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  • 1
    ISSN: 1432-1238
    Keywords: Key words Respiratory mechanics ; Monitor assessment ; Accuracy ; Interobserver agreement ; Ventilated child
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To evaluate a recently developed and manufactured device for monitoring respiratory parameters in mechanically ventilated children. Design: In vitro study using a lung model. Setting: University paediatric intensive care unit. Material and interventions: Evaluation of the accuracy of volume and pressure measurements, of the determination of respiratory system compliance (10 to 30 ml/cmH2O) and of resistance (20 and 50 cmH2O/l per s) by the inflation technique (volume- and pressure-controlled mode of ventilation); assessment of interobserver agreement for compliance (10, 15 ml/cmH2O) and resistance (20, 50 cmH2O/l per s) determinations (ANOVA, intraclass correlation coefficient). Measurements and results: The accuracy of volume measurements (No. 1 Fleisch pneumotachograph) was ≤ 5 % of true volumes up to 1 l (Flow: 30 l/min) even after the introduction of an endotracheal tube. The accuracy of pressure measurements up to 70 cmH2O was ≤ 2.5 % of the true values. Coefficients of variation of volume and pressure measurements were 〈 2 %. The accuracy of compliance and resistance determinations was, respectively, ≤ 17 and 25 % of the true values. No significant observer effect was found on compliance and resistance determinations. Indeed, mean differences in compliance and resistance determinations by pairs of observers were 〈 1 %. Intraclass correlation coefficients were 〉 0.98. Conclusions: The measuring error of volume, pressure, compliance and resistance determined using this monitoring system seems acceptable for monitoring purpose. Moreover, use of this system by members of the medical team can be recommended since results obtained by observers, even untrained ones, were similar. In vivo evaluation is now needed.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Acute respiratory distress syndrome ; Respiratory syncytial virus infection ; Bronchopulmonary dysplasia ; Nitric oxide ; Child
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To report the first case of ARDS in children treated with nitric oxide (NO) inhalation. Methods A 13-months infant presented with BPD and severe hypoxemia related to RSV infection and ARDS. Inhaled NO was delivered in the ventilatory circuit of a continuous flow ventilator (Babylog 8000, Dräger) in a concentration of 20–80 ppm for 7 days. NO and NO2 were continuously monitored (Polyton Draeger). Respiratory mechanics were evaluated by using the method of passive inflation by the ventilator. Results NO inhalation improved oxygenation (tcSaO2) and reduced respiratory system resistance without affecting arterial pressure. NO2 level remained below 5 ppm, and methaemoglobin level below 1%. The child survived without neurologic sequela. Conclusions Two mechanisms to explain oxygenation improvement can be suggested:selective improvement in perfusion of ventilated regions and bronchodilation.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1238
    Keywords: Key words Respiratory mechanics ; Mechanical ventilation ; Infants ; End-expiratory lung volume ; Dynamic elevation of FRC
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of the study was to compare measurements of the elevation of functional residual capacity (FRC) above the relaxation volume obtained in 34 mechanically ventilated infants (median weight 2.6 kg, range 1.2–9) from four different methods: (1) direct measurement of the complete exhalation volume after brief disconnection from the ventilator, (2) calculated measurement from total positive end-expiratory pressure (PEEP) measured by end-expiratory occlusion of the breathing circuit, (3) extrapolated evaluation from the mathematical model of Brody, (4) extrapolated evaluation from the passive expiration method. We considered the direct measurement (1) as the “gold standard”. Measurements obtained by total PEEP (2) and by the Brody's mathematical model (3) provided similar results than the direct measurement. Conversely, graphical extrapolation from the passive expiration method (4) underestimated the elevation of FRC. In conclusion, we suggest using the mathematical extrapolation from the Brody's model to evaluate the elevation of FRC in mechanically ventilated infants: this method is non-invasive, does not require disruption of gas flow, can be easily performed with all the neonatal ventilators, and allows continuous breath-by-breath measurements.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1076
