More sophisticated than a drink cooler or an old sphygmomanometer but still not adequate for prehospital blood: A market review of commercially available equipment for prehospital blood transport and administration.

BACKGROUND: Hemorrhage is the leading cause of death in trauma patients with most fatalities occurring before reaching a higher level of care-this applies to both the civilian setting and the military combat setting. Hemostatic resuscitation with increased emphasis on blood transfusion while limiting use of crystalloids has become routine in trauma care. However, the prehospital setting-especially in combat-presents unique challenges with regard to storage, transport, and administration. We sought to evaluate available technology on the market for storage and administration technology that is relevant to the prehospital setting. STUDY DESIGN AND METHODS: We conducted a market review of available technology through subject-matter expert inquiry, reviews of published literature, reviews of Federal Drug Administration databases, internal military publications, and searches of Google. RESULTS: We reviewed and described a total of 103 blood transporters, 22 infusers, and 6 warmers. CONCLUSIONS: The risk of on-scene fatality in trauma patients and recent developments in trauma care demonstrate the need for prehospital transfusion. These transfusions have been logistically prohibited in many operations. We have reviewed the current commercially available equipment and recommended pursuit of equipment that improves accessibility to field transfusion. Current technology has limited applicability for the prehospital setting and is further limited for the military setting.

Health benefits of electrically-assisted cycling: a systematic review.

BACKGROUND: Electrically assisted bicycles (e-bikes) have been highlighted as a method of active travel that could overcome some of the commonly reported barriers to cycle commuting. The objective of this systematic review was to assess the health benefits associated with e-cycling. METHOD: A systematic literature review of studies examining physical activity, cardiorespiratory, metabolic and psychological outcomes associated with e-cycling. Where possible these outcomes were compared to those from conventional cycling and walking. Seven electronic databases, clinical trial registers, grey literature and reference lists were searched up to November 2017. Hand searching occurred until June 2018. Experimental or observational studies examining the impact of e-cycling on physical activity and/or health outcomes of interest were included. E-bikes used must have pedals and require pedalling for electric assistance to be provided. RESULTS: Seventeen studies (11 acute experiments, 6 longitudinal interventions) were identified involving a total of 300 participants. There was moderate evidence that e-cycling provided physical activity of at least moderate intensity, which was lower than the intensity elicited during conventional cycling, but higher than that during walking. There was also moderate evidence that e-cycling can improve cardiorespiratory fitness in physically inactive individuals. Evidence of the impact of e-cycling on metabolic and psychological health outcomes was inconclusive. Longitudinal evidence was compromised by weak study design and quality. CONCLUSION: E-cycling can contribute to meeting physical activity recommendations and increasing physical fitness. As such, e-bikes offer a potential alternative to conventional cycling. Future research should examine the long-term health impacts of e-cycling using rigorous research designs.

How to transport veterinary drugs in insulated boxes to avoid thermal damage by heating or freezing.

BACKGROUND: The transport of veterinary drugs must comply with the general standards for drug storage. Although many vehicles are equipped with active heating and/or cooling devices assuring recommended storage conditions, simple insulated transport boxes are also often used. In this study, measurements for typical transport boxes were performed under laboratory conditions by the use of a climate chamber for a temperature of -20 °C and 45 °C to investigate the impact of box size, insulation material, liquid vs. dry filling products, filling degree and other parameters on the thermal performance of insulated boxes. Model calculations and instructions are presented to predict the retention time of recommended drug storage temperatures. RESULTS: The measurements and the model calculations showed that the loading of the transport boxes with additional water bottles to increase the heat capacity is appropriate to prolong the retention time of the recommended temperature range of the drugs. Insulated transport boxes are not suitable to store drugs over a period of more than approximately 12 h. For practical use a recipe is presented to measure the thermal properties of a transport box and the related retention time for which the recommended storage temperatures can be assured. CONCLUSIONS: The following principles for drug transportation in vehicles are recommended: (1) Before transfer into boxes, drugs should always be thermally preconditioned (2) Increase the filling degree of the boxes with thermally preconditioned water bottles or re-usable thermal packs will increase the heat capacity. Do not deep-freeze the bottles or packs below 0 °C to avoid drug freezing due to contact. (3) Open the lid of the boxes only to uncase drugs that are immediately needed. (4) The bigger the box and the higher the filling degree, the longer the retention time of the transport box. (5) Wherever possible, place the drug box at a cool site inside the vehicle. (6) The monitoring of the inside temperature of the transport boxes is recommended. By the proper use of such transport boxes the recommended temperatures can be maintained over one working day.

