Ultrasonic locating devices for central venous cannulation: meta-analysis

OBJECTIVES: To assess the evidence for the clinical effectiveness of ultrasound guided central venous cannulation. DATA SOURCES: 15 electronic bibliographic databases, covering biomedical, science, social science, health economics, and grey literature. DESIGN: Systematic review and meta-analysis of randomised controlled trials. POPULATIONS: Patients scheduled for central venous access. INTERVENTION REVIEWED: Guidance using real time two dimensional ultrasonography or Doppler needles and probes compared with the anatomical landmark method of cannulation. DATA EXTRACTION: Risk of failed catheter placement (primary outcome), risk of complications from placement, risk of failure on first attempt at placement, number of attempts to successful catheterisation, and time (seconds) to successful catheterisation. DATA SYNTHESIS: 18 trials (1646 participants) were identified. Compared with the landmark method, real time two dimensional ultrasound guidance for cannulating the internal jugular vein in adults was associated with a significantly lower failure rate both overall (relative risk 0.14, 95% confidence interval 0.06 to 0.33) and on the first attempt (0.59, 0.39 to 0.88). Limited evidence favoured two dimensional ultrasound guidance for subclavian vein and femoral vein procedures in adults (0.14, 0.04 to 0.57 and 0.29, 0.07 to 1.21, respectively). Three studies in infants confirmed a higher success rate with two dimensional ultrasonography for internal jugular procedures (0.15, 0.03 to 0.64). Doppler guided cannulation of the internal jugular vein in adults was more successful than the landmark method (0.39, 0.17 to 0.92), but the landmark method was more successful for subclavian vein procedures (1.48, 1.03 to 2.14). No significant difference was found between these techniques for cannulation of the internal jugular vein in infants. An indirect comparison of relative risks suggested that two dimensional ultrasonography would be more successful than Doppler guidance for subclavian vein procedures in adults (0.09, 0.02 to 0.38). CONCLUSIONS: Evidence supports the use of two dimensional ultrasonography for central venous cannulation

Toward digital twins for sawmill production planning and control : benefits, opportunities and challenges

Sawmills are key elements of the forest product industry supply chain, and they play important economic, social, and environmental roles. Sawmill production planning and control are, however, challenging owing to severalfactors, including, but not limited to, the heterogeneity of the raw material. The emerging concept of digital twins introduced in the context of Industry 4.0 has generated high interest and has been studied in a variety of domains, including production planning and control. In this paper, we investigate the benefits digital twins would bring to the sawmill industry via a literature review on the wider subject of sawmill production planning and control. Opportunities facilitating their implementation, as well as ongoing challenges from both academic and industrial perspectives, are also studied

Simulation for Product Driven Systems

Due to globalisation, companies have to become more and more agile in order to face demand fluctuations and growing customisation needs. Indeed, the mass production market moves to a mass customization one, which could be defined as the production of a wide variety of end products at a low unit cost. During last years, many efforts have been done in order to improve operating system reactivity (with the Flexible Manufacturing initiative for example), but the manufacturing decision process did not really change, and then doesn't enable to fully make the most of these new operating system skills. Facing these new trends, a lot of new research works are focusing on identification technologies, like Auto-ID, biometry or vision ones. Radio Frequency Identification technology (RFID) represents a quick and safe way to track products, opening the way of linking informational and physical flows, and providing an accurate, real time vision of the shop floor. These new technologies appear like a catalyst to change the fifty years old way of controlling production through traditional MRP² systems

Offersøy camping. Konsekvensutredning for naturmiljø

Foreliggende konsekvensutreding knyttet til naturmiljø for planlagt utvidelse av Offersøy camping i Alstahaug kommune, er gjort på oppdrag fra tiltakshaver Offersøy camping. Med bakgrunn i registrerte vegetasjonstyper og vilt, primært fugl, har naturmiljøet i planområdet blitt vurdert å ha liten verdi (1,0) og influensområdet å ha middels verdi (2,0). Omfanget av tiltakene vurderes til middels negativt (-1,0) for planområdet og lite negativt (-0,5) for influensområdet. Tiltakets samlede konsekvens blir dermed lite negativt (-) for naturmiljøet i planområdet. Ingen avbøtende tiltak er foreslått.publishedVersio

Multi-agent systems negotiation to deal with dynamic scheduling in disturbed industrial context

International audienceIt is now accepted that using multi-agent systems (MAS) improve the reactivity to treat perturbation(s) within flexible manufacturing system. Intelligent algorithms shall be used to address these perturbation(s) and all smart decision entities within their environment have to continuously negotiate until their common and final goal is achieved. This paper proposes a negotiation-based control approach to deal with variability on a manufacturing system. It has initially formulated and modeled an environment in which all contributing entities or agents operate, communicate, and interact with each other productively. Then after, simulation and applicability implementation experiments on the basis of full-sized academic experimental platform have been conducted to validate the proposed control approach. Product and resource entities negotiate considering different key performance measures in order to set best priority-based product sequencing. This has been done with expectations that the applicability of the negotiation-based decision-making will be more adaptable to deal with perturbation(s) than another alternative decision-making approach called pure reactive control approach. The result showed that negotiation among the decisional entities has brought significant improvement in reducing makespan and hence conveyed better global performance of a manufacturing system

Direct contact of platelets and their released products exert different effects on human dendritic cell maturation

<p>Abstract</p> <p>Background</p> <p>Dendritic cells (DCs) are antigen presenting cells capable of inducing innate and adaptive immune responses. According to the stimulus and their maturation state, DCs induce immunogenic or tolerogenic responses. Platelets (PLTs), which are involved in haemostasis and inflammation, can also interact with DCs. In this study, we examined the effect of PLTs on DC maturation <it>in vitro</it>. Human monocyte-derived DCs were co-cultured for 2 days with homologous PLTs either in the same well or in 0.4 μm-pore size filter-separated compartments.</p> <p>Results</p> <p>Confocal microscopy showed the attachment of PLTs to DC membranes. The DC receptor involved in this interactions was found to be CD162. In addition, we observed that DCs co-cultured with PLTs in filter-separated compartments acquired a mature phenotype (high CD80, CD86, and intermediate CD83 expression; IL-12(p70) production; efficient stimulation of autologous CD4+ T cell proliferation), while DCs co-cultured with PLTs in the same compartment did not undergo phenotypic maturation, did not secrete IL-12(p70) or IL-1β, but instead induced moderate Th2-polarized T cell proliferation.</p> <p>Conclusion</p> <p>These data indicate that (i) PLTs secrete a soluble DC-activating factor that was demonstrated not to be soluble CD40-Ligand (CD154; as could have been expected from <it>in vivo </it>and previous <it>in vitro </it>work) but to be nucleotide, and (ii) that cell-to-cell contact did not induce DC maturation, possibly because nucleotide release by PLTs was prevented by direct contact with DCs. This work demonstrates that PLTs are active elements of the immune system that might play a role in balancing the ability of DCs to polarize T cell responses, therefore making them critical factors in transfusion processes.</p