Characteristics of the Side Surfaces and Edges of Welded Wire Meshes Used in the Construction of Welded Slotted Screens.

Welded resistance slotted screens, also known as slotted screens, are a special type of screen primarily used for the filtration and separation of liquids and dust. They are characterized by slots with parallel geometry and precisely defined sizes. The quality of the side surfaces and edges of welded wires determines the durability of the slotted screens made from them. This article presents the results of tests for four types of wires: two types of working profile wires made from austenitic-ferritic steel (duplex) and two types of supporting cross wires made from ferritic steel. The wire surfaces were characterized using a profilometer and atomic force microscopy. Basic roughness parameters Ra, Rz, and SAD (surface area difference) were determined. Surface observations of the working profiles were conducted using scanning electron microscopy. These studies allowed for the characterization of the working wire surfaces used in the production of slotted screens. At work, the results of surface roughness were analyzed based on three measurement methods for wires used in the production of welded slot screens. These results allowed for the identification of the most reliable method for characterizing the surface condition of such products.

A randomized crossover comparison of the bébé VieScope and direct laryngoscope for pediatric airway management by nurses in medical simulation settings.

BACKGROUND: Airway management in life-threatening emergencies is essential for children, and endotracheal intubation is the gold standard. It protects against regurgitation and enables mechanical ventilation. New types of airway management equipment are being developed and implemented to meet the needs of medical personnel. RESEARCH DESIGN AND METHODS: This prospective, randomized, cross-over simulation trial evaluated the success of endotracheal intubation in three scenarios: normal airway (scenario-A), tongue edema (scenario-B), and continuous chest compression (scenario-C), using the bébé Vie Scope™ laryngoscope (VieScope) and the Macintosh blade laryngoscope (MAC) as a comparative tool performed by nurses with limited tracheal intubation experience. RESULTS: The results of the study showed that in scenario-A, there were no significant differences in the first attempt success rate or endotracheal intubation time between VieScope and MAC. However, VieScope was associated with better visualization of the glottis. In scenarios B and C, VieScope was significantly more effective than MAC in terms of first-pass success rate, time to intubate, Cormack-Lehane grade, POGO score, and ease of endotracheal intubation. CONCLUSIONS: Bébé VieScope may be useful for endotracheal intubation in pediatric patients, particularly in cases of tongue edema and ongoing chest compression, providing a higher first-pass success rate than conventional laryngoscopes.

ETView SL versus Macintosh Direct Laryngoscope for Endotracheal Intubation Amid Simulated COVID-19 Cardiac Arrest: A Randomized Crossover Study.

Airway management procedures, such as endotracheal intubation (ETI), pose a significant risk of aerosol generation, requiring robust personal protective equipment (PPE) against aerosol-generating procedures (AGP). This study aimed to assess the impact of PPE-AGP on intubation success rates, time to intubation, and glottic visualization using ETView and a standard Macintosh laryngoscope (MAC). A total of 52 physicians participated in this prospective, observational, randomized crossover study conducted in a medical simulation setting. Participants included COVID-19 patients with cardiac arrest scenarios with and without PPE-AGP who were intubated with ETView and MAC. During intubation without PPE-AGP, ETView showed a similar first-pass success rate (FPS) but had a shorter intubation time and better glottal hydration compared to MAC. In scenario B (with PPE-AGP), ETView outperformed MAC in FPS, initiation time, and glottic visualization. The use of PPE-AGP had little impact on ETView's performance. However, it negatively affected the Macintosh laryngoscope, reducing FPS and glottic visibility. Participants found intubation with ETView easier in both scenarios. In conclusion, as compared to the Macintosh laryngoscope, ETView demonstrated higher performance under the circumstances of the simulation, especially when PPE-AGP was used.

Electron Beam Welding Process for Ti6Al-4V Titanium Alloy.

The electron beam welding process of titanium alloys induces a series of physicochemical changes in the material that remain a relevant and necessary area of investigation. A necessary step performed after the electron beam welding process of titanium alloys in the Ti6Al-4V grade to mitigate the resulting thermal stresses is the post-weld heat-treatment process conducted through stress relieving. This study presents the comparative analysis results of the mechanical properties and structure of the Ti6Al-4V titanium alloy after electron beam welding and subsequent stress-relieving heat treatment at a temperature of 590 °C for 2 h. The analysis focused on the levels of mechanical properties such as microhardness in the heat-affected zone and weld, tensile strength, and microstructure analysis in the heat-affected zone and weld. The aim of the research was to answer the questions regarding whether the post-weld heat treatment through stress relieving after electron beam welding of the Ti6Al-4V titanium alloy would significantly affect the changes in mechanical properties and microstructure of the alloy and whether the applied welding speed in the study would cause a significant depletion of alloying elements in the material. During the course of the study, it was found that conducting the electron beam welding process at a speed of 8 mm/s resulted in a depletion of one of the alloying elements (aluminum) in the face area. However, the decrease in aluminum content was not significant and did not exceed the critical value of 6% specified in the material standards, which determined the material's application based on its strength properties.

