Inadequate Temperature Research Articles

Feeding in full-time public schools: Do students adhere and accept?

ABSTRACT Objective Identifying adherence to, and acceptance of school feeding, and analyzing the factors associated with non-adherence/non-acceptance in full-time public schools in Goiânia, Goiás, Brazil. Methods Cross-sectional study with students of both sexes aged 6-14 years. Issues regarding the consumption of meals, food distribution, food eaten outside the school and socioeconomic data, including nutritional assessment of students, were investigated. Adherence to meals was defined as the consumption of school meals four to five times/week, and acceptance was defined as meal approval, using the facial hedonic scale. Results A total of 359 students participated in this study and it was observed that adherence was high for lunch (95%) and afternoon snacks (78%), and low for morning snacks (44%). Acceptance did not reach the required minimum percentage of 85% for any of the meals. Factors associated with non-adherence were the presence of >4 people in a household, having meals in a refectory, the meal location being considered uncomfortable and a negative evaluation of utensils used in eating meals. Factors associated with non-acceptance were age >10 years, female sex, the negative evaluation of utensils used in eating meals and inadequate food temperature. Conclusion Lunch and afternoon snacks showed the highest adherence, but the stipulated acceptance was not reached. Non-adherence and non-acceptance were mainly associated with aspects related to school feeding. This study allowed the evaluation of feeding in full-time public schools, in order to influence its improvement.

Analysis of the influence of the return position in the vertical temperature gradient in displacement ventilation systems for large halls

Displacement ventilation systems are widely used in spaces of small and medium heights (up to 7.5m), taking advantage of their high efficiency in removing contaminants by means of the air stratification. This outcome usually hides major drawbacks compared to admixture systems, such as inadequate temperature gradient in the occupied zone and low cooling capacity. On the contrary, its use in large spaces with high ceilings displays the best features of the system, provided the return is placed near the ceiling. When, due to architectural reasons, this option is not feasible, alternatives for the return position are assessed using simulation tools that result in excessive time consumption during the design stage. In this article a simple Mundt’s equation based iterative process is proposed to quickly evaluate the influence of the return height in the vertical temperature gradient and the additional cooling load due to overheated ceiling. It has been applied to the case of Madrid airport new terminal, and their results have been compared to a CFD simulation, with a reasonable degree of accuracy for an initial stage of a design process. The results show that the higher the return is placed, the lesser airflow rate is needed to match the additional cooling load due to radiation from the ceiling. The calculation process also shows that Mundt’s radiant heat exchange coefficient is far from being constant, for it is affected by the height of the return point, and takes values much greater than the usually accepted.

Variation in Meat Quality Characteristics of Whitetail Deer (Odocoileus Virginianus) in Ohio

ObjectivesConsumption of venison from whitetail deer is increasing. However, due to certain hunting practices including improper exsanguination from marksmanship failures, inadequate postmortem temperature decline, and unhygienic conditions in the designated hunting areas, there is a potential for meat quality issues in venison. Therefore, the purpose of this research was to survey venison meat quality to provide characterization data for our meat processing partners from animals harvested during firearm season.Materials and MethodsWhole, boneless shoulders from 41 whitetail deer harvested from November 2015 to January 2016 were obtained from three separate venison processors. Shoulders were ground and a portion was frozen at –80°C for biochemical testing of pH, muscle pigment (myoglobin and hemoglobin) concentration, lactate, residual carbohydrate (glycogen + glucose + glucose 6-phosphate), and glycolytic potential. The remainder of the raw venison was mixed with a 15% NaCl solution at a 10:1 ratio (wt./vol.), formed into 70 g patties, vacuum sealed, and frozen at –20°C. After thawing overnight at 4°C, the patties were allowed to bloom at room temperature for 10 min and analyzed for Minolta color (L*, a*, and b*) and thaw loss. The patties were then cooked until an internal temperature of 71°C was achieved (∼2.5 min) and cooking loss, shrinkage, and Warner-Bratzler shear force were determined. Data are reported as mean ± SE with the minimum and maximum values from each analysis.ResultsIn general, venison meat quality varied dramatically (Table 1). Of the 41 samples, 15% (6/41) were classified as dark cutters (ultimate pH ≥ 6.0). The high prevalence of dark cutters could be due to antemortem stress and/or limited exsanguination allowing lactate transport out of the muscle prior to death. Despite a high degree of variability, ultimate pH was correlated to a number of biochemical and quality characteristics. The meat pH was negatively correlated with lactate (R2 = 0.51; P < 0.0001), residual carbohydrate (R2 = 0.28; P = 0.0002), and glycolytic potential (R2 = 0.37; P < 0.0001). The meat pH was also positively correlated with a* (R2 = 0.22; P = 0.0012) which suggests that pH affects meat color in whitetail deer which is consistent with other species.Table 1Fresh meat quality characteristics of whitetail deerMeasurementMinMaxMean ± SEpH5.586.425.81 ± 0.020Lactate, μmol/g32.6064.7049.40 ± 1.20Residual carbohydrate, μmol/g3.5078.3035.80 ± 3.00Glycolytic potential42.60210.90121.00 ± 6.60Muscle pigment, mg/g7.5014.9010.80 ± 0.30Lightness, L*31.7242.9536.22 ± 0.39Redness, a*8.4216.9011.70 ± 0.35Yellowness, b*3.058.665.75 ± 0.22Thaw loss, %0.253.861.45 ± 0.15Cooking loss, %8.4230.4921.47 ± 0.74Shrinkage, %5.1026.9012.4 ± 0.60WBSF, kg0.892.651.53 ± 0.07ConclusionThese data indicate that venison meat quality from whitetail deer harvested during firearm season in Ohio is highly variable.

