Intermittent Measurements Research Articles

Ternary all-lithium-reactive AlGeP solid solution as an advanced anode material for lithium-ion batteries

With the rapid development of portable electronic devices and electric vehicles, lithium-ion batteries (LIBs) are being used extensively as clean and efficient power sources. Among the various anode materials being explored for use in LIBs, Ge has attracted significant attention owing to its high theoretical specific capacity. However, low electronic conductivity, relative poor Li-ion mobility, large volume expansion impede its commercial application. Herein, we synthesize a single-phase AlGeP solid solution through a facile high-energy ball milling of the raw materials of Al, P and Ge. The ternary AlGeP exhibits superior Li-storage properties than the single-component phase of Ge in terms of longer cycling stability, and faster rate performance profiting from its faster electronic conductivity confirmed by electrochemical impedance spectra, and higher Li-ion mobility confirmed by galvanostatic intermittent titration technique measurements. Moreover, we further promote the electrochemical Li-storage properties of the ternary AlGeP through carbon modification which accommodate the volume expansion and improve the electronic conductivity. Broadly this work will stimulate more research interest on ternary all-lithium-reactive compounds in the energy storage field.

Energy-to-Peak State Estimation With Intermittent Measurement Outliers: The Single-Output Case.

This article is concerned with the energy-to-peak state estimation problem for a class of linear discrete-time systems with energy-bounded noises and intermittent measurement outliers (IMOs). In order to capture the intermittent nature, two sequences of step functions are introduced to model the occurrence of the IMOs. Furthermore, two special indices (i.e., minimum and maximum interval lengths) are adopted to describe the "occurrence frequency" of IMOs. Different from the considered energy-bounded noises, the outliers are assumed to have their magnitudes larger than certain thresholds. In order to achieve a satisfactory performance constraint on the energy-to-peak state estimation under the addressed kind of measurement outliers, a novel parameter-dependent (PD) state estimation strategy is developed to guarantee that the measurements contaminated by outliers would be removed in the estimation process. The proposed PD state estimation method is essentially a two-step process, where the first step is to examine the appearing and disappearing moments for each IMO by using a dedicatedly constructed outlier detection scheme, and the second step is to implement the state estimation task according to the outlier detection results. Sufficient conditions are obtained to ensure the existence of the desired estimator, and the gain matrix of the desired estimator is then derived by solving a constrained optimization problem. Finally, a simulation example is presented to illustrate the effectiveness of our developed PD state estimation strategy.

Atomic-scale interfacial engineering enables high-performance electrochemical glucose detection

Developing noble-metal free electrocatalysts with high sensitivity is critical for the large-scale application of electrochemical glucose sensors. This work reports an atomic-scale interfacial engineering strategy to construct highly-active electrocatalyst for glucose detection. Ni(OH)2 nanosheets are decorated with an ultra-thin layer of Co9S8 using the atomic layer deposition (ALD) technique. After in-situ reconstruction, we obtain Ni@Co heterostructure composed of Ni hydroxide nanosheets and CoOx clusters, which exhibits outstanding electrochemical glucose sensing performance. Combining synchrotron-based X-ray adsorption spectroscopy, in situ Raman Spectroscopy, intermittent electrochemical measurements and density functional theory (DFT) calculations, we find that the presence of surface CoOx not only lowers the valence state of Ni, but also facilitates the deprotonation of Ni(OH)2 to form NiOOH active species for glucose oxidation. The approach used in this work can be adapted to synthesizing high-performance electrocatalysts for other energy and environmental devices.

Asynchronously finite‐time fault detection for switched systems with unstable modes and intermittent measurements

This study proposes a novel fault detection (FD) filter design approach for switched systems with unstable modes and intermittent measurement; the FD filter design approach considers asynchronous switching and ensures finite-time stability (FTS). First, a model of switched systems with undesirable communication and unstable modes is established. The FD filter is developed using the observer technique, and the conditions of FTS and H∞ performance for the above systems are proposed and verified. The multiple discontinuous Lyapunov function (MDLF) method and the mode-dependent average dwell time (DT) method are used to obtain the switching strategy, which includes fast and slow switching to address the stability of unstable and stable modes, respectively. Compared with conventional approaches, the proposed method can realize less conservative stability conditions and a more flexible design framework, providing an efficient approach for improving system performance. Finally, based on the determined FTS criteria and H∞ performance, the FD filter for switched systems is presented. Simulation results are provided to verify the effectiveness of the proposed method.

