Sedation and Analgesia Using Medications Delivered via the Extravascular Route in Children Undergoing Laceration Repair

PubMed Central

Capino, Amanda C.; Thomas, Amber; Couloures, Kevin; Johnson, Peter N.

2018-01-01

OBJECTIVES To describe the method of delivery, dosage regimens, and outcomes of sedatives and analgesics administered via the extravascular route for laceration repair in children METHODS Medline, Embase, and International Pharmaceutical Abstracts were searched using the keywords “child,” “midazolam,” “ketamine,” dexmedetomidine,” “fentanyl,” “nitrous oxide” (N2O), and “laceration repair.” Articles evaluating the use of extravascular sedation in children for laceration repair published in the English language between 1946 and June 2017 were included. Two authors independently screened each article for inclusion. Reports were excluded if they did not contain sufficient details on dosage regimen and outcomes. RESULTS A total of 16 reports representing 953 children receiving sedatives and analgesics via the extravascular route were included for analyses. A statistical analysis was not performed because of heterogeneity in dosing and types of analyses conducted. Midazolam and N2O were the most common agents, with oral (PO) midazolam being the most common agent. Other agents that have supporting data were intranasal (IN) dexmedetomidine, IN ketamine, IN midazolam, PO diazepam, PO ketamine, transmucosal (TM) midazolam, and TM fentanyl. CONCLUSIONS Most of the agents administered through the extravascular route were efficacious. Selection of the agents should be based on perceived need for analgesia versus sedation, patient accessibility, and adverse drug events. Future research is needed to determine the optimal agent and route for laceration repair. PMID:29720907

Endotoxin increases pulmonary vascular protein permeability in the dog

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

Welsh, C.H.; Dauber, I.M.; Weil, J.V.

Endotoxin increases pulmonary vascular permeability consistently in some species but fails to reliably cause injury in the dog. We wondered whether this phenomenon depended on the method of injury assessment, as others have relied on edema measurement; we quantified injury by monitoring the rate of extravascular protein accumulation. /sup 113m/In-labeled protein and /sup 99m/Tc-labeled erythrocytes were injected into anesthetized dogs and monitored by an externally placed lung probe. A protein leak index, the rate of extravascular protein accumulation, was derived from the rate of increase in lung protein counts corrected for changes in intravascular protein activity. After administration of Salmonellamore » enteriditis endotoxin (4 micrograms/kg), the protein leak index was elevated 2.5-fold (41.1 +/- 4.6 X 10(-4) min-1) compared with control (16.0 +/- 2.8 X 10(-4) min-1). In contrast, wet-to-dry weight ratios failed to increase after endotoxin (4.6 +/- 0.8 vs. control values of 4.2 +/- 0.5 g/g dry bloodless lung). However, we observed that endotoxin increased lung dry weight (per unit body weight), which may have attenuated the change in wet-to-dry weight ratios. To determine whether low microvascular pressures following endotoxin attenuated edema formation, we increased pulmonary arterial wedge pressures in five dogs by saline infusion, which caused an increase in wet-to-dry weight ratios following endotoxin but no change in the five controls. We conclude that low dose endotoxin causes pulmonary vascular protein leak in the dog while edema formation is minimal or absent.« less

Extravascular lung water and the pulmonary vascular permeability index may improve the definition of ARDS.

PubMed

Perel, Azriel

2013-01-24

The recent Berlin definition has made some improvements in the older definition of acute respiratory distress syndrome (ARDS), although the concepts and components of the definition remained largely unchanged. In an effort to improve both predictive and face validity, the Berlin panel has examined a number of additional measures that may reflect increased pulmonary vascular permeability, including extravascular lung water. The panel concluded that although extravascular lung water has improved face validity and higher values are associated with mortality, it is infeasible to mandate on the basis of availability and the fact that it does not distinguish between hydrostatic and inflammatory pulmonary edema. However, the results of a multi-institutional study that appeared in the previous issue of Critical Care show that this latter reservation may not necessarily be true. By using extravascular lung water and the pulmonary vascular permeability index, both of which are derived from transpulmonary thermodilution, the authors could successfully differentiate between patients with ARDS and other patients in respiratory failure due to either cardiogenic edema or pleural effusion with atelectasis. This commentary discusses the merits and limitations of this study in view of the potential improvement that transpulmonary thermodilution may bring to the definition of ARDS.

Protein vs electrolytes and all of the Starling forces.

PubMed

Peters, R M; Hargens, A R

1981-10-01

Hemodilution-induced reductions of the intravascular protein concentration in patients and experimental animals with intact capillaries do not lead to pulmonary edema, despite significant increases in the amount of extravascular water in the systemic interstitial space. The protective factors are a drop in the extravascular concentration of protein, a rise in interstitial tissue pressure, and an increase in lymph flow. If the capillary endothelium is damaged, protein leaks into the extravascular space, and protein infusion has a diminished effect on fluid exchange across the capillary. Whether capillaries are intact or injured, prevention of increases in capillary hydrostatic pressure is the most important factor in preventing pulmonary edema. Administration of hypertonic fluids may provide a useful method of limiting total fluid infusion and reducing cell swelling after blood loss.

Competitive quenching: a possible novel approach in protecting RPE cells from damage during PDT.

PubMed

Weinberger, Dov; Ron, Yonina; Lusky, Moshe; Gaaton, Dan; Orenstein, Arie; Blank, Michael; Mandel, Mathilda; Livnat, Tamar; Barliya, Tilda; Lavie, Gad

2005-04-01

The purpose of this study is to demonstrate feasibility of using our novel concept, termed competitive quenching, for protecting the choroidal extravascular compartment and retinal pigment epithelium (RPE) from verteporfin (VP)-induced phototoxicity using hypericin. Furthermore, we aim to achieve partitioning of the quencher, hypericin, in the extravascular space and VP within the microvascular compartment of the chorio-retinal complex in vivo. We protect RPE cells from damage inflicted by photoactivated VP by introducing hypericin into these cells prior to photosensitization to quench the photosensitizing activity of VP. Cell protection levels were measured by MTT and Hemacolor viability assays. Wavelength range used for VP photoexcitation (700 +/- 40 nm) excludes the absorption range of hypericin, preventing the latter from photoactivation. Pharmacokinetic conditions, in which hypericin spreads throughout the choroidal and retinal extravascular space while VP is confined to the vasculature, are delineated using double-fluorescence imaging. Cell viability increased 3- to 5-fold when 10-20 microM hypericin were present in RPE cells during photosensitization with 0.1-0.5 microM VP. VP fluorescence intensity was unchanged by the presence of hypericin in the cells. Hypericin administered intravenously to rats was confined to the choroidal vasculature after 15 min to 2 hr. Subsequently, hypericin partitioned to the choroidal and retinal extravascular space. VP administered at this time was confined to the microvasculature. RPE and choroid may potentially be protected by compartmentalizing hypericin to the extravascular compartment while VP administered shortly before photosensitization is confined to the microvasculature. Adverse photodynamic therapy (PDT) damage to choroidal tissues adjacent to neovasculature targeted for photoablation have the potential of being prevented by competitive quenching with hypericin.

Total ginsenosides synergize with ulinastatin against septic acute lung injury and acute respir atory distress syndrome

PubMed Central

Sun, Rongju; Li, Yana; Chen, Wei; Zhang, Fei; Li, Tanshi

2015-01-01

Total ginsenosides synergize with ulinastatin (UTI) against septic acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). We randomly divided 80 cases of severe sepsis-induced ALI and ARDS into a UTI group and a ginsenosides (GS)+UTI group. Continuous electrocardiac monitoring of pulse, respiratory rate, blood pressure, and heart rate; invasive hemodynamic monitoring; ventilator-assisted breathing and circulation support; and anti-infection as well as UTI treatment were given in the UTI group with GS treatment added for 7 consecutive days in the GS+UTI group. The indicators of pulmonary vascular permeability, pulmonary circulation, blood gases, and hemodynamics as well as APACHE II and ALI scores were detected on days 1, 3, and 7. The ALI score in the GS+UTI group was significantly decreased (P < 0.05) compared with that of the UTI group, and the indicators of pulmonary capillary permeability such as pulmonary vascular permeability index, extravascular lung water index, and oxygenation index, in the GS+UTI group improved significantly more than that of the UTI group. The indicators of hemodynamics and pulmonary circulation such as cardiac index, intrathoracic blood volume index, and central venous pressure improved significantly (P < 0.05), and the APACHE II score in the GS+UTI group was lower than that of the UTI group. GS can effectively collaborate with UTI against ALI and/or ARDS. PMID:26261640

Ventilation with positive end-expiratory pressure reduces extravascular lung water and increases lymphatic flow in hydrostatic pulmonary edema.

PubMed

Fernández Mondéjar, E; Vazquez Mata, G; Cárdenas, A; Mansilla, A; Cantalejo, F; Rivera, R

1996-09-01

To analyze the effect of different levels of positive end-expiratory pressure (PEEP) on extravascular lung water and on lymphatic drainage through the thoracic duct during hydrostatic pulmonary edema. Randomized, controlled, experimental study. Research laboratory of a tertiary care hospital. Eighteen beagle dogs weighing between 10 and 19 kg. Dogs were anesthetized and cannulated via a thoracic duct. Hydrostatic pulmonary edema was provoked by inflating the balloon of a Foley catheter in the left atrium. Different amounts of PEEP were applied. Extravascular lung water was determined by the double indicator dilution method (indocyanine green in glucoside solution at 0 degree C), and lymphatic drainage was measured every 30 mins. After a baseline measurement, the left atrial pressure was increased to 24 to 26 mm Hg, and measurements were recorded after 30, 60, 90, and 120 mins. The animals were divided into three groups. Group I (n = 6): PEEP of 20 cm H2O was instituted at 120 mins, and the other determinations were made without PEEP; group II (n = 7): PEEP of 10 cm H2O was instituted at 60 and 90 mins; group III (n = 5): PEEP of 20 cm H2O was instituted at 60 and 90 mins. Extravascular lung water increased after the increase of left atrial pressure in all three groups. After 90 mins, the extravascular lung water was significantly greater (p < .01) in group I (no PEEP application) at 21.2 +/- 5.1 mL/kg than in groups II and III (with 10 and 20 cm H2O of PEEP) at 12.8 +/- 2.01 and 14.8 +/- 4.8 mL/kg, respectively. Lymphatic drainage tended to increase over time in all three groups. Ninety minutes after the left atrial pressure increase, lymphatic drainage was significantly greater (p < .05) in group II, at 6.06 +/- 2.53 mL/kg/30 mins, than in group I, at 2.83 +/- 0.76 mL/kg/30 mins. a) The application of PEEP levels of between 10 and 20 cm H2O limits the increase of extravascular lung water in cases of hydrostatic pulmonary edema; and b) the application of 10 cm H2O of PEEP increases the lymphatic flow through the thoracic duct.

Advanced life systems hardware development for future missions

NASA Technical Reports Server (NTRS)

1975-01-01

An examination of the pulse formation in an externalized vessel suggests that the vessel does not behave as a simple visco-elastic tube. Pressure-pulse waveform transducers are sensitive either to the pressure present at the vessel wall or to the volume of blood filling a region of tissue. Results of comparisons between intra-and extra-vascular pressure recordings suggest that changes in vasomotor tone and transducer-vessel pressures may be the greatest contributors to the divergence of extra-vascular waveforms from intra-vascular waveforms.

Effects of agmatine on blood-brain barrier stabilization assessed by permeability MRI in a rat model of transient cerebral ischemia.

PubMed

Ahn, S S; Kim, S H; Lee, J E; Ahn, K J; Kim, D J; Choi, H S; Kim, J; Shin, N-Y; Lee, S-K

2015-02-01

BBB disruption after acute ischemic stroke and subsequent permeability increase may be enhanced by reperfusion. Agmatine has been reported to attenuate BBB disruption. Our aim was to evaluate the effects of agmatine on BBB stabilization in a rat model of transient cerebral ischemia by using permeability dynamic contrast-enhanced MR imaging at early stages and subsequently to demonstrate the feasibility of dynamic contrast-enhanced MR imaging for the investigation of new therapies. Thirty-four male Sprague-Dawley rats were subjected to transient MCA occlusion for 90 minutes. Immediately after reperfusion, agmatine (100 mg/kg) or normal saline was injected intraperitoneally into the agmatine-treated group (n = 17) or the control group, respectively. MR imaging was performed after reperfusion. For quantitative analysis, regions of interest were defined within the infarct area, and values for volume transfer constant, rate transfer coefficient, volume fraction of extravascular extracellular space, and volume fraction of blood plasma were obtained. Infarct volume, infarct growth, quantitative imaging parameters, and numbers of factor VIII-positive cells after immunohistochemical staining were compared between control and agmatine-treated groups. Among the permeability parameters, volume transfer constant and volume fraction of extravascular extracellular space were significantly lower in the agmatine-treated group compared with the control group (0.05 ± 0.02 minutes(-1) versus 0.08 ± 0.03 minute(-1), P = .012, for volume transfer constant and 0.12 ± 0.06 versus 0.22 ± 0.15, P = .02 for volume fraction of extravascular extracellular space). Other permeability parameters were not significantly different between the groups. The number of factor VIII-positive cells was less in the agmatine-treated group than in the control group (3-fold versus 4-fold, P = .037). In ischemic stroke, agmatine protects the BBB, which can be monitored in vivo by quantification of permeability by using dynamic contrast-enhanced MR imaging. Therefore, dynamic contrast-enhanced MR imaging may serve as a potential imaging biomarker for assessing the BBB stabilization properties of pharmacologic agents. © 2015 by American Journal of Neuroradiology.

Intravenous bolus of 125I labeled meglumine diatrizoate. Early extravascular distribution.

PubMed

Dean, P B; Kormano, M

1977-05-01

A mixture of 125I labeled meglumine diatrizoate and 131I labeled human serum albumin was injected into the femoral vein of 26 anesthetized male rats. Measurements of the activities in cardiac blood and in different tissues of the lower extremity and in the testis were performed at time intervals ranging from 5 s to 5 min after injection. The determination of tissue uptake and distribution volumes of diatrizoate showed widely differing accumulation of contrast medium. Over 50 per cent of the intravenous bolus of diatrizoate was extravascular at 40 s.

Continuous renal replacement therapies: a brief primer for the neurointensivist.

PubMed

Patel, Pritesh; Nandwani, Veena; McCarthy, Paul J; Conrad, Steven A; Keith Scott, L

2010-10-01

Continuous renal replacement therapy (CRRT) is a renal replacement modality that is often used in the ICU setting, including the neuro-ICU. This form of renal replacement therapy has been used classically for acute renal failure in patients with hemodynamic compromise, but is gaining acceptance as a method to control vascular and extra-vascular volume and mediate cytokines in non-renal diseases. Although these uses are briefly discussed, this review concentrates on the different forms of continuous renal replacement, mainly focusing on the technology of convective versus diffusive modalities and briefly on filter technology. There is also discussion on the various anticoagulation regimes used in CRRT including data on performing CRRT without anticoagulation. This review is not meant to be a discussion on the pros and cons of CRRT versus intermittent dialysis, but rather a primer on the technology of CRRT and how this therapy may affect general care of the ICU patient.

Numerical Modeling of Interstitial Fluid Flow Coupled with Blood Flow through a Remodeled Solid Tumor Microvascular Network

PubMed Central

Soltani, M.; Chen, P.

2013-01-01

Modeling of interstitial fluid flow involves processes such as fluid diffusion, convective transport in extracellular matrix, and extravasation from blood vessels. To date, majority of microvascular flow modeling has been done at different levels and scales mostly on simple tumor shapes with their capillaries. However, with our proposed numerical model, more complex and realistic tumor shapes and capillary networks can be studied. Both blood flow through a capillary network, which is induced by a solid tumor, and fluid flow in tumor’s surrounding tissue are formulated. First, governing equations of angiogenesis are implemented to specify the different domains for the network and interstitium. Then, governing equations for flow modeling are introduced for different domains. The conservation laws for mass and momentum (including continuity equation, Darcy’s law for tissue, and simplified Navier–Stokes equation for blood flow through capillaries) are used for simulating interstitial and intravascular flows and Starling’s law is used for closing this system of equations and coupling the intravascular and extravascular flows. This is the first study of flow modeling in solid tumors to naturalistically couple intravascular and extravascular flow through a network. This network is generated by sprouting angiogenesis and consisting of one parent vessel connected to the network while taking into account the non-continuous behavior of blood, adaptability of capillary diameter to hemodynamics and metabolic stimuli, non-Newtonian blood flow, and phase separation of blood flow in capillary bifurcation. The incorporation of the outlined components beyond the previous models provides a more realistic prediction of interstitial fluid flow pattern in solid tumors and surrounding tissues. Results predict higher interstitial pressure, almost two times, for realistic model compared to the simplified model. PMID:23840579

Invariant natural killer T cells act as an extravascular cytotoxic barrier for joint-invading Lyme Borrelia.

PubMed

Lee, Woo-Yong; Sanz, Maria-Jesus; Wong, Connie H Y; Hardy, Pierre-Olivier; Salman-Dilgimen, Aydan; Moriarty, Tara J; Chaconas, George; Marques, Adriana; Krawetz, Roman; Mody, Christopher H; Kubes, Paul

2014-09-23

CXCR6-GFP(+) cells, which encompass 70% invariant natural killer T cells (iNKT cells), have been found primarily patrolling inside blood vessels in the liver. Although the iNKT cells fail to interact with live pathogens, they do respond to bacterial glycolipids presented by CD1d on liver macrophage that have caught the microbe. In contrast, in this study using dual laser multichannel spinning-disk intravital microscopy of joints, the CXCR6-GFP, which also made up 60-70% iNKT cells, were not found in the vasculature but rather closely apposed to and surrounding the outside of blood vessels, and to a lesser extent throughout the extravascular space. These iNKT cells also differed in behavior, responding rapidly and directly to joint-homing pathogens like Borrelia burgdorferi, which causes Lyme disease. These iNKT cells interacted with B. burgdorferi at the vessel wall and disrupted dissemination attempts by these microbes into joints. Successful penetrance of B. burgdorferi out of the vasculature and into the joint tissue was met by a lethal attack by extravascular iNKT cells through a granzyme-dependent pathway, an observation also made in vitro for iNKT cells from joint but not liver or spleen. These results suggest a novel, critical extravascular iNKT cell immune surveillance in joints that functions as a cytotoxic barrier and explains a large increase in pathogen burden of B. burgdorferi in the joint of iNKT cell-deficient mice, and perhaps the greater susceptibility of humans to this pathogen because of fewer iNKT cells in human joints.

Preventing the infiltration of leukocytes by monoclonal antibody blocks the development of progressive ischemia in rat burns.

PubMed

Choi, M; Rabb, H; Arnaout, M A; Ehrlich, H P

1995-10-01

Tissue loss as a consequence of thermal trauma occurs in two stages. There is immediate necrosis in tissues directly killed by the thermal energy, followed by a delayed secondary necrosis in neighboring tissues. The infiltration of neutrophils into traumatized tissues is a hallmark of the inflammatory response. Neutrophils have the machinery to kill invading microorganisms, but these same weapons have the capacity to destroy the host's viable tissues as well. Leukocyte infiltration requires their adherence to the vascular endothelial cell surface. Masking these adhesion sites on neutrophils will block the adhesion of neutrophils to the endothelium. A monoclonal antibody (mAb) was developed to guinea pig leukocyte adhesion sites CD11b/ CD18, and this mAb cross-reacts with rat leukocytes, blocking their adherence. Rats received a "comb burn" composed of four rectangular full-thickness burns placed in a row and separated by three areas left unburned. The four individual burns convert into a single large wound because the blood flow to the interspaces was terminated, blood vessels were occluded, and leukocytes were present in the extravascular space. The systemic administration of the mAb (50 to 150 microliters) immediately following a comb burn promoted the survival of the interspace, demonstrated by the prevention of loss of blood flow by laser Doppler monitoring, maintained patent vessels by latex vascular casts, blocked extravascular migration of neutrophils histologically at 2 hours, and limited the tissue loss to the original four burns.

Monitoring of intrathoracic volemia and cardiac output in critically ill children.

PubMed

Cecchetti, C; Stoppa, F; Vanacore, N; Barbieri, M A; Raucci, U; Pasotti, E; Tomasello, C; Marano, M; Pirozzi, N

2003-12-01

Hemodynamic monitoring is an important step in the management of critically ill children despite the difficulty in measuring preload indices continuously. The aim of the study was to analyze cardiac output parameters and preload indices after acute changes in mean airway pressure and volemia. Twenty-three children treated at our unit were enrolled in a prospective non randomized cohort study. Respiration was supported by controlled mechanical ventilation with positive expiratory-end pressure (PEEP), peak inspiratory pressure <20 cm H(2)O and mean airway pressure <10 cm H(2)O, and hemodynamic monitoring using the PiCCO system. Hemodynamic parameters were measured at T0 (base line), T(1) (after an increase in PEEP of 5 cm H(2)O for 10 min), and T(2) (after fluid challenge). The statistical analysis (BMPD New System software package) comprised comparison of changes at T(0) vs T(1), T(1) vs T(2) and T(0) vs T(2), construction of 3 correlation matrices and multiple linear regression analysis. Sixty-nine hemodynamic parameters were measured in the 23 patients. A comparison between T(0) and T(1) showed no significant changes; differences between T(0) and T(2) were found for cardiac index (CI), (p=0.003); between T(0) and T(2) significant differences were found for CI (p=0.0015), intrathoracic blood volume index (ITBVI) (p=0.04) and stroke volume index (SVI) (p=0.06). The analysis of the correlation matrices yielded ITBVI with CI (p=0.0006), ITBVI with SVI (p=1 x 10(-5)), CI with SVI (p=0.002); a significant correlation between CI and extravascular lung water index (EVLWI) was found only at T(1). Multiple linear regression analysis showed that ITBVI and SVI were predictive for variance of CI at each time point. ITBVI measured by a volumetric monitoring system such as the PiCCO may be considered a sensitive preload indicator also in critically ill children.

Ventilation and gas exchange management after cardiac arrest.

PubMed

Sutherasan, Yuda; Raimondo, Pasquale; Pelosi, Paolo

2015-12-01

For several decades, physicians had integrated several interventions aiming to improve the outcomes in post-cardiac arrest patients. However, the mortality rate after cardiac arrest is still as high as 50%. Post-cardiac arrest syndrome is associated with high morbidity and mortality due to not only poor neurological outcome and cardiovascular failure but also respiratory dysfunction. To minimize ventilator-associated lung injury, protective mechanical ventilation by using low tidal volume ventilation and driving pressure may decrease pulmonary complications and improve survival. Low level of positive end-expiratory pressure (PEEP) can be initiated and titrated with careful cardiac output and respiratory mechanics monitoring. Furthermore, optimizing gas exchange by avoiding hypoxia and hyperoxia as well as maintaining normocarbia may improve neurological and survival outcome. Early multidisciplinary cardiac rehabilitation intervention is recommended. Minimally invasive monitoring techniques, that is, echocardiography, transpulmonary thermodilution method measuring extravascular lung water, as well as transcranial Doppler ultrasound, might be useful to improve appropriate management of post-cardiac arrest patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prediction of distribution volume of vancomycin in critically ill patients using extravascular lung water and pulmonary vascular permeability indices.

PubMed

Imaura, Masaharu; Yokoyama, Haruko; Kohyama, Tomoki; Nagafuchi, Hiroyuki; Kohata, Yuji; Takahashi, Hiroyuki; Yamada, Yasuhiko

2012-11-01

Alterations in distribution volume affect the concentrations of hydrophilic drugs in plasma and tissues at the time of initial therapy. When the distribution volume of hydrophilic antimicrobials is increased in critically ill patients with a serious infection, antimicrobial concentrations are reduced, which may adversely affect the efficacy of antimicrobial therapy. A transpulmonary thermodilution technique system (PiCCO) enables measurements of pulmonary vascular permeability index (PVPI) and extravascular lung water index (EVLWI), which are related to pulmonary edema and pulmonary vascular permeability, respectively. In addition, those indices may also be related to the distribution volume of hydrophilic antimicrobials. The aim of this study was to investigate the relationships of PVPI and EVLWI with the distribution volume of vancomycin (Vss), as well as to establish a method for estimating Vss for planning an appropriate initial dose for individual patients. Seven patients were administered vancomycin intravenously and underwent extended hemodynamic monitoring with the PiCCO system in the intensive care unit (ICU) from April 2009 to March 2011. Vss was calculated using the Bayesian method, and the relationships of PVPI and EVLWI with Vss were investigated. The relationship between Vss/actual body weight (ABW) and median EVLWI on days when blood levels were measured was significant (r = 0.900, p = 0.0057), whereas the relationship between Vss/ABW and PVPI was not significant (r = 0.649, p = 0.1112). EVLWI determined by the PiCCO system is useful to predict Vss and should lead to more effective vancomycin therapy for critically ill patients at the initial stage.

A theoretical framework to model DSC-MRI data acquired in the presence of contrast agent extravasation

NASA Astrophysics Data System (ADS)

Quarles, C. C.; Gochberg, D. F.; Gore, J. C.; Yankeelov, T. E.

2009-10-01

Dynamic susceptibility contrast (DSC) MRI methods rely on compartmentalization of the contrast agent such that a susceptibility gradient can be induced between the contrast-containing compartment and adjacent spaces, such as between intravascular and extravascular spaces. When there is a disruption of the blood-brain barrier, as is frequently the case with brain tumors, a contrast agent leaks out of the vasculature, resulting in additional T1, T2 and T*2 relaxation effects in the extravascular space, thereby affecting the signal intensity time course and reducing the reliability of the computed hemodynamic parameters. In this study, a theoretical model describing these dynamic intra- and extravascular T1, T2 and T*2 relaxation interactions is proposed. The applicability of using the proposed model to investigate the influence of relevant MRI pulse sequences (e.g. echo time, flip angle), and physical (e.g. susceptibility calibration factors, pre-contrast relaxation rates) and physiological parameters (e.g. permeability, blood flow, compartmental volume fractions) on DSC-MRI signal time curves is demonstrated. Such a model could yield important insights into the biophysical basis of contrast-agent-extravasastion-induced effects on measured DSC-MRI signals and provide a means to investigate pulse sequence optimization and appropriate data analysis methods for the extraction of physiologically relevant imaging metrics.

Vascular viscoelasticity of perfused rat hindquarters.

PubMed

Chihara, E; Morimoto, T; Shigemi, K; Natsuyama, T; Hashimoto, S

1991-06-01

To determine viscoelastic features of the rat hindquarters vasculature, we measured pressure-volume curves. Male Wistar rats were transected at the lumbar level, and the perfused hindquarters were oxygenated with a hollow fiber artificial lung. The blood volume was measured by counting 51Cr-labeled red cells led to a gamma counter through an extracorporeal circuit at a constant rate. With continuous monitoring of the venous pressure and circulating blood volume, saline was infused into the circuit from a venous branch for 5 min [1.2 +/- 0.3% (SD) of tissue weight] followed by a 10-min recovery phase. In the recovery phase, the venous pressure promptly declined to the preinfusion level, whereas the circulating blood volume decreased more slowly. This implied vascular stress relaxation of the hindquarters. Maxwell's viscoelastic model, consisting of a spring component and a viscous component, was applied to analyze the venous pressure-volume diagram. With a curve-fitting method, the calculated vascular compliance and relaxation time (a time constant of stress relaxation) were 1.31 +/- 0.14 ml.mmHg-1.kg-1 and 15.7 +/- 4.0 min (means +/- SE), respectively. The value of compliance of the hindquarters was smaller than those of visceral organs reported. In addition, the value for relaxation time suggests that the viscous response of the vasculature simultaneously overlaps change in blood volume due to extravascular fluid shift during the postinfusion period.

Mechanical influences on skeletal muscle vascular tone in humans: insight into contraction-induced rapid vasodilatation

PubMed Central

Kirby, Brett S; Carlson, Rick E; Markwald, Rachel R; Voyles, Wyatt F; Dinenno, Frank A

2007-01-01

We tested the hypothesis that mechanical deformation of forearm blood vessels via acute increases in extravascular pressure elicits rapid vasodilatation in humans. In healthy adults, we measured forearm blood flow (Doppler ultrasound) and calculated forearm vascular conductance (FVC) responses to whole forearm compressions and isometric muscle contractions with the arm above heart level. We used several experimental protocols to gain insight into how mechanical factors contribute to contraction-induced rapid vasodilatation. The findings from the present study clearly indicate that acute increases in extravascular pressure (200 mmHg for 2 s) elicit a significant rapid vasodilatation in the human forearm (peak ΔFVC∼155%). Brief, 6 s sustained compressions evoked the greatest vasodilatation (ΔFVC∼260%), whereas the responses to single (2 s) and repeated compressions (five repeated 2 s compressions) were not significantly different (ΔFVC∼155%versus∼115%, respectively). This mechanically induced vasodilatation peaks within 1–2 cardiac cycles, and thus is dissociated from the temporal pattern normally observed in response to brief muscle contractions (∼4–7 cardiac cycles). A non-linear relation was found between graded increases in extravascular pressure and both the immediate and peak rapid vasodilatory response, such that the responses increased sharply from 25 to 100 mmHg, with no significant further dilatation until 300 mmHg (maximal ΔFVC∼185%). This was in contrast to the linear intensity-dependent relation observed with muscle contractions. Our collective findings indicate that mechanical influences contribute largely to the immediate vasodilatation (first cardiac cycle) observed in response to a brief, single contraction. However, it is clear that there are additional mechanisms related to muscle activation that continue to cause and sustain vasodilatation for several more cardiac cycles after contraction. Additionally, the potential contribution of mechanical influences to the total contraction-induced hyperaemia appears greatest for low to moderate intensity single muscle contractions, and this contribution becomes less significant for sustained and repeated contractions. Nevertheless, this mechanically induced vasodilatation could serve as a feedforward mechanism to increase muscle blood flow at the onset of exercise, as well as in response to changes in contraction intensity, prior to alterations in local vasodilating substances that influence vascular tone. PMID:17495044

Bioavailability of dexmedetomidine after extravascular doses in healthy subjects

PubMed Central

Anttila, Markku; Penttilä, Jani; Helminen, Antti; Vuorilehto, Lauri; Scheinin, Harry

2003-01-01

Aim To determine the absolute bioavailability of extravascularly administered dexmedetomidine, a novel a2-adrenoceptor agonist, in healthy subjects. Methods Single 2 µg kg−1 doses of dexmedetomidine were given intravenously, intramuscularly, perorally and buccally (where the solution is not swallowed) to 12 healthy male subjects. The drug concentration-time data were analysed using linear one-compartment (buccal and peroral data), or two-compartment modelling (intravenous data), or noncompartmental methods (intramuscular data). Results Mean (95% CI) absolute bioavailability after peroral, buccal and intramuscular administration was 16% (12–20%), 82% (73–92%) and 104% (96–112%), respectively. Conclusion Dexmedetomidine is well absorbed systemically through the oral mucosa, and therefore buccal dosing may provide an effective, noninvasive route to administer the drug. PMID:14616431

Effect of dobutamine on extravascular lung water index, ventilator function, and perfusion parameters in acute respiratory distress syndrome associated with septic shock.

PubMed

Zhou, Min; Dai, Ji; Du, Min; Wang, Wei; Guo, Changxing; Wang, Yi; Tang, Rui; Xu, Fengling; Rao, Zhuqing; Sun, Gengyun

2016-08-01

The role of dobutamine in the relief of pulmonary edema during septic shock-induced acute respiratory distress syndrome (ARDS) remains undetermined, due to a lack of controllable and quantitative clinical studies. Our objective was to assess the potential effects of dobutamine on extravascular lung water index (ELWI) in septic shock-induced ARDS, reflecting its importance in pulmonary edema. At the same time, ventilator function and perfusion parameters were evaluated. We designed a prospective, non-randomized, non-blinded, controlled study to compare the differences in PiCCO parameters after 6 h of constant dobutamine infusion (15 μg/kg/min), in the baseline parameters in 26 septic shock-related ARDS patients with cardiac index ≥ 2.5I/min/m(2) and hyperlactatemia. These patients (12 survivors/14 non-survivors) were monitored using the PiCCO catheter system within 48 h of onset of septic shock. The dynamic changes in ELWI, which is typically used for quantifying the extent of pulmonary edema, were evaluated, and the corresponding ventilator function and tissue perfusion parameters were also measured. Decreasing ELWI (p = 0.0376) was accompanied by significantly decreased SVRI (p < 0.0001). Despite a significant increase in cardiac output (p < 0.0001), no differences were found in ITBI or GEDI. Moreover, the required dose of norepinephrine was decreased (p = 0.0389), and urine output was increased (p = 0.0358), accompanied by stabilized lactacidemia and MAP. Additionally, airway pressure was moderately improved. During the early stage of septic shock-induced ARDS, dobutamine treatment demonstrated a beneficial effect by relieving pulmonary edema in patients, without a negative elevation in preload or hemodynamics, which might account for the improvements in ventilator function and tissue hypoperfusion.

Identification of involved tissue during surgical treatment of doxorubicin-induced extravasation necrosis.

PubMed

Cohen, F J; Manganaro, J; Bezozo, R C

1983-01-01

The extravascular escape of intravenously administered doxorubicin (Adriamycin) leads to a painful, slowly enlarging subcutaneous lesion which, if not diagnosed, will progress to a chronic severe cellulitis with inflammatory reaction, ulceration of the skin, and possible further involvement. Past attempts at immediate treatment have failed because of, or have been complicated by, incomplete removal of the doxorubicin with continuing tissue necrosis. Three patients who underwent antineoplastic therapy with doxorubicin suffered extravasation leading to deep tissue necrosis requiring skin grafts. In all cases identification of doxorubicin-containing tissue was accomplished by injection of fluorescein. The residual necrotic tissue that did not fluoresce was removed. A protocol is presented to detect doxorubicin extravasation and distinguish the viable from the nonviable components.

Preservation of tumour oxygen after hyperbaric oxygenation monitored by magnetic resonance imaging

PubMed Central

Kinoshita, Y; Kohshi, K; Kunugita, N; Tosaki, T; Yokota, A

1999-01-01

Hyperbaric oxygen (HBO) has been proposed to reduce tumour hypoxia by increasing the dissolved molecular oxygen in tissue. Using a non-invasive magnetic resonance imaging (MRI) technique, we monitored the changes in MRI signal intensity after HBO exposure because dissolved paramagnetic molecular oxygen itself shortens the T1 relation time. SCCVII tumour cells transplanted in mice were used. The molecular oxygen-enhanced MR images were acquired using an inversion recovery-preparation fast low angle shot (IR-FLASH) sequence sensitizing the paramagnetic effects of molecular oxygen using a 4.7 tesla MR system. MR signal of muscles decreased rapidly and returned to the control level within 40 min after decompression, whereas that of tumours decreased gradually and remained at a high level 60 min after HBO exposure. In contrast, the signal from the tumours in the normobaric oxygen group showed no significant change. Our data suggested that MR signal changes of tumours and muscles represent an alternation of extravascular oxygenation. The preserving tumour oxygen concentration after HBO exposure may be important regarding adjuvant therapy for cancer patients. © 2000 Cancer Research Campaign PMID:10638972

Glycerol-induced hyperhydration

NASA Technical Reports Server (NTRS)

Riedesel, Marvin L.; Lyons, Timothy P.; Mcnamara, M. Colleen

1991-01-01

Maintenance of euhydration is essential for maximum work performance. Environments which induce hypohydration reduce plasma volume and cardiovascular performance progressively declines as does work capacity. Hyperhydration prior to exposure to dehydrating environments appears to be a potential countermeasure to the debilitating effects of hypohydration. The extravascular fluid space, being the largest fluid compartment in the body, is the most logical space by which significant hyperhydration can be accomplished. Volume and osmotic receptors in the vascular space result in physiological responses which counteract hyperhydration. Our hypothesis is that glycerol-induced hyperhydration (GIH) can accomplish extravascular fluid expansion because of the high solubility of glycerol in lipid and aqueous media. A hypertonic solution of glycerol is rapidly absorbed from the gastrointestinal tract, results in mild increases in plasma osmolality and is distributed to 65 percent of the body mass. A large volume of water ingested within minutes after glycerol intake results in increased total body water because of the osmotic action and distribution of glycerol. The resulting expanded extravascular fluid space can act as a reservoir to maintain plasma volume during exposure to dehydrating environments. The fluid shifts associated with exposure to microgravity result in increased urine production and is another example of an environment which induces hypohydration. Our goal is to demonstrate that GIH will facilitate maintenance of euhydration and cardiovascular performance during space flight and upon return to a 1 g environment.

Apparent Diffusion Coefficient and Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Pancreatic Cancer: Characteristics and Correlation With Histopathologic Parameters.

PubMed

Ma, Wanling; Li, Na; Zhao, Weiwei; Ren, Jing; Wei, Mengqi; Yang, Yong; Wang, Yingmei; Fu, Xin; Zhang, Zhuoli; Larson, Andrew C; Huan, Yi

2016-01-01

To clarify diffusion and perfusion abnormalities and evaluate correlation between apparent diffusion coefficient (ADC), MR perfusion and histopathologic parameters of pancreatic cancer (PC). Eighteen patients with PC underwent diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Parameters of DCE-MRI and ADC of cancer and non-cancerous tissue were compared. Correlation between the rate constant that represents transfer of contrast agent from the arterial blood into the extravascular extracellular space (K, volume of the extravascular extracellular space per unit volume of tissue (Ve), and ADC of PC and histopathologic parameters were analyzed. The rate constant that represents transfer of contrast agent from the extravascular extracellular space into blood plasma, K, tissue volume fraction occupied by vascular space, and ADC of PC were significantly lower than nontumoral pancreases. Ve of PC was significantly higher than that of nontumoral pancreas. Apparent diffusion coefficient and K values of PC were negatively correlated to fibrosis content and fibroblast activation protein staining score. Fibrosis content was positively correlated to Ve. Apparent diffusion coefficient values and parameters of DCE-MRI can differentiate PC from nontumoral pancreases. There are correlations between ADC, K, Ve, and fibrosis content of PC. Fibroblast activation protein staining score of PC is negatively correlated to ADC and K. Apparent diffusion coefficient, K, and Ve may be feasible to predict prognosis of PC.

21 CFR 870.2850 - Extravascular blood pressure transducer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... used to measure blood pressure by changes in the mechanical or electrical properties of the device. The... electrical signal related to the electrical or mechanical changes produced in the transducer. (b...

A Concurrent Flow Model for Extraction during Transcapillary Passage

PubMed Central

Bassingthwaighte, James B.

2010-01-01

A model for capillary-tissue exchange in a uniformly perfused organ with uniform capillary transit times and no diffusional capillary interactions was designed to permit the exploration of the influences of various parameters on the interpretation of indicator-dilution curves obtained at the venous outflow following the simultaneous injection of tracers into the arterial inflow. These parameters include tissue geometric factors, longitudinal diffusion and volumes of distribution of tracers in blood and tissue, hematocrit, volumes of nonexchanging vessels and the sampling system, capillary permeability, P. capillary surface area, S, and flow of blood- or solute-containing fluid, Fs′. An assumption of instantaneous radial diffusion in the extravascular region is appropriate when intercapillary distances are small, as they are in the heart, or permeabilities are low, as they are for lipophobic solutes. Numerical solutions were obtained for dispersed input functions similar to normal intravascular dye-dilution curves. Axial extravascular diffusion showed a negligible influence at low permeabilities. The “instantaneous extraction” of a permeating solute can provide an estimate of PS/Fs′, the ratio of the capillary permeability–surface area product to the flow, when PS/Fs′ lies between approximately 0.05 and 3.0; the limits of the range depend on the extravascular volume of distribution and the influences of intravascular dispersion. The most accurate estimates were obtained when experiments were designed so that PS/Fs′ was between 0.2 and 1.0 or peak extractions were between 0.1 and 0.6. PMID:4608628

Laboratory testing of extravascular body fluids in Croatia: a survey of the Working group for extravascular body fluids of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

PubMed

Kopcinovic, Lara Milevoj; Vogrinc, Zeljka; Kocijan, Irena; Culej, Jelena; Aralica, Merica; Jokic, Anja; Antoncic, Dragana; Bozovic, Marija

2016-10-15

We hypothesized that extravascular body fluid (EBF) analysis in Croatia is not harmonized and aimed to investigate preanalytical, analytical and postanalytical procedures used in EBF analysis in order to identify key aspects that should be addressed in future harmonization attempts. An anonymous online survey created to explore laboratory testing of EBF was sent to secondary, tertiary and private health care Medical Biochemistry Laboratories (MBLs) in Croatia. Statements were designed to address preanalytical, analytical and postanalytical procedures of cerebrospinal, pleural, peritoneal (ascites), pericardial, seminal, synovial, amniotic fluid and sweat. Participants were asked to declare the strength of agreement with proposed statements using a Likert scale. Mean scores for corresponding separate statements divided according to health care setting were calculated and compared. The survey response rate was 0.64 (58 / 90). None of the participating private MBLs declared to analyse EBF. We report a mean score of 3.45 obtained for all statements evaluated. Deviations from desirable procedures were demonstrated in all EBF testing phases. Minor differences in procedures used for EBF analysis comparing secondary and tertiary health care MBLs were found. The lowest scores were obtained for statements regarding quality control procedures in EBF analysis, participation in proficiency testing programmes and provision of interpretative comments on EBF's test reports. Although good laboratory EBF practice is present in Croatia, procedures for EBF analysis should be further harmonized to improve the quality of EBF testing and patient safety.