Variation in Meat Quality Characteristics of Whitetail Deer (Odocoileus Virginianus) in Ohio

ObjectivesConsumption of venison from whitetail deer is increasing. However, due to certain hunting practices including improper exsanguination from marksmanship failures, inadequate postmortem temperature decline, and unhygienic conditions in the designated hunting areas, there is a potential for meat quality issues in venison. Therefore, the purpose of this research was to survey venison meat quality to provide characterization data for our meat processing partners from animals harvested during firearm season.Materials and MethodsWhole, boneless shoulders from 41 whitetail deer harvested from November 2015 to January 2016 were obtained from three separate venison processors. Shoulders were ground and a portion was frozen at –80°C for biochemical testing of pH, muscle pigment (myoglobin and hemoglobin) concentration, lactate, residual carbohydrate (glycogen + glucose + glucose 6-phosphate), and glycolytic potential. The remainder of the raw venison was mixed with a 15% NaCl solution at a 10:1 ratio (wt./vol.), formed into 70 g patties, vacuum sealed, and frozen at –20°C. After thawing overnight at 4°C, the patties were allowed to bloom at room temperature for 10 min and analyzed for Minolta color (L*, a*, and b*) and thaw loss. The patties were then cooked until an internal temperature of 71°C was achieved (∼2.5 min) and cooking loss, shrinkage, and Warner-Bratzler shear force were determined. Data are reported as mean ± SE with the minimum and maximum values from each analysis.ResultsIn general, venison meat quality varied dramatically (Table 1). Of the 41 samples, 15% (6/41) were classified as dark cutters (ultimate pH ≥ 6.0). The high prevalence of dark cutters could be due to antemortem stress and/or limited exsanguination allowing lactate transport out of the muscle prior to death. Despite a high degree of variability, ultimate pH was correlated to a number of biochemical and quality characteristics. The meat pH was negatively correlated with lactate (R2 = 0.51; P < 0.0001), residual carbohydrate (R2 = 0.28; P = 0.0002), and glycolytic potential (R2 = 0.37; P < 0.0001). The meat pH was also positively correlated with a* (R2 = 0.22; P = 0.0012) which suggests that pH affects meat color in whitetail deer which is consistent with other species.Table 1Fresh meat quality characteristics of whitetail deerMeasurementMinMaxMean ± SEpH5.586.425.81 ± 0.020Lactate, μmol/g32.6064.7049.40 ± 1.20Residual carbohydrate, μmol/g3.5078.3035.80 ± 3.00Glycolytic potential42.60210.90121.00 ± 6.60Muscle pigment, mg/g7.5014.9010.80 ± 0.30Lightness, L*31.7242.9536.22 ± 0.39Redness, a*8.4216.9011.70 ± 0.35Yellowness, b*3.058.665.75 ± 0.22Thaw loss, %0.253.861.45 ± 0.15Cooking loss, %8.4230.4921.47 ± 0.74Shrinkage, %5.1026.9012.4 ± 0.60WBSF, kg0.892.651.53 ± 0.07ConclusionThese data indicate that venison meat quality from whitetail deer harvested during firearm season in Ohio is highly variable.

