The SiPAP flow driver (Care Fusion, Dublin, Ohio, USA) offers synchronised nasal intermittent positive pressure ventilation (sNIPPV) using an abdominal capsule. This study aims to describe the ...accuracy and effects of synchronised NIPPV using SiPAP in preterm infants.
Ten infants, born <28 weeks' gestation, receiving synchronised SiPAP-generated NIPPV, in 'biphasic trigger' mode, were observed. Abdominal capsule signals, delivered pressures, respiratory pattern and oxygen saturations were recorded. Tidal volume (VT), apnoeas, proportion of breaths supported by SiPAP and time between inspiration onset and SiPAP pressure rise were analysed.
Infants were of median 26(+0) weeks' gestational age and birth weight 776 g. Mean (SD) respiratory rate (RR) was 53 (14)/min. 82% (17) of spontaneous breaths triggered a SiPAP pressure peak. Mean time between inspiration and SiPAP pressure rise was 28 (20) ms. There was no difference in VT when breaths triggered a SiPAP pressure peak compared with breaths without a pressure peak. No VT was generated by pressure peaks delivered during apnoea. Capsule signals were not recognised following >10% of breaths, resulting in asynchronous NIPPV delivery. Movements resulted in irregular SiPAP pressures and desaturation. When the RR was faster, >55/min, breaths irregularly triggered a SiPAP pressure peak (p=0.003). Compared with times when every breath resulted in a pressure peak, lower mean pressures were achieved, 7.9 vs 8.4 cm H2O (p=0.02).
The SiPAP synchronisation system triggered rapidly with most spontaneous breaths, but did not result in larger tidal volumes. When the RR was >55/min, the SiPAP delivered fewer pressure peaks at lower pressures.
Nasal intermittent positive pressure ventilation (NIPPV) may be beneficial but the mechanisms of action are undetermined.
To investigate the effects of non-synchronised NIPPV on spontaneous breathing ...in premature infants.
10 infants receiving ventilator generated non-synchronised NIPPV were studied for 30 min. Delivered pressure was measured at the nose; respiration was recorded using respiratory inductance plethysmography. Oxygen saturation, carbon dioxide, heart rate, inspired oxygen and video images were recorded.
Median gestational age, birth weight, age and study weight were 25(+3) weeks, 797 g, 24 days and 1076 g. When the NIPPV pressure peak commenced during spontaneous inspiration the inspiratory time increased by 21% (p=0.002), relative tidal volume increased by 15% (p=0.01) and expiratory time was unchanged. When the NIPPV pressure peak commenced during spontaneous expiration the expiratory time increased by 13% (p=0.04). NIPPV pressures delivered during apnoea (range 8-28 cm H(2)O) produced chest inflation 5% of the time, resulting in small tidal volumes (26.7% of spontaneous breath size) but reduced oxygen desaturation. NIPPV pressure peaks occurred throughout spontaneous respiration proportional to the inspiratory: expiratory ratio.
NIPPV pressure peaks only resulted in a small increase in relative tidal volumes when delivered during spontaneous inspiration. During apnoea pressure peaks occasionally resulted in chest inflation, which ameliorated oxygen desaturations. Infants did not become entrained with the NIPPV pressure changes. Synchronising every rise in applied pressure with spontaneous inspiration may increase the effectiveness of NIPPV and warrants investigation.
The vanilloid receptor (VR1) is a ligand‐gated ion channel, which plays an important role in nociceptive processing. Therefore, a pharmacological characterization of the recently cloned rat VR1 ...(rVR1) was undertaken.
HEK293 cells stable expressing rVR1 (rVR1‐HEK293) were loaded with Fluo‐3AM and then incubated at 25°C for 30 min with or without various antagonists or signal transduction modifying agents. Then intracellular calcium concentrations (Ca2+i) were monitored using FLIPR, before and after the addition of various agonists.
The rank order of potency of agonists (resiniferatoxin (RTX)>capsaicin>olvanil>PPAHV) was as expected, and all were full agonists. The potencies of capsaicin and olvanil, but not RTX or PPAHV, were enhanced at pH 6.4 (pEC50 values of 7.47±0.06, 7.16±0.06, 8.19±0.06 and 6.02±0.03 respectively at pH 7.4 vs 7.71±0.05, 7.58±0.14, 8.10±0.05 and 6.04±0.08 at pH 6.4).
Capsazepine, isovelleral and ruthenium red all inhibited the capsaicin (100 nM)‐induced Ca2+ response in rVR1‐HEK293 cells, with pKB values of 7.52±0.08, 6.92±0.11 and 8.09±0.12 respectively (n=6 each). The response to RTX and olvanil were also inhibited by these compounds. None displayed any agonist‐like activity.