Extravascular transport in normal and tumor tissues.

PubMed

Jain, R K; Gerlowski, L E

1986-01-01

The transport characteristics of the normal and tumor tissue extravascular space provide the basis for the determination of the optimal dosage and schedule regimes of various pharmacological agents in detection and treatment of cancer. In order for the drug to reach the cellular space where most therapeutic action takes place, several transport steps must first occur: (1) tissue perfusion; (2) permeation across the capillary wall; (3) transport through interstitial space; and (4) transport across the cell membrane. Any of these steps including intracellular events such as metabolism can be the rate-limiting step to uptake of the drug, and these rate-limiting steps may be different in normal and tumor tissues. This review examines these transport limitations, first from an experimental point of view and then from a modeling point of view. Various types of experimental tumor models which have been used in animals to represent human tumors are discussed. Then, mathematical models of extravascular transport are discussed from the prespective of two approaches: compartmental and distributed. Compartmental models lump one or more sections of a tissue or body into a "compartment" to describe the time course of disposition of a substance. These models contain "effective" parameters which represent the entire compartment. Distributed models consider the structural and morphological aspects of the tissue to determine the transport properties of that tissue. These distributed models describe both the temporal and spatial distribution of a substance in tissues. Each of these modeling techniques is described in detail with applications for cancer detection and treatment in mind.

Automated Processing of Dynamic Contrast-Enhanced MRI: Correlation of Advanced Pharmacokinetic Metrics with Tumor Grade in Pediatric Brain Tumors.

PubMed

Vajapeyam, S; Stamoulis, C; Ricci, K; Kieran, M; Poussaint, T Young

2017-01-01

Pharmacokinetic parameters from dynamic contrast-enhanced MR imaging have proved useful for differentiating brain tumor grades in adults. In this study, we retrospectively reviewed dynamic contrast-enhanced perfusion data from children with newly diagnosed brain tumors and analyzed the pharmacokinetic parameters correlating with tumor grade. Dynamic contrast-enhanced MR imaging data from 38 patients were analyzed by using commercially available software. Subjects were categorized into 2 groups based on pathologic analyses consisting of low-grade (World Health Organization I and II) and high-grade (World Health Organization III and IV) tumors. Pharmacokinetic parameters were compared between the 2 groups by using linear regression models. For parameters that were statistically distinct between the 2 groups, sensitivity and specificity were also estimated. Eighteen tumors were classified as low-grade, and 20, as high-grade. Transfer constant from the blood plasma into the extracellular extravascular space (K trans ), rate constant from extracellular extravascular space back into blood plasma (K ep ), and extracellular extravascular volume fraction (V e ) were all significantly correlated with tumor grade; high-grade tumors showed higher K trans , higher K ep , and lower V e . Although all 3 parameters had high specificity (range, 82%-100%), K ep had the highest specificity for both grades. Optimal sensitivity was achieved for V e , with a combined sensitivity of 76% (compared with 71% for K trans and K ep ). Pharmacokinetic parameters derived from dynamic contrast-enhanced MR imaging can effectively discriminate low- and high-grade pediatric brain tumors. © 2017 by American Journal of Neuroradiology.

Laboratory testing of extravascular body fluids in Croatia: a survey of the Working group for extravascular body fluids of the Croatian Society of Medical Biochemistry and Laboratory Medicine

PubMed Central

Kopcinovic, Lara Milevoj; Vogrinc, Zeljka; Kocijan, Irena; Culej, Jelena; Aralica, Merica; Jokic, Anja; Antoncic, Dragana; Bozovic, Marija

2016-01-01

Introduction We hypothesized that extravascular body fluid (EBF) analysis in Croatia is not harmonized and aimed to investigate preanalytical, analytical and postanalytical procedures used in EBF analysis in order to identify key aspects that should be addressed in future harmonization attempts. Materials and methods An anonymous online survey created to explore laboratory testing of EBF was sent to secondary, tertiary and private health care Medical Biochemistry Laboratories (MBLs) in Croatia. Statements were designed to address preanalytical, analytical and postanalytical procedures of cerebrospinal, pleural, peritoneal (ascites), pericardial, seminal, synovial, amniotic fluid and sweat. Participants were asked to declare the strength of agreement with proposed statements using a Likert scale. Mean scores for corresponding separate statements divided according to health care setting were calculated and compared. Results The survey response rate was 0.64 (58 / 90). None of the participating private MBLs declared to analyse EBF. We report a mean score of 3.45 obtained for all statements evaluated. Deviations from desirable procedures were demonstrated in all EBF testing phases. Minor differences in procedures used for EBF analysis comparing secondary and tertiary health care MBLs were found. The lowest scores were obtained for statements regarding quality control procedures in EBF analysis, participation in proficiency testing programmes and provision of interpretative comments on EBF’s test reports. Conclusions Although good laboratory EBF practice is present in Croatia, procedures for EBF analysis should be further harmonized to improve the quality of EBF testing and patient safety. PMID:27812307

Extravascular plasminogen activator and inhibitor activities detected at the site of a chronic mycobacterial-induced inflammation.

PubMed Central

O'Rourke, J.; Wang, W. P.; Donnelly, L.; Wang, E.; Kreutzer, D. L.

1987-01-01

Levels of extravascular tissue plasminogen activator activity (PA) and those of inhibitors of PA and of urokinase (UK) present within the anterior chamber of normal and inflamed feline eyes were assessed with the use of a direct PA assay of microsamples of aqueous humor. Purposes of the study were, first, to confirm prior indirect evidence that this extravascular space normally contains higher levels of uninhibited PA, but lower levels of inhibitor activity, than does plasma and, second, to determine patterns of change in these activities under in vivo conditions imposed by a chronic mycobacterial-induced uveitis (CMIU) disease model. The PA assay utilized a 125I-plasminogen substrate whose cleavage by PA contained in samples was both visualized during gel electrophoreis, and quantified by gamma counting. The results provided the first direct evidence that the higher fibrinolytic activity previously observed in normal aqueous in comparison with plasma is in fact associated with higher levels of available (uninhibited) PA (P less than 0.01) The data also indicated that normal aqueous contains a much higher level of PA inhibitor activity than previously suspected--roughly 40 times more than available PA levels. These normal values for PA and inhibitors occupied a relatively narrow, threefold range, in contrast to the wide scattering of individual values that appeared during 18-20 weeks of the chronic inflammation disease model. Despite this, however, the general pattern of observation for all individual eyes during CMIU was a significant increase in levels of both PA and inhibitors. The net effect of CMIU was thus to cause the 1:40 ratio noted above to be tilted more strongly in favor of inhibitor activity, ie, up to 1:80. Increases in local vasopermeability in this disease model were believed contributory to this change. However, local generations of PA and APA in vivo by inflammatory cells, especially monocyte-macrophages, must also be considered. Assays for UK inhibitor showed levels of activity and directions of change that closely followed those of PA inhibitor, which suggests the possibility that they may be identical. It is surmised that the above patterns, along with results of our prior studies, indicate an apparent need for a multistep, strict inhibitory control of plasmin generation and proteolysis in vivo within normal extravascular spaces such as the anterior chamber.(ABSTRACT TRUNCATED AT 400 WORDS) Images Figure 2 PMID:3493701

Goal-directed therapy improves the outcome of high-risk cardiac patients undergoing off-pump coronary artery bypass.

PubMed

Kapoor, Poonam Malhotra; Magoon, Rohan; Rawat, Rajinder Singh; Mehta, Yatin; Taneja, Sameer; Ravi, R; Hote, Milind P

2017-01-01

There has been a constant emphasis on developing management strategies to improve the outcome of high-risk cardiac patients undergoing surgical revascularization. The performance of coronary artery bypass surgery on an off-pump coronary artery bypass (OPCAB) avoids the risks associated with extra-corporeal circulation. The preliminary results of goal-directed therapy (GDT) for hemodynamic management of high-risk cardiac surgical patients are encouraging. The present study was conducted to study the outcome benefits with the combined use of GDT with OPCAB as compared to the conventional hemodynamic management. Patients with the European System for Cardiac Operative Risk Evaluation ≥3 scheduled for OPCAB were randomly divided into two groups; the control and GDT groups. The GDT group included the monitoring and optimization of advanced parameters, including cardiac index (CI), systemic vascular resistance index, oxygen delivery index, stroke volume variation; continuous central venous oxygen saturation (ScVO 2 ), global end-diastolic volume, and extravascular lung water (EVLW), using FloTrac™ , PreSep™ , and EV-1000 ® monitoring panels, in addition to the conventional hemodynamic management in the control group. The hemodynamic parameters were continuously monitored for 48 h in Intensive Care Unit (ICU) and corrected according to GDT protocol. A total of 163 patients consented for the study. Seventy-five patients were assigned to the GDT group and 88 patients were in the control group. In view of 9 exclusions from the GDT group and 12 exclusions from control group, 66 patients in the GDT group and 76 patients in control group completed the study. The length of stay in hospital (LOS-H) (7.42 ± 1.48 vs. 5.61 ± 1.11 days, P < 0.001) and ICU stay (4.2 ± 0.82 vs. 2.53 ± 0.56 days, P < 0.001) were significantly lower in the GDT group as compared to control group. The duration of inotropes (3.24 ± 0.73 vs. 2.89 ± 0.68 h, P = 0.005) was also significantly lower in the GDT group. The two groups did not differ in duration of ventilated hours, mortality, and other complications. The parameters such as ScVO 2 , CI, and EVLW had a strong negative and positive correlation with the LOS-H with r values of - 0.331, -0.319, and 0.798, respectively. The study elucidates the role of a goal-directed hemodynamic optimization for improved outcome in high-risk cardiac patients undergoing OPCAB.

Comparison of a single indicator and gravimetric technique for estimation of extravascular lung water in endotoxemic pigs.

PubMed

Rossi, Patrik; Wanecek, Michael; Rudehill, Anders; Konrad, David; Weitzberg, Eddie; Oldner, Anders

2006-05-01

To compare the single thermal indicator dilution (STID) technique for measurement of extravascular lung water (EVLW(STID)) with gravimetrically determined EVLW (EVLW(GRAV)) in anesthetized pigs under sham and endotoxemic conditions. Open experimental comparative animal study. University animal research laboratory. Fifteen anesthetized landrace pigs. Endotoxin infusion during 5 hrs in five pigs. Six animals were only anesthetized and rested for 5 hrs. In four additional animals, the impact on EVLW(STID) measurements by changes in pulmonary perfusion, ventilation, and the combination of the two was studied. The alterations in ventilation and perfusion were induced by caval balloon inflation, inflation of the pulmonary artery catheter balloon, and bronchial plugging respectively. The STID technique, with default settings of the intrathoracic blood volume (ITBV) to global end-diastolic volume (GEDV) (i.e., the extrapulmonary intravascular volume between the point of injection of the indicator, and the point of detection) relationship (ITBV = 1.25GEDV), systematically overestimated the EVLW index compared with the gravimetrical method (mean bias of 5.4 mL/kg). By adapting the ITBV to GEDV relationship to the current model (ITBV = 1.52GEDV + 49.7), the accuracy of the STID technique improved. Moreover, the measurement of EVLW(STID) proved to be reduced by manipulation of pulmonary perfusion and ventilation. However, the STID technique could detect an increase in EVLW during endotoxemia independent of the ITBV/GEDV relationship used. Despite technological improvement, the dilution techniques for the measurement of EVLW might still be influenced by changes in perfusion and ventilation. The STID technique, in addition, might demand adjustment of the ITBV/GEDV relationship to the particular condition and species subjected to measurement. The STID technique may, however, be a useful tool for monitoring changes of EVLW over time, but further studies are warranted to confirm this.

Extravascular lung water assessed by transpulmonary single thermodilution and postmortem gravimetry in sheep

PubMed Central

Kirov, Mikhail Y; Kuzkov, Vsevolod V; Kuklin, Vladimir N; Waerhaug, Kristine; Bjertnaes, Lars J

2004-01-01

Introduction Acute lung injury is associated with accumulation of extravascular lung water (EVLW). The aim of the present study was to compare two methods for quantification of EVLW: transpulmonary single thermodilution (EVLWST) and postmortem gravimetric (EVLWG). Methods Eighteen instrumented and awake sheep were randomly assigned to one of three groups. All groups received Ringer's lactate (5 ml/kg per hour intravenously). To induce lung injury of different severities, sheep received Escherichia coli lipopolysaccharide 15 ng/kg per min intravenously for 6 hours (n = 7) or oleic acid 0.06 ml/kg intravenously over 30 min (n = 7). A third group (n = 4) was subjected to sham operation. Haemodynamic variables, including EVLWST, were measured using a PiCCOplus monitor (Pulsion Medical Systems, Munich, Germany), and the last measurement of EVLWST was compared with EVLWG. Results At the end of experiment, values for EVLWST (mean ± standard error) were 8.9 ± 0.6, 11.8 ± 1.0 and 18.2 ± 0.9 ml/kg in the sham-operated, lipopolysaccharide and oleic acid groups, respectively (P < 0.05). The corresponding values for EVLWIG were 6.2 ± 0.3, 7.1 ± 0.6 and 11.8 ± 0.7 ml/kg (P < 0.05). Ranges of EVLWIST and EVLWIG values were 7.5–21.0 and 4.9–14.5 ml/kg. Regression analysis between in vivo EVLWST and postmortem EVLWG yielded the following relation: EVLWST = 1.30 × EVLWG + 2.32 (n = 18, r = 0.85, P < 0.0001). The mean bias ± 2 standard deviations between EVLWST and EVLWG was 4.9 ± 5.1 ml/kg (P < 0.001). Conclusion In sheep, EVLW determined using transpulmonary single thermodilution correlates closely with gravimetric measurements over a wide range of changes. However, transpulmonary single thermodilution overestimates EVLW as compared with postmortem gravimetry. PMID:15566591

Prolonged red cell storage before transfusion increases extravascular hemolysis

PubMed Central

Rapido, Francesca; Brittenham, Gary M.; Bandyopadhyay, Sheila; La Carpia, Francesca; L’Acqua, Camilla; McMahon, Donald J.; Rebbaa, Abdelhadi; Wojczyk, Boguslaw S.; Netterwald, Jane; Wang, Hangli; Schwartz, Joseph; Eisenberger, Andrew; Soffing, Mark; Yeh, Randy; Divgi, Chaitanya; Ginzburg, Yelena Z.; Shaz, Beth H.; Sheth, Sujit; Francis, Richard O.; Spitalnik, Steven L.; Hod, Eldad A.

2016-01-01

BACKGROUND. Some countries have limited the maximum allowable storage duration for red cells to 5 weeks before transfusion. In the US, red blood cells can be stored for up to 6 weeks, but randomized trials have not assessed the effects of this final week of storage on clinical outcomes. METHODS. Sixty healthy adult volunteers were randomized to a single standard, autologous, leukoreduced, packed red cell transfusion after 1, 2, 3, 4, 5, or 6 weeks of storage (n = 10 per group). 51-Chromium posttransfusion red cell recovery studies were performed and laboratory parameters measured before and at defined times after transfusion. RESULTS. Extravascular hemolysis after transfusion progressively increased with increasing storage time (P < 0.001 for linear trend in the AUC of serum indirect bilirubin and iron levels). Longer storage duration was associated with decreasing posttransfusion red cell recovery (P = 0.002), decreasing elevations in hematocrit (P = 0.02), and increasing serum ferritin (P < 0.0001). After 6 weeks of refrigerated storage, transfusion was followed by increases in AUC for serum iron (P < 0.01), transferrin saturation (P < 0.001), and nontransferrin-bound iron (P < 0.001) as compared with transfusion after 1 to 5 weeks of storage. CONCLUSIONS. After 6 weeks of refrigerated storage, transfusion of autologous red cells to healthy human volunteers increased extravascular hemolysis, saturated serum transferrin, and produced circulating nontransferrin-bound iron. These outcomes, associated with increased risks of harm, provide evidence that the maximal allowable red cell storage duration should be reduced to the minimum sustainable by the blood supply, with 35 days as an attainable goal. REGISTRATION. ClinicalTrials.gov NCT02087514. FUNDING. NIH grant HL115557 and UL1 TR000040. PMID:27941245

Effects of amlodipine and adenosine on coronary haemodynamics: in vivo study and numerical simulation.

PubMed

De Lazzari, Claudio; L'Abbate, Antonio; Micalizzi, Mauro; Trivella, Maria Giovanna; Neglia, Danilo

2014-11-01

Amlodipine (AMLO) is a calcium channel blocker with vasodilating properties, in which the specific effects on the coronary circulation are not fully known. Coronary flow velocity-pressure (F/P) curves were obtained at rest and during administration of AMLO (10 mg to 20 mg iv) or adenosine (ADO, 1 mg ic) in 10 normal subjects (six women, age 48 ± 14 years). F/P curves were reproduced in a numerical simulator of systemic and coronary circulations (CARDIOSIM(©)) by adjustment of coronary resistance ( > or < 100 μm diameter vessels) and extravascular resistance applied to smaller vessels at endocardial (ENDO), middle and epicardial (EPI) myocardial layers. Best matching of in silico to in vivo curves was achieved by trial and error approach. ADO induced 170% and 250% increase in coronary flow velocity CFV and F/P diastolic slope as compared to 80% and 25-30% increase induced by AMLO, respectively. In the cardiovascular model, AMLO effects were predicted by progressive reduction of>100 μm vessels resistance from EPI to ENDO. ADO effects were mimicked by reducing resistance of both>100 μm and < 100 μm vessels, progressively from EPI to ENDO in the latter. Additional reduction in extravascular resistance avoided to impose a transmural gradient of vasodilating effect for both drugs. Numerical simulation predicts vasodilating effects of AMLO mainly on larger arteries and of ADO on both>and < 100 μm vessels. In vivo F/P loops could be completely reproduced in silico by adding extravascular resistance reduction for both drugs. Numerical simulator is useful tool for exploring the coronary effects of cardioactive drugs.

HISTOTRIPSY LIQUEFACTION OF LARGE HEMATOMAS

PubMed Central

Khlokhova, Tatiana D.; Monsky, Wayne L.; Haider, Yasser A.; Maxwell, Adam; Wang, Yak-Nam; Matula, Thomas J.

2016-01-01

Intra- and extra-muscular hematomas result from repetitive injury as well as sharp and blunt limb trauma. The clinical consequences can be serious, including debilitating pain and functional deficit. There are currently no short-term treatment options for large hematomas, only lengthy conservative treatment. The goal of this work was to evaluate the feasibility of a high intensity focused ultrasound (HIFU)-based technique, termed histotripsy, for rapid (within a clinically relevant timeframe of 15–20 min) liquefaction of large volume (up to 20 mL) extra-vascular hematomas for subsequent fine-needle aspiration. Experiments were performed using in vitro extravascular hematoma phantoms—fresh bovine blood poured into 50 mL molds and allowed to clot. The resulting phantoms were treated by boiling histotripsy (BH), cavitation histotripsy (CH) or a combination in a degassed water tank under ultrasound guidance. Two different transducers operating at 1 MHz and 1.5 MHz with f-number = 1 were used. The liquefied lysate was aspirated and analyzed by histology and sized in a Coulter Counter. The peak instantaneous power to achieve BH was lower than (at 1.5 MHz) or equal to (at 1 MHz) that which was required to initiate CH. Under the same exposure duration, BH-induced cavities were one and a half to two times larger than the CH-induced cavities, but the CH-induced cavities were more regularly shaped, facilitating easier aspiration. The lysates contained a small amount of debris larger than 70 μm, and 99% of particulates were smaller than 10 μm. A combination treatment of BH (for initial debulking) and CH (for liquefaction of small residual fragments) yielded 20 mL of lysate within 17.5 minutes of treatment and was found to be most optimal for liquefaction of large extravascular hematomas. PMID:27126244

Management of Fractured Inferior Vena Cava Filters: Outcomes by Fragment Location.

PubMed

Trerotola, Scott O; Stavropoulos, S William

2017-09-01

Purpose To inform the management of fractured inferior vena cava filters on the basis of results from a tertiary referral center specializing in complex filter retrieval. Materials and Methods This study had institutional review board approval and was HIPAA compliant. Retrospective analysis of all patients with fractured filters and/or filter fragments evaluated for removal in a complex filter removal program was performed. Removal was attempted when fragments were intravascular or immediately extravascular by using primarily endobronchial forceps for caval fragments and snares for cardiac and pulmonary fragments. Data collected included success rate and complications of filter and fragment removal, symptoms relating to the filter or fragment, techniques used for removal, and follow-up of retained fragments. Results Sixty-five patients (12 men, 53 women) of a total of 222 patients referred for complex retrieval had fractured filters. Of these patients, two had undergone filter removal elsewhere and had retained fragments. All 63 filters were removed successfully with forceps (n = 61), a cone (n = 1), or a snare (n = 1). There were 116 separate filter fragments; removal was attempted for 78 fragments. Removal was successful for 63 (81%) of 78 fragments and varied by location. All extravascular fragments except one were retained. In all, 63 (54%) of 116 fragments were removed percutaneously, rendering 34 (54%) of 63 patients fragment free. Five minor (7.7% [five of 65]) and four major (6.2% [four of 65]) complications occurred. Conclusion Intravascular filter fragments can be removed safely with success rates that vary according to location. Because extravascular fragments are not readily accessible for removal, many patients are not rendered fragment free. © RSNA, 2017 Online supplemental material is available for this article.

'Universal' microstructural patterns in cortical and trabecular, extracellular and extravascular bone materials: micromechanics-based prediction of anisotropic elasticity.

PubMed

Fritsch, Andreas; Hellmich, Christian

2007-02-21

Bone materials are characterized by an astonishing variability and diversity. Still, because of 'architectural constraints' due to once chosen material constituents and their physical interaction, the fundamental hierarchical organization or basic building plans of bone materials remain largely unchanged during biological evolution. Such universal patterns of microstructural organization govern the mechanical interaction of the elementary components of bone (hydroxyapatite, collagen, water; with directly measurable tissue-independent elastic properties), which are here quantified through a multiscale homogenization scheme delivering effective elastic properties of bone materials: at a scale of 10nm, long cylindrical collagen molecules, attached to each other at their ends by approximately 1.5nm long crosslinks and hosting intermolecular water inbetween, form a contiguous matrix called wet collagen. At a scale of several hundred nanometers, wet collagen and mineral crystal agglomerations interpenetrate each other, forming the mineralized fibril. At a scale of 5-10microm, the extracellular solid bone matrix is represented as collagen fibril inclusions embedded in a foam of largely disordered (extrafibrillar) mineral crystals. At a scale above the ultrastructure, where lacunae are embedded in extracellular bone matrix, the extravascular bone material is observed. Model estimates predicted from tissue-specific composition data gained from a multitude of chemical and physical tests agree remarkably well with corresponding acoustic stiffness experiments across a variety of cortical and trabecular, extracellular and extravascular materials. Besides from reconciling the well-documented, seemingly opposed concepts of 'mineral-reinforced collagen matrix' and 'collagen-reinforced mineral matrix' for bone ultrastructure, this approach opens new possibilities in the exploitation of computer tomographic data for nano-to-macro mechanics of bone organs.

A mixture theory model of fluid and solute transport in the microvasculature of normal and malignant tissues. II: Factor sensitivity analysis, calibration, and validation.

PubMed

Schuff, M M; Gore, J P; Nauman, E A

2013-12-01

The treatment of cancerous tumors is dependent upon the delivery of therapeutics through the blood by means of the microcirculation. Differences in the vasculature of normal and malignant tissues have been recognized, but it is not fully understood how these differences affect transport and the applicability of existing mathematical models has been questioned at the microscale due to the complex rheology of blood and fluid exchange with the tissue. In addition to determining an appropriate set of governing equations it is necessary to specify appropriate model parameters based on physiological data. To this end, a two stage sensitivity analysis is described which makes it possible to determine the set of parameters most important to the model's calibration. In the first stage, the fluid flow equations are examined and a sensitivity analysis is used to evaluate the importance of 11 different model parameters. Of these, only four substantially influence the intravascular axial flow providing a tractable set that could be calibrated using red blood cell velocity data from the literature. The second stage also utilizes a sensitivity analysis to evaluate the importance of 14 model parameters on extravascular flux. Of these, six exhibit high sensitivity and are integrated into the model calibration using a response surface methodology and experimental intra- and extravascular accumulation data from the literature (Dreher et al. in J Natl Cancer Inst 98(5):335-344, 2006). The model exhibits good agreement with the experimental results for both the mean extravascular concentration and the penetration depth as a function of time for inert dextran over a wide range of molecular weights.

Octopus microvasculature: permeability to ferritin and carbon.

PubMed

Browning, J

1979-01-01

The permeability of Octopus microvasculature was investigated by intravascular injection of carbon and ferritin. Vessels were tight to carbon while ferritin penetrated the pericyte junction, and was found extravascularly 1-2 min after its introduction. Vesicles occurred rarely in pericytes; fenestrae were absent. The discontinuous endothelial layer did not consitute a permeability barrier. The basement membrane, although retarding the movement of ferritin, was permeable to it; carbon did not penetrate the basement membrane. Evidence indicated that ferritin, and thus similarly sized and smaller water soluble materials, traverse the pericyte junction as a result of bulk fluid flow. Comparisons are made with the convective (or junctional) and slower, diffusive (or vesicular) passage of materials known to occur across the endothelium of continuous capillaries in mammals. Previous macrophysiological determinations concerning the permeability of Octopus vessels are questioned in view of these findings. Possible reasons for some major structural differences in the microcirculatory systems of cephalopods and vertebrates are briefly discussed.

The heart as an extravascular target of endothelin-1 in particulate matter-induced cardiac dysfunction

EPA Science Inventory

Exposure to particulate matter air pollution has been causally linked to cardiovascular disease in humans. Several broad and overlapping hypotheses describing the biological mechanisms by which particulate matter exposure leads to cardiovascular disease and cardiac dysfunction ha...

Intergrin-dependent neutrophil migration in the injured mouse cornea

USDA-ARS?s Scientific Manuscript database

As an early responder to an inflammatory stimulus, neutrophils must exit the vasculature and migrate through the extravascular tissue to the site of insult, which is often remote from the point of extravasation. Following a central epithelial corneal abrasion, neutrophils recruited from the peripher...

Historical Review of Lower Body Negative Pressure Research in Space Medicine.

PubMed

Campbell, Mark R; Charles, John B

2015-07-01

Cephalad redistribution of intravascular and extravascular fluid occurs as a result of weightlessness during spaceflight. This provokes cardiovascular, cardiopulmonary, and autonomic nervous system responses. The resulting altered functional state can result in orthostatic hypotension and intolerance upon landing and return to a gravity environment. In-flight lower body negative pressure (LBNP) transiently restores normal body fluid distribution. Early in the U.S. space program, LBNP was devised as a way to test for orthostatic intolerance. With the development of the Skylab Program and longer duration spaceflight, it was realized that it could provide a method of monitoring orthostatic intolerance in flight and predicting the post-landing orthostatic response. LBNP was also investigated not only as an in-flight cardiovascular orthostatic stress test, but also as a countermeasure to cardiovascular deconditioning on Soviet space stations, Skylab, and the Shuttle. It is still being used by the Russian program on the International Space Station as an end-of-flight countermeasure.

21 CFR 870.4885 - External vein stripper.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false External vein stripper. 870.4885 Section 870.4885...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4885 External vein stripper. (a) Identification. An external vein stripper is an extravascular device used to remove a section of...

21 CFR 870.4885 - External vein stripper.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false External vein stripper. 870.4885 Section 870.4885...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4885 External vein stripper. (a) Identification. An external vein stripper is an extravascular device used to remove a section of...

21 CFR 870.4885 - External vein stripper.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false External vein stripper. 870.4885 Section 870.4885...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4885 External vein stripper. (a) Identification. An external vein stripper is an extravascular device used to remove a section of...

21 CFR 870.4885 - External vein stripper.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false External vein stripper. 870.4885 Section 870.4885...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4885 External vein stripper. (a) Identification. An external vein stripper is an extravascular device used to remove a section of...

21 CFR 870.4885 - External vein stripper.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External vein stripper. 870.4885 Section 870.4885...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4885 External vein stripper. (a) Identification. An external vein stripper is an extravascular device used to remove a section of...

Lung damage and pulmonary uptake of serotonin in intact dogs

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

Dawson, C.A.; Christensen, C.W.; Rickaby, D.A.

1985-06-01

The authors examined the influence of glass bead embolization and oleic acid, dextran, and imipramine infusion on the pulmonary uptake of trace doses of (/sup 3/H)serotonin and the extravascular volume accessible to (/sup 14/C)antipyrine in anesthetized dogs. Embolization and imipramine decreased serotonin uptake by 53 and 61%, respectively, but no change was observed with oleic acid or dextran infusion. The extravascular volume accessible to the antipyrine was reduced by 77% after embolization and increased by 177 and approximately 44% after oleic acid and dextran infusion, respectively. The results suggest that when the perfused endothelial surface is sufficiently reduced, as withmore » embolization, the uptake of trace doses of serotonin will be depressed. In addition, decreases in serotonin uptake in response to imipramine in this study and in response to certain endothelial toxins in other studies suggest that serotonin uptake can reveal certain kinds of changes in endothelial function. However, the lack of a response to oleic acid-induced damage in the present study suggests that serotonin uptake is not sensitive to all forms of endothelial damage.« less

[Peripheral artery disease in patients younger than 50 years old: Which etiology?].

PubMed

Cotard, S; Nouni, A; Jaquinandi, V; Gladu, G; Kaladji, A; Mahé, G

2016-09-01

Peripheral arterial disease (PAD) encompasses disease of all arteries of the body except the coronary arteries. The main etiology whatever the patient's age is atherosclerosis. Different etiologies can induce PAD especially when patients are younger than 50 years old and have no cardiovascular risk factors (smoking, hypertension, diabetes…). PAD that appears before 50 years old can be named juvenile PAD (JPAD) although there is no consensus about the definition. The aim of this work is to present the different etiologies of JPAD according to their hereditary, acquired or mixed origins. The following hereditary causes are addressed: Marfan syndrome, Ehlers-Danlos syndrome, homocystinuria, pseudoxanthoma elasticum, osteogenesis imperfecta "mid-aortic" syndrome. Among the acquired etiologies, inflammatory JPADs without extravascular signs such as atherosclerosis and Buerger's disease, inflammatory JPADs with extravascular signs as Takayasu's disease, Behçet's disease and Cogan's syndrome, JPADs like aortitis, embolic JPADs, iatrogenic JPADs, and mechanical or traumatic JPADs are described. Finally, mixed origins as thrombotic disease and fibromuscular dysplasia are presented. This work will assist clinicians in the diagnosis of JPAD. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Flip-flop pharmacokinetics – delivering a reversal of disposition: challenges and opportunities during drug development

PubMed Central

Yáñez, Jaime A; Remsberg, Connie M; Sayre, Casey L; Forrest, M Laird; Davies, Neal M

2011-01-01

Flip-flop pharmacokinetics is a phenomenon often encountered with extravascularly administered drugs. Occurrence of flip-flop spans preclinical to human studies. The purpose of this article is to analyze both the pharmacokinetic interpretation errors and opportunities underlying the presence of flip-flop pharmacokinetics during drug development. Flip-flop occurs when the rate of absorption is slower than the rate of elimination. If it is not recognized, it can create difficulties in the acquisition and interpretation of pharmacokinetic parameters. When flip-flop is expected or discovered, a longer duration of sampling may be necessary in order to avoid overestimation of fraction of dose absorbed. Common culprits of flip-flop disposition are modified dosage formulations; however, formulation characteristics such as the drug chemical entities themselves or the incorporated excipients can also cause the phenomenon. Yet another contributing factor is the physiological makeup of the extravascular site of administration. In this article, these causes of flip-flop pharmacokinetics are discussed with incorporation of relevant examples and the implications for drug development outlined. PMID:21837267

Exchange of potassium and strontium in adult bone

PubMed Central

MALTBY, BARRIE; LEMON, GERARD J.; BASSINGTHWAIGHTE, JAMES B.; KELLY, PATRICK J.

2010-01-01

The kinetics of exchange of strontium (85Sr) and potassium (42K) were studied in the midtibial cortical bone of 37 adult dogs. After injection of these two tracer cations and tracer-labeled albumin into the tibial nutrient artery, two types of observations were made: 1) collection of sequential venous samples to provide the outflow indicator-dilution curves and to calculate the extraction and retention at early times; and 2) detection of energy-selected gamma emissions via a detector over the tibia to give the time course of content of 42K and 85Sr in the tibia. Extractions of K+ and Sr2+ were 50 and 60% during a single transcapillary passage. More Sr2+ than K+ was retained in the first minutes. Their rates of washout over a 3-h period were similar. The interpretation is that the rate of uptake at extravascular sites is faster for Sr2+ than for K+, as is the rate of release, and that the extravascular volume of distribution for Sr2+ (adsorption sites in the interstitium or on bone) is much larger than that for K+ (intracellular). PMID:7065283

Thermal dye double indicator dilution measurement of lung water in man: comparison with gravimetric measurements.

PubMed Central

Mihm, F G; Feeley, T W; Jamieson, S W

1987-01-01

The thermal dye double indicator dilution technique for estimating lung water was compared with gravimetric analyses in nine human subjects who were organ donors. As observed in animal studies, the thermal dye measurement of extravascular thermal volume (EVTV) consistently overestimated gravimetric extravascular lung water (EVLW), the mean (SEM) difference being 3.43 (0.59) ml/kg. In eight of the nine subjects the EVTV -3.43 ml/kg would yield an estimate of EVLW that would be from 3.23 ml/kg under to 3.37 ml/kg over the actual value EVLW at the 95% confidence limits. Reproducibility, assessed with the standard error of the mean percentage, suggested that a 15% change in EVTV can be reliably detected with repeated measurements. One subject was excluded from analysis because the EVTV measurement grossly underestimated its actual EVLW. This error was associated with regional injury observed on gross examination of the lung. Experimental and clinical evidence suggest that the thermal dye measurement provides a reliable estimate of lung water in diffuse pulmonary oedema states. PMID:3616974

Toward a computational model of hemostasis

NASA Astrophysics Data System (ADS)

Leiderman, Karin; Danes, Nicholas; Schoeman, Rogier; Neeves, Keith

2017-11-01

Hemostasis is the process by which a blood clot forms to prevent bleeding at a site of injury. The formation time, size and structure of a clot depends on the local hemodynamics and the nature of the injury. Our group has previously developed computational models to study intravascular clot formation, a process confined to the interior of a single vessel. Here we present the first stage of an experimentally-validated, computational model of extravascular clot formation (hemostasis) in which blood through a single vessel initially escapes through a hole in the vessel wall and out a separate injury channel. This stage of the model consists of a system of partial differential equations that describe platelet aggregation and hemodynamics, solved via the finite element method. We also present results from the analogous, in vitro, microfluidic model. In both models, formation of a blood clot occludes the injury channel and stops flow from escaping while blood in the main vessel retains its fluidity. We discuss the different biochemical and hemodynamic effects on clot formation using distinct geometries representing intra- and extravascular injuries.

Investigation on vascular cytotoxicity and extravascular transport of cationic polymer nanoparticles using perfusable 3D microvessel model.

PubMed

Ahn, Jungho; Cho, Chong-Su; Cho, Seong Woo; Kang, Joo H; Kim, Sung-Yon; Min, Dal-Hee; Song, Joon Myong; Park, Tae-Eun; Jeon, Noo Li

2018-05-25

Vascular networks are the first sites exposed to cationic polymer nanoparticles (NPs) administered intravenously, and thus function as a barrier for NPs reaching the target organ. While cationic polymer NPs have been intensively studied as non-viral delivery systems, their biological effects in human microvessels have been poorly investigated due to a lack of appropriate in vitro systems. Here, we employed a three-dimensional microvessel on a chip, which accurately models in vivo conditions. An open and perfused microvessel surrounded by pericytes was shown to reproduce the important features of living vasculature, including barrier function and biomarkers. Using this microvessel chip, we observed contraction of the microvascular lumen induced by perfused polyethylenimine (PEI)/DNA NPs. We demonstrated that the oxidative stress present when microvessels were exposed to PEI NPs led to rearrangement of microtubules resulting in microvessel contraction. Furthermore, the transcytotic behavior of PEI NPs was analyzed in the microvessel by monitoring the escape of PEI NPs from the microvascular lumen into the perivascular region, which was not possible in two-dimensional culture systems. With our new understanding of the different behaviors of cationic polymer NPs depending on their transcytotic route, we suggest that caveolae-mediated transcytosis is a powerful route for efficient extravascular transport. Microvascular networks are not only biological system constituting largest surface area in the body and but also first site exposed to nanoparticle in vivo. While cationic polymer NPs have been intensively studied as non-viral delivery systems, its biological effects in human microvessel have been poorly investigated due to lack of appropriate in vitro systems. Here, we microengineered an open and perfused 3D pericyte incorporated microvessel model which possesses same morphological characteristic of in vivo. Using the microengineered model, this study represents the first report of transcytotic behavior of NPs in 3D microvessel, and its effect on extravasation efficiency. Our study lays the groundwork for the integration of innovative technologies to examine blood vessel-nanoparticle interaction, which a critical but ill-defined phenomenon. Copyright © 2018. Published by Elsevier Ltd.

Fluid management in critically ill patients: the role of extravascular lung water, abdominal hypertension, capillary leak, and fluid balance

PubMed Central

2012-01-01

Introduction Capillary leak in critically ill patients leads to interstitial edema. Fluid overload is independently associated with poor prognosis. Bedside measurement of intra-abdominal pressure (IAP), extravascular lung water index (EVLWI), fluid balance, and capillary leak index (CLI) may provide a valuable prognostic tool in mechanically ventilated patients. Methods We performed an observational study of 123 mechanically ventilated patients with extended hemodynamic monitoring, analyzing process-of-care variables for the first week of ICU admission. The primary outcome parameter was 28-day mortality. ΔmaxEVLWI indicated the maximum difference between EVLWI measurements during ICU stay. Patients with a ΔmaxEVLWI <−2 mL/kg were called 'responders'. CLI was defined as C-reactive protein (milligrams per deciliter) over albumin (grams per liter) ratio and conservative late fluid management (CLFM) as even-to-negative fluid balance on at least two consecutive days. Results CLI had a biphasic course. ΔmaxEVLWI was lower if CLFM was achieved and in survivors (−2.4 ± 4.8 vs 1.0 ± 5.5 mL/kg, p = 0.001; −3.3 ± 3.8 vs 2.5 ± 5.3 mL/kg, p = 0.001, respectively). No CLFM achievement was associated with increased CLI and IAPmean on day 3 and higher risk to be nonresponder (odds ratio (OR) 2.76, p = 0.046; OR 1.28, p = 0.011; OR 5.52, p = 0.001, respectively). Responders had more ventilator-free days during the first week (2.5 ± 2.3 vs 1.5 ± 2.3, p = 0.023). Not achieving CLFM and being nonresponder were strong independent predictors of mortality (OR 9.34, p = 0.001 and OR 7.14, p = 0.001, respectively). Conclusion There seems to be an important correlation between CLI, EVLWI kinetics, IAP, and fluid balance in mechanically ventilated patients, associated with organ dysfunction and poor prognosis. In this context, we introduce the global increased permeability syndrome. PMID:22873410

Histotripsy Liquefaction of Large Hematomas.

