamond, but may be cubic boron nitride. The manufacturing process involves: coating a configured tool substrate with layers of metals, such as titanium, copper and titanium, by physical vapor deposition (PVD); applying the abrasive particles to the coated surface by a slurry technique; and brazing the abrasive particles to the tool substrate by alloying the metal layers. The precision control of the composition and thickness of the metal layers enables the bonding of a single layer or several layers of micron size abrasive particles to the tool surface. By the incorporation of an easily dissolved metal layer in the composition such allows the removal and replacement of the abrasive particles, thereby providing a process for replenishing a precisely machined grinding tool with fine abrasive particles, thus greatly reducing costs as compared to replacing expensive grinding tools. 11 figs.

Precision replenishable grinding tool and manufacturing process

DOEpatents

Makowiecki, Daniel M.; Kerns, John A.; Blaedel, Kenneth L.; Colella, Nicholas J.; Davis, Pete J.; Juntz, Robert S.

1998-01-01

A reusable grinding tool consisting of a replaceable single layer of abrasive particles intimately bonded to a precisely configured tool substrate, and a process for manufacturing the grinding tool. The tool substrate may be ceramic or metal and the abrasive particles are preferably diamond, but may be cubic boron nitride. The manufacturing process involves: coating a configured tool substrate with layers of metals, such as titanium, copper and titanium, by physical vapor deposition (PVD); applying the abrasive particles to the coated surface by a slurry technique; and brazing the abrasive particles to the tool substrate by alloying the metal layers. The precision control of the composition and thickness of the metal layers enables the bonding of a single layer or several layers of micron size abrasive particles to the tool surface. By the incorporation of an easily dissolved metal layer in the composition such allows the removal and replacement of the abrasive particles, thereby providing a process for replenishing a precisely machined grinding tool with fine abrasive particles, thus greatly reducing costs as compared to replacing expensive grinding tools.

Mangrove Cultivation For Dealing With Coastal Abrasion Case Study Of Karangsong

NASA Astrophysics Data System (ADS)

Fatimatuzzahroh, Feti; Hadi, Sudharto P.; Purnaweni, Hartuti

2018-02-01

Coastal abrasion is consequence from destructive waves and sea current. One of cause is human intervention. The effort to solve of abrasion is by mangrove cultivation. Mangroves are halophyte plant that can restrain the sea wave. Mangrove cultivation required participation community that give awareness the importance of mangrove in coastal sustainability. Mangroves in coastal Karangsong, Indramayu west java, in 2007 was through abrasion approximately 127.30 ha. Mangrove cultivation in Karangsong has been replanting since 1998 to 2003, but there was no maintenance and management. In 2007 until 2015 Karangsong replanting mangroves and has been succeed. Karangsong became the center of mangrove study for west java area in 2015. This achievement is result of cooperation between community, NGO, and local government. In addition, this effort made not only overcome the abrasion problem but also give community awareness about the importance of mangrove cultivation in preventing coastal abrasion throughout community development. This paper reviews abrasion in Karangsong and the impact for local community and empowerment in mangrove cultivation. To achieve the success mangrove cultivation required community development approach from planning process, planting, maintenance and management.

METAL SPRAYER FOR USE IN VACUUM OR INERT ATMOSPHERE

DOEpatents

Monroe, R.E.

1958-10-14

A metal sprayer is described for use in a vacuum or inert atmosphere with a straight line wire feed and variable electrode contact angle. This apparatus comprises two wires which are fed through straight tubes of two mechanisms positioned on opposite sides of a central tube to which an inert gas is fed. The two mechanisms and the wires being fed constitute electrodes to which electrical current is supplied so that the wires are melted by the electric are formed at their contacting region and sprayed by the gas supplied by the central tube. This apparatus is designed specifically to apply a zirconium coating to uranium in an inert atmosphere and without the use of an oxidizing flame.

Thoracic empyema and lung abscess resulting from gastropulmonary fistula as a complication of esophagectomy.

PubMed

Osaki, Toshihiro; Matsuura, Hiroshi

2008-06-01

A benign fistula between the gastric tube and the airway resulting from esophagectomy is a rare complication, but it is a potentially life-threatening status. We present a 59-year-old man with thoracic empyema and lung abscess resulting from a benign gastric tube-to-pulmonary fistula caused by a penetration of the peptic ulcer in the gastric tube four years after an esophagectomy for esophageal cancer. After a thorough conservative management of infection and nutrition, the fistula was successfully repaired surgically with direct closure. The postoperative course was uneventful. Two years and nine months later, the patient retains satisfactory oral feeding status and is in good general condition.

A Population Intervention to Improve Outcomes in Children With Medical Complexity.

PubMed

Noritz, Garey; Madden, Melissa; Roldan, Dina; Wheeler, T Arthur; Conkol, Kimberly; Brilli, Richard J; Barnard, John; Gleeson, Sean

2017-01-01

Children with medical complexity experience frequent interactions with the medical system and often receive care that is costly, duplicative, and inefficient. The growth of value-based contracting creates incentives for systems to improve their care. This project was designed to improve the health, health care value, and utilization for a population-based cohort of children with neurologic impairment and feeding tubes. A freestanding children's hospital and affiliated accountable care organization jointly developed a quality improvement initiative. Children with a percutaneous feeding tube, a neurologic diagnosis, and Medicaid, were targeted for intervention within a catchment area of >300 000 children receiving Medicaid. Initiatives included standardizing feeding tube management, improving family education, and implementing a care coordination program. Between January 2011 and December 2014, there was an 18.0% decrease (P < .001) in admissions and a 31.9% decrease (P < .001) in the average length of stay for children in the cohort. Total inpatient charges were reduced by $11 764 856. There was an 8.2% increase (P < .001) in the percentage of children with weights between the fifth and 95th percentiles. The care coordination program enrolled 58.3% of the cohort. This population-based initiative to improve the care of children with medical complexity showed promising results, including a reduction in charges while improving weight status and implementing a care coordination program. A concerted institutional initiative, in the context of an accountable care organization, can be part of the solution for improving outcomes and health care value for children with medical complexity. Copyright © 2017 by the American Academy of Pediatrics.

Advance care planning and proxy decision making for patients with advanced Parkinson disease.

PubMed

Kwak, Jung; Wallendal, Maggie S; Fritsch, Thomas; Leo, Gary; Hyde, Trevor

2014-03-01

To examine advance care planning practices and proxy decision making by family healthcare proxies for patients with advanced Parkinson disease (PD). Sixty-four spouses and adult children, self-designated as a/the healthcare proxy for advanced patients with PD, participated in a cross-sectional survey study. Sixty patients with PD (95%) had completed a living will, but only 38% had shared the document with a physician. Among three life-support treatments--cardiopulmonary resuscitation (CPR), ventilator, and feeding tube--47% of patients opted for CPR, 16% for ventilator, and 20% for feeding tube. Forty-two percent of proxies did not know patients' preferences for one or more of the three life-support treatments. Only 28% of proxies reported that patients wanted hospice. Patients who shared advance directives with a physician were significantly less likely to choose CPR and a feeding tube and they were more likely to choose hospice. In a hypothetical end-of-life (EOL) scenario, the majority of proxies chose comfort care as the EOL goal of care (53%) and pain and symptom management only as the course of treatment option (72%); these proxy choices for patients, however, were not associated with patients' preferences for life support. Patients' proxies preferred a form of shared decision making with other family members and physicians. Advance care planning is effective when patients, families, and healthcare professionals together consider future needs for EOL care decisions. Further efforts are needed by healthcare professionals to provide evidence-based education about care options and facilitate advanced discussion and shared decision making by the patient and families.

Treatment-Related Toxicities in Older Adults with Head and Neck Cancer: A Population-Based Analysis

PubMed Central

O’Neill, Caitriona B.; Baxi, Shrujal S.; Atoria, Coral L.; O’Neill, James P.; Henman, Martin C.; Sherman, Eric J.; Lee, Nancy Y.; Pfister, David G.; Elkin, Elena B.

2016-01-01

Background Despite advantages in terms of cancer control and organ preservation, the benefits of chemoradiation (CTRT) may be offset by potentially severe, treatment-related toxicities particularly in older patients. Our objectives were to assess the type and frequency of toxicities in older adults with locally or regionally advanced, head and neck squamous cell carcinoma of the (HNSCC) receiving either primary CTRT or RT alone. Methods Using SEER cancer registry data linked with Medicare claims, we identified patients aged 66 years or older with locally advanced HNSCC, diagnosed 2001–2009, who received CTRT or RT alone. We examined differences in the frequency of toxicity-related hospital admissions and emergency room (ER) visits as well as feeding tube use and estimated the impact of chemotherapy on the likelihood of toxicity, controlling for demographic and disease characteristics. Results Of patients who received CTRT (N=1,502), 62% had a treatment-related toxicity, compared with 46% of patients who received RT alone (N=775). Controlling for demographic and disease characteristics, CTRT patients were twice as likely to experience an acute toxicity compared with their RT only peers. Fifty-five percent of CTRT patients had a feeding tube placed during or after treatment compared with 28% of the RT-only group. Conclusions In this population-based cohort of older adults with HNSCC, the rate of acute toxicities and feeding tube use in patients receiving CTRT was considerable. It is possible that for certain older patients, the potential benefit of adding CT to RT does not outweigh the harms of this combined modality therapy. PMID:25728057

Acute pancreatitis.

PubMed

Talukdar, Rupjyoti; Vege, Santhi S

2015-09-01

To summarize recent data on classification systems, cause, risk factors, severity prediction, nutrition, and drug treatment of acute pancreatitis. Comparison of the Revised Atlanta Classification and Determinant Based Classification has shown heterogeneous results. Simvastatin has a protective effect against acute pancreatitis. Young black male, alcohol, smoldering symptoms, and subsequent diagnosis of chronic pancreatitis are risk factors associated with readmissions after acute pancreatitis. A reliable clinical or laboratory marker or a scoring system to predict severity is lacking. The PYTHON trial has shown that oral feeding with on demand nasoenteric tube feeding after 72 h is as good as nasoenteric tube feeding within 24 h in preventing infections in predicted severe acute pancreatitis. Male sex, multiple organ failure, extent of pancreatic necrosis, and heterogeneous collection are factors associated with failure of percutaneous drainage of pancreatic collections. The newly proposed classification systems of acute pancreatitis need to be evaluated more critically. New biomarkers are needed for severity prediction. Further well designed studies are required to assess the type of enteral nutritional formulations for acute pancreatitis. The optimal minimally invasive method or combination to debride the necrotic collections is evolving. There is a great need for a drug to treat the disease early on to prevent morbidity and mortality.

21 CFR 524.1005 - Furazolidone aerosol powder.

Code of Federal Regulations, 2011 CFR

2011-04-01

... infection of superficial wounds, abrasions, lacerations, and pyogenic dermatitis. (ii) Horses. For treatment or prevention of bacterial infection of superficial wounds, abrasions, lacerations, and following... bacterial infection of superficial wounds, abrasions, and lacerations caused by Staphylococcus aureus...

21 CFR 524.1005 - Furazolidone aerosol powder.

Code of Federal Regulations, 2010 CFR

2010-04-01

... infection of superficial wounds, abrasions, lacerations, and pyogenic dermatitis. (ii) Horses. For treatment or prevention of bacterial infection of superficial wounds, abrasions, lacerations, and following... bacterial infection of superficial wounds, abrasions, and lacerations caused by Staphylococcus aureus...

Lapping slurry

DOEpatents

Simandl, R.F.; Upchurch, V.S.; Leitten, M.E.

1999-01-05

Improved lapping slurries provide for easier and more thorough cleaning of alumina work pieces, as well as inhibit corrosion of the lapping table and provide for easier cleaning of the lapping equipment. The unthickened lapping slurry comprises abrasive grains such as diamond abrasive dispersed in a carrier comprising water, glycerine, and triethanolamine. The thickened lapping slurry comprises abrasive grains such as diamond abrasive dispersed in a carrier comprising water, glycerine, triethanolamine, a water soluble silicate, and acid. 1 fig.

Behaviors of 40Cr steel treated by laser quenching on impact abrasive wear

NASA Astrophysics Data System (ADS)

Chen, Zhikai; Zhu, Qinghai; Wang, Jing; Yun, Xiao; He, Bing; Luo, Jingshuai

2018-07-01

In present work, laser quenching had been carried out to improve the impact abrasive wear resistance of 40Cr steel. The distinct microstructure between original and quenched region was demonstrated after laser quenching. Since the effect of temperature and cooling rate, the phase combinations were apparently different for quenched layer in depth. The impact abrasive wear resistance of sample was experimentally investigated and the improved level was assessed in light of the average mass loss of three repetitive tests. Worn surface was detected by means of SEM, OM and EDS, and results showed that three typical failure modes were performed during the processing of impact abrasive wear, including abrasive wear, impact effect and rolling contact fatigue. Basing on the different worn surface profile, the mainly failure mode was respectively pointed out for matrix and quenched sample, which was significantly in accordance with the result of impact abrasive wear.

Single Port Laparoscopic Gastrostomy: description of a technique and initial experience.

PubMed

Palermo, Mariano; Domínguez, Mario Luis; Acquafresca, Pablo; Duza, Guillermo; Giménez, Mariano

2015-12-01

Since the first classic descriptions of surgical gastrostomies for feeding by supra-umbilical medial incisions, patients were operated under general anesthesia, with prolonged time of surgery; these were patients in poor health status, undernourished due to inadequate intake or to neurological or tumor involvement, with prolonged hospitalization, both for the recovery of the intestinal motility as well as for the recovery of post-surgical wounds. Therefore, we describe a new minimally invasive technique as an alternative to the percutaneous or endoscopic gastrostomy, in patients where we are not allowed to place a nasogastric tube to insufflate the stomach. This is mostly seen in patients with tumors, which cause obstruction. Between July 2012 and June 2013, 8 patients underwent a single port laparoscopic gastrostomy. Five were females, mean age: 77 years (range: 67-87). In all the patients, it was impossible to place a nasogastric tube, due to obstructive tumor. The mean time of the procedure was 45 minutes. Seven patients underwent tolerance of dextrose 10% through the catheter after 12 hours and one 24 hours after the procedures. Enteral feeding was indicated after the dextrose 10% tolerance was performed. No complications related to the procedure were observed. Currently, the gold standard technique to perform a gastrostomy is the percutaneous or endoscopic approach. In patients with head and neck tumors, when it is not possible to insert a nasogastric tube to insufflate the stomach, a laparoscopic gastrostomy would be indicated. We describe a new technique, step by step, to perform less invasive laparoscopic surgery by a single port laparoscopic gastrostomy. The diameter created is the same as the one performed with an open technique, but in this case, with a minimally invasive approach, that allows us to start feeding the patient with a high quality of feeding, because of the wider lumen.