Comparison between Fourth-Generation FloTrac/Vigileo System and Continuous Thermodilution Technique for Cardiac Output Estimation after Time Adjustment during Off-Pump Coronary Artery Bypass Graft Surgery: A Retrospective Cohort Study.

(1) Background: Previous studies reported limited performance of arterial pressure waveform-based cardiac output (CO) estimation (FloTrac/Vigileo system; CO-FloTrac) compared with the intermittent thermodilution technique (COint). However, errors due to bolus maneuver and intermittent measurements of COint could limit its use as a reference. The continuous thermodilution technique (COcont) may relieve such limitations. (2) Methods: The performance of CO-FloTrac was retrospectively assessed using continuous recordings of intraoperative physiological data acquired from patients who underwent off-pump coronary artery bypass graft (OPCAB) surgery with CO monitoring using both CO-FloTrac and COcont. Optimal time adjustments between the two measurements were determined based on R-squared values. (3) Results: A total of 134.2 h of data from 30 patients was included in the final analysis. The mean bias was –0.94 (95% CI, −1.35 to −0.52) L/min and the limits of agreements were −3.64 (95% CI, −4.44 to −3.08) L/min and 1.77 (95% CI, 1.21 to 2.57) L/min. The percentage error was 66.1% (95% CI, 52.4 to 85.8%). Depending on the time scale and the size of the exclusion zone, concordance rates ranged from 61.0% to 75.0%. (4) Conclusion: Despite the time adjustments, CO-FloTrac showed non-negligible overestimation, clinically unacceptable precision, and poor trending ability during OPCAB surgery.

Effect of the Fraction of Inspired Oxygen on Intermittent Central Venous Oxygen Saturation Measurements.

Central venous oxygen saturation (ScvO2) is an essential test readily performed both by medical and nursing personnel in a critical care setting. It gives information on the patient's oxygen supply, oxygen consumption, and cardiac output. It plays an important role in early goal-directed treatment. This study was planned to assess the effect of different fractions of inspired oxygen (FiO2) levels on central venous oxygen saturation for consideration during the evaluation of central venous oxygen saturation. This interventional cross-over study enrolled 60 critically ill, nonmechanically ventilated patients. Blood samples were repeatedly drawn from the distal end of the central venous catheter for blood gas analysis after administration of 30%, 40%, and 50% FIO2 respectively. The results showed that increasing FiO2 from 30% to 40% resulted in a mean increase in ScvO2 of 6.2%. While increasing FiO2 from 40% to 50% resulted in a mean increase in ScvO2 of 3.2%. A significant increase in ScvO2 with changes in FiO2 level was recorded among patients in shock or patients with pneumonia (from 30% to 50%, p=0.002 in shock patients and from 30% to 40%, p=0.02 in patients with pneumonia). Increasing FiO2 resulted in a substantial rise in ScvO2. ScvO2 changes in response to a therapeutic challenge should be interpreted at constant FiO2 level, especially in patients with pneumonia.

Atrial fibrillation can be diagnosed using a combined wrist-worn photoplethysmography and electrocardiography

