Device Off Research Articles

Neuromuscular electrical stimulation reduces sludge in the popliteal vein

The common peroneal nerve stimulator (CPNS) is a UK-approved device for reducing venous thromboembolism (VTE) risk. It resembles a wrist watch and is placed over the common peroneal nerve, discharging electricity at a rate of 1 impulse/s. It has been presumed that as blood flow slows, erythrocytes aggregate into ultrasound-detectable echogenic particles, described as venous sludge. The aim of the study was to determine whether the CPNS reduces venous sludge by using an ultrasound-derived gray-scale (0-255) venous sludge index (VSI). Twenty-five healthy volunteers had their right popliteal vein video recorded using B-mode ultrasound at 22frames/s in longitudinal and transverse views, standing and lying. This was performed first with the CPNS off and then with the CPNS on. The CPNS impulse intensity used was set from 1 to 7 for each individual, and the level was sufficient to cause an outward jerking movement of the foot. A single frame of the possible 154 frames, lasting 7seconds, was selected using a random number generator for the image analysis. The "brightness" of the erythrocyte aggregates (pixels) within a circular sampling area was quantified using the VSI. The brighter the sample, the greater the sludge. Values are expressed as median (interquartile range). On standing with the device off, there was a significantly higher VSI (P< .0005) compared with lying (longitudinal view, 27.7 [18.8-41.4] vs 11.7 [5.5-17.5]; transverse view, 20.7 [13.6-32.2] vs 11.4 [6.3-15.9]). Activation of the CPNS significantly reduced all the VSI values (P< .0005) shown (longitudinal view, 2 [1.1-3.2] and 1.5 [0.5-3.1]; transverse view, 1.1 [0.6-2.7] and 0.8 [0.5-2.1]). The CPNS device significantly reduces venous sludge within the popliteal vein irrespective of whether the subject is standing or lying down or of the longitudinal or transverse position of the ultrasound transducer. The principal mode of action of the device in the claim that it may reduce venous thromboembolism risk may be through a reduction of venous sludge. However, the relationship between erythrocyte aggregation, venous stasis, and venous thromboembolism risk requires more investigation.

