Transthoracic defibrillation of swine with monophasic and biphasic waveforms

BACKGROUND: Biphasic waveforms have had a favorable impact on internal defibrillation but have seen minimal use in transthoracic defibrillation systems. The purpose of this study was to compare monophasic and biphasic waveforms for transthoracic defibrillation in swine. METHODS AND RESULTS: Three interrelated studies were performed in 19 swine to establish the relative transthoracic defibrillation efficacy of biphasic shock waveforms. In study 1, we measured voltage (V50) and energy (E50) strength-duration curves for monophasic and biphasic truncated exponential waveforms. We then independently examined the effects of phase duration and tilt on biphasic waveform defibrillation with a total waveform duration from study 1 that provided the minimum V50 (study 2) and the minimum E50 (study 3). At each pulse duration tested in study 1, biphasic waveforms defibrillated with significantly less voltage and energy than monophasic waveforms. At a duration of 12 ms, there was a voltage minimum for biphasic waveform defibrillation. At this duration, V50 was 1378 +/- 505 V for the biphasic waveform compared with 2185 +/- 361 V for the monophasic waveform, P = .01. For both monophasic and biphasic waveforms, E50 increased with pulse duration. With a total pulse duration of 12 ms, E50 was 169 +/- 101 J for the biphasic waveform compared with 414 +/- 114 J for the monophasic waveform, P = .003. In study 2, optimization of phase duration and total tilt reduced the defibrillation requirements of the 12-ms "minimum voltage" biphasic waveform to 1284 +/- 187 V and 129 +/- 36 J. In study 3, the 8-ms "minimum energy" biphasic waveform had an E50 of 115 +/- 35 J that was 11% less than the 12-ms biphasic waveform, P = .11; however, voltage requirements of 1476 +/- 239 V were 15% higher, P = .005. CONCLUSIONS: This study demonstrates the superiority of truncated biphasic waveforms over truncated monophasic waveforms for transthoracic defibrillation of swine. Biphasic waveforms should prove as advantageous at reducing voltage and energy requirements for transthoracic defibrillation as they have for internal defibrillation.     

Reduced brain serotonin transporter availability in major depression as measured by [123I]-2 beta-carbomethoxy-3 beta-(4-iodophenyl)tropane and single photon emission computed tomography

BACKGROUND: Prior research has suggested reductions in the density of serotonin transporter (SERT) binding sites in blood platelets and post-mortem brain tissue of depressed patients. We sought to determine whether patients with unipolar major depression have diminished SERT availability as assessed by both brainstem [123I] beta-CIT SPECT and platelet [3H]paroxetine binding. METHODS: Drug-free depressed and healthy subjects were injected with 211 +/- 22 MBq [123I] beta-CIT and imaged 24 +/- 2 h later under equilibrium conditions. A ratio of specific to nonspecific brain uptake (V3" = (brainstem-occipital)/occipital), a measure proportional to the binding potential (Bmax/Kd), was used for all comparisons. RESULTS: Results showed a statistically significant reduction in brainstem V3" values in depressed as compared to healthy subjects (3.1 +/- .9 vs. 3.8 +/- .8, p = .02). Platelet [3H]paroxetine binding was not altered (Bmax = 2389 +/- 484 vs. 2415 +/- 538 fmol/mg protein, p = .91) and was not significantly correlated with brainstem [123I] beta-CIT binding (r = -0.14, p = .48). CONCLUSIONS: These data are the first to suggest reductions in the density of brain SERT binding sites in living depressed patients. These findings provide further support for a preeminent role for alterations in serotonergic neurons in the pathophysiology of depression.     

Multidimensionality of oral health in dentate adults

OBJECTIVES: An understanding of the validity and usefulness of self-reported measures (as distinct from clinically determined measures) of oral health is emerging. These self-reported measures include self-rated oral health (SROH). Three objectives were to: (1) describe self-rated oral health in dentate adults, (2) quantify associations between self-rated oral health and other measures of oral health (oral disease and tissue damage, pain and discomfort, functional limitation, and disadvantage), and (3) assess the construct validity of a model of oral health proposed herein. METHODS: The Florida Dental Care Study is a longitudinal study of oral health, which included at baseline 873 subjects who had at least one tooth, were 45 years or older, and who participated for an interview and clinical examination. RESULTS: The prevalence of self-rated oral health decrements was substantial; approximately one fourth of subjects reported their oral health as only fair or poor. Bivariate and multivariate results provided consistent evidence of the construct validity of the proposed model of oral health. Additionally, the salience of one measure of dental appearance suggests that persons may use esthetic cues when rating their oral health. CONCLUSIONS: The proposed multidimensional model of oral health has construct validity. Self-rated oral health is affected by oral disease and tissue damage, oral pain and discomfort, oral functional limitation, and oral disadvantage. These self-reported measures and the proposed model should provide useful information for dental care effectiveness research. General health status has been disaggregated into the "physical" and the "mental;" an additional separation into the "oral" aspects of health seems warranted.     

