Abstract: The present invention relates to an improved process for the production of 4-alkanoyloxy-2-methylbutanoic acid, as well as to the use of such compounds in organic syntheses, especially in processes forming intermediates (building blocks) for the synthesis of organic compounds comprising isoprene (isoterpene) units, such as ?-carotene or other carotenoids (e.g. canthaxanthin, zeaxanthin or astaxanthin) or as vitamin E or vitamin A as well as other structurally similar compounds.

Abstract: The diallyl ether derivatives of the cis and trans stereoisomers of 2,5-bis(hydroxymethyl)tetrahydrofuran are produced. These materials are expected to be useful for making a variety of biobased polymers. Processes are further described for producing these diallyl ether derivatives in substantially quantitative yields.

Abstract: A continuous process for the production of an alkyl ester product is described. The process includes the steps of carbonylating ethylene with carbon monoxide in the presence of C1-6 alkanol co-reactant to form the alkyl ester product. The carbonylation takes place in the presence of a catalyst system that includes (a) a bidentate ligand, (b) a catalytic metal selected from a group 8, 9 or 10 metal or a compound thereof, and (c) a sulphonic acid capable of forming an acid alkyl ester with the C1-6 alkanol. The process includes the step of separating the alkyl ester product from a carbonylated crude product stream by treatment effective to vaporizing the alkyl ester product in a single stage flash distillation column and providing a purified alkyl ester product stream separated from the bidentate ligand and catalytic metal.

Abstract: Processes have been developed to obtain recycle ionic liquid streams which are active for oxidation of alkyl aromatic compounds, and which reduce the amount of 4-CBA in the solid oxidation products. The process can reduce the makeup amount of ionic liquid, carboxylic acid, catalyst, bromine source, and ammonia source.

Abstract: A process for oxidizing alkyl aromatic compounds is described. The alkyl aromatic compound is oxidized producing an aromatic carboxylic acid, and an aromatic amide compound. The aromatic amide compound is then hydrolyzed with a hydrolyzing agent to the aromatic carboxylic acid.

Abstract: Process for the preparation of 2-phenyl-2-methyl propanoic acid derivatives, useful as intermediates in the preparation of fexofenadine hydrochloride.

Abstract: An efficient and eco-friendly process for producing amide compounds comprising contacting a primary amine with molecular oxygen-containing gas, solvent and ammonia solution in the presence of a non-precious metal-containing ordered, mesoporous solid catalyst is disclosed.

Abstract: Provided is a method for efficiently producing high-purity hydrogenated biphenol based on a simple method that can be industrially utilized using easily-available biphenol as a starting material. The method for producing hydrogenated biphenol according to the present invention is a method for producing hydrogenated biphenol by hydrogenating biphenol represented by the following formula (1): to obtain hydrogenated biphenol represented by the following formula (2): the method comprising: a reaction step of hydrogenating the biphenol represented by formula (1); and a purification step of washing or crystallizing a reaction product obtained from the reaction step using an aromatic hydrocarbon.

Abstract: The present invention relates to an apparatus, which can be part of a pre-treatment system in a plant for the production of fuels, e. g. bio-ethanol, derived from plant biomass, e. g. first generation crops, such as grain, sugarcane and corn or second generation crops such as lignocellulosic biomass. The invention relates to an apparatus for processing, such as fluffing and mixing, at least two media, such as a solid, e. g. biomass, and a fluid, e. g. steam, so as to rendering the first medium susceptible to efficient receiving of energy and/or mass which is provided by localized release of the second medium. Although the description of the present invention focuses on biomass, it is envisaged that the invention is generally applicable to control the mixing of at least two media by crossing their stream of while dispersing at least one of them.

Abstract: Disclosed herein are processes for preparing an ?,?-Cn-diol, wherein n is 5 or greater, from a feedstock comprising a Cn oxygenate. In one embodiment, the process comprises contacting the feedstock with hydrogen gas in the presence of a catalyst comprising Pt, Cu, Ni, Pd, Pt, Rh, Ir, Ru, or Fe on a WO3 or WOx support. In one embodiment, the process comprises contacting the feedstock with hydrogen in the presence of a catalyst comprising a metal M1 and a metal M2 or an oxide of M2, and optionally a support. In one embodiment, M1 is Pd, Pt, or Ir; and M2 is Mo, W, V, Mn, Re, Zr, Ni, Cu, Zn, Cr, Ge, Sn, Ti, Au, or Co. The Cn oxygenate may be obtained from a biorenewable resource.