A Comparison of the bébé VieScope™ and Direct Laryngoscope for Use While Wearing PPE-AGP: A Randomized Crossover Simulation Trial.

This study aimed to compare the intubation effectiveness of the bébé Vie Scope™ (VieScope) and direct laryngoscopy for emergency intubation in a pediatric manikin model performed by paramedics with and without personal protective equipment for aerosol generating procedures (PPE-AGP). Participants performed endotracheal intubation using VieScope and standard Macintosh laryngoscope (MAC) in two research scenarios: (1) without PPE-AGP, and (2) with PPE-AGP. Fifty-one paramedics without any previous experience with the VieScope participated in this study. In the PPE-AGP scenario, in the VieScope group, the percentage of successful tracheal intubation on the first attempt was higher compared to the MAC group (94.1 vs. 78.4%, p = 0.031), intubation time was shorter (29.8 vs. 33.9 s, p < 0.001), and percentage of glottic opening (POGO) score was higher 91.0 vs 77.8 (p < 0.001). On the Cormack−Lehane scale, intubation with VieScope intubation was associated with higher scores rated at 1 (64.7 vs. 29.4%) than in the MAC group (p = 0.001). For intubation in the non-PPE scenario, there were no statistically significant differences between VieScope and MAC in relation to above parameters. Summarize, the bébé VieScope™ under PPE-AGP wearing conditions has proven to be a useful device for airway management in children providing better visualization of the larynx, better intubation conditions, and a higher success rate of tracheal intubation on the first attempt and reduced intubation time compared to the standard Macintosh laryngoscope.

Reference Ranges of Glycemic Variability in Infants after Surgery-A Prospective Cohort Study.

We aimed to define reference ranges of glycemic variability indices derived from continuous glucose monitoring data for non-diabetic infants during post-operative intensive care treatment after cardiac surgery procedures. We performed a prospective cohort intervention study in a pediatric intensive care unit (PICU). Non-diabetic infants aged 0-12 months after corrective cardiovascular surgery procedures were fitted upon arrival to the PICU with a continuous glucose monitoring system (iPro2, Medtronic, Minneapolis, MN, USA). Thirteen glycemic variability indices were calculated for each patient. Complete recordings of 65 patients were collected on the first postoperative day. During the first three postsurgical days 5%, 24% and 43% of patients experienced at least one hypoglycemia episode, and 40%, 10% and 15%-hyperglycemia episode, respectively, in each day. Due to significant differences between the first postoperative day (mean glycemia 130 ± 31 mg/dL) and the second and third day (105 ± 18 mg/dL, 101 ± 22.2 mg/dL; p < 0.0001), we proposed two separate reference ranges-for the acute and steady state patients. Thus, for individual glucose measurements, we proposed a reference range between 85 and 229 mg/dL and 69 and 149 mg/dL. For the mean daily glucose level, ranges between 122 and 137 mg/dL and 95 and 110 mg/dL were proposed. In conclusion, rt-CGM revealed a very high likelihood of hyperglycemia in the first postsurgical day. The widespread use of CGM systems in a pediatric ICU setting should be considered as a safeguard against dysglycemic episodes; however, reference ranges for those patients should be different to those used in diabetes care.

Efficacy and Safety of Video-Laryngoscopy versus Direct Laryngoscopy for Double-Lumen Endotracheal Intubation: A Systematic Review and Meta-Analysis.