Vapour-tight layer and its effect on surface temperatures of curtain walling

The primary function of a vapour-tight layer is to reduce or prevent the spread of humidity from the interior to other layers of the surrounding structures. This would otherwise result in condensation of (water) vapour due to a drop in temperature. In some cases, the behaviour of real structures differs from the structure modelled using a computational programme. This paper deals with the factors that can affect the features of a structure, specifically the internal and external surface temperature of curtain walling. The heat reflection effect of a vapour-tight layer was investigated on a model panel of curtain walling. An inadequate surface temperature can have a negative impact in that it promotes a biotic attack. This results in surface degradation which affects the continuous layers in the adjacent structures.

Vapour-tight layer and its effect on surface temperatures of curtain walling

The primary function of a vapour-tight layer is to reduce or prevent the spread of humidity from the interior to other layers of the surrounding structures. This would otherwise result in condensation of (water) vapour due to a drop in temperature. In some cases, the behaviour of real structures differs from the structure modelled using a computational programme. This paper deals with the factors that can affect the features of a structure, specifically the internal and external surface temperature of curtain walling. The heat reflection effect of a vapour-tight layer was investigated on a model panel of curtain walling. An inadequate surface temperature can have a negative impact in that it promotes a biotic attack. This results in surface degradation which affects the continuous layers in the adjacent structures.

DEVELOPMENT OF LOW COST BLOCK MOLD FOR COPPER ALLOY CASTING

Suitable block mold formulations for copper alloy casting have been developed and the formulations used were 25% plaster of paris (POP), 75% silica sand and 31-37% water. Silica sand with a grain size of 106-212 µm was added into dilute suspension of POP and the mixing process was continued until a thick slurry (mixture) was obtained. It has been found that the mixing time of molding materials was highly depended on the type of plaster and optimum slurry viscosity around the diameter of 7.7 – 9.6 cm (slump test) was essential to ensure that the wax pattern could be fully invested. In the dewaxing process, the mold was subjected to the temperature of 170oC for 3 hours and burnout process was effectively achieved by heating the molds at 750oC for 5 hours. The pouring process was successfully carried out without any leakage and it was found that all molds can be easily broken under a force of a hammer. The developed mold also able to produce fully formed of casting without any major defects such as misrun, fin or flash and rat tail, which can be associated with inadequate mold temperature, mold cracks and the separation of mold’s material respectively.

An Outbreak of Human Listeriosis in England between 2010 and 2012 Associated with the Consumption of Pork Pies

An outbreak of listeriosis in England affecting 14 people between 2010 and 2012 and linked to the consumption of pork pies was investigated. All 14 individuals were older than 55 years, 12 were men, and 10 reported the presence of an underlying condition. All were resident in or had visited either of two English regions and were infected with the same strain of Listeria monocytogenes. In interviews with 12 patients, 9 reported eating pork pies, and individuals that consumed pork pies were significantly more likely to be infected with an outbreak strain than were individuals with sporadic cases of listeriosis infections in England from 2010 to 2012. Pork pies were purchased from seven retailers in South Yorkshire or the East Midlands, and the outbreak strain was recovered from pork pies supplied by only the producer in South Yorkshire. The outbreak strain was also recovered from samples of finished product and from environmental samples collected from the manufacturer. The likely source of contamination was environmental sites within the manufacturing environment, and the contamination was associated with the process of adding gelatin to the pies after cooking. Inadequate temperature control and poor hygienic practices at one of the retailers were also identified as possible contributory factors allowing growth of the pathogen. Following improvements in manufacturing practices and implementation of additional control measures at the retailers' premises, L. monocytogenes was not recovered from subsequent food and environmental samples, and the outbreak strain was not detected in further individuals with listeriosis in England.

Outdoor production of Tisochrysis lutea in pilot-scale tubular photobioreactors

In this paper we study the outdoor production of Tisochrysis lutea in pilot-scale tubular photobioreactors (3.0 m3). Experiments were performed modifying the dilution rate and evaluating biomass productivity and quality, in addition to the overall performance of the system. Results confirm that T. lutea can be produced outdoors on a commercial scale in continuous mode, obtaining productivities of up to 20 g m−2 day−1 of biomass, which are rich in proteins (45 % d.wt.) and lipids (25 % d.wt.). The utilization of this type of photobioreactor allows one to control the levels of contamination and pH within the cultures, but daily variations in solar radiation impose elevated dissolved oxygen concentrations and insufficient temperature conditions on the cells inside the reactor. Excessive dissolved oxygen reduces biomass productivity to 68 % of that which is maximal, whereas inadequate temperature reduces it to 63 % of maximum. Thus, by optimally controlling these parameters, biomass productivity can be almost doubled. These results confirm the potential for producing this valuable strain on a commercial scale in optimally designed/operated tubular photobioreactors as a viable biotechnological industry.