Perancangan Smart Home Berbasis Jaringan Sensor Nirkabel

&lt;p&gt;&lt;em&gt;Abstrak&lt;/em&gt; - &lt;strong&gt;Keamanan rumah menjadi hal yang sangat penting ketika pemilik rumah meninggalkan rumah dalam keadaan kosong. Selain pencurian, kebakaran juga merupakan masalah yang sering kali terjadi ketika rumah ditinggal pemiliknya. Sebagai alternatif solusi untuk menjaga dan mengawasi rumah yang diajukan pada penelitian ini ialah menggunakan teknologi Jaringan Sensor Nirkabel yang terintegrasi dengan jaringan internet, sehingga pemilik rumah tetap dapat mengawasi keadaan rumah dari jarak jauh. Pada penelitian ini dirancang prototype sistem rumah pintar atau Smart Home yang memanfaatkan teknologi Jaringan Sensor Nirkabel menggunakan standard Zigbee. Beberapa node sensor ditempatkan pada peralatan rumah, dimana setiap node dapat saling berkomunikasi secara wireless dan terpusat di node kordinator. Selanjutnya node kordinatior akan terhubung ke jaringan internet sehingga pemilik rumah dapat membuka aplikasi smart home kapan saja dan dimana saja. Rancangan sistem &lt;em&gt;Smart Home&lt;/em&gt; disimulasikan menggunakan rumah model untuk menguji kinerja perangkat &lt;em&gt;Smart Home&lt;/em&gt;. Pengujian kinerja Smart Home dimulai dengan pengujian keakurasian masing masing data sensor hingga waktu respon komunikasi dari sensor ke pusat monitoring. Tingkat error pembacaan suhu disetiap ruangan ialah 1 - 4.27%. Sensor PIR berhasil mendeteksi keberadaan orang di suatu ruangan dengan waktu delay &lt;/strong&gt;&lt;strong&gt;adalah 2.8 detik dengan jarak maksimal 5 meter&lt;/strong&gt;&lt;strong&gt;. Fungsi kendali dan monitoring (&lt;em&gt;on/off&lt;/em&gt;) perangkat elektronik bekerja dengan baik, dengan waktu respon kurang dari 1 detik. Dari hasil pengujian komunikasi nirkabel antar node, diperoleh bahwa jarak maksimal antar node ialah sekitar 20 m, dengan rata-rata waktu respon pengiriman data ialah 1-2 detik. Adapun waktu respon mengalami delay mencapai 2 detik apabila beberapa perintah kendali dilakukan pada waktu yang bersamaan.&lt;/strong&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Kata Kunci - &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;Smart Home&lt;/em&gt;, Jaringan Sensor Nirkabel, Zigbee.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;em&gt;Abstrak&lt;/em&gt;&lt;strong&gt; - Home security becomes very important when homeowners leave the house empty. In addition to theft, fire is also a problem that often occurs when the house left the owner. As an alternative solution to maintain and supervise the homes submitted in this study is to use Wireless Sensor Network technology integrated with the Internet network, so that homeowners can still monitor the state of the house remotely. In this study designed prototype smart home system or Smart Home which utilizes Wireless Sensor Network technology using Zigbee standard. Some sensor nodes are placed in the home equipment, where each node can communicate wirelessly and centrally at the coordinator node. Next node coordinate will be connected to the internet network so that homeowners can open smart home application anytime and anywhere. The Smart Home system design is simulated using a home model to test the performance of Smart Home devices. Smart Home performance testing begins with testing the accuracy of each sensor data until the communication response time from the sensor to the monitoring center. The error rate of temperature readings in each room is 1 - 4.27%. PIR sensor successfully detects the presence of people in a room with a delay time is 2.8 seconds with a maximum distance of 5 meters. The control and monitoring functions (on / off) of electronic devices work well, with a response time of less than 1 second. From the results of testing wireless communication between nodes, obtained that the maximum distance between nodes is about 20 m, with the average response time of data transmission is 1-2 seconds. The response time has a delay of 2 seconds if some control commands are done at the same time.&lt;/strong&gt;&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords - &lt;/em&gt;&lt;/strong&gt; &lt;em&gt;Smart Home&lt;/em&gt;, Jaringan Sensor Nirkabel, Zigbee.&lt;/p&gt;

Low-pressure gas-discharge current interrupters in a generator of high-voltage nanosecond pulses with an inductive energy storage

Designs of grid units with slotted and multiple-aperture configurations of holes that allow an increase in the stability of the current-cutoff process and a reduction in the time to turn the device off in a high-voltage pulse generator with an inductive energy storage were created. Compared to a TGI2-500/20 thyratron, these designs made it possible to reduce the time instability of the instant of the current interruption by factors of 2 and 5 for switches with the multiple-aperture and slotted configurations of the grids, respectively. These constructions allowed the minimum time for disabling a device to be reduced by 25%.

Design and development of an Electrostatic Screen Battery for Emission Control (ESBEC)

Current diesel particulate filters (DPFs) can effectively capture the exhaust particles, but they add to engine backpressure and accumulate particles during their operation, which results in the need to regenerate the DPFs by burning off the collected particles periodically. This regeneration results in aerosol emissions, especially in the 10–30 nm size range and contributes to ultrafine particle pollution. In this research, we designed and developed a prototype of a novel diesel exhaust control device: the Electrostatic Screen Battery for Emissions Control (ESBEC). The device features high particle collection efficiency without adding to the exhaust backpressure and without the need for thermal regeneration of the collected particles. The ESBEC consists of a series of metal mesh screens coated with a superhydrophobic substance and an integrated carbon fiber ionizer to charge the incoming particles. Multiple pairs of screens (e.g., 5 pairs) are arranged in a battery, in which one screen of each pair is supplied with high voltage, and the other is grounded, producing electrostatic field produced across the screens. The application of a superhydrophobic coating onto the screens allows easy removal of the collected particles using liquid without the need for thermal regeneration. The current prototypes of the device were tested with fluorescent polystyrene latex (PSL) particles of 0.2 and 1.2µm in size and at 25 and 105L/min sampling flow rates. The average collection efficiency was ~87% for 0.2µm and ~95% for 1.2µm PSL particles. In addition, the ESBEC was tested with actual diesel exhaust particles; here its performance was verified by visually inspecting deposition of particles on an after-filter with the device ON and OFF. In the next stages of this work, the ESBEC will be challenged with diesel exhaust at different mass concentrations and for different collection time periods.