PubMed

Khokhlova, Tatiana D; Monsky, Wayne L; Haider, Yasser A; Maxwell, Adam D; Wang, Yak-Nam; Matula, Thomas J

2016-07-01

Intra- and extra-muscular hematomas result from repetitive injury as well as sharp and blunt limb trauma. The clinical consequences can be serious, including debilitating pain and functional deficit. There are currently no short-term treatment options for large hematomas, only lengthy conservative treatment. The goal of this work was to evaluate the feasibility of a high intensity focused ultrasound (HIFU)-based technique, termed histotripsy, for rapid (within a clinically relevant timeframe of 15-20 min) liquefaction of large volume (up to 20 mL) extra-vascular hematomas for subsequent fine-needle aspiration. Experiments were performed using in vitro extravascular hematoma phantoms-fresh bovine blood poured into 50 mL molds and allowed to clot. The resulting phantoms were treated by boiling histotripsy (BH), cavitation histotripsy (CH) or a combination in a degassed water tank under ultrasound guidance. Two different transducers operating at 1 MHz and 1.5 MHz with f-number = 1 were used. The liquefied lysate was aspirated and analyzed by histology and sized in a Coulter Counter. The peak instantaneous power to achieve BH was lower than (at 1.5 MHz) or equal to (at 1 MHz) that which was required to initiate CH. Under the same exposure duration, BH-induced cavities were one and a half to two times larger than the CH-induced cavities, but the CH-induced cavities were more regularly shaped, facilitating easier aspiration. The lysates contained a small amount of debris larger than 70 μm, and 99% of particulates were smaller than 10 μm. A combination treatment of BH (for initial debulking) and CH (for liquefaction of small residual fragments) yielded 20 mL of lysate within 17.5 minutes of treatment and was found to be most optimal for liquefaction of large extravascular hematomas. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Relating Venous Gas Emboli (VGE) Scores to Altitude Decompression Sickness (DCS) Symptoms

NASA Technical Reports Server (NTRS)

Pilmanis, A. A.; Kannan, N.; Krause, K. M.; Webb, J. T.

1999-01-01

Purpose. It is generally accepted that DCS symptoms are caused by gas bubbles in tissues. However, current technology of bubble detection only permits monitoring of circulating bubbles, primarily intracardiac. Since the majority of DCS symptoms appear to be caused by extravascular bubbles, it has been suggested that current bubble detection techniques target bubbles that are of importance in only a minority of DCS cases. The purpose of this study is to determine the relationships between measured VGE and DCS symptoms in human subjects exposed to altitude. Methods. The AFRL DCS Research Database contains records on 2044 subject-exposures to simulated altitudes in a hypobaric chamber. VGE monitoring was accomplished using Doppler/Echo Imaging techniques. The Spencer Scale was used to score the VGE. Reporting of DCS symptoms by the subject was the primary end-point of the exposures. Results: The Mantel- Haenzel test indicated a strong correlation between DCS and bubble grade (p-value =0.001). Conclusions. A positive correlation between increasing VGE scores and DCS symptoms, does not imply causatinn. If all non-zero VGE grades are considered, 45.9% of the cases had VGE, but no DCS symptoms. Conversely, almost 1 in 5 subject-exposures resulted in DCS with NO VGE detected. VGE scores are not . good predictors of altitude DCS symptoms and field use of bubble detection for DCS prevention is not supported by this study.

Pharmacokinetic Interpretation of Cephradine Levels in Serum After Intravenous and Extravascular Administration in Humans

PubMed Central

Rattie, Elisabeth S.; Bernardo, Peter D.; Ravin, Louis J.

1976-01-01

Pharmacokinetic parameters were calculated from intravenous data based upon a two-compartment open model. These parameters were subsequently used to determine the absorption rates and bioavailability of cephradine administered intramuscularly and orally. The results indicate that cephradine obeys dose-independent kinetics and that biological availability is complete from all dosage forms. PMID:984770

Specialized physiological studies in support of manned space flight

NASA Technical Reports Server (NTRS)

Luft, U. C.; Loeppky, J. A.; Venters, M. D.; Kobayashi, Y.

1978-01-01

The effects of a diuretic (Lasix) induced dehydration on the cardiovascular and hematological responses to lower body negative pressure (LBNP) were analyzed and compared to previous observations on dehydration following exercise in the heat. During LBNP runs the subjects were monitored for changes in blood volume, heart rate, blood pressure, and variations in the volume of the left calf. It was concluded that Lasix dehydration produced a depletion of the body electrolytes at the expense of both the plasma and extravascular compartments. Striking differences were found between those subjects who were physically active (Runners: R) and those who did not engage in any regular physical activity (Non-runners: NR). Tolerance to LBNP (Torr x min) was significantly lower in the R's than the NR's before and after dehydration, however the R's lost more of their tolerance after dehydration with Lasix than after exercise in the heat for about the same fluid loss. The opposite was true for the NR's. Two factors appear to be responsible for the lower LBNP tolerance in R's: parasympathetic inhibition of cardiac activity during LBNP and a greater propensity to pool blood in the lower extremities.

Role of atrial natriuretic peptide in systemic responses to acute isotonic volume expansion

NASA Technical Reports Server (NTRS)

Watenpaugh, Donald E.; Yancy, Clyde W.; Buckey, Jay C.; Lane, Lynda D.; Hargens, Alan R.; Blomqvist, C. G.

1992-01-01

A hypothesis is proposed that a temporal relationship exists between increases in cardiac filling pressure and plasma artrial natriuretic peptide (ANP) concentration and also between ANP elevation and vasodilation, fluid movement from plasma to interstitium, and increased urine volume (UV). To test the hypothesis, 30 ml/kg isotonic saline were infused in supine male subjects over 24 min and responses were monitored for 3 h postinfusion. Results show that at end infusion, mean arterial pressure (RAP), heart rate and plasma volume exhibited peak increases of 146, 23, and 27 percent, respectively. Mean plasma ANP and UV peaked (45 and 390 percent, respectively) at 30 min postinfusion. Most cardiovascular variables had returned toward control levels by 1 h postinfusion, and net reabsorption of extravascular fluid ensued. It is concluded that since ANP was not significantly increased until 30 min postinfusion, factors other than ANP initiate responses to intravascular fluid loading. These factors include increased vascular pressures, baroreceptor-mediated vasolidation, and hemodilution of plasma proteins. ANP is suggested to mediate, in part, the renal response to saline infusion.

An evaluation of the sonoporation potential of low-boiling point phase-change ultrasound contrast agents in vitro.

PubMed

Fix, Samantha M; Novell, Anthony; Yun, Yeoheung; Dayton, Paul A; Arena, Christopher B

2017-01-01

Phase-change ultrasound contrast agents (PCCAs) offer a solution to the inherent limitations associated with using microbubbles for sonoporation; they are characterized by prolonged circulation lifetimes, and their nanometer-scale sizes may allow for passive accumulation in solid tumors. As a first step towards the goal of extravascular cell permeabilization, we aim to characterize the sonoporation potential of a low-boiling point formulation of PCCAs in vitro. Parameters to induce acoustic droplet vaporization and subsequent microbubble cavitation were optimized in vitro using high-speed optical microscopy. Sonoporation of pancreatic cancer cells in suspension was then characterized at a range of pressures (125-600 kPa) and pulse lengths (5-50 cycles) using propidium iodide as an indicator molecule. We achieved sonoporation efficiencies ranging from 8 ± 1% to 36 ± 4% (percent of viable cells), as evidenced by flow cytometry. Increasing sonoporation efficiency trended with increasing pulse length and peak negative pressure. We conclude that PCCAs can be used to induce the sonoporation of cells in vitro, and our results warrant further investigation into the use of PCCAs as extravascular sonoporation agents in vivo.

Experimental investigation of the penetration of ultrasound nanobubbles in a gastric cancer xenograft.

PubMed

Fan, Xiaozhou; Wang, Luofu; Guo, Yanli; Tong, Haipeng; Li, Lang; Ding, Jun; Huang, Haiyun

2013-08-16

Nanobubbles as a type of ultrasound contrast agent have attracted much interest in recent years due to their many advantages, such as strong penetrating power and high stability. However, there is still insufficient morphological evidence concerning gas-filled nanobubbles in tumor tissue spaces and tumor angiogenesis. We used a gastric cancer xenograft as an example to study this question. Nanobubbles with a particle size of 435.2 ± 60.53 nm were prepared and compared with SonoVue® microbubbles in vitro and in vivo, and they exhibited a superior contrast imaging effect. After excluding the impact of the nanobubbles in blood vessels through saline flush, we used an ultrasound burst and frozen sectioning to investigate the distribution of nanobubbles in the gastric cancer xenografts and confirmed this by transmission electron microscopy. Preliminary results showed that the nanobubbles were able to pass through the gaps between the endothelial cells in the tumor vascular system to enter the tissue space. These findings could provide morphological evidence for extravascular ultrasound imaging of tumors and serve as a foundation for the application of nanobubbles in extravascular tumor-targeted ultrasonic diagnostics and therapy.

Modeling and measuring extravascular hemoglobin: aging contusions

NASA Astrophysics Data System (ADS)

Lines, Collin; Kim, Oleg; Duffy, Susan; Alber, Mark; Crawford, Gregory P.

2011-07-01

Medical expertise is frequently elicited to aid in determining the age and the cause of the trauma or injury. Child protection and law enforcement frequently rely on the physical assessment of the trauma which involves delineating intentional from unintentional types of trauma. Recent studies have shown that current methods to assess the age of traumatic injuries are highly inaccurate and do not give reasonable predictions. Hemoglobin is one of the strongest chromophores in human tissues. Transport of hemoglobin and its breakdown products in tissue determines the spectrophotometric characteristics of the skin and its variations in time. Therefore, measurements of diffuse reflective spectra of the skin allow noninvasive screening. This paper reviews potential transmission and diffusive reflection spectroscopy based techniques and predictive and quantitative modeling methods assisting in efficient retrieval of the age of extravascular contusions. This paper then presents a novel Monte Carlo technique for 3D photon tracking and blood transport model. In future studies, clinically obtained spectra will be used to validate the model as well as fine-tune coefficients for absorption. It is the goal of this study to develop a model that would allow a non-invasive, accurate determination of the age of a bruise.

Anthropometric changes and fluid shifts

NASA Technical Reports Server (NTRS)

Thornton, W. E.; Hoffler, G. W.; Rummel, J. A.

1974-01-01

Several observations of body size, shape, posture, and configuration were made to document changes resulting from direct effects of weightlessness during the Skylab 4 mission. After the crewmen were placed in orbit, a number of anatomical and anthropometric changes occurred including a straightening of the thoracolumbar spine, a general decrease in truncal girth, and an increase in height. By the time of the earliest in-flight measurement on mission day 3, all crewmen had lost more than two liters of extravascular fluid from the calf and thigh. The puffy facies, the bird legs effect, the engorgement of upper body veins, and the reduced volume of lower body veins were all documented with photographs. Center-of-mass measurements confirmed a fluid shift cephalad. This shift remained throughout the mission until recovery, when a sharp reversal occurred; a major portion of the reversal was completed in a few hours. The anatomical changes are of considerable scientific interest and of import to the human factors design engineer, but the shifts of blood and extravascular fluid are of more consequence. It is hypothesized that the driving force for the fluid shift is the intrinsic and unopposed lower limb elasticity that forces venous blood and then other fluid cephalad.

Measurement of net whole-body transcapillary fluid transport and effective vascular compliance in humans

NASA Technical Reports Server (NTRS)

Watenpaugh, D. E.; Gaffney, F. A.; Schneider, S. M. (Principal Investigator)

1998-01-01

BACKGROUND: Net whole-body transcapillary fluid transport (TFT) between the circulation and the interstitial (extravascular) space may be calculated as: IV - deltaPV - UV - IL, where IV=infused or ingested volume (when applicable), deltaPV = change in plasma volume, UV=urine volume, and IL=insensible loss. RESULTS: Infusion of 30 mL/kg isotonic saline over 25 minutes increased supine TFT from a basal capillary reabsorption of -106+/-24 mL/h (mean+/-SE) to a net filtration of 1,229+/-124 mL/h. One hour after infusion, reabsorption of -236+/-102 mL/h was seen, and control reabsorption levels returned by 3 hours. Four hours of 30 mm Hg lower body negative pressure (LBNP) elicited no net TFT, probably because of upper body reabsorptive compensation for lower body capillary filtration. When ingestion of 1 L of isotonic saline accompanied LBNP, filtration of 145+/-10 mL/h occurred. Reabsorption of extravascular fluid into the circulation always followed LBNP. CONCLUSION: Application of this technique could aid understanding of physiologic conditions, experimental interventions, disease states, and therapies that cause or are influenced by fluid shifts between intravascular and interstitial compartments.

The heart as an extravascular target of endothelin-1 in ...

EPA Pesticide Factsheets

Exposure to particulate matter air pollution has been causally linked to cardiovascular disease in humans. Several broad and overlapping hypotheses describing the biological mechanisms by which particulate matter exposure leads to cardiovascular disease and cardiac dysfunction have been explored, though linkage with specific factors or genes remains limited. Given evidence pointing to autocrine/paracrine signaling systems as modulators of cardiac dysfunction, the present review highlights the emerging role of endothelins as mediators of cardiac dysfunction following particulate matter exposure. Endothelin-1 is a small multifunctional protein expressed in the pulmonary and cardiovascular system, known for its ability to constrict blood vessels. Although endothelin-1 can also directly and indirectly (via secondary signaling events) modulate cardiac contractility, heart rate, and rhythm, research on the role of endothelins in the context of air pollution has tended to focus on the vascular effects. The plausibility of endothelin as a mechanism underlying particulate matter-induced cardiac dysfunction is further supported by the therapeutic utility of certain endothelin receptor antagonists. Extravascular effects of endothelin on the heart could better explain one mechanism by which particulate matter exposure may lead to cardiac dysfunction. We propose and support the novel hypothesis that autocrine/paracrine signaling systems, such as endothelins, mediate cardiac

Experimental investigation of the penetration of ultrasound nanobubbles in a gastric cancer xenograft

NASA Astrophysics Data System (ADS)

Fan, Xiaozhou; Wang, Luofu; Guo, Yanli; Tong, Haipeng; Li, Lang; Ding, Jun; Huang, Haiyun

2013-08-01

Nanobubbles as a type of ultrasound contrast agent have attracted much interest in recent years due to their many advantages, such as strong penetrating power and high stability. However, there is still insufficient morphological evidence concerning gas-filled nanobubbles in tumor tissue spaces and tumor angiogenesis. We used a gastric cancer xenograft as an example to study this question. Nanobubbles with a particle size of 435.2 ± 60.53 nm were prepared and compared with SonoVue® microbubbles in vitro and in vivo, and they exhibited a superior contrast imaging effect. After excluding the impact of the nanobubbles in blood vessels through saline flush, we used an ultrasound burst and frozen sectioning to investigate the distribution of nanobubbles in the gastric cancer xenografts and confirmed this by transmission electron microscopy. Preliminary results showed that the nanobubbles were able to pass through the gaps between the endothelial cells in the tumor vascular system to enter the tissue space. These findings could provide morphological evidence for extravascular ultrasound imaging of tumors and serve as a foundation for the application of nanobubbles in extravascular tumor-targeted ultrasonic diagnostics and therapy.

Lung recruitment maneuver effects on respiratory mechanics and extravascular lung water index in patients with acute respiratory distress syndrome.

PubMed

Zhang, Jian-Guo; Chen, Xiao-Juan; Liu, Fen; Zeng, Zhen-Guo; Qian, Ke-Jian

2011-01-01

Animal experiments showed that recruitment maneuver (RM) and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the effects of RM on respiratory mechanics and extravascular lung water index (EVLWI) in patients with acute respiratory distress syndrome (ARDS). Thirty patients with ARDS were randomized into a RM group and a non-RM group. In the RM group, after basic mechanical ventilation stabilized for 30 minutes, RM was performed and repeated once every 12 hours for 3 days. In the non-RM group, lung protective strategy was conducted without RM. Oxygenation index (PaO2/FiO2), peak inspiratory pressure (PIP), Plateau pressure (Pplat), static pulmonary compliance (Cst) and EVLWI of patients before treatment and at 12, 24, 48, 72 hours after the treatment were measured and compared between the groups. Hemodynamic changes were observed before and after RM. One-way ANOVA, Student's t test and Fisher's exact test were used to process the data. The levels of PaO2/FiO2 and Cst increased after treatment in the two groups, but they were higher in the RM group than in the non-RM group (P<0.05). The PIP and Pplat decreased after treatment in the two groups, but they were lower in the RM group than in the non-RM group (P<0.05). The EVLWI in the two groups showed downward trend after treatment (P<0.05), and the differences were signifcant at all time points (P<0.01); the EVLWI in the RM group was lower than that in the non-RM group at 12, 24, 48 and 72 hours (P<0.05 or P<0.01). Compared with pre-RM, hemodynamics changes during RM were significantly different (P<0.01); compared with pre-RM, the changes were not significantly different at 120 seconds after the end of RM (P>0.05). RM could reduce EVLWI, increase oxygenation and lung compliance. The effect of RM on hemodynamics was transient.

[Prognostic value of extra-vascular lung water index and pulmonary vascular permeability index in patients with ARDS].

PubMed

Liu, Danqin; Zeng, Weixian; Zhou, Wangfeng; Dai, Yuanrong

2015-11-24

To investigate the correlation of the extra-vascular lung water index (EVLWI) and the pulmonary vascular permeability index (PVPI) with disease severity and their prognostic value in patients with acute respiratory distress syndrome (ARDS). A total of 44 patients with ARDS from October 2012 to June 2014 admitted in the Second Affiliated Hospital of Wenzhou Medical University were recruited in this study. According to the severity, patients were divided into three groups (Mild group, Moderate group and Severe group); the acute physiology and chronic health evaluation system II score (APACHE II), the lung injury score (LIS), the pulse contour curve continuous cardiac output (PiCCO) and other clinical indicators were respectively monitored in the period of 24, 48, 72 hrs after admission; then the correlation of EVLWI, PVPI and oxygenation index (OI) among groups were analyzed; According to the prognosis, patients were divided into the survival group and the death group, both given the univariate and multivariate Logistic regression analysis; EVLWI, PVPI, APACHE II score, LIS and lactic acid were admitted into the receiver operating characteristic (ROC) curve analysis, and the prognosis was evaluated respectively. With the increase of disease severity, LIS and lactic acid gradually increased, the difference was significant among the three groups of Mild, Moderate and Severe (P<0.05). And the APACHE II score also increased gradually with the severity, but the difference was statistically significant only between the Mild group and the Severe group (P<0.01). And likewise, mild, moderate, severe ARDS patients had 1, 6, 9 cases of death, respectively. The 28-day mortality rate increased gradually after admission, with a significant difference between the Mild group and the Severe group (P<0.05). When all the 44 patients of three severities (during the 24 hrs period and during the 72 hrs period) were compared, the OI gradually decreased with the increase of severity of ARDS, while EVLWI and PVPI ascended, and differences between any two groups were statistically significant (P<0.05). In addition, there was a significant negative correlation between EVLWI and OI or between PVPI and OI (r=-0.666, -0.763, all P<0.01), and a significant positive correlation between EVLWI and PVPI, the APACHE II score or LIS (r=0.929, 0.895, 0.661, all P<0.01). Besides, OI was a predictive protection factor of ARDS, whereas lactic acid, EVLWI and PVPI were risk factors. Multivariate Logistic regression analysis showed that EVLWI and lactic acid were risk factors for ARDS death (all P<0.05). ROC curve analysis results suggested EVLWI and lactic acid were risk factors, (odd ratio (OR)> 1, and 95%CI: 1.071-5.201, 5.201-99.852, all P<0.05). EVLWI, PVPI were positively correlated with the severity of ARDS illness; EVLWI can be used as an independent risk factor for forecasting ARDS death, jointing EVLWI with PVPI could improve the accuracy of ARDS death forecasting.

Extravascular red blood cells and hemoglobin promote tumor growth and therapeutic resistance as endogenous danger signals.

PubMed

Yin, Tao; He, Sisi; Liu, Xiaoling; Jiang, Wei; Ye, Tinghong; Lin, Ziqiang; Sang, Yaxiong; Su, Chao; Wan, Yang; Shen, Guobo; Ma, Xuelei; Yu, Min; Guo, Fuchun; Liu, Yanyang; Li, Ling; Hu, Qiancheng; Wang, Yongsheng; Wei, Yuquan

2015-01-01

Hemorrhage is a common clinical manifestation in patients with cancer. Intratumor hemorrhage has been demonstrated to be a poor prognostic factor for cancer patients. In this study, we investigated the role of RBCs and hemoglobin (Hb) in the process of tumor progression and therapeutical response. RBCs and Hb potently promoted tumor cell proliferation and syngenic tumor growth. RBCs and Hb activated the reactive oxygen species-NF-κB pathway in both tumor cells and macrophages. RBCs and Hb also induced chemoresistance mediated, in part, by upregulating ABCB1 gene expression. Tumor growth induced by RBCs was accompanied by an inflammatory signature, increased tumor vasculature, and influx of M2 macrophages. In both the peritoneal cavity and tumor microenvironment, extravascular RBCs rapidly recruited monocyte-macrophages into the lesion sites. In addition, RBCs and Hb increased several nucleotide-binding oligomerization domain-like receptors' expression and induced IL-1β release. Our results provide novel insights into the protumor function of RBCs and Hb as endogenous danger signals, which can promote tumor cell proliferation, macrophage recruitment, and polarization. Hemorrhage may represent a useful prognostic factor for cancer patients because of its role in tumor promotion and chemoresistance. Copyright © 2014 by The American Association of Immunologists, Inc.

Extravascular use of drug-eluting beads: A promising approach in compartment-based tumor therapy

PubMed Central

Binder, Simon; Lewis, Andrew L; Löhr, J-Matthias; Keese, Michael

2013-01-01

Intraperitoneal carcinomatosis (PC) may occur with several tumor entities. The prognosis of patients suffering from PC is usually poor. Present treatment depends on the cancer entity and includes systemic chemotherapy, radiation therapy, hormonal therapy and surgical resection. Only few patients may also benefit from hyperthermic intraperitoneal chemotherapy with a complete tumor remission. These therapies are often accompanied by severe systemic side-effects. One approach to reduce side effects is to target chemotherapeutic agents to the tumor with carrier devices. Promising experimental results have been achieved using drug-eluting beads (DEBs). A series of in vitro and in vitro experiments has been conducted to determine the suitability of their extravascular use. These encapsulation devices were able to harbor CYP2B1 producing cells and to shield them from the hosts immune system when injected intratumorally. In this way ifosfamide - which is transformed into its active metabolites by CYP2B1 - could be successfully targeted into pancreatic tumor growths. Furthermore DEBs can be used to target chemotherapeutics into the abdominal cavity for treatment of PC. If CYP2B1 producing cells are proven to be save for usage in man and if local toxic effects of chemotherapeutics can be controlled, DEBs will become promising tools in compartment-based anticancer treatment. PMID:24282349

The Role of Plasminogen Activator Inhibitor-1 and Angiotensin-Converting Enzyme Gene Polymorphisms in Bronchopulmonary Dysplasia

PubMed Central

Atac, Fatma Belgin; Ozkiraz, Servet; Dilmen, Ugur; Gulcan, Hande; Tarcan, Aylin; Ozbek, Namik

2010-01-01

Background: Bronchopulmonary dysplasia (BPD) is a multifactorial disease of preterm infants that is characterized by airway injury, inflammation, and parencymal remodeling. Activation of the coagulation cascade leads to intraalveolar fibrin deposition in many inflammatory pulmonary disorders. Increased fibrin formation or decreased fibrinolysis may cause extravascular fibrin deposition. Extravascular fibrin deposits in septae and alveoli due to the altered fibrin turnover are the pathological hallmarks of BPD, which strongly indicate the importance of the imbalance in the competing activities of coagulation and fibrinolysis. Objective: We investigated the predictive value of variations in plasminogen activator inhibitor-1 (PAI-1) and angiotensin-converting enzyme (ACE) genes as molecular determinants for BPD in neonates. Methods: The study group comprised 98 preterm infants with BPD and a control group including 94 preterm infants without BPD. Restriction fragment size analyses were performed by visualizing digested polymerase chain reaction products for ACE and PAI-1 genotypes. Results: No significant associations were found between ACE, PAI-1 gene polymorphisms, and BPD phenotype in our population. Conclusions: The two gene polymorphisms (PAI-1 and ACE) had no role in the development of BPD in our study. Further studies with other genes are required for the identification of molecular predisposing factors for BPD that may help in the development of new treatments. PMID:20818980

Cerebral Microcirculation and Oxygen Tension in the Human Secondary Cortex

PubMed Central

Linninger, A. A.; Gould, I. G.; Marinnan, T.; Hsu, C.-Y.; Chojecki, M.; Alaraj, A.

2013-01-01

The three-dimensional spatial arrangement of the cortical microcirculatory system is critical for understanding oxygen exchange between blood vessels and brain cells. A three-dimensional computer model of a 3 × 3 × 3 mm3 subsection of the human secondary cortex was constructed to quantify oxygen advection in the microcirculation, tissue oxygen perfusion, and consumption in the human cortex. This computer model accounts for all arterial, capillary and venous blood vessels of the cerebral microvascular bed as well as brain tissue occupying the extravascular space. Microvessels were assembled with optimization algorithms emulating angiogenic growth; a realistic capillary bed was built with space filling procedures. The extravascular tissue was modeled as a porous medium supplied with oxygen by advection–diffusion to match normal metabolic oxygen demand. The resulting synthetic computer generated network matches prior measured morphometrics and fractal patterns of the cortical microvasculature. This morphologically accurate, physiologically consistent, multi-scale computer network of the cerebral microcirculation predicts the oxygen exchange of cortical blood vessels with the surrounding gray matter. Oxygen tension subject to blood pressure and flow conditions were computed and validated for the blood as well as brain tissue. Oxygen gradients along arterioles, capillaries and veins agreed with in vivo trends observed recently in imaging studies within experimental tolerances and uncertainty. PMID:23842693

[Current role of albumin in critical care].

PubMed

Aguirre Puig, P; Orallo Morán, M A; Pereira Matalobos, D; Prieto Requeijo, P

2014-11-01

The use of colloids in fluid therapy has been, and still continues to be a controversial topic, particularly when referring to the critical patient. The choice of the fluid that needs to be administered depends on several factors, many of which are theoretical, and continue being an object of debate. The interest in the clinical use of the albumin has emerged again, immediately after recent publications in the search of the most suitable colloid. It is the most abundant protein in the plasma, being responsible for 80% of the oncotic pressure. It regulates the balance between the intra- and extra-vascular volumes. Recent multicenter studies question the supposed lack of safety that was previously assigned to it. Furthermore, in vitro studies demonstrate other important actions besides oncotic, for example neutralization of free radicals, and exogenous (drugs) and endogenous substances (bile pigments, cholesterol). Being aware of these secondary properties of albumin, and evaluating the pathophysiology of the critical patient (in particular, sepsis), to maintain plasma albumin levels within the normal range, could be of great importance. Based on the most recent publications, the aim of this review is to briefly analyze the pathophysiology of albumin, as well as to discuss its possible indications in the critical patient. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

40 CFR 62.15220 - What additional requirements must I meet for the operation of my continuous emission monitoring...

Code of Federal Regulations, 2011 CFR

2011-07-01

... meet for the operation of my continuous emission monitoring systems and continuous opacity monitoring system? 62.15220 Section 62.15220 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... the operation of my continuous emission monitoring systems and continuous opacity monitoring system...

40 CFR 62.15220 - What additional requirements must I meet for the operation of my continuous emission monitoring...

Code of Federal Regulations, 2010 CFR

2010-07-01

... meet for the operation of my continuous emission monitoring systems and continuous opacity monitoring system? 62.15220 Section 62.15220 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... the operation of my continuous emission monitoring systems and continuous opacity monitoring system...

40 CFR 60.1765 - What additional requirements must I meet for the operation of my continuous emission monitoring...

Code of Federal Regulations, 2011 CFR

2011-07-01

... meet for the operation of my continuous emission monitoring systems and continuous opacity monitoring system? 60.1765 Section 60.1765 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... continuous emission monitoring systems and continuous opacity monitoring system? Use the required span values...

40 CFR 60.1765 - What additional requirements must I meet for the operation of my continuous emission monitoring...

Code of Federal Regulations, 2010 CFR

2010-07-01

... meet for the operation of my continuous emission monitoring systems and continuous opacity monitoring system? 60.1765 Section 60.1765 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... continuous emission monitoring systems and continuous opacity monitoring system? Use the required span values...

Oxycodone recycling: a novel hypothesis of opioid tolerance development in humans.

PubMed

Linares, Oscar A; Fudin, Jeffrey; Schiesser, William E; Linares, Annemarie Daly; Boston, Raymond C

2014-09-01

We hypothesize that oxycodone (OC) recycling promotes sustained synaptic OC content, which prolongs OC's exposure to local μ-opioid receptors (μORs). In that way, OC recycling gives rise to OC tolerance in humans. To pilot test our hypothesis, we developed a whole-body OC mass transport tolerance recovery model. The model derived quantifiable measure of tolerance is TΩ. TΩ estimates OC's tolerance recovery in days; It is defined as the rate of recovery of OC's pharmacologic response after OC is stopped. We studied a random sample of five opioid intolerant healthy male subjects with no history of opioid or illicit drug use, or comorbidities in silico. Subjects were age 24.5 ± 2.3 yr (all values mean ± SD), weight 93 ± 20 kg, and CYP2D6 EM phenotype. Each subject was studied under two experimental conditions: (1) administration of a single oral dose of OC 12 ± 7 mg; and, after complete washout of OC from the intravascular pool, (2) administration of repetitive oral OC doses every 4h for 5 half-lives (t1/2 = 4.5h)-after which time steady-state was assumed. Repetitive OC dose TΩ fell 61% compared to single OC dose TΩ (5.2 ± 1.1 vs. 3.5 ± 0.7 days, p = 0.001). The fall in TΩ was associated with a significant 3-fold increase in extravascular OC content, which was accompanied by 2-fold increase in OC spillover from the extravascular pool, into the intravascular pool. Thus, the model predicted that a single dose of orally administered OC could give rise to tolerance. This is consistent with the widely held view of acute opioid tolerance. In addition, the dynamic changes accompanying repetitive OC dosing suggested that local unbound OC gave rise to both higher extravascular OC content and increased OC spillover. This reflects that OC stimulated endocytosis of μORs was accompanied by a reduction in the availability OC responsive neuroeffector cell surface μOR binding sites. We conclude that our hypothesis extends current concepts of opioid tolerance development to include OC recycling. OC recycling is a novel hypothesis of OC tolerance development in humans. Copyright © 2014 Elsevier Ltd. All rights reserved.

40 CFR 63.7747 - How do I apply for alternative monitoring requirements for a continuous emissions monitoring system?

Code of Federal Regulations, 2011 CFR

2011-07-01

... monitoring requirements for a continuous emissions monitoring system? 63.7747 Section 63.7747 Protection of... apply for alternative monitoring requirements for a continuous emissions monitoring system? (a) You may... prevention technique, a description of the continuous monitoring system or method including appropriate...

40 CFR 63.7747 - How do I apply for alternative monitoring requirements for a continuous emissions monitoring system?

Code of Federal Regulations, 2010 CFR

2010-07-01

... monitoring requirements for a continuous emissions monitoring system? 63.7747 Section 63.7747 Protection of... apply for alternative monitoring requirements for a continuous emissions monitoring system? (a) You may... prevention technique, a description of the continuous monitoring system or method including appropriate...

40 CFR 60.1250 - What is my schedule for evaluating continuous emission monitoring systems?

Code of Federal Regulations, 2011 CFR

2011-07-01

... continuous emission monitoring systems? 60.1250 Section 60.1250 Protection of Environment ENVIRONMENTAL... Continuous Emission Monitoring § 60.1250 What is my schedule for evaluating continuous emission monitoring systems? (a) Conduct annual evaluations of your continuous emission monitoring systems no more than 13...

40 CFR 60.3040 - What is my schedule for evaluating continuous emission monitoring systems?

Code of Federal Regulations, 2010 CFR

2010-07-01

... continuous emission monitoring systems? 60.3040 Section 60.3040 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES... continuous emission monitoring systems? (a) Conduct annual evaluations of your continuous emission monitoring...

Contrast-enhanced dynamic and diffusion-weighted magnetic resonance imaging at 3.0 T to assess early-stage nasopharyngeal carcinoma.

PubMed

Ni, Liangping; Liu, Ying

2018-04-01

The present study aimed to assess early-stage nasopharyngeal carcinoma (NPC) with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) at 3.0 T. A total of 44 patients newly diagnosed with NPC were included in the present study. All patients underwent MR examination at 3.0 T using DCE-MRI and DWI. The volume transfer constant ( K trans ), flux rate constant between extravascular extracellular space and plasma ( K ep ), the volume of extravascular extracellular space per unit volume of tissue ( V e ) and the apparent diffusion coefficient (ADC) of tumours were investigated. Furthermore, the correlation between clinical stages and ADC value and K trans were analysed. The diagnostic accuracy of K trans and ADC were estimated using receiver operating characteristic curves. NPC stage correlated positively with K trans and negatively with ADC values. Additionally, tumour K trans negatively correlated with ADC value. The sensitivity and accuracy of combined K trans and ADC in distinguishing between stage II and stage III and stage III and IV were higher than the values of either measurement used separately. The present study suggested that K trans and ADC derived from DCE-MRI and DWI may be useful to detect stage early NPC accurately. K trans and ADC in combination were superior than either alone.

Transfusion of human volunteers with older, stored red blood cells produces extravascular hemolysis and circulating non–transferrin-bound iron

PubMed Central

Brittenham, Gary M.; Billote, Genia B.; Francis, Richard O.; Ginzburg, Yelena Z.; Hendrickson, Jeanne E.; Jhang, Jeffrey; Schwartz, Joseph; Sharma, Shruti; Sheth, Sujit; Sireci, Anthony N.; Stephens, Hannah L.; Stotler, Brie A.; Wojczyk, Boguslaw S.; Zimring, James C.; Spitalnik, Steven L.

2011-01-01

Transfusions of RBCs stored for longer durations are associated with adverse effects in hospitalized patients. We prospectively studied 14 healthy human volunteers who donated standard leuko-reduced, double RBC units. One unit was autologously transfused “fresh” (3-7 days of storage), and the other “older” unit was transfused after 40 to 42 days of storage. Of the routine laboratory parameters measured at defined times surrounding transfusion, significant differences between fresh and older transfusions were only observed in iron parameters and markers of extravascular hemolysis. Compared with fresh RBCs, mean serum total bilirubin increased by 0.55 mg/dL at 4 hours after transfusion of older RBCs (P = .0003), without significant changes in haptoglobin or lactate dehydrogenase. In addition, only after the older transfusion, transferrin saturation increased progressively over 4 hours to a mean of 64%, and non–transferrin-bound iron appeared, reaching a mean of 3.2μM. The increased concentrations of non–transferrin-bound iron correlated with enhanced proliferation in vitro of a pathogenic strain of Escherichia coli (r = 0.94, P = .002). Therefore, circulating non–transferrin-bound iron derived from rapid clearance of transfused, older stored RBCs may enhance transfusion-related complications, such as infection. The trial was registered with www.clinicaltrials.gov as #NCT01319552. PMID:22021369

Distribution of extravascular fluid volumes in isolated perfused lungs measured with H215O.

PubMed Central

Jones, T; Jones, H A; Rhodes, C G; Buckingham, P D; Hughes, J M

1976-01-01

The distributions per unit volume of extravascular water (EVLW), blood volume, and blood flow were measured in isolated perfused vertical dog lungs. A steady-state tracer technique was employed using oxygen-15, carbon-11, and nitrogen-13 isotopes and external scintillation counting of the 511-KeV annihilation radiation common to all three radionuclides. EVLW, and blood volume and flow increased from apex to base in all preparations, but the gradient of increasing flow exceeded that for blood and EVLW volumes. The regional distributions of EVLW and blood volume were almost identical. With increasing edema, lower-zone EVLW increased slightly relative to that in the upper zone. There was no change in the distribution of blood volume or flow until gross edema (100% wt gain) occurred when lower zone values were reduced. In four lungs the distribution of EVLW was compared with wet-to-dry ratios from lung biopsies taken immediately afterwards. Whereas the isotopically measured EVLW increased from apex to base, the wet-to-dry weight ratios remained essentially uniform. We concluded that isotopic methods measure only an "exchangeable" water pool whose volume is dependent on regional blood flow and capillary recruitment. Second, the isolated perfused lung can accommodate up to 60% wt gain without much change in the regional distribution of EVLW, volume, or flow. PMID:765354

DCE-MRI of hepatocellular carcinoma: perfusion quantification with Tofts model versus shutter-speed model--initial experience.

PubMed

Jajamovich, Guido H; Huang, Wei; Besa, Cecilia; Li, Xin; Afzal, Aneela; Dyvorne, Hadrien A; Taouli, Bachir

2016-02-01

To quantify hepatocellular carcinoma (HCC) perfusion and flow with the fast exchange regime-allowed Shutter-Speed model (SSM) compared to the Tofts model (TM). In this prospective study, 25 patients with HCC underwent DCE-MRI. ROIs were placed in liver parenchyma, portal vein, aorta and HCC lesions. Signal intensities were analyzed employing dual-input TM and SSM models. ART (arterial fraction), K (trans) (contrast agent transfer rate constant from plasma to extravascular extracellular space), ve (extravascular extracellular volume fraction), kep (contrast agent intravasation rate constant), and τi (mean intracellular water molecule lifetime) were compared between liver parenchyma and HCC, and ART, K (trans), v e and k ep were compared between models using Wilcoxon tests and limits of agreement. Test-retest reproducibility was assessed in 10 patients. ART and v e obtained with TM; ART, ve, ke and τi obtained with SSM were significantly different between liver parenchyma and HCC (p < 0.04). Parameters showed variable reproducibility (CV range 14.7-66.5% for both models). Liver K (trans) and ve; HCC ve and kep were significantly different when estimated with the two models (p < 0.03). Our results show differences when computed between the TM and the SSM. However, these differences are smaller than parameter reproducibilities and may be of limited clinical significance.

Stochastic modelling suggests that an elevated superoxide anion - hydrogen peroxide ratio can drive extravascular phagocyte transmigration by lamellipodium formation.

PubMed

Kundu, Siddhartha

2016-10-21

Chemotaxis, integrates diverse intra- and inter-cellular molecular processes into a purposeful patho-physiological response; the operatic rules of which, remain speculative. Here, I surmise, that superoxide anion induced directional motility, in a responding cell, results from a quasi pathway between the stimulus, surrounding interstitium, and its biochemical repertoire. The epochal event in the mounting of an inflammatory response, is the extravascular transmigration of a phagocyte competent cell towards the site of injury, secondary to the development of a lamellipodium. This stochastic-to-markovian process conversion, is initiated by the cytosolic-ROS of the damaged cell, but is maintained by the inverse association of a de novo generated pool of self-sustaining superoxide anions and sub-critical hydrogen peroxide levels. Whilst, the exponential rise of O2(.-) is secondary to the focal accumulation of higher order lipid raft-Rac1/2-actin oligomers; O2(.-) mediated inactivation and redistribution of ECSOD, accounts for the minimal concentration of H2O2 that the phagocyte experiences. The net result of this reciprocal association between ROS/ RNS members, is the prolonged perturbation and remodeling of the cytoskeleton and plasma membrane, a prelude to chemotactic migration. The manuscript also describes the significance of stochastic modeling, in the testing of plausible molecular hypotheses of observable phenomena in complex biological systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

40 CFR 60.1275 - What additional requirements must I meet for the operation of my continuous emission monitoring...

Code of Federal Regulations, 2010 CFR

2010-07-01

... meet for the operation of my continuous emission monitoring systems and continuous opacity monitoring... additional requirements must I meet for the operation of my continuous emission monitoring systems and continuous opacity monitoring system? Use the required span values and applicable performance specifications...

40 CFR 60.1275 - What additional requirements must I meet for the operation of my continuous emission monitoring...

Code of Federal Regulations, 2011 CFR

2011-07-01

... meet for the operation of my continuous emission monitoring systems and continuous opacity monitoring... additional requirements must I meet for the operation of my continuous emission monitoring systems and continuous opacity monitoring system? Use the required span values and applicable performance specifications...

40 CFR 60.2941 - What is my schedule for evaluating continuous emission monitoring systems?

Code of Federal Regulations, 2010 CFR

2010-07-01

... continuous emission monitoring systems? 60.2941 Section 60.2941 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES... emission monitoring systems? (a) Conduct annual evaluations of your continuous emission monitoring systems...

40 CFR 60.3040 - What is my schedule for evaluating continuous emission monitoring systems?

Code of Federal Regulations, 2011 CFR

2011-07-01

... continuous emission monitoring systems? 60.3040 Section 60.3040 Protection of Environment ENVIRONMENTAL... continuous emission monitoring systems? (a) Conduct annual evaluations of your continuous emission monitoring... emission monitoring systems daily and quarterly as specified in appendix F of this part. ...

40 CFR 60.2939 - What continuous emission monitoring systems must I install?

Code of Federal Regulations, 2010 CFR

2010-07-01

... and Qualification Monitoring § 60.2939 What continuous emission monitoring systems must I install? (a) You must install, calibrate, maintain, and operate continuous emission monitoring systems for carbon... carbon monoxide. (b) You must install, evaluate, and operate each continuous emission monitoring system...