Temperature Management During Circulatory Arrest in Cardiac Surgery.

Surgery for complex aortic pathologies, such as acute dissections and aneurysms involving the aortic arch, remains one of the most technically and strategically challenging intervention in aortic surgery, requiring thorough understanding not only of cardiovascular physiology but also of neurophysiology (cerebral and spinal cord), and is still associated with significant mortality and morbidity. The introduction of deep hypothermia in the mid 1970s, allowing defined periods of circulatory arrest, has made possible the advent of modern aortic surgery requiring prolonged ischemic tolerance of central nervous system. In the late 1980s, when deep hypothermic circulatory arrest was the standard operative strategy for aortic surgery, selective cerebral perfusion, as an adjunct to deep hypothermia, made possible excellent neuroprotection and improved overall outcome. This encouraged the use of selective cerebral perfusion in combination with steadily increasing body core temperatures, a trend culminating in progressive promotion of moderate to mild hypothermia and even normothermia. The motivation for progressive temperature elevation was the limitation of adverse effects of deep hypothermia, in particular, reduction of systemic inflammatory response (and organ dysfunctions) and diminution of the risk of severe postoperative bleeding. However, adverse outcomes due to inappropriate temperature management (core temperatures too high for the required duration of circulatory arrest) are probably underreported. Indeed, complications historically associated with hypothermia are possibly overestimated.

Modeling of photosynthesis and respiration rate for Isochrysis galbana (T-Iso) and its influence on the production of this strain

Isochrysis galbana is a widely-used strain in aquaculture in spite of its low productivity. To maximize the productivity of processes based on this microalgae strain, we have developed a model considering the influence of irradiance, temperature, pH and dissolved oxygen concentration on the photosynthesis and respiration rate. Results demonstrate that this strain tolerates temperatures up to 35°C but it is highly sensitive to irradiances higher than 500μEm−2s−1 and dissolved oxygen concentrations higher than 11mgl−1. We have validated the developed model using data from an industrial-scale outdoor tubular photobioreactor demonstrating that inadequate temperature and dissolved oxygen concentrations reduce productivity to half that which is maximal, according to light availability under real outdoor conditions. The developed model is a useful tool for managing working processes, but especially in the development of new processes based on this strain and to take decisions regarding optimal control strategies.

A importância da qualificação de manipuladores de alimentos: estudo de caso na produção de salgados na cidade de Mariana/MG

Between the years of 2011 and 2014, 102 people - of which 82.35% were women - have been trained in food handling. During the same period, at the request of VISA Mariana / MG, a survey on the bacteriological quality of Snack foods marketed was carried out on the city, in order to verify their bacteriological quality when sold by bakeries, cafeterias and private salting. 82.61% of the 23 analyzed samples had some type of contamination and 13% of the analyzed samples were rejected for having the presence of Staphylococcus aureus and Escherichia coli. It is therefore concluded that the need for capacity building in food handlers is real: because the sanitary conditions of the establishments were poor, snack foods were storage at inadequate temperature and there was breach of duty of the Good Practice rules.

A importância da qualificação de manipuladores de alimentos: estudo de caso na produção de salgados na cidade de Mariana/MG

Entre os anos de 2011 e 2014, 102 pessoas, 82,35% de mulheres, foram capacitadas em manipulacao de alimentos. Nesse mesmo periodo, a pedido da VISA de Mariana/MG realizou-se um levantamento da qualidade bacteriologica de salgados comercializados com o objetivo de verificar a qualidade dos mesmos quando vendidos por padarias, lanchonetes e salgadeiras particulares. 13% das amostras analisadas foram reprovadas por apresentarem a presenca de bacterias Staphylococcus aureus e Escherichia coli e 82,61% das 23 amostras analisadas apresentaram algum tipo de contaminacao. Conclui-se que a necessidade da capacitacao em Manipulador de alimentos e real, pois as condicoes sanitarias dos estabelecimentos eram precarias, a temperatura de armazenamento inadequada e observou-se descumprimento das regras de Boas Praticas. DOI: http://dx.doi.org/10.35700/ca.2015.ano2n3.p14-22.1824

Photo-thermal effect enhances the efficiency of radiotherapy using Arg-Gly-Asp peptides-conjugated gold nanorods that target αvβ3 in melanoma cancer cells.

