Alternatives to mercury thermometers

Training is essential to ensure the effectiveness of most temperature measurement devices. There are a number of factors that need to be considered when choosing a temperature measurement device for a particular clinical setting. There are currently four main alternatives to the mercury thermometer.     

Comparative accuracy of three automated techniques in the noninvasive estimation of central blood pressure in men

Automated devices have regularly replaced manual sphygmomanometry for the determination of blood pressure not only in homes and clinics, but also in emergency and critical care settings. Few studies exist that correctly assess the accuracy of these devices, and even fewer that specifically compare commercially available units that rely on different physiologic events for measurement. Six hundred pressure measurements were obtained from 120 subjects using 1 of 3 randomly selected blood pressure monitors. In addition, central arterial pressure measurements were obtained simultaneously and directly from the ascending aorta of each subject. Overall, these devices tended to overestimate diastolic (+2.5 mm Hg, p < 0.0001) and mean (+3.8 mm Hg, p < 0.0001) pressures, but not systolic (+0.7 mm Hg, p = NS) pressure. Compared with the other 2 devices, device I, relying on oscillometric detection, demonstrated a significantly smaller mean absolute error for diastolic pressure (4.9 +/- 3.0 vs 7.0 +/- 4.8 and 6.2 +/- 5.3 mm Hg, p < 0.0001) and mean pressure (4.0 +/- 3.2 vs 7.8 +/- 5.9 and 8.6 +/- 7.5 mm Hg, p < 0.0001), and a trend toward smaller error with systolic pressure (6.8 +/- 6.5 vs 7.3 +/- 6.8 and 8.0 +/-5.6 mm Hg, p = 0.19). Clinically significant (+/-10 mm Hg) errors were common with each device (24.8% overall), but serious (+/-20 mm Hg) errors were unusual (3.2%) and did not occur at all with device I during diastolic and mean pressure measurement. All of the devices tested could be expected to perform satisfactorily in most clinical settings provided that an average error of 4.0 to 8.6 mm Hg is tolerable. This level of accuracy typically extended throughout the range of pressures anticipated in most noncritical clinical situations. As implemented in the devices tested, noninvasive measurement by oscillometry with stepped deflation is more accurate than automated auscultation.     

TRT煤气流量测量装置的选型与应用

介绍了几种常用的流量测量装置的测量原理、特点及适用场所,通过对宣钢TRT发电机组中使用过的煤气流量测量装置实际应用情况的分析,对TRT煤气流量测量装置的选型提出了建议,并详细介绍了弯管流量计在宣钢TRT煤气流量测量中的实际应用情况。     

Home versus intensive care pressure support devices. Experimental and clinical comparison

A bench study using an artificial lung model and a clinical study in patients were performed to evaluate six commercially available home pressure support devices. Six devices were tested in the in vitro study, including five designed for home use and one designed for use in intensive care units. Minimal positive end-expiratory pressure (PEEP) varied across home devices, from 0.5 cm H2O to 4.3 cm H2O. Work imposed during exhalation varied up to six-fold across devices. A substantial rebreathing volume has present for the three home devices with a common inspiratory and expiratory line. This rebreathing volume decreased with increasing PEEP level, as expected, but remained substantial at the widely used PEEP level of 5 cm H2O. Use of a non-rebreathing valve increased both the work imposed by the circuit during the exhalation phase and the time required to attain the relaxation equilibrium. Except for two home devices and a bilevel positive airway pressure (BiPAP) device equipped with a non-rebreathing valve, differences in inspiratory trigger sensitivities were small between home and intensive care devices. During pressure support, the total work performed by the machines did not differ by more than 15% between devices, whereas differences of more than 300% were observed in flow acceleration. Only one home device gave a flow acceleration similar to or better than that obtained with the intensive care device. In a randomized, crossover clinical study, we compared a home device to a device specially designed for intensive care use in seven intubated patients during weaning from mechanical ventilation. The main differences between the two devices were trigger sensitivity and initial flow acceleration. For the same level of pressure support, there were no significant differences in arterial PCO2, tidal volume, respiratory rate, or minute ventilation between these two devices. However, the esophageal pressure-time product was 30% higher with the home device (165 +/- 93 versus 119 +/- 80 cm H2O/min, p < 0.05). In conclusion, differences exist between devices in terms of occurrence of rebreathing, speed of attainment of stable pressure support level, and expiratory resistance. These differences characterizing the delivery of pressure support may have clinical impact on the inspiratory effort of patients.     

Evaluation of input devices for a data setting task.

