New International Guidelines and Consensus on the Use of Lung Ultrasound

Following the innovations and new discoveries of the last 10 years in the field of lung ultrasound (LUS), a multidisciplinary panel of international LUS experts from six countries and from different fields (clinical and technical) reviewed and updated the original international consensus for point-of-care LUS, dated 2012. As a result, a total of 20 statements have been produced. Each statement is complemented by guidelines and future developments proposals. The statements are furthermore classified based on their nature as technical (5), clinical (11), educational (3), and safety (1) statements

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Technological aspects of turbogenerator bushing manufacturing

W artykule przedstawiono rozwiązanie konstrukcyjne i technologiczne wykonania izolatora przepustowego do turbogeneratora elektroenergetycznego średniego napięcia. Rozwią-zanie konstrukcyjne wykonano w oparciu o epoksydowy kompozyt lany. Izolatory te będą tańsze od ich importowanych odpowiedników. Wytworzenie izolatorów wymagało wykonania badań materiałowych parametrów elektrycznych, mechanicznych i cieplnych mających na celu optymalny dobór konstrukcji izolatorów oraz zagwarantowanie technologiczności wykonania przy wdrożeniu rozwiązania do produkcji. Przedstawiono zalety i wady tej technologii. Zaprezentowano wyniki badań materiałowych wykonanych na modelach i próbnych izolatorach. Stwierdzono przydatność wybranych materiałów i technologii do zastosowania w przewidywanej produkcji.The article presents a bushing technology implementation to turbo power. It was anticipated that the developed bushings would be cheaper than the imported ones. The body of the bushing was made of epoxy composite using a method of casting. For the optimal selection of the construction of insulators and to ensure manufacturability, the execution of prototypes of insulators needed a series of studies of material parameters (electrical, mechanical, thermal) and taking into account of the environmental policies, which is important in implementing solutions for large scale production. Advantages and disadvantages of this technology are presented. The results of material tests performed on the test model of the insulator are included. The usefulness of selected materials and technologies for the use in the production was asceratained

Technology of bushing for turbo-powergenerator

W artykule przedstawiono rozwiązanie technologiczne wykonania izolatora przepustowego do turbogeneratora elektroenergetycznego. Opracowane izolatory będą miały polimerową zewnętrzną izolację elektryczną spełniającą wymagania dotyczące izolatorów przepustowych dla generatorów elektroenergetycznych. Przewiduje się, że opracowane izolatory będą tańsze od ich importowanych odpowiedników. Przedstawiono opracowanie konstrukcji oraz technologii wykonania izolatorów przepustowych dla elektroenergetycznych turbogeneratorów średniego napięcia, spełniających funkcję izolowania elektrycznego elementów turbogeneratora, jak również funkcję przeprowadzenia toru prądowego z wnętrza generatora do sieci elektroenergetycznej. Rozwiązanie konstrukcyjne wykonano w oparciu o epoksydowy kompozyt lany. Wytworzenie prototypów izolatorów wymagało wykonania szeregu badań materiałowych parametrów: elektrycznych, mechanicznych, cieplnych i środowiskowych mających na celu optymalny dobór konstrukcji izolatorów oraz zagwarantowanie technologiczności wykonania, co jest istotne przy wdrożeniu rozwiązania do produkcji na skalę techniczną. Przedstawiono zalety i wady tej technologii. Zaprezentowano wyniki badań materiałowych wykonanych na próbnych modelach tego izolatora. Stwierdzono przydatność wybranych materiałów i technologii do zastosowania w przewidywanej produkcji.The article presents a bushing technology implementation to turbo power. A polymeric insulators outer electrical insulation that meets the requirements for bushings for power generators have been developed. It was anticipated that the developed bushings would be cheaper than the imported ones. The paper presents the design and technology of bushings for high voltage electrical turbogenerators, which role is to be an electrical insulation of turbogenerator elements, as well as to be a path for current from the inside of the generator to the grid. The body of bushing was made from epoxy composite using cast method. For the optimal selection of the construction of insulators and to ensure manufacturability, the execution of prototypes of insulators needed a series of studies of material parameters: electrical, mechanical, thermal and taking into account of the environmental policies, which is important in implementing solutions for large scale production. Advantages and disadvantages of this technology are presented. The results of material tests performed on the test model of the insulator are included. The usefulness of selected materials and technologies for the use in the production envisaged

