Microchip and wedge ion funnels and planar ion beam analyzers using same

DOEpatents

Shvartsburg, Alexandre A; Anderson, Gordon A; Smith, Richard D

2012-10-30

Electrodynamic ion funnels confine, guide, or focus ions in gases using the Dehmelt potential of oscillatory electric field. New funnel designs operating at or close to atmospheric gas pressure are described. Effective ion focusing at such pressures is enabled by fields of extreme amplitude and frequency, allowed in microscopic gaps that have much higher electrical breakdown thresholds in any gas than the macroscopic gaps of present funnels. The new microscopic-gap funnels are useful for interfacing atmospheric-pressure ionization sources to mass spectrometry (MS) and ion mobility separation (IMS) stages including differential IMS or FAIMS, as well as IMS and MS stages in various configurations. In particular, "wedge" funnels comprising two planar surfaces positioned at an angle and wedge funnel traps derived therefrom can compress ion beams in one dimension, producing narrow belt-shaped beams and laterally elongated cuboid packets. This beam profile reduces the ion density and thus space-charge effects, mitigating the adverse impact thereof on the resolving power, measurement accuracy, and dynamic range of MS and IMS analyzers, while a greater overlap with coplanar light or particle beams can benefit spectroscopic methods.

Preparation of lead oxide nanoparticles from cathode-ray tube funnel glass by self-propagating method.

PubMed

Wang, Yu; Zhu, Jianxin

2012-05-15

This paper presents a novel process of extracting lead oxide nanoparticles from cathode-ray tube (CRT) funnel glass using self-propagating high-temperature synthesis (SHS) method. The impacts of added amount of funnel glass on the extraction ratio of lead, the lead extraction velocity and the micromorphology, as well as particle size of extracted nanoparticles were investigated. We found that self-propagating reaction in the presence of Mg and Fe(2)O(3) could separate lead preferentially and superfine lead oxide nanoparticles were obtained from a collecting chamber. The separation ratio was related closely to the amount of funnel glass added in the original mixture. At funnel glass addition of no more than 40wt.%, over 90wt.% of lead was recovered from funnel glass. High extraction yield reveals that the network structure of funnel glass was fractured due to the dramatic energy generated during the SHS melting process. The PbO nanoparticles collected show good dispersion and morphology with a mean grain size of 40-50nm. Copyright © 2012 Elsevier B.V. All rights reserved.

Length of multiple-funnel traps affects catches of smoke bark and wood boring beetles in a slash pine stand in Northern Florida

Treesearch

Daniel R. Miller; Christopher M. Crowe

2010-01-01

The multiple-funnel trap has gained broad acceptance for catching bark and ambrosia beetles since the trap was developed more than 25 years ago (Coleoptera: Scolytidae) (Lindgren 1983). The trap consists of black plastic funnels aligned vertically over each other, allowing for intercepted beetles to fall through the funnels into a wet or dry collection cup located on...

Cross-reactivity of Sydney funnel-web spider antivenom: neutralization of the in vitro toxicity of other Australian funnel-web (Atrax and Hadronyche) spider venoms.

PubMed

Graudins, A; Wilson, D; Alewood, P F; Broady, K W; Nicholson, G M

2002-03-01

Australian funnel-web spiders are recognized as one of the most venomous spiders to humans world-wide. Funnel-web spider antivenom (FWS AV) reverses clinical effects of envenomation from the bite of Atrax robustus and a small number of related Hadronyche species. This study assessed the in vitro efficacy of FWS AV in neutralization of the effects of funnel-web spider venoms, collected from various locations along the eastern seaboard of Australia, in an isolated chick biventer cervicis nerve-muscle preparation. Venoms were separated by SDS-PAGE electrophoresis to compare protein composition and transblotted for Western blotting and incubation with FWS AV.SDS-PAGE of venoms revealed similar low and high molecular weight protein bands. Western blotting with FWS AV showed similar antivenom binding with protein bands in all the venoms tested. Male funnel-web spider venoms (7/7) and female venoms (5/10) produced muscle contracture and fasciculation when applied to the nerve-muscle preparation. Venom effects were reversed by subsequent application of FWS AV or prevented by pretreatment of the preparation with antivenom.FWS AV appears to reverse the in vitro toxicity of a number of funnel-web spider venoms from the eastern seaboard of Australia. FWS AV should be effective in the treatment of envenomation from most, if not all, species of Australian funnel-web spiders.

Orthogonal Injection Ion Funnel Interface Providing Enhanced Performance for Selected Reaction Monitoring-Triple Quadrupole Mass Spectrometry

DOE PAGES

Chen, Tsung-Chi; Fillmore, Thomas L.; Prost, Spencer A.; ...

2015-06-24

The electrodynamic ion funnel facilitates efficient focusing and transfer of charged particles in the higher pressure regions (e.g. ion source interfaces) of mass spectrometers, and thus providing increased sensitivity. An “off-axis” ion funnel design has been developed to reduce the source contamination and interferences from, e.g. ESI droplet residue and other poorly focused neutral or charged particles with very high mass-to charge ratios. In this study a dual ion funnel interface consisting of an orthogonal higher pressure electrodynamic ion funnel (HPIF) and an ion funnel trap combined with a triple quadruple mass spectrometer was developed and characterized. An orthogonal ionmore » injection inlet and a repeller plate electrode was used to direct ions to an ion funnel HPIF at 9-10 Torr pressure. Several critical factors for the HPIF were characterized, including the effects of RF amplitude, DC gradient and operating pressure. Compared to the triple quadrupole standard interface more than 4-fold improvement in the limit of detection for the direct quantitative MS analysis of low abundance peptides was observed. Lastly, the sensitivity enhancement in liquid chromatography selected reaction monitoring (SRM) analyses of low abundance peptides spiked into a highly complex mixture was also compared with that obtained using a both commercial s-lens interface and a in-line dual ion funnel interface.« less

Orthogonal Injection Ion Funnel Interface Providing Enhanced Performance for Selected Reaction Monitoring-Triple Quadrupole Mass Spectrometry

PubMed Central

Chen, Tsung-Chi; Fillmore, Thomas L.; Prost, Spencer A.; Moore, Ronald J.; Ibrahim, Yehia M.; Smith, Richard D.

2016-01-01

The electrodynamic ion funnel facilitates efficient focusing and transfer of charged particles in the higher-pressure regions (e.g., ion source interfaces) of mass spectrometers, thus providing increased sensitivity. An “off-axis” ion funnel design has been developed to reduce the source contamination and interferences from, e.g. ESI droplet residue and other poorly focused neutral or charged particles with very high mass-to-charge ratios. In this study, a dual ion funnel interface consisting of an orthogonal higher pressure electrodynamic ion funnel (HPIF) and an ion funnel trap combined with a triple quadrupole mass spectrometer was developed and characterized. An orthogonal ion injection inlet and a repeller plate electrode was used to direct ions to an ion funnel HPIF at a pressure of 9–10 Torr. Key factors for the HPIF performance characterized included the effects of RF amplitude, the DC gradient, and operating pressure. Compared to the triple quadrupole standard interface more than 4-fold improvement in the limit of detection for the direct quantitative MS analysis of low abundance peptides was observed. The sensitivity enhancement in liquid chromatography selected reaction monitoring (LC-SRM) analyses of low-abundance peptides spiked into a highly complex mixture was also compared with that obtained using both a commercial S-lens interface and an in-line dual-ion funnel interface. PMID:26107611

Laser Ablation Electrodynamic Ion Funnel for In Situ Mass Spectrometry on Mars

NASA Technical Reports Server (NTRS)

Johnson, Paul V.; Hodyss, Robert P.; Tang, Keqi; Smith, Richard D.

2012-01-01

A front-end instrument, the laser ablation ion funnel, was developed, which would ionize rock and soil samples in the ambient Martian atmosphere, and efficiently transport the product ions into a mass spectrometer for in situ analysis. Laser ablation creates elemental ions from a solid with a high-power pulse within ambient Mars atmospheric conditions. Ions are captured and focused with an ion funnel into a mass spectrometer for analysis. The electrodynamic ion funnel consists of a series of axially concentric ring-shaped electrodes whose inside diameters (IDs) decrease over the length of the funnel. DC potentials are applied to each electrode, producing a smooth potential slope along the axial direction. Two radio-frequency (RF) AC potentials, equal in amplitude and 180 out of phase, are applied alternately to the ring electrodes. This creates an effective potential barrier along the inner surface of the electrode stack. Ions entering the funnel drift axially under the influence of the DC potential while being restricted radially by the effective potential barrier created by the applied RF. The net result is to effectively focus the ions as they traverse the length of the funnel.

Light funnel concentrator panel for solar power

NASA Technical Reports Server (NTRS)

1987-01-01

The solar concentrator design concept provides a theoretical concentration efficiency of 96 percent with power-to-weight ratios as high as 50 W/kg. Further, it eliminates the need for fragile reflective coatings and is very tolerant to pointing inaccuracies. The concept differs from conventional reflective mirrors and lens design in that is uses the principle of total internal reflection in order to funnel incident sunlight into a concentrator photovoltaic cell. The feasibility of the light funnel concentrator concept was determined through a balanced approach of analysis, development, and fabrication of prototypes, and testing of components. A three-dimensional optical model of the light funnel concentrator and photovoltaic cell was developed in order to assess the ultimate performance of such systems. In addition, a thermal and structural analysis of a typical unit was made. Techniques of fabricating the light funnel cones, optically coupling them to GaAs concentrator cells, bonding the funnels to GaAs cells, making electrical interconnects, and bonding substrates was explored and a prototype light funnel concentrator unit was fabricated and tested. Testing of the system included measurements of optical concentrating efficiency, optical concentrator to cell coupling efficiency, and electrical efficiency.

Note: An inexpensive square waveform ion funnel driver

NASA Astrophysics Data System (ADS)

Hoffman, Nathan M.; Opačić, Bojana; Reilly, Peter T. A.

2017-01-01

An inexpensive frequency variable square waveform generator (WFG) was developed to use with existing sinusoidal waveform driven ion funnels. The developed WFG was constructed using readily available low voltage DC power supplies and discrete components placed in printed circuit boards. As applied to ion funnels, this WFG represents considerable cost savings over commercially available products without sacrificing performance. Operation of the constructed pulse generator has been demonstrated for a 1 nF ion funnel at an operating frequency of 1 MHz while switching 48 Vp-p.

Note: An inexpensive square waveform ion funnel driver.

PubMed

Hoffman, Nathan M; Opačić, Bojana; Reilly, Peter T A

2017-01-01

An inexpensive frequency variable square waveform generator (WFG) was developed to use with existing sinusoidal waveform driven ion funnels. The developed WFG was constructed using readily available low voltage DC power supplies and discrete components placed in printed circuit boards. As applied to ion funnels, this WFG represents considerable cost savings over commercially available products without sacrificing performance. Operation of the constructed pulse generator has been demonstrated for a 1 nF ion funnel at an operating frequency of 1 MHz while switching 48 V p-p .

Lead recovery from scrap cathode ray tube funnel glass by hydrothermal sulphidisation.

PubMed

Yuan, Wenyi; Meng, Wen; Li, Jinhui; Zhang, Chenglong; Song, Qingbin; Bai, Jianfeng; Wang, Jingwei; Li, Yingshun

2015-10-01

This research focused on the application of the hydrothermal sulphidisation method to separate lead from scrap cathode ray tube funnel glass. Prior to hydrothermal treatment, the cathode ray tube funnel glass was pretreated by mechanical activation. Under hydrothermal conditions, hydroxyl ions (OH(-)) were generated through an ion exchange reaction between metal ions in mechanically activated funnel glass and water, to accelerate sulphur disproportionation; no additional alkaline compound was needed. Lead contained in funnel glass was converted to lead sulphide with high efficiency. Temperature had a significant effect on the sulphidisation rate of lead in funnel glass, which increased from 25% to 90% as the temperature increased from 100 °C to 300 °C. A sulphidisation rate of 100% was achieved at a duration of 8 h at 300 °C. This process of mechanical activation and hydrothermal sulphidisation is efficient and promising for the treatment of leaded glass. © The Author(s) 2015.

[Contribution of computer-aided design for the conception of custom-made implants in Pectus Excavatum surgical treatment. Experience of the Nantes plastic surgery unit].

PubMed

Tilliet Le Dentu, H; Lancien, U; Sellal, O; Duteille, F; Perrot, P

2018-02-01

Pectus excavatum is the most common congenital chest malformation and is a common reason for consultation in plastic surgery. Our attitude is most often a filling of the depression with a custom-made silicone prosthesis. The objective of this work was to evaluate the interest of computer-aided design (CAD) of implants compared to the conventional plaster molds method. We have collected all the cases of custom-made silicone implants to treat funnel chests in our plastic surgery department. The quality of the results was evaluated by the patient, and in a blind manner by the surgical team using photographs and standardized surveys. The pre-operative delays, the operating time and length of hospital stays, the number of surgical recoveries, and the post-operative surgical outcomes were recorded. Between 1990 and 2016, we designed 29 silicone thoracic implants in our department. Before 2012, implants were made from plaster chest molds (n=13). After this date, implants were designed by CAD (n=16). Patients rated their results as "good" or "excellent" in 77% and 86% of cases respectively in the plaster and CAD groups. The surgical team's ratings for CAD implant reconstructions were better than in the plaster group: 8.17 versus 6.96 (P=0.001). CAD implants were significantly less detectable than the plaster group implants. The operating time was reduced in the CAO group: 60.2 compared to 74.7minutes in the plaster group (P=0.04), as was the length of hospitalization: 3.5 versus 5.3 days (P=0.01). There were no significant differences between the two groups in terms of post-operative complications. The management of pectus excavatum by a custom-made silicone implant is a minimally invasive method that provides good cosmetic results. The design of these implants is facilitated and qualitatively improved by CAD. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Optical Couplers

DTIC Science & Technology

1975-12-01

FUNNEL DIAMETER 250 DIA FUNNEL DIAMETER, Df SHOWN IN LIST 375 FUNNEL DIAMETER Df . 043 ,060 .173 .044 .062 .175 .045 .063 .176 .046...Physical Dimensions Nom . Size (mil) Fiber Count V (mi 1) d (mil) [ (nr ) 1) 1 (m- Df 1) 46 285 41 .58 2.463 45 79 46 .71 ^/2x46 570 58

The Enrollment Funnel

ERIC Educational Resources Information Center

Perna, Mark C.

2005-01-01

A smart marketing plan creates emotional attachment and loyalty in a school's prospective students, but how does a school go about creating this type of positive environment?. In this brief paper, the author describes a step-by-step approach that he created--the enrollment funnel. The enrollment funnel is a systematic method of moving…

Improving the Sensitivity of Mass Spectrometer using a High-Pressure Electrodynamic Ion Funnel Interface

PubMed Central

Ibrahim, Yehia; Tang, Keqi; Tolmachev, Aleksey V.; Shvartsburg, Alexandre A.

2006-01-01

We report on a new electrodynamic ion funnel that operates at a pressure of 30 Torr with no loss of ion transmission. The enhanced performance compared to previous ion funnel designs optimized for pressures of <5 Torr was achieved by reducing the ion funnel capacitance and increasing the RF drive frequency (1.7 MHz) and amplitude (100-170 V peak-to-peak). No degradation of ion transmission was observed for pressures from 2 - 30 Torr. The ability to operate at higher pressure enabled a new tandem ion funnel mass spectrometer (MS) interface design that can accommodate a greater gas load. When combined with a multicapillary inlet, the interface provided more efficient introduction of ions, resulting in a significant enhancement in MS sensitivity and detection limits. PMID:16839773

The effect of multimodal and enriched feedback on SMR-BCI performance.

PubMed

Sollfrank, T; Ramsay, A; Perdikis, S; Williamson, J; Murray-Smith, R; Leeb, R; Millán, J D R; Kübler, A

2016-01-01

This study investigated the effect of multimodal (visual and auditory) continuous feedback with information about the uncertainty of the input signal on motor imagery based BCI performance. A liquid floating through a visualization of a funnel (funnel feedback) provided enriched visual or enriched multimodal feedback. In a between subject design 30 healthy SMR-BCI naive participants were provided with either conventional bar feedback (CB), or visual funnel feedback (UF), or multimodal (visual and auditory) funnel feedback (MF). Subjects were required to imagine left and right hand movement and were trained to control the SMR based BCI for five sessions on separate days. Feedback accuracy varied largely between participants. The MF feedback lead to a significantly better performance in session 1 as compared to the CB feedback and could significantly enhance motivation and minimize frustration in BCI use across the five training sessions. The present study demonstrates that the BCI funnel feedback allows participants to modulate sensorimotor EEG rhythms. Participants were able to control the BCI with the funnel feedback with better performance during the initial session and less frustration compared to the CB feedback. The multimodal funnel feedback provides an alternative to the conventional cursorbar feedback for training subjects to modulate their sensorimotor rhythms. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

High Precision Pressure Measurement with a Funnel

ERIC Educational Resources Information Center

Lopez-Arias, T.; Gratton, L. M.; Oss, S.

2008-01-01

A simple experimental device for high precision differential pressure measurements is presented. Its working mechanism recalls that of a hydraulic press, where pressure is supplied by insufflating air under a funnel. As an application, we measure air pressure inside a soap bubble. The soap bubble is inflated and connected to a funnel which is…

Rectangular Ion Funnel: A New Ion Funnel Interface for Structures for Lossless Ion Manipulations

DOE PAGES

Chen, Tsung-Chi; Webb, Ian K.; Prost, Spencer A.; ...

2014-11-19

A recent achievement in Structures for Lossless Ion Manipulations (SLIM) is the ability for near lossless ion focusing, transfer, and trapping in sub-atmospheric pressure regions. While lossless ion manipulations are advantageously applied to the applications of ion mobility separations and gas phase reactions, ion introduction through ring electrode ion funnels or more conventional ion optics to SLIM can involve discontinuities in electric fields or other perturbations that result in ion losses. In this work, we investigated a new funnel design that aims to seamlessly couple to SLIM at the funnel exit. This rectangular ion funnel (RIF) was initially evaluated bymore » ion simulations, fabricated utilizing printed circuit board technology and tested experimentally. The RIF was integrated to a SLIM-TOFMS system, and the operating parameters, including RF, DC bias of the RIF electrodes, and electric fields for effectively interfacing with a SLIM were characterized. The RIF provided a 2-fold sensitivity increase without significant discrimination over a wide m/z range along with greatly improved SLIM operational stability.« less

Automatic Gain Control in Mass Spectrometry using a Jet Disrupter Electrode in an Electrodynamic Ion Funnel

PubMed Central

Page, Jason S.; Bogdanov, Bogdan; Vilkov, Andrey N.; Prior, David C.; Buschbach, Michael A.; Tang, Keqi; Smith, Richard D.

2007-01-01

We report on the use of a jet disrupter electrode in an electrodynamic ion funnel as an electronic valve to regulate the intensity of the ion beam transmitted through the interface of a mass spectrometer in order to perform automatic gain control (AGC). The ion flux is determined by either directly detecting the ion current on the conductance limiting orifice of the ion funnel or using a short mass spectrometry acquisition. Based upon the ion flux intensity, the voltage of the jet disrupter is adjusted to alter the transmission efficiency of the ion funnel to provide a desired ion population to the mass analyzer. Ion beam regulation by an ion funnel is shown to provide control to within a few percent of a targeted ion intensity or abundance. The utility of ion funnel AGC was evaluated using a protein tryptic digest analyzed with liquid chromatography Fourier transform ion cyclotron resonance (LC-FTICR) mass spectrometry. The ion population in the ICR cell was accurately controlled to selected levels, which improved data quality and provided better mass measurement accuracy. PMID:15694774

Solar cells using quantum funnels.

PubMed

Kramer, Illan J; Levina, Larissa; Debnath, Ratan; Zhitomirsky, David; Sargent, Edward H

2011-09-14

Colloidal quantum dots offer broad tuning of semiconductor bandstructure via the quantum size effect. Devices involving a sequence of layers comprised of quantum dots selected to have different diameters, and therefore bandgaps, offer the possibility of funneling energy toward an acceptor. Here we report a quantum funnel that efficiently conveys photoelectrons from their point of generation toward an intended electron acceptor. Using this concept we build a solar cell that benefits from enhanced fill factor as a result of this quantum funnel. This concept addresses limitations on transport in soft condensed matter systems and leverages their advantages in large-area optoelectronic devices and systems.

Efficacy of Three Funnel Traps for Capturing Amphibian Larvae in Seasonal Forest Ponds

Treesearch

Richard R. Buech; Leanna M. Egeland

2002-01-01

Among the many techniques that have been used to study amphibians, funnel traps are commonly recommended to determine species presence, breeding success, and relative abundance of amphibian larvae in aquatic habitats. Several authors have discussed the advantages and disadvantages of funnel traps for sampling amphibian larvae (Adams et al. 1997; Fronzuto and Verrell...

Energy-efficient modification of reduction-melting for lead recovery from cathode ray tube funnel glass

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

Okada, Takashi, E-mail: t-okada@u-fukui.ac.jp; Yonezawa, Susumu

2013-08-15

Highlights: • We recovered Pb from cathode ray tube funnel glass using reduction melting process. • We modified the melting process to achieve Pb recovery with low energy consumption. • Pb in the funnel glass is efficiently recovered at 1000 °C by adding Na{sub 2}CO{sub 3}. • Pb remaining in the glass after reduction melting is extracted with 1 M HCl. • 98% of Pb in the funnel glass was recovered by reduction melting and HCl leaching. - Abstract: Lead can be recovered from funnel glass of waste cathode ray tubes via reduction melting. While low-temperature melting is necessary formore » reduced energy consumption, previously proposed methods required high melting temperatures (1400 °C) for the reduction melting. In this study, the reduction melting of the funnel glass was performed at 900–1000 °C using a lab-scale reactor with varying concentrations of Na{sub 2}CO{sub 3} at different melting temperatures and melting times. The optimum Na{sub 2}CO{sub 3} dosage and melting temperature for efficient lead recovery was 0.5 g per 1 g of the funnel glass and 1000 °C respectively. By the reduction melting with the mentioned conditions, 92% of the lead in the funnel glass was recovered in 60 min. However, further lead recovery was difficult because the rate of the lead recovery decreased as with the recovery of increasing quantity of the lead from the glass. Thus, the lead remaining in the glass after the reduction melting was extracted with 1 M HCl, and the lead recovery improved to 98%.« less

A randomized comparison between league tables and funnel plots to inform health care decision-making.

PubMed

Anell, Anders; Hagberg, Oskar; Liedberg, Fredrik; Ryden, Stefan

2016-12-01

Comparison of provider performance is commonly used to inform health care decision-making. Little attention has been paid to how data presentations influence decisions. This study analyzes differences in suggested actions by decision-makers informed by league tables or funnel plots. Decision-makers were invited to a survey and randomized to compare hospital performance using either league tables or funnel plots for four different measures within the area of cancer care. For each measure, decision-makers were asked to suggest actions towards 12-16 hospitals (no action, ask for more information, intervene) and provide feedback related to whether the information provided had been useful. Swedish health care. Two hundred and twenty-one decision-makers at administrative and clinical levels. Data presentations in the form of league tables or funnel plots. Number of actions suggested by participants. Proportion of appropriate actions. For all four measures, decision-makers tended to suggest more actions based on the information provided in league tables compared to funnel plots (44% vs. 21%, P < 0.001). Actions were on average more appropriate for funnel plots. However, when using funnel plots, decision-makers more often missed to react even when appropriate. The form of data presentation had an influence on decision-making. With league tables, decision-makers tended to suggest more actions compared to funnel plots. A difference in sensitivity and specificity conditioned by the form of presentation could also be identified, with different implications depending on the purpose of comparisons. Explanations and visualization aids are needed to support appropriate actions. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Funnel traps capture a higher proportion of juvenile Great Tits Parus major than automatic traps

USGS Publications Warehouse

Senar, J.C.; Domenech, J.; Conroy, M.J.

1999-01-01

We compared capture rates of Great Tits at funnel traps, where several birds can be captured at once so that some decoy effect may appear, to those obtained at automatic traps, where only one bird can be trapped at a time, at trapping stations in northeastern Spain. Juvenile birds were mainly captured at funnel traps (79% of juvenile captures), whereas adult plumaged birds were captured at both types of traps (51% of captures were at the funnel traps) (test between ages, P<0.001). Juvenile Great Tits had lower body condition as measured by ptilochronology (P<0.01). These birds are more easily trapped in funnel traps, which may be acting as decoy traps, and thus are vulnerable to the same kinds of biases (eg age or body condition) that have been previously documented for decoy traps.

Light Trapping with Silicon Light Funnel Arrays

PubMed Central

Nissan, Yuval; Gabay, Tamir; Shalev, Gil

2018-01-01

Silicon light funnels are three-dimensional subwavelength structures in the shape of inverted cones with respect to the incoming illumination. Light funnel (LF) arrays can serve as efficient absorbing layers on account of their light trapping capabilities, which are associated with the presence of high-density complex Mie modes. Specifically, light funnel arrays exhibit broadband absorption enhancement of the solar spectrum. In the current study, we numerically explore the optical coupling between surface light funnel arrays and the underlying substrates. We show that the absorption in the LF array-substrate complex is higher than the absorption in LF arrays of the same height (~10% increase). This, we suggest, implies that a LF array serves as an efficient surface element that imparts additional momentum components to the impinging illumination, and hence optically excites the substrate by near-field light concentration, excitation of traveling guided modes in the substrate, and mode hybridization. PMID:29562685

Broadband light funneling in ultrasubwavelength channels having periodic connected unfilled apertures

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

Subramania, Ganapathi Subramanian; Brener, Igal; Foteinopoulou, Stavroula

2017-08-01

A structure for broadband light funneling comprises a two-dimensional periodic array of connected ultrasubwavelength apertures, each aperture comprising a large sub-aperture that aids in the coupling of the incoming incident light and a small sub-aperture that funnels a significant fraction of the incident light power. The structure possesses all the capabilities of prior extraordinary optical transmission platforms, yet operates nonresonantly on a distinctly different mechanism. The structure demonstrates efficient ultrabroadband funneling of optical power confined in an area as small as .about.(.lamda./500).sup.2, where optical fields are enhanced, thus exhibiting functional possibilities beyond resonant platforms.

Ion funnel with extended mass range and reduced conductance limit aperture

DOEpatents

Tolmachev, Aleksey V [Richland, WA; Smith, Richard D [Richland, WA

2008-04-01

An improved ion funnel design is disclosed that decreases the axial RF (parasite) fields at the ion funnel exit. This is achieved by addition of one or more compensation electrodes after the conductance limit electrode. Various RF voltage profiles may be applied to the various electrodes minimizing the parasite axial potential wells. The smallest RF aperture that serves as the conductance limiting electrode is further reduced over standard designs. Overall, the ion funnel improves transmission ranges of both low m/z and high m/z ions, reducing RF activation of ions and decreasing the gas load to subsequent differential pumping stages.

Nano-funnels as electro-osmotic ``tweezers and pistons''

NASA Astrophysics Data System (ADS)

Wang, Yanqian; Panyukov, Sergey; Zhou, Jinsheng; Menard, Laurent D.; Ramsey, J. Michael; Rubinstien, Michael

2014-03-01

An electric field is used to force a DNA molecule into a nano-channel by compensating the free energy penalty that results from the reduced conformational entropy of the confined macromolecule. Narrow nano-channels require high critical electric fields to achieve DNA translocation, leading to short dwell times of DNA in these channels. We demonstrate that nano-funnels integrated with nano-channels reduce the free energy barrier and lower the critical electric field required for DNA translocation. A focused electric field within the funnel increases the electric force on the DNA, compresses the molecule, and increases the osmotic pressure at the nano-channel entrance. This ``electro-osmotic piston'' forces the molecule into the nano-channel at lower electric fields than those observed without the funnel. Appropirately designed nano-funnels can also function as tweezers that allow manipulation of the position of the DNA molecule. The predictions of our theory describing double-stranded DNA behavior in nano-funnel - nano-channel devices are consistent with experimental results. Thanks for the financial support from NSF (DMR-1309892, DMR-1121107, DMR-1122483), NIH (1-P50-HL107168, 1-P01-HL108808-01A1, R01HG02647), NHGRI and CF Foundation.

Evaluation of funnel traps for characterizing the bark beetle (Coleoptera: Scolytidae) communities in ponderosa pine forests of North-Central Arizona

Treesearch

Christopher J. Hayes; Tom E. DeGomez; Karen M. Clancy; Kelly K. Williams; Joel D. McMillin; John A. Anhold

2008-01-01

Lindgren funnel traps baited with aggregation pheromones are widely used to monitor and manage populations of economically important bark beetles (Coleoptera: Scolytidae). This study was designed to advance our understanding of how funnel trap catches assess bark beetle communities and relative abundance of individual species. In the second year (2005) of a 3-yr study...

The role of gravity in the nutrition and formation of Bacillus colonies

NASA Astrophysics Data System (ADS)

Puzyr, A.; Tirranen, L.; Krylova, T.

The soil-like substrate is used to cultivate higher plants in man-made closed ecosystems. It allows increasing the closeness of the systems and decreasing the plant solid residues and human wastes. Unusual funnel-shaped bacterial colonies of Bacillus species have been observed during analysis of microflora of plant nutritional solution. The colonies have the following characteristics: a) the diameter of "funnel socket" (the biomass contacting with nutritional agar) is 10.0-15.0 mm; b) the thickness of "funnel socket" is 0.5-2.5 mm; c) the diameter of the middle part of the "funnel spout" (the biomass contacting with the gas phase) is 1,0-1,5 mm; d) the length of the "funnel spout" is 10.0-15.0 mm. In the socket and the middle part of the "funnel spout" there is a gas cavity which is most probably formed by bacterial gas metabolites. It has been shown that: i) the surface of these funnel-shaped colonies of Bacillus species is hydrophobic, as is the surface of other Bacillus species ( . brevis, B. cellulomonos, B. flavus, B.B formosus, B. subtilis); ii) the forms of colonies can be changed by varying the position of the growing biomass in relation to the gravitation forces. The experiment proved that the form of the "funnel sockets" and the length of the "funnel spouts" of the colonies are determined by hydrophobic air-contacting surface layer, which does not leak and stretches under the weight of accumulated water. A hypothesis has been suggested that the gravity force plays the role of a "pump" supplying and holding water within the colony. Thus, the water that comes under the gravity force contains dissolved nutrients and bacterial cells in the hydrophobic layer. These cells that are situated far away from the nutrient agar have no nutrient deficiency. The water accumulated by the colonies might be free water of agar media or it can be produced by metabolic disruption of medium fat. Hence, when growing a colony in agar media the water-soluble nutrient substances enter the growing colonies not only due to diffusion processes but also with the directional water flow under the gravity force.

Funnel for localizing biological cell placement and arrangement

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

Soscia, David; Benett, William J.; Mukerjee, Erik V.

2018-03-06

The present disclosure relates to a funnel apparatus for channeling cells onto a plurality of distinct, closely spaced regions of a seeding surface. The funnel apparatus has a body portion having an upper surface and a lower surface. The body portion forms a plurality of flow paths, at least one of which is shaped to have a decreasing cross-sectional area from the upper surface to the lower surface. The flow paths are formed at the lower surface to enable cells deposited into the flow paths at the upper surface of the funnel apparatus to be channeled into a plurality ofmore » distinct, closely spaced regions on the seeding surface positioned adjacent the lower surface.« less

Standardized mean differences cause funnel plot distortion in publication bias assessments.

PubMed

Zwetsloot, Peter-Paul; Van Der Naald, Mira; Sena, Emily S; Howells, David W; IntHout, Joanna; De Groot, Joris Ah; Chamuleau, Steven Aj; MacLeod, Malcolm R; Wever, Kimberley E

2017-09-08

Meta-analyses are increasingly used for synthesis of evidence from biomedical research, and often include an assessment of publication bias based on visual or analytical detection of asymmetry in funnel plots. We studied the influence of different normalisation approaches, sample size and intervention effects on funnel plot asymmetry, using empirical datasets and illustrative simulations. We found that funnel plots of the Standardized Mean Difference (SMD) plotted against the standard error (SE) are susceptible to distortion, leading to overestimation of the existence and extent of publication bias. Distortion was more severe when the primary studies had a small sample size and when an intervention effect was present. We show that using the Normalised Mean Difference measure as effect size (when possible), or plotting the SMD against a sample size-based precision estimate, are more reliable alternatives. We conclude that funnel plots using the SMD in combination with the SE are unsuitable for publication bias assessments and can lead to false-positive results.

Standardized mean differences cause funnel plot distortion in publication bias assessments

PubMed Central

Van Der Naald, Mira; Sena, Emily S; Howells, David W; IntHout, Joanna; De Groot, Joris AH; Chamuleau, Steven AJ; MacLeod, Malcolm R

2017-01-01

Meta-analyses are increasingly used for synthesis of evidence from biomedical research, and often include an assessment of publication bias based on visual or analytical detection of asymmetry in funnel plots. We studied the influence of different normalisation approaches, sample size and intervention effects on funnel plot asymmetry, using empirical datasets and illustrative simulations. We found that funnel plots of the Standardized Mean Difference (SMD) plotted against the standard error (SE) are susceptible to distortion, leading to overestimation of the existence and extent of publication bias. Distortion was more severe when the primary studies had a small sample size and when an intervention effect was present. We show that using the Normalised Mean Difference measure as effect size (when possible), or plotting the SMD against a sample size-based precision estimate, are more reliable alternatives. We conclude that funnel plots using the SMD in combination with the SE are unsuitable for publication bias assessments and can lead to false-positive results. PMID:28884685

Ejector device for direct injection fuel jet

DOEpatents

Upatnieks, Ansis [Livermore, CA

2006-05-30

Disclosed is a device for increasing entrainment and mixing in an air/fuel zone of a direct fuel injection system. The device comprises an ejector nozzle in the form of an inverted funnel whose central axis is aligned along the central axis of a fuel injector jet and whose narrow end is placed just above the jet outlet. It is found that effective ejector performance is achieved when the ejector geometry is adjusted such that it comprises a funnel whose interior surface diverges about 7.degree. to about 9.degree. away from the funnel central axis, wherein the funnel inlet diameter is about 2 to about 3 times the diameter of the injected fuel plume as the fuel plume reaches the ejector inlet, and wherein the funnel length equal to about 1 to about 4 times the ejector inlet diameter. Moreover, the ejector is most effectively disposed at a separation distance away from the fuel jet equal to about 1 to about 2 time the ejector inlet diameter.

The problem of natural funnel asymmetries: a simulation analysis of meta-analysis in macroeconomics.

PubMed

Callot, Laurent; Paldam, Martin

2011-06-01

Effect sizes in macroeconomic are estimated by regressions on data published by statistical agencies. Funnel plots are a representation of the distribution of the resulting regression coefficients. They are normally much wider than predicted by the t-ratio of the coefficients and often asymmetric. The standard method of meta-analysts in economics assumes that the asymmetries are because of publication bias causing censoring and adjusts the average accordingly. The paper shows that some funnel asymmetries may be 'natural' so that they occur without censoring. We investigate such asymmetries by simulating funnels by pairs of data generating processes (DGPs) and estimating models (EMs), in which the EM has the problem that it disregards a property of the DGP. The problems are data dependency, structural breaks, non-normal residuals, non-linearity, and omitted variables. We show that some of these problems generate funnel asymmetries. When they do, the standard method often fails. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

Early Development and Orientation of the Acoustic Funnel Provides Insight into the Evolution of Sound Reception Pathways in Cetaceans

PubMed Central

Yamato, Maya; Pyenson, Nicholas D.

2015-01-01

Whales receive underwater sounds through a fundamentally different mechanism than their close terrestrial relatives. Instead of hearing through the ear canal, cetaceans hear through specialized fatty tissues leading to an evolutionarily novel feature: an acoustic funnel located anterior to the tympanic aperture. We traced the ontogenetic development of this feature in 56 fetal specimens from 10 different families of toothed (odontocete) and baleen (mysticete) whales, using X-ray computed tomography. We also charted ear ossification patterns through ontogeny to understand the impact of heterochronic developmental processes. We determined that the acoustic funnel arises from a prominent V-shaped structure established early in ontogeny, formed by the malleus and the goniale. In odontocetes, this V-formation develops into a cone-shaped funnel facing anteriorly, directly into intramandibular acoustic fats, which is likely functionally linked to the anterior orientation of sound reception in echolocation. In contrast, the acoustic funnel in balaenopterids rotates laterally, later in fetal development, consistent with a lateral sound reception pathway. Balaenids and several fossil mysticetes retain a somewhat anteriorly oriented acoustic funnel in the mature condition, indicating that a lateral sound reception pathway in balaenopterids may be a recent evolutionary innovation linked to specialized feeding modes, such as lunge-feeding. PMID:25760328

Funnel plot control limits to identify poorly performing healthcare providers when there is uncertainty in the value of the benchmark.

PubMed

Manktelow, Bradley N; Seaton, Sarah E; Evans, T Alun

2016-12-01

There is an increasing use of statistical methods, such as funnel plots, to identify poorly performing healthcare providers. Funnel plots comprise the construction of control limits around a benchmark and providers with outcomes falling outside the limits are investigated as potential outliers. The benchmark is usually estimated from observed data but uncertainty in this estimate is usually ignored when constructing control limits. In this paper, the use of funnel plots in the presence of uncertainty in the value of the benchmark is reviewed for outcomes from a Binomial distribution. Two methods to derive the control limits are shown: (i) prediction intervals; (ii) tolerance intervals Tolerance intervals formally include the uncertainty in the value of the benchmark while prediction intervals do not. The probability properties of 95% control limits derived using each method were investigated through hypothesised scenarios. Neither prediction intervals nor tolerance intervals produce funnel plot control limits that satisfy the nominal probability characteristics when there is uncertainty in the value of the benchmark. This is not necessarily to say that funnel plots have no role to play in healthcare, but that without the development of intervals satisfying the nominal probability characteristics they must be interpreted with care. © The Author(s) 2014.

Funnel-web spider bite: a systematic review of recorded clinical cases.

PubMed

Isbister, Geoffrey K; Gray, Michael R; Balit, Corrine R; Raven, Robert J; Stokes, Barrie J; Porges, Kate; Tankel, Alan S; Turner, Elizabeth; White, Julian; Fisher, Malcolm McD

2005-04-18

To investigate species-specific envenoming rates and spectrum of severity of funnel-web spider bites, and the efficacy and adverse effects of funnel-web spider antivenom. Cases were identified from a prospective study of spider bite presenting to four major hospitals and three state poisons information centres (1999-2003); museum records of spider specimens since 1926; NSW Poisons Information Centre database; MEDLINE and EMBASE search; clinical toxinology textbooks; the media; and the manufacturer's reports of antivenom use. Patient age and sex, geographical location, month, expert identification of the spider, clinical effects and management; envenoming was classified as severe, mild-moderate or minor/local effects. 198 potential funnel-web spider bites were identified: 138 were definite (spider expertly identified to species or genus), and 77 produced severe envenoming. All species-identified severe cases were attributed to one of six species restricted to NSW and southern Queensland. Rates of severe envenoming were: Hadronyche cerberea (75%), H. formidabilis (63%), Atrax robustus (17%), Hadronyche sp. 14 (17%), H. infensa (14%) and H. versuta (11%). Antivenom was used in 75 patients, including 22 children (median dose, 3 ampoules; range, 1-17), with a complete response in 97% of expertly identified cases. Three adverse reactions were reported, all in adults: two early allergic reactions (one mild and one with severe systemic effects requiring adrenaline), and one case of serum sickness. Severe funnel-web spider envenoming is confined to NSW and southern Queensland; tree-dwelling funnel webs (H. cerberea and H. formidabilis) have the highest envenoming rates. Funnel-web spider antivenom appears effective and safe; severe allergic reactions are uncommon.

A new sternum elevator reduces severe complications during minimally invasive repair of the pectus excavatum.

PubMed

Takagi, Satoshi; Oyama, Takuto; Tomokazu, Nishihira; Kinoshita, Koji; Makino, Taro; Ohjimi, Hiroyuki

2012-06-01

Although the Nuss procedure for pectus excavatum is widely employed, a variety of complications have been reported with relatively high frequency; those that involve cardiac and pericardial injuries can be life threatening. To reduce such dangers, we present here a newly developed sternal elevator. The elevator is horseshoe shaped. Its elevator side has the same curvature as a Nuss introducer, so that interference between devices is minimal and no extra skin incision is needed for the elevator insertion. The elevator holds the sternum forward and enlarges the retrosternal space for safer passage of thoracoscopically guided introducer. The authors have used the elevator for 61 pectus excavatum cases between March 2004 and December 2009 without any major complications. The entire process of substernal tunneling was endoscopically observed, which eliminated any blunt and blind dissection, even in a significantly depressed funnel chest case. With the device, the sternum was effectively elevated again for the placement of the second plate in 30 cases. Our newly developed sternum elevator makes the Nuss procedure safer and more affordable without introducing any extra scarring.

Detecting small-study effects and funnel plot asymmetry in meta-analysis of survival data: A comparison of new and existing tests.

PubMed

Debray, Thomas P A; Moons, Karel G M; Riley, Richard D

2018-03-01

Small-study effects are a common threat in systematic reviews and may indicate publication bias. Their existence is often verified by visual inspection of the funnel plot. Formal tests to assess the presence of funnel plot asymmetry typically estimate the association between the reported effect size and their standard error, the total sample size, or the inverse of the total sample size. In this paper, we demonstrate that the application of these tests may be less appropriate in meta-analysis of survival data, where censoring influences statistical significance of the hazard ratio. We subsequently propose 2 new tests that are based on the total number of observed events and adopt a multiplicative variance component. We compare the performance of the various funnel plot asymmetry tests in an extensive simulation study where we varied the true hazard ratio (0.5 to 1), the number of published trials (N=10 to 100), the degree of censoring within trials (0% to 90%), and the mechanism leading to participant dropout (noninformative versus informative). Results demonstrate that previous well-known tests for detecting funnel plot asymmetry suffer from low power or excessive type-I error rates in meta-analysis of survival data, particularly when trials are affected by participant dropout. Because our novel test (adopting estimates of the asymptotic precision as study weights) yields reasonable power and maintains appropriate type-I error rates, we recommend its use to evaluate funnel plot asymmetry in meta-analysis of survival data. The use of funnel plot asymmetry tests should, however, be avoided when there are few trials available for any meta-analysis. © 2017 The Authors. Research Synthesis Methods Published by John Wiley & Sons, Ltd.

Exploring and accounting for publication bias in mental health: a brief overview of methods.

PubMed

Mavridis, Dimitris; Salanti, Georgia

2014-02-01

OBJECTIVE Publication bias undermines the integrity of published research. The aim of this paper is to present a synopsis of methods for exploring and accounting for publication bias. METHODS We discussed the main features of the following methods to assess publication bias: funnel plot analysis; trim-and-fill methods; regression techniques and selection models. We applied these methods to a well-known example of antidepressants trials that compared trials submitted to the Food and Drug Administration (FDA) for regulatory approval. RESULTS The funnel plot-related methods (visual inspection, trim-and-fill, regression models) revealed an association between effect size and SE. Contours of statistical significance showed that asymmetry in the funnel plot is probably due to publication bias. Selection model found a significant correlation between effect size and propensity for publication. CONCLUSIONS Researchers should always consider the possible impact of publication bias. Funnel plot-related methods should be seen as a means of examining for small-study effects and not be directly equated with publication bias. Possible causes for funnel plot asymmetry should be explored. Contours of statistical significance may help disentangle whether asymmetry in a funnel plot is caused by publication bias or not. Selection models, although underused, could be useful resource when publication bias and heterogeneity are suspected because they address directly the problem of publication bias and not that of small-study effects.

Chemical, corrosion and topographical analysis of stainless steel implants after different implantation periods.

PubMed

Chrzanowski, Wojciech; Armitage, David Andrew; Knowles, Jonathan Campbell; Szade, Jacek; Korlacki, Wojciech; Marciniak, Jan

2008-07-01

The aim of this work is to examine the corrosion properties, chemical composition, and material-implant interaction after different periods of implantation of plates used to correct funnel chest. The implants are made of 316L stainless steel. Examinations are carried out on three implants: new (nonimplanted) and two implanted for 29 and 35 months. The corrosion study reveals that in the potential range that could occur in the physiological condition the new bar has the lowest current density and the highest corrosion potential. This indicates that the new plate has the highest corrosion resistance and the corrosion resistance could be reduced during implantation by the instruments used during the operation. XPS analysis reveals changes in the surface chemistry. The longer the implantation time the more carbon and oxygen are observed and only trace of elements such as Cr, Mo are detected indicating that surface is covered by an organic layer. On some parts of the implants whitish tissue is observed: the thickness of which increased with the time of implantation. This tissue was identified as an organic layer; mainly attached to the surface on the areas close to where the implant was bent to attain anatomical fit and thus where the implant has higher surface roughness. The study indicates that the chest plates are impaired by the implantation procedure and contact with biological environment. The organic layer on the surface shows that the implant did not stay passive but some reactions at the tissue-implant interface occurred. These reactions should be seen as positive, as it indicates that the implants were accepted by the tissues. Nevertheless, if the implants react, they may continue to release chromium, nickel, and other harmful ions long term as indicated by lower corrosion resistance of the implants following implantation.

Correction of Pectus Excavatum by Custom-Made Silicone Implants: Contribution of Computer-Aided Design Reconstruction. A 20-Year Experience and 401 Cases.

PubMed

Chavoin, Jean-Pierre; Grolleau, Jean-Louis; Moreno, Benjamin; Brunello, Jérémie; André, Aymeric; Dahan, Marcel; Garrido, Ignacio; Chaput, Benoit

2016-05-01

In the absence of demonstrable functional impairment, pectus excavatum is merely a congenital deformity, albeit with a marked psychological impact. Many patients do not wish to undergo thoracic remodeling operations, which are invasive and do not clearly result in respiratory or cardiac improvement. From 1993 to 2015, the authors designed 401 custom-made silicone implants to treat funnel chests. Before 2007, implants were made from plaster chest molds. Beginning in 2007, three-dimensional reconstructions were made from computed tomographic scans by computer-aided design. The authors prospectively recorded all assessments and follow-up data since 1993. Preoperative and postoperative photographs of two random groups of 50 patients were analyzed, in a blinded manner, by two surgeons independently. Intraoperative and postoperative complications, clinical outcomes, patient satisfaction, and quality of life were evaluated. One infection and three hematomas were recorded. Periprosthetic seroma was evident in all cases. Patients rated the cosmetic outcomes of computer-aided design implants significantly higher than those of the earlier implants made using plaster molds (p = 0.030). Malformations were better corrected in the computer-aided design group (86 percent) than in the plaster group (72 percent) (p = 0.038). Patient satisfaction was higher in the former group (p = 0.011). Medical Outcomes Study 36-Item Short-Form Health Survey scores revealed significant improvements, both socially and emotionally. Correction of pectus excavatum using a computer-aided design silicone implant fulfils aesthetic and psychological demands. The technique is simple and reliable and yields high-quality results. In the medium term, the approach may render invasive techniques obsolete. These operations remain risky and of doubtful functional utility. Therapeutic, III.

Funnel plots and choropleth maps in cancer risk communication: a comparison of tools for disseminating population-based incidence data to stakeholders

PubMed Central

Cusimano, Rosanna; Zarcone, Maurizio; Mazzola, Sergio; Vitale, Francesco

2017-01-01

Background Population-based cancer registries provide epidemiological cancer information, but the indicators are often too complex to be interpreted by local authorities and communities, due to numeracy and literacy limitations. The aim of this paper is to compare the commonly used visual formats to funnel plots to enable local public health authorities and communities to access valid and understandable cancer incidence data obtained at the municipal level. Methods A funnel plot representation of standardised incidence ratio (SIR) was generated for the 82 municipalities of the Palermo Province with the 2003–2011 data from the Palermo Province Cancer Registry (Sicily, Italy). The properties of the funnel plot and choropleth map methodologies were compared within the context of disseminating epidemiological data to stakeholders. Results The SIRs of all the municipalities remained within the control limits, except for Palermo city area (SIR=1.12), which was sited outside the upper control limit line of 99.8%. The Palermo Province SIRs funnel plot representation was congruent with the choropleth map generated from the same data, but the former resulted more informative as shown by the comparisons of the weaknesses and strengths of the 2 visual formats. Conclusions Funnel plot should be used as a complementary valuable tool to communicate epidemiological data of cancer registries to communities and local authorities, visually conveying an efficient and simple way to interpret cancer incidence data. PMID:28363917

Fluorescence polarization measures energy funneling in single light-harvesting antennas—LH2 vs conjugated polymers

NASA Astrophysics Data System (ADS)

Camacho, Rafael; Tubasum, Sumera; Southall, June; Cogdell, Richard J.; Sforazzini, Giuseppe; Anderson, Harry L.; Pullerits, Tõnu; Scheblykin, Ivan G.

2015-10-01

Numerous approaches have been proposed to mimic natural photosynthesis using artificial antenna systems, such as conjugated polymers (CPs), dendrimers, and J-aggregates. As a result, there is a need to characterize and compare the excitation energy transfer (EET) properties of various natural and artificial antennas. Here we experimentally show that EET in single antennas can be characterized by 2D polarization imaging using the single funnel approximation. This methodology addresses the ability of an individual antenna to transfer its absorbed energy towards a single pool of emissive states, using a single parameter called energy funneling efficiency (ɛ). We studied individual peripheral antennas of purple bacteria (LH2) and single CP chains of 20 nm length. As expected from a perfect antenna, LH2s showed funneling efficiencies close to unity. In contrast, CPs showed lower average funneling efficiencies, greatly varying from molecule to molecule. Cyclodextrin insulation of the conjugated backbone improves EET, increasing the fraction of CPs possessing ɛ = 1. Comparison between LH2s and CPs shows the importance of the protection systems and the protein scaffold of LH2, which keep the chromophores in functional form and at such geometrical arrangement that ensures excellent EET.

Fluorescence polarization measures energy funneling in single light-harvesting antennas--LH2 vs conjugated polymers.

PubMed

Camacho, Rafael; Tubasum, Sumera; Southall, June; Cogdell, Richard J; Sforazzini, Giuseppe; Anderson, Harry L; Pullerits, Tõnu; Scheblykin, Ivan G

2015-10-19

Numerous approaches have been proposed to mimic natural photosynthesis using artificial antenna systems, such as conjugated polymers (CPs), dendrimers, and J-aggregates. As a result, there is a need to characterize and compare the excitation energy transfer (EET) properties of various natural and artificial antennas. Here we experimentally show that EET in single antennas can be characterized by 2D polarization imaging using the single funnel approximation. This methodology addresses the ability of an individual antenna to transfer its absorbed energy towards a single pool of emissive states, using a single parameter called energy funneling efficiency (ε). We studied individual peripheral antennas of purple bacteria (LH2) and single CP chains of 20 nm length. As expected from a perfect antenna, LH2s showed funneling efficiencies close to unity. In contrast, CPs showed lower average funneling efficiencies, greatly varying from molecule to molecule. Cyclodextrin insulation of the conjugated backbone improves EET, increasing the fraction of CPs possessing ε = 1. Comparison between LH2s and CPs shows the importance of the protection systems and the protein scaffold of LH2, which keep the chromophores in functional form and at such geometrical arrangement that ensures excellent EET.

Lead recovery and the feasibility of foam glass production from funnel glass of dismantled cathode ray tube through pyrovacuum process.

PubMed

Chen, Mengjun; Zhang, Fu-Shen; Zhu, Jianxin

2009-01-30

Cathode ray tube (CRT) is the first and foremost problem that must be solved in electronic waste disposal, and the key of which lies in the detoxification and reutilization of lead-contained funnel glass. In this study, a novel and effective process for funnel glass of dismantled CRT treatment was developed. The key point of the process was to recover metallic lead from the funnel glass and to prepare foam glass synchronously. Experimental results showed that lead recovery rate increased first with the increase of temperature, carbon adding amount, and holding time, then reached a plateau value, but pressure was on the contrary. The optimum temperature, pressure, carbon adding amount and holding time for lead recovery were 1000 degrees C, 1000 Pa, 5% and 4h, respectively, and the maximum lead recovery rate was 98.6%. In the pyrovacuum process, lead in the funnel glass was firstly detached and changed to PbO, then reduced and evaporated, and was recovered in the form of pure metal with a purity of 99.3%. The residue porous glass was environmentally acceptable for construction application.

[Comparative quality measurements part 3: funnel plots].

PubMed

Kottner, Jan; Lahmann, Nils

2014-02-01

Comparative quality measurements between organisations or institutions are common. Quality measures need to be standardised and risk adjusted. Random error must also be taken adequately into account. Rankings without consideration of the precision lead to flawed interpretations and enhances "gaming". Application of confidence intervals is one possibility to take chance variation into account. Funnel plots are modified control charts based on Statistical Process Control (SPC) theory. The quality measures are plotted against their sample size. Warning and control limits that are 2 or 3 standard deviations from the center line are added. With increasing group size the precision increases and so the control limits are forming a funnel. Data points within the control limits are considered to show common cause variation; data points outside special cause variation without the focus of spurious rankings. Funnel plots offer data based information about how to evaluate institutional performance within quality management contexts.

Adapting the buying funnel model of consumer behavior to the design of an online health research recruitment tool.

PubMed

Doshi, Aalap; Connally, Lisa; Spiroff, Meghan; Johnson, Anita; Mashour, George A

2017-08-01

UMHealthResearch is the University of Michigan's digital health research recruitment platform. It allows health researchers to connect efficiently with potentially eligible volunteers. In 2013, the UMHealthResearch team strategically adapted a consumer behavior model, the buying funnel, to create the Digital Health Research Participation Funnel. The Digital Health Research Participation Funnel was then used to design a more active way for potential participants to volunteer for research studies through UMHealthResearch. In the 5 years before the redesign (2007-2012), an average of 1844 new accounts were created every year, whereas in the completed years after the redesign (2013-2016) the annual average improved to 3906, an increase of 111%. Although a randomized design was not possible in this instance, these preintervention and postintervention data suggest that the focus on user experience is an effective strategy for improving web-based research recruitment platforms.

Evaluation of funnel traps for characterizing the bark beetle (Coleoptera: Scolytidae) communities in ponderosa pine forests of north-central Arizona.

PubMed

Hayes, Christopher J; DeGomez, Tom E; Clancy, Karen M; Williams, Kelly K; McMillin, Joel D; Anhold, John A

2008-08-01

Lindgren funnel traps baited with aggregation pheromones are widely used to monitor and manage populations of economically important bark beetles (Coleoptera: Scolytidae). This study was designed to advance our understanding of how funnel trap catches assess bark beetle communities and relative abundance of individual species. In the second year (2005) of a 3-yr study of the bark beetle community structure in north-central Arizona pine (Pinus spp.) forests, we collected data on stand structure, site conditions, and local bark beetle-induced tree mortality at each trap site. We also collected samples of bark from infested (brood) trees near trap sites to identify and determine the population density of bark beetles that were attacking ponderosa pine, Pinus ponderosa Douglas ex Lawson, in the area surrounding the traps. Multiple regression models indicated that the number of Dendroctonus and Ips beetles captured in 2005 was inversely related to elevation of the trap site, and positively associated with the amount of ponderosa pine in the stand surrounding the site. Traps located closer to brood trees also captured more beetles. The relationship between trap catches and host tree mortality was weak and inconsistent in forest stands surrounding the funnel traps, suggesting that trap catches do not provide a good estimate of local beetle-induced tree mortality. However, pheromone-baited funnel trap data and data from gallery identification in bark samples produced statistically similar relative abundance profiles for the five species of bark beetles that we examined, indicating that funnel trap data provided a good assessment of species presence and relative abundance.

Evolved Minimal Frustration in Multifunctional Biomolecules.

PubMed

Röder, Konstantin; Wales, David J

2018-05-25

Protein folding is often viewed in terms of a funnelled potential or free energy landscape. A variety of experiments now indicate the existence of multifunnel landscapes, associated with multifunctional biomolecules. Here, we present evidence that these systems have evolved to exhibit the minimal number of funnels required to fulfil their cellular functions, suggesting an extension to the principle of minimum frustration. We find that minimal disruptive mutations result in additional funnels, and the associated structural ensembles become more diverse. The same trends are observed in an atomic cluster. These observations suggest guidelines for rational design of engineered multifunctional biomolecules.

Nature of inclined growth in thin-layer electrodeposition under uniform magnetic fields.

PubMed

Soba, Alejandro; González, Graciela; Calivar, Lucas; Marshall, Guillermo

2012-11-01

Electrochemical deposition (ECD) in thin cells in a vertical position relative to gravity, subject to an external uniform magnetic field, yields a growth pattern formation with dense branched morphology with branches tilted in the direction of the magnetic force. We study the nature of the inclined growth through experiments and theory. Experiments in ECD, in the absence of magnetic forces, reveal that a branch grows by allowing fluid to penetrate its tip and to be ejected from the sides through a pair of symmetric vortices attached to the tip. The upper vortices zone defines an arch separating an inner zone ion depleted and an outer zone in a funnel-like form with a concentrated solution through which metal ions are carried into the tip. When a magnetic field is turned on, vortex symmetry is broken, one vortex becoming weaker than the other, inducing an inclination of the funnel. Consequently, particles entering the funnel give rise to branch growth tilted in the same direction. Theory predicts, in the absence of a magnetic force, funnel symmetry induced through symmetric vortices driven by electric and gravitational forces; when the magnetic force is on, it is composed with the pair of clockwise and counterclockwise vortices, reducing or amplifying one or the other. In turn, funnel tilting modifies particle trajectories, thus, growth orientation.

Fluorescence polarization measures energy funneling in single light-harvesting antennas—LH2 vs conjugated polymers

PubMed Central

Camacho, Rafael; Tubasum, Sumera; Southall, June; Cogdell, Richard J.; Sforazzini, Giuseppe; Anderson, Harry L.; Pullerits, Tõnu; Scheblykin, Ivan G.

2015-01-01

Numerous approaches have been proposed to mimic natural photosynthesis using artificial antenna systems, such as conjugated polymers (CPs), dendrimers, and J-aggregates. As a result, there is a need to characterize and compare the excitation energy transfer (EET) properties of various natural and artificial antennas. Here we experimentally show that EET in single antennas can be characterized by 2D polarization imaging using the single funnel approximation. This methodology addresses the ability of an individual antenna to transfer its absorbed energy towards a single pool of emissive states, using a single parameter called energy funneling efficiency (ε). We studied individual peripheral antennas of purple bacteria (LH2) and single CP chains of 20 nm length. As expected from a perfect antenna, LH2s showed funneling efficiencies close to unity. In contrast, CPs showed lower average funneling efficiencies, greatly varying from molecule to molecule. Cyclodextrin insulation of the conjugated backbone improves EET, increasing the fraction of CPs possessing ε = 1. Comparison between LH2s and CPs shows the importance of the protection systems and the protein scaffold of LH2, which keep the chromophores in functional form and at such geometrical arrangement that ensures excellent EET. PMID:26478272

Validation of the Berlese-funnel technique for thrips extraction.

PubMed

Casteels, H; Witters, J; De Bondt, G; Desamblanx, J

2009-01-01

In order to get the accreditation EN ISO/IEC 17025 for Thrips palmi the Berlese-funnel technique, which is used for the isolation of quarantine insects out of plant material, was validated. Following parameters were investigated: cleaning of the funnel, temperature during isolation, detection limit and duration of the isolation period. Thrips fuscipennis was collected from heavily infected rosehip and used as target organism. Besides orchids, artificially contaminated maple leaves (Acer pseudoplatanus) were used for the validation. Results showed that thrips and other organisms can be present alive or dead in the funnel after removing the treated plants and can contaminate the next sample or isolate. Cleaning of the funnel with a vacuum cleaner and compressed-air apparatus is necessary before running a new extraction. Contamination of the recipient is also possible from the environment. This can be avoided by closing the opening between the funnel and the recipient. To reach an optimal temperature for isolation of the thrips a 60 Watt bulb is necessary. The results showed that the maximum temperature doesn't reach a temperature above 51 degrees C, the average temperatures were situated between 35, 74 degrees C and 39, 38 degrees C. A 40 Watt bulb doesn't create enough heat to guarantee an efficient isolation of the thrips; the average temperature was 34, 74 degrees C and the maximum temperature 36, 80 degrees C. Based on the results we can conclude that an isolation time of 20 hours is necessary to obtain accurate data. Dependent on the number of thrips in the artificially infected samples 87 to 95% is isolated after 20 hours. The detection limit is 1 thrips with a probability of 95% being isolated after 20 hours.

Biomimetic light-harvesting funnels for re-directioning of diffuse light.

PubMed

Pieper, Alexander; Hohgardt, Manuel; Willich, Maximilian; Gacek, Daniel Alexander; Hafi, Nour; Pfennig, Dominik; Albrecht, Andreas; Walla, Peter Jomo

2018-02-14

Efficient sunlight harvesting and re-directioning onto small areas has great potential for more widespread use of precious high-performance photovoltaics but so far intrinsic solar concentrator loss mechanisms outweighed the benefits. Here we present an antenna concept allowing high light absorption without high reabsorption or escape-cone losses. An excess of randomly oriented pigments collects light from any direction and funnels the energy to individual acceptors all having identical orientations and emitting ~90% of photons into angles suitable for total internal reflection waveguiding to desired energy converters (funneling diffuse-light re-directioning, FunDiLight). This is achieved using distinct molecules that align efficiently within stretched polymers together with others staying randomly orientated. Emission quantum efficiencies can be >80% and single-foil reabsorption <0.5%. Efficient donor-pool energy funneling, dipole re-orientation, and ~1.5-2 nm nearest donor-acceptor transfer occurs within hundreds to ~20 ps. Single-molecule 3D-polarization experiments confirm nearly parallel emitters. Stacked pigment selection may allow coverage of the entire solar spectrum.

Particle injector for fluid systems

DOEpatents

Ruch, Jeffrey F.

1997-01-01

A particle injector device provides injection of particles into a liquid eam. The device includes a funnel portion comprising a conical member having side walls tapering from a top opening (which receives the particles) down to a relatively smaller exit opening. A funnel inlet receives a portion of the liquid stream and the latter is directed onto the side walls of the conical member so as to create a cushion of liquid against which the particles impact. A main section of the device includes an inlet port in communication with the exit opening of the funnel portion. A main liquid inlet receives the main portion of the liquid stream at high pressure and low velocity and a throat region located downstream of the main liquid inlet accelerates liquid received by this inlet from the low velocity to a higher velocity so as to create a low pressure area at the exit opening of the funnel portion. An outlet opening of the main section enables the particles and liquid stream to exit from the injector device.

Encapsulated Essential Oils as an Alternative to Insecticides in Funnel Traps.

PubMed

Pascual-Villalobos, M J; López, M D; Castañé, C; Soler, A; Riudavets, J

2015-08-01

Pheromone-lured funnel traps are widely used for pest monitoring and mass trapping in agricultural fields and stores. DDVP vapona (dichlorvos), the insecticide of choice as a killing agent inside traps, has been banned, and research on new products is being pursued. Essential oils (EO) could be an alternative if properly formulated. To test their potential, beads of encapsulated coriander and basil EO were tested in funnel traps in stores of almonds and pet foods during 2 mo. The number of adult moth (Plodia interpunctella (Hübner) and Ephestia kuehniella Zeller) dead captures was similar with either coriander or basil EO beads and with vapona tablets while there were more insects alive in the control. These preliminary results indicate a good potential for the development of such natural products as an alternative to synthetic insecticides to include them inside funnel traps. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Solar Chromosphere/Corona Interface. I; FUV-EUV Observations and Modeling of Unresolved Coronal Funnels

NASA Technical Reports Server (NTRS)

Martinez-Galarce, D. S.; Walker, A. B. C.; Barbee, T. W., II; Hoover, R. B.

2003-01-01

A coronal funnel model, developed by Rabin (199l), was tested against a calibrated spectroheliogram recorded in 171 - 175 Angstrom bandpass. This image was recorded on board a sounding rocket experiment flown on 1994 November 3, called the Multi-Spectral Solar Telescope Array, II (MSSTA II), MSSTA, a joint project of Stanford University, the NASA Marshall Space Flight Center and the Lawrence Livermore National Laboratory, is an observing platform composed of a set of normal-incidence, multilayer-coated optics designed to obtain narrow bandpass, high resolution images (1 - 3 arc sec) at selected FUV, EUV and soft X-ray wavelengths (44 Angstroms - 1550 Angstroms). Using full-disk images centered at 1550 Angstroms (C IV) and 173 Angstroms (FE IX/X), the funnel model, which is based on coronal back-heating, was tested against the data incorporating observed constraints on global coverage and measured flux. Found, was a class of funnel models that could account for the quiescent, globally diffuse and unresolved emission seen in the 171 - 175 Angstrom bandpass, where the funnels are assumed to be rooted in the C IV supergranular network. These models, when incorporated with the Chianti spectral code, suggest that this emission is mostly of upper transition region origin and primarily composed of FE IX plasma. The funnels are found to have constrictions, Gamma approx. 6 - 20, which is in good agreement with the observations. Further, the fitted models simultaneously satisfy global areal constraints seen in both images; namely, that a global network of funnels must cover approx. 70 - 95 % of the total solar surface area seen in the 171 - 175 Angstrom image, and = 45 % of the disk area seen in the 1550 Angstrom bandpass. These findings support the configuration of the EUV magnetic network as suggested by Reeves et af. (1974) and put forth in more detail by Gabriel (1976). Furthermore, the models are in good agreement with differential emission measure estimates made of the transition region by Raymond & Doyle (1981) for temperatures, 250,000 K = T = 650,000 K, based on full-disk observations made on board by SkyLab.

The Solar Chromosphere/Corona Interface. I. Far-Ultraviolet to Extreme-Ultraviolet Observations and Modeling of Unresolved Coronal Funnels

NASA Technical Reports Server (NTRS)

Martinez-Galarce, Dennis S.; Walker, Arthur C., III; Barbee, Troy W., II; Hoover, Richard B.

2003-01-01

A coronal funnel model, developed by D. Rabin, was tested against a calibrated spectroheliogram recorded in the 170-1 75 A bandpass. This image was recorded on board a sounding-rocket experiment flown on 1994 November 3, called the Multi-Spectral Solar Telescope Array II (MSSTA II). MSSTA, a joint project of Stanford University, the NASA Marshall Space Flight Center, and the Lawrence Livermore National Laboratory' is an observing platform composed of a set of normal-incidence, multilayer-coated optics designed to obtain narrow-bandpass, high-resolution images (1 sec.- 3 sec.) at selected far-ultraviolet (FUV), extreme-ultraviolet (EUV), and soft X-ray wavelengths (44-1550 A). Using full disk images centered at 1550 A (C IV) and 173 A (Fe IX/X), the funnel model, which is based on coronal back-heating, was tested against the data incorporating observed constraints on global coverage and measured flux. Found was a class of funnel models that could account for the quiescent, globally diffuse and unresolved emission seen in the 171-175 A bandpass, where the funnels are assumed to be rooted in the C IV supergranular network. These models, when incorporated with the CHIANTI spectral code, suggest that this emission is mostly of upper transition region origin and primarily composed of Fe IX plasma. The funnels are found to have constrictions, Gamma approx. 6-20, which is in good agreement with the observations. Further, the fitted models simultaneously satisfy global areal constraints seen in both images; namely,that a global network of funnels must cover approx. 700 - 95% of the total solar surface area seen in the 171-175 A image, and a 5% of the disk area seen in the 1550 A bandpass. These findings support the configuration of the EUV magnetic network as suggested by Reeves et al. and put forth in more detail by Gabriel. Furthermore, the models are in good agreement with differential emission measure estimates made of the transition region by J. C. Raymond & J. G. Doyle for temperatures 250,000 K less than or = T less than or = 650,000 K, based on full-disk observations made on board Skylab.

Ionization source utilizing a jet disturber in combination with an ion funnel and method of operation

DOEpatents

Smith, Richard D.; Kim, Taeman; Tang, Keqi; Udseth, Harold R.

2003-06-24

A jet disturber used in combination with an ion funnel to focus ions and other charged particles generated at or near atmospheric pressure into a relatively low pressure region, which allows increased conductance of the ions and other charged particles. The jet disturber is positioned within an ion funnel and may be interfaced with a multi-capillary inlet juxtaposed between an ion source and the interior of an instrument maintained at near atmospheric pressure. The invention finds particular advantages when deployed to improve the ion transmission between an electrospray ionization source and the first vacuum stage of a mass spectrometer.

Lead recovery and glass microspheres synthesis from waste CRT funnel glasses through carbon thermal reduction enhanced acid leaching process.

PubMed

Mingfei, Xing; Yaping, Wang; Jun, Li; Hua, Xu

2016-03-15

In this study, a novel process for detoxification and reutilization of waste cathode ray tube (CRT) funnel glass was developed by carbon thermal reduction enhanced acid leaching process. The key to this process is removal of lead from the CRT funnel glass and synchronous preparation of glass microspheres. Carbon powder was used as an isolation agent and a reducing agent. Under the isolation of the carbon powder, the funnel glass powder was sintered into glass microspheres. In thermal reduction, PbO in the funnel glass was first reduced to elemental Pb by carbon monoxide and then located on the surface of glass microspheres which can be removed easily by acid leaching. Experimental results showed that temperature, carbon adding amount and holding time were the major parameters that controlled lead removal rate. The maximum lead removal rate was 94.80% and glass microspheres that measured 0.73-14.74μm were obtained successfully by setting the temperature, carbon adding amount and holding time at 1200°C, 10% and 30min, respectively. The prepared glass microspheres may be used as fillers in polymer materials and abrasive materials, among others. Accordingly, this study proposed a practical and economical process for detoxification and recycling of waste lead-containing glass. Copyright © 2015 Elsevier B.V. All rights reserved.