40 CFR 60.2939 - What continuous emission monitoring systems must I install?

Code of Federal Regulations, 2011 CFR

2011-07-01

... and Qualification Monitoring § 60.2939 What continuous emission monitoring systems must I install? (a) You must install, calibrate, maintain, and operate continuous emission monitoring systems for carbon... carbon monoxide. (b) You must install, evaluate, and operate each continuous emission monitoring system...

40 CFR 60.1235 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission monitoring systems used? 60.1235 Section 60.1235 Protection of Environment ENVIRONMENTAL... Continuous Emission Monitoring § 60.1235 How are the data from the continuous emission monitoring systems used? You must use data from the continuous emission monitoring systems for sulfur dioxide, nitrogen...

40 CFR 60.1235 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission monitoring systems used? 60.1235 Section 60.1235 Protection of Environment ENVIRONMENTAL... Continuous Emission Monitoring § 60.1235 How are the data from the continuous emission monitoring systems used? You must use data from the continuous emission monitoring systems for sulfur dioxide, nitrogen...

Hibernation-Based Therapy to Improve Survival of Severe Blood Loss

DTIC Science & Technology

2016-06-01

leaks extravascularly • Necrosis and inflammation involving the ear tip is considered to be a more severe manifestation of vascular damage associated...similar lesions to the 2M test solution, it appears that 2M test solution is more likely to cause vascular necrosis and inflammation (noted at 24 hours...injections • Although DMSO induced similar lesions to the 4M test solution, it appears that 4M test solution is more likely to cause vascular necrosis and

Hibernation Based Therapy to Improve Survival of Severe Blood Loss

DTIC Science & Technology

2016-06-01

leaks extravascularly • Necrosis and inflammation involving the ear tip is considered to be a more severe manifestation of vascular damage associated...similar lesions to the 2M test solution, it appears that 2M test solution is more likely to cause vascular necrosis and inflammation (noted at 24 hours...injections • Although DMSO induced similar lesions to the 4M test solution, it appears that 4M test solution is more likely to cause vascular necrosis and

[Otolaryngologic manifestations of Churg-Strauss sindrome. Report of a case and review of the literature].

PubMed

Pino Rivero, V; González Palomino, A; Pantoja Hernández, C G; Trinidad Ruíz, G; Pardo Romero, G; Montero García, C; Blasco Huelva, A

2006-01-01

Churg-Strauss Sindrome or allergic granulomatosis is a small vessel systemic vasculitis characterized by asthma, hypereosinophilia and necrotizing vasculitis with extravascular eosinophil granulomas. We describe a case assisted in our hospital who presented pulmonary infiltrates, fever, peripherical neuropathy, weight loss, myalgia, rhinosinusitis, with antecedents of nasal polyposis, and facial edema. Our aim is to review the main otolaryngologic manifestations of this rare illness that is treated with oral corticosteroids, immunosupresor drugs like ciclofosfamide and plasmapheresis.

Blood Ferrokinetics in Normal Man*

PubMed Central

Hosain, Fazle; Marsaglia, George; Finch, Clement A.

1967-01-01

The clearance of radioiron from plasma and its appearance in circulating erythrocytes in normal subjects are studied. The importance of correcting for plasma iron fluctuations and for mean body hematocrit is illustrated. The data are analyzed by probability theory to determine relationships between intravascular and extravascular iron. Two refluxes are described, one of about 7 particles of every 100 leaving the plasma, and the second of about 23. The return times of these are about 5 hours and 8 days, respectively. Images PMID:6018746

Continuous Seismic Threshold Monitoring

DTIC Science & Technology

1992-05-31

Continuous threshold monitoring is a technique for using a seismic network to monitor a geographical area continuously in time. The method provides...area. Two approaches are presented. Site-specific monitoring: By focusing a seismic network on a specific target site, continuous threshold monitoring...recorded events at the site. We define the threshold trace for the network as the continuous time trace of computed upper magnitude limits of seismic

40 CFR 62.15180 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission monitoring systems used? 62.15180 Section 62.15180 Protection of Environment ENVIRONMENTAL... Constructed on or Before August 30, 1999 Continuous Emission Monitoring § 62.15180 How are the data from the continuous emission monitoring systems used? You must use data from the continuous emission monitoring...

40 CFR 62.15205 - What minimum amount of monitoring data must I collect with my continuous emission monitoring...

Code of Federal Regulations, 2010 CFR

2010-07-01

... must I collect with my continuous emission monitoring systems and is this requirement enforceable? 62... with my continuous emission monitoring systems and is this requirement enforceable? (a) Where continuous emission monitoring systems are required, obtain 1-hour arithmetic averages. Make sure the...

40 CFR 62.15205 - What minimum amount of monitoring data must I collect with my continuous emission monitoring...

Code of Federal Regulations, 2011 CFR

2011-07-01

... must I collect with my continuous emission monitoring systems and is this requirement enforceable? 62... with my continuous emission monitoring systems and is this requirement enforceable? (a) Where continuous emission monitoring systems are required, obtain 1-hour arithmetic averages. Make sure the...

40 CFR 60.1725 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission monitoring systems used? 60.1725 Section 60.1725 Protection of Environment ENVIRONMENTAL... Before August 30, 1999 Model Rule-Continuous Emission Monitoring § 60.1725 How are the data from the continuous emission monitoring systems used? You must use data from the continuous emission monitoring...

40 CFR 60.2942 - What is the minimum amount of monitoring data I must collect with my continuous emission...

Code of Federal Regulations, 2010 CFR

2010-07-01

... monitoring data I must collect with my continuous emission monitoring systems, and is the data collection... with my continuous emission monitoring systems, and is the data collection requirement enforceable? (a) Where continuous emission monitoring systems are required, obtain 1-hour arithmetic averages. Make sure...

40 CFR 60.3041 - What is the minimum amount of monitoring data I must collect with my continuous emission...

Code of Federal Regulations, 2010 CFR

2010-07-01

... monitoring data I must collect with my continuous emission monitoring systems, and is the data collection... collect with my continuous emission monitoring systems, and is the data collection requirement enforceable? (a) Where continuous emission monitoring systems are required, obtain 1-hour arithmetic averages...

40 CFR 60.3041 - What is the minimum amount of monitoring data I must collect with my continuous emission...

Code of Federal Regulations, 2011 CFR

2011-07-01

... monitoring data I must collect with my continuous emission monitoring systems, and is the data collection... collect with my continuous emission monitoring systems, and is the data collection requirement enforceable? (a) Where continuous emission monitoring systems are required, obtain 1-hour arithmetic averages...

40 CFR 62.15280 - What minimum amount of monitoring data must I collect with my continuous parameter monitoring...

Code of Federal Regulations, 2010 CFR

2010-07-01

... must I collect with my continuous parameter monitoring systems and is this requirement enforceable? 62... with my continuous parameter monitoring systems and is this requirement enforceable? (a) Where continuous parameter monitoring systems are used, obtain 1-hour arithmetic averages for three parameters: (1...

40 CFR 62.15280 - What minimum amount of monitoring data must I collect with my continuous parameter monitoring...

Code of Federal Regulations, 2011 CFR

2011-07-01

... must I collect with my continuous parameter monitoring systems and is this requirement enforceable? 62... with my continuous parameter monitoring systems and is this requirement enforceable? (a) Where continuous parameter monitoring systems are used, obtain 1-hour arithmetic averages for three parameters: (1...

40 CFR 62.15180 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission monitoring systems used? 62.15180 Section 62.15180 Protection of Environment ENVIRONMENTAL... Constructed on or Before August 30, 1999 Continuous Emission Monitoring § 62.15180 How are the data from the continuous emission monitoring systems used? You must use data from the continuous emission monitoring...

40 CFR 60.2942 - What is the minimum amount of monitoring data I must collect with my continuous emission...

Code of Federal Regulations, 2011 CFR

2011-07-01

... monitoring data I must collect with my continuous emission monitoring systems, and is the data collection... with my continuous emission monitoring systems, and is the data collection requirement enforceable? (a) Where continuous emission monitoring systems are required, obtain 1-hour arithmetic averages. Make sure...

40 CFR 60.1725 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission monitoring systems used? 60.1725 Section 60.1725 Protection of Environment ENVIRONMENTAL... Before August 30, 1999 Model Rule-Continuous Emission Monitoring § 60.1725 How are the data from the continuous emission monitoring systems used? You must use data from the continuous emission monitoring...

40 CFR 60.1825 - What is the minimum amount of monitoring data I must collect with my continuous parameter...

Code of Federal Regulations, 2010 CFR

2010-07-01

... monitoring data I must collect with my continuous parameter monitoring systems and is the data collection... must collect with my continuous parameter monitoring systems and is the data collection requirement enforceable? (a) Where continuous parameter monitoring systems are used, obtain 1-hour arithmetic averages for...

40 CFR 60.1750 - What is the minimum amount of monitoring data I must collect with my continuous emission...

Code of Federal Regulations, 2011 CFR

2011-07-01

... monitoring data I must collect with my continuous emission monitoring systems and is the data collection... I must collect with my continuous emission monitoring systems and is the data collection requirement enforceable? (a) Where continuous emission monitoring systems are required, obtain 1-hour arithmetic averages...

40 CFR 60.1825 - What is the minimum amount of monitoring data I must collect with my continuous parameter...

Code of Federal Regulations, 2011 CFR

2011-07-01

... monitoring data I must collect with my continuous parameter monitoring systems and is the data collection... must collect with my continuous parameter monitoring systems and is the data collection requirement enforceable? (a) Where continuous parameter monitoring systems are used, obtain 1-hour arithmetic averages for...

40 CFR 60.1750 - What is the minimum amount of monitoring data I must collect with my continuous emission...

Code of Federal Regulations, 2010 CFR

2010-07-01

... monitoring data I must collect with my continuous emission monitoring systems and is the data collection... I must collect with my continuous emission monitoring systems and is the data collection requirement enforceable? (a) Where continuous emission monitoring systems are required, obtain 1-hour arithmetic averages...

77 FR 18709 - Quality Assurance Requirements for Continuous Opacity Monitoring Systems at Stationary Sources

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... Quality Assurance Requirements for Continuous Opacity Monitoring Systems at Stationary Sources AGENCY... direct final rule titled ``Quality Assurance Requirements for Continuous Opacity Monitoring Systems at...--Quality Assurance Requirements for Continuous Opacity Monitoring Systems at Stationary Sources Docket, EPA...

40 CFR 60.1740 - What is my schedule for evaluating continuous emission monitoring systems?

Code of Federal Regulations, 2010 CFR

2010-07-01

... continuous emission monitoring systems? 60.1740 Section 60.1740 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES... evaluating continuous emission monitoring systems? (a) Conduct annual evaluations of your continuous emission...

40 CFR 60.1270 - What is required for my continuous opacity monitoring system and how are the data used?

Code of Federal Regulations, 2011 CFR

2011-07-01

... opacity monitoring system and how are the data used? 60.1270 Section 60.1270 Protection of Environment... Continuous Emission Monitoring § 60.1270 What is required for my continuous opacity monitoring system and how... system. (b) Install, evaluate, and operate each continuous opacity monitoring system according to § 60.13...

Redistribution of pulmonary blood flow impacts thermodilution-based extravascular lung water measurements in a model of acute lung injury

PubMed Central

Easley, R. Blaine; Mulreany, Daniel G.; Lancaster, Christopher T.; Custer, Jason W.; Fernandez-Bustamante, Ana; Colantuoni, Elizabeth; Simon, Brett A.

2009-01-01

Background Studies using transthoracic thermodilution have demonstrated increased extravascular lung water (EVLW) measurements attributed to progression of edema and flooding during sepsis and acute lung injury. We hypothesize that redistribution of pulmonary blood flow can cause increased apparent EVLW secondary to increased perfusion of thermally silent tissue, not increased lung edema. Methods Anesthetized, mechanically ventilated canines were instrumented with PiCCO® (Pulsion Medical, Munich, Germany) catheters and underwent lung injury by repetitive saline lavage. Hemodynamic and respiratory physiologic data were recorded. After stabilized lung injury, endotoxin was administered to inactivate hypoxic pulmonary vasoconstriction. Computerized tomographic imaging was performed to quantify in vivo lung volume, total tissue (fluid) and air content, and regional distribution of blood flow. Results Lavage injury caused an increase in airway pressures and decreased arterial oxygen content with minimal hemodynamic effects. EVLW and shunt fraction increased after injury and then markedly following endotoxin administration. Computerized tomographic measurements quantified an endotoxin-induced increase in pulmonary blood flow to poorly aerated regions with no change in total lung tissue volume. Conclusions The abrupt increase in EVLW and shunt fraction after endotoxin administration is consistent with inactivation of hypoxic pulmonary vasoconstriction and increased perfusion to already flooded lung regions that were previously thermally silent. Computerized tomographic studies further demonstrate in vivo alterations in regional blood flow (but not lung water) and account for these alterations in shunt fraction and EVLW. PMID:19809280

30 CFR 77.211-1 - Continuous methane monitoring device; installation and operation; automatic deenergization of...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Continuous methane monitoring device... Installations § 77.211-1 Continuous methane monitoring device; installation and operation; automatic deenergization of electric equipment. Continuous methane monitoring devices shall be set to deenergize...

40 CFR 60.1235 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2013 CFR

2013-07-01

... emission monitoring systems used? 60.1235 Section 60.1235 Protection of Environment ENVIRONMENTAL... Continuous Emission Monitoring § 60.1235 How are the data from the continuous emission monitoring systems... oxides, and carbon monoxide to demonstrate continuous compliance with the emission limits specified in...

40 CFR 60.1235 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2014 CFR

2014-07-01

... emission monitoring systems used? 60.1235 Section 60.1235 Protection of Environment ENVIRONMENTAL... Continuous Emission Monitoring § 60.1235 How are the data from the continuous emission monitoring systems... oxides, and carbon monoxide to demonstrate continuous compliance with the emission limits specified in...

40 CFR 60.1235 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission monitoring systems used? 60.1235 Section 60.1235 Protection of Environment ENVIRONMENTAL... Continuous Emission Monitoring § 60.1235 How are the data from the continuous emission monitoring systems... oxides, and carbon monoxide to demonstrate continuous compliance with the emission limits specified in...

30 CFR 77.211-1 - Continuous methane monitoring device; installation and operation; automatic deenergization of...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Continuous methane monitoring device... Installations § 77.211-1 Continuous methane monitoring device; installation and operation; automatic deenergization of electric equipment. Continuous methane monitoring devices shall be set to deenergize...

40 CFR 60.1740 - What is my schedule for evaluating continuous emission monitoring systems?

Code of Federal Regulations, 2011 CFR

2011-07-01

... continuous emission monitoring systems? 60.1740 Section 60.1740 Protection of Environment ENVIRONMENTAL... evaluating continuous emission monitoring systems? (a) Conduct annual evaluations of your continuous emission monitoring systems no more than 13 months after the previous evaluation was conducted. (b) Evaluate your...

40 CFR 62.15195 - What is my schedule for evaluating continuous emission monitoring systems?

Code of Federal Regulations, 2010 CFR

2010-07-01

... continuous emission monitoring systems? 62.15195 Section 62.15195 Protection of Environment ENVIRONMENTAL... evaluating continuous emission monitoring systems? (a) Conduct annual evaluations of your continuous emission monitoring systems no more than 13 months after the previous evaluation was conducted. (b) Evaluate your...

40 CFR 62.15195 - What is my schedule for evaluating continuous emission monitoring systems?

Code of Federal Regulations, 2011 CFR

2011-07-01

... continuous emission monitoring systems? 62.15195 Section 62.15195 Protection of Environment ENVIRONMENTAL... evaluating continuous emission monitoring systems? (a) Conduct annual evaluations of your continuous emission monitoring systems no more than 13 months after the previous evaluation was conducted. (b) Evaluate your...

40 CFR 60.3038 - What continuous emission monitoring systems must I install?

Code of Federal Regulations, 2011 CFR

2011-07-01

... December 9, 2004 Model Rule-Monitoring § 60.3038 What continuous emission monitoring systems must I install? (a) You must install, calibrate, maintain, and operate continuous emission monitoring systems for... system according to the “Monitoring Requirements” in § 60.13. ...

40 CFR 60.3038 - What continuous emission monitoring systems must I install?

Code of Federal Regulations, 2010 CFR

2010-07-01

... December 9, 2004 Model Rule-Monitoring § 60.3038 What continuous emission monitoring systems must I install? (a) You must install, calibrate, maintain, and operate continuous emission monitoring systems for... system according to the “Monitoring Requirements” in § 60.13. ...

Patient attitudes towards remote continuous vital signs monitoring on general surgery wards: An interview study.

PubMed

Downey, C L; Brown, J M; Jayne, D G; Randell, R

2018-06-01

Vital signs monitoring is used to identify deteriorating patients in hospital. The most common tool for vital signs monitoring is an early warning score, although emerging technologies allow for remote, continuous patient monitoring. A number of reviews have examined the impact of continuous monitoring on patient outcomes, but little is known about the patient experience. This study aims to discover what patients think of monitoring in hospital, with a particular emphasis on intermittent early warning scores versus remote continuous monitoring, in order to inform future implementations of continuous monitoring technology. Semi-structured interviews were undertaken with 12 surgical inpatients as part of a study testing a remote continuous monitoring device. All patients were monitored with both an early warning score and the new device. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Patients can see the value in remote, continuous monitoring, particularly overnight. However, patients appreciate the face-to-face aspect of early warning score monitoring as it allows for reassurance, social interaction, and gives them further opportunity to ask questions about their medical care. Early warning score systems are widely used to facilitate detection of the deteriorating patient. Continuous monitoring technologies may provide added reassurance. However, patients value personal contact with their healthcare professionals and remote monitoring should not replace this. We suggest that remote monitoring is best introduced in a phased manner, and initially as an adjunct to usual care, with careful consideration of the patient experience throughout. Copyright © 2018 Elsevier B.V. All rights reserved.

The clinical usefulness of extravascular lung water and pulmonary vascular permeability index to diagnose and characterize pulmonary edema: a prospective multicenter study on the quantitative differential diagnostic definition for acute lung injury/acute respiratory distress syndrome

PubMed Central

2012-01-01

Introduction Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is characterized by features other than increased pulmonary vascular permeability. Pulmonary vascular permeability combined with increased extravascular lung water content has been considered a quantitative diagnostic criterion of ALI/ARDS. This prospective, multi-institutional, observational study aimed to clarify the clinical pathophysiological features of ALI/ARDS and establish its quantitative diagnostic criteria. Methods The extravascular lung water index (EVLWI) and the pulmonary vascular permeability index (PVPI) were measured using the transpulmonary thermodilution method in 266 patients with PaO2/FiO2 ratio ≤ 300 mmHg and bilateral infiltration on chest radiography, in 23 ICUs of academic tertiary referral hospitals. Pulmonary edema was defined as EVLWI ≥ 10 ml/kg. Three experts retrospectively determined the pathophysiological features of respiratory insufficiency by considering the patients' history, clinical presentation, chest computed tomography and radiography, echocardiography, EVLWI and brain natriuretic peptide level, and the time course of all preceding findings under systemic and respiratory therapy. Results Patients were divided into the following three categories on the basis of the pathophysiological diagnostic differentiation of respiratory insufficiency: ALI/ARDS, cardiogenic edema, and pleural effusion with atelectasis, which were noted in 207 patients, 26 patients, and 33 patients, respectively. EVLWI was greater in ALI/ARDS and cardiogenic edema patients than in patients with pleural effusion with atelectasis (18.5 ± 6.8, 14.4 ± 4.0, and 8.3 ± 2.1, respectively; P < 0.01). PVPI was higher in ALI/ARDS patients than in cardiogenic edema or pleural effusion with atelectasis patients (3.2 ± 1.4, 2.0 ± 0.8, and 1.6 ± 0.5; P < 0.01). In ALI/ARDS patients, EVLWI increased with increasing pulmonary vascular permeability (r = 0.729, P < 0.01) and was weakly correlated with intrathoracic blood volume (r = 0.236, P < 0.01). EVLWI was weakly correlated with the PaO2/FiO2 ratio in the ALI/ARDS and cardiogenic edema patients. A PVPI value of 2.6 to 2.85 provided a definitive diagnosis of ALI/ARDS (specificity, 0.90 to 0.95), and a value < 1.7 ruled out an ALI/ARDS diagnosis (specificity, 0.95). Conclusion PVPI may be a useful quantitative diagnostic tool for ARDS in patients with hypoxemic respiratory failure and radiographic infiltrates. Trial registration UMIN-CTR ID UMIN000003627 PMID:23232188

40 CFR 60.2941 - What is my schedule for evaluating continuous emission monitoring systems?

Code of Federal Regulations, 2011 CFR

2011-07-01

... continuous emission monitoring systems? 60.2941 Section 60.2941 Protection of Environment ENVIRONMENTAL... emission monitoring systems? (a) Conduct annual evaluations of your continuous emission monitoring systems... emission monitoring systems daily and quarterly as specified in appendix F of this part. ...

Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment.

PubMed

2018-01-01

Type 1 diabetes is a condition in which the pancreas produces little or no insulin. People with type 1 diabetes must manage their blood glucose levels by monitoring the amount of glucose in their blood and administering appropriate amounts of insulin via injection or an insulin pump. Continuous glucose monitoring may be beneficial compared to self-monitoring of blood glucose using a blood glucose meter. It provides insight into a person's blood glucose levels on a continuous basis, and can identify whether blood glucose levels are trending up or down. We conducted a health technology assessment, which included an evaluation of clinical benefit, value for money, and patient preferences related to continuous glucose monitoring. We compared continuous glucose monitoring with self-monitoring of blood glucose using a finger-prick and a blood glucose meter. We performed a systematic literature search for studies published since January 1, 2010. We created a Markov model projecting the lifetime horizon of adults with type 1 diabetes, and performed a budget impact analysis from the perspective of the health care payer. We also conducted interviews and focus group discussions with people who self-manage their type 1 diabetes or support the management of a child with type 1 diabetes. Twenty studies were included in the clinical evidence review. Compared with self-monitoring of blood glucose, continuous glucose monitoring improved the percentage of time patients spent in the target glycemic range by 9.6% (95% confidence interval 8.0-11.2) to 10.0% (95% confidence interval 6.75-13.25) and decreased the number of severe hypoglycemic events.Continuous glucose monitoring was associated with higher costs and small increases in health benefits (quality-adjusted life-years). Incremental cost-effectiveness ratios (ICERs) ranged from $592,206 to $1,108,812 per quality-adjusted life-year gained in analyses comparing four continuous glucose monitoring interventions to usual care. However, the uncertainty around the ICERs was large. The net budget impact of publicly funding continuous glucose monitoring assuming a 20% annual increase in adoption of continuous glucose monitoring would range from $8.5 million in year 1 to $16.2 million in year 5.Patient engagement surrounding the topic of continuous glucose monitoring was robust. Patients perceived that these devices provided important social, emotional, and medical and safety benefits in managing type 1 diabetes, especially in children. Continuous glucose monitoring was more effective than self-monitoring of blood glucose in managing type 1 diabetes for some outcomes, such as time spent in the target glucose range and time spent outside the target glucose range (moderate certainty in this evidence). We were less certain that continuous glucose monitoring would reduce the number of severe hypoglycemic events. Compared with self-monitoring of blood glucose, the costs of continuous glucose monitoring were higher, with only small increases in health benefits. Publicly funding continuous glucose monitoring for the type 1 diabetes population in Ontario would result in additional costs to the health system over the next 5 years. Adult patients and parents of children with type 1 diabetes reported very positive experiences with continuous glucose monitoring. The high ongoing cost of continuous glucose monitoring devices was seen as the greatest barrier to their widespread use.

Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment

PubMed Central

Vandersluis, Stacey; Kabali, Conrad; Djalalov, Sandjar; Gajic-Veljanoski, Olga; Wells, David; Holubowich, Corinne

2018-01-01

Background Type 1 diabetes is a condition in which the pancreas produces little or no insulin. People with type 1 diabetes must manage their blood glucose levels by monitoring the amount of glucose in their blood and administering appropriate amounts of insulin via injection or an insulin pump. Continuous glucose monitoring may be beneficial compared to self-monitoring of blood glucose using a blood glucose meter. It provides insight into a person's blood glucose levels on a continuous basis, and can identify whether blood glucose levels are trending up or down. Methods We conducted a health technology assessment, which included an evaluation of clinical benefit, value for money, and patient preferences related to continuous glucose monitoring. We compared continuous glucose monitoring with self-monitoring of blood glucose using a finger-prick and a blood glucose meter. We performed a systematic literature search for studies published since January 1, 2010. We created a Markov model projecting the lifetime horizon of adults with type 1 diabetes, and performed a budget impact analysis from the perspective of the health care payer. We also conducted interviews and focus group discussions with people who self-manage their type 1 diabetes or support the management of a child with type 1 diabetes. Results Twenty studies were included in the clinical evidence review. Compared with self-monitoring of blood glucose, continuous glucose monitoring improved the percentage of time patients spent in the target glycemic range by 9.6% (95% confidence interval 8.0–11.2) to 10.0% (95% confidence interval 6.75–13.25) and decreased the number of severe hypoglycemic events. Continuous glucose monitoring was associated with higher costs and small increases in health benefits (quality-adjusted life-years). Incremental cost-effectiveness ratios (ICERs) ranged from $592,206 to $1,108,812 per quality-adjusted life-year gained in analyses comparing four continuous glucose monitoring interventions to usual care. However, the uncertainty around the ICERs was large. The net budget impact of publicly funding continuous glucose monitoring assuming a 20% annual increase in adoption of continuous glucose monitoring would range from $8.5 million in year 1 to $16.2 million in year 5. Patient engagement surrounding the topic of continuous glucose monitoring was robust. Patients perceived that these devices provided important social, emotional, and medical and safety benefits in managing type 1 diabetes, especially in children. Conclusions Continuous glucose monitoring was more effective than self-monitoring of blood glucose in managing type 1 diabetes for some outcomes, such as time spent in the target glucose range and time spent outside the target glucose range (moderate certainty in this evidence). We were less certain that continuous glucose monitoring would reduce the number of severe hypoglycemic events. Compared with self-monitoring of blood glucose, the costs of continuous glucose monitoring were higher, with only small increases in health benefits. Publicly funding continuous glucose monitoring for the type 1 diabetes population in Ontario would result in additional costs to the health system over the next 5 years. Adult patients and parents of children with type 1 diabetes reported very positive experiences with continuous glucose monitoring. The high ongoing cost of continuous glucose monitoring devices was seen as the greatest barrier to their widespread use. PMID:29541282

40 CFR Table 4 to Subpart Hhhhhhh... - Applicability of the General Provisions to Part 63

Code of Federal Regulations, 2014 CFR

2014-07-01

... SSM plan for continuous monitoring systems No. § 63.8(c)(5) Continuous opacity monitoring system...) Written procedures for continuous monitoring systems Yes, except for last sentence, which refers to an SSM plan. SSM plans are not required § 63.8(e) Continuous monitoring systems performance evaluation Yes...

40 CFR 60.1240 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission monitoring systems are operating correctly? 60.1240 Section 60.1240 Protection of Environment... Continuous Emission Monitoring § 60.1240 How do I make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous...

40 CFR 60.1240 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2013 CFR

2013-07-01

... emission monitoring systems are operating correctly? 60.1240 Section 60.1240 Protection of Environment... Continuous Emission Monitoring § 60.1240 How do I make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous...

40 CFR 60.1240 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission monitoring systems are operating correctly? 60.1240 Section 60.1240 Protection of Environment... Continuous Emission Monitoring § 60.1240 How do I make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous...

40 CFR 60.1240 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2014 CFR

2014-07-01

... emission monitoring systems are operating correctly? 60.1240 Section 60.1240 Protection of Environment... Continuous Emission Monitoring § 60.1240 How do I make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous...

40 CFR 60.1240 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission monitoring systems are operating correctly? 60.1240 Section 60.1240 Protection of Environment... Continuous Emission Monitoring § 60.1240 How do I make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous...

40 CFR Table 3 of Subpart Aaaa to... - Requirements for Validating Continuous Emission Monitoring Systems (CEMS)

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Requirements for Validating Continuous Emission Monitoring Systems (CEMS) 3 Table 3 of Subpart AAAA to Part 60 Protection of Environment... Continuous Emission Monitoring Systems (CEMS) For the following continuous emission monitoring systems Use...

40 CFR Table 3 of Subpart Aaaa to... - Requirements for Validating Continuous Emission Monitoring Systems (CEMS)

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 6 2011-07-01 2011-07-01 false Requirements for Validating Continuous Emission Monitoring Systems (CEMS) 3 Table 3 of Subpart AAAA to Part 60 Protection of Environment... Continuous Emission Monitoring Systems (CEMS) For the following continuous emission monitoring systems Use...

Accuracy of continuous noninvasive arterial pressure monitoring in living-liver donors during transplantation.

PubMed

Araz, Coskun; Zeyneloglu, Pinar; Pirat, Arash; Veziroglu, Nukhet; Camkiran Firat, Aynur; Arslan, Gulnaz

2015-04-01

Hemodynamic monitoring is vital during liver transplant surgeries because distinct hemodynamic changes are expected. The continuous noninvasive arterial pressure (CNAP) monitor is a noninvasive device for continuous arterial pressure measurement by a tonometric method. This study compared continuous noninvasive arterial pressure monitoring with invasive direct arterial pressure monitoring in living-liver donors during transplant. There were 40 patients analyzed while undergoing hepatic lobectomy for liver transplant. Invasive pressure monitoring was established at the radial artery and continuous noninvasive arterial pressure monitoring using a finger sensor was recorded simultaneously from the contralateral arm. Systolic, diastolic, and mean arterial pressures from the 2 methods were compared. Correlation between the 2 methods was calculated. A total of 5433 simultaneous measurements were obtained. For systolic arterial blood pressure, 55% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.479, continuous noninvasive arterial pressure bias was -0.3 mm Hg, and limits of agreement were 32.0 mm Hg. For diastolic arterial blood pressure, 50% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.630, continuous noninvasive arterial pressure bias was -0.4 mm Hg, and limits of agreement were 21.1 mm Hg. For mean arterial blood pressure, 60% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.692, continuous noninvasive arterial pressure bias was +0.4 mm Hg, and limits of agreement were 20.8 mm Hg. The 2 monitoring techniques did not show acceptable agreement. Our results suggest that continuous noninvasive arterial pressure monitoring is not equivalent to invasive arterial pressure monitoring in donors during living-donor liver transplant.

40 CFR 60.1760 - What is required for my continuous opacity monitoring system and how are the data used?

Code of Federal Regulations, 2011 CFR

2011-07-01

... opacity monitoring system and how are the data used? 60.1760 Section 60.1760 Protection of Environment... continuous opacity monitoring system and how are the data used? (a) Install, calibrate, maintain, and operate a continuous opacity monitoring system. (b) Install, evaluate, and operate each continuous opacity...

40 CFR Table 6 to Subpart Bbbb of... - Model Rule-Requirements for Validating Continuous Emission Monitoring Systems (CEMS)

Code of Federal Regulations, 2010 CFR

2010-07-01

... Continuous Emission Monitoring Systems (CEMS) 6 Table 6 to Subpart BBBB of Part 60 Protection of Environment...—Requirements for Validating Continuous Emission Monitoring Systems (CEMS) For the following continuous emission monitoring systems Use the following methods in appendix A of this part to validate poollutant concentratin...

40 CFR Table 6 to Subpart Bbbb of... - Model Rule-Requirements for Validating Continuous Emission Monitoring Systems (CEMS)

Code of Federal Regulations, 2011 CFR

2011-07-01

... Continuous Emission Monitoring Systems (CEMS) 6 Table 6 to Subpart BBBB of Part 60 Protection of Environment...—Requirements for Validating Continuous Emission Monitoring Systems (CEMS) For the following continuous emission monitoring systems Use the following methods in appendix A of this part to validate poollutant concentratin...

40 CFR 60.1335 - What is the minimum amount of monitoring data I must collect with my continuous parameter...

Code of Federal Regulations, 2011 CFR

2011-07-01

... monitoring data I must collect with my continuous parameter monitoring systems and is the data collection... parameter monitoring systems and is the data collection requirement enforceable? (a) Where continuous parameter monitoring systems are used, obtain 1-hour arithmetic averages for three parameters: (1) Load...

40 CFR 60.1335 - What is the minimum amount of monitoring data I must collect with my continuous parameter...

Code of Federal Regulations, 2010 CFR

2010-07-01

... monitoring data I must collect with my continuous parameter monitoring systems and is the data collection... parameter monitoring systems and is the data collection requirement enforceable? (a) Where continuous parameter monitoring systems are used, obtain 1-hour arithmetic averages for three parameters: (1) Load...

[Acute myocardial infarction as Eosinophilic granulomatosis with polyangiitis (formerly Churg Strauss syndrome) initial presentation].

PubMed

Sulaiman, Wahinuddin; Seung, Ong Ping; Noor, Sabariah Mohd

2014-01-01

Eosinophilic granulomatosis with polyangiitis is a rare primary vasculitic disease characterized by hypereosinophilia, late onset asthma and extravascular eosinophil granulomas. We report a case presented initially with acute myocardial infarction which later only proceed with asthma, skin manifestations and peripheral neuropathy. Laboratory parameters showed hypereosinohpilia with negative perinuclear pattern of antineutrophil cytoplasmic autoantibodies (p-ANCA). Skin biopsy showed leucocytoclastic vasculitis with eosinophilic infiltration while coronary angiography was normal. The patient's symptoms improved with IV methylprednisolone, pulse cyclophosphamide and azathioprine. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

Chronic calcific constrictive pericarditis complicating Churg-Strauss syndrome: first reported case.

PubMed

Aboukhoudir, Falah; Pansieri, Michel; Rekik, Sofiene

2014-10-01

Churg-Strauss syndrome is a necrotizing systemic vasculitis characterized by extravascular granulomas and eosinophilic infiltrates of small vessels. Although cardiac complications are considered to be relatively common, no case of constrictive calcified pericarditis has ever been previously described in this setting. In this report, we present the case of a 46-year-old man with Churg-Strauss syndrome, in whom we were able to document the development of symptomatic calcific constrictive pericarditis during a 10-year period despite long-term corticosteroid therapy. Georg Thieme Verlag KG Stuttgart · New York.

Microbiopsy/precision cutting devices

DOEpatents

Krulevitch, Peter A.; Lee, Abraham P.; Northrup, M. Allen; Benett, William J.

1999-01-01

Devices for performing tissue biopsy on a small scale (microbiopsy). By reducing the size of the biopsy tool and removing only a small amount of tissue or other material in a minimally invasive manner, the risks, costs, injury and patient discomfort associated with traditional biopsy procedures can be reduced. By using micromachining and precision machining capabilities, it is possible to fabricate small biopsy/cutting devices from silicon. These devices can be used in one of four ways 1) intravascularly, 2) extravascularly, 3) by vessel puncture, and 4) externally. Additionally, the devices may be used in precision surgical cutting.

21 CFR 26.45 - Monitoring continued equivalence.

Code of Federal Regulations, 2013 CFR

2013-04-01

... COMMUNITY Specific Sector Provisions for Medical Devices § 26.45 Monitoring continued equivalence. Monitoring activities will be carried out in accordance with § 26.69. ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Monitoring continued equivalence. 26.45 Section 26...

21 CFR 26.45 - Monitoring continued equivalence.

Code of Federal Regulations, 2012 CFR

2012-04-01

... COMMUNITY Specific Sector Provisions for Medical Devices § 26.45 Monitoring continued equivalence. Monitoring activities will be carried out in accordance with § 26.69. ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Monitoring continued equivalence. 26.45 Section 26...

21 CFR 26.45 - Monitoring continued equivalence.

Code of Federal Regulations, 2014 CFR

2014-04-01

... COMMUNITY Specific Sector Provisions for Medical Devices § 26.45 Monitoring continued equivalence. Monitoring activities will be carried out in accordance with § 26.69. ... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Monitoring continued equivalence. 26.45 Section 26...

21 CFR 26.45 - Monitoring continued equivalence.

Code of Federal Regulations, 2011 CFR

2011-04-01

... COMMUNITY Specific Sector Provisions for Medical Devices § 26.45 Monitoring continued equivalence. Monitoring activities will be carried out in accordance with § 26.69. ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Monitoring continued equivalence. 26.45 Section 26...

40 CFR 75.40 - General demonstration requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) CONTINUOUS EMISSION MONITORING Alternative Monitoring Systems § 75.40 General demonstration... continuous emission monitoring system may apply to the Administrator for approval of an alternative monitoring system (or system component) to determine average hourly emission data for SO2, NOX, and/or...

PNU-282987 improves the hemodynamic parameters by alleviating vasopermeability and tissue edema in dogs subjected to a lethal burns shock.

PubMed

Hu, Quan; Du, Ming-Hua; Hu, Sen; Chai, Jia-ke; Luo, Hong-Min; Hu, Xiao-Han; Zhang, Lin; Lin, Zhi-Long; Ma, Li; Wang, Huan; Sheng, Zhi-Yong

2014-01-01

Excessive inflammation and high vasopermeability can lead to blood volume loss and tissue edema, which can affect the resuscitation and prognosis for serious burn patients. In this experiment, we investigated the effect of PNU-282987, an α7 nicotine cholinergic receptor agonist on the hemodynamic parameters and survival rate by inhibiting vasopermeability and tissue edema during the fluid resuscitation for lethal burn shock. Forty Beagle dogs with intubation of the carotid artery and jugular vein 24 hours before the injury were subjected to 50% TBSA full-thickness burns, and were randomly divided into following four groups: no resuscitation group (group NR), venous fluid resuscitation group (group R), PNU-282987 treatment group (group P), and fluid resuscitation group plus PNU-282987 group (group RP), with 10 dogs in each group. Hemodynamic variables and biochemical parameters were determined with animals in a conscious and cooperative state. The plasma volume and the vasopermeability were determined by indocyanine green and fluorescein isothiocyanate-dextran, respectively. The level of tumor necrosis factor-α and interleukin-1β in plasma, and the water content of different organs were also determined. The mean arterial pressure, cardiac output, and plasma volume of all dogs decreased significantly, and the lung extravascular water index and pulmonary vascular permeability index increased remarkably after burn. The hemodynamic parameters deteriorated continually in group N dogs, and then anuria, hyperlactacidemia, and multiple organ dysfunctions developed. The mean arterial pressure and cardiac output of dogs in group R and group RP returned to preinjury levels at 48 hours postburn. The lung extravascular water index and pulmonary vascular permeability in group R were higher than those before preinjury. The dogs in group RP were found to have a significant increase in plasma volume and urine output, and a remarkable decrease in the levels of tumor necrosis factor-α, interleukin-1α, lactic acid, and organ functions compared with those of group R (P <.05). The survival rate of RP group (100%; 10/10) was significantly higher than that of group N (0; 0/10), group P (20%; 2/10), and group R (60%; 6/10). PNU-282987 combined with intravenous fluid resuscitation significantly improved hemodynamics and the survival rate in the early period after this lethal burn shock. The mechanism may be attributable to the lowering of the level of proinflammatory mediators, amelioration of vasopermeability-induced visceral edema, less of blood volume loss, and protection of vital organs through activation of cholinergic anti-inflammatory pathway.

40 CFR 60.1230 - What continuous emission monitoring systems must I install for gaseous pollutants?

Code of Federal Regulations, 2012 CFR

2012-07-01

... according to the “Monitoring Requirements” in § 60.13. (c) You must monitor the oxygen (or carbon dioxide... systems must I install for gaseous pollutants? 60.1230 Section 60.1230 Protection of Environment... Continuous Emission Monitoring § 60.1230 What continuous emission monitoring systems must I install for...

40 CFR 60.1230 - What continuous emission monitoring systems must I install for gaseous pollutants?

Code of Federal Regulations, 2014 CFR

2014-07-01

... according to the “Monitoring Requirements” in § 60.13. (c) You must monitor the oxygen (or carbon dioxide... systems must I install for gaseous pollutants? 60.1230 Section 60.1230 Protection of Environment... Continuous Emission Monitoring § 60.1230 What continuous emission monitoring systems must I install for...

40 CFR 60.1230 - What continuous emission monitoring systems must I install for gaseous pollutants?

Code of Federal Regulations, 2013 CFR

2013-07-01

... according to the “Monitoring Requirements” in § 60.13. (c) You must monitor the oxygen (or carbon dioxide... systems must I install for gaseous pollutants? 60.1230 Section 60.1230 Protection of Environment... Continuous Emission Monitoring § 60.1230 What continuous emission monitoring systems must I install for...

40 CFR 60.1260 - What is the minimum amount of monitoring data I must collect with my continuous emission...

Code of Federal Regulations, 2010 CFR

2010-07-01

... monitoring data I must collect with my continuous emission monitoring systems and is the data collection... monitoring systems and is the data collection requirement enforceable? (a) Where continuous emission monitoring systems are required, obtain 1-hour arithmetic averages. Make sure the averages for sulfur dioxide...

