Non-invasive programmed stimulation to identify high-risk patients with implanted cardioverter defibrillator (the NIPS-ICD study): study protocol for a randomized controlled trial

Background: The use of an implantable cardioverter defibrillator (ICD) is a widely used and effective therapy, which reduces the risk of cardiac death in many cardiac diseases, both implanted for secondary and primary prevention. However, recurrent arrhythmias and ICD discharges have adverse prognostic significance. Additional parameters that would identify patients who are at increased risk of arrhythmias and appropriate ICD interventions would be of clinical value. Modern ICDs are relatively complex devices with a number of functions, including the possibility to perform noninvasive programmed stimulation (NIPS) with an implanted electrode located in the right ventricle.Methods/DesignThe aim of the study is to evaluate the usefulness of NIPS in determining the likelihood of life-threatening arrhythmic events in patients with ICD. The study will include 150 consecutive patients with an ICD implanted both for primary and secondary prevention, regardless of etiology, who are followed in the outpatient clinic of our center and do not meet the exclusion criteria. A 12-step St. George's Hospital NIPS protocol using ICD will be performed. The endpoint is to induce sustained ventricular arrhythmia (VT lasting more than 30 seconds or hemodynamically unstable VT/VF) or the end of the protocol. In case of serious and/or hemodynamically unstable heart rhythm disorders resistant to treatment with a low-energy antiarrhythmic pacing (ATP), the patient receives a short-term intravenous general anesthesia, and internal or external defibrillation is performed. Outpatient follow-up will be conducted during the pre-scheduled ICD control visits. An analysis of records of a registered memory device will be collected, a patient will be interviewed, and physical examination will be carried out. The follow-ups will be held every 3 months for 1 year. The primary endpoint of the follow-up will be appropriate intervention of ICD or sudden cardiac (arrhythmic) death; the secondary, appropriate ICD intervention, or death from cardiovascular causes; and the tertiary, appropriate ICD intervention, death or hospitalization for cardiovascular causes.DiscussionIt is expected that appropriate ICD interventions during follow-up will occur more often in patients who had sustained ventricular arrhythmias induced during NIPS.Clinical trials registryClinicalTrials.gov, NCT02373306, date of registration: 26 February 2015.

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Applied Sciences, Vol. 6, Pages 32: Research on a Composite Power-Superimposed Ultrasonic Vibrator for Wire Drawing

Vibration power and amplitude are essential factors in ultrasonic drawing processes, especially for difficult-to-draw materials like titanium and its alloys. This paper presents a new composite power-superimposed ultrasonic vibrator for wire drawing which was driven by three separate ultrasonic transducers. The transducers were uniformly distributed around the circular cross section of the vibrator, with their axes along the radial direction and pointing to the center. The vibrator can concentrate the vibrational energy of multiple transducers and transform the radial vibration into a longitudinal vibrator because of the Poisson effect and therefore output larger vibration power and amplitude. In the paper, the four-terminal network method was used to establish the vibration equations of the vibrator. The FE model was established in ANSYS to investigate its characteristics under various excitation conditions. A prototype was manufactured and measurements were performed to verify the validation of FEA results. The results matched well with the theoretical results. It was found that the composite vibrator achieved an amplitude of about 40 μm when driven by square wave signals with 120° in phase difference, which implies a potential way of applying ultrasonic vibration to the processing of difficult-to-draw materials.

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Applied Sciences, Vol. 6, Pages 31: Phosphorus Distribution in Soils from Australian Dairy and Beef Rearing Pastoral Systems