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

Cameron, Maria K., E-mail: cameron@math.umd.edu

We develop computational tools for spectral analysis of stochastic networks representing energy landscapes of atomic and molecular clusters. Physical meaning and some properties of eigenvalues, left and right eigenvectors, and eigencurrents are discussed. We propose an approach to compute a collection of eigenpairs and corresponding eigencurrents describing the most important relaxation processes taking place in the system on its way to the equilibrium. It is suitable for large and complex stochastic networks where pairwise transition rates, given by the Arrhenius law, vary by orders of magnitude. The proposed methodology is applied to the network representing the Lennard-Jones-38 cluster created bymore » Wales's group. Its energy landscape has a double funnel structure with a deep and narrow face-centered cubic funnel and a shallower and wider icosahedral funnel. However, the complete spectrum of the generator matrix of the Lennard-Jones-38 network has no appreciable spectral gap separating the eigenvalue corresponding to the escape from the icosahedral funnel. We provide a detailed description of the escape process from the icosahedral funnel using the eigencurrent and demonstrate a superexponential growth of the corresponding eigenvalue. The proposed spectral approach is compared to the methodology of the Transition Path Theory. Finally, we discuss whether the Lennard-Jones-38 cluster is metastable from the points of view of a mathematician and a chemical physicist, and make a connection with experimental works.« less

Observational Signatures of Mass-loading in Jets Launched by Rotating Black Holes

NASA Astrophysics Data System (ADS)

O’ Riordan, Michael; Pe’er, Asaf; McKinney, Jonathan C.

2018-01-01

It is widely believed that relativistic jets in X-ray binaries (XRBs) and active-galactic nuclei are powered by the rotational energy of black holes. This idea is supported by general-relativistic magnetohydrodynamic (GRMHD) simulations of accreting black holes, which demonstrate efficient energy extraction via the Blandford–Znajek mechanism. However, due to uncertainties in the physics of mass loading, and the failure of GRMHD numerical schemes in the highly magnetized funnel region, the matter content of the jet remains poorly constrained. We investigate the observational signatures of mass loading in the funnel by performing general-relativistic radiative transfer calculations on a range of 3D GRMHD simulations of accreting black holes. We find significant observational differences between cases in which the funnel is empty and cases where the funnel is filled with plasma, particularly in the optical and X-ray bands. In the context of Sgr A*, current spectral data constrains the jet filling only if the black hole is rapidly rotating with a ≳ 0.9. In this case, the limits on the infrared flux disfavor a strong contribution from material in the funnel. We comment on the implications of our models for interpreting future Event Horizon Telescope observations. We also scale our models to stellar-mass black holes, and discuss their applicability to the low-luminosity state in XRBs.

Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction.

PubMed

Steinmann, Cornelia; Krille, Stefanie; Mueller, Astrid; Weber, Peter; Reingruber, Bertram; Martin, Alexandra

2011-11-01

The aim of this study was to evaluate the effects of anterior chest-wall deformities on disease-specific and health-related quality of life, body image, and psychiatric comorbidity prior to surgical correction. A total of 90 patients (71 with pectus excavatum, 19 with pectus carinatum) presenting themselves for pectus repair and 82 control subjects were recruited for this study. The objective severity of the deformity was determined through the funnel-chest index by Hümmer and the Haller index. Disease-specific quality of life was measured with the Nuss Questionnaire modified for Adults (NQ-mA) and health-related quality of life was determined by the Short-Form-36 Health Survey (SF-36). Body image was assessed via the Body Image Questionnaire (FKB-20), the Dysmorphic Concern Questionnaire (DCQ), and a self-evaluation of the subjective impairment of the appearance. The Diagnostic Interview for Mental Disorders - Short Version (Mini-DIPS), the General Depression Scale (Allgemeine Depressionsskala, ADS), and a self-rating of self-esteem were used to evaluate general psychological impairment. Compared with control group results, physical quality of life was reduced in patients with pectus excavatum, while mental quality of life was decreased in patients with pectus carinatum (p<0.05). Body image was highly disturbed in all the patients and differed significantly from the control group (p<0.01). Patients with pectus carinatum appeared to be less satisfied with their appearance than those with pectus excavatum (p=0.07). Body image distress was multivariately associated with both reduced mental quality of life and low self-esteem (p<0.001). Body image did not influence physical quality of life. Patients displayed no elevated rates of mental disorders according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. Since self-perception is a major contributor to therapeutic decision making, a systematic evaluation of body image should be included in the assessment of patients with chest deformities. Body image concerns may be even more relevant to the decision-making process than physical restrictions. Exaggerated dysmorphic concerns should be prospectively investigated in their ability to influence the extent of satisfaction with the surgical outcome. Copyright © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Evidence from mixed hydrate nucleation for a funnel model of crystallization.

PubMed

Hall, Kyle Wm; Carpendale, Sheelagh; Kusalik, Peter G

2016-10-25

The molecular-level details of crystallization remain unclear for many systems. Previous work has speculated on the phenomenological similarities between molecular crystallization and protein folding. Here we demonstrate that molecular crystallization can involve funnel-shaped potential energy landscapes through a detailed analysis of mixed gas hydrate nucleation, a prototypical multicomponent crystallization process. Through this, we contribute both: (i) a powerful conceptual framework for exploring and rationalizing molecular crystallization, and (ii) an explanation of phenomenological similarities between protein folding and crystallization. Such funnel-shaped potential energy landscapes may be typical of broad classes of molecular ordering processes, and can provide a new perspective for both studying and understanding these processes.

Evidence from mixed hydrate nucleation for a funnel model of crystallization

PubMed Central

Hall, Kyle Wm.; Carpendale, Sheelagh; Kusalik, Peter G.

2016-01-01

The molecular-level details of crystallization remain unclear for many systems. Previous work has speculated on the phenomenological similarities between molecular crystallization and protein folding. Here we demonstrate that molecular crystallization can involve funnel-shaped potential energy landscapes through a detailed analysis of mixed gas hydrate nucleation, a prototypical multicomponent crystallization process. Through this, we contribute both: (i) a powerful conceptual framework for exploring and rationalizing molecular crystallization, and (ii) an explanation of phenomenological similarities between protein folding and crystallization. Such funnel-shaped potential energy landscapes may be typical of broad classes of molecular ordering processes, and can provide a new perspective for both studying and understanding these processes. PMID:27790987

Lead recovery from waste CRT funnel glass by high-temperature melting process.

PubMed

Hu, Biao; Hui, Wenlong

2018-02-05

In this research, a novel and effective process for waste CRT funnel glass treatment was developed. The key to this process is removal of lead from the CRT funnel glass by high-temperature melting process. Sodium carbonate powder was used as a fusion agent, sodium sulfide serves as a catalytic agent and carbon powder acts as reducing agent. Experimental results showed that lead recovery rate increased with an increase in the amount of added sodium carbonate, sodium sulfide, carbonate, temperature and holding time initially, and then reached a stable value. The maximum lead recovery rate was approximately 94%, when the optimum adding amount of sodium carbonate, sodium sulfide, carbonate, temperature and holding time were 25%, 8%, 3.6%, 1200°C and 120min, respectively. In the high-temperature melting process, lead silicate in the funnel glass was firstly reduced, and then removed. The glass slag can be made into sodium and potassium silicate by hydrolysis process. This study proposed a practical and economical process for recovery of lead and utilization of waste glass slag. Copyright © 2017 Elsevier B.V. All rights reserved.

Funnel metadynamics as accurate binding free-energy method

PubMed Central

Limongelli, Vittorio; Bonomi, Massimiliano; Parrinello, Michele

2013-01-01

A detailed description of the events ruling ligand/protein interaction and an accurate estimation of the drug affinity to its target is of great help in speeding drug discovery strategies. We have developed a metadynamics-based approach, named funnel metadynamics, that allows the ligand to enhance the sampling of the target binding sites and its solvated states. This method leads to an efficient characterization of the binding free-energy surface and an accurate calculation of the absolute protein–ligand binding free energy. We illustrate our protocol in two systems, benzamidine/trypsin and SC-558/cyclooxygenase 2. In both cases, the X-ray conformation has been found as the lowest free-energy pose, and the computed protein–ligand binding free energy in good agreement with experiments. Furthermore, funnel metadynamics unveils important information about the binding process, such as the presence of alternative binding modes and the role of waters. The results achieved at an affordable computational cost make funnel metadynamics a valuable method for drug discovery and for dealing with a variety of problems in chemistry, physics, and material science. PMID:23553839

The Sternocleidomastoid Muscle Flap: A Versatile Local Method for Repair of External Penetrating Injuries of Hypopharyngeal-Cervical Esophageal Funnel.

PubMed

Ellabban, Mohamed A

2016-04-01

A primary repair of external penetrating injury to hypopharyngeal-cervical esophageal (HP-CE) funnel without reinforcement has more complications if compared with muscle reinforcement. The aim of the present study was to assess the outcome of using sternocleidomastoid (SCM) muscle flap for reinforcement of primary repair of HP-CE funnel injury. The study proposed an algorithm for different uses of SCM flap repair according to site and size of funnel perforation. A prospective analysis of 12 patients, who had surgical treatment for external penetrating injuries of HP-CE funnel between January 2011 and September 2014, was recorded. The following factors were studied for each case: demographic data, Revised Trauma Score (RTS), mechanism of injury, time interval between injury and definitive surgical care, injury morphology, any associated injuries, technique of SCM flap used, length of hospital stay, and surgical outcome and complications. They were 10 males and 2 females and the mean age was 31.9 years. The cause of injury was stab wound in 5 (41.7 %) cases, gunshot injury in 4 (33.3 %) cases and 3 (25 %) cases after anterior cervical spine surgery. Isolated injury to HP and CE was recorded in 5 cases (41.7 %) for each site. However, 2 (16.7 %) cases had injury to both HP and CE. Cranially based SCM flap was mainly used in cases with HP injury and caudally based flap in CE cases with some limitations. The whole muscle flap was used in large (≥ 1 cm) defects while and the split muscle flap in small (<1 cm) defects. Oral intake started 7 days postoperatively with only one (8.3 %) case of small leakage, which was treated conservatively. The SCM flap is a very useful and versatile tool in reinforcement of HP-CE funnel injury with the advantages of high success rates of leakage prevention.

Completing the census of young stars near the Sun with the FunnelWeb spectroscopic survey

NASA Astrophysics Data System (ADS)

Lawson, Warrick; Murphy, Simon; Tinney, Christopher G.; Ireland, Michael; Bessell, Michael S.

2016-06-01

From late 2016, the Australian FunnelWeb survey will obtain medium-resolution (R~2000) spectra covering the full optical range for 2 million of the brightest stars (I<12) in the southern sky. It will do so using an upgraded UK Schmidt Telescope at Siding Spring Observatory, equipped with a revolutionary, parallelizable optical fibre positioner ("Starbugs") and spectrograph. The ability to reconfigure a multi-fibre plate in less than 5 minutes allows FunnelWeb to observe more stars per night than any other competing multi-fibre spectrograph and enables a range of previously inefficient bright star science not attempted since the completion of the HD catalogues in the 1940s. Among its key science aims, FunnelWeb will obtain spectra for thousands of young and adolescent (<1 Gyr) stars near the Sun (<200 pc) across a wide range of spectral types. These spectra will include well-studied youth and activity indicators such as H-alpha, Li I 6708A, Ca II H&K, as well as surface gravity diagnostics (e.g. Na I, K I). In addition, FunnelWeb will obtain stellar parameters (Teff, logg, vsini), abundances (Fe/H, alpha/Fe) and radial velocities to 1-2 km/s for every star in the survey. When combined with high precision parallaxes and proper motions from the Gaia mission expected from 2017, this dataset will provide a near-complete census of adolescent stars in the solar neighbourhood. It will help reveal the typical formation environments of young solar-type stars, how such stars move from their stellar nurseries to their adult lives in the field, and identifying thousands of high-priority targets for follow-up direct imaging (GPI, SPHERE), transit (including TESS) and radial velocity exoplanet studies. In this poster contribution we introduce the FunnelWeb survey, its science goals and input catalogue, as well as provide an update on the status of the fibre positioner and spectrograph commissioning at Siding Spring.

Trapping Douglas-fir beetle (Dendroctonus pseudotsugae) with pheromone baited multiple-funnel traps does not reduce Douglas-fir (Pseudotsuga menziesii) mortality

Treesearch

R.A. Progar; N. Sturdevant; M.J. Rinella

2010-01-01

Douglas-fir beetle (Dendroctonus pseudotsugae Hopkins) (DFB) causes considerable mortality to Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) in western North American forests. We evaluated the use of semiochemical-baited multiple-funnel traps for the protection of small, high-value stands of trees, such as those occurring...

Evaluation of funnel traps for estimating tree mortality and associated population phase of spruce beetle in Utah

Treesearch

E. Matthew Hansen; Barbara J. Bentz; A. Steven Munson; James C. Vandygriff; David L. Turner

2006-01-01

Although funnel traps are routinely used to manage bark beetles, little is known regarding the relationship between trap captures of spruce beetle (Dendroctonus rufipennis Kirby) and mortality of Engelmann spruce (Picea engelmannii Parry ex Engelm.) within a 10 ha block of the trap. Using recursive partitioning tree analyses, rules...

Retooling the Enrollment Funnel: Strategies and Metrics for a New Era. Noel-Levitz White Paper

ERIC Educational Resources Information Center

Noel-Levitz, Inc, 2009

2009-01-01

For more than two decades, the enrollment funnel has shaped how enrollment managers planned their enrollment strategies. It was a reliable, effective model for enrollment behavior, and campuses could shape their strategies around it. In recent years, however, demographic changes as well as technological advances have rendered the traditional…

Ion funnel ion trap and process

DOEpatents

Belov, Mikhail E [Richland, WA; Ibrahim, Yehia M [Richland, WA; Clowers, Biran H [West Richland, WA; Prior, David C [Hermiston, OR; Smith, Richard D [Richland, WA

2011-02-15

An ion funnel trap is described that includes a inlet portion, a trapping portion, and a outlet portion that couples, in normal operation, with an ion funnel. The ion trap operates efficiently at a pressure of .about.1 Torr and provides for: 1) removal of low mass-to-charge (m/z) ion species, 2) ion accumulation efficiency of up to 80%, 3) charge capacity of .about.10,000,000 elementary charges, 4) ion ejection time of 40 to 200 .mu.s, and 5) optimized variable ion accumulation times. Ion accumulation with low concentration peptide mixtures has shown an increase in analyte signal-to-noise ratios (SNR) of a factor of 30, and a greater than 10-fold improvement in SNR for multiply charged analytes.

An Open-source Low-cost Portable Apparatus for Soil Fauna Sampling

NASA Astrophysics Data System (ADS)

Daliakopoulos, Ioannis; Wagner, Karl; Grillakis, Manolis; Apostolakis, Antonios; Tsanis, Ioannis

2016-04-01

A low-cost apparatus for the extraction of living soil animals from soil or litter samples is presented. The main unit consists of a modular bank system with three horizontal shelves designed to accommodate lamps and soil samples over funnel and jar systems for animal collection, thus serving as a practical and standardized modification of the well-documented Berlese-Tullgren funnel. Shelves are vertically adjustable, sliding on 5 mm threaded rods and securing with wing nuts for easy assembly/disassembly and stability. Shelf material is 4 mm plywood (or similar), laser-cut (or similar) to accommodate lamp sockets, tubes and funnels at respective levels. Soil samples are inserted in 10 cm tubes from standard Ø50 mm PVC piping that can also function as direct collection corers for softer soils. Tubes are fitted in the tube bank shelf, each directly under a 25 W reflector lamp and over a funnel and jar system. Lamps are located 25 mm over the tubes' top creating a relatively constant 10 oC temperature gradient that drives soil animals away from heat and light, and towards the bottom end of the tube which is fitted with a suitable fabric mesh. Standard 106 ml panelled jars, filled with a safe-to-handle preservative (e.g. propylene glycol) to the lower end of the funnel fitted in them, trap and preserve soil organisms until identification. The apparatus offers flat-pack portability and scalability using low-cost standard material. Design specifications and Drawing eXchange Format (dxf) files for apparatus reproduction are provided.

Specific Resistance. Operational Control Tests for Wastewater Facilities. Instructor's Manual [and] Student Workbook.

ERIC Educational Resources Information Center

Wooley, John F.

A commonly used test for determining filterability of conditioned sludge is the specific resistance (Buchner funnel) test. The sludge is filtered through filter paper using a Buchner funnel, and the time needed to obtain a given volume of filtrate (or for cake residue to begin to crack) is measured. The shorter the time, the better the…

Thermotropic Liquid Crystals with Nitrocinnamylidene Unit

DTIC Science & Technology

1988-10-14

added through dropping funnel. Stir for 2 hrs before precipitated from distilled water . The crude yellow product was redissolved in chloroform and dried...rate 1O*C/hr) for overnight. Filter through celite and ceramic filtration funnel before precipitating with distilled water . The crude product was...Table 1. Cinnamylidene-P-octyloxyaniline was synthesized primarily by reacting cinnamaldehyde with p-octyloxyaniline and exhibits no mesomorphic property

Admissions Funnel Benchmarks for Four-Year Public and Private Institutions, 2010. Noel-Levitz Report on Undergraduate Enrollment Trends

ERIC Educational Resources Information Center

Noel-Levitz, Inc, 2010

2010-01-01

To assist campuses with accurately forecasting enrollments, this report continues Noel-Levitz's long-standing research into admissions funnel conversion and yield rates. The report is based on a Web-based survey of college and university admissions officials in September and October, 2010, in which respondents reported fall 2010 and fall 2009…

Dynamics and thermodynamics of a tornado: Rotation effects

NASA Astrophysics Data System (ADS)

Ben-Amots, N.

2016-09-01

This paper investigates the relevant processes in the tornado including the dynamics of rotation and thermodynamics as well as condensation. The main novelty of this paper is the explanation of the phenomena occurring in the central downflow. The reduced pressure in the tornado's funnel sucks air and water vapor from the cloud above the tornado. The latent heat of condensation is released in the funnel. The centrifugal force drives the generated water drops out of the funnel. The latent heat of condensation released is also transferred out of the funnel, and supplies the helically ascending air flow surrounding the tornado with additional buoyancy energy. This process gives the tornado increased strength compared to the dust devil type of flow, thus explaining why tornadoes occur always under a cloud, and why the tornado pipe can reach a height of a kilometer and more. To sustain a tornado, the temperature of water vapor at the cloud's base should be higher than the surroundings by a certain minimal value. Remote infrared temperature measurements of clouds' bases may provide indications of the probability that a cloud can spawn a tornado, which may increase the lead time.

Ion funnel device

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

Ibrahim, Yehia M.; Chen, Tsung-Chi; Harrer, Marques B.

2017-11-21

An ion funnel device is disclosed. A first pair of electrodes is positioned in a first direction. A second pair of electrodes is positioned in a second direction. The device includes an RF voltage source and a DC voltage source. A RF voltage with a superimposed DC voltage gradient is applied to the first pair of electrodes, and a DC voltage gradient is applied to the second pair of electrodes.

Comparison of arboreal beetle catches in wet and dry collection cups with lindgren multiple funnel traps

Treesearch

Daniel R. Miller; Donald A. Duerr

2008-01-01

We compared the effectiveness of a dry collection cup (with an insecticide killing strip) to a wet collection cup (containing antifreeze) for use with Lindgren multiple-funnel traps in catching several common species of bark and wood-boring beetles, and their associates in southern pine forests. All traps were baited with either the binary combination of ethanol and...

Considering species richness and rarity when selecting optimal survey traps: comparison of semiochecmial baited flight intercept traps for Cerambycidae in eastern North America

Treesearch

Kevin J. Dodds; Jeremy D. Allison; Daniel R. Miller; Ryan P. Hanavan; Jon Sweeney

2015-01-01

1.) We compared standard multiple-funnel, modified multiple-funnel, intercept panel and canopy malaise (SLAM) traps with top and bottom collecting cups for their effectiveness (species richness, rarity, abundance) at capturing Cerambycidae in eastern North America. 2.) Experiments were conducted in New York, Louisiana, Massachusetts and Georgia in 2011 and 2012. A...

Ion transfer from an atmospheric pressure ion funnel into a mass spectrometer with different interface options: Simulation-based optimization of ion transmission efficiency.

PubMed

Mayer, Thomas; Borsdorf, Helko

2016-02-15

We optimized an atmospheric pressure ion funnel (APIF) including different interface options (pinhole, capillary, and nozzle) regarding a maximal ion transmission. Previous computer simulations consider the ion funnel itself and do not include the geometry of the following components which can considerably influence the ion transmission into the vacuum stage. Initially, a three-dimensional computer-aided design (CAD) model of our setup was created using Autodesk Inventor. This model was imported to the Autodesk Simulation CFD program where the computational fluid dynamics (CFD) were calculated. The flow field was transferred to SIMION 8.1. Investigations of ion trajectories were carried out using the SDS (statistical diffusion simulation) tool of SIMION, which allowed us to evaluate the flow regime, pressure, and temperature values that we obtained. The simulation-based optimization of different interfaces between an atmospheric pressure ion funnel and the first vacuum stage of a mass spectrometer require the consideration of fluid dynamics. The use of a Venturi nozzle ensures the highest level of transmission efficiency in comparison to capillaries or pinholes. However, the application of radiofrequency (RF) voltage and an appropriate direct current (DC) field leads to process optimization and maximum ion transfer. The nozzle does not hinder the transfer of small ions. Our high-resolution SIMION model (0.01 mm grid unit(-1) ) under consideration of fluid dynamics is generally suitable for predicting the ion transmission through an atmospheric-vacuum system for mass spectrometry and enables the optimization of operational parameters. A Venturi nozzle inserted between the ion funnel and the mass spectrometer permits maximal ion transmission. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Surgeon-level reporting presented by funnel plot is understood by doctors but inaccurately interpreted by members of the public.

PubMed

Bhalla, Ashish; Mehrotra, Prerna; Amawi, Falah; Lund, Jonathan N

2015-01-01

Risk-adjusted outcome data for general surgeons practicing in the United Kingdom were published for the first time in 2013 with the aim of increasing transparency, improving standards, and providing the public with information to aid decision making. Most specialties used funnel plots to present their data. We assess the ability of members of the public (MoP), medical students, nonsurgical doctors (NSD), and surgeons to understand risk-adjusted surgical outcome data. A fictitious outcome dataset was created and presented in the form of a funnel plot to 10 participants from each of the aforementioned group. Standard explanatory text was provided. Each participant was given 5 minutes to review the funnel plot and complete a questionnaire. For each question, there was only 1 correct answer. Completion rate was 100% (n = 40). No difference existed between NSD and surgeons. A significant difference for identification of the "worst performing surgeon" was noted between surgeons and MoP (p < 0.01) and between NSD and MoP (p < 0.01). Half of medical students and MoP claimed they would use this information to aid decision making compared with 80% of doctors. MoP reported the funnel plot significantly "more difficult" to interpret than surgeons did (p < 0.01) and NSD (p < 0.01). MoP found these data significantly more "difficult to understand" and were less likely to both spot "outliers" and use this data to inform decisions than doctors. Surgeons should be aware that outcome data may require an alternative method of presentation to be understood by MoP. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Funnel plots, performance variation and the Myocardial Infarction National Audit Project 2003-2004.

PubMed

Gale, Christopher P; Roberts, Anthony P; Batin, Phil D; Hall, Alistair S

2006-08-02

Clinical governance requires health care professionals to improve standards of care and has resulted in comparison of clinical performance data. The Myocardial Infarction National Audit Project (a UK cardiology dataset) tabulates its performance. However funnel plots are the display method of choice for institutional comparison. We aimed to demonstrate that funnel plots may be derived from MINAP data and allow more meaningful interpretation of data. We examined the attainment of National Service Framework standards for all hospitals (n = 230) and all patients (n = 99,133) in the MINAP database between 1st April 2003 and 31st March 2004. We generated funnel plots (with control limits at 3 sigma) of Door to Needle and Call to Needle thrombolysis times, and the use of aspirin, beta-blockers and statins post myocardial infarction. Only 87,427 patients fulfilled criteria for analysis of the use of secondary prevention drugs and 15,111 patients for analysis by Door to Needle and Call to Needle times (163 hospitals achieved the standards for Door to Needle times and 215 were within or above their control limits). One hundred and sixteen hospitals fell outside the 'within 25%' and 'more than 25%' standards for Call to Needle times, but 28 were below the lower control limits. Sixteen hospitals failed to reach the standards for aspirin usage post AMI and 24 remained below the lower control limits. Thirty hospitals were below the lower CL for beta-blocker usage and 49 outside the standard. Statin use was comparable. Funnel plots may be applied to a complex dataset and allow visual comparison of data derived from multiple health-care units. Variation is readily identified permitting units to appraise their practices so that effective quality improvement may take place.

Absolute ion detection efficiencies of microchannel plates and funnel microchannel plates for multi-coincidence detection

NASA Astrophysics Data System (ADS)

Fehre, K.; Trojanowskaja, D.; Gatzke, J.; Kunitski, M.; Trinter, F.; Zeller, S.; Schmidt, L. Ph. H.; Stohner, J.; Berger, R.; Czasch, A.; Jagutzki, O.; Jahnke, T.; Dörner, R.; Schöffler, M. S.

2018-04-01

Modern momentum imaging techniques allow for the investigation of complex molecules in the gas phase by detection of several fragment ions in coincidence. For these studies, it is of great importance that the single-particle detection efficiency ɛ is as high as possible, as the overall efficiency scales with ɛn, i.e., the power of the number of detected particles. Here we present measured absolute detection efficiencies for protons of several micro-channel plates (MCPs), including efficiency enhanced "funnel MCPs." Furthermore, the relative detection efficiency for two-, three-, four-, and five-body fragmentation of CHBrClF has been examined. The "funnel" MCPs exhibit an efficiency of approximately 90%, gaining a factor of 24 (as compared to "normal" MCPs) in the case of a five-fold ion coincidence detection.

Funnel Libraries for Real-Time Robust Feedback Motion Planning

DTIC Science & Technology

2016-07-21

motion plans for a robot that are guaranteed to suc- ceed despite uncertainty in the environment, parametric model uncertainty, and disturbances...resulting funnel library is then used to sequentially compose motion plans at runtime while ensuring the safety of the robot . A major advantage of...the work presented here is that by explicitly taking into account the effect of uncertainty, the robot can evaluate motion plans based on how vulnerable

Using maps and funnel plots to explore variation in place of death from cancer within London, 2002-2007.

PubMed

Madden, P; Coupland, Vh; Møller, H; Davies, Ea

2011-06-01

London has a high proportion of hospital deaths, which health policy seeks to reduce. We explore variation and trends in place of death from cancer within London between 2002 and 2007. Mortality data based on death certificates were used to define deaths from cancer at home, hospice, hospital and nursing home and examine trends over time for London. Proportions of deaths in each place were presented in maps for 31 London primary care trusts (PCTs). Funnel plots were used to identify consistent performance outside the control limits of three standard deviations. There was little overall change in place of death for London, but consistent variation between PCTs. Outer London PCTs had higher proportions of home deaths and inner London PCTs higher proportions of hospice deaths. Funnel plots identified consistent high outlying performance for home, hospice and hospital deaths. No PCT showed a change of 10% or more in home deaths, but five showed decreasing hospital deaths and three increasing hospice deaths. Maps and funnel plots appear useful for identifying areas with differing performance for home, hospital, nursing home and hospice deaths. These methods may help further investigation of how local services may successfully support deaths outside hospital. © The Author(s) 2011

The pros and cons of funnel plots as an aid to risk communication and patient decision making.

PubMed

Rakow, Tim; Wright, Rebecca J; Spiegelhalter, David J; Bull, Catherine

2015-05-01

Funnel plots, which simultaneously display a sample statistic and the corresponding sample size for multiple cases, have a range of applications. In medicine, they are used to display treatment outcome rates and caseload volume by institution, which can inform strategic decisions about health care delivery. We investigated lay people's understanding of such plots and explored their suitability as an aid to individual treatment decisions. In two studies, 172 participants answered objective questions about funnel plots representing the surgical outcomes (survival or mortality rates) of institutions varying in caseload, and indicated their preferred institutions. Accuracy for extracting objective information was high, unless question phrasing was inconsistent with the plot's survival/mortality framing, or participants had low numeracy levels. Participants integrated caseload-volume and outcome-rate data when forming preferences, but were influenced by reference lines on the plot to make inappropriate discriminations between institutions with similar outcome rates. With careful choice of accompanying language, funnel plots can be readily understood and are therefore a useful tool for communicating risk. However, they are less effective as a decision aid for individual patient's treatment decisions, and we recommend refinements to the standard presentation of the plots if they are to be used for that purpose. © 2014 The British Psychological Society.

Two-phase flows in the formed tornado funnel

NASA Astrophysics Data System (ADS)

Sinkevich, O. A.; Bortsova, A. A.

2017-10-01

At present, it is obvious that the problem of the tornado is important not only for our planetЮ to determine the conditions for the formation of a tornado, it is required to take into account a number of hydrodynamic and plasma processes [1 - 6]. Along to prediction of a tornado generation conditions [1 - 3] it is necessary to evaluate the characteristics of its quasi-stationary motion in a formed funnel: the mass of the moving moist air involved in the funnel and the size and form of the funnel. For a complete description of the phenomena, it is necessary to involve numerical calculations. We note that even for numerical calculations using powerful computers, the problem is very difficult because of the need to calculate multiphase turbulent flows with free, self-organizing boundaries [1, 6]. However, “strict” numerical calculations, it is impossible to do without the use of many, often mutually exclusive, models. For example, how to choice an adequate model of turbulence (algebraic, k-ε model, etc.) or the use of additional, often not accepted, hypotheses about certain processes used in calculations (mechanisms on the nature of moisture condensation, etc.). Therefore, along with numerical calculations of such flows, modeling problems that allow an exact solution and allow to determine the most important and observed characteristics of a tornado.

A theoretical analysis of steady-state photocurrents in simple silicon diodes

NASA Technical Reports Server (NTRS)

Edmonds, L.

1995-01-01

A theoretical analysis solves for the steady-state photocurrents produced by a given photo-generation rate function with negligible recombination in simple silicon diodes, consisting of a uniformly doped quasi-neutral region (called 'substrate' below) adjacent to a p-n junction depletion region (DR). Special attention is given to conditions that produce 'funneling' (a term used by the single-eventeffects community) under steady-state conditions. Funneling occurs when carriers are generated so fast that the DR becomes flooded and partially or completely collapses. Some or nearly all of the applied voltage, plus built-in potential normally across the DR, is now across the substrate. This substrate voltage drop affects substrate currents. The steady-state problem can provide some qualitative insights into the more difficult transient problem. First, it was found that funneling can be induced from a distance, i.e., from carriers generated at locations outside of the DR. Secondly, it was found that the substrate can divide into two subregions, with one controlling substrate resistance and the other characterized by ambipolar diffusion. Finally, funneling was found to be more difficult to induce in the p(sup +)/n diode than in the n(sup +)/p diode. The carrier density exceeding the doping density in the substrate and at the DR boundary is not a sufficient condition to collapse a DR.

Graphical augmentations to the funnel plot assess the impact of additional evidence on a meta-analysis.

PubMed

Langan, Dean; Higgins, Julian P T; Gregory, Walter; Sutton, Alexander J

2012-05-01

We aim to illustrate the potential impact of a new study on a meta-analysis, which gives an indication of the robustness of the meta-analysis. A number of augmentations are proposed to one of the most widely used of graphical displays, the funnel plot. Namely, 1) statistical significance contours, which define regions of the funnel plot in which a new study would have to be located to change the statistical significance of the meta-analysis; and 2) heterogeneity contours, which show how a new study would affect the extent of heterogeneity in a given meta-analysis. Several other features are also described, and the use of multiple features simultaneously is considered. The statistical significance contours suggest that one additional study, no matter how large, may have a very limited impact on the statistical significance of a meta-analysis. The heterogeneity contours illustrate that one outlying study can increase the level of heterogeneity dramatically. The additional features of the funnel plot have applications including 1) informing sample size calculations for the design of future studies eligible for inclusion in the meta-analysis; and 2) informing the updating prioritization of a portfolio of meta-analyses such as those prepared by the Cochrane Collaboration. Copyright © 2012 Elsevier Inc. All rights reserved.

Design and Performance of a High-Flux Electrospray Ionization Source for Ion Soft-Landing

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

Gunaratne, Kalupathirannehelage Don D.; Prabhakaran, Venkateshkumar; Ibrahim, Yehia M.

2015-01-01

We report the design and evaluation of a new high-intensity electrospray ionization source for ion soft-landing experiments. The source incorporates a dual ion funnel, which enables operation with a higher gas load through an expanded heated inlet into the additional first region of differential pumping. This capability allowed us to examine the effect of the inner diameter (ID) of the heated stainless steel inlet on the total ion current transmitted through the dual funnel interface and, more importantly, the mass-selected ion current delivered to the deposition target. The ion transmission of the dual funnel is similar to the transmission ofmore » the single funnel used in our previous soft landing studies. However, substantially higher ion currents were obtained using larger ID heated inlets and an orthogonal inlet geometry, in which the heated inlet is positioned perpendicular to the direction of ion propagation through the instrument. The highest ion currents were obtained using the orthogonal geometry and a 1.4 mm ID heated inlet. The corresponding stable deposition rate of ~1 μg of mass-selected ions per day will facilitate future studies focused on the controlled deposition of biological molecules on substrates and preparation of materials for studies in catalysis, energy storage, and self-assembly« less

Abundance and species richness of snakes along the Middle Rio Grande riparian forest in New Mexico

Treesearch

Heather L. Bateman; Alice Chung-MacCoubrey; Howard L. Snell; Deborah M. Finch

2009-01-01

To understand the effects of removal of non-native plants and fuels on wildlife in the riparian forest of the Middle Rio Grande in New Mexico, we monitored snakes from 2000 to 2006 using trap arrays of drift fences, pitfalls, and funnel traps. We recorded 158 captures of 13 species of snakes from 12 study sites. We captured more snakes in funnel traps than in pitfalls...

Gravitational radiation from magnetically funneled supernova fallback onto a magnetar

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

Melatos, A.; Priymak, M., E-mail: amelatos@unimelb.edu.au, E-mail: m.priymak@pgrad.unimelb.edu.au

2014-10-20

Protomagnetars spun up to millisecond rotation periods by supernova fallback are predicted to radiate gravitational waves via hydrodynamic instabilities for ∼10{sup 2} s before possibly collapsing to form a black hole. It is shown that magnetic funneling of the accretion flow (1) creates a magnetically confined polar mountain, which boosts the gravitational wave signal, and (2) 'buries' the magnetic dipole moment, delaying the propeller phase and assisting black hole formation.

21 CFR Appendix A to Part 74 - The Procedure for Determining Ether Soluble Material in D&C Red Nos. 6 and 7

Code of Federal Regulations, 2010 CFR

2010-04-01

... throughout method.) Allow the funnel to stand until the layers have separated. Transfer the bottom (aqueous) layer to a 500 mL separatory funnel, add 100 mL of ether, stopper and shake for one minute. When the layers have separated, drain off the bottom layer into a waste beaker. Pour the ether layer in the 500 mL...

An Assembly Funnel Makes Biomolecular Complex Assembly Efficient

PubMed Central

Zenk, John; Schulman, Rebecca

2014-01-01

Like protein folding and crystallization, the self-assembly of complexes is a fundamental form of biomolecular organization. While the number of methods for creating synthetic complexes is growing rapidly, most require empirical tuning of assembly conditions and/or produce low yields. We use coarse-grained simulations of the assembly kinetics of complexes to identify generic limitations on yields that arise because of the many simultaneous interactions allowed between the components and intermediates of a complex. Efficient assembly occurs when nucleation is fast and growth pathways are few, i.e. when there is an assembly “funnel”. For typical complexes, an assembly funnel occurs in a narrow window of conditions whose location is highly complex specific. However, by redesigning the components this window can be drastically broadened, so that complexes can form quickly across many conditions. The generality of this approach suggests assembly funnel design as a foundational strategy for robust biomolecular complex synthesis. PMID:25360818

Evolution, Energy Landscapes and the Paradoxes of Protein Folding

PubMed Central

Wolynes, Peter G.

2014-01-01

Protein folding has been viewed as a difficult problem of molecular self-organization. The search problem involved in folding however has been simplified through the evolution of folding energy landscapes that are funneled. The funnel hypothesis can be quantified using energy landscape theory based on the minimal frustration principle. Strong quantitative predictions that follow from energy landscape theory have been widely confirmed both through laboratory folding experiments and from detailed simulations. Energy landscape ideas also have allowed successful protein structure prediction algorithms to be developed. The selection constraint of having funneled folding landscapes has left its imprint on the sequences of existing protein structural families. Quantitative analysis of co-evolution patterns allows us to infer the statistical characteristics of the folding landscape. These turn out to be consistent with what has been obtained from laboratory physicochemical folding experiments signalling a beautiful confluence of genomics and chemical physics. PMID:25530262

General mechanism of two-state protein folding kinetics.

PubMed

Rollins, Geoffrey C; Dill, Ken A

2014-08-13

We describe here a general model of the kinetic mechanism of protein folding. In the Foldon Funnel Model, proteins fold in units of secondary structures, which form sequentially along the folding pathway, stabilized by tertiary interactions. The model predicts that the free energy landscape has a volcano shape, rather than a simple funnel, that folding is two-state (single-exponential) when secondary structures are intrinsically unstable, and that each structure along the folding path is a transition state for the previous structure. It shows how sequential pathways are consistent with multiple stochastic routes on funnel landscapes, and it gives good agreement with the 9 order of magnitude dependence of folding rates on protein size for a set of 93 proteins, at the same time it is consistent with the near independence of folding equilibrium constant on size. This model gives estimates of folding rates of proteomes, leading to a median folding time in Escherichia coli of about 5 s.

Apple Snail: a Bio Cleaner of the Water Free Surface.

NASA Astrophysics Data System (ADS)

Bassiri, Golnaz

2005-11-01

Oil spills from tankers represent a threat for shorelines and marine life. Despite continuing research, there has been little change in the fundamental technology for dealing with oil spills. An experimental investigation of the feeding strategy of Apple snails from the water free surface, called surface film feeding, is being studied motivated by the need to develop new techniques to recover oil spills. To feed on floating food (usually a thin layer of microorganisms), the apple snail forms a funnel with its foot and pulls the free surface toward the funnel. High speed imaging and particle image velocimetry were used in the present investigation to measure the free surface motion and to investigate the mechanism used by the apple snails to pull the free surface. The results suggest that the snail pulls the free surface via the wavy motion of the muscles in its funnel.

Plasmonic Circuit Theory for Multiresonant Light Funneling to a Single Spatial Hot Spot.

PubMed

Hughes, Tyler W; Fan, Shanhui

2016-09-14

We present a theoretical framework, based on plasmonic circuit models, for generating a multiresonant field intensity enhancement spectrum at a single "hot spot" in a plasmonic device. We introduce a circuit model, consisting of an array of coupled LC resonators, that directs current asymmetrically in the array, and we show that this circuit can funnel energy efficiently from each resonance to a single element. We implement the circuit model in a plasmonic nanostructure consisting of a series of metal bars of differing length, with nearest neighbor metal bars strongly coupled electromagnetically through air gaps. The resulting nanostructure resonantly traps different wavelengths of incident light in separate gap regions, yet it funnels the energy of different resonances to a common location, which is consistent with our circuit model. Our work is important for a number of applications of plasmonic nanoantennas in spectroscopy, such as in single-molecule fluorescence spectroscopy or Raman spectroscopy.

Guiding and focusing of fast electron beams produced by ultra-intense laser pulse using a double cone funnel target

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

Zhang, Wen-shuai; Cai, Hong-bo, E-mail: Cai-hongbo@iapcm.ac.cn; HEDPS, Center for Applied Physics and Technology, Peking University, Beijing 100871

A novel double cone funnel target design aiming at efficiently guiding and focusing fast electron beams produced in high intensity (>10{sup 19 }W/cm{sup 2}) laser-solid interactions is investigated via two-dimensional particle-in-cell simulations. The forward-going fast electron beams are shown to be directed and focused to a smaller size in comparison with the incident laser spot size. This plasma funnel attached on the cone target guides and focuses electrons in a manner akin to the control of liquid by a plastic funnel. Such device has the potential to add substantial design flexibility and prevent inefficiencies for important applications such as fast ignition.more » Two reasons account for the collimation of fast electron beams. First, the sheath electric fields and quasistatic magnetic fields inside the vacuum gap of the double cone provide confinement of the fast electrons in the laser-plasma interaction region. Second, the interface magnetic fields inside the beam collimator further guide and focus the fast electrons during the transport. The application of this technique to cone-guided fast ignition is considered, and it is shown that it can enhance the laser energy deposition in the compressed fuel plasma by a factor of 2 in comparison with the single cone target case.« less

Safety of thoracic pedicle screw application using the funnel technique in Asians: a cadaveric evaluation.

PubMed

Chan, Chris Yin Wei; Kwan, Mun Keong; Saw, Lim Beng

2010-01-01

The objective of this cadaveric study is to determine the safety and outcome of thoracic pedicle screw placement in Asians using the funnel technique. Pedicle screws have superior biomechanical as well as clinical data when compared to other methods of instrumentation. However, misplacement in the thoracic spine can result in major neurological implications. There is great variability of the thoracic pedicle morphometry between the Western and the Asian population. The feasibility of thoracic pedicle screw insertion in Asians has not been fully elucidated yet. A pre-insertion radiograph was performed and surgeons were blinded to the morphometry of the thoracic pedicles. 240 pedicle screws were inserted in ten Asian cadavers from T1 to T12 using the funnel technique. 5.0 mm screws were used from T1 to T6 while 6.0 mm screws were used from T7 to T12. Perforations were detected by direct visualization via a wide laminectomy. The narrowest pedicles are found between T3 and T6. T5 pedicle width is smallest measuring 4.1 +/- 1.3 mm. There were 24 (10.0%) Grade 1 perforations and only 1 (0.4%) Grade 2 perforation. Grade 2 or worse perforation is considered significant perforation which would threaten the neural structures. There were twice as many lateral and inferior perforations compared to medial perforations. 48.0% of the perforations occurred at T1, T2 and T3 pedicles. Pedicle fracture occurred in 10.4% of pedicles. Intra-operatively, the absence of funnel was found in 24.5% of pedicles. In conclusion, thoracic pedicle screws using 5.0 mm at T1-T6 and 6.0 mm at T7-T12 can be inserted safely in Asian cadavers using the funnel technique despite having smaller thoracic pedicle morphometry.

Assessment of Detection and Refinement Strategies for de novo Protein Structures using Force Field and Statistical Potentials

DTIC Science & Technology

2007-01-01

energy landscape of real proteins . As such, real proteins may have a subtle free energy gradient toward the native that requires long folding times...some leaning, however slight, toward the lowest free - energy basin .9 One caveat in the connection between the scoring funnel and the folding funnel is... protein sets. The average DFIRE-AA scores from each cluster were ranked, and the lowest- energy conformers from each of the top 16 clusters

Method of measuring field funneling and range straggling in semiconductor charge-collecting junctions

NASA Technical Reports Server (NTRS)

Zoutendyk, John A. (Inventor); Malone, Carl J. (Inventor)

1987-01-01

Electric-field funneling length is measured while irradiating a semiconductor charge-collecting junction with electron-hole-pair generating charged particles at a first junction bias voltage. The bias voltage is then reduced to a second level in order to reduce the depth of the depletion region such that the total charge can no longer be collected by drift and measured in the energy band previously displayed in the multichannel analyzer. This is representative of the maximum electric field funnelling length which may be calculated by measuring the difference at the second bias voltage level of the depletion width and the ion penetration range. The bias voltage is further lowered to a third level at which the particles are collected over a spread of energy levels while at least some of the particles are still collected at the selected energy level. From this the different depths of penetration of the particles are determined while additional effects due to diffusion are minimized.

Method of measuring field funneling and range straggling in semiconductor charge-collecting junctions

NASA Technical Reports Server (NTRS)

Zoutendyk, J. A. (Inventor)

1985-01-01

Electric-field funneling length is measured while irradiating a semiconductor charge-collecting junction with electron-hole-pair generating charged particles at a first junction bias voltage. The bias voltage is then reduced to a second level in order to reduce the depth of the depletion region such that the total charge can no longer be collected by drift and measured in the energy band previously displayed in the multichannel analyzer. This is representative of the maximum electric field funneling length which may be calculated by measuring the difference at the second bias voltage level of the depletion width and the ion penetration range. The bias voltage is further lowered to a third level at which the particles are collected over a spread of energy levels while at least some of the particles are still collected at the selected energy level. From this the different depths of penetration of the particles are determined while additional effects due to diffusion are minimized.

Golf-course and funnel energy landscapes: Protein folding concepts in martensites

NASA Astrophysics Data System (ADS)

Shankaraiah, N.

2017-06-01

We use protein folding energy landscape concepts such as golf course and funnel to study re-equilibration in athermal martensites under systematic temperature quench Monte Carlo simulations. On quenching below a transition temperature, the seeded high-symmetry parent-phase austenite that converts to the low-symmetry product-phase martensite, through autocatalytic twinning or elastic photocopying, has both rapid conversions and incubation delays in the temperature-time-transformation phase diagram. We find the rapid (incubation delays) conversions at low (high) temperatures arises from the presence of large (small) size of golf-course edge that has the funnel inside for negative energy states. In the incubating state, the strain structure factor enters into the Brillouin-zone golf course through searches for finite transitional pathways which close off at the transition temperature with Vogel-Fulcher divergences that are insensitive to Hamiltonian energy scales and log-normal distributions, as signatures of dominant entropy barriers. The crossing of the entropy barrier is identified through energy occupancy distributions, Monte Carlo acceptance fractions, heat emission, and internal work.

General Mechanism of Two-State Protein Folding Kinetics

PubMed Central

Rollins, Geoffrey C.; Dill, Ken A.

2016-01-01

We describe here a general model of the kinetic mechanism of protein folding. In the Foldon Funnel Model, proteins fold in units of secondary structures, which form sequentially along the folding pathway, stabilized by tertiary interactions. The model predicts that the free energy landscape has a volcano shape, rather than a simple funnel, that folding is two-state (single-exponential) when secondary structures are intrinsically unstable, and that each structure along the folding path is a transition state for the previous structure. It shows how sequential pathways are consistent with multiple stochastic routes on funnel landscapes, and it gives good agreement with the 9 order of magnitude dependence of folding rates on protein size for a set of 93 proteins, at the same time it is consistent with the near independence of folding equilibrium constant on size. This model gives estimates of folding rates of proteomes, leading to a median folding time in Escherichia coli of about 5 s. PMID:25056406

Watching Electrons at Conical Intersections and Funnels

NASA Astrophysics Data System (ADS)

Jonas, David M.; Smith, Eric R.; Peters, William K.; Kitney, Katherine A.

2009-06-01

The electronic motion at conical intersections and funnels is probed after polarized excitation of aligned electronic wavepackets. The pulses have bandwidth sufficient to observe vibrations mainly through their effect on the electrons. Vibrational symmetry can be identified by the polarization anisotropy of vibrational quantum beats. The polarized transients show signatures of electronic wavepacket motion (due to the energy gaps) and of electron transfer between orbitals (due to the couplings) driven by the conical intersection. For a conical intersection in a four-fold symmetric symmetry silicon naphthalocyanine molecule, electronic motions on a 100 fs timescale are driven by couplings of 1 meV. In the lower symmetry free-base naphthalocyanine, the conical intersection may be missed or missing (conical funnel), and the motions are nearly as rapid, but electronic equilibration is incomplete for red-edge excitation. These experiments probe non-adiabatic electronic dynamics with near-zero nuclear momentum - the electronic motions are determined by the principal slopes of the conical intersection and the width of the vibrational wavepacket.

Where does the waiting list begin? A short review of the dynamics and organization of modern waiting lists.

PubMed

Rotstein, Dalia L; Alter, David A

2006-06-01

Waiting for medical care is the by-product of system rationing, where demand exceeds supply. In this short report we expand on the conventional concept of the queue, by focusing on the regulation of demand and by incorporating a funnel and spout analogy. Real-world examples are used to illustrate the infancy of funnel or demand-side reform initiatives targeting the queue, and the suggestion is made that policy needs to address the concept of 'waiting' much earlier in the treatment cycle.

Outdoor Weathering and Dissolution of TNT and Tritonal

DTIC Science & Technology

2009-01-01

ranged from 0.361 to 1.975 g and the Tritonal chunks ran- ged from 2.162 to 5.320 g. Each funnel was attached to a 1-L glass bottle with a #4 rubber ... stopper fitted with two holes, one hole for the funnel stem and the other for a bent copper tube that allows air exchange. The bottles fit snuggly into...dissolved mass averaged about one-third of the total TNT mass loss. This result was surprising because we have had excel- lent HE mass- closure during

Single Event Upset Rate Estimates for a 16-K CMOS (Complementary Metal Oxide Semiconductor) SRAM (Static Random Access Memory).

DTIC Science & Technology

1986-09-30

4 . ~**..ft.. ft . - - - ft SI TABLES 9 I. SA32~40 Single Event Upset Test, 1140-MeV Krypton, 9/l8/8~4. . .. .. .. .. .. .16 II. CRUP Simulation...cosmic ray interaction analysis described in the remainder of this report were calculated using the CRUP computer code 3 modified for funneling. The... CRUP code requires, as inputs, the size of a depletion region specified as a retangular parallel piped with dimensions a 9 b S c, the effective funnel

Emlen funnel experiments revisited: methods update for studying compass orientation in songbirds.

PubMed

Bianco, Giuseppe; Ilieva, Mihaela; Veibäck, Clas; Öfjäll, Kristoffer; Gadomska, Alicja; Hendeby, Gustaf; Felsberg, Michael; Gustafsson, Fredrik; Åkesson, Susanne

2016-10-01

Migratory songbirds carry an inherited capacity to migrate several thousand kilometers each year crossing continental landmasses and barriers between distant breeding sites and wintering areas. How individual songbirds manage with extreme precision to find their way is still largely unknown. The functional characteristics of biological compasses used by songbird migrants has mainly been investigated by recording the birds directed migratory activity in circular cages, so-called Emlen funnels. This method is 50 years old and has not received major updates over the past decades. The aim of this work was to compare the results from newly developed digital methods with the established manual methods to evaluate songbird migratory activity and orientation in circular cages.We performed orientation experiments using the European robin ( Erithacus rubecula ) using modified Emlen funnels equipped with thermal paper and simultaneously recorded the songbird movements from above. We evaluated and compared the results obtained with five different methods. Two methods have been commonly used in songbirds' orientation experiments; the other three methods were developed for this study and were based either on evaluation of the thermal paper using automated image analysis, or on the analysis of videos recorded during the experiment.The methods used to evaluate scratches produced by the claws of birds on the thermal papers presented some differences compared with the video analyses. These differences were caused mainly by differences in scatter, as any movement of the bird along the sloping walls of the funnel was recorded on the thermal paper, whereas video evaluations allowed us to detect single takeoff attempts by the birds and to consider only this behavior in the orientation analyses. Using computer vision, we were also able to identify and separately evaluate different behaviors that were impossible to record by the thermal paper.The traditional Emlen funnel is still the most used method to investigate compass orientation in songbirds under controlled conditions. However, new numerical image analysis techniques provide a much higher level of detail of songbirds' migratory behavior and will provide an increasing number of possibilities to evaluate and quantify specific behaviors as new algorithms will be developed.

Powerful radiative jets in supercritical accretion discs around non-spinning black holes

NASA Astrophysics Data System (ADS)

Sądowski, Aleksander; Narayan, Ramesh

2015-11-01

We describe a set of simulations of supercritical accretion on to a non-rotating supermassive black hole (BH). The accretion flow takes the form of a geometrically thick disc with twin low-density funnels around the rotation axis. For accretion rates {gtrsim } 10 dot{M}_Edd, there is sufficient gas in the funnel to make this region optically thick. Radiation from the disc first flows into the funnel, after which it accelerates the optically thick funnel gas along the axis. The resulting jet is baryon loaded and has a terminal density-weighted velocity ≈0.3c. Much of the radiative luminosity is converted into kinetic energy by the time the escaping gas becomes optically thin. These jets are not powered by BHrotation or magnetic driving, but purely by radiation. Their characteristic beaming angle is ˜0.2 rad. For an observer viewing down the axis, the isotropic equivalent luminosity of total energy is as much as 1048 erg s- 1 for a 107 M⊙ BH accreting at 103 Eddington. Therefore, energetically, the simulated jets are consistent with observations of the most powerful tidal disruption events, e.g. Swift J1644. The jet velocity is, however, too low to match the Lorentz factor γ > 2 inferred in J1644. There is no such conflict in the case of other tidal disruption events. Since favourably oriented observers see isotropic equivalent luminosities that are highly super-Eddington, the simulated models can explain observations of ultraluminous X-ray sources, at least in terms of luminosity and energetics, without requiring intermediate-mass BHs.

Opportunities and challenges in biological lignin valorization

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

Beckham, Gregg T.; Johnson, Christopher W.; Karp, Eric M.

Lignin is a primary component of lignocellulosic biomass that is an underutilized feedstock in the growing biofuels industry. Despite the fact that lignin depolymerization has long been studied, the intrinsic heterogeneity of lignin typically leads to heterogeneous streams of aromatic compounds, which in turn present significant technical challenges when attempting to produce lignin-derived chemicals where purity is often a concern. In Nature, microorganisms often encounter this same problem during biomass turnover wherein powerful oxidative enzymes produce heterogeneous slates of aromatics compounds. Some microbes have evolved metabolic pathways to convert these aromatic species via ‘upper pathways’ into central intermediates, which canmore » then be funneled through ‘lower pathways’ into central carbon metabolism in a process we dubbed ‘biological funneling’. This funneling approach offers a direct, biological solution to overcome heterogeneity problems in lignin valorization for the modern biorefinery. Coupled to targeted separations and downstream chemical catalysis, this concept offers the ability to produce a wide range of molecules from lignin. This perspective describes research opportunities and challenges ahead for this new field of research, which holds significant promise towards a biorefinery concept wherein polysaccharides and lignin are treated as equally valuable feedstocks. In particular, we discuss tailoring the lignin substrate for microbial utilization, host selection for biological funneling, ligninolytic enzyme–microbe synergy, metabolic engineering, expanding substrate specificity for biological funneling, and process integration, each of which presents key challenges. Ultimately, for biological solutions to lignin valorization to be viable, multiple questions in each of these areas will need to be addressed, making biological lignin valorization a multidisciplinary, co-design problem.« less

The simplest "field" methods for extractin of nematodes from plants, wood, insects and soil, with additional description how to keep extracted nematodes alive for a long time.

PubMed

Ryss, A Yu

2017-01-01

The simplest modification of the dynamic extraction method using cottonwool filter based on the Baermann funnel principle, is described. This modification excludes the funnel because a great share of Sticky worms attach to sloping walls of a funnel and thus do not reach the collector Eppendorf tube. But the main principle of the Baermann funnel is used, I. e. sinking down of actively moving heavy narrow bodies via wide holes of filter and thus separating the active worms from passive non-Brownian moving substrate particles, which do not pass the filter and remain above it. This principle is illustrated because it has never been described before. In the proposed modification any sloping walls in the extraction paths are excluded and thus the probability to attach sticky nemotodes to walls is also excluded; only cylindrical equipment with abrupt vertical walls is used; procedures are extremely simplified to be user-friendly for beginners: only filter (cotton pads), Eppendorf tubes, plastic glasses and narrow PVC tubing are applied. The new simplified modification allows one to collect nematodes by non-professional workers, e. g. in Polar expeditions without microscopic study of results. As an addition, an efficient method to maintain extracted nematodes alive is proposed, using the "effect of water film" in foam rubber inside the Eppendorf tube. To maintain nematodes alive during several months it is recommended to suppress bacteria via addition of 0.2-0.4% formaldehyde solution and then keep the tube with nematodes in a refrigerator.

Ultrastructure of the anterior organ and posterior funnel-shaped canal of Gyrocotyle urna Wagener, 1852 (Cestoda: Gyrocotylidea).

PubMed

Poddubnaya, Larisa G; Kuchta, Roman; Bristow, Glenn A; Scholz, Tomas

2015-05-22

Using scanning and transmission electron microscopy, ultrastructure of the anterior organ and posterior funnel-shaped canal of Gyrocotyle urna Wagener, 1852 (Cestoda: Gyrocotylidea) from ratfish, Chimaera monstrosa (Holocephali), was studied for the first time. The proper anterior organ is localised at a short distance (about 170 µm) from an apical pore surrounded by a receptor field, whereas its distal end is marked by a muscular sphincter. The tegumental surface of this organ is covered with short filitriches of irregular length; large area of muscle layers traverse beneath the tegumental layer. The funnel-shaped canal of G. urna (2.5-3.0 mm long) is a specialised, muscular part of the posterior attachment organ; it opens on the rounded elevation on the dorsal body surface. The tegumental layer bears conical sclerite-like structures (up to 1.5 µm long). It produces electron-dense bodies that are transported into a canal lumen and surrounded thick muscle area mixed with numerous nerve fibres. The present ultrastructural study of G. urna indicates that gyrocotylideans share some ultrastructural characters of the anterior organ with spathebothriidean cestodes with a single anterior attachment sucker-like organ. In contrast, the unique posterior rosette attachment organ with funnel-shaped canal of the Gyrocotylidea resembles the haptor of polyopisthocotylean monogeneans in its position at the posterior end of the body and presumed origin. The above-mentioned features add more clarity to support the basal position of the Gyrocotylidea Poche, 1926 among cestodes. In addition, they also indicate a possible relationship of gyrocotylidean ancestors with monogeneans.

Simulation of primary-slag melting behavior in the cohesive zone of a blast furnace, considering the effect of Al{sub 2}O{sub 3}, Fe{sub t}O, and basicity in the sinter ore

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

Hino, Mitsutaka; Nagasaka, Tetsuya; Katsumata, Akitoshi

1999-08-01

The alumina content in the iron ore imported to Japan is increasing year by year, and some problems in blast furnace operation, due to the use of the high-alumina-containing sinter, have already been reported. In order to clarify the mechanism of the harmful effect of alumina on the blast furnace operation, the behavior of the primary melt, which is formed in the sinter at the cohesive zone of the blast furnace, has been simulated by dripping slag through an iron or oxide funnel. The effects of basicity, Al{sub 2}O{sub 3}, and Fe{sub t}O contents in the five slag systems onmore » the dripping temperature and weight of slag remaining on the funnel have been discussed. It was found that the eutectic melt formed in the sinter would play an important role in the dripping behavior of the slag in the blast furnace through the fine porosity of the reduced iron and ore particles. Al{sub 2}O{sub 3} increased the weight of the slag remaining on the funnel, and its effect became very significant in the acidic and low-Fe{sub t}O-containing slag. It was estimated that the increase of the weight of the slag remaining on the funnel by Al{sub 2}O{sub 3} in the ore could result in a harmful effect on the permeability resistance and an indirect reduction rate of the sinter in the blast furnace.« less

A Comparison of the Pitfall Trap, Winkler Extractor and Berlese Funnel for Sampling Ground-Dwelling Arthropods in Tropical Montane Cloud Forests

PubMed Central

Sabu, Thomas K.; Shiju, Raj T.; Vinod, KV.; Nithya, S.

2011-01-01

Little is known about the ground-dwelling arthropod diversity in tropical montane cloud forests (TMCF). Due to unique habitat conditions in TMCFs with continuously wet substrates and a waterlogged forest floor along with the innate biases of the pitfall trap, Berlese funnel and Winkler extractor are certain to make it difficult to choose the most appropriate method to sample the ground-dwelling arthropods in TMCFs. Among the three methods, the Winkler extractor was the most efficient method for quantitative data and pitfall trapping for qualitative data for most groups. Inclusion of floatation method as a complementary method along with the Winkler extractor would enable a comprehensive quantitative survey of ground-dwelling arthropods. Pitfall trapping is essential for both quantitative and qualitative sampling of Diplopoda, Opiliones, Orthoptera, and Diptera. The Winkler extractor was the best quantitative method for Psocoptera, Araneae, Isopoda, and Formicidae; and the Berlese funnel was best for Collembola and Chilopoda. For larval forms of different insect orders and the Acari, all the three methods were equally effective. PMID:21529148

In-Plane Heterostructures Enable Internal Stress Assisted Strain Engineering in 2D Materials.

PubMed

Liu, Feng; Wang, Tzu-Chiang; Tang, Qiheng

2018-04-01

Conventional methods to induce strain in 2D materials can hardly catch up with the sharp increase in requirements to design specific strain forms, such as the pseudomagnetic field proposed in graphene, funnel effect of excitons in MoS 2 , and also the inverse funnel effect reported in black phosphorus. Therefore, a long-standing challenge in 2D materials strain engineering is to find a feasible scheme that can be used to design given strain forms. In this article, combining the ability of experimentally synthetizing in-plane heterostructures and elegant Eshelby inclusion theory, the possibility of designing strain fields in 2D materials to manipulate physical properties, which is called internal stress assisted strain engineering, is theoretically demonstrated. Particularly, through changing the inclusion's size, the stress or strain gradient can be controlled precisely, which is never achieved. By taking advantage of it, the pseudomagnetic field as well as the funnel effect can be accurately designed, which opens an avenue to practical applications for strain engineering in 2D materials. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Interface and process for enhanced transmission of non-circular ion beams between stages at unequal pressure

DOEpatents

Tang, Keqi [Richland, WA; Shvartsburg, Alexandre A [Richland, WA; Smith, Richard D [Richland, WA

2008-03-04

The invention discloses a new interface with non-circular conductance limit aperture(s) useful for effective transmission of non-circular ion beams between stages with different gas pressure. In particular, the invention provides an improved coupling of field asymmetric waveform ion mobility spectrometry (FAIMS) analyzers of planar or side-to-side geometry to downstream stages such as mass spectrometry or ion mobility spectrometry. In this case, the non-circular aperture is rectangular; other geometries may be optimum in other applications. In the preferred embodiment, the non-circular aperture interface is followed by an electrodynamic ion funnel that may focus wide ion beams of any shape into tight circular beams with virtually no losses. The jet disrupter element of the funnel may also have a non-circular geometry, matching the shape of arriving ion beam. The improved sensitivity of planar FAIMS/MS has been demonstrated in experiments using a non-contiguous elongated aperture but other embodiments (e.g., with a contiguous slit aperture) may be preferable, especially in conjunction with an ion funnel operated at high pressures.

Towards a microscopic description of the free-energy landscape of water.

PubMed

Prada-Gracia, Diego; Shevchuk, Roman; Hamm, Peter; Rao, Francesco

2012-10-14

Free-energy landscape theory is often used to describe complex molecular systems. Here, a microscopic description of water structure and dynamics based on configuration-space-networks and molecular dynamics simulations of the TIP4P/2005 model is applied to investigate the free-energy landscape of water. The latter is built on top of a large set of water microstates describing the kinetic stability of local hydrogen-bond arrangements up to the second solvation shell. In temperature space, the landscape displays three different regimes. At around ambient conditions, the free-energy surface is characterized by many short-lived basins of attraction which are structurally well-defined (inhomogeneous regime). At lower temperatures instead, the liquid rapidly becomes homogeneous. In this regime, the free energy is funneled-like, with fully coordinated water arrangements at the bottom of the funnel. Finally, a third regime develops below the temperature of maximal compressibility (Widom line) where the funnel becomes steeper with few interconversions between microstates other than the fully coordinated ones. Our results present a way to manage the complexity of water structure and dynamics, connecting microscopic properties to its ensemble behavior.

Folding of the 25 residue Abeta(12-36) peptide in TFE/water: temperature-dependent transition from a funneled free-energy landscape to a rugged one.

PubMed

Kamiya, Narutoshi; Mitomo, Daisuke; Shea, Joan-Emma; Higo, Junichi

2007-05-17

The free-energy landscape of the Alzheimer beta-amyloid peptide Abeta(12-36) in a 40% (v/v) 2,2,2-trifluoroethanol (TFE)/water solution was determined by using multicanonical molecular dynamics simulations. Simulations using this enhanced conformational sampling technique were initiated from a random unfolded polypeptide conformation. Our simulations reliably folded the peptide to the experimental NMR structure, which consists of two linked helices. The shape of the free energy landscape for folding was found to be strongly dependent on temperature: Above 325 K, the overall shape was funnel-like, with the bottom of the funnel coinciding exactly with the NMR structure. Below 325 K, on the other hand, the landscape became increasingly rugged, with the emergence of new conformational clusters connected by low free-energy pathways. Finally, our simulations reveal that water and TFE solvate the polypeptide in different ways: The hydrogen bond formation between TFE and Abeta was enhanced with decreasing temperature, while that between water and Abeta was depressed.

Evaluation of lead recovery efficiency from waste CRT funnel glass by chlorinating volatilization process.

PubMed

Erzat, Aris; Zhang, Fu-Shen

2014-01-01

The current study was carried out to develop a novel process, namely chloride volatilization procedure for lead recovery from waste cathode ray tube (CRT) funnel glass. In the recovery system, the glass powder was first compressed into cylindrical pellet homogeneously with chlorinating agents, and then subjected to thermal treatment for solid-phase reaction. In this case, lead could be easily released from the silicon oxide network of the glass and it was recovered in the form of PbCl₂. It was found that CaCl2 was the most effective chlorinating agent, and the optimum operation temperature, holding time and system pressure were 1000 °C, 2 h, 600 ± 50 Pa, respectively. The evaporated PbCl₂could be easily recovered by a cooling device. The evaporation ratio of lead from waste CRT was 99.1% and the purity of the recovered PbCl₂product was 97.0%. The reaction routes and lead recovery mechanisms of the process were identified. This study provides an efficient and practical process for waste CRT funnel glass detoxification and recycling.

Nesting bird "host funnel" increases mosquito-bird contact rate.

PubMed

Caillouët, Kevin A; Riggan, Anna E; Bulluck, Lesley P; Carlson, John C; Sabo, Roy T

2013-03-01

Increases in vector-host contact rates can enhance arbovirus transmission intensity. We investigated weekly fluctuations in contact rates between mosquitoes and nesting birds using the recently described Nest Mosquito Trap (NMT). The number of mosquitoes per nestling increased from < 1 mosquito per trap night to 36.2 in the final 2 wk of the nesting season. Our evidence suggests the coincidence of the end of the avian nesting season and increasing mosquito abundances may have caused a "host funnel," concentrating host-seeking mosquitoes to the few remaining nestlings. The relative abundance of mosquitoes collected by the NMT suggests that significantly more Aedes albopictus (Skuse) and Culex pipiens (L.) /restuans (Theobald) sought nesting bird bloodmeals than were predicted by their relative abundances in CO2-baited Centers for Disease Control and Prevention light and gravid traps. Culex salinarius (Coquillett) and Culex erraticus Dyar and Knab were collected in NMTs in proportion to their relative abundances in the generic traps. Temporal host funnels and nesting bird host specificity may enhance arbovirus amplification and explain observed West Nile virus and St. Louis encephalitis virus amplification periods.

A simple estimate of funneling-assisted charge collection

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

Edmonds, L.D.

In this paper, funneling is qualitatively discussed in detail and quantitative analysis is given for the total (time-integrated) collected charge. It is shown that for an n{sup +}/p junction, the total collected charge Q{sub T} is given by Q{sub R} = (1 + {mu}{sub n}/{mu}{sub p})Q{sub D} + 2Q{sub diff} where Q{degrees}D is the charge initially liberated in the depletion region and Q{sub diff} is charge collected by diffusion. This equation does not apply to very short ion tracks or to device having a thin epilayer.

The optimal number of menu options per panel

NASA Technical Reports Server (NTRS)

Paap, Kenneth R.; Roske-Hofstrand, Renate J.

1986-01-01

An evaluation is made of the effects of the 'funneling' phenomenon, in an analysis of hierarchical menu structures' optimal search times which builds on the work of Lee and MacGregor (1985). Funneling is a reduction in the total number of options processed through the design of a system of greater choice 'depth' and correspondingly restricted choice 'breadth'. Both random and ordered menus are treated. The available evidence is found to support the general conclusion that randomly ordered menu panels should have only a few (4-8) options, while organized menus should contain as many options as 64.

Diffracted field distributions from the HE11 mode in a hollow optical fibre for an atomic funnel

NASA Astrophysics Data System (ADS)

Ni, Yun; Liu, Nanchun; Yin, Jianping

2003-06-01

The diffracted near field distribution from an LP01 mode in a hollow optical fibre was recently calculated using a scalar model based on the weakly waveguiding approximation (Yoo et al 1999 J. Opt. B: Quantum Semiclass. Opt. 1 364). It showed a dominant Gaussian-like distribution with an increased axial intensity in the central region (not a doughnut-like distribution), so the diffracted output beam from the hollow fibre cannot be used to form an atomic funnel. Using exact solutions of the Maxwell equations based on a vector model, however, we calculate the electric field and intensity distributions of the HE11 mode in the same hollow fibre and study the diffracted near- and far-field distributions of the HE11-mode output beam under the Fresnel approximation. We analyse and compare the differences between the output beams from the HE11 and LP01 modes. Our study shows that both the near- and far-field intensity distributions of the HE11-mode output beam are doughnut-like and can be used to form a simple atomic funnel. However, it is not suitable to use the weakly waveguiding approximation to calculate the diffracted near-field distribution of the hollow fibre due to the greater refractive-index difference between the hollow region (n0 = 1) and the core (n1 = 1.45 or 1.5). Finally, the 3D intensity distribution of the HE11-mode output beam is modelled and the corresponding optical potentials for cold atoms are calculated. Some potential applications of the HE11-mode output beam in an atomic guide and funnel are briefly discussed.