Use of a Dental Vibration Tool to Reduce Pain From Digital Blocks: A Randomized Controlled Trial.

The infiltration of local anesthetic is consistently described as painful by patients. Vibration anesthesia has been studied in the dental literature as a promising tool to alleviate the pain from dental nerve blocks. Many of these studies used a specific device, the DentalVibe. To date, there have not been any studies applying this technology to digital blocks of the hand in human subjects. We hypothesized that the use of microvibratory stimulation during digital blocks of the hand would decrease pain reported by patients. This was a randomized controlled trial of consenting adult emergency department patients who received digital block anesthesia for hand digit therapy when study authors were present. The study period was 24 months at an academic emergency department. A sample size of 50 injections (25 subjects) was necessary for a power of 80% to detect a mean difference of 2 (SD, 2.5) on the pain scale. A 2-sided dorsal injection approach was used for digital blocks. Subjects were randomized to either intervention (vibration) for the first injection or sham (device off). Both intervention and sham were held in place for 5 seconds prior to and during injection. Subjects were given 2 mL of 1% lidocaine and asked to rate the injection pain on a 1- to 10-point scale. This process was then repeated. Mean pain scores were compared using paired t tests. Our primary outcome was the difference in mean injection pain score between sham versus intervention groups. There were 25 patients in the study group (mean age, 35.52 years [range, 18-58 years]; 8 females; 11 non-Hispanic white). The mean injection pain score in the sham group was 4.28 (95% confidence interval [CI], 3.14-5.42), and in the intervention group, the mean pain score was 2.52 (95% CI, 1.62-3.42). For the primary outcome, the mean injection pain score difference between the sham and intervention groups across all subjects was 1.76 (95% CI, 0.49-3.03; P = 0.009). The mean injection pain score differences were similar across groups: females versus males (0.24; 95% CI, -2.31 to 2.79; P = 0.85), non-Hispanic whites versus other races (0.76; 95% CI, -1.78 to 3.29; P = 0.54), intervention first versus sham first (-0.43; 95% CI, -3.25 to 2.40; P = 0.75). Our results show a statistically significant difference in mean injection pain score during digital block of the hand when the DentalVibe device is used for vibration anesthesia. Larger studies are warranted to confirm our findings.

Gate-Induced Drain Leakage Reduction in Cylindrical Dual-Metal Hetero-Dielectric Gate All Around MOSFET

In this paper, an analytical model of dual-metal hetero-dielectric (DM-HD) cylindrical gate all around (GAA) MOSFET has been proposed to address and solve a substantial issue of gate-induced drain leakage (GIDL) current in order to improve the device reliability, band-to-band tunneling (BTBT), and OFF state leakages. The structure is based upon asymmetric gate oxide structure by combining silicon dioxide (SiO2) gate dielectric at source side and vacuum dielectric at drain side, which significantly reduces BTBT and OFF-state gate leakages, thereby making it suitable for low-power applications. It is examined that GIDL i.e., an OFF-state leakage phenomenon, is reduced in DM-HD GAA MOSFET by lowering the BTBT. This can be done by reducing OFF-state leakages due to: 1) increase in tunneling width and 2) increased barrier height from source to channel. The results show that the OFF-state leakage current in DM-HD GAA MOSFET reduces to an order of $10^{-\textsf {13}}$ over $10^{-\textsf {9}}$ A as in the case of conventional GAA MOSFET. The results so obtained are compared with those of cylindrical dual-metal GAA (DM-GAA) MOSFET and GAA MOSFET to analyze its performance. OFF-state leakages at higher temperatures have also been analyzed.

Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia: a sham-controlled randomized clinical trial

We report a transcranial direct current stimulation (tDCS) protocol over the dorsolateral prefrontal cortex (DLPFC) combined with cognitive training in schizophrenia. We assessed psychotic symptoms in nine patients using the Positive and Negative Syndrome Scale (PANSS). All evaluations were scored at baseline, at the end of the intervention protocol, and during a 4-week follow-up. The tDCS protocol consisted of 10 consecutive sessions over 5-day periods. We placed the cathode over the right and the anode over the left DLPFC. For sham stimulation, we turned the device off after 60 seconds. Cognitive training consisted of the administration of N-back and sequence learning tasks. We performed an analysis of covariance (ANCOVA) to adjust for the dependent variable PANSS, considering the interaction with baseline severity scores (p = 0.619). Mixed analysis of variance (ANOVA) showed no statistical significance between the groups regarding final PANSS scores. The results failed to demonstrate that the concomitant use of tDCS and cognitive training is effective to improve clinical outcomes in patients with schizophrenia. The present findings should be analyzed with care, considering the small sample size. Larger controlled trials on electric/cognitive stimulation should be produced in order to enhance therapeutic strategies in schizophrenia.

Numerical Study of the Aerodynamic Loads on Offshore Wind Turbines under Typhoon with Full Wind Direction

Super typhoon activity is likely to make the electric power network fail, or blow the wind-measuring device off, which all lead to the yaw control system of wind turbine being inactive. Under this condition, blades can be blown by the violent side wind from unfavorable directions, and the aerodynamic loads on the wind turbine will be increased by a large amount, which can lead to low-cycle fatigue damage and other catastrophic collapses. So far, not enough consideration has been given to the above problems in wind turbine design. Using the transient computational fluid dynamics (CFD), this study investigates the wind load characteristics of offshore wind turbines under typhoon condition with 360-degree full wind directions. Two primary influence factors of the aerodynamic characteristics of wind turbines are clarified: variation of the wind direction and different parking positions of the wind rotor. Using 3D-numerical simulation results, this study provides detailed references for the ultimate strength and fatigue life in wind turbine design, and presents the best parking position of the wind turbine with a free yawing strategy.

An analysis of observer‐rated functional vision in patients implanted with the Argus II Retinal Prosthesis System at three years

ObjectiveThe purpose of this analysis was to compare observer‐rated tasks in patients implanted with the Argus II Retinal Prosthesis System, when the device is ON versus OFF.MethodsThe Functional Low‐Vision Observer Rated Assessment (FLORA) instrument was administered to 26 blind patients implanted with the Argus II Retinal Prosthesis System at a mean follow‐up of 36 months. FLORA is a multi‐component instrument that consists in part of observer‐rated assessment of 35 tasks completed with the device ON versus OFF. The ease with which a patient completes a task is scored using a four‐point scale, ranging from easy (score of 1) to impossible (score of 4). The tasks are evaluated individually and organised into four discrete domains, including ‘Visual orientation’, ‘Visual mobility’, ‘Daily life and ‘Interaction with others’.ResultsTwenty‐six patients completed each of the 35 tasks. Overall, 24 out of 35 tasks (69 per cent) were statistically significantly easier to achieve with the device ON versus OFF. In each of the four domains, patients’ performances were significantly better (p < 0.05) with the device ON versus OFF, ranging from 19 to 38 per cent improvement.ConclusionPatients with an Argus II Retinal Prosthesis implanted for 18 to 44 months (mean 36 months), demonstrated significantly improved completion of vision‐related tasks with the device ON versus OFF.

