Few measurements of exposure to secondhand smoke (SHS) in close proximity to a smoker are available. Recent health studies have demonstrated an association between acute (<2 h) exposures to high ...concentrations of SHS and increased risk of cardiovascular and respiratory disease. We performed 15 experiments inside naturally ventilated homes and 16 in outdoor locations, each with 2–4 non‐smokers sitting near a cigarette smoker. The smoker's and non‐smokers' real‐time exposures to PM2.5 from SHS were measured by using TSI SidePak monitors to sample their breathing zones. In 87% of the residential indoor experiments, the smoker received the highest average exposure to SHS, with PM2.5 concentrations ranging from 50–630 μg/m3. During the active smoking period, individual non‐smokers sitting within approximately 1 m of a smoker had average SHS exposures ranging from negligible up to >160 μg/m3 of PM2.5. The average incremental exposure of the non‐smokers was higher indoors (42 μg/m3, n = 35) than outdoors (29 μg/m3, n = 47), but the overall indoor and outdoor frequency distributions were similar. The 10‐s PM2.5 averages during the smoking periods showed great variability, with multiple high concentrations of short duration (microplumes) both indoors and outdoors.
Identifying and quantifying secondhand tobacco smoke (SHS) that drifts between multiunit homes is critical to assessing exposure. Twenty‐three different gaseous and particulate measurements were ...taken during controlled emissions from smoked cigarettes and six other common indoor source types in 60 single‐room and 13 two‐room experiments. We used measurements from the 60 single‐room experiments for (i) the fitting of logistic regression models to predict the likelihood of SHS and (ii) the creation of source profiles for chemical mass balance (CMB) analysis to estimate source apportionment. We then applied these regression models and source profiles to the independent data set of 13 two‐room experiments. Several logistic regression models correctly predicted the presence of cigarette smoke more than 80% of the time in both source and receptor rooms, with one model correct in 100% of applicable cases. CMB analysis of the source room provided significant PM2.5 concentration estimates of all true sources in 9 of 13 experiments and was half‐correct (i.e., included an erroneous source or missed a true source) in the remaining four. In the receptor room, CMB provided significant estimates of all true sources in 9 of 13 experiments and was half‐correct in another two.
Personal exposure to air pollutants can be substantially higher in close proximity to an active source due to non-instantaneous mixing of emissions. The research presented in this paper quantifies ...this proximity effect for a non-buoyant source in 2 naturally ventilated homes in Northern California (CA), assessing its spatial and temporal variation and the influence of factors such as ventilation rate on its magnitude. To quantify how proximity to residential sources of indoor air pollutants affects human exposure, we performed 16 separate monitoring experiments in the living rooms of two detached single-family homes. CO (as a tracer gas) was released from a point source in the center of the room at a controlled emission rate for 5-12 h per experiment, while an array of 30-37 real-time monitors simultaneously measured CO concentrations with 15 s time resolution at radial distances ranging from 0.25-5 m under a range of ventilation conditions. Concentrations measured in close proximity (within 1 m) to the source were highly variable, with 5 min averages that typically varied by >100-fold. This variability was due to short-duration (<1 min) pollutant concentration peaks ("microplumes") that were frequently recorded in close proximity to the source. We decomposed the random microplume component from the total concentrations by subtracting predicted concentrations that assumed uniform, instantaneous mixing within the room and found that these microplumes can be modeled using a 3-parameter lognormal distribution. Average concentrations measured within 0.25 m of the source were 6-20 times as high as the predicted well-mixed concentrations.
Plaque morphologic features have been suggested as a complement to luminal narrowing measurements for assessing the risk of stroke associated with carotid atherosclerotic disease, giving rise to the ...concept of "vulnerable plaque." The purpose of this study was to evaluate the ability of multidetector-row CT angiography (CTA) to assess the composition and characteristics of carotid artery atherosclerotic plaques with use of histologic examination as the gold standard.
Eight patients with transient ischemic attacks who underwent carotid CTA and "en bloc" endarterectomy were enrolled in a prospective study. An ex vivo micro-CT study of each endarterectomy specimen was obtained, followed by histologic examination. A systematic comparison of CTA images with histologic sections and micro-CT images was performed to determine the CT attenuation associated with each component of the atherosclerotic plaques. A computer algorithm was subsequently developed that automatically identifies the components of the carotid atherosclerotic plaques, based on the density of each pixel. A neuroradiologist's reading of this computer analysis was compared with the interpretation of the histologic slides by a pathologist with respect to the types and characteristics of the carotid plaques.
There was a 72.6% agreement between CTA and histologic examination in carotid plaque characterization. CTA showed perfect concordance for calcifications. A significant overlap between densities associated with lipid-rich necrotic core, connective tissue, and hemorrhage limited the reliability of individual pixel readings to identify these components. However, CTA showed good correlation with histologic examination for large lipid cores (kappa = 0.796; P < .001) and large hemorrhages (kappa = 0.712; P = .102). CTA performed well in detecting ulcerations (kappa = 0.855) and in measuring the fibrous cap thickness (R(2) = 0.77; P < .001).
The composition of carotid atherosclerotic plaques determined by CTA reflects plaque composition defined by histologic examination.