The relationship between nutritional status and physical function, admission frequency, length of hospital stay, and mortality in old people living in long-term care facilities.

PubMed

Lin, Sin-Jie; Hwang, Shinn-Jang; Liu, Chieh-Yu; Lin, Hung-Ru

2012-06-01

Nutrition is an important issue for elderly residents of long-term care facilities (LTCFs). About 20% of elderly LTCF residents in Taiwan are malnourished. This study investigated correlations between nutritional status and physical function, admission frequency, hospitalstay duration, and mortality in elderly LTCF residents. Researchers used a retrospective study design and convenient sampling to enroll 174 subjects aged 67 to 105 years (average, 82.5 years) who were living in legally registered LTCFs in Beitou District, Taipei City, Taiwan. A review of LTCF resident files provided data on subjects' demographics, physical examination laboratory results for the most recent 1-year period, anthropometry, physical function, admission frequency, hospital stay duration, and causes of admissions. Subjects had lived in their LTCF for more than 1 year before their enrollment date. Subjects who died during and after the study period were also included in analysis. Results showed significant changes over the study year in subjects' nutritional status, physical function, and calf circumference. Physical function was found significantly correlated with calf circumference, hospitalization status was found correlated with nasal-gastric tube feeding status, and eating pattern was found correlated with calf circumference and levels of both serum albumin and cholesterol. Nutritional status, calf circumference, albumin level, and cholesterol level also correlated significantly with hospitalization status. In this study, the likelihood of hospitalization increased with age and nasal-gastric tube feeding use. Hospital stay duration for subjects receiving nasal-gastric tube feeding was longer than that for those receiving oral feeding. Also, weak nutritional status scores for calf circumference and hemoglobin levels were factors associated with increased mortality risk. Findings recommend that greater attention should be paid to the nutritional status of elderly persons living in LTCFs to reduce hospitalization and death risks, cut medical expenses, and improve quality of care.

Necrotizing enterocolitis - classification and two initial steps towards prevention.

PubMed

Juhl, Sandra Meinich

2017-06-01

The premature infant suffers from immaturity of all organ systems, one of them being the gastrointestinal tract. When the infant is born, the immature gastrointestinal tract is exposed to milk and simultaneously colonized by high densities of bacteria. The combination of milk, microbiota and an immature gut, leaves the infant vulnerable to developing the dreaded intestinal emergency necrotizing enterocolitis (NEC). NEC is often very aggressive and no cure exists, which means that prevention is an utmost important topic to researchers, physicians, parents - and infants.   Despite immense research during the last decades, no specific test to determine if an infant suffers from NEC exists. Most neonatal units use Bell's staging criteria, which are based on clinical and radiographic findings, as a diagnostic tool; however the diagnosis given according to Bell's stages has not been validated. In study I, we aimed to determine the validity of the NEC diagnosis given at discharge. An expert panel consisting of a neonatologist, a paediatric surgeon and a paediatric radiologist served as the golden standard. We found that the diagnosis given at discharge had a poor validity which significantly affected the reported incidence of NEC in the neonatal department at Rigshospitalet, Denmark. The validity of the NEC diagnosis was worse than the validity of most other paediatric diagnoses that had been investigated.   In studies II and III, we aimed to explore possible means of NEC prevention. The role of nutrition in NEC development is well established with mother's milk as the best option to avoid NEC in the preterm infant. Maternal milk is, however, most often not available in sufficient amounts during the first days of life, and preterm infant formula or human donor milk is used in its absence. Studies in preterm piglets showed that bovine colostrum equally to human donor milk protected against NEC compared to infant formula. Furthermore, bovine colostrum was superior to human donor milk in stimulating gut immunity and digestive functions.   Hence, in study II we aimed to design a pilot study of bovine colostrum used as a supplement to maternal milk in the first days of life and to determine if the study was feasible. In the paper, we present the protocol and the results of the first two phases of the Precolos study in which 12 infants were included and received pasteurized, spray-dried and reconstituted bovine colostrum during the first days of life as the first infants in the world. We found that the infants tolerated bovine colostrum without clinical adverse effects, but we also observed a transient hypertyrosinemia on day seven of life in five infants. The results were evaluated by a safety management board which encouraged us to continue the pilot study with the last phase, which was a randomized controlled trial of 20+20 infants comparing supplementation with bovine colostrum to supplementation with standard nutrition. The randomized trial has just finished recruitment.   At last, we wanted to shed light on a possible microbiological angle of NEC prevention. Dysbiosis and bacterial translocation are believed to play a crucial role in the development of NEC as intestinal pneumatosis, which occurs when bacteria produce gas inside the intestinal wall, is a pathognomonic radiographic finding. In a quality improvement study from the US published in 2014, NEC incidence was significantly reduced after the implementation of several quality improvement interventions. Standardized weekly exchange of nasogastric feeding tubes was suggested as one of the potential NEC-reducing interventions.   In the neonatal unit at Rigshospitalet, Denmark, preterm infants are fed 8-12 times daily through a resident nasogastric feeding tube which is exposed to body temperature, contains milk residuals from the last meal and is handled by both parents and personnel. Since bacterial pollution of milk given through the nasogastric feeding tube might be NEC-inducing, we aimed in study III to determine the bacterial load given to the infants when feeding them through a tube. We collected 92 used nasogastric feeding tubes and flushed them with one ml saline each to imitate a meal given through them. Eighty-nine percent of the tubes contaminated the meals with more than 1000 colony-forming units of bacteria and fifty-five percent contaminated the meals with the possible pathogens Enterobacteriaceae or Staphylococcus aureus. The concentration of bacteria in the saline flushed through the tubes was as high as 109 colony-forming units per ml; however, neither the risk of contamination nor the concentration of bacteria in the flush was associated with the duration of use. Implementation of standardized weekly exchange of feeding tubes would therefore not prevent the contamination of meals.   In conclusion, the studies included in this thesis serve as a base for future studies investigating the prevention of NEC. We found a poor validity of the NEC diagnosis given at discharge. This should be kept in mind when conducting epidemiological studies of NEC and especially when conducting interventional trials with NEC as an outcome. If the findings of the randomized part of the Precolos study indicate a positive effect of bovine colostrum and do not give rise to concerns regarding feasibility, safety or tolerability, a large-scale randomized controlled study with NEC as the primary outcome will be planned. Based on the high concentrations of bacteria found in the nasogastric feeding tubes, a randomized controlled trial investigating whether the frequency of feeding tube exchange affects the early colonization has been commenced in the neonatal department at Rigshospitalet. Hopefully, the results of these studies will bring us closer to preventing NEC in the future. Articles published in the Danish Medical Journal are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Improved Zirconia Oxygen-Separation Cell

NASA Technical Reports Server (NTRS)

Walsh, John V.; Zwissler, James G.

1988-01-01

Cell structure distributes feed gas more evenly for more efficent oxygen production. Multilayer cell structure containing passages, channels, tubes, and pores help distribute pressure evenly over zirconia electrolytic membrane. Resulting more uniform pressure distribution expected to improve efficiency of oxygen production.

Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers

MedlinePlus

... What Should You Do for a Child With Depression? A child or adolescent with MDD should be ... Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS Feed NIMH ...

Three-Body Abrasion Testing Using Lunar Dust Simulants to Evaluate Surface System Materials

NASA Technical Reports Server (NTRS)

Kobrick, Ryan L.; Budinski, Kenneth G.; Street, Kenneth W., Jr.; Klaus, David M.

2010-01-01

Numerous unexpected operational issues relating to the abrasive nature of lunar dust, such as scratched visors and spacesuit pressure seal leaks, were encountered during the Apollo missions. To avoid reoccurrence of these unexpected detrimental equipment problems on future missions to the Moon, a series of two- and three-body abrasion tests were developed and conducted in order to begin rigorously characterizing the effect of lunar dust abrasiveness on candidate surface system materials. Two-body scratch tests were initially performed to examine fundamental interactions of a single particle on a flat surface. These simple and robust tests were used to establish standardized measurement techniques for quantifying controlled volumetric wear. Subsequent efforts described in the paper involved three-body abrasion testing designed to be more representative of actual lunar interactions. For these tests, a new tribotester was developed to expose samples to a variety of industrial abrasives and lunar simulants. The work discussed in this paper describes the three-body hardware setup consisting of a rotating rubber wheel that applies a load on a specimen as a loose abrasive is fed into the system. The test methodology is based on ASTM International (ASTM) B611, except it does not mix water with the abrasive. All tests were run under identical conditions. Abraded material specimens included poly(methyl methacrylate) (PMMA), hardened 1045 steel, 6061-T6 aluminum (Al) and 1018 steel. Abrasives included lunar mare simulant JSC- 1A-F (nominal size distribution), sieved JSC-1A-F (<25 m particle diameter), lunar highland simulant NU-LHT-2M, alumina (average diameter of 50 m used per ASTM G76), and silica (50/70 mesh used per ASTM G65). The measured mass loss from each specimen was converted using standard densities to determine total wear volume in cm3. Abrasion was dominated by the alumina and the simulants were only similar to the silica (i.e., sand) on the softer materials of aluminum and PMMA. The nominal JSC- 1A-F consistently showed more abrasion wear than the sieved version of the simulant. The lunar dust displayed abrasivity to all of the test materials, which are likely to be used in lunar landing equipment. Based on this test experience and pilot results obtained, recommendations are made for systematic abrasion testing of candidate materials intended for use in lunar exploration systems and in other environments with similar dust challenges.

Transcutaneous neuromuscular electrical stimulation (VitalStim) curative therapy for severe dysphagia: myth or reality?

PubMed

Shaw, Gary Y; Sechtem, Phillip R; Searl, Jeff; Keller, Kristina; Rawi, Taib A; Dowdy, Emily

2007-01-01

VitalStim therapy was approved by the US Food and Drug Administration in 2001 for the treatment of dysphagia through the application of neuromuscular electrical stimulation to cervical swallowing muscles. This approval was based upon submission of data on more than 800 patients who received this therapy collected by the principal developer and patent-holder of the device. The therapy is marketed as successful in restoring long-term swallowing function in 97.5% of dysphagic patients past the point of requiring a feeding tube and as significantly better than existing therapies. More than 2,500 speech-language pathologists have taken the certification course, and thousands of devices have been sold. To date, however, aside from the developer's own studies, there are no peer-reviewed publications supporting these claims. We sought to evaluate the effectiveness of VitalStim therapy in a heterogeneous group of dysphagic patients. We performed a retrospective analysis of 18 patients who received this therapy at an urban tertiary referral center. All patients underwent pretherapy evaluation by speech-language pathologists, including modified barium swallow and/or functional endoscopic evaluation of swallowing and clinical evaluation of swallowing that included assessment of laryngeal elevation, diet tolerance, and swallowing delay, and were then assigned an overall dysphagia severity score. After therapy, all patients underwent the same assessments. Twelve of the 18 also underwent a functional swallowing telephone survey months (range, 1 to 21 months) after their therapy to assess whether the improvement was worthwhile and sustained. Eleven of the 18 patients (61%) demonstrated some improvement in their swallowing. Six of the 18 patients (33%) were improved enough to no longer require a feeding tube. However, of the 5 patients categorized as having "severe dysphagia" before therapy, only 2 showed any improvement, and these patients still required a feeding tube for adequate nutrition. Telephone surveys did confirm that those who improved with their therapy seemed to maintain their progress and that most patients were satisfied with their therapy. VitalStim therapy seems to help those with mild to moderate dysphagia. However, the patients with the most severe dysphagia in our study did not gain independence from their feeding tubes. The authors conclude that VitalStim therapy clearly has a place in the management of dysphagia, but that the most severely afflicted are unlikely to gain dramatic improvement.

Twyman effect mechanics in grinding and microgrinding.

PubMed

Lambropoulos, J C; Xu, S; Fang, T; Golini, D

1996-10-01

In the Twyman effect (1905), when one side of a thin plate with both sides polished is ground, the plate bends: The ground side becomes convex and is in a state of compressive residual stress, described in terms of force per unit length (Newtons per meter) induced by grinding, the stress (Newtons per square meter) induced by grinding, and the depth of the compressive layer (micrometers). We describe and correlate experiments on optical glasses from the literature in conditions of loose abrasive grinding (lapping at fixed nominal pressure, with abrasives 4-400 μm in size) and deterministic microgrinding experiments (at a fixed infeed rate) conducted at the Center for Optics Manufacturing with bound diamond abrasive tools (with a diamond size of 3-40 μm, embedded in metallic bond) and loose abrasive microgrinding (abrasives of less than 3 μm in size). In brittle grinding conditions, the grinding force and the depth of the compressive layer correlate well with glass mechanical properties describing the fracture process, such as indentation crack size. The maximum surface residual compressive stress decreases, and the depth of the compressive layer increases with increasing abrasive size. In lapping conditions the depth of the abrasive grain penetration into the glass surface scales with the surface roughness, and both are determined primarily by glass hardness and secondarily by Young's modulus for various abrasive sizes and coolants. In the limit of small abrasive size (ductile-mode grinding), the maximum surface compressive stress achieved is near the yield stress of the glass, in agreement with finite-element simulations of indentation in elastic-plastic solids.

Abrasion by aeolian particles: Earth and Mars

NASA Technical Reports Server (NTRS)

Greeley, R.; Marshall, J. R.; White, B. R.; Pollack, J. B.; Marshall, J.; Krinsley, D.