A novel ultra steep dynamically reconfigurable electrostatically doped silicon nanowire Schottky Barrier FET

In this paper, an ultra steep, symmetric and dynamically configurable, electrostatically doped silicon nanowire Schottky FET (E-SiNW-SB-FET) based on dopant-free technology is investigated. It achieves the ultra steep sub-threshold slope (SS) due to the cumulative effect of weak impact-ionization induced positive feedback and electrostatic modulation of Schottky barrier heights at both source and drain terminals. It consists of axial nanowire heterostructure (silicide-intrinsic silicon-silicide) with three independent all-around gates, two gates are polarity control gates for dynamically reconfiguring the device polarity by modulating the effective Schottky barrier heights and a control gate switches the device ON and OFF. The most interesting features of the proposed structure are simplified fabrication process as the state-of-the-art for ion implantation and high thermal budget no more required for annealing. It is highly immune to process variations, doping control issues and random dopant fluctuations (RDF) and there are no mobility degradation issues related to high doping. A calibrated 3-D TCAD simulation results exhibit the SS of 2 mV/dec for n-type E-SiNW-SB-FET and 9 mV/dec for p-type E-SiNW-SB-FET for about five decades of current. Further, it resolves all the reliability related issues of IMOS as hot electron effects are no more limiting our device performance. It offers significant drive current of the order of 10−5-10−4 A and magnificently high ION/IOFF ratio of ∼108 along with the inherent advantages of symmetric device structure for its circuit realization.

Stimulation latency and comparison of cycling regimens in women using sacral neuromodulation

In this two-part study, we sought to define how long sacral neuromodulation users with overactive bladder should trial a new setting before attributing symptoms to that setting. Subsequently, we evaluated patient preferences of variable stimulation regimens. In the initial phase of this prospective pilot study, participants' devices were turned off and later reactivated; time to symptom recurrence and resolution were recorded. In phase two, participants trialed four settings in a masked fashion with random order. After unmasking, participants chose their preferred setting and were followed 1 year. Twelve subjects completed phase one. With the device off, the mean time to symptom recurrence was 11.25 days. Mean time to symptom regression following reactivation was 6.42 days. Combined, the 90th percentile was 15 days for symptoms to reflect the device's new setting. Among 23 women completing part two, the most popular setting at the time of unmasking was a 1-hr on, 2-hr off cycled setting chosen by 7 (30%) participants. According to published estimates of battery longevity, 14 (61%) participants chose a more energy-conserving setting at the time of unmasking. The mean difference in estimated battery longevity between the chosen and baseline regimens was 14.5 months. These gains diminished in the following year with clinical changes in device settings by patients and providers. Sacral neuromodulation patients should allow a 2-week trial before attributing symptoms to a new setting. With additional information, many opt for energy-conserving settings. A 1-hr on, 2-hr off regimen warrants further study. Neurourol. Urodynam. 36:486-489, 2017. © 2016 Wiley Periodicals, Inc.

Low Frequency Noise Reduction Using Multiple Transistors With Variable Duty Cycle Switched Biasing

Randomization of the trap state of defects present at the gate Si-SiO2 interface of MOSFET is responsible for the low-frequency noise phenomena such as random telegraph signal (RTS) and 1/ ${f}$ noise. Random activity of trapping and de-trapping of mobile charge carriers, in to these defects, can be reduced by switching the device ON and OFF periodically. The analysis of the low-frequency noise considers the non-stationary behavior of traps in time-periodic biasing conditions. In this paper, analysis of the low-frequency noise by deriving a model for RTS noise power spectral density for variable duty cycle switched biasing, is presented. It is concluded that the low-frequency noise can be reduced by using a multi-stage configuration of multiple transistors in place of a single transistor. In this configuration, each transistor has a decreased duty cycle and it is shown from simulation that the noise reduction obtained can be as large as 26 dB for a 40 stage configuration.

