Assessing the Asynchrony Event Based on the Ventilation Mode for Mechanically Ventilated Patients in ICU

Respiratory system modelling can assist clinicians in making clinical decisions during mechanical ventilation (MV) management in intensive care. However, there are some cases where the MV patients produce asynchronous breathing (asynchrony events) due to the spontaneous breathing (SB) effort even though they are fully sedated. Currently, most of the developed models are only suitable for fully sedated patients, which means they cannot be implemented for patients who produce asynchrony in their breathing. This leads to an incorrect measurement of the actual underlying mechanics in these patients. As a result, there is a need to develop a model that can detect asynchrony in real-time and at the bedside throughout the ventilated days. This paper demonstrates the asynchronous event detection of MV patients in the ICU of a hospital by applying a developed extended time-varying elastance model. Data from 10 mechanically ventilated respiratory failure patients admitted at the International Islamic University Malaysia (IIUM) Hospital were collected. The results showed that the model-based technique precisely detected asynchrony events (AEs) throughout the ventilation days. The patients showed an increase in AEs during the ventilation period within the same ventilation mode. SIMV mode produced much higher asynchrony compared to SPONT mode (p < 0.05). The link between AEs and the lung elastance (AUC Edrs) was also investigated. It was found that when the AEs increased, the AUC Edrs decreased and vice versa based on the results obtained in this research. The information of AEs and AUC Edrs provides the true underlying lung mechanics of the MV patients. Hence, this model-based method is capable of detecting the AEs in fully sedated MV patients and providing information that can potentially guide clinicians in selecting the optimal ventilation mode of MV, allowing for precise monitoring of respiratory mechanics in MV patients.

Public and Private Social Welfare

This chapter contributes to the discussion of public and private social welfare by drawing together recent information on these different ways of providing social benefits. It presents data on public social expenditure for 2015–17 and accounts for the impact of the tax system and private social expenditure to develop indicators on net social expenditure for 2015. The chapter shows that conventional estimates of gross public spending differ significantly from estimates of net public spending and net total social expenditure, leading to an incorrect measurement and ranking of total social welfare effort across countries.Just as importantly, the fact that total social welfare support is incorrectly measured implies that the outcomes of welfare state support may also be incorrectly measured. Thus, the main objectives of the chapter include considering the implications of this more comprehensive definition of welfare state effort for analysis of the distributional impact of the welfare state and for an assessment of the efficiency and incentive effects of different welfare state arrangements.

Demonstration of the Systematic Evaluation of an Optical Lattice Clock Using the Drift-Insensitive Self-Comparison Method

The self-comparison method is a powerful tool in the uncertainty evaluation of optical lattice clocks, but any drifts will cause a frequency offset between the two compared clock loops and thus lead to incorrect measurement result. We propose a drift-insensitive self-comparison method to remove this frequency offset by adjusting the clock detection sequence. We also experimentally demonstrate the validity of this method in a one-dimensional 87Sr optical lattice clock. As the clock laser frequency drift exists, the measured frequency difference between two identical clock loops is (240 ± 34) mHz using the traditional self-comparison method, while it is (−15 ± 16) mHz using the drift-insensitive self-comparison method, indicating that this frequency offset is cancelled within current measurement precision. We further use the drift-insensitive self-comparison technique to measure the collisional shift and the second-order Zeeman shift of our clock and the results show that the fractional collisional shift and the second-order Zeeman shift are 4.54(28) × 10−16 and 5.06(3) × 10−17, respectively.

Structural features of the temporomandibular joint in patients with gnathic mesial occlusion

The aim of the study was to evaluate the structural features of the temporomandibular joint in patients with a gnatic form of mesial occlusion of the dentition. Materials and methods. In studying the structural features of the facial skull in patients with gnatic mesial occlusion, the height of the condylar process was separately evaluated in the course of the study in order to avoid the incorrect measurement of the branch height in cases of degenerative changes in the condylar process. Results. The structural features of the temporomandibular joint were determined in 50 adult patients (aged 1844 years old) using cone-beam computed tomography.Сonclusion. Patients with gnathic mesial occlusion of the asymmetric group showed identical articular spaces (anterior and posterior) in the sagittal direction on both the deviating and non-deviating sides, suggesting that the bilateral relationship between the head and fossa may be as symmetrical as in patients with symmetry. However, the axial condylar angle had a bilateral difference only among patients in the asymmetric group; namely, it was significantly greater on the side of the deviating condyle.

COMPARATIVE ANALYSIS OF ALGORITHMS BEING USED FOR MEASUREMENT OF DISCHARGE THROUGH RADIAL GATES OF CANAL CONVEYANCE SYSTEM

The efficiency at field level is in large part measured in terms of the evenness of depth of moisture of the soil, which is directly related to the constant delivery of discharge. The deficiency in operation of networks may be due to incorrect measurement of discharge passing through the Check Structure. For measuring the discharge through gate, the value of Coefficient of Discharge Cd is one of the important factors. The value of Cd for any gate can be assessed either by continuous observation at site for long duration or by regression analysis or by developing a laboratory model. The discharge algorithms accurately represent the complete discharge characteristics for the range of water levels and radial gate geometry normally encountered at canal radial gate check structures. The primary disadvantage of the discharge algorithms is their complexity

Are We over Dissecting the Cord in Orchidopexy?