The available meta-analyses have inconclusively indicated the advantages of video-laryngoscopy (VL) in different clinical situations; therefore, we conducted a systematic review and meta-analysis to determine efficacy outcomes such as successful first attempt or time to perform endotracheal intubation as well as adverse events of VL vs. direct laryngoscopes (DL) for double-lumen intubation. First intubation attempt success rate was 87.9% for VL and 84.5% for DL (OR = 1.64; 95% CI: 0.95 to 2.86; I2 = 61%; p = 0.08). Overall success rate was 99.8% for VL and 98.8% for DL, respectively (OR = 3.89; 95%CI: 0.95 to 15.93; I2 = 0; p = 0.06). Intubation time for VL was 43.4 ± 30.4 s compared to 54.0 ± 56.3 s for DL (MD = -11.87; 95%CI: -17.06 to -6.68; I2 = 99%; p < 0.001). Glottic view based on Cormack-Lehane grades 1 or 2 equaled 93.1% and 88.1% in the VL and DL groups, respectively (OR = 3.33; 95% CI: 1.18 to 9.41; I2 = 63%; p = 0.02). External laryngeal manipulation was needed in 18.4% cases of VL compared with 42.8% for DL (OR = 0.28; 95% CI: 0.20 to 0.40; I2 = 69%; p < 0.001). For double-lumen intubation, VL offers shorter intubation time, better glottic view based on Cormack-Lehane grade, and a lower need for ELM, but comparable first intubation attempt success rate and overall intubation success rate compared with DL.

Microstructure and Mechanical Properties of Modern 11%Cr Heat-Resistant Steel Weld Joints.

In addition to good high-temperature creep resistance and adequate heat resistance, steels for the power industry must have, among other things, good weldability. Weldability of such steels is one of the criteria determining whether or not the material is suitable for applications in the power industry. Therefore, when materials such as martensitic steel Thor 115 (T115) are introduced into the modern power industry, the quality and properties of welded joints must be assessed. The paper presents the results of metallographic and mechanical investigations of T115 martensitic steel welded joints. The analysis was carried out on joints welded with two filler metals: WCrMo91 (No. 1) and EPRI P87 (No. 2). The scope of the investigations included: microstructural investigations carried out using optical, scanning and transmission electron microscopy and mechanical testing, i.e., Vickers microhardness and hardness measurement, static tensile test and impact test. The macro- and microstructural investigations revealed correct structure of the weld, without welding imperfections. The microstructural investigations of joint No. 1 revealed a typical structure of this type of joint, i.e., the martensitic structure with numerous precipitates, while in joint No. 2, the so-called Nernst's layers and δ-ferrite patches were observed in the weld fusion zone as well as the heat affected zone (HAZ). The mechanical properties of the test joints met the requirements for the base material. A slight influence of the δ-ferrite patch on the strength properties of joint No. 2 was observed, and its negative effect on the impact energy of HAZ was visible.

Evaluation of Usefulness of AlCrN Coatings for Increased Life of Tools Used in Friction Stir Welding (FSW) of Sheet Aluminum Alloy.

The study presents the results of examinations of wear in tools made of 1.2344 steel without and with an anti-wear coating in the process of welding overlap joints of sheet metal made of 7075-T6 aluminum alloy using friction stir welding (FSW) technology. A commercial anti-wear AlCrN coating (Balinit® Alcrona Pro by Oerlikon Balzers Coating Poland Sp. z o.o., Polkowice, Poland) was examined, applied using physical vapor deposition (PVD) and used to improve tool life in metalworking processes. Wear tests for the tools were conducted in industrial conditions at specific parameters of the friction stir welding process. Tool wear was evaluated through examination of the tool working surface. The results of the static tensile strength tests and metallographic examinations of the joints were used to evaluate the effect of tool wear and the coating impact on joint quality. The results obtained in the study show that the tool made of 1.2344 steel was intensively worn after the welding of a joint with the length of 200 m, increasing the risk associated with further use of the tool and suggesting the tool's low durability. The use of the AlCrN coating led to an increase in tool life. The coating limits the process of tool wear and can be used as an anti-wear coating for tools used in the FSW of aluminum alloys.

Clinical application of 2D and 3D pelvic floor ultrasound of mid-urethral slings and vaginal wall mesh.

INTRODUCTION AND HYPOTHESIS: This mini-review demonstrates the clinical application of pelvic floor ultrasound for imaging women with mesh following incontinence and prolapse surgical procedures. METHODS: The images are obtained using two-dimensional (2D) perineal pelvic floor ultrasound (pPFUS) and three-dimensional (3D) endovaginal ultrasound (EVUS). RESULTS: 2D pPFUS and 3D EVUS provide confirmation of the presence or absence of vaginal wall mesh (VWM), bulking agents, and the type of mid-urethral sling (MUS). Residual mesh following excision can be located, and presence in the bladder/urethra may be demonstrated. These are crucial for surgical planning and counselling, with the potential to be useful intraoperatively also. The shape and position relative to urethral length and lumen can be assessed, which may correspond with voiding dysfunction or recurrent incontinence. Evidence of inflammation/sepsis or folding of the VWM may be useful in the investigation of pain. CONCLUSIONS: Pelvic floor ultrasound is the standard of care where imaging is available and utilised and is the only modality capable of reliably visualising mesh. It is clear that there are significant benefits and uses for the clinician for investigating complications of VWM or MUS; although many of the findings may be associated with clinical symptoms, some are incidental findings. Therefore, these scans should be performed by pelvic floor specialists with core competency in pelvic floor ultrasound and interpreted by those familiar with their significance, as an adjunct to patient history, examination and other investigations to assist in the most appropriate management plan for the patient. In addition, there is still a need for standardisation in terminology and measurement techniques, to allow for consistent and comparable reporting.