1984-01-01

Estimation of the rate of aeolian abrasion of rocks on Mars requires knowledge of: (1) particle flux, (2) susceptibilities to abrasion of various rocks, and (3) wind frequencies on Mars. Fluxes and susceptibilities for a wide range of conditions were obtained in the laboratory and combined with wind data from the Viking meteorology experiment. Assuming an abundant supply of sand-sized particles, estimated rates range up to 2.1 x 10 to the minus 2 power cm of abrasion per year in the vicinity of Viking Lander 1. This rate is orders of magnitude too great to be in agreement with the inferred age of the surface based on models of impact crater flux. The discrepancy in the estimated rate of abrasion and the presumed old age of the surface cannot be explained easily by changes in climate or exhumation of ancient surfaces. The primary reason is thought to be related to the agents of abrasion. At least some sand-sized (approx. 100 micrometers) grains appear to be present, as inferred from both lander and orbiter observations. High rates of abrasion occur for all experimental cases involving sands of quartz, basalt, or ash. However, previous studies have shown that sand is quickly comminuted to silt- and clay-sized grains in the martian aeolian regime. Experiments also show that these fine grains are electrostatically charged and bond together as sand-sized aggregates. Laboratory simulations of wind abrasion involving aggregates show that at impact velocities capable of destroying sand, aggregates from a protective veneer on the target surface and can give rise to extremely low abrasion rates.

The vascularization of a gastric tube as a substitute for the esophagus is affected by its diameter.

PubMed

Pierie, J P; de Graaf, P W; van Vroonhoven, T J; Obertop, H

1998-10-01

The stomach is used for reconstruction of the upper gastrointestinal tract after esophageal resection for cancer. The whole stomach can be used, but also a wide or narrow gastric tube can be constructed. Short-term functional results are superior after use of a narrow tube. Healing of the cervical esophagogastrostomy can be impaired, leading to leakage and stricture. The decreased vascularization at the site of the anastomosis may be one reason. It was hypothesized that the quality of the vascularization of the gastric tube, used as a substitute for the oesophagus after esophagectomy, depends on its diameter. The vascularization of postmortem specimens was studied using angiography. Whole stomachs (3), wide (3) and narrow gastric tubes (3) were constructed. In a patient with an anastomotic stricture of a narrow tube with a cervical esophagogastrostomy vascularisation was evaluated by angiography. After infusion of contrast through the supplying arteries, the whole stomachs and wide gastric tubes showed adequate vascularization, whereas the narrow gastric tube showed poor vascularization especially at the site of the anastomosis. In narrow gastric tubes, the right gastroepiploic artery was the only feeding artery. In the patient's angiography, a limited contrast visualization of the proximal end of the gastric tube could be demonstrated. Although a narrow gastric tube is favoured by some surgeons, the use of whole stomach or a type of gastric tube with preservation of the right gastric artery may lead to a better anastomotic healing.

Durability of resin cement bond to aluminium oxide and zirconia ceramics after air abrasion and laser treatment.

PubMed

Foxton, Richard M; Cavalcanti, Andrea N; Nakajima, Masatoshi; Pilecki, Peter; Sherriff, Martyn; Melo, Luciana; Watson, Timothy F

2011-02-01

The erbium laser has been introduced for cutting enamel and dentin and may have an application in the surface modification of high-strength aluminum oxide and zirconia ceramics. The aim of this study was to evaluate the durability of the bond of conventional dual-cured resin cements to Procera Al(2)O(3) and zirconium oxide ceramics after surface treatment with air abrasion and erbium laser. One hundred twenty Al(2)O(3) and 120 zirconia specimens measuring 3 × 3 × 0.7 mm(3) were divided equally into three groups, and their surfaces treated as follows: either untreated (controls), air abraded with Al(2)O(3) particles, or erbium-laser-treated at a power setting of 200 mJ. The surface of each specimen was then primed and bonded with one of two dual-cured resin cements (either SCP-100 Ceramic Primer and NAC-100 or Monobond S and Variolink II) using a 1-mm thick Tygon tube mold with a 0.75-mm internal bore diameter. After 24 hours and 6 months of water storage at 37°C, a microshear bond strength test was performed at a crosshead speed of 1 mm/min. Surface morphology was examined using a confocal microscope, and failure modes were observed using an optical microscope. The data were analyzed using the Kaplan-Meier nonparametric survival analysis. In the case of zirconia, air abrasion and Erbium:yttrium-aluminum-garnet (Er:YAG) laser treatment of the ceramic surface resulted in a significant reduction in the bond strengths of both resin cements after 6 months water storage; however, when the zirconia surface was left untreated, the SCP-100/NAC-100 group did not significantly reduce in bond strength. In the case of alumina, no treatment, air abrasion and Er:YAG laser treatment of the surface led to no significant reduction in the bond strengths of the three SCP-100/NAC-100 groups after 6 months water storage, whereas all three Monobond S/Variolink II groups showed a significant reduction. Er:YAG laser treatment of the zirconia surface did not result in a durable resin cement/ceramic bond; however, a durable bond between a conventional dual-cured resin cement and Procera All Ceram and Procera All Zirkon was formed using a ceramic primer containing the phosphate monomer, MDP, without any additional surface treatment. © 2011 by The American College of Prosthodontists.

Comparison of nutritional status indicators according to feeding methods in patients with acute stroke.

PubMed

Kim, Sanghee; Byeon, Youngsoon

2014-04-01

Feeding methods for patients with acute stroke differ based on their ability to swallow; therefore, it is necessary to determine whether these methods deliver enough nourishment to these patients. Although nutrition could affect recovery from acute stroke, it is often overlooked. Indicators of nutritional status are important for the nutritional assessment of patients. The purpose of this study was to compare changes in nutritional indicators with various feeding methods in patients with acute stroke. Data on 261 patients with acute stroke who were admitted to a stroke unit in 2010 and met the inclusion criteria of the study were retrospectively analyzed. For comparative analysis, we investigated the participants' National Institutes of Health Stroke Scale score, feeding methods using the Modified Gugging Swallowing Screen, and indicators of nutritional status, such as body mass index, pre-albumin level, albumin level, total lymphocyte count, and total protein level. All nutritional indicators were compared at the time of admission to the stroke unit and at 7 days after admission. At the time of admission, indicators of nutritional status were within normal ranges in all feeding groups (tube, dysphagia, and general diet). At 7 days after admission, pre-albumin (P = 0.003), albumin (P = 0.001), and total protein (P = 0.000) values in the tube feeding group were below the normal range, and the pre-albumin value and total lymphocyte count were below the normal range in the dysphagia diet group (P = 0.027). The values for all nutritional indicators were within normal limits in the general diet group. Indicators of nutritional status change according to the swallowing ability of patients with acute stroke. At 7 days after admission to the stroke unit, patients with severe dysphagia had higher levels of indicators of malnutrition. Health care providers should consider whether the feeding method of each patient with stroke provides suitable nourishment. Additionally, it is important to know why these indicators vary based on swallowing abilities and what these patients require for adequate nutrition.

No gastric mill in sauropod dinosaurs: new evidence from analysis of gastrolith mass and function in ostriches

PubMed Central

Wings, Oliver; Sander, P. Martin

2006-01-01

Polished pebbles occasionally found within skeletons of giant herbivorous sauropod dinosaurs are very likely to be gastroliths (stomach stones). Here, we show that based on feeding experiments with ostriches and comparative data for relative gastrolith mass in birds, sauropod gastroliths do not represent the remains of an avian-style gastric mill. Feeding experiments with farm ostriches showed that bird gastroliths experience fast abrasion in the gizzard and do not develop a polish. Relative gastrolith mass in sauropods (gastrolith mass much less than 0.1% of body mass) is at least an order of magnitude less than that in ostriches and other herbivorous birds (gastrolith mass approximates 1% of body mass), also arguing against the presence of a gastric mill in sauropods. Sauropod dinosaurs possibly compensated for their limited oral processing and gastric trituration capabilities by greatly increasing food retention time in the digestive system. Gastrolith clusters of some derived theropod dinosaurs (oviraptorosaurs and ornithomimosaurs) compare well with those of birds, suggesting that the gastric mill evolved in the avian stem lineage. PMID:17254987

Experimental investigation and statistical modeling of temperature rise in rotary ultrasonic bone drilling.

PubMed

Gupta, Vishal; Pandey, Pulak M

2016-11-01

Thermal necrosis is one of the major problems associated with the bone drilling process in orthopedic/trauma surgical operations. To overcome this problem a new bone drilling method has been introduced recently. Studies have been carried out with rotary ultrasonic drilling (RUD) on pig bones using diamond coated abrasive hollow tools. In the present work, influence of process parameters (rotational speed, feed rate, drill diameter and vibrational amplitude) on change in the temperature was studied using design of experiment technique i.e., response surface methodology (RSM) and data analysis was carried out using analysis of variance (ANOVA). Temperature was recorded and measured by using embedded thermocouple technique at a distance of 0.5mm, 1.0mm, 1.5mm and 2.0mm from the drill site. Statistical model was developed to predict the maximum temperature at the drill tool and bone interface. It was observed that temperature increased with increase in the rotational speed, feed rate and drill diameter and decreased with increase in the vibrational amplitude. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

Experience in Bedside Placement, Clinical Validity, and Cost-Efficacy of a Self-Propelled Nasojejunal Feeding Tube

PubMed Central

Puiggròs, Carolina; Molinos, Rosa; Ortiz, M. Dolors; Ribas, Montserrat; Romero, Carlos; Vázquez, Concepcion; Segurola, Hegoi; Burgos, Rosa

2015-01-01

Background: The procedures needed to insert nasojejunal tubes (NJTs) are often invasive or uncomfortable for the patient and require hospital resources. The objectives of this study were to describe our experience in inserting a self-propelling NJT with distal pigtail end and evaluate clinical validity and cost efficacy of this enteral nutrition (EN) approach compared with parenteral nutrition (PN). Materials and Methods: Prospective study from July 2009 to December 2010, including hospitalized noncritical patients who required short-term jejunal EN. The tubes were inserted at bedside, using intravenous erythromycin as a prokinetic drug. Positioning was considered correct when the distal end was beyond the ligament of Treitz. Migration failure was considered when the tube was not positioned into the jejunum within 48 hours postinsertion. Results: Fifty-six insertions were recorded in 47 patients, most frequently in severe acute pancreatitis (69.6%). The migration rates at 18 and 48 hours postinsertion were 73.2% and 82.1%, respectively. There was migration failure in 8.9% of cases, and 8.9% were classified null (the tube was no longer in the gastrointestinal tract at 18 hours). There were no reported or observed complications. The mean duration of the EN was 12 ± 10.8 days. Five different types of EN formula were used. The total study cost was 53.9% lower compared with using PN in all patients. Conclusions: Our study demonstrated that bedside insertion of a self-propelling NJT is a safe, cost-effective, and successful technique for postpyloric enteral feeding in at least 73% of the patients, and only 18% of patients could eventually need other placement techniques. It can avoid the need for more aggressive or expensive placement techniques or even PN if we cannot achieve enteral access. PMID:26214512

A modeling of elementary passes taking into account the firing angle in abrasive water jet machining of titanium alloy

NASA Astrophysics Data System (ADS)

Bui, Van-Hung; Gilles, Patrick; Cohen, Guillaume; Rubio, Walter

2018-05-01

The use of titanium alloys in the aeronautical and high technology domains is widespread. The high strength and the low mass are two outstanding characteristics of titanium alloys which permit to produce parts for these domains. As other hard materials, it is challenging to generate 3D surfaces (e.g. pockets) when using conventional cutting methods. The development of Abrasive Water Jet Machining (AWJM) technology shows the capability to cut any kind of materials and it seems to be a good solution for such titanium materials with low specific force, low deformation of parts and low thermal shocks. Applying this technology for generating 3D surfaces requires to adopt a modelling approach. However, a general methodology results in complex models due to a lot of parameters of the machining process and based on numerous experiments. This study introduces an extended geometry model of an elementary pass when changing the firing angle during machining Ti-6AL-4V titanium alloy with a given machine configuration. Several experiments are conducted to observe the influence of major kinematic operating parameters, i.e. jet inclination angle (α) (perpendicular to the feed direction) and traverse speed (Vf). The material exposure time and the erosion capability of abrasives particles are affected directly by a variation of the traverse speed (Vf) and firing angle (α). These variations lead to different erosion rates along the kerf profile characterized by the depth and width of cut. A comparison demonstrated an efficiency of the proposed model for depth and width of elementary passes. Based on knowledge of the influence of both firing angle and traverse speed on the elementary pass shape, the proposed model allows to develop the simulation of AWJM process and paves a way for milling flat bottom pockets and 3D complex shapes.