40 CFR 60.1260 - What is the minimum amount of monitoring data I must collect with my continuous emission...

Code of Federal Regulations, 2011 CFR

2011-07-01

... monitoring data I must collect with my continuous emission monitoring systems and is the data collection... monitoring systems and is the data collection requirement enforceable? (a) Where continuous emission monitoring systems are required, obtain 1-hour arithmetic averages. Make sure the averages for sulfur dioxide...

21 CFR 26.15 - Monitoring continued equivalence.

Code of Federal Regulations, 2014 CFR

2014-04-01

... COMMUNITY Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.15 Monitoring continued equivalence. Monitoring activities for the purpose of maintaining equivalence shall include review... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Monitoring continued equivalence. 26.15 Section 26...

21 CFR 26.15 - Monitoring continued equivalence.

Code of Federal Regulations, 2013 CFR

2013-04-01

... COMMUNITY Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.15 Monitoring continued equivalence. Monitoring activities for the purpose of maintaining equivalence shall include review... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Monitoring continued equivalence. 26.15 Section 26...

21 CFR 26.15 - Monitoring continued equivalence.

Code of Federal Regulations, 2012 CFR

2012-04-01

... COMMUNITY Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.15 Monitoring continued equivalence. Monitoring activities for the purpose of maintaining equivalence shall include review... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Monitoring continued equivalence. 26.15 Section 26...

SU-D-207A-02: Possible Characterization of the Brain Tumor Vascular Environment by a Novel Strategy of Quantitative Analysis in Dynamic Contrast Enhanced MR Imaging: A Combination of Both Patlak and Logan Analyses

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

Yee, S; Chinnaiyan, P; Wloch, J

Purpose: The majority of quantitative analyses involving dynamic contrast enhanced (DCE) MRI have been performed to obtain kinetic parameters such as Ktrans and ve. Such analyses are generally performed assuming a “reversible” tissue compartment, where the tracer is assumed to be rapidly equilibrated between the plasma and tissue compartments. However, some tumor vascular environments may be more suited for a “non-reversible” tissue compartment, where, as with FDG PET imaging, the tracer is continuously deposited into the tissue compartment (or the return back to the plasma compartment is very slow in the imaging time scale). Therefore, Patlak and Logan analyses, whichmore » represent tools for the “non-reversible” and “reversible” modeling, respectively, were performed to better characterize the brain tumor vascular environment. Methods: A voxel-by-voxel analysis was performed to generate both Patlak and Logan plots in two brain tumor patients, one with grade III astrocytoma and the other with grade IV astrocytoma or glioblastoma. The slopes of plots and the r-square were then obtained by linear fitting and compared for each voxel. Results: The 2-dimensional scatter plots of Logan (Y-axis) vs. Patlak slopes (X-axis) clearly showed increased Logan slopes for glioblastoma (Figure 3A). The scatter plots of goodness-of-fit (Figure 3B) also suggested glioblastoma, relative to grade III astrocytoma, might consist of more voxels that are kinetically Logan-like (i.e. rapidly equilibrated extravascular space and active vascular environment). Therefore, the enhanced Logan-like behavior (and the Logan slope) in glioblastoma may imply an increased fraction of active vascular environment, while the enhanced Patlak-like behavior implies the vascular environment permitting a relatively slower washout of the tracer. Conclusion: Although further verification is required, the combination of Patlak and Logan analyses in DCE MRI may be useful in characterizing the tumor vascular environment, and thus, may have implications in tumor grading and monitoring response to anti-vascular therapy.« less

40 CFR 60.2939 - What continuous emission monitoring systems must I install?

Code of Federal Regulations, 2012 CFR

2012-07-01

... systems must I install? 60.2939 Section 60.2939 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... and Qualification Monitoring § 60.2939 What continuous emission monitoring systems must I install? (a) You must install, calibrate, maintain, and operate continuous emission monitoring systems for carbon...

40 CFR 62.15190 - Am I exempt from any 40 CFR part 60 appendix B or appendix F requirements to evaluate continuous...

Code of Federal Regulations, 2010 CFR

2010-07-01

... appendix B or appendix F requirements to evaluate continuous emission monitoring systems? 62.15190 Section... evaluate continuous emission monitoring systems? Yes, the accuracy tests for your sulfur dioxide continuous emission monitoring system require you to also evaluate your oxygen (or carbon dioxide) continuous emission...

40 CFR 62.15190 - Am I exempt from any 40 CFR part 60 appendix B or appendix F requirements to evaluate continuous...

Code of Federal Regulations, 2011 CFR

2011-07-01

... appendix B or appendix F requirements to evaluate continuous emission monitoring systems? 62.15190 Section... evaluate continuous emission monitoring systems? Yes, the accuracy tests for your sulfur dioxide continuous emission monitoring system require you to also evaluate your oxygen (or carbon dioxide) continuous emission...

40 CFR 60.1730 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission monitoring systems are operating correctly? 60.1730 Section 60.1730 Protection of Environment... continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure oxygen (or carbon dioxide...

40 CFR 60.1730 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2014 CFR

2014-07-01

... emission monitoring systems are operating correctly? 60.1730 Section 60.1730 Protection of Environment... continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure oxygen (or carbon dioxide...

40 CFR 62.15185 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission monitoring systems are operating correctly? 62.15185 Section 62.15185 Protection of Environment... make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure oxygen (or...

40 CFR 60.1730 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission monitoring systems are operating correctly? 60.1730 Section 60.1730 Protection of Environment... continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure oxygen (or carbon dioxide...

40 CFR 60.1730 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2013 CFR

2013-07-01

... emission monitoring systems are operating correctly? 60.1730 Section 60.1730 Protection of Environment... continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure oxygen (or carbon dioxide...

40 CFR 62.15185 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2014 CFR

2014-07-01

... emission monitoring systems are operating correctly? 62.15185 Section 62.15185 Protection of Environment... make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure oxygen (or...

40 CFR 60.1730 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission monitoring systems are operating correctly? 60.1730 Section 60.1730 Protection of Environment... continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure oxygen (or carbon dioxide...

40 CFR 62.15185 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission monitoring systems are operating correctly? 62.15185 Section 62.15185 Protection of Environment... make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure oxygen (or...

40 CFR 62.15185 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission monitoring systems are operating correctly? 62.15185 Section 62.15185 Protection of Environment... make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure oxygen (or...

40 CFR 62.15185 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2013 CFR

2013-07-01

... emission monitoring systems are operating correctly? 62.15185 Section 62.15185 Protection of Environment... make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure oxygen (or...

40 CFR 60.1315 - Must I meet other requirements for continuous monitoring?

Code of Federal Regulations, 2012 CFR

2012-07-01

... continuous monitoring? 60.1315 Section 60.1315 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Requirements § 60.1315 Must I meet other requirements for continuous monitoring? You must also monitor three... at the inlet of your particulate matter air pollution control device. (c) Carbon feed rate if...

40 CFR 60.1315 - Must I meet other requirements for continuous monitoring?

Code of Federal Regulations, 2010 CFR

2010-07-01

... continuous monitoring? 60.1315 Section 60.1315 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Requirements § 60.1315 Must I meet other requirements for continuous monitoring? You must also monitor three... at the inlet of your particulate matter air pollution control device. (c) Carbon feed rate if...

40 CFR 60.1315 - Must I meet other requirements for continuous monitoring?

Code of Federal Regulations, 2014 CFR

2014-07-01

... continuous monitoring? 60.1315 Section 60.1315 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Requirements § 60.1315 Must I meet other requirements for continuous monitoring? You must also monitor three... at the inlet of your particulate matter air pollution control device. (c) Carbon feed rate if...

40 CFR 60.1315 - Must I meet other requirements for continuous monitoring?

Code of Federal Regulations, 2013 CFR

2013-07-01

... continuous monitoring? 60.1315 Section 60.1315 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Requirements § 60.1315 Must I meet other requirements for continuous monitoring? You must also monitor three... at the inlet of your particulate matter air pollution control device. (c) Carbon feed rate if...

40 CFR 60.1315 - Must I meet other requirements for continuous monitoring?

Code of Federal Regulations, 2011 CFR

2011-07-01

... continuous monitoring? 60.1315 Section 60.1315 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Requirements § 60.1315 Must I meet other requirements for continuous monitoring? You must also monitor three... at the inlet of your particulate matter air pollution control device. (c) Carbon feed rate if...

Environmental Technology Verification Report for Applikon MARGA Semi-Continuous Ambient Air Monitoring System

EPA Science Inventory

The verification test was conducted oer a period of 30 days (October 1 to October 31, 2008) and involved the continuous operation of duplicate semi-continuous monitoring technologies at the Burdens Creek Air Monitoring Site, an existing ambient-air monitoring station located near...

Evaluation of heart perfusion in patients with acute myocardial infarction using dynamic contrast-enhanced magnetic resonance imaging.

PubMed

Nielsen, Gitte; Fritz-Hansen, Thomas; Dirks, Christina G; Jensen, Gorm B; Larsson, Henrik B W

2004-09-01

To investigate the diagnostic ability of quantitative magnetic resonance imaging (MRI) heart perfusion in acute heart patients, a fast, multislice dynamic contrast-enhanced MRI sequence was applied to patients with acute myocardial infarction. Seven patients with acute transmural myocardial infarction were studied using a Turbo-fast low angle shot (FLASH) MRI sequence to monitor the first pass of an extravascular contrast agent (CA), gadolinium diethylene triamine pentaacetic acid (Gd-DTPA). Quantitation of perfusion, expressed as Ki (mL/100 g/minute), in five slices, each having 60 sectors, provided an estimation of the severity and extent of the perfusion deficiency. Reperfusion was assessed both by noninvasive criteria and by coronary angiography (CAG). The Ki maps clearly delineated the infarction in all patients. Thrombolytic treatment was clearly beneficial in one case, but had no effect in the two other cases. Over the time-course of the study, normal perfusion values were not reestablished following thrombolytic treatment in all cases investigated. This study shows that quantitative MRI perfusion values can be obtained from acutely ill patients following acute myocardial infarction. The technique provides information on both the volume and severity of affected myocardial tissue, enabling the power of treatment regimes to be assessed objectively, and this approach should aid individual patient stratification and prognosis. Copyright 2004 Wiley-Liss, Inc.

Is there really a clinical benefit of using minimized extracorporeal circulation for coronary artery bypass grafting?

PubMed

Schöttler, J; Lutter, G; Böning, A; Soltau, D; Bein, B; Caliebe, D; Haake, N; Schoeneich, F; Cremer, J

2008-03-01

Minimized extracorporeal circulation is intended to reduce the negative effects associated with cardiopulmonary bypass. This prospective study was performed to evaluate whether minimized extracorporeal circulation has a clinical benefit for coronary artery surgery patients compared to standard extracorporeal circulation. Sixty patients were randomized into two study groups: 30 patients underwent coronary artery bypass grafting using minimized extracorporeal circulation and 30 patients were operated using standard extracorporeal circulation. Baseline characteristics, intraoperative details, postoperative data, perioperative blood chemistry determinations of hematocrit, platelets, muscle-brain fraction of the creatine kinase, cardiac troponin T and colloid osmotic pressure as measurements of intrathoracic blood volume index and extravascular lung water index were compared. Baseline characteristics and intraoperative details of both groups were similar. Patients who underwent minimized extracorporeal circulation showed more short-term dependency on norepinephrine ( P < 0.01). Their maximal postoperative muscle-brain fraction of the creatine kinase was lower ( P < 0.05) and their hematocrit on arrival in the intensive care unit was higher ( P < 0.01). No other significant differences were found. In both collectives, values for hematocrit ( P < 0.001), platelets ( P < 0.001), colloid osmotic pressure ( P < 0.001) and intrathoracic blood volume index ( P < 0.05) decreased, while the extravascular lung water index did not change significantly during cardiopulmonary bypass. A clinical advantage of minimized over standard extracorporeal circulation was not found. Furthermore, a higher number of patients in the minimized extracorporeal circulation group required postoperative norepinephrine infusions for hemodynamic stabilization. In summary, the presumed superiority of minimized extracorporeal circulation for coronary artery bypass grafting in standard patients could not be confirmed.

Production and characterization of a novel long-acting Herceptin-targeted nanobubble contrast agent specific for Her-2-positive breast cancers.

PubMed

Jiang, Qiongchao; Hao, Shaoyun; Xiao, Xiaoyun; Yao, Jiyi; Ou, Bing; Zhao, Zizhuo; Liu, Fengtao; Pan, Xin; Luo, Baoming; Zhi, Hui

2016-05-01

There is an unmet need for specific and sensitive imaging techniques to assess the efficacy of breast cancer therapy, particularly Her-2-expressing cancers. Ultrasonic microbubbles are being developed for use as diagnostic and therapeutic tools. However, nanobubbles circulate longer, are smaller, and diffuse into extravascular tissue to specifically bind target molecules. Here, we characterize a novel Herceptin-conjugated nanobubble for use against Her-2-expressing tumors. Phospholipid-shelled nanobubbles conjugated with Herceptin (NBs-Her) were fabricated using a thin-film hydration method and characterized in vitro in breast cancer cell lines and in vivo in a mouse model. The average size of the unconjugated nanobubbles (NBs-Blank) and NBs-Her was 447.1 ± 18.4 and 613.0 ± 25.4 nm, respectively. In cell culture, the NBs-Her adhered to Her-2-positive cells significantly better than to Her-2-negative cells (p < 0.05). In vivo, the peak intensity and the half-time to washout of the NBs-Her were significantly greater than those of the NBs-Blank (p < 0.05). In addition, contrast-enhanced ultrasound imaging quality was improved through the use of the NBs-Her. The nanobubbles were able to penetrate into tumor tissue to allow extravascular imaging, but did not penetrate normal skeletal muscle. The Herceptin-conjugated nanobubble had many properties that made it useful for in vivo imaging, including longer circulation time and better tumor selectivity. This platform may be able to provide targeted delivery of therapeutic drugs or genes.

Influence of anatomical dominance and hypertension on coronary conduit arterial and microcirculatory flow patterns: a multiscale modeling study.

PubMed

Mynard, Jonathan P; Smolich, Joseph J

2016-07-01

Coronary hemodynamics are known to be affected by intravascular and extravascular factors that vary regionally and transmurally between the perfusion territories of left and right coronary arteries. However, despite clinical evidence that left coronary arterial dominance portends greater cardiovascular risk, relatively little is known about the effects of left or right dominance on regional conduit arterial and microcirculatory blood flow patterns, particularly in the presence of systemic or pulmonary hypertension. We addressed this issue using a multiscale numerical model of the human coronary circulation situated in a closed-loop cardiovascular model. The coronary model represented left or right dominant anatomies and accounted for transmural and regional differences in vascular properties and extravascular compression. Regional coronary flow dynamics of the two anatomical variants were compared under normotensive conditions, raised systemic or pulmonary pressures with maintained flow demand, and after accounting for adaptations known to occur in acute and chronic hypertensive states. Key findings were that 1) right coronary arterial flow patterns were strongly influenced by dominance and systemic/pulmonary hypertension; 2) dominance had minor effects on left coronary arterial and all microvascular flow patterns (aside from mean circumflex flow); 3) although systemic hypertension favorably increased perfusion pressure, this benefit varied regionally and transmurally and was offset by increased left ventricular and septal flow demands; and 4) pulmonary hypertension had a substantial negative effect on right ventricular and septal flows, which was exacerbated by greater metabolic demands. These findings highlight the importance of interactions between coronary arterial dominance and hypertension in modulating coronary hemodynamics. Copyright © 2016 the American Physiological Society.

Formulation and acoustic studies of a new phase-shift agent for diagnostic and therapeutic ultrasound.

PubMed

Sheeran, Paul S; Luois, Samantha; Dayton, Paul A; Matsunaga, Terry O

2011-09-06

Recent efforts in the area of acoustic droplet vaporization with the objective of designing extravascular ultrasound contrast agents has led to the development of stabilized, lipid-encapsulated nanodroplets of the highly volatile compound decafluorobutane (DFB). We developed two methods of generating DFB droplets, the first of which involves condensing DFB gas (boiling point from -1.1 to -2 °C) followed by extrusion with a lipid formulation in HEPES buffer. Acoustic droplet vaporization of micrometer-sized lipid-coated droplets at diagnostic ultrasound frequencies and mechanical indices were confirmed optically. In our second formulation methodology, we demonstrate the formulation of submicrometer-sized lipid-coated nanodroplets based upon condensation of preformed microbubbles containing DFB. The droplets are routinely in the 200-300 nm range and yield microbubbles on the order of 1-5 μm once vaporized, consistent with ideal gas law expansion predictions. The simple and effective nature of this methodology allows for the development of a variety of different formulations that can be used for imaging, drug and gene delivery, and therapy. This study is the first to our knowledge to demonstrate both a method of generating ADV agents by microbubble condensation and formulation of primarily submicrometer droplets of decafluorobutane that remain stable at physiological temperatures. Finally, activation of DFB nanodroplets is demonstrated using pressures within the FDA guidelines for diagnostic imaging, which may minimize the potential for bioeffects in humans. This methodology offers a new means of developing extravascular contrast agents for diagnostic and therapeutic applications. © 2011 American Chemical Society

Effect of intravascular-to-extravascular water exchange on the determination of blood-to-tissue transfer constant by magnetic resonance imaging.

PubMed

Cao, Y; Brown, S L; Knight, R A; Fenstermacher, J D; Ewing, J R

2005-02-01

Water exchange across capillary walls couples intra- and extravascular (IV-EV) protons and their magnetization. A bolus i.v. injection of an extracellular MRI contrast agent (MRCA) causes a large increase in the spin-lattice relaxation rate, R1, of water protons in the plasma and blood cells within the capillaries and changes the effective relaxation rate R1eff in tissue via IV-EV water exchange. An analysis of the effect of plasma-red cell and IV-EV water exchange on the MRI-measured influx and permeability of capillaries to the MRCA is presented and focused on the brain and the blood-brain barrier. The effect of arrival of a bolus of an MRCA in the capillary on the relaxation rate R1eff in tissue via IV-EV water exchange occurs more rapidly than the MRCA uptake in tissue and can dominate the initial time curve of the R1eff change before the MRCA uptake in tissue becomes significant. This raises the possibility that (tissue dependent) IV-EV rate of exchange of water molecules can affect estimates of MRCA transfer constant. We demonstrate that an approach that considers IV-EV water exchange and uses the theoretical model of blood-brain tracer distribution developed by Patlak et al. (J Cereb Blood Flow Metab 1983;3:1-7) can lead to an accurate estimate of the MRI-determined influx rate constant of the MRCA and to an underestimation of the tissue blood volume.

A new method to evaluate extravascular albumin and blood cell accumulation in the lung

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

Bureau, M.F.; Malanchere, E.; Pretolani, M.

A method was developed to evaluate blood volume, accumulation of extravascular albumin (ALBev), and platelet (PL) or polymorphonuclear neutrophil (PMN) sequestration in lungs after challenge with inflammatory agents. Erythrocytes (RBC), albumin, and PL or PMN, labeled with 99mTc, 131I, and 111In,-respectively, were injected intravenously into anesthetized and ventilated guinea pigs. The different parameters were calculated from in vivo lung and blood radioactivity values. When N-formyl-L-methionyl-L-leucyl-L-phenylalanine (fMLP) was injected intravenously at 10 micrograms.kg-1, lung RBC content dropped by 14.7 +/- 1.8% (SE; n = 10), indicating a reduced lung blood volume, ALBev rose to 15.0 +/- 3.2% of the initial albuminmore » vascular content, and the circulating PMN were sequestered by 9.2 +/- 1.7%. A transient PL sequestration was also observed 1 min after the injection of fMLP (13.1 +/- 2.0%, n = 7). During the infusion of 1-O-hexadecyl-2-acetyl-sn-glycero-3-phosphorylcholine, the lung PL content rose dose dependently from 10.1 +/- 2.2% of the circulating pool with 3 ng.kg-1.min-1 to 54.9 +/- 20.1% with 44 ng.kg-1.min-1, the lung RBC content decreased by greater than 10%, and the ALBev increased beyond 16%. Our method allows the study of the correlations between cell entrapment and the variations of the albumin exchanges in the lung and may lead to a better understanding of the correlations between cell activation and edema.« less

A randomized clinical trial of hydroxymethylglutaryl- coenzyme a reductase inhibition for acute lung injury (The HARP Study).

PubMed

Craig, Thelma R; Duffy, Martin J; Shyamsundar, Murali; McDowell, Cliona; O'Kane, Cecilia M; Elborn, J Stuart; McAuley, Daniel F

2011-03-01

There is no effective pharmacological treatment for acute lung injury (ALI). Statins are a potential new therapy because they modify many of the underlying processes important in ALI. To test whether simvastatin improves physiological and biological outcomes in ALI. We conducted a randomized, double-blinded, placebo-controlled trial in patients with ALI. Patients received 80 mg simvastatin or placebo until cessation of mechanical ventilation or up to 14 days. Extravascular lung water was measured using thermodilution. Measures of pulmonary and nonpulmonary organ function were assessed daily. Pulmonary and systemic inflammation was assessed by bronchoalveolar lavage fluid and plasma cytokines. Systemic inflammation was also measured by plasma C-reactive protein. Sixty patients were recruited. Baseline characteristics, including demographics and severity of illness scores, were similar in both groups. At Day 7, there was no difference in extravascular lung water. By Day 14, the simvastatin-treated group had improvements in nonpulmonary organ dysfunction. Oxygenation and respiratory mechanics improved, although these parameters failed to reach statistical significance. Intensive care unit mortality was 30% in both groups. Simvastatin was well tolerated, with no increase in adverse events. Simvastatin decreased bronchoalveolar lavage IL-8 by 2.5-fold (P = 0.04). Plasma C-reactive protein decreased in both groups but failed to achieve significance in the placebo-treated group. Treatment with simvastatin appears to be safe and may be associated with an improvement in organ dysfunction in ALI. These clinical effects may be mediated by a reduction in pulmonary and systemic inflammation. Clinical trial registered with www.controlled-trials.com (ISRCTN70127774).

Tumors: Wounds that do not heal--Redux

PubMed Central

Dvorak, Harold F.

2014-01-01

Similarities between tumors and the inflammatory response associated with wound healing have been recognized for more than 150 years and continue to intrigue. Some years ago, based on our then recent discovery of vascular permeability factor (VPF)/vascular endothelial growth factor (VEGF), I suggested that tumors behaved as wounds that do not heal. More particularly, I proposed that tumors co-opted the wound healing response in order to induce the stroma they required for maintenance and growth. Work over the past few decades has supported this hypothesis and has put it on a firmer molecular basis. In outline, VPF/VEGF initiates a sequence of events in both tumors and wounds that includes the following: increased vascular permeability; extravasation of plasma, fibrinogen and other plasma proteins; activation of the clotting system outside the vascular system; deposition of an extravascular fibrin gel which serves as a provisional stroma and a favorable matrix for cell migration; induction of angiogenesis and arterio-venogenesis; subsequent degradation of fibrin and its replacement by “granulation tissue” (highly vascular connective tissue); and, finally, vascular resorption and collagen synthesis, resulting in the formation of dense fibrous connective tissue (called “scar tissue” in wounds and “desmoplasia” in cancer). A similar sequence of events also takes place in a variety of important inflammatory diseases that involve cellular immunity. PMID:25568067

Tumors: wounds that do not heal-redux.

PubMed

Dvorak, Harold F

2015-01-01

Similarities between tumors and the inflammatory response associated with wound healing have been recognized for more than 150 years and continue to intrigue. Some years ago, based on our then recent discovery of vascular permeability factor (VPF)/VEGF, I suggested that tumors behaved as wounds that do not heal. More particularly, I proposed that tumors co-opted the wound-healing response to induce the stroma they required for maintenance and growth. Work over the past few decades has supported this hypothesis and has put it on a firmer molecular basis. In outline, VPF/VEGF initiates a sequence of events in both tumors and wounds that includes the following: increased vascular permeability; extravasation of plasma, fibrinogen and other plasma proteins; activation of the clotting system outside the vascular system; deposition of an extravascular fibrin gel that serves as a provisional stroma and a favorable matrix for cell migration; induction of angiogenesis and arterio-venogenesis; subsequent degradation of fibrin and its replacement by "granulation tissue" (highly vascular connective tissue); and, finally, vascular resorption and collagen synthesis, resulting in the formation of dense fibrous connective tissue (called "scar tissue" in wounds and "desmoplasia" in cancer). A similar sequence of events also takes place in a variety of important inflammatory diseases that involve cellular immunity. ©2015 American Association for Cancer Research.

76 FR 25277 - Lowering Miners' Exposure to Respirable Coal Mine Dust, Including Continuous Personal Dust Monitors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... 1219-AB64 Lowering Miners' Exposure to Respirable Coal Mine Dust, Including Continuous Personal Dust... to Respirable Coal Mine Dust, Including Continuous Personal Dust Monitors. This extension gives... Miners' Exposure to Respirable Coal Mine Dust, Including Continuous Personal Dust Monitors. In response...

40 CFR 60.1720 - What continuous emission monitoring systems must I install for gaseous pollutants?

Code of Federal Regulations, 2014 CFR

2014-07-01

... systems must I install for gaseous pollutants? 60.1720 Section 60.1720 Protection of Environment... or Before August 30, 1999 Model Rule-Continuous Emission Monitoring § 60.1720 What continuous..., maintain, and operate continuous emission monitoring systems for oxygen (or carbon dioxide), sulfur dioxide...

40 CFR 60.1720 - What continuous emission monitoring systems must I install for gaseous pollutants?

Code of Federal Regulations, 2012 CFR

2012-07-01

... systems must I install for gaseous pollutants? 60.1720 Section 60.1720 Protection of Environment... or Before August 30, 1999 Model Rule-Continuous Emission Monitoring § 60.1720 What continuous..., maintain, and operate continuous emission monitoring systems for oxygen (or carbon dioxide), sulfur dioxide...

40 CFR 60.1720 - What continuous emission monitoring systems must I install for gaseous pollutants?

Code of Federal Regulations, 2013 CFR

2013-07-01

... systems must I install for gaseous pollutants? 60.1720 Section 60.1720 Protection of Environment... or Before August 30, 1999 Model Rule-Continuous Emission Monitoring § 60.1720 What continuous..., maintain, and operate continuous emission monitoring systems for oxygen (or carbon dioxide), sulfur dioxide...

40 CFR 60.2940 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2013 CFR

2013-07-01

... emission monitoring systems are operating correctly? 60.2940 Section 60.2940 Protection of Environment... 16, 2006 Monitoring § 60.2940 How do I make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous...

40 CFR 60.2940 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2014 CFR

2014-07-01

... emission monitoring systems are operating correctly? 60.2940 Section 60.2940 Protection of Environment... 16, 2006 Monitoring § 60.2940 How do I make sure my continuous emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous...

Professionals' views of fetal-monitoring support the development of devices to provide objective longer-term assessment of fetal wellbeing.

PubMed

Brown, Rebecca; Johnstone, Edward D; Heazell, Alexander E P

2016-01-01

Continuous longer-term fetal monitoring has been proposed to address limitations of current technologies in the detection of fetal compromise. We aimed to assess professionals' views regarding current fetal-monitoring techniques and proposed longer-term continuous fetal monitoring. A questionnaire was designed and validated to assess obstetricians' and midwives' use of current fetal-monitoring techniques and their views towards continuous monitoring. 125 of 173 received responses (72% obstetricians, 28% midwives) were analysed. Professionals had the strongest views about supporting evidence for the most commonly employed fetal-monitoring techniques (maternal awareness of fetal movements, ultrasound assessment of fetal growth and umbilical artery Doppler). 45.1% of professionals agreed that a continuous monitoring device would be beneficial (versus 28.7% who disagreed); this perceived benefit was not influenced by professionals' views regarding current techniques or professional background. Professionals have limited experience of continuous fetal monitoring, but most respondents believed that it would increase maternal anxiety (64.3%) and would have concerns with its use in clinical practice (81.7%). Continuous fetal monitoring would be acceptable to the majority of professionals. However, development of these technologies must be accompanied by extended examination of professionals' and women's views to determine barriers to its introduction.

40 CFR 60.1735 - Am I exempt from any appendix B or appendix F requirements to evaluate continuous emission...

Code of Federal Regulations, 2012 CFR

2012-07-01

... appendix F requirements to evaluate continuous emission monitoring systems? 60.1735 Section 60.1735... Combustion Units Constructed on or Before August 30, 1999 Model Rule-Continuous Emission Monitoring § 60.1735... to also evaluate your oxygen (or carbon dioxide) continuous emission monitoring system. Therefore...

40 CFR 60.1760 - What is required for my continuous opacity monitoring system and how are the data used?

Code of Federal Regulations, 2010 CFR

2010-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... monitoring system according to § 60.13. (c) Complete an initial evaluation of your continuous opacity monitoring system according to Performance Specification 1 in appendix B of this part. Complete the...

40 CFR 60.1245 - Am I exempt from any appendix B or appendix F requirements to evaluate continuous emission...

Code of Federal Regulations, 2011 CFR

2011-07-01

... appendix F requirements to evaluate continuous emission monitoring systems? 60.1245 Section 60.1245... appendix F requirements to evaluate continuous emission monitoring systems? Yes, the accuracy tests for your sulfur dioxide continuous emission monitoring system require you to also evaluate your oxygen (or...

40 CFR 60.1735 - Am I exempt from any appendix B or appendix F requirements to evaluate continuous emission...

Code of Federal Regulations, 2011 CFR

2011-07-01

... appendix F requirements to evaluate continuous emission monitoring systems? 60.1735 Section 60.1735... systems? Yes, the accuracy tests for your sulfur dioxide continuous emission monitoring system require you to also evaluate your oxygen (or carbon dioxide) continuous emission monitoring system. Therefore...

40 CFR 60.1735 - Am I exempt from any appendix B or appendix F requirements to evaluate continuous emission...

Code of Federal Regulations, 2010 CFR

2010-07-01

... appendix F requirements to evaluate continuous emission monitoring systems? 60.1735 Section 60.1735... systems? Yes, the accuracy tests for your sulfur dioxide continuous emission monitoring system require you to also evaluate your oxygen (or carbon dioxide) continuous emission monitoring system. Therefore...

40 CFR 60.1245 - Am I exempt from any appendix B or appendix F requirements to evaluate continuous emission...

Code of Federal Regulations, 2010 CFR

2010-07-01

... appendix F requirements to evaluate continuous emission monitoring systems? 60.1245 Section 60.1245... appendix F requirements to evaluate continuous emission monitoring systems? Yes, the accuracy tests for your sulfur dioxide continuous emission monitoring system require you to also evaluate your oxygen (or...

40 CFR 60.1715 - What types of continuous emission monitoring must I perform?

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines... must I perform? To continuously monitor emissions, you must perform four tasks: (a) Install continuous...

40 CFR 60.4345 - What are the requirements for the continuous emission monitoring system equipment, if I choose to...

Code of Federal Regulations, 2010 CFR

2010-07-01

... continuous emission monitoring system equipment, if I choose to use this option? 60.4345 Section 60.4345... PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Stationary Combustion Turbines Monitoring § 60.4345 What are the requirements for the continuous emission monitoring system equipment, if I...

40 CFR 60.1280 - What must I do if any of my continuous emission monitoring systems are temporarily unavailable to...

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission monitoring systems are temporarily unavailable to meet the data collection requirements? 60.1280... Modification or Reconstruction is Commenced After June 6, 2001 Continuous Emission Monitoring § 60.1280 What must I do if any of my continuous emission monitoring systems are temporarily unavailable to meet the...

40 CFR 62.15215 - What is required for my continuous opacity monitoring system and how are the data used?

Code of Federal Regulations, 2011 CFR

2011-07-01

... opacity monitoring system and how are the data used? 62.15215 Section 62.15215 Protection of Environment... required for my continuous opacity monitoring system and how are the data used? (a) Install, calibrate, maintain, and operate a continuous opacity monitoring system. (b) Install, evaluate, and operate each...

40 CFR 60.4345 - What are the requirements for the continuous emission monitoring system equipment, if I choose to...

Code of Federal Regulations, 2011 CFR

2011-07-01

... continuous emission monitoring system equipment, if I choose to use this option? 60.4345 Section 60.4345... PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Stationary Combustion Turbines Monitoring § 60.4345 What are the requirements for the continuous emission monitoring system equipment, if I...

40 CFR 60.1280 - What must I do if any of my continuous emission monitoring systems are temporarily unavailable to...

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission monitoring systems are temporarily unavailable to meet the data collection requirements? 60.1280... Modification or Reconstruction is Commenced After June 6, 2001 Continuous Emission Monitoring § 60.1280 What must I do if any of my continuous emission monitoring systems are temporarily unavailable to meet the...

Improving nurses' knowledge of continuous ST-segment monitoring.

PubMed

Chronister, Connie

2014-01-01

Continuous ST-segment monitoring can result in detection of myocardial ischemia, but in clinical practice, continuous ST-segment monitoring is conducted incorrectly and underused by many registered nurses (RNs). Many RNs are unable to correctly institute ST-segment monitoring guidelines because of a lack of education. To evaluate whether an educational intervention, provided to 32 RNs, increases knowledge and correct clinical decision making (CDM) for the use of continuous ST-segment monitoring. At a single institution, an ST-segment monitoring class was provided to RNs in 2 cardiovascular units. Knowledge and correct CDM instruments were used for a baseline pretest and subsequent posttest after ST-segment monitoring education. Statistical significance between pretest and posttest scores for knowledge and correct CDM practice was noted with dependent t tests (P = .0001). Many RNs responsible for electrocardiographic monitoring are not aware of evidence-based ST-segment monitoring practice guidelines and cannot properly place precordial leads needed for ST-segment monitoring. Knowledge and correct CDM with ST-segment monitoring can be improved with focused education.

PROFESSIONAL FLASH CONTINUOUS GLUCOSE MONITORING WITH AMBULATORY GLUCOSE PROFILE REPORTING TO SUPPLEMENT A1C: RATIONALE AND PRACTICAL IMPLEMENTATION.

PubMed

Hirsch, Irl B; Verderese, Carol A

2017-11-01

Recent consensus statements strongly advocate downloading and interpreting continuous glucose data for diabetes management in patients with type 1 or 2 diabetes. Supplementing periodic glycated hemoglobin (A1C) testing with intermittent continuous glucose monitoring (CGM) using a standardized report form known as the ambulatory glucose profile (AGP) is an evolving standard of care. The rationale for this approach and its implementation with a recently approved novel monitoring technology are explored. Search of the medical literature, professional guidelines, and real-world evidence guided this introduction of an integrative practice framework that uses AGP in conjunction with intermittent flash continuous glucose monitoring (FCGM) as a supplement to A1C testing. The combination of intermittent continuous glucose pattern analysis, standardized glucose metrics, and a readily interpretable data report has the potential to practically extend the recognized benefits of CGM to more patients and clarify the relationship between A1C and average glucose levels in individual cases. Novel FCGM technologies portend greater use of continuous forms of glucose monitoring and wider adoption of AGP report analysis. Additional formal and empirical evidence is needed to more fully characterize best practice. A1C = glycated hemoglobin; AGP = ambulatory glucose profile; CGM = continuous glucose monitoring; FCGM = flash continuous glucose monitoring; IQR = interquartile range; SMBG = self-monitoring of blood glucose.

National survey of cardiologists' standard of practice for continuous ST-segment monitoring.

PubMed

Sandau, Kristin E; Sendelbach, Sue; Frederickson, Joel; Doran, Karen

2010-03-01

Continuous ST-segment monitoring can be used to detect early and transient cardiac ischemia. The American Heart Association and American Association of Critical-Care Nurses recommend its use among specific patients, but such monitoring is routine practice in only about half of US hospitals. To determine cardiologists' awareness and practice standards regarding continuous ST-segment monitoring and the physicians' perceptions of appropriate patient selection, benefits and barriers, and usefulness of this technology. An electronic survey was sent to a random sample of 915 US cardiologists from a pool of 4985 certified cardiologists. Of 200 responding cardiologists, 55% were unaware of the consensus guidelines. Of hospitals where respondents admitted patients, 49% had a standard of practice for using continuous ST-segment monitoring for cardiac patients. Most cardiologists agreed or strongly agreed that patients in the cardiovascular laboratory (87.5%) and intensive care unit (80.5%) should have such monitoring. Cardiologists routinely ordered ST monitoring for patients with acute coronary syndrome (67%) and after percutaneous coronary intervention (60%). The primary factor associated with higher perceptions for benefits, clinical usefulness, and past use of continuous ST-segment monitoring was whether or not hospitals in which cardiologists practiced had a standard of practice for using this monitoring. A secondary factor was awareness of published consensus guidelines for such monitoring. Respondents (55%) were unaware of published monitoring guidelines. Hospital leaders could raise awareness by multidisciplinary review of evidence and possibly incorporating continuous ST-segment monitoring into hospitals' standards of practice.

Microbiopsy/precision cutting devices

DOEpatents

Krulevitch, P.A.; Lee, A.P.; Northrup, M.A.; Benett, W.J.

1999-07-27

Devices are disclosed for performing tissue biopsy on a small scale (microbiopsy). By reducing the size of the biopsy tool and removing only a small amount of tissue or other material in a minimally invasive manner, the risks, costs, injury and patient discomfort associated with traditional biopsy procedures can be reduced. By using micromachining and precision machining capabilities, it is possible to fabricate small biopsy/cutting devices from silicon. These devices can be used in one of four ways (1) intravascularly, (2) extravascularly, (3) by vessel puncture, and (4) externally. Additionally, the devices may be used in precision surgical cutting. 6 figs.

Intra-arterial bolus of 125I labeled meglumine diatrizoate. Early extravascular distribution.

PubMed

Dean, P B; Kormano, M

1977-07-01

A mixture of 125I labeled meglumine diatrizoate and 131I labeled human serum albumin was injected into the lower abdominal aorta of 30 anesthetized, laparotomized male rats. Measurements of the activities in cardiac blood and in different tissues of the hindlimbs and tests were perfomed at six time intervals ranging from 5 seconds to 2 minutes after injection, the determine early uptake and distribution volumes of diatrizoate. Concentrations and distribution volumes were initially much greater than values obtained after intravenous injection, but these differences had considerably decreased or disappeared by 2 minutes.

40 CFR 60.1245 - Am I exempt from any appendix B or appendix F requirements to evaluate continuous emission...

Code of Federal Regulations, 2012 CFR

2012-07-01

... appendix F requirements to evaluate continuous emission monitoring systems? 60.1245 Section 60.1245... Commenced After June 6, 2001 Continuous Emission Monitoring § 60.1245 Am I exempt from any appendix B or... carbon dioxide) continuous emission monitoring system. Therefore, your oxygen (or carbon dioxide...

40 CFR 63.7947 - What are my monitoring alternatives?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 14 2014-07-01 2014-07-01 false What are my monitoring alternatives? 63.7947 Section 63.7947 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Site Remediation Continuous Monitoring...

40 CFR 63.7947 - What are my monitoring alternatives?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 14 2013-07-01 2013-07-01 false What are my monitoring alternatives? 63.7947 Section 63.7947 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Site Remediation Continuous Monitoring...

40 CFR 63.7947 - What are my monitoring alternatives?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 13 2011-07-01 2011-07-01 false What are my monitoring alternatives? 63.7947 Section 63.7947 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Site Remediation Continuous Monitoring...

40 CFR 75.13 - Specific provisions for monitoring CO 2 emissions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the general operating requirements in § 75.10 for a CO2 continuous emission monitoring system and flow... specified in §§ 75.11(a) through (e) or § 75.16, except that the phrase “CO2 continuous emission monitoring system” shall apply rather than “SO2 continuous emission monitoring system,” the phrase “CO2...

40 CFR 75.13 - Specific provisions for monitoring CO 2 emissions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the general operating requirements in § 75.10 for a CO2 continuous emission monitoring system and flow... specified in §§ 75.11(a) through (e) or § 75.16, except that the phrase “CO2 continuous emission monitoring system” shall apply rather than “SO2 continuous emission monitoring system,” the phrase “CO2...

40 CFR 75.16 - Special provisions for monitoring emissions from common, bypass, and multiple stacks for SO2...

Code of Federal Regulations, 2010 CFR

2010-07-01

... maintain an SO2 continuous emission monitoring system and flow monitoring system in the duct to the common... emission monitoring system and flow monitoring system in the common stack and combine emissions for the... continuous emission monitoring system and flow monitoring system in the duct to the common stack from each...

30 CFR 74.11 - Tests of the continuous personal dust monitor.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Tests of the continuous personal dust monitor. 74.11 Section 74.11 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH COAL MINE DUST SAMPLING DEVICES Requirements for Continuous Personal Dust Monitors § 74.11 Tests of the continuous personal...

