Displacement of water from a titanium dioxide surface by an organic liquid

Imperial Users onl

Cric-guide – A review of an innovative scalpel designed for adult surgical cricothyroidotomy

This is a review of the design, development and peer evaluation of Cric-Guide – an innovative scalpel device for emergency front of neck access in adults. The Cric-Guide is designed to replace the standard scalpel blade in the scalpel-bougie-tube technique and improve its success by guiding the bougie into the airway. The handle incorporates two depth guards which impact on the skin each side of the incision to limit insertion depth and reduce posterior damage to the airway. Five research evaluations of Cric-Guide during simulated cricothyroidotomy have been completed. Four compared the performance of Cric-Guide with the standard scalpel in the scalpel-bougie-tube technique, in manikins using porcine larynxes made more difficult with simulated obesity or bleeding or both. Cric-Guide had a lower failure rate on the first attempt particularly with the bleeding simulation and a lower false passage rate in the obese simulations. The other study evaluated Cric-Guide during cricothyroidotomy on intact human cadavers and was successful in all 12 cadavers on the first attempt with no false passages. The Cric-Guide performs surgical cricothyroidotomy effectively in human cadavers and porcine models and is presented as a possible alternative to the standard scalpel for emergency front of neck access.</p

High-resolution quantification of stress perfusion defects by cardiac magnetic resonance

Aims Quantitative stress perfusion cardiac magnetic resonance (CMR) is becoming more widely available, but it is still unclear how to integrate this information into clinical decision-making. Typically, pixel-wise perfusion maps are generated, but diagnostic and prognostic studies have summarized perfusion as just one value per patient or in 16 myocardial segments. In this study, the reporting of quantitative perfusion maps is extended from the standard 16 segments to a high-resolution bullseye. Cut-off thresholds are established for the high-resolution bullseye, and the identified perfusion defects are compared with visual assessment. Methods and results Thirty-four patients with known or suspected coronary artery disease were retrospectively analysed. Visual perfusion defects were contoured on the CMR images and pixel-wise quantitative perfusion maps were generated. Cut-off values were established on the high-resolution bullseye consisting of 1800 points and compared with the per-segment, per-coronary, and per-patient resolution thresholds. Quantitative stress perfusion was significantly lower in visually abnormal pixels, 1.11 (0.75–1.57) vs. 2.35 (1.82–2.9) mL/min/g (Mann–Whitney U test P < 0.001), with an optimal cut-off of 1.72 mL/min/g. This was lower than the segment-wise optimal threshold of 1.92 mL/min/g. The Bland–Altman analysis showed that visual assessment underestimated large perfusion defects compared with the quantification with good agreement for smaller defect burdens. A Dice overlap of 0.68 (0.57–0.78) was found. Conclusion This study introduces a high-resolution bullseye consisting of 1800 points, rather than 16, per patient for reporting quantitative stress perfusion, which may improve sensitivity. Using this representation, the threshold required to identify areas of reduced perfusion is lower than for segmental analysis

Identifying prognostic indicators for cognitive stimulation therapy for dementia: protocol for a systematic review and individual participant data meta-analysis

BACKGROUND: Cognitive stimulation therapy (CST) is the only non-pharmacological, treatment for dementia recommended by the UK National Institute for Health and Care Excellence, following multiple international trials demonstrating beneficial cognitive outcomes in people with mild-to-moderate dementia. However, there is limited understanding of whether treatment prognosis is influenced by sociodemographic and clinical variables (such as dementia subtype and gender), information which could inform clinical decision-making. AIM: We describe the protocol for a systematic review and individual patient data meta-analysis assessing the prognostic factors related to CST. In publishing this protocol, we hope to increase the transparency of our work, and keep healthcare professionals aware of the latest evidence for effective CST. METHOD: A systematic review will be conducted with searches of the bibliographic databases Medline, EMBASE and PsycINFO, from inception to 7 February 2023. Studies will be included if they are clinical trials of CST, use the Alzheimer's Disease Assessment Scale - Cognitive Subscale (gold-standard measure of cognition in dementia in clinical trials) and include participants with mild-to-moderate dementia. Following harmonisation of the data-set, mixed-effect models will be constructed to explore the relationship between the prognostic indicators and change scores post-treatment. CONCLUSIONS: This is the first individual patient data meta-analyses on CST, and has the potential to significantly optimise patient care. Previous analyses suggest people with advanced dementia could benefit more from CST treatment. Given that CST is currently used post-diagnosis in people with mild-to-moderate dementia, the implications of confirming this finding, among identifying other prognostic indicators, are profound

Modelling and calibration of a domestic building using high-resolution monitoring data

Reducing energy consumption and managing energy supply/demand responses are key challenges facing the future built environment. The use of de-carbonised electricity to deliver space heating will make significant impact on CO2 emissions for the UK. A likely technology in UK homes is to replace conventional gas boilers with heat pumps. A high coefficient of performance may mean a reduction in energy consumed, in addition the potential to contribute to demand side response through switching controlled via pricing signals. Evaluating the likely energy demand patterns from such systems and understanding how the characteristics of such systems might affect comfort can be estimated using building simulation. This paper describes the modelling and calibration process of an UK family dwelling using high-resolution monitoring data. Monitoring data describing gas, electricity, hot water, window operation and room temperature at minutely interval are used in the process

Validation of a Model for Prediction of Percent Intramuscular Fat on Live Feedlot Cattle

A prediction model from a previous study was utilized to evaluate the degree of fit when this model is applied to an independent data set. The degree of fit was evaluated using means, regression analysis, correlation coefficient, distribution of residuals, and mean square error of prediction (MSEP). The model provided a reasonably accurate prediction of intramuscular fat with a mean bias of 0.13%. For 47.1% of the steers, percent intramuscular fat was predicted within ± 0.5%, and for 77.6% of the steers, prediction of percent intramuscular fat was made within ± 1%. Pearson product moment correlation between predicted and actual percent intramuscular fat was 0.74 (p \u3c .01), and the square root of MSEP indicated a prediction error of 0.9%