Manipulating and dispensing liquids on the micrometre- and nanoscale is important in biotechnology and combinatorial chemistry, and also for patterning inorganic, organic and biological inks. Several ...methods for dispensing liquids exist, but many require complicated electrodes and high-voltage circuits. Here, we show a simple way to draw attolitre liquid droplets from one or multiple sessile drops or liquid film reservoirs using a pyroelectrohydrodynamic dispenser. Local pyroelectric forces, which are activated by scanning a hot tip or an infrared laser beam over a lithium niobate substrate, draw liquid droplets from the reservoir below the substrate, and deposit them on the underside of the lithium niobate substrate. The shooting direction is altered by moving the hot tip or laser to form various patterns at different angles and locations. Our system does not require electrodes, nozzles or circuits, and is expected to have many applications in biochemical assays and various transport and mixing processes.
Acute brain injury (ABI) covers various clinical entities that may require invasive mechanical ventilation (MV) in the intensive care unit (ICU). The goal of MV, which is to protect the lung and the ...brain from further injury, may be difficult to achieve in the most severe forms of lung or brain injury. This narrative review aims to address the respiratory issues and ventilator management, specific to ABI patients in the ICU.
Patients with acute brain injury have been excluded in the majority of the randomized clinical trials which evaluated a lung protective strategy in patients with acute respiratory failure. It remains ...unclear if low tidal volume, higher PEEP levels and recruitment maneuvers by increasing both the intracranial and intrathoracic pressure and by leading to a permissible hypercapnia could furthermore deteriorate the acute brain injury and the final outcome. Mechanical power has been associated with the outcome in ARDS patients without brain injury. Jiang et al. demonstrated in neurocritical patients that non-survivors had a higher mechanical power compared to survivors. Mechanical power was associated with an increase in intensive care mortality risk and also to an enhanced risk of hospital mortality, prolonged intensive care length of stay and fewer ventilatory free days; in addition, the mechanical power could better predict mortality compared to the Glasgow Coma Scale.
Aggressive fibromatosis (AF) is a monoclonal proliferative disease but does not metastasize and does not dedifferentiate to a high-grade malignancy in case of recurrence. Biopsy is usually necessary ...to confirm the diagnosis. A hallmark is its apparent unpredictable clinical course producing a large heterogeneity even with an indistinguishable morphology. Additional studies of the molecular determinants of desmoid behavior are needed to guide selection of the various therapeutic modalities. During the last 10 years, the treatment of AF has evolved and the role of routine, aggressive first-line treatment (radiotherapy and surgery) is now debated. If a wait-and-see policy is used at initial presentation, it is observed that >50% of patients will have relatively indolent disease. Aggressive treatments that take their indications from retrospective studies should be re-evaluated in the light of new data. The objective of this article is to propose an algorithm that commences with more conservative approaches before treatments that have associated long-term morbidity, the more aggressive therapies being reserved only for those who really need it.
Falling injuries pose serious health risks to people of all ages, and knowing the extent of exposure to irregular surfaces will increase the ability to measure fall risk. Current gait analysis ...methods require overly complicated instrumentation and have not been tested for external factors such as walking surfaces that are encountered in the real-world, thus the results are difficult to extrapolate to real-world situations. Artificial intelligence approaches (in particular deep learning networks of varied architectures) to analyze data collected from wearable sensors were used to identify irregular surface exposure in a real-world setting. Thirty young adults wore six Inertial Measurement Unit (IMU) sensors placed on their body (right wrist, trunks at the L5/S1 level, left and right thigh, left and right shank) while walking over eight different surfaces commonly encountered in the living community as well as occupational settings. Three variations of deep learning models were trained to solve this walking surface recognition problem: 1) convolution neural network (CNN); 2) long short term memory (LSTM) network and 3) LSTM structure with an extra global pooling layer (Global-LSTM) which learns the coordination between different data streams (e.g. different channels of the same sensor as well as different sensors). Results indicated that all three deep learning models can recognize walking surfaces with above 0.90 accuracy, with the Global-LSTM yielding the best performance at 0.92 accuracy. In terms of individual sensors, the right thigh based Global-LSTM model reported the highest accuracy (0.90 accuracy). Results from this study provide further evidence that deep learning and wearable sensors can be utilized to recognize irregular walking surfaces induced motion alteration and applied to prevent falling injuries.
•Falling injuries pose serious health risks to people of all ages.•AI methods were used to analyze wearable data to identify irregular surface exposure in a real-world setting•Three variations of deep learning models were trained to solve this walking surface recognition problem.•Results indicated that all three deep learning models can recognize walking surfaces with above 0.90 accuracy.•The Global-LSTM yielding the best performance at 0.92 accuracy.
