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O processo de geração de um modelo matemático deve ter como resultado uma simulação que represente o conjunto de dados experimentais. Diversos fenômenos na Natureza apresentam flutuações erráticas que são fenomenológicas. Um exemplo significativo é a trajetória que desenvolve um pólen que se movimenta na superfície de um rio, o movimento browniano. A Engenharia Química engloba diversos itens que são avaliados por processos estocásticos como otimização e controle de processos, difusão e cinética de reações químicas. No presente trabalho são apresentados conceitos fundamentais relacionados com equações diferenciais estocásticas, alguns exemplos clássicos e um em engenharia química. Para gerar as trajetórias amostrais foi usada a ferramenta aberta Python, especificamente a biblioteca sdeint do PyPI.

O poli (metil azoteto de glicidila) - GAP - é um material energético que pode ser utilizado como aglutinante (binder) e como plastificante energético em compostos explosivos e propulsores de foguetes. Neste trabalho, foi abordada a síntese do (GAP) através da conversão direta da epicloridrina (ECH) a GAP. Os reagentes utilizados foram azida de sódio, epicloridrina e vários álcoois extensores de cadeias, o etanodiol, o 1,4-butanodiol, o dietilenoglicol e o glicerol. Alguns parâmetros de operação foram avaliados, como o tempo de reação, a proporção entre os reagentes, dois tipos de solvente e a ordem de adição dos reagentes. A variável observada para a análise foi a massa molecular do GAP. Todos os materiais sintetizados também foram caracterizados por análises de FTIR, UV, RMN, DSC, análise elementar e TGA. Uma maior massa molecular, maior rendimento e uma melhor conversão do grupo azida a GAP foram obtidos com a adição de epicloridrina sobre a azida de sódio e usando DMF como solvente.GAP is an aliphatic polyether that includes hydroxyl groups and highly energetic azide groups. Thus, it is an energetic material that can be used as binder or plasticizing agent in propellants and explosive mixtures. The glycidyl azide polymer (GAP) was synthesized and characterized by direct conversion of epichlorohydrin. GAP was synthesized by reaction of sodium azide, epichlorohydrin, and some extensor alcohols. The investigation focused on the effects of some key reaction parameters including reagent proportions, reaction time and two different solvents. The product was characterized by FTIR, UV, NMR, DSC, elemental analysis, TGA and GPC. The species were also evaluated through molecular weight (GPC), glass transition temperature (DSC), ignition time and sensitivity.

O poli (metil azoteto de glicidila) - GAP - é um material energético que pode ser utilizado como aglutinante (binder) e como plastificante energético em compostos explosivos e propulsores de foguetes. O GAP de baixo peso molecular pode ser obtido pela conversão direta da epicloridrina (ECH) a GAP. Neste trabalho, é proposto um possível mecanismo para esta conversão direta, fundamentado em análises de infravermelho de espécies intermediárias.

A caracterização da fluidodinâmica de um reator tubular de polimerização foi realizada através da técnica de resposta a estímulo, sendo usada a perturbação com traçador. As curvas obtidas (F(t)) como respostas às perturbações tipo degrau com traçador indicam que pode ocorrer comportamento fluidodinâmico complexo com modos aleatórios, pois são observadas oscilações da resposta F(t) em torno do valor 1, mesmo quando se mantêm as mesmas condições experimentais. Para explicar o comportamento oscilatório na segunda parte de F(t) foi proposto um modelo estocástico. Três são os parâmetros que compõem o modelo: a espessura da camada estagnada junto ao reator: representada pela posição radial no reator em que se posiciona a camada (sigma); o intervalo de tempo em que ocorrem mudanças aleatórias na velocidade: (Dt); e a velocidade máxima de escoamento que a camada lenta pode alcançar junto à parede: (vm2). O modelo estocástico representa bem os dados experimentais obtidos, com conjuntos de parâmetros semelhantes nos vários experimentos, fatos que validam o modelo.The fluid dynamics of a tubular polymerization reactor is evaluated by tracer perturbation. The residence time distribution (F(t)) obtained experimentally seems to be governed by stochastic phenomena, since F(t) oscillations that cannot be explained by experimental errors are observed around the value 1. In order to explain the oscillatory behavior of F(t), a stochastic model was proposed. The model depends on three distinct parameters: the thickness of the stagnant layer placed near the reactor walls (1-j); the characteristic time interval of the random fluctuations, Dt; and the maximum flow velocity of the stagnant layer, vm2. It is shown that the stochastic model represents the experimental data quite well and that similar parameters can be used to describe the results observed in all experiments.

