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Central Line (central + line)
Selected AbstractsCentral lines in patients with AV fistulaANAESTHESIA, Issue 8 2006R. M. Williamson No abstract is available for this article. [source] Characteristics of creeping discharge along aerial insulated wire under impulse voltages with various wave front durationsELECTRICAL ENGINEERING IN JAPAN, Issue 3 2007Toshiyuki Nishi Abstract When lightning occurs in the neighborhood of outdoor high-voltage distribution lines, creeping discharges propagate along the wire surface from the binding wire tip just after insulator flashover. These discharges give rise to various faults on distribution lines, for instance, disconnection and melting of wire, punch-through breakdown, and so on. We must clarify the creeping discharge characteristics associated with various inductive lightning surges from the viewpoint of safety in high-voltage distribution systems. In our previous paper, it was reported that the lengths and aspects of the negative creeping discharges were influenced by the wave front durations of impulse voltages applied to the central line with a grounded binding wire. The present study was performed to obtain more information on such creeping discharges. This paper describes the distinctive characteristics of a creeping discharge along the insulated wire surface when impulse voltages with various wave front durations are applied to the binding wire. © 2006 Wiley Periodicals, Inc. Electr Eng Jpn, 158(3): 29,37, 2007; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.20430 [source] THIS IS NOT AMERICA: EMBEDDING THE COGNITIVE-CULTURAL URBAN ECONOMYGEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 2 2010Robert C. Kloosterman ABSTRACT. The aim of this article is to broaden the epistemological basis for investigating the current shift to cognitive-cultural economies and the resurgence of cities and its socio-spatial articulation. The point of departure here is that the drivers of the structural changes are indeed more or less ubiquitous, but are played out in different national institutional and urban contexts resulting in potentially diverging cognitive-cultural economies. Four main drivers of change after 1980 are distinguished. The first is the rise of a new technological paradigm based on digital technology. The second is the thrust towards deregulation and privatization as planks of the neo-liberal political programme. The third is the intensification of all kinds of linkages between regions across the globe. The fourth driver constitutes the processes of individualization and increasing reflexivity that have fragmented consumer markets. By identifying distinct filters which might shape and mould the impact of these more general drivers on concrete urban areas, a comprehensive framework is presented that can be used to analyse and compare the trajectories of cities while linking them to a larger narrative of societal change. A central line of reasoning is that agglomeration economies , pivotal in Allen Scott's analysis of the emergence of a cognitive-cultural economy , are themselves embedded in concrete social and institutional contexts which impact on how they are played out. To make this point, we build upon Richard Whitley's business systems. Given this institutional diversity, we expect that various institutional contexts will generate different cognitive-cultural economies. [source] Central venous lines in haemophiliaHAEMOPHILIA, Issue 2003R. Ljung Summary., Infections and technical problems are the most frequent complications when using implantable central venous access devices in patients with haemophilia. There are two major experiences reported concerning infections in noninhibitor patients: one is approximately 0.2 infections per 1000 days and the other approximately 1.0 (0.7,1.6) per 1000 days. Infections are more frequent in inhibitor patients and approximately one infection per 6,12 months of use can be expected. The figures are low for clinically apparent thrombosis in the larger series on record, but routine venograms were not carried out in most of these series. In studies where this has been done, a high frequency of abnormalities on venograms has been seen in some but not in others. The final decision to use a central line has to take into account the medical goal, the patient's bleeding tendency, the social situation and the expected risk of complications at the particular haemophilia centre. Some of the complications may be reduced by adequate aseptic measures both during implantation and in subsequent use, and by clear basic routines for surveillance of the systems and repeated education of the users. [source] Blocked arrow central lineACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2008R. Gupta No abstract is available for this article. [source] Artifact due to B0 fluctuations in fMRI: Correction using the k- space central lineMAGNETIC RESONANCE IN MEDICINE, Issue 1 2001Emmanuel Durand Abstract Magnetic resonance experiments require the main magnetic field, B0, to remain very stable. Several external