High voltage breakdown initiated by particle impact

High voltage breakdown initiated by particle impact across electrode ga

Ultrasound Guided Placement of Single-Lumen Peripheral Intravenous Catheters in the Internal Jugular Vein

Introduction: The peripheral internal jugular (IJ), also called the “easy IJ,” is an alternative to peripheral venous access reserved for patients with difficult intravenous (IV) access. The procedure involves placing a single-lumen catheter in the IJ vein under ultrasound (US) guidance. As this technique is relatively new, the details regarding the ease of the procedure, how exactly it should be performed, and the safety of the procedure are uncertain. Our primary objective was to determine the success rate for peripheral IJ placement. Secondarily, we evaluated the time needed to complete the procedure and assessed for complications. Methods: This was a prospective, single-center study of US-guided peripheral IJ placement using a 2.5-inch, 18-gauge catheter on a convenience sample of patients with at least two unsuccessful attempts at peripheral IV placement by nursing staff. Peripheral IJ lines were placed by emergency medicine (EM) attending physicians and EM residents who had completed at least five IJ central lines. All physicians who placed lines for the study watched a 15-minute lecture about peripheral IJ technique. A research assistant monitored each line to assess for complications until the patient was discharged. Results: We successfully placed a peripheral IJ in 34 of 35 enrolled patients (97.1%). The median number of attempts required for successful cannulation was one (interquartile range (IQR): 1 to 2). The median time to successful line placement was 3 minutes and 6 seconds (IQR: 59 seconds to 4 minutes and 14 seconds). Two lines failed after placement, and one of the 34 successfully placed peripheral IJ lines (2.9%) had a complication – a local hematoma. There were, however, no arterial punctures or pneumothoraces. Although only eight of 34 lines were placed using sterile attire, there were no line infections. Conclusion: Our research adds to the growing body of evidence supporting US-guided peripheral internal jugular access as a safe and convenient procedure alternative for patients who have difficult IV access

Slip or not slip? A methodical examination of the interface formation model using two-dimensional droplet spreading on a horizontal planar substrate as a prototype system

We consider the spreading of a thin two-dimensional droplet on a planar substrate as a prototype system to compare the contemporary model for contact line motion based on interface formation of Shikhmurzaev [Int. J. Multiphas. Flow 19, 589 (1993)], to the more commonly used continuum fluid dynamical equations augmented with the Navier-slip condition. Considering quasistatic droplet evolution and using the method of matched asymptotics, we find that the evolution of the droplet radius using the interface formation model reduces to an equivalent expression for a slip model, where the prescribed microscopic dynamic contact angle has a velocity dependent correction to its static value. This result is found for both the original interface formation model formulation and for a more recent version, where mass transfer from bulk to surface layers is accounted for through the boundary conditions. Various features of the model, such as the pressure behaviour and rolling motion at the contact line, and their relevance, are also considered in the prototype system we adopt.Comment: 45 pages, 18 figure

Continuous Glucose Monitoring: A Brief Review for Primary Care Practitioners

Glycated hemoglobin A1c (HbA1c) is routinely used as a marker of average glycemic control, but it fails to provide data on hypoglycemia and glycemic variability, both of which are associated with adverse clinical outcomes. Self-monitoring of blood glucose (SMBG), particularly in insulin-treated patients, is a cornerstone in the management of patients with diabetes. SMBG helps with treatment decisions that aim to reduce high glucose levels while avoiding hypoglycemia and limiting glucose variability. However, repeated SMBG can be inconvenient to patients and difficult to maintain in the long term. By contrast, continuous glucose monitoring (CGM) provides a convenient, comprehensive assessment of blood glucose levels, allowing the identification of high and low glucose levels, in addition to evaluating glycemic variability. CGM using newer detection and visualization systems can overcome many of the limitations of an HbA1c-based approach while addressing the inconvenience and fragmented glucose data associated with SMBG. When used together with HbA1c monitoring, CGM provides complementary information on glucose levels, thus facilitating the optimization of diabetes therapy while reducing the fear and risk of hypoglycemia. Here we review the capabilities and benefits of CGM, including cost-effectiveness data, and discuss the potential limitations of this glucose-monitoring strategy for the management of patients with diabetes

From Service to Experience: Understanding and Defining the Hospitality Business

Failure adequately to define or understand hospitality as a commercial phenomenon has created a fragmented academic environment and a schizophrenia in the industry that has the potential to limit its development as a global industry. This article suggests that, by redefining hospitality as behaviour and experience, a new perspective emerges that has exciting implications for the management of hospitality businesses. A framework to describe hospitality in the commercial domain is proposed. This framework suggests a focus on the host–guest relationship, generosity, theatre and performance, ‘lots of little surprises’, and the security of strangers – a focus that provides guests with experiences that are personal, memorable and add value to their lives

Analysis of Health Benefits Conferred by Lactobacillus Species from Kefir

peer-reviewedLactobacilli are among the most common microorganisms found in kefir; a traditional fermented milk beverage produced locally in many locations around the world. Kefir has been associated with a wide range of purported health benefits; such as antimicrobial activity; cholesterol metabolism; immunomodulation; anti-oxidative effects; anti-diabetic effects; anti-allergenic effects; and tumor suppression. This review critically examines and assesses these claimed benefits and mechanisms with regard to particular Lactobacillus species and/or strains that have been derived from kefir; as well as detailing further potential avenues for experimentation.Work in PWOTs laboratory is supported by grants from Science Foundation Ireland to APC Microbiome Ireland, and from the (Govt. Ireland) Department of Agriculture, Food and Marine FIRM scheme. Work in PCs laboratory is supported by grants from Science Foundation Ireland to APC Microbiome Ireland and Vistamilk, from the (Govt. Ireland) Department of Agriculture, Food and Marine FIRM scheme, Enterprise Ireland and by the EU (MASTER; an Innovation Action funded by the European Commission under the Horizon 2020 Programme under grant number 818368)

ArborX: A Performance Portable Geometric Search Library

Searching for geometric objects that are close in space is a fundamental component of many applications. The performance of search algorithms comes to the forefront as the size of a problem increases both in terms of total object count as well as in the total number of search queries performed. Scientific applications requiring modern leadership-class supercomputers also pose an additional requirement of performance portability, i.e. being able to efficiently utilize a variety of hardware architectures. In this paper, we introduce a new open-source C++ search library, ArborX, which we have designed for modern supercomputing architectures. We examine scalable search algorithms with a focus on performance, including a highly efficient parallel bounding volume hierarchy implementation, and propose a flexible interface making it easy to integrate with existing applications. We demonstrate the performance portability of ArborX on multi-core CPUs and GPUs, and compare it to the state-of-the-art libraries such as Boost.Geometry.Index and nanoflann