Abstract Background Current ESC Clinical Practice Guideline for management of atrial fibrillation requires a minimum of 30-seconds of atrial fibrillation (AF) to be visually confirmed from an electrocardiography (ECG) recording for diagnosis. Single-channel ECG recorded from any measurement lead is sufficient. The current method of 24–48 h Holter ECG may not detect rarely occurring AF episodes, and thus extended duration recording devices are needed. Intermittent portable ECG devices intended for clinical use exist but those lack continuous rhythm monitoring and are thus unable to notify the user in case of asymptomatic episode. Purpose We evaluated the performance of a wrist-worn solution (Fig. 1) intended for clinical use that combines continuous photoplethysmography (PPG) -based rhythm assessment with intermittent ECG measurements in the detection of atrial fibrillation in ambulatory conditions. Methods 30 adult patients with previous diagnosis of AF were recruited for 48-hour measurements. Simultaneous 5-lead Holter monitoring was used as the reference. The patients were taking intermittent ECG measurements at pre-scheduled times (4 times a day), when notified by the device (irregular rhythm detected by PPG), and if feeling symptoms of AF. Results The obtained sensitivity and specificity for PPG-based AF detection were 95.5% and 99.2%, respectively when evaluated in 5-minute segments. Only the segments during which adequate amount, approximately 30-seconds, of good quality PPG data was available, were considered in the analysis. On average this equals 54% of the segments. Patients took in total 456 30-second ECG measurements. Out of these 411 and 392 were assessed as analysable quality by ECG algorithm and visually by two cardiologists, HS and KK, respectively. Automatic ECG analysis algorithm labelled ECG measurements taken during atrial fibrillation correctly as “Possible arrhythmia” with 95.7% sensitivity and 92.0% specificity. 99.5% of the analysable quality ECGs measured during AF were marked with any type of label e.g., tachycardia that highlights them to the clinician. An example ECG measurement with markings of the analysis algorithm an overall classification is shown in Fig. 2. All patients having AF during the 48-hour monitoring (14/30) were correctly identified based on the wrist device data. Conclusion Based on the obtained results, wrist-worn device combining continuous PPG and intermittent ECG measurements can be reliably used in detecting atrial fibrillation in ambulatory conditions. The user-friendliness and unobtrusiveness of wrist-worn technology enables virtually unlimited monitoring time thus facilitating the detection of rarely occurring AF episodes. The information of continuous rhythm monitoring can also be used for the estimation of AF burden. The solution used in the study has received medical device CE certification in early 2022. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): The study was funded by PulseOn company.

Initial-State Observability of Mealy-Based Finite-State Machine With Nondeterministic Output Functions

In mobile systems or the failure detection applications, the output for some input event is state-dependent and nondeterministic after intermittent sensor failures or measurement uncertainties, which does not hold under the conventional observability hypothesis. In this article, such cases can be modeled by a Mealy-based finite-state machine (FSM) with nondeterministic output functions, and we investigate the “initial-state” observability by use of matrix semitensor product (matrix-STP). First, to characterize the nondeterministic output functions, a virtual state set consisting of state–event pairs is introduced to obtain an augmented FSM. By resorting to the matrix-STP, the algebraic expression of augmented FSM is proposed. Subsequently, based on the newly constructed model, the initial-state observability can be verified by checking the distinguishability of state trajectories of the augmented FSM. Meanwhile, the necessary and sufficient condition for such initial-state observability is derived from a discriminant matrix consisting of polynomial elements. Finally, numerical examples show the validity of the proposed method. The current results are further conducive to explore the critical safety of cyber–physical systems in many real-world systems.

Photoplethysmography-Based Blood Pressure Monitoring Could Improve Patient Outcome during Anesthesia Induction

During anesthesia, noncritical patients are routinely monitored via noninvasive cuff-based blood pressure (BP) monitors. Due to the noncontinuous nature of the monitoring, the BP values of the patient remain unavailable between consecutive cuff measurements, carrying the risk of missing rapid and sudden variations in BP. We evaluated the added value of using a photoplethysmography (PPG)-based continuous BP measurement device in addition to the standard cuff-based monitoring in a cohort of 40 patients in comparison with the current approach, in which only intermittent cuff-based measurements are available. When using a three-minute cuff measurement interval, using the PPG-based BP measurement in addition to the cuff-based monitor reduced the error (mean ± SD) of systolic (SBP) and mean (MBP) BP from 2.6 ± 19.6 mmHg and 1.2 ± 13.2 mmHg to 0.5 ± 11.2 mmHg and 0.0 ± 8.1 mmHg, respectively. Error grid analysis was also used to assess the improvement in patient safety. The additional use of the PPG-based BP measurement reduced the amount of data falling into higher risk categories. For SBP, points falling in the significant-, moderate-, and low-risk categories decreased from 1.1%, 8.7%, and 19.3% to 0.0%, 2.3%, and 9.6%, respectively. Similar results were obtained for MBP. These results suggest that using a PPG-based BP monitor—in addition to the standard cuff-based monitor—can improve patient safety during anesthesia induction, with no additional sensor needed.