Photophysics of conjugated polymers: interplay between Förster energy migration and defect concentration in shaping a photochemical funnel in PPV.

PubMed

Saini, Sangeeta; Bagchi, Biman

2010-07-21

Recent single molecule experiments have suggested the existence of a photochemical funnel in the photophysics of conjugated polymers, like poly[2-methoxy-5-(2'-ethylhexyl)oxy-1,4-phenylenevinylene] (MEH-PPV). The funnel is believed to be a consequence of the presence of conformational or chemical defects along the polymer chain and efficient non-radiative energy transfer among different chromophore segments. Here we address the effect of the excitation energy dynamics on the photophysics of PPV. The PPV chain is modeled as a polymer with the length distribution of chromophores given either by a Gaussian or by a Poisson distribution. We observe that the Poisson distribution of the segment lengths explains the photophysics of PPV better than the Gaussian distribution. A recently proposed version of an extended 'particle-in-a-box' model is used to calculate the exciton energies and the transition dipole moments of the chromophores, and a master equation to describe the excitation energy transfer among different chromophores. The rate of energy transfer is assumed to be given here, as a first approximation, by the well-known Förster expression. The observed excitation population dynamics confirms the photochemical funneling of excitation energy from shorter to longer chromophores of the polymer chain. The time scale of spectral shift and energy transfer for our model polymer, with realistic values of optical parameters, is in the range of 200-300 ps. We find that the excitation energy may not always migrate towards the longest chromophore segments in the polymer chain as the efficiency of energy transfer between chromophores depends on the separation distance between the two and their relative orientation.

A new improved graphical and quantitative method for detecting bias in meta-analysis.

PubMed

Furuya-Kanamori, Luis; Barendregt, Jan J; Doi, Suhail A R

2018-04-04

Detection of publication and related biases remains suboptimal and threatens the validity and interpretation of meta-analytical findings. When bias is present, it usually differentially affects small and large studies manifesting as an association between precision and effect size and therefore visual asymmetry of conventional funnel plots. This asymmetry can be quantified and Egger's regression is, by far, the most widely used statistical measure for quantifying funnel plot asymmetry. However, concerns have been raised about both the visual appearance of funnel plots and the sensitivity of Egger's regression to detect such asymmetry, particularly when the number of studies is small. In this article, we propose a new graphical method, the Doi plot, to visualize asymmetry and also a new measure, the LFK index, to detect and quantify asymmetry of study effects in Doi plots. We demonstrate that the visual representation of asymmetry was better for the Doi plot when compared with the funnel plot. We also show that the diagnostic accuracy of the LFK index in discriminating between asymmetry due to simulated publication bias versus chance or no asymmetry was also better with the LFK index which had areas under the receiver operating characteristic curve of 0.74-0.88 with simulations of meta-analyses with five, 10, 15, and 20 studies. The Egger's regression result had lower areas under the receiver operating characteristic curve values of 0.58-0.75 across the same simulations. The LFK index also had a higher sensitivity (71.3-72.1%) than the Egger's regression result (18.5-43.0%). We conclude that the methods proposed in this article can markedly improve the ability of researchers to detect bias in meta-analysis.

Calculation of the cardiothoracic ratio from portable anteroposterior chest radiography.

PubMed

Chon, Sung Bin; Oh, Won Sup; Cho, Jun Hwi; Kim, Sam Soo; Lee, Seung-Joon

2011-11-01

Cardiothoracic ratio (CTR), the ratio of cardiac diameter (CD) to thoracic diameter (TD), is a useful screening method to detect cardiomegaly, but is reliable only on posteroanterior chest radiography (chest PA). We performed this cross-sectional 3-phase study to establish reliable CTR from anteroposterior chest radiography (chest AP). First, CD(Chest PA)/CD(Chest AP) ratios were determined at different radiation distances by manipulating chest computed tomography to simulate chest PA and AP. CD(Chest PA) was inferred from multiplying CD(Chest AP) by this ratio. Incorporating this CD and substituting the most recent TD(Chest PA), we calculated the 'corrected' CTR and compared it with the conventional one in patients who took both the chest radiographies. Finally, its validity was investigated among the critically ill patients who performed portable chest AP. CD(Chest PA)/CD(Chest AP) ratio was {0.00099 × (radiation distance [cm])} + 0.79 (n = 61, r = 1.00, P < 0.001). The corrected CTR was highly correlated with the conventional one (n = 34, difference: 0.00016 ± 0.029; r = 0.92, P < 0.001). It was higher in congestive than non-congestive patients (0.53 ± 0.085; n = 38 vs 0.49 ± 0.061; n = 46, P = 0.006). Its sensitivity and specificity was 61% and 54%. In summary, reliable CTR can be calculated from chest AP with an available previous chest PA. This might help physicians detect congestive cardiomegaly for patients undergoing portable chest AP.

An energy-based perturbation and a taboo strategy for improving the searching ability of stochastic structural optimization methods

NASA Astrophysics Data System (ADS)

Cheng, Longjiu; Cai, Wensheng; Shao, Xueguang

2005-03-01

An energy-based perturbation and a new idea of taboo strategy are proposed for structural optimization and applied in a benchmark problem, i.e., the optimization of Lennard-Jones (LJ) clusters. It is proved that the energy-based perturbation is much better than the traditional random perturbation both in convergence speed and searching ability when it is combined with a simple greedy method. By tabooing the most wide-spread funnel instead of the visited solutions, the hit rate of other funnels can be significantly improved. Global minima of (LJ) clusters up to 200 atoms are found with high efficiency.

The progress of funnelling gun high voltage condition and beam test

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

Wang, E.; Ben-Zvi, I.; Gassner, D. M.

A prototype of a high average current polarized electron funneling gun as an eRHIC injector has been built at BNL. The gun was assembled and tested at Stangenes Incorporated. Two beams were generated from two GaAs photocathodes and combined by a switched combiner field. We observed the combined beams on a YAG crystal and measured the photocurrent by a Faraday cup. The gun has been shipped to Stony Brook University and is being tested there. In this paper we will describe the major components of the gun and recent beam test results. High voltage conditioning is discussed as well.

Ion funnel augmented Mars atmospheric pressure photoionization mass spectrometry for in situ detection of organic molecules.

PubMed

Johnson, Paul V; Hodyss, Robert; Beauchamp, J L

2014-11-01

Laser desorption is an attractive technique for in situ sampling of organics on Mars given its relative simplicity. We demonstrate that under simulated Martian conditions (~2.5 Torr CO(2)) laser desorption of neutral species (e.g., polycyclic aromatic hydrocarbons), followed by ionization with a simple ultraviolet light source such as a discharge lamp, offers an effective means of sampling organics for detection and identification with a mass spectrometer. An electrodynamic ion funnel is employed to provide efficient ion collection in the ambient Martian environment. This experimental methodology enables in situ sampling of Martian organics with minimal complexity and maximum flexibility.

Alternative theoretical method for motion of a sand-filled funnel experiment

NASA Astrophysics Data System (ADS)

Byrd, David; White, Gary

2001-11-01

In "Motion of a Sand-Filled Funnel," Peter Sullivan and Anna McLoon described how to use numerical methods and a Microsoft Excel spreadsheet to predict the motion of a variant of Atwood's machine with variable mass. They wrote for noncalculus-based physics classes, but we solve the same problem using the methods of calculus. Our method highlights the less-familiar but more accurate version of Newton's second law, ∑F =dp/dt. This can help introductory physics students understand a broader definition of Newton's second law and enhance their calculus skills. It also teaches students how to solve a variable-mass problem.

Evidence-based decision-making 7: Knowledge translation.

PubMed

Manns, Braden J

2015-01-01

There is a significant gap between what is known and what is implemented by key stakeholders in practice (the evidence to practice gap). The primary purpose of knowledge translation is to address this gap, bridging evidence to clinical practice. The knowledge to action cycle is one framework for knowledge translation that integrates policy-makers throughout the research cycle. The knowledge to action cycle begins with the identification of a problem (usually a gap in care provision). After identification of the problem, knowledge creation is undertaken, depicted at the center of the cycle as a funnel. Knowledge inquiry is at the wide end of the funnel, and moving down the funnel, the primary data is synthesized into knowledge products in the form of educational materials, guidelines, decision aids, or clinical pathways. The remaining components of the knowledge to action cycle refer to the action of applying the knowledge that has been created. This includes adapting knowledge to local context, assessing barriers to knowledge use, selecting, tailoring implementing interventions, monitoring knowledge use, evaluating outcomes, and sustaining knowledge use. Each of these steps is connected by bidirectional arrows and ideally involves healthcare decision-makers and key stakeholders at each transition.

Extraction of lead from waste CRT funnel glass by generating lead sulfide - An approach for electronic waste management.

PubMed

Hu, Biao; Hui, Wenlong

2017-09-01

Waste cathode ray tube (CRT) funnel glass is the key and difficult points in waste electrical and electronic equipment (WEEE) disposal. In this paper, a novel and effective process for the detoxification and reutilization of waste CRT funnel glass was developed by generating lead sulfide precipitate via a high-temperature melting process. The central function in this process was the generation of lead sulfide, which gathered at the bottom of the crucible and was then separated from the slag. Sodium carbonate was used as a flux and reaction agent, and sodium sulfide was used as a precipitating agent. The experimental results revealed that the lead sulfide recovery rate initially increased with an increase in the amount of added sodium carbonate, the amount of sodium sulfide, the temperature, and the holding time and then reached an equilibrium value. The maximum lead sulfide recovery rate was approximately 93%, at the optimum sodium carbonate level, sodium sulfide level, temperature, and holding time of 25%, 8%, 1200°C, and 2h, respectively. The glass slag can be made into sodium and potassium silicate by hydrolysis in an environmental and economical process. Copyright © 2017 Elsevier Ltd. All rights reserved.

MSSM A-funnel and the galactic center excess: prospects for the LHC and direct detection experiments

DOE PAGES

Freese, Katherine; López, Alejandro; Shah, Nausheen R.; ...

2016-04-11

The pseudoscalar resonance or “A-funnel” in the Minimal Supersymmetric Standard Model (MSSM) is a widely studied framework for explaining dark matter that can yield interesting indirect detection and collider signals. The well-known Galactic Center excess (GCE) at GeV energies in the gamma ray spectrum, consistent with annihilation of a ≲ 40 GeV dark matter particle, has more recently been shown to be compatible with significantly heavier masses following reanalysis of the background.For this study, we explore the LHC and direct detection implications of interpreting the GCE in this extended mass window within the MSSM A-funnel framework. We find that compatibilitymore » with relic density, signal strength, collider constraints, and Higgs data can be simultaneously achieved with appropriate parameter choices. The compatible regions give very sharp predictions of 200-600 GeV CP-odd/even Higgs bosons at low tan β at the LHC and spin-independent cross sections ≈ 10 -11 pb at direct detection experiments. Finally, regardless of consistency with the GCE, this study serves as a useful template of the strong correlations between indirect, direct, and LHC signatures of the MSSM A-funnel region.« less

Diagnostic value of chest ultrasound after cardiac surgery: a comparison with chest X-ray and auscultation.

PubMed

Vezzani, Antonella; Manca, Tullio; Brusasco, Claudia; Santori, Gregorio; Valentino, Massimo; Nicolini, Francesco; Molardi, Alberto; Gherli, Tiziano; Corradi, Francesco

2014-12-01

Chest auscultation and chest x-ray commonly are used to detect postoperative abnormalities and complications in patients admitted to intensive care after cardiac surgery. The aim of the study was to evaluate whether chest ultrasound represents an effective alternative to bedside chest x-ray to identify early postoperative abnormalities. Diagnostic accuracy of chest auscultation and chest ultrasound were compared in identifying individual abnormalities detected by chest x-ray, considered the reference method. Cardiac surgery intensive care unit. One hundred fifty-one consecutive adult patients undergoing cardiac surgery. All patients included were studied by chest auscultation, ultrasound, and x-ray upon admission to intensive care after cardiac surgery. Six lung pathologic changes and endotracheal tube malposition were found. There was a highly significant correlation between abnormalities detected by chest ultrasound and x-ray (k = 0.90), but a poor correlation between chest auscultation and x-ray abnormalities (k = 0.15). Chest auscultation may help identify endotracheal tube misplacement and tension pneumothorax but it may miss most major abnormalities. Chest ultrasound represents a valid alternative to chest x-ray to detect most postoperative abnormalities and misplacements. Copyright © 2014 Elsevier Inc. All rights reserved.

Angina - when you have chest pain

MedlinePlus

... Coronary heart disease - chest pain; ACS - chest pain; Heart attack - chest pain; Myocardial infarction - chest pain; MI - chest pain ... AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College ...

Magnetocentrifugally Driven Flows from Young Stars and Disks. IV. The Accretion Funnel and Dead Zone

NASA Astrophysics Data System (ADS)

Ostriker, Eve C.; Shu, Frank H.

1995-07-01

We formulate the time-steady, axisymmetric problem of stellar magnetospheric inflow of gas from a surrounding accretion disk. The computational domain is bounded on the outside by a surface of given shape containing the open field lines associated with an induced disk wind. The mechanism for this wind has been investigated in previous publications in this journal. Our zeroth-order solution incorporates an acceptable accounting of the pressure balance between the magnetic field lines loaded with accreting gas (funnel flow) and those empty of matter (dead zone). In comparison with previous models, our funnel-flow/dead-zone solution has the following novel features: (1) Because of a natural tendency for the trapped stellar magnetic flux to pinch toward the corotation radius Rx (X-point of the effective potential), most of the interesting magnetohydrodynamics is initiated within a small neighborhood of Rx (X-region), where the Keplerian angular speed of rotation in the disk equals the spin rate of the star. (2) Unimpeded funnel flow from the inner portion of the X-region to the star can occur when the amount of trapped magnetic flux equals or exceeds 1.5 times the unperturbed dipole flux that would lie outside Rx in the absence of an accretion disk. (3). Near the equatorial plane, radial infall from the X-point is terminated at a "kink" point Rk = 0.74Rx that deflects the flow away from the midplane, mediating thereby between the field topology imposed by a magnetic fan of trapped flux at Rx and the geometry of a strong stellar dipole. (4) The excess angular momentum of accretion that would otherwise spin up the star rapidly is deposited by the magnetic torques of the funnel flow into the inner portion of the X-region of the disk. (5) An induced disk wind arises in the outer portion of the .X-region, where the stellar field lines have been blown open, and removes whatever excess angular momentum that viscous torques do not transport to the outer disk. (6) The interface between open field lines loaded with outflowing matter (connected to the disk) and those not loaded (connected to the star) forms a "helmet streamer," along which major mass-ejection and reconnection events may arise in response to changing boundary conditions (e.g., stellar magnetic cycles), much the way that such events occur in the active Sun. (7) Pressure balance across the dead-zone/wind interface will probably yield an asymptotically vertical (i.e., "jetlike") trajectory for the matter ejected along the helmet streamer, but mathematical demonstration of this fact is left for future studies. (8) In steady state the overall balance of angular momentum in the star/disk/ magnetosphere system fixes the fractions, f and 1 - f, of the disk mass accretion rate into the X-region carried away, respectively, by the wind and funnel flows.

Thin chest wall is an independent risk factor for the development of pneumothorax after chest tube removal.

PubMed

Anand, Rahul J; Whelan, James F; Ferrada, Paula; Duane, Therese M; Malhotra, Ajai K; Aboutanos, Michel B; Ivatury, Rao R

2012-04-01

The factors contributing to the development of pneumothorax after removal of chest tube thoracostomy are not fully understood. We hypothesized that development of post pull pneumothorax (PPP) after chest tube removal would be significantly lower in those patients with thicker chest walls, due to the "protective" layer of adipose tissue. All patients on our trauma service who underwent chest tube thoracostomy from July 2010 to February 2011 were retrospectively reviewed. Patient age, mechanism of trauma, and chest Abbreviated Injury Scale score were analyzed. Thoracic CTs were reviewed to ascertain chest wall thickness (CW). Thickness was measured at the level of the nipple at the midaxillary line, as perpendicular distance between skin and pleural cavity. Chest X-ray reports from immediately prior and after chest tube removal were reviewed for interval development of PPP. Data are presented as average ± standard deviation. Ninety-one chest tubes were inserted into 81 patients. Patients who died before chest tube removal (n = 11), or those without thoracic CT scans (n = 13) were excluded. PPP occurred in 29.9 per cent of chest tube removals (20/67). When PPP was encountered, repeat chest tube was necessary in 20 per cent of cases (4/20). After univariate analysis, younger age, penetrating mechanism, and thin chest wall were found to be significant risk factors for development of PPP. Chest Abbreviated Injury Scale score was similar in both groups. Logistic regression showed only chest wall thickness to be an independent risk factor for development of PPP.

Method and apparatus for directing ions and other charged particles generated at near atmospheric pressures into a region under vacuum

DOEpatents

Smith, Richard D.; Shaffer, Scott A.

2000-01-01

A method and apparatus for focusing dispersed charged particles. More specifically, a series of elements within a region maintained at a pressure between 10.sup.-1 millibar and 1 bar, each having successively larger apertures forming an ion funnel, wherein RF voltages are applied to the elements so that the RF voltage on any element has phase, amplitude and frequency necessary to define a confinement zone for charged particles of appropriate charge and mass in the interior of the ion funnel, wherein the confinement zone has an acceptance region and an emmitance region and where the acceptance region area is larger than the emmitance region area.

Ionization source utilizing a multi-capillary inlet and method of operation

DOEpatents

Smith, Richard D.; Kim, Taeman; Udseth, Harold R.

2004-10-12

A multi-capillary inlet to focus ions and other charged particles generated at or near atmospheric pressure into a relatively low pressure region, which allows increased conductance of ions and other charged particles. The multi-capillary inlet is juxtaposed between an ion source and the interior of an instrument maintained at near atmospheric pressure, it finds particular advantages when deployed to improve the ion transmission between an electrospray ionization source and the first vacuum stage of a mass spectrometer, and finds its greatest advantages when deployed in conjunction with an electrodynamic (RF) ion funnel deployed within the interior of the mass spectrometer, particularly an ion funnel equipped with a jet disturber.

Cardiopulmonary resuscitation by chest compression alone or with mouth-to-mouth ventilation.

PubMed

Hallstrom, A; Cobb, L; Johnson, E; Copass, M

2000-05-25

Despite extensive training of citizens of Seattle in cardiopulmonary resuscitation (CPR), bystanders do not perform CPR in almost half of witnessed cardiac arrests. Instructions in chest compression plus mouth-to-mouth ventilation given by dispatchers over the telephone can require 2.4 minutes. In experimental studies, chest compression alone is associated with survival rates similar to those with chest compression plus mouth-to-mouth ventilation. We conducted a randomized study to compare CPR by chest compression alone with CPR by chest compression plus mouth-to-mouth ventilation. The setting of the trial was an urban, fire-department-based, emergency-medical-care system with central dispatching. In a randomized manner, telephone dispatchers gave bystanders at the scene of apparent cardiac arrest instructions in either chest compression alone or chest compression plus mouth-to-mouth ventilation. The primary end point was survival to hospital discharge. Data were analyzed for 241 patients randomly assigned to receive chest compression alone and 279 assigned to chest compression plus mouth-to-mouth ventilation. Complete instructions were delivered in 62 percent of episodes for the group receiving chest compression plus mouth-to-mouth ventilation and 81 percent of episodes for the group receiving chest compression alone (P=0.005). Instructions for compression required 1.4 minutes less to complete than instructions for compression plus mouth-to-mouth ventilation. Survival to hospital discharge was better among patients assigned to chest compression alone than among those assigned to chest compression plus mouth-to-mouth ventilation (14.6 percent vs. 10.4 percent), but the difference was not statistically significant (P=0.18). The outcome after CPR with chest compression alone is similar to that after chest compression with mouth-to-mouth ventilation, and chest compression alone may be the preferred approach for bystanders inexperienced in CPR.

Clogging and transport of driven particles in asymmetric funnel arrays

NASA Astrophysics Data System (ADS)

Reichhardt, C. J. O.; Reichhardt, C.

2018-06-01

We numerically examine the flow and clogging of particles driven through asymmetric funnel arrays when the commensurability ratio of the number of particles per plaquette is varied. The particle–particle interactions are modeled with a soft repulsive potential that could represent vortex flow in type-II superconductors or driven charged colloids. The velocity-force curves for driving in the easy flow direction of the funnels exhibit a single depinning threshold; however, for driving in the hard flow direction, we find that there can be both negative mobility where the velocity decreases with increasing driving force as well as a reentrant pinning effect in which the particles flow at low drives but become pinned at intermediate drives. This reentrant pinning is associated with a transition from smooth 1D flow at low drives to a clogged state at higher drives that occurs when the particles cluster in a small number of plaquettes and block the flow. When the drive is further increased, particle rearrangements occur that cause the clog to break apart. We map out the regimes in which the pinned, flowing, and clogged states appear as a function of plaquette filling and drive. The clogged states remain robust at finite temperatures but develop intermittent bursts of flow in which a clog temporarily breaks apart but quickly reforms.

Stemflow-induced processes of soil water storage

NASA Astrophysics Data System (ADS)

Germer, Sonja

2013-04-01

Compared to stemflow production studies only few studies deal with the fate of stemflow at the near-stem soil. To investigate stemflow contribution to the root zone soil moisture by young and adult babassu palms (Attalea speciosa Mart.), I studied stemflow generation, subsequent soil water percolation and root distributions. Rainfall, stemflow and perched water tables were monitored on an event basis. Perched water tables were monitored next to adult palms at two depths and three stem distances. Dye tracer experiments monitored stemflow-induced preferential flow paths. Root distributions of fine and coarse roots were related to soil water redistribution. Average rainfall-collecting area per adult palm was 6.4 m², but variability between them was high. Funneling ratios ranged between 16-71 and 4-55 for adult and young palms, respectively. Nonetheless, even very small rainfall events of 1 mm can generate stemflow. On average, 9 liters of adult palm stemflow were intercepted and stemflow tended to decrease for-high intensity rainfall events. Young babassu palms funneled rainfall via their fronds, directly to their subterranean stems. The funneling of rainfall towards adult palm stems, in contrast, led to great stemflow fluxes down to the soil and induced initial horizontal water flows through the soil, leading to perched water tables next to palms, even after small rainfall events. The perched water tables extended, however, only a few decimeters from palm stems. After perched water tables became established, vertical percolation through the soil dominated. To my knowledge, this process has not been described before, and it can be seen as an addition to the two previously described stemflow-induced processes of Horton overland flow and fast, deep percolation along roots. This study has demonstrated that Babassu palms funnel water to their stems and subsequently store it in the soil next to their stems in areas where coarse root length density is very high. This might partly explain the competitive position of babassu palms on pastures or secondary forests.

The Time-Course of Sentence Meaning Composition. N400 Effects of the Interaction between Context-Induced and Lexically Stored Affordances

PubMed Central

Cosentino, Erica; Baggio, Giosuè; Kontinen, Jarmo; Werning, Markus

2017-01-01

Contemporary semantic theories can be classified along two dimensions: (i) the way and time-course in which contextual factors influence sentence truth-conditions; and (ii) whether and to what extent comprehension involves sensory, motor and emotional processes. In order to explore this theoretical space, our ERP study investigates the time-course of the interaction between the lexically specified telic component of a noun (the function of the object to which the noun refers to, e.g., a funnel is generally used to pour liquids into containers) and an ad-hoc affordance contextually induced by the situation described in the discourse. We found that, if preceded by a neutral discourse context, a verb incongruent with the noun's telic component as in “She uses the funnel to hang her coat” elicited an enhanced N400 compared to a congruent verb as in “She uses the funnel to pour water into a container.” However, if the situation introduced in the preceding discourse induced a new function for the object as an ad-hoc affordance (e.g., the funnel is glued to the wall and the agent wants to hang the coat), we observed a crossing-over regarding the direction of the N400 effect: comparing the ad-hoc affordance-inducing context with the neutral context, the N400 for the incongruent verb was significantly reduced, whereas the N400 for the congruent verb was significantly enhanced. We explain these results as a consequence of the incorporation of the contextually triggered ad-hoc affordance into the meaning of the noun. Combining these results with an analysis of semantic similarity values between test sentences and contexts, we argue that one possibility is that the incorporation of an ad-hoc affordance may be explained on the basis of the mental simulation of concurrent motor information. PMID:28603506

The Time-Course of Sentence Meaning Composition. N400 Effects of the Interaction between Context-Induced and Lexically Stored Affordances.

PubMed

Cosentino, Erica; Baggio, Giosuè; Kontinen, Jarmo; Werning, Markus

2017-01-01

Contemporary semantic theories can be classified along two dimensions: (i) the way and time-course in which contextual factors influence sentence truth-conditions; and (ii) whether and to what extent comprehension involves sensory, motor and emotional processes. In order to explore this theoretical space, our ERP study investigates the time-course of the interaction between the lexically specified telic component of a noun (the function of the object to which the noun refers to, e.g., a funnel is generally used to pour liquids into containers) and an ad-hoc affordance contextually induced by the situation described in the discourse. We found that, if preceded by a neutral discourse context, a verb incongruent with the noun's telic component as in "She uses the funnel to hang her coat" elicited an enhanced N400 compared to a congruent verb as in "She uses the funnel to pour water into a container." However, if the situation introduced in the preceding discourse induced a new function for the object as an ad-hoc affordance (e.g., the funnel is glued to the wall and the agent wants to hang the coat), we observed a crossing-over regarding the direction of the N400 effect: comparing the ad-hoc affordance-inducing context with the neutral context, the N400 for the incongruent verb was significantly reduced, whereas the N400 for the congruent verb was significantly enhanced. We explain these results as a consequence of the incorporation of the contextually triggered ad-hoc affordance into the meaning of the noun. Combining these results with an analysis of semantic similarity values between test sentences and contexts, we argue that one possibility is that the incorporation of an ad-hoc affordance may be explained on the basis of the mental simulation of concurrent motor information.

Water storage capacity, stemflow and water funneling in Mediterranean shrubs

NASA Astrophysics Data System (ADS)

Garcia-Estringana, P.; Alonso-Blázquez, N.; Alegre, J.

2010-08-01

SummaryTo predict water losses and other hydrological and ecological features of a given vegetation, its water storage capacity and stemflow need to be accurately determined. Vast areas of the Mediterranean region are occupied by shrublands yet there is scarce data available on their rainwater interception capacity. In this study, simulated rainfall tests were conducted in controlled conditions on nine Mediterranean shrubs of varying anatomic and morphological features to determine water storage capacity, stemflow and the funneling ratio. After assessing correlations between these hydrological variables and the biometric characteristics of the shrubs, we compared two methods of determining storage capacity: rainfall simulation and immersion. Mean water storage capacity was 1.02 mm (0.35-3.24 mm), stemflow was 16% (3.8-26.4%) and the funneling ratio was 104 (30-260). Per unit biomass, mean storage capacity was 0.66 ml g -1 and ranged from 0.23 ml g -1 for Cistus ladanifer to 2.26 ml g -1 for Lavandula latifolia. Despite their small size, shrubs may generate high water losses to the atmosphere when they form dense communities and this can have a significant impact in regions where water is scarce. When considered the whole shrubs in absolute terms (ml per plant), water storage capacity and stemflow were correlated to biomass and the dendrometric characteristics of the shrubs, yet in relative terms (expressed per surface area unit or as %), anatomic features such as pubescence, branch rigidity or leaf insertion angle emerged as determining factors. The use of a simple procedure to assess storage capacity was inefficient. The immersion method underestimated storage capacity to a different extent for each species. Some shrubs returned high stemflow values typical of their adaptation to the semiarid climate. In contrast, other shrubs seem to have structures that promote stemflow yet have developed other drought-adaptation mechanisms. In this report, we discuss the ecological and hydrological significance of stemflow and the funneling ratio.

Evaluation of capture techniques on lesser prairie-chicken trap injury and survival

USGS Publications Warehouse

Grisham, Blake A.; Boal, Clint W.; Mitchell, Natasia R.; Gicklhorn, Trevor S.; Borsdorf, Philip K.; Haukos, David A.; Dixon, Charles

2015-01-01

Ethical treatment of research animals is required under the Animal Welfare Act. This includes trapping methodologies that reduce unnecessary pain and duress. Traps used in research should optimize animal welfare conditions within the context of the proposed research study. Several trapping techniques are used in the study of lesser prairie-chickens, despite lack of knowledge of trap injury caused by the various methods. From 2006 to 2012, we captured 217, 40, and 144 lesser prairie-chickens Tympanuchus pallidicinctus using walk-in funnel traps, rocket nets, and drop nets, respectively, in New Mexico and Texas, to assess the effects of capture technique on injury and survival of the species. We monitored radiotagged, injured lesser prairie-chickens 7–65 d postcapture to assess survival rates of injured individuals. Injuries occurred disproportionately among trap type, injury type, and sex. The predominant injuries were superficial cuts to the extremities of males captured in walk-in funnel traps. However, we observed no mortalities due to trapping, postcapture survival rates of injured birds did not vary across trap types, and the daily survival probability of an injured and uninjured bird was ≥99%. Frequency and intensity of injuries in walk-in funnel traps are due to the passive nature of these traps (researcher cannot select specific individuals for capture) and incidental capture of individuals not needed for research. Comparatively, rocket nets and drop nets allow observers to target birds for capture and require immediate removal of captured individuals from the trap. Based on our results, trap injuries would be reduced if researchers monitor and immediately remove birds from walk-in funnels before they injure themselves; move traps to target specific birds and reduce recaptures; limit the number of consecutive trapping days on a lek; and use proper netting techniques that incorporate quick, efficient, trained handling procedures.

Funneled potential and flux landscapes dictate the stabilities of both the states and the flow: Fission yeast cell cycle.

PubMed

Luo, Xiaosheng; Xu, Liufang; Han, Bo; Wang, Jin

2017-09-01

Using fission yeast cell cycle as an example, we uncovered that the non-equilibrium network dynamics and global properties are determined by two essential features: the potential landscape and the flux landscape. These two landscapes can be quantified through the decomposition of the dynamics into the detailed balance preserving part and detailed balance breaking non-equilibrium part. While the funneled potential landscape is often crucial for the stability of the single attractor networks, we have uncovered that the funneled flux landscape is crucial for the emergence and maintenance of the stable limit cycle oscillation flow. This provides a new interpretation of the origin for the limit cycle oscillations: There are many cycles and loops existed flowing through the state space and forming the flux landscapes, each cycle with a probability flux going through the loop. The limit cycle emerges when a loop stands out and carries significantly more probability flux than other loops. We explore how robustness ratio (RR) as the gap or steepness versus averaged variations or roughness of the landscape, quantifying the degrees of the funneling of the underlying potential and flux landscapes. We state that these two landscapes complement each other with one crucial for stabilities of states on the cycle and the other crucial for the stability of the flow along the cycle. The flux is directly related to the speed of the cell cycle. This allows us to identify the key factors and structure elements of the networks in determining the stability, speed and robustness of the fission yeast cell cycle oscillations. We see that the non-equilibriumness characterized by the degree of detailed balance breaking from the energy pump quantified by the flux is the cause of the energy dissipation for initiating and sustaining the replications essential for the origin and evolution of life. Regulating the cell cycle speed is crucial for designing the prevention and curing strategy of cancer.

Funneled potential and flux landscapes dictate the stabilities of both the states and the flow: Fission yeast cell cycle

PubMed Central

2017-01-01

Using fission yeast cell cycle as an example, we uncovered that the non-equilibrium network dynamics and global properties are determined by two essential features: the potential landscape and the flux landscape. These two landscapes can be quantified through the decomposition of the dynamics into the detailed balance preserving part and detailed balance breaking non-equilibrium part. While the funneled potential landscape is often crucial for the stability of the single attractor networks, we have uncovered that the funneled flux landscape is crucial for the emergence and maintenance of the stable limit cycle oscillation flow. This provides a new interpretation of the origin for the limit cycle oscillations: There are many cycles and loops existed flowing through the state space and forming the flux landscapes, each cycle with a probability flux going through the loop. The limit cycle emerges when a loop stands out and carries significantly more probability flux than other loops. We explore how robustness ratio (RR) as the gap or steepness versus averaged variations or roughness of the landscape, quantifying the degrees of the funneling of the underlying potential and flux landscapes. We state that these two landscapes complement each other with one crucial for stabilities of states on the cycle and the other crucial for the stability of the flow along the cycle. The flux is directly related to the speed of the cell cycle. This allows us to identify the key factors and structure elements of the networks in determining the stability, speed and robustness of the fission yeast cell cycle oscillations. We see that the non-equilibriumness characterized by the degree of detailed balance breaking from the energy pump quantified by the flux is the cause of the energy dissipation for initiating and sustaining the replications essential for the origin and evolution of life. Regulating the cell cycle speed is crucial for designing the prevention and curing strategy of cancer. PMID:28892489

On-demand rather than daily-routine chest radiography prescription may change neither the number nor the impact of chest computed tomography and ultrasound studies in a multidisciplinary intensive care unit.

PubMed

Kröner, Anke; Binnekade, Jan M; Graat, Marleen E; Vroom, Margreeth B; Stoker, Jaap; Spronk, Peter E; Schultz, Marcus J

2008-01-01

Elimination of daily-routine chest radiographs (CXRs) may influence chest computed tomography (CT) and ultrasound practice in critically ill patients. This was a retrospective cohort study including all patients admitted to a university-affiliated intensive care unit during two consecutive periods of 5 months, one before and one after elimination of daily-routine CXR. Chest CT and ultrasound studies were identified retrospectively by using the radiology department information system. Indications for and the diagnostic/therapeutic yield of chest CT and ultrasound studies were collected. Elimination of daily-routine CXR resulted in a decrease of CXRs per patient day from 1.1 +/- 0.3 to 0.6 +/- 0.4 (P < 0.05). Elimination did not affect duration of stay or mortality rates. Neither the number of chest CT studies nor the ratio of chest CT studies per patient day changed with the intervention: Before elimination of daily-routine CXR, 52 chest CT studies were obtained from 747 patients; after elimination, 54 CT studies were obtained from 743 patients. Similarly, chest ultrasound practice was not affected by the change of CXR strategy: Before and after elimination, 21 and 27 chest ultrasound studies were performed, respectively. Also, timing of chest CT and ultrasound studies was not different between the two study periods. During the two periods, 40 of 106 chest CT studies (38%) and 18 of 48 chest ultrasound studies (38%) resulted in a change in therapy. The combined therapeutic yield of chest CT and ultrasound studies did not change with elimination of daily-routine CXR. Elimination of daily-routine CXRs may not affect chest CT and ultrasound practice in a multidisciplinary intensive care unit.

Evaluation of chest tomosynthesis for the detection of pulmonary nodules: effect of clinical experience and comparison with chest radiography

NASA Astrophysics Data System (ADS)

Zachrisson, Sara; Vikgren, Jenny; Svalkvist, Angelica; Johnsson, Åse A.; Boijsen, Marianne; Flinck, Agneta; Månsson, Lars Gunnar; Kheddache, Susanne; Båth, Magnus

2009-02-01

Chest tomosynthesis refers to the technique of collecting low-dose projections of the chest at different angles and using these projections to reconstruct section images of the chest. In this study, a comparison of chest tomosynthesis and chest radiography in the detection of pulmonary nodules was performed and the effect of clinical experience of chest tomosynthesis was evaluated. Three senior thoracic radiologists, with more than ten years of experience of chest radiology and 6 months of clinical experience of chest tomosynthesis, acted as observers in a jackknife free-response receiver operating characteristics (JAFROC-1) study, performed on 42 patients with and 47 patients without pulmonary nodules examined with both chest tomosynthesis and chest radiography. MDCT was used as reference and the total number of nodules found using MDCT was 131. To investigate the effect of additional clinical experience of chest tomosynthesis, a second reading session of the tomosynthesis images was performed one year after the initial one. The JAFROC-1 figure of merit (FOM) was used as the principal measure of detectability. In comparison with chest radiography, chest tomosynthesis performed significantly better with regard to detectability. The observer-averaged JAFROC-1 FOM was 0.61 for tomosynthesis and 0.40 for radiography, giving a statistically significant difference between the techniques of 0.21 (p<0.0001). The observer-averaged JAFROC-1 FOM of the second reading of the tomosynthesis cases was not significantly higher than that of the first reading, indicating no improvement in detectability due to additional clinical experience of tomosynthesis.

Managing a chest tube and drainage system.

PubMed

Durai, Rajaraman; Hoque, Happy; Davies, Tony W

2010-02-01

Intercostal drainage tubes (ie, chest tubes) are inserted to drain the pleural cavity of air, blood, pus, or lymph. The water-seal container connected to the chest tube allows one-way movement of air and liquid from the pleural cavity. The container should not be changed unless it is full, and the chest tube should not be clamped unnecessarily. After a chest tube is inserted, a nurse trained in chest-tube management is responsible for managing the chest tube and drainage system. This entails monitoring the chest-tube position, controlling fluid evacuation, identifying when to change or empty the containers, and caring for the tube and drainage system during patient transport. This article provides an overview of indications, insertion techniques, and management of chest tubes. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Nurse and patient factors that influence nursing time in chest tube management early after open heart surgery: A descriptive, correlational study.

PubMed

Cook, Myra; Idzior, Laura; Bena, James F; Albert, Nancy M

2017-10-01

Determine nurse characteristics and patient factors that affect nurses' time in managing chest tubes in the first 24-hours of critical-care stay. Prospective, descriptive. Cardiovascular critical-care nurses and post-operative heart surgery patients with chest tubes were enrolled from a single center in Ohio. Nurses completed case report forms about themselves, comfort and time in managing chest tubes, chest tube placement and management factors. Analysis included correlational and comparative statistics; Bonferroni corrections were applied, as appropriate. Of 29 nurses, 86.2% were very comfortable managing chest tubes and oozing/non-secure dressings, but only 41.4% were very comfortable managing clogged chest tubes. Of 364 patients, mean age was 63.1 (±12.3) years and 36% had previous heart surgery. Total minutes of chest tube management was higher with≥3 chest tubes, tube size <28 French, and when both mediastinal and pleural tubes were present (all p<0.001). In the first 4-hours, time spent on chest tubes was higher when patients had previous cardiac surgeries (p≤0.002), heart failure (p<0.001), preoperative anticoagulant medications (p=0.031) and reoperation for postoperative bleeding/tamponade (p=0.005). Time to manage chest tubes can be anticipated by patient characteristics. Nurse comfort with chest tube-related tasks affected time spent on chest tube management. Published by Elsevier Ltd.

Structural analysis of N-linked carbohydrate chains of funnel web spider (Agelenopsis aperta) venom peptide isomerase.

PubMed

Shikata, Y; Ohe, H; Mano, N; Kuwada, M; Asakawa, N

1998-06-01

The structure of the N-linked carbohydrate chains of peptide isomerase from the venom of the funnel web spider (Agelenopsis aperta) has been analyzed. Carbohydrates were released from peptide isomerase by hydrazinolysis and reductively aminated with 2-aminopyridine. The fluorescent derivatives were purified by phenol/chloroform extraction, followed by size-exclusion HPLC. The structure of the purified pyridylamino (PA-) carbohydrate chains were analyzed by a combination of two-dimensional HPLC mapping, sugar composition analysis, sequential exoglycosidase digestions, and mass spectrometry. The peptide isomerase contains six kinds of N-linked carbohydrate chains of truncated high-mannose type, with a fucose alpha 1-6 linked to the reducing N-acetylglucosamine in approximately 80% of them.

Improved ion optics for introduction of ions into a 9.4-T Fourier transform ion cyclotron resonance mass spectrometer

DOE PAGES

Chen, Yu; Leach, Franklin E.; Kaiser, Nathan K.; ...

2015-01-19

Fourier transform ion cyclotron resonance (FT-ICR) mass spectrometry provides unparalleled mass accuracy and resolving power.[1],[2] With electrospray ionization (ESI), ions are typically transferred into the mass spectrometer through a skimmer, which serves as a conductance-limiting orifice. However, the skimmer allows only a small fraction of incoming ions to enter the mass spectrometer. An ion funnel, originally developed by Smith and coworkers at Pacific Northwest National Laboratory (PNNL)[3-5] provides much more efficient ion focusing and transfer. The large entrance aperture of the ion funnel allows almost all ions emanating from a heated capillary to be efficiently captured and transferred, resulting inmore » nearly lossless transmission.« less

Device for two-dimensional gas-phase separation and characterization of ion mixtures

DOEpatents

Tang, Keqi [Richland, WA; Shvartsburg, Alexandre A [Richland, WA; Smith, Richard D [Richland, WA

2006-12-12

The present invention relates to a device for separation and characterization of gas-phase ions. The device incorporates an ion source, a field asymmetric waveform ion mobility spectrometry (FAIMS) analyzer, an ion mobility spectrometry (IMS) drift tube, and an ion detector. In one aspect of the invention, FAIMS operating voltages are electrically floated on top of the IMS drift voltage. In the other aspect, the FAIMS/IMS interface is implemented employing an electrodynamic ion funnel, including in particular an hourglass ion funnel. The present invention improves the efficiency (peak capacity) and sensitivity of gas-phase separations; the online FAIMS/IMS coupling creates a fundamentally novel two-dimensional gas-phase separation technology with high peak capacity, specificity, and exceptional throughput.

Flail chest as a complication of cardiopulmonary resuscitation.

PubMed

Enarson, D A; Didier, E P; Gracey, D R

1977-01-01

Records of all patients who developed flail chest after cardiopulmonary resuscitation at Rochester Methodist Hospital between January, 1966 and March 1976 were reviewed. Also, for comparison, records of patients with flail chest resulting from motor vehicle accidents and those of a matched group of patients who underwent cardiopulmonary resuscitation without developing flail chest were reviewed. The incidence of flail chest after cardiopulmonary resuscitation was about 5.6 per 100 survivors. The groups who did and did not have flail chest after cardiopulmonary resuscitation were alike in age and in frequency and duration of the resuscitation. Stabilization of the flail chest required mechanical ventilation for 1 to 24 days (mean, 10.7). Flail chest did not significantly lengthen the hospitalization of patients who survived after cardiopulmonary resuscitation. The occurrence of flail chest after cardiopulmonary resuscitation did not seem to increase the mortality rate.

Diagnostic Yield of Recommendations for Chest CT Examination Prompted by Outpatient Chest Radiographic Findings

PubMed Central

Harvey, H. Benjamin; Gilman, Matthew D.; Wu, Carol C.; Cushing, Matthew S.; Halpern, Elkan F.; Zhao, Jing; Pandharipande, Pari V.; Shepard, Jo-Anne O.

2015-01-01

Purpose To evaluate the diagnostic yield of recommended chest computed tomography (CT) prompted by abnormalities detected on outpatient chest radiographic images. Materials and Methods This HIPAA-compliant study had institutional review board approval; informed consent was waived. Reports of all outpatient chest radiographic examinations performed at a large academic center during 2008 (n = 29 138) were queried to identify studies that included a recommendation for a chest CT imaging. The radiology information system was queried for these patients to determine if a chest CT examination was obtained within 1 year of the index radiographic examination that contained the recommendation. For chest CT examinations obtained within 1 year of the index chest radiographic examination and that met inclusion criteria, chest CT images were reviewed to determine if there was an abnormality that corresponded to the chest radiographic finding that prompted the recommendation. All corresponding abnormalities were categorized as clinically relevant or not clinically relevant, based on whether further work-up or treatment was warranted. Groups were compared by using t test and Fisher exact test with a Bonferroni correction applied for multiple comparisons. Results There were 4.5% (1316 of 29138 [95% confidence interval {CI}: 4.3%, 4.8%]) of outpatient chest radiographic examinations that contained a recommendation for chest CT examination, and increasing patient age (P < .001) and positive smoking history (P = .001) were associated with increased likelihood of a recommendation for chest CT examination. Of patients within this subset who met inclusion criteria, 65.4% (691 of 1057 [95% CI: 62.4%, 68.2%) underwent a chest CT examination within the year after the index chest radiographic examination. Clinically relevant corresponding abnormalities were present on chest CT images in 41.4% (286 of 691 [95% CI: 37.7%, 45.2%]) of cases, nonclinically relevant corresponding abnormalities in 20.6% (142 of 691 [95% CI: 17.6%, 23.8%]) of cases, and no corresponding abnormalities in 38.1% (263 of 691 [95% CI: 34.4%, 41.8%]) of cases. Newly diagnosed, biopsy-proven malignancies were detected in 8.1% (56 of 691 [95% CI: 6.2%, 10.4%]) of cases. Conclusion A radiologist recommendation for chest CT to evaluate an abnormal finding on an outpatient chest radiographic examination has a high yield of clinically relevant findings. © RSNA, 2014 PMID:25531242

Conventional versus pigtail chest tube-are they similar for treatment of malignant pleural effusions?

PubMed

Mendes, Maria Aurora; China Pereira, Nuno; Ribeiro, Carla; Vanzeller, Manuela; Shiang, Teresa; Gaio, Rita; Campainha, Sérgio

2018-08-01

The optimal chest tube type and size for drainage and chemical pleurodesis of malignant pleural effusions remains controversial. This retrospective study was conducted to compare the efficacy of conventional versus pigtail chest tube in the treatment of malignant pleural effusions. Patients submitted to chest tube drainage and slurry talc pleurodesis due to malignant pleural effusion in our pulmonology ward from 2012 to 2016 were eligible. According to the type of chest tube, they were divided into two groups: group I-conventional chest tube and group II-pigtail chest tube. Number of deaths, recurrence of malignant pleural effusion, and timelines associated with the procedures were reviewed and compared between groups. Out of the 61 included patients, 46 (75.4%) were included in group I and 15 (24.6%) in group II. Only one patient had pigtail chest tube obstruction, with posterior insertion of conventional chest tube. Death during hospital stay and up to 3 months, recurrence at 4 weeks, total duration of hospital stay, time from chest tube insertion to pleurodesis, and time from chest tube insertion to removal were not significantly different between the two groups (all p > 0.05). These findings suggest that pigtail chest tube can be an alternative on palliation, with no compromise in pleurodesis performance.

[Use and versatility of titanium for the reconstruction of the thoracic wall].

PubMed

Córcoles Padilla, Juan Manuel; Bolufer Nadal, Sergio; Kurowski, Krzysztof; Gálvez Muñoz, Carlos; Rodriguez Paniagua, José Manuel

2014-02-01

Chest wall deformities/defects and chest wall resections, as well as complex rib fractures require reconstruction with various prosthetic materials to ensure the basic functions of the chest wall. Titanium provides many features that make it an ideal material for this surgery. The aim is to present our initial results with this material in several diseases. From 2008 to 2012, 14 patients were operated on and titanium was used for reconstruction of the chest wall. A total of 7 patients had chest wall tumors, 2 with sternal resection, 4 patients with chest wall deformities/defects and 3 patients with severe rib injury due to traffic accident. The reconstruction was successful in all cases, with early extubation without detecting problems in the functionality of the chest wall at a respiratory level. Patients with chest wall tumors including sternal resections were extubated in the operating room as well as the chest wall deformities. Chest trauma cases were extubated within 24h from internal rib fixation. There were no complications related to the material used and the method of implementation. Titanium is an ideal material for reconstruction of the chest wall in several clinical situations allowing for great versatility and adaptability in different chest wall reconstructions. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

Large pneumothorax in blunt chest trauma: Is a chest drain always necessary in stable patients? A case report.

PubMed

Idris, Baig M; Hefny, Ashraf F

2016-01-01

Pneumothorax is the most common potentially life-threatening blunt chest injury. The management of pneumothorax depends upon the etiology, its size and hemodynamic stability of the patient. Most clinicians agree that chest drainage is essential for the management of traumatic large pneumothorax. Herein, we present a case of large pneumothorax in blunt chest trauma patient that resolved spontaneously without a chest drain. A 63- year- old man presented to the Emergency Department complaining of left lateral chest pain due to a fall on his chest at home. On examination, he was hemodynamically stable. An urgent chest X-ray showed evidence of left sided pneumothorax. CT scan of the chest showed pneumothorax of more than 30% of the left hemithorax (around 600ml of air) with multiple left ribs fracture. Patient refused tube thoracostomy and was admitted to surgical department for close observation. The patient was managed conservatively without chest tube insertion. A repeat CT scan of the chest has shown complete resolution of the pneumothorax. The clinical spectrum of pneumothorax varies from asymptomatic to life threatening tension pneumothorax. In stable patients, conservative management can be safe and effective for small pneumothorax. To the best of our knowledge, this is the second reported case in the English literature with large pneumothorax which resolved spontaneously without chest drain. Blunt traumatic large pneumothorax in a clinically stable patient can be managed conservatively. Current recommendations for tube placement may need to be reevaluated. This may reduce morbidity associated with chest tube thoracostomy. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Prevalence and Clinical Import of Thoracic Injury Identified by Chest Computed Tomography but Not Chest Radiography in Blunt Trauma: Multicenter Prospective Cohort Study.

PubMed

Langdorf, Mark I; Medak, Anthony J; Hendey, Gregory W; Nishijima, Daniel K; Mower, William R; Raja, Ali S; Baumann, Brigitte M; Anglin, Deirdre R; Anderson, Craig L; Lotfipour, Shahram; Reed, Karin E; Zuabi, Nadia; Khan, Nooreen A; Bithell, Chelsey A; Rowther, Armaan A; Villar, Julian; Rodriguez, Robert M

2015-12-01

Chest computed tomography (CT) diagnoses more injuries than chest radiography, so-called occult injuries. Wide availability of chest CT has driven substantial increase in emergency department use, although the incidence and clinical significance of chest CT findings have not been fully described. We determine the frequency, severity, and clinical import of occult injury, as determined by changes in management. These data will better inform clinical decisions, need for chest CT, and odds of intervention. Our sample included prospective data (2009 to 2013) on 5,912 patients at 10 Level I trauma center EDs with both chest radiography and chest CT at physician discretion. These patients were 40.6% of 14,553 enrolled in the parent study who had either chest radiography or chest CT. Occult injuries were pneumothorax, hemothorax, sternal or greater than 2 rib fractures, pulmonary contusion, thoracic spine or scapula fracture, and diaphragm or great vessel injury found on chest CT but not on preceding chest radiography. A priori, we categorized thoracic injuries as major (having invasive procedures), minor (observation or inpatient pain control >24 hours), or of no clinical significance. Primary outcome was prevalence and proportion of occult injury with major interventions of chest tube, mechanical ventilation, or surgery. Secondary outcome was minor interventions of admission rate or observation hours because of occult injury. Two thousand forty-eight patients (34.6%) had chest injury on chest radiography or chest CT, whereas 1,454 of these patients (71.0%, 24.6% of all patients) had occult injury. Of these, in 954 patients (46.6% of injured, 16.1% of total), chest CT found injuries not observed on immediately preceding chest radiography. In 500 more patients (24.4% of injured patients, 8.5% of all patients), chest radiography found some injury, but chest CT found occult injury. Chest radiography found all injuries in only 29.0% of injured patients. Two hundred and two patients with occult injury (of 1,454, 13.9%) had major interventions, 343 of 1,454 (23.6%) had minor interventions, and 909 (62.5%) had no intervention. Patients with occult injury included 514 with pulmonary contusions (of 682 total, 75.4% occult), 405 with pneumothorax (of 597 total, 67.8% occult), 184 with hemothorax (of 230 total, 80.0% occult), those with greater than 2 rib fractures (n=672/1,120, 60.0% occult) or sternal fracture (n=269/281, 95.7% occult), 12 with great vessel injury (of 18 total, 66.7% occult), 5 with diaphragm injury (of 6, 83.3% occult), and 537 with multiple occult injuries. Interventions for patients with occult injury included mechanical ventilation for 31 of 514 patients with pulmonary contusion (6.0%), chest tube for 118 of 405 patients with pneumothorax (29.1%), and 75 of 184 patients with hemothorax (40.8%). Inpatient pain control or observation greater than 24 hours was conducted for 183 of 672 patients with rib fractures (27.2%) and 79 of 269 with sternal fractures (29.4%). Three of 12 (25%) patients with occult great vessel injuries had surgery. Repeated imaging was conducted for 50.6% of patients with occult injury (88.1% chest radiography, 11.9% chest CT, 7.5% both). For patients with occult injury, 90.9% (1,321/1,454) were admitted, with 9.1% observed in the ED for median 6.9 hours. Forty-four percent of observed patients were then admitted (4.0% of patients with occult injury). In a more seriously injured subset of patients with blunt trauma who had both chest radiography and chest CT, occult injuries were found by chest CT in 71% of those with thoracic injuries and one fourth of all those with blunt chest trauma. More than one third of occult injury had intervention (37.5%). Chest tubes composed 76.2% of occult injury major interventions, with observation or inpatient pain control greater than 24 hours in 32.4% of occult fractures. Only 1 in 20 patients with occult injury was discharged home from the ED. For these patients with blunt trauma, chest CT is useful to identify otherwise occult injuries. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

46 CFR 169.743 - Portable magazine chests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Portable magazine chests. 169.743 Section 169.743... Vessel Control, Miscellaneous Systems, and Equipment Markings § 169.743 Portable magazine chests. Portable magazine chests must be marked in letters at least 3 inches high: “PORTABLE MAGAZINE CHEST...

Inventory Control.

ERIC Educational Resources Information Center

Byrum, David L., Ed.

1984-01-01

Describes an electronic thermometer using a precision temperature sensor (includes detailed schematic of circuits) and inexpensive ring holders for round-bottomed flasks. Also describes a method for reducing funnel breakage. (JN)

Lessons from a large trauma center: impact of blunt chest trauma in polytrauma patients-still a relevant problem?

PubMed

Chrysou, Konstantina; Halat, Gabriel; Hoksch, Beatrix; Schmid, Ralph A; Kocher, Gregor J

2017-04-20

Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014. Data collection included details of treatment and outcome. Patients with chest trauma and Injury Severity Score (ISS) ≥18 and Abbreviated Injury Scale (AIS) >2 in more than one body region were included. A total of 110 polytrauma patients with blunt chest injury were evaluated. 82 of them were males and median age was 48.5 years. Car accidents, falls from a height and motorbike accidents were the most common causes (>75%) for blunt chest trauma. Rib fractures, pneumothorax and pulmonary contusion were the most common chest injuries. Most patients (64.5%) sustained a serious chest injury (AIS thorax 3), 19.1% a severe chest injury (AIS thorax 4) and 15.5% a moderate chest injury (AIS thorax 2). 90% of patients with blunt chest trauma were treated conservatively. Chest tube insertion was indicated in 54.5% of patients. The need for chest tube was significantly higher among the AIS thorax 4 group in comparison to the AIS groups 3 and 2 (p < 0.001). Also, admission to the ICU was directly related to the severity of the AIS thorax (p < 0.001). The severity of chest trauma did not correlate with ICU length of stay, intubation days, complications or mortality. Although 84.5% of patients suffered from serious or even severe chest injury, neither in the conservative nor in the surgically treated group a significant impact of injury severity on ICU stay, intubation days, complications or mortality was observed. AIS thorax was only related to the rate of chest tube insertions and ICU admission. Management with early chest tube insertion when necessary, pain control and chest physiotherapy resulted in good outcome in the majority of patients.

Limiting chest computed tomography in the evaluation of pediatric thoracic trauma.

PubMed

Golden, Jamie; Isani, Mubina; Bowling, Jordan; Zagory, Jessica; Goodhue, Catherine J; Burke, Rita V; Upperman, Jeffrey S; Gayer, Christopher P

2016-08-01

Computed tomography (CT) of the chest (chest CT) is overused in blunt pediatric thoracic trauma. Chest CT adds to the diagnosis of thoracic injury but rarely changes patient management. We sought to identify a subset of blunt pediatric trauma patients who would benefit from a screening chest CT based on their admission chest x-ray (CXR) findings. We hypothesize that limiting chest CT to patients with an abnormal mediastinal silhouette identifies intrathoracic vascular injuries not otherwise seen on CXR. All blunt trauma activations that underwent an admission CXR at our Level 1 pediatric trauma center from 2005 to 2013 were retrospectively reviewed. Patients who had a chest CT were evaluated for added diagnoses and change in management after CT. An admission CXR was performed in 1,035 patients. One hundred thirty-nine patients had a CT, and the diagnosis of intra-thoracic injury was added in 42% of patients. Chest CT significantly increased the diagnosis of contusion or atelectasis (30.3% vs 60.4%; p < 0.05), pneumothorax (7.2% vs 18.7%; p < 0.05), and other fractures (4.3% vs 10.8%; p < 0.05) on CXR compared to chest CT. Chest CT changed the management of only 4 patients (2.9%). Two patients underwent further radiologic evaluation that was negative for injury, one had a chest tube placed for an occult pneumothorax before exploratory laparotomy, and one patient had a thoracotomy for repair of aortic injury. Chest CT for select patients with an abnormal mediastinal silhouette on CXR would have decreased CT scans by 80% yet still identified patients with an intrathoracic vascular injury. The use of chest CT should be limited to the identification of intrathoracic vascular injuries in the setting of an abnormal mediastinal silhouette on CXR. Therapeutic study, level IV; diagnostic study, level III.

46 CFR 196.37-47 - Portable magazine chests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE — KEEP...

[Imaging of pleural diseases: evaluation of imaging methods based on chest radiography].

PubMed

Poyraz, Necdet; Kalkan, Havva; Ödev, Kemal; Ceran, Sami

2017-03-01

The most commonly employed radiologic method in diagnosis of pleural diseases is conventional chest radiograph. The commonest chest- X-Ray findings are the presence of pleural effusion and thickening. Small pleural effusions are not readily identified on posteroanterior chest radiograph. However, lateral decubitus chest radiograph and chest ultrasonography may show small pleural effusions. These are more efficient methods than posteroanterior chest radiograph in the erect position for demonstrating small amounts of free pleural effusions. Chest ultrasonograph may be able to help in distinguishing the pleural pathologies from parenchymal lesions. On chest radiograph pleural effusions or pleural thickening may obscure the visibility of the underlying disease or parenchymal abnormality. Thus, computed tomography (CT) may provide additional information of determining the extent and severity of pleural disease and may help to differentiate malign pleural lesions from the benign ones. Moreover, CT may provide the differentiation of parenchmal abnormalities from pleural pathologies. CT (coronal and sagittal reformatted images) that also show invasion of chest wall, mediastinum and diaphragm, as well as enlarged hilar or mediastinal lymph nodes. Standart non-invasive imaging techniques may be supplemented with magnetic resonans imaging (MRI).

Pulmonary embolism presenting with itinerant chest pain and migratory pleural effusion: A case report.

PubMed

Li, Wei; Chen, Chen; Chen, Mo; Xin, Tong; Gao, Peng

2018-06-01

Pulmonary embolism (PE) presents with complex clinical manifestations ranging from asymptomatic to chest pain, hemoptysis, syncope, shock, or sudden death. To the authors' knowledge, itinerant chest pain has not been reported as sign or symptom of PE. A 41-year-old woman presenting with left chest pain, no hemoptysis, or breathing difficulties. The chest pain was more severe on deep inspiration. Chest computed tomography (CT) and ultrasound imaging showed left pleural effusion. After antibiotic treatment, the left chest pain was alleviated, but a similar pain appeared in the right chest. Electrocardiogram, blood gas analysis, echocardiography, and D-dimer levels were unremarkable. Chest CT showed right pleural effusion. A CT pulmonary angiography (CTPA) unexpectedly revealed a PE in the right pulmonary artery. The patient was administered anticoagulant therapy and made a complete recovery. The use of CTPA to investigate the possible presence of PE in patients with unexplained migratory pleural effusion complaining of itinerant chest pain is important. Lessons should be learned from the early use of CTPA to investigate the possible presence of PE in patients.

Clogging and transport of driven particles in asymmetric funnel arrays

DOE PAGES

Olson Reichhardt, Cynthia J.; Reichhardt, Charles

2018-05-03

In this paper, we numerically examine the flow and clogging of particles driven through asymmetric funnel arrays when the commensurability ratio of the number of particles per plaquette is varied. The particle-particle interactions are modeled with a soft repulsive potential that could represent vortex flow in type-II superconductors or driven charged colloids. The velocity-force curves for driving in the easy flow direction of the funnels exhibit a single depinning threshold; however, for driving in the hard flow direction, we find that there can be both negative mobility where the velocity decreases with increasing driving force as well as a reentrantmore » pinning effect in which the particles flow at low drives but become pinned at intermediate drives. This reentrant pinning is associated with a transition from smooth one-dimensional flow at low drives to a clogged state at higher drives that occurs when the particles cluster in a small number of plaquettes and block the flow. When the drive is further increased, particle rearrangements occur that cause the clog to break apart. We map out the regimes in which the pinned, flowing, and clogged states appear as a function of plaquette filling and drive. Finally, the clogged states remain robust at finite temperatures but develop intermittent bursts of flow in which a clog temporarily breaks apart but quickly reforms.« less

Clogging and transport of driven particles in asymmetric funnel arrays

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

Olson Reichhardt, Cynthia J.; Reichhardt, Charles

In this paper, we numerically examine the flow and clogging of particles driven through asymmetric funnel arrays when the commensurability ratio of the number of particles per plaquette is varied. The particle-particle interactions are modeled with a soft repulsive potential that could represent vortex flow in type-II superconductors or driven charged colloids. The velocity-force curves for driving in the easy flow direction of the funnels exhibit a single depinning threshold; however, for driving in the hard flow direction, we find that there can be both negative mobility where the velocity decreases with increasing driving force as well as a reentrantmore » pinning effect in which the particles flow at low drives but become pinned at intermediate drives. This reentrant pinning is associated with a transition from smooth one-dimensional flow at low drives to a clogged state at higher drives that occurs when the particles cluster in a small number of plaquettes and block the flow. When the drive is further increased, particle rearrangements occur that cause the clog to break apart. We map out the regimes in which the pinned, flowing, and clogged states appear as a function of plaquette filling and drive. Finally, the clogged states remain robust at finite temperatures but develop intermittent bursts of flow in which a clog temporarily breaks apart but quickly reforms.« less

Acidity of vapor plume from cooling tower mixed with flue gases emitted from coal-fired power plant.

PubMed

Hlawiczka, Stanislaw; Korszun, Katarzyna; Fudala, Janina

2016-06-01

Acidity of products resulting from the reaction of flue gas components emitted from a coal-fired power plant with water contained in a vapor plume from a wet cooling tower was analyzed in a close vicinity of a power plant (710 m from the stack and 315 m from the cooling tower). Samples of this mixture were collected using a precipitation funnel where components of the mixed plumes were discharged from the atmosphere with the rainfall. To identify situations when the precipitation occurred at the same time as the wind directed the mixed vapor and flue gas plumes above the precipitation funnel, an ultrasound anemometer designed for 3D measurements of the wind field located near the funnel was used. Precipitation samples of extremely high acidity were identified - about 5% of samples collected during 12 months showed the acidity below pH=3 and the lowest recorded pH was 1.4. During the measurement period the value of pH characterizing the background acidity of the precipitation was about 6. The main outcome of this study was to demonstrate a very high, and so far completely underestimated, potential of occurrence of episodes of extremely acid depositions in the immediate vicinity of a coal-fired power plant. Copyright © 2016 Elsevier B.V. All rights reserved.

Probing the Magnetic Field Structure in Sgr A* on Black Hole Horizon Scales with Polarized Radiative Transfer Simulations

NASA Astrophysics Data System (ADS)

Gold, Roman; McKinney, Jonathan C.; Johnson, Michael D.; Doeleman, Sheperd S.

2017-03-01

Magnetic fields are believed to drive accretion and relativistic jets in black hole accretion systems, but the magnetic field structure that controls these phenomena remains uncertain. We perform general relativistic (GR) polarized radiative transfer of time-dependent three-dimensional GR magnetohydrodynamical simulations to model thermal synchrotron emission from the Galactic Center source Sagittarius A* (Sgr A*). We compare our results to new polarimetry measurements by the Event Horizon Telescope (EHT) and show how polarization in the visibility (Fourier) domain distinguishes and constrains accretion flow models with different magnetic field structures. These include models with small-scale fields in disks driven by the magnetorotational instability as well as models with large-scale ordered fields in magnetically arrested disks. We also consider different electron temperature and jet mass-loading prescriptions that control the brightness of the disk, funnel-wall jet, and Blandford-Znajek-driven funnel jet. Our comparisons between the simulations and observations favor models with ordered magnetic fields near the black hole event horizon in Sgr A*, though both disk- and jet-dominated emission can satisfactorily explain most of the current EHT data. We also discuss how the black hole shadow can be filled-in by jet emission or mimicked by the absence of funnel jet emission. We show that stronger model constraints should be possible with upcoming circular polarization and higher frequency (349 GHz) measurements.

Nano-lead particle synthesis from waste cathode ray-tube funnel glass.

PubMed

Xing, Mingfei; Zhang, Fu-Shen

2011-10-30

Waste cathode ray-tube (CRT) funnel glass is classified as hazardous waste since it contains high amount of lead. In the present study, a novel process for lead nanopowder synthesis from this type of glass was developed by combining vacuum carbon-thermal reduction and inert-gas consolidation procedures. The key trait of the process was to evaporate lead out of the glass to obtain harmless glass powder and synchronously produce lead nanoparticles. In the synthesis process, lead oxide in the funnel glass was firstly reduced to elemental lead, and evaporated rapidly in vacuum circumstance, then quenched and formed nano-size particles on the surface of the cooling device. Experimental results showed that temperature, pressure and argon gas flow rate were the major parameters controlling lead evaporation ratio and the morphology of lead nanoparticles. The maximum lead evaporation ratio was 96.8% and particles of 4-34 nm were successfully obtained by controlling the temperature, holding time, process pressure, argon gas flow rate at 1000°C, 2-4h, 500-2000 Pa, 50-200 ml/min, respectively. Toxicity characteristic leaching procedure (TCLP) results showed that lead leaching from the residue glass met the USEPA threshold. Accordingly, this study developed a practical and environmental-friendly process for detoxification and reclamation of waste lead-containing glass. Copyright © 2011 Elsevier B.V. All rights reserved.

Nanoplasmonic generation of ultrashort EUV pulses

NASA Astrophysics Data System (ADS)

Choi, Joonhee; Lee, Dong-Hyub; Han, Seunghwoi; Park, In-Yong; Kim, Seungchul; Kim, Seung-Woo

2012-10-01

Ultrashort extreme-ultraviolet (EUV) light pulses are an important tool for time-resolved pump-probe spectroscopy to investigate the ultrafast dynamics of electrons in atoms and molecules. Among several methods available to generate ultrashort EUV light pulses, the nonlinear frequency upconversion process of high-harmonic generation (HHG) draws attention as it is capable of producing coherent EUV pulses with precise control of burst timing with respect to the driving near-infrared (NIR) femtosecond laser. In this report, we present and discuss our recent experimental data obtained by the plasmon-driven HHG method that generate EUV radiation by means of plasmonic nano-focusing of NIR femtosecond pulses. For experiment, metallic waveguides having a tapered hole of funnel shape inside were fabricated by adopting the focused-ion-beam process on a micro-cantilever substrate. The plasmonic field formed within the funnelwaveguides being coupled with the incident femtosecond pulse permitted intensity enhancement by a factor of ~350, which creates a hot spot of sub-wavelength size with intensities strong enough for HHG. Experimental results showed that with injection of noble gases into the funnel-waveguides, EUV radiation is generated up to wavelengths of 32 nm and 29.6 nm from Ar and Ne gas atoms, respectively. Further, it was observed that lower-order EUV harmonics are cut off in the HHG spectra by the tiny exit aperture of the funnel-waveguide.

Intermittent chest tube clamping may shorten chest tube drainage and postoperative hospital stay after lung cancer surgery: a propensity score matching analysis.

PubMed

Yan, Shi; Wang, Xing; Wang, Yaqi; Lv, Chao; Wang, Yuzhao; Wang, Jia; Yang, Yue; Wu, Nan

2017-12-01

Postoperative pleural drainage markedly influences the length of hospital stay and the financial costs of medical care. The safety of chest tube clamping before removal has been documented. This study aims to determine if intermittent chest tube clamping shortens the duration of chest tube drainage and hospital stay after lung cancer surgery. We retrospectively analyzed 285 consecutive patients with operable lung cancer treated using lobectomy and systematic mediastinal lymphadenectomy. The chest tube management protocol in our institution was changed in January 2014, and thus, 222 patients (clamping group) were managed with intermittent chest tube clamping, while 63 patients (control group) were managed with a traditional protocol. Propensity score matching at a 1:1 ratio was applied to balance variables potentially affecting the duration of chest tube drainage. Analyses were performed to compare drainage duration and postoperative hospital stay between the two groups in the matched cohort. Multivariate logistic regression analyses were performed to predict the factors associated with chest tube drainage duration. The rates of thoracocentesis after chest tube removal were similar between the clamping and control groups in the whole cohort (0.5% vs. 1.6%, P=0.386). The rates of pyrexia were also comparable in the two groups (2.3% vs. 3.2%, P=0.685). After propensity score matching, 61 cases remained in each group. Both chest tube drainage duration (3.9 vs. 4.8 days, P=0.001) and postoperative stay (5.7 vs. 6.4 days, P=0.025) were significantly shorter in the clamping group than in the control group. Factors significantly associated with shorter chest tube drainage duration were female sex, chest tube clamping, left lobectomy, and video-assisted thoracoscopic surgery (VATS) (P<0.05). Intermittent postoperative chest tube clamping may decrease the duration of chest tube drainage and postoperative hospital stay while maintaining patient safety.