30 CFR 74.11 - Tests of the continuous personal dust monitor.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tests of the continuous personal dust monitor. 74.11 Section 74.11 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH COAL MINE DUST SAMPLING DEVICES Requirements for Continuous Personal Dust Monitors § 74.11 Tests of the continuous personal...

A quantitative method for optimized placement of continuous air monitors.

PubMed

Whicker, Jeffrey J; Rodgers, John C; Moxley, John S

2003-11-01

Alarming continuous air monitors (CAMs) are a critical component for worker protection in facilities that handle large amounts of hazardous materials. In nuclear facilities, continuous air monitors alarm when levels of airborne radioactive materials exceed alarm thresholds, thus prompting workers to exit the room to reduce inhalation exposures. To maintain a high level of worker protection, continuous air monitors are required to detect radioactive aerosol clouds quickly and with good sensitivity. This requires that there are sufficient numbers of continuous air monitors in a room and that they are well positioned. Yet there are no published methodologies to quantitatively determine the optimal number and placement of continuous air monitors in a room. The goal of this study was to develop and test an approach to quantitatively determine optimal number and placement of continuous air monitors in a room. The method we have developed uses tracer aerosol releases (to simulate accidental releases) and the measurement of the temporal and spatial aspects of the dispersion of the tracer aerosol through the room. The aerosol dispersion data is then analyzed to optimize continuous air monitor utilization based on simulated worker exposure. This method was tested in a room within a Department of Energy operated plutonium facility at the Savannah River Site in South Carolina, U.S. Results from this study show that the value of quantitative airflow and aerosol dispersion studies is significant and that worker protection can be significantly improved while balancing the costs associated with CAM programs.

Women's experiences of continuous fetal monitoring - a mixed-methods systematic review.

PubMed

Crawford, Alexandra; Hayes, Dexter; Johnstone, Edward D; Heazell, Alexander E P

2017-12-01

Antepartum stillbirth is often preceded by detectable signs of fetal compromise, including changes in fetal heart rate and movement. It is hypothesized that continuous fetal monitoring could detect these signs more accurately and objectively than current forms of fetal monitoring and allow for timely intervention. This systematic review aimed to explore available evidence on women's experiences of continuous fetal monitoring to investigate its acceptability before clinical implementation and to inform clinical studies. Systematic searching of four electronic databases (Embase, PsycINFO, MEDLINE and CINAHL), using key terms defined by initial scoping searches, identified a total of 35 studies. Following title and abstract screening by two independent researchers, five studies met the inclusion criteria. Studies were not excluded based on language, methodology or quality assessment. An integrative methodology was used to synthesize qualitative and quantitative data together. Forms of continuous fetal monitoring used included Monica AN24 monitors (n = 4) and phonocardiography (n = 1). Four main themes were identified: practical limitations of the device, negative emotions, positive perceptions, and device implementation. Continuous fetal monitoring was reported to have high levels of participant satisfaction and was preferred by women to intermittent cardiotocography. This review suggests that continuous fetal monitoring is accepted by women. However, it has also highlighted both the paucity and heterogeneity of current studies and suggests that further research should be conducted into women's experiences of continuous fetal monitoring before such devices can be used clinically. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Usefulness of continuous glucose monitoring for the diagnosis of hypoglycemia after a gastric bypass in a patient previously treated for type 2 diabetes.

PubMed

Hanaire, Hélène; Dubet, Audrey; Chauveau, Marie-Emilie; Anduze, Yves; Fernandes, Martine; Melki, Vincent; Ritz, Patrick

2010-01-01

Hypoglycemia is rare after a gastric bypass and can be taken for a dumping syndrome. There is no report in the literature of the contribution of continuous glucose monitoring to the diagnosis of hypoglycemia in these circumstances. The present case report shows that continuous glucose monitoring can be a useful tool for the diagnosis and the management of such episodes. Continuous glucose monitoring revealed hypoglycemic episodes in free living circumstances that were not present during 72-h fasting. These episodes followed wide hyperglycemic swings. No such episode resumed over 8 months after specific dietary advices and treatment by 50 mg TID of acarbose. Because hypoglycemia can be difficult to diagnose from dumping syndrome, continuous glucose monitoring is a very useful tool revealing the episodes in free living circumstances and can be used to monitor the treatment success.

49 CFR 220.39 - Continuous radio monitoring.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Continuous radio monitoring. 220.39 Section 220.39..., DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Radio and Wireless Communication Procedures § 220.39 Continuous radio monitoring. Each radio used in a railroad operation shall be turned on to the appropriate...

49 CFR 220.39 - Continuous radio monitoring.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Radio and Wireless Communication Procedures § 220.39 Continuous radio monitoring. Each radio used in a railroad operation shall be turned on to the appropriate... 49 Transportation 4 2014-10-01 2014-10-01 false Continuous radio monitoring. 220.39 Section 220.39...

49 CFR 220.39 - Continuous radio monitoring.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Radio and Wireless Communication Procedures § 220.39 Continuous radio monitoring. Each radio used in a railroad operation shall be turned on to the appropriate... 49 Transportation 4 2013-10-01 2013-10-01 false Continuous radio monitoring. 220.39 Section 220.39...

40 CFR 75.32 - Determination of monitor data availability for standard missing data procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... availability for standard missing data procedures. 75.32 Section 75.32 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.32 Determination of monitor data availability for standard missing data procedures...

40 CFR 75.32 - Determination of monitor data availability for standard missing data procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... availability for standard missing data procedures. 75.32 Section 75.32 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.32 Determination of monitor data availability for standard missing data procedures...

40 CFR 75.32 - Determination of monitor data availability for standard missing data procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... availability for standard missing data procedures. 75.32 Section 75.32 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.32 Determination of monitor data availability for standard missing data procedures...

40 CFR 75.32 - Determination of monitor data availability for standard missing data procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... availability for standard missing data procedures. 75.32 Section 75.32 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.32 Determination of monitor data availability for standard missing data procedures...

40 CFR 75.32 - Determination of monitor data availability for standard missing data procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... availability for standard missing data procedures. 75.32 Section 75.32 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.32 Determination of monitor data availability for standard missing data procedures...

Test/QA Plan (TQAP) for Verification of Semi-Continuous Ambient Air Monitoring Systems

EPA Science Inventory

The purpose of the semi-continuous ambient air monitoring technology (or MARGA) test and quality assurance plan is to specify procedures for a verification test applicable to commercial semi-continuous ambient air monitoring technologies. The purpose of the verification test is ...

40 CFR 75.13 - Specific provisions for monitoring CO2 emissions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Specific provisions for monitoring CO2... monitoring CO2 emissions. (a) CO 2 continuous emission monitoring system. If the owner or operator chooses to... operating requirements in § 75.10 for a CO2 continuous emission monitoring system and flow monitoring system...

40 CFR 75.13 - Specific provisions for monitoring CO2 emissions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Specific provisions for monitoring CO2... monitoring CO2 emissions. (a) CO 2 continuous emission monitoring system. If the owner or operator chooses to... operating requirements in § 75.10 for a CO2 continuous emission monitoring system and flow monitoring system...

40 CFR 75.13 - Specific provisions for monitoring CO2 emissions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Specific provisions for monitoring CO2... monitoring CO2 emissions. (a) CO 2 continuous emission monitoring system. If the owner or operator chooses to... operating requirements in § 75.10 for a CO2 continuous emission monitoring system and flow monitoring system...

40 CFR 75.12 - Specific provisions for monitoring NOX emission rate.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.12 Specific provisions for monitoring NOX emission rate. (a) Coal-fired units, gas-fired nonpeaking units or oil-fired... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Specific provisions for monitoring NOX...

40 CFR 75.11 - Specific provisions for monitoring SO2 emissions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Specific provisions for monitoring SO2... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.11 Specific provisions for monitoring SO2 emissions. (a) Coal-fired units. The owner or operator shall meet the general operating...

40 CFR 75.12 - Specific provisions for monitoring NOX emission rate.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.12 Specific provisions for monitoring NOX emission rate. (a) Coal-fired units, gas-fired nonpeaking units or oil-fired... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Specific provisions for monitoring NOX...

40 CFR 75.11 - Specific provisions for monitoring SO2 emissions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Specific provisions for monitoring SO2... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.11 Specific provisions for monitoring SO2 emissions. (a) Coal-fired units. The owner or operator shall meet the general operating...

40 CFR 75.12 - Specific provisions for monitoring NOX emission rate.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.12 Specific provisions for monitoring NOX emission rate. (a) Coal-fired units, gas-fired nonpeaking units or oil-fired... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Specific provisions for monitoring NOX...

40 CFR 75.14 - Specific provisions for monitoring opacity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.14 Specific provisions for monitoring opacity. (a) Coal-fired units and oil-fired units. The owner or operator shall meet the general... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Specific provisions for monitoring...

40 CFR 75.14 - Specific provisions for monitoring opacity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.14 Specific provisions for monitoring opacity. (a) Coal-fired units and oil-fired units. The owner or operator shall meet the general... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Specific provisions for monitoring...

40 CFR 75.12 - Specific provisions for monitoring NOX emission rate.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.12 Specific provisions for monitoring NOX emission rate. (a) Coal-fired units, gas-fired nonpeaking units or oil-fired... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Specific provisions for monitoring NOX...

40 CFR 75.14 - Specific provisions for monitoring opacity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.14 Specific provisions for monitoring opacity. (a) Coal-fired units and oil-fired units. The owner or operator shall meet the general... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Specific provisions for monitoring...

40 CFR 75.12 - Specific provisions for monitoring NOX emission rate.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.12 Specific provisions for monitoring NOX emission rate. (a) Coal-fired units, gas-fired nonpeaking units or oil-fired... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Specific provisions for monitoring NOX...

40 CFR 75.11 - Specific provisions for monitoring SO2 emissions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Specific provisions for monitoring SO2... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.11 Specific provisions for monitoring SO2 emissions. (a) Coal-fired units. The owner or operator shall meet the general operating...

40 CFR 75.14 - Specific provisions for monitoring opacity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.14 Specific provisions for monitoring opacity. (a) Coal-fired units and oil-fired units. The owner or operator shall meet the general... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Specific provisions for monitoring...

40 CFR 75.14 - Specific provisions for monitoring opacity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Monitoring Provisions § 75.14 Specific provisions for monitoring opacity. (a) Coal-fired units and oil-fired units. The owner or operator shall meet the general... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Specific provisions for monitoring...

Overnight non-contact continuous vital signs monitoring using an intelligent automatic beam-steering Doppler sensor at 2.4 GHz.

PubMed

Batchu, S; Narasimhachar, H; Mayeda, J C; Hall, T; Lopez, J; Nguyen, T; Banister, R E; Lie, D Y C

2017-07-01

Doppler-based non-contact vital signs (NCVS) sensors can monitor heart rates, respiration rates, and motions of patients without physically touching them. We have developed a novel single-board Doppler-based phased-array antenna NCVS biosensor system that can perform robust overnight continuous NCVS monitoring with intelligent automatic subject tracking and optimal beam steering algorithms. Our NCVS sensor achieved overnight continuous vital signs monitoring with an impressive heart-rate monitoring accuracy of over 94% (i.e., within ±5 Beats-Per-Minute vs. a reference sensor), analyzed from over 400,000 data points collected during each overnight monitoring period of ~ 6 hours at a distance of 1.75 meters. The data suggests our intelligent phased-array NCVS sensor can be very attractive for continuous monitoring of low-acuity patients.

NREL Patents Method for Continuous Monitoring of Materials During

Science.gov Websites

Manufacturing | News | NREL NREL Patents Method for Continuous Monitoring of Materials During Manufacturing News Release: NREL Patents Method for Continuous Monitoring of Materials During Manufacturing patent for a novel method that rapidly characterizes specialized materials during the manufacturing

40 CFR 75.39 - Missing data procedures for sorbent trap monitoring systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Missing data procedures for sorbent... (CONTINUED) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.39 Missing data procedures for sorbent trap monitoring systems. (a) If a primary sorbent trap...

40 CFR 60.1805 - Must I meet other requirements for continuous monitoring?

Code of Federal Regulations, 2010 CFR

2010-07-01

... continuous monitoring? 60.1805 Section 60.1805 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY..., 1999 Model Rule-Other Monitoring Requirements § 60.1805 Must I meet other requirements for continuous... device. (c) Carbon feed rate if activated carbon is used to control dioxins/furans or mercury emissions. ...

40 CFR 60.2939 - What continuous emission monitoring systems must I install?

Code of Federal Regulations, 2013 CFR

2013-07-01

... systems must I install? 60.2939 Section 60.2939 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 60.2939 What continuous emission monitoring systems must I install? (a) You must install, calibrate, maintain, and operate continuous emission monitoring systems for carbon monoxide and for oxygen. You must...

40 CFR 60.1805 - Must I meet other requirements for continuous monitoring?

Code of Federal Regulations, 2014 CFR

2014-07-01

... continuous monitoring? 60.1805 Section 60.1805 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY..., 1999 Model Rule-Other Monitoring Requirements § 60.1805 Must I meet other requirements for continuous... device. (c) Carbon feed rate if activated carbon is used to control dioxins/furans or mercury emissions. ...

40 CFR 60.2939 - What continuous emission monitoring systems must I install?

Code of Federal Regulations, 2014 CFR

2014-07-01

... systems must I install? 60.2939 Section 60.2939 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 60.2939 What continuous emission monitoring systems must I install? (a) You must install, calibrate, maintain, and operate continuous emission monitoring systems for carbon monoxide and for oxygen. You must...

40 CFR 60.1805 - Must I meet other requirements for continuous monitoring?

Code of Federal Regulations, 2012 CFR

2012-07-01

... continuous monitoring? 60.1805 Section 60.1805 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY..., 1999 Model Rule-Other Monitoring Requirements § 60.1805 Must I meet other requirements for continuous... device. (c) Carbon feed rate if activated carbon is used to control dioxins/furans or mercury emissions. ...

40 CFR 60.1805 - Must I meet other requirements for continuous monitoring?

Code of Federal Regulations, 2013 CFR

2013-07-01

... continuous monitoring? 60.1805 Section 60.1805 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY..., 1999 Model Rule-Other Monitoring Requirements § 60.1805 Must I meet other requirements for continuous... device. (c) Carbon feed rate if activated carbon is used to control dioxins/furans or mercury emissions. ...

40 CFR 60.1805 - Must I meet other requirements for continuous monitoring?

Code of Federal Regulations, 2011 CFR

2011-07-01

... continuous monitoring? 60.1805 Section 60.1805 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY..., 1999 Model Rule-Other Monitoring Requirements § 60.1805 Must I meet other requirements for continuous... device. (c) Carbon feed rate if activated carbon is used to control dioxins/furans or mercury emissions. ...

Alpha-environmental continuous air monitor inlet

DOEpatents

Rodgers, John C.

2003-01-01

A wind deceleration and protective shroud that provides representative samples of ambient aerosols to an environmental continuous air monitor (ECAM) has a cylindrical enclosure mounted to an input on the continuous air monitor, the cylindrical enclosure having shrouded nozzles located radially about its periphery. Ambient air flows, often along with rainwater flows into the nozzles in a sampling flow generated by a pump in the continuous air monitor. The sampling flow of air creates a cyclonic flow in the enclosure that flows up through the cylindrical enclosure until the flow of air reaches the top of the cylindrical enclosure and then is directed downward to the continuous air monitor. A sloped platform located inside the cylindrical enclosure supports the nozzles and causes any moisture entering through the nozzle to drain out through the nozzles.

A Modified Method for Creating Elastase-Induced Aneurysms by Ligation of Common Carotid Arteries in Rabbits and Its Effect on Surrounding Arteries.

PubMed

Kainth, Daraspreet; Salazar, Pascal; Safinia, Cyrus; Chow, Ricky; Bachour, Ornina; Andalib, Sasan; McKinney, Alexander M; Divani, Afshin A

2017-01-01

Rabbit models of intracranial aneurysms are frequently used in pre-clinical settings. This study aimed to demonstrate an alternative, extravascular method for creating elastase-induced aneurysms, and how ligation of the right common carotid arteries (RCCA) can impact flow redistribution into left CCA (LCCA). Elastase-induced aneurysms in 18 New Zealand rabbits (4.14 ± 0.314 kg) were created by applying 3-5 U of concentrated elastase solution to the exterior of the right and left CCA roots (RCCA and LCCA). After the induction of the aneurysm, the aneurysm was either kept intact to the rest of the corresponding CCA, severed from the rest of the CCA to allow for a free standing aneurysm, or was anchored to nearby tissue to influence the angle and orientation of the aneurysm with respect to the parent vessel. Ultrasound studies were performed before and after creation of aneurysms to collect blood flow measurements inside the aneurysm pouch and surrounding arteries. Prior to sacrificing the animals, computed tomography angiography studies were performed. Harvested aneurysmal tissues were used for histological analysis. Elastase-induced aneurysms were successfully created by the extravascular approach. Histological studies showed that the biological response was similar to human cerebral aneurysms and previously published elastase-induced rabbit aneurysm models. Ultrasound measurements indicated that after the RCCA was ligated, blood flow significantly increased in the LCCA at one-month follow-up. An alternate method for creating elastase-induced aneurysms has been demonstrated. The novel aspects of our method allow for ligation of one or both common carotid arteries to create a single or bilateral aneurysm with an ability to control the orientation of the induced aneurysm.

On-chip human microvasculature assay for visualization and quantitation of tumor cell extravasation dynamics

PubMed Central

Chen, Michelle B.; Whisler, Jordan A.; Fröse, Julia; Yu, Cathy; Shin, Yoojin

2017-01-01

Distant metastasis, which results in >90% of cancer related deaths, is enabled by hematogenous dissemination of tumor cells via the circulation. This requires the completion of a sequence of complex steps including transit, initial arrest, extravasation, survival and proliferation. Increased understanding of the cellular and molecular players enabling each of these steps is key in uncovering new opportunities for therapeutic intervention during early metastatic dissemination. Here, we describe an in vitro model of the human microcirculation with the potential to recapitulate discrete steps of early metastatic seeding, including arrest, transendothelial migration and early micrometastases formation. The microdevice features self-organized human microvascular networks formed over 4–5 days, after which tumor can be perfused and extravasation events easily tracked over 72 hours, via standard confocal microscopy. Contrary to most in vivo and in vitro extravasation assays, robust and rapid scoring of extravascular cells combined with high-resolution imaging can be easily achieved due to the confinement of the vascular network to one plane close to the surface of the device. This renders extravascular cells clearly distinct and allows tumor cells of interest to be identified quickly compared to those in thick tissues. The ability to generate large numbers of devices (~36) per experiment coupled with fast quantitation further allows for highly parametric studies, which is required when testing multiple genetic or pharmacological perturbations. This is coupled with the capability for live tracking of single cell extravasation events allowing both tumor and endothelial morphological dynamics to be observed in high detail with a moderate number of data points. This Protocol Extension describes an adaptation of an existing Protocol describing a microfluidic platform that offers additional applications. PMID:28358393

Small-molecule factor D inhibitors selectively block the alternative pathway of complement in paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome.

PubMed

Yuan, Xuan; Gavriilaki, Eleni; Thanassi, Jane A; Yang, Guangwei; Baines, Andrea C; Podos, Steven D; Huang, Yongqing; Huang, Mingjun; Brodsky, Robert A

2017-03-01

Paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome are diseases of excess activation of the alternative pathway of complement that are treated with eculizumab, a humanized monoclonal antibody against the terminal complement component C5. Eculizumab must be administered intravenously, and moreover some patients with paroxysmal nocturnal hemoglobinuria on eculizumab have symptomatic extravascular hemolysis, indicating an unmet need for additional therapeutic approaches. We report the activity of two novel small-molecule inhibitors of the alternative pathway component Factor D using in vitro correlates of both paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome. Both compounds bind human Factor D with high affinity and effectively inhibit its proteolytic activity against purified Factor B in complex with C3b. When tested using the traditional Ham test with cells from paroxysmal nocturnal hemoglobinuria patients, the Factor D inhibitors significantly reduced complement-mediated hemolysis at concentrations as low as 0.01 μM. Additionally the compound ACH-4471 significantly decreased C3 fragment deposition on paroxysmal nocturnal hemoglobinuria erythrocytes, indicating a reduced potential relative to eculizumab for extravascular hemolysis. Using the recently described modified Ham test with serum from patients with atypical hemolytic uremic syndrome, the compounds reduced the alternative pathway-mediated killing of PIGA -null reagent cells, thus establishing their potential utility for this disease of alternative pathway of complement dysregulation and validating the modified Ham test as a system for pre-clinical drug development for atypical hemolytic uremic syndrome. Finally, ACH-4471 blocked alternative pathway activity when administered orally to cynomolgus monkeys. In conclusion, the small-molecule Factor D inhibitors show potential as oral therapeutics for human diseases driven by the alternative pathway of complement, including paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome. Copyright© Ferrata Storti Foundation.

Analysis of factors that influence rates of carbon monoxide uptake, distribution, and washout from blood and extravascular tissues using a multicompartment model.

PubMed

Bruce, Margaret C; Bruce, Eugene N

2006-04-01

To better understand factors that influence carbon monoxide (CO) washout rates, we utilized a multicompartment mathematical model to predict rates of CO uptake, distribution in vascular and extravascular (muscle vs. other soft tissue) compartments, and washout over a range of exposure and washout conditions with varied subject-specific parameters. We fitted this model to experimental data from 15 human subjects, for whom subject-specific parameters were known, multiple washout carboxyhemoglobin (COHb) levels were available, and CO exposure conditions were identical, to investigate the contributions of exposure conditions and individual variability to CO washout from blood. We found that CO washout from venous blood was biphasic and that postexposure times at which COHb samples were obtained significantly influenced the calculated CO half times (P < 0.0001). The first, more rapid, phase of CO washout from the blood reflected the loss of CO to the expired air and to a slow uptake by the muscle compartment, whereas the second, slower washout phase was attributable to CO flow from the muscle compartment back to the blood and removal from blood via the expired air. When the model was used to predict the effects of varying exposure conditions for these subjects, the CO exposure duration, concentration, peak COHb levels, and subject-specific parameters each influenced washout half times. Blood volume divided by ventilation correlated better with half-time predictions than did cardiac output, muscle mass, or ventilation, but it explained only approximately 50% of half-time variability. Thus exposure conditions, COHb sampling times, and individual parameters should be considered when estimating CO washout rates for poisoning victims.

Toxicokinetic and toxicodynamic analyses of Androctonus australis hector venom in rats: Optimization of antivenom therapy

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

Hammoudi-Triki, D.; Laboratoire de Biologie Cellulaire et Moleculaire, Faculte des Sciences Biologiques, Universite des Sciences et de la Technologie 'Houari Boumedienne' Bab Ezzouar, Alger, Algerie; Laboratoire de Recherche et de Developpement sur les Venins, Institut Pasteur d'Algerie, Algerie

2007-02-01

This paper reports the simultaneous determination of toxicokinetic and toxicodynamic properties of Androctonus australis hector venom, in the absence and presence of antivenom (F(ab'){sub 2} and Fab), in envenomed rats. After subcutaneous injection of the venom, toxins showed a complete absorption phase from the site of injection associated with a distribution into a large extravascular compartment. The injection of Fab and F(ab'){sub 2} induced the neutralization of venom antigens in the blood compartment, as well as the redistribution of venom components from the extravascular compartment to the blood compartment. Interestingly, F(ab'){sub 2} and Fab showed distinct efficiencies depending on theirmore » route of injection. F(ab'){sub 2} induced a faster venom neutralization and redistribution than Fab when injected intravenously. Fab was more effective than F(ab'){sub 2} by the intramuscular route. The hemodynamic effects of Aah venom were further investigated. Changes in mean arterial pressure and heart rate were observed in parallel with an upper airway obstruction. Fab was more effective than F(ab'){sub 2} for preventing early symptoms of envenomation, whatever their route of administration. Intraperitoneal injection of F(ab'){sub 2} and Fab was similar for the prevention of the delayed symptoms, even after a late administration. Fab was more effective than F(ab'){sub 2} in the inhibition of airway resistance, independent of the route and time of administration. These results show that the treatment for scorpion stings might be improved by the intravascular injection of a mixture of Fab and F(ab'){sub 2}. If antivenom cannot be administered intravenously, Fab might be an alternative as they are more effective than F(ab'){sub 2} when injected intramuscularly.« less

Intravital Imaging of a Massive Lymphocyte Response in the Cortical Dura of Mice after Peripheral Infection by Trypanosomes

PubMed Central

Coles, Jonathan A.; Myburgh, Elmarie; Ritchie, Ryan; Hamilton, Alana; Rodgers, Jean; Mottram, Jeremy C.; Barrett, Michael P.; Brewer, James M.

2015-01-01

Peripheral infection by Trypanosoma brucei, the protozoan responsible for sleeping sickness, activates lymphocytes, and, at later stages, causes meningoencephalitis. We have videoed the cortical meninges and superficial parenchyma of C56BL/6 reporter mice infected with T.b.brucei. By use of a two-photon microscope to image through the thinned skull, the integrity of the tissues was maintained. We observed a 47-fold increase in CD2+ T cells in the meninges by 12 days post infection (dpi). CD11c+ dendritic cells also increased, and extravascular trypanosomes, made visible either by expression of a fluorescent protein, or by intravenous injection of furamidine, appeared. The likelihood that invasion will spread from the meninges to the parenchyma will depend strongly on whether the trypanosomes are below the arachnoid membrane, or above it, in the dura. Making use of optical signals from the skull bone, blood vessels and dural cells, we conclude that up to 40 dpi, the extravascular trypanosomes were essentially confined to the dura, as were the great majority of the T cells. Inhibition of T cell activation by intraperitoneal injection of abatacept reduced the numbers of meningeal T cells at 12 dpi and their mean speed fell from 11.64 ± 0.34 μm/min (mean ± SEM) to 5.2 ± 1.2 μm/min (p = 0.007). The T cells occasionally made contact lasting tens of minutes with dendritic cells, indicative of antigen presentation. The population and motility of the trypanosomes tended to decline after about 30 dpi. We suggest that the lymphocyte infiltration of the meninges may later contribute to encephalitis, but have no evidence that the dural trypanosomes invade the parenchyma. PMID:25881126

A novel platform for minimally invasive delivery of cellular therapy as a thin layer across the subretina for treatment of retinal degeneration

NASA Astrophysics Data System (ADS)

Rotenstreich, Ygal; Tzameret, Adi; Kalish, Sapir E.; Belkin, Michael; Meir, Amilia; Treves, Avraham J.; Nagler, Arnon; Sher, Ifat

2015-03-01

Incurable retinal degenerations affect millions worldwide. Stem cell transplantation rescued visual functions in animal models of retinal degeneration. In those studies cells were transplanted in subretinal "blebs", limited number of cells could be injected and photoreceptor rescue was restricted to areas in proximity to the injection sites. We developed a minimally-invasive surgical platform for drug and cell delivery in a thin layer across the subretina and extravascular spaces of the choroid. The novel system is comprised of a syringe with a blunt-tipped needle and an adjustable separator. Human bone marrow mesenchymal stem cells (hBM-MSCs) were transplanted in eyes of RCS rats and NZW rabbits through a longitudinal triangular scleral incision. No immunosuppressants were used. Retinal function was determined by electroretinogram analysis and retinal structure was determined by histological analysis and OCT. Transplanted cells were identified as a thin layer across the subretina and extravascular spaces of the choroid. In RCS rats, cell transplantation delayed photoreceptor degeneration across the entire retina and significantly enhanced retinal functions. No retinal detachment or choroidal hemorrhages were observed in rabbits following transplantation. This novel platform opens a new avenue for drug and cell delivery, placing the transplanted cells in close proximity to the damaged RPE and retina as a thin layer, across the subretina and thereby slowing down cell death and photoreceptor degeneration, without retinal detachment or choroidal hemorrhage. This new transplantation system may increase the therapeutic effect of other cell-based therapies and therapeutic agents. This study is expected to directly lead to phase I/II clinical trials for autologous hBM-MSCs transplantation in retinal degeneration patients.

A no-decompression air dive and ultrasound lung comets.

PubMed

Dujic, Zeljko; Marinovic, Jasna; Obad, Ante; Ivancev, Vladimir; Breskovic, Toni; Jovovic, Pavle; Ljubkovic, Marko

2011-01-01

Increased accumulation of extravascular lung water after repetitive deep trimix dives was recently reported. This effect was evident 40 min post-dive, but in subsequent studies most signs of this lung congestion were not evident 2-3 h post-dive, indicating no major negative effects on respiratory gas exchange following deep dives. Whether this response is unique for trimix dives or also occurs in more frequent air dives is presently unknown. A single no-decompression field dive to 33 m with 20 min bottom time was performed by 12 male divers. Multiple ultrasound lung comets (ULC), bubble grade (BG), and single-breath lung diffusing capacity (DLCO) measurements were made before and up to 120 min after the dive. Median BG was rather high with maximal values observed at 40 min post-dive [median 4 (4-4)]. Arterialization of bubbles from the venous side was observed only in one diver lasting up to 60 min post-dive. Despite high BG, no DCS symptoms were noted. DLCO and ULC were unchanged after the dive at any time point (DLCO(corr) was 33.6 +/- 1.9 ml x min(-1) mmHg(-1) pre-dive, 32.7 +/- 3.8 ml x min(-1) x mmHg(-1) at 60 min post-dive, and 33.2 +/- 5.3 ml x min(-1) x mmHg(-1) at 120 min post-dive; ULC count was 4.1 +/- 1.9 pre-dive, 4.9 +/- 3.3 at 20 min post-dive, and 3.3 +/- 1.9 at 60 min post-dive. These preliminary findings show no evidence of increased accumulation of extravascular lung water in male divers after a single no-decompression air dive at the limits of accepted Norwegian diving tables.

[Design and implementation of real-time continuous glucose monitoring instrument].

PubMed

Huang, Yonghong; Liu, Hongying; Tian, Senfu; Jia, Ziru; Wang, Zi; Pi, Xitian

2017-12-01

Real-time continuous glucose monitoring can help diabetics to control blood sugar levels within the normal range. However, in the process of practical monitoring, the output of real-time continuous glucose monitoring system is susceptible to glucose sensor and environment noise, which will influence the measurement accuracy of the system. Aiming at this problem, a dual-calibration algorithm for the moving-window double-layer filtering algorithm combined with real-time self-compensation calibration algorithm is proposed in this paper, which can realize the signal drift compensation for current data. And a real-time continuous glucose monitoring instrument based on this study was designed. This real-time continuous glucose monitoring instrument consisted of an adjustable excitation voltage module, a current-voltage converter module, a microprocessor and a wireless transceiver module. For portability, the size of the device was only 40 mm × 30 mm × 5 mm and its weight was only 30 g. In addition, a communication command code algorithm was designed to ensure the security and integrity of data transmission in this study. Results of experiments in vitro showed that current detection of the device worked effectively. A 5-hour monitoring of blood glucose level in vivo showed that the device could continuously monitor blood glucose in real time. The relative error of monitoring results of the designed device ranged from 2.22% to 7.17% when comparing to a portable blood meter.

The Effects of Continuous Vs. Intermittent Self-Monitoring on the Duration and Magnitude of Behavior Change.

ERIC Educational Resources Information Center

Schayer, Laurel L.; Schroeder, Harold E.

Continuous self-monitoring (CSM) was compared with a demand characteristics control condition (non self-monitoring), with intermittent self-monitoring (ISM) and with another control condition. It was predicted that both self-monitoring conditions would produce effects over and above the demand characteristics inherent in the self-monitoring…

40 CFR 58.61 - Monitoring other pollutants.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Monitoring other pollutants. 58.61 Section 58.61 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) AMBIENT AIR QUALITY SURVEILLANCE Federal Monitoring § 58.61 Monitoring other pollutants. The...

40 CFR 58.13 - Monitoring network completion.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 6 2012-07-01 2012-07-01 false Monitoring network completion. 58.13 Section 58.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) AMBIENT AIR QUALITY SURVEILLANCE Monitoring Network § 58.13 Monitoring network completion. (a...

40 CFR 58.13 - Monitoring network completion.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 6 2014-07-01 2014-07-01 false Monitoring network completion. 58.13 Section 58.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) AMBIENT AIR QUALITY SURVEILLANCE Monitoring Network § 58.13 Monitoring network completion. (a...

40 CFR 58.13 - Monitoring network completion.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 6 2013-07-01 2013-07-01 false Monitoring network completion. 58.13 Section 58.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) AMBIENT AIR QUALITY SURVEILLANCE Monitoring Network § 58.13 Monitoring network completion. (a...

Clinical outcome of continuous facial nerve monitoring during primary parotidectomy.

PubMed

Terrell, J E; Kileny, P R; Yian, C; Esclamado, R M; Bradford, C R; Pillsbury, M S; Wolf, G T

1997-10-01

To assess whether continuous facial nerve monitoring during parotidectomy is associated with a lower incidence of facial nerve paresis or paralysis compared with parotidectomy without monitoring and to assess the cost of such monitoring. A retrospective analysis of outcomes for patients who underwent parotidectomy with or without continuous facial nerve monitoring. University medical center. Fifty-six patients undergoing parotidectomy in whom continuous electromyographic monitoring was used and 61 patients in whom it was not used. (1) The incidence of early and persistent facial nerve paresis or paralysis and (2) the cost associated with facial nerve monitoring. Early, unintentional facial weakness was significantly lower in the group monitored by electromyograpy (43.6%) than in the unmonitored group (62.3%) (P=.04). In the subgroup of patients without comorbid conditions or surgeries, early weakness in the monitored group (33.3%) remained statistically lower than the rate of early weakness in the unmonitored group (57.5%) (P=.03). There was no statistical difference in the final facial nerve function or incidence of permanent nerve injury between the groups or subgroups. After multivariate analysis, nonmonitored status (odds ratio [OR], 3.22), advancing age (OR, 1.47 per 10 years), and longer operative times (OR, 1.3 per hour) were the only significant independent predictive variables significantly associated with early postoperative facial weakness. The incremental cost of facial nerve monitoring was $379. The results suggest that continuous electromyographic monitoring of facial muscle during primary parotidectomy reduces the incidence of short-term postoperative facial paresis. Advantages and disadvantages of this technique need to be considered together with the additional costs in deciding whether routine use of continuous monitoring is a useful, cost-effective adjunct to parotid surgery.

40 CFR Table 1 to Subpart Llllll... - Applicability of General Provisions to Subpart LLLLLL

Code of Federal Regulations, 2011 CFR

2011-07-01

... Modacrylic Fibers Production Area Sources Pt. 63, Subpt. LLLLLL, Table 1 Table 1 to Subpart LLLLLL of Part 63... not include opacity or visible emissions standards or require a continuous opacity monitoring system... does not require a continuous opacity monitoring system or continuous emissions monitoring system. 63.9...

40 CFR Table 1 to Subpart Llllll... - Applicability of General Provisions to Subpart LLLLLL

Code of Federal Regulations, 2010 CFR

2010-07-01

... Modacrylic Fibers Production Area Sources Pt. 63, Subpt. LLLLLL, Table 1 Table 1 to Subpart LLLLLL of Part 63... not include opacity or visible emissions standards or require a continuous opacity monitoring system... does not require a continuous opacity monitoring system or continuous emissions monitoring system. 63.9...

78 FR 65306 - Best Practices for Continuous Monitoring of Temperature and Flow in Wadeable Streams

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... Practices for Continuous Monitoring of Temperature and Flow in Wadeable Streams AGENCY: Environmental... Monitoring of Temperature and Flow in Wadeable Streams'' (EPA/600/R-13/170). The EPA also is announcing that... Development. The report describes best practices for the deployment of continuous temperature and flow sensors...

40 CFR 60.1725 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2013 CFR

2013-07-01

... emission monitoring systems used? 60.1725 Section 60.1725 Protection of Environment ENVIRONMENTAL... Before August 30, 1999 Model Rule-Continuous Emission Monitoring § 60.1725 How are the data from the... systems for sulfur dioxide, nitrogen oxides, and carbon monoxide to demonstrate continuous compliance with...

40 CFR 60.1725 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2014 CFR

2014-07-01

... emission monitoring systems used? 60.1725 Section 60.1725 Protection of Environment ENVIRONMENTAL... Before August 30, 1999 Model Rule-Continuous Emission Monitoring § 60.1725 How are the data from the... systems for sulfur dioxide, nitrogen oxides, and carbon monoxide to demonstrate continuous compliance with...

40 CFR 60.1365 - What records must I keep for continuously monitored pollutants or parameters?

Code of Federal Regulations, 2010 CFR

2010-07-01

... diluent gas, document the relationship between oxygen and carbon dioxide, as specified in § 60.1255. (h... continuously monitored pollutants or parameters? 60.1365 Section 60.1365 Protection of Environment... Recordkeeping § 60.1365 What records must I keep for continuously monitored pollutants or parameters? You must...

40 CFR 60.1365 - What records must I keep for continuously monitored pollutants or parameters?

Code of Federal Regulations, 2011 CFR

2011-07-01

... diluent gas, document the relationship between oxygen and carbon dioxide, as specified in § 60.1255. (h... continuously monitored pollutants or parameters? 60.1365 Section 60.1365 Protection of Environment... Recordkeeping § 60.1365 What records must I keep for continuously monitored pollutants or parameters? You must...

40 CFR 60.1365 - What records must I keep for continuously monitored pollutants or parameters?

Code of Federal Regulations, 2013 CFR

2013-07-01

... diluent gas, document the relationship between oxygen and carbon dioxide, as specified in § 60.1255. (h... continuously monitored pollutants or parameters? 60.1365 Section 60.1365 Protection of Environment... Recordkeeping § 60.1365 What records must I keep for continuously monitored pollutants or parameters? You must...

40 CFR 60.1365 - What records must I keep for continuously monitored pollutants or parameters?

Code of Federal Regulations, 2012 CFR

2012-07-01

... diluent gas, document the relationship between oxygen and carbon dioxide, as specified in § 60.1255. (h... continuously monitored pollutants or parameters? 60.1365 Section 60.1365 Protection of Environment... Recordkeeping § 60.1365 What records must I keep for continuously monitored pollutants or parameters? You must...

40 CFR 60.1365 - What records must I keep for continuously monitored pollutants or parameters?

Code of Federal Regulations, 2014 CFR

2014-07-01

... diluent gas, document the relationship between oxygen and carbon dioxide, as specified in § 60.1255. (h... continuously monitored pollutants or parameters? 60.1365 Section 60.1365 Protection of Environment... Recordkeeping § 60.1365 What records must I keep for continuously monitored pollutants or parameters? You must...

40 CFR 60.1725 - How are the data from the continuous emission monitoring systems used?

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission monitoring systems used? 60.1725 Section 60.1725 Protection of Environment ENVIRONMENTAL... Before August 30, 1999 Model Rule-Continuous Emission Monitoring § 60.1725 How are the data from the... systems for sulfur dioxide, nitrogen oxides, and carbon monoxide to demonstrate continuous compliance with...

40 CFR Table 7 to Subpart Jjj of... - Requirements for Continuous Emission Monitoring Systems (CEMS) a

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 8 2011-07-01 2011-07-01 false Requirements for Continuous Emission Monitoring Systems (CEMS) a 7 Table 7 to Subpart JJJ of Part 62 Protection of Environment ENVIRONMENTAL...—Requirements for Continuous Emission Monitoring Systems (CEMS) a ER31JA03.013 ...

40 CFR Table 7 to Subpart Jjj of... - Requirements for Continuous Emission Monitoring Systems (CEMS) a

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Requirements for Continuous Emission Monitoring Systems (CEMS) a 7 Table 7 to Subpart JJJ of Part 62 Protection of Environment ENVIRONMENTAL...—Requirements for Continuous Emission Monitoring Systems (CEMS) a ER31JA03.013 ...

Evaluation of continuous air monitor placement in a plutonium facility.

PubMed

Whicker, J J; Rodgers, J C; Fairchild, C I; Scripsick, R C; Lopez, R C

1997-05-01

Department of Energy appraisers found continuous air monitors at Department of Energy plutonium facilities alarmed less than 30% of the time when integrated room plutonium air concentrations exceeded 500 DAC-hours. Without other interventions, this alarm percentage suggests the possibility that workers could be exposed to high airborne concentrations without continuous air monitor alarms. Past research has shown that placement of continuous air monitors is a critical component in rapid and reliable detection of airborne releases. At Los Alamos National Laboratory and many other Department of Energy plutonium facilities, continuous air monitors have been primarily placed at ventilation exhaust points. The purpose of this study was to evaluate and compare the effectiveness of exhaust register placement of workplace continuous air monitors with other sampling locations. Polydisperse oil aerosols were released from multiple locations in two plutonium laboratories at Los Alamos National Laboratory. An array of laser particle counters positioned in the rooms measured time-resolved aerosol dispersion. Results showed alternative placement of air samplers generally resulted in aerosol detection that was faster, often more sensitive, and equally reliable compared with samplers at exhaust registers.