Modélisation du comportement hydromécanique d’un joint rocheux sous contrainte normale

Cet article présente une modélisation du comportement normal, hydromécanique, d’un joint rocheux. Souvent, un tel comportement est décrit par des relations empiriques permettant de reproduire la non-linéarité de la courbe d’écrasement (l’effet d’hystérésis observé pendant la réourverture du joint est rarement modélisé). Le modèle que nous exposons ici est une approche physique du processus d’écrasement. La rugosité du joint est prise en compte par un modèle géométrique composé d’un ensemble de plots de hauteurs et surfaces différentes qui se mettent successivement en contact avec l’augmentation de la contrainte normale. La non-réversibilité à la réouverture est obtenue en prenant un comportement élastoplastique avec écrouissage cinématique pour le plot. Moyennant l’identification de quelques paramètres par méthode inverse, il est possible avec ce modèle de reproduire avec une bonne corrélation le comportement de joints de roches de natures différentes (granité ; marbre...). Le modèle permet de trouver la surface en contact des différents plots et donc en cas de pression de liquide de définir une notion du type contrainte effective. On reproduit dans ce cas assez fidèlement le comportement d’une fracture sous contrainte normale et pression interne. Cette approche permet de calculer l’ouverture moyenne du joint, localement en fonction de la contrainte et de la pression. A partir de cette ouverture et de l’utilisation d’une loi classique d’écoulement - la loi cubique - il est possible de modéliser le comportement hydraulique du joint et d’y évaluer la distribution des pressions. De nouveau la correspondance entre la simulation et les résultats expérimentaux est bonne

On the possibility of obtaining a physical map of genomes by photoelectron imaging.

Photoelectron imaging provides the possibility of a new method of mapping chromosomes. The basic concept is to cause DNA to emit electrons under the action of UV light. The criteria which must be met to map genomes by photoelectron imaging are set forth and discussed. Forming an image of the DNA by accelerating and focusing the electrons is a necessary but not sufficient condition for genome mapping. Equally important is to identify wavelengths of UV light which will cause selective emission from the base pairs, adenine-thymine and guanine-cytosine. The resulting image would then contain a modulation in the image brightness along the DNA duplex. By examining the photoelectron current from uniform films of homopolymers, a wavelength region is identified where marked differences in emission from base pairs is observed. At 160 nm, for example, the relative electron emission from a film of poly(dGdC) is approximately 5 times greater than for an equivalent film of poly(dAdT). Using the experimental data and known sequences, photoelectron gene maps are calculated for the bacteriophage lambda and for a short interspersed repetitive DNA sequence (an Alu repeat) of the human genome. The results suggest that a 5-nm physical map of chromosomes generated by photoelectron imaging would be informative and useful in mapping human and other large genomes

Biological photocathodes.

Biological surfaces emit electrons when subjected to UV light. This emission is increased greatly after exposure to cesium vapor. Increases from 2 to 3 orders of magnitude are observed, depending on the biochemicals present. Heme and chlorophyll exhibit unusually high photoemission currents, which are increased further after cesiation. Photoemission from proteins and lipids is much less but also is increased by exposure to cesium. The formation of photocathodes with cesium greatly increases the practical magnifications attainable in photoelectron microscopy of organic and biological specimens. Photoelectron micrographs taken at magnifications greater than or equal to X 100,000 of chlorophyll-rich thylakoid membranes and of colloidal gold-labeled cytoskeleton preparations of cultured epithelial cells demonstrate the improvement in magnification. The selectivity and stability of the photocathodes suggest the possibility of detecting chromophore binding proteins in membranes and the design of photoelectron labels for tagging specific sites on biological surfaces