Abstract: Recovery of ethanol from a crude ethanol product obtained from the hydrogenation of acetic acid using a low energy process. The crude ethanol product is separated in a column to produce a distillate stream comprising acetaldehyde and a residue stream comprising ethanol, acetic acid, ethyl acetate and water. The ethanol product is recovered from the residue stream.

Abstract: A process for recovering ethanol obtained from the hydrogenation of acetic acid. The crude ethanol product is separated in a column to produce a distillate stream comprising acetaldehyde and ethyl acetate and a residue stream comprising ethanol, acetic acid, ethyl acetate and water. The ethanol product is recovered from the residue stream.

Abstract: The present invention relates to a method for producing nitrobenzene, in which the waste gas streams accruing in the process and containing benzene and (traces of) nitrobenzene, possibly low- and medium-boiling components, possibly non-condensable gases and possibly water, optionally after removal of nitrogen oxides, are scrubbed in an absorption column with nitrobenzene, which comprises only very small amounts (maximum 50 ppm) of benzene and is distributed by means of a liquid distributor at a rate of 50 to 200 drip points per square metre, preferably 60 to 120 drip points per square metre, wherein (i) a liquid stream containing benzene and nitrobenzene, possibly organic low- and medium-boiling components and additionally containing sulfuric acid if sulfuric acid is used as the scrubbing agent and (ii) waste gas depleted in benzene and possibly in organic low- and medium-boiling components are obtained.

Abstract: A method for producing a desired isomer of 1-chloro-3,3,3-trifluoro-1-propene or a desired isomer of 1,3,3,3-tetrafluoropropene at a high conversion ratio with no use of a solid catalyst is provided. Since no solid catalyst is used, a desired isomer of 1-chloro-3,3,3-trifluoro-1-propene and a desired isomer of 1,3,3,3-tetrafluoropropene can be stably obtained with no undesired possibility that the solid catalyst is deteriorated due to coking or the like caused as a result of long-time use thereof.

Abstract: Devices and methods for preparing oxygen-containing liquid fuel by bio-oil catalytic conversion. A device includes a biomass fast thermal cracking system for preparing bio-oil, a bio-oil oil-water separating system for separating the bio-oil into oil phase bio-oil and water phase bio-oil that is output to an oil phase bio-oil chemical chain hydrogen production system, and a water phase bio-oil catalytic hydrogenation system. The hydrogen production system outputs produced hydrogen to the water phase bio-oil catalytic hydrogenation system to prepare a liquid fuel. A method includes the steps: thermally cracking the biomass to prepare bio-oil, separating the water phase and the oil phase, producing hydrogen from the oil phase bio-oil through a chemical chain method so as to provide a hydrogen source for the water phase bio-oil to carry out two-stage catalytic hydrogenation in a slurry bed, and separating and purifying the hydrogenated products to obtain an oxygen-containing liquid fuel.

Abstract: A system for converting animal waste into fuel, oil and other useful products is presented and includes a confinement building, a waste storage facility or lagoon for holding animal waste, a solids separating system for separating solids from liquids, a mixing and macerating unit for mixing the proper combination of fluids and solids and for managing the particle size, a pumping unit for pressurizing the system, a first heat exchanger unit, a reactor vessel, a second heat exchanger unit, an oil and water separating unit and an oil storage facility. The reactor vessel includes at least one auger blade that extend around a centrally positioned column that conducts heat into the reactor vessel. The animal waste is pumped through the reactor vessel as heated is applied. The heat and pressure converts the animal waste to oil and water which is later separated.

Abstract: A process for activating a hydroalkylation catalyst in a first state comprising an acid component and a hydrogenating metal component, including: (i) treatment at a temperature of at least 120° C. in the presence of hydrogen for a first duration to produce a catalyst in a second state having a first hydroalkylation activity; (ii) contacting the catalyst in the second state with an aromatic compound and hydrogen under a hydroalkylation condition effective to convert at least part of the aromatic compound to a cycloalkylaromatic compound and produce a catalyst in a third state; and (iii) treating the catalyst in the third state at a temperature of at least 160° C. in the presence of hydrogen but advantageously in the substantial absence of the aromatic compound for a third duration to produce an activated catalyst in a fourth state having a third hydroalkylation activity greater than the first hydroalkylation activity.