Pedelecs as a physically active transportation mode.

INTRODUCTION: Pedelecs are bicycles that provide electric assistance only when a rider is pedaling and have become increasingly popular. PURPOSE: Our purpose was to quantify usage patterns over 4 weeks of real-world commuting with a pedelec and to determine if pedelec use would improve cardiometabolic risk factors. METHODS: Twenty sedentary commuters visited the laboratory for baseline physiological measurements [body composition, maximum oxygen consumption ([Formula: see text]), mean arterial blood pressure (MAP), blood lipid profile, and 2-h oral glucose tolerance test (OGTT)]. The following 4 weeks, participants were instructed to commute using a pedelec at least 3 days week(-1) for 40 min day(-1) while wearing a heart rate monitor and a GPS device. Metabolic equivalents (METS) were estimated from heart rate data. Following the intervention, we repeated the physiological measurements. RESULTS: Average total distance and time were 317.9 ± 113.8 km and 15.9 ± 3.4 h, respectively. Participants averaged 4.9 ± 1.2 METS when riding. Four weeks of pedelec commuting significantly improved 2-h post-OGTT glucose (5.53 ± 1.18-5.03 ± 0.91 mmol L(-1), p < 0.05), [Formula: see text] (2.21 ± 0.48-2.39 ± 0.52 L min(-1), p < 0.05), and end of [Formula: see text] test power output (165.1 ± 37.1-189.3 ± 38.2 W, p < 0.05). There were trends for improvements in MAP (84.6 ± 10.5-83.2 ± 9.4 mmHg, p = 0.15) and fat mass (28.6 ± 11.3-28.2 ± 11.4 kg, p = 0.07). CONCLUSION: Participants rode a pedelec in the real world at a self-selected moderate intensity, which helped them meet physical activity recommendations. Pedelec commuting also resulted in significant improvements in 2-h post-OGTT glucose, [Formula: see text], and power output. Pedelecs are an effective form of active transportation that can improve some cardiometabolic risk factors within only 4 weeks.

Towards the lean lab: the industry challenge.

In anatomic pathology, the current state encompassing the pre-analytic processes of tissue collection, handling, examination, preparation, processing, and storage are largely uncontrolled, inconsistently performed, and/or not standardized according to the sound scientific data. Pre-analytic defects result in nearly three-quarters of the problems in laboratory diagnostics. This is evident in quality surveys from well-respected institutions that document high miss rates in the required basics of information related to patient and tissue identity, let alone parameters documenting quality aspects related to the surgical specimen and its preservation. This talk will describe the historical approach to tissue processing and identify gaps from worldwide observations in current laboratory practices. It will also offer potential methodological and technological solutions and process improvements that laboratories may consider in serving the ultimate users of pathology information: the clinician and the patient. It illustrates the need for scientifically validated specimen guidelines and a performance based, standardized and documented "chain of custody" of the pre-analytical steps from the patient's body through fixation. For thought leaders and professional standard setters, opportunities for optimizing molecular studies exist in specimen collection, transfer, grossing, fixation, and decalcification protocols. In this evolving era of molecular profiling and personalized therapeutic decision-making, a well-reasoned and coordinated focus on pre-analytic processes that optimizes specimens for subsequent testing will result in: Improved specimen quality for molecular testing Improved accuracy of diagnostic and molecular test results Reduced Turnaroundtimes for same-day diagnosis Enhanced satisfaction of clinicians and patients.