The influence of soil type and management practices on P distribution in soils from Australian dairy and beef rearing pastoral systems has been investigated by chemical measurements and phosphorus-31 (31P) nuclear magnetic resonance (NMR) spectroscopy. The amount and forms of P within the soil profile varied with soil type, with the acidic red Ferrosols containing relatively high orthophosphate concentrations, averaging 72.2% compared with 66.8% for Dermosols, under similar management conditions. Soil from Sodosol sites which received less fertiliser P addition had the lowest orthophosphate concentration with only 57.6%. In contrast, relatively high proportions of organic P were found in soil samples from unfertilised Sodosol sites. On average, soil from Sodosol sites contained 37.5% organic P (combined monoester P and diester P), while those from Dermosol and Ferrosol sites contained 31.7% and 25.8%, respectively. Of these, the highest monoester phosphate proportions of 44.6% (site M3) and 46.4% (site M4) were found in Sodosol sites with no recent P inputs, but the highest proportion of diester phosphate (5.7%) was found in an unclassified grey sandy loam Dermosol. The higher organic P concentrations in soil from Sodosol sites may be associated with more regular moisture input from both rainfall and boarder-check (flood) irrigation. The highest level of pyrophosphate (8.5%) was also found in a grey/yellow Sodosol. Overall, the results indicate that P speciation in the Australian soils is strongly influenced by soil type, fertiliser P application rate and timing, and moisture variations.

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Applied Sciences, Vol. 6, Pages 33: Proof of Concept of Crack Localization Using Negative Pressure Waves in Closed Tubes for Later Application in Effective SHM System for Additive Manufactured Components

Additive manufactured components have a different metallurgic structure and are more prone to fatigue cracks than conventionally produced metals. In earlier papers, an effective Structural Health Monitoring solution was presented to detect fatigue cracks in additive manufactured components. Small subsurface capillaries are embedded in the structure and pressurized (vacuum or overpressure). A crack that initiated at the component's surface will propagate towards the capillary and finally breach it. One capillary suffices to inspect a large area of the component, which makes it interesting to locate the crack on the basis of the pressure measurements. Negative pressure waves (NPW) arise from the abrupt encounter of high pressure fluid with low pressure fluid and can serve as a basis to locate the crack. A test set-up with a controllable leak valve was built to investigate the feasibility of using NPW to localize a leak in closed tubes with small lengths. Reflections are expected to occur at the ends of the tube, possibly limiting the localization accuracy. In this paper, the results of the tests on the test set-up are reported. It will be shown that the crack could be localized with high accuracy (millimeter accuracy) which proves the concept of crack localization on basis of NPW in a closed tube of small length.

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Magnetochemistry, Vol. 2, Pages 4: Magnetochemistry: From Fundamentals to Applications

It is well knowm that Magnetochemistry is a multidisplinary area that deals with many different materials and properties. [...]

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Machines, Vol. 4, Pages 5: Joint Mechanism That Mimics Elastic Characteristics in Human Running

Analysis of human running has revealed that the motion of the human leg can be modeled by a compression spring because the joints of the leg behave like a torsion spring in the stance phase. In this paper, we describe the development of a joint mechanism that mimics the elastic characteristics of the joints of the stance leg. The knee was equipped with a mechanism comprising two laminated leaf springs made of carbon fiber-reinforced plastic for adjusting the joint stiffness and a worm gear in order to achieve active movement. Using this mechanism, we were able to achieve joint stiffness mimicking that of a human knee joint that can be adjusted by varying the effective length of one of the laminated leaf springs. The equation proposed for calculating the joint stiffness considers the difference between the position of the fixed point of the leaf spring and the position of the rotational center of the joint. We evaluated the performance of the laminated leaf spring and the effectiveness of the proposed equation for joint stiffness. We were able to make a bipedal robot run with one leg using pelvic oscillation for storing energy produced by the resonance related to leg elasticity.

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Education Sciences, Vol. 6, Pages 2: Terminology Standardization in Education and the Construction of Resources: The Welsh Experience

This paper describes developments in Welsh-language terminology within the education system in Wales. Following an outline of historical terminology work, it concentrates on the consolidation of terminology standardization at the Language Technologies Unit, Bangor University, with particular reference to two projects, one concerned with terminology for school-age and further education, the second concerned with higher education. The developments described include the adoption of international standards in terminology standardization and their incorporation in an online terminology standardization environment and dissemination platform that enable access to the centralized terminological dictionaries via a number of sophisticated websites, portals and mobile apps featuring rich dictionary entries. Some of the issues in managing large term collections are explored, and usage statistics are presented for the resources described.

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