Abstract: A process is disclosed that includes brominating a C2, C3 , C4, C5 or C6 alkane with elemental bromine to form a bromo-alkane. The bromo-alkane is reacted to form a C2, C3, C4, C5 or C6 alkene and HBr. The HBr is oxidized to form elemental bromine.

Abstract: The present invention relates to a process to make light olefins, in a combined XTO-OC process, from an oxygen-containing, halogenide-containing or sulphur-containing organic feedstock comprising: a) providing a catalyst comprising zeolitic molecular sieves containing 10 member and larger channels in their microporous structure, b) providing an XTO reaction zone, an OC reaction zone and a catalyst regeneration zone, said catalyst circulating in the three zones, such that at least a portion of the regenerated catalyst is passed to the OC reaction zone, at least a portion of the catalyst in the OC reaction zone is passed to the XTO reaction zone and at least a portion of the catalyst in the XTO reaction zone is passed to the regeneration zone; c) contacting said oxygen-containing, halogenide-containing or sulphur-containing organic feedstock in the XTO reactor with the catalyst at conditions effective to convert at least a portion of the feedstock to form a XTO reactor effluent comprising light olefins and a

Abstract: A methanol conversion process comprises contacting a feedstream comprising methanol, optionally with dimethyl ether or other oxygenates with a catalyst comprising a physical mixture of a molecular sieve, preferably an intermediate or small pore size zeolite such as an MFI zeolite, with a basic metal oxide to provide extended catalyst cycle life by reducing the incidence of coke formation. The process may be applied to the methanol-to-gasoline (MTG), methanol to distillate (MOD), methanol-to-olefins (MTO), methanol-to-chemicals (MTC) and combination processes such as the MTO/OCP Process.

Abstract: A process for the aromatization of a methane-containing gas stream comprising: contacting the methane-containing gas stream in a reactor with a fluidized bed comprising an aromatization catalyst and a hydrogen acceptor under methane-containing gas aromatization conditions to produce a product stream comprising aromatics and hydrogen wherein the hydrogen is, at least in part, bound by the hydrogen acceptor in the reaction zone and removed from the product and the reaction zone.

Abstract: A process for producing short-chain olefins by conversion of oxygenates in a multi-stage fixed-bed reactor, in which the individual stages for reaction zones are covered with beds of a granular, form-selective zeolite catalyst and the feed mixture containing oxygenates is added distributed over the reaction stages. An increase of the availability of the fixed-bed reactor for the olefin production with the same or an increased yield of short-chain olefins is achieved in that one or more reaction zones are charged with a distinctly reduced mass flow of the feed mixture containing oxygenates, wherein the reduced mass flow fraction is distributed over other reaction zones.

Abstract: Head and neck radiation therapy for the treatment of cancer or the like is carried out using a mask which comprises a heat-softenable, conformable and perforate plastic sheet and a frame which can be secured to the surface of a treatment table or chair to immobilize the patient's head and neck. An inhaler is placed on the patient's face prior to molding the thermoplastic sheet over the patient's face such that the resulting contoured sheet captures the inhaler and produces a unitary assembly. Inlet and outlet hoses can be attached to the inhaler for administering an anesthetic or soporific in gaseous form, such as nitrous oxide, for the purpose of calming and tranquilizing the patient for reducing feelings of claustrophobic anxiety during the treatment. A separate scavenging unit may be added.

Abstract: A system and a method improve a quality of beam delivery in proton therapy by pencil beam scanning of a predeterminable volume within a patient that minimizes beam position errors. The system has a proton source generating a proton beam, a number of proton beam bending/focusing units, a beam nozzle having an outlet for the proton beam to penetrate the predetermined volume, a beam bending magnet, and a couple of sweeper magnets to sweep the proton beam in both lateral directions. A position-sensitive detector is aligned with the nozzle to control the position of the proton beam and control logic controls the position and the energy of the proton beam and has a beam steering data set. A correction logic is aligned with the control logic for correcting beam position errors by comparing an expected beam position with the actual beam position detected and generates beam position correction data.

