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At least 1,225 records · Page 68Linked to original sources
PubMed2003

Evaluation of NO(x) flue gas analyzers for accuracy and their applicability for low-concentration measurements.

The requirements of the Texas State Implementation Plan of the U.S. Clean Air Act for the Houston-Galveston Ozone Nonattainment Area stipulate large reductions in oxides of nitrogen (NO(x)) emissions. A large number of sources at Dow Chemical Co. sites within the nonattainment area may require the addition of continuous emission monitoring systems (CEMS) for online analysis of NO(x), CO, and O2. At the outset of this work, it was not known whether the analyzers could accurately measure NO(x) as low as 2 ppm. Therefore, NO(x) CEMS analyzers from five different companies were evaluated for their ability to reliably measure NO(x) in the 2-20 ppm range. Testing was performed with a laboratory apparatus that accurately simulated different mixtures of flue gas and, on a limited basis, simulated a dual-train sampling system on a gas turbine. The results indicate that this method is a reasonable approach for analyzer testing and reveal important technical performance aspects for accurate NO(x) measurements. Several commercial analyzers, if installed in a CEMS application with sampling conditioning components similar to those used in this study, can meet the U.S. Environmental Protection Agency's measurement data quality requirements for accuracy.

Air Pollutants, Occupational↗
PubMed1999

Activation of Ca(2+)-dependent K(+) channels contributes to rhythmic firing of action potentials in mouse pancreatic beta cells.

We have applied the perforated patch whole-cell technique to beta cells within intact pancreatic islets to identify the current underlying the glucose-induced rhythmic firing of action potentials. Trains of depolarizations (to simulate glucose-induced electrical activity) resulted in the gradual (time constant: 2.3 s) development of a small (<0.8 nS) K(+) conductance. The current was dependent on Ca(2+) influx but unaffected by apamin and charybdotoxin, two blockers of Ca(2+)-activated K(+) channels, and was insensitive to tolbutamide (a blocker of ATP-regulated K(+) channels) but partially (>60%) blocked by high (10-20 mM) concentrations of tetraethylammonium. Upon cessation of electrical stimulation, the current deactivated exponentially with a time constant of 6.5 s. This is similar to the interval between two successive bursts of action potentials. We propose that this Ca(2+)-activated K(+) current plays an important role in the generation of oscillatory electrical activity in the beta cell.

ATP-Binding Cassette Transporters↗
PubMed2006

Laparoscopic urethrovesical anastomosis: a model to assess surgical competency.

PURPOSE: To create a model for the evaluation of resident competency and performance of laparoscopic skills in compliance with Accreditation Council for Graduate Medical Education (ACGME) outcome assessment guidelines for urology residency programs. MATERIALS AND METHODS: A model of laparoscopic interrupted urethrovesical anastomosis was developed using chicken skin from a local supermarket. Eight residents at various training levels utilized a simulator with a camera-operating assistant to practice placing interrupted stitches. The time necessary for completion of an anastomosis and the quality of the anastomosis were documented. RESULTS: The time required to recreate a simulated urethrovesical anastomosis by placing six interrupted stitches declined from an initial mean of 60.75 minutes to 20.5 minutes after each resident had performed 20 anastomoses each. The mean improvement was 39.5 minutes, with one postgraduate year-3 resident demonstrating an improvement of 50 minutes. CONCLUSION: This model can be used by ACGME-certified urology residency programs to assess the laparoscopic skills of residents.

Anastomosis, Surgical↗
PubMed1993

Planning for medical provision on-board ship.

This paper describes the medical provision on board a 76 m passenger vessel. It discusses the floor space necessary, together with essential equipment to provide a high level of medical care particularly in the event of major emergencies. It stresses the necessity for training and practice of simulated emergencies to ensure a high state of readiness.

Emergency Medical Services↗
PubMed1988

Chest wall acceleration and force measurements in simulated manual and mechanical cardiopulmonary resuscitation.

