We report in detail on SuNAM's reactive co-evaporation by deposition and reaction (RCE-DR) process. We have successfully fabricated a high performance GdBCO coated conductor (CC) with high throughput by the RCE-DR process, that consists of two steps for the deposition of elemental metal oxides and the conversion of cation oxides into the GdBCO superconducting phase. Constituting metals such as Gd, Ba and Cu were first deposited on LaMnO 3 (LMO)-buffered IBAD-MgO templates at low temperatures and low pressures followed by a high temperature treatment step under high oxygen partial pressure for fast phase conversion. GdBCO CCs fabricated by RCE-DR showed excellent transport properties such as a critical current of 794 A cm −1 width at 77 K in self-field. With the RCE-DR process, we have achieved an overall processing speed of more than 120 m h −1 (in terms of a real process linear tape speed equivalent). SuNAM's RCE-DR technique showed great potential as the highest throughput fabrication process compared with other methods developed previously for second generation high temperature superconducting wires, meeting the current and future need of industry in terms of price and production speed.
The revision modified Broström procedure augmented with suture tape is an effective form of treatment for recurrent instability of the ankle following a failed Broström procedure. This technique provides reliable stability and satisfactory clinical outcomes at intermediate-term follow-up. Cite this article: 2017;99-B:1183-9.
BACKGROUND
Ultrasound-guided alveolar recruitment, regardless of the technique, could be more effective because it facilitates real-time monitoring of the expansion of collapsed alveoli.
OBJECTIVES
To evaluate and compare the effects of an ultrasound-guided lung recruitment manoeuvre with those of a conventional recruitment manoeuvre on the occurrence of postoperative atelectasis and clinical outcomes in children.
DESIGN
A randomised controlled trial.
SETTING
Tertiary children's hospital.
PATIENTS
Children aged 6 years or less.
INTERVENTION
Children scheduled for simple, superficial procedures underwent lung ultrasound after tracheal intubation (T1), at the end of surgery (T2) and before discharge from the postanaesthesia care unit (T3). Following lung ultrasound evaluation at T1 and T2, the conventional recruitment manoeuvre with a maximal airway pressure of 30 cmH2O was performed in the control group, while an ultrasound-guided recruitment manoeuvre was performed in the ultrasound group.
MAIN OUTCOME MEASURES
The primary outcome was the incidence of significant atelectasis at T3.
RESULTS
The incidences of atelectasis at T3 were 20.9 and 11.6% in the control (n = 43) and ultrasound groups (n = 43), respectively (odds ratio [OR], 2.012; 95% confidence interval [CI], 0.614 to 6.594; P = 0.249). The lung ultrasound scores were better in the ultrasound group than in the control group at T2 and T3, and the incidence of postoperative desaturation was higher in the control group than in the ultrasound group (16.3 vs. 2.3%; OR, 0.12; 95% CI 0.01 to 1.04; P = 0.05). The median airway pressure required for full lung expansion in the ultrasound group was 35 cmH2O at T1 and T2. Other postoperative outcomes were similar between groups.
CONCLUSION
Ultrasound-guided lung recruitment may be more effective than the conventional procedure in terms of the prevention of intra-operative atelectasis and postoperative desaturation; however, its beneficial effects on postoperative atelectasis remain unclear. An inspiratory airway pressure of more than 30 cmH2O is required for full recruitment of alveoli in healthy children.
CLINICAL TRIAL REGISTRY
ClinicalTrials.gov (NCT03453762).
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