Tornadoes

MedlinePlus

Tornadoes are nature's most violent storms. They are rotating, funnel-shaped clouds that extend from a thunderstorm ... over a mile wide and 50 miles long. Tornadoes can also accompany tropical storms and hurricanes as ...

Characterization of Pediatric In-Hospital Cardiopulmonary Resuscitation Quality Metrics Across an International Resuscitation Collaborative.

PubMed

Niles, Dana E; Duval-Arnould, Jordan; Skellett, Sophie; Knight, Lynda; Su, Felice; Raymond, Tia T; Sweberg, Todd; Sen, Anita I; Atkins, Dianne L; Friess, Stuart H; de Caen, Allan R; Kurosawa, Hiroshi; Sutton, Robert M; Wolfe, Heather; Berg, Robert A; Silver, Annemarie; Hunt, Elizabeth A; Nadkarni, Vinay M

2018-05-01

Pediatric in-hospital cardiac arrest cardiopulmonary resuscitation quality metrics have been reported in few children less than 8 years. Our objective was to characterize chest compression fraction, rate, depth, and compliance with 2015 American Heart Association guidelines across multiple pediatric hospitals. Retrospective observational study of data from a multicenter resuscitation quality collaborative from October 2015 to April 2017. Twelve pediatric hospitals across United States, Canada, and Europe. In-hospital cardiac arrest patients (age < 18 yr) with quantitative cardiopulmonary resuscitation data recordings. None. There were 112 events yielding 2,046 evaluable 60-second epochs of cardiopulmonary resuscitation (196,669 chest compression). Event cardiopulmonary resuscitation metric summaries (median [interquartile range]) by age: less than 1 year (38/112): chest compression fraction 0.88 (0.61-0.98), chest compression rate 119/min (110-129), and chest compression depth 2.3 cm (1.9-3.0 cm); for 1 to less than 8 years (42/112): chest compression fraction 0.94 (0.79-1.00), chest compression rate 117/min (110-124), and chest compression depth 3.8 cm (2.9-4.6 cm); for 8 to less than 18 years (32/112): chest compression fraction 0.94 (0.85-1.00), chest compression rate 117/min (110-123), chest compression depth 5.5 cm (4.0-6.5 cm). "Compliance" with guideline targets for 60-second chest compression "epochs" was predefined: chest compression fraction greater than 0.80, chest compression rate 100-120/min, and chest compression depth: greater than or equal to 3.4 cm in less than 1 year, greater than or equal to 4.4 cm in 1 to less than 8 years, and 4.5 to less than 6.6 cm in 8 to less than 18 years. Proportion of less than 1 year, 1 to less than 8 years, and 8 to less than 18 years events with greater than or equal to 60% of 60-second epochs meeting compliance (respectively): chest compression fraction was 53%, 81%, and 78%; chest compression rate was 32%, 50%, and 63%; chest compression depth was 13%, 19%, and 44%. For all events combined, total compliance (meeting all three guideline targets) was 10% (11/112). Across an international pediatric resuscitation collaborative, we characterized the landscape of pediatric in-hospital cardiac arrest chest compression quality metrics and found that they often do not meet 2015 American Heart Association guidelines. Guideline compliance for rate and depth in children less than 18 years is poor, with the greatest difficulty in achieving chest compression depth targets in younger children.

Chest tube insertion

MedlinePlus

... leaks from inside the lung into the chest ( pneumothorax ) Fluid buildup in the chest (called a pleural ... on the reason a chest tube is inserted. Pneumothorax most often improves, but sometimes surgery is needed ...

Usefulness of routine computed tomography in the evaluation of penetrating war injuries to the chest.

PubMed

Darwish, Bassam; Mahfouz, Mohammad Z; Izzat, Mohammad Bashar

2018-05-02

This review was conducted to compare the contributions of chest X-ray (CXR) and computed tomography (CT) towards detecting intrathoracic damage in patients with penetrating war injuries to the chest and to determine whether identification of additional injuries by chest CT will have an impact on the choice of therapeutic interventions and clinical outcomes. We reviewed records of 449 patients (374 men, mean age 29.3 ± 14.8 years) who were admitted to our hospital with penetrating war injuries to the chest over a 7-year period. Collected data included mechanisms of injury, associated injuries, results of CXRs and chest CTs, methods of management, in-hospital stays, complications and mortalities. Immediate screening CXRs were obtained in all patients not requiring emergent thoracotomies, of which 91.4% showed positive signs of injury. Chest CTs were performed at the discretion of the physicians in 49.4% of patients, and CXR-positive findings were confirmed in all cases, while revealing additional injuries in 11% of patients. Chest CT findings led to additional closed chest drainage in 5.6% of patients but had no impact on treatment strategy in 94.4% of scanned patients. Follow-up CXRs showed new positive findings in 22 patients, leading to additional closed chest drainage in 3 patients and delayed open thoracotomies in 7 other patients. CXRs continue as the primary diagnostic modality in the assessment of patients with penetrating war injuries to the chest. Chest CTs can be omitted in most patients, thus reducing CT imaging case-load substantially, while most clinically significant chest injuries remain sufficiently recognized.

Diagnostic value of chest radiographs in bedridden patients suspected of having pneumonia.

PubMed

Esayag, Yaacov; Nikitin, Irina; Bar-Ziv, Jacob; Cytter, Ruth; Hadas-Halpern, Irith; Zalut, Todd; Yinnon, Amos M

2010-01-01

To assess the diagnostic value of the chest radiograph for the diagnosis of pneumonia in bedridden patients, using non-contrast-enhanced high-resolution chest computed tomography (CT) as the gold standard. We prospectively evaluated bedridden patients hospitalized with moderate to high clinical probability of pneumonia. Chest radiographs were interpreted in a blinded fashion by 3 observers and classified as definite, normal, or uncertain for pneumonia. Chest CT was obtained within 12 hours of chest radiograph. We applied Bayesian analysis to assess the accuracy of chest radiograph in the diagnosis of pneumonia. In a 5-month period, 58 patients were evaluated, 31 (53%) were female. Their chest radiographs were interpreted as negative, uncertain, or positive for pneumonia in 31 (53%), 15 (26%), and 12 (21%) patients, respectively, while CT confirmed pneumonia in 11 (35%), 10 (67%), and in 10 (83%). The sensitivity of the chest radiograph to diagnose pneumonia was 65%, the specificity was 93%, the positive and negative predictive values were, respectively, 83% and 65%, while the overall accuracy was 69% (95% confidence interval, 50%-79%). In bedridden patients with suspected pneumonia, a normal chest radiograph does not rule out the diagnosis, hence, a chest CT scan might provide valuable diagnostic information. Copyright 2010 Elsevier Inc. All rights reserved.

Use of chest sonography in acute-care radiology☆

PubMed Central

De Luca, C.; Valentino, M.; Rimondi, M.R.; Branchini, M.; Baleni, M. Casadio; Barozzi, L.

2008-01-01

Diagnosis of acute lung disease is a daily challenge for radiologists working in acute-care areas. It is generally based on the results of chest radiography performed under technically unfavorable conditions. Computed tomography (CT) is undoubtedly more accurate in these cases, but it cannot always be performed on critically ill patients who need continuous care. The use of thoracic ultrasonography (US) has recently been proposed for the study of acute lung disease. It can be carried out rapidly at the bedside and does not require any particularly sophisticated equipment. This report analyzes our experience with chest sonography as a supplement to chest radiography in an Emergency Radiology Unit. We performed chest sonography – as an adjunct to chest radiography – on 168 patients with acute chest pathology. Static and dynamic US signs were analyzed in light of radiographic findings and, when possible, CT. The use of chest US improved the authors' ability to provide confident diagnoses of acute disease of the chest and lungs. PMID:23397048

Predicting Chest Wall Pain From Lung Stereotactic Body Radiotherapy for Different Fractionation Schemes

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

Woody, Neil M.; Videtic, Gregory M.M.; Stephans, Kevin L.

Purpose: Recent studies with two fractionation schemes predicted that the volume of chest wall receiving >30 Gy (V30) correlated with chest wall pain after stereotactic body radiation therapy (SBRT) to the lung. This study developed a predictive model of chest wall pain incorporating radiobiologic effects, using clinical data from four distinct SBRT fractionation schemes. Methods and Materials: 102 SBRT patients were treated with four different fractionations: 60 Gy in three fractions, 50 Gy in five fractions, 48 Gy in four fractions, and 50 Gy in 10 fractions. To account for radiobiologic effects, a modified equivalent uniform dose (mEUD) model calculatedmore » the dose to the chest wall with volume weighting. For comparison, V30 and maximum point dose were also reported. Using univariable logistic regression, the association of radiation dose and clinical variables with chest wall pain was assessed by uncertainty coefficient (U) and C statistic (C) of receiver operator curve. The significant associations from the univariable model were verified with a multivariable model. Results: 106 lesions in 102 patients with a mean age of 72 were included, with a mean of 25.5 (range, 12-55) months of follow-up. Twenty patients reported chest wall pain at a mean time of 8.1 (95% confidence interval, 6.3-9.8) months after treatment. The mEUD models, V30, and maximum point dose were significant predictors of chest wall pain (p < 0.0005). mEUD improved prediction of chest wall pain compared with V30 (C = 0.79 vs. 0.77 and U = 0.16 vs. 0.11). The mEUD with moderate weighting (a = 5) better predicted chest wall pain than did mEUD without weighting (a = 1) (C = 0.79 vs. 0.77 and U = 0.16 vs. 0.14). Body mass index (BMI) was significantly associated with chest wall pain (p = 0.008). On multivariable analysis, mEUD and BMI remained significant predictors of chest wall pain (p = 0.0003 and 0.03, respectively). Conclusion: mEUD with moderate weighting better predicted chest wall pain than did V30, indicating that a small chest wall volume receiving a high radiation dose is responsible for chest wall pain. Independently of dose to the chest wall, BMI also correlated with chest wall pain.« less

Kidney stones

MedlinePlus Videos and Cool Tools

... kidneys, ureters, bladder and urethra. Within each kidney, urine flows from the outer cortex to the inner ... The renal pelvis is the funnel through which urine exits the kidney and enters the ureter. As ...

A simple technique for trapping Siren lacertina, Amphiuma means, and other aquatic vertebrates

USGS Publications Warehouse

Johnson, S.A.; Barichivich, W.J.

2004-01-01

We describe a commercially-available funnel trap for sampling aquatic vertebrates. The traps can be used in heavily vegetated wetlands and can be set in water up to 60 cm deep without concern for drowning the animals. They were especially useful for capturing the aquatic salamanders Siren lacertina and Amphiuma means, which have been difficult to capture with traditional sampling methods. They also were effective for sampling small fishes, particularly centrarchids, and larval anurans. In total, 14 species of amphibians, nine species of aquatic reptiles, and at least 32 fish species were captured. The trap we describe differs significantly from traditional funnel traps (e.g., minnow traps) and holds great promise for studies of small, aquatic vertebrates, in particular Siren and Amphiuma species.

Calculation of the Cardiothoracic Ratio from Portable Anteroposterior Chest Radiography

PubMed Central

Chon, Sung Bin; Oh, Won Sup; Cho, Jun Hwi; Kim, Sam Soo

2011-01-01

Cardiothoracic ratio (CTR), the ratio of cardiac diameter (CD) to thoracic diameter (TD), is a useful screening method to detect cardiomegaly, but is reliable only on posteroanterior chest radiography (chest PA). We performed this cross-sectional 3-phase study to establish reliable CTR from anteroposterior chest radiography (chest AP). First, CDChest PA/CDChest AP ratios were determined at different radiation distances by manipulating chest computed tomography to simulate chest PA and AP. CDChest PA was inferred from multiplying CDChest AP by this ratio. Incorporating this CD and substituting the most recent TDChest PA, we calculated the 'corrected' CTR and compared it with the conventional one in patients who took both the chest radiographies. Finally, its validity was investigated among the critically ill patients who performed portable chest AP. CDChest PA/CDChest AP ratio was {0.00099 × (radiation distance [cm])} + 0.79 (n = 61, r = 1.00, P < 0.001). The corrected CTR was highly correlated with the conventional one (n = 34, difference: 0.00016 ± 0.029; r = 0.92, P < 0.001). It was higher in congestive than non-congestive patients (0.53 ± 0.085; n = 38 vs 0.49 ± 0.061; n = 46, P = 0.006). Its sensitivity and specificity was 61% and 54%. In summary, reliable CTR can be calculated from chest AP with an available previous chest PA. This might help physicians detect congestive cardiomegaly for patients undergoing portable chest AP. PMID:22065900

Improved drainage with active chest tube clearance.

PubMed

Shiose, Akira; Takaseya, Tohru; Fumoto, Hideyuki; Arakawa, Yoko; Horai, Tetsuya; Boyle, Edward M; Gillinov, A Marc; Fukamachi, Kiyotaka

2010-05-01

This study was performed to evaluate the efficacy of a novel chest drainage system. This system employs guide wire-based active chest tube clearance to improve drainage and maintain patency. A 32 Fr chest tube was inserted into pleural cavities of five pigs. On the left, a tube was connected to the chest canister, and on the right, the new system was inserted between the chest tube and chest canister. Acute bleeding was mimicked by periodic infusion of blood. The amount of blood drained from each chest cavity was recorded every 15 min for 2 h. After completion of the procedure, all residual blood and clots in each chest cavity were assessed. The new system remained widely patent, and the amount of drainage achieved with this system (670+/-105 ml) was significantly (P=0.01) higher than that with the standard tube (239+/-131 ml). The amount of retained pleural blood and clots with this system (150+/-107 ml) was significantly (P=0.04) lower than that with the standard tube (571+/-248 ml). In conclusion, a novel chest drainage system with active tube clearance significantly improved drainage without tube manipulations. 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

Community-Acquired Pneumonia Visualized on CT Scans but Not Chest Radiographs: Pathogens, Severity, and Clinical Outcomes.

PubMed

Upchurch, Cameron P; Grijalva, Carlos G; Wunderink, Richard G; Williams, Derek J; Waterer, Grant W; Anderson, Evan J; Zhu, Yuwei; Hart, Eric M; Carroll, Frank; Bramley, Anna M; Jain, Seema; Edwards, Kathryn M; Self, Wesley H

2018-03-01

The clinical significance of pneumonia visualized on CT scan in the setting of a normal chest radiograph is uncertain. In a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia (CAP), we compared the presenting clinical features, pathogens present, and outcomes of patients with pneumonia visualized on a CT scan but not on a concurrent chest radiograph (CT-only pneumonia) and those with pneumonia visualized on a chest radiograph. All patients underwent chest radiography; the decision to obtain CT imaging was determined by the treating clinicians. Chest radiographs and CT images were interpreted by study-dedicated thoracic radiologists blinded to the clinical data. The study population included 2,251 adults with CAP; 2,185 patients (97%) had pneumonia visualized on chest radiography, whereas 66 patients (3%) had pneumonia visualized on CT scan but not on concurrent chest radiography. Overall, these patients with CT-only pneumonia had a clinical profile similar to those with pneumonia visualized on chest radiography, including comorbidities, vital signs, hospital length of stay, prevalence of viral (30% vs 26%) and bacterial (12% vs 14%) pathogens, ICU admission (23% vs 21%), use of mechanical ventilation (6% vs 5%), septic shock (5% vs 4%), and inhospital mortality (0 vs 2%). Adults hospitalized with CAP who had radiological evidence of pneumonia on CT scan but not on concurrent chest radiograph had pathogens, disease severity, and outcomes similar to patients who had signs of pneumonia on chest radiography. These findings support using the same management principles for patients with CT-only pneumonia and those with pneumonia seen on chest radiography. Copyright © 2017 American College of Chest Physicians. All rights reserved.

The effect of cold application on pain due to chest tube removal.

PubMed

Ertuğ, Nurcan; Ulker, Saadet

2012-03-01

The aim of the research is to determine the effect of cold application on the pain owing to chest tube removal for patients with single pleural chest tube. Removal of chest tubes causes patients to feel pain and interventions used for reducing the pain owing to the removal of chest tubes are not sufficient. Controlled clinical trial with repeated measures. This study was conducted with 140 patients, of whom 70 patients were in the experimental group and 70 patients were in the control group, in a thoracic hospital in Turkey. Data were collected using a data collection form consisting of patients' demographic and health history and Visual Analogue Scale. Cold was applied to patients in the experimental group prior to chest tube removal. In the experimental group, skin temperature and pain intensity was measured for each patient at four time points. In the control group, pain intensity was evaluated for each patient at three time points. Data were evaluated using Chi-square and Repeated Measurements two-way anova tests. The Visual Analogue Scale score was measured immediately after the chest tube removal in the experimental group was 3·85, compared with 5·60 in the control group. There were significant differences on pain with cold application between the two groups prior and after the intervention. Age, gender, the number of days the chest tube was inserted and the chest tube insertion indication had no effect on the pain owing to chest tube removal. Cold application is effective in reducing the pain owing to chest tube removal. Cold application was recommended prior to chest tube removal to reduce the pain owing to removal of chest tube. © 2011 Blackwell Publishing Ltd.

Selective chest imaging for blunt trauma patients: The national emergency X-ray utilization studies (NEXUS-chest algorithm).

PubMed

Rodriguez, Robert M; Hendey, Gregory W; Mower, William R

2017-01-01

Chest imaging plays a prominent role in blunt trauma patient evaluation, but indiscriminate imaging is expensive, may delay care, and unnecessarily exposes patients to potentially harmful ionizing radiation. To improve diagnostic chest imaging utilization, we conducted 3 prospective multicenter studies over 12years to derive and validate decision instruments (DIs) to guide the use of chest x-ray (CXR) and chest computed tomography (CT). The first DI, NEXUS Chest x-ray, consists of seven criteria (Age >60years; rapid deceleration mechanism; chest pain; intoxication; altered mental status; distracting painful injury; and chest wall tenderness) and exhibits a sensitivity of 99.0% (95% confidence interval [CI] 98.2-99.4%) and a specificity of 13.3% (95% CI, 12.6%-14.0%) for detecting clinically significant injuries. We developed two NEXUS Chest CT DIs, which are both highly reliable in detecting clinically major injuries (sensitivity of 99.2%; 95% CI 95.4-100%). Designed primarily to focus on detecting major injuries, the NEXUS Chest CT-Major DI consists of six criteria (abnormal CXR; distracting injury; chest wall tenderness; sternal tenderness; thoracic spine tenderness; and scapular tenderness) and exhibits higher specificity (37.9%; 95% CI 35.8-40.1%). Designed to reliability detect both major and minor injuries (sensitivity 95.4%; 95% CI 93.6-96.9%) with resulting lower specificity (25.5%; 95% CI 23.5-27.5%), the NEXUS CT-All rule consists of seven elements (the six NEXUS CT-Major criteria plus rapid deceleration mechanism). The purpose of this review is to synthesize the three DIs into a novel, cohesive summary algorithm with practical implementation recommendations to guide selective chest imaging in adult blunt trauma patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Chest Seal Placement for Penetrating Chest Wounds by Prehospital Ground Forces in Afghanistan.

PubMed

Schauer, Steven G; April, Michael D; Naylor, Jason F; Simon, Erica M; Fisher, Andrew D; Cunningham, Cord W; Morissette, Daniel M; Fernandez, Jessie Renee D; Ryan, Kathy L

Thoracic trauma represents 5% of all battlefield injuries. Communicating pneumothoraces resulting in tension physiology remain an important etiology of prehospital mortality. In addressing penetrating chest trauma, current Tactical Combat Casualty Care (TCCC) guidelines advocate the immediate placement of a vented chest seal device. Although the Committee on TCCC (CoTCCC) has approved numerous chest seal devices for battlefield use, few data exist regarding their use in a combat zone setting. To evaluate adherence to TCCC guidelines for chest seal placement among personnel deployed to Afghanistan. We obtained data from the Prehospital Trauma Registry (PHTR). Joint Trauma System personnel linked patients to the Department of Defense Trauma Registry, when available, for outcome data upon reaching a fixed facility. In the PHTR, we identified 62 patients with documented gunshot wound (GSW) or puncture wound trauma to the chest. The majority (74.2%; n = 46) of these were due to GSW, with the remainder either explosive-based puncture wounds (22.6%; n = 14) or a combination of GSW and explosive (3.2%; n = 2). Of the 62 casualties with documented GSW or puncture wounds, 46 (74.2%) underwent chest seal placement. Higher proportions of patients with medical officers in their chain of care underwent chest seal placement than those that did not (63.0% versus 37.0%). The majority of chest seals placed were not vented. Of patients with a GSW or puncture wound to the chest, 74.2% underwent chest seal placement. Most of the chest seals placed were not vented in accordance with guidelines, despite the guideline update midway through the study period. These data suggest the need to improve predeployment training on TCCC guidelines and matching of the Army logistical supply chain to the devices recommended by the CoTCCC. 2017.

Small-bore chest tubes seem to perform better than larger tubes in treatment of spontaneous pneumothorax.

PubMed

Iepsen, Ulrik Winning; Ringbæk, Thomas

2013-06-01

The aim of this study was to compare the efficacy and complications of surgical (large-bore) chest tube drainage with smaller and less invasive chest tubes in the treatment of non-traumatic pneumothorax (PT).  This was a retrospective study of 104 cases (94 patients) of non-traumatic PT treated with chest tubes - either by pulmonary physicians (daytime and weekdays) using small-bore chest tubes, or by orthopaedic surgeons (remaining time slots) using large-bore chest tubes.  A total of 62 had primary spontaneous PT, 30 had secondary spontaneous PT and 12 had iatrogenic PT. A total of 62 patients were treated with large-bore (20-28 Fr) chest tubes placed with traditional thoracotomy, 42 patients were treated by a pulmonary physician, and in 30 of these cases a True-Close thoracic vent (11-13 Fr) was inserted. Patients treated with surgical chest tubes were comparable with patients treated with smaller chest tubes in terms of demographic data and type and size of PT. Compared with patients treated with smaller chest tubes, patients with surgical large-bore tubes had more complications (27.4% versus 9.5%; p = 0.026), a lower success rate (56.5% versus 85.7%; p = 0.002), and longer duration of chest tube (8.3 versus 4.9 days; p = 0.001) and of hospitalisation (11.8 versus 6.9 days; p = 0.004).  We found small chest tubes to be superior to large-bore chest tubes with regard to short-term outcomes in the treatment of non-traumatic PT.  not relevant. The project was approved by the Danish Data Protection Agency, file no. 2012-41-0554. 

Costochondritis

MedlinePlus

Chest wall pain; Costosternal syndrome; Costosternal chondrodynia; Chest pain - costochondritis ... The most common symptom of costochondritis is pain and tenderness in the chest. You may feel: Sharp pain at the front of your chest wall, which may move to your back ...

Unravelling the complex venom landscapes of lethal Australian funnel-web spiders (Hexathelidae: Atracinae) using LC-MALDI-TOF mass spectrometry.

PubMed

Palagi, Alexandre; Koh, Jennifer M S; Leblanc, Mathieu; Wilson, David; Dutertre, Sébastien; King, Glenn F; Nicholson, Graham M; Escoubas, Pierre

2013-03-27

Spider venoms represent vast sources of bioactive molecules whose diversity remains largely unknown. Indeed, only a small subset of species have been studied out of the ~43,000 extant spider species. The present study investigated inter- and intra-species venom complexity in 18 samples collected from a variety of lethal Australian funnel-web spiders (Mygalomorphae: Hexathelidae: Atracinae) using C4 reversed-phase separation coupled to offline MALDI-TOF mass spectrometry (LC-MALDI-TOF MS). An in-depth investigation focusing on four atracine venoms (male Illawarra wisharti, male and female Hadronyche cerberea, and female Hadronyche infensa Toowoomba) revealed, on average, ~800 peptides in female venoms while male venoms contained ~400 peptides, distributed across most HPLC fractions. This is significantly higher than previous estimates of peptide expression in mygalomorph venoms. These venoms also showed distinct intersexual as well as intra- and inter-species variation in peptide masses. Construction of both 3D and 2D contour plots revealed that peptide mass distributions in all 18 venoms were centered around the 3200-5400m/z range and to a lesser extent the 6600-8200m/z range, consistent with previously described hexatoxins. These findings highlight the extensive diversity of peptide toxins in Australian funnel-web spider venoms that that can be exploited as novel therapeutic and biopesticide lead molecules. In the present study we describe the complexity of 18 venoms from lethal Australian funnel-web spiders using LC-MALDI-TOF MS. The study includes an in-depth investigation, focusing on four venoms, that revealed the presence of ~800 peptides in female venoms and ~400 peptides in male venoms. This is significantly higher than previous estimates of peptide expression in spider venoms. By constructing both 3D and 2D contour plots we were also able to reveal the distinct intersexual as well as intra- and inter-species variation in venom peptide masses. We show that peptide mass distributions in all 18 venoms were centered around the 3200-5400 m/z range and to a lesser extent the 6600-8200 m/z range, consistent with the small number of previously described hexatoxins from these spiders. These findings highlight the extensive diversity of peptide toxins in Australian funnel-web spider venoms that that can be exploited as novel therapeutic and biopesticide lead molecules. The present study has greatly expanded our understanding of peptide variety and complexity in these lethal mygalomorph spiders. Specifically it highlights both the utility of LC-MALDI-TOF in spider taxonomy and the massive combinatorial peptide libraries that spider venoms offer the pharmaceutical and agrochemical industry. Copyright © 2013 Elsevier B.V. All rights reserved.

A Simple and Inexpensive Device for Slow, Controlled Addition of a Solution to a Reaction Mixture

NASA Astrophysics Data System (ADS)

Osvath, Peter

1995-07-01

A number of reactions require the slow and controlled addition of a solution containing one reagent to another. Attempting to control the flow rate over a number of hours using a conventional constant pressure addition funnel is a frustrating exercise; commercially available constant volume addition funnels are expensive and must be adjusted by trial and error each time a reaction is carried out. The use of an (expensive) peristaltic pump or syringe pump overcomes these problems but can introduce other complications. We have recently had occasion to carry out the synthesis of thioether macrocycles and cages requiring the slow and controlled addition of DMF solutions of (offensively odoriferous) thiols or (air-sensitive) thiolates to a reactant solution under nitrogen(1), Although the use of a syringe pump was called for, there are obvious difficulties associated with purging the solution and assembling such an apparatus under nitrogen, and we report a simple and inexpensive solution. A Male Luer Lock tip (recovered from a broken syringe) was sweated onto the flattened tip of a pressure-equalizing addition funnel and a syringe needle was attached. Judicious selection of needle length, bore size, and reactant volume can be used to control the addition time simply and reproducibly. With a 250-mL funnel, the flow rate changes by <25% from the beginning to the end of the addition. (In fact, a reduction in the rate of addition may even be advantageous as the reaction proceeds, the reagent in the receiving flask is consumed, its concentration drops, and the rate of reaction will decrease). A piece of fine Teflon tubing of appropriate length attached to the needle can be used to reduce the flow rate even further, but this is only necessary for very slow rates of addition. For example, the time of addition of 200 mL, of an ethanolic solution could be varied from approximately 5 minutes (150mm/17 gauge) to approximately 5 h (200mm/22 gauge), and once the addition time for a particular needle length/bore is determined, the tap on the addition funnel is turned fully on, so no adjustment is necessary. When needles with a particularly fine bore are used, a small plug of glass wool should be inserted in the constriction above the tap, to filter the solution and prevent blockage of the needle. An inert atmosphere is readily maintained throughout the system. The elimination of atmospheric contamination, containment of odors and controlled slow addition have led to improved yields and less complaints from fellow inhabitants of the laboratory! Literature Cited 1. Osvath, P.; Sargeson, A. M.; Skelton, B. W.; White, A. H. J. Chem. Soc., Chem. Commun. 1991, 1036. Osvath. P.; Sargeson, A. J. Chem. Soc., Chem. Commun. 1993, 40.

Retrospective Cohort Analysis of Chest Injury Characteristics and Concurrent Injuries in Patients Admitted to Hospital in the Wenchuan and Lushan Earthquakes in Sichuan, China

PubMed Central

Yuan, Yong; Zhao, Yong-Fan

2014-01-01

Background The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity. Methods We compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients. Results The incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries. Conclusions Previous studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries. PMID:24816485

Retrospective cohort analysis of chest injury characteristics and concurrent injuries in patients admitted to hospital in the Wenchuan and Lushan earthquakes in Sichuan, China.

PubMed

Zheng, Xi; Hu, Yang; Yuan, Yong; Zhao, Yong-Fan

2014-01-01

The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity. We compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients. The incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries. Previous studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries.

Safety and efficacy of 2,790-nm laser resurfacing for chest photoaging.

PubMed

Grunebaum, Lisa D; Murdock, Jennifer; Cofnas, Paul; Kaufman, Joely

2015-01-01

Chest photodamage is a common cosmetic complaint. Laser treatment of the chest may be higher risk than other areas. The objective of this study was to assess the safety and efficacy of 2,790-nm chest resurfacing for photodamage. Twelve patients with Fitzpatrick skin types I-III were enrolled in this university IRB-approved study. Photo documentation was obtained at baseline and each visit. A test spot with the 2,790-nm resurfacing laser was performed on the chest. Patients who did not have adverse effects from the test spot went on to have a full chest resurfacing procedure. Patients were instructed on standardized aftercare, including sunscreen. A 5-point healing and photodamage improvement scale was used to rate improvement by both investigators and the patients and was obtained at 2 weeks, 1 month, 2 months, and 3 months. One pass chest treatment with the 2,790-nm resurfacing laser at fluences greater than or equal to 3.0 mJ with 10% overlap leads to unacceptable rates of hyperpigmentation. Double pass chest treatment at fluences less than or equal to 2.5 mJ with 10% overlap leads to mild improvement in chest photodamage parameters without significant or persistent adverse effects. Laser treatment of aging/photodamaged chest skin remains a challenge due to the delicacy of chest skin. Mild improvement may be obtained with double pass resurfacing with the 2,790-nm wavelength.

[Chest pain units or chest pain algorithm?].

PubMed

Christ, M; Dormann, H; Enk, R; Popp, S; Singler, K; Müller, C; Mang, H

2014-10-01

A large number of patients present to the emergency department (ED) for evaluation of acute chest pain. About 10-15% are caused by acute myocardial infarction (MI), and over 50% of cases are due to noncardiac reasons. Further improvement for chest pain evaluation appears necessary. What are current options to improve chest pain evaluation in Germany? A selective literature search was performed using the following terms: "chest pain", "emergency department", "acute coronary syndrome" and "chest pain evaluation". A working group of the German Society of Cardiology published recommendations for infrastructure, equipment and organisation of chest pain units in Germany, which should be separated from the ED of hospitals and be under the leadership of a cardiologist. A symptom-based decision for acute care would be preferable if all differential diagnoses of diseases could be managed by one medical specialty: However, all four main symptoms of patients with acute MI (chest pain, acute dyspnea, abdominal pain, dizziness) are also caused by diseases of different specialties. Evaluation and treatment of acute chest pain by representatives of one specialty would lead to over- or undertreatment of affected patients. Therefore we suggest a multidisciplinary evaluation of patients with acute chest pain including representatives of emergency and critical care physicians, cardiologists, internists, geriatricians, family physicians, premedics and emergency nurses. Definition of key indicators of performance and institutionalized feedback will help to further improve quality of care.

A System Approach to Navy Medical Education and Training. Appendix 37. Competency Curricula for Respiratory Therapy Assistant and Respiratory Therapy Technician.

DTIC Science & Technology

1974-08-31

of Intermittent Positive Pressure Breathing Treatment . . . . . . . . ... 13 5. Chest Physiotherapy ...... . .. . . . . . 14 6. Respiratory Exercises...12 4 Administration of Intermittent Positive Pressure Breathing Treatment . . .. .. . . . 13 5 Chest Physiotherapy ................... 14...MODULE 5- CHEST PHYSIOTHERAPY TASK(S a. Perform chest vibration and cupping treatmen~t, i.e., chest physiotherapy b. Place patient in postural

A Novel Method of Newborn Chest Compression: A Randomized Crossover Simulation Study.

PubMed

Smereka, Jacek; Szarpak, Lukasz; Ladny, Jerzy R; Rodriguez-Nunez, Antonio; Ruetzler, Kurt

2018-01-01

Objective: To compare a novel two-thumb chest compression technique with standard techniques during newborn resuscitation performed by novice physicians in terms of median depth of chest compressions, degree of full chest recoil, and effective compression efficacy. Patients and Methods: The total of 74 novice physicians with less than 1-year work experience participated in the study. They performed chest compressions using three techniques: (A) The new two-thumb technique (nTTT). The novel method of chest compressions in an infant consists in using two thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist. (B) TFT. With this method, the rescuer compresses the sternum with the tips of two fingers. (C) TTHT. Two thumbs are placed over the lower third of the sternum, with the fingers encircling the torso and supporting the back. Results: The median depth of chest compressions for nTTT was 3.8 (IQR, 3.7-3.9) cm, for TFT-2.1 (IQR, 1.7-2.5) cm, while for TTHT-3.6 (IQR, 3.5-3.8) cm. There was a significant difference between nTTT and TFT, and TTHT and TFT ( p < 0.001) for each time interval during resuscitation. The degree of full chest recoil was 93% (IQR, 91-97) for nTTT, 99% (IQR, 96-100) for TFT, and 90% (IQR, 74-91) for TTHT. There was a statistically significant difference in the degree of complete chest relaxation between nTTT and TFT ( p < 0.001), between nTTT and TTHT ( p = 0.016), and between TFT and TTHT ( p < 0.001). Conclusion: The median chest compression depth for nTTT and TTHT is significantly higher than that for TFT. The degree of full chest recoil was highest for TFT, then for nTTT and TTHT. The effective compression efficiency with nTTT was higher than for TTHT and TFT. Our novel newborn chest compression method in this manikin study provided adequate chest compression depth and degree of full chest recoil, as well as very good effective compression efficiency. Further clinical studies are necessary to confirm these initial results.

Impacts to the chest of PMHSs - Influence of impact location and load distribution on chest response.

PubMed

Holmqvist, Kristian; Svensson, Mats Y; Davidsson, Johan; Gutsche, Andreas; Tomasch, Ernst; Darok, Mario; Ravnik, Dean

2016-02-01

The chest response of the human body has been studied for several load conditions, but is not well known in the case of steering wheel rim-to-chest impact in heavy goods vehicle frontal collisions. The aim of this study was to determine the response of the human chest in a set of simulated steering wheel impacts. PMHS tests were carried out and analysed. The steering wheel load pattern was represented by a rigid pendulum with a straight bar-shaped front. A crash test dummy chest calibration pendulum was utilised for comparison. In this study, a set of rigid bar impacts were directed at various heights of the chest, spanning approximately 120mm around the fourth intercostal space. The impact energy was set below a level estimated to cause rib fracture. The analysed results consist of responses, evaluated with respect to differences in the impacting shape and impact heights on compression and viscous criteria chest injury responses. The results showed that the bar impacts consistently produced lesser scaled chest compressions than the hub; the Middle bar responses were around 90% of the hub responses. A superior bar impact provided lesser chest compression; the average response was 86% of the Middle bar response. For inferior bar impacts, the chest compression response was 116% of the chest compression in the middle. The damping properties of the chest caused the compression to decrease in the high speed bar impacts to 88% of that in low speed impacts. From the analysis it could be concluded that the bar impact shape provides lower chest criteria responses compared to the hub. Further, the bar responses are dependent on the impact location of the chest. Inertial and viscous effects of the upper body affect the responses. The results can be used to assess the responses of human substitutes such as anthropomorphic test devices and finite element human body models, which will benefit the development process of heavy goods vehicle safety systems. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sexual signalling in Propithecus verreauxi: male "chest badge" and female mate choice.

PubMed

Dall'Olio, Stefania; Norscia, Ivan; Antonacci, Daniela; Palagi, Elisabetta

2012-01-01

Communication, an essential prerequisite for sociality, involves the transmission of signals. A signal can be defined as any action or trait produced by one animal, the sender, that produces a change in the behaviour of another animal, the receiver. Secondary sexual signals are often used for mate choice because they may inform on a potential partner's quality. Verreaux's sifaka (Propithecus verreauxi) is characterized by the presence of two different morphs of males (bimorphism), which can show either a stained or clean chest. The chest becomes stained by secretions of the sternal gland during throat marking (rubbing throat and chest on a vertical substrate while smearing the scent deposition). The role of the chest staining in guiding female mate choice was previously hypothesized but never demonstrated probably due to the difficulty of observing sifaka copulations in the wild. Here we report that stained-chested males had a higher throat marking activity than clean-chested males during the mating season, but not during the birth season. We found that females copulated more frequently with stained-chested males than the clean-chested males. Finally, in agreement with the biological market theory, we found that clean-chested males, with a lower scent-releasing potential, offered more grooming to females. This "grooming for sex" tactic was not completely unsuccessful; in fact, half of the clean-chested males copulated with females, even though at low frequency. In conclusion, the chest stain, possibly correlated with different cues targeted by females, could be one of the parameters which help females in selecting mates.

Sexual Signalling in Propithecus verreauxi: Male “Chest Badge” and Female Mate Choice

PubMed Central

Dall'Olio, Stefania; Norscia, Ivan; Antonacci, Daniela; Palagi, Elisabetta

2012-01-01

Communication, an essential prerequisite for sociality, involves the transmission of signals. A signal can be defined as any action or trait produced by one animal, the sender, that produces a change in the behaviour of another animal, the receiver. Secondary sexual signals are often used for mate choice because they may inform on a potential partner's quality. Verreaux's sifaka (Propithecus verreauxi) is characterized by the presence of two different morphs of males (bimorphism), which can show either a stained or clean chest. The chest becomes stained by secretions of the sternal gland during throat marking (rubbing throat and chest on a vertical substrate while smearing the scent deposition). The role of the chest staining in guiding female mate choice was previously hypothesized but never demonstrated probably due to the difficulty of observing sifaka copulations in the wild. Here we report that stained-chested males had a higher throat marking activity than clean-chested males during the mating season, but not during the birth season. We found that females copulated more frequently with stained-chested males than the clean-chested males. Finally, in agreement with the biological market theory, we found that clean-chested males, with a lower scent-releasing potential, offered more grooming to females. This “grooming for sex” tactic was not completely unsuccessful; in fact, half of the clean-chested males copulated with females, even though at low frequency. In conclusion, the chest stain, possibly correlated with different cues targeted by females, could be one of the parameters which help females in selecting mates. PMID:22615982

Optimal control of CPR procedure using hemodynamic circulation model

DOEpatents

Lenhart, Suzanne M.; Protopopescu, Vladimir A.; Jung, Eunok

2007-12-25

A method for determining a chest pressure profile for cardiopulmonary resuscitation (CPR) includes the steps of representing a hemodynamic circulation model based on a plurality of difference equations for a patient, applying an optimal control (OC) algorithm to the circulation model, and determining a chest pressure profile. The chest pressure profile defines a timing pattern of externally applied pressure to a chest of the patient to maximize blood flow through the patient. A CPR device includes a chest compressor, a controller communicably connected to the chest compressor, and a computer communicably connected to the controller. The computer determines the chest pressure profile by applying an OC algorithm to a hemodynamic circulation model based on the plurality of difference equations.

Herniation of unruptured tuberculous lung abscess into chest wall without pleural or bronchial spillage

PubMed Central

Magazine, Rahul; Mohapatra, Aswini K.; Manu, Mohan K.; Srivastava, Rajendra K.

2011-01-01

A 22-year-old unmarried man presented to the chest outpatient department with a history of productive cough of two-month duration. He also complained of pain and swelling on the anterior aspect of right side of chest of one-month duration. Imaging studies of the thorax, including chest roentgenography and computerized tomography, revealed an unruptured lung abscess which had herniated into the chest wall. Culture of pus aspirated from the chest wall swelling grew Mycobacterium tuberculosis. He was diagnosed to have a tuberculous lung abscess which had extended into the chest wall, without spillage into the pleural cavity or the bronchial tree. Antituberculosis drugs were prescribed, and he responded to the treatment with complete resolution of the lesion. PMID:22084547

Update on mechanical cardiopulmonary resuscitation devices.

PubMed

Rubertsson, Sten

2016-06-01

The aim of this review is to update and discuss the use of mechanical chest compression devices in treatment of cardiac arrest. Three recently published large multicenter randomized trials have not been able to show any improved outcome in adult out-of-hospital cardiac arrest patients when compared with manual chest compressions. Mechanical chest compression devices have been developed to better deliver uninterrupted chest compressions of good quality. Prospective large randomized studies have not been able to prove a better outcome compared to manual chest compressions; however, latest guidelines support their use when high-quality manual chest compressions cannot be delivered. Mechanical chest compressions can also be preferred during transportation, in the cath-lab and as a bridge to more invasive support like extracorporeal membrane oxygenation.

Group A beta-haemolytic streptococcal acute chest event in a child with sickle cell anaemia.

PubMed

Suara, R O

2001-06-01

Acute chest syndrome is a major cause of death and hospitalisation in children with sickle cell anaemia. It is often initiated by an infection, particularly pneumonia. Microbial agents previously not associated with acute chest syndrome are becoming increasingly important. Group A beta-haemolytic Streptococcus (GABHS) is thought to be an uncommon cause of pneumonia in children with sickle cell anaemia. We report a 15-year-old African-American girl who presented with an acute chest event characterised by fever, cough, chest pain, shortness of breath, right upper abdominal quadrant pain, jaundice and otitis media. Chest radiograph showed multi-lobar pneumonia with left pleural effusion. Group A beta-haemolytic Streptococcus was isolated from culture of pleural and middle ear fluids. She responded to therapy that included antibiotics, exchange blood transfusion, oxygen, thoracotomy chest tube drainage and decortication. In a child with sickle cell anaemia presenting with fever and an acute chest event, pneumonia should be considered and GABHS recognised as a possible aetiological agent. In addition, a chest X-ray should be obtained and antibiotics against agents causing community-acquired pneumonia instituted.

Reconstruction of chest wall using a two-layer prolene mesh and bone cement sandwich.

PubMed

Aghajanzadeh, Manouchehr; Alavi, Ali; Aghajanzadeh, Gilda; Ebrahimi, Hannan; Jahromi, Sina Khajeh; Massahnia, Sara

2015-02-01

Wide surgical resection is the most effective treatment for the vast majority of chest wall tumors. This study evaluated the clinical success of chest wall reconstruction using a Prolene mesh and bone cement prosthetic sandwich. The records of all patients undergoing chest wall resection and reconstruction were reviewed. Surgical indications, the location and size of the chest wall defect, diaphragm resection, pulmonary performance, postoperative complications, and survival of each patient were recorded. From 1998 to 2008, 43 patients (27 male, 16 female; mean age of 48 years) underwent surgery in our department to treat malignant chest wall tumors: chondrosarcoma (23), osteosarcoma (8), spindle cell sarcoma (6), Ewing's sarcoma (2), and others (4). Nine sternectomies and 34 antero-lateral and postero-lateral chest wall resections were performed. Postoperatively, nine patients experienced respiratory complications, and one patient died because of respiratory failure. The overall 4-year survival rate was 60 %. Chest wall reconstruction using a Prolene mesh and bone cement prosthetic sandwich is a safe and effective surgical procedure for major chest wall defects.

Chest Fat Quantification via CT Based on Standardized Anatomy Space in Adult Lung Transplant Candidates

PubMed Central

Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.; Odhner, Dewey; Wu, Caiyun; Pednekar, Gargi; Palmer, Scott; Rozenshtein, Anna; Shirk, Melissa A.; Newell, John D.; Porteous, Mary; Diamond, Joshua M.

2017-01-01

Purpose Overweight and underweight conditions are considered relative contraindications to lung transplantation due to their association with excess mortality. Yet, recent work suggests that body mass index (BMI) does not accurately reflect adipose tissue mass in adults with advanced lung diseases. Alternative and more accurate measures of adiposity are needed. Chest fat estimation by routine computed tomography (CT) imaging may therefore be important for identifying high-risk lung transplant candidates. In this paper, an approach to chest fat quantification and quality assessment based on a recently formulated concept of standardized anatomic space (SAS) is presented. The goal of the paper is to seek answers to several key questions related to chest fat quantity and quality assessment based on a single slice CT (whether in the chest, abdomen, or thigh) versus a volumetric CT, which have not been addressed in the literature. Methods Unenhanced chest CT image data sets from 40 adult lung transplant candidates (age 58 ± 12 yrs and BMI 26.4 ± 4.3 kg/m2), 16 with chronic obstructive pulmonary disease (COPD), 16 with idiopathic pulmonary fibrosis (IPF), and the remainder with other conditions were analyzed together with a single slice acquired for each patient at the L5 vertebral level and mid-thigh level. The thoracic body region and the interface between subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in the chest were consistently defined in all patients and delineated using Live Wire tools. The SAT and VAT components of chest were then segmented guided by this interface. The SAS approach was used to identify the corresponding anatomic slices in each chest CT study, and SAT and VAT areas in each slice as well as their whole volumes were quantified. Similarly, the SAT and VAT components were segmented in the abdomen and thigh slices. Key parameters of the attenuation (Hounsfield unit (HU) distributions) were determined from each chest slice and from the whole chest volume separately for SAT and VAT components. The same parameters were also computed from the single abdominal and thigh slices. The ability of the slice at each anatomic location in the chest (and abdomen and thigh) to act as a marker of the measures derived from the whole chest volume was assessed via Pearson correlation coefficient (PCC) analysis. Results The SAS approach correctly identified slice locations in different subjects in terms of vertebral levels. PCC between chest fat volume and chest slice fat area was maximal at the T8 level for SAT (0.97) and at the T7 level for VAT (0.86), and was modest between chest fat volume and abdominal slice fat area for SAT and VAT (0.73 and 0.75, respectively). However, correlation was weak for chest fat volume and thigh slice fat area for SAT and VAT (0.52 and 0.37, respectively), and for chest fat volume for SAT and VAT and BMI (0.65 and 0.28, respectively). These same single slice locations with maximal PCC were found for SAT and VAT within both COPD and IPF groups. Most of the attenuation properties derived from the whole chest volume and single best chest slice for VAT (but not for SAT) were significantly different between COPD and IPF groups. Conclusions This study demonstrates a new way of optimally selecting slices whose measurements may be used as markers of similar measurements made on the whole chest volume. The results suggest that one or two slices imaged at T7 and T8 vertebral levels may be enough to estimate reliably the total SAT and VAT components of chest fat and the quality of chest fat as determined by attenuation distributions in the entire chest volume. PMID:28046024

Chest Fat Quantification via CT Based on Standardized Anatomy Space in Adult Lung Transplant Candidates.

PubMed

Tong, Yubing; Udupa, Jayaram K; Torigian, Drew A; Odhner, Dewey; Wu, Caiyun; Pednekar, Gargi; Palmer, Scott; Rozenshtein, Anna; Shirk, Melissa A; Newell, John D; Porteous, Mary; Diamond, Joshua M; Christie, Jason D; Lederer, David J

2017-01-01

Overweight and underweight conditions are considered relative contraindications to lung transplantation due to their association with excess mortality. Yet, recent work suggests that body mass index (BMI) does not accurately reflect adipose tissue mass in adults with advanced lung diseases. Alternative and more accurate measures of adiposity are needed. Chest fat estimation by routine computed tomography (CT) imaging may therefore be important for identifying high-risk lung transplant candidates. In this paper, an approach to chest fat quantification and quality assessment based on a recently formulated concept of standardized anatomic space (SAS) is presented. The goal of the paper is to seek answers to several key questions related to chest fat quantity and quality assessment based on a single slice CT (whether in the chest, abdomen, or thigh) versus a volumetric CT, which have not been addressed in the literature. Unenhanced chest CT image data sets from 40 adult lung transplant candidates (age 58 ± 12 yrs and BMI 26.4 ± 4.3 kg/m2), 16 with chronic obstructive pulmonary disease (COPD), 16 with idiopathic pulmonary fibrosis (IPF), and the remainder with other conditions were analyzed together with a single slice acquired for each patient at the L5 vertebral level and mid-thigh level. The thoracic body region and the interface between subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in the chest were consistently defined in all patients and delineated using Live Wire tools. The SAT and VAT components of chest were then segmented guided by this interface. The SAS approach was used to identify the corresponding anatomic slices in each chest CT study, and SAT and VAT areas in each slice as well as their whole volumes were quantified. Similarly, the SAT and VAT components were segmented in the abdomen and thigh slices. Key parameters of the attenuation (Hounsfield unit (HU) distributions) were determined from each chest slice and from the whole chest volume separately for SAT and VAT components. The same parameters were also computed from the single abdominal and thigh slices. The ability of the slice at each anatomic location in the chest (and abdomen and thigh) to act as a marker of the measures derived from the whole chest volume was assessed via Pearson correlation coefficient (PCC) analysis. The SAS approach correctly identified slice locations in different subjects in terms of vertebral levels. PCC between chest fat volume and chest slice fat area was maximal at the T8 level for SAT (0.97) and at the T7 level for VAT (0.86), and was modest between chest fat volume and abdominal slice fat area for SAT and VAT (0.73 and 0.75, respectively). However, correlation was weak for chest fat volume and thigh slice fat area for SAT and VAT (0.52 and 0.37, respectively), and for chest fat volume for SAT and VAT and BMI (0.65 and 0.28, respectively). These same single slice locations with maximal PCC were found for SAT and VAT within both COPD and IPF groups. Most of the attenuation properties derived from the whole chest volume and single best chest slice for VAT (but not for SAT) were significantly different between COPD and IPF groups. This study demonstrates a new way of optimally selecting slices whose measurements may be used as markers of similar measurements made on the whole chest volume. The results suggest that one or two slices imaged at T7 and T8 vertebral levels may be enough to estimate reliably the total SAT and VAT components of chest fat and the quality of chest fat as determined by attenuation distributions in the entire chest volume.

Chest X-Ray (Chest Radiography)

MedlinePlus

... may be necessary to clarify the results of a chest x-ray or to look for abnormalities not visible on the chest x-ray. top of page Additional Information and Resources RTAnswers.org Radiation Therapy for Lung Cancer top of page This page ...

Tube thoracostomy; chest tube implantation and follow up

PubMed Central

Kuhajda, Ivan; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Huang, Haidong; Li, Qiang; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Papaiwannou, Antonis; Lampaki, Sofia; Papaiwannou, Antonis; Zaric, Bojan; Branislav, Perin; Porpodis, Konstantinos

2014-01-01

Pneumothorax is an urgent medical situation that requires urgent treatment. We can divide this entity based on the etiology to primary and secondary. Chest tube implantation can be performed either in the upper chest wall or lower. Both thoracic surgeons and pulmonary physicians can place a chest tube with minimal invasive techniques. In our current work, we will demonstrate chest tube implantation to locations, methodology and tools. PMID:25337405

Advances in chest drain management in thoracic disease

PubMed Central

George, Robert S.

2016-01-01

An adequate chest drainage system aims to drain fluid and air and restore the negative pleural pressure facilitating lung expansion. In thoracic surgery the post-operative use of the conventional underwater seal chest drainage system fulfills these requirements, however they allow great variability amongst practices. In addition they do not offer accurate data and they are often inconvenient to both patients and hospital staff. This article aims to simplify the myths surrounding the management of chest drains following chest surgery, review current experience and explore the advantages of modern digital chest drain systems and address their disease-specific use. PMID:26941971

Management of Congenital Chest Wall Deformities

PubMed Central

Blanco, Felix C.; Elliott, Steven T.; Sandler, Anthony D.

2011-01-01

Congenital chest wall deformities are considered to be anomalies in chest wall growth. These can be categorized as either rib cage overgrowth or deformities related to inadequate growth (aplasia or dysplasia). Rib cage overgrowth leads to depression of the sternum (pectus excavatum) or protuberance of the sternum (pectus carinatum) and accounts for greater than 90% of congenital chest wall deformities. The remaining deformities are a result of inadequate growth. Evolution in the management of congenital chest wall deformities has made significant progress over the past 25 years. This article will review chest wall deformities and the current management strategies of these interesting anomalies. PMID:22294949

Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients.

PubMed

Omar, Hesham R; Mangar, Devanand; Khetarpal, Suneel; Shapiro, David H; Kolla, Jaya; Rashad, Rania; Helal, Engy; Camporesi, Enrico M

2011-09-27

Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP) chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a true occult pneumothorax where an initial AP chest X-ray revealed no evidence of pneumothorax and a CT chest immediately performed revealed evidence of pneumothorax. The second case represents an example of a missed rather than a truly occult pneumothorax where the initial chest radiograph revealed clues suggesting the presence of pneumothorax which were missed by the reading radiologist. The third case emphasizes the fact that "occult pneumothorax is predictable". The presence of subcutaneous emphesema and pulmonary contusion should call for further imaging with CT chest to rule out pneumothorax. Thoracic CT scan is therefore the "gold standard" for early detection of a pneumothorax in trauma patients. This report aims to sensitize readers to the entity of occult pneumothorax and create awareness among intensivists and ER physicians regarding the proper diagnosis and management.

Sound transmission in the chest under surface excitation - An experimental and computational study with diagnostic applications

PubMed Central

Peng, Ying; Dai, Zoujun; Mansy, Hansen A.; Sandler, Richard H.; Balk, Robert A; Royston, Thomas. J

2014-01-01

Chest physical examination often includes performing chest percussion, which involves introducing sound stimulus to the chest wall and detecting an audible change. This approach relies on observations that underlying acoustic transmission, coupling, and resonance patterns can be altered by chest structure changes due to pathologies. More accurate detection and quantification of these acoustic alterations may provide further useful diagnostic information. To elucidate the physical processes involved, a realistic computer model of sound transmission in the chest is helpful. In the present study, a computational model was developed and validated by comparing its predictions with results from animal and human experiments which involved applying acoustic excitation to the anterior chest while detecting skin vibrations at the posterior chest. To investigate the effect of pathology on sound transmission, the computational model was used to simulate the effects of pneumothorax on sounds introduced at the anterior chest and detected at the posterior. Model predictions and experimental results showed similar trends. The model also predicted wave patterns inside the chest, which may be used to assess results of elastography measurements. Future animal and human tests may expand the predictive power of the model to include acoustic behavior for a wider range of pulmonary conditions. PMID:25001497

Chest Reconstruction and Chest Dysphoria in Transmasculine Minors and Young Adults: Comparisons of Nonsurgical and Postsurgical Cohorts.

PubMed

Olson-Kennedy, Johanna; Warus, Jonathan; Okonta, Vivian; Belzer, Marvin; Clark, Leslie F

2018-05-01

Transmasculine youth, who are assigned female at birth but have a gender identity along the masculine spectrum, often report considerable distress after breast development (chest dysphoria). Professional guidelines lack clarity regarding referring minors (defined as people younger than 18 years) for chest surgery because there are no data documenting the effect of chest surgery on minors. To examine the amount of chest dysphoria in transmasculine youth who had had chest reconstruction surgery compared with those who had not undergone this surgery. Using a novel measure of chest dysphoria, this cohort study at a large, urban, hospital-affiliated ambulatory clinic specializing in transgender youth care collected survey data about testosterone use and chest distress among transmasculine youth and young adults. Additional information about regret and adverse effects was collected from those who had undergone surgery. Eligible youth were 13 to 25 years old, had been assigned female at birth, and had an identified gender as something other than female. Recruitment occurred during clinical visits and via telephone between June 2016 and December 2016. Surveys were collected from participants who had undergone chest surgery at the time of survey collection and an equal number of youth who had not undergone surgery. Outcomes were chest dysphoria composite score (range 0-51, with higher scores indicating greater distress) in all participants; desire for chest surgery in patients who had not had surgery; and regret about surgery and complications of surgery in patients who were postsurgical. Of 136 completed surveys, 68 (50.0%) were from postsurgical participants, and 68 (50.0%) were from nonsurgical participants. At the time of the survey, the mean (SD) age was 19 (2.5) years for postsurgical participants and 17 (2.5) years for nonsurgical participants. Chest dysphoria composite score mean (SD) was 29.6 (10.0) for participants who had not undergone chest reconstruction, which was significantly higher than mean (SD) scores in those who had undergone this procedure (3.3 [3.8]; P < .001). Among the nonsurgical cohort, 64 (94%) perceived chest surgery as very important, and chest dysphoria increased by 0.33 points each month that passed between a youth initiating testosterone therapy and undergoing surgery. Among the postsurgical cohort, the most common complication of surgery was loss of nipple sensation, whether temporary (59%) or permanent (41%). Serious complications were rare and included postoperative hematoma (10%) and complications of anesthesia (7%). Self-reported regret was near 0. Chest dysphoria was high among presurgical transmasculine youth, and surgical intervention positively affected both minors and young adults. Given these findings, professional guidelines and clinical practice should consider patients for chest surgery based on individual need rather than chronologic age.

Pectus excavatum repair from a plastic surgeon's perspective.

PubMed

Schwabegger, Anton H

2016-09-01

Minimally invasive repair of pectus excavatum (MIRPE) or similar procedures for pectus excavatum (PE) repair, nowadays no longer performed by one single speciality, may not always achieve sufficient aesthetic results, particularly in the infrapectoral or infraxiphoidal region. Reasons for this include the diaphragm inhibiting correct positioning of the bars, as well as asymmetric deformities which may still be present after remodelling attempts. Furthermore, some cases develop a mild recurrence or partial concavity once the correction bar is removed. However, any secondary re-do MIRPE procedure remains risky because of adhesions between the pleura, lung, pericardium, thoracic wall as residuals from the primary intervention. Treatment options as secondary correction for these deformities may include open access surgery, resection or reshaping of deformed costal cartilage. Moreover, augmentation of a residual concave area can be achieved by autologous transplantation of resected over-abundant cartilage, as well as by liposhifting or implantation of customized alloplastics. A physician dealing with PE corrections should be familiar with various shaping and complementary reconstructive techniques in order to provide the best options for a variety of expressions of anterior wall deformities. Among treating surgeons, there is an awareness that no single method can be applied for every kind of funnel chest deformity. An appropriate technique, either as a single approach for the ordinary deformities or in conjunction with ancillary procedures for the intricate cases, should be selected carefully based on the heterogeneity of symptoms, severity, expectations and surgical skill in addition to the available equipment. Out of a variety of such ancillary procedures available and based on experience within general plastic reconstructive surgery, some techniques for PE repair are explained and illustrated here with their advantages and disadvantages.

Pectus excavatum repair from a plastic surgeon’s perspective

PubMed Central

2016-01-01

Minimally invasive repair of pectus excavatum (MIRPE) or similar procedures for pectus excavatum (PE) repair, nowadays no longer performed by one single speciality, may not always achieve sufficient aesthetic results, particularly in the infrapectoral or infraxiphoidal region. Reasons for this include the diaphragm inhibiting correct positioning of the bars, as well as asymmetric deformities which may still be present after remodelling attempts. Furthermore, some cases develop a mild recurrence or partial concavity once the correction bar is removed. However, any secondary re-do MIRPE procedure remains risky because of adhesions between the pleura, lung, pericardium, thoracic wall as residuals from the primary intervention. Treatment options as secondary correction for these deformities may include open access surgery, resection or reshaping of deformed costal cartilage. Moreover, augmentation of a residual concave area can be achieved by autologous transplantation of resected over-abundant cartilage, as well as by liposhifting or implantation of customized alloplastics. A physician dealing with PE corrections should be familiar with various shaping and complementary reconstructive techniques in order to provide the best options for a variety of expressions of anterior wall deformities. Among treating surgeons, there is an awareness that no single method can be applied for every kind of funnel chest deformity. An appropriate technique, either as a single approach for the ordinary deformities or in conjunction with ancillary procedures for the intricate cases, should be selected carefully based on the heterogeneity of symptoms, severity, expectations and surgical skill in addition to the available equipment. Out of a variety of such ancillary procedures available and based on experience within general plastic reconstructive surgery, some techniques for PE repair are explained and illustrated here with their advantages and disadvantages. PMID:27747184

Riociguat for the treatment of chronic thromboembolic pulmonary hypertension: a long-term extension study (CHEST-2).

PubMed

Simonneau, Gérald; D'Armini, Andrea M; Ghofrani, Hossein-Ardeschir; Grimminger, Friedrich; Hoeper, Marius M; Jansa, Pavel; Kim, Nick H; Wang, Chen; Wilkins, Martin R; Fritsch, Arno; Davie, Neil; Colorado, Pablo; Mayer, Eckhard

2015-05-01

Riociguat is a soluble guanylate cyclase stimulator approved for the treatment of inoperable and persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH). In the 16-week CHEST-1 study, riociguat showed a favourable benefit-risk profile and improved several clinically relevant end-points in patients with CTEPH. The CHEST-2 open-label extension evaluated the long-term safety and efficacy of riociguat. Eligible patients from CHEST-1 received riociguat individually adjusted up to a maximum dose of 2.5 mg three times daily. The primary objective was the safety and tolerability of riociguat; exploratory efficacy end-points included 6-min walking distance (6MWD) and World Health Organization (WHO) functional class (FC). Overall, 237 patients entered CHEST-2 and 211 (89%) were ongoing at this interim analysis (March 2013). The safety profile of riociguat in CHEST-2 was similar to CHEST-1, with no new safety signals. Improvements in 6MWD and WHO FC observed in CHEST-1 persisted for up to 1 year in CHEST-2. In the observed population at 1 year, mean±sd 6MWD had changed by +51±62 m (n=172) versus CHEST-1 baseline (n=237), and WHO FC had improved/stabilised/worsened in 47/50/3% of patients (n=176) versus CHEST-1 baseline (n=236). Long-term riociguat had a favourable benefit-risk profile and apparently showed sustained benefits in exercise and functional capacity for up to 1 year. Copyright ©ERS 2015.

The effect of a chest imaging lecture on emergency department doctors' ability to interpret chest CT images: a randomized study.

PubMed

Keijzers, Gerben; Sithirasenan, Vasugi

2012-02-01

To assess the chest computed tomography (CT) imaging interpreting skills of emergency department (ED) doctors and to study the effect of a CT chest imaging interpretation lecture on these skills. Sixty doctors in two EDs were randomized, using computerized randomization, to either attend a chest CT interpretation lecture or not to attend this lecture. Within 2 weeks of the lecture, the participants completed a questionnaire on demographic variables, anatomical knowledge, and diagnostic interpretation of 10 chest CT studies. Outcome measures included anatomical knowledge score, diagnosis score, and the combined overall score, all expressed as a percentage of correctly answered questions (0-100). Data on 58 doctors were analyzed, of which 27 were randomized to attend the lecture. The CT interpretation lecture did not have an effect on anatomy knowledge scores (72.9 vs. 70.2%), diagnosis scores (71.2 vs. 69.2%), or overall scores (71.4 vs. 69.5%). Twenty-nine percent of doctors stated that they had a systematic approach to chest CT interpretation. Overall self-perceived competency for interpreting CT imaging (brain, chest, abdomen) was low (between 3.2 and 5.2 on a 10-point Visual Analogue Scale). A single chest CT interpretation lecture did not improve chest CT interpretation by ED doctors. Less than one-third of doctors had a systematic approach to chest CT interpretation. A standardized systematic approach may improve interpretation skills.

Chest pain in patients with arterial hypertension, angiographically normal coronary arteries and stiff aorta: the aortic pain syndrome.

PubMed

Stakos, Dimitrios A; Tziakas, Dimitrios N; Chalikias, George; Mitrousi, Konstantina; Tsigalou, Christina; Boudoulas, Harisios

2013-01-01

Arterial hypertension is often associated with a stiff aorta as a result of collagen accumulation in the aortic wall and may produce chest pain. In the present study, possible interrelationships between aortic function, collagen turnover and exercise-induced chest pain in patients with arterial hypertension and angiographically normal coronary arteries were investigated. Ninety-seven patients with arterial hypertension, angiographically normal coronary arteries and no evidence of myocardial ischemia on nuclear cardiac imaging during exercise test were studied. Of these, 43 developed chest pain during exercise (chest pain group) while 54 did not (no chest pain group). Carotid femoral pulse-wave velocity (PWVc-f) was used to assess the elastic properties of the aorta. Amino-terminal pro-peptides of pro-collagen type I, (PINP, reflecting collagen synthesis), serum telopeptides of collagen type I (CITP, reflecting collagen degradation), pro-metalloproteinase 1 (ProMMP-1), and tissue inhibitor of metalloproteinase 1 (TIMP-1, related to collagen turnover) were measured in plasma by immunoassay. The chest pain group had higher PWVc-f, higher and /CITP ratio, and lower proMMP-1/ TIMP-1 ratio compared to the no chest pain group. PWVc-f (t=2.53, p=0.02) and PINP (t=2.42, p=0.02) were independently associated with the presence of chest pain in multiple regression analysis. Patients with arterial hypertension, exercise-induced chest pain and angiographically normal coronary arteries, without evidence of exercise-induced myocardial ischemia, had a stiffer aorta compared to those without chest pain. Alterations in collagen type I turnover that favor collagen accumulation in the aortic wall may contribute to aortic stiffening and chest pain in these patients.

Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures.

PubMed

Chapman, Brandon C; Overbey, Douglas M; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T; French, Andrew; Johnson, Jeffrey L; Burlew, Clay C; Barnett, Carlton; Moore, Ernest E; Pieracci, Fredric M

2016-12-01

Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest. The CT finding of ≥ 3 additional fractures in patients with ≤ 3 rib fractures on CXR was considered clinically meaningful. Student's t-test and chi-square analysis were used for comparison. We identified 499 patients with rib fractures: 93 (18.6%) had CXR only, 7 (1.4%) had chest CT only, and 399 (79.9%) had both CXR and chest CT. Among these 399 patients, a total of 1,969 rib fractures were identified: 1,467 (74.5%) were missed by CXR. The median number of additional fractures identified by CT was 3 (range, 4 - 15). Of 212 (53.1%) patients with a clinically meaningful increase in the number of fractures, 68 patients underwent one or more clinical interventions: 36 SICU admissions, 20 pain catheter placements, 23 epidural placements, and 3 SSRF. Additionally, 70 patients had a chest tube placed for retained hemothorax or occult pneumothorax. Overall, 138 patients (34.5%) had a change in clinical management based upon CT chest. The chest X-ray missed ~75% of rib fractures seen on chest CT. Although patients with a clinical meaningful increase in the number of rib fractures were more likely to be admitted to the intensive care unit, there was no associated improvement in pulmonary outcomes.

The single chest tube versus double chest tube application after pulmonary lobectomy: A systematic review and meta-analysis.

PubMed

Zhang, Xuefei; Lv, Desheng; Li, Mo; Sun, Ge; Liu, Changhong

2016-12-01

Draining of the chest cavity with two chest tubes after pulmonary lobectomy is a common practice. The objective of this study was to evaluate whether using two tubes after a pulmonary lobectomy is more effective than using a single tube. We performed a meta-analysis of five randomized studies that compared the single chest tube with double chest tube application after pulmonary lobectomy. The primary end-point was amount of drainage and duration of chest tube drainage. The secondary end-points were the patient's numbers of new drain insertion after operation, hospital stay after operation, the patient's numbers of subcutaneous emphysema after operation, the patient's numbers of residual pleural air space, pain score, the number of patients who need thoracentesis, and cost. Five randomized controlled trials totaling 502 patients were included. Meta-analysis results are as follows: There were statistically significant differences in amount of drainage (risk ratio [RR] = -0.15; 95% confidence interval [CI] = -3.17, -0.12, P = 0. 03), duration of chest tube drainage (RR = -0.43; 95% CI = -0.57, -0.19, P = 0.02), pain score (P < 0.05). Compared with patients receiving the double chest tube group, there were no statistically significant differences between the two groups with regard to the patient's numbers of new drain insertion after operation. Compared with the double chest tube, the single chest tube significantly decreases amount of drainage, duration of chest tube drainage, pain score, the number of patients who need thoracentesis, and cost. Although there is convincing evidence to confirm the results mentioned herein, they still need to be confirmed by large-sample, multicenter, randomized, controlled trials.

Comparison of chest compression quality between the modified chest compression method with the use of smartphone application and the standardized traditional chest compression method during CPR.

PubMed

Park, Sang-Sub

2014-01-01

The purpose of this study is to grasp difference in quality of chest compression accuracy between the modified chest compression method with the use of smartphone application and the standardized traditional chest compression method. Participants were progressed 64 people except 6 absentees among 70 people who agreed to participation with completing the CPR curriculum. In the classification of group in participants, the modified chest compression method was called as smartphone group (33 people). The standardized chest compression method was called as traditional group (31 people). The common equipments in both groups were used Manikin for practice and Manikin for evaluation. In the meantime, the smartphone group for application was utilized Android and iOS Operating System (OS) of 2 smartphone products (G, i). The measurement period was conducted from September 25th to 26th, 2012. Data analysis was used SPSS WIN 12.0 program. As a result of research, the proper compression depth (mm) was shown the proper compression depth (p< 0.01) in traditional group (53.77 mm) compared to smartphone group (48.35 mm). Even the proper chest compression (%) was formed suitably (p< 0.05) in traditional group (73.96%) more than smartphone group (60.51%). As for the awareness of chest compression accuracy, the traditional group (3.83 points) had the higher awareness of chest compression accuracy (p< 0.001) than the smartphone group (2.32 points). In the questionnaire that was additionally carried out 1 question only in smartphone group, the modified chest compression method with the use of smartphone had the high negative reason in rescuer for occurrence of hand back pain (48.5%) and unstable posture (21.2%).

Conceptus radiation dose and risk from chest screen-film radiography.