The removal of extracellular Ca2+ abolished, whilst inhibition of protein kinase C with chelerythrine chloride (10 μM) partially (∼20%) inhibited, the capsaicin (10 μM)‐induced Ca2+ response. However, tetrodotoxin (3 μM), nimodipine (10 μM), ω‐GVIA conotoxin (1 μM), thapsigargin (1 μM), U73122 (3 μM) or H‐89 (3 μM) had no effect on the capsaicin (100 nM)‐induced response.
In conclusion, the recombinant rVR1 stably expressed in HEK293 cells acts as a ligand‐gated Ca2+ channel with the appropriate agonist and antagonist pharmacology, and therefore is a suitable model for studying the effects of drugs at this receptor.
British Journal of Pharmacology (2000) 130, 916–922; doi:10.1038/sj.bjp.0703390
In today's increasingly competitive health care marketplace, consumer satisfaction has become an important measure of quality. Furthermore, measures of satisfaction with treatment inteerventions are ...influential factors in determining patients' and payers' choices of health care. This study sought to evaluate satisfaction with postmastectomy breast reconstruction and to assess the effects of procedure type and timing on patient satisfaction. As part of the Michigan Breast Reconstruction Outcome Study, patients undergoing first-time mastectomy reconstruction were prospectively evaluated, including cohorts of women choosing expander/implant, pedicle TRFAM flap, and free TRAM flap procedures. Preoperatively and 1 year postoperatively, participants completed a questionnaire that collected a variety of health status information. The postoperative questionnaire had an additional seven items assessing both general satisfaction with reconstruction (five items) and aesthetic satisfaction (two items) as separate subscales. Patients were asked to respond to each item using a five-point Likert scale. Item responses ranged from 1, indicating high satisfaction, to 5, reflecting low satisfaction. In the data analysis, only patients responding with a 1 or 2 for all of the items within a subscale were classified as "satisfied" for the subscale. To assess the effects of procedure type (implant, pedicle TRAM flap, and free TRAM flap) and timing (immediate versus delayed) on satisfaction and to control for possible confounding effects from other independent variables, multiple logistic regression was employed. In our analysis, odds ratios and associated 95 percent confidence intervals were calculated for each independent variable in the regression. Statistical significance was designated at the p < or = 0.05 level. A total of 212 patients were followed during the period of 1994 to 1997, including 141 immediate and 71 delayed reconstructions. The study population consisted of 49 expander/implant, 102 pedicle TRAM flap, and 61 free TRAM flap reconstruction patients. The analysis showed a significant association between procedure type and patient satisfaction. TRAM flap patients (both free and pedicle) appeared to have significantly greater general and aesthetic satisfaction compared with expander/implant patients (p = 0.03 and 0.001, respectively). Furthermore, pedicle TRAM flap patients were more aesthetically satisfied than those with free TRAM flaps (p = 0.072). The other independent variables of age and procedure timing did not appear to significantly affect either general or aesthetic satisfaction. However, preoperative physical activity was positively correlated with general satisfaction at the p = 0.034 level. The choice of procedure seems to have a significant effect on both aesthetic and general patient satisfaction with breast reconstruction. In this study, autogenous tissue reconstructions produced higher levels of patient aesthetic and general satisfaction compared with implant techniques. Pedicle and free TRAM flap patients do not seem to differ significantly in general satisfaction. However, women receiving pedicle TRAM flaps reported greater aesthetic satisfaction compared with patients undergoing free TRAM flaps. Furthermore, patient age and procedure timing may not have an effect on patient satisfaction with breast reconstruction.
Abstract
We tested the capabilities of urban greenhouse gas (GHG) measurement networks to detect abrupt changes in emissions, such as those caused by the roughly 6-week COVID-19 lockdown in March ...2020 using hourly
in situ
GHG mole fraction measurements from six North American cities. We compared observed changes in CO
2
, CO, and CH
4
for different mole fraction metrics (diurnal amplitude, vertical gradients, enhancements, within-hour variances, and multi-gas enhancement ratios) during 2020 relative to previous years for three periods: pre-lockdown, lockdown, and ongoing recovery. The networks showed decreases in CO
2
and CO metrics during the lockdown period in all cities for all metrics, while changes in the CH
4
metrics were variable across cities and not statistically significant. Traffic decreases in 2020 were correlated with the changes in GHG metrics, whereas changes in meteorology and biology were not, implying that decreases in the CO
2
and CO metrics were related to reduced emissions from traffic and demonstrating the sensitivity of these tower networks to rapid changes in urban emissions. The enhancements showed signatures of the lockdowns more consistently than the three micrometeorological methods, possibly because the urban measurements are collected at relatively high altitudes to be sensitive to whole-city emissions. This suggests that urban observatories might benefit from a mixture of measurement altitudes to improve observational network sensitivity to both city-scale and more local fluxes.