Advantage of Vital Sign Monitoring Using a Wireless Wearable Device for Predicting Septic Shock in Febrile Patients in the Emergency Department: A Machine Learning-Based Analysis.

Intermittent manual measurement of vital signs may not rapidly predict sepsis development in febrile patients admitted to the emergency department (ED). We aimed to evaluate the predictive performance of a wireless monitoring device that continuously measures heart rate (HR) and respiratory rate (RR) and a machine learning analysis in febrile but stable patients in the ED. We analysed 468 patients (age, ≥18 years; training set, n = 277; validation set, n = 93; test set, n = 98) having fever (temperature >38 °C) and admitted to the isolation care unit of the ED. The AUROC of the fragmented model with device data was 0.858 (95% confidence interval [CI], 0.809–0.908), and that with manual data was 0.841 (95% CI, 0.789–0.893). The AUROC of the accumulated model with device data was 0.861 (95% CI, 0.811–0.910), and that with manual data was 0.853 (95% CI, 0.803–0.903). Fragmented and accumulated models with device data detected clinical deterioration in febrile patients at risk of septic shock 9 h and 5 h 30 min earlier, respectively, than those with manual data. Continuous vital sign monitoring using a wearable device could accurately predict clinical deterioration and reduce the time to recognise potential clinical deterioration in stable ED patients with fever.

Cardiac output monitoring with pulmonary versus trans-cardiopulmonary thermodilution in left ventricular assist devices: Interchangeable methods?

Cardiac output (CO) measurement is mandatory in patients with left ventricular assist devices (LVADs). Thermodilution with pulmonary artery catheter (PAC) remains the clinical gold standard to measure CO in these patients, however it is associated with several complications. Therefore, the agreement between PAC and new, minimally invasive monitoring methods in LVAD needs to be further investigated. The aim of this study was to assess the accuracy and reliability of transpulmonary thermodilution with a PiCCO2 monitor compared with pulmonary artery thermodilution with PAC in a LVAD. Continuous-flow LVADs were implanted in six mini-pigs to assist the left ventricle. We studied two methods of measuring CO—intermittent transpulmonary thermodilution (COTPTD) by PiCCO2 and intermittent pulmonary artery thermodilution by CAP, standard technique (COPTD)—obtained in four consecutive moments of the study: before starting the LVAD (basal moment), and with the LVAD started in normovolemia, hypervolemia (fluid overloading) and hypovolemia (shock hemorrhage). A total of 72 paired measurements were analysed. At the basal moment, COTPTD and COPTD were closely correlated (r 2 = 0.89), with a mean bias of −0.085 ± 0.245 L/min and percentage error of 16%. After 15 min of partial support LVAD, COTPTD and COPTD were closely correlated (r 2 = 0.79), with a mean bias of −0.040 ± 0.417 L/min and percentage error of 26%. After inducing hypervolemia, COTPTD and COPTD were closely correlated (r 2 = 0.78), with a mean bias of −0.093 ± 0.339 L/min and percentage error of 13%. After inducing hypovolemia, COTPTD and COPTD were closely correlated (r 2 = 0.76), with a mean bias of −0.045 ± 0.281 L/min and percentage error of 28%. This study demonstrates a good agreement between transpulmonary thermodilution by PiCCO monitor and pulmonary thermodilution by PAC in the intermittent measurement of CO in a porcine model with a continuous-flow LVAD.

Systolic blood pressure estimation using ECG and PPG in patients undergoing surgery

Background and ObjectivesIn a significant portion of surgeries, blood pressure (BP) is often measured non-invasively in an intermittent manner. This practice has a risk of missing clinically relevant BP changes between two adjacent intermittent BP measurements. This study proposes a method to non-invasively estimate systolic blood pressure (SBP) with high accuracy in patients undergoing surgery. MethodsContinuous arterial BP, electrocardiography (ECG), and photoplethysmography (PPG) signals were acquired from 29 patients undergoing surgery. After extracting 9 features from the PPG and ECG signals, we dynamically selected features upon each intermittent measurement (every 10 min) of SBP based on feature robustness and the principle of correlation-based feature selection. Finally, multiple linear regression models were built to combine these features to estimate SBP every 30 s. ResultsCompared to the reference SBP, the proposed method achieved a mean of difference at 0.08 mmHg, a standard deviation of difference at 7.97 mmHg, and a correlation coefficient at 0.89 (p < 0.001). ConclusionsThis study demonstrates the feasibility of non-invasively estimating SBP every 30 s with high accuracy during surgery by using ECG, PPG, and intermittent SBP measurements every 10 min, which meets the standard of the Association for the Advancement of Medical Instrumentation. The proposed method has the potential to enhance BP monitoring in the operating room, improving patient outcomes and experiences.