Wrinkling has recently attracted an increasing interest by suggesting a number of unforeseeable applications in many emerging material science and engineering fields. If guided and somehow designed, ...wrinkles could be in fact used as an alternative printing way for realizing complex surface geometries and thus employed as an innovative bottom-up process in the fabrication of nano- and micro-devices. For these reasons, the prediction of wrinkles of films adhering on flat as well as on structured substrata is a challenging task, genesis and development of the phenomenon being not yet completely understood both when thin membranes are coupled with soft supports and in cases where the geometry of the surfaces are characterized by complex three-dimensional profiles. Here we investigate the experimental formation of new intriguing and somehow unforeseeable wrinkled patterns achieved on periodic structures, by showing prediction through a new hybrid analytical-numerical strategy capable to overcome some common obstacles encountered in modeling film wrinkling on flat and 3D-shaped substrata. The proposed approach, which drastically reduces the computational effort, furnishes a helpful way for predicting both qualitative and quantitative results in terms of wrinkling patterns, magnitude and wavelength, by also allowing to follow the onset of film instabilities and the progressive evolution of the phenomenon until its final stage.
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•We investigated the experimental formation of wrinkled patterns achieved on periodic structures;•Different parameters (substrates, coating metals and shapes) have been analysed;•Hybrid analytical-numerical strategy for predicting the onset, evolution of wrinkling in metal film on 3D-shaped substrates.•The results might be helpfully utilized for predicting hierarchical organizations of wrinkle patterns
Purpose
Single studies of Noninvasive Ventilation (NIV) in the management of acute respiratory failure in chest trauma patients have produced controversial findings. The aim of this study is to ...critically review the literature to investigate whether NIV reduces mortality, intubation rate, length of stay and complications in patients with chest trauma, compared to standard therapy.
Methods
We performed a systematic review and meta-analysis of randomized controlled trials, prospective and retrospective observational studies, by searching PubMed, EMBASE and bibliographies of articles retrieved. We screened for relevance studies that enrolled adults with chest trauma who developed mild to severe acute respiratory failure and were treated with NIV. We included studies reporting at least one clinical outcome of interest to perform a meta-analysis.
Results
Ten studies (368 patients) met the inclusion criteria and were included for the meta-analysis. Five studies (219 patients) reported mortality and results were quite homogeneous across studies, with a summary relative risk for patients treated with NIV compared with standard care (oxygen therapy and invasive mechanical ventilation) of 0.26 (95 % confidence interval 0.09–0.71,
p
= 0.003). There was no advantage in mortality of continuous positive airway pressure over noninvasive pressure support ventilation. NIV significantly increased arterial oxygenation and was associated with a significant reduction in intubation rate, in the incidence of overall complications and infections.
Conclusions
These results suggest that NIV could be useful in the management of acute respiratory failure due to chest trauma.
The anaerobic digestion (AD) process is influenced by a variety of operation parameters, such as sludge rheology, mixing, temperature, solid retention time (SRT), hydraulic retention time (HRT) and ...solids concentration. The optimum in the mixing lies somewhere between no-mixing and continuous mixing, as the lack or excessive mixing can lead to poor AD performance instead. A three-dimensional computational fluid dynamics steady/unsteady model, incorporating the rheological properties of the sludge, was developed and applied to quantify mixing in a full-scale anaerobic digester. Mechanical and gas mixing solutions were taken into account, keeping constant the daily energy consumption. Results, consisting of velocity magnitude and patterns, dead zone formation and turbulence levels were discussed. Compared to the mechanical mixing, gas mixing had lower percentage of dead zones (about 5% against 50%), larger maximum velocity (about 3 m/s against 1 m/s) as well as larger turbulent kinetic energy levels (0.24 m
/s
against 0.001 m
/s
).
Severe cases of coronavirus disease 2019 develop ARDS requiring admission to the ICU. This study aimed to investigate the ultrasound characteristics of respiratory and peripheral muscles of patients ...affected by COVID19 who require mechanical ventilation.
This is a prospective observational study. We performed muscle ultrasound at the admission of ICU in 32 intubated patients with ARDS COVID19. The ultrasound was comprehensive of thickness and echogenicity of both parasternal intercostal and diaphragm muscles, and cross-sectional area and echogenicity of the rectus femoris.
Patients who survived showed a significantly lower echogenicity score as compared with those who did not survive for both parasternal intercostal muscles. Similarly, the diaphragmatic echogenicity was significantly different between alive or dead patients. There was a significant correlation between right parasternal intercostal or diaphragm echogenicity and the cumulative fluid balance and urine protein output. Similar results were detected for rectus femoris echogenicity.
The early changes detected by echogenicity ultrasound suggest a potential benefit of proactive early therapies designed to preserve respiratory and peripheral muscle architecture to reduce days on MV, although what constitutes a clinically significant change in muscle echogenicity remains unknown.
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