Abstract: A radiation measuring device having a plurality of sensors configured to generate charges in response to the radiation includes a signal processing device. The signal processing device uses an signal generated by a proton beam irradiation device upon changing of beam energy and causes accumulation values of charges output from the sensors to be separately stored in a main control device for each value of the energy. The main control device calculates depth dose profiles for values of the beam energy from the accumulation values stored in the main control device and representing the charges. The main control device calculates a range of the beam for each of the values of the beam energy from the depth dose profiles, corrects the depth dose profiles for the values of the beam energy using a correction coefficient that depends on the range and sums the corrected depth dose profiles.

Abstract: A system for the physical manipulation of free magnetic rotors in a circulatory system using a remotely placed magnetic field-generating stator is provided. In one embodiment, the invention relates to the control of magnetic particles in a fluid medium using permanent magnet-based or electromagnetic field-generating stator sources. Such a system can be useful for increasing the diffusion of therapeutic agents in a fluid medium, such as a human circulatory system, which can result in substantial clearance of fluid obstructions, such as vascular occlusions, in a circulatory system resulting in increased blood flow. Examples of vascular occlusions targeted by the system include, but are not limited to, atherosclerotic plaques, including fibrous caps, fatty buildup, coronary occlusions, arterial stenosis, restenosis, vein thrombi, arterial thrombi, cerebral thrombi, embolisms, hemorrhages, other blood clots, and very small vessels.

Abstract: A magnetic field applicator for the magnetic stimulation of body tissues comprising a core carrier (1) in which a plurality of magnetically conductive flow guide pieces comprised of layered iron sheets is disposed, upon which at least one live coil (3) is disposed that generates an upward-emitted magnetic field having a plurality of field line bundles (8), wherein the magnetic field applicator comprises a polygonal coil (3) that is wound as a pancake coil in one or more planes in such a way that the direction of the individual coil conductors (27) is selected such that the coil conductors (27) run in pieces in a predominantly straight line and perpendicular to the plane of the flow guide pieces that are made of layered sector iron cores (5-8).

Abstract: Methods and systems for transcranial magnetic stimulation applied to the posterior cingulate including bundle fibers to treat Alzheimer's. Excitatory impulses from (or triggered by) the applied TMS may be transmitted through to the entorhinal cortex and hippocampus, which are early sites in which Alzheimer's disease begins to develop. Excitatory signals in the hippocampus and entorhinal cortex strengthen connectivity between cells, and increase. Overall metabolic activity may be increased, serving to help promote resistance to the Alzheimer's disease process and encouraging maturation and integration of neural stem cells native to this region of the brain.

Abstract: An impeller for a pump is disclosed herein. The impeller can include a hub having a fixed end and a free end. The impeller can also have a plurality of blades supported by the hub. Each blade can have a fixed end coupled to the hub and a free end. The impeller can have a stored configuration and a deployed configuration, the blades in the deployed configuration extending away from the hub, and the blades in the stored configuration being compressed against the hub.

Abstract: A system for assisting the right heart of a patient includes a PA cannula adapted for insertion into a PA of a patient through the right internal jugular vein of the patient. The system includes a percutaneous RA cannula adapted for insertion into an RA of the patient. The system includes a blood pump disposed outside of the patient to which the RA cannula and the PA cannula are connected to provide right ventricular circulatory support to the patient without any left ventricular assist. A method for assisting the right heart of a patient includes the steps of inserting a PA cannula into a PA of a patient. There is the step of inserting an RA cannula into an RA of the patient. There is the step of connecting the RA cannula and the PA cannula to a blood pump disposed outside of the patient. There is the step of activating the blood pump to provide right ventricular circulatory support to assist the heart of the patient.

Abstract: A splinting appliance for use in repair of the vaginal wall or uterus includes a body portion, securing means and coupling means. The body portion is shaped to support a substantially normal vaginal apex. The securing means is configured to enable removable securing of the splinting appliance within the vaginal canal. The coupling means enables the splinting appliance to releasably couple with a vaginal elevator device when inserted in the vaginal canal during surgery. Use of the vaginal elevator device when coupled with the splinting appliance aids in location of the vaginal apex. The splinting appliance provides a substantially rigid support which, when in use, facilitates manipulation of tissue at the vaginal wall when approaching through the abdomen e.g. for dissection and/or attachment of a repair graft.

Abstract: The insertion tube of an endoscope is equipped with an array of pressure sensors that provide real-time information of the pressure exerted by the insertion tube as it passes through a patient's body during an endoscopic procedure. Pressure information may be displayed in real time, wherein regions of high pressure are highlighted. An alarm is generated when the pressure applied at any location inside the patient's body exceeds safe limits. Further, sensors may be placed along the length of the insertion tube for measurement of distance travelled by the tip of an endoscope, which is integrated with measurement of the force applied by a physician in maneuvering the endoscope to determine applied force at a given location.