sources, such as moving ferromagnetic objects and/or changing electromagnetic fields, can significantly change the value of B0 over time. This work describes an apparent displacement along the phase-encoding axis caused by a variation in B0. This artifact was observed in fMRI images acquired with EPI. The effect was characterized and tested using an immobile phantom. The image displacement motion along the phase-encoding axis closely followed the changes in B0. The phase of the central line in the Fourier space was successfully used to correct this artifact. Fluctuations in B0 may result in artifacts that mimic subject head motion, and must be appropriately corrected. Magn Reson Med 46:198,201, 2001. © 2001 Wiley-Liss, Inc. [source] Critical management in patients with severe enterovirus 71 infectionPEDIATRICS INTERNATIONAL, Issue 3 2006JIEH-NENG WANG Abstract Objective: The aim of this study was to analyze clinical details occurring in children with severe enterovirus 71 (EV71) infection and synthesize the critical care experience for patients with severe EV71 infection. Methods: A retrospective clinical, laboratory, and hemodynamic study was performed in a pediatric intensive care unit in a university hospital. From March 1998 to April 2000, seven consecutive pediatric patients with severe EV71 infection were retrospectively analyzed as the comparison group. From May 2000 to March 2003, eight consecutive patients with severe EV71 infection who had received the protocol therapy were enrolled as the study group. Detailed information about clinical treatment and pharmacological therapy was collected for comparison. Results: The clinical presentations and laboratory findings between the comparison and the study groups were not significantly different. The amount of intravenous fluid in the first 24 h was significantly higher in the comparison group (9.2 ± 5.0 vs 4.9 ± 1.3 mL/kg per h). More patients in the study group received low doses of dopamine infusion, patients in the comparison group received more epinephrine, and none of them received milrinone. The acute-stage and long-term survival rates were higher in the study group (100% vs 43%, 87% vs 29%). Conclusion: Early cardiopulmonary support may prevent the vicious cycle of cardiopulmonary failure and improve the clinical outcome of severe EV71 infection. Milrinone may be the ideal inotropic agent for these patients. Echocardiography, a central line, and an arterial line could be an alternate method to replace direct intracardiac hemodynamic monitoring for guiding critical management. [source] QUASI-NATURALISM AND MORAL REALITYRATIO, Issue 1 2006Brad Majors In his recent book Moral Reality, Paul Bloomfield has put forward an original set of arguments for moral realism. Central to his treatment is an argument for the reality of moral properties, one which models them on the property of being healthy. The paper is a critical examination of Bloomfield's central line of argument. It is contended that his proposed method of grounding moral realism fails, inasmuch as his Distinction Test criterion for property reality , essentially the claim that a property exists if its existence is required for distinctions that we make and must make , is inadequate. An alternative approach toward properties is suggested, which has the result, inter alia, that Bloomfield's quasi-naturalistic approach is unnecessary for the defense of moral realism.1 [source] Hydrodynamics and Mass Transfer in Gas-Liquid-Solid Circulating Fluidized BedsCHEMICAL ENGINEERING & TECHNOLOGY (CET), Issue 12 2003Z. Liu Abstract Although extensive work has been performed on the hydrodynamics and gas-liquid mass transfer in conventional three-phase fluidized beds, relevant documented reports on gas-liquid-solid circulating fluidized beds (GLSCFBs) are scarce. In this work, the radial distribution of gas and solid holdups were investigated at two axial positions in a GLSCFB. The results show that gas bubbles and solid particles distribute uniformly in the axial direction but non-uniformly in the radial direction. The radial non-uniformity demonstrates a strong factor on the gas-liquid mass transfer coefficients. A local mass transfer model is proposed to describe the gas-liquid mass transfer at various radial positions. The local mass transfer coefficients appear to be symmetric about the central line of the riser with a lower value in the wall region. The effects of gas flow rates, particle circulating rates and liquid velocities on gas-liquid mass transfer have also been investigated. [source] Emergency Nurses' Utilization of Ultrasound Guidance for Placement of Peripheral Intravenous Lines in Difficult-access PatientsACADEMIC EMERGENCY MEDICINE, Issue 12 2004Larry Brannam MD Objectives: Emergency nurses (ENs) typically place peripheral intravenous (IV) lines, but if repeated attempts fail, emergency physicians have to obtain peripheral or central access. The authors describe the patient population for which ultrasound (US)-guided peripheral IVs are used and evaluate the success rates for such lines by ENs. Methods: This was a prospective observational study of ENs in a Level I trauma center with a census of 75,000, performing US-guided IV line placement on difficult-to-stick patients (repeated blind IV placement failure or established history). ENs were trained on an inanimate model after a 45-minute lecture. Surveys were filled out after each US-guided IV attempt on a patient. ENs could decline to fill out surveys, which recorded the reason for use of US, type of patient, and success. Successful cannulation was confirmed by drawing blood and flushing fluids. Descriptive statistics were used to evaluated data. Results: A total of 321 surveys were collected in a five-month period no ENs declined to participate. There were 280 (87%) successful attempts. Twelve (29%) of the 41 failure patients required central lines, 9 (22%) received external jugular IVs, and 20 (49%) had peripheral IV access placed under US guidance by another nurse or physician. Twenty-eight percent (90) of all patients were obese, 18% (57) had sickle cell anemia, 10% (31) were renal dialysis patients, 12% (40) were IV drug abusers, and 19% (61) had unspecified chronic illness. The remainder had no reason for difficult access given. There were four arterial punctures. Conclusions: ENs had a high success rate and few complications with use of US guidance for vascular access in a variety of difficult-access patients. [source] THE NEW INSTITUTIONAL ECONOMICS , A DIFFERENT APPROACH TO ECONOMIC ANALYSISECONOMIC AFFAIRS, Issue 3 2008Eirik G. Furubotn The initial objective of the paper is to describe the way in which the term ,New Institutional Economics' (NIE) emerged in the literature and became the designation for a new field concerned with the study of various analytical techniques designed for the exploration of institutional phenomena. It is then shown how some of the more important of these techniques, transaction-cost economics, property-rights analysis and contract theory, have been applied in two central lines of neoinstitutional thought , the Williamsonian and the Northian. Criticisms of these two disparate theoretical positions on the NIE are considered and assessed. Next, a brief review of some of the empirical literature is undertaken so that the explanatory powers of NIE themes can be gauged. Finally, the paper offers a few general remarks on the present state of the NIE and its possible influence on the further development of economics. [source] Assessment of a New Model for Femoral Ultrasound-guided Central Venous Access Procedural Training: A Pilot StudyACADEMIC EMERGENCY MEDICINE, Issue 1 2010Michael C. Wadman MD Abstract Objectives:, Repetitive practice with feedback in residency training is essential in the development of procedural competency. Lightly embalmed cadaver laboratories provide excellent simulation models for a variety of procedures, but to the best of our knowledge, none describe a central venous access model that includes the key psychomotor feedback elements for the procedure, namely intravascular contents that allow for determination of correct needle position by either ultrasonographic imaging and/or aspiration or vascular contents. Methods:, A cadaver was lightly embalmed using a technique that preserves tissue texture and elasticity. We then performed popliteal fossa dissections exposing the popliteal artery and vein. Vessels were ligated distally, and 14-gauge catheters were introduced into the lumen of each artery and vein. The popliteal artery and vein were then infused with 200 mL of icterine/gel and 200 mL of methylene blue/gel, respectively. Physician evaluators then performed ultrasound (US)-guided femoral central venous line placements and rated the key psychomotor elements on a five-point Likert scale. Results:, The physician evaluators reported a median of 10.5 years of clinical emergency medicine (EM) experience with an interquartile range (IQR) of 16 and a median of 10 central lines placed annually (IQR = 10). Physician evaluators rated the key psychomotor elements of the simulated procedure as follows: ultrasonographic image of vascular elements, 4 (IQR = 0); needle penetration of skin, 4.5 (IQR = 1); needle penetration of vein, 5 (IQR = 1); US image of needle penetrating vein, 4 (IQR = 2); aspiration of vein contents, 3 (IQR = 2); passage of dilator into vein, 4 (IQR = 2); insertion of central venous catheter, 5 (IQR = 1); US image of catheter insertion into vein, 5 (IQR = 1); and overall psychomotor feedback of the simulated procedure compared to the evaluators' actual patient experience, 4 (IQR = 1). Conclusions:, For the key psychomotor elements of central venous access, the lightly embalmed cadaver with intravascular water-soluble gel infusion provided a procedural model that closely simulated clinicians' experience with patients. ACADEMIC EMERGENCY MEDICINE 2010; 17:88,92 © 2009 by the Society for Academic Emergency Medicine [source] 29Si spin-lattice NMR relaxation in microporous silica-based materials with high Mn2+ concentrationsMAGNETIC RESONANCE IN CHEMISTRY, Issue 11 2006Vladimir I. Bakhmutov Abstract The 29Si T1 