Measuring Venous Oxygen Saturation Using the Photoplethysmograph Waveform

The pulse oximeter is now a standard-of-care monitor. In its most basic form it measures the arterial oxygenation saturation. It accomplishes this through the use of the photoplethysmograph waveform (PPG) at two or more wavelengths. Advances in digital signal processing are allowing for a re-examination of these waveforms. It has been recognized for some time that the movement of venous blood can be detected (1, 2) using the PPG. For the most part, this phenomenon has been seen as a source of artifact which interferes with calculation of arterial saturation. On the other hand, if venous saturation can be reliably measured, interesting new possibilities are opened. We hypothesize that the PPG waveform, obtained non-invasively by modern pulse oximeters, can be analyzed via digital signal processing to infer the venous oxygen saturation

Protecting a Client’s Confidences: Recent Developments in Privileged Communication Between Attorneys and Accountants

oai:jlc.law-dev.library.pitt.edu:article/1The attorney-client privilege is one of the foundations of ourjurisprudence. Originally, designed to prevent attorneys from testifying against their clients, the privilege eventually evolved to reflect legal, societal, and financial complexities. This privilege depends on full disclosure and open communication between attorney and the client in order to provide competent and adequate representation. Today, attorneys often require and rely on expert guidance of accountants for various issues pertaining to litigation and transactional work.This article illustrates how the recent cases of Commissioner v. Comcast Corp. and United States v. Textron affect privileged communications in complex tax and transactional matters between attorneys and accountants retained for the purposes of client representation. The article also offers guidance on how to preserve privilege in communication between attorneys and accountants as waiver of such privilege may have significant and costly implications. At conclusion, unresolved issues pertaining to privileged communication are discussed and solutions are offered

Modulation of finger photoplethysmographic traces during forced respiration: venous blood in motion?

Photoplethysmographic (PPG) signals were recorded from the fingers of 10 healthy volunteers during forced respiratory inspiration. The aim of this pilot study was to assess the effect of negative airway pressure on the blood volumes within the tissue bed of the finger, and the resultant modulation of PPG signals. The acquired signals were analysed and oxygen saturations estimated from the frequency spectra in the cardiac and respiratory frequency ranges. Assuming that respiratory modulation affects blood volumes in veins to a greater extent than in arteries, the local venous oxygen saturation was estimated. Estimated venous oxygen saturation was found to be 3.1% (±4.2%) lower than the estimated arterial saturation

Cavitation-induced force transition in confined viscous liquids under traction

We perform traction experiments on simple liquids highly confined between parallel plates. At small separation rates, we observe a simple response corresponding to a convergent Poiseuille flow. Dramatic changes in the force response occur at high separation rates, with the appearance of a force plateau followed by an abrupt drop. By direct observation in the course of the experiment, we show that cavitation accounts for these features which are reminiscent of the utmost complex behavior of adhesive films under traction. Surprisingly enough, this is observed here in purely viscous fluids.Comment: Submitted to Physical Review Letters on May 31, 2002. Related informations on http://www.crpp.u-bordeaux.fr/tack.htm

Modification of the Two-Point Scaling Theory for the Description of the Phase Transition in Solution. Analysis of Sodium Octanoate Aqueous Solutions

On the basis of conventional scaling theory, the two-point scaling theory was modified in order to describe the influence of composition on the partial molar heat capacity and volume during the micellization process. To verify the theory, isobaric heat capacities and densities of aqueous sodium octanoate solutions were measured over wide composition and temperature ranges and the modified approach was used to analyze the calculated partial molar heat capacities and volumes of the surfactant in water. The results obtained indicate that the micellization process is subject to the scaling laws. The results were compared with those for other systems. Peculiar behavior of the critical indices was observed and correlated with the structure of the micelles

Phenotypic Characterization, Osteoblastic Differentiation, and Bone Regeneration Capacity of Human Embryonic Stem Cell-Derived Mesenchymal Stem Cells