Is short-term PEG-tube placement beneficial in acutely ill cognitively intact elderly patients? A proposed decision making algorithm

PubMed Central

Abraham, Rtika R; Girotra, Mohit; Wei, Jeanne Y.; Azhar, Gohar

2014-01-01

Aim Percutaneous Endoscopic Gastrostomy (PEG) tube is an important method of enteral feeding for patients who require temporary or long-term artificial nutritional support to prevent or correct disease-related malnutrition. However, there is paucity of data on the utility of short-term PEG tube placements in acute illnesses in cognitively intact elderly. Methods We present a series of seven, cognitively intact patients (age range = 72 to 93 years), who had PEG tubes placed for short periods. These patients were diagnosed with “failure to thrive” and were managed by placing a PEG tube temporarily for nutritional management. None of these patients had terminal illness or hospice eligibility and all of our patients were community dwellers. Results All our elderly patients experienced good outcomes in terms of their functional status and nutritional support. Conclusions Our series clearly supports the notion that short-term PEG tube placement in cognitively-intact elderly patients could be a successful strategy to support them during an episode of acute illness and to improve their nutritional deficits and survival. PMID:25109444

Quantitative image analysis for evaluating the abrasion resistance of nanoporous silica films on glass

PubMed Central

Nielsen, Karsten H.; Karlsson, Stefan; Limbach, Rene; Wondraczek, Lothar

2015-01-01

The abrasion resistance of coated glass surfaces is an important parameter for judging lifetime performance, but practical testing procedures remain overly simplistic and do often not allow for direct conclusions on real-world degradation. Here, we combine quantitative two-dimensional image analysis and mechanical abrasion into a facile tool for probing the abrasion resistance of anti-reflective (AR) coatings. We determine variations in the average coated area, during and after controlled abrasion. Through comparison with other experimental techniques, we show that this method provides a practical, rapid and versatile tool for the evaluation of the abrasion resistance of sol-gel-derived thin films on glass. The method yields informative data, which correlates with measurements of diffuse reflectance and is further supported by qualitative investigations through scanning electron microscopy. In particular, the method directly addresses degradation of coating performance, i.e., the gradual areal loss of antireflective functionality. As an exemplary subject, we studied the abrasion resistance of state-of-the-art nanoporous SiO2 thin films which were derived from 5–6 wt% aqueous solutions of potassium silicates, or from colloidal suspensions of SiO2 nanoparticles. It is shown how abrasion resistance is governed by coating density and film adhesion, defining the trade-off between optimal AR performance and acceptable mechanical performance. PMID:26656260

Silicon Ingot Casting - Heat Exchanger Method Multi-wire Slicing - Fixed Abrasive Slicing Technique. Phase 3 Silicon Sheet Growth Development for the Large Area Sheet Task of the Low-cost Solar Array Project

NASA Technical Reports Server (NTRS)

Schmid, F.; Khattak, C. P.

1979-01-01

Several 20 cm diameter silicon ingots, up to 6.3 kg. were cast with good crystallinity. The graphite heat zone can be purified by heating it to high temperatures in vacuum. This is important in reducing costs and purification of large parts. Electroplated wires with 45 um synthetic diamonds and 30 um natural diamonds showed good cutting efficiency and lifetime. During slicing of a 10 cm x 10 cm workpiece, jerky motion occurred in the feed and rocking mechanisms. This problem is corrected and modifications were made to reduce the weight of the bladeheat by 50%.

Toothbrushing abrasion susceptibility of enamel and dentin bleached with calcium-supplemented hydrogen peroxide gel.

PubMed

Borges, A B; Santos, L F T F; Augusto, M G; Bonfiette, D; Hara, A T; Torres, C R G

2016-06-01

The objective of this study was to evaluate enamel and dentin susceptibility to toothbrushing abrasion, after bleaching with 7.5% hydrogen peroxide (HP) gel supplemented or not with 0.5% calcium gluconate (Ca). Toothbrushing was performed immediately and 1h after bleaching, with two suspensions (high and low abrasivity). Bovine enamel and dentin specimens were divided into 12 groups (n=10) according to the bleaching gel (with and without Ca), slurry abrasivity (high or low) and elapsed time after bleaching (immediately and after 1h). As control, a group was not bleached, but abraded. The treatment cycle (7 d) consisted of bleaching (1h) and toothbrushing (135 strokes/day) immediatelly or after 1h of artificial saliva exposure. Surface roughness and surface loss (μm) were measured by profilometry and analysed by three-way ANOVA (5%). Surface roughness means were significantly influenced by slurry abrasivity (p<0.0001). For enamel loss, significant triple interaction was observed (p<0.0001). HP-bleached groups and immediately brushed with high-abrasive slurry exhibited increased loss (1.41±0.14) compared to other groups (μm). Control and HP+Ca-bleached groups brushed after 1h with low abrasive slurry presented the lowest loss (0.21±0.03/0.27±0.02). For dentin loss, significant interaction was observed for bleaching and interval factors (p<0.001). 7.5%HP-bleached groups and immediately brushed showed significantly higher loss (8.71±2.45) than the other groups. It was concluded that surface roughness increased when high abrasive was used, independently of bleaching. 7.5%HP increased enamel and dentin loss, mainly with high abrasive slurries. Calcium supplementation of bleaching gel reduced surface loss. Additionally, in order to minimize tooth wear susceptibility, it is recommended to delay brushing after bleaching. After bleaching gel application, postponing toothbrushing is recommended, as well as brushing with low abrasive dentifrices. Additionally, supplementation of hydrogen peroxide gel with calcium-based remineralizing agent potentially reduces tooth loss after abrasion. Copyright © 2016 Elsevier Ltd. All rights reserved.

Interventions for maintaining nasogastric feeding after stroke: An integrative review of effectiveness and acceptability.

PubMed

Mahoney, Catherine; Veitch, Linda

2018-02-01

To investigate the effectiveness and acceptability of interventions for maintaining nasogastric tubes in adult stroke patients. Internationally, incidence of cerebral vascular disease continues to increase and stroke is the largest cause of complex disability in adults. Dysphagia is common following a stroke which necessitates feeding via a nasogastric tube. Nasogastric tubes are not well tolerated by stroke patients and may be frequently dislodged. Hence, interventions such as tape, the nasal bridle/loop or hand mittens may be used to maintain nasogastric tube position. However, evidence around the effectiveness and acceptability of these interventions has not been reviewed and synthesised. Integrative literature review. Database searches in MEDLINE, PubMed, CINAHL, Scopus, Cochrane and EMBASE; manual reference list searches. Seven studies met the eligibility criteria and were included in the review. Evidence for the effectiveness of nasal bridle/loop and hand mittens to maintain nasogastric tube position in patients after a stroke is spare and methodologically poor, and especially limited around hand mittens use. There is insufficient evidence about the acceptability of both nasal bridle/loop and hand mittens among stroke patients. Current clinical practice is underpinned by assumptions around the acceptability of nasal bridle/loop and hand mittens to secure nasogastric tubes. This results in reliance on consensual judgement between professional, patients and their families to guide their use among individuals with dysphagia after stroke. Further research is required to assess the effectiveness of hand mittens and acceptability of both nasal bridle/loop and hand mittens among stroke patients to inform guideline development. Given the lack of evidence on the acceptability of hand mittens and nasal bridle/loop among stroke patients to inform evidence-based guidelines and protocols, healthcare professionals should reach consensus on their use by exercising clinical judgement and through consultation with patients (if possible) and their families. © 2017 John Wiley & Sons Ltd.

Ultrasonic Abrasive Removal Of EDM Recast

NASA Technical Reports Server (NTRS)

Mandel, Johnny L.; Jacobson, Marlowe S.

1990-01-01

Ultrasonic abrasive process removes layer of recast material generated during electrical-discharge machining (EDM) of damper pocket on turbine blade. Form-fitted tool vibrated ultrasonically in damper pocket from which material removed. Vibrations activate abrasive in pocket. Amount of material removed controlled precisely.

Evaluation of Needle Gun and Abrasive Blasting Technologies in Bridge Paint Removal Practices.

PubMed

Randall, Paul M; Kranz, Paul B; Sonntag, Mary L; Stadelmaier, James E

1998-03-01

This paper reviews the results of a U.S. Environmental Protection Agency (EPA) study that assessed needle gun technology as an alternative to conventional abrasive blasting technology to remove lead-based paint from steel bridges in western New York State. The study analyzed the operational and logistical aspects as they relate to worker health and safety, environmental protection, hazardous waste generation, and costs as compared to those arising from conventional abrasive blasting. In this 1992 EPA study, the costs and the product quality aspects favored conventional abrasive blasting over the needle gun technology for removing lead paint. However, abrasive blasting exposed workers to airborne lead levels that exceeded Permissible Exposure Limits (PELs) as established by the Occupational Safety and Health Administration (OSHA), as well as emitting high levels of lead-contaminated dusts and debris into the environment. It was estimated that more than 500 lbs of lead-contaminated spent abrasives and paint waste were released into the environment during paint removal operations. The needle gun system reduced (up to 97.5%) the generation of hazardous waste and the airborne concentrations (up to 99%) of respirable dusts and lead-containing particulates generated during paint removal operations. However, labor costs for the needle gun were three times higher than those for abrasive blasting primarily because of slower production rates that necessitated more operating personnel. The higher labor costs of the needle gun are partially offset by the increased costs associated with the expendable abrasive blast media and hazardous waste disposal. In the EPA study, the productivity of the needle gun system was 12.2 ft 2 /hr vs. 147.5 ft 2 /hr for abrasive blasting. A post blast was needed for the needle gun system to meet surface preparation specifications. When factoring in the costs of full containment structures to meet OSHA's 1993 Lead Exposure in Construction regulation, the needle gun system has the potential to be economically competitive with conventional abrasive blasting.

Pebble Puzzle Solved

NASA Technical Reports Server (NTRS)

2004-01-01

[figure removed for brevity, see original site] Figure 1 In the quest to determine if a pebble was jamming the rock abrasion tool on NASA's Mars Exploration Rover Opportunity, scientists and engineers examined this up-close, approximate true-color image of the tool. The picture was taken by the rover's panoramic camera, using filters centered at 601, 535, and 482 nanometers, at 12:47 local solar time on sol 200 (August 16, 2004).

Colored spots have been drawn on this image corresponding to regions where panoramic camera reflectance spectra were acquired (see chart in Figure 1). Those regions are: the grinding wheel heads (yellow); the rock abrasion tool magnets (green); the supposed pebble (red); a sunlit portion of the aluminum rock abrasion tool housing (purple); and a shadowed portion of the rock abrasion tool housing (brown). These spectra demonstrated that the composition of the supposed pebble was clearly different from that of the sunlit and shadowed portions of the rock abrasion tool, while similar to that of the dust-coated rock abrasion tool magnets and grinding heads. This led the team to conclude that the object disabling the rock abrasion tool was indeed a martian pebble.

Analysis of Abrasive Blasting of DOP-26 Iridium Alloy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ohriner, Evan Keith; Zhang, Wei; Ulrich, George B

2012-01-01

The effects of abrasive blasting on the surface geometry and microstructure of DOP-26 iridium alloy (Ir-0.3% W-0.006% Th 0.005% Al) have been investigated. Abrasive blasting has been used to control emissivity of components operating at elevated temperature. The effects of abrasive blasting conditions on surface morphology were investigated both experimentally and by numerical modeling. The simplified model, based on finite element analysis of a single angular particle impacting on Ir alloy disk, calculates the surface deformation and residual strain distribution. The experimental results and modeling results both indicate that the surface geometry is not sensitive to the abrasive blast processmore » conditions of nozzle pressure and standoff distance considered in this study. On the other hand, the modeling results suggest that the angularity of the abrasive particle has an important role in determining surface geometry, which in turn, affects the emissivity. Abrasive blasting causes localized surface strains and localized recrystallization, but it does not affect grain size following extended exposure at elevated temperature. The dependence of emissivity of the DOP-26 alloy on mean surface slope follows a similar trend to that reported for pure iridium.« less

Another one bites the dust: faecal silica levels in large herbivores correlate with high-crowned teeth

PubMed Central

Hummel, Jürgen; Findeisen, Eva; Südekum, Karl-Heinz; Ruf, Irina; Kaiser, Thomas M.; Bucher, Martin; Clauss, Marcus; Codron, Daryl

2011-01-01

The circumstances of the evolution of hypsodonty (= high-crowned teeth) are a bone of contention. Hypsodonty is usually linked to diet abrasiveness, either from siliceous phytoliths (monocotyledons) or from grit (dusty environments). However, any empirical quantitative approach testing the relation of ingested silica and hypsodonty is lacking. In this study, faecal silica content was quantified as acid detergent insoluble ash and used as proxy for silica ingested by large African herbivores of different digestive types, feeding strategies and hypsodonty levels. Separate sample sets were used for the dry (n = 15 species) and wet (n = 13 species) season. Average faecal silica contents were 17–46 g kg−1 dry matter (DM) for browsing and 52–163 g kg−1 DM for grazing herbivores. No difference was detected between the wet (97.5 ± 14.4 g kg−1 DM) and dry season (93.5 ± 13.7 g kg−1 DM) faecal silica. In a phylogenetically controlled analysis, a strong positive correlation (dry season r = 0.80, p < 0.0005; wet season r = 0.74, p < 0.005) was found between hypsodonty index and faecal silica levels. While surprisingly our results do not indicate major seasonal changes in silica ingested, the correlation of faecal silica and hypsodonty supports a scenario of a dominant role of abrasive silica in the evolution of high-crowned teeth. PMID:21068036

Responsive versus scheduled feeding for preterm infants.

PubMed

Watson, Julie; McGuire, William

2015-10-13

Feeding preterm infants in response to their hunger and satiation cues (responsive, cue-based, or infant-led feeding) rather than at scheduled intervals might enhance infants' and parents' experience and satisfaction, help in the establishment of independent oral feeding, increase nutrient intake and growth rates, and allow earlier hospital discharge. To assess the effect of feeding preterm infants on a responsive basis versus feeding prescribed volumes at scheduled intervals on growth, duration of hospital stay, and parental satisfaction. We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 9, 2015), MEDLINE (1966 to September 2015), EMBASE (1980 to September 2015), and CINAHL (1982 to September 2015), conference proceedings, previous reviews, and trial registries. Randomised controlled trials (RCTs) or quasi-RCTs that compared a policy of feeding preterm infants on a responsive basis versus feeding at scheduled intervals. Two review authors assessed trial eligibility and risk of bias and undertook data extraction independently. We analysed the treatment effects in the individual trials and reported the risk ratio and risk difference for dichotomous data and mean difference (MD) for continuous data, with respective 95% confidence intervals (CIs). We used a fixed-effect model in meta-analyses and explored the potential causes of heterogeneity in sensitivity analyses. We found nine eligible RCTs including 593 infants in total. These trials compared responsive with scheduled interval regimens in preterm infants in the transition phase from intragastric tube to oral feeding. The trials were generally small and contained various methodological weaknesses including lack of blinding and incomplete assessment of all randomised participants. Meta-analyses, although limited by data quality and availability, suggest that responsive feeding results in slightly slower rates of weight gain (MD -1.4, 95% CI -2.4 to -0.3 g/kg/day), and provide some evidence that responsive feeding reduces the time taken for infants to transition from enteral tube to oral feeding (MD -5.5, 95% CI -6.8 to -4.2 days). The importance of this finding is uncertain as the trials did not find a strong or consistent effect on the duration of hospitalisation. None of the included trials reported any parent, caregiver, or staff views. Overall, the data do not provide strong or consistent evidence that responsive feeding affects important outcomes for preterm infants or their families. Some evidence exists that preterm infants fed in response to feeding and satiation cues achieve full oral feeding earlier than infants fed prescribed volumes at scheduled intervals. However, this finding should be interpreted cautiously because of methodological weaknesses in the included trials. A large RCT would be needed to confirm this finding and to determine if responsive feeding of preterm infants affects other important outcomes.