time measurements have been performed under magic angle spinning for supermicroporous Si/Mn materials 1,6 containing Mn2+ in concentrations of 0 (1), 1.2 (2), 2.5 (3), 3.8 (4), 15 (5) and 19.8 wt% (6). It has been found that the central lines, corresponding to isotropic chemical shifts, and their sidebands relax differently in samples 2,4 with relatively small Mn2+ contents. Because the relaxation curves for 1,6 are nonexponential and identical for 6 at spinning rates of 5, 10 and 12 kHz, dipolar relaxation via the paramagnetic centers is dominant. The relaxation data have been interpreted as a function of Mn2+ concentrations in terms of incorporation of the Mn2+ ions into the silica lattice when their concentration is small (,2.5 wt%). At higher concentrations, most of the manganese is located on the surface of the silica. Copyright © 2006 John Wiley & Sons, Ltd. [source] Needle-stick injuries from securing central linesANAESTHESIA, Issue 2 2007W Salamut No abstract is available for this article. [source] Serious Bacterial Infections in Febrile Outpatient Pediatric Heart Transplant RecipientsACADEMIC EMERGENCY MEDICINE, Issue 10 2009Shan Yin MD Abstract Objectives:, The purpose of this study was to describe the incidence of serious bacterial infections (SBIs) in febrile outpatient pediatric heart transplant recipients and to assess the utility of using white blood cell (WBC) indices to identify patients at low risk for bacteremia. Methods:, A retrospective study was conducted on all heart transplant recipients followed at a single children's hospital. All outpatient visits from January 1, 1995, to June 1, 2007, in which fever was evaluated were reviewed. Patients with history of a primary immunodeficiency, receiving concurrent chemotherapy, or having had a stem cell or small bowel transplant were excluded. Demographic, historical, physical examination, laboratory, and radiographic data were then recorded. Results:, Sixty-nine patients had 238 individual episodes of fever evaluation; of these, 217 (91.2%) had blood cultures drawn with results available in their initial evaluation. There were six (2.8%) true-positive blood cultures and eight (3.7%) false-positive cultures. Chest radiography was done in 185 evaluations (77.8%), and 44 episodes of pneumonia (23.8%) were diagnosed. Of 112 urine cultures done, one (0.9%) was positive. Neither of two lumbar punctures performed were positive. In non,ill-appearing children without indwelling central lines or focal bacterial infections (pneumonia, cellulitis), the incidence of bacteremia was 1.2%. In children with a focal bacterial infection, the rate of bacteremia was 6.3%. WBC indices were not significantly different between bacteremic and nonbacteremic patients. A band-to-neutrophil ratio (BNR) of ,0.25 and a published guideline for identifying low-risk infants using WBC indices identified all bacteremic patients, each with a sensitivity of 100% (95% confidence interval [CI] = 48% to 100% and 54% to 100%, respectively). Conclusions:, The incidence of bacteremia was low in febrile, outpatient pediatric heart transplant patients, especially in those who were not ill-appearing and did not have a focus of serious infection. Two different low-risk criteria performed well in identifying the bacteremic patients, although given the low number of true-positive cultures, the CIs for the sensitivities of these tests were extremely wide, and neither test could be reliably used at present. A prospective multicenter study is required to confirm the low incidence of bacteremia and low-risk criteria in this population. [source] Venous thromboembolism associated with the management of acute thrombotic thrombocytopenic purpuraBRITISH JOURNAL OF HAEMATOLOGY, Issue 5 2003Helen Yarranton Summary. Venous thromboembolism (VTE) is not a feature of thrombotic thrombocytopenic purpura (TTP), but there has been a recent report of VTE in association with plasma exchange (PEX) treatment for TTP using the solvent detergent (SD) plasma, PLAS+®SD. We reviewed the occurrence of VTE in 68 consecutive patients with TTP (25 men, 43 women). Eight documented VTE events [six deep venous thromboses (DVTs), three pulmonary emboli] were identified in seven patients (all female) during PEX therapy. All six DVTs were associated with central lines at the site of thrombosis. Other known precipitating factors included pregnancy, immobility, obesity and factor V Leiden heterozygosity. VTE occurred at a mean of 53 d following the first PEX. The European SD plasma, Octaplas® was the last plasma to be used in PEX prior to the VTE in 7/8 events. This is the first report of VTE following Octaplas® infusion. VTE is a multifactorial disease and, although several known precipitating factors were present in all patients in this study, the use of large volumes of SD plasma in PEX may be an additional risk factor. We recommend prevention of VTE with graduated elastic compression stockings (class I) at diagnosis and prophylactic low-molecular-weight heparin once the platelet count rises above 50 × 109/l. [source] | ||||||||||||||||||||||||||||