Residence time distributions were evaluated experimentally for three tubular solution polymerization reactors to analyze aspects of the fluid-dynamic behavior of these reactors. The analysis of the available experimental data indicates that the flow characteristics of these reactors may be subject to stochastic perturbations. A stochastic flow model is then proposed by assuming that a viscous polymer layer is formed in the proximities of the reactor walls and that plugs of polymer material are released at random during the operations. This model is able to represent the available experimental data fairly well for three tubular reactors with different configurations. POLYM. ENG. SCI., 47:1839-1846, 2007. © 2007 Society of Plastics Engineers, INTRODUCTION The engineering of polymerization reactors may constitute a very complex issue, as it depends on countless aspects, such as the polymerization kinetics (reaction mechanism), physical properties related to transport [...]

In 1994, the government of Brazil implemented the so-called Plano Real to control the country's rampant inflation. The plan enabled the government to follow structural adjustment a la Brasilera, that [...]

OBJETIVO: Realizar uma análise comparativa entre os principais mecanismos de trauma, a gravidade das vítimas e os principais ferimentos que proporcionaram. MÉTODO: Estudo randomizado de 1486 fichas de vítimas traumatizadas atendidas pela Unidade de Resgate do Corpo de Bombeiros em Catanduva - SP, no período de janeiro/1997 a dezembro/2003. Foi realizada uma avaliação a partir dos itens ferimentos, Revised Trauma Score e mecanismos de trauma, cujas variáveis foram expressas em porcentagens e correlacionadas pelo Teste X². RESULTADOS: Houve predomínio de acidentes motociclísticos com 42,2% dos traumas. As regiões corpóreas mais acometidas foram os membros inferiores/cintura pélvica (32,2%). Os ferimentos superficiais acometeram 88% das vítimas. Para todos os eventos, prevaleceram vítimas com RTS=6 excetuando-se os acidentes envolvendo veículos pesados em que 25% das vítimas obtiveram RTS

The present work is a velocity field simulation of a cylindrical vessel agitated by a Rushton turbine (a disk with six flat blades). The ?-e turbulence model and hexaedric mesh were applied. The commercial CFD software Phoenics is used. The results derived from a progression of different degrees of complexity, started with a tutorial. The results point to a continuous velocity distribution, i.e., there are not sudden changes in the profile and they are almost symmetrical, which is important to the survival of many living organisms. [ABSTRACT FROM AUTHOR]

Focuses on a study which assessed if the length of interposed segment in the Henley procedure influence duodenogastric reflux (DGR). Background on DGR; Methods; Results and discussion.