PubMed

Damilakis, John; Perisinakis, Kostas; Prassopoulos, Panos; Dimovasili, Evangelia; Varveris, Haralambos; Gourtsoyiannis, Nicholas

2003-02-01

The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d(a)) was estimated for 51 women of childbearing age from chest CT examinations. The value of d(a) was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10(-3) mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d(a) estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is no need for individual conceptus dose estimations.

21 CFR 172.250 - Petroleum naphtha.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... At the end of this time, disconnect the flask and evaporate the methyl alcohol on the steam bath... transfer the isooctane extract to a 250-milliliter separatory funnel. Dissolve the crystals in the flask...

Primary Chest Wall Abscess Mimicking a Breast Tumor That Occurred after Blunt Chest Trauma: A Case Report

PubMed Central

Masuda, Norikazu; Yasojima, Hiroyuki; Mizutani, Makiko; Nakamori, Shoji; Kanazawa, Toru; Kuriyama, Keiko; Mano, Masayuki; Sekimoto, Mitsugu

2014-01-01

Primary chest wall abscess occurring after blunt chest trauma is rare. We present the case of a 50-year-old woman who presented with a swelling in her left breast. The patient had experienced blunt chest trauma 2 months back. Needle aspiration revealed pus formation in the patient's chest. Computed tomography revealed a mass in the lower region of the left mammary gland, with thickening of the parietal pleura and skin and fracture of the fifth rib under the abscess. Following antibiotic administration and irrigation of the affected region, surgical debridement was performed. During surgery, we found that the pectoralis major muscle at the level of the fifth rib was markedly damaged, although the necrotic tissue did not contact the mammary gland. We diagnosed the lesion as a chest wall abscess that occurred in response to blunt chest trauma. Her postoperative course was uneventful. There has been no recurrence for six months after surgery. PMID:24660001

Funneling Child Welfare Consumers into and through the Mental Health System: Assessment, Referral, and Quality Issues

PubMed Central

Fedoravicius, Nicole; McMillen, J. Curtis; Rowe, Jill E.; Kagotho, Njeri; Ware, Norma C.

2012-01-01

This qualitative study explores how consumers of child welfare services reach nonpsychiatric mental health providers and the perceived quality of these services. It relies on iterative interviews with individuals and groups, as well as on court observations from one metropolitan area. Results suggest that, consistent with theories of street-level bureaucracy, efficiency issues drive mental health service use, as clients are routinely subjected to psychological evaluations and funneled into mental health services as a matter of course. Referral practices are shaped by child welfare professionals' routines, discretion, and desire to meet such system objectives as providing short turnaround times for reports. The results suggest that, despite stakeholders' best intentions, maltreated children are not benefiting from thoughtful processes geared to screen for, assess, and provide targeted treatment for unmet mental health needs. PMID:22740722

Memory effects in funnel ratchet of self-propelled particles

NASA Astrophysics Data System (ADS)

Hu, Cai-Tian; Wu, Jian-Chun; Ai, Bao-Quan

2017-05-01

The transport of self-propelled particles with memory effects is investigated in a two-dimensional periodic channel. Funnel-shaped barriers are regularly arrayed in the channel. Due to the asymmetry of the barriers, the self-propelled particles can be rectified. It is found that the memory effects of the rotational diffusion can strongly affect the rectified transport. The memory effects do not always break the rectified transport, and there exists an optimal finite value of correlation time at which the rectified efficiency takes its maximal value. We also find that the optimal values of parameters (the self-propulsion speed, the translocation diffusion coefficient, the rotational noise intensity, and the self-rotational diffusion coefficient) can facilitate the rectified transport. When introducing a finite load, particles with different self-propulsion speeds move to different directions and can be separated.

Apparatus for sectioning demountable semiconductor samples

DOEpatents

Sopori, B.L.; Wolf, A.

1984-01-01

Apparatus for use during polishing and sectioning operations of a ribbon sample is described. The sample holder includes a cylinder having an axially extending sample cavity terminated in a first funnel-shaped opening and a second slot-like opening. A spring-loaded pressure plunger is located adjacent the second opening of the sample cavity for frictional engagement of the sample cavity. A heat softenable molding medium is inserted in the funnel-shaped opening, to surround the sample. After polishing, the heater is energized to allow draining of the molding medium from the sample cavity. During manual polishing, the second end of the sample holder is inserted in a support ring which provides mechanical support as well as alignment of the sample holder during polishing. A gauge block for measuring the protrusion of a sample beyond the second wall of the holder is also disclosed.

Characteristics of SCC with Fly Ash and Manufactured Sand

NASA Astrophysics Data System (ADS)

Praveen Kumar, K.; Radhakrishna

2016-09-01

Self compacting concrete (SCC) of M40 grade was designed. The binder in SCC consists of OPC and fly ash in the ratio of 65:35. River sand was replaced by manufactured sand (M-sand) at replacement levels of 20,40,60,80 and 100%. An attempt was made to evaluate the workability and strength characteristics of self compacting concrete with river sand and manufactured sand as fine aggregates. For each replacement level, constant workability was maintained by varying the dosage of superplasticizer. T50 flow time, V Funnel time, V-funnel T5 time as well as compressive, split tensile and flexural strength of SCC were found at each replacement level of M-sand. They were compared to SCC with river sand. Results indicate favourable use of M-sand in preparation of Self Compacting Concrete.

Geometrical Effects on Nonlinear Electrodiffusion in Cell Physiology

NASA Astrophysics Data System (ADS)

Cartailler, J.; Schuss, Z.; Holcman, D.

2017-12-01

We report here new electrical laws, derived from nonlinear electrodiffusion theory, about the effect of the local geometrical structure, such as curvature, on the electrical properties of a cell. We adopt the Poisson-Nernst-Planck equations for charge concentration and electric potential as a model of electrodiffusion. In the case at hand, the entire boundary is impermeable to ions and the electric field satisfies the compatibility condition of Poisson's equation. We construct an asymptotic approximation for certain singular limits to the steady-state solution in a ball with an attached cusp-shaped funnel on its surface. As the number of charge increases, they concentrate at the end of cusp-shaped funnel. These results can be used in the design of nanopipettes and help to understand the local voltage changes inside dendrites and axons with heterogeneous local geometry.

Self-consolidating concretes containing waste PET bottles as sand replacement

NASA Astrophysics Data System (ADS)

Khalid, Faisal Sheikh; Azmi, Nurul Bazilah; Mazenan, Puteri Natasya; Shahidan, Shahiron; Othman, Nor hazurina; Guntor, Nickholas Anting Anak

2018-02-01

This study evaluates the effect of self-consolidating concrete (SCC) containing waste polyethylene terephthalate (PET) granules on the fresh, mechanical and water absorption properties. Fine aggregates were replaced from 0% to 8% by PET granules. The fresh properties of SCC containing PET granules were determined using slump flow and V-funnel flow time tests. The compressive and splitting tensile strength were evaluated. The results indicated that utilization of waste PET granules in production of SCC could be an effective way for recycling purpose. The maximum amount of PET replacement should be limited to 5%. Exceeding 5% of PET content may result in an increase of V-funnel flow time to overpass the limiting value, decrease in strength. The production of high performance SCC containing 5% PET granules satisfies all the requirements for SCC with satisfactory outputs.

Comparative Evaluation of Arabin Pessary and Cervical Cerclage for the Prevention of Preterm Labor in Asymptomatic Women with High Risk Factors

PubMed Central

Tsikouras, Panagiotis; Anastasopoulos, George; Maroulis, Vasileios; Bothou, Anastasia; Chalkidou, Anna; Deuteraiou, Dorelia; Anthoulaki, Xanthoula; Bourazan, Arzou Halil; Iatrakis, George; Zervoudis, Stefanos; Galazios, Georgios; Inagamova, Lola-Katerina; Csorba, Roland; Teichmann, Alexander-Tobias

2018-01-01

Objective: Preterm labor is one of the most significant obstetric problems associated with high rate of actual and long-term perinatal complications. Despite the creation of scoring systems, uterine activity monitoring, cervical ultrasound and several biochemical markers, the prediction and prevention of preterm labor is still a matter of concern. The aim of this study was to examine cervical findings for the prediction and the comparative use of Arabin pessary or cerclage for the prevention of preterm birth in asymptomatic women with high risk factors for preterm labor. Material and methods: The study group was composed of singleton pregnancies (spontaneously conceived) with high risk factors for preterm labor. Cervical length, dilatation of the internal cervical os and funneling, were estimated with transvaginal ultrasound during the first and the second trimesters of pregnancy. Results: Cervical funneling, during the second trimester of pregnancy, was the most significant factor for the prediction of preterm labor. The use of Arabin cervical pessary was found to be more effective than cerclage in the prolongation of pregnancy. Conclusion: In women at risk for preterm labor, the detection of cervical funneling in the second trimester of pregnancy may help to predict preterm labor and to apply the appropriate treatment for its prevention. Although the use of cervical pessary was found to be more effective than cerclage, more studies are needed to classify the effectiveness of different methods for such prevention. PMID:29670041

Environmentally friendly tool to control mosquito populations without risk of insecticide resistance: the Lehmann’s funnel entry trap

PubMed Central

2013-01-01

Background Current malaria control strategies have cut down the malaria burden in many endemic areas, however the emergence and rapid spread of insecticide and drug resistance undermine the success of these efforts. There is growing concern that malaria eradication will not be achieved without the introduction of novel control tools. One approach that has been developed in the last few years is based on house screening to reduce indoor mosquito vector densities and consequently decrease malaria transmission. Here screening and trapping were combined in one tool to control mosquito populations. The trap does not require an insecticide or even an attractant, yet it effectively collects incoming resistant and susceptible mosquitoes and kills them. Results Performance of the funnel entry trap was tested in low and high malaria vector density areas. An overall reduction of 70 to 80% of mosquito density was seen in both. Species and molecular forms of Anopheles gambiae identification indicated no variation in the number of Anopheles arabiensis and the molecular forms of An. gambiae between houses and traps. Mosquitoes collected in the traps and in houses were highly resistant to pyrethroids (0.9 kdr-based mechanism). Conclusion There is a global consensus that new intervention tools are needed to cross the last miles in malaria elimination/eradication. The funnel entry trap showed excellent promise in suppressing mosquito densities even in area of high insecticide resistance. It requires no chemicals and is self-operated. PMID:23758904

Probing the Magnetic Field Structure in Sgr A* on Black Hole Horizon Scales with Polarized Radiative Transfer Simulations

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

Gold, Roman; McKinney, Jonathan C.; Johnson, Michael D.

Magnetic fields are believed to drive accretion and relativistic jets in black hole accretion systems, but the magnetic field structure that controls these phenomena remains uncertain. We perform general relativistic (GR) polarized radiative transfer of time-dependent three-dimensional GR magnetohydrodynamical simulations to model thermal synchrotron emission from the Galactic Center source Sagittarius A* (Sgr A*). We compare our results to new polarimetry measurements by the Event Horizon Telescope (EHT) and show how polarization in the visibility (Fourier) domain distinguishes and constrains accretion flow models with different magnetic field structures. These include models with small-scale fields in disks driven by the magnetorotationalmore » instability as well as models with large-scale ordered fields in magnetically arrested disks. We also consider different electron temperature and jet mass-loading prescriptions that control the brightness of the disk, funnel-wall jet, and Blandford–Znajek-driven funnel jet. Our comparisons between the simulations and observations favor models with ordered magnetic fields near the black hole event horizon in Sgr A*, though both disk- and jet-dominated emission can satisfactorily explain most of the current EHT data. We also discuss how the black hole shadow can be filled-in by jet emission or mimicked by the absence of funnel jet emission. We show that stronger model constraints should be possible with upcoming circular polarization and higher frequency (349 GHz) measurements.« less

Efficacy of trap modifications for increasing capture rates of aquatic snakes in floating aquatic funnel traps

USGS Publications Warehouse

Halstead, Brian J.; Wylie, Glenn D.; Casazza, Michael L.

2013-01-01

Increasing detection and capture probabilities of rare or elusive herpetofauna of conservation concern is important to inform the scientific basis for their management and recovery. The Giant Gartersnake (Thamnophis gigas) is an example of a secretive, wary, and generally difficult-to-sample species about which little is known regarding its patterns of occurrence and demography. We therefore evaluated modifications to existing traps to increase the detection and capture probabilities of the Giant Gartersnake to improve the precision with which occurrence, abundance, survival, and other demographic parameters are estimated. We found that adding a one-way valve constructed of cable ties to the small funnel opening of traps and adding hardware cloth extensions to the wide end of funnels increased capture rates of the Giant Gartersnake by 5.55 times (95% credible interval = 2.45–10.51) relative to unmodified traps. The effectiveness of these modifications was insensitive to the aquatic habitat type in which they were deployed. The snout-vent length of the smallest and largest captured snakes did not vary among trap modifications. These trap modifications are expected to increase detection and capture probabilities of the Giant Gartersnake, and show promise for increasing the precision with which demographic parameters can be estimated for this species. We anticipate that the trap modifications found effective in this study will be applicable to a variety of aquatic and semi-aquatic reptiles and amphibians and improve conservation efforts for these species.

Adherence evaluation of vented chest seals in a swine skin model.

PubMed

Arnaud, Françoise; Maudlin-Jeronimo, Eric; Higgins, Adam; Kheirabadi, Bijan; McCarron, Richard; Kennedy, Daniel; Housler, Greggory

2016-10-01

Perforation of the chest (open pneumothorax) with and without lung injury can cause air accumulation in the chest, positive intrapleural pressure and lead to tension pneumothorax if untreated. The performance of chest seals to prevent tension physiology depends partially on their ability to adhere to the skin and seal the chest wound. Novel non-occlusive vented chest seals were assessed for their adhesiveness on skin of live swine under normal and extreme environmental conditions to simulate austere battlefield conditions. Chest seals were applied on the back of the swine on skin that was soiled by various environmental contaminants to represent battlefield situations. A peeling (horizontal rim peeling) and detachment and breaching (vertical pulling) techniques were used to quantify the adhesive performance of vented chest seals. Among eight initially selected vented seals, five (Bolin, Russell, Fast breathe, Hyfin and SAM) were further down-selected based on their superior adherence scores at ambient temperatures. The adherence of these seals was then assessed after approximately 17h storage at extreme cold (-19.5°C) and hot (71.5°C) temperatures. Adherence scores for peeling (above 90%) and detachment scores (less than 25%) were comparable for four vented chest seals when tested at ambient temperature, except for the Bolin seal which had higher breaching. Under extreme storage temperatures, adherence peeling scores were comparable to those at ambient temperatures for four chest seals. Scores were significantly lower for the Bolin seal at extreme temperatures. This seal also had the highest detachment and breaching scores. In contrast, the Russell, Fast breathe, Hyfin and SAM seals showed similar ability to stay air tight without breaching after hot storage. No significant difference was found in skin adherence of the five vented chest seals at ambient temperature and the four seals (Russell, Fast breathe, Hyfin and SAM) maintained superior adherence even after exposure to extreme temperatures compared to the Bolin. To select the most effective product from the 5 selected vented chest seals, further functional evaluation of the valve of these chest seals on a chest wound with the potential for tension in the pneumothorax or hemopneumothorax is warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

Induction of a shorter compression phase is correlated with a deeper chest compression during metronome-guided cardiopulmonary resuscitation: a manikin study.

PubMed

Chung, Tae Nyoung; Bae, Jinkun; Kim, Eui Chung; Cho, Yun Kyung; You, Je Sung; Choi, Sung Wook; Kim, Ok Jun

2013-07-01

Recent studies have shown that there may be an interaction between duty cycle and other factors related to the quality of chest compression. Duty cycle represents the fraction of compression phase. We aimed to investigate the effect of shorter compression phase on average chest compression depth during metronome-guided cardiopulmonary resuscitation. Senior medical students performed 12 sets of chest compressions following the guiding sounds, with three down-stroke patterns (normal, fast and very fast) and four rates (80, 100, 120 and 140 compressions/min) in random sequence. Repeated-measures analysis of variance was used to compare the average chest compression depth and duty cycle among the trials. The average chest compression depth increased and the duty cycle decreased in a linear fashion as the down-stroke pattern shifted from normal to very fast (p<0.001 for both). Linear increase of average chest compression depth following the increase of the rate of chest compression was observed only with normal down-stroke pattern (p=0.004). Induction of a shorter compression phase is correlated with a deeper chest compression during metronome-guided cardiopulmonary resuscitation.

Rib fixation for severe chest deformity due to multiple rib fractures.

PubMed

Igai, Hitoshi; Kamiyoshihara, Mitsuhiro; Nagashima, Toshiteru; Ohtaki, Yoichi

2012-01-01

The operative indications for rib fracture repair have been a matter of debate. However, several reports have suggested that flail chest, pain on respiration, and chest deformity/defect are potential conditions for rib fracture repair. We describe our experience of rib fixation in a patient with severe chest deformity due to multiple rib fractures. A 70-year-old woman was admitted with right-sided multiple rib fractures (2nd to 7th) and marked chest wall deformity without flailing caused by an automobile accident. Collapse of the chest wall was observed along the middle anterior axillary line. At 11 days after the injury, surgery was performed to repair the chest deformity, as it was considered to pose a risk of restrictive impairment of pulmonary function or chronic intercostal pain in the future. Operative findings revealed marked displacement of the superior 4 ribs, from the 2nd to the 5th, and collapse of the osseous chest wall towards the thoracic cavity. After exposure of the fracture regions, ribs fixations were performed using rib staplers. The total operation time was 90 minutes, and the collapsed portion of the chest wall along the middle anterior axillary line was reconstructed successfully.

Management of chest drainage tubes after lung surgery.

PubMed

Satoh, Yukitoshi

2016-06-01

Since chest tubes have been routinely used to drain the pleural space, particularly after lung surgery, the management of chest tubes is considered to be essential for the thoracic surgeon. The pleural drainage system requires effective drainage, suction, and water-sealing. Another key point of chest tube management is that a water seal is considered to be superior to suction for most air leaks. Nowadays, the most common pleural drainage device attached to the chest tube is the three-bottle system. An electronic chest drainage system has been developed that is effective in standardizing the postoperative management of chest tubes. More liberal use of digital drainage devices in the postoperative management of the pleural space is warranted. The removal of chest tubes is a common procedure occurring almost daily in hospitals throughout the world. Extraction of the tube is usually done at the end of full inspiration or at the end of full expiration. The tube removal technique is not as important as how it is done and the preparation for the procedure. The management of chest tubes must be based on careful observation, the patient's characteristics, and the operative procedures that had been performed.

A study on the evaluation of pneumothorax by imaging methods in patients presenting to the emergency department for blunt thoracic trauma.

PubMed

Kaya, Şeyhmus; Çevik, Arif Alper; Acar, Nurdan; Döner, Egemen; Sivrikoz, Cumhur; Özkan, Ragıp

2015-09-01

Pneumothorax (PNX) is the collection of air between parietal and visceral pleura, and collapsed lung develops as a complication of the trapped air. PNX is likely to develop spontaneously in people with risk factors. However, it is mostly seen with blunt or penetrating trauma. Diagnosis is generally confirmed by chest radiography [posteroanterior chest radiography (PACR)]. Chest ultrasound (US) is also a promising technique for the detection of PNX in trauma patients. There is not much literature on the evaluation of blunt thoracic trauma (BTT) and pneumothorax (PNX) in the emergency department (ED). The aim of this study was to investigate the effectiveness of chest US for the diagnosis of PNX in patients presenting to ED with BTT. This study was carried out for a period of nine months in the ED of a university hospital. The chest US of patients was performed by emergency physicians trained in the field. The results were compared with anteroposterior chest radiography and/or CT scan of the chest. The APCR and chest CT results were evaluated by a radiology specialist blind to US findings. The evaluation of the radiology specialist was taken as the gold standard for diagnosis by imaging methods. Clinical follow-up was taken into consideration for the diagnosis of PNX in patients on whom CT scan was not performed. Chest US was performed on all two hundred and twelve patients (144 female and 68 male patients; mean age 45.8) who participated in this study. The supine APCR was performed on two hundred and ten (99%) patients and chest CT was performed on one hundred and twenty (56.6%). Out of the twenty-five (11.8%) diagnosed cases of PNX, 22 (88%) were diagnosed by chest US and 8 were diagnosed by APCR. For the detection of PNX, compared to clinical follow-up and chest CT, the sensitivity of chest US was 88%, specificity 99.5%, positive predictive value 95.7% and negative predictive value 98.4%. Chest US has not superseded supine and standing chest radiography for PNX diagnosis yet in many healthcare centers, but it is performed by emergency physicians and it is an effective and important method for early and bedside diagnosis of PNX.

[Chest Injury and its Surgical Treatment in Polytrauma Patients. Five-Year Experience].

PubMed

Vodička, J; Doležal, J; Vejvodová, Š; Šafránek, J; Špidlen, V; Třeška, V

2016-01-01

PURPOSE OF THE STUDY Thoracic trauma, one of the most frequent injuries in patients with multiple traumata, is found in 50 to 80% of these patients and it is crucial for the patient's prognosis. It accounts for 25% of all death from polytraumatic injuries. The aim of this retrospective study was an analysis of the occurrence of chest injuries in polytrauma patients and their surgical treatment in the Trauma Centre or Department of Surgery of the University Hospital Pilsen in a five-year period. MATERIAL AND METHODS Patients with injuries meeting the definition of polytrauma and an Injury Severity Score (ISS) ≥16 were included. The demographic characteristics, mechanism of multiple trauma, ISS value and chest injury were recorded in each patient. The number of injured patients in each year of the study was noted. In the patients with chest injury, the type of injury and method of treatment were assessed. The therapy was further analysed including its timing. The number of deaths due to polytrauma involving chest injury, the cause of death and its time in relation to the patient's admission to the Trauma Centre were evaluated. RESULTS In the period 2010-14, 513 polytrauma patients were treated; of them 371 (72.3%) were men with an average age of 40.5 years. The most frequent cause of injury was a traffic accident (74%). The average ISS of the whole group was 35 points. Chest injury was diagnosed in 469 patients (91.4%) of whom only five (1.1%) had penetrating injury. Pulmonary contusion was most frequent (314 patients; 67%). A total of 212 patients with chest injury underwent surgery (45.2%); urgent surgery was performed in 143 (67.5%), acute surgery in 49 (23.1%) and delayed surgery in 63 (29.7%) patients. Chest drainage was the major surgical procedure used in the whole group. Of 61 patients who died, 52 had chest injury. In this subgroup the most frequent cause of death was decompensated traumatic shock (26 patients; 50%). In the whole group, 32 polytrauma patients died within 24 hours of injury (61.5%). CONCLUSIONS Chest injury, almost always blunt, is often diagnosed in polytrauma patients. A prevalent cause of multiple trauma is a traffic accident. Chest injury most frequently involves pulmonary contusion. Nearly half of chest injuries require surgery, of which 2/3 are urgent procedures. The procedure most frequently performed in polytrauma patients with chest injury is chest drainage and this is also a sufficient procedure in 75% of surgically treated patients. polytrauma, chest injury, pulmonary contusion, surgical treatment, chest drainage.

A higher chest compression rate may be necessary for metronome-guided cardiopulmonary resuscitation.

PubMed

Chung, Tae Nyoung; Kim, Sun Wook; You, Je Sung; Cho, Young Soon; Chung, Sung Phil; Park, Incheol

2012-01-01

Metronome guidance is a simple and economical feedback system for guiding cardiopulmonary resuscitation (CPR). However, a recent study showed that metronome guidance reduced the depth of chest compression. The results of previous studies suggest that a higher chest compression rate is associated with a better CPR outcome as compared with a lower chest compression rate, irrespective of metronome use. Based on this finding, we hypothesized that a lower chest compression rate promotes a reduction in chest compression depth in the recent study rather than metronome use itself. One minute of chest compression-only CPR was performed following the metronome sound played at 1 of 4 different rates: 80, 100, 120, and 140 ticks/min. Average compression depths (ACDs) and duty cycles were compared using repeated measures analysis of variance, and the values in the absence and presence of metronome guidance were compared. Both the ACD and duty cycle increased when the metronome rate increased (P = .017, <.001). Average compression depths for the CPR procedures following the metronome rates of 80 and 100 ticks/min were significantly lower than those for the procedures without metronome guidance. The ACD and duty cyle for chest compression increase as the metronome rate increases during metronome-guided CPR. A higher rate of chest compression is necessary for metronome-guided CPR to prevent suboptimal quality of chest compression. Copyright © 2012 Elsevier Inc. All rights reserved.

[Tension Pneumothorax Developing Hemothorax after Chest Tube Drainage].

PubMed

Sakai, Takehiro; Sawada, Masahiro; Sato, Yutaka; Kimura, Futoshi; Yagihashi, Nobuo; Iwabuchi, Tadashi; Kimura, Daisuke; Tsushima, Takao; Hatanaka, Ryo

2016-11-01

A 61-year-old man visited a physician complaining of progressive chest pain and dyspnea. The chest radiography showed complete collapse of the right lung suggesting tension pneumothorax. The patient was transferred to our hospital. A small amount of the right pleural effusion was also seen in addition to pulmonary collapse on the chest radiography. Chest drainage was performed, and continuous air leakage was seen. At 2 hours later, air leakage was disappeared but the bloody effusion was noted. The chest radiography revealed massive effusion and the enhanced computed tomography showed active bleeding. The emergency surgery was conducted. The bleeding point was a ruptured vessel between the apical parietal pleura and the pulmonary bulla. Hemostasis and the resection of the bullae was performed. Careful observation after chest drainage is necessary to prepare unexpected hemothorax in case of tension pneumothorax with pleural effusion.

Ultrasound detection of pneumothorax compared with chest X-ray and computed tomography scan.

PubMed

Nagarsheth, Khanjan; Kurek, Stanley

2011-04-01

Pneumothorax after trauma can be a life threatening injury and its care requires expeditious and accurate diagnosis and possible intervention. We performed a prospective, single blinded study with convenience sampling at a Level I trauma center comparing thoracic ultrasound with chest X-ray and CT scan in the detection of traumatic pneumothorax. Trauma patients that received a thoracic ultrasound, chest X-ray, and chest CT scan were included in the study. The chest X-rays were read by a radiologist who was blinded to the thoracic ultrasound results. Then both were compared with CT scan results. One hundred and twenty-five patients had a thoracic ultrasound performed in the 24-month period. Forty-six patients were excluded from the study due to lack of either a chest X-ray or chest CT scan. Of the remaining 79 patients there were 22 positive pneumothorax found by CT and of those 18 (82%) were found on ultrasound and 7 (32%) were found on chest X-ray. The sensitivity of thoracic ultrasound was found to be 81.8 per cent and the specificity was found to be 100 per cent. The sensitivity of chest X-ray was found to be 31.8 per cent and again the specificity was found to be 100 per cent. The negative predictive value of thoracic ultrasound for pneumothorax was 0.934 and the negative predictive value for chest X-ray for pneumothorax was found to be 0.792. We advocate the use of chest ultrasound for detection of pneumothorax in trauma patients.

42 CFR 37.50 - Interpreting and classifying chest radiographs-film.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Interpreting and classifying chest radiographs-film. 37.50 Section 37.50 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Radiographs § 37.50 Interpreting and classifying chest radiographs—film. (a) Chest radiographs must be...

42 CFR 37.50 - Interpreting and classifying chest radiographs-film.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Interpreting and classifying chest radiographs-film. 37.50 Section 37.50 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Interpreting and classifying chest radiographs—film. (a) Chest radiographs must be interpreted and classified...

46 CFR 108.651 - Portable magazine chests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Portable magazine chests. 108.651 Section 108.651... AND EQUIPMENT Equipment Markings and Instructions § 108.651 Portable magazine chests. Each portable magazine chest must be marked: “PORTABLE MAGAZINE CHEST—FLAMMABLE—KEEP LIGHTS AND FIRE AWAY” in letters at...

20 CFR 718.102 - Chest roentgenograms (X-rays).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Chest roentgenograms (X-rays). 718.102... roentgenograms (X-rays). (a) A chest roentgenogram (X-ray) shall be of suitable quality for proper classification of pneumoconiosis and shall conform to the standards for administration and interpretation of chest X...

20 CFR 718.102 - Chest roentgenograms (X-rays).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Chest roentgenograms (X-rays). 718.102... roentgenograms (X-rays). (a) A chest roentgenogram (X-ray) shall be of suitable quality for proper classification of pneumoconiosis and shall conform to the standards for administration and interpretation of chest X...

20 CFR 718.102 - Chest roentgenograms (X-rays).

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Chest roentgenograms (X-rays). 718.102... roentgenograms (X-rays). (a) A chest roentgenogram (X-ray) shall be of suitable quality for proper classification of pneumoconiosis and shall conform to the standards for administration and interpretation of chest X...

20 CFR 718.102 - Chest roentgenograms (X-rays).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Chest roentgenograms (X-rays). 718.102... roentgenograms (X-rays). (a) A chest roentgenogram (X-ray) shall be of suitable quality for proper classification of pneumoconiosis and shall conform to the standards for administration and interpretation of chest X...

CT detection of occult pneumothorax in head trauma

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

Tocino, I.M.; Miller, M.H.; Frederick, P.R.

1984-11-01

A prospective evaluation for occult pneumothorax was performed in 25 consecutive patients with serious head trauma by combining a limited chest CT examination with the emergency head CT examination. Of 21 pneuomothoraces present in 15 patients, 11 (52%) were found only by chest CT and were not identified clinically or by supine chest radiograph. Because of pending therapeutic measures, chest tubes were placed in nine of the 11 occult pneumothoraces, regardless of the volume. Chest CT proved itself as the most sensitive method for detection of occult pneumothorax, permitting early chest tube placement to prevent transition to a tension pneumothoraxmore » during subsequent mechanical ventilation or emergency surgery under general anesthesia.« less

A Community-acquired Lung Abscess Attributable to Streptococcus pneumoniae which Extended Directly into the Chest Wall

PubMed Central

Ko, Yuki; Tobino, Kazunori; Yasuda, Yuichiro; Sueyasu, Takuto; Nishizawa, Saori; Yoshimine, Kouhei; Munechika, Miyuki; Asaji, Mina; Yamaji, Yoshikazu; Tsuruno, Kosuke; Miyajima, Hiroyuki; Mukasa, Yosuke; Ebi, Noriyuki

2017-01-01

We herein report the case of 75-year-old Japanese female with a community-acquired lung abscess attributable to Streptococcus pneumoniae (S. penumoniae) which extended into the chest wall. The patient was admitted to our hospital with a painful mass on the left anterior chest wall. A contrast-enhanced chest computed tomography scan showed a lung abscess in the left upper lobe which extended into the chest wall. Surgical debridement of the chest wall abscess and percutaneous transthoracic tube drainage of the lung abscess were performed. A culture of the drainage specimen yielded S. pneumoniae. The patient showed a remarkable improvement after the initiation of intravenous antibiotic therapy. PMID:28049987

A Community-acquired Lung Abscess Attributable to Streptococcus pneumoniae which Extended Directly into the Chest Wall.

PubMed

Ko, Yuki; Tobino, Kazunori; Yasuda, Yuichiro; Sueyasu, Takuto; Nishizawa, Saori; Yoshimine, Kouhei; Munechika, Miyuki; Asaji, Mina; Yamaji, Yoshikazu; Tsuruno, Kosuke; Miyajima, Hiroyuki; Mukasa, Yosuke; Ebi, Noriyuki

We herein report the case of 75-year-old Japanese female with a community-acquired lung abscess attributable to Streptococcus pneumoniae (S. penumoniae) which extended into the chest wall. The patient was admitted to our hospital with a painful mass on the left anterior chest wall. A contrast-enhanced chest computed tomography scan showed a lung abscess in the left upper lobe which extended into the chest wall. Surgical debridement of the chest wall abscess and percutaneous transthoracic tube drainage of the lung abscess were performed. A culture of the drainage specimen yielded S. pneumoniae. The patient showed a remarkable improvement after the initiation of intravenous antibiotic therapy.

Direct 2-D reconstructions of conductivity and permittivity from EIT data on a human chest.

PubMed

Herrera, Claudia N L; Vallejo, Miguel F M; Mueller, Jennifer L; Lima, Raul G

2015-01-01

A novel direct D-bar reconstruction algorithm is presented for reconstructing a complex conductivity distribution from 2-D EIT data. The method is applied to simulated data and archival human chest data. Permittivity reconstructions with the aforementioned method and conductivity reconstructions with the previously existing nonlinear D-bar method for real-valued conductivities depicting ventilation and perfusion in the human chest are presented. This constitutes the first fully nonlinear D-bar reconstructions of human chest data and the first D-bar permittivity reconstructions of experimental data. The results of the human chest data reconstructions are compared on a circular domain versus a chest-shaped domain.

Nonspecific motility disorders, irritable esophagus, and chest pain.

PubMed

Krarup, Anne Lund; Liao, Donghua; Gregersen, Hans; Drewes, Asbjørn Mohr; Hejazi, Reza A; McCallum, Richard W; Vega, Kenneth J; Frazzoni, Marzio; Frazzoni, Leonardo; Clarke, John O; Achem, Sami R

2013-10-01

This paper presents commentaries on whether Starling's law applies to the esophagus; whether erythromycin affects esophageal motility; the relationship between hypertensive lower esophageal sphincter and vigorous achalasia; whether ethnic- and gender-based norms affect diagnosis and treatment of esophageal motor disorders; health care and epidemiology of chest pain; whether normal pH excludes esophageal pain; the role of high-resolution manometry in noncardiac chest pain; whether pH-impedance should be included in the evaluation of noncardiac chest pain; whether there are there alternative therapeutic options to PPI for treating noncardiac chest pain; and the usefulness of psychological treatment and alternative medicine in noncardiac chest pain. © 2013 New York Academy of Sciences.

The value of routine chest radiographs in acute asthma admissions.

PubMed

Ismail, Y; Loo, C S; Zahary, M K

1994-04-01

We reviewed 116 chest radiographs done in 70 adult asthmatic patients who were admitted to the Hospital Universiti Sains Malaysia from January to December 1989. The chest radiographs were abnormal in 23% of cases. Twelve percent showed hyperinflation and 7% had pneumonia. Eight patients diagnosed clinically to have pneumonia had normal chest radiographs. Seven patients had radiographic findings of conditions which were unsuspected clinically. These included two cases of pneumonia, one case each of fibrosing alveolitis, pneumothorax, pneumomediastinum, mitral stenosis with left ventricular failure and right pleural effusion. In conclusion, we found that significant chest radiograph abnormalities in adult patients admitted for asthma were uncommon although chest radiographs were helpful in detecting complications or coincidental conditions. Chest radiograph is therefore an important investigation in adult asthmatic patients who are admitted. However, considering the cost and the risk of radiation, it should be done only in selective cases rather than as a routine procedure.

Anxiety and depressive symptoms and anxiety sensitivity in youngsters with noncardiac chest pain and benign heart murmurs.

PubMed

Lipsitz, Joshua D; Masia-Warner, Carrie; Apfel, Howard; Marans, Zvi; Hellstern, Beth; Forand, Nicholas; Levenbraun, Yosef; Fyer, Abby J

2004-12-01

Chest pain in children and adolescents is rarely associated with cardiac disease. We sought to examine psychological symptoms in youngsters with medically unexplained chest pain. We hypothesized that children and adolescents with medically unexplained chest pain would have high rates of anxiety and depressive symptoms. We assessed 65 youngsters with noncardiac chest pain (NCCP) and 45 comparison youngsters with benign heart murmurs using self-report measures of anxiety and depressive symptoms and anxiety sensitivity. Compared with the asymptomatic benign-murmur group, youngsters with NCCP had higher levels of some anxiety symptoms and anxiety sensitivity. Differences on depressive symptoms were not significant. Though preliminary, results suggest that youngsters with chest pain may experience increased levels of some psychological symptoms. Future studies of noncardiac chest pain in youngsters should include larger samples and comprehensive diagnostic assessments as well as long-term follow-up evaluations.

46 CFR 78.47-70 - Portable magazine chests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 3 2010-10-01 2010-10-01 false Portable magazine chests. 78.47-70 Section 78.47-70... Fire and Emergency Equipment, Etc. § 78.47-70 Portable magazine chests. (a) Portable magazine chest shall be marked in letters of at least 3 inches high “PORTABLE MAGAZINE CHEST—FLAMMABLE—KEEP LIGHTS AND...

46 CFR 97.37-47 - Portable magazine chests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Portable magazine chests. 97.37-47 Section 97.37-47... OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: “PORTABLE MAGAZINE CHEST—FLAMMABLE—KEEP...

Reconstruction with a patient-specific titanium implant after a wide anterior chest wall resection

PubMed Central

Turna, Akif; Kavakli, Kuthan; Sapmaz, Ersin; Arslan, Hakan; Caylak, Hasan; Gokce, Hasan Suat; Demirkaya, Ahmet

2014-01-01

The reconstruction of full-thickness chest wall defects is a challenging problem for thoracic surgeons, particularly after a wide resection of the chest wall that includes the sternum. The location and the size of the defect play a major role when selecting the method of reconstruction, while acceptable cosmetic and functional results remain the primary goal. Improvements in preoperative imaging techniques and reconstruction materials have an important role when planning and performing a wide chest wall resection with a low morbidity rate. In this report, we describe the reconstruction of a wide anterior chest wall defect with a patient-specific custom-made titanium implant. An infected mammary tumour recurrence in a 62-year old female, located at the anterior chest wall including the sternum, was resected, followed by a large custom-made titanium implant. Latissimus dorsi flap and split-thickness graft were also used for covering the implant successfully. A titanium custom-made chest wall implant could be a viable alternative for patients who had large chest wall tumours. PMID:24227881

A method to detect occult pneumothorax with chest radiography.

PubMed

Matsumoto, Shokei; Kishikawa, Masanobu; Hayakawa, Koichi; Narumi, Atsushi; Matsunami, Katsutoshi; Kitano, Mitsuhide

2011-04-01

Small pneumothoraces are often not visible on supine screening chest radiographs because they develop anteriorly to the lung. These pneumothoraces are termed occult. Occult pneumothoraces account for an astonishingly high 52% to 63% of all traumatic pneumothoraces. A 19-year-old obese woman was involved in a head-on car accident. The admission anteroposterior chest radiographs were unremarkable. Because of the presence of right chest tenderness and an abrasion, we suspected the presence of a pneumothorax. Thus, we decided to take a supine oblique chest radiograph of the right side of the thorax, which clearly revealed a visceral pleural line, consistent with a diagnosis of traumatic pneumothorax. A pneumothorax may be present when a supine chest radiograph reveals either an apparent deepening of the costophrenic angle (the "deep sulcus sign") or the presence of 2 diaphragm-lung interfaces (the "double diaphragm sign"). However, in practice, supine chest radiographs have poor sensitivity for occult pneumothoraces. Oblique chest radiograph is a useful and fast screening tool that should be considered for cases of blunt chest trauma, especially when transport of critically ill patients to the computed tomographic suite is dangerous or when imminent transfer to another hospital is being arranged and early diagnosis of an occult pneumothorax is essential. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Chest tube management following pulmonary lobectomy: change of protocol results in fewer air leaks.

PubMed

Bertholet, Joost W M; Joosten, Joris J A; Keemers-Gels, Mariël E; van den Wildenberg, Frits J H; Barendregt, Wouter B

2011-01-01

Much controversy exists regarding the management of chest tubes following pulmonary lobectomy. The objective of this study was to analyse the effect of a new chest tube management protocol on clinical features, such as postoperative air leak, drain characteristics, 30-day postoperative complications and length of hospital stay. We retrospectively analysed 133 patients who underwent pulmonary lobectomy, from January 2005 to December 2008. A new chest tube protocol was introduced on 1 January 2007 and included placement of a single chest tube and early conversion to water seal. The chest tube was removed when air leak had resolved and (non-chylous) fluid drainage was <400 ml/day. The results of patients in the old (n=68) and the new protocol (n=65) were compared. In the new protocol group the median duration of air leak and duration of chest tube drainage declined significantly. Also the length of hospital stay decreased significantly to a median of eight days. The number of reinterventions and 30-day morbidity and mortality rates did not differ significantly. Our data suggest that placement of a single chest tube and early conversion to water seal decreases the duration of air leak and chest tube drainage and length of hospital stay.

Place Atrium to Water Seal (PAWS): Assessing Wall Suction Versus No Suction for Chest Tubes After Open Heart Surgery.

PubMed

Kruse, Tamara; Wahl, Sharon; Guthrie, Patricia Finch; Sendelbach, Sue

2017-08-01

Traditionally chest tubes are set to -20 cm H 2 O wall suctioning until removal to facilitate drainage of blood, fluid, and air from the pleural or mediastinal space in patients after open heart surgery. However, no clear evidence supports using wall suction in these patients. Some studies in patients after pulmonary surgery indicate that using chest tubes with a water seal is safer, because this practice decreases duration of chest tube placement and eliminates air leaks. To show that changing chest tubes to a water seal after 12 hours of wall suction (intervention) is a safe alternative to using chest tubes with wall suction until removal of the tubes (usual care) in patients after open heart surgery. A before-and-after quality improvement design was used to evaluate the differences between the 2 chest tube management approaches in chest tube complications, output, and duration of placement. A total of 48 patients received the intervention; 52 received usual care. The 2 groups (intervention vs usual care) did not differ significantly in complications (0 vs 2 events; P = .23), chest tube output (H 1 = 0.001, P = .97), or duration of placement (median, 47 hours for both groups). Changing chest tubes from wall suction to water seal after 12 hours of wall suction is a safe alternative to using wall suctioning until removal of the tubes. ©2017 American Association of Critical-Care Nurses.

Real-time feedback can improve infant manikin cardiopulmonary resuscitation by up to 79%--a randomised controlled trial.

PubMed

Martin, Philip; Theobald, Peter; Kemp, Alison; Maguire, Sabine; Maconochie, Ian; Jones, Michael

2013-08-01

European and Advanced Paediatric Life Support training courses. Sixty-nine certified CPR providers. CPR providers were randomly allocated to a 'no-feedback' or 'feedback' group, performing two-thumb and two-finger chest compressions on a "physiological", instrumented resuscitation manikin. Baseline data was recorded without feedback, before chest compressions were repeated with one group receiving feedback. Indices were calculated that defined chest compression quality, based upon comparison of the chest wall displacement to the targets of four, internationally recommended parameters: chest compression depth, release force, chest compression rate and compression duty cycle. Baseline data were consistent with other studies, with <1% of chest compressions performed by providers simultaneously achieving the target of the four internationally recommended parameters. During the 'experimental' phase, 34 CPR providers benefitted from the provision of 'real-time' feedback which, on analysis, coincided with a statistical improvement in compression rate, depth and duty cycle quality across both compression techniques (all measures: p<0.001). Feedback enabled providers to simultaneously achieve the four targets in 75% (two-finger) and 80% (two-thumb) of chest compressions. Real-time feedback produced a dramatic increase in the quality of chest compression (i.e. from <1% to 75-80%). If these results transfer to a clinical scenario this technology could, for the first time, support providers in consistently performing accurate chest compressions during infant CPR and thus potentially improving clinical outcomes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Chest radiography practice in critically ill patients: a postal survey in the Netherlands

PubMed Central

Graat, Marleen E; Hendrikse, Karin A; Spronk, Peter E; Korevaar, Johanna C; Stoker, Jaap; Schultz, Marcus J

2006-01-01

Background To ascertain current chest radiography practice in intensive care units (ICUs) in the Netherlands. Methods Postal survey: a questionnaire was sent to all ICUs with > 5 beds suitable for mechanical ventilation; pediatric ICUs were excluded. When an ICU performed daily-routine chest radiographs in any group of patients it was considered to be a "daily-routine chest radiography" ICU. Results From the number of ICUs responding, 63% practice a daily-routine strategy, in which chest radiographs are obtained on a daily basis without any specific reason. A daily-routine chest radiography strategy is practiced less frequently in university-affiliated ICUs (50%) as compared to other ICUs (68%), as well as in larger ICUs (> 20 beds, 50%) as compared to smaller ICUs (< 20 beds, 65%) (P > 0.05). Remarkably, physicians that practice a daily-routine strategy consider daily-routine radiographs helpful in guiding daily practice in less than 30% of all performed radiographs. Chest radiographs are considered essential for verification of the position of invasive devices (81%) and for diagnosing pneumothorax, pneumonia or acute respiratory distress syndrome (82%, 74% and 69%, respectively). On demand chest radiographs are obtained after introduction of thoracic drains, central venous lines and endotracheal tubes in 98%, 84% and 75% of responding ICUs, respectively. Chest films are also obtained in case of ventilatory deterioration (49% of responding ICUs), and after cardiopulmonary resuscitation (59%), tracheotomy (58%) and mini-tracheotomy (23%). Conclusion There is notable lack of consensus on chest radiography practice in the Netherlands. This survey suggests that a large number of intensivists may doubt the value of daily-routine chest radiography, but still practice a daily-routine strategy. PMID:16848892

Average chest wall thickness at two anatomic locations in trauma patients.

PubMed

Schroeder, Elizabeth; Valdez, Carrie; Krauthamer, Andres; Khati, Nadia; Rasmus, Jessica; Amdur, Richard; Brindle, Kathleen; Sarani, Babak

2013-09-01

Needle thoracostomy is the emergent treatment for tension pneumothorax. This procedure is commonly done using a 4.5cm catheter, and the optimal site for chest wall puncture is controversial. We hypothesize that needle thoracostomy cannot be performed using this catheter length irrespective of the site chosen in either gender. A retrospective review of all chest computed tomography (CT) scans obtained on trauma patients from January 1, 2011 to December 31, 2011 was performed. Patients aged 18 and 80 years were included and patients whose chest wall thickness exceeded the boundary of the images acquired were excluded. Chest wall thickness was measured at the 2nd intercostal (ICS), midclavicular line (MCL) and the 5th ICS, anterior axillary line (AAL). Injury severity score (ISS), chest wall thickness, and body mass index (BMI) were analyzed. 201 patients were included, 54% male. Average (SD) BMI was 26 (7)kg/m(2). The average chest wall thickness in the overall cohort was 4.08 (1.4)cm at the 2nd ICS/MCL and 4.55 (1.7)cm at the 5th ICS/AAL. 29% of the overall cohort (27 male and 32 female) had a chest wall thickness greater than 4.5cm at the 2nd ICS/MCL and 45% (54 male and 36 female) had a chest wall thickness greater than 4.5cm at the 5th ICS/AAL. There was no significant interaction between gender and chest wall thickness at either site. BMI was positively associated with chest wall thickness at both the 2nd and 5th ICS/AAL. A 4.5cm catheter is inadequate for needle thoracostomy in most patients regardless of puncture site or gender. Copyright © 2013 Elsevier Ltd. All rights reserved.

Improved recognition of ineffective chest compressions after a brief Crew Resource Management (CRM) training: a prospective, randomised simulation study.

PubMed

Haffner, Leopold; Mahling, Moritz; Muench, Alexander; Castan, Christoph; Schubert, Paul; Naumann, Aline; Reddersen, Silke; Herrmann-Werner, Anne; Reutershan, Jörg; Riessen, Reimer; Celebi, Nora

2017-03-03

Chest compressions are a core element of cardio-pulmonary resuscitation. Despite periodic training, real-life chest compressions have been reported to be overly shallow and/or fast, very likely affecting patient outcomes. We investigated the effect of a brief Crew Resource Management (CRM) training program on the correction rate of improperly executed chest compressions in a simulated cardiac arrest scenario. Final-year medical students (n = 57) were randomised to receive a 10-min computer-based CRM or a control training on ethics. Acting as team leaders, subjects performed resuscitation in a simulated cardiac arrest scenario before and after the training. Team members performed standardised overly shallow and fast chest compressions. We analysed how often the team leader recognised and corrected improper chest compressions, as well as communication and resuscitation quality. After the CRM training, team leaders corrected improper chest compressions (35.5%) significantly more often compared with those undergoing control training (7.7%, p = 0.03*). Consequently, four students have to be trained (number needed to treat = 3.6) for one improved chest compression scenario. Communication quality assessed by the Leader Behavior Description Questionnaire significantly increased in the intervention group by a mean of 4.5 compared with 2.0 (p = 0.01*) in the control group. A computer-based, 10-min CRM training improved the recognition of ineffective of chest compressions. Furthermore, communication quality increased. As guideline-adherent chest compressions have been linked to improved patient outcomes, our CRM training might represent a brief and affordable approach to increase chest compression quality and potentially improve patient outcomes.

2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

PubMed

Atkins, Dianne L; de Caen, Allan R; Berger, Stuart; Samson, Ricardo A; Schexnayder, Stephen M; Joyner, Benny L; Bigham, Blair L; Niles, Dana E; Duff, Jonathan P; Hunt, Elizabeth A; Meaney, Peter A

2018-01-02

This focused update to the American Heart Association guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care follows the Pediatric Task Force of the International Liaison Committee on Resuscitation evidence review. It aligns with the International Liaison Committee on Resuscitation's continuous evidence review process, and updates are published when the International Liaison Committee on Resuscitation completes a literature review based on new science. This update provides the evidence review and treatment recommendation for chest compression-only CPR versus CPR using chest compressions with rescue breaths for children <18 years of age. Four large database studies were available for review, including 2 published after the "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." Two demonstrated worse 30-day outcomes with chest compression-only CPR for children 1 through 18 years of age, whereas 2 studies documented no difference between chest compression-only CPR and CPR using chest compressions with rescue breaths. When the results were analyzed for infants <1 year of age, CPR using chest compressions with rescue breaths was better than no CPR but was no different from chest compression-only CPR in 1 study, whereas another study observed no differences among chest compression-only CPR, CPR using chest compressions with rescue breaths, and no CPR. CPR using chest compressions with rescue breaths should be provided for infants and children in cardiac arrest. If bystanders are unwilling or unable to deliver rescue breaths, we recommend that rescuers provide chest compressions for infants and children. © 2017 American Heart Association, Inc.

Aortic valve calcifications on chest films: how much calcium do I need?

PubMed

Mahnken, Andreas H; Dohmen, Guido; Koos, Ralf

2011-08-01

Aortic valve calcifications (AVC) as seen on conventional chest films or on CT are associated with aortic valve stenosis (AVS). The absence of AVC on chest films does not exclude high grade AVS. The aim of this study was to analyse if there is a threshold for the detection of AVC from conventional chest films in patients suffering from high grade AVS. The explanted aortic valves of 29 patients (16 male, mean age 72.3 +/- 11.5 years) with high grade AVS were examined by dual-source CT. AVC were quantified using the Agatston AVC score. In all patients conventional chest films obtained the day before surgery were evaluated for the presence of AVC. Results were analysed with students t-test, Spearman's rank correlation and ROC analysis. On conventional chest films AVC were visible in 18 patients. On CT all specimen presented with AVC with an Agatston AVC score ranging from 40.7 to 1870 (mean 991.3 +/- 463.1). In patients with AVC visible on chest films the AVC score was significantly higher (1264.0 +/- 318.2) when compared with patients without visible calcifications (544.9 +/- 274.4; P < 0.0001). There was a strong correlation between the AVC score and the visibility of AVC on chest films (r = 0.781). ROC analysis identified an ideal threshold of 718 for AVC score to separate conventional chest films with and without visible AVC. Unlike in coronary calcifications, there is a threshold for identifying AVC from conventional chest films. This finding may be of diagnostic value, as conventional chest films may be used to semiquantitatively evaluate the extent of AVC.

Electronic versus traditional chest tube drainage following lobectomy: a randomized trial.

PubMed

Lijkendijk, Marike; Licht, Peter B; Neckelmann, Kirsten

2015-12-01

Electronic drainage systems have shown superiority compared with traditional (water seal) drainage systems following lung resections, but the number of studies is limited. As part of a medico-technical evaluation, before change of practice to electronic drainage systems for routine thoracic surgery, we conducted a randomized controlled trial (RCT) investigating chest tube duration and length of hospitalization. Patients undergoing lobectomy were included in a prospective open label RCT. A strict algorithm was designed for early chest tube removal, and this decision was delegated to staff nurses. Data were analysed by Cox proportional hazard regression model adjusting for lung function, gender, age, BMI, video-assisted thoracic surgery (VATS) or open surgery and presence of incomplete fissure or pleural adhesions. Time was distinguished as possible (optimal) and actual time for chest tube removal, as well as length of hospitalization. A total of 105 patients were randomized. We found no significant difference between the electronic group and traditional group in optimal chest tube duration (HR = 0.83; 95% CI: 0.55-1.25; P = 0.367), actual chest tube duration (HR = 0.84; 95% CI: 0.55-1.26; P = 0.397) or length of hospital stay (HR = 0.91; 95% CI: 0.59-1.39; P = 0.651). No chest tubes had to be reinserted. Presence of pleural adhesions or an incomplete fissure was a significant predictor of chest tube duration (HR = 1.72; 95% CI: 1.15-2.77; P = 0.014). Electronic drainage systems did not reduce chest tube duration or length of hospitalization significantly compared with traditional water seal drainage when a strict algorithm for chest tube removal was used. This algorithm allowed delegation of chest tube removal to staff nurses, and in some patients chest tubes could be removed safely on the day of surgery. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Take-Home Challenges: Extending Discovery-Based Activities beyond the General Chemistry Classroom

NASA Astrophysics Data System (ADS)

Mason, P. K.; Sarquis, A. M.

1996-04-01

In an effort to more effectively integrate the experimental nature of chemistry into our students' experiences, we are developing and implementing discovery-based activities into both the laboratory and lecture components of general chemistry. Below we describe and provide an example of a "take-home challenge" intended to supplement the lecture component of the course. These take-home challenges involve the student in chemistry exploration outside of class and extend the context of content and experimentation into a nontraditional laboratory environment. Over 25 take-home challenges have been developed to date. Preliminary evaluation of the impact of the take-home challenges shows that students reporting themselves as receiving a B or C grade in the course find the challenges very useful in helping them gain a conceptual understanding of the phenomena addressed. Students earning an A grade report little or no impact on their learning. Prepared as one-page handouts, each take-home challenge begins with a scene-setting introduction followed by pertinent background information, a list of materials to be collected, and any appropriate safety precautions. The exploration component of the activity integrates leading questions with the procedural instructions to help guide the students through the discovery process and challenge them to stretch their understanding of the chemistry. After completing a take-home challenge activity, students submit written reports containing responses to the questions posed, observations of data collected, and their responses to the challenge. The accompanying sample take-home challenge activity is provided as a novel adaptation of the belch phenomenon that challenges students to experiment in order to explain the factors that account for the observed behavior. Persons interested in field testing the take-home challenges with their classes should contact the authors. Belch Bottle Challenge: What factors are responsible for the behavior of a "belch bottle"? Introductory Remarks. Have you ever belched? Belching is caused when there is an accumulation of gas in the digestive system. The "belch" occurs when the gas is released through the mouth. You can construct a "belch bottle" to imitate this action. Try this activity to find out how. Materials. 2 plastic soft-drink bottles of the same size one of the following sets of materials: potato; barrel of a Bic pen; tape (cellophane, electrical, or masking); 8-in. piece of wire, or 2 1-hole #3 stoppers; barrel of a Bic pen; tape (cellophane, electrical, or masking) water shallow tray or sink (optional) food color (optional) narrow-necked bottle made of glass (or other rigid material) Getting Ready. Cut one of the soft-drink bottles a few inches above the bottom to make a tall funnel as shown in Figure 1. Fill the second, uncut bottle half-full with water. If there is a hole in the side of the pen barrel, wrap tape around it. If 1-hole stoppers are available, slide one onto each end of the pen barrel and use this assembly to connect the cut funnel and the half-filled, uncut bottle. Alternatively, push the barrel all the way through a potato, leaving an approximately equal amount of pen barrel sticking out each side of the potato. If potato becomes lodged inside the pen barrel (that would restrict air or water flow), use a wire to push it out. Slide one end of the pen barrel into the mouth of the funnel all the way to the potato and gently screw the potato onto the thread of the funnel. Gently screw the other end of the potato onto the threads of the neck of the half-filled, uncut bottle. (See Fig. 2.) Your goal is to create an airtight seal between the funnel and the uncut soft-drink bottle. Procedure. Place the apparatus in a shallow tray or sink. Fill the funnel 3/4 full with water. (Colored water is easier to see.) Give the bottle a slight squeeze. Watch for several minutes. What do you observe? Explain your observations. Disconnect the bottle from the connector. Pour water out of the bottle until it is again only half full. Reconnect the connector to the bottle and fill the funnel full of water. Do not squeeze the bottle to start the "belch." How long does it take to begin on its own? Explain any differences in time from that observed in Step 1. What is the importance of having water in both the funnel and bottle? Why is it important that all seals be airtight? Try to make a "belch bottle" using a bottle made of glass (or other rigid material) instead of the uncut soft-drink bottle. Why or why not were you able to get it to belch? Draw or describe your setup and results. Answer the challenge!

Evaluation of a newly developed infant chest compression technique

PubMed Central

Smereka, Jacek; Bielski, Karol; Ladny, Jerzy R.; Ruetzler, Kurt; Szarpak, Lukasz

2017-01-01

Abstract Background: Providing adequate chest compression is essential during infant cardio-pulmonary-resuscitation (CPR) but was reported to be performed poor. The “new 2-thumb technique” (nTTT), which consists in using 2 thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist, was recently introduced. Therefore, the aim of this study was to compare 3 chest compression techniques, namely, the 2-finger-technique (TFT), the 2-thumb-technique (TTHT), and the nTTT in an randomized infant-CPR manikin setting. Methods: A total of 73 paramedics with at least 1 year of clinical experience performed 3 CPR settings with a chest compression:ventilation ratio of 15:2, according to current guidelines. Chest compression was performed with 1 out of the 3 chest compression techniques in a randomized sequence. Chest compression rate and depth, chest decompression, and adequate ventilation after chest compression served as outcome parameters. Results: The chest compression depth was 29 (IQR, 28–29) mm in the TFT group, 42 (40–43) mm in the TTHT group, and 40 (39–40) mm in the nTTT group (TFT vs TTHT, P < 0.001; TFT vs nTTT, P < 0.001; TTHT vs nTTT, P < 0.01). The median compression rate with TFT, TTHT, and nTTT varied and amounted to 136 (IQR, 133–144) min–1 versus 117 (115–121) min–1 versus 111 (109–113) min–1. There was a statistically significant difference in the compression rate between TFT and TTHT (P < 0.001), TFT and nTTT (P < 0.001), as well as TTHT and nTTT (P < 0.001). Incorrect decompressions after CC were significantly increased in the TTHT group compared with the TFT (P < 0.001) and the nTTT (P < 0.001) group. Conclusions: The nTTT provides adequate chest compression depth and rate and was associated with adequate chest decompression and possibility to adequately ventilate the infant manikin. Further clinical studies are necessary to confirm these initial findings. PMID:28383397

Evaluation of a newly developed infant chest compression technique: A randomized crossover manikin trial.

PubMed

Smereka, Jacek; Bielski, Karol; Ladny, Jerzy R; Ruetzler, Kurt; Szarpak, Lukasz

2017-04-01

Providing adequate chest compression is essential during infant cardio-pulmonary-resuscitation (CPR) but was reported to be performed poor. The "new 2-thumb technique" (nTTT), which consists in using 2 thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist, was recently introduced. Therefore, the aim of this study was to compare 3 chest compression techniques, namely, the 2-finger-technique (TFT), the 2-thumb-technique (TTHT), and the nTTT in an randomized infant-CPR manikin setting. A total of 73 paramedics with at least 1 year of clinical experience performed 3 CPR settings with a chest compression:ventilation ratio of 15:2, according to current guidelines. Chest compression was performed with 1 out of the 3 chest compression techniques in a randomized sequence. Chest compression rate and depth, chest decompression, and adequate ventilation after chest compression served as outcome parameters. The chest compression depth was 29 (IQR, 28-29) mm in the TFT group, 42 (40-43) mm in the TTHT group, and 40 (39-40) mm in the nTTT group (TFT vs TTHT, P < 0.001; TFT vs nTTT, P < 0.001; TTHT vs nTTT, P < 0.01). The median compression rate with TFT, TTHT, and nTTT varied and amounted to 136 (IQR, 133-144) min versus 117 (115-121) min versus 111 (109-113) min. There was a statistically significant difference in the compression rate between TFT and TTHT (P < 0.001), TFT and nTTT (P < 0.001), as well as TTHT and nTTT (P < 0.001). Incorrect decompressions after CC were significantly increased in the TTHT group compared with the TFT (P < 0.001) and the nTTT (P < 0.001) group. The nTTT provides adequate chest compression depth and rate and was associated with adequate chest decompression and possibility to adequately ventilate the infant manikin. Further clinical studies are necessary to confirm these initial findings.

Use of a Real-Time Training Software (Laerdal QCPR®) Compared to Instructor-Based Feedback for High-Quality Chest Compressions Acquisition in Secondary School Students: A Randomized Trial.

PubMed

Cortegiani, Andrea; Russotto, Vincenzo; Montalto, Francesca; Iozzo, Pasquale; Meschis, Roberta; Pugliesi, Marinella; Mariano, Dario; Benenati, Vincenzo; Raineri, Santi Maurizio; Gregoretti, Cesare; Giarratano, Antonino

2017-01-01

High-quality chest compressions are pivotal to improve survival from cardiac arrest. Basic life support training of school students is an international priority. The aim of this trial was to assess the effectiveness of a real-time training software (Laerdal QCPR®) compared to a standard instructor-based feedback for chest compressions acquisition in secondary school students. After an interactive frontal lesson about basic life support and high quality chest compressions, 144 students were randomized to two types of chest compressions training: 1) using Laerdal QCPR® (QCPR group- 72 students) for real-time feedback during chest compressions with the guide of an instructor who considered software data for students' correction 2) based on standard instructor-based feedback (SF group- 72 students). Both groups had a minimum of a 2-minute chest compressions training session. Students were required to reach a minimum technical skill level before the evaluation. We evaluated all students at 7 days from the training with a 2-minute chest compressions session. The primary outcome was the compression score, which is an overall measure of chest compressions quality calculated by the software expressed as percentage. 125 students were present at the evaluation session (60 from QCPR group and 65 from SF group). Students in QCPR group had a significantly higher compression score (median 90%, IQR 81.9-96.0) compared to SF group (median 67%, IQR 27.7-87.5), p = 0.0003. Students in QCPR group performed significantly higher percentage of fully released chest compressions (71% [IQR 24.5-99.0] vs 24% [IQR 2.5-88.2]; p = 0.005) and better chest compression rate (117.5/min [IQR 106-123.5] vs 125/min [115-135.2]; p = 0.001). In secondary school students, a training for chest compressions based on a real-time feedback software (Laerdal QCPR®) guided by an instructor is superior to instructor-based feedback training in terms of chest compression technical skill acquisition. Australian New Zealand Clinical Trials Registry ACTRN12616000383460.

Follow-up chest radiographic findings in patients with MERS-CoV after recovery

PubMed Central

Das, Karuna M; Lee, Edward Y; Singh, Rajvir; Enani, Mushira A; Al Dossari, Khalid; Van Gorkom, Klaus; Larsson, Sven G; Langer, Ruth D

2017-01-01

Purpose: To evaluate the follow-up chest radiographic findings in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) who were discharged from the hospital following improved clinical symptoms. Materials and Methods: Thirty-six consecutive patients (9 men, 27 women; age range 21–73 years, mean ± SD 42.5 ± 14.5 years) with confirmed MERS-CoV underwent follow-up chest radiographs after recovery from MERS-CoV. The 36 chest radiographs were obtained at 32 to 230 days with a median follow-up of 43 days. The reviewers systemically evaluated the follow-up chest radiographs from 36 patients for lung parenchymal, airway, pleural, hilar and mediastinal abnormalities. Lung parenchyma and airways were assessed for consolidation, ground-glass opacity (GGO), nodular opacity and reticular opacity (i.e., fibrosis). Follow-up chest radiographs were also evaluated for pleural thickening, pleural effusion, pneumothorax and lymphadenopathy. Patients were categorized into two groups: group 1 (no evidence of lung fibrosis) and group 2 (chest radiographic evidence of lung fibrosis) for comparative analysis. Patient demographics, length of ventilations days, number of intensive care unit (ICU) admission days, chest radiographic score, chest radiographic deterioration pattern (Types 1-4) and peak lactate dehydrogenase level were compared between the two groups using the student t-test, Mann-Whitney U test and Fisher's exact test. Results: Follow-up chest radiographs were normal in 23 out of 36 (64%) patients. Among the patients with abnormal chest radiographs (13/36, 36%), the following were found: lung fibrosis in 12 (33%) patients GGO in 2 (5.5%) patients, and pleural thickening in 2 (5.5%) patients. Patients with lung fibrosis had significantly greater number of ICU admission days (19 ± 8.7 days; P value = 0.001), older age (50.6 ± 12.6 years; P value = 0.02), higher chest radiographic scores [10 (0-15.3); P value = 0.04] and higher peak lactate dehydrogenase levels (315-370 U/L; P value = 0.001) when compared to patients without lung fibrosis. Conclusion: Lung fibrosis may develop in a substantial number of patients who have recovered from Middle East respiratory syndrome coronavirus (MERS-CoV). Significantly greater number of ICU admission days, older age, higher chest radiographic scores, chest radiographic deterioration patterns and peak lactate dehydrogenase levels were noted in the patients with lung fibrosis on follow-up chest radiographs after recovery from MERS-CoV. PMID:29089687

An assessment of the isotopic (2H/18O) integrity of water samples collected and stored by unattended precipitation totalizers

NASA Astrophysics Data System (ADS)

Terzer, Stefan; Wassenaar, Leonard I.; Douence, Cedric; Araguas-Araguas, Luis

2016-04-01

The IAEA-WMO Global Network of Isotopes in Precipitation (GNIP) provides worldwide δ18O and δ2H data for numerous hydrological and climatological studies. The traditional GNIP sample collection method relies on weather station operators to accumulate precipitation obtained from manual rain gauges. Over the past decades, widespread weather station automatization resulted in the increased use of unattended precipitation totalizers that accumulate and store the rainwater in the field for up to one month. Several low-tech measures were adopted to prevent in situ secondary evaporative isotopic enrichment (SEE) of totalized water samples (i.e. disequilibrium isotopic fractionation after precipitation is stored in the collection device). These include: (a) adding a 0.5-1 cm floating layer of paraffin oil to the totalizer bottle, (b) using an intake tube leading from the collection funnel and submerged to the bottom of the totalizer bottle, or (c) placing a table tennis ball in the funnel aiming to reduce evaporation of the collected water from the receiving bottle to the atmosphere. We assessed the isotopic integrity of stored rainwater samples for three totalizers under controlled settings: each aforementioned totalizer was filled with a 100 or 500 mL of isotopically known water and installed in the field with the intake funnels sheltered to prevent rainwater collection. Potential evapotranspiration (PET) was obtained from on-site meteorological recordings. Stored evaporative loss from each totalizer was evaluated on a monthly basis; gravimetrically and by analysing δ18O and δ2H of the stored water, for a period of 6 months and a cumulative PET of ˜500 mm. The gravimetric and isotope results revealed that for smaller water volumes (100 ml, corresponding to ca. 5 mm of monthly precipitation), negligible isotope enrichment (δ18O) was observed in the paraffin-oil based totalizer, whereas unacceptable evaporative isotope effects were observed for the ball-in-funnel collector. For the submerged-tube sampler, the evaporative effect depended on the amount of stored water: 100 ml showed unacceptable isotopic enrichment, whereas the SEE of 500 ml stored water was acceptable. These data allowed us to estimate the impact of secondary evaporative enrichment on a device-specific basis as a function of PET. Based on global PET grids (e.g. CGIAR data), and benchmarking the expected SEE against the reasonable uncertainty of isotope spectrometry (< ±0.1‰ for δ18O), these findings reveal the most suitable totalizer device for any given climatic condition. Under extreme conditions (e.g. high aridity, little precipitation vs. high PET), a paraffin-oil based rain totalizer is most appropriate for monthly collections. Submerged-tube samplers may be considered if either a higher frequency of collection were possible, or monthly under pluvial/temperate climate conditions. The use of ball-in-funnel type totalizers are not recommended at all, unless samples could be collected on a daily basis.

75 FR 15448 - Notice of Issuance of Final Determination Concerning a Wood Chest

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

... Determination Concerning a Wood Chest AGENCY: U.S. Customs and Border Protection, Department of Homeland... certain wood chest. Based upon the facts presented, CBP has concluded in the final determination that the U.S. is the country of origin of the wood chest for purposes of U.S. government procurement. DATES...

Pediatric chest imaging.

PubMed

Gross, G W

1992-10-01

The highlight of recent articles published on pediatric chest imaging is the potential advantage of digital imaging of the infant's chest. Digital chest imaging allows accurate determination of functional residual capacity as well as manipulation of the image to highlight specific anatomic features. Reusable photostimulable phosphor imaging systems provide wide imaging latitude and lower patient dose. In addition, digital radiology permits multiple remote-site viewing on monitor displays. Several excellent reviews of the imaging features of various thoracic abnormalities and the application of newer imaging modalities, such as ultrafast CT and MR imaging to the pediatric chest, are additional highlights.

Surgical Management of Lung Cancer Involving the Chest Wall.

PubMed

Lanuti, Michael

2017-05-01

The prevalence of chest wall invasion by non-small cell lung cancer is < 10% in published surgical series. The role of radiation or chemotherapy around the complete resection of lung cancer invading the chest wall, excluding the superior sulcus of the chest, is poorly defined. Survival of patients with lung cancer invading the chest wall is dependent on lymph node involvement and completeness of en-bloc resection. In some patients harboring T3N0 disease, 5-year survival in excess of 50% can be achieved. Offering en-bloc resection of lung cancer invading chest wall to patients with T3N1 or T3N2 disease is controversial. Copyright © 2017 Elsevier Inc. All rights reserved.