Dysphagia

MedlinePlus

... or surgical intervention may be necessary for the short-term as you recover. In progressive conditions such as amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease), a feeding tube in the stomach may be necessary for the long-term. For some people, treatment may involve muscle ...

Microwave sintering of sol-gel derived abrasive grain

DOEpatents

Plovnick, Ross; Celikkaya, Ahmet; Blake, Rodger D.

1997-01-01

A method is provided for making microwave-sintered, free flowing alpha alumina-based ceramic abrasive grain, under conditions effective to couple microwaves with calcined alpha alumina-based abrasive gain precursor and sinter it at a temperature of at least about 1150.degree. C.

Method for forming an abrasive surface on a tool

DOEpatents

Seals, Roland D.; White, Rickey L.; Swindeman, Catherine J.; Kahl, W. Keith

1999-01-01

A method for fabricating a tool used in cutting, grinding and machining operations, is provided. The method is used to deposit a mixture comprising an abrasive material and a bonding material on a tool surface. The materials are propelled toward the receiving surface of the tool substrate using a thermal spray process. The thermal spray process melts the bonding material portion of the mixture, but not the abrasive material. Upon impacting the tool surface, the mixture or composition solidifies to form a hard abrasive tool coating.

Evaluation of the Effectiveness of Wet Blast Cleaning Methods of Surface Preparation

DTIC Science & Technology

1985-06-01

for Air Abrasive Wet Blast: Complete System Water Abrasive Mixing Chamber in Slurry Blast Unit Schematic of unit Control Unit Slurry Blast — Air/Water...this discussion we present some general. user guidelines regarding what to look for in con- sidering the use or purchase of wet blasting equipment...These units use compressed air as the medium to propel the eroding material. They differ from air abrasive wet blast units in that the abrasive is mixed

Artificial Neural Networks-Based Software for Measuring Heat Collection Rate and Heat Loss Coefficient of Water-in-Glass Evacuated Tube Solar Water Heaters

PubMed Central

Liu, Zhijian; Liu, Kejun; Li, Hao; Zhang, Xinyu; Jin, Guangya; Cheng, Kewei

2015-01-01

Measurements of heat collection rate and heat loss coefficient are crucial for the evaluation of in service water-in-glass evacuated tube solar water heaters. However, conventional measurement requires expensive detection devices and undergoes a series of complicated procedures. To simplify the measurement and reduce the cost, software based on artificial neural networks for measuring heat collection rate and heat loss coefficient of water-in-glass evacuated tube solar water heaters was developed. Using multilayer feed-forward neural networks with back-propagation algorithm, we developed and tested our program on the basis of 915measuredsamples of water-in-glass evacuated tube solar water heaters. This artificial neural networks-based software program automatically obtained accurate heat collection rateand heat loss coefficient using simply "portable test instruments" acquired parameters, including tube length, number of tubes, tube center distance, heat water mass in tank, collector area, angle between tubes and ground and final temperature. Our results show that this software (on both personal computer and Android platforms) is efficient and convenient to predict the heat collection rate and heat loss coefficient due to it slow root mean square errors in prediction. The software now can be downloaded from http://t.cn/RLPKF08. PMID:26624613

Corrosion evaluation of heat recovery steam generator superheater tube in two methods of testing: Tafel polarization and electrochemical impedance spectroscopy (EIS)

NASA Astrophysics Data System (ADS)

Santoso, Rio Pudjidarma; Riastuti, Rini

2018-05-01

The purpose of this research is to evaluate the corrosion process which occurs on the water side of Heat Recovery Steam Generator (HRSG) superheater tube. The tube was 13CrMo44 and divided into 3 types of specimen: new tube, used tube (with oxide layer on surface), cleaned-used tube (without oxide layer on surface). The evaluation of corrosion parameters wasperformed using deaerated ultra-high purity water (boiler feed water) in two methods of testing: Tafel polarization and Electrochemical Impedance Spectroscopy (EIS). Tafel polarization was excellent as its capability to show the value of corrosion current and the corrosion rate explicitly, on the other hand, EIS was excellent as its capability to explain for corrosion mechanism on metal interface in detail. Both methods showed that the increase of electrolyte temperature from 25°C to 55°C would increase the corrosion rate with the mechanism of decreasing polarization resistance due to thinning out the passive film thickness and enlarge the area of reduction reaction of cathode. Magnetite oxide scale which is laid on the surface of used tube specimen shows protective nature to reduce the corrosion rate, and clear up this oxide would increase the corrosion rate back as new tube.

Artificial Neural Networks-Based Software for Measuring Heat Collection Rate and Heat Loss Coefficient of Water-in-Glass Evacuated Tube Solar Water Heaters.

PubMed

Liu, Zhijian; Liu, Kejun; Li, Hao; Zhang, Xinyu; Jin, Guangya; Cheng, Kewei

2015-01-01

Measurements of heat collection rate and heat loss coefficient are crucial for the evaluation of in service water-in-glass evacuated tube solar water heaters. However, conventional measurement requires expensive detection devices and undergoes a series of complicated procedures. To simplify the measurement and reduce the cost, software based on artificial neural networks for measuring heat collection rate and heat loss coefficient of water-in-glass evacuated tube solar water heaters was developed. Using multilayer feed-forward neural networks with back-propagation algorithm, we developed and tested our program on the basis of 915 measured samples of water-in-glass evacuated tube solar water heaters. This artificial neural networks-based software program automatically obtained accurate heat collection rate and heat loss coefficient using simply "portable test instruments" acquired parameters, including tube length, number of tubes, tube center distance, heat water mass in tank, collector area, angle between tubes and ground and final temperature. Our results show that this software (on both personal computer and Android platforms) is efficient and convenient to predict the heat collection rate and heat loss coefficient due to it slow root mean square errors in prediction. The software now can be downloaded from http://t.cn/RLPKF08.

Effect of nanofillers' size on surface properties after toothbrush abrasion.

PubMed

Cavalcante, Larissa M; Masouras, Konstantinos; Watts, David C; Pimenta, Luiz A; Silikas, Nick

2009-02-01

To investigate the effect of filler-particle size of experimental and commercial resin composites, undergoing toothbrush abrasion, on three surface properties: surface roughness (SR), surface gloss (G) and color stability (CS). Four model (Ivoclar/Vivadent) and one commercial resin composite (Tokuyama) with varying filler-size from 100-1000 nm were examined. Six discs (10 mm x 2 mm) from each product were prepared and mechanically polished. The samples were then submitted to 20,000 brushing strokes in a toothbrush abrasion machine. SR parameters (Ra, Rt and RSm), G, and CS were measured before and after toothbrush abrasion. Changes in SR and G were analyzed by 2-way ANOVA, with Bonferroni post hoc test. CS values were submitted to one-way ANOVA and Bonferroni post hoc test (alpha=0.05). Initial G values ranged between 73-87 gloss units (GU) and were reduced after toothbrush abrasion to a range of 8-64 GU. Toothbrush abrasion resulted in significant modifications in SR and G amongst the materials tested, attributed to filler sizes. There was statistically significant difference in color (delta E* ranged from 0.38-0.88). Filler size did not affect color stability. Toothbrush abrasion resulted in rougher and matte surfaces for all materials tested. Although the individual differences in surface roughness among filler sizes were not always significant, the correlation showed a trend that larger filler sizes resulted in higher surface roughness after abrasion for the SR parameters Ra and Rt (r = 0.95; r = 0.93, respectively). RSm showed an increase after toothbrush abrasion for all resin composites, however no significant correlation was detected (r = 0.21).There was a significant correlation between G and Ra ratios (r = - 0.95).

Characterization of Conventional and High-Translucency Y-TZP Dental Ceramics Submitted to Air Abrasion.

PubMed

Tostes, Bhenya Ottoni; Guimarães, Renato Bastos; Noronha-Filho, Jaime Dutra; Botelho, Glauco Dos Santos; Guimarães, José Guilherme Antunes; Silva, Eduardo Moreira da

2017-01-01

This study evaluated the effect of air-abrasion on t®m phase transformation, roughness, topography and the elemental composition of three Y-TZP (Yttria-stabilized tetragonal zirconia polycrystal) dental ceramics: two conventional (Lava Frame and IPS ZirCad) and one with high-translucency (Lava Plus). Plates obtained from sintered blocks of each ceramic were divided into four groups: AS (as-sintered); 30 (air-abrasion with 30 mm Si-coated Al2O3 particles); 50 (air-abrasion with 50 mm Al2O3 particles) and 150 (air-abrasion with 150 mm Al2O3 particles). After the treatments, the plates were submitted to X-ray diffractometry; 3-D profilometry and SEM/EDS. The AS surfaces were composed of Zr and t phases. All treatments produced t®m phase transformation in the ceramics. The diameter of air-abrasion particles influenced the roughness (150>50>30>AS) and the topography. SEM analysis showed that the three treatments produced groove-shaped microretentions on the ceramic surfaces, which increased with the diameter of air-abrasion particles. EDS showed a decrease in Zr content along with the emergence of O and Al elements after air-abrasion. Presence of Si was also detected on the plates air-abraded with 30 mm Si-coated Al2O3 particles. It was concluded that irrespective of the type and diameter of the particles, air-abrasion produced t®m phase transformation, increased the roughness and changed the elemental composition of the three Y-TZP dental ceramics. Lava Plus also behaved similarly to the conventional Y-TZP ceramics, indicating that this high translucency ceramic could be more suitable to build monolithic ceramic restorations in the aesthetic restorative dentistry field.

Dentifrice fluoride and abrasivity interplay on artificial caries lesions.

PubMed

Nassar, Hani M; Lippert, Frank; Eckert, George J; Hara, Anderson T

2014-01-01

Incipient caries lesions on smooth surfaces may be subjected to toothbrushing, potentially leading to remineralization and/or abrasive wear. The interplay of dentifrice abrasivity and fluoride on this process is largely unknown and was investigated on three artificially created lesions with different mineral content/distribution. 120 bovine enamel specimens were randomly allocated to 12 groups (n = 10), resulting from the association of (1) lesion type [methylcellulose acid gel (MeC); carboxymethylcellulose solution (CMC); hydroxyethylcellulose gel (HEC)], (2) slurry abrasive level [low (REA 4/ RDA 69); high (REA 7/RDA 208)], and (3) fluoride concentration [0/275 ppm (14.5 mM) F as NaF]. After lesion creation, specimens were brushed in an automated brushing machine with the test slurries (50 strokes 2×/day). Specimens were kept in artificial saliva in between brushings and overnight. Enamel surface loss (SL) was determined by optical profilometry after lesion creation, 1, 3 and 5 days. Two enamel sections (from baseline and post-brushing areas) were obtained and analyzed microradiographically. Data were analyzed by analysis of variance and Tukey's tests (α = 5%). Brushing with high-abrasive slurry caused more SL than brushing with low-abrasive slurry. For MeC and CMC lesions, fluoride had a protective effect on SL from day 3 on. Furthermore, for MeC and CMC, there was a significant mineral gain in the remaining lesions except when brushed with high-abrasive slurries and 0 ppm F. For HEC, a significant mineral gain took place when low-abrasive slurry was used with fluoride. The tested lesions responded differently to the toothbrushing procedures. Both slurry fluoride content and abrasivity directly impacted SL and mineral gain of enamel caries lesions.

Control of brushing variables for the in vitro assessment of toothpaste abrasivity using a novel laboratory model.

PubMed

Parry, Jason; Harrington, Edward; Rees, Gareth D; McNab, Rod; Smith, Anthony J

2008-02-01

Design and construct a tooth-brushing simulator incorporating control of brushing variables including brushing force, speed and temperature, thereby facilitating greater understanding of their importance in toothpaste abrasion testing methodologies. A thermostable orbital shaker was selected as a base unit and 16- and 24-specimen brushing rigs were constructed to fit inside, consisting of: a square bath partitioned horizontally to provide brushing channels, specimen holders for 25 mm diameter mounted specimens to fit the brushing channels and individually weighted brushing arms, able to support four toothbrush holders suspended over the brushing channels. Brush head holders consisted of individually weighted blocks of Delrin, or PTFE onto which toothbrush heads were fixed. Investigating effects of key design criteria involved measuring abrasion depths of polished human enamel and dentine. The brushing simulator demonstrated good reproducibility of abrasion on enamel and dentine across consecutive brushing procedures. Varying brushing parameters had a significant impact on wear results: increased brushing force demonstrated a trend towards increased wear, with increased reproducibility for greater abrasion levels, highlighting the importance of achieving sufficient wear to optimise accuracy; increasing brushing temperature demonstrated increased enamel abrasion for silica and calcium carbonate systems, which may be related to slurry viscosities and particle suspension; varying brushing speed showed a small effect on abrasion of enamel at lower brushing speed, which may indicate the importance of maintenance of the abrasive in suspension. Adjusting key brushing variables significantly affected wear behaviour. The brushing simulator design provides a valuable model system for in vitro assessment of toothpaste abrasivity and the influence of variables in a controlled manner. Control of these variables will allow more reproducible study of in vitro tooth wear processes.

Tubing misconnections: normalization of deviance.