During CPR, the dynamics of the chest compression process play a major role in determining the outcome of the resuscitation effort. To quantify chest wall motion during CPR, a number of important variables must be determined, including maximum downward acceleration and velocity of the chest wall, time during which the wall is held in compression, and maximum depth and rate of chest compression. In this study, miniature accelerometers were used to record chest wall motion during simulated CPR with standard training manikins. One series of CPR tests included force measurements from a three-dimensional force platform placed under the manikin. The results of this investigation showed that American Heart Association (AHA)-certified rescuers are able to produce a consistent pattern of chest wall displacement during a manikin training exercise, and only small differences in displacement recordings are found when comparing one certified rescuer to another. Any given rescuer will usually generate a consistently repeatable acceleration pattern during CPR. However, these cyclical acceleration patterns differ markedly when comparing different certified rescuers. Mechanical CPR with a standard device produced larger peak accelerations than manual CPR. However, the maximum downward velocity was usually higher with manual CPR. In comparison with trained but clinically inexperienced individuals, rescuers with extensive in hospital experience produced relatively larger downward accelerations, longer "hold" times with the chest in compression, and maximum chest displacements that exceeded the current AHA recommendations. Measurements of the force transmitted through the manikin to a force platform clearly indicated the presence of a "hold" phase (if present) and the existence of large force components in the horizontal plane.

Acceleration↗
PubMed1997

Skeletal muscle adaptations to training under normobaric hypoxic versus normoxic conditions.

This study examined whether training under normobaric hypoxic conditions (simulating medium level altitude) would enhance physical performance and selected muscle adaptations over and above that which occurs with normoxic training. Ten healthy males (19-25 yr) underwent 8 wk of unilateral cycle ergometry training so that one leg was trained while breathing an inspirate of 13.5% O2 and the other while breathing normal ambient air. Pre- and post-training measurements included single leg VO2max and time to fatigue at 95% VO2max. Needle biopsies from quadriceps were assayed for oxidative and glycolytic enzyme activity and analyzed for capillary density, fiber area, % fiber type, and mitochondrial and lipid volume density. VO2max, time to fatigue, citrate synthase (CS), succinate dehydrogenase, and phosphofructokinase activity increased significantly (P > 0.05) in both legs following training. The increase in CS activity in the hypoxically trained leg was also significantly greater than that in the normoxically trained leg. It thus appears that training under moderate normobaric hypoxic conditions enhances muscle citrate synthase activity to a greater extent than training under normoxic conditions.

Adaptation, Physiological↗
PubMed1994

Action potential propagation through embryonic dorsal root ganglion cells in culture. II. Decrease of conduction reliability during repetitive stimulation.

1. The reliability of the propagation of action potentials (AP) through dorsal root ganglion (DRG) cells in embryonic slice cultures was investigated during repetitive stimulation at 1-20 Hz. Membrane potentials of DRG cells were recorded intracellularly while the axons were stimulated by an extracellular electrode. 2. In analogy to the double-pulse experiments reported previously, either one or two types of propagation failures were recorded during repetitive stimulation, depending on the cell morphology. In contrast to the double-pulse experiments, the failures appeared at longer interpulse intervals and usually only after several tens of stimuli with reliable propagation. 3. In the period with reliable propagation before the failures, a decrease in the conduction velocity and in the amplitude of the afterhyperpolarization (AHP), an increase in the total membrane conductance, and the disappearance of the action potential "shoulder" were observed. 4. The reliability of conduction during repetitive stimulation was improved by lowering the extracellular calcium concentration or by replacing the extracellular calcium by strontium. The reliability of conduction decreased by the application of cadmium, a calcium channel blocker, 4-amino pyridine, a fast potassium channel blocker, or apamin or muscarine, the blockers of calcium-dependent potassium channels. The reliability of conduction was not effected by blocking the sodium potassium pump with ouabain or by replacing extracellular sodium with lithium. 5. In the period with reliable propagation cadmium, apamin, and muscarine reduced the amplitude of the AHP. The shoulder of the action potential was more pronounced and not sensitive to repetitive stimulation when extracellular calcium was replaced by strontium. It disappeared when cadmium was applied. 6. In DRG somata changes of the intracellular Ca2+ concentration were monitored by measuring the fluorescence of the Ca2+ indicator Fluo-3 with a laser-scanning confocal microscope. During repetitive stimulation, an accumulation of intracellular calcium occurred that recovered very slowly (tens of seconds) after the AP trains. 7. Computer model simulations performed in analogy to the experimental protocols produced conduction failures during repetitive stimulation only when the calcium currents during the APs were reduced. 8. From these findings it is concluded that conduction failures during repetitive stimulation are dependent on an accumulation of intracellular calcium leading to an inactivation of calcium currents, combined with small contributions of an accumulation of extracellular potassium and a summation of slow potassium conductances.