Intraoperative Management of a Severely Kinked Endotracheal Tube and Difficult Airway.

This figure is a lateral cervical radiograph of a nasally intubated 16-yr-old patient with Crouzon syndrome obtained after completion of cranial fossa surgery for Chiari malformation and returning to supine from a prone position. The standard endotracheal tube was severely kinked in the nasopharynx, as shown in the image, and the location of the kinking is indicated with a red arrow. This was likely caused by the warming of the endotracheal tube and the patient’s unique pharyngeal anatomy. The tracheal intubation of the patient was difficult, requiring 11 attempts due to midface hypoplasia, obesity, macroglossia, and cervical spine instability. After the start of surgery, elevated airway pressures and the inability to pass a suction catheter suggested kinking of the endotracheal tube. Due to extremely difficult intubation, endotracheal tube replacement was not attempted. Because the severely kinked endotracheal tube limited inspiratory and expiratory airflow, adequate tidal volume was achieved by increasing peak inspiratory pressure.1 Intermittent measurement of plateau pressure with an expiratory hold yielded additional information about the pressure at the alveoli. Because expiration was passive, increasing the expiratory time facilitated exhalation and reduced the risk of breath stacking.2 A helium–oxygen mixture can also be used to improve ventilation by reducing gas density, increasing the likelihood of maintaining laminar flow across the point of obstruction, and improving bulk flow.3 If the patient can tolerate permissive hypercapnia, a reduction in minute ventilation is also an option to minimize turbulent flow. The use of a wire-reinforced tube is often recommended to prevent endotracheal tube kinking in such a patient.The authors declare no competing interests.

Genomic epidemiology of seasonal influenza circulation in China during prolonged border closure from 2020 to 2021.

China experienced a resurgence of seasonal influenza activity throughout 2021 despite intermittent control measures and prolonged international border closure. We show genomic evidence for multiple A(H3N2), A(H1N1), and B/Victoria transmission lineages circulating over 3 years, with the 2021 resurgence mainly driven by two B/Victoria clades. Phylodynamic analysis revealed unsampled ancestry prior to widespread outbreaks in December 2020, showing that influenza lineages can circulate cryptically under non-pharmaceutical interventions enacted against COVID-19. Novel haemagglutinin gene mutations and altered age profiles of infected individuals were observed, and Jiangxi province was identified as a major source for nationwide outbreaks. Following major holiday periods, fluctuations in the effective reproduction number were observed, underscoring the importance of influenza vaccination prior to holiday periods or travel. Extensive heterogeneity in seasonal influenza circulation patterns in China determined by historical strain circulation indicates that a better understanding of demographic patterns is needed for improving effective controls.

Blood Pressure Response and Pulse Arrival Time During Exercise Testing in Well-Trained Individuals.

Introduction: There is a lack of data describing the blood pressure response (BPR) in well-trained individuals. In addition, continuous bio-signal measurements are increasingly investigated to overcome the limitations of intermittent cuff-based BP measurements during exercise testing. Thus, the present study aimed to assess the BPR in well-trained individuals during a cycle ergometer test with a particular focus on the systolic BP (SBP) and to investigate pulse arrival time (PAT) as a continuous surrogate for SBP during exercise testing. Materials and Methods: Eighteen well-trained male cyclists were included (32.4 ± 9.4 years; maximal oxygen uptake 63 ± 10 ml/min/kg) and performed a stepwise lactate threshold test with 5-minute stages, followed by a continuous test to voluntary exhaustion with 1-min increments when cycling on an ergometer. BP was measured with a standard automated exercise BP cuff. PAT was measured continuously with a non-invasive physiological measurements device (IsenseU) and metabolic consumption was measured continuously during both tests. Results: At lactate threshold (281 ± 56 W) and maximal intensity test (403 ± 61 W), SBP increased from resting values of 136 ± 9 mmHg to maximal values of 219 ± 21 mmHg and 231 ± 18 mmHg, respectively. Linear within-participant regression lines between PAT and SBP showed a mean r 2 of 0.81 ± 17. Conclusion: In the present study focusing on the BPR in well-trained individuals, we observed a more exaggerated systolic BPR than in comparable recent studies. Future research should follow up on these findings to clarify the clinical implications of the high BPR in well-trained individuals. In addition, PAT showed strong intra-individual associations, indicating potential use as a surrogate SBP measurement during exercise testing.