PubMed

Simmons, Debora; Symes, Lene; Guenter, Peggi; Graves, Krisanne

2011-06-01

Accidental connection of an enteral system to an intravenous (IV) system frequently results in the death of the patient. Misconnections are commonly attributed to the presence of universal connectors found in the majority of patient care tubing systems. Universal connectors allow for tubing misconnections between physiologically incompatible systems. The purpose of this review of case studies of tubing misconnections and of current expert recommendations for safe tubing connections was to answer the following questions: In tubing connections that have the potential for misconnections between enteral and IV tubing, what are the threats to safety? What are patient outcomes following misconnections between enteral and IV tubing? What are the current recommendations for preventing misconnections between enteral and IV tubing? Following an extensive literature search and guided by 2 models of threats and errors, the authors analyzed case studies and expert opinions to identify technical, organizational, and human errors; patient-related threats; patient outcomes; and recommendations. A total of 116 case studies were found in 34 publications. Each involved misconnections of tubes carrying feedings, intended for enteral routes, to IV lines. Overwhelmingly, the recommendations were for redesign to eliminate universal connectors and prevent misconnections. Other recommendations were made, but the analysis indicates they would not prevent all misconnections. This review of the published case studies and current expert recommendations supports a redesign of connectors to ensure incompatibility between enteral and IV systems. Despite the cumulative evidence, little progress has been made to safeguard patients from tubing misconnections.

Numerical Simulation Analysis of High-precision Dispensing Needles for Solid-liquid Two-phase Grinding

NASA Astrophysics Data System (ADS)

Li, Junye; Hu, Jinglei; Wang, Binyu; Sheng, Liang; Zhang, Xinming

2018-03-01

In order to investigate the effect of abrasive flow polishing surface variable diameter pipe parts, with high precision dispensing needles as the research object, the numerical simulation of the process of polishing high precision dispensing needle was carried out. Analysis of different volume fraction conditions, the distribution of the dynamic pressure and the turbulence viscosity of the abrasive flow field in the high precision dispensing needle, through comparative analysis, the effectiveness of the abrasive grain polishing high precision dispensing needle was studied, controlling the volume fraction of silicon carbide can change the viscosity characteristics of the abrasive flow during the polishing process, so that the polishing quality of the abrasive grains can be controlled.

Evaluation of abrasion resistance of pipe and pipe lining materials.

DOT National Transportation Integrated Search

2007-09-01

This project summarizes an evaluation of pipe material resistance to abrasion over a 5-year period (2001-2006) at a site known to be abrasive. : The key focus of the project was to gather more information to compare against existing guidance to desig...

Comparative evaluation of enamel abrasivity by toothbrush and velcro: An in vitro scanning electron microscope study

PubMed Central

Ojha, Saroj Kumar; Javdekar, Sadashiv Bhaskar; Dhir, Sangeeta

2015-01-01

Context: Plaque control has been shown to be pivotal in maintaining the optimal periodontal health. Mechanical plaque control is the most popular option for establishing the optimal oral health. Toothbrushes have been the novel tool for mechanical cleansing. However, the abrasive potential of the toothbrushes on the enamel surface is an area in gray. Aims: The aim of this in vitro study is to evaluate the abrasivity of the toothbrush versus the velcro fasteners. Materials and Methods: The mounted teeth of both the groups were subjected to abrasion test, and the tooth surfaces were observed for the possible abrasions from the oscillating strokes (toothbrush) and frictional contacts (hook and loop velcro) and examined under the scanning electron microscope. Results: Comparative assessment of both velcro (hook and loop) and toothbrush bristles did not reveal any evidence of abrasion on the tooth specimens. Conclusions: Veclro fasteners are safe and qualitatively at par to the manual toothbrush for their efficacy and efficiency in teeth cleansing PMID:26229264

Effect of ceramic coating by aerosol deposition on abrasion resistance of a resin composite material.

PubMed

Taira, Yohsuke; Hatono, Hironori; Mizukane, Masahiro; Tokita, Masahiro; Atsuta, Mitsuru

2006-12-01

Aerosol deposition (AD coating) is a novel technique to coat solid substances with a ceramic film. The purpose of the present study was to investigate the effect of AD coating on abrasion resistance of a resin composite material. A 5-microm-thick aluminum oxide layer was created on the polymerized resin composite. The specimen was cyclically abraded using a toothbrush abrasion simulator for 100,000 cycles. Abraded surface was then measured with a profilometer to determine the average roughness (Ra) and maximum roughness (Rmax). It was found that abrasion cycling increased the Ra value of the No-AD-coating group, but decreased the Ra and Rmax values of the AD coating group. Moreover, the AD coating group showed significantly smaller Ra and Rmax values after 100,000 abrasion cycles as compared to the No-coating control group. Microscopic observation supported these findings. In conclusion, the resistance of the resin composite against toothbrush abrasion was improved by AD coating.

Finishing of display glass for mobile electronics using 3M Trizact diamond tile abrasive pads

NASA Astrophysics Data System (ADS)

Zheng, Lianbin; Fletcher, Tim; Na, Tee Koon; Sventek, Bruce; Romero, Vince; Lugg, Paul S.; Kim, Don

2010-10-01

This paper will describe a new method being used during the finishing of glass displays for mobile electronics including mobile hand held devices and notebook computers. The new method consists of using 3M TrizactTM Diamond Tile Abrasive Pads. TrizactTM Diamond Tile is a structured fixed abrasive grinding technology developed by 3M Company. The TrizactTM Diamond Tile structured abrasive pad consists of an organic (polymeric binder) - inorganic (abrasive mineral, i.e., diamond) composite that is used with a water-based coolant. TrizactTM Diamond Tile technology can be applied in both double and single side grinding applications. A unique advantage of TrizactTM Diamond Tile technology is the combination of high stock removal and low sub-surface damage. Grinding results will be presented for both 9 micron and 20 micron grades of TrizactTM Diamond Tile abrasive pads used to finish several common display glasses including Corning GorillaTM glass and Soda Lime glass.

Lack of Feeding Progression in a Preterm Infant: A Case Study

PubMed Central

White-Traut, Rosemary; Shapiro, Nicole; Healy-Baker, Elissa; Menchavez, Lina; Rankin, Kristin; Medoff-Cooper, Barbara

2012-01-01

Purpose To present the case of a premature infant who displayed immature feeding progression due to nasal occlusion. Subjects Two male preterm infants 33 weeks gestational age at birth from a larger randomized trial. Design Comparative case study. Methods Using a prospective design, feeding assessments were conducted weekly from initiation of oral feeding until hospital discharge. Sucking organization was measured using the Medoff-Cooper Nutritive Sucking Apparatus (M-CNSA) which measured negative sucking pressure generated during oral feedings. Oral and nasogastric (NG) intake and vital signs were recorded. Results At 35 weeks, Infant A demonstrated an immature feeding pattern with NG feedings prevailing over oral feedings. When attempting to feed orally, Infant A exhibited labored breathing and an erratic sucking pattern. During the third weekly feeding evaluation, nasal occlusion was discovered, the NG tube was discontinued, and neosynephrene and humidified air were administered. Following treatment, Infant A’s sucking pattern normalized and the infant maintained complete oral feeding. Infant B demonstrated normal feeding progression. Conclusion Nasal occlusion prevented Infant A from achieving successful oral feeding. The M-CNSA has the ability to help clinicians detect inconsistencies in the breath-suck-swallow feeding patterns of infants and objectively measures patterns of nutritive sucking. The M-CNSA has the potential to influence clinical decision making and identify the need for intervention. PMID:23722488

A Profilometry-Based Dentifrice Abrasion Method for V8 Brushing Machines Part II: Comparison of RDA-PE and Radiotracer RDA Measures.

PubMed

Schneiderman, Eva; Colón, Ellen; White, Donald J; St John, Samuel

2015-01-01

The purpose of this study was to compare the abrasivity of commercial dentifrices by two techniques: the conventional gold standard radiotracer-based Radioactive Dentin Abrasivity (RDA) method; and a newly validated technique based on V8 brushing that included a profilometry-based evaluation of dentin wear. This profilometry-based method is referred to as RDA-Profilometry Equivalent, or RDA-PE. A total of 36 dentifrices were sourced from four global dentifrice markets (Asia Pacific [including China], Europe, Latin America, and North America) and tested blindly using both the standard radiotracer (RDA) method and the new profilometry method (RDA-PE), taking care to follow specific details related to specimen preparation and treatment. Commercial dentifrices tested exhibited a wide range of abrasivity, with virtually all falling well under the industry accepted upper limit of 250; that is, 2.5 times the level of abrasion measured using an ISO 11609 abrasivity reference calcium pyrophosphate as the reference control. RDA and RDA-PE comparisons were linear across the entire range of abrasivity (r2 = 0.7102) and both measures exhibited similar reproducibility with replicate assessments. RDA-PE assessments were not just linearly correlated, but were also proportional to conventional RDA measures. The linearity and proportionality of the results of the current study support that both methods (RDA or RDA-PE) provide similar results and justify a rationale for making the upper abrasivity limit of 250 apply to both RDA and RDA-PE.

Physics of loose abrasive microgrinding.

PubMed

Golini, D; Jacobs, S D

1991-07-01

This study examined the physics of loose abrasive microgrinding (grinding with micron and submicron sized abrasives). More specifically, it focused on the transition from brittle to ductile mode grinding which occurs in this region of abrasive sizes. Process dependency on slurry chemistry was the primary area of emphasis and was studied for diamond abrasives varying in size from 3.0 to 0.75 microm on both ULE and Zerodur, with emphasis on ULE. Ductile mode grinding was achieved with smaller abrasives, as expected, however two significant discoveries were made. The first observation was that by simply changing slurry chemistry, it was possible to induce the transition from brittle fracture to ductile mode grinding in ULE. This transition point could be intentionally moved about for diamonds 3.0-0.75 microm in diameter. For any given abrasive size within these limits, either brittle fracture or ductile removal may be achieved, depending on the slurry used to suspend the diamonds. Several slurries were studied, including water, a series of homologous n-alcohols, and other solvents chosen for properties varying from molecular size to dielectric constant and zeta potential. The study revealed that this slurry dependency is primarily a Rebinder effect. The second finding was that a tremendous amount of surface stress is introduced in loose abrasive ductile mode grinding. This stress was observed when the Twyman Effect in ULE plates increased by a factor of 4 in the transition from the brittle to the ductile mode. An assessment of the cause of this stress is discussed.

Feasiblity study for a 34 GHz (Ka band) gyroamplifier

NASA Technical Reports Server (NTRS)

Stone, D. S.; Bier, R. E.; Caplan, M.; Huey, H. E.; Pirkle, D. R.; Robinson, J. D.; Thompson, L.

1984-01-01

The feasibility of using a gyroklystron power tube as the final amplifier in a 400 kW CW 34 GHz transmitter on the Goldstone Antenna is investigated. A conceptual design of the gyroklystron and the transmission line connecting it with the antenna feed horn is presented. The performance characteristics of the tube and transmission line are compared to the transmitter requirements for a deep space radar system. Areas of technical risk for a follow-on hardware development program for the gyroklystron amplifier and overmoded transmission line components are discussed.

Recurrent convulsions in a thoroughbred foal: management and treatment.

PubMed

May, C J; Greenwood, R E

1977-07-23

A thoroughbred foal had a convulsive attack 12 hours after birth followed by further convulsions on the 10th, 11th and 12th days after birth. It was treated successfully by medication with primidone, feeding by stomach tube and careful nursing.

Development and evaluation of a home enteral nutrition team.

PubMed

Dinenage, Sarah; Gower, Morwenna; Van Wyk, Joanna; Blamey, Anne; Ashbolt, Karen; Sutcliffe, Michelle; Green, Sue M

2015-03-05

The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF) at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN) can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1) prevention of hospital admission and related transport for ETF related issues; (2) effective management and reduction of waste of feed and thickener; (3) balloon gastrostomy tube replacement by the HEN Team in the patient's home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.

Percutaneous Endoscopic Gastrostomy Tube Is a Negative Prognostic Factor for Recurrent/Metastatic Head and Neck Cancer.

PubMed

Siano, Marco; Jarisch, Nadine; Joerger, Markus; Espeli, Vittoria

2018-06-01

Recurrent/metastatic head and neck squamous cell cancer (r/mHNSCC) patients often need a percutaneous endoscopic gastrostomy feeding tube (PEG). Among known prognostic factors, PEG could be prognostic as well. We retrospectively analyzed r/mHNSCC patients referred for systemic treatment. Kaplan-Meier and multivariate cox regression models were applied to assess prognostic impact of PEG. One hunderd and ten patients were identified, 42 had a PEG at treatment start. Median survival from start of 1st-line systemic treatment was 8 months (95%CI=6.5-12.0 months), 4.5 months (95%CI=2.5-7.0 months) for patients with PEG and 11.5 months (95%CI=7.5-14.5 months) without PEG (adjusted HR=1.98, p=0.011). Similarly, survival from first recurrence of distant metastases was lower in patients with PEG as compared to patients without (7.5 vs. 15.5 months, adjusted HR=2.60, p<0.001). Presence of PEG feeding tube has an unfavourable prognostic impact on survival in patients with r/mHNSCC. While any causality remains speculative, potential complications should be appreciated before PEG implantation. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Liquid over-feeding refrigeration system and method with integrated accumulator-expander-heat exchanger

DOEpatents

Mei, Viung C.; Chen, Fang C.

1997-01-01

A refrigeration system having a vapor compression cycle utilizing a liquid over-feeding operation with an integrated accumulator-expander-heat exchanger. Hot, high-pressure liquid refrigerant from the condenser passes through one or more lengths of capillary tubing substantially immersed in a pool liquid refrigerant in the accumulator-expander-heat exchanger for simultaneously sub-cooling and expanding the liquid refrigerant while vaporizing liquid refrigerant from the pool for the return thereof to the compressor as saturated vapor. The sub-cooling of the expanded liquid provides for the flow of liquid refrigerant into the evaporator for liquid over-feeding the evaporator and thereby increasing the efficiency of the evaporation cycle.

Liquid over-feeding refrigeration system and method with integrated accumulator-expander-heat exchanger

DOEpatents

Mei, V.C.; Chen, F.C.