Dynamic Radioactive Source for Evaluating and Demonstrating Time-dependent Performance of Continuous Air Monitors.

PubMed

McLean, Thomas D; Moore, Murray E; Justus, Alan L; Hudston, Jonathan A; Barbé, Benoît

2016-11-01

Evaluation of continuous air monitors in the presence of a plutonium aerosol is time intensive, expensive, and requires a specialized facility. The Radiation Protection Services Group at Los Alamos National Laboratory has designed a Dynamic Radioactive Source, intended to replace plutonium aerosol challenge testing. The Dynamic Radioactive Source is small enough to be inserted into the sampler filter chamber of a typical continuous air monitor. Time-dependent radioactivity is introduced from electroplated sources for real-time testing of a continuous air monitor where a mechanical wristwatch motor rotates a mask above an alpha-emitting electroplated disk source. The mask is attached to the watch's minute hand, and as it rotates, more of the underlying source is revealed. The measured alpha activity increases with time, simulating the arrival of airborne radioactive particulates at the air sampler inlet. The Dynamic Radioactive Source allows the temporal behavior of puff and chronic release conditions to be mimicked without the need for radioactive aerosols. The new system is configurable to different continuous air monitor designs and provides an in-house testing capability (benchtop compatible). It is a repeatable and reusable system and does not contaminate the tested air monitor. Test benefits include direct user control, realistic (plutonium) aerosol spectra, and iterative development of continuous air monitor alarm algorithms. Data obtained using the Dynamic Radioactive Source has been used to elucidate alarm algorithms and to compare the response time of two commercial continuous air monitors.

Dynamic Radioactive Source for Evaluating and Demonstrating Time-dependent Performance of Continuous Air Monitors

DOE PAGES

McLean, Thomas D.; Moore, Murray E.; Justus, Alan L.; ...

2016-01-01

Evaluation of continuous air monitors in the presence of a plutonium aerosol is time intensive, expensive, and requires a specialized facility. The Radiation Protection Services Group at Los Alamos National Laboratory has designed a Dynamic Radioactive Source, intended to replace plutonium aerosol challenge testing. Furthermore, the Dynamic Radioactive Source is small enough to be inserted into the sampler filter chamber of a typical continuous air monitor. Time-dependent radioactivity is introduced from electroplated sources for real-time testing of a continuous air monitor where a mechanical wristwatch motor rotates a mask above an alpha-emitting electroplated disk source. The mask is attached tomore » the watch’s minute hand, and as it rotates, more of the underlying source is revealed. The alpha activity we measured increases with time, simulating the arrival of airborne radioactive particulates at the air sampler inlet. The Dynamic Radioactive Source allows the temporal behavior of puff and chronic release conditions to be mimicked without the need for radioactive aerosols. The new system is configurable to different continuous air monitor designs and provides an in-house testing capability (benchtop compatible). It is a repeatable and reusable system and does not contaminate the tested air monitor. Test benefits include direct user control, realistic (plutonium) aerosol spectra, and iterative development of continuous air monitor alarm algorithms. We also used data obtained using the Dynamic Radioactive Source to elucidate alarm algorithms and to compare the response time of two commercial continuous air monitors.« less

Long-Term Continuous Ambulatory ECG Monitors and External Cardiac Loop Recorders for Cardiac Arrhythmia: A Health Technology Assessment

PubMed Central

Kabali, Conrad; Xie, Xuanqian; Higgins, Caroline

2017-01-01

Background Ambulatory electrocardiography (ECG) monitors are often used to detect cardiac arrhythmia. For patients with symptoms, an external cardiac loop recorder will often be recommended. The improved recording capacity of newer Holter monitors and similar devices, collectively known as longterm continuous ambulatory ECG monitors, suggests that they will perform just as well as, or better than, external loop recorders. This health technology assessment aimed to evaluate the effectiveness, cost-effectiveness, and budget impact of longterm continuous ECG monitors compared with external loop recorders in detecting symptoms of cardiac arrhythmia. Methods Based on our systematic search for studies published up to January 15, 2016, we did not identify any studies directly comparing the clinical effectiveness of longterm continuous ECG monitors and external loop recorders. Therefore, we conducted an indirect comparison, using a 24-hour Holter monitor as a common comparator. We used a meta-regression model to control for bias due to variation in device-wearing time and baseline syncope rate across studies. We conducted a similar systematic search for cost-utility and cost-effectiveness studies comparing the two types of devices; none were found. Finally, we used historical claims data (2006–2014) to estimate the future 5-year budget impact in Ontario, Canada, of continued public funding for both types of longterm ambulatory ECG monitors. Results Our clinical literature search yielded 7,815 non-duplicate citations, of which 12 cohort studies were eligible for indirect comparison. Seven studies assessed the effectiveness of longterm continuous monitors and five assessed external loop recorders. Both types of devices were more effective than a 24-hour Holter monitor, and we found no substantial difference between them in their ability to detect symptoms (risk difference 0.01; 95% confidence interval −0.18, 0.20). Using GRADE for network meta-analysis, we evaluated the quality of the evidence as low. Our budget impact analysis showed that use of the longterm continuous monitors has grown steadily in Ontario since they became publicly funded in 2006, particularly since 2011 when monitors that can record for 14 days or longer became funded, and the use of external cardiac loop recorders has correspondingly declined. The analysis suggests that, with these trends, continued public funding of both types of longterm ambulatory ECG testing will result in additional costs ranging from $130,000 to $370,000 per year over the next 5 years. Conclusions Although both longterm continuous ambulatory ECG monitors and external cardiac loop recorders were more effective than a 24-hour Holter monitor in detecting symptoms of cardiac arrhythmia, we found no evidence to suggest that these two devices differ in effectiveness. Assuming that the use of longterm continuous monitors will continue to increase in the next 5 years, the public health care system in Ontario can expect to see added costs of $130,000 to $370,000 per year. PMID:28194254

21 CFR 884.2800 - Computerized Labor Monitoring System.

Code of Federal Regulations, 2014 CFR

2014-04-01

... monitoring system is a system intended to continuously measure cervical dilation and fetal head descent and... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Computerized Labor Monitoring System. 884.2800... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Monitoring...

21 CFR 884.2800 - Computerized Labor Monitoring System.

Code of Federal Regulations, 2012 CFR

2012-04-01

... monitoring system is a system intended to continuously measure cervical dilation and fetal head descent and... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Computerized Labor Monitoring System. 884.2800... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Monitoring...

21 CFR 884.2800 - Computerized Labor Monitoring System.

Code of Federal Regulations, 2013 CFR

2013-04-01

... monitoring system is a system intended to continuously measure cervical dilation and fetal head descent and... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Computerized Labor Monitoring System. 884.2800... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Monitoring...

40 CFR 64.3 - Monitoring design criteria.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Monitoring design criteria. 64.3 Section 64.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.3 Monitoring design criteria. (a) General criteria. To provide a...

40 CFR 64.3 - Monitoring design criteria.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Monitoring design criteria. 64.3 Section 64.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.3 Monitoring design criteria. (a) General criteria. To provide a...

Procedure 5 Quality Assurance Requirements For Vapor Phase Mercury Continuous Emissions Monitoring Systems And Sorbent Trap Monitoring Systems Used For Compliance Determination At Stationary Sources

EPA Pesticide Factsheets

Promulgated quality assurance Procedure 5 Quality Assurance Requirements For Vapor Phase Mercury Continuous Emissions Monitoring Systems And Sorbent Trap Monitoring Systems Used For Compliance Determination At Stationary Sources

40 CFR 63.7120 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Lime Manufacturing Plants Continuous Compliance Requirements § 63.7120 How do I monitor and collect data to...

40 CFR 63.7120 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Lime Manufacturing Plants Continuous Compliance Requirements § 63.7120 How do I monitor and collect data to...

40 CFR 63.7120 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Lime Manufacturing Plants Continuous Compliance Requirements § 63.7120 How do I monitor and collect data to...

40 CFR 63.7120 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Lime Manufacturing Plants Continuous Compliance Requirements § 63.7120 How do I monitor and collect data to...

U.S. Geological Survey continuous monitoring workshop—Workshop summary report

USGS Publications Warehouse

Sullivan, Daniel J.; Joiner, John K.; Caslow, Kerry A.; Landers, Mark N.; Pellerin, Brian A.; Rasmussen, Patrick P.; Sheets, Rodney A.

2018-04-20

Executive SummaryThe collection of high-frequency (in other words, “continuous”) water data has been made easier over the years because of advances in technologies to measure, transmit, store, and query large, temporally dense datasets. Commercially available, in-situ sensors and data-collection platforms—together with new techniques for data analysis—provide an opportunity to monitor water quantity and quality at time scales during which meaningful changes occur. The U.S. Geological Survey (USGS) Continuous Monitoring Workshop was held to build stronger collaboration within the Water Mission Area on the collection, interpretation, and application of continuous monitoring data; share technical approaches for the collection and management of continuous data that improves consistency and efficiency across the USGS; and explore techniques and tools for the interpretation of continuous monitoring data, which increases the value to cooperators and the public. The workshop was organized into three major themes: Collecting Continuous Data, Understanding and Using Continuous Data, and Observing and Delivering Continuous Data in the Future. Presentations each day covered a variety of related topics, with a special session at the end of each day designed to bring discussion and problem solving to the forefront.The workshop brought together more than 70 USGS scientists and managers from across the Water Mission Area and Water Science Centers. Tools to manage, assure, control quality, and explore large streams of continuous water data are being developed by the USGS and other organizations and will be critical to making full use of these high-frequency data for research and monitoring. Disseminating continuous monitoring data and findings relevant to critical cooperator and societal issues is central to advancing the USGS networks and mission. Several important outcomes emerged from the presentations and breakout sessions.

40 CFR 58.15 - Annual air monitoring data certification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Annual air monitoring data certification. 58.15 Section 58.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) AMBIENT AIR QUALITY SURVEILLANCE Monitoring Network § 58.15 Annual air monitoring data...

40 CFR 58.15 - Annual air monitoring data certification.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 5 2011-07-01 2011-07-01 false Annual air monitoring data certification. 58.15 Section 58.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) AMBIENT AIR QUALITY SURVEILLANCE Monitoring Network § 58.15 Annual air monitoring data...

40 CFR 64.6 - Approval of monitoring.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Approval of monitoring. 64.6 Section 64.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.6 Approval of monitoring. (a) Based on an application that includes the...

76 FR 18415 - Continuous Emission Monitoring

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-04

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 75 Continuous Emission Monitoring CFR Correction In... Sec. 75.11, paragraph (f) is added to read as follows: Sec. 75.11 Specific provisions for monitoring... wood, refuse, or other material in addition to oil or gas shall comply with the monitoring provisions...

40 CFR 64.6 - Approval of monitoring.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Approval of monitoring. 64.6 Section 64.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.6 Approval of monitoring. (a) Based on an application that includes the...

40 CFR 64.7 - Operation of approved monitoring.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Operation of approved monitoring. 64.7 Section 64.7 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.7 Operation of approved monitoring. (a) Commencement of operation. The...

[Effects of lung protective ventilation strategy combined with lung recruitment maneuver on patients with severe burn complicated with acute respiratory distress syndrome].

PubMed

Li, Xiaojian; Zhong, Xiaomin; Deng, Zhongyuan; Zhang Xuhui; Zhang, Zhi; Zhang, Tao; Tang, Wenbin; Chen, Bib; Liu, Changling; Cao, Wenjuan

2014-08-01

To investigate the effects of lung protective ventilation strategy combined with lung recruitment maneuver on ARDS complicating patients with severe burn. Clinical data of 15 severely burned patients with ARDS admitted to our burn ICU from September 2011 to September 2013 and conforming to the study criteria were analyzed. Right after the diagnosis of acute lung injury/ARDS, patients received mechanical ventilation with lung protective ventilation strategy. When the oxygenation index (OI) was below or equal to 200 mmHg (1 mmHg = 0. 133 kPa), lung recruitment maneuver was performed combining incremental positive end-expiratory pressure. When OI was above 200 mmHg, lung recruitment maneuver was stopped and ventilation with lung protective ventilation strategy was continued. When OI was above 300 mmHg, mechanical ventilation was stopped. Before combining lung recruitment maneuver, 24 h after combining lung recruitment maneuver, and at the end of combining lung recruitment maneuver, variables of blood gas analysis (pH, PaO2, and PaCO2) were obtained by blood gas analyzer, and the OI values were calculated; hemodynamic parameters including heart rate, mean arterial pressure (MAP), central venous pressure (CVP) of all patients and the cardiac output (CO), extravascular lung water index (EVLWI) of 4 patients who received pulse contour cardiac output (PiCCO) monitoring were monitored. Treatment measures and outcome of patients were recorded. Data were processed with analysis of variance of repeated measurement of a single group and LSD test. (1) Before combining lung recruitment maneuver, 24 h after combining lung recruitment maneuver, and at the end of combining lung recruitment maneuver, the levels of PaO2 and OI of patients were respectively (77 ± 8), (113 ± 5), (142 ± 6) mmHg, and (128 ± 12), (188 ± 8), (237 ± 10) mmHg. As a whole, levels of PaO2 and OI changed significantly at different time points (with F values respectively 860. 96 and 842. 09, P values below 0. 01); levels of pH and PaCO2 showed no obvious changes (with F values respectively 0.35 and 3.13, P values above 0.05). (2) Levels of heart rate, MAP, CVP of all patients and CO of 4 patients who received PiCCO monitoring showed no significant changes at different time points (with F values from 0. 13 to 4. 26, P values above 0.05). Before combining lung recruitment maneuver, 24 h after combining lung recruitment maneuver, and at the end of combining lung recruitment maneuver, the EVLWI values of 4 patients who received PiCCO monitoring were respectively (13.5 ± 1.3), (10.2 ± 1.0), (7.0 ± 0.8) mL/kg ( F =117.00, P <0.01). (3) The patients received mechanical ventilation at 2 to 72 h after burn, lasting for 14-32 (21 ± 13) d. At post injury day 3-14 (7 ± 5) d, lung recruitment maneuver was applied for 2-5 (3.0 ± 2.0) d. All 15 patients recovered without other complications. Lung protective ventilation strategy combining lung recruitment maneuver can significantly improve the oxygenation in patients with severe burn complicated with ARDS and may therefore improve the prognosis.

Nanoparticles for Imaging: Top or Flop?

PubMed Central

Mertens, Marianne E.; Grimm, Jan; Lammers, Twan

2014-01-01

Nanoparticles are frequently suggested as diagnostic agents. However, except for iron oxide nanoparticles, diagnostic nanoparticles have been barely incorporated into clinical use so far. This is predominantly due to difficulties in achieving acceptable pharmacokinetic properties and reproducible particle uniformity as well as to concerns about toxicity, biodegradation, and elimination. Reasonable indications for the clinical utilization of nanoparticles should consider their biologic behavior. For example, many nanoparticles are taken up by macrophages and accumulate in macrophage-rich tissues. Thus, they can be used to provide contrast in liver, spleen, lymph nodes, and inflammatory lesions (eg, atherosclerotic plaques). Furthermore, cells can be efficiently labeled with nanoparticles, enabling the localization of implanted (stem) cells and tissue-engineered grafts as well as in vivo migration studies of cells. The potential of using nanoparticles for molecular imaging is compromised because their pharmacokinetic properties are difficult to control. Ideal targets for nanoparticles are localized on the endothelial luminal surface, whereas targeted nanoparticle delivery to extravascular structures is often limited and difficult to separate from an underlying enhanced permeability and retention (EPR) effect. The majority of clinically used nanoparticle-based drug delivery systems are based on the EPR effect, and, for their more personalized use, imaging markers can be incorporated to monitor biodistribution, target site accumulation, drug release, and treatment efficacy. In conclusion, although nanoparticles are not always the right choice for molecular imaging (because smaller or larger molecules might provide more specific information), there are other diagnostic and theranostic applications for which nanoparticles hold substantial clinical potential. PMID:25247562

Variations of the blood gas levels and thermodilutional parameters during ICP monitoring after severe head trauma in children.

PubMed

Lubrano, Riccardo; Elli, Marco; Stoppa, Francesca; Di Traglia, Mario; Di Nardo, Matteo; Perrotta, Daniela; David, Piero; Paoli, Sara; Cecchetti, Corrado

2015-08-01

The purpose of this study was to define, in children following head trauma and GSC ≤ 8, at which level of intracranial pressure (ICP), the thermodilutional, and gas analytic parameters implicated in secondary cerebral insults shows initial changes. We enrolled in the study 56 patients: 30 males and 26 females, mean age 71 ± 52 months. In all children, volumetric hemodynamic and blood gas parameters were monitored following initial resuscitation and every 4 h thereafter or whenever a hemodynamic deterioration was suspected. During the cumulative hospital stay, a total of 1050 sets of measurements were done. All parameters were stratified in seven groups according to ICP (group A1 = 0-5 mmHg, group A2 = 6-10 mmHg, group A3 = 11-15 mmHg, group A4 16-20 mmHg, group A5 21-25 mmHg, group A6 26-30 mmHg, group A7 >31 mmHg). Mean values of jugular oxygen saturation (SJO2), jugular oxygen partial pressure (PJO2), extravascular lung water (EVLWi), pulmonary vascular permeability (PVPi), fluid overload (FO), and cerebral extraction of oxygen (CEO2) vary significantly from A3 (11-15 mmHg) to A4 (16-20 mmHg). They relate to ICP in a four-parameter sigmoidal function (4PS function with: r(2) = 0.90), inflection point of 15 mmHg of ICP, and a maximum curvature point on the left horizontal asymptote at 13 mmHg of ICP. Mean values of SJO2, PJO2, EVLWi, PVPi, FO, and CEO2 become pathologic at 15 mmHg of ICP; however, the curve turns steeper at 13 mmHg, possibly a warning level in children for the development of post head trauma secondary insult.

New Continuous Monitoring Technologies for Vapor Intrusion, Remediation and Site Assessment: Benefits of Time Series Data

DTIC Science & Technology

2011-03-31

00-00-2011 4. TITLE AND SUBTITLE New Continuous Monitoring Technologies for Vapor Intrusion, Remediation and Site Assessment . Benefits of Time...Std Z39-18 Dr Peter Morris, Geoff Hewitt New Continuous Monitoring Technologies for Vapor Intrusion, Remediation and Site Assessment . Benefits of...but which poses a greater risk ? V O C p p m Acetone Industrial facility with VOC Leak Site characterisation and Real time monitoring of Remediation

40 CFR 63.5895 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true How do I monitor and collect data to... Composites Production Continuous Compliance Requirements § 63.5895 How do I monitor and collect data to demonstrate continuous compliance? (a) During production, you must collect and keep a record of data as...

40 CFR 63.5895 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I monitor and collect data to... Composites Production Continuous Compliance Requirements § 63.5895 How do I monitor and collect data to demonstrate continuous compliance? (a) During production, you must collect and keep a record of data as...

40 CFR Table 6 to Subpart Jjj of... - Requirements for Validating Continuous Emission Monitoring Systems (CEMS)

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 8 2011-07-01 2011-07-01 false Requirements for Validating Continuous Emission Monitoring Systems (CEMS) 6 Table 6 to Subpart JJJ of Part 62 Protection of Environment... of Part 62—Requirements for Validating Continuous Emission Monitoring Systems (CEMS) ER31JA03.012 ...

40 CFR Table 4 to Subpart Ffff of... - Model Rule-Requirements for Continuous Emission Monitoring Systems (CEMS)

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Model Rule-Requirements for Continuous Emission Monitoring Systems (CEMS) 4 Table 4 to Subpart FFFF of Part 60 Protection of Environment...—Model Rule—Requirements for Continuous Emission Monitoring Systems (CEMS) As stated in § 60.3039, you...

40 CFR Table 4 to Subpart Ffff of... - Model Rule-Requirements for Continuous Emission Monitoring Systems (CEMS)

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 6 2011-07-01 2011-07-01 false Model Rule-Requirements for Continuous Emission Monitoring Systems (CEMS) 4 Table 4 to Subpart FFFF of Part 60 Protection of Environment...—Model Rule—Requirements for Continuous Emission Monitoring Systems (CEMS) As stated in § 60.3039, you...

40 CFR Table 6 to Subpart Jjj of... - Requirements for Validating Continuous Emission Monitoring Systems (CEMS)

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Requirements for Validating Continuous Emission Monitoring Systems (CEMS) 6 Table 6 to Subpart JJJ of Part 62 Protection of Environment... of Part 62—Requirements for Validating Continuous Emission Monitoring Systems (CEMS) ER31JA03.012 ...

Subarachnoid and Intracerebral Hemorrhage in Patients with Churg-Strauss Syndrome: Two Case Reports

PubMed Central

Go, Myeong Hoon; Park, Jeong Un; Kang, Jae Gyu

2012-01-01

Churg-Strauss syndrome (CSS) is a systemic necrotizing vasculitis of the small and medium vessels, associated with extravascular eosinophilic granulomas, peripheral eosinophilia, and asthma. The exact etiology of CSS is unknown. This syndrome commonly affects the lungs, peripheral nerves, skin, heart, and gastrointestinal tract, but rarely the central nervous system. Subarachnoid and intracerebral hemorrhage in CSS patients is extremely rare; however, clinicians should consider that CSS may be a cause of intracranial hemorrhage and its high rate of mortality and morbidity. The authors report on two cases of subarachnoid and intracerebral hemorrhage with CSS and discuss a brief review of CSS. PMID:23210058

Metabolism and Distribution of 131 I-labelled Albumin in the Pig *

PubMed Central

Dich, John; Nielsen, Knud

1963-01-01

The biological behaviour of porcine 131I-albumin has been investigated in 11 normal pigs, weight appr. 20 kg. Mean values obtained from the experiments are: Albumin degradation: 15.1 ± 2.1 per cent/day (0.18 ± 0.01 g/kg/day), extravascular: intravascular albumin ratio: 1.71 ± 0.29. Fecal excretion of radio-activity ranged from 0.77—1.87 per cent of the dose (mean: 1.11 per cent) during the first 4 days of the experiment. The results are discussed with special reference to the rôle of the gastrointestinal tract in health and in various digestive disorders. PMID:17649473

Simultaneous determination of the intravenous and oral pharmacokinetic parameters of D,L-verapamil using stable isotope-labelled verapamil.

PubMed

Eichelbaum, M; Somogyi, A; von Unruh, G E; Dengler, H J

1981-01-01

Following i.v. administration, the plasma concentration-time curve of verapamil could best be described by either a mono- or biexponential equation. Total plasma clearance (1.26 1/min) approached liver blood flow (1.51/min), so it can be concluded that its clearance is liver blood flow-dependent. Although absorption was almost complete after oral administration, absolute bioavailability (20%) was low, due to extensive hepatic first-pass metabolism. The approach using stable isotope-labelled and unlabelled drug permits simultaneous administration by the intravascular and extravascular routes, thus allowing determination of absolute bioavailability in a single experiment.

40 CFR 63.2270 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... appropriate, monitor malfunctions, associated repairs, and required quality assurance or control activities... monitoring in continuous operation at all times that the process unit is operating. For purposes of calculating data averages, you must not use data recorded during monitoring malfunctions, associated repairs...

40 CFR 63.2270 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... appropriate, monitor malfunctions, associated repairs, and required quality assurance or control activities... monitoring in continuous operation at all times that the process unit is operating. For purposes of calculating data averages, you must not use data recorded during monitoring malfunctions, associated repairs...

40 CFR 60.343 - Monitoring of emissions and operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... device for the continuous measurement of the pressure loss of the gas stream through the scrubber. The monitoring device must be accurate within ±250 pascals (one inch of water). (2) A monitoring device for continuous measurement of the scrubbing liquid supply pressure to the control device. The monitoring device...

40 CFR 64.3 - Monitoring design criteria.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Monitoring design criteria. 64.3 Section 64.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.3 Monitoring design criteria. (a) General criteria. To provide a reasonable assurance of compliance with...

40 CFR 60.2940 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission monitoring systems are operating correctly? 60.2940 Section 60.2940 Protection of Environment... monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure carbon monoxide and oxygen. (b) Complete your...

40 CFR 60.3039 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission monitoring systems are operating correctly? 60.3039 Section 60.3039 Protection of Environment... emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure carbon monoxide and oxygen. (b...

40 CFR 60.2940 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission monitoring systems are operating correctly? 60.2940 Section 60.2940 Protection of Environment... monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure carbon monoxide and oxygen. (b) Complete your...

40 CFR 60.2940 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission monitoring systems are operating correctly? 60.2940 Section 60.2940 Protection of Environment... monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure carbon monoxide and oxygen. (b) Complete your...

40 CFR 60.3039 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission monitoring systems are operating correctly? 60.3039 Section 60.3039 Protection of Environment... emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure carbon monoxide and oxygen. (b...

40 CFR 60.3039 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2014 CFR

2014-07-01

... emission monitoring systems are operating correctly? 60.3039 Section 60.3039 Protection of Environment... emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure carbon monoxide and oxygen. (b...

40 CFR 60.3039 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission monitoring systems are operating correctly? 60.3039 Section 60.3039 Protection of Environment... emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure carbon monoxide and oxygen. (b...

40 CFR 60.3039 - How do I make sure my continuous emission monitoring systems are operating correctly?

Code of Federal Regulations, 2013 CFR

2013-07-01

... emission monitoring systems are operating correctly? 60.3039 Section 60.3039 Protection of Environment... emission monitoring systems are operating correctly? (a) Conduct initial, daily, quarterly, and annual evaluations of your continuous emission monitoring systems that measure carbon monoxide and oxygen. (b...

40 CFR 141.29 - Monitoring of consecutive public water systems.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Monitoring of consecutive public water systems. 141.29 Section 141.29 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Monitoring and Analytical Requirements § 141.29 Monitoring of consecutive...

40 CFR 65.161 - Continuous records and monitoring system data handling.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Routing to a Fuel Gas System or a Process § 65.161 Continuous records and monitoring system data handling...) Monitoring system breakdowns, repairs, preventive maintenance, calibration checks, and zero (low-level) and... section unless an alternative monitoring or recordkeeping system has been requested and approved under...

40 CFR 65.161 - Continuous records and monitoring system data handling.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Routing to a Fuel Gas System or a Process § 65.161 Continuous records and monitoring system data handling...) Monitoring system breakdowns, repairs, preventive maintenance, calibration checks, and zero (low-level) and... section unless an alternative monitoring or recordkeeping system has been requested and approved under...

40 CFR 63.2996 - What must I monitor?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 13 2013-07-01 2012-07-01 true What must I monitor? 63.2996 Section 63.2996 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Requirements § 63.2996 What must I monitor? You must monitor the parameters listed in table 1 of this subpart...

40 CFR 63.2996 - What must I monitor?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true What must I monitor? 63.2996 Section 63.2996 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED....2996 What must I monitor? You must monitor the parameters listed in table 1 of this subpart and any...

40 CFR 63.2996 - What must I monitor?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 12 2011-07-01 2009-07-01 true What must I monitor? 63.2996 Section 63.2996 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED....2996 What must I monitor? You must monitor the parameters listed in table 1 of this subpart and any...

Current concepts in blood glucose monitoring

PubMed Central

Khadilkar, Kranti Shreesh; Bandgar, Tushar; Shivane, Vyankatesh; Lila, Anurag; Shah, Nalini

2013-01-01

Blood glucose monitoring has evolved over the last century. The concept of adequate glycemic control and minimum glycemic variability requires an ideal, accurate and reliable glucose monitoring system. The search for an ideal blood glucose monitoring system still continues. This review explains the various blood glucose monitoring systems with special focus on the monitoring systems like self- monitored blood glucose (SMBG) and continuous glucose monitoring system (CGMS). It also focuses on the newer concepts of blood glucose monitoring and their incorporation in routine clinical management of diabetes mellitus. PMID:24910827

40 CFR 75.24 - Out-of-control periods and adjustment for system bias.

Code of Federal Regulations, 2013 CFR

2013-07-01

... § 75.24 Out-of-control periods and adjustment for system bias. (a) If an out-of-control period occurs... monitor or continuous emission monitoring system is out-of-control, any data recorded by the monitor or... pursuant to § 75.32 of this part. (c) When a monitor or continuous emission monitoring system is out-of...

40 CFR 63.8690 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Asphalt Processing and Asphalt Roofing Manufacturing Continuous Compliance Requirements § 63.8690 How do I monitor...

40 CFR 63.8690 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Asphalt Processing and Asphalt Roofing Manufacturing Continuous Compliance Requirements § 63.8690 How do I monitor...

40 CFR 63.8690 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Asphalt Processing and Asphalt Roofing Manufacturing Continuous Compliance Requirements § 63.8690 How do I monitor...

40 CFR 63.8690 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Asphalt Processing and Asphalt Roofing Manufacturing Continuous Compliance Requirements § 63.8690 How do I monitor...

40 CFR Table 4 to Subpart Hhhhhhh... - Applicability of the General Provisions to Part 63

Code of Federal Regulations, 2013 CFR

2013-07-01

... to develop SSM plan for continuous monitoring systems No. § 63.8(c)(5) Continuous opacity monitoring... to an SSM plan. SSM plans are not required § 63.8(e) Continuous monitoring systems performance...)(iv), (b)(2)(v) Actions taken to minimize emissions during SSM No. § 63.10(b)(2)(vi) Recordkeeping for...

40 CFR Table 31 to Subpart Uuu of... - Continuous Monitoring Systems for HAP Emissions From Sulfur Recovery Units

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Continuous Monitoring Systems for HAP Emissions From Sulfur Recovery Units 31 Table 31 to Subpart UUU of Part 63 Protection of Environment..., Subpt. UUU, Table 31 Table 31 to Subpart UUU of Part 63—Continuous Monitoring Systems for HAP Emissions...

40 CFR Table 31 to Subpart Uuu of... - Continuous Monitoring Systems for HAP Emissions From Sulfur Recovery Units

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Continuous Monitoring Systems for HAP Emissions From Sulfur Recovery Units 31 Table 31 to Subpart UUU of Part 63 Protection of Environment..., Subpt. UUU, Table 31 Table 31 to Subpart UUU of Part 63—Continuous Monitoring Systems for HAP Emissions...

U.S. Geological Survey quality-assurance plan for continuous water-quality monitoring in Kansas, 2014

USGS Publications Warehouse

Bennett, Trudy J.; Graham, Jennifer L.; Foster, Guy M.; Stone, Mandy L.; Juracek, Kyle E.; Rasmussen, Teresa J.; Putnam, James E.

2014-01-01

A quality-assurance plan for use in conducting continuous water-quality monitoring activities has been developed for the Kansas Water Science Center in accordance with guidelines set forth by the U.S. Geological Survey. This quality-assurance plan documents the standards, policies, and procedures used by the U.S. Geological Survey in Kansas for activities related to the collection, processing, storage, analysis, and release of continuous water-quality monitoring data. The policies and procedures that are documented in this quality-assurance plan for continuous water-quality monitoring activities complement quality-assurance plans for surface-water and groundwater activities in Kansas.

Diagnostic yield and optimal duration of continuous-loop event monitoring for the diagnosis of palpitations. A cost-effectiveness analysis

NASA Technical Reports Server (NTRS)

Zimetbaum, P. J.; Kim, K. Y.; Josephson, M. E.; Goldberger, A. L.; Cohen, D. J.

1998-01-01

BACKGROUND: Continuous-loop event recorders are widely used for the evaluation of palpitations, but the optimal duration of monitoring is unknown. OBJECTIVE: To determine the yield, timing, and incremental cost-effectiveness of each week of event monitoring for palpitations. DESIGN: Prospective cohort study. PATIENTS: 105 consecutive outpatients referred for the placement of a continuous-loop event recorder for the evaluation of palpitations. MEASUREMENTS: Diagnostic yield, incremental cost, and cost-effectiveness for each week of monitoring. RESULTS: The diagnostic yield of continuous-loop event recorders was 1.04 diagnoses per patient in week 1, 0.15 diagnoses per patient in week 2, and 0.01 diagnoses per patient in week 3 and beyond. Over time, the cost-effectiveness ratio increased from $98 per new diagnosis in week 1 to $576 per new diagnosis in week 2 and $5832 per new diagnosis in week 3. CONCLUSIONS: In patients referred for evaluation of palpitations, the diagnostic yield of continuous-loop event recording decreases rapidly after 2 weeks of monitoring. A 2-week monitoring period is reasonably cost-effective for most patients and should be the standard period for continuous-loop event recording for the evaluation of palpitations.

Continuous Metabolic Monitoring Based on Multi-Analyte Biomarkers to Predict Exhaustion

PubMed Central

Kastellorizios, Michail; Burgess, Diane J.

2015-01-01

This work introduces the concept of multi-analyte biomarkers for continuous metabolic monitoring. The importance of using more than one marker lies in the ability to obtain a holistic understanding of the metabolism. This is showcased for the detection and prediction of exhaustion during intense physical exercise. The findings presented here indicate that when glucose and lactate changes over time are combined into multi-analyte biomarkers, their monitoring trends are more sensitive in the subcutaneous tissue, an implantation-friendly peripheral tissue, compared to the blood. This unexpected observation was confirmed in normal as well as type 1 diabetic rats. This study was designed to be of direct value to continuous monitoring biosensor research, where single analytes are typically monitored. These findings can be implemented in new multi-analyte continuous monitoring technologies for more accurate insulin dosing, as well as for exhaustion prediction studies based on objective data rather than the subject’s perception. PMID:26028477

Continuous metabolic monitoring based on multi-analyte biomarkers to predict exhaustion.

PubMed

Kastellorizios, Michail; Burgess, Diane J

2015-06-01

This work introduces the concept of multi-analyte biomarkers for continuous metabolic monitoring. The importance of using more than one marker lies in the ability to obtain a holistic understanding of the metabolism. This is showcased for the detection and prediction of exhaustion during intense physical exercise. The findings presented here indicate that when glucose and lactate changes over time are combined into multi-analyte biomarkers, their monitoring trends are more sensitive in the subcutaneous tissue, an implantation-friendly peripheral tissue, compared to the blood. This unexpected observation was confirmed in normal as well as type 1 diabetic rats. This study was designed to be of direct value to continuous monitoring biosensor research, where single analytes are typically monitored. These findings can be implemented in new multi-analyte continuous monitoring technologies for more accurate insulin dosing, as well as for exhaustion prediction studies based on objective data rather than the subject's perception.

A continuous glucose monitoring and problem-solving intervention to change physical activity behavior in women with type 2 diabetes: a pilot study.

PubMed

Allen, Nancy; Whittemore, Robin; Melkus, Gail

2011-11-01

Diabetes technology has the potential to provide useful data for theory-based behavioral counseling. The aims of this study are to evaluate the feasibility, acceptability, and preliminary efficacy of a continuous glucose monitoring and problem-solving counseling intervention to change physical activity (PA) behavior in women with type 2 diabetes. Women (n=29) with type 2 diabetes were randomly assigned to one of two treatment conditions: continuous glucose counseling and problem-solving skills or continuous glucose monitoring counseling and general diabetes education. Feasibility data were obtained on intervention dose, implementation, and satisfaction. Preliminary efficacy data were collected at baseline and 12 weeks on the following measures: PA amount and intensity, diet, problem-solving skills, self-efficacy for PA, depression, hemogoloin A1c, weight, and blood pressure. Demographic and implementation variables were described using frequency distributions and summary statistics. Satisfaction data were analyzed using Wilcoxon rank. Differences between groups were analyzed using linear mixed-modeling. Women were mostly white/non-Latina with a mean age of 53 years, a 6.5-year history of diabetes, and suboptimal glycemic control. Continuous glucose monitoring plus problem-solving group participants had significantly greater problem-solving skills and had greater, although not statistically significant, dietary adherence, moderate activity minutes, weight loss, and higher intervention satisfaction pre- to post-intervention than did participants in the continuous glucose monitoring plus education group. A continuous glucose monitoring plus problem-solving intervention was feasible and acceptable, and participants had greater problem-solving skills than continuous glucose monitoring plus education group participants.

40 CFR 60.1225 - What types of continuous emission monitoring must I perform?

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Small Municipal Waste Combustion Units for Which Construction is Commenced After August 30... emissions, you must perform four tasks: (a) Install continuous emission monitoring systems for certain...

40 CFR 60.1250 - What is my schedule for evaluating continuous emission monitoring systems?

Code of Federal Regulations, 2010 CFR

2010-07-01

... continuous emission monitoring systems? 60.1250 Section 60.1250 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Small Municipal Waste Combustion Units for Which Construction is Commenced...

40 CFR 60.2730 - What monitoring equipment must I install and what parameters must I monitor?

Code of Federal Regulations, 2014 CFR

2014-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... Units Model Rule-Monitoring § 60.2730 What monitoring equipment must I install and what parameters must...) of this section must be expressed in milligrams per dry standard cubic meter corrected to 7 percent...

40 CFR 60.2730 - What monitoring equipment must I install and what parameters must I monitor?

Code of Federal Regulations, 2013 CFR

2013-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... Units Model Rule-Monitoring § 60.2730 What monitoring equipment must I install and what parameters must...) of this section must be expressed in milligrams per dry standard cubic meter corrected to 7 percent...

40 CFR 75.10 - General operating requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... part, a flow monitoring system and a CO2 continuous emission monitoring system that uses an O2...) Primary Measurement Requirement. The owner or operator shall measure opacity, and all SO2, NOX, and CO2... continuous emission monitoring system (consisting of a NOX pollutant concentration monitor and an O2 or CO2...

40 CFR 75.10 - General operating requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... part, a flow monitoring system and a CO2 continuous emission monitoring system that uses an O2...) Primary Measurement Requirement. The owner or operator shall measure opacity, and all SO2, NOX, and CO2... continuous emission monitoring system (consisting of a NOX pollutant concentration monitor and an O2 or CO2...

40 CFR 60.3038 - What continuous emission monitoring systems must I install?

Code of Federal Regulations, 2012 CFR

2012-07-01

... systems must I install? 60.3038 Section 60.3038 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... December 9, 2004 Model Rule-Monitoring § 60.3038 What continuous emission monitoring systems must I install... carbon monoxide and for oxygen. You must monitor the oxygen concentration at each location where you...

40 CFR 60.3038 - What continuous emission monitoring systems must I install?

Code of Federal Regulations, 2014 CFR

2014-07-01

... systems must I install? 60.3038 Section 60.3038 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... December 9, 2004 Model Rule-Monitoring § 60.3038 What continuous emission monitoring systems must I install... carbon monoxide and for oxygen. You must monitor the oxygen concentration at each location where you...

40 CFR 60.3038 - What continuous emission monitoring systems must I install?

Code of Federal Regulations, 2013 CFR

2013-07-01

... systems must I install? 60.3038 Section 60.3038 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... December 9, 2004 Model Rule-Monitoring § 60.3038 What continuous emission monitoring systems must I install... carbon monoxide and for oxygen. You must monitor the oxygen concentration at each location where you...

Noninvasive Continuous Monitoring of Tear Glucose Using Glucose-Sensing Contact Lenses.

PubMed

Ascaso, Francisco J; Huerva, Valentín

2016-04-01

: The incidence of diabetes mellitus is dramatically increasing in the developed countries. Tight control of blood glucose concentration is crucial to diabetic patients to prevent microvascular complications. Self-monitoring of blood glucose is widely used for controlling blood glucose levels and usually performed by an invasive test using a portable glucometer. Many technologies have been developed over the past decades with the purpose of obtaining a continuous physiological glycemic monitoring. A contact lens is the ideal vehicle for continuous tear glucose monitoring of glucose concentration in tear film. There are several research groups that are working in the development of contact lenses with embedded biosensors for continuously and noninvasively monitoring tear glucose levels. Although numerous aspects must be improved, contact lens technology is one step closer to helping diabetic subjects better manage their condition, and these contact lenses will be able to measure the level of glucose in the wearer's tears and communicate the information to a mobile phone or computer. This article reviews studies on ocular glucose and its monitoring methods as well as the attempts to continuously monitor the concentration of tear glucose by using contact lens-based sensors.

Continuous Glucose Monitoring: Impact on Hypoglycemia.

