The Experts below are selected from a list of 71427 Experts worldwide ranked by ideXlab platform
Sai Haranath - One of the best experts on this subject based on the ideXlab platform.
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Pressure Control ventilation.
Critical Care Clinics, 2007Co-Authors: Dane J. Nichols, Sai HaranathAbstract:As mechanical ventilators become increasingly sophisticated, clinicians are faced with a variety of ventilatory modes that use volume, Pressure, and time in combination to achieve the overall goal of assisted ventilation. Although much has been written about the advantages and disadvantages of these increasingly complex modalities, currently there is no convincing evidence of the superiority of one mode of ventilation over another. Pressure Control ventilation may offer particular advantages in certain circumstances in which variable flow rates are preferred or when Pressure and volume limitation is required. The goal of this article is to provide clinicians with a fundamental understanding of the dependent and independent variables active in Pressure Control ventilation and describe features of the mode that may contribute to improved gas exchange and patient-ventilator synchronization.
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Pressure Control Ventilation
Critical Care Clinics, 2007Co-Authors: Dane Nichols, Sai HaranathAbstract:As mechanical ventilators become increasingly sophisticated, clinicians are faced with a variety of ventilatory modes that use volume, Pressure, and time in combination to achieve the overall goal of assisted ventilation. Although much has been written about the advantages and disadvantages of these increasingly complex modalities, currently there is no convincing evidence of the superiority of one mode of ventilation over another. Pressure Control ventilation may offer particular advantages in certain circumstances in which variable flow rates are preferred or when Pressure and volume limitation is required. The goal of this article is to provide clinicians with a fundamental understanding of the dependent and independent variables active in Pressure Control ventilation and describe features of the mode that may contribute to improved gas exchange and patient-ventilator synchronization. © 2007 Elsevier Inc. All rights reserved.
Dane Nichols - One of the best experts on this subject based on the ideXlab platform.
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Pressure Control Ventilation
Critical Care Clinics, 2007Co-Authors: Dane Nichols, Sai HaranathAbstract:As mechanical ventilators become increasingly sophisticated, clinicians are faced with a variety of ventilatory modes that use volume, Pressure, and time in combination to achieve the overall goal of assisted ventilation. Although much has been written about the advantages and disadvantages of these increasingly complex modalities, currently there is no convincing evidence of the superiority of one mode of ventilation over another. Pressure Control ventilation may offer particular advantages in certain circumstances in which variable flow rates are preferred or when Pressure and volume limitation is required. The goal of this article is to provide clinicians with a fundamental understanding of the dependent and independent variables active in Pressure Control ventilation and describe features of the mode that may contribute to improved gas exchange and patient-ventilator synchronization. © 2007 Elsevier Inc. All rights reserved.
Klavs F Jensen - One of the best experts on this subject based on the ideXlab platform.
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membrane based liquid liquid separator with integrated Pressure Control
Industrial & Engineering Chemistry Research, 2013Co-Authors: Andrea Adamo, Patrick L Heider, Nopphon Weeranoppanant, Klavs F JensenAbstract:We describe the development and application of an improved, membrane-based, liquid–liquid separator. Membrane-based separation relies on the exploitation of surface forces and the use of a membrane wetted by one of the phases; however, successful separation requires accurate Control of Pressures, making the operation and implementation cumbersome. Here we present an improved separator design that integrates a Pressure Control element to ensure that adequate operating conditions are always maintained. Additionally, the integrated Pressure Control decouples the separator from downstream unit operations. A detailed examination of the Controlling physical equations shows how to design the device to allow operation across a wide range of conditions. Easy to implement, multistage separations such as solvent swaps and countercurrent extractions are demonstrated. The presented design significantly simplifies applications ranging from multistep synthesis to complex multistage separations.
Robert N Frank - One of the best experts on this subject based on the ideXlab platform.