High Frequency-Low Amplitude Oscillometry: Continuous Unobtrusive Monitoring of Respiratory Function on PAP Machines.

Oscillometry or Forced Oscillation Technique, traditionally used in intermittent clinical measurements, has recently gained substantial attention from its application as a continuous monitoring tool for large and small airways. However, low frequency (<8 Hz) continuous oscillometry faces high breathing noise, and hence requires high oscillation amplitudes to maintain an acceptable signal-to-noise ratio. Therefore, PAP machines that utilize low frequency oscillometry do so intermittently to distinguish airway patency several seconds after a breathing pause has occurred. We hypothesized that high frequency and low amplitude (HFLA) oscillometry may be as sensitive and applicable for monitoring upper airway patency to distinguish between central and obstructive apnea and hypopnea events, and for monitoring respiratory impedance. An inline oscillometry prototype device was developed and connected to commercial PAP machines to test whether oscillometry at 17, 43, and 79 Hz are as sensitive to airway patency as oscillometry at 4 Hz. Analysis of 11 patients with 171 apneas and hypopneas showed that all frequency oscillometry inputs were equally sensitive in distinguishing between central and obstructive apneas, while 17 Hz and 43 Hz oscillometry were most sensitive in distinguishing between central and obstructive hypopneas. Observations during normal breathing also showed the same periodicity and cross-correlation between impedance measurements from HFLA oscillometry compared to 4 Hz. Our findings provide an unobtrusive means of distinguishing airway patency during sleep and a means of continuous monitoring of respiratory function, with the potential for detection and prediction of developing respiratory diseases and significantly richer context for data analytics.

Multitime structure functions and the Lagrangian scaling of turbulence

Large-scale flow components are known to affect Lagrangian inertial-range turbulent statistics. Multitime structure functions are shown to be a powerful and robust tool to disentangle these contributions from tracers' statistics in a turbulent von K\'arm\'an experiment, in Taylor-Green direct numerical simulations, and in isotropic and homogeneous turbulence. Multitime statistics also improve Lagrangian intermittency measurements.

Effects of Forearm Compression Sleeves on Muscle Hemodynamics and Muscular Strength and Endurance Parameters in Sports Climbing: A Randomized, Controlled Crossover Trial.

Purpose: Wearing compression garments is a commonly used intervention in sports to improve performance and facilitate recovery. Some evidence supports the use of forearm compression to improve muscle tissue oxygenation and enhance sports climbing performance. However, evidence is lacking for an effect of compression garments on hand grip strength and specific sports climbing performance. The purpose of this study was to evaluate the immediate effects of forearm compression sleeves on muscular strength and endurance of finger flexor muscles in sports climbers. Materials and Methods: This randomized crossover study included 24 sports climbers who performed one familiarization trial and three subsequent test trials while wearing compression forearm sleeves (COMP), non-compressive placebo forearm sleeves (PLAC), or no forearm sleeves (CON). Test trials consisted of three performance measurements (intermittent hand grip strength and endurance measurements, finger hang, and lap climbing) at intervals of at least 48 h in a randomized order. Muscle oxygenation during hand grip and finger hang measurements was assessed by near-infrared spectroscopy. The maximum blood lactate level, rate of perceived exertion, and forearm muscle pain were also determined directly after the lap climbing trials. Results: COMP resulted in higher changes in oxy[heme] and tissue oxygen saturation (StO2) during the deoxygenation (oxy[heme]: COMP –10.7 ± 5.4, PLAC –6.7 ± 4.3, CON –6.9 ± 5.0 [μmol]; p = 0.014, ηp 2 = 0.263; StO2: COMP –4.0 ± 2.2, PLAC –3.0 ± 1.4, CON –2.8 ± 1.8 [%]; p = 0.049, ηp 2 = 0.194) and reoxygenation (oxy [heme]: COMP 10.2 ± 5.3, PLAC 6.0 ± 4.1, CON 6.3 ± 4.9 [μmol]; p = 0.011, ηp 2 = 0.274; StO2: COMP 3.5 ± 1.9, PLAC 2.4 ± 1.2, CON 2.3 ± 1.9 [%]; p = 0.028, ηp 2 = 0.225) phases of hand grip measurements, whereas total [heme] concentrations were not affected. No differences were detected between the conditions for the parameters of peak force and fatigue index in the hand grip, time to failure and hemodynamics in the finger hang, or performance-related parameters in the lap climbing measurements (p ≤ 0.05). Conclusions: Forearm compression sleeves did not enhance hand grip strength and endurance, sports climbing performance parameters, physiological responses, or perceptual measures. However, they did result in slightly more pronounced changes of oxy [heme] and StO2 in the deoxygenation and reoxygenation phases during the hand grip strength and endurance measurements.