Background: Orchidopexy is a procedure of securing the testis inside the scrotum in patients with cryptorchidism. In the literature, various dissection techniques have been described to lengthen the spermatic cord to ensure a tension-free fixation of the testis to the lowest point of the scrotum.Objectives: The aim of this study is to determine if incorrect measurement of the spermatic cord’s length during open inguinal orchidopexy had led surgeons to over dissect the cord in a way that may pose an increased risk of testes, vas deferens and spermatic vessels.Materials and Methods: We prospectively studied the results of 40 orchidopexies performed in 40 patients with peeping or canalicular undescended testis , which was done at the Jordan university hospital in Amman from April 2018 to March 2019 , We compared the position of the testis before and after tunneling inside the inguinal canal. The difference in length is measured and analyzed.Conclusion: Failure to account for the subcutaneous fat layer thickness during orchidopexy increases the likelihood of over dissecting the spermatic cord which increases the risk of vas and vessels injury In this study we found that there is a difference between the cord length outside and inside the canal with excess length after passing the cord inside the canal ranges from 1-3 cm . This means that we do not need to dissect the cord to make the testis reaches the scrotum from outside. This decreases the risk of harming the cord and its contents.

Analysis of 2ЭС10 electric locomotive wheelset binding bands wear

The article focuses on monitoring of wheelset binding bands condition of electric locomotives with rotary-field traction motors and, since it is a very important factor in reliability of the electric locomotive by and large, the obtained decisions are based on its results. In analysis there were examined wheelset defects of common occurrence and their natural wear during exploitation. The electric rolling stock works under complicated conditions which affect the nature of wear and electric and mechanical equipment damage. One of the main tasks is to ensure reliable operation of different machinery, as failures on track disorder the traffic schedule, distort the transportation rhythm, leading to considerable loss of throughput capacity of sections, which also reduces movement safety and results in great economic losses. Reliability evaluation is a set of measures aimed at monitoring of condition of electric locomotives, which is based on real operational particulars. By virtue of these particulars one can see an ultimately complete picture, analyze it and correct the structure of repair cycle of electric locomotive particulars. The article accentuates the analysis of risks, related to probable defects, unexpectedly high wear out, incorrect choice of repair cycle structure, ways and tools of reliability evaluation, incorrect statutory, results of incorrect measurement.

Control of Reliability of Measurements in Power Systems According to the First Increment and on the Basis of Extrapolating Filters

Reliability of operation of power systems is determined by reliability of the power equipment, and reliability of the measuring information characterizing a condition of power equipment and the technological processes of generation, transfer, distribution and consumption of energy proceeding in it. Unreliable information causes errors in the diagnosis of equipment malfunctions, improper operation of process control systems and reduction the operational technical and economic performance of power systems. Along with the methods of hardware control of the reliability of measurements using digital codes, there are methods of software and logic control based on the technological meaning of the measured data, their logical consistency and consistency. Control of reliability of measurements by limit values is often applied when the result of measurement of a variable is compared with its known upper and lower limits of reliable values. The resolution of the control by limit values is sharply decreased with the expansion of the range of reliable values. The article deals with the reliability control based on the analysis of the rate of alteration of the controlled variables. At control in accordance with the first increments, the first increment, i.e. the difference of results of measurements in the current and previous moments of time is compared with the known range of the first increments of reliable results of measurements. Control in accordance with the first increments is most effective in cases where the controlled processes are sufficiently inertial and the rate of alteration of variables is relatively small. The resolution of the control by the first increment can be enhanced through the use of extrapolation filters. In this case, the current measured value of the variable is compared with its extrapolated value at the previous time and the result of the comparison reveals an incorrect measurement result.

The IG- file use to Gauge the Apical Diameter in Endodontics: An In Vitro Study

Aim: The aim of this study was to evaluate the efficacy of the IG-file, a new instrument designed for apical diameter gauging. Materials and Methods: After shaping with F1 Universal Protaper, 60 roots were randomly divided into two groups and assigned to two operators, One Expert in Endodontics (EO) and One Unexpert (UO). In each sample, after canal curvatures have been detected, the apical diameters were measured with the IG-file and the K-NiTi. The results were compared with the reference value obtained by retrograde apical gauging. The data were statistically analyzed. Results: Among 60 samples, 10% of errors were recorded when the IG-files were used; in the K-NiTi group the incorrect measurements were 70%. In both groups (expert and unexpert) the IG-file measurements were more accurate than the K-NiTi (90 vs 33 and 90 vs 26,7). The differences were statistically significant. In curved canals, the difference between measurement rates performed with both instruments was statistically significant (85,7% IG-file vs 28,6% K-NiTi) as well as for the samples without curvatures (92,3% IG file vs 30,8% NiTi file). In root canals without curvatures overestimation errors in K-NiTi file group are more frequent than underestimation errors. This difference was statistically significant. Conclusion: A proper gauging of the apical diameter has a key role in endodontic therapy; an incorrect measurement can lead to clinical failures. This “in vitro” study highlights that IG-file improves measurement accuracy independently from clinician experience. Furthermore, in curved canals, the IG-file is more accurate than K-NiTi.