Efficacy and safety of a form of cranial electrical stimulation (CES) as an add-on intervention for treatment-resistant major depressive disorder: A three week double blind pilot study

We examined efficacy and safety of one specific cranial electrical stimulator (CES) device at a fixed setting in subjects with treatment-resistant major depressive disorder (MDD). Thirty subjects (57% female, mean age 48.1 ± 12.3 years) with MDD and inadequate response to standard antidepressants were randomized to 3 weeks of treatment with CES (15/500/15,000 Hz, symmetrical rectangular biphasic current of 1–4 mAmp, 40 V) or sham CES (device off) for 20 min, 5 days per week. The primary outcome measure was improvement in the 17-item Hamilton Depression Rating Scale (HAM-D-17). Adverse effects (AEs) were assessed using the Patient Related Inventory of Side Effects (PRISE). Completion rates were 88% for CES, 100% for sham. Both treatment groups demonstrated improvement of about 3–5 points in HAM-D-17 scores (p < 0.05 for both), and no significant differences were observed between groups. Remission rates were 12% for CES, and 15% for sham, a nonsignificant difference. CES was deemed safe, with good tolerability; poor concentration and malaise were the only distressing AEs that differed significantly between CES and sham (p = 0.019 and p = 0.043, respectively). Limitations include a small sample and lack of an active comparator therapy. Although both treatment groups improved significantly, this CES at the setting chosen did not separate from sham in this sample. Thus we cannot rule out that the benefit from this setting used in this particular form of CES was due to placebo effects. Since this form of CES has other settings, future studies should test these settings and compare it against other CES devices.Clinicaltrials.gov ID: NCT01325532

High-Frequency Spinal Cord Stimulation and Pregnancy: A Case Report

High-frequency spinal cord stimulation (HF SCS) is a relatively new modality of SCS. The present general advice concerning pregnancy and SCS, in general, is to turn the device off because of insufficient knowledge concerning the impact on the developing fetus. As HF stimulation generates higher energies, potential adverse fetal effects could be theoretically stronger. This case report describes a 36-year-old woman who had two pregnancies with an active HF SCS system. Her first pregnancy ended in a miscarriage. During her second pregnancy, she continued stimulation treatment during the whole pregnancy. She gave birth to a healthy baby. This case describes both a miscarriage and the birth of a healthy baby in a patient treated with HF SCS. It is not possible to rule out that the HF SCS could have caused the miscarriage. Also, the birth of the healthy baby after the second pregnancy in which HF SCS was used the whole period, is not a valid reason to declare HF SCS and SCS, in general, safe during pregnancy. As no sufficient data are available, we must remain cautious about any unknown possible adverse effects or delayed adverse events because of SCS and maybe especially HF stimulation. All outcome data on pregnancies during all types of SCS ideally should be collected and analyzed.

Evaluation of Ejection Fraction in Patients with cardiac Resynchronization Therapy by Two and Three Dimensional Echocardiography

Introduction: Since assessment of left ventricular ejection fraction (LVEF) is crucial for evaluation of patients with cardiac resynchronization therapy (CRT) device both for selection of potential candidates for CRT as well as assessing outcome of therapy, we compared LVEF in patients with CRT device by two dimensional and three dimensional echocardiography. Methods: Two dimensional echocardiography (2DE) was performed first with CRT device on. LVEF obtained by modified biplane Simpson’s Rule. Then real time three dimensional echocardiography (3DE) was performed by (iE 33, PHILIPS Machine). Procedure was repeated with CRT device off. Results: A total of 19 patients aged 54.6 ±11.2 years (Range: 32 years to 75 years) were studied. LVEF measured by 2DE and 3DE, with CRT device off, was 22±4% (17-27%) and 24 ±3% (15-27%) respectively. With CRT device on, LVEF measured by 2DE and 3DE was 26.6±4.1% (22-32%) and 31.3±5.8% (25-41%) respectively. Conclusion: Two dimensional echocardiography underestimates LVEF as compared to three dimensional echocardiography. Cardiac resynchronization therapy (CRT) improves LVEF measured either by two or three dimensional echocardiography.

CE: Original research: the use of surveillance technology in residential facilities for people with dementia or intellectual disabilities: a study among nurses and support staff.

