Thermomechanical properties of Ni-Ti shape memory wires containing nanoscale precipitates induced by stress-assisted ageing.

This paper systematically examines the thermomechanical properties and phase transformation behaviour of slightly Ni-rich Ni-Ti biomedical shape memory wires containing homogeneously distributed nanoscale precipitates induced by stress-assisted ageing. In contrast to previous studies, particular attention is paid to the role of precipitates in impeding twin boundary movement (TBM) and its underlying mechanisms. The size and volume fraction of precipitates are altered by changing the ageing time. The martensitic transformation temperatures increase with prolonged ageing time, whereas the R-phase transformation temperature remains relatively unchanged. The stress-strain behaviour in different phase regions during both cooling and heating is comprehensively examined, and the underlying mechanisms for the temperature- and thermal-history-dependent behaviour are elucidated with the help of the established stress-temperature phase diagram. The effect of precipitates on TBM is explored by mechanical testing at 133K. It is revealed that the critical stress for TBM (σcr) increases with increasing ageing time. There is a considerable increase of 104MPa in σcr in the sample aged at 773K for 120min under 70MPa compared with the solution-treated sample, owing to the presence of precipitates. The Orowan strengthening model of twinning dislocations is insufficient to account for this increase in σcr. The back stress generation is the predominant mechanism for the interactions between precipitates and twin boundaries during TBM that give rise to the increase in σcr. Such results provide new insights into the thermomechanical properties of precipitate containing Ni-Ti biomedical shape memory wires, which are instructive for developing high-performance biomedical shape memory alloys.

Establishing intravenous access: a study of local anesthetic efficacy.

We performed a double-blind, randomized, prospective study to determine the local anesthetic that provided the best analgesia for insertion of an 18-gauge intravenous (i.v.) catheter and to determine whether alkalinization of lidocaine decreases the pain of intradermal injection. There were 280 healthy adult patients assigned randomly to seven different groups: benzyl alcohol 0.9% in normal saline, 2-chloroprocaine 3%, lidocaine 1%, lidocaine 1% with preservative, alkalinized lidocaine 1% with preservative, normal saline, and a control group that received i.v. catheter placement without previous drug injection. A 10-cm visual analog pain scale (VAPS) was used to obtain pain scores after pre-i.v. drug injection and after iv catheter insertion. Benzyl alcohol in normal saline (0.61 +/- 0.11) and alkalinized lidocaine (0.69 +/- 0.10) had the lowest mean pain scores for drug injection and these were significantly different from other drugs (P < 0.05). Alkalinized lidocaine (0.7 +/- 0.18) had the lowest mean pain score for i.v. catheter insertion with nothing (no previous drug injected) (3.47 +/- 0.38) and normal saline (3.97 +/- 0.18) had the highest mean pain scores (P < 0.05). We conclude that alkalinized lidocaine decreased the pain associated with its injection. Alkalinized lidocaine was the best local anesthetic for i.v. catheter placement. Benzyl alcohol in normal saline was also effective.

"Health care litigation: the arbitration alternative for dispute resolution.".

In the recent case of Gross v. Recabaren, the California Court of Appeal issued a decision favorable to physicians on the question of a patient's ability to bind his or her spouse to arbitrate claims for loss of consortium.