This study evaluates a set of numeric manual entry devices. The task required was to set numeric data into the devices. The devices evaluated in this study were: a 10-key keyboard, levers, a matrix keyboard, and rotary knobs. The criteria by which the devices were evaluated were: error rate, entry time, and operator preferences. A repeated measurement design was utilized. Each of 24 subjects made 175 10-digit entries into each of the 4 devices. The conclusions based upon the data are: (a) the 10-key keyboard yields a significantly lower error rate and is significantly preferred compared to the other devices. This device required significantly less time per entry compared to the level and rotary knobs. (b) The matrix device required significantly less time per entry and was significantly preferred compared to the level and rotory knobs. The matrix device does not result in a significantly lower error rate than the latter 2 devices. (c) There were no significant differences between the lever and rotary knob devices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contrast-agent phase effects: an experimental system for analysis of susceptibility, concentration, and bolus input function kinetics

A system is presented for experimental arterial input function (AIF) simulation and for accurate measurement of the concentration, susceptibility effects, and magnetic moment of paramagnetic MR contrast agents. Signal effects of contrast agents are evaluated with a stable, well-characterized, and precise experimental setup. A cylindrical phantom and a closed-loop circulating flow system were designed for AIF simulation, assessment of the physical determinants of contrast-agent phase effects, and measurement of contrast-agent properties under controlled conditions. A mathematical model of the AIF dynamics is proposed. From the experimental phase shift (delta phi), either the concentration or molar susceptibility, chiM, is determined. The linear dependence of delta phi on concentration and echo time (TE), the orientation dependence, and the lack of dependence on T1, T2, and diffusion time are proven precisely for water solutions under a wide variety of conditions. The measured effective magnetic moment of Gd+3, mu(eff), was 7.924 +/- 0.015 Bohr magnetons in agreement with the theoretical value of 7.937.     

Blood pressure measurement in epidemiological studies: a comparative analysis of two methods. Data from the EPIC-Potsdam Study. European Prospective Investigation into Cancer and Nutrition

OBJECTIVE: To investigate the impact of a device replacement in blood pressure measurement in epidemiological studies on comparison and interpretation of epidemiological data by replacing traditional aneroid manometry with automated oscillometric devices. DESIGN: Within the context of a continuing epidemiological study (EPIC-Potsdam Study), blood pressure measurements were performed simultaneously with an aneroid sphygmomanometer and an automated oscillometric device for each subject. We randomly selected 400 men and women from the main study population and one observer performed three consecutive blood pressure measurements for each subject according to a standardized procedure. In total, 10 oscillometric devices of the same type were used. Demographic and anthropometric data for each subject were obtained by trained interviewers. RESULTS: The mean difference between the aneroid and the oscillometric measurements of systolic blood pressure was 0.2 +/- 5.6 mmHg (aneroid value greater, NS), whereas the mean difference in diastolic blood pressure, 0.5 +/- 3.5 mmHg (aneroid value smaller), attained statistical significance (P = 0.0001). Estimates of prevalence for hypertension differed by 0.4% for women, and by 2.9% for men. Associations with the differences between methods were observed with age, blood pressure, lean body mass, upper arm circumference and specific devices without indicating a strong and consistent pattern. CONCLUSIONS: The use of automated oscillometric devices in epidemiological studies introduces a bias of very small magnitude compared with use of the aneroid method. The effect of the change to this automated measurement procedure on prevalence estimates is small but might affect comparability of data. Minor differences in measurement performance between devices of one type might affect population parameters.     

Characteristics of glaucoma drainage implants during dynamic and steady-state flow conditions

OBJECTIVE: This study aimed to ascertain whether the Optimed, Krupin, and Ahmed drainage devices function as valves that vary resistance depending on flow conditions to maintain pressure within a desired range. STUDY DESIGN: Experimental study. INTERVENTION: The three devices and a control cannula were submerged in fluid and perfused with balanced salt solution using a computer-driven apparatus that continuously monitors flow (Q) and pressure (P). In one set of experiments, the flow rates were maintained at 2, 5, 10, 25, or 50 microliters/min until steady-state pressures were achieved. In another set of experiments, the flow rate was increased linearly from 0 to 100 microliters/min over 15 to 20 minutes. MAIN OUTCOME MEASURES: The resistance of each implant was calculated from the first set of experiments by dividing the change in pressure (P) by the change in flow (Q) between successive perfusion rates. Flow-pressure curves were plotted from the experiments in which perfusion rate was increased linearly. RESULTS: Resistance remained relatively constant for the cannula (0.18-0.24 mmHg/microliter/min), the Krupin (0.09-0.25 mmHg/microliter/min), and the Optimed implants (0.04-0.08) throughout the tested flow rates. For the Ahmed device, conversely, resistance decreased proportionally (2.86-0.05 mmHg/microliter/min) to the increase in flow. When flow rate was increased linearly from 0 to 100 microliters/min, the Optimed and Krupin devices as well as the cannula generated a linear pressure response with a constant slope. The pressure in the two devices increased at a rate of 0.11 mmHg/microliter compared to 0.23 mmHg/microliter/min for the cannula. The flow-pressure curve for the Ahmed implant was distinct with a steep initial pressure rise and an essentially constant pressure of 12 mmHg thereafter. CONCLUSION: The Optimed and Krupin devices displayed resistance and pressure responses to various flow conditions that were similar to those of a cannula or flow resistor. In these devices, resistance remained relatively stable and pressure increased linearly with flow. The Ahmed device, conversely, functioned as a valve that closely regulated pressure within a desired range by decreasing or increasing resistance as a function of flow.     