We present a new reconstruction of the interplanetary magnetic field (IMF, B) for 1846–2012 with a full analysis of errors, based on the homogeneously constructed IDV(1d) composite of geomagnetic ...activity presented in Part 1 (Lockwood et al., 2013a). Analysis of the dependence of the commonly used geomagnetic indices on solar wind parameters is presented which helps explain why annual means of interdiurnal range data, such as the new composite, depend only on the IMF with only a very weak influence of the solar wind flow speed. The best results are obtained using a polynomial (rather than a linear) fit of the form B = χ · (IDV(1d) − β)α with best-fit coefficients χ = 3.469, β = 1.393 nT, and α = 0.420. The results are contrasted with the reconstruction of the IMF since 1835 by Svalgaard and Cliver (2010).
The CUORE Cryostat D’Addabbo, A.; Alduino, C.; Bersani, A. ...
Journal of low temperature physics,
12/2018, Letnik:
193, Številka:
5-6
Journal Article
Recenzirano
Odprti dostop
The Cryogenic Underground Observatory for Rare Events (CUORE) is a bolometric experiment for neutrinoless double-beta decay in
130
Te
search, currently taking data at the underground facility of ...Laboratori Nazionali del Gran Sasso (LNGS). The CUORE cryostat successfully cooled down a mass of about 1 ton at
∼
7
mK
, delivering a uniform and constant base temperature. This result marks a fundamental milestone in low-temperature detector techniques, opening the path for future ton-scale bolometric experiments searching for rare events. In this paper, we present the CUORE cryogenic infrastructure, briefly describing its critical subsystems.
Recent years have seen important advances in our understanding of the etiology, biology and genetics of kidney cancer. To summarize important achievements and identify prominent research questions ...that remain, a workshop was organized by IARC and the US NCI. A series of ‘difficult questions’ were formulated, which should be given future priority in the areas of population, genomic and clinical research.
OBJECTIVESAcute heart failure (AHF) hospitalisation is associated with 10% mortality. Outpatient based management (OPM) of AHF appeared effective in observational studies. We conducted a pilot ...randomised controlled trial (RCT) comparing OPM with standard inpatient care (IPM). METHODSWe randomised patients with AHF, considered to need IV diuretic treatment for ≥2 days, to IPM or OPM. We recorded all-cause mortality, and the number of days alive and out-of-hospital (DAOH). Quality of life, mental well-being and Hope scores were assessed. Mean NHS cost savings and 95% central range (CR) were calculated from bootstrap analysis. Follow-up: 60 days. RESULTSEleven patients were randomised to IPM and 13 to OPM. There was no statistically significant difference in all-cause mortality during the index episode (1/11 vs 0/13) and up to 60 days follow-up (2/11 vs 2/13) p = .86. The OPM group accrued more DAOH {47 36,51 vs 59 41,60, p = .13}. Two patients randomised to IPM (vs 6 OPM) were readmitted p = .31. Hope scores increased more with OPM within 30 days but dropped to lower levels than IPM by 60 days. More out-patients had increased total well-being scores by 60 days (p = .04). OPM was associated with mean cost savings of £2658 (95% CR 460-4857) per patient. CONCLUSIONSPatients with acute HF randomised to OPM accrued more days alive out of hospital (albeit not statistically significantly in this small pilot study). OPM is favoured by patients and carers and is associated with improved mental well-being and cost savings.
In vitro data suggest that a subgroup of NLR proteins, including NLRP12, inhibits the transcription factor NF-κB, although physiologic and disease-relevant evidence is largely missing. Dysregulated ...NF-κB activity is associated with colonic inflammation and cancer, and we found Nlrp12−/− mice were highly susceptible to colitis and colitis-associated colon cancer. Polyps isolated from Nlrp12−/− mice showed elevated noncanonical NF-κB activation and increased expression of target genes that were associated with cancer, including Cxcl13 and Cxcl12. NLRP12 negatively regulated ERK and AKT signaling pathways in affected tumor tissues. Both hematopoietic- and nonhematopoietic-derived NLRP12 contributed to inflammation, but the latter dominantly contributed to tumorigenesis. The noncanonical NF-κB pathway was regulated upon degradation of TRAF3 and activation of NIK. NLRP12 interacted with both NIK and TRAF3, and Nlrp12−/− cells have constitutively elevated NIK, p100 processing to p52 and reduced TRAF3. Thus, NLRP12 is a checkpoint of noncanonical NF-κB, inflammation, and tumorigenesis.
► Nlrp12−/− mice are significantly more susceptible to colitis-associated colon cancer ► NLRP12 is a negative regulator NIK, CXCL12, CXCL13, ERK, and AKT in vivo ► Hematopoietic and nonhematopoietic compartments contribute to Nlrp12−/− phenotype ► NLRP12 functionally interacts with and alters the balance of NIK and TRAF3
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