Implementing IoT/WSN based smart Saskatchewan Healthcare System

Wireless Networks - The Internet of Things (IoT) technology has recently experienced popularity and growth in every facet of life, and it has been applied to every industry in recent years. The...     

Comparison of polysaccharide degradations by dynamic high-pressure homogenization

The mechanical degradation of polysaccharides was investigated using dynamic high and ultra-high-pressure homogenization (HPH). The objectives were to reduce the molar mass of polymer chains, and simultaneously, the apparent and intrinsic viscosity of polysaccharides in solution. The influence of homogenization pressure (up to 200 MPa) and cycles was compared on polysaccharides with different physical and structure properties: namely, guar gum, hydroxyethylcellulose (HEC), sodium carboxymethylcellulose (Na-CMC), sodium alginate (Na-alginate) and gum arabic. HPH was applied on semi-dilute solutions. The apparent changes in molar mass, gyration radius and intrinsic viscosity were deduced from size exclusion chromatography coupled on-line with multi-angle laser light scattering, differential viscometer detector and differential refractive index detector (SEC/MALS/DV/DRI), while the evolution of the critical overlap concentration (C^∗) was obtained by viscosimetry. A method based on a succession of homogenization cycles and polymer pre-concentration steps was developed to determine the minimum molar mass achieved at constant pressure. Molar mass, and intrinsic viscosity were shown to fall simultaneously while logically C^∗ increased during HPH for all polysaccharides, except gum arabic, probably because of its globular and branched structure. This highlights that the differences of polysaccharide structures and conformation (linear, branched…) exhibit a stronger impact on HPH treatments than polymer charge or molar mass. Finally, via an empirical approach linking the decrease of both molar masses and viscosities, we have evidenced a specific scaling exponent that should characterize the flexibility of the treated polymer (i.e. its ability to be degraded by HPH).     

Annual anomalies and trends for TOMS reflectivities (1978–2005) in the Southern Hemisphere

Annual anomalies of Lambertian equivalent reflectivity (LER) retrieved from the total ozone mapping spectrometer spanning the period November 1978–November 2005 were studied in the Southern Hemisphere, in a region bounded by 0° S and 60° S, and their trends were estimated. With the exception of few regions where the variable may represent the contribution of both cloudiness and snow, trends in LER anomalies provided an evolution of total cloudiness. On average, the study region experienced a net increase in LER values of 0.78 reflectivity units (RU) decade^?1; if only significant trend values are considered this figure increased to 1.18 RU decade^?1. The region that showed the largest upward trend, up to 4 RU decade^?1, was located over the eastern Pacific, off the coasts of Chile and Peru, where the presence of marine stratocumulus is frequent. Despite the overall positive trend there were regions that yielded a negative one, most notably the tropical latitudes of South America and Africa. The yearly zonal means also showed a positive trend at all latitudes, but significance occurred beyond 20° S only. Correlation maps between LER anomalies and five different circulation indices were also introduced. The indices with the highest and lowest number of significant correlation values were the Madden–Julian oscillation at 70° E and the quasi-biennial Oscillation, respectively.     

Identification of 130 kDa cell surface LDL-binding protein from smooth muscle cells as a partially processed T-cadherin precursor

Atypical cell surface lipoprotein-binding proteins of 105 kDa and 130 kDa are present in membranes of vascular smooth muscle cells. We recently identified the 105 kDa protein from human aortic media as T-cadherin, an unusual glycosylphosphatidylinositol (GPI)-anchored member of the cadherin family of cell adhesion proteins. The goal of the present study was to determine the identity of 130 kDa lipoprotein-binding protein of smooth muscle cells. We applied different approaches that included protein sequencing of purified protein from human aortic media, the use of human T-cadherin peptide-specific antisera, and enzymatic treatment of cultured cells with trypsin and GPI-specific phospholipase C. Our results indicate that the 130 kDa protein is a partially processed form of T-cadherin which is attached to the membrane surface of smooth muscle cells via a GPI anchor and contains uncleaved N-terminal propeptide sequence. Our data disclose that, in contrast to classical cadherins, T-cadherin is expressed on the cell surface in both its precursor (130 kDa) and mature (105 kDa) forms.     

Assessing neuromuscular block at the larynx: the effect of change in resting cuff pressure and a comparison with video imaging in anesthetized humans

Neuromuscular block (NMB) at the larynx has been assessed by measuring the cuff pressure (CP) in an endotracheal tube (ETT) placed between the vocal cords. In this study, we evaluated the decrease in resting cuff pressure (RCP) after the administration of rocuronium and the effect of this decrease on the assessment of NMB, and we compared CP measurement with an alternative technique, video imaging (VI). In 20 patients, NMB was determined at the hand by mechanomyography and at the larynx initially by CP and subsequently by VI, recording images using a fiberoptic bronchoscope via a laryngeal mask. Train-of-four stimuli were applied at both sites. After baseline measurements, the ETT was replaced, and rocuronium was infused to achieve a steady-state 50% (n = 10) or 75% (n = 10) block at the hand. CP measurements were recorded before and after restoration of RCP to prerocuronium pressure, followed by further VI measurements. The mean RCP decreased from 21 +/- 4 to 12 +/- 5 mm Hg after rocuronium. At 50% block at the hand, the CP estimate of block at the larynx with reduced RCP was 62% +/- 18%, and that after restoring RCP was 29% +/- 13%; VI estimated 27% +/- 14% block. At 75% block at the hand, CP and VI estimated 52% +/- 11% and 46% +/- 9% block, respectively (RCP maintained). We conclude that RCP decreases after the administration of rocuronium, that restoring RCP significantly alters CP estimates of NMB, and that VI is in agreement with CP measurement if RCP is maintained at prerelaxant values. Implications: In this study, we show that a muscle relaxant-induced decrease in resting tension at the larynx may confound the assessment of neuromuscular block by cuff pressure measurement. The preliminary data suggest that video imaging may provide a suitable alternative to cuff pressure measurement to assess neuromuscular block at the larynx.     