Numerical Simulation of Flows in Cut-Throat Flumes

A numerical simulation is presented to obtain the flow characteristics of cut-throat flumes in rectangular open channels. Cut-throat flumes with a horizontal floor are used as simple devices for flow measurement in open channels. Since the flow in the throat section is highly three dimensional and curvilinear, the three-dimensional turbulence Reynolds stress model was applied in the present study to obtain the flow parameters such as the water surface profiles, the pressure distributions, and the mean velocity distributions. The volume of fluid scheme was used to determine the shape of the free surface by computing the fraction of each near-interface cell of a fixed grid that is partially filled with water. The previously published experimental data as well as data based on a new test related to cut-throat flumes were used to validate the simulation results.     

Analysis of distribution of alternating-sign charged clusters on the surface of globular proteins

PURPOSE: In vitro evaluation of three prototype devices designed to trap emboli that are generated by intravascular procedures. MATERIALS AND METHODS: Three prototypes of the safety net were tested in a water flow model. Angioplasty of human endarterectomy specimens was performed upstream of the device (n = 8). In other tests, polyvinyl alcohol particles were injected into the water flow model upstream of the device (n = 15). The safety nets and the effluent that passed through them were examined for embolic particles. A third prototype was tested (n = 5) to evaluate whether the device could be deployed and retrieved as designed. RESULTS: The safety net was able to trap debris released by angioplasty of endarterectomy specimens in every case. Most, but not all, polyvinyl alcohol particles were trapped by the safety net. Four of five devices tested were deployed and retrieved as designed. One became caught in the introducing valve, which prevented deployment. CONCLUSION: The vascular safety net is effective in trapping small volumes of emboli. It can be deployed and retrieved as designed.     

On the evolution of some endoscopic light delivery systems for photodynamic therapy

Progress in photodynamic therapy (PDT) depends on the development of: (1) photosensitizers, (2) optical devices among which are lasers and light delivery systems, and (3) clinical procedure. The light delivery systems which are the focus of this article are fiberoptic devices developed in Lausanne, Switzerland for use in the endoscopic treatment of cancer or precancerous lesions in the bronchi, the esophagus, the uterus, the cervix, the upper aerodigestive tract and thoracic cavity. Light delivery systems for both surface and interstitial application are presented, together with some of the physical principles on which they are based. Incorporation in these devices of the possibility for in-situ measurement of reflected therapeutic light and/or fluorescence emitted by endogenous and/or exogenous dyes allows for improved light and drug dosimetry, as well as the measurement of photobleaching, local oxygenation and other tissue properties. The necessity of information on tissue optical parameters, as well as the use of simple mathematical models and tissue phantoms, for optimizing light distributing devices is underlined. The devices are optimized for delivering the desired light intensity distribution to the targeted region with minimal losses. In some cases this implies using the device to modify the shape of the hollow organ during PDT, an example of which is given for the case of the esophagus. In another strategy, one adapts the shape of the device to that of the organ, using an elastic balloon catheter. Here examples are given for the uterus, the bronchi and the thoracic cavity. The mechanical properties, the sizes, shapes and materials of the light delivery systems must be optimized for safe use while retaining low cost. Furthermore, the devices must whenever possible be rendered compatible with existing medical technology. A significant improvement in clinical efficacy has been demonstrated in the testing of some of these new fiberoptic light delivery systems. For endoscopic PDT in the hollow organs, the design and optimalization of multiple new approaches to light distribution will continue to lead to improved clinical results.     