Background/aims: Optical coherence tomography angiography (OCT-A) images are subject to variability, but the extent to which learning impacts OCT-A measurements is unknown. We determined whether there is a learning effect in glaucoma patients and healthy controls imaged with OCT-A., Methods: Ninety-one open-angle glaucoma patients and 54 healthy controls were imaged every 4 months over a period of approximately 1 year in this longitudinal cohort study. We analysed 15°×15° scans, centred on the fovea, in one eye of each participant. Two-dimensional projection images for the superficial, intermediate and deep vascular plexuses were exported and binarised after which perfusion density was calculated. Linear mixed-effects models were used to investigate the association between perfusion density and follow-up time., Results: The mean (SD) age of glaucoma patients and healthy controls was 67.3 (8.1) years and 62.1 (9.0) years, respectively. There was a significant correlation between perfusion density and scan quality in both glaucoma patients (r=0.50 (95% CI 0.42 to 0.58); p<0.05) and healthy controls (r=0.41 (95% CI 0.29 to 0.52); p<0.05). An increase in perfusion density occurred over time and persisted, even after adjustment for scan quality (1.75% per year (95% CI 1.14 to 2.37), p<0.01)., Conclusions: Perfusion density measurements are subject to increasing experience of either the operator or participant, or a combination of both. These findings have implications for the interpretation of longitudinal measurements with OCT-A., Competing Interests: Competing interests: JRV: EadieTech (Consultant); PER: Allergan, Bausch and Lomb (Consultant); LMS: Alcon, Allergan, Basuch and Lomb (Consultant); MTN: Allergan (Consultant and Lecturer), Alcon (Lecturer), Bausch and Lomb (Consultant), Heidelberg Engineering (Equipment Support), Labtican (Consultant), Thea (Consultant); BCC: CenterVue, Heidelberg Engineering, Topcon (Equipment Support), (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Previous studies have suggested risk factors for graft dislocation after Descemet stripping automated endothelial keratoplasty (DSAEK). We aimed to investigate the influence of eye bank storage solution as a risk factor for graft dislocation, as this could have significant implications for eye banking practices. This retrospective analysis compared cohorts from the QEII Health Sciences Center, Halifax, Canada (donor corneas preserved in Optisol GS) and the Royal Victorian Eye and Ear Hospital, Melbourne, Australia (donor corneas preserved in organ culture). Patient, surgical, and post-operative data were collected for consecutive DSAEK surgeries performed between 2012 and 2020. Risk factors were analyzed using univariate and multivariate logistic regression modeling. 654 DSAEK surgeries were performed during the study period: 271 in the Optisol GS storage cohort and 383 in the organ culture cohort. The most common indications were pseudophakic bullous keratopathy, Fuchs endothelial dystrophy, and failed previous DSAEK. The incidence of graft dislocation requiring surgical repositioning was 9.6% (n = 26) in the Optisol GS cohort and 12.0% (n = 46) in the organ culture cohort (OR, 0.50, 95% CI, 0.20-1.13). Development of graft dislocation was associated with intraoperative venting incisions (OR, 2.50, 95% CI, 1.12-5.51) and a post-operative wound leak (OR, 55.24, 95% CI, 10.20-514.85). The incidence of DSAEK dislocation was similar between study sites using Optisol GS and organ culture, suggesting changes in eye bank storage solution would not mitigate this post-operative complication. Intraoperative creation of venting incisions and post-operative wound leaks and were factors associated with graft dislocation., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: Post-acute non-arteritic ischemic optic neuropathy (NAION) and glaucomatous optic neuropathy (GON) can be difficult to differentiate clinically. Our objective was to identify optical coherence tomography (OCT) parameters to help differentiate these optic neuropathies., Methods: We compared 12 eyes of 8 patients with NAION and 12 eyes of 12 patients with GON, matched for age and visual field mean deviation (MD). All patients underwent clinical assessment, automated perimetry (Humphrey Field Analyzer II; Carl Zeiss Meditec, Dublin, CA, USA), and OCT imaging (Spectralis OCT2; Heidelberg Engineering, Heidelberg, Germany) of the optic nerve head and macula. We derived the neuroretinal minimum rim width (MRW), peripapillary retinal nerve fibre layer (RNFL) thickness, central anterior lamina cribrosa depth, and macular retinal thickness., Results: MRW was markedly thicker, both globally and in all sectors, in the NAION group compared to the GON group. There was no significant group difference in RFNL thickness, globally or in any sector, with the exception of the temporal sector that was thinner in the NAION group. The group difference in MRW increased with increasing visual field loss. Other differences observed included lamina cribrosa depth significantly greater in the GON group and significantly thinner central macular retinal layers in the NAION group. The ganglion cell layer was not significantly different between the groups., Conclusions: The neuroretinal rim is altered in a dissimilar manner in NAION and GON and MRW is a clinically useful index for differentiating these two neuropathies. The fact that the difference in MRW between the two groups increased with disease severity suggests distinct remodelling patterns in response to differing insults with NAION and GON., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Eadie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: The purpose of this study was to determine if there is asymmetry in retinal blood vessel (RBV) position and thickness between right and left eyes (R-L) and evaluate whether R-L asymmetry in RBV thickness is related to R-L asymmetry of retinal nerve fiber layer thickness (RNFLT)., Methods: We analyzed peripapillary circle scan optical coherence tomography (OCT) examinations from healthy White subjects to measure RNFLT and RBV thickness and position relative to the fovea to Bruch's membrane opening axis, for all visible RBV. The R-L asymmetries of RNFLT and RBV thickness were computed for each A-scan. Four major vessels (superior temporal artery [STA] and superior temporal vein [STV], inferior temporal artery [ITA], and vein [ITV]) were identified using infrared images., Results: We included 219 individuals. The mean (standard deviation) number of RBV measured per eye was 15.0 (SD = 2.2). The position of the STV and STA was more superior in left eyes than in right eyes, by 2.4 degrees and 3.7 degrees, respectively (P < 0.01). There was no region with significant R-L asymmetry in RBV thickness. RNFLT was thicker in right eyes in the temporal superior region and thicker in left eyes in the superior and nasal superior regions, with the asymmetry profile resembling in a "W" shape. This shape was also present in post hoc analyses in two different populations. The R-L asymmetries of RBV and RNFLT at each A-scan were not significantly associated (P = 0.37)., Conclusions: There is little R-L asymmetry in RBV, and it is not related to RNFLT asymmetry. This study suggests that R-L RNFLT asymmetry is due to factors other than RBV.