Early Childhood: Discovery through Sand Play.

ERIC Educational Resources Information Center

McIntyre, Margaret

1982-01-01

Suggestions are given for using sand play to teach science related vocabulary and concepts to preschool and primary age children by using dry sand, wet sand, different sizes and shapes of spoons and containers, sieves, and funnels. (DC)

DefenseLink.mil - Special Report - Travels With Gates

Science.gov Websites

International Security Assistance Force soldiers in Afghanistan to shut down drug networks that funnel money to Halt Taliban Drug Money BUDAPEST, Hungary, Oct. 9, 2008 - NATO should go after the drug trade in

Apparatus for sectioning demountable semiconductor samples

DOEpatents

Sopori, Bhushan L.; Wolf, Abraham

1984-01-01

Apparatus for use during polishing and sectioning operations of a ribbon sample is described. The sample holder includes a cylinder having an axially extending sample cavity terminated in a first funnel-shaped opening and a second slot-like opening. A spring-loaded pressure plunger is located adjacent the second opening of the sample cavity for frictional engagement of the sample prior to introduction of a molding medium in the sample cavity. A heat softenable molding medium is inserted in the funnel-shaped opening, to surround the sample. After polishing, the heater is energized to allow draining of the molding medium from the sample cavity. During manual polishing, the second end of the sample holder is inserted in a support ring which provides mechanical support as well as alignment of the sample holder during polishing. A gauge block for measuring the protrusion of a sample beyond the second wall of the holder is also disclosed.

An RF-only ion-funnel for extraction from high-pressure gases

DOE PAGES

Brunner, T.; Fudenberg, D.; Varentsov, V.; ...

2015-01-27

An RF ion-funnel technique has been developed to extract ions from a high-pressure (10 bar) noble-gas environment into a vacuum (10 -6 mbar). Detailed simulations have been performed and a prototype has been developed for the purpose of extracting 136Ba ions from Xe gas with high efficiency. With this prototype, ions have been extracted for the first time from high-pressure xenon gas and argon gas. Systematic studies have been carried out and compared to simulations. This demonstration of extraction of ions, with mass comparable to that of the gas generating the high-pressure, has applications to Ba tagging from a Xe-gasmore » time-projection chamber for double-beta decay, as well as to the general problem of recovering trace amounts of an ionized element in a heavy (m > 40 u) carrier gas.« less

Effects of Storage Temperature and Extraction Procedure on Recovery of Plant-parasitic Nematodes from Field Soils

PubMed Central

Barker, K. R.; Nusbaum, C. J.; Nelson, L. A.

1969-01-01

Storage of nematodes in soil at -15 C for 1 to 16 weeks greatly increased nematode recovery by a sugar-flotation-sieving procedure. One week of exposure to -15 C killed all nematodes except Pratylenchus zeae and Tylenchorhynchus claytoni which were recoverable in decreasing numbers up to 10 weeks by the Baermann funnel method. Optimum storage temperature for survival of most nematode species was 13 C. The numbers of Meloidogyne incognita, T. claytoni, Belonolaimus Iongicaudatus, and P. zeae recoverable by either extraction method remained constant or increased when stored at 13-24 C for 16 weeks. This was also true for Helicotylenchtts dihystera and Xiphinema americanum extracted by the Baermann funnel technique, whereas the numbers retrieved by the sugar-flotation-sieving method decreased slightly. All species except T. claytoni decreased appreciably in soil stored at 36 C. PMID:19325684

Magneto-optical trapping of potassium isotopes

NASA Astrophysics Data System (ADS)

Williamson, Robert Sylvester, III

1997-12-01

We have demonstrated a magneto-optical trap (scMOT) suitable for capturing radioactive potassium produced on- line with the UW-Madison 12MeV tandem electrostatic accelerator. To do this, we made and characterized the first scMOT for potassium, measured the potassium ultracold collision rate, and developed a numerical trap- loading rate model that makes useful quantitative predictions. We have created a cold beam of collimated potassium atoms using a pyramidal magneto-optical funnel and used it to load a long-lifetime scMOT operating at ultrahigh vacuum. We have also built a target that produces a beam of radioactive 37K and 38K and coupled it to the magneto-optical funnel and trap. Once a trap of radioactive 38K has been demonstrated, the primary goal of this project is to measure the beta-asymmetry parameter in the decay of 38K, performing a sensitive test of the Standard Model of weak interactions.

Analytic studies of local-severe-storm observables by satellites

NASA Technical Reports Server (NTRS)

Dergarabedian, P.; Fendell, F.

1977-01-01

Attention is concentrated on the exceptionally violet whirlwind, often characterized by a fairly vertical axis of rotation. For a cylindrical polar coordinate system with axis coincident with the axis of rotation, the secondary flow involves the radial and axial velocity components. The thesis advanced is, first, that a violent whirlwind is characterized by swirl speeds relative to the axis of rotation on the order of 90 m/s, with 100 m/s being close to an upper bound. This estimate is based on interpretation of funnel-cloud shape (which also suggests properties of the radial profile of swirl, as well as the maximum magnitude); an error assessment of the funnel-cloud interpretation procedure is developed. Second, computation of ground-level pressure deficits achievable from typical tornado-spawning ambients by idealized thermohydrostatic processes suggests that a two-cell structure is required to sustain such large speeds.

FRB as products of accretion disc funnels

NASA Astrophysics Data System (ADS)

Katz, J. I.

2017-10-01

The repeating FRB 121102, the only fast radio burst (FRB) with an accurately determined position, is associated with a variable persistent radio source. I suggest that an FRB originates in the accretion disc funnels of black holes. Narrowly collimated radiation is emitted along the wandering instantaneous angular momentum axis of accreted matter. This emission is observed as a fast radio burst when it sweeps across the direction to the observer. In this model, in contrast to neutron star (pulsar, RRAT or SGR) models, repeating FRBs do not have underlying periodicity and are co-located with persistent radio sources resulting from their off-axis emission. The model is analogous, on smaller spatial, lower mass and accretion rate and shorter temporal scales, to an active galactic nucleus (AGN), with FRB corresponding to blazars in which the jets point towards us. The small inferred black hole masses imply that FRBs are not associated with galactic nuclei.

Strain-engineered inverse charge-funnelling in layered semiconductors.

PubMed

De Sanctis, Adolfo; Amit, Iddo; Hepplestone, Steven P; Craciun, Monica F; Russo, Saverio

2018-04-25

The control of charges in a circuit due to an external electric field is ubiquitous to the exchange, storage and manipulation of information in a wide range of applications. Conversely, the ability to grow clean interfaces between materials has been a stepping stone for engineering built-in electric fields largely exploited in modern photovoltaics and opto-electronics. The emergence of atomically thin semiconductors is now enabling new ways to attain electric fields and unveil novel charge transport mechanisms. Here, we report the first direct electrical observation of the inverse charge-funnel effect enabled by deterministic and spatially resolved strain-induced electric fields in a thin sheet of HfS 2 . We demonstrate that charges driven by these spatially varying electric fields in the channel of a phototransistor lead to a 350% enhancement in the responsivity. These findings could enable the informed design of highly efficient photovoltaic cells.

Propagation and Dissipation of MHD Waves in Coronal Holes

NASA Astrophysics Data System (ADS)

Dwivedi, B. N.

2006-11-01

bholadwivedi@gmail.com In view of the landmark result on the solar wind outflow, starting between 5 Mm and 20 Mm above the photosphere in magnetic funnels, we investigate the propagation and dissipation of MHD waves in coronal holes. We underline the importance of Alfvén wave dissipation in the magnetic funnels through the viscous and resistive plasma. Our results show that Alfvén waves are one of the primary energy sources in the innermost part of coronal holes where the solar wind outflow starts. We also consider compressive viscosity and thermal conductivity to study the propagation and dissipation of long period slow longitudinal MHD waves in polar coronal holes. We discuss their likely role in the line profile narrowing, and in the energy budget for coronal holes and the solar wind. We compare the contribution of longitudinal MHD waves with high frequency Alfvén waves.

Using a Smart-pulley Atwood machine to study rocket motion

NASA Astrophysics Data System (ADS)

Greenwood, M. Stautberg; Bernett, R.; Benavides, M.; Granger, S.; Plass, R.; Walters, S.

1989-10-01

The Atwood machine consisted of a funnel partly filled with water on one side and a fixed mass of 400 g on the other side. The ``rocket'' begins to ascend when the acceleration is momentarily zero. This occurs when the total mass of the rocket is slightly larger than 400 g due to the rocket's thrust. As the wheel of Pasco's Smart pulley rotates, signals are sent to the Apple computer and the software generates tables and graphs of position, speed, and acceleration as a function of time. Also presented is a numerical differentiation scheme that greatly reduces the scatter in the experimental data for the acceleration. The data are compared with theory, assuming that dm/dt is constant. The value of dm/dt necessary to fit the data is compared with that found by measuring the flow rate from the funnel directly. Excellent agreement is obtained for the two values of dm/dt.

Computer-aided detection system for chest radiography: reducing report turnaround times of examinations with abnormalities.

PubMed

Kao, E-Fong; Liu, Gin-Chung; Lee, Lo-Yeh; Tsai, Huei-Yi; Jaw, Twei-Shiun

2015-06-01

The ability to give high priority to examinations with pathological findings could be very useful to radiologists with large work lists who wish to first evaluate the most critical studies. A computer-aided detection (CAD) system for identifying chest examinations with abnormalities has therefore been developed. To evaluate the effectiveness of a CAD system on report turnaround times of chest examinations with abnormalities. The CAD system was designed to automatically mark chest examinations with possible abnormalities in the work list of radiologists interpreting chest examinations. The system evaluation was performed in two phases: two radiologists interpreted the chest examinations without CAD in phase 1 and with CAD in phase 2. The time information recorded by the radiology information system was then used to calculate the turnaround times. All chest examinations were reviewed by two other radiologists and were divided into normal and abnormal groups. The turnaround times for the examinations with pathological findings with and without the CAD system assistance were compared. The sensitivity and specificity of the CAD for chest abnormalities were 0.790 and 0.697, respectively, and use of the CAD system decreased the turnaround time for chest examinations with abnormalities by 44%. The turnaround times required for radiologists to identify chest examinations with abnormalities could be reduced by using the CAD system. This system could be useful for radiologists with large work lists who wish to first evaluate the most critical studies. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Accuracy of transthoracic ultrasound for the prediction of chest wall infiltration by lung cancer and of lung infiltration by chest wall tumours.

PubMed

Caroli, Guido; Dell'Amore, Andrea; Cassanelli, Nicola; Dolci, Giampiero; Pipitone, Emanuela; Asadi, Nizar; Stella, Franco; Bini, Alessandro

2015-10-01

We wanted to determine the accuracy of transthoracic ultrasound in the prediction of chest wall infiltration by lung cancer or lung infiltration by chest wall tumours. Patients having preoperative CT-scan suspect for lung/chest wall infiltration were prospectively enrolled. Inclusion criteria for lung cancer were: obliteration of extrapleural fat, obtuse angle between tumour and chest wall, associated pleural thickening. The criteria for chest wall tumours were: rib destruction and intercostal muscles infiltration with extrapleural fat obliteration and intrathoracic extension. Lung cancer patients with evident chest wall infiltration were excluded. Transthoracic ultrasound was preoperatively performed. Predictions were checked during surgical intervention. Twenty-three patients were preoperatively examined. Sensitivity, specificity, positive and negative predictive values of transthoracic ultrasound were 88.89%, 100%, 100% and 93.3%, respectively. Youden index was used to determine the best cut-off for tumour size in predicting lung/chest wall infiltration: 4.5cm. At univariate logistic regression, tumour size (<4.5 vs ≥ 4.5cm) (p=0.0072) was significantly associated with infiltration. Transthoracic ultrasound is a useful instrument for predicting neoplastic lung or chest wall infiltration in cases of suspect CT-scans and could be used as part of the preoperative workup to assess tumour staging and to plan the best surgical approach. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Usefulness of Chest Radiographs for Scoliosis Screening: A Comparison with Thoraco-Lumbar Standing Radiographs

PubMed Central

Oh, Chang Hyun; Kim, Chan Gyu; Lee, Myoung Seok; Park, Hyeong-Chun; Park, Chong Oon

2012-01-01

Purpose The purposes of this study were to evaluate the usefulness and limitations of chest radiographs in scoliosis screening and to compare these results with those of thoraco-lumbar standing radiographs (TLSR). Materials and Methods During Korean conscription, 419 males were retrospectively examined using both chest radiographs and TLSR to confirm the scoliosis and Cobb angle at the Regional Military Manpower. We compared the types of spinal curves and Cobb angles as measured from different radiographs. Results In the pattern of spinal curves, the overall matching rate of chest radiographs using TLSR was about 58.2% (244 of 419 cases). Cobb angle differences between chest radiographs and TLSR with meaningful difference was observed in 156 cases (37.2%); a relatively high proportion (9.5%) of Cobb angle differences more than 10 degrees was also observed. The matching rate of both spinal curve types and Cobb angle accuracy between chest radiographs and TLSR was 27.9% (117 among 419 cases). Chest radiographs for scoliosis screening were observed with 93.94% of sensitivity and 61.67% of specificity in thoracic curves; however, less than 40% of sensitivity (38.27%, 20.00%, and 25.80%) and more than 95% of specificity (97.34%, 99.69%, and 98.45%) were observed in thoraco-lumbar, lumbar, and double major curves, respectively. Conclusion The accuracy of chest radiographs for scoliosis screening was low. The incidence of thoracic curve scoliosis was overestimated and lumbar curve scoliosis was easily missed by chest radiography. Scoliosis screening using chest radiography has limited values, nevertheless, it is useful method for detecting thoracic curve scoliosis. PMID:23074120

Evaluation of chest compression effect on airway management with air-Q, aura-i, i-gel, and Fastrack intubating supraglottic devices by novice physicians: a randomized crossover simulation study.

PubMed

Komasawa, Nobuyasu; Ueki, Ryusuke; Kaminoh, Yoshiroh; Nishi, Shin-Ichi

2014-10-01

In the 2010 American Heart Association guidelines, supraglottic devices (SGDs) such as the laryngeal mask are proposed as alternatives to tracheal intubation for cardiopulmonary resuscitation. Some SGDs can also serve as a means for tracheal intubation after successful ventilation. The purpose of this study was to evaluate the effect of chest compression on airway management with four intubating SGDs, aura-i (aura-i), air-Q (air-Q), i-gel (i-gel), and Fastrack (Fastrack), during cardiopulmonary resuscitation using a manikin. Twenty novice physicians inserted the four intubating SGDs into a manikin with or without chest compression. Insertion time and successful ventilation rate were measured. For cases of successful ventilation, blind tracheal intubation via the intubating SGD was performed with chest compression and success or failure within 30 s was recorded. Chest compression did not decrease the ventilation success rate of the four intubating SGDs (without chest compression (success/total): air-Q, 19/20; aura-i, 19/20; i-gel, 18/20; Fastrack, 19/20; with chest compression: air-Q, 19/20; aura-i, 19/20; i-gel, 16/20; Fastrack, 18/20). Insertion time was significantly lengthened by chest compression in the i-gel trial (P < 0.05), but not with the other three devices. The blind intubation success rate with chest compression was the highest in the air-Q trial (air-Q, 15/19; aura-i, 14/19; i-gel, 12/16; Fastrack, 10/18). This simulation study revealed the utility of intubating SGDs for airway management during chest compression.

Omitting chest tube drainage after thoracoscopic major lung resection.

PubMed

Ueda, Kazuhiro; Hayashi, Masataro; Tanaka, Toshiki; Hamano, Kimikazu

2013-08-01

Absorbable mesh and fibrin glue applied to prevent alveolar air leakage contribute to reducing the length of chest tube drainage, length of hospitalization and the rate of pulmonary complications. This study investigated the feasibility of omitting chest tube drainage in selected patients undergoing thoracoscopic major lung resection. Intraoperative air leakages were sealed with fibrin glue and absorbable mesh in patients undergoing thoracoscopic major lung resection. The chest tube was removed just after tracheal extubation if no air leakages were detected in a suction-induced air leakage test, which is an original technique to confirm pneumostasis. Patients with bleeding tendency or extensive thoracic adhesions were excluded. Chest tube drainage was omitted in 29 (58%) of 50 eligible patients and was used in 21 (42%) on the basis of suction-induced air leakage test results. Male gender and compromised pulmonary function were significantly associated with the failure to omit chest tube drainage (both, P < 0.05). Regardless of omitting the chest tube drainage, there were no adverse events during hospitalization, such as subcutaneous emphysema, pneumothorax, pleural effusion or haemothorax, requiring subsequent drainage. Furthermore, there was no prolonged air leakage in any patients: The mean length of chest tube drainage was only 0.9 days. Omitting the chest tube drainage was associated with reduced pain on the day of the operation (P = 0.046). The refined strategy for pneumostasis allowed the omission of chest tube drainage in the majority of patients undergoing thoracoscopic major lung resection without increasing the risk of adverse events, which may contribute to a fast-track surgery.

[Development of a digital chest phantom for studies on energy subtraction techniques].

PubMed

Hayashi, Norio; Taniguchi, Anna; Noto, Kimiya; Shimosegawa, Masayuki; Ogura, Toshihiro; Doi, Kunio

2014-03-01

Digital chest phantoms continue to play a significant role in optimizing imaging parameters for chest X-ray examinations. The purpose of this study was to develop a digital chest phantom for studies on energy subtraction techniques under ideal conditions without image noise. Computed tomography (CT) images from the LIDC (Lung Image Database Consortium) were employed to develop a digital chest phantom. The method consisted of the following four steps: 1) segmentation of the lung and bone regions on CT images; 2) creation of simulated nodules; 3) transformation to attenuation coefficient maps from the segmented images; and 4) projection from attenuation coefficient maps. To evaluate the usefulness of digital chest phantoms, we determined the contrast of the simulated nodules in projection images of the digital chest phantom using high and low X-ray energies, soft tissue images obtained by energy subtraction, and "gold standard" images of the soft tissues. Using our method, the lung and bone regions were segmented on the original CT images. The contrast of simulated nodules in soft tissue images obtained by energy subtraction closely matched that obtained using the gold standard images. We thus conclude that it is possible to carry out simulation studies based on energy subtraction techniques using the created digital chest phantoms. Our method is potentially useful for performing simulation studies for optimizing the imaging parameters in chest X-ray examinations.

Nurses’ knowledge of care of chest drain: A survey in a Nigerian semiurban university hospital

PubMed Central

Kesieme, Emeka Blessius; Essu, Ifeanyichukwu Stanley; Arekhandia, Bruno Jeneru; Welcker, Katrin; Prisadov, Georgi

2016-01-01

Background/Objective: Inefficient nursing care of chest drains may associated with unacceptable and sometimes life-threatening complications. This report aims to ascertain the level of knowledge of care of chest drains among nurses working in wards in a teaching hospital in Nigeria. Methods: A cross-sectional study among nurses at teaching hospital using pretested self-administered questionnaires. Results: The majority were respondents aged between 31 and 40 years (45.4%) and those who have nursing experience between 6 and 10 years. Only 37 respondents (26.2%) had a good knowledge of nursing care of chest drains. Knowledge was relatively higher among nurses who cared for chest drains daily, nurses who have a work experience of <10 years, low-rank nurses and those working in the female medical ward; however, the relationship cant (P > 0.05). Performance was poor on the questions on position of drainage system were not statistically significant with relationship to waist level while mobilizing the patient, application of suction to chest drains, daily changing of dressing over chest drain insertion site, milking of tubes and drainage system with dependent loop. Conclusion: The knowledge of care of chest drains among nurses is poor, especially in the key post procedural care. There is an urgent need to train them so as to improve the nursing care of patients managed with chest drains. PMID:26857934

The safe volume threshold for chest drain removal following pulmonary resection.

PubMed

Yap, Kok Hooi; Soon, Jia Lin; Ong, Boon Hean; Loh, Yee Jim

2017-11-01

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'In patients undergoing pulmonary resection, is there a safe drainage volume threshold for chest drain removal?' Altogether 1054 papers were found, of which 5 papers represented the best evidence. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Chest drainage threshold, where used, ranged from 250 to 500 ml/day. Both randomized controlled trials showed no significant difference in reintervention rates with a higher chest drainage volume threshold. Four studies that performed analysis on other complications showed no statistical significant difference with a higher chest drainage volume threshold. Four studies evaluating length of hospital stay showed reduced or no difference in the length of stay with a higher chest drainage volume threshold. Two cohort studies reported the mortality rate of 0-0.01% with a higher chest drainage volume threshold. We conclude that early chest drain removal after pulmonary resection, accepting a higher chest drainage volume threshold of 250-500 ml/day is safe, and may result in shorter hospital stay without increasing reintervention, morbidity or mortality. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Application of Deconvolution Algorithm of Point Spread Function in Improving Image Quality: An Observer Preference Study on Chest Radiography.

PubMed

Chae, Kum Ju; Goo, Jin Mo; Ahn, Su Yeon; Yoo, Jin Young; Yoon, Soon Ho

2018-01-01

To evaluate the preference of observers for image quality of chest radiography using the deconvolution algorithm of point spread function (PSF) (TRUVIEW ART algorithm, DRTECH Corp.) compared with that of original chest radiography for visualization of anatomic regions of the chest. Prospectively enrolled 50 pairs of posteroanterior chest radiographs collected with standard protocol and with additional TRUVIEW ART algorithm were compared by four chest radiologists. This algorithm corrects scattered signals generated by a scintillator. Readers independently evaluated the visibility of 10 anatomical regions and overall image quality with a 5-point scale of preference. The significance of the differences in reader's preference was tested with a Wilcoxon's signed rank test. All four readers preferred the images applied with the algorithm to those without algorithm for all 10 anatomical regions (mean, 3.6; range, 3.2-4.0; p < 0.001) and for the overall image quality (mean, 3.8; range, 3.3-4.0; p < 0.001). The most preferred anatomical regions were the azygoesophageal recess, thoracic spine, and unobscured lung. The visibility of chest anatomical structures applied with the deconvolution algorithm of PSF was superior to the original chest radiography.

Optimized coupling of cold atoms into a fiber using a blue-detuned hollow-beam funnel

NASA Astrophysics Data System (ADS)

Poulin, Jerome; Light, Philip S.; Kashyap, Raman; Luiten, Andre N.

2011-11-01

We theoretically investigate the process of coupling cold atoms into the core of a hollow-core photonic-crystal optical fiber using a blue-detuned Laguerre-Gaussian beam. In contrast to the use of a red-detuned Gaussian beam to couple the atoms, the blue-detuned hollow beam can confine cold atoms to the darkest regions of the beam, thereby minimizing shifts in the internal states and making the guide highly robust to heating effects. This single optical beam is used as both a funnel and a guide to maximize the number of atoms into the fiber. In the proposed experiment, Rb atoms are loaded into a magneto-optical trap (MOT) above a vertically oriented optical fiber. We observe a gravito-optical trapping effect for atoms with high orbital momentum around the trap axis, which prevents atoms from coupling to the fiber: these atoms lack the kinetic energy to escape the potential and are thus trapped in the laser funnel indefinitely. We find that by reducing the dipolar force to the point at which the trapping effect just vanishes, it is possible to optimize the coupling of atoms into the fiber. Our simulations predict that by using a low-power (2.5 mW) and far-detuned (300 GHz) Laguerre-Gaussian beam with a 20-μm-radius core hollow fiber, it is possible to couple 11% of the atoms from a MOT 9 mm away from the fiber. When the MOT is positioned farther away, coupling efficiencies over 50% can be achieved with larger core fibers.

The behavior of self-compacting concrete (SCC) with bagasse ash

NASA Astrophysics Data System (ADS)

Hanafiah, Saloma, Whardani, Putri Nurul Kusuma

2017-11-01

Self-Compacting Concrete (SCC) has the ability to flow and self-compacting. One of the benefit of SCC can reduced the construction time and labor cost. The materials to be used for see slightly different with the conventional concrete. Less coarse aggregate to be used up to 50%. The maximum size of coarse aggregate was also limited e.g. 10 mm. Other material was quartz sand with grain size of 50-650 µm. For reducing the around of cement, bagasse ash was used as partial replacement of cement. In this research, the variations of w/c to be used, e.g. 0.275, 0.300, 0.325 and the percentage of bagasse ash substitution were 10%, 15%, and 20%. EFNARC standard was conducted for slump flow test following the V-funnel test and L-box shape test. The maximum value of slump flow test was 75.75 cm, V-funnel test was 4.95 second, and L-box test was 1.000 yielded by mixture with w/c = 0.325 and 0% of bagasse ash. The minimum value of slump flow test was 61.50 cm, V-funnel test is 21.05 second, and L-box test was 0.743 yielded by mixture with w/c = 0.275 and 20% of bagasse ash. The maximum value of compressive strength was 67.239 MPa yielded by mixture with w/c = 0.275 and 15% of bagasse ash. And the minimum value of compressive strength was 41.813 MPa yielded by mixture with w/c = 0.325 and 20% bagasse ash.

Next Generation Quality: Assessing the Physician in Clinical History Completeness and Diagnostic Interpretations Using Funnel Plots and Normalized Deviations Plots in 3,854 Prostate Biopsies.

PubMed

Bonert, Michael; El-Shinnawy, Ihab; Carvalho, Michael; Williams, Phillip; Salama, Samih; Tang, Damu; Kapoor, Anil

2017-01-01

Observational data and funnel plots are routinely used outside of pathology to understand trends and improve performance. Extract diagnostic rate (DR) information from free text surgical pathology reports with synoptic elements and assess whether inter-rater variation and clinical history completeness information useful for continuous quality improvement (CQI) can be obtained. All in-house prostate biopsies in a 6-year period at two large teaching hospitals were extracted and then diagnostically categorized using string matching, fuzzy string matching, and hierarchical pruning. DRs were then stratified by the submitting physicians and pathologists. Funnel plots were created to assess for diagnostic bias. 3,854 prostate biopsies were found and all could be diagnostically classified. Two audits involving the review of 700 reports and a comparison of the synoptic elements with the free text interpretations suggest a categorization error rate of <1%. Twenty-seven pathologists each read >40 cases and together assessed 3,690 biopsies. There was considerable inter-rater variability and a trend toward more World Health Organization/International Society of Urologic Pathology Grade 1 cancers in older pathologists. Normalized deviations plots, constructed using the median DR, and standard error can elucidate associated over- and under-calls for an individual pathologist in relation to their practice group. Clinical history completeness by submitting medical doctor varied significantly (100% to 22%). Free text data analyses have some limitations; however, they could be used for data-driven CQI in anatomical pathology, and could lead to the next generation in quality of care.

Evaluation of a Noise Reduction Procedure for Chest Radiography

PubMed Central

Fukui, Ryohei; Ishii, Rie; Kodani, Kazuhiko; Kanasaki, Yoshiko; Suyama, Hisashi; Watanabe, Masanari; Nakamoto, Masaki; Fukuoka, Yasushi

2013-01-01

Background The aim of this study was to evaluate the usefulness of noise reduction procedure (NRP), a function in the new image processing for chest radiography. Methods A CXDI-50G Portable Digital Radiography System (Canon) was used for X-ray detection. Image noise was analyzed with a noise power spectrum (NPS) and a burger phantom was used for evaluation of density resolution. The usefulness of NRP was evaluated by chest phantom images and clinical chest radiography. We employed the Bureau of Radiological Health Method for scoring chest images while carrying out our observations. Results NPS through the use of NRP was improved compared with conventional image processing (CIP). The results in image quality showed high-density resolution through the use of NRP, so that chest radiography examination can be performed with a low dose of radiation. Scores were significantly higher than for CIP. Conclusion In this study, use of NRP led to a high evaluation in these so we are able to confirm the usefulness of NRP for clinical chest radiography. PMID:24574577

Headaches

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Cough

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Fever

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Diarrhea

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The intersection between asthma and acute chest syndrome in children with sickle-cell anaemia

PubMed Central

DeBaun, Michael R; Strunk, Robert C

2016-01-01

Acute chest syndrome is a frequent cause of acute lung disease in children with sickle-cell disease. Asthma is common in children with sickle-cell disease and is associated with increased incidence of vaso-occlusive pain events, acute chest syndrome episodes, and earlier death. Risk factors for asthma exacerbation and an acute chest syndrome episode are similar, and both can present with shortness of breath, chest pain, cough, and wheezing. Despite overlapping risk factors and symptoms, an acute exacerbation of asthma or an episode of acute chest syndrome are two distinct entities that need disease-specific management strategies. Although understanding has increased about asthma as a comorbidity in sickle-cell disease and its effects on morbidity, substantial gaps remain in knowledge about best management. PMID:27353685

Regionally adaptive histogram equalization of the chest.

PubMed

Sherrier, R H; Johnson, G A

1987-01-01

Advances in the area of digital chest radiography have resulted in the acquisition of high-quality images of the human chest. With these advances, there arises a genuine need for image processing algorithms specific to the chest, in order to fully exploit this digital technology. We have implemented the well-known technique of histogram equalization, noting the problems encountered when it is adapted to chest images. These problems have been successfully solved with our regionally adaptive histogram equalization method. With this technique histograms are calculated locally and then modified according to both the mean pixel value of that region as well as certain characteristics of the cumulative distribution function. This process, which has allowed certain regions of the chest radiograph to be enhanced differentially, may also have broader implications for other image processing tasks.

Chest injuries related to surfing.

PubMed

Sano, Atsushi; Yotsumoto, Takuma

2015-09-01

Surfing is a popular sport in coastal areas, which can be associated with chest injuries. Between 2008 and 2013, 6 patients were referred to our hospital with chest injuries sustained during surfing. Clinical data were collected from their medical records and analyzed retrospectively. Patient age ranged from 35 to 52 years. Five of the 6 patients were male. Four patients were injured in August, and the other two were injured in September and October. Rib fractures were observed in 3 of the 6 patients. The other 3 patients were diagnosed with chest contusions only. Hemothorax occurred in one patient. No lacerations were observed in any of the 6 patients. Chest injuries associated with surfing are usually blunt chest injuries; however, they may occasionally be life-threatening. © The Author(s) 2015.

End of Lethe Vallis

NASA Image and Video Library

2010-11-15

This image from NASA Mars Reconnaissance Orbiter shows the funnel-shaped terminus of Lethe Vallis, a winding channel in the Elysium Planitia region of Mars; the floor is covered in solidified lava and blanketed by a thin layer of light-toned dust.

Chest Wall Trauma.

PubMed

Majercik, Sarah; Pieracci, Fredric M

2017-05-01

Chest wall trauma is common, and contributes significantly to morbidity and mortality of trauma patients. Early identification of major chest wall and concomitant intrathoracic injuries is critical. Generalized management of multiple rib fractures and flail chest consists of adequate pain control (including locoregional modalities); management of pulmonary dysfunction by invasive and noninvasive means; and, in some cases, surgical fixation. Multiple studies have shown that patients with flail chest have substantial benefit (decreased ventilator and intensive care unit days, improved pulmonary function, and improved long-term functional outcome) when they undergo surgery compared with nonoperative management. Copyright © 2017 Elsevier Inc. All rights reserved.

Chest Wall Diseases: Respiratory Pathophysiology.

PubMed

Tzelepis, George E

2018-06-01

The chest wall consists of various structures that function in an integrated fashion to ventilate the lungs. Disorders affecting the bony structures or soft tissues of the chest wall may impose elastic loads by stiffening the chest wall and decreasing respiratory system compliance. These alterations increase the work of breathing and lead to hypoventilation and hypercapnia. Respiratory failure may occur acutely or after a variable period of time. This review focuses on the pathophysiology of respiratory function in specific diseases and disorders of the chest wall, and highlights pathogenic mechanisms of respiratory failure. Copyright © 2018 Elsevier Inc. All rights reserved.

Improving Hybrid III injury assessment in steering wheel rim to chest impacts using responses from finite element Hybrid III and human body model.

PubMed

Holmqvist, Kristian; Davidsson, Johan; Mendoza-Vazquez, Manuel; Rundberget, Peter; Svensson, Mats Y; Thorn, Stefan; Törnvall, Fredrik

2014-01-01

The main aim of this study was to improve the quality of injury risk assessments in steering wheel rim to chest impacts when using the Hybrid III crash test dummy in frontal heavy goods vehicle (HGV) collision tests. Correction factors for chest injury criteria were calculated as the model chest injury parameter ratios between finite element (FE) Hybrid III, evaluated in relevant load cases, and the Total Human Model for Safety (THUMS). This is proposed to be used to compensate Hybrid III measurements in crash tests where steering wheel rim to chest impacts occur. The study was conducted in an FE environment using an FE-Hybrid III model and the THUMS. Two impactor shapes were used, a circular hub and a long, thin horizontal bar. Chest impacts at velocities ranging from 3.0 to 6.0 m/s were simulated at 3 impact height levels. A ratio between FE-Hybrid III and THUMS chest injury parameters, maximum chest compression C max, and maximum viscous criterion VC max, were calculated for the different chest impact conditions to form a set of correction factors. The definition of the correction factor is based on the assumption that the response from a circular hub impact to the middle of the chest is well characterized and that injury risk measures are independent of impact height. The current limits for these chest injury criteria were used as a basis to develop correction factors that compensate for the limitations in biofidelity of the Hybrid III in steering wheel rim to chest impacts. The hub and bar impactors produced considerably higher C max and VC max responses in the THUMS compared to the FE-Hybrid III. The correction factor for the responses of the FE-Hybrid III showed that the criteria responses for the bar impactor were consistently overestimated. Ratios based on Hybrid III and THUMS responses provided correction factors for the Hybrid III responses ranging from 0.84 to 0.93. These factors can be used to estimate C max and VC max values when the Hybrid III is used in crash tests for which steering wheel rim to chest interaction occurs. For the FE-Hybrid III, bar impacts caused higher chest deflection compared to hub impacts, although the contrary results were obtained with the more humanlike THUMS. Correction factors were developed that can be used to correct the Hybrid III chest responses. Higher injury criteria capping limits for steering wheel impacts are acceptable. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.

Accretion Flows in Magnetic White Dwarf Systems

NASA Technical Reports Server (NTRS)

Imamura, James N.

2005-01-01

We received Type A and B funding under the NASA Astrophysics Data Program for the analysis and interpretation of hard x-ray data obtained by the Rossi X-ray Timing Explorer and other NASA sponsored missions for Intermediate Polars (IPS) and Polars. For some targets, optical data was available. We reduced and analyzed the X-ray spectra and the X-ray and optical (obtained at the Cerro Tololo Inter-American Observatory) timing data using detailed shock models (which we constructed) to place constraints on the properties of the accreting white dwarfs, the high energy emission mechanisms of white dwarfs, and the large-scale accretion flows of Polars and IPS. IPS and Polars are white dwarf mass-transfer binaries, members of the larger class of cata,clysmic variables. They differ from the bulk of the cataclysmic variables in that they contain strongly magnetic white dwarfs; the white dwarfs in Polars have B, = 7 to 230 MG and those in IPS have B, less than 10 MG. The IPS and Polars are both examples of funneled accretion flows in strong magnetic field systems. The IPS are similar to x-ray pulsars in that accretion disks form in the systems which are disrupted by the strong stellar magnetic fields of the white dwarfs near the stellar surface from where the plasma is funneled to the surface of the white dwarf. The localized hot spots formed at the footpoints of the funnels coupled with the rotation of the white dwarf leads to coherent pulsed x-ray emission. The Polars offer an example of a different accretion topology; the magnetic field of the white dwarf controls the accretion flow from near the inner Lagrangian point of the system directly to the stellar surface. Accretion disks do not form. The strong magnetic coupling generally leads to synchronous orbital/rotational motion in the Polars. The physical system in this sense resembles the Io/Jupiter system. In both IPS and Polars, pulsed emission from the infrared to x-rays is produced as the funneled flows merge onto the white dwarfs through the formation of strong radiating shock waves. A comparative study of the IPS and Polars can elucidate the primary effects of the magnetic fields on the dynamics and thermodynamics in accreting white dwarf systems.

Facial Swelling

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Elimination Problems

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Tooth Problems

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Mouth Problems

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Hip Problems

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Ankle Problems

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... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Knee Problems

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Leg Problems

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Collapsed lung (pneumothorax)

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... provider will listen to your breathing with a stethoscope. If you have a collapsed lung, there are ... rupture, chest x-ray Pneumothorax - chest x-ray Respiratory system Chest tube insertion - series Pneumothorax - series References ...

Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

PubMed Central

Zhang, Yakun; Li, Xiang; Segars, W. Paul; Samei, Ehsan

2014-01-01

Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definium 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDIvol and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose metrics only increased slightly for radiographic modalities and for chest tomosynthesis. Effective and organ doses normalized to mAs all illustrated an exponential decrease with increasing patient size. As a surface organ, breast doses had less correlation with body size than that of lungs or liver. Conclusions: Patient body size has a much greater impact on radiation dose of chest CT examinations than chest radiography and tomosynthesis. The size of a patient should be considered when choosing the best thoracic imaging modality. PMID:24506654

"Anterior convergent" chest probing in rapid ultrasound transducer positioning versus formal chest ultrasonography to detect pneumothorax during the primary survey of hospital trauma patients: a diagnostic accuracy study.

PubMed

Ziapour, Behrad; Haji, Houman Seyedjavady

2015-01-01

Occult pneumothorax represents a diagnostic pitfall during the primary survey of trauma patients, particularly if these patients require early positive pressure ventilation. This study investigated the accuracy of our proposed rapid model of ultrasound transducer positioning during the primary survey of trauma patients after their arrival at the hospital. This diagnostic trial was conducted over 12 months and was based on the results of 84 ultrasound (US) exams performed on patients with severe multiple trauma. Our index test (US) was used to detect pneumothorax in four pre-defined locations on the anterior of each hemi-thorax using the "Anterior Convergent" approach, and its performance was limited to the primary survey. Consecutively, patients underwent chest-computed tomography (CT) with or without chest radiography. The diagnostic findings of both chest radiography and chest ultrasounds were compared to the gold-standard test (CT). The diagnostic sensitivity was 78 % for US and 36.4 % for chest radiography (p < 0.001); the specificity was 92 % for US and 98 % for chest radiography (not significant); the positive predictive values were 74 % for US and 80 % for chest radiography (not significant); the negative predictive values were 94 % for US and 87 % for chest radiography (not significant); the positive likelihood ratio was 10 for US and 18 for chest radiography (p = 0.007); and the negative likelihood ratio was 0.25 for US and 0.65 for chest radiography (p = 0.001). The mean required time for performing the new method was 64 ± 10 s. An absence of the expected diffused dynamic view among ultrasound images obtained from patients with pneumothorax was also observed. We designated this phenomenon "Gestalt Lung Recession." "Anterior convergent" chest US probing represents a brief but efficient model that provides clinicians a safe and accurate exam and adequate resuscitation during critical minutes of the primary survey without interrupting other medical staff activities taking place around the trauma patient. The use of the new concept of "Gestalt Lung Recession" instead of the absence of "lung sliding" might improve the specificity of US in detecting pneumothorax.

Cold and Flu

MedlinePlus

... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Shortness of Breath

MedlinePlus

... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Non-Cardiac Chest Pain

MedlinePlus

... Home / Digestive Health Topic / Non-cardiac Chest Pain Non-cardiac Chest Pain Basics Overview and Symptoms What ... at a reduced dose such as Omeprazole (or equivalent PPI medication ) 20 mg twice daily about 40 ...

Microsurgical Chest Wall Reconstruction After Oncologic Resections

PubMed Central

Sauerbier, Michael; Dittler, S.; Kreutzer, C.

2011-01-01

Defect reconstruction after radical oncologic resection of malignant chest wall tumors requires adequate soft tissue reconstruction with function, stability, integrity, and an aesthetically acceptable result of the chest wall. The purpose of this article is to describe possible reconstructive microsurgical pathways after full-thickness oncologic resections of the chest wall. Several reliable free flaps are described, and morbidity and mortality rates of patients are discussed. PMID:22294944

Occult pneumomediastinum in blunt chest trauma: clinical significance.

PubMed

Rezende-Neto, J B; Hoffmann, J; Al Mahroos, M; Tien, H; Hsee, L C; Spencer Netto, F; Speers, V; Rizoli, S B

2010-01-01

Thoracic injuries are potentially responsible for 25% of all trauma deaths. Chest X-ray is commonly used to screen patients with chest injury. However, the use of computed tomography (CT) scan for primary screening is increasing, particularly for blunt trauma. CT scans are more sensitive than chest X-ray in detecting intra-thoracic abnormalities such as pneumothoraces and pneumomediastinums. Pneumomediastinum detected by chest X-ray or "overt pneumomediastinum", raises the concern of possible aerodigestive tract injuries. In contrast, there is scarce information on the clinical significance of pneumomediastinum diagnosed by CT scan only or "occult pneumomediastinum". Therefore we investigated the clinical consequences of occult pneumomediastinum in our blunt trauma population. A 2-year retrospective chart review of all blunt chest trauma patients with initial chest CT scan admitted to a level I trauma centre. Data extracted from the medical records include; demographics, occult, overt, or no pneumomediastinum, the presence of intra-thoracic aerodigestive tract injuries (trachea, bronchus, and/or esophagus), mechanism and severity of injury, endotracheal intubation, chest thoracostomy, operations and radiological reports by an attending radiologist. All patients with intra-thoracic aerodigestive tract injuries from 1994 to 2004 were also investigated. Of 897 patients who met the inclusion criteria 839 (93.5%) had no pneumomediastinum. Five patients (0.6%) had overt pneumomediastinum and 53 patients (5.9%) had occult pneumomediastinum. Patients with occult pneumomediastinum had significantly higher ISS and AIS chest (p<0.0001) than patients with no pneumomediastinum. A chest thoracostomy tube was more common (p<0.0001) in patients with occult pneumomediastinum (47.2%) than patients with no pneumomediastinum (10.4%), as well as occult pneumothorax. None of the patients with occult pneumomediastinum had aerodigestive tract injuries (95%CI 0-0.06). Follow up CT scan of patients with occult pneumomediastinum showed complete resolution in all cases, in average 3 h after the initial exam. Occult pneumomediastinum occurred in approximately 6% of all trauma patients with blunt chest injuries in our institution. Patients who had occult pneumomediastinum were more severely injured than those who without. However, none of the patients with occult pneumomediastinum had aerodigestive tract injuries and follow up chest CT scans demonstrated their complete and spontaneous resolution.

CIVILIAN GUNSHOT WOUNDS TO THE CHEST: A CLINICOPATHOLOGICAL ANALYSIS OF AN ANNUAL CASELOAD AT A LEVEL 1 TRAUMA CENTRE.

PubMed

Meijering, V M; Hattam, A T; Navsaria, P H; Nicol, A J; Edu, S

2017-06-01

Gunshot wounds (GSW) to the chest are common presentations to trauma centres in South Africa. The clinical management and outcome of GSW to the chest are significantly altered by missile trajectory and the associated anatomical structures injured making them challenging injuries to treat. Currently, the management of GSW chest is based on scant evidence and treatment is typically according to algorithms based largely on the anecdotal experience of high volume institutions and experienced clinicians. Ethical approval was obtained for this study. The Electronic Trauma Health Registry (eTHR) Application of the Trauma Centre at Groote Schuur Hospital in Cape Town was interrogated for the year 2015 for all patients with GSW chest. The data was then analysed using descriptive statistics. A total of 141 patients with GSW to the chest were admitted to the Trauma Centre with a median age of 26 years. More than half of the patients, 53. 2% (n = 75) sustained an isolated GSW to the chest. Overall, 29.1% (n = 41) patients sustained a thoracoabdominal injury, which accounts for a significant higher amount of emergency surgeries compared to patients with non thoracoabdominal injuries (54% vs 15%, p = < 0.01). 9.2% (n = 13) of all patients required an emergency thoracotomy or emergency chest surgery of which 5 patients survived. Overall mortality was 7.1% (n = 10) of which 5 patients died from a thoracic cause. Civilian GSW to the chest are common injuries seen in Cape Town, often with concomitant injuries leading to increased morbidity. Significantly more emergency surgeries were done in patients with thoracoabdominal injury. Overall few patients needed chest-related emergency operative intervention (9.2%) with a survival rate of 38.5%. Overall mortality of patients with GSW chest who reached the hospital was 7.1% of whom 50% died from a thoracic cause.

CIVILIAN GUNSHOT WOUNDS TO THE CHEST: A CLINICOPATHOLOGICAL ANALYSIS OF AN ANNUAL CASELOAD AT A LEVEL 1 TRAUMA CENTRE.

PubMed

Meijering, V M; Hattam, A T

2017-06-01

Gunshot wounds (GSW) to the chest are common presentations to trauma centres both in South Africa and internationally. The clinical management and outcome of GSW to the chest are significantly altered by missile trajectory and the associated anatomical structures injured making them challenging injuries to treat. Currently, the management of GSW chest is based on scant evidence and treatment is typically according to algorithms based largely on the anecdotal experience of high volume institutions and experienced clinicians. Ethical approval was obtained for this study. The Electronic Trauma Health Registry (eTHR) Application of the Trauma Centre at Groote Schuur Hospital in Cape Town was interrogated for the year 2015 for all patients with GSW chest. The data was then analysed using descriptive statistics. A total of 141 patients with GSW to the chest were admitted to the Trauma Centre with a median age of 26 years . More than half of the patients, 53.2% (n = 75), sustained an isolated GSW to the chest. Overall, 29.1% (n = 41) patients sustained thoraco-abdominal injury, which accounts for a significant higher number of emergency surgeries compared to patients with non thoraco-abdominal injury (54% vs 15%, p = < 0.01). 9.2% (n = 13) of all patients required an emergency thoracotomy or emergency chest surgery (resp. 3.5% and 5.7%) of which 5 patients survived. Overall mortality was 7.1% (n = 10) of which 5 patients died from a thoracic cause. Civilian GSW to the chest are common injuries seen in Cape Town, often with concomitant injuries leading to increased morbidity. Significantly more emergency surgeries were done in patients with thoraco-abdominal injury. Overall few patients needed chest-related emergency operative intervention (9.2%) with a survival rate of 38.5%. Overall mortality of patients with GSW chest who reached the hospital was 7.1% of whom 50% died from a thoracic cause.

NCAP test improvements with pretensioners and load limiters.

PubMed

Walz, Marie

2004-03-01

New Car Assessment Program (NCAP) test scores, measured by the United States Department of Transportation's (USDOT) National Highway Traffic Safety Administration (NHTSA), were analyzed in order to assess the benefits of equipping safety belt systems with pretensioners and load limiters. Safety belt pretensioners retract the safety belt almost instantly in a crash to remove excess slack. They tie the occupant to the vehicle's deceleration early during the crash, reducing the peak load experienced by the occupant. Load limiters and other energy management systems allow safety belts to yield in a crash, preventing the shoulder belt from directing too much energy on the chest of the occupant. In NCAP tests, vehicles are crashed into a fixed barrier at 35 mph. During the test, instruments measure the accelerations of the head and chest, as well as the force on the legs of anthropomorphic dummies secured in the vehicle by safety belts. NCAP data from model year 1998 through 2001 cars and light trucks were examined. The combination of pretensioners and load limiters is estimated to reduce Head Injury Criterion (HIC) by 232, chest acceleration by an average of 6.6 g's, and chest deflection (displacement) by 10.6 mm, for drivers and right front passengers. The unit used to measure chest acceleration (g) is defined as a unit of force equal to the force exerted by gravity. All of these reductions are statistically significant. When looked at individually, pretensioners are more effective in reducing HIC scores for both drivers and right front passengers, as well as chest acceleration and chest deflection scores for drivers. Load limiters show greater reductions in chest acceleration and chest deflection scores for right front passengers. By contrast, in make-models for which neither load limiters nor pretensioners have been added, there is little change during 1998 to 2001 in HIC, chest acceleration, or chest deflection values in NCAP tests.

Genital Problems in Women

MedlinePlus

... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Neck Swelling (Symptom Checker)

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... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Hand/Wrist/Arm Problems

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... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

CT angiography - chest

MedlinePlus

... aortic aneurysm - CTA chest; Venous thromboembolism - CTA lung; Blood clot - CTA lung; Embolus - CTA lung; CT pulmonary angiogram ... angiogram may be done: For symptoms that suggest blood clots in the lungs, such as chest pain, rapid ...

The transverse diameter of the chest on routine radiographs reliably estimates gestational age and weight in premature infants.

PubMed

Dietz, Kelly R; Zhang, Lei; Seidel, Frank G

2015-08-01

Prior to digital radiography it was possible for a radiologist to easily estimate the size of a patient on an analog film. Because variable magnification may be applied at the time of processing an image, it is now more difficult to visually estimate an infant's size on the monitor. Since gestational age and weight significantly impact the differential diagnosis of neonatal diseases and determine the expected size of kidneys or appearance of the brain by MRI or US, this information is useful to a pediatric radiologist. Although this information may be present in the electronic medical record, it is frequently not readily available to the pediatric radiologist at the time of image interpretation. To determine if there was a correlation between gestational age and weight of a premature infant with their transverse chest diameter (rib to rib) on admission chest radiographs. This retrospective study was approved by the institutional review board, which waived informed consent. The maximum transverse chest diameter outer rib to outer rib was measured on admission portable chest radiographs of 464 patients admitted to the neonatal intensive care unit (NICU) during the 2010 calendar year. Regression analysis was used to investigate the association between chest diameter and gestational age/birth weight. Quadratic term of chest diameter was used in the regression model. Chest diameter was statistically significantly associated with both gestational age (P < 0.0001) and birth weight (P < 0.0001). An infant's gestational age and birth weight can be reliably estimated by comparing a simple measurement of the transverse chest diameter on digital chest radiograph with the tables and graphs in our study.

The uniform chest compression depth of 50 mm or greater recommended by current guidelines is not appropriate for all adults.

PubMed

Lee, Soo Hoon; Kim, Dong Hoon; Kang, Tae-Sin; Kang, Changwoo; Jeong, Jin Hee; Kim, Seong Chun; Kim, Dong Seob

2015-08-01

This study was conducted to evaluate the appropriateness of the chest compression (CC) depth recommended in the current guidelines and simulated external CCs, and to characterize the optimal CC depth for an adult by body mass index (BMI). Adult patients who underwent chest computed tomography as a screening test for latent pulmonary diseases in the health care center were enrolled in this study. We calculated the internal anteroposterior (AP) diameter (IAPD) and external AP diameter (EAPD) of the chest across BMIs (<18.50, 18.50-24.99, 25.00-29.99, and ≥30.00 kg/m(2)) for simulated CC depth. We also calculated the residual chest depths less than 20 mm for simulated CC depth. There was a statistically significant difference in the chest EAPD and IAPD measured at the lower half of the sternum for each BMI groups (EAPD: R(2) = 0.638, P < .001; IAPD: R(2) = 0.297, P < .001). For one-half external AP CC, 100% of the patients, regardless of BMI, had a calculated residual internal chest depth less than 20 mm. For one-fourth external AP CC, no patients had a calculated residual internal chest depth less than 20 mm. For one-third external AP CC, only 6.48% of the patients had a calculated residual internal chest depth less than 20 mm. It is not appropriate that the current CC depth (≥50 mm), expressed only as absolute measurement without a fraction of the depth of the chest, is applied uniformly in all adults. In addition, in terms of safety and efficacy, simulated CC targeting approximately between one-third and one-fourth EAPD CC depth might be appropriate. Copyright © 2015 Elsevier Inc. All rights reserved.

The Interest of Performing "On-Demand Chest X-rays" after Lung Resection by Minimally Invasive Surgery.

PubMed

Haddad, Laura; Bubenheim, Michael; Bernard, Alain; Melki, Jean; Peillon, Christophe; Baste, Jean-Marc

2017-10-01

Background  There is a lack of consensus in hospital centers regarding costly daily routine chest X-rays after lung resection by minimally invasive surgery. Indeed, there is no evidence that performing daily chest X-rays prevents postoperative complications. Our objective was to compare chest X-rays performed on demand when there was clinical suspicion of postoperative complications and chest X-rays performed systematically in daily routine practice. Methods  This prospective single-center study compared 55 patients who had on-demand chest X-rays and patients in the literature who had daily routine chest X-rays. Our primary evaluation criterion was length of hospitalization. Results  The length of hospitalization was 5.3 ± 3.3 days for patients who had on-demand X-rays, compared with 4 to 9.7 days for patients who had daily routine X-rays. Time to chest tube removal (4.34 days), overall complication rate (27.2%), reoperation rate (3.6%), and mortality rate (1.8%) were comparable to those in the literature. On average, our patients only had 1.22 ± 1.8 on-demand X-rays, compared with 3.3 X-rays if daily routine protocol had been applied. Patients with complications had more X-rays (3.4 ± 1.8) than patients without complications (0.4 ± 0.7). Conclusion  On-demand chest X-rays do not seem to delay the diagnosis of postoperative complications or increase morbidity-mortality rates. Performing on-demand chest X-rays could not only simplify surgical practice but also have a positive impact on health care expenses. However, a broader randomized study is warranted to validate this work and ultimately lead to national consensus. Georg Thieme Verlag KG Stuttgart · New York.

Chest CT in children: anesthesia and atelectasis.

PubMed

Newman, Beverley; Krane, Elliot J; Gawande, Rakhee; Holmes, Tyson H; Robinson, Terry E

2014-02-01

There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain reliable and reproducible high-quality, motion-free chest CT images in children.

Correlation of B-Lines on Ultrasonography With Interstitial Lung Disease on Chest Radiography and CT Imaging.

PubMed

Dubinsky, Theodore J; Shah, Hardik; Sonneborn, Rachelle; Hippe, Daniel S

2017-11-01

We prospectively identified B-lines in patients undergoing ultrasonographic (US) examinations following liver transplantation who also had chest radiography (CXR) or chest CT imaging, or both, on the same day to determine if an association between the presence of B-lines from the thorax on US images correlates with the presence of lung abnormalities on CXR. Following institutional review board (IRB) approval, patients who received liver transplants and underwent routine US examinations and chest radiography or CT imaging, or both, on the same day between January 1, 2015 through July 1, 2016 were prospectively identified. Two readers who were blinded to chest films and CT images and reports independently reviewed the US interreader agreement for the presence or absence of B-lines and performed an evaluation for the presence or absence of diffuse parenchymal lung disease (DPLD) on chest films and CT images as well as from clinical evaluation. Receiver operating characteristic (ROC) curves were constructed. There was good agreement between the two readers on the presence of absence of B-lines (kappa = 0.94). The area under the ROC curve for discriminating between positive DPLD and negative DPLD for both readers was 0.79 (95% CI, 0.71-0.87). There is an association between the presence of extensive B-lines to the point of confluence and "dirty shadowing" on US examinations of the chest and associated findings on chest radiographs and CT scans of DPLD. Conversely, isolated B-lines do not always correlate with abnormalities on chest films and in fact sometimes appear to be a normal variant. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Evaluation of a new chest tube removal protocol using digital air leak monitoring after lobectomy: a prospective randomised trial.

PubMed

Brunelli, Alessandro; Salati, Michele; Refai, Majed; Di Nunzio, Luca; Xiumé, Francesco; Sabbatini, Armando

2010-01-01

The objective of this randomised trial was to assess the effectiveness of a new fast-track chest tube removal protocol taking advantage of digital monitoring of air leak compared to a traditional protocol using visual and subjective assessment of air leak (bubbles). One hundred and sixty-six patients submitted to pulmonary lobectomy for lung cancer were randomised in two groups with different chest tube removal protocols: (1) in the new protocol, chest tube was removed based on digitally recorded measurements of air leak flow; (2) in the traditional protocol, the chest tube removal was based on an instantaneous assessment of air leak during daily rounds. The two groups were compared in terms of chest tube duration, hospital stay and costs. The two groups were well matched for several preoperative and operative variables. Compared to the traditional protocol, the new digital recording protocol showed mean reductions in chest tube duration (p=0.0007), hospital stay (p=0.007) of 0.9 day, and a mean cost saving of euro 476 per patient (p=0.008). In the new chest tube removal protocol, 51% of patients had their chest tube removed by the second postoperative day versus only 12% of those in the traditional protocol. The application of a chest tube removal protocol using a digital drainage unit featuring a continuous recording of air leak was safe and cost effective. Although future studies are warranted to confirm these results in other settings, the use of this new protocol is now routinely applied in our practice. Copyright 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Comparative study evaluating the role of color Doppler sonography and computed tomography in predicting chest wall invasion by lung tumors.

PubMed

Sripathi, Smiti; Mahajan, Abhishek

2013-09-01

To analyze qualitative and quantitative parameters of lung tumors by color Doppler sonography, determine the role of color Doppler sonography in predicting chest wall invasion by lung tumors using spectral waveform analysis, and compare color Doppler sonography and computed tomography (CT) for predicting chest wall invasion by lung tumors. Between March and September 2007, 55 patients with pleuropulmonary lesions on chest radiography were assessed by grayscale and color Doppler sonography for chest wall invasion. Four patients were excluded from the study because of poor acoustic windows. Quantitative and qualitative sonographic examinations of the lesions were performed using grayscale and color Doppler imaging. The correlation between the color Doppler and CT findings was determined, and the final outcomes were correlated with the histopathologic findings. Of a total of 51 lesions, 32 were malignant. Vascularity was present on color Doppler sonography in 28 lesions, and chest wall invasion was documented in 22 cases. Computed tomography was performed in 24 of 28 evaluable malignant lesions, and the findings were correlated with the color Doppler findings for chest wall invasion. Of the 24 patients who underwent CT, 19 showed chest wall invasion. The correlation between the color Doppler and CT findings revealed that color Doppler sonography had sensitivity of 95.6% and specificity of 100% for assessing chest wall invasion, whereas CT had sensitivity of 85.7% and specificity of 66.7%. Combined qualitative and quantitative color Doppler sonography can predict chest wall invasion by lung tumors with better sensitivity and specificity than CT. Although surgery is the reference standard, color Doppler sonography is a readily available, affordable, and noninvasive in vivo diagnostic imaging modality that is complementary to CT and magnetic resonance imaging for lung cancer staging.

Chest MR imaging in the follow-up of pulmonary alterations in paediatric patients with middle lobe syndrome: comparison with chest X-ray.

PubMed

Fraioli, F; Serra, G; Ciarlo, G; Massaccesi, V; Liberali, S; Fiorelli, A; Macrì, F; Catalano, C

2013-04-01

The authors evaluated the role of magnetic resonance (MR) imaging of the chest in comparison with chest X-ray in the follow-up of pulmonary abnormalities detected by computed tomography (CT) in paediatric patients with middle lobe syndrome. Seventeen patients with middle lobe syndrome (mean age 6.2 years) underwent chest CT at the time of diagnosis (100 kV, CARE dose with quality reference of 70 mAs; collimation 24×1.2 mm; rotation time 0.33 s; scan time 5 s); at follow-up after a mean of 15.3 months, all patients were evaluated with chest MR imaging with a respiratory-triggered T2-weighted BLADE sequence (TR 2,000; TE 27 ms; FOV 400 mm; flip angle 150°; slice thickness 5 mm) and chest X-ray. Images from each modality were assessed for the presence of pulmonary consolidations, bronchiectases, bronchial wall thickening and mucous plugging. Hilar and mediastinal lymphadenopathies were assessed on CT and MR images. Baseline CT detected consolidations in 100% of patients, bronchiectases in 35%, bronchial wall thickening in 53% and mucous plugging in 35%. MR imaging and chest X-ray identified consolidations in 65% and 35%, bronchiectases in 35% and 29%, bronchial wall thickening in 59% and 6% and mucous plugging in 25% and 0%, respectively. Lymphadenopathy was seen in 64% of patients at CT and in 47% at MR imaging. Patients with middle lobe syndrome show a wide range of parenchymal and bronchial abnormalities at diagnosis. Compared with MR imaging, chest X-ray seems to underestimate these changes. Chest MR imaging might represent a feasible and radiation-free option for an overall assessment of the lung in the follow-up of patients with middle lobe syndrome.

Intergenerational changes in chest size and proportions in children and adolescents aged 3-18 from Kraków (Poland), within the last 70 years.

PubMed

Kryst, Łukasz; Woronkowicz, Agnieszka; Kowal, Małgorzata; Sobiecki, Jan

2017-03-01

The size and proportions of the human body change continuously in response to social change and economic development. As reported by papers on intergenerational changes in chest size, this part of the human body is also influenced by environmental factors. The aim of this study was to assess changes in the dimensions and proportions of the chest of children and adolescents over a span of 70 years. In 2010 an anthropological study was conducted on 3878 children and adolescents aged 3-18 years living in Kraków (Poland). Data on chest dimensions (breadth, depth, circumference, chest index) were compared to data from 1938 (3719 children) and 1983 (6464 children). In boys, chests became increasingly deep; in boys 18 years of age, the chest index increased by 4.8 units, unlike girls, whose chests markedly flattened. The chest index in girls 18 years of age decreased by 4.2 units. In almost all age categories these differences were statistically significant. Also, in all age categories, children studied in 2010 had a significantly bigger chest circumference than boys and girls surveyed in 1983, respectively, by averages of 3.6 cm and 3 cm. The main reason for these changes may be the socio-economic transformation, which has been especially strong in recent decades. These results may have practical importance in many areas of knowledge, including medicine, nutritional science, and sports. They can also be important for informing preventive measures that should be taken in order to increase the physical activity of children and youth, especially boys. © 2016 Wiley Periodicals, Inc.

Chest Tube Thoracostomy

MedlinePlus

... outside the lung, causing its collapse (called a pneumothorax ). Chest tube thoracostomy involves placing a hollow plastic ... a chest tube is needed include: ■ ■ Collapsed lung (pneumothorax)— This occurs when air has built up in ...

Eye Problems: Symptom Checker Flowchart

MedlinePlus

... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Shoulder Problems: Symptom Checker Flowchart

MedlinePlus

... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Elimination Problems in Infants and Children

MedlinePlus

... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Feeding Problems in Infants and Children

MedlinePlus

... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Abdominal Pain (Stomach Pain), Short-Term

MedlinePlus

... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Mouth Problems in Infants and Children

MedlinePlus

... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Genital Problems in Infants (Female)

MedlinePlus

... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

[How to do - the chest tube drainage].

PubMed

Klopp, Michael; Hoffmann, Hans; Dienemann, Hendrik

2015-03-01

A chest tube is used to drain the contents of the pleural space to reconstitute the physiologic pressures within the pleural space and to allow the lungs to fully expand. Indications for chest tube placement include pneumothorax, hemothorax, pleural effusion, pleural empyema, and major thoracic surgery. The most appropriate site for chest tube placement is the 4th or 5th intercostal space in the mid- or anterior- axillary line. Attention to technique in placing the chest tube is vital to avoid complications from the procedure. Applying the step-by-step technique presented, placement of a chest tube is a quick and safe procedure. Complications - frequently occurring when the tube is inserted with a steel trocar - include hemothorax, dislocation, lung lacerations, and injury to organs in the thoracic or abdominal cavity." © Georg Thieme Verlag KG Stuttgart · New York.

Outcomes of Complete Versus Partial Surgical Stabilization of Flail Chest.

PubMed

Nickerson, Terry P; Thiels, Cornelius A; Kim, Brian D; Zielinski, Martin D; Jenkins, Donald H; Schiller, Henry J

2016-01-01

Rib fractures are common after chest wall trauma. For patients with flail chest, surgical stabilization is a promising technique for reducing morbidity. Anatomical difficulties often lead to an inability to completely repair the flail chest; thus, the result is partial flail chest stabilization (PFS). We hypothesized that patients with PFS have outcomes similar to those undergoing complete flail chest stabilization (CFS). A prospectively collected database of all patients who underwent rib fracture stabilization procedures from August 2009 until February 2013 was reviewed. Abstracted data included procedural and complication data, extent of stabilization, and pulmonary function test results. Of 43 patients who underwent operative stabilization of flail chest, 23 (53%) had CFS and 20 (47%) underwent PFS. Anterior location of the fracture was the most common reason for PFS (45%). Age, sex, operative time, pneumonia, intensive care unit and hospital length of stay, and narcotic use were the same in both groups. Total lung capacity was significantly improved in the CFS group at 3 months. No chest wall deformity was appreciated on follow-up, and no patients underwent additional stabilization procedures following PFS. Despite advances in surgical technique, not all fractures are amenable to repair. There was no difference in chest wall deformity, narcotic use, or clinically significant impairment in pulmonary function tests among patients who underwent PFS compared with CFS. Our data suggest that PFS is an acceptable strategy and that extending or creating additional incisions for CFS is unnecessary.

Assessing astronaut injury potential from suit connectors using a human body finite element model.

PubMed

Danelson, Kerry A; Bolte, John H; Stitzel, Joel D

2011-02-01

The new Orion space capsule requires additional consideration of possible injury during landing due to the dynamic nature of the impact. The purpose of this parametric study was to determine changes in the injury response of a human body finite element model with a suit connector (SC). The possibility of thoracic bony injury, thoracic soft tissue injury, and femur injury were assessed in 24 different model configurations. These simulations had two SC placements and two SC types, a 2.27-kg rectangular and a 3.17-kg circular SC. A baseline model was tested with the same acceleration pulses and no SC for comparison. Further simulations were conducted to determine the protective effect of SC location changes and adding small and large rigid chest plates. The possibilities of rib, chest soft tissue, and femur injury were evaluated using sternal deflection, chest deflection, viscous criterion, and strain values. The results indicated a higher likelihood of chest injury than femur injury. The mean first principal strain in the femur was 0.136 +/- 0.007%, which is well below the failure limit for cortical bone. The placement of chest plates had a protective effect and reduced the sternal deflection, chest deflection, and viscous criterion values. If possible, the SC should be placed on the thigh to minimize injury risk metrics. Chest plates appear to offer some protective value; therefore, a large rigid chest plate or similar countermeasure should be considered for chest SC placement.

Totally implanted ports: the trapezius approach in practice.

PubMed

Hill, Steve

Implanted ports (IPs) are an essential device for many patients who require long-term vascular access. IPs offer some advantages over other central venous access devices, such as lifestyle, body image benefits and lower infection rates. A typical implantation site for a port is the anterior chest wall. For some patients with breast cancer who have metastatic chest wall disease this site may lead to problems with the function of the device if disease spreads to the port site. One option for this patient group is to place the implanted port over the trapezius muscle. This article discusses six patients, all of whom had metastatic breast cancer with some degree of subcutaneous disease on the anterior chest wall. Three patients had received trapezius port placements and three had anterior chest wall placements. A retrospective review of the patients' medical records was undertaken from the time of insertion until removal or until the patient died. The anterior chest wall group of patients had their devices in for an average of 368 days vs 214 in the trapezius group. The total complications were higher in the anterior chest wall group (7 vs 2 in the trapezius group). Disease spread to two of the devices in the anterior chest wall group meaning the devices could no longer be used. The trapezius approach appears to be a safe and a reliable form of vascular access and may offer fewer complications than the traditional method of anterior chest wall placement when standard anterior chest wall approach is not suitable.

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

Welsh, James, E-mail: jwelsh@mdanderson.org; Thomas, Jimmy; Shah, Deep

Purpose: Stereotactic body radiation therapy (SBRT) is increasingly being used to treat thoracic tumors. We attempted here to identify dose-volume parameters that predict chest wall toxicity (pain and skin reactions) in patients receiving thoracic SBRT. Patients and Methods: We screened a database of patients treated with SBRT between August 2004 and August 2008 to find patients with pulmonary tumors within 2.5 cm of the chest wall. All patients received a total dose of 50 Gy in four daily 12.5-Gy fractions. Toxicity was scored according to the NCI-CTCAE V3.0. Results: Of 360 patients in the database, 265 (268 tumors) had tumorsmore » within <2.5 cm of the chest wall; 104 (39%) developed skin toxicity (any grade); 14 (5%) developed acute pain (any grade), and 45 (17%) developed chronic pain (Grade 1 in 22 cases [49%] and Grade 2 or 3 in 23 cases [51%]). Both skin toxicity and chest wall pain were associated with the V{sub 30}, or volume of the chest wall receiving 30 Gy. Body mass index (BMI) was also strongly associated with the development of chest pain: patients with BMI {>=}29 had almost twice the risk of chronic pain (p = 0.03). Among patients with BMI >29, diabetes mellitus was a significant contributing factor to the development of chest pain. Conclusion: Safe use of SBRT with 50 Gy in four fractions for lesions close to the chest wall requires consideration of the chest wall volume receiving 30 Gy and the patient's BMI and diabetic state.« less

ANMCO-SIMEU Consensus Document: in-hospital management of patients presenting with chest pain.

PubMed

Zuin, Guerrino; Parato, Vito Maurizio; Groff, Paolo; Gulizia, Michele Massimo; Di Lenarda, Andrea; Cassin, Matteo; Cibinel, Gian Alfonso; Del Pinto, Maurizio; Di Tano, Giuseppe; Nardi, Federico; Rossini, Roberta; Ruggieri, Maria Pia; Ruggiero, Enrico; Scotto di Uccio, Fortunato; Valente, Serafina

2017-05-01

Chest pain is a common general practice presentation that requires careful diagnostic assessment because of its diverse and potentially serious causes. However, the evaluation of acute chest pain remains challenging, despite many new insights over the past two decades. The percentage of patients presenting to the emergency departments because of acute chest pain appears to be increasing. Nowadays, there are two essential chest pain-related issues: (i) the missed diagnoses of acute coronary syndromes with a poor short-term prognosis; and (ii) the increasing percentage of hospitalizations of low-risk cases. It is well known that hospitalization of a low-risk chest pain patient can lead to unnecessary tests and procedures, with an increasing trend of complications and burden of costs. Therefore, the significantly reduced financial resources of healthcare systems induce physicians and administrators to improve the efficiency of care protocols for patients with acute chest pain. Despite the efforts of the Scientific Societies in producing statements on this topic, in Italy there is still a significant difference between emergency physicians and cardiologists in managing patients with chest pain. For this reason, the aim of the present consensus document is double: first, to review the evidence-based efficacy and utility of various diagnostic tools, and, second, to delineate the critical pathways (describing key steps) that need to be implemented in order to standardize the management of chest pain patients, making a correct diagnosis and treatment as uniform as possible across the entire country.