Evolution of intracranial aneurysmal disease is known to be related to hemodynamic forces acting on the vessel wall. Low wall shear stress (WSS) has been reported to have a negative effect on ...endothelial cells normal physiology and may be an important contributor to local remodeling of the arterial wall and to aneurysm growth and rupture.
Seven patient-specific models of intracranial aneurysms were constructed using MR angiography data acquired at two different time points (mean 16.4+/-7.4 months between the two time points). Numeric simulations of the flow in the baseline geometries were performed to compute WSS distributions. The lumenal geometries constructed from the two time points were manually coregistered, and the radial displacement of the wall was calculated on a pixel-by-pixel basis. This displacement, corresponding to the local growth of the aneurysm, was compared to the time-averaged wall shear stress (WSS TA) through the cardiac cycle at that location. For statistical analysis, radial displacement was considered to be significant if it was larger than half of the MR pixel resolution (0.3 mm).
Mean WSS TA values obtained for the areas with a displacement smaller and greater than 0.3 mm were 2.55+/-3.6 and 0.76+/-1.5 Pa, respectively (P<0.001). A linear correlation analysis demonstrated a significant relationship between WSS TA and surface displacement (P<0.001).
These results indicate that aneurysm growth is likely to occur in regions where the endothelial layer lining the vessel wall is exposed to abnormally low wall shear stress.
The deposition of intralumenal thrombus in intracranial aneurysms adds a risk of thrombo-embolism over and above that posed by mass effect and rupture. In addition to biochemical factors, hemodynamic ...factors that are governed by lumenal geometry and blood flow rates likely play an important role in the thrombus formation and deposition process. In this study, patient-specific computational fluid dynamics (CFD) models of blood flow were constructed from MRA data for three patients who had fusiform basilar aneurysms that were thrombus free and then proceeded to develop intralumenal thrombus. In order to determine whether features of the flow fields could suggest which regions had an elevated potential for thrombus deposition, the flow was modeled in the baseline, thrombus-free geometries. Pulsatile flow simulations were carried out using patient-specific inlet flow conditions measured with MR velocimetry. Newtonian and non-Newtonian blood behavior was considered. A strong similarity was found between the intra-aneurysmal regions with CFD-predicted slow, recirculating flows and the regions of thrombus deposition observed in vivo in the follow-up MR studies. In two cases with larger aneurysms, the agreement between the low velocity zones and clotted-off regions improved when non-Newtonian blood behavior was taken into account. A similarity was also found between the calculated low shear stress regions and the regions that were later observed to clot.
Electrochemical sensors are commonly used to measure concentrations of gaseous air pollutants in real time, especially for personal exposure investigations. The monitors are small, portable, and have ...suitable response times for estimating time-averaged concentrations. However, for transient exposures to air pollutants lasting only seconds to minutes, a non-instantaneous time response can cause measured values to diverge from actual input concentrations, especially when the pollutant fluctuations are pronounced and rapid. Using 38 Langan carbon monoxide (CO) monitors, which can be set to log data every 2 s, we found electrochemical sensor response times of 30-50 s. We derived a simple model based on Fick's Law to reconstruct a close to accurate time series from logged data. Starting with experimentally measured data for repetitive step input signals of alternating high and low CO concentrations, we were able to reconstruct a much improved 2-s concentration time series using the model. We also utilized the model to examine errors in monitor measurements for different averaging times. By selecting the averaging time based on the response time of the monitor, the error between actual and measured pollutant levels can be minimized. The methodology presented in this study is useful when aiming to accurately determine a time series of rapidly time-varying concentrations, such as for locations close to an active point source or near moving traffic.
In cases where surgeons consider different interventional options for flow alterations in the setting of pathological basilar artery hemodynamics, a virtual model demonstrating the flow fields ...resulting from each of these options can assist in making clinical decisions. In this study, image-based computational fluid dynamics (CFD) models were used to simulate the flow in four basilar artery aneurysms in order to evaluate postoperative hemodynamics that would result from flow-altering interventions. Patient-specific geometries were constructed using MR angiography and velocimetry data. CFD simulations carried out for the preoperative flow conditions were compared to
in vivo
phase-contrast MRI measurements (4D Flow MRI) acquired prior to the interventions. The models were then modified according to the procedures considered for each patient. Numerical simulations of the flow and virtual contrast transport were carried out in each case in order to assess postoperative flow fields and estimate the likelihood of intra-aneurysmal thrombus deposition following the procedures. Postoperative imaging data, when available, were used to validate computational predictions. In two cases, where the aneurysms involved vital pontine perforator arteries branching from the basilar artery, idealized geometries of these vessels were incorporated into the CFD models. The effect of interventions on the flow through the perforators was evaluated by simulating the transport of contrast in these vessels. The computational results were in close agreement with the MR imaging data. In some cases, CFD simulations could help determine which of the surgical options was likely to reduce the flow into the aneurysm while preserving the flow through the basilar trunk. The study demonstrated that image-based computational modeling can provide guidance to clinicians by indicating possible outcome complications and indicating expected success potential for ameliorating pathological aneurysmal flow, prior to a procedure.
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