PubMed

van Beers, Cornelis A J; DeVries, J Hans

2016-11-01

The necessity of strict glycemic control is unquestionable. However, hypoglycemia remains a major limiting factor in achieving satisfactory glucose control, and evidence is mounting to show that hypoglycemia is not benign. Over the past decade, evidence has consistently shown that real-time continuous glucose monitoring improves glycemic control in terms of lowering glycated hemoglobin levels. However, real-time continuous glucose monitoring has not met the expectations of the diabetes community with regard to hypoglycemia prevention. The earlier trials did not demonstrate any effect on either mild or severe hypoglycemia and the effect of real-time continuous glucose monitoring on nocturnal hypoglycemia was often not reported. However, trials specifically designed to reduce hypoglycemia in patients with a high hypoglycemia risk have demonstrated a reduction in hypoglycemia, suggesting that real-time continuous glucose monitoring can prevent hypoglycemia when it is specifically used for that purpose. Moreover, the newest generation of diabetes technology currently available commercially, namely sensor-augmented pump therapy with a (predictive) low glucose suspend feature, has provided more convincing evidence for hypoglycemia prevention. This article provides an overview of the hypoglycemia outcomes of randomized controlled trials that investigate the effect of real-time continuous glucose monitoring alone or sensor-augmented pump therapy with a (predictive) low glucose suspend feature. Furthermore, several possible explanations are provided why trials have not shown a reduction in severe hypoglycemia. In addition, existing evidence is presented of real-time continuous glucose monitoring in patients with impaired awareness of hypoglycemia who have the highest risk of severe hypoglycemia. © 2016 Diabetes Technology Society.

Continuous Glucose Monitoring

PubMed Central

van Beers, Cornelis A. J.; DeVries, J. Hans

2016-01-01

The necessity of strict glycemic control is unquestionable. However, hypoglycemia remains a major limiting factor in achieving satisfactory glucose control, and evidence is mounting to show that hypoglycemia is not benign. Over the past decade, evidence has consistently shown that real-time continuous glucose monitoring improves glycemic control in terms of lowering glycated hemoglobin levels. However, real-time continuous glucose monitoring has not met the expectations of the diabetes community with regard to hypoglycemia prevention. The earlier trials did not demonstrate any effect on either mild or severe hypoglycemia and the effect of real-time continuous glucose monitoring on nocturnal hypoglycemia was often not reported. However, trials specifically designed to reduce hypoglycemia in patients with a high hypoglycemia risk have demonstrated a reduction in hypoglycemia, suggesting that real-time continuous glucose monitoring can prevent hypoglycemia when it is specifically used for that purpose. Moreover, the newest generation of diabetes technology currently available commercially, namely sensor-augmented pump therapy with a (predictive) low glucose suspend feature, has provided more convincing evidence for hypoglycemia prevention. This article provides an overview of the hypoglycemia outcomes of randomized controlled trials that investigate the effect of real-time continuous glucose monitoring alone or sensor-augmented pump therapy with a (predictive) low glucose suspend feature. Furthermore, several possible explanations are provided why trials have not shown a reduction in severe hypoglycemia. In addition, existing evidence is presented of real-time continuous glucose monitoring in patients with impaired awareness of hypoglycemia who have the highest risk of severe hypoglycemia. PMID:27257169

75 FR 18782 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Alternate Monitoring...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-13

...EPA is proposing to approve a revision to Indiana's State Implementation Plan alternative monitoring requirements for Indianapolis Power and Light Company (IPL) at its Harding Street Generating Station. On December 31, 2008, Indiana requested approval of alternative monitoring requirements that allow the use of a particulate matter continuous emissions monitoring system in place of a continuous opacity monitor.

Validation of Spectral Analysis as a Noninvasive Tool to Assess Autonomic Regulation of Cardiovascular Function

NASA Technical Reports Server (NTRS)

Knapp, Charles F.; Evans, Joyce M.

1996-01-01

A major focus of our program has been to develop a sensitive noninvasive procedure to quantify early weightlessness-induced changes in cardiovascular function or potential dysfunction. Forty studies of healthy young volunteers (10 men and 10 women, each studied twice) were conducted to determine changes in the sympatho-vagal balance of autonomic control of cardiovascular regulation during graded headward and footward blood volume shifts. Changes in sympatho-vagal balance were classified by changes in the mean levels and spectral content of cardiovascular variables and verified by changes in circulating levels of catecholamines and pancreatic polypeptide. Possible shifts in intra/extravascular fluid were assessed from changes in hematocrit and plasma mass density while changes in the stimulus to regulate plasma volume were determined from Plasma Renin Activity (PRA). Autonomic blockade was used to unmask the relative contribution of sympathetic and parasympathetic efferent influences in response to 10 min each of 0, 20 and 40 mmHg Lower Body Negative Pressure (LBNP) and 15 and 30 mmHg Positive Pressure (LBPP). The combination of muscarinic blockade with graded LBNP and LBPP was used to evoke graded increases and decreases in sympathetic activity without parasympathetic contributions. The combination of beta blockade with graded LBNP and LBPP was used to produce graded increases and decreases in parasympathetic activity without beta sympathetic contributions. Finally, a combination of both beta and muscarinic blockades with LBNP and LBPP was used to determine the contribution from other, primarily alpha adrenergic, sources. Mean values, spectral analyses and time frequency analysis of R-R interval (HR), Arterial Pressure (AP), peripheral blood flow (RF), Stroke Volume (SV) and peripheral resistance (TPR) were performed for all phases of the study. Skin blood Flow (SF) was also measured in other studies and similarly analyzed. Spectra were examined for changes in three frequency regions (low 0.006 - 0.005 Hz (LF), mid 0.05 - 0.15 Hz (W), and high 0.15 - 0.45 Hz (EF)). The primary objective of the study was to indicate which changes in the mean values and/or spectra of cardiovascular variables consistently correlated with changes in sympatho-vagal balance in response to headward and footward fluid shifts. A secondaey objective was to quantify the vascular and extravascular fluid shifts evoked by LBNP and LBPP. The principal hypothesis being tested was that headward fluid shifts would evoke an increase in parasympathetic activity and footward fluid shifts would evoke an increase in sympathetic activity both of which would be detected by spectral analysis and verified by circulating hormones. Hematocrit (HCT), plasma mass density and plasma renin activity increased with muscarinic blockade and with LBNP, a response indicative of a plasma shift to extravascular spaces. Beta blockade alone or after muscarinic blockade had no effect on HCT or plasma mass density. With respect to intravascular fluid volume distribution, LBNP and LBPP produced sufficient upper body vascular fluid shifts to evoke appropriate autonomic regulatory responses.

40 CFR 63.9035 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 14 2010-07-01 2010-07-01 false How do I monitor and collect data to demonstrate continuous compliance? 63.9035 Section 63.9035 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

40 CFR 63.9035 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 14 2011-07-01 2011-07-01 false How do I monitor and collect data to demonstrate continuous compliance? 63.9035 Section 63.9035 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

40 CFR 63.7535 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 13 2010-07-01 2010-07-01 false How do I monitor and collect data to demonstrate continuous compliance? 63.7535 Section 63.7535 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

40 CFR 63.7332 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 13 2010-07-01 2010-07-01 false How do I monitor and collect data to demonstrate continuous compliance? 63.7332 Section 63.7332 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

40 CFR 63.6635 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 13 2010-07-01 2010-07-01 false How do I monitor and collect data to demonstrate continuous compliance? 63.6635 Section 63.6635 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

40 CFR 63.7120 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 13 2010-07-01 2010-07-01 false How do I monitor and collect data to demonstrate continuous compliance? 63.7120 Section 63.7120 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

40 CFR 63.7946 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 13 2010-07-01 2010-07-01 false How do I monitor and collect data to demonstrate continuous compliance? 63.7946 Section 63.7946 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

40 CFR 63.9922 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 14 2011-07-01 2011-07-01 false How do I monitor and collect data to demonstrate continuous compliance? 63.9922 Section 63.9922 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

40 CFR 63.9633 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 14 2011-07-01 2011-07-01 false How do I monitor and collect data to demonstrate continuous compliance? 63.9633 Section 63.9633 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

Prognostic value of extravascular lung water and its potential role in guiding fluid therapy in septic shock after initial resuscitation.

PubMed

Wang, Hao; Cui, Na; Su, Longxiang; Long, Yun; Wang, Xiaoting; Zhou, Xiang; Chai, Wenzhao; Liu, Dawei

2016-06-01

To explore whether extravascular lung water (EVLW) provides a valuable prognostic tool guiding fluid therapy in septic shock patients after initial resuscitation. We performed a retrospective study of septic shock patients who achieved adequate initial fluid resuscitation with extended hemodynamic monitoring, analyzing the prognostic value of EVLW and whether fluid therapy for 24 (T24) or 24-48 hours (T24-48) after initial resuscitation with a recommended value of EVLW yielded a 28-day mortality advantage. One hundred five patients with septic shock were included in this study, 60 (57.1%) of whom died after 28 days. For 48 hours after initial resuscitation, the daily fluid balance (DFB; T24: 2494 ± 1091 vs 1965 ± 964 mL [P = .011] and T24-48: 2127 ± 783 vs 1588 ± 665 mL [P < .001]) and daily maximum values of the EVLW index (EVLWImax; T24: 13.9 ± 3.7 vs 11.5 ± 3.2 mL/kg [P < .001] and T24-48: 14.4 ± 5.3 vs 12.0 ± 4.4 mL/kg [P < .001]) were significantly higher in nonsurvivors than in survivors. In multivariate regression analysis, the DFB (T24: odds ratio [OR] 1.001 [P = .016] and T24-48: OR 1.001 [P = .008]), EVLWImax (T24: OR 2.158 [P = .002] and T24-48: OR 3.277 [P = .001]), blood lactate (T24: OR 1.368 [P = .021] and T24-48: OR 4.112 [P < .001]), and central venous blood oxygen saturation (T24: OR 0.893 [P = .013] and T24-48: OR 0.780 [P = .004]) were all independently associated with the 28-day mortality. A receiver operating characteristic analysis revealed that area under the curve values of 0.82 (95% confidence interval, 0.74-0.91; P < .001) and 0.90 (95% confidence interval, 0.83-0.96; P < .001) for EVLWImax ≥ 12.5 mL/kg (T24 and T24-48) predicted a 28-day mortality with sensitivities of 88% (80%-96%) and 95% (90%-100%) and specificities of 60% (46%-74%) and 76% (63%-89%).The EVLWImax was correlated with DFB with Spearman ρ values of 0.497 (T24: P < .001) and 0.650 (T24-48: P < .001). Cox survival and regression analyses demonstrated that EVLWImax ≥ 12.5 mL/kg (T24 and T24-48) was associated with higher risk and increased mortality, with adjusted ORs of 4.77 (P < .001) and 10.86 (P < .001). A higher EVLW in septic shock patients after initial resuscitation was associated with a more positive fluid balance and increased mortality, which is an independent predictor of the 28-day mortality in septic shock patients after initial resuscitation. Copyright © 2016 Elsevier Inc. All rights reserved.

40 CFR 401.17 - pH Effluent limitations under continuous monitoring.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 30 2012-07-01 2012-07-01 false pH Effluent limitations under... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PROVISIONS § 401.17 pH Effluent limitations under continuous monitoring. (a) Where a permittee continuously measures the pH of wastewater pursuant to a...

40 CFR 401.17 - pH Effluent limitations under continuous monitoring.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 30 2013-07-01 2012-07-01 true pH Effluent limitations under... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PROVISIONS § 401.17 pH Effluent limitations under continuous monitoring. (a) Where a permittee continuously measures the pH of wastewater pursuant to a...

40 CFR 401.17 - pH Effluent limitations under continuous monitoring.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 29 2014-07-01 2012-07-01 true pH Effluent limitations under... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PROVISIONS § 401.17 pH Effluent limitations under continuous monitoring. (a) Where a permittee continuously measures the pH of wastewater pursuant to a...

40 CFR 401.17 - pH Effluent limitations under continuous monitoring.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 29 2011-07-01 2009-07-01 true pH Effluent limitations under... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PROVISIONS § 401.17 pH Effluent limitations under continuous monitoring. (a) Where a permittee continuously measures the pH of wastewater pursuant to a...

40 CFR 401.17 - pH Effluent limitations under continuous monitoring.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 28 2010-07-01 2010-07-01 true pH Effluent limitations under... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PROVISIONS § 401.17 pH Effluent limitations under continuous monitoring. (a) Where a permittee continuously measures the pH of wastewater pursuant to a...

40 CFR 63.9920 - What are my continuous monitoring requirements?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Continuous Compliance Requirements § 63.9920 What are my continuous monitoring requirements? For each wet scrubber subject to the operating limits for pressure drop and scrubber water flow rates in § 63.9890(b...

40 CFR 63.9920 - What are my continuous monitoring requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Continuous Compliance Requirements § 63.9920 What are my continuous monitoring requirements? For each wet scrubber subject to the operating limits for pressure drop and scrubber water flow rates in § 63.9890(b...

EVALUATION OF DIOXIN EMISSIONS MONITORING SYSTEMS

EPA Science Inventory

Continuous samplers and real or semi-real-time continuous monitors for polychlorinated dibenzodioxins and furans provide significant advantages relative to conventional methods of extractive sampling. Continuous samplers collect long term samples over a time period of days to wee...

Department of Defense Chemical and Biological Defense Program. FY2004-2006 Performance Plan

DTIC Science & Technology

2005-03-01

Agents (NTAs) Compare the direct effects of PAF on smooth muscle, hematic constituents, and lung to determine role in toxicity. Continue to identify...Range Biometric Target ID System Explore technologies for a long range biometric target identification system. Air Containment Monitoring System...Continue development of systems for contained air monitoring for chemical agents.Long Range Biometric Air Containment Monitoring System Continued

40 CFR Table 31 to Subpart Uuu of... - Continuous Monitoring Systems for HAP Emissions From Sulfur Recovery Units

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 13 2014-07-01 2014-07-01 false Continuous Monitoring Systems for HAP Emissions From Sulfur Recovery Units 31 Table 31 to Subpart UUU of Part 63 Protection of Environment... Units Pt. 63, Subpt. UUU, Table 31 Table 31 to Subpart UUU of Part 63—Continuous Monitoring Systems for...

40 CFR Table 31 to Subpart Uuu of... - Continuous Monitoring Systems for HAP Emissions From Sulfur Recovery Units

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 13 2013-07-01 2012-07-01 true Continuous Monitoring Systems for HAP Emissions From Sulfur Recovery Units 31 Table 31 to Subpart UUU of Part 63 Protection of Environment... Units Pt. 63, Subpt. UUU, Table 31 Table 31 to Subpart UUU of Part 63—Continuous Monitoring Systems for...

40 CFR Table 31 to Subpart Uuu of... - Continuous Monitoring Systems for HAP Emissions From Sulfur Recovery Units

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 13 2012-07-01 2012-07-01 false Continuous Monitoring Systems for HAP Emissions From Sulfur Recovery Units 31 Table 31 to Subpart UUU of Part 63 Protection of Environment... Units Pt. 63, Subpt. UUU, Table 31 Table 31 to Subpart UUU of Part 63—Continuous Monitoring Systems for...

Connecticut permanent long-term bridge monitoring network, volume 6 : monitoring of a continuous plate girder bridge with load restrictions - Route 15 over the Housatonic River in Stratford (Bridge #761).

DOT National Transportation Integrated Search

2014-08-01

This report describes the instrumentation and data acquisition system for monitoring of a continuous span steel plate : girder bridge with a composite concrete deck located on a limited access highway. The monitoring system was : developed and instal...

40 CFR 63.2164 - If I monitor brew ethanol, what are my monitoring installation, operation, and maintenance...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 12 2011-07-01 2009-07-01 true If I monitor brew ethanol, what are my monitoring installation, operation, and maintenance requirements? 63.2164 Section 63.2164 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR...

40 CFR 62.15225 - What must I do if my continuous emission monitoring system is temporarily unavailable to meet the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission monitoring system is temporarily unavailable to meet the data collection requirements? 62.15225... Emission Monitoring § 62.15225 What must I do if my continuous emission monitoring system is temporarily... methods for collecting data when these systems malfunction or when repairs, calibration checks, or zero...

40 CFR 60.1770 - What must I do if any of my continuous emission monitoring systems are temporarily unavailable to...

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission monitoring systems are temporarily unavailable to meet the data collection requirements? 60.1770... Emission Monitoring § 60.1770 What must I do if any of my continuous emission monitoring systems are... alternate methods for collecting data when systems malfunction or when repairs, calibration checks, or zero...

40 CFR 62.15225 - What must I do if my continuous emission monitoring system is temporarily unavailable to meet the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission monitoring system is temporarily unavailable to meet the data collection requirements? 62.15225... Emission Monitoring § 62.15225 What must I do if my continuous emission monitoring system is temporarily... methods for collecting data when these systems malfunction or when repairs, calibration checks, or zero...

40 CFR 60.1770 - What must I do if any of my continuous emission monitoring systems are temporarily unavailable to...

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission monitoring systems are temporarily unavailable to meet the data collection requirements? 60.1770... Emission Monitoring § 60.1770 What must I do if any of my continuous emission monitoring systems are... alternate methods for collecting data when systems malfunction or when repairs, calibration checks, or zero...

40 CFR 63.1415 - Monitoring requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... thermocouple, ultra-violet beam sensor, or infrared sensor) capable of continuously detecting the presence of a... an absorber is used, a scrubbing liquid temperature monitoring device and a specific gravity... condenser exit temperature (product side) monitoring device equipped with a continuous recorder is required...

40 CFR 63.1415 - Monitoring requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... thermocouple, ultra-violet beam sensor, or infrared sensor) capable of continuously detecting the presence of a... an absorber is used, a scrubbing liquid temperature monitoring device and a specific gravity... condenser exit temperature (product side) monitoring device equipped with a continuous recorder is required...

40 CFR 63.1415 - Monitoring requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... thermocouple, ultra-violet beam sensor, or infrared sensor) capable of continuously detecting the presence of a...) Where an absorber is used, a scrubbing liquid temperature monitoring device and a specific gravity... condenser exit temperature (product side) monitoring device equipped with a continuous recorder is required...

40 CFR 63.6003 - How do I monitor and collect data to demonstrate continuous compliance with the emission limits...

Code of Federal Regulations, 2010 CFR

2010-07-01

... demonstrate continuous compliance with the emission limits for tire production affected sources? 63.6003... Standards for Hazardous Air Pollutants: Rubber Tire Manufacturing Continuous Compliance Requirements for Tire Production Affected Sources § 63.6003 How do I monitor and collect data to demonstrate continuous...

40 CFR 62.15215 - What is required for my continuous opacity monitoring system and how are the data used?

Code of Federal Regulations, 2010 CFR

2010-07-01

... initial evaluation of your continuous opacity monitoring system according to Performance Specification 1 in appendix B of 40 CFR part 60. Complete this evaluation by 180 days after your final compliance... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF STATE PLANS...

International AGN Watch: Continuous Monitoring of NGC 4151

NASA Technical Reports Server (NTRS)

Crenshaw, D. M.

1995-01-01

The nucleus of NGC 4151 was observed continuously with the International Ultraviolet Explorer (IUE) for 9.3 days, yielding a pair of LWP and SWP spectra every 70 minutes, and during four-hour periods for 4 days prior to and 5 days after the continuous monitoring period. The sampling frequency of the observations is an order of magnitude higher than that of any previous UV monitoring campaign on a Seyfert galaxy.

40 CFR 63.9335 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Cells/Stands Continuous Compliance Requirements § 63.9335 How do I monitor and collect data to... continuous operation at all times the engine test cell/stand is operating. (b) Do not use data recorded...

40 CFR 63.9335 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Cells/Stands Continuous Compliance Requirements § 63.9335 How do I monitor and collect data to... continuous operation at all times the engine test cell/stand is operating. (b) Do not use data recorded...

40 CFR 63.9335 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Cells/Stands Continuous Compliance Requirements § 63.9335 How do I monitor and collect data to... continuous operation at all times the engine test cell/stand is operating. (b) Do not use data recorded...

40 CFR 63.9335 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Cells/Stands Continuous Compliance Requirements § 63.9335 How do I monitor and collect data to... continuous operation at all times the engine test cell/stand is operating. (b) Do not use data recorded...

40 CFR 63.9335 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Cells/Stands Continuous Compliance Requirements § 63.9335 How do I monitor and collect data to... continuous operation at all times the engine test cell/stand is operating. (b) Do not use data recorded...

40 CFR 75.42 - Reliability criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Reliability criteria. 75.42 Section 75...) CONTINUOUS EMISSION MONITORING Alternative Monitoring Systems § 75.42 Reliability criteria. To demonstrate reliability equal to or better than the continuous emission monitoring system, the owner or operator shall...

Sensing system development for HOV/HOT (high occupancy vehicle) lane monitoring.

DOT National Transportation Integrated Search

2011-02-01

With continued interest in the efficient use of roadways the ability to monitor the use of HOV/HOT lanes is essential for management, planning and operation. A system to reliably monitor these lanes on a continuous basis and provide usage statistics ...

Sensing system development for HOV/HOT (high occupancy vehicle) lane monitoring.

DOT National Transportation Integrated Search

2011-02-01

. : ii : ABSTRACT : With continued interest in the efficient use of roadways the ability to monitor the use of HOV/HOT lanes is essential for management, planning and operation. A system to reliably monitor these lanes on a continuous basis and provi...

40 CFR 63.7947 - What are my monitoring alternatives?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 14 2012-07-01 2011-07-01 true What are my monitoring alternatives? 63.7947 Section 63.7947 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS...) National Emission Standards for Hazardous Air Pollutants: Site Remediation Continuous Monitoring Systems...

40 CFR 60.175 - Monitoring of operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Primary Zinc... monitor and record the opacity of gases discharged into the atmosphere from any sintering machine. The... volume. (i) The continuous monitoring system performance evaluation required under § 60.13(c) shall be...

40 CFR 65.86 - Monitoring.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Monitoring. 65.86 Section 65.86 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONSOLIDATED FEDERAL AIR RULE Transfer Racks § 65.86 Monitoring. The owner or operator of a transfer rack equipped with...

Continuous wireless pressure monitoring and mapping with ultra-small passive sensors for health monitoring and critical care

NASA Astrophysics Data System (ADS)

Chen, Lisa Y.; Tee, Benjamin C.-K.; Chortos, Alex L.; Schwartz, Gregor; Tse, Victor; J. Lipomi, Darren; Wong, H.-S. Philip; McConnell, Michael V.; Bao, Zhenan

2014-10-01

Continuous monitoring of internal physiological parameters is essential for critical care patients, but currently can only be practically achieved via tethered solutions. Here we report a wireless, real-time pressure monitoring system with passive, flexible, millimetre-scale sensors, scaled down to unprecedented dimensions of 1 × 1 × 0.1 cubic millimeters. This level of dimensional scaling is enabled by novel sensor design and detection schemes, which overcome the operating frequency limits of traditional strategies and exhibit insensitivity to lossy tissue environments. We demonstrate the use of this system to capture human pulse waveforms wirelessly in real time as well as to monitor in vivo intracranial pressure continuously in proof-of-concept mice studies using sensors down to 2.5 × 2.5 × 0.1 cubic millimeters. We further introduce printable wireless sensor arrays and show their use in real-time spatial pressure mapping. Looking forward, this technology has broader applications in continuous wireless monitoring of multiple physiological parameters for biomedical research and patient care.

Continuous wireless pressure monitoring and mapping with ultra-small passive sensors for health monitoring and critical care.

PubMed

Chen, Lisa Y; Tee, Benjamin C-K; Chortos, Alex L; Schwartz, Gregor; Tse, Victor; Lipomi, Darren J; Wong, H-S Philip; McConnell, Michael V; Bao, Zhenan

2014-10-06

Continuous monitoring of internal physiological parameters is essential for critical care patients, but currently can only be practically achieved via tethered solutions. Here we report a wireless, real-time pressure monitoring system with passive, flexible, millimetre-scale sensors, scaled down to unprecedented dimensions of 1 × 1 × 0.1 cubic millimeters. This level of dimensional scaling is enabled by novel sensor design and detection schemes, which overcome the operating frequency limits of traditional strategies and exhibit insensitivity to lossy tissue environments. We demonstrate the use of this system to capture human pulse waveforms wirelessly in real time as well as to monitor in vivo intracranial pressure continuously in proof-of-concept mice studies using sensors down to 2.5 × 2.5 × 0.1 cubic millimeters. We further introduce printable wireless sensor arrays and show their use in real-time spatial pressure mapping. Looking forward, this technology has broader applications in continuous wireless monitoring of multiple physiological parameters for biomedical research and patient care.

Continuous noninvasive monitoring in the neonatal ICU.

PubMed

Sahni, Rakesh

2017-04-01

Standard hemodynamic monitoring such as heart rate and systemic blood pressure may only provide a crude estimation of organ perfusion during neonatal intensive care. Pulse oximetry monitoring allows for continuous noninvasive monitoring of hemoglobin oxygenation and thus provides estimation of end-organ oxygenation. This review aims to provide an overview of pulse oximetry and discuss its current and potential clinical use during neonatal intensive care. Technological advances in continuous assessment of dynamic changes in systemic oxygenation with pulse oximetry during transition to extrauterine life and beyond provide additional details about physiological interactions among the key hemodynamic factors regulating systemic blood flow distribution along with the subtle changes that are frequently transient and undetectable with standard monitoring. Noninvasive real-time continuous systemic oxygen monitoring has the potential to serve as biomarkers for early-organ dysfunction, to predict adverse short-term and long-term outcomes in critically ill neonates, and to optimize outcomes. Further studies are needed to establish values predicting adverse outcomes and to validate targeted interventions to normalize abnormal values to improve outcomes.

40 CFR Table 17 to Subpart Uuu of... - Continuous Monitoring Systems for Organic HAP Emissions From Catalytic Reforming Units

Code of Federal Regulations, 2011 CFR

2011-07-01

... sensor, or infrared sensor to continuously detect the presence of a pilot flame. 2. Option 2: percent... flame zone Continuous parameter monitoring systems to measure and record the combustion zone temperature...

40 CFR Table 17 to Subpart Uuu of... - Continuous Monitoring Systems for Organic HAP Emissions From Catalytic Reforming Units

Code of Federal Regulations, 2010 CFR

2010-07-01

... sensor, or infrared sensor to continuously detect the presence of a pilot flame. 2. Option 2: percent... flame zone Continuous parameter monitoring systems to measure and record the combustion zone temperature...

Lens-free shadow image based high-throughput continuous cell monitoring technique.

PubMed

Jin, Geonsoo; Yoo, In-Hwa; Pack, Seung Pil; Yang, Ji-Woon; Ha, Un-Hwan; Paek, Se-Hwan; Seo, Sungkyu

2012-01-01

A high-throughput continuous cell monitoring technique which does not require any labeling reagents or destruction of the specimen is demonstrated. More than 6000 human alveolar epithelial A549 cells are monitored for up to 72 h simultaneously and continuously with a single digital image within a cost and space effective lens-free shadow imaging platform. In an experiment performed within a custom built incubator integrated with the lens-free shadow imaging platform, the cell nucleus division process could be successfully characterized by calculating the signal-to-noise ratios (SNRs) and the shadow diameters (SDs) of the cell shadow patterns. The versatile nature of this platform also enabled a single cell viability test followed by live cell counting. This study firstly shows that the lens-free shadow imaging technique can provide a continuous cell monitoring without any staining/labeling reagent and destruction of the specimen. This high-throughput continuous cell monitoring technique based on lens-free shadow imaging may be widely utilized as a compact, low-cost, and high-throughput cell monitoring tool in the fields of drug and food screening or cell proliferation and viability testing. Copyright © 2012 Elsevier B.V. All rights reserved.

[Type IIb primary hyperlipoproteinemia. An homogenous series of 412 cases].

PubMed

Rouffy, J; Loeper, J; Dreux, C; Lemogne, M; Loeper, J; Pestel, M; Dakkak, R

1976-03-20

On the basis of a homogeneous series of 412 cases of type IIb primary hyperlipoproteinaemia, the authors compare their experience with findings in the literature. The prevalence of this type of hyperlipoproteinaemia in the general population has been underestimated at 3%. Biological diagnosis remains simple (identification of a double and distinct excess in beta and pre beta lipoproteins). Extravascular lipid deposits (gerontoxon, xanthelasma, tendon xanthomata) are not type specific. Hyperlipidaemic syndrome is rare. Above all, the importance of type IIb in atheromatous disease in the young subject now seems obvious. The mode of hereditary transmission of the familial anomaly is not certain but would appear to be often associated with a double heterozygote condition.

Crescentic glomerulonephritis in non-asthmatic Churg-Strauss syndrome.

PubMed

Kaul, Anupma; Sharma, Raj Kumar; Jaisuresh, Krishna Swamy; Agrawal, Vinita

2014-03-01

A 58-year-old male presented with sensory motor polyneuropathy and rapidly progressive renal failure. Investigations revealed marked peripheral eosinophilia and elevated perinuclear antineutrophil cytoplasmic antibody titers. Renal biopsy showed pauci-immune cre-scentic glomerulonephritis with interstitial eosinophil infiltrates. He had no history of asthma. Computed tomography of the chest and X-ray of the paranasal sinuses were normal. On Day 1, the patient developed ileal perforation. Resected ileal segments showed small vessel vasculitis with extravascular eosinophils. A diagnosis of non-asthmatic variant of Churg-Strauss syndrome was made. Renal recovery was achieved in 12 weeks with a combination therapy of corticosteroid and cyclophosphamide. The patient has been relapse-free for 12 months on oral prednisolone therapy.

Haemolytic anaemia associated with Theileria sp. in an orphaned platypus.

PubMed

Kessell, A E; Boulton, J G; Dutton, G J; Woodgate, R; Shamsi, S; Peters, A; Connolly, J H

2014-11-01

The clinical and laboratory findings in an orphaned juvenile female platypus (Ornithorhynchus anatinus) that presented with a severe anaemia and tick infestation are reported. The animal developed a terminal septicaemia and died. Antemortem clinical pathology, postmortem histopathology and 18S rDNA sequencing supported a diagnosis of extravascular haemolytic anaemia secondary to Theileria ornithorhynchi infection. Although T. ornithorhynchi infection is common in the platypus, this is the first case in which it has been shown to cause a haemolytic anaemia in this species and molecular characterisation of the organism has been described. A review of the previous literature concerning T. ornithorhynchi and possible treatment options for future cases are discussed. © 2014 Australian Veterinary Association.

CHF: circulatory homeostasis gone awry.

PubMed

Weber, Karl T; Burlew, Brad S; Davis, Richard C; Newman, Kevin P; D'Cruz, Ivan A; Hawkins, Ralph G; Wall, Barry M; Parker, Robert B

2002-01-01

The role of the renin-angiotensin-aldosterone system (RAAS) is integral to salt and water retention, particularly by the kidneys. Over time, positive sodium balance leads first to intra- and then to extravascular volume expansion, with subsequent symptomatic heart failure. This report examines the role of the RAAS in regulating a less well recognized component essential to circulatory homeostasis--central blood volume. The regulation of central blood volume draws on integrative cardiorenal physiology and a key role played by the RAAS in its regulation. In presenting insights into the role of the RAAS in regulating central blood volume, this review also addresses other sodium-retaining states with a predisposition to edema formation, such as cirrhosis and nephrosis. (c)2002 CHF, Inc

40 CFR Appendix D to Part 52 - Determination of Sulfur Dioxide Emissions From Stationary Sources by Continuous Monitors

Code of Federal Regulations, 2011 CFR

2011-07-01

... Emissions From Stationary Sources by Continuous Monitors D Appendix D to Part 52 Protection of Environment... equipment required for the continuous determination of SO2 gas concentration in a given source effluent. 1... Drift. The change in measurement system output over a stated period of time of normal continuous...

40 CFR 63.2170 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I monitor and collect data to demonstrate continuous compliance? 63.2170 Section 63.2170 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission...

40 CFR 63.5560 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true How do I monitor and collect data to demonstrate continuous compliance? 63.5560 Section 63.5560 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission...

40 CFR 63.6135 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true How do I monitor and collect data to demonstrate continuous compliance? 63.6135 Section 63.6135 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission...

40 CFR 63.5355 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I monitor and collect data to demonstrate continuous compliance? 63.5355 Section 63.5355 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission...

40 CFR 63.5560 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I monitor and collect data to demonstrate continuous compliance? 63.5560 Section 63.5560 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission...

40 CFR 63.2170 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true How do I monitor and collect data to demonstrate continuous compliance? 63.2170 Section 63.2170 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission...

40 CFR 63.6135 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I monitor and collect data to demonstrate continuous compliance? 63.6135 Section 63.6135 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission...

40 CFR 63.1023 - Instrument and sensory monitoring for leaks.

Code of Federal Regulations, 2010 CFR

2010-07-01

... leaks. 63.1023 Section 63.1023 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... (CONTINUED) National Emission Standards for Equipment Leaks-Control Level 2 Standards § 63.1023 Instrument and sensory monitoring for leaks. (a) Monitoring for leaks. The owner or operator of a regulated...

40 CFR 98.44 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Monitoring and QA/QC requirements. 98.44 Section 98.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electricity Generation § 98.44 Monitoring and QA/QC...

40 CFR 98.44 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Monitoring and QA/QC requirements. 98.44 Section 98.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electricity Generation § 98.44 Monitoring and QA/QC...

40 CFR 98.44 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Monitoring and QA/QC requirements. 98.44 Section 98.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electricity Generation § 98.44 Monitoring and QA/QC...

40 CFR 98.44 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Monitoring and QA/QC requirements. 98.44 Section 98.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electricity Generation § 98.44 Monitoring and QA/QC...

40 CFR 98.44 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Monitoring and QA/QC requirements. 98.44 Section 98.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electricity Generation § 98.44 Monitoring and QA/QC...

40 CFR 98.64 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Monitoring and QA/QC requirements. 98.64 Section 98.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Aluminum Production § 98.64 Monitoring and QA/QC requirements...

40 CFR 63.1429 - Process vent monitoring requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... thermocouple, ultra-violet beam sensor, or infrared sensor) capable of continuously detecting the presence of a... used, a temperature monitoring device equipped with a continuous recorder is required. (i) Where an incinerator other than a catalytic incinerator is used, a temperature monitoring device shall be installed in...

40 CFR 63.1429 - Process vent monitoring requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... thermocouple, ultra-violet beam sensor, or infrared sensor) capable of continuously detecting the presence of a... used, a temperature monitoring device equipped with a continuous recorder is required. (i) Where an incinerator other than a catalytic incinerator is used, a temperature monitoring device shall be installed in...

40 CFR 63.1324 - Batch process vents-monitoring equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... beam sensor, or infrared sensor) capable of continuously detecting the presence of a pilot flame is...) Where an incinerator is used, a temperature monitoring device equipped with a continuous recorder is required. (i) Where an incinerator other than a catalytic incinerator is used, the temperature monitoring...

40 CFR 63.1324 - Batch process vents-monitoring equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... beam sensor, or infrared sensor) capable of continuously detecting the presence of a pilot flame is...) Where an incinerator is used, a temperature monitoring device equipped with a continuous recorder is required. (i) Where an incinerator other than a catalytic incinerator is used, the temperature monitoring...

40 CFR 63.1429 - Process vent monitoring requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... thermocouple, ultra-violet beam sensor, or infrared sensor) capable of continuously detecting the presence of a... used, a temperature monitoring device equipped with a continuous recorder is required. (i) Where an incinerator other than a catalytic incinerator is used, a temperature monitoring device shall be installed in...

40 CFR 65.65 - Monitoring.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Monitoring. 65.65 Section 65.65 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONSOLIDATED FEDERAL AIR RULE Process Vents § 65.65 Monitoring. (a) An owner or operator of a Group 2A process vent...

40 CFR 141.706 - Reporting source water monitoring results.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Reporting source water monitoring results. 141.706 Section 141.706 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Treatment for Cryptosporidium Source Water Monitoring Requirements §...

40 CFR 98.64 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Monitoring and QA/QC requirements. 98.64 Section 98.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Aluminum Production § 98.64 Monitoring and QA/QC requirements...

40 CFR 98.84 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Monitoring and QA/QC requirements. 98.84 Section 98.84 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Cement Production § 98.84 Monitoring and QA/QC requirements...

40 CFR 52.1680 - Control strategy: Monitoring and reporting.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Monitoring and reporting. 52.1680 Section 52.1680 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New York § 52.1680...

40 CFR 63.9631 - What are my monitoring requirements?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 14 2011-07-01 2011-07-01 false What are my monitoring requirements? 63.9631 Section 63.9631 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Taconite Iron Ore Processing Continuous...

40 CFR 75.21 - Quality assurance and quality control requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Quality assurance and quality control... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Operation and Maintenance Requirements § 75.21 Quality assurance and quality control requirements. (a) Continuous emission monitoring systems. The owner or...

40 CFR 63.7742 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... continuous compliance? (a) Except for monitoring malfunctions, associated repairs, and required quality assurance or control activities (including as applicable, calibration checks and required zero and span... emissions is operating. (b) You may not use data recorded during monitoring malfunctions, associated repairs...

40 CFR 63.7742 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... continuous compliance? (a) Except for monitoring malfunctions, associated repairs, and required quality assurance or control activities (including as applicable, calibration checks and required zero and span... emissions is operating. (b) You may not use data recorded during monitoring malfunctions, associated repairs...

40 CFR 63.7832 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... and collect data to demonstrate continuous compliance? (a) Except for monitoring malfunctions, out-of... control activities (including as applicable, calibration checks and required zero and span adjustments... source is operating. (b) You may not use data recorded during monitoring malfunctions, associated repairs...

40 CFR 63.9922 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... demonstrate continuous compliance? (a) Except for monitoring malfunctions, associated repairs, and required quality assurance or control activities (including, as applicable, calibration checks and required zero... all times an affected source is operating. (b) You may not use data recorded during monitoring...

40 CFR 63.7832 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... and collect data to demonstrate continuous compliance? (a) Except for monitoring malfunctions, out-of... control activities (including as applicable, calibration checks and required zero and span adjustments... source is operating. (b) You may not use data recorded during monitoring malfunctions, associated repairs...

40 CFR 63.9922 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... demonstrate continuous compliance? (a) Except for monitoring malfunctions, associated repairs, and required quality assurance or control activities (including, as applicable, calibration checks and required zero... all times an affected source is operating. (b) You may not use data recorded during monitoring...

40 CFR 63.7742 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... continuous compliance? (a) Except for monitoring malfunctions, associated repairs, and required quality assurance or control activities (including as applicable, calibration checks and required zero and span... emissions is operating. (b) You may not use data recorded during monitoring malfunctions, associated repairs...

40 CFR 63.7832 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... and collect data to demonstrate continuous compliance? (a) Except for monitoring malfunctions, out-of... control activities (including as applicable, calibration checks and required zero and span adjustments... source is operating. (b) You may not use data recorded during monitoring malfunctions, associated repairs...

40 CFR 63.2270 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... control activities (including, as applicable, calibration checks and required zero and span adjustments), you must conduct all monitoring in continuous operation at all times that the process unit is operating. For purposes of calculating data averages, you must not use data recorded during monitoring...

40 CFR 63.9633 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... continuous compliance? (a) Except for monitoring malfunctions, associated repairs, and required quality assurance or control activities (including as applicable, calibration checks and required zero and span... affected source is operating. (b) You may not use data recorded during monitoring malfunctions, associated...

40 CFR 63.7832 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... and collect data to demonstrate continuous compliance? (a) Except for monitoring malfunctions, out-of... control activities (including as applicable, calibration checks and required zero and span adjustments... source is operating. (b) You may not use data recorded during monitoring malfunctions, associated repairs...

40 CFR 63.9922 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... demonstrate continuous compliance? (a) Except for monitoring malfunctions, associated repairs, and required quality assurance or control activities (including, as applicable, calibration checks and required zero... all times an affected source is operating. (b) You may not use data recorded during monitoring...

40 CFR 63.2270 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... control activities (including, as applicable, calibration checks and required zero and span adjustments), you must conduct all monitoring in continuous operation at all times that the process unit is operating. For purposes of calculating data averages, you must not use data recorded during monitoring...

40 CFR 63.9922 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... demonstrate continuous compliance? (a) Except for monitoring malfunctions, associated repairs, and required quality assurance or control activities (including, as applicable, calibration checks and required zero... all times an affected source is operating. (b) You may not use data recorded during monitoring...

40 CFR 63.7742 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... continuous compliance? (a) Except for monitoring malfunctions, associated repairs, and required quality assurance or control activities (including as applicable, calibration checks and required zero and span... emissions is operating. (b) You may not use data recorded during monitoring malfunctions, associated repairs...

40 CFR 63.7742 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... continuous compliance? (a) Except for monitoring malfunctions, associated repairs, and required quality assurance or control activities (including as applicable, calibration checks and required zero and span... emissions is operating. (b) You may not use data recorded during monitoring malfunctions, associated repairs...

40 CFR 63.7832 - How do I monitor and collect data to demonstrate continuous compliance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... and collect data to demonstrate continuous compliance? (a) Except for monitoring malfunctions, out-of... control activities (including as applicable, calibration checks and required zero and span adjustments... source is operating. (b) You may not use data recorded during monitoring malfunctions, associated repairs...