Impact of the anode operating conditions on the liquid water distribution in the cathode gas diffusion layer

Previous experimental results indicate that the humidification conditions at the anode have an impact on the liquid water distribution in the cathode gas diffusion layer. Numerical simulations are developed to reproduce and analyze this effect. Results consistent with the experimental results are first obtained by playing with the partition coefficients of an advanced pore network model computing the liquid water formation and transfer in the cathode gas diffusion layer (GDL) for a large range of operating conditions. Then, a model for the full anode – cathode assembly is developed by combining the pore network model of the cathode GDL and a 1D model describing the heat and water transfer in the various components of the anode-cathode assembly. This enables one to generalize the dry – wet regime diagram introduced in a previous work by incorporating the effect of the humidity condition at the anode.     

Full-arch implant framework casting accuracy: preliminary in vitro observation for in vivo testing

PURPOSE: Conventional techniques for implant metal framework fabrication produce error of a magnitude that is inconsistent with the passive-fit requirement for osseointegrated implants. To understand the correlation between prosthesis fit and the implant-tissue response, evaluation of the interface tissue reactions to customary levels of fit is required. The purpose of this study is to determine the accuracy of torch casting full arch frameworks using a high palladium alloy and a ringless phosphate-bonded investment technique. MATERIALS AND METHODS: Three different variables were considered relative to casting accuracy effect. The first variable, completeness of mold-fill, compared cast specimens where the entire sprue system was filled as part of the casting and cast specimens without the sprue system filled. The second variable, phosphate-bonded investment special liquid concentrations, compared groups of castings produced from 0%, 12%, 25%, and 50% special liquid. The third variable, investment mold shape, compared casting produced from a conventional ringless mold shape with a modified ringless mold shape where the investment in the same horizontal plane as the pattern was equal in thickness at the internal and external surfaces. Horizontal and vertical distances on the wax pattern and resulting framework were measured using a machinists microscope to determine casting error. Combined vertical and horizontal error was used for comparison between groups (one-way analysis of variance). RESULTS: No significant differences existed among the three groups compared (P > 0.05). The mean error comparison between the complete and incomplete mold-fill groups showed no statistical difference, while the incomplete fill group was found to be more porous. The mean error of all groups (0.130 mm) exceeded the recommended level of fit needed to satisfy the passive fit requirement by more than 10-fold. CONCLUSIONS: These results verify clinical observation and suggest that the use of conventional lost wax casting technique to cast one-piece full arch implant frameworks is both imprecise and inaccurate as judged against the passive fit requirement. The consequences of screw-fastening misfitting prostheses to osseointegrated implants is currently under investigation.     

The quality management journey: the progress of health facilities in Australia

Many facilities in Australia have taken the Total Quality Management (TQM) step. The objective of this study was to examine progress of adopted formal quality systems in health. Sixty per cent of organizations surveyed have adopted formal systems. Of these, Deming adherents are the most common, followed by eclectic choices. Only 35% considered the quality transition as reasonably easy. There was no relationship between accreditation and formal quality systems identified. The most common improvement techniques were: flow charts, histograms, and cause and effect diagrams. Quality practitioners are happy to use several tools exceptionally well rather than have many tools at their disposal. The greatest impediment to the adoption of quality was the lack of top management support. This study did not support the view that clinicians are not readily actively supporting quality initiatives. Total Quality Management is not a mature concept; however, Chief Executive Officers are assured that rewards will be realized over time.     

Lactate clearance and survival following injury

Previous reports cite optimization of O2 delivery (DO2) to 660 mL/min/m2, O2 consumption (VO2) to 170 mL/min/m2, and cardiac index (CI) of 4.5 L/min as predicting survival. We prospectively evaluated 76 consecutive patients with multiple trauma admitted directly to the ICU from the operating room or emergency department. Patients had serum lactate levels and oxygen transport measured on ICU admission and at 8, 16, 24, 36, and 48 hours. Patients were analyzed with respect to survival (S) versus nonsurvival (NS), lactate clearance to normal (< or = 2 mmol/L) by 24 and 48 hours, hemodynamic optimization as defined above, as well as Injury Severity Score (ISS), ICU stay (LOS), and admission blood pressure. All patients achieved non-flow-dependent VO2. There was no difference in CI, DO2, VO2, or ISS when S was compared with NS. All 27 patients whose lactate level normalized in 24 hours survived. If lactate levels cleared to normal between 24 and 48 hours, the survival rate was 75%. Only 3 of the 22 patients who did not clear their lactate level to normal by 48 hours survived. Ten of the 25 nonsurvivors (40%) achieved the above arbitrary optimization criteria. Fifteen of the survivors never achieved any of these criteria. Optimization alone does not predict survival. However, the time needed to normalize serum lactate levels is an important prognostic factor for survival in severely injured patients.     

The prevalence of clinically significant anaemia and haemoglobinopathy in children requiring dental treatment under general anaesthesia: a retrospective study of 1000 patients

There is little information on the possible value of screening children who are liable to haemoglobinopathies as part of pre-operative assessment for dental treatment under general anaesthesia. The present retrospective investigation examined, first, the number of patients having low haemoglobin levels among 1000 patients who had undergone haematological investigation prior to general anaesthesia in a dental outpatient unit, and, secondly, the subsequent clinical management of these patients. Haemoglobin levels of 10.0 g/dl or less were found in 31 children: 13 Asian, 7 Afro-Caribbean, 5 Mediterranean, 3 Arabic, 1 white Caucasian and 2 Oriental children. In addition, 17 patients had sickle-cell trait and 2 had beta-thalassaemia trait, but there was no relationship between the presence of haemoglobinopathy and low levels of haemoglobin. The planned general anaesthesia was undertaken for 22 of the 31 children who had low levels of haemoglobin and for the 19 children with haemoglobinopathy. Only 6 children ultimately did not undergo general anaesthesia, all failing to return. It is concluded that pre-anaesthetic haematological assessment of children needing minor dental surgery is rarely of any significant clinical value.     

A guided wave inspection technique for nuclear steam generator tubing

The utility of guided ultrasonic waves for increasing the efficiency and sensitivity of nuclear steam generator tubing evaluation by nondestructive means is explored. The basic theoretical background of guided waves in tubes is presented, with major emphasis placed on those results with direct relevance to NDE applications. The possibility of increasing the inspection range of the guided wave modes as well as their sensitivity to defects by proper choice of mode and frequency is also discussed.     

Efficient generation of a reshaped human mAb specific for the {alpha} toxin of Clostridium perfringens

We have used the technique of antibody reshaping to producea humanized antibody specific for the a toxin of Clostridiumperfringens. The starting antibody was from a mouse hybridomafrom which variable (V) region nucleo-tide sequences were determined.The complementarity-determining regions (CDRs) from these Vregions were then inserted into human heavy and light chainV region genes with human constant region gene fragments subsequentlyadded. The insertion of CDRs alone into human frameworks didnot produce a functional reshaped antibody and modificationsto the V region framework were required. With minor frameworkmodifications, the affinity of the original murine mAb was restoredand even exceeded. Where affinity was increased, an alteredbinding profile to overlapping peptides was observed. Computermodelling of the reshaped heavy chain V regions suggested thatamino acids adjacent to CDRs can either contribute to, or distort,CDR loop conformation and must be adjusted to achieve high bindingaffinity.