ANMCO-SIMEU Consensus Document: in-hospital management of patients presenting with chest pain

PubMed Central

Zuin, Guerrino; Groff, Paolo; Gulizia, Michele Massimo; Di Lenarda, Andrea; Cassin, Matteo; Cibinel, Gian Alfonso; Del Pinto, Maurizio; Di Tano, Giuseppe; Nardi, Federico; Rossini, Roberta; Ruggieri, Maria Pia; Ruggiero, Enrico; Scotto di Uccio, Fortunato; Valente, Serafina

2017-01-01

Abstract Chest pain is a common general practice presentation that requires careful diagnostic assessment because of its diverse and potentially serious causes. However, the evaluation of acute chest pain remains challenging, despite many new insights over the past two decades. The percentage of patients presenting to the emergency departments because of acute chest pain appears to be increasing. Nowadays, there are two essential chest pain-related issues: (i) the missed diagnoses of acute coronary syndromes with a poor short-term prognosis; and (ii) the increasing percentage of hospitalizations of low-risk cases. It is well known that hospitalization of a low-risk chest pain patient can lead to unnecessary tests and procedures, with an increasing trend of complications and burden of costs. Therefore, the significantly reduced financial resources of healthcare systems induce physicians and administrators to improve the efficiency of care protocols for patients with acute chest pain. Despite the efforts of the Scientific Societies in producing statements on this topic, in Italy there is still a significant difference between emergency physicians and cardiologists in managing patients with chest pain. For this reason, the aim of the present consensus document is double: first, to review the evidence-based efficacy and utility of various diagnostic tools, and, second, to delineate the critical pathways (describing key steps) that need to be implemented in order to standardize the management of chest pain patients, making a correct diagnosis and treatment as uniform as possible across the entire country. PMID:28751843

[ANMCO/SIMEU Consensus document: In-hospital management of patients presenting with chest pain].

PubMed

Zuin, Guerrino; Parato, Vito Maurizio; Groff, Paolo; Gulizia, Michele Massimo; Di Lenarda, Andrea; Cassin, Matteo; Cibinel, Gian Alfonso; Del Pinto, Maurizio; Di Tano, Giuseppe; Nardi, Federico; Rossini, Roberta; Ruggieri, Maria Pia; Ruggiero, Enrico; Scotto Di Uccio, Fortunato; Valente, Serafina

2016-06-01

Chest pain is a common general practice presentation that requires careful diagnostic assessment because of its diverse and potentially serious causes. However, the evaluation of acute chest pain remains challenging, despite many new insights over the past two decades. The percentage of patients presenting to the emergency departments because of acute chest pain appears to be increasing. Nowadays, there are two essential chest pain-related issues: 1) the missed diagnoses of acute coronary syndromes with a poor short-term prognosis; 2) the increasing percentage of hospitalizations of low-risk cases.It is well known that hospitalization of a low-risk chest pain patient can lead to unnecessary tests and procedures, with an increasing trend of complications and burden of costs. Therefore, the significantly reduced financial resources of healthcare systems induce physicians and administrators to improve the efficiency of care protocols for patients with acute chest pain. Despite the efforts of the Scientific Societies in producing statements on this topic, in Italy there is still a significant difference between emergency physicians and cardiologists in managing patients with chest pain. For this reason, the aim of the present consensus document is double: first, to review the evidence-based efficacy and utility of various diagnostic tools, and, second, to delineate the critical pathways (describing key steps) that need to be implemented in order to standardize the management of chest pain patients, making a correct diagnosis and treatment as uniform as possible across the entire country.

Rib fracture after stereotactic radiotherapy on follow-up thin-section computed tomography in 177 primary lung cancer patients

PubMed Central

2011-01-01

Background Chest wall injury after stereotactic radiotherapy (SRT) for primary lung cancer has recently been reported. However, its detailed imaging findings are not clarified. So this study aimed to fully characterize the findings on computed tomography (CT), appearance time and frequency of chest wall injury after stereotactic radiotherapy (SRT) for primary lung cancer Materials and methods A total of 177 patients who had undergone SRT were prospectively evaluated for periodical follow-up thin-section CT with special attention to chest wall injury. The time at which CT findings of chest wall injury appeared was assessed. Related clinical symptoms were also evaluated. Results Rib fracture was identified on follow-up CT in 41 patients (23.2%). Rib fractures appeared at a mean of 21.2 months after the completion of SRT (range, 4 -58 months). Chest wall edema, thinning of the cortex and osteosclerosis were findings frequently associated with, and tending to precede rib fractures. No patients with rib fracture showed tumors > 16 mm from the adjacent chest wall. Chest wall pain was seen in 18 of 177 patients (10.2%), of whom 14 patients developed rib fracture. No patients complained of Grade 3 or more symptoms. Conclusion Rib fracture is frequently seen after SRT for lung cancer on CT, and is often associated with chest wall edema, thinning of the cortex and osteosclerosis. However, related chest wall pain is less frequent and is generally mild if present. PMID:21995807

Comparison consequences of Jackson-Pratt drain versus chest tube after coronary artery bypass grafting: A randomized controlled clinical trial.

PubMed

Mirmohammad-Sadeghi, Mohsen; Pourazari, Pejman; Akbari, Mojtaba

2017-01-01

Chest tubes are used in every case of coronary artery bypass grafting (CABG) to evacuate shed blood from around the heart and lungs. This study was designed to assess the effective of Jackson-Pratt drain in compare with conventional chest drains after CABG. This was a randomized controlled trial that conducted on 218 patients in Chamran hospital from February to December 2016. Eligible patients were randomized in a 1:1 ratio. Jackson-Pratt drain group had 109 patients who received a chest tube insertion in the pleural space of the left lung and a Jackson-Pratt drain in mediastinum, and Chest tube drainage group had 109 patients who received double chest tube insertion in the pleural space of the left lung and the mediastinum. The incidence of pleural effusions in Jackson-Pratt drain group and chest tube group were not statistically different. The pain score at 2-h in Drain group was significantly higher than chest tube group ( P = 0.001), but the trend of pain score between groups was not significantly different ( P = 0.097). The frequency of tamponade and atrial fibrillation (AF) were significantly lower in Jackson-Pratt drain group ( P < 0.05). The Jackson-Pratt drain is equally effective for preventing cardiac tamponade, pleural effusions, and pain intensity in patients after CABG when compared with conventional chest tubes, but was significantly superior regarding efficacy to hospital and Intensive Care Unit length of stay and the incidence of AF.

Comparison of Small Bore Catheter Aspiration and Chest Tube Drainage in the Management of Spontaneous Pneumothorax.

PubMed

Korczyński, P; Górska, K; Nasiłowski, J; Chazan, R; Krenke, R

2015-01-01

Beside standard chest tube drainage other less invasive techniques have been used in the management of patients with an acute episode of spontaneous pneumothorax. The aim of the study was to evaluate the short term effect of spontaneous pneumothorax treatment with small-bore pleural catheter and manual aspiration as compared to large-bore chest tube drainage. Patients with an episode of pneumothorax who required pleural intervention were enrolled in the study and randomly assigned to one of the treatment arms: (1) small-bore pleural catheter (8 Fr) with manual aspiration; (2) standard chest tube drainage (20-24 Fr). Success rate of the first line treatment, duration of catheter or chest tube drainage, and the need for surgical intervention were the outcome measures. The study group included 49 patients (mean age 46.9±21.3 years); with 22 and 27 allocated to small bore manual aspiration and chest tube drainage groups, respectively. There were no significant differences in the baseline characteristics of patients in both therapeutic arms. First line treatment success rates were 64% and 82% in the manual aspiration and chest tube drainage groups, respectively; the difference was insignificant. Median time of treatment with small bore catheter was significantly shorter than conventional chest tube drainage (2.0 vs. 6.0 days; p<0.05). Our results show that treatment of spontaneous pneumothorax with small-bore pleural catheter and manual aspiration might be similarly effective as is chest tube drainage in terms of immediate lung re-expansion.

Chest physiotherapy during immediate postoperative period among patients undergoing upper abdominal surgery: randomized clinical trial.

PubMed

Manzano, Roberta Munhoz; Carvalho, Celso Ricardo Fernandes de; Saraiva-Romanholo, Beatriz Mangueira; Vieira, Joaquim Edson

2008-09-01

Abdominal surgical procedures increase pulmonary complication risks. The aim of this study was to evaluate the effectiveness of chest physiotherapy during the immediate postoperative period among patients undergoing elective upper abdominal surgery. This randomized clinical trial was performed in the post-anesthesia care unit of a public university hospital. Thirty-one adults were randomly assigned to control (n = 16) and chest physiotherapy (n = 15) groups. Spirometry, pulse oximetry and anamneses were performed preoperatively and on the second postoperative day. A visual pain scale was applied on the second postoperative day, before and after chest physiotherapy. The chest physiotherapy group received treatment at the post-anesthesia care unit, while the controls did not. Surgery duration, length of hospital stay and postoperative pulmonary complications were gathered from patients' medical records. The control and chest physiotherapy groups presented decreased spirometry values after surgery but without any difference between them (forced vital capacity from 83.5 +/- 17.1% to 62.7 +/- 16.9% and from 95.7 +/- 18.9% to 79.0 +/- 26.9%, respectively). In contrast, the chest physiotherapy group presented improved oxygen-hemoglobin saturation after chest physiotherapy during the immediate postoperative period (p < 0.03) that did not last until the second postoperative day. The medical record data were similar between groups. Chest physiotherapy during the immediate postoperative period following upper abdominal surgery was effective for improving oxygen-hemoglobin saturation without increased abdominal pain. Breathing exercises could be adopted at post-anesthesia care units with benefits for patients.

Surgical management of chest wall trauma.

PubMed

Molnar, Tamas F

2010-11-01

Recent paradigm shift in major trauma profile elevates chest wall injuries among the most important topics of the specialty. Due to mass casualties of terror attacks and asymmetric warfare, civilian and military trauma care challenges thoracic surgery, traumatology, intensive anesthesiology, and related specialties. Contemporary advances of the main issues are systemically presented and discussed, such as soft tissue and bony structure injuries, complex traumas like flail chest, and extensively destroyed chest wall.

Routine Chest Radiographs After Central Line Insertion: Mandatory Postprocedural Evaluation or Unnecessary Waste of Resources?

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

Lucey, Brian; Varghese, Jose C.; Haslam, Philip

1999-09-15

Purpose: To study the cost and impact on patient management of the routine performance of chest radiographs in patients undergoing imaged-guided central venous catheter insertion. Methods: Six hundred and twenty-one catheters placed in 489 patients over a 42-month period formed the study group. Catheters were placed in the right internal jugular vein (425), left internal jugular vein (133), and subclavian veins (63). At the end of the procedure fluoroscopy was used to assess catheter position and check for complications. A postprocedural chest radiograph was obtained in all patients. Results: Postprocedural chest fluoroscopy showed no evidence of pneumothorax, hemothorax, or mediastinalmore » hematoma. Inappropriate catheter tip position or catheter kinks were noted with 90 catheters. These problems were all corrected while the patient was on the interventional table. Postprocedural chest radiographs showed no complications but proximal catheter tip migration was noted in six of 621 catheters (1%). These latter six catheters required further manipulation. The total technical and related charges for the postprocedural chest radiographs in this series were estimated at Pounds 15,525. Conclusion: Postprocedural chest radiographs after image-guided central venous catheter insertion are not routinely required. A postprocedural chest radiograph can be performed on a case-by-case basis at the discretion of the interventional radiologist.« less

[A case of group G Streptococcus sepsis, chest wall abscess, and vertebral osteomyelitis mimicking a primary lung cancer with bone metastasis].

PubMed

Hayashi, Yumeko; Ishii, Yoshiki; Arai, Ryo; Obara, Kazuki; Kamada, Aya; Takizawa, Hidenori; Hase, Isano; Mashio, Kazuki; Yamada, Issei; Takemasa, Akihiro; Sugiyama, Kumiya; Fukushima, Yasutsugu; Fukuda, Takeshi

2007-01-01

A 73-year-old woman who had been followed in our department of gynecology because of ovarian cancer since 2002, was admitted with liver dysfunction and complaining of back pain and light precordial chest pain. The chest radiograph on admission revealed a tumor in her left upper lung field, and chest CT revealed a tumor adjacent to the chest wall and mediastinum. FDG-positron emission tomography (PET) showed abnormal uptake in the tumor and Th6/7, and the subaortic lymph nodes. On the basis of these findings, primary lung cancer with bone metastasis was suspected. She had a high grade fever on admission, and blood cultures were positive for group G streptococcus. The treatment with intravenous penicillin was started. Percutaneous biopsy of the tumor in her left chest showed an abscess wall in the chest wall, but no evidence of malignancy. Transbronchial lung biopsy and CT-guided biopsy also showed no malignant cells. Since the tumor decreased in size and back pain improved gradually by only antibiotic treatment, a diagnosis of sepsis of group G streptococcus, chest wall abscess, and vertebral osteomyelitis was made. She was treated with intravenous penicillin for 4 weeks and oral amoxicillin for another 4 weeks. After 60 days of antibiotic treatment, the tumor vanished.

Chest tube drainage of pleural effusions--an audit of current practice and complications at Hutt Hospital.

PubMed

Epstein, Erica; Jayathissa, Sisira; Dee, Stephen

2012-05-11

The aims of the study were to review small-bore chest tube insertion practices for drainage of pleural fluid at Hutt Valley District Health Board (HVDHB), to assess complications, and compare the findings with international data. Retrospective analysis of clinical records was completed on all chest tube insertions for drainage of pleural fluid at HVDHB from December 2008 to November 2009. Descriptive statistics were used to present demographics and tube-associated complications. Comparison was made to available similar international data. Small-bore tubes comprised 59/65 (91%) chest tube insertions and 23/25 (92%) complications. Available comparative data was limited. Ultrasound was used in 36% of insertions. Nearly half of chest drains placed for empyema required subsequent cardiothoracic surgical intervention. Chest drain complication rates at HVDHB were comparable to those seen internationally. Referral rates to cardiothoracic surgery for empyema were within described ranges. The importance of procedural training for junior medical staff, optimising safety of drain insertions with ultrasound guidance, and clear clinical governance for chest tube insertions are important in minimising harm from this procedure. Specialist societies need to take a leadership in providing guidance on chest drain insertions to secondary and tertiary hospitals in Australia and New Zealand.

Anxiety, depression, suicidal ideation, and stressful life events in non-cardiac adolescent chest pain: a comparative study about the hidden part of the iceberg.

PubMed

Eliacik, Kayi; Kanik, Ali; Bolat, Nurullah; Mertek, Hilal; Guven, Baris; Karadas, Ulas; Dogrusoz, Buket; Bakiler, Ali Rahmi

2017-08-01

Chest pain in adolescents is rarely associated with cardiac disease. Adolescents with medically unexplained chest pain usually have high levels of anxiety and depression. Psychological stress may trigger non-cardiac chest pain. This study evaluated risk factors that particularly characterise adolescence, such as major stressful events, in a clinical population. The present study was conducted on 100 adolescents with non-cardiac chest pain and 76 control subjects. Stressful life events were assessed by interviewing patients using a 36-item checklist, along with the Children's Depression Inventory and Spielberger's State-Trait Anxiety Inventory for children, in both groups. Certain stressful life events, suicidal thoughts, depression, and anxiety were more commonly observed in adolescents with non-cardiac chest pain compared with the control group. Moreover, binary logistic regression analysis showed that trouble with bullies, school-related problems, and depression may trigger non-cardiac chest pain in adolescents. Non-cardiac chest pain on the surface may point to the underlying psychosocial health problems such as depression, suicidal ideas, or important life events such as academic difficulties or trouble with bullies. The need for a psychosocial evaluation that includes assessment of negative life events and a better management have been discussed in light of the results.

A computerized method for automated identification of erect posteroanterior and supine anteroposterior chest radiographs

NASA Astrophysics Data System (ADS)

Kao, E.-Fong; Lin, Wei-Chen; Hsu, Jui-Sheng; Chou, Ming-Chung; Jaw, Twei-Shiun; Liu, Gin-Chung

2011-12-01

A computerized scheme was developed for automated identification of erect posteroanterior (PA) and supine anteroposterior (AP) chest radiographs. The method was based on three features, the tilt angle of the scapula superior border, the tilt angle of the clavicle and the extent of radiolucence in lung fields, to identify the view of a chest radiograph. The three indices Ascapula, Aclavicle and Clung were determined from a chest image for the three features. Linear discriminant analysis was used to classify PA and AP chest images based on the three indices. The performance of the method was evaluated by receiver operating characteristic analysis. The proposed method was evaluated using a database of 600 PA and 600 AP chest radiographs. The discriminant performances Az of Ascapula, Aclavicle and Clung were 0.878 ± 0.010, 0.683 ± 0.015 and 0.962 ± 0.006, respectively. The combination of the three indices obtained an Az value of 0.979 ± 0.004. The results indicate that the combination of the three indices could yield high discriminant performance. The proposed method could provide radiologists with information about the view of chest radiographs for interpretation or could be used as a preprocessing step for analyzing chest images.

On electro-hydrodynamic effects over liquids under influence of corona discharge

NASA Astrophysics Data System (ADS)

Bychkov, V. L.; Abakumov, V. I.; Bikmukhametova, A. R.; Chernikov, V. A.; Safronenkov, D. A.

2018-03-01

Electrohydrodynamic effects over liquids under high voltage electrode are considered in experiments with corona discharge. Simple theory is applied for description of a funnel appearance over a liquid is presented. New types of electrohydrodynamic instabilities are revealed.

Self-Field-Dominated Plasma

DTIC Science & Technology

1998-03-31

plasma focus discharges. Part of the tests summarized here address methods and means for achieving controlled variations of the current sheath (CS) structure via electrode geometry modifications. CS parameters are monitored with multiple magnetic probes in the case of cylindrical - and open-funnel electrode

Thoracic Trauma: Which Chest Tube When and Where?

PubMed

Molnar, Tamas F

2017-02-01

Clinical suspicion of hemo/pneumothorax: when in doubt, drain the chest. Stable chest trauma with hemo/pneumothorax: drain and wait. Unstable patient with dislocated trachea must be approached with drain in hand and scalpel ready. Massive hemo/pneumothorax may be controlled by drainage alone. The surgeon should not hesitate to open the chest if too much blood drains over a short period. The chest drainage procedure does not end with the last stitch; the second half of the match is still ahead. The drained patient is in need of physiotherapy and proper pain relief with an extended pleural space: control the suction system. Copyright © 2016 Elsevier Inc. All rights reserved.

Late clotted haemothorax after blunt chest trauma.

PubMed Central

Sinha, P; Sarkar, P

1998-01-01

A clotted haemothorax can develop any time after blunt chest trauma. Two cases are described in which late clotted haemothoraces developed which were treated by limited thoracotomy and evacuation of clots. Late clotted haemothorax may occur even in the absence of any abnormal initial clinical findings. Early detection and treatment is important to avoid the complications of fibrothorax and empyema with permanent pulmonary dysfunction. After blunt chest trauma patients should be advised to return to the accident and emergency department for assessment on development of any new chest symptom. Under these circumstances a chest x ray is mandatory to exclude a haemothorax. Images Figure 1 PMID:9639184

Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

PubMed Central

Matos, António P.; Mascarenhas, Vasco; Herédia, Vasco

2014-01-01

Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT) has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall. PMID:25295188

Multidetector computer tomography: evaluation of blunt chest trauma in adults.

PubMed

Palas, João; Matos, António P; Mascarenhas, Vasco; Herédia, Vasco; Ramalho, Miguel

2014-01-01

Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT) has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

Nausea and Vomiting in Infants and Children

MedlinePlus

... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Can Chest Computed Tomography Be Replaced by Lung Ultrasonography With or Without Plain Chest Radiography in Pediatric Pneumonia?

PubMed

Hajalioghli, Parisa; Nemati, Masoud; Dinparast Saleh, Leila; Fouladi, Daniel F

2016-07-01

The purpose of this study was to answer the following question: can chest computed tomography (CT) requested by pediatricians be replaced by lung ultrasonography (US) with or without chest radiography in pediatric pneumonia? A total of 98 children with suspected pneumonia who were referred by pediatricians for CT examinations were prospectively studied. Levels of agreement between CT findings and plain radiography, lung US, and chest radiography plus lung US results were investigated. CT defined pneumonia in 84 patients, among which 26 cases were complicated. κ values between radiography and CT findings were 0.82 in complicated cases, 0.67 in uncomplicated cases, and 0.72 overall. The corresponding values between US and CT findings were 1, 0.52, and 0.62, respectively, and between radiography plus US and CT findings were 1, 0.86, and 0.88, respectively. CT can be replaced by US when complex effusions are present in children with pneumonia. In case of an ambiguous diagnosis of pediatric pneumonia with or without complex effusions, a combination of chest radiography and US is a reliable surrogate for chest CT.

Impacted thoracic foreign bodies after penetrating chest trauma.

PubMed

Sersar, Sameh I; Albohiri, Khalid A; Abdelmohty, Hysam

2016-10-01

Retained foreign bodies in the chest may include shell fragments, bullets, shrapnel, pieces of clothing, bones, and rib fragments. The risks of removal of foreign bodies must be weighed against the complications of leaving them inside the chest. We treated 90 cases of retained intrathoracic foreign bodies in patients admitted to 3 tertiary centers in Saudi Arabia between March 2015 and March 2016. Sixty patients were injured by shrapnel, 26 had one or more bullets, 3 had broken rib fragments, and one had a metal screw. The chest wall was site of impaction in 48 cases, the lungs in 24, pleura in 14, and mediastinum in 4. Removal of the retained foreign body was carried out in 12 patients only: bullets in 9 cases, bone fragments in 2, and a metal screw in one. The predictors for removal were bullets, female sex, and mediastinal position with bilateral chest injury, especially with fracture ribs. Retained intrathoracic foreign bodies due to penetrating chest trauma are treated mainly conservatively unless there is another indication for chest exploration. © The Author(s) 2016.

Prevalence of chest trauma, associated injuries and mortality: a level I trauma centre experience.

PubMed

Veysi, Veysi T; Nikolaou, Vassilios S; Paliobeis, Christos; Efstathopoulos, Nicolas; Giannoudis, Peter V

2009-10-01

A review of prospectively collected data in our trauma unit for the years 1998-2003 was undertaken. Adult patients who suffered multiple trauma with an Injury Severity Score (ISS) of >/=16, admitted to hospital for more than 72 hours and with sustained blunt chest injuries were included in the study. Demographic details including pre-hospital care, trauma history, admission vital signs, blood transfusions, details of injuries and their abbreviated injury scores (AIS), operations, length of intensive care unit and hospital stays, Injury Severity Score (ISS) and mortality were analysed. Fulfilling the inclusion criteria with at least one chest injury were 1,164 patients. The overall mortality reached 18.7%. As expected, patients in the higher AIS groups had both a higher overall ISS and mortality rate with one significant exception; patients with minor chest injuries (AIS(chest) = 1) were associated with mortality comparable to injuries involving an AIS(chest) = 3. Additionally, the vast majority of polytraumatised patients with an AIS(chest) = 1 died in ICU sooner than patients of groups 2-5.

Derivation and validation of two decision instruments for selective chest CT in blunt trauma: a multicenter prospective observational study (NEXUS Chest CT).

PubMed

Rodriguez, Robert M; Langdorf, Mark I; Nishijima, Daniel; Baumann, Brigitte M; Hendey, Gregory W; Medak, Anthony J; Raja, Ali S; Allen, Isabel E; Mower, William R

2015-10-01

Unnecessary diagnostic imaging leads to higher costs, longer emergency department stays, and increased patient exposure to ionizing radiation. We sought to prospectively derive and validate two decision instruments (DIs) for selective chest computed tomography (CT) in adult blunt trauma patients. From September 2011 to May 2014, we prospectively enrolled blunt trauma patients over 14 y of age presenting to eight US, urban level 1 trauma centers in this observational study. During the derivation phase, physicians recorded the presence or absence of 14 clinical criteria before viewing chest imaging results. We determined injury outcomes by CT radiology readings and categorized injuries as major or minor according to an expert-panel-derived clinical classification scheme. We then employed recursive partitioning to derive two DIs: Chest CT-All maximized sensitivity for all injuries, and Chest CT-Major maximized sensitivity for only major thoracic injuries (while increasing specificity). In the validation phase, we employed similar methodology to prospectively test the performance of both DIs. We enrolled 11,477 patients-6,002 patients in the derivation phase and 5,475 patients in the validation phase. The derived Chest CT-All DI consisted of (1) abnormal chest X-ray, (2) rapid deceleration mechanism, (3) distracting injury, (4) chest wall tenderness, (5) sternal tenderness, (6) thoracic spine tenderness, and (7) scapular tenderness. The Chest CT-Major DI had the same criteria without rapid deceleration mechanism. In the validation phase, Chest CT-All had a sensitivity of 99.2% (95% CI 95.4%-100%), a specificity of 20.8% (95% CI 19.2%-22.4%), and a negative predictive value (NPV) of 99.8% (95% CI 98.9%-100%) for major injury, and a sensitivity of 95.4% (95% CI 93.6%-96.9%), a specificity of 25.5% (95% CI 23.5%-27.5%), and a NPV of 93.9% (95% CI 91.5%-95.8%) for either major or minor injury. Chest CT-Major had a sensitivity of 99.2% (95% CI 95.4%-100%), a specificity of 31.7% (95% CI 29.9%-33.5%), and a NPV of 99.9% (95% CI 99.3%-100%) for major injury and a sensitivity of 90.7% (95% CI 88.3%-92.8%), a specificity of 37.9% (95% CI 35.8%-40.1%), and a NPV of 91.8% (95% CI 89.7%-93.6%) for either major or minor injury. Regarding the limitations of our work, some clinicians may disagree with our injury classification and sensitivity thresholds for injury detection. We prospectively derived and validated two DIs (Chest CT-All and Chest CT-Major) that identify blunt trauma patients with clinically significant thoracic injuries with high sensitivity, allowing for a safe reduction of approximately 25%-37% of unnecessary chest CTs. Trauma evaluation protocols that incorporate these DIs may decrease unnecessary costs and radiation exposure in the disproportionately young trauma population.

Blunt chest trauma.

PubMed

Stewart, Daphne J

2014-01-01

Blunt chest trauma is associated with a wide range of injuries, many of which are life threatening. This article is a case study demonstrating a variety of traumatic chest injuries, including pathophysiology, diagnosis, and treatment. Literature on the diagnosis and treatment was reviewed, including both theoretical and research literature, from a variety of disciplines. The role of the advance practice nurse in trauma is also discussed as it relates to assessment, diagnosis, and treatment of patients with traumatic chest injuries.

CPDX (Chest Pain Diagnostic Program) - A Decision Support System for the Management of Acute Chest Pain (User’s Manual)

DTIC Science & Technology

1988-02-25

chest pain and/or dyspnea are present. a. Musculoskeletal pain b. Pleurisy c. Pulmonary embolus d. Spontaneous mediastinal emphysema a...Treatment includes mild analgesics, heat therapy, and, perhaps, rest. b) Pleurisy denotes inflammation of the pleura. It is seen in the setting of...bronchitis or pneumonia; the symptoms of both assist in differentiating pleurisy from pneumothorax. Chest discomfort is pleuristic. Unless there are

Chest wall myositis in a patient with acute coronary syndrome

PubMed Central

Hussein, Laila; Al-Rawi, Harith

2014-01-01

We describe a case of a 42-year-old man who presented to the emergency department with severe left-sided chest pain and chest tenderness of 1-day duration. The pain was episodic and was aggravated by any chest wall movement. His initial blood tests and ECG were suggestive of acute coronary syndrome (ACS). However, his pattern of pain, lack of response to opiates, raised creatine kinase and signs of pleurisy on chest radiograph raised a suspicion of an alternative diagnosis. The patient showed a dramatic response in pain relief to non-steroidal anti-inflammatory medication. He was suspected to have chest wall myositis with pleural involvement in the form of pleurodynia. His serology test was positive for coxsackie virus antibodies. We will discuss in this case report the pathognomonic features, diagnosis and treatment of a rare infectious condition known as Bornholm disease. PMID:25312897

Is it adequate to carry out a chest-CT in patients with mild-moderate chest trauma?

PubMed

García de Pereda de Blas, V; Carreras Aja, M; Carbajo Azabal, S; Arana-Arri, E

2017-10-12

Mild-moderate blunt chest trauma is defined as a blunt chest trauma that is not caused by a high-energy mechanism, causing thoracic tenderness with or without rib fractures and that has no immediate life-threatening consequences for the patient. It is a frequent clinical situation in the emergency department. The most common radiological techniques that are used in this context are chest X-ray and thoracic computed tomography (CT). The CT scan is set as the gold standard. However, there are no current clinical-radiological guidelines that establish the adequacy of the requests of the CT scan. Therefore, we decided to search for evidence-based recommendations to improve the adequacy of the chest X-ray and CT scan in our daily practice in order to reduce the costs and avoid unnecessary radiation exposure. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

[Musculoskeletal-related chest pain].

PubMed

Sturm, C; Witte, T

2017-01-01

Approximately 10-50% of chest pains are caused by musculoskeletal disorders. The association is twice as frequent in primary care as in emergency admissions. This article provides an overview of the most important musculoskeletal causes of chest pain and on the diagnostics and therapy. A selective search and analysis of the literature related to the topic of musculoskeletal causes of chest pain were carried out. Non-inflammatory diseases, such as costochondritis and fibromyalgia are frequent causes of chest pain. Inflammatory diseases, such as rheumatoid arthritis, spondyloarthritis and systemic lupus erythematosus are much less common but are more severe conditions and therefore have to be diagnosed and treated. The diagnostics and treatment often necessitate interdisciplinary approaches. Chest pain caused by musculoskeletal diseases always represents a diagnosis by exclusion of other severe diseases of the heart, lungs and stomach. Physiotherapeutic and physical treatment measures are particularly important, including manual therapy, transcutaneous electrical stimulation and stabilization exercises, especially for functional myofascial disorders.

Tube thorocostomy: management and outcome in patients with penetrating chest trauma.

PubMed

Muslim, Muhammad; Bilal, Amer; Salim, Muhammad; Khan, Muhammad Abid; Baseer, Abdul; Ahmed, Manzoor

2008-01-01

Penetrating chest trauma is common in this part of the world due to present situation in tribal areas. The first line of management after resuscitation in these patients is tube thoracostomy combined with analgesia and incentive spirometry. After tube thoracostomy following surgery or trauma there are two schools of thought one favours application of continuous low pressure suction to the chest tubes beyond the water seal while other are against it. We studied the application of continuous low pressure suction in patients with penetrating chest trauma. This Randomized clinical controlled trial was conducted in the department of thoracic surgery Post Graduate Medical Institute Lady Reading Hospital Peshawar from July 2007 to March 2008. The objectives of study were to evaluate the effectiveness of continuous low pressure suction in patients with penetrating chest trauma for evacuation of blood, expansion of lung and prevention of clotted Haemothorax. One hundred patients who underwent tube thoracostomy after penetrating chest trauma from fire arm injury or stab wounds were included in the study. Patients with multiple trauma, blunt chest trauma and those intubated for any pulmonary or pleural disease were excluded from the study. After resuscitation, detailed examination and necessary investigations patients were randomized to two groups. Group I included patients who had continuous low pressure suction applied to their chest drains. Group II included those patients whose chest drains were placed on water seal only. Lung expansion development of pneumothorax or clotted Haemothorax, time to removal of chest drain and hospital stay was noted in each group. There were fifty patients in each group. The two groups were not significantly different from each other regarding age, sex, pre-intubation haemoglobin and pre intubation nutritional status. Full lung expansion was achieved in forty six (92%) patients in group I and thirty seven (74%) in group II. Partial lung expansion or pneumothorax was present in three (60%) in group I and 10 (20%) in group II. One patient in group I and three (6%) patients in group II had no response. The mean time to removal of chest drains were 8.2 +/- 3.14 days in group I and 12.6 +/- 4.20 days in group II. The length of hospital stay was 7.2 +/- 2.07 days and 12.4 +/- 3.63 days in group I and II respectively. Clotted Haemothorax requiring surgery developed in three (6%) patients in group I and 8 (16%) patients in group II. Placing chest tubes on continuous low pressure suction after penetrating chest trauma helps evacuation of blood, expansion of lung and prevents the development of clotted Haemothorax. It also reduces the time to removal of chest drains, the hospital stay and the chances of surgery for clotted Haemothorax or Empyema.

Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

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

Zhang, Yakun; Li, Xiang; Segars, W. Paul

2014-02-15

Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definiummore » 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDI{sub vol} and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose metrics only increased slightly for radiographic modalities and for chest tomosynthesis. Effective and organ doses normalized to mAs all illustrated an exponential decrease with increasing patient size. As a surface organ, breast doses had less correlation with body size than that of lungs or liver. Conclusions: Patient body size has a much greater impact on radiation dose of chest CT examinations than chest radiography and tomosynthesis. The size of a patient should be considered when choosing the best thoracic imaging modality.« less

Detection failure rate of chest radiography for the identification of nursing and healthcare-associated pneumonia.

PubMed

Miyashita, Naoyuki; Kawai, Yasuhiro; Tanaka, Takaaki; Akaike, Hiroto; Teranishi, Hideto; Wakabayashi, Tokio; Nakano, Takashi; Ouchi, Kazunobu; Okimoto, Niro

2015-07-01

To clarify the detection failure rate of chest radiography for the identification of nursing and healthcare-associated pneumonia (NHCAP), we compared high-resolution computed tomography (HRCT) with chest radiography simultaneously for patients with clinical symptoms and signs leading to a suspicion of NHCAP. We analyzed 208 NHCAP cases and compared them based on four groups defined using NHCAP criteria, patients who were: Group A) resident in an extended care facility or nursing home; Group B) discharged from a hospital within the preceding 90 days; Group C) receiving nursing care and had poor performance status; and Group D) receiving regular endovascular treatment. Chest radiography was inferior to HRCT for the identification of pneumonia (149 vs 208 cases, p < 0.0001). Among the designated NHCAP criteria, chest radiography identified pneumonia cases at a significantly lower frequency than HRCT in Group A (70 vs 97 cases, p = 0.0190) and Group C (86 vs 136 cases, p < 0.0001). The detection failure rate of chest radiography differed among NHCAP criteria; 27.8% in Group A, 26.5% in Group B, 36.7% in Group C and 5.8% in Group D. Cerebrovascular disease and poor functional status were significantly more frequent in patients in Groups A and C compared with those in Groups B and D. Physicians may underestimate pneumonia shadow in chest radiographs in patients with NHCAP, and the detection failure rate of chest radiography differed among NHCAP criteria. Poor functional status may correlate with the low accuracy of chest radiography in diagnosing pneumonia. Copyright © 2015. Published by Elsevier Ltd.

Management of computed tomography-detected pneumothorax in patients with blunt trauma: experience from a community-based hospital

PubMed Central

Hefny, Ashraf F; Kunhivalappil, Fathima T; Matev, Nikolay; Avila, Norman A; Bashir, Masoud O; Abu-Zidan, Fikri M

2018-01-01

INTRODUCTION Diagnoses of pneumothorax, especially occult pneumothorax, have increased as the use of computed tomography (CT) for imaging trauma patients becomes near-routine. However, the need for chest tube insertion remains controversial. We aimed to study the management of pneumothorax detected on CT among patients with blunt trauma, including the decision for tube thoracostomy, in a community-based hospital. METHODS Chest CT scans of patients with blunt trauma treated at Al Rahba Hospital, Abu Dhabi, United Arab Emirates, from October 2010 to October 2014 were retrospectively studied. Variables studied included demography, mechanism of injury, endotracheal intubation, pneumothorax volume, chest tube insertion, Injury Severity Score, hospital length of stay and mortality. RESULTS CT was performed in 703 patients with blunt trauma. Overall, pneumothorax was detected on CT for 74 (10.5%) patients. Among the 65 patients for whom pneumothorax was detected before chest tube insertion, 25 (38.5%) needed chest tube insertion, while 40 (61.5%) did not. Backward stepwise likelihood regression showed that independent factors that significantly predicted chest tube insertion were endotracheal intubation (p = 0.01), non-United Arab Emirates nationality (p = 0.01) and pneumothorax volume (p = 0.03). The receiver operating characteristic curve showed that the best pneumothorax volume that predicted chest tube insertion was 30 mL. CONCLUSION Chest tube was inserted in less than half of the patients with blunt trauma for whom pneumothorax was detected on CT. Pneumothorax volume should be considered in decision-making regarding chest tube insertion. Conservative treatment may be sufficient for pneumothorax of volume < 30 mL. PMID:28741012

Management of computed tomography-detected pneumothorax in patients with blunt trauma: experience from a community-based hospital.

PubMed

Hefny, Ashraf F; Kunhivalappil, Fathima T; Matev, Nikolay; Avila, Norman A; Bashir, Masoud O; Abu-Zidan, Fikri M

2018-03-01

Diagnoses of pneumothorax, especially occult pneumothorax, have increased as the use of computed tomography (CT) for imaging trauma patients becomes near-routine. However, the need for chest tube insertion remains controversial. We aimed to study the management of pneumothorax detected on CT among patients with blunt trauma, including the decision for tube thoracostomy, in a community-based hospital. Chest CT scans of patients with blunt trauma treated at Al Rahba Hospital, Abu Dhabi, United Arab Emirates, from October 2010 to October 2014 were retrospectively studied. Variables studied included demography, mechanism of injury, endotracheal intubation, pneumothorax volume, chest tube insertion, Injury Severity Score, hospital length of stay and mortality. CT was performed in 703 patients with blunt trauma. Overall, pneumothorax was detected on CT for 74 (10.5%) patients. Among the 65 patients for whom pneumothorax was detected before chest tube insertion, 25 (38.5%) needed chest tube insertion, while 40 (61.5%) did not. Backward stepwise likelihood regression showed that independent factors that significantly predicted chest tube insertion were endotracheal intubation (p = 0.01), non-United Arab Emirates nationality (p = 0.01) and pneumothorax volume (p = 0.03). The receiver operating characteristic curve showed that the best pneumothorax volume that predicted chest tube insertion was 30 mL. Chest tube was inserted in less than half of the patients with blunt trauma for whom pneumothorax was detected on CT. Pneumothorax volume should be considered in decision-making regarding chest tube insertion. Conservative treatment may be sufficient for pneumothorax of volume < 30 mL. Copyright: © Singapore Medical Association.

Chest pain in daily practice: occurrence, causes and management.

PubMed

Verdon, François; Herzig, Lilli; Burnand, Bernard; Bischoff, Thomas; Pécoud, Alain; Junod, Michel; Mühlemann, Nicole; Favrat, Bernard

2008-06-14

We assessed the occurrence and aetiology of chest pain in primary care practice. These features differ between primary and emergency care settings, where most previous studies have been performed. 59 GPs in western Switzerland recorded all consecutive cases presenting with chest pain. Clinical characteristics, laboratory tests and other investigations as well as the diagnoses remaining after 12 months of follow-up were systematically registered. Among 24,620 patients examined during a total duration of 300 weeks of observation, 672 (2.7%) presented with chest pain (52% female, mean age 55 +/- 19(SD)). Most cases, 442 (1.8%), presented new symptoms and in 356 (1.4%) it was the reason for consulting. Over 40 ailments were diagnosed: musculoskeletal chest pain (including chest wall syndrome) (49%), cardiovascular (16%), psychogenic (11%), respiratory (10%), digestive (8%), miscellaneous (2%) and without diagnosis (3%). The three most prevalent diseases were: chest wall syndrome (43%), coronary artery disease (12%) and anxiety (7%). Unstable angina (6), myocardial infarction (4) and pulmonary embolism (2) were uncommon (1.8%). Potentially serious conditions including cardiac, respiratory and neoplasic diseases accounted for 20% of cases. A large number of laboratory tests (42%), referral to a specialist (16%) or hospitalisation (5%) were performed. Twentyfive patients died during follow-up, of which twelve were for a reason directly associated with thoracic pain [cancer (7) and cardiac causes (5)]. Thoracic pain was present in 2.7% of primary care consultations. Chest wall syndrome pain was the main aetiology. Cardio - vascular emergencies were uncommon. However chest pain deserves full consideration because of the occurrence of potentially serious conditions.

The utility of computed tomography as a screening tool for the evaluation of pediatric blunt chest trauma.

PubMed

Markel, Troy A; Kumar, Rajiv; Koontz, Nicholas A; Scherer, L R; Applegate, Kimberly E

2009-07-01

There is a growing concern that computed tomography (CT) is being unnecessarily overused for the evaluation of pediatric patients. The purpose of this study was to analyze the trends and utility of chest CT use compared with chest X-ray (CXR) for the evaluation of children with blunt chest trauma. A 4-year retrospective review was performed for pediatric patients who underwent chest CT within 24 hours of sustaining blunt trauma at a Level-I trauma center. Trends in the use of CT and CXR were documented, and results of radiology reports were analyzed and compared with clinical outcomes. Three hundred thirty-three children, mean age 11 years, had chest CTs, increasing from 5.5% in 2001-2002 to 10.5% in 2004-2005 (p < 0.001). Conversely, in those children who underwent chest CT, the rate of initial CXR use decreased from 84% to 56% during the same period (p < 0.001). Twenty percent of chest CTs had significant positive findings. Six patients underwent emergency surgery for cardiac or arterial injuries, and all demonstrated abnormal findings on CXR or CT scout imaging. When compared with the CT, only 5% of initial CXRs falsely reported normal findings that may have altered management. CT use in children has increased rapidly for the initial evaluation of chest trauma, whereas CXR use has decreased. Despite this trend, CXR remains an acceptable screening tool to analyze which patients may require CT evaluation. A multidisciplinary approach is warranted to develop guidelines that standardize the use of CT and thereby decreases unnecessary radiation exposure to pediatric patients.

Longest delayed hemothorax reported after blunt chest injury.

PubMed

Yap, Darren; Ng, Miane; Chaudhury, Madhu; Mbakada, Nik

2018-01-01

Blunt chest injury is a common presentation to the emergency department. However, a delayed hemothorax after blunt trauma is rare; current literature reports a delay of up to 30days. We present a case of 44-day delay in hemothorax which has not been previously reported in current literature. A 52-year-old Caucasian male first presented to the emergency department complaining of persistent right sided chest pain 2weeks after having slipped on a wet surface at home. His initial chest X-ray showed fractures of the right 7th and 8th ribs without a hemothorax or pneumothorax. He returned 30days after the initial consultation (44days post-trauma) having increasing shortness of breath. A chest X-ray this time revealed a large right hemothorax and 1850ml of blood drained from his chest. There was a complete resolution of the hemothorax within 48h and the patient was discharged after a 6-week follow-up with the chest physicians. Delayed hemothorax after blunt trauma is a rare clinical occurrence but associated with significant morbidity and mortality. The management of delayed hemothorax includes draining the hemothorax and controlling the bleeding. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be vigilant and weary that hemothorax could be a possibility after a chest injury despite a delay in presentation. A knowledge of delayed hemothorax will prompt physicians in providing important advice, warning signs and information to patients after a chest injury to avoid a delay in seeking medical attention. Copyright © 2017 Elsevier Inc. All rights reserved.

Psychiatric Characteristics of the Cardiac Outpatients with Chest Pain.

PubMed

Lee, Jea-Geun; Choi, Joon Hyouk; Kim, Song-Yi; Kim, Ki-Seok; Joo, Seung-Jae

2016-03-01

A cardiologist's evaluation of psychiatric symptoms in patients with chest pain is rare. This study aimed to determine the psychiatric characteristics of patients with and without coronary artery disease (CAD) and explore their relationship with the intensity of chest pain. Out of 139 consecutive patients referred to the cardiology outpatient department, 31 with atypical chest pain (heartburn, acid regurgitation, dyspnea, and palpitation) were excluded and 108 were enrolled for the present study. The enrolled patients underwent complete numerical rating scale of chest pain and the symptom checklist for minor psychiatric disorders at the time of first outpatient visit. The non-CAD group consisted of patients with a normal stress test, coronary computed tomography angiogram, or coronary angiogram, and the CAD group included those with an abnormal coronary angiogram. Nineteen patients (17.6%) were diagnosed with CAD. No differences in the psychiatric characteristics were observed between the groups. "Feeling tense", "self-reproach", and "trouble falling asleep" were more frequently observed in the non-CAD (p=0.007; p=0.046; p=0.044) group. In a multiple linear regression analysis with a stepwise selection, somatization without chest pain in the non-CAD group and hypochondriasis in the CAD group were linearly associated with the intensity of chest pain (β=0.108, R(2)=0.092, p=0.004; β= -0.525, R(2)=0.290, p=0.010). No differences in psychiatric characteristics were observed between the groups. The intensity of chest pain was linearly associated with somatization without chest pain in the non-CAD group and inversely linearly associated with hypochondriasis in the CAD group.

Rib Radiography versus Chest Computed Tomography in the Diagnosis of Rib Fractures.

PubMed

Sano, Atsushi

2018-05-01

 The accurate diagnosis of rib fractures is important in chest trauma. Diagnostic images following chest trauma are usually obtained via chest X-ray, chest computed tomography, or rib radiography. This study evaluated the diagnostic characteristics of rib radiography and chest computed tomography.  Seventy-five rib fracture patients who underwent both chest computed tomography and rib radiography between April 2008 and December 2013 were included. Rib radiographs, centered on the site of pain, were taken from two directions. Chest computed tomography was performed using a 16-row multidetector scanner with 5-mm slice-pitch without overlap, and axial images were visualized in a bone window.  In total, 217 rib fractures were diagnosed in 75 patients. Rib radiography missed 43 rib fractures in 24 patients. The causes were overlap with organs in 15 cases, trivial fractures in 21 cases, and injury outside the imaging range in 7 cases. Left lower rib fractures were often missed due to overlap with the heart, while middle and lower rib fractures were frequently not diagnosed due to overlap with abdominal organs. Computed tomography missed 21 rib fractures in 17 patients. The causes were horizontal fractures in 10 cases, trivial fractures in 9 cases, and insufficient breath holding in 1 case.  In rib radiography, overlap with organs and fractures outside the imaging range were characteristic reasons for missed diagnoses. In chest computed tomography, horizontal rib fractures and insufficient breath holding were often responsible. We should take these challenges into account when diagnosing rib fractures. Georg Thieme Verlag KG Stuttgart · New York.

Comparison consequences of Jackson-Pratt drain versus chest tube after coronary artery bypass grafting: A randomized controlled clinical trial

PubMed Central

Mirmohammad-Sadeghi, Mohsen; Pourazari, Pejman; Akbari, Mojtaba

2017-01-01

Background: Chest tubes are used in every case of coronary artery bypass grafting (CABG) to evacuate shed blood from around the heart and lungs. This study was designed to assess the effective of Jackson-Pratt drain in compare with conventional chest drains after CABG. Materials and Methods: This was a randomized controlled trial that conducted on 218 patients in Chamran hospital from February to December 2016. Eligible patients were randomized in a 1:1 ratio. Jackson-Pratt drain group had 109 patients who received a chest tube insertion in the pleural space of the left lung and a Jackson-Pratt drain in mediastinum, and Chest tube drainage group had 109 patients who received double chest tube insertion in the pleural space of the left lung and the mediastinum. Results: The incidence of pleural effusions in Jackson-Pratt drain group and chest tube group were not statistically different. The pain score at 2-h in Drain group was significantly higher than chest tube group (P = 0.001), but the trend of pain score between groups was not significantly different (P = 0.097). The frequency of tamponade and atrial fibrillation (AF) were significantly lower in Jackson-Pratt drain group (P < 0.05). Conclusion: The Jackson-Pratt drain is equally effective for preventing cardiac tamponade, pleural effusions, and pain intensity in patients after CABG when compared with conventional chest tubes, but was significantly superior regarding efficacy to hospital and Intensive Care Unit length of stay and the incidence of AF. PMID:29387121

Chest tube drainage of transudative pleural effusions hastens liberation from mechanical ventilation.

PubMed

Kupfer, Yizhak; Seneviratne, Chanaka; Chawla, Kabu; Ramachandran, Kavan; Tessler, Sidney

2011-03-01

Pleural effusions occur frequently in patients requiring mechanical ventilatory support. Treatment of the precipitating cause and resolution of the pleural effusion may take considerable time. We retrospectively studied the effect of chest tube drainage of transudative pleural effusions on the liberation of patients from mechanical ventilatory support. Patients in the medical ICU (MICU) at Maimonides Medical Center between January 1, 2009, and October 31, 2009, requiring mechanical ventilatory support with a transudative pleural effusion, were studied retrospectively. They were divided into two groups: standard care and standard care plus chest tube drainage. Chest tubes were placed under ultrasound guidance by trained intensivists. Duration of mechanical ventilatory support was the primary end point. Secondary end points included measures of oxygenation, amount of fluid drained, and complications associated with the chest tube. A total of 168 patients were studied; 88 were treated with standard care and 80 underwent chest tube drainage. Total duration of mechanical ventilatory support was significantly shorter for patients who had chest tube drainage: 3.8±0.5 days vs 6.5±1.1 days for the standard group (P=.03). No differences in oxygenation were noted between the two groups. The average amount of fluid drained was 1,220 mL. No significant complications were caused by chest tube drainage. Chest tube drainage of transudative pleural effusions resulted in more rapid liberation from mechanical ventilatory support. It is a very safe procedure when performed under ultrasound guidance by experienced personnel. ClinicalTrials.gov; Identifier: NCT0114285; URL: www.clinicaltrials.gov.

Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease?

PubMed Central

Oshaug, Katja; Halvorsen, Peder A; Melbye, Hasse

2013-01-01

Background Although proven to be associated with bronchial obstruction, chest signs are not listed among cues that should prompt spirometry in the early diagnosis of chronic obstructive pulmonary disease (COPD) in established guidelines. Aims We aimed to explore how chest findings add to respiratory symptoms and a history of smoking in the diagnosis of COPD. Methods In a cross-sectional study, patients aged 40 years or older, previously diagnosed with either asthma or COPD in primary care, answered questionnaires and underwent physical chest examination and spirometry. Results Among the 375 patients included, 39.7% had forced expiratory volume in 1 second/forced vital capacity <0.7. Hyperresonance to percussion was the strongest predictor of COPD, with a sensitivity of 20.8, a specificity of 97.8, and likelihood ratio of 9.5. In multivariate logistic regression, where pack-years, shortness of breath, and chest findings were among the explanatory variables, three physical chest findings were independent predictors of COPD. Hyperresonance to percussion yielded the highest odds ratio (OR = 6.7), followed by diminished breath sounds (OR = 5.0), and thirdly wheezes (OR = 2.3). These three chest signs also gave significant diagnostic information when added to shortness of breath and pack-years in receiver operating-characteristic curve analysis. Conclusion We found that chest signs may add to respiratory symptoms and a history of smoking in the diagnosis of COPD, and we conclude that chest signs should be reinstated as cues to early diagnosis of COPD in patients 40 years or older. PMID:23983462

Preliminary report from the World Health Organisation Chest Radiography in Epidemiological Studies project.

PubMed

Mahomed, Nasreen; Fancourt, Nicholas; de Campo, John; de Campo, Margaret; Akano, Aliu; Cherian, Thomas; Cohen, Olivia G; Greenberg, David; Lacey, Stephen; Kohli, Neera; Lederman, Henrique M; Madhi, Shabir A; Manduku, Veronica; McCollum, Eric D; Park, Kate; Ribo-Aristizabal, Jose Luis; Bar-Zeev, Naor; O'Brien, Katherine L; Mulholland, Kim

2017-10-01

Childhood pneumonia is among the leading infectious causes of mortality in children younger than 5 years of age globally. Streptococcus pneumoniae (pneumococcus) is the leading infectious cause of childhood bacterial pneumonia. The diagnosis of childhood pneumonia remains a critical epidemiological task for monitoring vaccine and treatment program effectiveness. The chest radiograph remains the most readily available and common imaging modality to assess childhood pneumonia. In 1997, the World Health Organization Radiology Working Group was established to provide a consensus method for the standardized definition for the interpretation of pediatric frontal chest radiographs, for use in bacterial vaccine efficacy trials in children. The definition was not designed for use in individual patient clinical management because of its emphasis on specificity at the expense of sensitivity. These definitions and endpoint conclusions were published in 2001 and an analysis of observer variation for these conclusions using a reference library of chest radiographs was published in 2005. In response to the technical needs identified through subsequent meetings, the World Health Organization Chest Radiography in Epidemiological Studies (CRES) project was initiated and is designed to be a continuation of the World Health Organization Radiology Working Group. The aims of the World Health Organization CRES project are to clarify the definitions used in the World Health Organization defined standardized interpretation of pediatric chest radiographs in bacterial vaccine impact and pneumonia epidemiological studies, reinforce the focus on reproducible chest radiograph readings, provide training and support with World Health Organization defined standardized interpretation of chest radiographs and develop guidelines and tools for investigators and site staff to assist in obtaining high-quality chest radiographs.

THE URBAN FUNNEL MODEL AND SPATIALLY HETEROGENEOUS ECOLOGICAL FOOTPRINT. (R827676)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Value Added

ERIC Educational Resources Information Center

Welch, Matt

2004-01-01

This article profiles retiring values teacher Gene Doxey and describes his foundational contributions to the students of California's Ramona Unified School District. Every one of the Ramona Unified School District's 7,200 students is eventually funneled through Doxey's Contemporary Issues class, a required rite of passage between elementary school…

Multi-Institutional Evaluation of Digital Tomosynthesis, Dual-Energy Radiography, and Conventional Chest Radiography for the Detection and Management of Pulmonary Nodules.

PubMed

Dobbins, James T; McAdams, H Page; Sabol, John M; Chakraborty, Dev P; Kazerooni, Ella A; Reddy, Gautham P; Vikgren, Jenny; Båth, Magnus

2017-01-01

Purpose To conduct a multi-institutional, multireader study to compare the performance of digital tomosynthesis, dual-energy (DE) imaging, and conventional chest radiography for pulmonary nodule detection and management. Materials and Methods In this binational, institutional review board-approved, HIPAA-compliant prospective study, 158 subjects (43 subjects with normal findings) were enrolled at four institutions. Informed consent was obtained prior to enrollment. Subjects underwent chest computed tomography (CT) and imaging with conventional chest radiography (posteroanterior and lateral), DE imaging, and tomosynthesis with a flat-panel imaging device. Three experienced thoracic radiologists identified true locations of nodules (n = 516, 3-20-mm diameters) with CT and recommended case management by using Fleischner Society guidelines. Five other radiologists marked nodules and indicated case management by using images from conventional chest radiography, conventional chest radiography plus DE imaging, tomosynthesis, and tomosynthesis plus DE imaging. Sensitivity, specificity, and overall accuracy were measured by using the free-response receiver operating characteristic method and the receiver operating characteristic method for nodule detection and case management, respectively. Results were further analyzed according to nodule diameter categories (3-4 mm, >4 mm to 6 mm, >6 mm to 8 mm, and >8 mm to 20 mm). Results Maximum lesion localization fraction was higher for tomosynthesis than for conventional chest radiography in all nodule size categories (3.55-fold for all nodules, P < .001; 95% confidence interval [CI]: 2.96, 4.15). Case-level sensitivity was higher with tomosynthesis than with conventional chest radiography for all nodules (1.49-fold, P < .001; 95% CI: 1.25, 1.73). Case management decisions showed better overall accuracy with tomosynthesis than with conventional chest radiography, as given by the area under the receiver operating characteristic curve (1.23-fold, P < .001; 95% CI: 1.15, 1.32). There were no differences in any specificity measures. DE imaging did not significantly affect nodule detection when paired with either conventional chest radiography or tomosynthesis. Conclusion Tomosynthesis outperformed conventional chest radiography for lung nodule detection and determination of case management; DE imaging did not show significant differences over conventional chest radiography or tomosynthesis alone. These findings indicate performance likely achievable with a range of reader expertise. © RSNA, 2016 Online supplemental material is available for this article.

Multi-Institutional Evaluation of Digital Tomosynthesis, Dual-Energy Radiography, and Conventional Chest Radiography for the Detection and Management of Pulmonary Nodules

PubMed Central

McAdams, H. Page; Sabol, John M.; Chakraborty, Dev P.; Kazerooni, Ella A.; Reddy, Gautham P.; Vikgren, Jenny; Båth, Magnus

2017-01-01

Purpose To conduct a multi-institutional, multireader study to compare the performance of digital tomosynthesis, dual-energy (DE) imaging, and conventional chest radiography for pulmonary nodule detection and management. Materials and Methods In this binational, institutional review board–approved, HIPAA-compliant prospective study, 158 subjects (43 subjects with normal findings) were enrolled at four institutions. Informed consent was obtained prior to enrollment. Subjects underwent chest computed tomography (CT) and imaging with conventional chest radiography (posteroanterior and lateral), DE imaging, and tomosynthesis with a flat-panel imaging device. Three experienced thoracic radiologists identified true locations of nodules (n = 516, 3–20-mm diameters) with CT and recommended case management by using Fleischner Society guidelines. Five other radiologists marked nodules and indicated case management by using images from conventional chest radiography, conventional chest radiography plus DE imaging, tomosynthesis, and tomosynthesis plus DE imaging. Sensitivity, specificity, and overall accuracy were measured by using the free-response receiver operating characteristic method and the receiver operating characteristic method for nodule detection and case management, respectively. Results were further analyzed according to nodule diameter categories (3–4 mm, >4 mm to 6 mm, >6 mm to 8 mm, and >8 mm to 20 mm). Results Maximum lesion localization fraction was higher for tomosynthesis than for conventional chest radiography in all nodule size categories (3.55-fold for all nodules, P < .001; 95% confidence interval [CI]: 2.96, 4.15). Case-level sensitivity was higher with tomosynthesis than with conventional chest radiography for all nodules (1.49-fold, P < .001; 95% CI: 1.25, 1.73). Case management decisions showed better overall accuracy with tomosynthesis than with conventional chest radiography, as given by the area under the receiver operating characteristic curve (1.23-fold, P < .001; 95% CI: 1.15, 1.32). There were no differences in any specificity measures. DE imaging did not significantly affect nodule detection when paired with either conventional chest radiography or tomosynthesis. Conclusion Tomosynthesis outperformed conventional chest radiography for lung nodule detection and determination of case management; DE imaging did not show significant differences over conventional chest radiography or tomosynthesis alone. These findings indicate performance likely achievable with a range of reader expertise. © RSNA, 2016 Online supplemental material is available for this article. PMID:27439324

Intramammary Findings on CT of the Chest – a Review of Normal Anatomy and Possible Findings

PubMed Central

Gossner, Johannes

2016-01-01

Summary Computed tomography (CT) is a frequently performed examination in women of all ages. In all thoracic CT examinations of the chest at least parts of the breasts are included. Therefore incidental breast pathology may be observed. It has been suggested that one out of 250 women undergoing chest CT will show a malignant incidental breast lesion. Given the high number of performed chest CT examinations, this contributes to a significant number of malignancies. In this review, after a brief discussion of the value of computed tomography in breast imaging, normal and pathologic findings are discussed to create awareness of this potential “black box” on chest CT. PMID:28058068

Spontaneous pneumomediastinum: A rare complication of methamphetamine use.

PubMed

Albanese, Jessica; Gross, Cole; Azab, Mohamed; Mahalean, Sinziana; Makar, Ranjit

2017-01-01

To present an unusual case of spontaneous pneumomediastinum subsequent to recreational amphetamine use. A young African American adult male was admitted to internal medicine service for treatment of rhabdomyolysis secondary to methamphetamine use. On admission, he was complaining of chest pain in addition to nausea and generalized muscle aches. By his second hospital day, chest pain had resolved yet physical exam demonstrated crepitation of the anterior chest and left axilla. Portable chest x-ray revealed subcutaneous emphysema in addition to pneumomediastinum. Spontaneous pneumomediastinum is a rare complication of amphetamine use that is often associated with subcutaneous emphysema and can be diagnosed with chest x-ray. Management is conservative, with observation, pain control, and supplemental oxygen as needed.

Chest drainage systems in use

PubMed Central

Zisis, Charalambos; Tsirgogianni, Katerina; Lazaridis, George; Lampaki, Sofia; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Rapti, Aggeliki; Trakada, Georgia; Karapantzos, Ilias; Karapantzou, Chrysanthi; Zissimopoulos, Athanasios; Zarogoulidis, Konstantinos

2015-01-01

A chest tube is a flexible plastic tube that is inserted through the chest wall and into the pleural space or mediastinum. It is used to remove air in the case of pneumothorax or fluid such as in the case of pleural effusion, blood, chyle, or pus when empyema occurs from the intrathoracic space. It is also known as a Bülau drain or an intercostal catheter. Insertion of chest tubes is widely performed by radiologists, pulmonary physicians and thoracic surgeons. Large catheters or small catheters are used based on each situation that the medical doctor encounters. In the current review we will focus on the chest drain systems that are in use. PMID:25815304

Pulmonary effects of synthetic marijuana: chest radiography and CT findings.

PubMed

Berkowitz, Eugene A; Henry, Travis S; Veeraraghavan, Srihari; Staton, Gerald W; Gal, Anthony A

2015-04-01

The purpose of this article is to present the first chest radiographic and CT descriptions of organizing pneumonia in response to smoking synthetic marijuana. Chest radiographs showed a diffuse miliary-micronodular pattern. Chest CT images showed diffuse centrilobular nodules and tree-in-bud pattern and a histopathologic pattern of organizing pneumonia with or without patchy acute alveolar damage. This distinct imaging pattern should alert radiologists to include synthetic marijuana abuse in the differential diagnosis.

Chest pain of gastrointestinal origin.

PubMed Central

Berezin, S; Medow, M S; Glassman, M S; Newman, L J

1988-01-01

Twenty seven children who had been diagnosed as having idiopathic chest pain were investigated to find out if the pain was of gastrointestinal origin. The symptoms had lasted from two weeks to eight months. In 21 of the 27 children (78%) the chest pain had a gastrointestinal cause: 16 had oesophagitis, four had gastritis, and one had diffuse oesophageal spasm. All patients responded to medical treatment of their gastrointestinal symptoms, resulting in disappearance of the chest pain. PMID:3232993

Management of Open Pneumothorax in Tactical Combat Casualty Care: TCCC Guidelines Change 13-02.

PubMed

Butler, Frank K; Dubose, Joseph J; Otten, Edward J; Bennett, Donald R; Gerhardt, Robert T; Kheirabadi, Bijan S; Gross, Kriby R; Cap, Andrew P; Littlejohn, Lanny F; Edgar, Erin P; Shackelford, Stacy A; Blackbourne, Lorne H; Kotwal, Russ S; Holcomb, John B; Bailey, Jeffrey A

2013-01-01

During the recent United States Central Command (USCENTCOM) and Joint Trauma System (JTS) assessment of prehospital trauma care in Afghanistan, the deployed director of the Joint Theater Trauma System (JTTS), CAPT Donald R. Bennett, questioned why TCCC recommends treating a nonlethal injury (open pneumothorax) with an intervention (a nonvented chest seal) that could produce a lethal condition (tension pneumothorax). New research from the U.S. Army Institute of Surgical Research (USAISR) has found that, in a model of open pneumothorax treated with a chest seal in which increments of air were added to the pleural space to simulate an air leak from an injured lung, use of a vented chest seal prevented the subsequent development of a tension pneumothorax, whereas use of a nonvented chest seal did not. The updated TCCC Guideline for the battlefield management of open pneumothorax is: ?All open and/ or sucking chest wounds should be treated by immediately applying a vented chest seal to cover the defect. If a vente chest seal is not available, use a non-vented chest seal. Monitor the casualty for the potential development of a subsequent tension pneumothorax. If the casualty develops increasing hypoxia, respiratory distress, or hypotension and a tension pneumothorax is suspected, treat by burping or removing the dressing or by needle decompression.? This recommendation was approved by the required two-thirds majority of the Committee on TCCC in June 2013. 2013.

Convolution neural-network-based detection of lung structures

NASA Astrophysics Data System (ADS)

Hasegawa, Akira; Lo, Shih-Chung B.; Freedman, Matthew T.; Mun, Seong K.

1994-05-01

Chest radiography is one of the most primary and widely used techniques in diagnostic imaging. Nowadays with the advent of digital radiology, the digital medical image processing techniques for digital chest radiographs have attracted considerable attention, and several studies on the computer-aided diagnosis (CADx) as well as on the conventional image processing techniques for chest radiographs have been reported. In the automatic diagnostic process for chest radiographs, it is important to outline the areas of the lungs, the heart, and the diaphragm. This is because the original chest radiograph is composed of important anatomic structures and, without knowing exact positions of the organs, the automatic diagnosis may result in unexpected detections. The automatic extraction of an anatomical structure from digital chest radiographs can be a useful tool for (1) the evaluation of heart size, (2) automatic detection of interstitial lung diseases, (3) automatic detection of lung nodules, and (4) data compression, etc. Based on the clearly defined boundaries of heart area, rib spaces, rib positions, and rib cage extracted, one should be able to use this information to facilitate the tasks of the CADx on chest radiographs. In this paper, we present an automatic scheme for the detection of lung field from chest radiographs by using a shift-invariant convolution neural network. A novel algorithm for smoothing boundaries of lungs is also presented.

Analysis of actual pressure point using the power flexible capacitive sensor during chest compression.

PubMed

Minami, Kouichiro; Kokubo, Yota; Maeda, Ichinosuke; Hibino, Shingo

2017-02-01

In chest compression for cardiopulmonary resuscitation (CPR), the lower half of the sternum is pressed according to the American Heart Association (AHA) guidelines 2010. These have been no studies which identify the exact location of the applied by individual chest compressions. We developed a rubber power-flexible capacitive sensor that could measure the actual pressure point of chest compression in real time. Here, we examined the pressure point of chest compression by ambulance crews during CPR using a mannequin. We included 179 ambulance crews. Chest compression was performed for 2 min. The pressure position was monitored, and the quality of chest compression was analyzed by using a flexible pressure sensor (Shinnosukekun™). Of the ambulance crews, 58 (32.4 %) pressed the center and 121 (67.6 %) pressed outside the proper area of chest compression. Many of them pressed outside the center; 8, 7, 41, and 90 pressed on the caudal, left, right, and cranial side, respectively. Average compression rate, average recoil, average depth, and average duty cycle were 108.6 counts per minute, 0.089, 4.5 cm, and 48.27 %, respectively. Many of the ambulance crews did not press on the sternal lower half definitely. This new device has the potential to improve the quality of CPR during training or in clinical practice.

Improvement of the clinical use of computed radiography for mobile chest imaging: Image quality and patient dose

NASA Astrophysics Data System (ADS)

Rill, Lynn Neitzey

Chest radiography is technically difficult because of the wide variation of tissue attenuations in the chest and limitations of screen-film systems. Mobile chest radiography, performed bedside on hospital inpatients, presents additional difficulties due to geometrical and equipment limitations inherent to mobile x-ray procedures and the severity of illness in patients. Computed radiography (CR) offers a new approach for mobile chest radiography by utilizing a photostimulable phosphor. Photostimulable phosphors are more efficient in absorbing lower-energy x-rays than standard intensifying screens and overcome some image quality limitations of mobile chest imaging, particularly because of the inherent latitude. This study evaluated changes in imaging parameters for CR to take advantage of differences between CR and screen-film radiography. Two chest phantoms, made of acrylic and aluminum, simulated x-ray attenuation for average-sized and large- sized adult chests. The phantoms contained regions representing the lungs, heart and subdiaphragm. Acrylic and aluminum disks (1.9 cm diameter) were positioned in the chest regions to make signal-to-noise ratio (SNR) measurements for different combinations of imaging parameters. Disk thicknesses (contrast) were determined from disk visibility. Effective dose to the phantom was also measured for technique combinations. The results indicated that using an anti-scatter grid and lowering x- ray tube potential improved the SNR significantly; however, the dose to the phantom also increased. An evaluation was performed to examine the clinical applicability of the observed improvements in SNR. Parameter adjustments that improved phantom SNRs by more than 50% resulted in perceived image quality improvements in the lung region of clinical mobile chest radiographs. Parameters that produced smaller improvements in SNR had no apparent effect on clinical image quality. Based on this study, it is recommended that a 3:1 grid be used for mobile chest radiography with CR in order to improve image quality. Using a higher kVp (+15 kVp) did not have a detrimental effect on image quality and offered a patient dose savings, including effective dose and breast dose. Higher kVp techniques should be considered when using a grid is not possible.

Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank.