    Keywords: Key words Newborn ; Acute respiratory failure ; Persistent pulmonary hypertension of the newborn ; Inhaled nitric oxide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Inhaled nitric oxide (iNO) has been shown to improve oxygenation in severe persistent pulmonary hypertension of the newborn (PPHN). However, PPHN is often associated with various lung diseases. Thus, response to iNO may depend upon the aetiology of neonatal acute respiratory failure. A total of 150 (29 preterm and 121 term) newborns with PPHN were prospectively enrolled on the basis of oxygenation index (OI) higher than 30 and 40, respectively. NO dosage was stepwise increased (10–80 ppm) during conventional mechanical or high-frequency oscillatory ventilation while monitoring the oxygenation. Effective dosages ranged from 5 to 20 ppm in the responders, whereas iNO levels were unsuccessfully increased up to 80 ppm in the nonresponders. Within 30 min of iNO therapy, OI was significantly reduced in either preterm neonates (51 ± 21 vs 23 ± 17, P 〈 .0001) or term infants with idiopathic or acute respiratory distress syndrome (45 ± 20 vs 20 ± 17, P 〈 .0001), `idiopathic' PPHN (39 ± 14 vs 14 ± 9, P 〈 .0001), and sepsis (55 ± 25 vs 26 ± 20, P 〈 .0001) provided there was no associated refractory shock. Improvement in oxygenation was less significant and sustained (OI = 41 ± 16 vs 28 ± 18, P 〈 .001) in term neonates with meconium aspiration syndrome and much less (OI = 58 ± 25 vs 46 ± 32, P 〈 .01) in those with congenital diaphragmatic hernia. Only 21 of the 129 term newborns (16%) required extracorporeal membrane oxygenation (57% survival). Survival was significantly associated with the magnitude in the reduction in OI at 30 min of iNO therapy, a gestational age ≥34 weeks, and associated diagnosis other than congenital diaphragmatic hernia. Conclusion, iNO improves the oxygenation in most newborns with severe hypoxaemic respiratory failure including preterm neonates. However, response to iNO is disease-specific. Furthermore, iNO when combined with adequate alveolar recruitment and limited barotrauma using exogenous surfactant and HFOV may obviate the need for extracorporeal membrane oxygenation in many term infants.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Designs, codes and cryptography 18 (1999), S. 199-216 
    ISSN: 1573-7586
    Keywords: spreads ; partial spreads ; projective spaces
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Mathematics
    Notes: Abstract This article first of all discusses the problem of the cardinality of maximal partial spreads in PG(3,q), q square, q〉4. Let r be an integer such that 2r≤q+1 and such that every blocking set of PG(2,q) with at most q+r points contains a Baer subplane. If S is a maximal partial spread of PG(3,q) with q 2-1-r lines, then r=s( $$\sqrt q$$ +1) for an integer s≥2 and the set of points of PG(3,q) not covered byS is the disjoint union of s Baer subgeometriesPG(3, $$\sqrt q$$ ). We also discuss maximal partial spreads in PG(3,p 3), p=p 0 h , p 0 prime, p 0 ≥ 5, h ≥ 1, p ≠ 5. We show that if p is non-square, then the minimal possible deficiency of such a spread is equal to p 2+p+1, and that if such a maximal partial spread exists, then the set of points of PG(3,p 3) not covered by the lines of the spread is a projected subgeometryPG(5,p) in PG(3,p 3). In PG(3,p 3),p square, for maximal partial spreads of deficiency δ ≤ p 2+p+1, the combined results from the preceding two cases occur. In the final section, we discuss t-spreads in PG(2t+1,q), q square or q a non-square cube power. In the former case, we show that for small deficiencies δ, the set of holes is a disjoint union of subgeometries PG(2t+1, $$\sqrt q$$ ), which implies that δ ≡ 0 (mod $$\sqrt q$$ +1) and, when (2t+1)( $$\sqrt q$$ -1) 〈q-1, that δ ≥ 2( $$\sqrt q$$ +1). In the latter case, the set of holes is the disjoint union of projected subgeometries PG(3t+2, $$\sqrt[3]{q}$$ ) and this implies δ ≡ 0 (mod q 2/3+q 1/3+1). A more general result is also presented.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Designs, codes and cryptography 21 (2000), S. 235-251 
    ISSN: 1573-7586
    Keywords: 1-blocking sets ; Baer subgeometries
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Mathematics
    Notes: Abstract In this article we study minimal1-blocking sets in finite projective spaces PG(n,q),n ≥ 3. We prove that in PG(n,q 2),q = p h , p prime, p 〉 3,h ≥ 1, the second smallest minimal 1-blockingsets are the second smallest minimal blocking sets, w.r.t.lines, in a plane of PG(n,q 2). We also study minimal1-blocking sets in PG(n,q 3), n ≥ 3, q = p h, p prime, p 〉 3,q ≠ 5, and prove that the minimal 1-blockingsets of cardinality at most q 3 + q 2 + q + 1 are eithera minimal blocking set in a plane or a subgeometry PG(3,q).
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Journal of geometry 41 (1991), S. 72-78 
    ISSN: 1420-8997
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mathematics
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Journal of geometry 68 (2000), S. 16-22 
    ISSN: 1420-8997
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mathematics
    Notes: Abstract We prove that a parabolic unitalU in a translation plane π of orderq 2 with kernel containing GF(q) is a Buekenhout-Metz unital if and only if certain Baer subplanes containing the translation line of π meetU in 1 moduloq points. As a corollary we show that a unital 16-03 in PG(2,q 2) is classical if and only if it meets each Baer subplane of PG(2,q 2) in 1 moduloq points.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Geometriae dedicata 45 (1993), S. 163-169 
    ISSN: 1572-9168
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mathematics
    Notes: Abstract Letm′2(3,q) be the largest value ofk(k〈q 2+1) for which there exists a completek-cap in PG(3,q),q even. In this paper, the known upper bound onm′2(3,q) is improved. We also describe a number of intervals, fork, for which there does not exist a completek-cap in PG(3,q),q even. These results are then used to improve the known upper bounds on the number of points of a cap in PG(n, q),q even,n⩾4.
    Type of Medium: Electronic Resource
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