Design, fabrication and analysis of micromachined high sensitivity and 0% cross-axis sensitivity capacitive accelerometers

This paper presents the design and fabrication of three MEMS based capacitive accelerometers. The first design illustrates the achievement of an accelerometer with 0% cross-axis sensitivity and has been fabricated using PolyMUMPs, a multi-user surface-micromachining process. A unidirectional parallel plate configuration is utilized in this design to illustrate the achievement of 0% cross-axis sensitivity and an acceptable performance range. In addition, a method is introduced to improve the sensitivity of a capacitive sensor employing a transverse configuration based on the relationship of initial gaps setup in comb-finger arrangements. A design based on this technique and the PolyMUMPs fabrication process is illustrated which demonstrates a sensitivity value of 4.07 fF/μm, with a nonlinearity of 2.05% for a ±3 μm sensor operating range. The last design based on this method and the SOIMUMPs fabrication process exhibits a sensitivity of 3.45 pF/μm for ±1 μm operating range of the sensor.     

Bovine muscle shortening and protein degradation after electrical stimulation, excision and chilling

Electrical stimulation-dependent improvement in beef tenderness resulted from mechanisms other than avoidance of cold shortening in excised muscle chilled at a normal rate (10°C at 10h post-stimulation). At normal chilling rate, electrical stimulation enhanced degradation of the myofibrillar proteins, alpha actinin and troponin-T, and increased the amount of a 30 000 dalton protein, as assessed by gel electrophoresis, whereas sarcomere lengths were not different from unstimulated muscle. Under slightly accelerated chilling conditions (10°C at 5 h post stimulation), electrical stimulation prevented cold shortening but the meat was more tender than, and had the same sarcomere length as, unstimulated muscle chilled to 10°C in 10 h. Electrical stimulation did not improve the tenderness of beef chilled at a rapid rate (10°C at 2 h post stimulation), nor did it prevent cold shortening when muscles were chilled rapidly.     

An OSCA™ architecture characterization of network functionality and data

This article demonstrates that the Bellcore OSCA architecture can serve as a basis for the metaarchitecture for software architectures that must support interoperability among functionality that traditionally has resided in operation systems and functionality that traditionally has resided in network elements (NE) (i.e., interoperability among operations functionality and network functionality). The need for this interoperability is driven by such telephone company business needs, as the need for customers to access operations capabilities spanning operations systems and NEs, the need for new service offerings to span operations systems and NEs, the need for a flexible environment for service development, and the need to manage all corporate data as a company resource. As a result, it is becoming beneficial to apply interoperability requirements to the network functionality that interfaces with operations systems. Therefore, it is reasonable to apply the OSCA architecture to network functionality. This article applies the OSCA architecture interoperability principles of separation of concerns to current and emerging network functionality. It demonstrates that this functionality can be partitioned among the three OSCA architecture layers of corporate data, processing, and user, and that there are a number of benefits to applying the OSCA interoperability principles to network functionality.     

The mechanism of brittle fracture in notched impact tests on polycarbonate

The impact testing of notched polycarbonate bars that are thick enough to yield in plane strain has been investigated. Shear bands occur in the plastic zone that resemble the slip line field for yielding from a circular notch. Eventually, an internal craze nucleates at the tip of the plastic zone, where the stresses are highest, and a crack forms in the thickest part of the craze. Above –15 C the stress for the craze to nucleate is a nearly constant multiple of the yield stress. It is shown that previous observations that annealing polycarbonate causes a ductile to brittle transition is a consequence of testing bars of thickness less than 5 mm.     

Choroidal neovascular membrane in Best's vitelliform macular dystrophy

The right eye of a 9-year-old white boy with Best's vitelliform macular dystrophy had an intact egg-yolk lesion and a retinal pigment epithelial defect superiorly, suggesting an early pseudohypopyon stage. The disruptive phase of the left eye showed subretinal hemorrhages, a "signet ring," and a subretinal neovascular membrane.