Nephrocalcinosis in adolescent girl with medullary sponge kidney and mild hemihypertrophy: A case report.

RATIONALE: Medullary sponge kidney (MSK) is a rare congenital abnormality characterized by cystic dilatation of the medullary collecting tubules. The disorder is likely to be complicated by nephrocalcinosis, urolithiasis, tubular dysfunctions, and urinary tract infections. In addition, it may be rarely associated with extrarenal anomalies. PATIENT CONCERN: We present a case of 17-year old girl who was referred for metabolic evaluation of bilateral nephrocalcinosis. Physical examination showed signs of mild, left-sided hemihypertrophy involving the lower limb, buttock, trunk, face, and tongue. The imaging studies of kidneys including intravenous urography and contrast computed tomography showed numerous medullary calcification and a typical picture of MSK-"paint brush"/"bouquet of flowers" appearance of the dilated tubules within the renal medulla. Laboratory evaluation revealed sterile pyuria, hypercalciuria, and hypocitraturia. INTERVENTION: The patient was subsequently treated with potassium citrate, hydrochlorothiazide, low sodium and low oxalate diet accompanied by high fluid intake. OUTCOMES: After a 1-year therapy the normalization of calciuria and citraturia occurred and no progression of nephrocalcinosis was observed. LESSONS: We conclude that MSK should always be considered as a cause of nephrocalcinosis. Since the final diagnosis requires specific imaging techniques, the concomitant extrarenal abnormalities such as hemihypertrophy may facilitate diagnostic decisions.

Inosine monophosphate dehydrogenase 2 as a marker of aggressive and advanced prostate cancer.

INTRODUCTION: There is a need for a new biochemical marker of aggressive prostate cancer (PCa). Inosine monophosphate dehydrogenase 2 (IMPDH2) is a candidate for such a marker - its activity is increased in certain tumors and neoplastic cell lines, including PCa, and may correlate with cancer aggressiveness. MATERIAL AND METHODS: IMPDH2 levels were measured in blood samples from 34 PCa patients. The results were analyzed and correlated with prostate-specific antigen (PSA), digital rectal examination (DRE), Gleason score, risk groups according to d'Amico and metastatic disease. Twenty healthy (non-PCa) patients served as the control group. RESULTS: There was no significant difference in IMPDH2 level between the PCa and control group, and no significant correlation between PSA and IMPDH2. IMPDH2 levels were significantly higher in the DRE (+) patients (148.5 ±174.8 vs. 33.4 ±46.4, p <0.05), in patients with metastatic disease (100.1 ±139.0 vs. 25.3 ±25.9, p <0.05) and in the high-risk group according to d'Amico (93.4 ±129.2 vs. 18.8 ±10.4, p <0.05). There was a significant correlation between the Gleason score and IMPDH2. CONCLUSIONS: These results suggest that IMPDH2 is a promising candidate as a biomarker for those with advanced PCa and those at high risk of progression towards advanced PCa.

Residual defects after repair of obstetric anal sphincter injuries and pelvic floor muscle strength are related to anal incontinence symptoms.

INTRODUCTION AND HYPOTHESIS: The aim was to analyze the correlation between residual anal sphincter (AS) defects and pelvic floor muscle (PFM) strength on anal incontinence (AI) in patients with a history of obstetric AS injuries (OASIS). METHODS: From September 2012 to February 2015, an observational study was conducted on a cohort of females who underwent repair of OASIS intrapartum. The degree of OASIS was scored intrapartum according to Sultan's classification. Participants were assessed at 6 months postpartum. Incontinence symptoms were evaluated using Wexner's score and PFM strength using the Modified Oxford Scale (MOS). 3D-endoanal ultrasound was performed to classify AS defects according to Starck's system. Correlation between Sultan's and Starck's classifications was calculated using Cohen's kappa and Spearman's rho (Rs) test. The impact of residual AS defects and PFM strength on AI was analyzed using a multiple regression model. RESULTS: A total of 95 women were included in the study. Good correlation (κ= 0.72) was found between Sultan's and Starck's classifications. Significant positive correlation was observed between Wexner's score and both Sultan's (p = 0.023, Rs =0.212) and Starck's (p < 0.001, Rs =0.777) scores. The extent of the residual AS defect was the most relevant factor correlating with AI symptoms. In patients with severe AS injuries, higher MOS values were associated with lower Wexner's score. CONCLUSIONS: The degree of AS tear measured intrapartum was the most important factor related to AI after primary repair of OASIS. PFM strength was associated with lower incontinence symptoms in the postpartum period.