1997-04-22

A refrigeration system is described having a vapor compression cycle utilizing a liquid over-feeding operation with an integrated accumulator-expander-heat exchanger. Hot, high-pressure liquid refrigerant from the condenser passes through one or more lengths of capillary tubing substantially immersed in a pool liquid refrigerant in the accumulator-expander-heat exchanger for simultaneously sub-cooling and expanding the liquid refrigerant while vaporizing liquid refrigerant from the pool for the return thereof to the compressor as saturated vapor. The sub-cooling of the expanded liquid provides for the flow of liquid refrigerant into the evaporator for liquid over-feeding the evaporator and thereby increasing the efficiency of the evaporation cycle. 4 figs.

Gastrostomy Tube Use after Transoral Robotic Surgery for Oropharyngeal Cancer

PubMed Central

Al-khudari, Samer; Bendix, Scott; Lindholm, Jamie; Simmerman, Erin; Hall, Francis; Ghanem, Tamer

2013-01-01

Objective. To evaluate factors that influence gastrostomy tube (g-tube) use after transoral robotic surgery (TORS) for oropharyngeal (OP) cancer. Study Design/Methods. Retrospective review of TORS patients with OP cancer. G-tube presence was recorded before and after surgery at followup. Kaplan-Meier and Cox hazards model evaluated effects of early (T1 and T2) and advanced (T3, T4) disease, adjuvant therapy, and free flap reconstruction on g-tube use. Results. Sixteen patients had tonsillar cancer and 13 tongue base cancer. Of 22 patients who underwent TORS as primary therapy, 17 had T1 T2 stage and five T3 T4 stage. Seven underwent salvage therapy (four T1 T2 and three T3 T4). Nine underwent robotic-assisted inset free flap reconstruction. Seventeen received adjuvant therapy. Four groups were compared: primary early disease (PED) T1 and T2 tumors, primary early disease with adjunctive therapy (PEDAT), primary advanced disease (PAD) T3 and T4 tumors, and salvage therapy. Within the first year of treatment, 0% PED, 44% PEDAT, 40% PAD, and 57% salvage patients required a g-tube. Fourteen patients had a temporary nasoenteric tube (48.3%) postoperatively, and 10 required a g-tube (34.5%) within the first year. Four of 22 (18.2%) with TORS as primary treatment were g-tube dependent at one year and had received adjuvant therapy. Conclusion. PED can be managed without a g-tube after TORS. Similar feeding tube rates were found for PEDAT and PAD patients. Salvage patients have a high rate of g-tube need after TORS. PMID:23936676

Cranial architecture of tube-snouted gasterosteiformes (Syngnathus rostellatus and Hippocampus capensis).

PubMed

Leysen, Heleen; Jouk, Philippe; Brunain, Marleen; Christiaens, Joachim; Adriaens, Dominique

2010-03-01

The long snout of pipefishes and seahorses (Syngnathidae, Gasterosteiformes) is formed as an elongation of the ethmoid region. This is in contrast to many other teleosts with elongate snouts (e.g., butterflyfishes) in which the snout is formed as an extension of the jaws. Syngnathid fishes perform very fast suction feeding, accomplished by powerful neurocranial elevation and hyoid retraction. Clearly, suction through a long and narrow tube and its hydrodynamic implications can be expected to require certain adaptations in the cranium, especially in musculoskeletal elements of the feeding apparatus. Not much is known about which skeletal elements actually support the snout and what the effect of elongation is on related structures. Here, we give a detailed morphological description of the cartilaginous and bony feeding apparatus in both juvenile and adult Syngnathus rostellatus and Hippocampus capensis. Our results are compared with previous morphological studies of a generalized teleost, Gasterosteus aculeatus. We found that the ethmoid region is elongated early during development, with the ethmoid plate, the hyosymplectic, and the basihyal cartilage being extended in the chondrocranium. In the juveniles of both species almost all bones are forming, although only as a very thin layer. The elongation of the vomeral, mesethmoid, quadrate, metapterygoid, symplectic, and preopercular bones is already present. Probably, because of the long and specialized parental care which releases advanced developmental stages from the brooding pouch, morphology of the feeding apparatus of juveniles is already very similar to that of the adults. We describe morphological features related to snout elongation that may be considered adaptations for suction feeding; e.g. the peculiar shape of the interhyal bone and its saddle-shaped articulation with the posterior ceratohyal bone might aid in explosive hyoid retraction by reducing the risk of hyoid dislocation.

Carers' experiences of home enteral feeding: A survey exploring medicines administration challenges and strategies.

PubMed

Alsaeed, D; Furniss, D; Blandford, A; Smith, F; Orlu, M

2018-06-01

The use of enteral tube feeding at home is becoming more widespread, with patients ranging in age and diseases. Dysphagia and swallowing difficulties can compromise nutritional intake and the administration of oral medications, affecting therapeutic outcomes negatively. Carers' experiences of medicines administration and medicines optimization have not been explored fully. The objectives of this study were to identify issues carers experience in medicines administration; the strategies they have developed to cope; and suggestions to improve the medicines administration process. An online survey was promoted nationally; 42 carers completed it. Descriptive statistical analysis was applied, as well as thematic analysis of open-ended responses. Results were compared against the 4 principles of medicines optimization. 93% of respondents administered medications with enteral feeding tubes, but only 62% had received advice from healthcare professionals and only 8% had received written information on how to do so. Responses identified 5 medicines administration issues experienced by carers; 4 strategies they developed to cope; and 3 main areas of suggestions to improve medicines administration via enteral feeding at home. The 4 principles of medicines optimization have not previously been applied to enteral feeding. We present a novel account of carers' experiences, for example coping with ill-suited formulations and a lack of training and support, which should inform better practice (Principle 1). Carers sometimes experience suboptimal choice of medicines (Principle 2). Carers' practices are not always well-informed and may affect therapeutic outcomes and safety (Principle 3). There is scope for improvement in carer training, education and support to better support medicines optimization (Principle 4). © 2018 The Authors. Journal of Clinical Pharmacy and Therapeutics Published by John Wiley & Sons Ltd.

Alkaline tide and nitrogen conservation after feeding in an elasmobranch (Squalus acanthias).

PubMed

Wood, Chris M; Kajimura, Makiko; Mommsen, Thomas P; Walsh, Patrick J

2005-07-01

We investigated the consequences of feeding for acid-base balance, nitrogen excretion, blood metabolites and osmoregulation in the Pacific spiny dogfish. Sharks that had been starved for 7 days were surgically fitted with indwelling stomach tubes for gastric feeding and blood catheters for repetitive blood sampling and were confined in chambers, allowing measurement of ammonia-N and urea-N fluxes. The experimental meal infused via the stomach tube consisted of flatfish muscle (2% of body mass) suspended in saline (4% of body mass total volume). Control animals received only saline (4% of body mass). Feeding resulted in a marked rise in both arterial and venous pH and HCO3- concentrations at 3-9 h after the meal, with attenuation by 17 h. Venous P(O2) also fell. As there were negligible changes in P(CO2), the response was interpreted as an alkaline tide without respiratory compensation, associated with elevated gastric acid secretion. Urea-N excretion, which comprised >90% of the total, was unaffected, while ammonia-N excretion was very slightly elevated, amounting to <3% of the total-N in the meal over 45 h. Plasma ammonia-N rose slightly. Plasma urea-N, TMAO-N and glucose concentrations remained unchanged, while free amino acid and beta-hydroxybutyrate levels exhibited modest declines. Plasma osmolality was persistently elevated after the meal relative to controls, partially explained by a significant rise in plasma Cl-. This marked post-prandial conservation of nitrogen is interpreted as reflecting the needs for urea synthesis for osmoregulation and protein growth in animals that are severely N-limited due to their sporadic and opportunistic feeding lifestyle in nature.

Enteral tube feeding in adults with cystic fibrosis; patient choice and impact on long term outcomes.

PubMed

White, H; Morton, A M; Conway, S P; Peckham, D G

2013-12-01

Enteral tube feeding (ETF) has been evaluated in paediatric and mixed child and adult populations with cystic fibrosis, demonstrating positive outcomes from 6 months to 2 years post insertion. No studies have examined the longer term nutritional and clinical outcomes in an exclusively adult population with cystic fibrosis or compared the outcomes for those who meet standard criteria and opt to undertake or decline ETF. Twenty three out of 380 patients attending the Leeds Regional Adult CF unit fulfilled the standard criteria for commencing ETF (CF Trust, 2002) between 2004 and 2008. Weight, BMI, FEV1, FVC, CFRD, and number of intravenous antibiotic treatment days were collected at 1 year pre baseline, at baseline, and at 1, 2, and 3 years post baseline for all these patients whether they accepted or declined ETF. Seventeen of the 23 patients agreed to accept a programme of ETF, two of whom died within the first year of ETF. In the remaining patients (n=15), weight increased by 19.5% from baseline (p<0.001), BMI increased to within the normal range and lung function stabilised. There was no reduction in the requirement for intravenous antibiotic treatment. The six patients who declined ETF had a decline in lung function and no weight gain. Supplemental enteral tube feeding improves clinical outcomes when administered over 3 years, resulting in significant weight gain, a normal BMI and stabilisation of lung function. It does not reduce intravenous antibiotic treatment days. In contrast those patients eligible for, but who declined ETF, showed a deterioration in lung function and a failure to gain weight and to achieve normal BMI status. Copyright © 2013 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Ceramic-bonded abrasive grinding tools

DOEpatents

Holcombe, C.E. Jr.; Gorin, A.H.; Seals, R.D.

1994-11-22

Abrasive grains such as boron carbide, silicon carbide, alumina, diamond, cubic boron nitride, and mullite are combined with a cement primarily comprised of zinc oxide and a reactive liquid setting agent and solidified into abrasive grinding tools. Such grinding tools are particularly suitable for grinding and polishing stone, such as marble and granite.

Ceramic-bonded abrasive grinding tools

DOEpatents

Holcombe, Jr., Cressie E.; Gorin, Andrew H.; Seals, Roland D.

1994-01-01

Abrasive grains such as boron carbide, silicon carbide, alumina, diamond, cubic boron nitride, and mullite are combined with a cement primarily comprised of zinc oxide and a reactive liquid setting agent and solidified into abrasive grinding tools. Such grinding tools are particularly suitable for grinding and polishing stone, such as marble and granite.

Design and evaluation of high-volume fly ash (HVFA) concrete mixes, report D : creep, shrinkage, and abrasion resistance of HVFA concrete.

DOT National Transportation Integrated Search

2012-10-01

The main objective of this study was to determine the effect on shrinkage, creep, : and abrasion resistance of high-volume fly ash (HVFA) concrete. The HVFA concrete : test program consisted of comparing the shrinkage, creep, and abrasion performance...

7 CFR 3201.66 - Cuts, burns, and abrasions ointments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Cuts, burns, and abrasions ointments. 3201.66 Section... PROCUREMENT Designated Items § 3201.66 Cuts, burns, and abrasions ointments. (a) Definition. Products designed..., in accordance with this part, will give a procurement preference for qualifying biobased cuts, burns...

7 CFR 3201.66 - Cuts, burns, and abrasions ointments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Cuts, burns, and abrasions ointments. 3201.66 Section... PROCUREMENT Designated Items § 3201.66 Cuts, burns, and abrasions ointments. (a) Definition. Products designed..., in accordance with this part, will give a procurement preference for qualifying biobased cuts, burns...

7 CFR 3201.66 - Cuts, burns, and abrasions ointments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Cuts, burns, and abrasions ointments. 3201.66 Section... PROCUREMENT Designated Items § 3201.66 Cuts, burns, and abrasions ointments. (a) Definition. Products designed..., in accordance with this part, will give a procurement preference for qualifying biobased cuts, burns...

Optical-model abrasion cross sections for high-energy heavy ions

NASA Technical Reports Server (NTRS)

Townsend, L. W.

1981-01-01

Within the context of eikonal scattering theory, a generalized optical model potential approximation to the nucleus-nucleus multiple scattering series is used in an abrasion-ablation collision model to predict abrasion cross sections for relativistic projectile heavy ions. Unlike the optical limit of Glauber theory, which cannot be used for very light nuclei, the abrasion formalism is valid for any projectile target combination at any incident kinetic energy for which eikonal scattering theory can be utilized. Results are compared with experimental results and predictions from Glauber theory.

Target correlation effects on neutron-nucleus total, absorption, and abrasion cross sections

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.; Townsend, Lawrence W.; Wilson, John W.

1991-01-01

Second order optical model solutions to the elastic scattering amplitude were used to evaluate total, absorption, and abrasion cross sections for neutron nucleus scattering. Improved agreement with experimental data for total and absorption cross sections is found when compared with first order (coherent approximation) solutions, especially below several hundred MeV. At higher energies, the first and second order solutions are similar. There are also large differences in abrasion cross section calculations; these differences indicate a crucial role for cluster knockout in the abrasion step.

Method of fabricating a whispering gallery mode resonator

NASA Technical Reports Server (NTRS)

Savchenkov, Anatoliy A. (Inventor); Matkso, Andrey B. (Inventor); Iltchenko, Vladimir S. (Inventor); Maleki, Lute (Inventor)

2011-01-01

A method of fabricating a whispering gallery mode resonator (WGMR) is provided. The WGMR can be fabricated from a particular material, annealed, and then polished. The WGMR can be repeatedly annealed and then polished. The repeated polishing of the WGMR can be carried out using an abrasive slurry. The abrasive slurry can have a predetermined, constant grain size. Each subsequent polishing of the WGMR can use an abrasive slurry having a grain size that is smaller than the grain size of the abrasive slurry of the previous polishing iteration.

Theoretical study on removal rate and surface roughness in grinding a RB-SiC mirror with a fixed abrasive.

PubMed

Wang, Xu; Zhang, Xuejun

2009-02-10

This paper is based on a microinteraction principle of fabricating a RB-SiC material with a fixed abrasive. The influence of the depth formed on a RB-SiC workpiece by a diamond abrasive on the material removal rate and the surface roughness of an optical component are quantitatively discussed. A mathematical model of the material removal rate and the simulation results of the surface roughness are achieved. In spite of some small difference between the experimental results and the theoretical anticipation, which is predictable, the actual removal rate matches the theoretical prediction very well. The fixed abrasive technology's characteristic of easy prediction is of great significance in the optical fabrication industry, so this brand-new fixed abrasive technology has wide application possibilities.