Abstract: The insertion tube of an endoscope is equipped with an array of pressure sensors that provide real-time information of the pressure exerted by the insertion tube as it passes through a patient's body during an endoscopic procedure. Pressure information may be displayed in real time, wherein regions of high pressure are highlighted. An alarm is generated when the pressure applied at any location inside the patient's body exceeds safe limits. Further, sensors may be placed along the length of the insertion tube for measurement of distance travelled by the tip of an endoscope, which is integrated with measurement of the force applied by a physician in maneuvering the endoscope to determine applied force at a given location.

Abstract: Devices, systems and methods for improved intubation which have particular application for awake or sedated intubation are described. An intubation scope having a handle, a flexible probe, and an articulatable tip where the handle has a control lever coupled to a rotary control wheel, which is in turn connected to control wires which when moved by the rotary control wheel cause articulation of the tip of the intubation scope. Systems utilizing the intubation scope may also include endotracheal tubes adapted to fit over the tip of the intubation scope.

Abstract: In one aspect, the invention provides injectable compositions that comprise a suitable hydrophilic polymer (e.g., a suitable polysaccharide) and water, as well as other optional components. In various embodiments, the composition may be provided in a suitable container, for example, in a pre-loaded syringe. In another aspect, methods of performing medical procedures in a tract of a body are provided. In yet another aspect, the invention provides systems for performing medical procedures in a tract of a body.

Abstract: Imaging apparatus, including an imaging unit, which consists of an image sensor, configured to capture images of a region and to output image signals in response to the captured images and an illumination source, configured to illuminate the region. The unit further includes a driver circuit, which is coupled to receive a digital value indicative of a target luminous flux of the illumination source and to generate a pulse-width-modulated (PWM) signal to drive the illumination source with a duty cycle of the signal determined by the value. The apparatus includes a camera control unit, which is configured to process the image signals so as to generate images of the region and to output the digital value indicative of the target luminous flux based on the images. A single cable connects the imaging unit to the camera control unit so as to convey the image signals and the digital value.

Abstract: In one embodiment, an access sheath includes a sheath assembly including sheath tubing, the sheath tubing having a main lumen and a secondary lumen that extends along the length of the main lumen. The main lumen has a first cross-sectional area, a first length, and a distal end outlet. The secondary lumen has a second cross-sectional area less than the first cross-sectional area, a second length less than the first length, and a distal end outlet terminating proximal of the main lumen distal outlet.

Abstract: A device for accessing tissue within a body lumen comprises an elongated body portion defining a lumen and an anchoring mechanism including an expanding structure on a distal portion of the elongated body portion. The anchoring mechanism moves the expanding structure from an insertion configuration in which the expanding structure is constricted against the device to an operative configuration in a body in which the expanding structure expands away from the device without altering a length of the anchoring mechanism in combination with a control mechanism for selectively engaging the anchoring mechanism.

Abstract: A fluorescent type of green light source of a semiconductor in a light source apparatus for an endoscope includes a blue excitation light source device and green emitting phosphor. The blue excitation light source device emits blue excitation light. The green emitting phosphor is excited by the blue excitation light, and emits green fluorescence. A dichroic filter in a dichroic mirror cuts off the blue excitation light from an emission spectrum of mixed light of the blue excitation light and green fluorescence from the fluorescent type of green light source. Thus, illumination light with the emission spectrum of a target can be stably supplied without influence of the blue excitation light to a light amount of blue light from a blue light source of a semiconductor.

Abstract: A sheath for an endotracheal intubation device includes an elongate flexible portion defining a closed conduit and an adjacent open channel defined by opposing lips for releasably retaining an endotracheal tube, and a rigid portion extending from a distal end of the flexible portion, the flexible portion including a gap in one of the lips adjacent the rigid portion to expose an edge of the rigid portion, the gap allowing the endotracheal tube to be pinched between the edge of the rigid portion and a lip of the flexible portion to enhance retention of the tube when an articulated arm disposed in the closed conduit is curved, and facilitate release of the tube when the arm is not curved.