Investigation of Water-Soluble Binders for LiNi0.5 Mn1.5 O4 -Based Full Cells.

Two water‐soluble binders of carboxymethyl cellulose (CMC) and sodium alginate (SA) have been studied in comparison with N‐methylpyrrolidone‐soluble poly(vinylidene difluoride–co‐hexafluoropropylene) (PVdF‐HFP) to understand their effect on the electrochemical performance of a high‐voltage lithium nickel manganese oxide (LNMO) cathode. The electrochemical performance has been investigated in full cells using a Li4Ti5O12 (LTO) anode. At room temperature, LNMO cathodes prepared with aqueous binders provided a similar electrochemical performance as those prepared with PVdF‐HFP. However, at 55 °C, the full cells containing LNMO with the aqueous binders showed higher cycling stability. The results are supported by intermittent current interruption resistance measurements, wherein the electrodes with SA showed lower resistance. The surface layer formed on the electrodes after cycling has been characterized by X‐ray photoelectron spectroscopy. The amount of transition metal dissolutions was comparable for all three cells. However, the amount of hydrogen fluoride (HF) content in the electrolyte cycled at 55 °C is lower in the cell with the SA binder. These results suggest that use of water‐soluble binders could provide a practical and more sustainable alternative to PVdF‐based binders for the fabrication of LNMO electrodes.

Noninvasive Blood Pressure Measurement Using the NICCI Monitor in Adolescents During Intraoperative Anesthetic Care.

BackgroundThe intermittent measurement of blood pressure (BP) remains the standard of care during anesthesia or procedural sedation. To improve the early identification of hemodynamic compromise, various noninvasive BP devices have been developed which provide a continuous BP reading. The current study evaluates the accuracy of a novel continuous BP device, the NICCI system, in adolescents weighing 40 - 80 kg.MethodsDuring intraoperative anesthetic care, BP readings (systolic, diastolic, and mean) were captured from the arterial cannula and the NICCI device every second.ResultsThe study cohort included 44 pediatric patients undergoing major orthopedic, cardiac, and neurosurgical procedures. A total of 383,126 pairs of systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) values from the arterial cannula and the NICCI device were analyzed. The absolute difference for SBP, DBP, and MAP values from the NICCI monitor and the arterial cannula were 10 ± 8, 9 ± 7, and 9 ± 7 mm Hg, respectively. The difference between the BP values from the NICCI and the arterial cannula was ≤ 10 mm Hg for 60% of the SBP readings, 67% of the DBP readings, and 56% of the MAP readings. Using Bland-Altman analysis, the bias was 2, 3, and 4 mm Hg for the SBP, DBP, and MAP.ConclusionsAlthough there were technical limitations related to patient size that affected its ability to meet the strict accuracy criteria set by the American National Standards Institute/Association for the Advancement of Medical Instrumentation standards for noninvasive BP measurement (ANSI/AAMI SP10), the NICCI system provided a continuous noninvasive beat-to-beat BP measurement which was clinically relevant during a significant portion of intraoperative care.