BackgroundThermotherapy has been known to be one of the most effective adjuvants to radiotherapy (RT) in cancer treatment, but it is not widely implemented clinically due to some limitations, such as, inadequate temperature concentrations to the tumor tissue, nonspecific and non-uniform distribution of heat. So we constructed arginine-glycine-aspartate peptides-conjugated gold nanorods (RGD-GNRs) that target the alpha(v) beta(3) Integrin (αvβ3) and investigate whether the photo-thermal effect of RGD-GNRs by near infrared radiation (NIR) could enhance the efficiency of RT in melanoma cancer cells.ResultsRGD-GNRs could be seen both on the surface of the cell membranes and cytoplasm of A375 cells with high expression of αvβ3. After exposed to 808 nm NIR, RGD-GNRs with various concentrations could be rapidly heated up. Compared to other treatments, flow cytometric analysis indicated that RT + NIR + RGD-GNRs increased apoptosis (p < 0.001) and decreased the proportion of cells in the more radioresistant S phase (p = 0.014). Treated with NIR + RGD-GNRs, the radiosensitivity was also significantly enhanced (DMFSF2: 1.41).ConclusionResults of the current study showed the feasibility of using RGD-GNRs for synergetic RT with photo-thermal therapy. And it would greatly benefit the therapeutic effects of refractory or recurrent malignant cancers.

Malignant Hyperthermia Deaths Related to Inadequate Temperature Monitoring, 2007–2012

Malignant Hyperthermia Deaths Related to Inadequate Temperature Monitoring, 2007–2012

Nutrition quality control in the prescription and administration of parenteral nutrition therapy for hospitalized patients.

Nutrition quality control in parenteral nutrition therapy (PNT) allows the identification of inadequate processes in parenteral nutrition (PN). The objective of this study was to assess the quality of PNT at a hospital with an established nutrition support team (NST). This observational, longitudinal, analytical, and prospective study examined 100 hospitalized PNT adult patients under the care of an NST for 21 days or until death/hospital discharge. The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) 2007 guidelines for PNT prescription were followed. PNT indications were not in accordance with the A.S.P.E.N. 2007 guidelines in 15 patients. Among the remaining 85 patients, 48 (56.5%) did not receive adequate PNT (≥80% of the total volume prescribed). Non-NST medical orders, progression to and from enteral nutrition, changes in the central venous catheter, unknown causes, and operational errors (eg, medical prescription loss, PN nondelivery, pharmacy delays, inadequate PN bag temperature) were associated with PNT inadequacy (P < .005). Compared with patients who died, the discharged patients received PN volumes ≥80% on most days (P = .047). The quality indicators for nutrition therapy related to estimated energy expenditure and protein requirements and glycemia levels reached the expected targets; however, the central venous catheter infection rate was higher than 6 per 1000 catheters/d and did not meet the expected targets. Despite an established NST, there was a moderate level of PNT inadequacy in indications, administration, and monitoring. It is important to establish periodic meetings among different health professionals who prescribe and deliver PNT to define responsibilities and protocols.

High Relative Cooling Power in a Multiphase Magnetocaloric FeNiB Alloy

Low-cost magnetic cooling based on the magnetocaloric effect is an energy efficient, environmentally friendly, thermal management technology. However, inadequate temperature span is often a challenge in developing a magnetic cooling system. We report the novel use of multiphase materials to enhance the working temperature span (δT <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">FWHM</sub> ) of the magnetic entropy change and the relative cooling power of a Fe-Ni-B bulk alloy. The coexistence of bcc, fcc, and spinel phases results in large working temperature spans of 322.3 and 439.0 K for magnetic field change of 1 and 5 T, respectively. δT <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">FWHM</sub> for this multiphase (Fe <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">70</sub> Ni <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">30</sub> ) <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">89</sub> B <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">11</sub> alloy is about 86% higher than the corresponding value for single-phase γ-(Fe <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">70</sub> Ni <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">30</sub> ) <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">89</sub> B <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">11</sub> alloy for ΔH = 1 T. These values are the largest for any bulk magnetocaloric material and even higher than most magnetocaloric nanoparticles. The relative cooling power is also higher than comparable materials, including the benchmark magnetocaloric material, gadolinium.

Lack of evidence so far for Noroviruses in food samples collected on cruise ships sailing the Mediterranean waters.