Purpose: To determine the impact of glaucoma severity on rates of change of minimum rim width (MRW), peripapillary retinal nerve fiber layer (RNFL), and macular ganglion cell layer (GCL) thickness., Design: Prospective, cohort study., Methods: Glaucoma patients and healthy subjects had optical coherence tomography scans at 6-month intervals. Individual rates of change for MRW, RNFL, and GCL thickness were estimated with ordinary least-squares regression. Linear mixed-effect models were used to estimate the rate of change of each parameter and evaluate the impact of glaucoma severity (expressed by visual field mean deviation, MD) and age on these rates., Results: A total of 132 glaucoma patients and 57 healthy subjects were followed for a median of 4.3 years and 3.7 years, respectively. Healthy subjects had a statistically significant deterioration in MRW (-1.66 µm/year), RNFL (-0.46 µm/year), and GCL thickness (-0.22 µm/year). While glaucoma patients had a faster rate of change in each parameter compared with healthy subjects, only GCL thickness showed a statistically significant group difference (mean difference: -0.17 µm/year; P = .03). Older baseline age was associated with faster GCL thickness change (-0.07 µm/year; P = .03), but not other parameters. Baseline MD had no impact on the subsequent rates of change in any of the parameters., Conclusions: The rates of MRW, RNFL, and GCL thickness change were not significantly influenced by glaucoma severity at baseline; however, GCL thickness was able to statistically contrast the rate of change between healthy subjects and glaucoma patients throughout the disease spectrum., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Correlation between structural data from optical coherence tomography and functional data from the visual field may be suboptimal because of poor mapping of OCT measurement locations to VF stimuli. We tested the hypothesis that stronger structure-function correlations in the macula can be achieved with fundus-tracking perimetery, by precisely mapping OCT measurements to VF sensitivity at the same location. The conventional 64 superpixel (3° × 3°) OCT grid was mapped to VF sensitivities averaged in 40 corresponding VF units with standard automated perimetry (conventional mapped approach, CMA) in 38 glaucoma patients and 10 healthy subjects. Similarly, a 144 superpixel (2° × 2°) OCT grid was mapped to each of the 68 locations with fundus-tracking perimetry (localized mapped approach, LMA). For each approach, the correlation between sensitivity at each VF unit and OCT superpixel was computed. Vector maps showing the maximum correlation between each VF unit and OCT pixel was generated. CMA yielded significantly higher structure-function correlations compared to LMA. Only 20% of the vectors with CMA and < 5% with LMA were within corresponding mapped OCT superpixels, while most were directed towards loci with structural damage. Measurement variability and patterns of structural damage more likely impact correlations compared to precise mapping of VF stimuli., (© 2022. The Author(s).)