Acetylcholine↗
PubMed2001

Laryngeal mask vs intubating laryngeal mask: insertion and ventilation by inexperienced resuscitators.

The laryngeal mask airway (LMA) has been shown to be useful in airway maintenance during resuscitation. The intubating laryngeal mask (ILM) is a modified LMA permitting both ventilation and rapid endotracheal intubation. We aimed to compare the LMA and the ILM with regard to ease of insertion and successful ventilation by inexperienced personnel. We have used anaesthetized, apnoeic, non-paralysed patients as a model to simulate resuscitation. Following standardized training, non-anaesthetic medical staff with no previous experience in laryngeal mask airway insertion (novices) inserted either the LMA or ILM in 55 patients following induction of anaesthesia. There were no differences between the two patient groups included in our study with regard to mean age and body mass index (BMI). The success rate for inserting the airway device and achieving a significant end-tidal CO2 recording within two minutes was 23/28 for the LMA (82.1%) and 22/27 for the ILM (81.5%). Reasons for failure included inability to insert the ILM past the teeth and insertion of the LMA upside down. There were no clinically relevant differences in the mean time to airway insertion and successful ventilation (62.6 vs 62 seconds) or expired tidal volume (781 vs 767 ml) for the LMA and ILM respectively. We conclude that the ILM is as easily inserted and effectively used as an LMA by novices and, because it allows the option offacilitating endotracheal intubation, may be the preferred device for maintaining an airway during resuscitation.

Adult↗
PubMed1991

Training breast self-examination: a research review and critique.

Despite an increase in knowledge about breast cancer, a relatively low percentage of women practice breast self-examination (BSE) regularly and competently. This article reviews the BSE literature with a focus on training of BSE components, discrimination training, and the effectiveness of training procedures. Methodological issues such as the absence of control groups, lack of criteria for termination of training and reliance on self-reports of BSE frequency are identified weaknesses of BSE training studies. A theoretical analysis of BSE highlights potential difficulties in maintaining regular practice of BSE. Recommendations regarding training of proficient BSE skills and promoting regular practice of BSE are offered, and suggestions for further refinement of BSE training and directions for future research are discussed. Promising avenues of research in BSE training technology include discrimination training (on real or simulated breast tissue) together with computerized assessment of skill proficiency.

Adolescent↗
PubMed1995

Design of a clinical data-collection form for remote health care.

A clinical data-collection form was designed for use in the consultation process between an astronaut and Earth. It can also be applied in most remote health-care settings. The form was tested by non-medically trained individuals in 101 simulated and 19 real cases. A completion rate of 88% was achieved, with a diagnostic accuracy of 85%. This compares favourably with studies by other workers in the field of medical decision support. Space telemedicine research will contribute to developments that will benefit not only space activities but also terrestrial applications.

Aerospace Medicine↗
PubMed1999

Visual perception of the relative phasing of human limb movements.

Studies of bimanual coordination have found that only two stable relative phases (0 degree and 180 degrees) are produced when a participant rhythmically moves two joints in different limbs at the same frequency. Increasing the frequency of oscillation causes an increase in relative phase variability in both of these phase modes. However, relative phasing at 180 degrees is more variable than relative phasing at 0 degree, and when the frequency of oscillation reaches a critical frequency, a transition to 0 degree occurs. These results have been replicated when 2 people have coordinated their respective limb movements using vision. This inspired us to investigate the visual perception of relative phase. In Experiment 1, recordings of human interlimb oscillations exhibiting different frequencies, mean relative phases, and different amounts of phase variability were used to generate computer displays of spheres oscillating either side to side in a frontoparallel plane or in depth. Participants judged the stability of relative phase. Judgments covaried with phase variability only when the mean phase was 0 degree or 180 degrees. Otherwise, judgments covaried with mean relative phase, even after extensive instruction and demonstration. In Experiment 2, mean relative phase and phase variability were manipulated independently via simulations, and participants were trained to perceive phase variability in testing sessions in which mean phase was held constant. The results of Experiment 1 were replicated. The HKB model was fitted to mean judgment standard deviations.

Adolescent↗
PubMed2001

Nonpharmacologic interventions for inappropriate behaviors in dementia: a review, summary, and critique.