Dysglycemia in critically ill children.

Stress hyperglycemia remains a significant and unsolved medical condition in critically ill children. Treatment for hyperglycemia is controversial and, to date, no recommendations exist from pediatric professional society regarding the management of hyperglycemia in critically ill children. This review summarizes recent work investigating the pathogenesis of stress hyperglycemia, the importance of hypoglycemic episodes and glycemic variability among critically ill patients.

Cervical lymphadenopathy in children--incidence and diagnostic management.

OBJECTIVE: Palpable lymph nodes are common due to the reactive hyperplasia of lymphatic tissue mainly connected with local inflammatory process. Differential diagnosis of persistent nodular change on the neck is different in children, due to higher incidence of congenital abnormalities and infectious diseases and relative rarity of malignancies in that age group. The aim of our study was to analyse the most common causes of childhood cervical lymphadenopathy and determine of management guidelines on the basis of clinical examination and ultrasonographic evaluation. MATERIAL AND METHODS: The research covered 87 children with cervical lymphadenopathy. Age, gender and accompanying diseases of the patients were assessed. All the patients were diagnosed radiologically on the basis of ultrasonographic evaluation. RESULTS: Reactive inflammatory changes of bacterial origin were observed in 50 children (57.5%). Fever was the most common general symptom accompanying lymphadenopathy and was observed in 21 cases (24.1%). The ultrasonographic evaluation revealed oval-shaped lymph nodes with the domination of long axis in 78 patients (89.66%). The proper width of hilus and their proper vascularization were observed in 75 children (86.2%). Some additional clinical and laboratory tests were needed in the patients with abnormal sonographic image. CONCLUSIONS: Ultrasonographic imaging is extremely helpful in diagnostics, differentiation and following the treatment of childhood lymphadenopathy. Failure of regression after 4-6 weeks might be an indication for a diagnostic biopsy.

[Comparison of lipid and lipoprotein(a) metabolism in blood serum and the thickness of common carotid artery (intima-media thickness complex-- IMT), in children from families at risk for cardiovascular disease and in families without risk]. / Porównanie przemiany lipidowej i lipoproteiny(a) w surowicy krwi oraz grubosci sciany tetnicy szyjnej wspólnej (IMT) u dzieci z rodzin obciazonych i nie obciazonych chorobami ukladu krazenia.

THE AIM: The aim of the study was to compare selected parameters of lipid and lipoprotein metabolism in blood serum and the thickness of common carotid artery wall (intima-media thickness complex -- IMT) in children from families at risk for circulatory system disease in their history and in families without this risk. MATERIAL AND METHODS: The study included 18 children aged 2-3 years from families with circulatory system disease in their history. The control group was composed of 16 children aged 2-3 years from families without that risk. In all of the subjects concentrations of triglycerides, total cholesterol and its fractions: LDL, VLDL, HDL and of lipoprotein(a) in blood serum were determined. The intima-media thickness (IMT) measurement in children was made with ultrasonographic method. RESULTS: The concentration of triglycerides, VLDL cholesterol and lipoprotein(a) had the highest value in the blood serum of the children from the families with circulatory system disease in their history as compared to the levels of the children from families without that risk and the differences were statistically significant (p<0.05). The mean values of IMT in children from families with positive history were higher than in children in the control group, but these differences were not statistically significant. CONCLUSIONS: The appearance of lipid metabolism disorders and higher lipoprotein concentration in children from families with circulatory system disease in their history allows us to conclude that the children from those families constitute a high risk group. Lipid profile should be periodically controlled in those children. Moreover, in justifiable cases atherosclerosis changes indexes should be controlled as well. However; IMT examination of the carotid artery, as a non-invasion method, can be a very useful method in tracing the early development of atherosclerosis changes in children's vessels, especially in children from families with circulatory system disease in their history.