Purpose: No consensus exists on the relative superiority among criteria for evaluating glaucomatous visual field (VF) damage. We compared the sensitivities and specificities of 5 criteria-Glaucoma Hemifield Test (GHT), Hoddap-Anderson-Parrish 2 (HAP2), Foster, United Kingdom Glaucoma Treatment Study (UKGTS), and Low-pressure Glaucoma Treatment Study (LoGTS)-across various levels of functional and structural glaucomatous damage., Design: Retrospective cross-sectional study., Methods: This single-center study included patients with suspect or known glaucoma with reliable VF (Humphrey 24-2 Swedish Interactive Thresholding Algorithm) and optical coherence tomography (OCT; Spectralis, Heidelberg Engineering) examinations within a 4-month period. One eye per patient was included. The level of functional and structural damage was defined by mean deviation (MD) and by an OCT score, respectively. We created the OCT score by counting the number of abnormal (MD percentile [P] <1%) global and sectoral averages of optic nerve head MRW, circumpapillary RNFL thickness, and macular GCL thickness. We inferred specificities and sensitivities from positive rates of the criteria in patients with low glaucomatous damage (MD at P ≥ 10% or OCT score = 0) and with higher damage (MD at P < 10% or OCT score > 0), respectively., Results: We included 1230 patients. In patients with low glaucomatous damage, HAP2 and UKGTS had higher positive rates, suggesting lower specificities, whereas GHT, Foster, and LoGTS had lower positive rates, suggesting higher specificities. In patients with higher glaucomatous damage, HAP2 and UKGTS had higher positive rates, indicating higher sensitivities, whereas GHT, Foster, and LoGTS had lower positive rates, indicating lower sensitivities., Conclusions: No criteria had uniformly superior performance. Selection of criteria should consider the degree of damage anticipated and the desire for either higher sensitivity or specificity., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to develop nomograms for converting Full Threshold (FT) and Swedish Interactive Threshold Algorithm (SITA) Fast (SF) tests to SITA Standard (SS) tests with the Humphrey Field Analyzer in patients with glaucoma and healthy subjects., Methods: One eye each of 49 patients with glaucoma and 50 healthy subjects was tested in 4 and 2 sessions (each containing the 3 strategies), respectively, over 4 weeks. The difference between pointwise Best Available Estimate (BAE; mean of all FT tests) and SS sensitivity at each session was used to derive four nomograms. Nomogram accuracy was assessed by: (1) comparing the converted FT to actual SS sensitivity (omitting the test session used to derive the nomogram) and (2) comparing the distribution of the differences between the converted and actual SS sensitivity to the actual SS test-retest differences. The process was repeated for SF and healthy subjects., Results: In patients with glaucoma, 39.85% and 59.69% of the conversion differences from FT were within 1 dB and 2 dB of the mean, respectively. The respective figures for SF were 45.69% and 65.04%, and in healthy subjects, they were 54.34% and 76.48% for FT and 61.17% and 82.66% for SF. The difference in the mean conversion and test-retest differences was <0.5 dB for all comparisons, with an overlap in distributions ranging from 78.75% to 85.24. There was no association between conversion differences and BAE for either FT or SF in either subject group., Conclusions: Nomograms to convert FT and SF tests to SS tests yield accuracies that are negligibly different from test-retest differences with SS., Translational Relevance: Nomograms allow direct comparisons between different perimetric strategies for a more comprehensive assessment of visual field change.

Purpose: To characterize in vivo dendritic changes in retinal ganglion cells (RGCs) after acute (optic nerve transection, ONT) and chronic (experimental glaucoma, EG) optic nerve injury., Methods: ONT and EG (microbead model) were carried out in Thy1-YFP mice in which the entire RGC dendritic arbor was imaged with confocal fluorescence scanning laser ophthalmoscopy over two weeks in the ONT group and over two and six months, respectively, in two (groups 1 and 2) EG groups. Sholl analysis was used to quantify dendritic structure with the parameters: area under the curve (AUC), radius of the dendritic field, peak number of intersections (PI), and distance to the PI (PD)., Results: Dendritic changes were observed after three days post-ONT with significant decreases in all parameters at two weeks. In group 1 EG mice, mean (SD) intraocular pressure (IOP) was 15.2 (1.1) and 9.8 (0.3) mmHg in the EG and untreated contralateral eyes, respectively, with a significant corresponding decrease in AUC, PI, and PD, but not radius. In group 2 mice, the respective IOP was 13.1 (1.0) and 8.8 (0.1) mmHg, peaking at two months before trending towards baseline. Over the first two months, AUC, PI, and PD decreased significantly, with no further subsequent changes. The rates of change of the parameters after ONT was 5 to 10 times faster than in EG., Conclusions: Rapid dendritic changes occurred after ONT, while changes in EG were slower and associated with level of IOP increase. The earliest alterations were loss of inner neurites without change in dendritic field.