大型空分高压电动机起动装置的比较

主要论述了空分装置配套大型电动机的软起动,介绍了当前国内国际正在应用和新推出的几种中压软起动装置,并对它们的性能作了比较,以期对相关设备的设计选型和运行维护有所帮助。     

Magnetovisual method for monitoring thermal demagnetization of permanent magnets used in magnetostrictive actuators

The design and measuring potential of the latest generation of the magnetic scanner called Magscanner-Maglab System （MMS） was presented. It enabled the fast acquisition of 3D signals from magnetic sensors and their visualization as digitalized mag- netic images. This system was used for monitoring of a thermal demagnetization process of permanent magnets. The original method and measurement devices were capable for examination of magnetic, mechanical and thermal defects in cylindrical rods made of NdFeB and non-rare earth components. Effectiveness of the method and device was tested for the reference demagnetized magnet dedicated for magnetostrictive actuators.     

Accuracy of a new wrist cuff oscillometric blood pressure device: comparisons with intraarterial and mercury manometer measurements

Accurate measurement of arterial blood pressure is of great importance for the diagnosis and treatment of hypertension. Because of the chronic nature of antihypertensive drug therapy, the involvement of the patient in blood pressure control is desirable. Such an involvement, however, is only feasible if simple, user-friendly, and precise blood pressure measurement devices are available. In this study we tested a new wrist cuff oscillometric blood pressure measurement device in 100 consecutive patients undergoing cardiac catheterization. Blood pressures were simultaneously taken intraarterially (axillary artery) and with a mercury manometer and stethoscope or noninvasive measurement device (OMRON R3). Intraarterial measurements were directly compared with two measurements taken in random order with either an arm cuff mercury manometer or the wrist cuff device. Systolic and diastolic blood pressure as assessed with the mercury manometer was higher, especially when compared with the intraarterial and the wrist cuff values, which were comparable. Correlations of blood pressure values with intraarterial measurement were 0.86 systolic and 0.75 diastolic (P < .01) for the wrist cuff and 0.84 systolic (P < .01) and 0.59 diastolic (P < .05) for the mercury manometer measurements. Reproducibility of both measurements was good for the wrist cuff device ([systolic/diastolic]: r = 0.94/0.92; P < .01) and the mercury manometer (r = 0.97/0.88; P < .01). Both methods overestimated high diastolic values, whereas only the wrist cuff underestimated high systolic values. Thus, the new oscillometric wrist cuff blood pressure measurement device measures arterial blood pressure with great accuracy and reproducibility. As compared with intraarterial values, the wrist cuff device overestimated high diastolic and underestimated high systolic blood pressure values. Blood pressure values as measured by the mercury manometer were higher than intraarterial values and those of the wrist cuff. Both noninvasive devices overestimated high diastolic values.     

A multiple-site laboratory evaluation of three on-site urinalysis drug-testing devices

Presented are findings from a multisite laboratory evaluation comparing on-site urinalysis drug-test results to results from Syva EMIT immunoassay and gas chromatography-mass spectrometry (GC-MS). Three laboratories participated in the NHTSA-funded project. Specimens were tested for amphetamines, benzodiazepines, cocaine, cannabinoids, and opiates. Each laboratory selected 20 urines that tested positive for a single drug/drug class and 20 that tested negative to challenge the on-site drug-testing devices. Qualitative and quantitative GC-MS confirmations were performed to ensure that all positive samples contained the target drug(s)/metabolite(s) and that all negative samples did not contain the target analytes. EZ-SCREEN, ONTRAK, and TRIAGE on-site test kits were selected for evaluation. On-site false-positive results, in which GC-MS-verified negative urine samples gave positive on-site results, were rare. Two such errors were recorded with both EZ-SCREEN and TRIAGE. Cross-reactivity from samples containing GC-MS-verified high concentrations of alternate drugs was also rare. One cross-reactive error was recorded while testing for cocaine with EZ-SCREEN, a second while testing for benzodiazepines with ONTRAK, and a third while testing for cocaine with ONTRAK. The EZ-SCREEN kit did not appear to adhere to a cutoff concentration as demonstrated by the number of samples that contained low concentrations of the target drugs that tested positive with this device. A significant finding of this study was that comparing on-site test device results with those of EMIT for samples with drug concentrations near the reporting cutoff was very complex. It required a thorough knowledge of the performance of each device, EMIT, and GC-MS. It also required an investigation of each discrepant result-a consideration not taken in many previous evaluations of on-site testing devices. Compared with current federal guidelines for workplace urinalysis testing, more donor samples would screen positive for cannabinoids and cocaine by the on-site devices than by EMIT immunoassay. However, fewer would be reported as positive because most contained GC-MS-determined drug concentrations lower than the federal confirmation and reporting limits.     

