Characteristics of oxygen concentration and the role of correction factor in real-time GI breath test.

OBJECTIVE: A high quality end-expiratory breath sample is required for a reliable gastrointestinal breath test result. Oxygen (O2) concentration in the breath sample can be used as a quality marker. This study investigated the characteristics of O2 concentration in the breath sample and the impact of using a correction factor in real-time breath measurement. DESIGN: This study includes two separate groups of patient data. Part 1 of the study analysed the patient's ability to deliver end-expiratory breath samples over a 2-year period (n=564). Part 2 of the study analysed a separate group of patients (n=47) with additional data to investigate the O2 characteristics and the role of correction factor in breath test. RESULTS: The results indicated 95.4% of 564 patients were able to achieve an O2 concentration below 14% in their end-expiratory breath. Part 2 of the study revealed that the distribution of O2 concentration was between 9.5% and 16.2%. Applying a correction factor to predict the end-expiratory H2 and CH4 values led to an average measurement error of -36.4% and -12.8%, respectively. CONCLUSION: The majority of patients are able to deliver a high quality end-expiratory breath sample, regardless of age or gender. The correction factor algorithm is unreliable when predicting the end-expiratory result at 15% O2 and it would have resulted in false negative result for 50% of the positive cases in this study. It has also indicated that the continuous O2 measurement is essential to ensure breath sample quality by preventing secondary breathing during real-time breath collection.

A simple method to estimate flow restriction for dual ventilation of dissimilar patients: The BathRC model.

BACKGROUND: With large numbers of COVID-19 patients requiring mechanical ventilation and ventilators possibly being in short supply, in extremis two patients may have to share one ventilator. Careful matching of patient ventilation requirements is necessary. However, good matching is difficult to achieve as lung characteristics can have a wide range and may vary over time. Adding flow restriction to the flow path between ventilator and patient gives the opportunity to control the airway pressure and hence flow and volume individually for each patient. This study aimed to create and validate a simple model for calculating required flow restriction. METHODS AND FINDINGS: We created a simple linear resistance-compliance model, termed the BathRC model, of the ventilator tubing system and lung allowing direct calculation of the relationships between pressures, volumes, and required flow restriction. Experimental measurements were made for parameter determination and validation using a clinical ventilator connected to two test lungs. For validation, differing amounts of restriction were introduced into the ventilator circuit. The BathRC model was able to predict tidal lung volumes with a mean error of 4% (min:1.2%, max:9.3%). CONCLUSION: We present a simple model validated model that can be used to estimate required flow restriction for dual patient ventilation. The BathRC model is freely available; this tool is provided to demonstrate that flow restriction can be readily estimated. Models and data are available at DOI 10.15125/BATH-00816.

Electromagnetic interference from lasers and intense light sources in the treatment of patients with artificial pacemakers and other implantable cardiac devices.

Measurements of the electric and magnetic field strengths surrounding six laser systems and one intense pulsed light system were carried out. The results were compared to exposure limits published by cardiac device manufacturers to assess the risk of electromagnetic interference to implantable cardiac devices such as pacemakers or implantable cardioverter defibrillators. The majority of lasers assessed in this study were found to produce electric and magnetic field strengths below the published exposure limits for cardiac devices. However, the low-frequency electric field and static magnetic field of both the CO2 laser and the ruby laser were found to exceed these limits. Ensuring that a small separation is maintained at all times between the laser unit and any patient with a pacemaker or implantable cardioverter defibrillator appears to be a sensible expedient in avoiding overexposure of an implantable cardiac device to electromagnetic interference. Due to the single-shot fast discharge nature of the intense pulsed light system, changes in electromagnetic field strength were too fast for some of the measuring equipment used in this study to register accurate readings during operation.

Light curing in orthodontics; should we be concerned?

OBJECTIVES: Light cured materials are increasingly used in orthodontic clinical practice and concurrent with developments in materials have been developments in light curing unit technology. In recent years the irradiances of these units have increased. The aim of this study was to determine the safe exposure times to both direct and reflected light. METHODS: The weighted irradiance and safe exposure times of 11 dental curing lights (1 plasma arc, 2 halogen and 8 LED lights) were determined at 6 distances (2-60 cm) from the light guide tip using a spectroradiometer. In addition, using the single most powerful light, the same two parameters were determined for reflected light. This was done at a distance of 10 cm from the reflected light, but during simulated bonding of 8 different orthodontic brackets of three material types, namely stainless steel, ceramic and composite. RESULTS: The results indicate that the LED Fusion lamp had the highest weighted irradiance and the shortest safe exposure time. With this light the maximum safe exposure time without additional eye protection for the patient (at 10 cm), the operator (at 30 cm) and the assistant (at 60 cm) ranged from 2.5 min, 22.1 min and 88.8 min respectively. This indicates a relatively low short term risk during normal operation of dental curing lights. For reflected light at a distance of 10 cm the risk was even lower, but was affected by the material and shape of the orthodontic bracket under test. SIGNIFICANCE: The short term risks associated with the use of dental curing lights, halogen, LED or plasma, appear to be low, particularly if as is the case adequate safety precautions are employed. The same is true for reflected light from orthodontic brackets during bonding. What is still unclear is the potential long term ocular effects of prolonged exposure to the blue light generated from dental curing lights.

Impact of Natural Organic Matter on H2O2-Mediated Oxidation of Fe(II) in Coastal Seawaters.

Whereas the oxidation of inorganic Fe(II) by H(2)O(2) in seawater has been well studied, the oxidation of Fe(II) complexes with natural organic matter (NOM) by this ubiquitous oxidant has received little attention. Suwannee River fulvic acid (SRFA), a proxy for terrestrial NOM, is shown to have a much smaller impact upon Fe(II) oxidation kinetics in seawater than the strong effect previously observed in freshwater conditions. However, the oxidation kinetics of Fe(II) in seawater and freshwater can be quantitatively described employing the same mechanistic kinetic model, except that the apparent formation constant of Fe(II)-SRFA complexes is substantially decreased under conditions representative of estuarine and river-influenced coastal waters. This implies that the same basic processes occur in both systems, with differences between Fe(II) oxidation kinetics in seawater and freshwater largely attributable to effects of ionic strength and matrix composition. This was confirmed with studies employing NaCl solutions with or without Mg(2+)/Ca(2+) addition demonstrating that both ionic strength and divalent cations effect a decrease in the Fe(II)-binding affinity of SRFA. The impact of NOM upon iron redox transformation kinetics is therefore greatly influenced by changes in both ionic strength and the presence of cations able to compete with Fe(II) for binding sites.