Agreement and clinical utility of 2 techniques for measuring cardiac output in patients with low cardiac output

BACKGROUND: The reliability of cardiac output obtained with the bolus technique is a problem. OBJECTIVES: To compare measurements of cardiac output measured with bolus and continuous techniques in patients with low cardiac output and to determine if measurements obtained with the continuous technique increased the number of subsequent clinical decisions. METHODS: In 60 intensive care patients, a nurse recorded a single continuous cardiac output measurement and then obtained the mean of 3 consecutive bolus determinations. The medical records of these 60 patients (experimental group) for the next 48 hours and of 60 other patients with regular or mixed venous oximetry catheters (control group) were reviewed to assess the occurrence of cardiac output events and the frequency of clinical decisions based on the events. RESULTS: Mean cardiac output was 4.46 L/min by the continuous technique and 5.20 L/min by the bolus technique (P = .011) for the experimental group. Median bias between the 2 types of measurements was -0.10 L/min (P = .79). Twenty-three of the pairs (38%) had an absolute percent difference greater than 15%. Of these, 18 (78%) had a higher bolus reading. Treatment decisions per 48 hours were 9.9 for the experimental group and 8.6 for the control group (P = .014). Median length of stay was 2 days less in the experimental group (P = .02), and mean highest cardiac output was 0.81 L/min higher (P = .009). CONCLUSIONS: Measurements of cardiac output determined with the continuous technique may be more precise than measurements determined with the bolus technique. Continuous cardiac output information increases the number of treatment decisions and actions that may shorten hospital length of stay.     

Vaccination and the population structure of antigenically diverse pathogens that exchange genetic material

Populations of antigenically diverse pathogens undergoing genetic exchange may be categorized into strains on the basis of a set of principal protective antigens. The extent to which polyvalent vaccines based on these protective antigens can alter the population structure of the pathogen is determined by the degree of cross-protection between strains. In the case where there is no cross-protection, vaccinating against a particular strain will have no effect on the others. As cross-protection increases, the strains containing the antigenic variants included in the vaccine will be diminished in prevalence, and those that do not will increase in prevalence. The rise in prevalence of the latter will become more and more exaggerated as cross-protection increases. However, beyond a critical level of cross-protection, in the absence of vaccination, the steady state of the system is asymmetric in that a certain subset of strains (with non-overlapping repertoires of antigenic variants) will dominate over the others in terms of prevalence. Under these circumstances, a vaccine consisting of the most immunogenic combinations of antigenic variants can cause a dramatic increase in frequency of a subset of rare strains.     

Rat insulinoma-derived pancreatic beta-cells express a functional leptin receptor that mediates a proliferative response

In addition to its interaction at hypothalamic sites to affect feeding and energy expenditure, leptin has been shown to exhibit a proliferative response in erythropoietic cells. The functional leptin receptor is also present in pancreatic islets and we now demonstrate that a commonly used clonal insulin secreting beta-cell line, RINm5F, expresses high levels of the Ob-Rb mRNA. Leptin causes an increase in tyrosine phosphorylation of a number of intracellular proteins and a dose related (10 nM-200 nM) increase in expression of the immediate-early gene, c-fos. This precedes a leptin induced proliferative response in serum-deprived RINm5F cells, which suggests that leptin might be involved in the complex regulation of proliferation of the pancreatic beta-cell.     

Management of chylothorax

BACKGROUND: Chylothorax is a rare primary or secondary condition the optimum management of which remains uncertain. METHODS: Twenty cases of chylothorax, including ten of primary chylothorax and ten secondary to either malignancy, subclavian vein thrombosis or lymphangioma treated between 1956 and 1986 have been reviewed. RESULTS: Open pleurectomy was the most successful treatment in preventing reaccumulation of the effusion. Three patients had thoracic duct-azygous vein anastomoses, but all anastomoses were probably occluded within a year of surgery. Three patients have been lost to follow-up and five died within 2 years of their treatment, but 12 patients were alive and free from an effusion 3-22 years after treatment. CONCLUSION: Patients with chylothorax should undergo lymphangiography to identify the cause and site of the lymphatic abnormality. Conservative treatment is successful in some patients but should be abandoned if the fluid loss exceeds 1.5 l/day for more than 5-7 days in an adult or more than 100 ml/day in a child. Parietal pleurectomy is the most successful treatment when no distinct chylous leak can be identified. Less commonly, an isolated chylous leak either in the chest or in the abdomen may be identified and this should be treated by direct ligation.