Purpose: To determine whether the 10-2 test of the Humphrey Field Analyzer detected a higher proportion of abnormal visual fields compared with the 24-2 test in the central 10° of patients with early glaucomatous visual field damage., Design: Prospective observational study., Participants: Patients with open-angle glaucoma and healthy control participants., Methods: All participants underwent a 24-2 and 10-2 test. Only the 12 central test locations of the 24-2 test were included to analyze equivalent visual field areas. The performance of the 2 tests was compared across 4 pointwise criteria: total deviation (TD) and pattern deviation (PD) analyses at the 5% and 2% levels. Analyses also were conducted for 2 pairs of follow-up tests, each performed 4 months apart., Main Outcome Measures: (1) Area under the receiver operating characteristic curve (AUC), (2) sensitivity at identically matched specificity for the 4 criteria, (3) overlap (entire field and by quadrant) of abnormal visual fields with both tests, and (4) repeatability of the findings in 2 subsequent follow-up tests., Results: One eye each of 97 glaucoma patients (median mean deviation, -2.31 dB) and 65 control participants were included in the study. The AUCs for the 24-2 and 10-2 tests were not significantly different for any of the 4 criteria and ranged from 0.88 to 0.93 and from 0.91 to 0.94, respectively. At matched specificity, the sensitivity of the 24-2 test was significantly higher for all criteria except for PD analysis at 5%. In patients with an abnormal field with either test, the overlap varied from 60% to 86% depending on the criterion, whereas by quadrant, concordance ranged from 70% to 87%. Over the follow-up, the repeatability of test results (both 24-2 and 10-2 abnormal, either abnormal, or both normal) was achieved in 55% to 70% of patients., Conclusions: In this study of glaucoma patients with early damage with the 24-2 test, there was little evidence that adding the 10-2 test revealed additional undetected defects in the central visual field. It may be more prudent to reserve 10-2 testing for following up selected patients with higher risk of central visual field progression., (Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Purpose: To identify characteristics of patients with early open-angle glaucoma exhibiting greater macular perfusion density (PD) loss compared with macular ganglion cell layer (GCL) thickness loss., Design: Cross-sectional study., Methods: Optical coherence tomography (OCT) imaging of the optic nerve head and macula was conducted in patients and healthy control subjects. Minimum rim width, retinal nerve fiber layer and GCL thickness, and PD from OCT angiography were derived. Only high-quality images were included. For direct comparison, raw PD and GCL thickness values in patients were converted to relative age-corrected loss values based on data from controls. Demographic and ocular variables related to greater PD loss compared with GCL thickness loss were identified with multivariate logistic regression., Results: Data from 89 patients (median mean deviation with the 24-2 and 10-2 tests, Humphrey Field Analyzer: -1.96 dB and -1.49 dB, respectively) and 54 controls were analyzed. Sixty-three (71%) patients had relatively more GCL thickness loss, whereas 26 (29%) had relatively more PD loss. More PD loss was associated with lower OCT and OCT-angiography signal strength (odds ratio [95% confidence interval], 0.64 [0.40, 0.96] and 0.60 [0.38, 0.86], per dB, respectively), thicker retinal nerve fiber layer thickness (1.08 [1.01, 1.16] per μm), and female sex (6.57 [1.25, 48.79])., Conclusion: Less than one-third of patients with early glaucoma had more loss of perfusion compared with conventional structural loss in the macula. Even within a range of high-quality images, lower signal strength may be at least partially responsible for apparent perfusion loss., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Hyperoxygenation and hyperinflation, preferably with a mechanical ventilator, is the most commonly used technique to prevent the adverse effects of open endotracheal suctioning on arterial oxygenation and pulmonary volume. However, limited data are available on the effects of oxygen concentrations < 100% and PEEP with zero end-expiratory pressure (0 PEEP) to improve oxygenation and to maintain adequate ventilation during open endotracheal suctioning. The aim of this study was to analyze the behavior of [Formula: see text] and end-tidal CO 2 pressure ([Formula: see text]) in open endotracheal suctioning using the 0 PEEP technique with baseline [Formula: see text] (0 PEEP baseline [Formula: see text]) and 0 PEEP + hyperoxygenation of 20% above the baseline value (0 PEEP [Formula: see text] + 0.20) in critically ill subjects receiving mechanical ventilation., Methods: This was a prospective, randomized, single-blind crossover study, for which 48 subjects with various clinical and surgical conditions were selected; of these, 38 subjects completed the study. The subjects were randomized for 2 interventions: 0 PEEP baseline [Formula: see text] and 0 PEEP [Formula: see text] + 0.20 during the open endotracheal suctioning procedure. Oxygenation was assessed via oxygen saturation as measured with pulse oximetry ([Formula: see text]), and changes in lung were monitored via [Formula: see text] using volumetric capnography., Results: In the intragroup analysis with 0 PEEP baseline [Formula: see text], there was no significant increase after open endotracheal suctioning in either [Formula: see text] ( P = .63) or [Formula: see text] ( P = .11). With 0 PEEP [Formula: see text] + 0.20, there was a significant increase in [Formula: see text] ( P < .001), with no significant changes in [Formula: see text] ( P = .55). In the intergroup comparisons, there was a significant increase compared to the basal values only with the 0 PEEP + 0.20 method at 1 min after hyperoxygenation ( P < .001), post-immediately ( P < .001), at 1 min after ( P < .001), and at 2 min after open endotracheal suctioning ( P < .001)., Conclusions: The appropriate indication of the hyperinflation strategy via mechanical ventilation using 0 PEEP with or without hyperoxygenation proved to be efficient to maintain [Formula: see text] and [Formula: see text] levels. These results suggest that the technique can minimize the loss of lung volume due to open endotracheal suctioning. (ClinicalTrials.gov registration NCT02440919)., Competing Interests: The authors have disclosed no conflicts of interest., (Copyright © 2020 by Daedalus Enterprises.)