PubMed

Dehghan, Niloofar; de Mestral, Charles; McKee, Michael D; Schemitsch, Emil H; Nathens, Avery

2014-02-01

Flail chest injuries are associated with severe pulmonary restriction, a requirement for intubation and mechanical ventilation, and high rates of morbidity and mortality. Our goals were to investigate the prevalence, current treatment practices, and outcomes of flail chest injuries in polytrauma patients. The National Trauma Data Bank was used for a retrospective analysis of the injury patterns, management, and clinical outcomes associated with flail chest injuries. Patients with a flail chest injury admitted from 2007 to 2009 were included in the analysis. Outcomes included the number of days on mechanical ventilation, days in the intensive care unit (ICU), days in the hospital, and rates of pneumonia, sepsis, tracheostomy, chest tube placement, and death. Flail chest injury was identified in 3,467 patients; the mean age was 52.5 years, and 77% of the patients were male. Significant head injury was present in 15%, while 54% had lung contusions. Treatment practices included epidural catheters in 8% and surgical fixation of the chest wall in 0.7% of the patients. Mechanical ventilation was required in 59%, for a mean of 12.1 days. ICU admission was required in 82%, for a mean of 11.7 days. Chest tubes were used in 44%, and 21% required a tracheostomy. Complications included pneumonia in 21%, adult respiratory distress syndrome in 14%, sepsis in 7%, and death in 16%. Patients with concurrent severe head injury had higher rates of ventilatory support and ICU stay and had worse outcomes in every category compared with those without a head injury. Patients who have sustained a flail chest have significant morbidity and mortality. More than 99% of these patients were treated nonoperatively, and only a small proportion (8%) received aggressive pain management with epidural catheters. Given the high rates of morbidity and mortality in patients with a flail chest injury, alternate methods of treatment including more consistent use of epidural catheters for pain or surgical fixation need to be investigated with large randomized controlled trials. Epidemiologic/prognostic study, level IV.

Lung nodule detection by microdose CT versus chest radiography (standard and dual-energy subtracted).

PubMed

Ebner, Lukas; Bütikofer, Yanik; Ott, Daniel; Huber, Adrian; Landau, Julia; Roos, Justus E; Heverhagen, Johannes T; Christe, Andreas

2015-04-01

The purpose of this study was to investigate the feasibility of microdose CT using a comparable dose as for conventional chest radiographs in two planes including dual-energy subtraction for lung nodule assessment. We investigated 65 chest phantoms with 141 lung nodules, using an anthropomorphic chest phantom with artificial lung nodules. Microdose CT parameters were 80 kV and 6 mAs, with pitch of 2.2. Iterative reconstruction algorithms and an integrated circuit detector system (Stellar, Siemens Healthcare) were applied for maximum dose reduction. Maximum intensity projections (MIPs) were reconstructed. Chest radiographs were acquired in two projections with bone suppression. Four blinded radiologists interpreted the images in random order. A soft-tissue CT kernel (I30f) delivered better sensitivities in a pilot study than a hard kernel (I70f), with respective mean (SD) sensitivities of 91.1%±2.2% versus 85.6%±5.6% (p=0.041). Nodule size was measured accurately for all kernels. Mean clustered nodule sensitivity with chest radiography was 45.7%±8.1% (with bone suppression, 46.1%±8%; p=0.94); for microdose CT, nodule sensitivity was 83.6%±9% without MIP (with additional MIP, 92.5%±6%; p<10(-3)). Individual sensitivities of microdose CT for readers 1, 2, 3, and 4 were 84.3%, 90.7%, 68.6%, and 45.0%, respectively. Sensitivities with chest radiography for readers 1, 2, 3, and 4 were 42.9%, 58.6%, 36.4%, and 90.7%, respectively. In the per-phantom analysis, respective sensitivities of microdose CT versus chest radiography were 96.2% and 75% (p<10(-6)). The effective dose for chest radiography including dual-energy subtraction was 0.242 mSv; for microdose CT, the applied dose was 0.1323 mSv. Microdose CT is better than the combination of chest radiography and dual-energy subtraction for the detection of solid nodules between 5 and 12 mm at a lower dose level of 0.13 mSv. Soft-tissue kernels allow better sensitivities. These preliminary results indicate that microdose CT has the potential to replace conventional chest radiography for lung nodule detection.

Patterns in diurnal airspace use by migratory landbirds along an ecological barrier.

PubMed

Peterson, Anna C; Niemi, Gerald J; Johnson, Douglas H

2015-04-01

Migratory bird populations and survival are affected by conditions experienced during migration. While many studies and conservation and management efforts focus on terrestrial stoppage and staging areas, the aerial environment through which migrants move also is subjected to anthropogenic impacts with potential consequences to migratory movement and survival. During autumn migration, the northern coastline of Lake Superior acts as an ecological barrier for many landbirds migrating out of the boreal forests of North America. From 24 observation points, we assessed the diurnal movements of birds throughout autumn migration, 2008-2010, within a 210 × 10 km coastal region along the northern coast of Lake Superior. Several raptor species showed patterns in airspace associated with topographic features such as proximity to the coastline and presence of ridgelines. Funneling movement, commonly used to describe the concentration of raptors along a migratory diversion line that either prevents or enhances migration progress, occurred only for Bald and Golden Eagles. This suggests a "leaky" migration funnel for most migratory raptors (e.g., migrating birds exiting the purported migration corridor). Passerines migrating during the late season showed more spatial and temporal structure in airspace distribution than raptors did, including funneling and an association with airspace near the coast. We conclude that (1) the diurnal use of airspace by many migratory landbirds is patterned in space and time, (2) autumn count sites situated along ecological barriers substantially underestimate the number of raptors due to "leakage" out of these concentration areas, and (3) the magnitude and structure of diurnal passerine movements in airspace have been overlooked. The heavy and structured use of airspace by migratory landbirds, especially the airspace associated with anthropogenic development (e.g., buildings, towers, turbines) necessitates a shift in focus to airspace management and conservation attention for these animals.

Evidence for Ventilation through Collective Respiratory Movements in Giant Honeybee (Apis dorsata) Nests.

PubMed

Kastberger, Gerald; Waddoup, Dominique; Weihmann, Frank; Hoetzl, Thomas

2016-01-01

The Asian giant honeybees (Apis dorsata) build single-comb nests in the open, which makes this species particularly susceptible to environmental strains. Long-term infrared (IR) records documented cool nest regions (CNR) at the bee curtain (nCNR = 207, nnests > 20) distinguished by marked negative gradients (ΔTCNR/d < -3°C / 5 cm) at their margins. CNRs develop and recede within minutes, predominantly at higher ambient temperatures in the early afternoon. The differential size (ΔACNR) and temperature (ΔTCNR) values per time unit correlated mostly positively (RAT > 0) displaying the Venturi effect, which evidences funnel properties of CNRs. The air flows inwards through CNRs, which is verified by the negative spatial gradient ΔTCNR/d, by the positive grading of TCNR with Tamb and lastly by fanners which have directed their abdomens towards CNRs. Rare cases of RAT < 0 (< 3%) document closing processes (for ΔACNR/Δt < -0.4 cm2/s) but also suggest ventilation of the bee curtain (for ΔACNR/Δt > +0.4 cm2/s) displaying "inhalation" and "exhalation" cycling. "Inhalation" could be boosted by bees at the inner curtain layers, which stretch their extremities against the comb enlarging the inner nest lumen and thus causing a pressure fall which drives ambient air inwards through CNR funnels. The relaxing of the formerly "activated" bees could then trigger the "exhalation" process, which brings the bee curtain, passively by gravity, close to the comb again. That way, warm, CO2-enriched nest-borne air is pressed outwards through the leaking mesh of the bee curtain. This ventilation hypothesis is supported by IR imaging and laser vibrometry depicting CNRs in at least four aspects as low-resistance convection funnels for maintaining thermoregulation and restoring fresh air in the nest.

Captures of Ostrinia furnacalis (Lepidoptera: Crambidae) With Sex Pheromone Traps in NE China Corn and Soybeans.

PubMed

Chen, Ri-Zhao; Li, Lian-Bing; Klein, Michael G; Li, Qi-Yun; Li, Peng-Pei; Sheng, Cheng-Fa

2016-02-01

Ostrinia furnacalis (Guenée) (Lepidoptera: Crambidae), commonly referred to as the Asian corn borer, is the most important corn pest in Asia. Although capturing males with pheromone traps has recently been the main monitoring tool and suppression technique, the best trap designs remain unclear. Commercially available Delta and funnel traps, along with laboratory-made basin and water traps, and modified Delta traps, were evaluated in corn and soybean fields during 2013-2014 in NE China. The water trap was superior for capturing first-generation O. furnacalis (1.37 times the Delta trap). However, the basin (8.3 ± 3.2 moths/trap/3 d), Delta (7.9 ± 2.5), and funnel traps (7.0 ± 2.3) were more effective than water traps (1.4 ± 0.4) during the second generation. Delta traps gave optimal captures when deployed at ca. 1.57 × the highest corn plants, 1.36× that of average soybean plants, and at the field borders. In Delta traps modified by covering 1/3 of their ends, captures increased by ca. 15.7 and 8.1% in the first and second generations, respectively. After 35 d in the field, pheromone lures were still ca. 50% as attractive as fresh lures, and retained this level of attraction for ca. 25 more days. Increased captures (first and second generation: 90.9 ± 9.5%; 78.3 ± 9.3%) were obtained by adding a lure exposed for 5 d to funnel traps baited with a 35-d lure. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Stability of Balloon-Retention Gastrostomy Tubes with Different Concentrations of Contrast Material: In Vitro Study

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

Lopera, Jorge E., E-mail: Lopera@uthscsa.ed; Alvarez, Alex; Trimmer, Clayton

2009-01-15

The purpose of this study was to determine the performance of two balloon-retention-type gastrostomy tubes when the balloons are inflated with two types of contrast materials at different concentrations. Two commonly used balloon-retention-type tubes (MIC and Tri-Funnel) were inflated to the manufacturer's recommended volumes (4 and 20 cm{sup 3}, respectively) with normal saline or normal saline plus different concentrations of contrast material. Five tubes of each brand were inflated with normal saline and 0%, 25%, 50%, 75%, and 100% contrast material dilutions, using either nonionic hyperosmolar contrast, or nonionic iso-osmolar contrast. The tubes were submerged in a glass basin containingmore » a solution with a pH of 4. Every week the tubes were visually inspected to determine the integrity of the balloons, and the diameter of the balloons was measured with a caliper. The tests were repeated every week for a total of 12 weeks. The MIC balloons deflated slightly faster over time than the Tri-Funnel balloons. The Tri-Funnel balloons remained relatively stable over the study period for the different concentrations of contrast materials. The deflation rates of the MIC balloons were proportionally related to the concentration of saline and inversely related to the concentration of the contrast material. At high contrast material concentrations, solidification of the balloons was observed. In conclusion, this in vitro study confirms that the use of diluted amounts of nonionic contrast materials is safe for inflating the balloons of two types of balloon-retention feeding tubes. High concentrations of contrast could result in solidification of the balloons and should be avoided.« less

Complete validation of a unique digestion assay to detect Trichinella larvae in horse meat demonstrates the reliability of this assay for meeting food safety and trade requirements.

PubMed

Forbes, L B; Hill, D E; Parker, S; Tessaro, S V; Gamble, H R; Gajadhar, A A

2008-03-01

A tissue digestion assay using a double separatory funnel procedure for the detection of Trichinella larvae in horse meat was validated for application in food safety programs and trade. The assay consisted of a pepsin-HCl digestion step to release larvae from muscle tissue and two sequential sedimentation steps in separatory funnels to recover and concentrate larvae for detection with a stereomicroscope. With defined critical control points, the assay was conducted within a quality assurance system compliant with International Organization for Standardization-International Electrotechnical Commission (ISO/IEC) 17025 guidelines. Samples used in the validation were obtained from horses experimentally infected with Trichinella spiralis to obtain a range of muscle larvae densities. One-, 5-, and 10-g samples of infected tissue were combined with 99, 95, and 90 g, respectively, of known negative horse tissue to create a 100-g sample for testing. Samples of 5 and 10 g were more likely to be positive than were 1-g samples when larval densities were less than three larvae per gram (lpg). This difference is important because ingested meat with 1 lpg is considered the threshold for clinical disease in humans. Using a 5-g sample size, all samples containing 1.3 to 2 lpg were detected, and 60 to 100% of samples with infected horse meat containing 0.1 to 0.7 lpg were detected. In this study, the double separatory funnel digestion assay was efficient and reliable for its intended use in food safety and trade. This procedure is the only digestion assay for Trichinella in horse meat that has been validated as consistent and effective at critical levels of sensitivity.

Patterns in diurnal airspace use by migratory landbirds along an ecological barrier

USGS Publications Warehouse

Peterson, Anna C.; Niemi, Gerald J.; Johnson, Douglas H.

2015-01-01

Migratory bird populations and survival are affected by conditions experienced during migration. While many studies and conservation and management efforts focus on terrestrial stoppage and staging areas, the aerial environment through which migrants move also is subjected to anthropogenic impacts with potential consequences to migratory movement and survival. During autumn migration, the northern coastline of Lake Superior acts as an ecological barrier for many landbirds migrating out of the boreal forests of North America. From 24 observation points, we assessed the diurnal movements of birds throughout autumn migration, 2008-2010, within a 210 km by 10 km coastal region along the northern coast of Lake Superior. Several raptor species showed patterns in airspace associated with topographic features such as proximity to the coastline and presence of ridgelines. Funneling movement, commonly used to describe the concentration of raptors along a migratory diversion line that either prevents or enhances migration progress, occurred only for Bald and Golden Eagles. This suggests a "leaky" migration funnel for most migratory raptors (e.g., migrating birds exiting the purported migration corridor). Passerines migrating during the late season showed more spatial and temporal structure in airspace distribution than raptors, including funneling and an association with airspace near the coast. We conclude that a) the diurnal use of airspace by many migratory landbirds is patterned in space and time, b) autumn count sites situated along ecological barriers substantially underestimate the number of raptors due to 'leakage' out of these concentration areas, and c) the magnitude and structure of diurnal passerine movements in airspace have been overlooked. The heavy and structured use of airspace by migratory landbirds, especially the airspace associated with anthropogenic development (e.g., buildings, towers, turbines) necessitates a shift in focus to airspace management and conservation attention for these animals.

The probability of being identified as an outlier with commonly used funnel plot control limits for the standardised mortality ratio.

PubMed

Seaton, Sarah E; Manktelow, Bradley N

2012-07-16

Emphasis is increasingly being placed on the monitoring of clinical outcomes for health care providers. Funnel plots have become an increasingly popular graphical methodology used to identify potential outliers. It is assumed that a provider only displaying expected random variation (i.e. 'in-control') will fall outside a control limit with a known probability. In reality, the discrete count nature of these data, and the differing methods, can lead to true probabilities quite different from the nominal value. This paper investigates the true probability of an 'in control' provider falling outside control limits for the Standardised Mortality Ratio (SMR). The true probabilities of an 'in control' provider falling outside control limits for the SMR were calculated and compared for three commonly used limits: Wald confidence interval; 'exact' confidence interval; probability-based prediction interval. The probability of falling above the upper limit, or below the lower limit, often varied greatly from the nominal value. This was particularly apparent when there were a small number of expected events: for expected events ≤ 50 the median probability of an 'in-control' provider falling above the upper 95% limit was 0.0301 (Wald), 0.0121 ('exact'), 0.0201 (prediction). It is important to understand the properties and probability of being identified as an outlier by each of these different methods to aid the correct identification of poorly performing health care providers. The limits obtained using probability-based prediction limits have the most intuitive interpretation and their properties can be defined a priori. Funnel plot control limits for the SMR should not be based on confidence intervals.

Analysis of mortality in colorectal surgery in the Bi-National Colorectal Cancer Audit.

PubMed

Teloken, Patrick Ely; Spilsbury, Katrina; Platell, Cameron

2016-06-01

In the last decade, there has been a significant increase in interest for public reporting of outcome data and performance comparison across institutions and surgeons. This study aims at comparing postoperative mortality after colorectal cancer surgery across units and individual consultants in Australia and New Zealand using funnel plots. The Bi-National Colorectal Cancer Audit database was used. Unadjusted and adjusted funnel plots of inpatient mortality were constructed. Risk adjustment was based upon multivariable logistic regression models using purposeful covariate selection. A total of 10 008 patients undergoing surgery for colorectal cancer from 56 surgical units and 90 consultants were identified. Overall inpatient mortality was 1.51%, corresponding to 1.1% for elective and 3.9% for urgent cases. Logistic regression identified age, American Society of Anesthesiologists score, urgent surgery and open surgery to be independently associated with inpatient mortality. Unadjusted and adjusted funnel plot analysis identified three (5.3%) units exceeding the inner limit and none exceeding the outer limit. Six (6.6%) consultants had inpatient mortality between the upper inner and outer limits and one (1.1%) between the inferior inner and outer limits. Upon adjustment, seven (7.7%) consultants had inpatient mortality between the inner and outer limit. Potential limitations of this study include: residual confounding being responsible for the association of open surgery and mortality; incomplete case-mix adjustment resulting in outlier identification; and bias towards inclusion of larger institutions. Mortality figures in Australia and New Zealand are comparable to recently reported international data. The vast majority of units and consultants are performing within the expected boundaries. © 2016 Royal Australasian College of Surgeons.

Avoid cruising on the uroflowmeter: evaluation of cruising artifact on spinning disc flowmeters in an experimental setup.

PubMed

Addla, Sanjai Kumar; Marri, Rajender Reddy; Daayana, Sai Lakshmi; Irwin, Paul

2010-09-01

The aim of our study was to access the variability of maximum flow rate (Q(max)), average flow rate (Q(av)) and flow pattern while varying the point of impact of flow on the flowmeter. Water was delivered through a motorised tube holder in a standardised experimental set up. Flow was directed in 4 different directions on the funnel; 1) Periphery, 2) Base, 3) Centre and, 4) in a cruising motion from the periphery of the funnel to the centre and back again. The variation in the Q(max), Q(av) and the flow pattern were studied at 4 different flow rates. The variables recorded when the flow was directed at the centre of the funnel was taken as baseline. There was a significant difference in the Q(max) and Q(av)when the point of impact was at the periphery or in a cruising motion compared to the centre. The difference was more marked with cruising motion with a characteristic flow pattern. The maximum percentage difference in Q(av) was 4.1%, whereas the difference in Q(max) was higher at 16.6% on comparing crusing motion with the values from the centre. We have demonstrated a significant variation in Q(max), Q(av) and flow pattern with change in the point of impact on the flowmeter. Though the changes in Q(av) were statistically significant, the alteration in the recorded Q(max) values was more striking. Our study emphasizes the importance of combining Q(av) and flow pattern along with Q(max) in interpretation of results of uroflowmetry. © 2010 Wiley-Liss, Inc.

Remediation of PCB contaminated soils in the Canadian Arctic: excavation and surface PRB technology.

PubMed

Kalinovich, Indra; Rutter, Allison; Poland, John S; Cairns, Graham; Rowe, R Kerry

2008-12-15

The site BAF-5 is located on the summit of Resolution Island, Nunavut, just southeast of Baffin Island at 61 degrees 35'N and 60 degrees 40'W. The site was part of a North American military defense system established in the 1950s that became heavily contaminated with PCBs during and subsequent, its operational years. Remediation through excavation of the PCB contaminated soil at Resolution Island began in 1999 and at its completion in 2006 approximately 5 tonnes of pure PCBs in approximately 20,000 m3 of soil were remediated. Remediation strategies were based on both quantity of soil and level of contamination in the soil. Excavation removed 96% of the PCB contaminated soil on site. In 2003, a surface funnel-and-gate permeable reactive barrier was design and constructed to treat the remaining contamination left in rock crevices and inaccessible areas of the site. Excavation had destabilized contaminated soil in the area, enabling contaminant migration through erosion and runoff pathways. The barrier was designed to maximize sedimentation through settling ponds. This bulk removal enabled the treatment of highly contaminated fines and water through a permeable gate. The increased sediment loading during excavation required both modifications to the funnel and a shift to a more permeable, granular system. Granulated activated charcoal was chosen for its ability to both act as a particle retention filter and adsorptive filter. The reduction in mass of PCB and volume of soils trapped by the funnel of the barrier indicate that soils are re-stabilizing. In 2007, nonwoven geotextiles were re-introduced back into the filtration system as fine filtering could be achieved without clogging. Monitoring sites downstream indicate that the barrier system is effective. This paper describes the field progress of PCB remediation at Resolution Island.

Variation in hospital mortality in an Australian neonatal intensive care unit network.

PubMed

Abdel-Latif, Mohamed E; Nowak, Gen; Bajuk, Barbara; Glass, Kathryn; Harley, David

2018-07-01

Studying centre-to-centre (CTC) variation in mortality rates is important because inferences about quality of care can be made permitting changes in practice to improve outcomes. However, comparisons between hospitals can be misleading unless there is adjustment for population characteristics and severity of illness. We sought to report the risk-adjusted CTC variation in mortality among preterm infants born <32 weeks and admitted to all eight tertiary neonatal intensive care units (NICUs) in the New South Wales and the Australian Capital Territory Neonatal Network (NICUS), Australia. We analysed routinely collected prospective data for births between 2007 and 2014. Adjusted mortality rates for each NICU were produced using a multiple logistic regression model. Output from this model was used to construct funnel plots. A total of 7212 live born infants <32 weeks gestation were admitted consecutively to network NICUs during the study period. NICUs differed in their patient populations and severity of illness.The overall unadjusted hospital mortality rate for the network was 7.9% (n=572 deaths). This varied from 5.3% in hospital E to 10.4% in hospital C. Adjusted mortality rates showed little CTC variation. No hospital reached the +99.8% control limit level on adjusted funnel plots. Characteristics of infants admitted to NICUs differ, and comparing unadjusted mortality rates should be avoided. Logistic regression-derived risk-adjusted mortality rates plotted on funnel plots provide a powerful visual graphical tool for presenting quality performance data. CTC variation is readily identified, permitting hospitals to appraise their practices and start timely intervention. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Breathlessness during daily activity: The psychometric properties of the London Chest Activity of Daily Living Scale in patients with advanced disease and refractory breathlessness.

PubMed

Reilly, Charles C; Bausewein, Claudia; Garrod, Rachel; Jolley, Caroline J; Moxham, John; Higginson, Irene J

2017-10-01

The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034). All patients completed the following questionnaires: the London Chest Activities of Daily Living Scale, Chronic Respiratory Questionnaire, the Palliative care Outcome Scale, Palliative care Outcome Scale-symptoms, the Hospital Anxiety and Depression Scale and breathlessness measured on a numerical rating scale. Data quality, scaling assumptions, acceptability, internal consistency and construct validity of the London Chest Activities of Daily Living Scale were determined using standard psychometric approaches. Breathless patients with advanced malignant and non-malignant disease. A total of 88 patients were studied, primary diagnosis included; chronic obstructive pulmonary disease = 53, interstitial lung disease = 17, cancer = 18. Median (range) London Chest Activities of Daily Living Scale total score was 46.5 (14-67). No floor or ceiling effect was observed for the London Chest Activities of Daily Living Scale total score. Internal consistency was good, and Cronbach's alpha for the London Chest Activities of Daily Living Scale total score was 0.90. Construct validity was good with 13 out of 15 a priori hypotheses met. Psychometric analyses suggest that the London Chest Activities of Daily Living Scale is acceptable, reliable and valid in patients with advanced disease and refractory breathlessness.

Breathlessness during daily activity: The psychometric properties of the London Chest Activity of Daily Living Scale in patients with advanced disease and refractory breathlessness

PubMed Central

Reilly, Charles C; Bausewein, Claudia; Garrod, Rachel; Jolley, Caroline J; Moxham, John; Higginson, Irene J

2016-01-01

Background: The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. Aim: To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. Design: A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034). All patients completed the following questionnaires: the London Chest Activities of Daily Living Scale, Chronic Respiratory Questionnaire, the Palliative care Outcome Scale, Palliative care Outcome Scale–symptoms, the Hospital Anxiety and Depression Scale and breathlessness measured on a numerical rating scale. Data quality, scaling assumptions, acceptability, internal consistency and construct validity of the London Chest Activities of Daily Living Scale were determined using standard psychometric approaches. Setting/participants: Breathless patients with advanced malignant and non-malignant disease. Results: A total of 88 patients were studied, primary diagnosis included; chronic obstructive pulmonary disease = 53, interstitial lung disease = 17, cancer = 18. Median (range) London Chest Activities of Daily Living Scale total score was 46.5 (14–67). No floor or ceiling effect was observed for the London Chest Activities of Daily Living Scale total score. Internal consistency was good, and Cronbach’s alpha for the London Chest Activities of Daily Living Scale total score was 0.90. Construct validity was good with 13 out of 15 a priori hypotheses met. Conclusion: Psychometric analyses suggest that the London Chest Activities of Daily Living Scale is acceptable, reliable and valid in patients with advanced disease and refractory breathlessness. PMID:27932629

Factors that influence chest injuries in rollovers.

PubMed

Digges, Kennerly; Eigen, Ana; Tahan, Fadi; Grzebieta, Raphael

2014-01-01

The design of countermeasures to reduce serious chest injuries for belted occupants involved in rollover crashes requires an understanding of the cause of these injuries and of the test conditions to assure the effectiveness of the countermeasures. This study defines rollover environments and occupant-to-vehicle interactions that cause chest injuries for belted drivers. The NASS-CDS was examined to determine the frequency and crash severity for belted drivers with serious (Abbreviated Injury Scale [AIS] 3+) chest injuries in rollovers. Case studies of NASS crashes with serious chest injuries sustained by belted front occupants were undertaken and damage patterns were determined. Vehicle rollover tests with dummies were examined to determine occupant motion in crashes with damage similar to that observed in the NASS cases. Computer simulations were performed to further explore factors that could contribute to chest injury. Finite element model (FEM) vehicle models with both the FEM Hybrid III dummy and THUMS human model were used in the simulations. Simulation of rollovers with 6 quarter-turns or less indicated that increases in the vehicle pitch, either positive or negative, increased the severity of dummy chest loadings. This finding was consistent with vehicle damage observations from NASS cases. For the far-side occupant, the maximum chest loadings were caused by belt and side interactions during the third quarter-turn and by the center console loading during the fourth quarter-turn. The results showed that the THUMS dummy produced more realistic kinematics and improved insights into skeletal and chest organ loadings compared to the Hybrid III dummy. These results suggest that a dynamic rollover test to encourage chest injury reduction countermeasures should induce a roll of at least 4 quarter-turns and should also include initial vehicle pitch and/or yaw so that the vehicle's axis of rotation is not aligned with its inertial roll axis during the initial stage of the rollover.

Clinical value of chest pain presentation and prodromes on the assessment of cardiovascular disease: a cohort study.

PubMed

Robson, John; Ayerbe, Luis; Mathur, Rohini; Addo, Juliet; Wragg, Andrew

2015-04-15

The recognition of coronary artery disease (CAD) among patients who report chest pain remains difficult in primary care. This study investigates the association between chest pain (specified, unspecified or musculoskeletal) and prodromes (dyspepsia, fatigue or dyspnoea), with first-ever acute CAD, and increased longer term cardiovascular risk. Cohort study. Anonymised clinical data recorded electronically by general practitioners from 140 primary care surgeries in London (UK) between April 2008 and April 2013. Data were extracted for all patients aged 30 years and over at the beginning of the study period, registered in the surgeries. Clinical data included chest pain, dyspepsia, dyspnoea and fatigue, first-ever CAD and long-term cardiovascular risk (QRisk2). Regression models were used to analyse the association between chest pain together with prodromes and CAD and QRisk2≥20%. 354,052 patients were included in the study. 4842 patients had first-ever CAD of which 270 reported chest pain in the year before the acute event. 257,019 patients had QRisk2 estimations. Chest pain was associated with a higher risk of CAD. HRs: 21.12 (16.68 to 26.76), p<0.001; 7.51 (6.49 to 8.68), p<0.001; and 1.84 (1.14 to 3.00), p<0.001 for specified, unspecified and musculoskeletal chest pain. Dyspepsia, dyspnoea or fatigue was also associated with a higher risk of CAD. Chest pain of all subtypes, dyspepsia and dyspnoea were also associated with an increased 10-year cardiovascular risk of 20% or more. All patients with chest pain, including those with atypical symptoms, require careful assessment for acute and longer term cardiovascular risk. Prodromes may have independent diagnostic value in the estimation of cardiovascular disease risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A pilot study of chest tube versus pigtail catheter drainage of acute hemothorax in swine.

PubMed

Russo, Rachel M; Zakaluzny, Scott A; Neff, Lucas P; Grayson, J Kevin; Hight, Rachel A; Galante, Joseph M; Shatz, David V

2015-12-01

Evacuation of traumatic hemothorax (HTx) is typically accomplished with large-bore (28-40 Fr) chest tubes, often resulting in patient discomfort. Management of HTx with smaller (14 Fr) pigtail catheters has not been widely adopted because of concerns about tube occlusion and blood evacuation rates. We compared pigtail catheters with chest tubes for the drainage of acute HTx in a swine model. Six Yorkshire cross-bred swine (44-54 kg) were anesthetized, instrumented, and mechanically ventilated. A 32 Fr chest tube was placed in one randomly assigned hemithorax; a 14 Fr pigtail catheter was placed in the other. Each was connected to a chest drainage system at -20 cm H2O suction and clamped. Over 15 minutes, 1,500 mL of arterial blood was withdrawn via femoral artery catheters. Seven hundred fifty milliliters of the withdrawn blood was instilled into each pleural space, and fluid resuscitation with colloid was initiated. The chest drains were then unclamped. Output from each drain was measured every minute for 5 minutes and then every 5 minutes for 40 minutes. The swine were euthanized, and thoracotomies were performed to quantify the volume of blood remaining in each pleural space and to examine the position of each tube. Blood drainage was more rapid from the chest tube during the first 3 minutes compared with the pigtail catheter (348 ± 109 mL/min vs. 176 ± 53 mL/min), but this difference was not statistically significant (p = 0.19). Thereafter, the rates of drainage between the two tubes were not substantially different. The chest tube drained a higher total percentage of the blood from the chest (87.3% vs. 70.3%), but this difference did not reach statistical significance (p = 0.21). We found no statistically significant difference in the volume of blood drained by a 14 Fr pigtail catheter compared with a 32 Fr chest tube.

The effect of correct cross-chest clip use on injury outcomes in young children during motor vehicle crashes.

PubMed

Woodford, Evangeline; Brown, Julie; Bilston, Lynne E

2018-05-19

Traffic crashes have high mortality and morbidity for young children. Though many specialized child restraint systems improve injury outcomes, no large-scale studies have investigated the cross-chest clip's role during a crash, despite concerns in some jurisdictions about the potential for neck contact injuries from the clips. This study aimed to investigate the relationship between cross-chest clip use and injury outcomes in children between 0 and 4 years of age. Child passengers between 0 and 4 years of age were selected from the NASS-CDS data sets (2003-2014). Multiple regression analysis was used to model injury outcomes while controlling for age, crash severity, crash direction, and restraint type. The primary outcomes were overall Abbreviated Injury Score (AIS) 2+ injury, and the presence of any neck injury. Across all children aged 0-4 years, correct chest clip use was associated with decreased Abbreviated Injury Scale (AIS) 2+ injury (odds ratio [OR] = 0.44, 95% confidence interval [CI], 0.21-0.91) and was not associated with neck injury. However, outcomes varied by age. In children <12 months old, chest clip use was associated with decreased AIS 2+ injury (OR = 0.09, 95% CI, 0.02-0.44). Neck injury (n = 7, all AIS 1) for this age group only occurred with correct cross-chest clip use. For 1- to 4-year-old children, cross-chest clip use had no association with AIS 2+ injury, and correct use significantly decreased the odds of neck injury (OR = 0.49; 95% CI, 0.27-0.87) compared to an incorrectly used or absent cross-chest clip. No serious injuries were directly caused by the chest clips. Correct cross-chest clip use appeared to reduce injury in crashes, and there was no evidence of serious clip-induced injury in children in 5-point harness restraints.

Dynamic chest radiography: flat-panel detector (FPD) based functional X-ray imaging.

PubMed

Tanaka, Rie

2016-07-01

Dynamic chest radiography is a flat-panel detector (FPD)-based functional X-ray imaging, which is performed as an additional examination in chest radiography. The large field of view (FOV) of FPDs permits real-time observation of the entire lungs and simultaneous right-and-left evaluation of diaphragm kinetics. Most importantly, dynamic chest radiography provides pulmonary ventilation and circulation findings as slight changes in pixel value even without the use of contrast media; the interpretation is challenging and crucial for a better understanding of pulmonary function. The basic concept was proposed in the 1980s; however, it was not realized until the 2010s because of technical limitations. Dynamic FPDs and advanced digital image processing played a key role for clinical application of dynamic chest radiography. Pulmonary ventilation and circulation can be quantified and visualized for the diagnosis of pulmonary diseases. Dynamic chest radiography can be deployed as a simple and rapid means of functional imaging in both routine and emergency medicine. Here, we focus on the evaluation of pulmonary ventilation and circulation. This review article describes the basic mechanism of imaging findings according to pulmonary/circulation physiology, followed by imaging procedures, analysis method, and diagnostic performance of dynamic chest radiography.

The phrenic nerve with accompanying vessels: a silent cause of cardiovascular border obliteration on chest radiography.

PubMed

Farhana, Shiri; Ashizawa, Kazuto; Hayashi, Hideyuki; Ogihara, Yukihiro; Aso, Nobuya; Hayashi, Kuniaki; Uetani, Masataka

2015-12-01

Our aim was to clarify the frequency of cardiovascular border obliteration on frontal chest radiography and to prove that the phrenic nerve with accompanying vessels can be considered as a cause of obliteration of cardiovascular border on an otherwise normal chest radiography. Two radiologists reviewed chest radiographs and computed tomography (CT) images of 100 individuals. CT confirmed the absence of intrapulmonary or extrapulmonary abnormalities in all of them. We examined the frequency of cardiovascular border obliteration on frontal chest radiography and summarized the causes of obliteration as pericardial fat pad, phrenic nerve, intrafissure fat, pulmonary vessels, and others, comparing them with CT in each case. Cardiovascular border was obliterated on frontal chest radiography in 46 cases on the right and in 61 on the left. The phrenic nerve with accompanying vessels was found to be a cause of obliteration in 34 of 46 cases (74%) on the right and 29 of 61 (48%) cases on the left. The phrenic nerve was the most frequent cause of cardiovascular border obliteration on both sides. The phrenic nerve with accompanying vessels, forming a prominent fold of parietal pleura, can be attributed as a cause of cardiovascular border obliteration on frontal chest radiography.

Prevalence and Diagnostic Performance of Isolated and Combined NEXUS Chest CT Decision Criteria.

PubMed

Raja, Ali S; Mower, William R; Nishijima, Daniel K; Hendey, Gregory W; Baumann, Brigitte M; Medak, Anthony J; Rodriguez, Robert M

2016-08-01

The use of chest computed tomography (CT) to evaluate emergency department patients with adult blunt trauma is rising. The NEXUS Chest CT decision instruments are highly sensitive identifiers of adult blunt trauma patients with thoracic injuries. However, many patients without injury exhibit one of more of the criteria so cannot be classified "low risk." We sought to determine screening performance of both individual and combined NEXUS Chest CT criteria as predictors of thoracic injury to inform chest CT imaging decisions in "non-low-risk" patients. This was a secondary analysis of data on patients in the derivation and validation cohorts of the prospective, observational NEXUS Chest CT study, performed September 2011 to May 2014 in 11 Level I trauma centers. Institutional review board approval was obtained at all study sites. Adult blunt trauma patients receiving chest CT were included. The primary outcome was injury and major clinical injury prevalence and screening performance in patients with combinations of one, two, or three of seven individual NEXUS Chest CT criteria. Across the 11 study sites, rates of chest CT performance ranged from 15.5% to 77.2% (median = 43.6%). We found injuries in 1,493/5,169 patients (28.9%) who had chest CT; 269 patients (5.2%) had major clinical injury (e.g., pneumothorax requiring chest tube). With sensitivity of 73.7 (95% confidence interval [CI] = 68.1 to 78.6) and specificity of 83.9 (95% CI = 83.6 to 84.2) for major clinical injury, abnormal chest-x-ray (CXR) was the single most important screening criterion. When patients had only abnormal CXR, injury and major clinical injury prevalences were 60.7% (95% CI = 52.2% to 68.6%) and 12.9% (95% CI = 8.3% to 19.4%), respectively. Injury and major clinical injury prevalences when any other single criterion alone (other than abnormal CXR) was present were 16.8% (95% CI = 15.2% to 18.6%) and 1.1% (95% CI = 0.1% to 1.8%), respectively. Injury and major clinical injury prevalences among patients when two and three criteria (not abnormal CXR) were present were 25.5% (95% CI = 23.1% to 28.0%) and 3.2% (95% CI = 2.3% to 4.4%) and 34.9% (95% CI = 31.0% to 39.0%) and 2.7% (95% CI = 1.6% to 4.5%), respectively. We recommend that clinicians check for the six clinical NEXUS Chest CT criteria and review the CXR (if obtained). If patients have one clinical criterion (other than abnormal CXR), they will have a very low risk of clinically major injury. We recommend that clinicians discuss the potential risks and benefit of chest CT in these cases. The risks of injury and major clinical injury rise incrementally with more criteria, rendering the risk/benefit ratio toward performing CT in most cases. If the patient has an abnormal CXR, the risks of major clinical injury and minor injury are considerably higher than with the other criteria-chest CT may be indicated in cases requiring greater anatomic detail and injury characterization. © 2016 by the Society for Academic Emergency Medicine.

Derivation and Validation of Two Decision Instruments for Selective Chest CT in Blunt Trauma: A Multicenter Prospective Observational Study (NEXUS Chest CT)

PubMed Central

Rodriguez, Robert M.; Langdorf, Mark I.; Nishijima, Daniel; Baumann, Brigitte M.; Hendey, Gregory W.; Medak, Anthony J.; Raja, Ali S.; Allen, Isabel E.; Mower, William R.

2015-01-01

Background Unnecessary diagnostic imaging leads to higher costs, longer emergency department stays, and increased patient exposure to ionizing radiation. We sought to prospectively derive and validate two decision instruments (DIs) for selective chest computed tomography (CT) in adult blunt trauma patients. Methods and Findings From September 2011 to May 2014, we prospectively enrolled blunt trauma patients over 14 y of age presenting to eight US, urban level 1 trauma centers in this observational study. During the derivation phase, physicians recorded the presence or absence of 14 clinical criteria before viewing chest imaging results. We determined injury outcomes by CT radiology readings and categorized injuries as major or minor according to an expert-panel-derived clinical classification scheme. We then employed recursive partitioning to derive two DIs: Chest CT-All maximized sensitivity for all injuries, and Chest CT-Major maximized sensitivity for only major thoracic injuries (while increasing specificity). In the validation phase, we employed similar methodology to prospectively test the performance of both DIs. We enrolled 11,477 patients—6,002 patients in the derivation phase and 5,475 patients in the validation phase. The derived Chest CT-All DI consisted of (1) abnormal chest X-ray, (2) rapid deceleration mechanism, (3) distracting injury, (4) chest wall tenderness, (5) sternal tenderness, (6) thoracic spine tenderness, and (7) scapular tenderness. The Chest CT-Major DI had the same criteria without rapid deceleration mechanism. In the validation phase, Chest CT-All had a sensitivity of 99.2% (95% CI 95.4%–100%), a specificity of 20.8% (95% CI 19.2%–22.4%), and a negative predictive value (NPV) of 99.8% (95% CI 98.9%–100%) for major injury, and a sensitivity of 95.4% (95% CI 93.6%–96.9%), a specificity of 25.5% (95% CI 23.5%–27.5%), and a NPV of 93.9% (95% CI 91.5%–95.8%) for either major or minor injury. Chest CT-Major had a sensitivity of 99.2% (95% CI 95.4%–100%), a specificity of 31.7% (95% CI 29.9%–33.5%), and a NPV of 99.9% (95% CI 99.3%–100%) for major injury and a sensitivity of 90.7% (95% CI 88.3%–92.8%), a specificity of 37.9% (95% CI 35.8%–40.1%), and a NPV of 91.8% (95% CI 89.7%–93.6%) for either major or minor injury. Regarding the limitations of our work, some clinicians may disagree with our injury classification and sensitivity thresholds for injury detection. Conclusions We prospectively derived and validated two DIs (Chest CT-All and Chest CT-Major) that identify blunt trauma patients with clinically significant thoracic injuries with high sensitivity, allowing for a safe reduction of approximately 25%–37% of unnecessary chest CTs. Trauma evaluation protocols that incorporate these DIs may decrease unnecessary costs and radiation exposure in the disproportionately young trauma population. PMID:26440607

Stress Tests for Chest Pain: When You Need an Imaging Test -- and When You Don't

MedlinePlus

... Resources Adult , Geriatric Stress Tests for Chest Pain Stress Tests for Chest Pain When you need an ... pain isn’t from heart disease. A cardiac stress test makes the heart work hard so your ...

46 CFR 160.038-5 - Marking.

Code of Federal Regulations, 2010 CFR

2010-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Magazine Chests, Portable, for Merchant Vessels § 160.038-5 Marking. (a) Portable magazine chests used for the stowage of pyrotechnic signals, rockets, and powder for...: “Portable Magazine Chest, Inflammable—Keep Lights and Fire Away.” (b) [Reserved] ...

When the Battle is Lost and Won: Delayed Chest Closure After Bilateral Lung Transplantation.

PubMed

Soresi, Simona; Sabashnikov, Anton; Weymann, Alexander; Zeriouh, Mohamed; Simon, André R; Popov, Aron-Frederik

2015-10-12

In this article we summarize benefits of delayed chest closure strategy in lung transplantation, addressing indications, different surgical techniques, and additional perioperative treatment. Delayed chest closure seems to be a valuable and safe strategy in managing patients with various conditions after lung transplantation, such as instable hemodynamics, need for high respiratory pressures, coagulopathy, and size mismatch. Therefore, this approach should be considered in lung transplant centers to give patients time to recover before the chest is closed.

Male chest enhancement: pectoral implants.

PubMed

Benito-Ruiz, J; Raigosa, J M; Manzano-Surroca, M; Salvador, L

2008-01-01

The authors present their experience with the pectoral muscle implant for male chest enhancement in 21 patients. The markings and technique are thoroughly described. The implants used were manufactured and custom made. The candidates for implants comprised three groups: group 1 (18 patients seeking chest enhancement), group 2 (1 patient with muscular atrophy), and group 3 (2 patients with muscular injuries). Because of the satisfying results obtained, including significant enhancement of the chest contour and no major complications, this technique is used for an increasing number of male cosmetic surgeries.

Medic - Chest Pain: A Decision Support Program for the Management of Acute Chest Pain (User’s Manual)

DTIC Science & Technology

1989-10-05

musculoskeletal chest pain; b) pleurisy ; c) pulmonary erbolus; d) mediastinal emphysema a) Musculoskeletal chest pain and the pain of costochondritis denote muscle...includes mild A-22 analgesics/anti-inflammatory drugs, heat therapy, and rest. b) Pleurisy denotes inflammation of the pleura. It may be seen in the...setting of bronchitis or pneumonia. The symptoms of both assist in differentiating pleurisy fru pneumothorax. In the absence of signs of pneumonia or

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

Miyamoto, Y.; Hattori, T.; Niimoto, M.

In 15 patients chest walls were excised because of recurrent breast cancer, radiation ulcer, or rib tumor. In most cases the full-thickness defect of the chest wall was about 10 x 10 cm. Reconstruction was performed using only a rectus abdominis musculocutaneous flap. No patient developed circulation problems in the flap or severe flail chest, and we had successful results in all our cases. These results show that the rectus abdominis musculocutaneous flap is quite effective and safe to use in the reconstruction of chest wall defects.

Quality assessment of digital X-ray chest images using an anthropomorphic chest phantom

NASA Astrophysics Data System (ADS)

Vodovatov, A. V.; Kamishanskaya, I. G.; Drozdov, A. A.; Bernhardsson, C.

2017-02-01

The current study is focused on determining the optimal tube voltage for the conventional X-ray digital chest screening examinations, using a visual grading analysis method. Chest images of an anthropomorphic phantom were acquired in posterior-anterior projection on four digital X-ray units with different detector types. X-ray images obtained with an anthropomorphic phantom were accepted by the radiologists as corresponding to a normal human anatomy, hence allowing using phantoms in image quality trials without limitations.

KSC-2011-2646

NASA Image and Video Library

2011-03-31

CAPE CANAVERAL, Fla. – An osprey wades in flooded grass near the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. Severe storms associated with a frontal system are moving through Central Florida, producing strong winds, heavy rain, frequent lightning and even funnel clouds. Photo credit: NASA/Ben Smegelsky

KSC-2011-2649

NASA Image and Video Library

2011-03-31

CAPE CANAVERAL, Fla. – An osprey wades in flooded grass near the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. Severe storms associated with a frontal system are moving through Central Florida, producing strong winds, heavy rain, frequent lightning and even funnel clouds. Photo credit: NASA/Ben Smegelsky

KSC-2011-2647

NASA Image and Video Library

2011-03-31

CAPE CANAVERAL, Fla. – An osprey wades in flooded grass near the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. Severe storms associated with a frontal system are moving through Central Florida, producing strong winds, heavy rain, frequent lightning and even funnel clouds. Photo credit: NASA/Ben Smegelsky

PRB CHEMISTRY CASE STUDY: DENVER FEDERAL CENTER

EPA Science Inventory

The Denver Federal Center permeable reactive barrier is a funnel-and-gate system with four reactive gates, each separated by up to about 120 m of metal sheet pile. In this study, ground water sampling, core collection, and solid phase characterization studies were carried out in...

Mechanism of pH-dependent activation of the sodium-proton antiporter NhaA

NASA Astrophysics Data System (ADS)

Huang, Yandong; Chen, Wei; Dotson, David L.; Beckstein, Oliver; Shen, Jana

2016-10-01

Escherichia coli NhaA is a prototype sodium-proton antiporter, which has been extensively characterized by X-ray crystallography, biochemical and biophysical experiments. However, the identities of proton carriers and details of pH-regulated mechanism remain controversial. Here we report constant pH molecular dynamics data, which reveal that NhaA activation involves a net charge switch of a pH sensor at the entrance of the cytoplasmic funnel and opening of a hydrophobic gate at the end of the funnel. The latter is triggered by charging of Asp164, the first proton carrier. The second proton carrier Lys300 forms a salt bridge with Asp163 in the inactive state, and releases a proton when a sodium ion binds Asp163. These data reconcile current models and illustrate the power of state-of-the-art molecular dynamics simulations in providing atomic details of proton-coupled transport across membrane which is challenging to elucidate by experimental techniques.

The Laser Ablation Ion Funnel: Sampling for in situ Mass Spectrometry on Mars

NASA Technical Reports Server (NTRS)

Johnson, Paul V.; Hodyss, Robert; Tang, Keqi; Brinckerhoff, William B.; Smith, Richard D.

2011-01-01

A considerable investment has been made by NASA and other space agencies to develop instrumentation suitable for in situ analytical investigation of extra terrestrial bodies including various mass spectrometers (time-of-flight, quadrupole ion trap, quadrupole mass filters, etc.). However, the front-end sample handling that is needed to collect and prepare samples for interrogation by such instrumentation remains underdeveloped. Here we describe a novel approach tailored to the exploration of Mars where ions are created in the ambient atmosphere via laser ablation and then efficiently transported into a mass spectrometer for in situ analysis using an electrodynamic ion funnel. This concept would enable elemental and isotopic analysis of geological samples with the analysis of desorbed organic material a possibility as well. Such an instrument would be suitable for inclusion on all potential missions currently being considered such as the Mid-Range Rover, the Astrobiology Field Laboratory, and Mars Sample Return (i.e., as a sample pre-selection triage instrument), among others.

Spin Funneling for Enhanced Spin Injection into Ferromagnets

PubMed Central

Sayed, Shehrin; Diep, Vinh Q.; Camsari, Kerem Yunus; Datta, Supriyo

2016-01-01

It is well-established that high spin-orbit coupling (SOC) materials convert a charge current density into a spin current density which can be used to switch a magnet efficiently and there is increasing interest in identifying materials with large spin Hall angle for lower switching current. Using experimentally benchmarked models, we show that composite structures can be designed using existing spin Hall materials such that the effective spin Hall angle is larger by an order of magnitude. The basic idea is to funnel spins from a large area of spin Hall material into a small area of ferromagnet using a normal metal with large spin diffusion length and low resistivity like Cu or Al. We show that this approach is increasingly effective as magnets get smaller. We avoid unwanted charge current shunting by the low resistive NM layer utilizing the newly discovered phenomenon of pure spin conduction in ferromagnetic insulators via magnon diffusion. We provide a spin circuit model for magnon diffusion in FMI that is benchmarked against recent experiments and theory. PMID:27374496

Spin Funneling for Enhanced Spin Injection into Ferromagnets

NASA Astrophysics Data System (ADS)

Sayed, Shehrin; Diep, Vinh Q.; Camsari, Kerem Yunus; Datta, Supriyo

2016-07-01

It is well-established that high spin-orbit coupling (SOC) materials convert a charge current density into a spin current density which can be used to switch a magnet efficiently and there is increasing interest in identifying materials with large spin Hall angle for lower switching current. Using experimentally benchmarked models, we show that composite structures can be designed using existing spin Hall materials such that the effective spin Hall angle is larger by an order of magnitude. The basic idea is to funnel spins from a large area of spin Hall material into a small area of ferromagnet using a normal metal with large spin diffusion length and low resistivity like Cu or Al. We show that this approach is increasingly effective as magnets get smaller. We avoid unwanted charge current shunting by the low resistive NM layer utilizing the newly discovered phenomenon of pure spin conduction in ferromagnetic insulators via magnon diffusion. We provide a spin circuit model for magnon diffusion in FMI that is benchmarked against recent experiments and theory.

Synthesis of half-sphere/half-funnel-shaped silica structures by reagent localization and the role of water in shape control

DOE PAGES

Datskos, Panos; Polizos, Georgios; Cullen, David A.; ...

2016-11-11

Role of water and ammonium hydroxide is investigated in evolution of shape of silica structures in the polyvinylpyrrolidone-pentanol emulsion droplet system. Shape control of silica structures is demonstrated by localization of the reagents. A uniform dispersion of reagents provided straight silica rods, while localization of the reagents at the emulsion droplet periphery provided a new type of structures half sphere-half funnel. The absence of water in the initial stages prompted a different nucleation process for the structure growth compared to when water was present in the intial stages. Effect of effective water concentration appeared to be related to the easemore » of diffusion of silica percursor inside the emulsion droplet,i.e., the higher the water concentration, the lower the silica precursor diffusion. Additionally, mixing the reagents in different combinations before adding to the reaction mixture also affected the silica structure thickness, length, and shape.« less

Investigation of local evaporation flux and vapor-phase pressure at an evaporative droplet interface.

PubMed

Duan, Fei; Ward, C A

2009-07-07

In the steady-state experiments of water droplet evaporation, when the throat was heating at a stainless steel conical funnel, the interfacial liquid temperature was found to increase parabolically from the center line to the rim of the funnel with the global vapor-phase pressure at around 600 Pa. The energy conservation analysis at the interface indicates that the energy required for evaporation is maintained by thermal conduction to the interface from the liquid and vapor phases, thermocapillary convection at interface, and the viscous dissipation globally and locally. The local evaporation flux increases from the center line to the periphery as a result of multiple effects of energy transport at the interface. The local vapor-phase pressure predicted from statistical rate theory (SRT) is also found to increase monotonically toward the interface edge from the center line. However, the average value of the local vapor-phase pressures is in agreement with the measured global vapor-phase pressure within the measured error bar.

Hooked differential mobility spectrometry apparatus and method therefore

DOEpatents

Shvartsburg, Alexandre A [Richland, WA; Tang, Keqi [Richland, WA; Ibrahim, Yehia M [Richland, WA; Smith, Richard D [Richland, WA

2009-02-17

Disclosed are a device and method for improved interfacing of differential mobility spectrometry (DMS) or field asymmetric waveform ion mobility spectrometry (FAIMS) analyzers of substantially planar geometry to subsequent or preceding instrument stages. Interfacing is achieved using curved DMS elements, where a thick ion beam emitted by planar DMS analyzers or injected into them for ion filtering is compressed to the gap median by DMS ion focusing effect in a spatially inhomogeneous electric field. Resulting thinner beams are more effectively transmitted through necessarily constrained conductance limit apertures to subsequent instrument stages operated at a pressure lower than DMS, and/or more effectively injected into planar DMS analyzers. The technology is synergetic with slit apertures, slit aperture/ion funnels, and high-pressure ion funnel interfaces known in the art which allow for increasing cross-sectional area of MS inlets. The invention may be used in integrated analytical platforms, including, e.g., DMS/MS, LC/DMS/MS, and DMS/IMS/MS that could replace and/or enhance current LC/MS methods, e.g., for proteomics research.

A parallel implementation of the Wuchty algorithm with additional experimental filters to more thoroughly explore RNA conformational space.

PubMed

Stone, Jonathan W; Bleckley, Samuel; Lavelle, Sean; Schroeder, Susan J

2015-01-01

We present new modifications to the Wuchty algorithm in order to better define and explore possible conformations for an RNA sequence. The new features, including parallelization, energy-independent lonely pair constraints, context-dependent chemical probing constraints, helix filters, and optional multibranch loops, provide useful tools for exploring the landscape of RNA folding. Chemical probing alone may not necessarily define a single unique structure. The helix filters and optional multibranch loops are global constraints on RNA structure that are an especially useful tool for generating models of encapsidated viral RNA for which cryoelectron microscopy or crystallography data may be available. The computations generate a combinatorially complete set of structures near a free energy minimum and thus provide data on the density and diversity of structures near the bottom of a folding funnel for an RNA sequence. The conformational landscapes for some RNA sequences may resemble a low, wide basin rather than a steep funnel that converges to a single structure.

Migrating songbirds tested in computer-controlled Emlen funnels use stellar cues for a time-independent compass.

PubMed

Mouritsen, H; Larsen, O N

2001-11-01

This paper investigates how young pied flycatchers, Ficedula hypoleuca, and blackcaps, Sylvia atricapilla, interpret and use celestial cues. In order to record these data, we developed a computer-controlled version of the Emlen funnel, which enabled us to make detailed temporal analyses. First, we showed that the birds use a star compass. Then, we tested the birds under a stationary planetarium sky, which simulated the star pattern of the local sky at 02:35 h for 11 consecutive hours of the night, and compared the birds' directional choices as a function of time with the predictions from five alternative stellar orientation hypotheses. The results supported the hypothesis suggesting that birds use a time-independent star compass based on learned geometrical star configurations to pinpoint the rotational point of the starry sky (north). In contrast, neither hypotheses suggesting that birds use the stars for establishing their global position and then perform true star navigation nor those suggesting the use of a time-compensated star compass were supported.

Flow generation by the corona ciliata in Chaetognatha - quantification and implications for current functional hypotheses.

PubMed

Bleich, Steffen; Müller, Carsten H G; Graf, Gerhard; Hanke, Wolf

2017-12-01

The corona ciliata of Chaetognatha (arrow worms) is a circular or elliptical groove lined by a rim from which multiple lines of cilia emanate, located dorsally on the head and/or trunk. Mechanoreception, chemosensation, excretion, respiration, and support of reproduction have been suggested to be its main functions. Here we provide the first experimental evidence that the cilia produce significant water flow, and the first visualisation and quantification of this flow. In Spadella cephaloptera, water is accelerated toward the corona ciliata from dorsal and anterior of the body in a funnel-shaped pattern, and expelled laterally and caudally from the corona, with part of the water being recirculated. Maximal flow speeds were approximately 140μms -1 in adult specimens. Volumetric flow rate was Q=0.0026μls -1 . The funnel-shaped directional flow can possibly enable directional chemosensation. The flow measurements demonstrate that the corona ciliata is well suited as a multifunctional organ. Copyright © 2017 Elsevier GmbH. All rights reserved.

Synthesis of half-sphere/half-funnel-shaped silica structures by reagent localization and the role of water in shape control

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

Datskos, Panos; Polizos, Georgios; Cullen, David A.

Role of water and ammonium hydroxide is investigated in evolution of shape of silica structures in the polyvinylpyrrolidone-pentanol emulsion droplet system. Shape control of silica structures is demonstrated by localization of the reagents. A uniform dispersion of reagents provided straight silica rods, while localization of the reagents at the emulsion droplet periphery provided a new type of structures half sphere-half funnel. The absence of water in the initial stages prompted a different nucleation process for the structure growth compared to when water was present in the intial stages. Effect of effective water concentration appeared to be related to the easemore » of diffusion of silica percursor inside the emulsion droplet,i.e., the higher the water concentration, the lower the silica precursor diffusion. Additionally, mixing the reagents in different combinations before adding to the reaction mixture also affected the silica structure thickness, length, and shape.« less

Male adaptations to minimize sexual cannibalism during reproduction in the funnel-web spider Hololena curta.

PubMed

Xiao, Yong-Hong; Zunic-Kosi, Alenka; Zhang, Long-Wa; Prentice, Thomas R; McElfresh, J Steven; Chinta, Satya P; Zou, Yun-Fan; Millar, Jocelyn G

2015-12-01

Males of many spider species risk being attacked and cannibalized while searching for, courting, and mating with conspecific females. However, there are exceptions. We show that the funnel-web spider, Hololena curta, has 3 adaptations that minimize risk to males during courtship and mating, and enhance reproductive success. First, males detected chemical or tactile signals associated with webs of virgin females, and differentiated them from webs of mated females, enabling males to increase encounter rates with virgin females and avoid aggressive mated females. Second, males produced stereotyped vibrational signals during courting which induced female quiescence and suppressed female aggression. Third, when touched by males, sexually receptive females entered a cataleptic state, allowing males to safely approach and copulate. Because males can mate multiple times and the sex ratio in natural populations of H. curta is female biased, overall reproductive output is likely increased by males of this species avoiding sexual cannibalism. © 2015 Institute of Zoology, Chinese Academy of Sciences.

Single-step fabrication of quantum funnels via centrifugal colloidal casting of nanoparticle films

PubMed Central

Kim, Jin Young; Adinolfi, Valerio; Sutherland, Brandon R.; Voznyy, Oleksandr; Kwon, S. Joon; Kim, Tae Wu; Kim, Jeongho; Ihee, Hyotcherl; Kemp, Kyle; Adachi, Michael; Yuan, Mingjian; Kramer, Illan; Zhitomirsky, David; Hoogland, Sjoerd; Sargent, Edward H.

2015-01-01

Centrifugal casting of composites and ceramics has been widely employed to improve the mechanical and thermal properties of functional materials. This powerful method has yet to be deployed in the context of nanoparticles—yet size–effect tuning of quantum dots is among their most distinctive and application-relevant features. Here we report the first gradient nanoparticle films to be constructed in a single step. By creating a stable colloid of nanoparticles that are capped with electronic-conduction-compatible ligands we were able to leverage centrifugal casting for thin-films devices. This new method, termed centrifugal colloidal casting, is demonstrated to form films in a bandgap-ordered manner with efficient carrier funnelling towards the lowest energy layer. We constructed the first quantum-gradient photodiode to be formed in a single deposition step and, as a result of the gradient-enhanced electric field, experimentally measured the highest normalized detectivity of any colloidal quantum dot photodetector. PMID:26165185

[Primary investigation of formation and genetic mechanism of land subsidence based on PS-InSAR technology in Beijing].

PubMed

Lei, Kun-chao; Chen, Bei-bei; Jia, San-man; Wang, Shu-fang; Luo, Yong

2014-08-01

The present paper adopts permanent scatterer interferometric synthetic aperture radar(PS-InSAR) technique to obtain land subsidence information in Beijing plain area. Then, combined with the time series of meteorological data, groundwater dynamic monitoring data, interferometric data and geological structure data, the formation and evolution mechanism of land subsidence were revealed. The results show that (1) Beijing regional land subsidence characteristics are obvious, more land subsidence funnel areas are interconnected, the settlement is influenced by rainfall recharge and exhibits seasonal fluctuation characteristics; (2) The land subsidence center and groundwater drawdown funnel centre are not fully consistent, unconfined aquifer and shallow confined aquifer are the major contribution factors and have greater impact on the land subsidence; (3) Land subsidence mainly occurred in the clay layer with a thickness of 50-70 m; (4) Land subsidence caused by tectonic controls is significant and the deformation gradient is great on both sides of the fault.

Folding energy landscape and network dynamics of small globular proteins

PubMed Central

Hori, Naoto; Chikenji, George; Berry, R. Stephen; Takada, Shoji

2009-01-01

The folding energy landscape of proteins has been suggested to be funnel-like with some degree of ruggedness on the slope. How complex the landscape, however, is still rather unclear. Many experiments for globular proteins suggested relative simplicity, whereas molecular simulations of shorter peptides implied more complexity. Here, by using complete conformational sampling of 2 globular proteins, protein G and src SH3 domain and 2 related random peptides, we investigated their energy landscapes, topological properties of folding networks, and folding dynamics. The projected energy surfaces of globular proteins were funneled in the vicinity of the native but also have other quite deep, accessible minima, whereas the randomized peptides have many local basins, including some leading to seriously misfolded forms. Dynamics in the denatured part of the network exhibited basin-hopping itinerancy among many conformations, whereas the protein reached relatively well-defined final stages that led to their native states. We also found that the folding network has the hierarchic nature characterized by the scale-free and the small-world properties. PMID:19114654

Folding energy landscape and network dynamics of small globular proteins.

PubMed

Hori, Naoto; Chikenji, George; Berry, R Stephen; Takada, Shoji

2009-01-06

The folding energy landscape of proteins has been suggested to be funnel-like with some degree of ruggedness on the slope. How complex the landscape, however, is still rather unclear. Many experiments for globular proteins suggested relative simplicity, whereas molecular simulations of shorter peptides implied more complexity. Here, by using complete conformational sampling of 2 globular proteins, protein G and src SH3 domain and 2 related random peptides, we investigated their energy landscapes, topological properties of folding networks, and folding dynamics. The projected energy surfaces of globular proteins were funneled in the vicinity of the native but also have other quite deep, accessible minima, whereas the randomized peptides have many local basins, including some leading to seriously misfolded forms. Dynamics in the denatured part of the network exhibited basin-hopping itinerancy among many conformations, whereas the protein reached relatively well-defined final stages that led to their native states. We also found that the folding network has the hierarchic nature characterized by the scale-free and the small-world properties.

Paragnomoxyala gen. nov. (Xyalidae, Monhysterida, Nematoda) from the East China Sea.

PubMed

Jiang, Weijun; Huang, Yong

2015-11-05

A new genus, Paragnomoxyala gen. nov., and a new species, Paragnomoxyala breviseta sp. nov. are described from the East China Sea. Paragnomoxyala gen. nov. is characterized by having large funnel-shaped buccal cavity with cuticularized walls and extended anteriorly; lips very high; striated cuticle; four cephalic setae, absence of outer labial setae; circular amphidial fovea; straight spicules and absence of gubernaculum; tail conico-cylindrical with three terminal setae; female monodelphic with an anterior outstretched ovary. It differs from similar genera by having a large buccal cavity unique in Xyalidae, straight spicules, lacking gubernaculum, and conico-cylindrical tail with terminal setae. Paragnomoxyala breviseta sp. nov. is characterized by having a large funnel-shaped buccal cavity, with cuticularized walls and extended anteriorly, 1.6-1.8 hd long and 63-79% cbd wide; four cephalic setae 3-4 µm long; circular amphids 6-9 µm in diameter; spicules straight but slightly bent at both ends; absence of gubernaculum and precloacal supplement.

Orthogonal Simulation Experiment for Flow Characteristics of Ore in Ore Drawing and Influencing Factors in a Single Funnel Under a Flexible Isolation Layer

NASA Astrophysics Data System (ADS)

Chen, Qingfa; Zhao, Fuyu; Chen, Qinglin; Wang, Yuding; Zhong, Yu; Niu, Wenjing

2017-12-01

A study on the flow characteristics of ore and factors that influence these characteristics is important to master ore flow laws. An orthogonal ore-drawing numerical model was established and the flow characteristics were explored. A weight matrix was obtained and the effect of the factors was determined. It was found that (1) the entire isolation-layer interface presents a Gaussian curve morphology and marked particles in each layer show a funnel morphology; (2) the drawing amount, Q, and the isolation layer half-width, W, are correlated positively with the fall depth, H, of the isolation layer; (3) factors that affect the characteristics sequentially include the particle friction coefficient, the interface friction coefficient, the isolation layer thickness, and the particle radius, and (4) the optimal combination is an isolation layer thickness of 0.005 m, an interface friction coefficient of 0.8, a particle friction coefficient of 0.2, and a particle radius of 0.007 m.

Phloem unloading in Arabidopsis roots is convective and regulated by the phloem-pole pericycle

PubMed Central

Ross-Elliott, Timothy J; Jensen, Kaare H; Haaning, Katrine S; Wager, Brittney M; Knoblauch, Jan; Howell, Alexander H; Mullendore, Daniel L; Monteith, Alexander G; Paultre, Danae; Yan, Dawei; Otero, Sofia; Bourdon, Matthieu; Sager, Ross; Lee, Jung-Youn; Helariutta, Ykä; Knoblauch, Michael; Oparka, Karl J

2017-01-01

In plants, a complex mixture of solutes and macromolecules is transported by the phloem. Here, we examined how solutes and macromolecules are separated when they exit the phloem during the unloading process. We used a combination of approaches (non-invasive imaging, 3D-electron microscopy, and mathematical modelling) to show that phloem unloading of solutes in Arabidopsis roots occurs through plasmodesmata by a combination of mass flow and diffusion (convective phloem unloading). During unloading, solutes and proteins are diverted into the phloem-pole pericycle, a tissue connected to the protophloem by a unique class of ‘funnel plasmodesmata’. While solutes are unloaded without restriction, large proteins are released through funnel plasmodesmata in discrete pulses, a phenomenon we refer to as ‘batch unloading’. Unlike solutes, these proteins remain restricted to the phloem-pole pericycle. Our data demonstrate a major role for the phloem-pole pericycle in regulating phloem unloading in roots. DOI: http://dx.doi.org/10.7554/eLife.24125.001 PMID:28230527

The role of chest computed tomography (CT) as a surveillance tool in children with high-risk neuroblastoma.

PubMed

Federico, Sara M; Brady, Samuel L; Pappo, Alberto; Wu, Jianrong; Mao, Shenghua; McPherson, Valerie J; Young, Alison; Furman, Wayne L; Kaufman, Robert; Kaste, Sue

2015-06-01

Standardization of imaging obtained in children with neuroblastoma is not well established. This study examines chest CT in pediatric patients with high-risk neuroblastoma. Medical records and imaging from 88 patients with high-risk neuroblastoma, diagnosed at St. Jude Children's Research Hospital between January, 2002 and December, 2009, were reviewed. Surveillance imaging was conducted through 2013. Ten patients with thoracic disease at diagnosis were excluded. Event free survival (EFS) and overall survival (OS) were estimated. Size specific dose estimates for CT scans of the chest, abdomen, and pelvis were used to estimate absolute organ doses to 23 organs. Organ dosimetry was used to calculate cohort effective dose. The 5 year OS and EFS were 51.9% ± 6.5% and 42.6% ± 6.5%, respectively. Forty-six (58.9%) patients progressed/recurred and 41 (52.6%) died of disease. Eleven patients (14%) developed thoracic disease progression/recurrence identified by chest CT (1 paraspinal mass, 1 pulmonary nodules, and 9 nodal). MIBG (metaiodobenzylguanidine) scans identified thoracic disease in six patients. Five of the 11 had normal chest MIBG scans; three were symptomatic and two were asymptomatic with normal chest MIBG scans but avid bone disease. The estimated radiation dose savings from surveillance without CT chest imaging was 42%, 34% when accounting for modern CT acquisition (2011-2013). Neuroblastoma progression/recurrence in the chest is rare and often presents with symptoms or is identified using standard non-CT imaging modalities. For patients with non-thoracic high-risk neuroblastoma at diagnosis, omission of surveillance chest CT imaging can save 35-42% of the radiation burden without compromising disease detection. © 2015 Wiley Periodicals, Inc.

Personality subtypes and chest pain in patients with nonobstructive coronary artery disease from the TweeSteden Mild Stenosis study: mediating effect of anxiety and depression.

PubMed

Mommersteeg, P M C; Widdershoven, J W; Aarnoudse, W; Denollet, J

2016-03-01

Patients presenting with chest pain in nonobstructive coronary artery disease (CAD, luminal narrowing <60%) are at risk for emotional distress and future events. We aimed to examine the association of personality subtypes with persistent chest pain, and investigated the potential mediating effects of negative mood states. Any chest pain in the past month was the primary outcome measure reported by 523 patients with nonobstructive CAD (mean age 61.4 years, SD = 9.4; 48% men), who participate in the TweeSteden Mild Stenosis (TWIST) observational cohort. Personality was categorized into a 'reference group', a high social inhibition ('SI only'), a high negative affectivity ('NA only') and a 'Type D' (NA and SI) group. Negative mood states included symptoms of depression and anxiety (Hospital Anxiety and Depression Scale) and cognitive and somatic depression (Beck Depression Inventory). The PROCESS macro was used to examine the relation between personality subtypes and chest pain presence, with the negative mood states as potential mediators. Persistent chest pain was present in 44% of the patients with nonobstructive CAD. Type D personality (OR = 1.91, 95% CI 1.24-2.95), but not the 'NA only' (OR = 1.48, 95% CI 0.89-2.44) or the 'SI only' (OR = 0.93, 95% CI 0.53-1.64) group was associated with chest pain, adjusted for age and sex. Negative mood states mediated the association between personality and chest pain. Type D personality, but not negative affectivity or social inhibition, was related to chest pain in nonobstructive CAD, which was mediated by negative mood states. © 2015 European Pain Federation - EFIC®