三流Τ型中间包内控流装置优化的物理模拟

通过三流T型连铸中间包物理模拟实验,研究了直挡墙、V型挡墙及其与抑湍器组合控流装置对中间包流动特性的影响。结果表明,直挡墙控流装置的控流效果优于无控流装置的中间包,但不如设计合理的V型挡墙控流装置;V型挡墙与挡坝组合控流装置（方案Ⅴ）的控流效果较好,在其基础上加入抑湍器后控流效果并不理想。因此,提出了针对三流T型中间包控流装置的优化设计方案。     

Systematic Evaluation of One-Dimensional Unsteady Friction Models in Simple Pipelines

In this paper, basic unsteady flow types and transient event types are categorized, and then unsteady friction models are tested for each type of transient event. One important feature of any unsteady friction model is its ability to correctly model frictional dissipation in unsteady flow conditions under a wide a range of possible transient event types. This is of importance to the simulation of transients in pipe networks or pipelines with various devices in which a complex series of unsteady flow types are common. Two common one-dimensional unsteady friction models are considered, namely, the constant coefficient instantaneous acceleration-based model and the convolution-based model. The modified instantaneous acceleration-based model, although an improvement, is shown to fail for certain transient event types. Additionally, numerical errors arising from the approximate implementation of the instantaneous acceleration-based model are determined, suggesting some previous good fits with experimental data are due to numerical error rather than the unsteady friction model. The convolution-based model is successful for all transient event types. Both approaches are tested against experimental data from a laboratory pipeline.     

Case report of severe multiple trauma. Anesthesiologic techniques

The modern anaesthetic devices have now put an end to the sixties-fashioned aphorism: "Closed circuit=open coffin". The currently renewed interest in the recirculation systems is justified by the following reasons: economic benefit; environmental advantages; clinical features, such as: 1) better humidification of gases; 2) better preservation of warmth; 3) monitoring of O2 consume; 4) gas analysis on each respiratory act. This allows the use of fresh gases at low flow without the risk of hypoxia or overdosage in patients and it guarantees for safe anaesthesia. The following clinical case clearly shows the application of the above mentioned principles. An extremely serious case of head, chest and abdominal multiple trauma, personally observed, is described. The so called technics "partial rebreathing" was adopted thanks to the availability of a device which permits a punctual monitoring of SAO2, ETCO2, FI and FET, FLO2, VM, VT, VEmin, % of N2O, invasive SAP and body temperature. These are very important parameters for a safe anaesthesia and in conditions like those of the above described clinical case.     

电动机起动时电网压降计算与分析

针对工程应用上使用的多种软起动装置,介绍了高压鼠笼型(同步)大功率电动机使用软起装置或直接起动时电网电压降的三种计算方法,并以计算实例的对比得出在电网容量有限的情况下使用液态电阻软起动装置是最有效和最实用的结论。     

Ultrasonographic estimate of birth weight at 24 to 34 weeks: a multicenter study

OBJECTIVE: The study was intended to compare the accuracies of ultrasonographic estimates of birth weights among infants born between 24 and 34 weeks' gestation at 3 tertiary centers. STUDY DESIGN: In this retrospective study subjects were matched for gestational age (1:1); all underwent ultrasonographic examination within 2 weeks of delivery. The estimates of birth weight were obtained according to 26 published regression equations and their accuracies were assessed with the mean standardized absolute error. For each center the equation with the lowest error was selected to generate (1) receiver-operating characteristic curves for an estimate to identify actual weight < 1500 g and (2) prediction limit calculations to determine the estimate that ensures at 70% confidence a birth weight > 1500 g. RESULTS: One hundred seventy-one cases were analyzed at each center. Comparison of the 26 mean standardized errors at each center indicated that (1) the range was rather wide (eg, 89 +/- 87 to 365 +/- 313 g/kg) and (2) 73% (19/26) of the equations had significantly (P < .05) different accuracies. Receiver-operator characteristic curves show that fetal weight estimates of > or = 1600 g at 2 centers and > or = 1700 g at the third center are required to predict actual birth weight < 1500 g. Prediction limit calculation suggests that different fetal weight estimates (> 1600 g at center 1, > 1900 g for the center II, and > 1800 g at center III) are needed to predict actual weight > 1500 g with a 70% accuracy. CONCLUSIONS: Ultrasonographic estimates of weight for preterm infants, as obtained from 26 equations, are characterized by a rather wide range of accuracy; for most of the equations the accuracies of estimates differ markedly among centers.