Validation of cold chain shipping environment for transport of allografts as part of a human tissue bank returns policy.

Human tissue is shipped to surgeons in the UK in either a freeze-dried or frozen state. To ensure quality and safety of the tissue, frozen tissue must be shipped in insulated containers such that tissue is maintained at an appropriate temperature. UK Blood Transfusion Service regulations state "Transportation systems must be validated to show maintenance of the required storage temperature" and also state that frozen, non-cryopreserved tissue "must be transported… at -20 °C or lower" (Guidelines for the Blood Transfusion Services in the United Kingdom, 8th Edn. 2013). To maintain an expiry date for frozen tissue longer than 6 months, the tissue must be maintained at a temperature of -40 °C or below. The objective of this study was to evaluate and validate the capability of a commercially available insulated polystyrene carton (XPL10), packed with dry ice, to maintain tissue temperature below -40 °C. Tissue temperature of a single frozen femoral head or a single frozen Achilles tendon, was recorded over a 4-day period at 37 °C, inside a XPL10 carton with dry ice as refrigerant. The data demonstrate that at 37 °C, the XPL10 carton with 9.5 kg of dry ice maintained femoral head and tendon tissue temperature below -55 °C for at least 48 h; tissue temperature did not rise above -40 °C until at least 70 h. Data also indicated that at a storage temperature lower than 37 °C, tissue temperature was maintained for longer periods.

Radiofrequency electromagnetic radiation exposure inside the metro tube infrastructure in Warszawa.

Antennas from various wireless communications systems [e.g. mobile phones base transceiver stations (BTS) and handsets used by passengers, public Internet access, staff radiophone transmitters used between engine-drivers and traffic operators] emitting radiofrequency electromagnetic radiation (RF-EMR) are used inside underground metro public transportation. Frequency-selective exposimetric investigations of RF-EMR exposure inside the metro infrastructure in Warsaw (inside metro cars passing between stations and on platforms) were performed. The statistical parameters of exposure to the E-field were analyzed for each frequency range and for a total value (representing the wide-band result of measurements of complex exposure). The recorded exposimetric profiles showed the dominant RF-EMR sources: handsets and BTS of mobile communication systems (GSM 900 and UMTS 2100) and local wireless Internet access (WiFi 2G). Investigations showed that the GSM 900 system is the dominant source of exposure - BTS (incessantly active) on platforms, and handsets - used by passengers present nearby during the tube drive. The recorded E-field varies between sources (for BTS were: medians - 0.22 V/m and 75th percentile - 0.37 V/m; and for handsets: medians - 0.28 V/m and 75th percentile - 0.47 V/m). Maximum levels (peaks) of exposure recorded from mobile handsets exceeded 10 V/m (upper limit of used exposimeters). Broadband measurements of E-field, including the dominant signal emitted by staff radiophones (151 MHz), showed that the level of this exposure of engine-drivers does not exceed 2.5 V/m.

[Implementation of modern approaches to medical equipment of medical service's troops].

Implementation of modern approaches to medical equipment of medical service's troops. The authors give essential characteristics of modern approaches to equipment of medical small and large units and troops. It is shown that for medical evacuation under field conditions it is neccessary to use modern complete-basic equipment that allows effectively providing medical assistance to the wounded and sick, maintaining the established level of readiness of medical troops, unifying norms of medical equipping, operatively deploying organisational stages of medical evacuation, optimizing planning of medical equipment. Medical equipment in peacetime should be carried out on the basis of standards and orders of medical care delivery that ensures harmonization with requirements of public health.

Adaptive super-twisting observer for estimation of random road excitation profile in automotive suspension systems.