Interaction between attrition,abrasion and erosion in tooth wear.

PubMed

Addy, M; Shellis, R P

2006-01-01

Tooth wear is the result of three processes: abrasion (wear produced by interaction between teeth and other materials), attrition (wear through tooth-tooth contact) and erosion (dissolution of hard tissue by acidic substances). A further process (abfraction) might potentiate wear by abrasion and/or erosion. Both clinical and experimental observations show that individual wear mechanisms rarely act alone but interact with each other. The most important interaction is the potentiation of abrasion by erosive damage to the dental hard tissues. This interaction seems to be the major factor in occlusal and cervical wear. The available evidence seems insufficient to establish whether abfraction is an important contributor to tooth wear in vivo. Saliva can modulate erosive/abrasive tooth wear through formation of pellicle and by remineralisation but cannot prevent it.

Kinetic energy density and agglomerate abrasion rate during blending of agglomerates into powders.

PubMed

Willemsz, Tofan A; Hooijmaijers, Ricardo; Rubingh, Carina M; Tran, Thanh N; Frijlink, Henderik W; Vromans, Herman; van der Voort Maarschalk, Kees

2012-01-23

Problems related to the blending of a cohesive powder with a free flowing bulk powder are frequently encountered in the pharmaceutical industry. The cohesive powder often forms lumps or agglomerates which are not dispersed during the mixing process and are therefore detrimental to blend uniformity. Achieving sufficient blend uniformity requires that the blending conditions are able to break up agglomerates, which is often an abrasion process. This study was based on the assumption that the abrasion rate of agglomerates determines the required blending time. It is shown that the kinetic energy density of the moving powder bed is a relevant parameter which correlates with the abrasion rate of agglomerates. However, aspects related to the strength of agglomerates should also be considered. For this reason the Stokes abrasion number (St(Abr)) has been defined. This parameter describes the ratio between the kinetic energy density of the moving powder bed and the work of fracture of the agglomerate. The St(Abr) number is shown to predict the abrasion potential of agglomerates in the dry-mixing process. It appeared possible to include effects of filler particle size and impeller rotational rate into this concept. A clear relationship between abrasion rate of agglomerates and the value of St(Abr) was demonstrated. Copyright © 2011 Elsevier B.V. All rights reserved.

Bio-active glass air-abrasion has the potential to remove resin composite restorative material selectively

NASA Astrophysics Data System (ADS)

Milly, Hussam; Andiappan, Manoharan; Thompson, Ian; Banerjee, Avijit

2014-06-01

The aims of this study were to assess: (a) the chemistry, morphology and bioactivity of bio-active glass (BAG) air-abrasive powder, (b) the effect of three air-abrasion operating parameters: air pressure, powder flow rate (PFR) and the abrasive powder itself, on the selective removal of resin composite and (c) the required "time taken". BAG abrasive particles were characterised using scanning electron microscopy-energy dispersive X-ray spectrometry (SEM-EDX) and Fourier-transform infrared spectroscopy (FTIR). Standardised resin composite restorations created within an enamel analogue block (Macor™) in vitro, were removed using air-abrasion undersimulated clinical conditions. 90 standardised cavities were scanned before and after resin composite removal using laser profilometry and the volume of the resulting 3D images calculated. Multilevel linear model was used to identify the significant factors affecting Macor™ removal. BAG powder removed resin composite more selectively than conventional air-abrasion alumina powder using the same operating parameters (p < 0.001) and the effect of altering the unit's operating parameters was significant (p < 0.001). In conclusion, BAG powder is more efficient than alumina in the selective removal of resin composite particularly under specific operating parameters, and therefore may be recommended clinically as a method of preserving sound enamel structure when repairing and removing defective resin composite restorations.

Evaluation of Feed for Thin-Tailed Sheep Fattening with Supplemented Protected and Unprotected Aldehide

NASA Astrophysics Data System (ADS)

Riyanto, J.; Sudibya

2018-02-01

The purpose of this study was to determine the effect of the use of soybean protection supplements in sheep ration in vivo in terms of consumption, digestibility, nutrient value index, and the digestible nutrients in the ration. Livestock used in this study were 15 heads of thintailed sheep male with an average body weight of 20.81 ± 1.40kg. The rations used in this study consisted of elephant grass, basal concentrate, soybean groats protected and without protected. The comparison between elephant grass and basalt concentrate is 30:70. Feed treatment in the form of supplementary concentrate from soybean groats ingredients without protection and protection. Protection of soybeans using 37% formaldehyde. The treatment given is P0 = 30% Elephant grass + 70% Basal concentrate, P1 = 30% Elephant grass + 60% Basal Concentrate + 10% soybeans groats without formaldehyde protection, and P2 = 30% Elephant grass + 60% Basal Concentrate + 10% soybeans groats formaldehyde protection. Supplementation of 10% soybean protected feeding in male thin tail sheep fattening ration had significant effect (P <0.05) on crude protein digestibility, nutrient value index and digested crude protein. The use of 10% of soybean protected 37% formaldehyde protected soy by 1% of the dry weight of the concentrate in thin tail fattening rations could improve protein digestibility, nutrient value index and abrasive proteins that can be ingested in vivo.

Gigantism Precedes Filter Feeding in Baleen Whale Evolution.

PubMed

Fordyce, R Ewan; Marx, Felix G

2018-05-21

Baleen whales (Mysticeti) are the largest animals on Earth, thanks to their ability to filter huge volumes of small prey from seawater. Mysticetes appeared during the Late Eocene, but evidence of their early evolution remains both sparse and controversial [1, 2], with several models competing to explain the origin of baleen-based bulk feeding [3-6]. Here, we describe a virtually complete skull of Llanocetus denticrenatus, the second-oldest (ca. 34 Ma) mysticete known. The new material represents the same individual as the type and only specimen, a fragmentary mandible. Phylogenetic analysis groups Llanocetus with the oldest mysticete, Mystacodon selenensis [2], into the basal family Llanocetidae. Llanocetus is gigantic (body length ∼8 m) compared to other early mysticetes [7-9]. The broad rostrum has sharp, widely spaced teeth with marked dental abrasion and attrition, suggesting biting and occlusal shearing. As in extant mysticetes, the palate bears many sulci, commonly interpreted as osteological correlates of baleen [3]. Unexpectedly, these sulci converge on the upper alveoli, suggesting a peri-dental blood supply to well-developed gums, rather than to inter-alveolar racks of baleen. We interpret Llanocetus as a raptorial or suction feeder, revealing that whales evolved gigantism well before the emergence of filter feeding. Rather than driving the origin of mysticetes, baleen and filtering most likely only arose after an initial phase of suction-assisted raptorial feeding [2, 4, 5]. This scenario differs strikingly from that proposed for odontocetes, whose defining adaptation-echolocation-was present even in their earliest representatives [10]. Copyright © 2018 Elsevier Ltd. All rights reserved.

Extraction and characterization of cashew tree (Anacardium occidentale) gum; use in aceclofenac dental pastes.

PubMed

Hasnain, M Saquib; Rishishwar, Poonam; Rishishwar, Sanjay; Ali, Sadath; Nayak, Amit Kumar

2018-05-20

In the current work, the usefulness of extracted cashew tree gum (CG) as pharmaceutical excipient in dental pastes containing aceclofenac (AC) for the pain management in the periodontitis treatment was investigated. CG was extracted from crude exudate of cashew tree (Anacardium occidentale, family: Anacardiaceae) (yield 19.22%). Physicochemical characteristics like colour, odour, taste, solubility, pH and viscosity of extracted CG were estimated; the phytochemical identification tests indicated the presence of carbohydrates and mucilage within it. It was also characterized by FTIR spectroscopy and 1 H NMR analyses. Using the extracted CG (as natural mucoadhesive polymer) with calcium carbonate (abrasive agent), glycerin (humectant and cosolvent), methyl paraben (preservative), sodium lauryl sulfate (surfactant) and camphor (flavoring agent), 1% w/w AC dental pastes was formulated via conventional trituration. The drug contents, viscosities and pHs, tube extrudabilities and tube spreadabilities of these dental pastes were observed within permissible ranges. The dental pastes demonstrated sustained AC releasing over 6 h, in vitro and also revealed good adhesion to the oral mucosal membrane. These 1% w/w AC dental pastes can be used in the effectual management of dental inflammation and pain through local delivery of AC over a prolonged in the periodontitis treatment. Copyright © 2018 Elsevier B.V. All rights reserved.

Ad libitum or demand/semi-demand feeding versus scheduled interval feeding for preterm infants.

PubMed

Tosh, K; McGuire, W

2006-07-19

Feeding preterm infants in response to their hunger and satiation cues (ad libitum or demand/semi demand) rather than at scheduled intervals might help in the establishment of independent oral feeding, increase nutrient intake and growth rates, and allow earlier hospital discharge. To assess the effect of a policy of feeding preterm infants on an ad libitum or demand/semi-demand basis versus feeding prescribed volumes at scheduled intervals on growth rates and the time to hospital discharge. We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2006), MEDLINE (1966 - March 2006), EMBASE (1980 - March 2006), CINAHL (1982 - March 2006), conference proceedings, and previous reviews. Randomised or quasi-randomised controlled trials (including cluster randomised trials) that compared a policy of feeding preterm infants on an ad libitum or demand/semi-demand basis versus feeding at scheduled intervals. The standard methods of the Cochrane Neonatal Review Group with separate evaluation of trial quality and data extraction by two review authors. The primary outcomes of interest were growth rates and age at hospital discharge. We found seven randomised controlled trials that compared ad libitum or demand/semi-demand regimes with scheduled interval regimes in preterm infants in the transition phase from intragastric tube to oral feeding. The trials were generally small and of variable methodological quality. The duration of the intervention and the duration of data collection and follow up in most of the trials is not likely to have allowed detection of measurable effects on growth. The single trial that assessed growth for longer than one week found that the rate of weight gain was lower in the ad libitum fed infants [mean difference -3.30 (95% confidence interval -6.2 to -0.4) grams per kilogram per day]. Two trials reported that feeding preterm infants using an ad libitum or demand/semi-demand feeding regime allowed earlier discharge from hospital, but the other trials did not confirm this finding. We were not able to undertake meta-analyses because of differences in study design and in the way the findings were reported. There are insufficient data at present to guide clinical practice. A large randomised controlled trial is needed to determine if ad libitum of demand/semi-demand feeding of preterm infants affects clinically important outcomes. This trial should focus on infants in the transition phase from intragastric tube to oral feeding and should be of sufficient duration to assess effects on growth and time to oral feeding and hospital discharge.

Comparative Efficacy of a Soft Toothbrush with Tapered-tip Bristles to an ADA Reference Toothbrush on Gingival Abrasion over a 12-Week Period.

PubMed

Gallob, John; Petrone, Dolores M; Mateo, Luis R; Chaknis, Patricia; Morrison, Boyce M; Panagakos, Foti; Williams, Malcolm

2016-06-01

Evaluation of the impact of a soft toothbrush with tapered-tip (Test Toothbrush) bristles and an ADA reference toothbrush (ADA Toothbrush) on gingival abrasion over a 12-week period. This was a randomized, single-center, examiner-blind, two-cell, parallel clinical research study and used the Danser Gingival Abrasion Index to assess the level of gingival abrasion after a single brushing, as well as after six weeks and 12 weeks of twice-daily brushing. Adult male and female subjects from the Central New Jersey, USA area refrained from all oral hygiene procedures for 24 hours. They reported to the study site after refraining from eating, drinking, and smoking for four hours. Following a qualifying examination using plaque and gingivitis scores along with a baseline gingival abrasion examination, subjects were randomized into two balanced groups, each group using one of the two study toothbrushes. Subjects were instructed to brush their teeth for one minute, under supervision, with their assigned toothbrush and a commercially available fluoride toothpaste (Colgate© Cavity Protection Toothpaste), after which they were again evaluated for gingival abrasion. Subjects were dismissed from the study site with their assigned toothbrush and toothpaste, and instructed to brush twice daily at home for the next 12 weeks. The subjects were instructed to brush for one minute during each tooth brushing. The subjects reported to the study site after six weeks and 12 weeks of product use, at which time they were evaluated for gingival abrasion. Seventy-one (71) subjects complied with the protocol and completed the clinical study. The results of this study showed that the Test Toothbrush provided statistically significantly (p < 0.05) greater reductions in gingival abrasion scores as compared to the gingival abrasion scores of the ADA Toothbrush after a single tooth brushing, after six weeks, and after 12 weeks of product use (75.0%, 85.5%, 73.9%, respectively). The soft toothbrush with tapered-tip bristles produced significantly less gingival abrasion after 12 weeks of product use as compared to the ADA reference toothbrush.

Recovery of normal esophageal function in a kitten with diffuse megaesophagus and an occult lower esophageal stricture.

PubMed

Schneider, Jaycie; Ames, Marisa; DiCicco, Michael; Savage, Mason; Atkins, Clarke; Wood, Michael; Gookin, Jody L

2015-06-01

An 8-week-old male domestic shorthair was presented to the Internal Medicine Service at North Carolina State University for regurgitation. Radiographic diagnosis of generalized esophageal dilation and failure of esophageal peristalsis were compatible with diagnosis of congenital megaesophagus. Endoscopic examination of the esophagus revealed a fibrous stricture just orad to the lower esophageal sphincter. Conservative management to increase the body condition and size of the kitten consisted of feeding through a gastrostomy tube, during which time the esophagus regained normal peristaltic function, the stricture orifice widened in size and successful balloon dilatation of the stricture was performed. Esophageal endoscopy should be considered to rule out a stricture near the lower esophageal sphincter in kittens with radiographic findings suggestive of congenital megaesophagus. Management of such kittens by means of gastrostomy tube feeding may be associated with a return of normal esophageal motility and widening of the esophageal stricture, and facilitate subsequent success of interventional dilation of the esophageal stricture. © ISFM and AAFP 2014.