Abstract: The invention provides a laryngoscopic device that can be paired with any video baton imaging system to concurrently view the upper airway, deliver oxygen and administer a topical anesthetic to select areas in the airway as needed. The invention also provides a video laryngoscope that includes two conduits, one for delivering oxygen and the other for delivering a pharmaceutical agent to select areas of the airway under real-time visualization.

Abstract: A tracheal intubation system including a laryngoscope is disclosed. An endotracheal tube exchange system is also disclosed. In some examples, the system includes a laryngoscope, a stylet, and an endotracheal tube. In some examples the stylet is an articulating stylet. An endotracheal tube with one or more depth-assessment bands is also disclosed. An articulating stylet with one or more depth-assessment bands and an orientation mark is also disclosed. A method of positioning an endotracheal tube in a patient is also disclosed. A method of positioning a stylet for placement of an endotracheal tube is also disclosed. A method of performing an endotracheal tube exchange procedure is also disclosed.

Abstract: Devices, systems and methods are provided for accessing a target location in the body of a patient, particularly within the epidural space. A system includes a sheath and a sheath support supporting the sheath to reduce or avoid kinking. The sheath support closely fits within the sheath while maintaining free sliding therein. The sheath support has a non-compliant outer diameter maintaining the inner diameter of the sheath and preventing the sheath walls from collapsing into a kink, particularly during low radius bends that may occur during delivery. The sheath support may include a distal tip configured to resist retraction into the sheath until a threshold force is reached which causes the distal tip to at least partially retract into the lumen of the sheath. Likewise, the distal tip may be fully retractable through the sheath so that the sheath support is removable from the proximal end of the sheath.

Abstract: An access assembly includes a body portion defining a longitudinal axis and having at least one lumen defined therethrough. The at least one lumen is configured for passage of a surgical instrument therethrough. An outer sleeve is disposed about the body portion to define a chamber therebetween. The chamber is selectively inflatable from a deflated condition, for positioning the access assembly within an opening in tissue, and an inflated condition, for retaining the access assembly within the opening in tissue in sealing relation therewith.

Abstract: Methods and devices are provided for providing surgical access into a body cavity. In one embodiment, a surgical access device is provided that includes a housing coupled to a retractor. The housing can be have one or more movable sealing ports for receiving surgical instruments. Each movable sealing port can include one or more sealing elements therein for sealing the port and/or forming a seal around a surgical instrument disposed therethrough. Each movable sealing port can be rotatable relative to the housing and each sealing element can be rotatable relative to the housing along a predetermined orbital path.

Abstract: The present application relates to a double blade for a surgical retractor having a base body with a substantially cylindrical mounting mandrel for mounting the double blade on a surgical retractor, and at least two blade elements that are so mounted on the base body as to be rotatable and/or displaceable through at least a certain angular range with respect to the base body. Moreover, the present application relates to a blade arrangement in which a double blade is connected to a connecting element of a further double blade, or a single blade. In this case, the at least one double blade or, optionally, the single blade is rotatable with respect to the connecting element. In addition, the application relates to a retractor with a double blade, a blade arrangement or a blade assembly comprising double blades and a blade arrangement.

Abstract: A luminaire includes a reflector arrangement and a light generating unit, which emits its light onto the reflector arrangement. The reflector arrangement includes at least two shell-layer-shaped reflector rings which are arranged coincidentally with regard to their axes of symmetry. The reflector rings have different middle radii, are arranged in a manner one nested in another, and are embodied as total internal reflection reflectors.

Abstract: A monitoring system includes a wearable appliance; and a processor coupled to the wearable appliance to analyze vital data or wellness data.

Abstract: A catheter for delivering securing elements to a tissue, such as a blood vessel, and imaging the tissue before, after, or during the imaging. The catheters incorporate intravascular ultrasound (IVUS) imaging, including Focused Acoustic Computed Tomography (FACT), as well as optical coherence tomography (OCT).

Abstract: A wearable physiological sensing device with optical pathways is described. The wearable physiological sensing device may include at least one light source; a first light pipe coupled with the at least one light source, the first light pipe at least partially circumscribing an extremity of a patient, and including at least one aperture for radiating light from the light source into the extremity. The wearable physiological sensing device may also include a second light pipe including at least one aperture for receiving the light radiated through the extremity, the second light pipe at least partially circumscribing the extremity of the patient, and an optical receiver coupled with the second light pipe configured to receive the light and output one or more signals representative of the received light.