Inappropriate behaviors are very common in dementia and impose an enormous toll both emotionally and financially. Three main psychosocial theoretical models have generally been utilized to explain inappropriate behaviors in dementia: the "unmet needs" model, a behavioral/learning model, and an environmental vulnerability/reduced stress-threshold model. A literature search yielded 83 nonpharmacological intervention studies, which utilized the following categories of interventions: sensory, social contact (real or simulated), behavior therapy, staff training, structured activities, environmental interventions, medical/nursing care interventions, and combination therapies. The majority are reported to have a positive, albeit not always significant, impact. Better matching of the available interventions to patients' needs and capabilities may result in greater benefits to patients and their caregivers.

Aged↗
PubMed1992

LIED--liver: information, education and diagnosis.

In this paper we describe LIED (Liver: Information, Education and Diagnosis), a diagnostic expert system devoted to medical education in the field of hepatology. LIED combines the facilities of a traditional expert system for clinical diagnosis with several modules designed for educational purposes. The goal of such modules is to train physicians, in particular as regards the improvement of their problem solving ability (at the end of their curricula students in medicine usually lack experience in organizing an efficient and accurate diagnostic process). Training on real and simulated cases has been widely recognized as a proper approach to clinical experience. The architecture of the diagnostic system is introduced, which forms the core of LIED, and which has been derived from our previous experience, and the various educational functions are discussed that were developed on top of the basic architecture.

Computer Simulation↗
PubMed2004

Virtual reality and psychotherapy.

Virtual Reality (VR) is a new technology consisting on a graphic environment in which the user, not only has the feeling of being physically present in a virtual world, but he/she can interact with it. The first VR workstations were designed for big companies in order to create environments that simulate certain situations to train professionals. However, at this moment a great expansion of this technology is taking place in several fields, including the area of health. Especially interesting for us is the use of VR as a therapeutic tool in the treatment of psychological disorders. Compared to the traditional treatments, VR has many advantages (e.g., it is a protected environment for the patient, he/she can re-experience many times the feared situation, etc.). There are already data on the effectiveness of this technology in the treatment of different psychological disorders; here anxiety disorders, eating disorders and sexual disorders are reviewed. Finally, this chapter ends with some words about the limitations of VR and future perspectives.

Humans↗
PubMed1992

How pigeons estimate rates of prey encounter.

Pigeons were trained on operant schedules simulating successive encounters with prey items. When items were encountered on variable-interval schedules, birds were more likely to accept a poor item (long delay to food) the longer they had just searched, as if they were averaging prey density over a short memory window (Experiment 1). Responding as if the immediate future would be like the immediate past was reversed when a short search predicted a long search next time (Experiment 2). Experience with different degrees of environmental predictability appeared to change the length of the memory window (Experiment 3). The results may reflect linear waiting (Higa, Wynne, & Staddon, 1991), but they differ in some respects. The findings have implications for possible mechanisms of adjusting behavior to current reinforcement conditions.

Analysis of Variance↗
PubMed2005

Automated external defibrillators on board merchant vessels? Preliminary report article for discussion.

OBJECTIVES: Acute heart diseases are the most frequent causes for fatalities on merchant vessels. Presently there is no sufficient therapy available to treat ventricular fibrillation. The aim of this study was to test whether common automated external defibrillators [AED] may be appropriate for the use aboard merchant vessels. METHODS: In 2005, nine seafarers were introduced to four common models of AED (HeartStartFR2+, Lifepak500, AEDplus, FREDeasy) using standard video or DVD presentations. AED handling by the subjects was tested in standardized simulated emergency scenarios. After training, they subjectively rated each AED on 24 factors involved in the introduction and handling of the device. An actual ECG was then obtained with each AED at a site located beside the ship's main engine to test under maximum vibration. The ECG data were extracted and sent as an e-mail attachment via satellite to the German Telemedical Maritime Assistance Service [TMAS] in Cuxhaven. RESULTS AND CONCLUSIONS: All subjects handled the AED correctly. The AED received a total amount of points in the range between 2125 to 2241 (of 2400 possible). The subjects preferred AED with coloured as well as light marked buttons which gave a feedback (e.g. audible tones) when they were pressed. All AED were able to register an ECG in the vibrating ambient. Due to interface problems it was only possible to extract three ECG files, and only two files (data < 300 kB) could be sent as e-mail attachment via satellite to the German TMAS. In noisy areas the AED must guide the user, e.g. by screen massages and/or pictograms. Displays should provide additional data to help assess resuscitation effectiveness. A special procedure is necessary to ensure that ships and TMAS own the same software to read the transmitted ECG files, which are not allowed to exceed a size of 300 kB.

Adolescent↗