To enhance the understanding of differentiation patterns and bone formation capacity of hESCs, we determined (1) the temporal pattern of osteoblastic differentiation of human embryonic stem cell derived mesenchymal stem cells (hESC-MSCs), (2) the influence of a three-dimensional matrix on the osteogenic differentiation of hESC-MSCs in long-term culture, and (3) the bone-forming capacity of osteoblast-like cells derived from hESC-MSCs in calvarial defects. Incubation of hESC-MSCs in osteogenic medium induced osteoblastic differentiation of hESC-MSCs into mature osteoblasts in a similar chronological pattern to human bone marrow stromal cells and primary osteoblasts. Osteogenic differentiation was enhanced by culturing the cells on three-dimensional collagen scaffolds. Fluorescent-activated cell sorting of alkaline phosphatase expressing cells was used to obtain an enriched osteogenic cell population for in vivo transplantation. The identification of green fluorescence protein and expression of human-specific nuclear antigen in osteocytes in newly formed bone verified the role of transplanted human cells in the bone regeneration process. The current cell culture model and osteogenic cell enrichment method could provide large numbers of osteoprogenitor cells for analysis of differentiation patterns and cell transplantation to regenerate skeletal defects.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78154/1/scd.2008.0310.pd

On Singularity Formation of a Nonlinear Nonlocal System

We investigate the singularity formation of a nonlinear nonlocal system. This nonlocal system is a simplified one-dimensional system of the 3D model that was recently proposed by Hou and Lei in [13] for axisymmetric 3D incompressible Navier-Stokes equations with swirl. The main difference between the 3D model of Hou and Lei and the reformulated 3D Navier-Stokes equations is that the convection term is neglected in the 3D model. In the nonlocal system we consider in this paper, we replace the Riesz operator in the 3D model by the Hilbert transform. One of the main results of this paper is that we prove rigorously the finite time singularity formation of the nonlocal system for a large class of smooth initial data with finite energy. We also prove the global regularity for a class of smooth initial data. Numerical results will be presented to demonstrate the asymptotically self-similar blow-up of the solution. The blowup rate of the self-similar singularity of the nonlocal system is similar to that of the 3D model.Comment: 28 pages, 9 figure

Chemistry and the Science of Transformation in Mary Shelley’s Frankenstein

This essay reads the novel in a new way, examining the way that Victor Frankenstein's chemical education (he does not train to be a doctor!) enables his creation of the monster. It reveals that chemists of the period had a different worldview to others where they saw the world in constant transformation and flux. I have written this essay co-written the introduction to the special issue, and co-edited the whole

Instantaneous venous oxygenation estimation using the Photoplethysmograph (PPG) waveform

In this study oesophageal photoplethysmograph data from eight patients under positive pressure ventilation were analysed in order to test the hypothesis that the modulations created by the ventilation in the AC Photoplethysmograph (PPG) signal could be used to estimate venous oxygen saturation. In order to estimate the instantaneous arterial and venous oxygen saturation Smoothed-pseudo Wigner-Ville Distribution (SPWVD) was utilised. The result from this study showed that there was no significant different in the conventional (time domain) arterial saturation and the instantaneous arterial saturation. However, the instantaneous venous oxygen saturation estimated with the ventilator modulation were significantly lower then the conventional arterial saturation (P=0.008) and also from the instantaneous arterial saturation (P=0.008)

Attracting Manifold for a Viscous Topology Transition

An analytical method is developed describing the approach to a finite-time singularity associated with collapse of a narrow fluid layer in an unstable Hele-Shaw flow. Under the separation of time scales near a bifurcation point, a long-wavelength mode entrains higher-frequency modes, as described by a version of Hill's equation. In the slaved dynamics, the initial-value problem is solved explicitly, yielding the time and analytical structure of a singularity which is associated with the motion of zeroes in the complex plane. This suggests a general mechanism of singularity formation in this system.Comment: 4 pages, RevTeX, 3 ps figs included with text in uuencoded file, accepted in Phys. Rev. Let