A minimally invasive technique for closing an iatrogenic subclavian artery cannulation using the Angio-Seal closure device: two case reports

<p>Abstract</p> <p>Introduction</p> <p>In the two cases described here, the subclavian artery was inadvertently cannulated during unsuccessful access to the internal jugular vein. The puncture was successfully closed using a closure device based on a collagen plug (Angio-Seal, St Jude Medical, St Paul, MN, USA). This technique is relatively simple and inexpensive. It can provide clinicians, such as intensive care physicians and anesthesiologists, with a safe and straightforward alternative to major surgery and can be a life-saving procedure.</p> <p>Case presentation</p> <p>In the first case, an anesthetist attempted ultrasound-guided access to the right internal jugular vein during the preoperative preparation of a 66-year-old Caucasian man. A 7-French (Fr) triple-lumen catheter was inadvertently placed into his arterial system. In the second case, an emergency physician inadvertently placed a 7-Fr catheter into the subclavian artery of a 77-year-old Caucasian woman whilst attempting access to her right internal jugular vein. Both arterial punctures were successfully closed by means of a percutaneous closure device (Angio-Seal). No complications were observed.</p> <p>Conclusions</p> <p>Inadvertent subclavian arterial puncture can be successfully managed with no adverse clinical sequelae by using a percutaneous vascular closure device. This minimally invasive technique may be an option for patients with non-compressible arterial punctures. This report demonstrates two practical points that may help clinicians in decision-making during daily practice. First, it provides a practical solution to a well-known vascular complication. Second, it emphasizes a role for proper vascular ultrasound training for the non-radiologist.</p

Seatbelt use and risk of major injuries sustained by vehicle occupants during motor-vehicle crashes: A systematic review and meta-analysis of cohort studies

BackgroundIn 2004, a World Health Report on road safety called for enforcement of measures such as seatbelt use, effective at minimizing morbidity and mortality caused by road traffic accidents. However, injuries caused by seatbelt use have also been described. Over a decade after publication of the World Health Report on road safety, this study sought to investigate the relationship between seatbelt use and major injuries in belted compared to unbelted passengers.MethodsCohort studies published in English language from 2005 to 2018 were retrieved from seven databases. Critical appraisal of studies was carried out using the Scottish Intercollegiate Guidelines Network (SIGN) checklist. Pooled risk of major injuries was assessed using the random effects meta-analytic model. Heterogeneity was quantified using I-squared and Tau-squared statistics. Funnel plots and Egger's test were used to investigate publication bias. This review is registered in PROSPERO (CRD42015020309).ResultsEleven studies, all carried out in developed countries were included. Overall, the risk of any major injury was significantly lower in belted passengers compared to unbelted passengers (RR 0.47; 95%CI, 0.29 to 0.80; I-2=99.7; P=0.000). When analysed by crash types, belt use significantly reduced the risk of any injury (RR 0.35; 95%CI, 0.24 to 0.52). Seatbelt use reduces the risk of facial injuries (RR=0.56, 95% CI=0.37 to 0.84), abdominal injuries (RR=0.87; 95% CI=0.78 to 0.98) and, spinal injuries (RR=0.56, 95% CI=0.37 to 0.84). However, we found no statistically significant difference in risk of head injuries (RR=0.49; 95% CI=0.22 to 1.08), neck injuries (RR=0.69: 95%CI 0.07 to 6.44), thoracic injuries (RR 0.96, 95%CI, 0.74 to 1.24), upper limb injuries (RR=1.05, 95%CI 0.83 to 1.34) and lower limb injuries (RR=0.77, 95%CI 0.58 to 1.04) between belted and non-belted passengers.ConclusionIn sum, the risk of most major road traffic injuries is lower in seatbelt users. Findings were inconclusive regarding seatbelt use and susceptibility to thoracic, head and neck injuries during road traffic accidents. Awareness should be raised about the dangers of inadequate seatbelt use. Future research should aim to assess the effects of seatbelt use on major injuries by crash type

A review of composite product data interoperability and product life-cycle management challenges in the composites industry

A review of composite product data interoperability and product life-cycle management challenges is presented, which addresses “Product Life-cycle Management”, developments in materials. The urgent need for this is illustrated by the life-cycle management issues faced in modern military aircraft, where in-service failure of composite parts is a problem, not just in terms of engineering understanding, but also in terms of the process for managing and maintaining the fleet. A demonstration of the use of ISO 10303-235 for a range of through-life composite product data is reported. The standardization of the digital representation of data can help businesses to automate data processing. With the development of new materials, the requirements for data information models for materials properties are evolving, and standardization drives transparency, improves the efficiency of data analysis, and enhances data accuracy. Current developments in Information Technology, such as big data analytics methodologies, have the potential to be highly transformative