Aims: To evaluate contrast sensitivity (CS) in patients with advanced glaucomatous visual field damage, and to compare two clinical CS tests., Methods: This was a cross-sectional test-retest study. Twenty-eight patients with open-angle glaucoma, visual acuity (VA) better than 20/40 and visual field mean deviation (MD) worse than -15 dB were enrolled. Patients underwent VA, visual field and CS testing with the Pelli-Robson (PR) chart and the Freiburg Visual Acuity and Contrast Test (FrACT). Retest measurements were obtained within 1 week to 1 month., Results: Median (IQR) age and MD were 61.5 (55.5 to 69.2) years and -27.7 (-29.7 to -22.7) dB, respectively. Median (IQR) VA was 0.08 logarithm minimum angle of resolution (0.02 to 0.16), corresponding to 20/25 (20/20 to 20/30). Median (IQR) CS was 1.35 (1.11 to 1.51) log units with the PR chart and 1.39 (1.24 to 1.64) log units with FrACT. VA explained less than 40% of the variance in CS (adjusted R 2 =0.36). CS estimates of both tests were closely related (rho=0.88, p=0.001), but CS was 0.09 log units higher with FrACT compared with the PR chart, and the 95% repeatability intervals (Bland-Altman) were 46% tighter with the PR chart., Conclusions: Despite near-normal VA, almost all patients showed moderate to profound deficits in CS. CS measurement provides additional information on central visual function in patients with advanced glaucoma., Competing Interests: Competing interests: VPC has been paid for developing and delivering educational presentations for Iridex Inc. and is a consultant for Alcon Laboratories, Allergan and Aerie; no other relationships or activities that could appear to have influenced the submitted work. The funding organisations had no role in the design or conduct of this research., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: To measure the magnitude and direction of anterior scleral canal opening (ASCO) offset relative to the Bruch membrane opening (BMO) (ASCO/BMO offset) to characterize neural canal obliqueness and minimum cross-sectional area (NCMCA) in 69 highly myopic and 138 healthy, age-matched, control eyes., Design: Cross-sectional study., Methods: Using optical coherence tomography (OCT) scans of the optic nerve head (ONH), BMO and ASCO were manually segmented and their centroids and size and shape were calculated. ASCO/BMO offset magnitude and direction were measured after projecting the ASCO/BMO centroid vector onto the BMO plane. Neural canal axis obliqueness was defined as the angle between the ASCO/BMO centroid vector and the vector perpendicular to the BMO plane. NCMCA was defined by projecting BMO and ASCO points onto a plane perpendicular to the neural canal axis and measuring their overlapping area., Results: ASCO/BMO offset magnitude was greater (highly myopic eyes 264.3 ± 131.1 μm; healthy control subjects 89.0 ± 55.8 μm, P < .001, t test) and ASCO centroid was most frequently nasal relative to BMO centroid (94.2% of eyes) in the highly myopic eyes. BMO and ASCO areas were significantly larger (P < .001, t test), NCMCA was significantly smaller (P < .001), and all 3 were significantly more elliptical (P ≤ .001) in myopic eyes. Neural canal obliqueness was greater in myopic (65.17° ± 14.03°) compared with control eyes (40.91° ± 16.22°; P < .001, t test)., Conclusions: Our data suggest that increased temporal displacement of BMO relative to the ASCO, increased BMO and ASCO area, decreased NCMCA, and increased neural canal obliqueness are characteristic components of ONH morphology in highly myopic eyes., (Copyright © 2020 Elsevier Inc. All rights reserved.)