Closed living spaces like cruise ship settings create an environment in which enteric viruses including Noroviruses (NoVs) can easily spread and outbreaks readily occur. The contribution of sources other than common confirmed vehicles to foodborne illness in cruise ships was investigated. None of the 189 collected samples (including meat, fish, buffet meals, fruits, vegetables etc.) tested by real-time RT-PCR (ISO/TS 15216-2:2013) reveled NoVs genome. Naturally contaminated food items other than shellfish have been demonstrated to be cause of NoVs infection thus, our results could neither indicate nor exclude food items as possible vehicle of infection. Reducing risk factors associated with NoVs outbreaks (contaminated raw ingredients, cross contamination, infected food handlers, inadequate temperature controls, heat treatments) is always strongly recommended.

Malignant hyperthermia deaths related to inadequate temperature monitoring, 2007-2012: a report from the North American malignant hyperthermia registry of the malignant hyperthermia association of the United States.

AMRA (adverse metabolic or muscular reaction to anesthesia) reports submitted to The North American Malignant Hyperthermia Registry of the Malignant Hyperthermia Association of the United States from 1987 to 2006 revealed a 2.7% cardiac arrest and a 1.4% death rate for 291 malignant hyperthermia (MH) events. We analyzed 6 years of recent data to update MH cardiac arrest and death rates, summarized characteristics associated with cardiac arrest and death, and documented differences between early and recent cohorts of patients in the MH Registry. We also tested whether the available data supported the hypothesis that risk of dying from an episode of MH is increased in patients with inadequate temperature monitoring. We included U.S. or Canadian reports of adverse events after administration of at least 1 anesthetic drug, received between January 1, 2007, and December 31, 2012, with an MH clinical grading scale rank of "very likely MH" or "almost certain MH." We excluded reports that, after review, were judged to be due to pathologic conditions other than MH. We analyzed patient demographics, family and patient anesthetic history, anesthetic management including temperature monitoring, initial dantrolene dose, use of cardiopulmonary resuscitation, MH complications, survival, and reported molecular genetic DNA analysis of RYR1 and CACNA1S. A one-sided Cochran-Armitage test for proportions evaluated associations between mode of monitoring and mortality. We used Miettinen and Nurminen's method for assessing the relative risk of dying according to monitoring method. We used the P value of the slope to evaluate the relationship between duration of anesthetic exposure before dantrolene administration and peak temperature. We calculated the relative risk of death in this cohort compared with our previous cohort by using the Miettinen and Nurminen method adjusted for 4 comparisons. Of 189 AMRA reports, 84 met our inclusion criteria. These included 7 (8.3%) cardiac arrests, no successful resuscitations, and 8 (9.5%) deaths. Of the 8 patients who died, 7 underwent elective surgeries considered low to intermediate risk. The average age of patients who died was 31.4 ± 16.9 years. Five were healthy preoperatively. Three of the 8 patients had unrevealed MH family history. Four of 8 anesthetics were performed in freestanding facilities. In those who died, 3 MH-causative RYR1 mutations and 3 RYR1 variants likely to have been pathogenic were found in the 6 patients in whom RYR1 was examined. Compared to core temperature monitoring, the relative risk of dying with no temperature monitoring was 13.8 (lower limit 2.1). Compared to core temperature monitoring, the relative risk of dying with skin temperature monitoring was 9.7 (1.5). Temperature monitoring mode best distinguished patients who lived from those who died. End-tidal CO2 was the worst physiologic measure to distinguish patients who lived from those who died. Longer anesthetic exposures before dantrolene were associated with higher peak temperatures (P = 0.00056). Compared with the early cohort, the recent cohort had a higher percentage of MH deaths (4/291 vs 8/84; relative risk = 6.9; 95% confidence interval, 1.7-28; P = 0.0043 after adjustment for 4 comparisons). Despite a thorough understanding of the management of MH and the availability of a specific antidote, the risk of dying from an MH episode remains unacceptably high. To increase the chance of successful MH treatment, the American Society of Anesthesiologists and Malignant Hyperthermia Association of the U.S. monitoring standards should be altered to require core temperature monitoring for all general anesthetics lasting 30 minutes or longer.

동파방지 발열선용 온도제어기 개발 및 전기에너지 절감 효과 분석

Although anti-freezing heating cable has been widely installed in most residential boiler pipe, there were excessive energy consumption and fire risk due to inadequate temperature control. In this paper, a new energy saving fire risk-free controller was developed by using microprocessing operation which include detection of not only boiler room temperature but also pipe surface one. Its actual effect has been verified to save more than a half of the energy consumption comparing to conventional controller through temperature and humidity chamber experiment.