JESS-BASED WEB INTERFACE FOR XML DOCUMENT VALIDATION

Ensuring consistency among data exchange specifications in XML is critical to seamless integration of various business-to-business (B2B) applications. To this end, a specification should be thoroughly verified in manifold perspectives such as grammar/syntax conformance, design compliance, and canonical semantics accordance. A single hand-woven testbed implementation will fail to versatilely support such a variety of testings. In this paper, we propose a novel validation tool of XML documents using an expert system and open validation rule scripts. Particularly, we illustrate a web-based implementation to ensure an XML schema&apos;s design compliance to design and naming rules (NDR), namely a quality of schema design (QoD) test. (C) 2007 Elsevier Ltd. All rights reserved.X11sciescopu

Allocation of manufacturers through internet-based collaboration for distributed process planning

The pursuit of lower cost, shorter time-to-market, and better quality has led to a shift toward global production in today&apos;s competitive business environment. This shift however, forces manufacturing enterprises to have separate design houses and manufacturing facilities. In general, design houses are located in the same regions as customers to enable them to respond to the rapidly changing demands of customers. By contrast, manufacturing facilities can be placed in regions in which production costs are lower. However, this physical and logical separation between designers and manufacturers (or between upstream manufacturers and downstream manufacturers) raises various integration issues. The present paper addresses two of these issues: the framework for representing the data necessary to communicate requirements and objectives of the designer, and the methodology for utilizing such data to optimize the business objectives related to production cost and quality. The proposed representation, collaboration framework, and methodology will enable design houses and manufacturing facilities to realize the benefits of global production and to accommodate the management of loosely integrated supply chains.X115sciescopu

A Kernel Method for Measuring Structural Similarity between XML Documents

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Discovering and integrating distributed manufacturing services with semantic manufacturing capability profiles

Integrating distributed manufacturing systems is a longstanding dream of industrial engineers. The advent of internet technologies has provided opportunities to fulfill this dream, and has presented new challenges to overcome. Since most current internet technologies (e.g. SOA, web service) originated in business applications, it is difficult to apply them directly to manufacturing systems. The difficulties stem particularly from differences in meaning and usage of manufacturing terms and an inability to express semantic information about manufacturing services. The present paper aims to extend the universal description, discovery, and integration (UDDI) registry specification to include semantic descriptions about manufacturing services and to support reasoning of those descriptions for service discovery. Specifically, we provide OWL-based definitions for manufacturing service capability profiles and a description logic (DL)-based reasoning procedure for matching queries to service descriptions. An illustrative process is presented with a prototype implementation for a discrete part manufacturing case.X1127sciescopu

Using business process specifications and agents to integrate a scenario-driven supply chain

In today&apos;s increasingly competitive global market, most enterprises place great stress on reducing order fulfillment costs, minimizing time-to-market and maximizing product quality. The desire of businesses to achieve these goals has seen a shift from a make-to-stock paradigm to a make-to-order paradigm. The success of the make-to-order paradigm requires robust and efficient supply chain integration and implementation in the business-to-business (B2B) environment. Recent Internet-based approaches to this problem have enabled efficient and effective information sharing among trading partners (i.e., customers, manufacturers and suppliers). Here we present an integration framework for supply chain operations among trading partners in the B2B environment. A supply chain scenario is formed, for which an integration framework is proposed by using the concepts of business process specifications (BPS) and agent technology. The BPS with message choreographies among the trading partners is detailed by using a modified unified modelling language (UML). The behaviour of the enterprise applications within each trading partner is modelled as agent concepts by using Petri-nets, which depict how the enterprise applications respond to external events specified in the BPS. The concepts and models proposed in this paper should provide the starting point for the formulation of a structured approach to B2B supply chain integration and implementation.X114sciescopu

Integration framework of process planning based on resource independent operation summary to support collaborative manufacturing

In today&apos;s global manufacturing environment, manufacturing functions are distributed as never before. Design, engineering, fabrication, and assembly of new products are done routinely in many different enterprises scattered around the world. Successful business transactions require the sharing of design and engineering data on an unprecedented scale. This paper describes a framework that facilitates the collaboration of engineering tasks, particularly process planning and analysis, to support such globalized manufacturing activities. The information models of data and the software components that integrate those information models are described. The integration framework uses an Integrated Product and Process Data ( IPPD) representation called a Resource Independent Operation Summary (RIOS) to facilitate the communication of business and manufacturing requirements. Hierarchical process modelling, process planning decomposition and an augmented AND/OR directed graph are used in this representation. The Resource Specific Process Planning (RSPP) module assigns the required equipment and tools, selects process parameters, and determines manufacturing costs based on two-level hierarchical RIOS data. The shop floor knowledge ( resource and process knowledge) and a hybrid approach ( heuristic and linear programming) to linearize the AND/OR graph provide the basis for the planning. Finally, a prototype system is developed and demonstrated with an exemplary part. Java and XML ( Extensible Mark-up Language) are used to ensure software and information portability.X1114sciescopu