The estimation of road excitation profile is important for evaluation of vehicle stability and vehicle suspension performance for autonomous vehicle control systems. In this work, the nonlinear dynamics of the active automotive system that is excited by the unknown road excitation profile are considered for modeling. To address the issue of estimation of road profile, we develop an adaptive supertwisting observer for state and unknown road profile estimation. Under Lipschitz conditions for the nonlinear functions, the convergence of the estimation error is proven. Simulation results with Ford Fiesta MK2 demonstrate the effectiveness of the proposed observer for state and unknown input estimation for nonlinear active suspension system.

Multiobjective robust design of the double wishbone suspension system based on particle swarm optimization.

The performance of the suspension system is one of the most important factors in the vehicle design. For the double wishbone suspension system, the conventional deterministic optimization does not consider any deviations of design parameters, so design sensitivity analysis and robust optimization design are proposed. In this study, the design parameters of the robust optimization are the positions of the key points, and the random factors are the uncertainties in manufacturing. A simplified model of the double wishbone suspension is established by software ADAMS. The sensitivity analysis is utilized to determine main design variables. Then, the simulation experiment is arranged and the Latin hypercube design is adopted to find the initial points. The Kriging model is employed for fitting the mean and variance of the quality characteristics according to the simulation results. Further, a particle swarm optimization method based on simple PSO is applied and the tradeoff between the mean and deviation of performance is made to solve the robust optimization problem of the double wishbone suspension system.

Further specimens of the Asian tiger mosquito Aedes albopictus (Diptera, Culicidae) trapped in southwest Germany.

After two previous demonstrations of introductions of the Asian tiger mosquito, Aedes albopictus, into southern Germany in 2007 and 2011, another three specimens were trapped in the city of Freiburg in the Upper Rhine Valley. The females were caught in early September 2011 (n = 2) and mid-July 2012 (n = 1). The trap was located at a railway container station where cargo is transferred to trains from trucks predominantly coming from southern Europe where A. albopictus is widely distributed. The reported findings confirm vehicle transport of A. albopictus to be an important and probably frequent mode of importation, and suggest that more regular and intense monitoring for invasive mosquito species in the Upper Rhine Valley should be undertaken in order to detect an establishment and implement adequate control measures in good time.

Acoustic scattering from a double periodically bulkheaded and ribbed finite cylindrical shell.

The sound scattering from a finite vacuumed cylindrical shell simultaneously loaded with the bulkheads and the ribs are studied. The motions of the shell are described by the Donnell equations. Each rib is modeled as a rod of circular curvature where only the normal force is applied. The motions of the bulkheads are decomposed into the out-plate bending motions and the in-plate extensional motions, which are independent of each other. The backscattered sound field is analyzed via the frequency-angle spectra. Compared against the backscattered sound from a ribbed cylindrical shell, the Bloch-Floquet waves disappear at low frequencies but still exist at mid and high frequencies. The Bragg scattering excited by the ribs is unchanged at mid and high frequencies. Besides the ribs' Bloch-Floquet waves and Bragg scattering, there exists the Bragg scattering excited by the bulkheads. The backscattering from a cylindrical shell loaded with just the bulkheads is calculated. When the spacing and the thickness of the bulkheads are equal to those of the ribs, the crests of the Bragg scattering and the Bloch-Floquet waves on the frequency-angle spectra are almost the same as those of the ribbed cylindrical shell. The resonances of the bulkheads are also excited in this case.

Underwater noise of small personal watercraft (jet skis).

Personal watercraft (water scooters, jet skis) were recorded under water in Bramble Bay, Queensland, Australia. Underwater noise emissions consisted of broadband energy between 100 Hz and 10 kHz due to the vibrating bubble cloud generated by the jet stream, overlain with frequency-modulated tonals corresponding to impeller blade rates and harmonics. Broadband monopole source levels were 149, 137, and 122 dB re 1 µPa @ 1 m (5th, 50th, and 95th percentiles). Even though these are lower than those of small propeller-driven boats, it is not necessarily the broadband source level that correlates with the bioacoustic impact on marine fauna.