The use of surveillance technology in residential care facilities for people with dementia or intellectual disabilities is often promoted both as a solution to understaffing and as a means to increasing clients' autonomy. But there are fears that such use might attenuate the care relationship. To investigate how surveillance technology is actually being used by nurses and support staff in residential care facilities for people with dementia or intellectual disabilities, in order to explore the possible benefits and drawbacks of this technology in practice. An ethnographic field study was carried out in two residential care facilities: a nursing home for people with dementia and a facility for people with intellectual disabilities. Data were collected through field observations and informal conversations as well as through formal interviews. Five overarching themes on the use of surveillance technology emerged from the data: continuing to do rounds, alarm fatigue, keeping clients in close proximity, locking the doors, and forgetting to take certain devices off. Despite the presence of surveillance technology, participants still continued their rounds. Alarm fatigue sometimes led participants to turn devices off. Though the technology allowed wandering clients to be tracked more easily, participants often preferred keeping clients nearby, and preferably behind locked doors at night. At times participants forgot to remove less visible devices (such as electronic bracelets) when the original reason for use expired. A more nuanced view of the benefits and drawbacks of surveillance technology is called for. Study participants tended to incorporate surveillance technology into existing care routines and to do so with some reluctance and reservation. They also tended to favor certain technologies, for example, making intensive use of certain devices (such as digital enhanced cordless telecommunications phones) while demonstrating ambivalence about others (such as the tagging and tracking systems). Client safety and physical proximity seemed to be dominant values, suggesting that the fear that surveillance technology will cause attenuation of the care relationship is unfounded. On the other hand, the values of client freedom and autonomy seemed less influential; participants often appeared unwilling to take risks with the technology. Care facilities wishing to implement surveillance technology should encourage ongoing dialogue on how staff members view and understand the concepts of autonomy and risk. A clear and well-formulated vision for the use of surveillance technology-one understood and supported by all stakeholders-seems imperative to successful implementation.

Electrostatic precipitation is a novel way of maintaining visual field clarity during laparoscopic surgery: a prospective double-blind randomized controlled pilot study

Ultravision™ is a new device that utilizes electrostatic precipitation to clear surgical smoke. The aim was to evaluate its performance during laparoscopic cholecystectomy. Patients undergoing laparoscopic cholecystectomy were randomized into "active (device on)" or "control (device off)." Three operating surgeons scored the percentage effective visibility and three reviewers scored the percentage of the procedure where smoke was present. All assessors also used a 5-point scale (1 = imperceptible/excellent and 5 = very annoying/bad) to rate visual impairment. Secondary outcomes were the number of smoke-related pauses, camera cleaning, and pneumoperitoneum reductions. Mean results are presented with 95% confidence intervals (CI). In 30 patients (active 13, control 17), the effective visibility was 89.2% (83.3-95.0) for active cases and 71.2% (65.7-76.7) for controls. The proportion of the procedure where smoke was present was 41.1% (33.8-48.3) for active cases and 61.5% (49.0-74.1) for controls. Operating surgeons rated the visual impairment as 2.2 (1.7-2.6) for active cases and 3.2 (2.8-3.5) for controls. Reviewers rated the visual impairment as 2.3 (2.0-2.5) for active cases and 3.2 (2.8-3.7) for controls. In the active group, 23% of procedures were paused to allow smoke clearance compared to 94% of control cases. Camera cleaning was not needed in 85% of active procedures and 35% of controls. The pneumoperitoneum was reduced in 0% of active cases and 88% of controls. Ultravision™ improves visibility during laparoscopic surgery and reduces delays in surgery for smoke clearance and camera cleaning.