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blood Pressure Control for diabetic retinopathy
Cochrane Database of Systematic Reviews, 2015Co-Authors: Diana V Do, Xue Wang, Swaroop S Vedula, Michael Marrone, Gina Sleilati, Barbara S Hawkins, Robert N FrankAbstract:Background Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose Control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood Pressure Control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood Pressure. Objectives The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to Control or reduce blood Pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes. Search methods We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. Selection criteria We included in this review randomized Controlled trials (RCTs) in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood Pressure Control, to blood Pressure Control versus usual care or no intervention on blood Pressure, or to different classes of anti-hypertensive agents versus placebo. Data collection and analysis Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We extracted data regarding trial characteristics, incidence and progression of retinopathy, visual acuity, quality of life, and cost-effectiveness at annual intervals after study entry whenever provided in published reports and other documents available from included trials. Main results We included 15 RCTs, conducted primarily in North America and Europe, that had enrolled 4157 type 1 and 9512 type 2 diabetic participants, ranging from 16 to 2130 participants in individual trials. In 10 of the 15 RCTs, one group of participants was assigned to one or more anti-hypertensive agents and the Control group received placebo. In three trials, intense blood Pressure Control was compared to less intense blood Pressure Control. In the remaining two trials, blood Pressure Control was compared with usual care. Five of the 15 trials enrolled type 1 diabetics, and 10 trials enrolled type 2 diabetics. Six trials were sponsored entirely by pharmaceutical companies, seven trials received partial support from pharmaceutical companies, and two studies received support from government-sponsored grants and institutional support. Study designs, populations, interventions, and lengths of follow-up (range one to nine years) varied among the included trials. Overall, the quality of the evidence for individual outcomes was low to moderate. For the primary outcomes, incidence and progression of retinopathy, the quality of evidence was downgraded due to inconsistency and imprecision of estimates from individual studies and differing characteristics of participants. For primary outcomes among type 1 diabetics, one of the five trials reported incidence of retinopathy and one trial reported progression of retinopathy after 4 to 5 years of treatment and follow-up; four of the five trials reported a combined outcome of incidence and progression over the same time interval. Among type 2 diabetics, 5 of the 10 trials reported incidence of diabetic retinopathy and 3 trials reported progression of retinopathy; one of the 10 trials reported a combined outcome of incidence and progression during a 4- to 5-year follow-up period. One trial in which type 2 diabetics participated had reported no primary (or secondary) outcome targeted for this review. The evidence from these trials supported a benefit of more intensive blood Pressure Control intervention with respect to 4- to 5-year incidence of diabetic retinopathy (estimated risk ratio (RR) 0.80; 95% confidence interval (CI) 0.71 to 0.92) and the combined outcome of incidence and progression (estimated RR 0.78; 95% CI 0.63 to 0.97). The available evidence provided less support for a benefit with respect to 4- to 5-year progression of diabetic retinopathy (point estimate was closer to 1 than point estimates for incidence and combined incidence and progression, and the CI overlapped 1; estimated RR 0.88; 95% CI 0.73 to 1.05). The available evidence regarding progression to proliferative diabetic retinopathy or clinically significant macular edema or moderate to severe loss of best-corrected visual acuity did not support a benefit of intervention on blood Pressure: estimated RRs and 95% CIs 0.95 (0.83 to 1.09) and 1.06 (0.85 to 1.33), respectively, after 4 to 5 years of follow-up. Findings within subgroups of trial participants (type 1 and type 2 diabetics; participants with normal blood Pressure levels at baseline and those with elevated levels) were similar to overall findings. The adverse event reported most often (7 of 15 trials) was death, yielding an estimated RR 0.86 (95% CI 0.64 to 1.14). Hypotension was reported from three trials; the estimated RR was 2.08 (95% CI 1.68 to 2.57). Other adverse ocular events were reported from single trials. Authors' conclusions Hypertension is a well-known risk factor for several chronic conditions in which lowering blood Pressure has proven to be beneficial. The available evidence supports a beneficial effect of intervention to reduce blood Pressure with respect to preventing diabetic retinopathy for up to 4 to 5 years. However, the lack of evidence to support such intervention to slow progression of diabetic retinopathy or to prevent other outcomes considered in this review, along with the relatively modest support for the beneficial effect on incidence, weakens the conclusion regarding an overall benefit of intervening on blood Pressure solely to prevent diabetic retinopathy.