Enhancement of detection by selective modification of silicon nanobelt field-effect transistors via localized Joule heating

We utilized localized Joule heating to ablate methoxy-poly (ethylene-glycol)-silane (mPEG-sil) modified on the p− region of an n+–p−–n+ silicon nanobelt field-effect transistor (SNFET). SNFETs with selective modifications of 3-aminopropyltrimethoxysilane (APTMS) and NHS-biotin on the ablated region exhibited a faster sensing response rate and a higher sensitivity in real-time detection of Streptavidin (SA). Characterization of the ablated region via lateral force microscopy and the fluorescence image show that the ablation region occurs only in the p− region near the drain side and is believed to be a result of the impact ionization mechanism during Joule heating. Moreover, a bias of 20V pulse voltage for 1ms successfully ablates mPEG-sil and reduces the device off leakage current by 1 order after Joule heating. However, Joule heating with a pulse voltage larger than 20V (1ms) yielded an increase of device off leakage owing to damage to gate dielectrics during Joule heating. A comparison of real-time detection of SA between selectively and non-selectively modified chips shows that selectively modified ones exhibit a better limit of detection (LOD) that is one order lower than non-selectively modified ones, and a sensing response rate twice as fast as the non-selectively modified one for every target concentration.

Gastric electrical stimulation with Enterra therapy improves symptoms of idiopathic gastroparesis.

BackgroundGastric electrical stimulation (GES) is a therapeutic option for intractable symptoms of gastroparesis (GP). Idiopathic GP (ID-GP) represents a subset of GP. AIMS: A prospective, multicenter, double-blinded, randomized, crossover study to evaluate the safety and efficacy of Enterra GES in the treatment of chronic vomiting in ID-GP.MethodsThirty-two ID-GP subjects (mean age 39; 81% F, mean 7.7 years of GP) were implanted with GES. The stimulator was turned ON for 1½ months followed by double-blind randomization to consecutive 3-month crossover periods with the device either ON or OFF. ON stimulation was followed in unblinded fashion for another 4.5 months. Twenty-five subjects completed the crossover phase and 21 finished 1 year of follow-up.Key ResultsDuring the unblinded ON period, there was a reduction in weekly vomiting frequency (WVF) from baseline (61.2%, P < 0.001). There was a non-significant reduction in WVF between ON vs OFF periods (the primary outcome) with median reduction of 17% (P > 0.10). Seventy-five percent of patients preferred the ON vs OFF period (P = 0.021). At 1 year, WVF remained decreased (median reduction = 87%, P < 0.001), accompanied by improvements in GP symptoms, gastric emptying and days of hospitalization (P < 0.05).Conclusions & Inferences(i) In this prospective study of Enterra GES for ID-GP, there was a reduction in vomiting during the initial ON period; (ii) The double-blind 3-month periods showed a non-significant reduction in vomiting in the ON vs OFF period, the primary outcome variable; (iii) At 12 months with ON stimulation, there was a sustained decrease in vomiting and days of hospitalizations.

Fine-scale vertical and horizontal movements of juvenile yellowfin tuna (Thunnus albacares ) associated with a subsurface fish aggregating device (FAD) off southwestern Taiwan

Summary An increase in yellowfin tuna (Thunnus albacares) catch by danish seine fisheries around the subsurface fish aggregating devices (FADs) in southern Taiwan waters has been a concern of local government and environmental groups. However, the attraction mechanism of aggregating tunas at the subsurface FADs is still poorly understood. The objective of this study is to examine the fine-scale vertical and horizontal movements of juvenile yellowfin tunas around a subsurface FAD. In total, 53 tunas (35–81 cm fork length) were tagged with ultrasonic telemetry tags and released at a subsurface FAD in the waters off Shiao-Liu-Chiu Island, southwestern Taiwan from October 2008 to December 2009. These tunas stayed at the subsurface FAD for up to 31 days, with daytime vertical movement depths averaging 60–80 m at a maximum depth of 250 m. At night, the tuna gathered at a shallow depth of 40 m. The mean depth of vertical movement in the daytime is significantly different from that of the nighttime (P < 0.05). The maximum detectable distance of horizontal movement was 1.6 km, with 80% of the long horizontal movements occurring in the daytime. It is likely that the purpose of these vertical and horizontal movements was for feeding or avoiding predators. Moreover, the tagged tunas did not depart from the subsurface FAD simultaneously, suggesting distinct behaviors in their movements.