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blood Pressure Control for diabetic retinopathy
Sao Paulo Medical Journal, 2015Co-Authors: Diana V Do, Xue Wang, Swaroop S Vedula, Michael Marrone, Gina Sleilati, Barbara S Hawkins, Robert N FrankAbstract:BACKGROUND: Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose Control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood Pressure Control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood Pressure.OBJECTIVES: The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to Control or reduce blood Pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes.METHODS:Search methods: We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. Selection criteria: We included in this review randomized Controlled trials (RCTs) in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood Pressure Control, to blood Pressure Control versus usual care or no intervention on blood Pressure, or to different classes of anti-hypertensive agents versus placebo. Data collection and analysis: Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We extracted data regarding trial characteristics, incidence and progression of retinopathy, visual acuity, quality of life, and cost-effectiveness at annual intervals after study entry whenever provided in published reports and other documents available from included trials.MAIN RESULTS: We included 15 RCTs, conducted primarily in North America and Europe, that had enrolled 4157 type 1 and 9512 type 2 diabetic participants, ranging from 16 to 2130 participants in individual trials. In 10 of the 15 RCTs, one group of participants was assigned to one or more anti-hypertensive agents and the Control group received placebo. In three trials, intense blood Pressure Control was compared to less intense blood Pressure Control. In the remaining two trials, blood Pressure Control was compared with usual care. Five of the 15 trials enrolled type 1 diabetics, and 10 trials enrolled type 2 diabetics. Six trials were sponsored entirely by pharmaceutical companies, seven trials received partial support from pharmaceutical companies, and two studies received support from government-sponsored grants and institutional support. Study designs, populations, interventions, and lengths of follow-up (range one to nine years) varied among the included trials. Overall, the quality of the evidence for individual outcomes was low to moderate. For the primary outcomes, incidence and progression of retinopathy, the quality of evidence was downgraded due to inconsistency and imprecision of estimates from individual studies and differing characteristics of participants. For primary outcomes among type 1 diabetics, one of the five trials reported incidence of retinopathy and one trial reported progression of retinopathy after 4 to 5 years of treatment and follow-up; four of the five trials reported a combined outcome of incidence and progression over the same time interval. Among type 2 diabetics, 5 of the 10 trials reported incidence of diabetic retinopathy and 3 trials reported progression of retinopathy; one of the 10 trials reported a combined outcome of incidence and progression during a 4- to 5-year follow-up period. One trial in which type 2 diabetics participated had reported no primary (or secondary) outcome targeted for this review. The evidence from these trials supported a benefit of more intensive blood Pressure Control intervention with respect to 4- to 5-year incidence of diabetic retinopathy (estimated risk ratio (RR) 0.80; 95% confidence interval (CI) 0.71 to 0.92) and the combined outcome of incidence and progression (estimated RR 0.78; 95% CI 0.63 to 0.97). The available evidence provided less support for a benefit with respect to 4- to 5-year progression of diabetic retinopathy (point estimate was closer to 1 than point estimates for incidence and combined incidence and progression, and the CI overlapped 1; estimated RR 0.88; 95% CI 0.73 to 1.05). The available evidence regarding progression to proliferative diabetic retinopathy or clinically significant macular edema or moderate to severe loss of best-corrected visual acuity did not support a benefit of intervention on blood Pressure: estimated RRs and 95% CIs 0.95 (0.83 to 1.09) and 1.06 (0.85 to 1.33), respectively, after 4 to 5 years of follow-up. Findings within subgroups of trial participants (type 1 and type 2 diabetics; participants with normal blood Pressure levels at baseline and those with elevated levels) were similar to overall findings. The adverse event reported most often (7 of 15 trials) was death, yielding an estimated RR 0.86 (95% CI 0.64 to 1.14). Hypotension was reported from three trials; the estimated RR was 2.08 (95% CI 1.68 to 2.57). Other adverse ocular events were reported from single trials.AUTHORS' CONCLUSIONS: Hypertension is a well-known risk factor for several chronic conditions in which lowering blood Pressure has proven to be beneficial. The available evidence supports a beneficial effect of intervention to reduce blood Pressure with respect to preventing diabetic retinopathy for up to 4 to 5 years. However, the lack of evidence to support such intervention to slow progression of diabetic retinopathy or to prevent other outcomes considered in this review, along with the relatively modest support for the beneficial effect on incidence, weakens the conclusion regarding an overall benefit of intervening on blood Pressure solely to prevent diabetic retinopathy.
Andrea Adamo - One of the best experts on this subject based on the ideXlab platform.
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membrane based liquid liquid separator with integrated Pressure Control
Industrial & Engineering Chemistry Research, 2013Co-Authors: Andrea Adamo, Patrick L Heider, Nopphon Weeranoppanant, Klavs F JensenAbstract:We describe the development and application of an improved, membrane-based, liquid–liquid separator. Membrane-based separation relies on the exploitation of surface forces and the use of a membrane wetted by one of the phases; however, successful separation requires accurate Control of Pressures, making the operation and implementation cumbersome. Here we present an improved separator design that integrates a Pressure Control element to ensure that adequate operating conditions are always maintained. Additionally, the integrated Pressure Control decouples the separator from downstream unit operations. A detailed examination of the Controlling physical equations shows how to design the device to allow operation across a wide range of conditions. Easy to implement, multistage separations such as solvent swaps and countercurrent extractions are demonstrated. The presented design significantly simplifies applications ranging from multistep synthesis to complex multistage separations.
