Extracorporeal lessons from sheep

Background: Extracorporeal circulation (ECC), the diversion of blood flow through a circuit located outside of the body, has been one of the major advances in modern medicine. Cardio-pulmonary bypass (CPB), renal dialysis, apheresis and extracorporeal membrane oxygenation (ECMO) are all different forms of ECC. Despite its major benefits, when blood comes into contact with foreign material, both the coagulation and inflammation cascades are activated simultaneously. Short periods of exposure to ECC e.g. CPB (�2 h duration), are known to be associated with haemolysis, coagulopathies, bleeding and inflammation which demand blood product support. Therefore, it is not unexpected that these complications would be exaggerated with prolonged periods of ECC such as in ECMO (days to weeks duration). The variability and complexities of the underlying pathologies of patients requiring ECC makes it difficult to study the cause and effect of these complications. To overcome this problem we developed an ovine (sheep) model of ECC. Method: Healthy female sheep (1–3 y.o.) weighing 40–50 kg were fasted overnight, anaesthetised, intubated and ventilated [1]. Half the group received smoke induced acute lung injury (S-ALI group) (n = 8) and the other half did not (healthy group) (n = 8). Sheep were subsequently cannulated (Medtronic Inc, Minneapolis, MN, USA) and veno-venous ECMO commenced using PLS ECMO circuit and Quadrox D oxygenator (Maquet Cardiopulmonary AG, Hechinger Straße, Germany). There was continuous physiological monitoring and blood was collected at specified time intervals for full blood counts, platelet function analysis (by Multiplate®), routine coagulation and assessment of clot formation and lysis (by ROTEM®). Preliminary results Full blood counts and routine coagulation results from normal healthy sheep were comparable to those of normal human adults. Within 15 min of initiating of ECMO, PT, PTT and EXTEM clot formation time increased, whilst EXTEM maximum clot firmness decreased in both cohorts. Discussion & Conclusions: Preliminary results of sheep from both 2 h ECMO cohorts showed that the anatomy, haematology and coagulation parameters of an adult sheep are comparable to that a human adult. Experiments are currently underway with healthy (n = 8) and S-ALI (n = 8) sheep on ECMO for 24 h. In addition to characterising how ECMO alters haematology and coagulation parameters, we hope that it will also define which blood components will be most effective to correct bleeding or clotting complications during ECMO support.

Application of profluorescent nitroxides for measurements of oxidative capacity of combustion generated particles

Oxidative stress caused by generation of free radicals and related reactive oxygen species (ROS) at the sites of deposition has been proposed as a mechanism for many of the adverse health outcomes associated with exposure to particulate matter (PM). Recently, a new profluorescent nitroxide molecular probe (BPEAnit) developed at QUT was applied in an entirely novel, rapid and non-cell based assay for assessing the oxidative potential of particles (i.e. potential of particles to induce oxidative stress). The technique was applied on particles produced by several combustion sources, namely cigarette smoke, diesel exhaust and wood smoke. One of the main findings from the initial studies undertaken at QUT was that the oxidative potential per PM mass significantly varies for different combustion sources as well as the type of fuel used and combustion conditions. However, possibly the most important finding from our studies was that there was a strong correlation between the organic fraction of particles and the oxidative potential measured by the PFN assay, which clearly highlights the importance of organic species in particle-induced toxicity.

Rates of attendance at a smoking cessation clinic within a cardiac rehabilitation service

Objectives: Smoking cessation has been shown to be an important intervention for preventing cardiovascular events and improving the health of patients with heart disease. However, unaided quit attempts in these patients often leads to high rates of failure and a return to smoking. Outpatient smoking cessation clinics using face-to-face counseling, ongoing behavioral support, advice on smoking pharmacotherapy and objective monitoring, have been found to be one of the most effective interventions for improving quit smoking rates. An outpatient smoking cessation clinic was trialed within a cardiac rehabilitation service in order to explore its effects on smoking rates for patients with or at risk of heart disease. Attendance rates to the clinic were also monitored. Methods: A descriptive exploratory design was used for this newly developed clinic. Patients who currently smoked tobacco and who had a history of either coronary artery disease, heart failure, atrial fibrillation or those seen under a chest pain assessment service were invited to an outpatient ‘Cardiac Patients Smokers Clinic’. Initially patients were offered up to 10 clinic visits over a 3 month period. Follow-up clinic visits were conducted at 3, 6 and 12 months. A portable carbon monoxide meter was used to objectively measure levels of smoking and validate smoking abstinence. Primary outcomes included rates of attendance. Results: Preliminary findings showed 24 per cent of participants (N = 6) completed all their clinic visits and remained smoke free as measured by their ongoing expired carbon monoxide readings. Clinic attendance rates appeared lowest for those with significant mental health issues such as schizophrenia or substance abuse. However, rates of attendance were improved by having an administration officer make reminder telephone calls prior to clinic visits. Conclusions: Early findings indicate the feasibility of providing a specialist smoking cessation clinic within a cardiac rehabilitation service. Further, that reminder telephone calls prior to appointments improved attendance rates in patients with heart disease to this type of clinic. However, future investigations are warranted.

Indoor aerosols : from personal exposure to risk assessment

Motivated by growing considerations of the scale, severity and risks associated with human exposure to indoor particulate matter, this work reviewed existing literature to: (i) identify state-of-the-art experimental techniques used for personal exposure assessment; (ii) compare exposure levels reported for domestic/school settings in different countries (excluding exposure to environmental tobacco smoke and particulate matter from biomass cooking in developing countries); (iii) assess the contribution of outdoor background vs indoor sources to personal exposure; and (iv) examine scientific understanding of the risks posed by personal exposure to indoor aerosols. Limited studies assessing integrated daily residential exposure to just one particle size fraction, ultrafine particles, show that the contribution of indoor sources ranged from 19-76%. This indicates a strong dependence on resident activities, source events and site specificity, and highlights the importance of indoor sources for total personal exposure. Further, it was assessed that 10-30% of the total burden-of-disease from particulate matter exposure was due to indoor generated particles, signifying that indoor environments are likely to be a dominant environmental factor affecting human health. However, due to challenges associated with conducting epidemiological assessments, the role of indoor generated particles has not been fully acknowledged, and improved exposure/risk assessment methods are still needed, together with a serious focus on exposure control.

The hazards of starting and quitting smoking: Some Australian evidence

The empirical analysis employs individual level data from the Australian Health Survey combined with retrospective data on tobacco price matched to the age at which the individual started and quit smoking. Split-population hazard models are estimated for both starting and quitting smoking. The analysis suggests price plays a significant role in the decision to start smoking but not in the decision to quit. Further sensitivity analysis of different age groups and an alternative data source, questions the robustness of the significant role of price in the smoking initiation decision. From a policy perspective, the results indicate that increases in tobacco taxation can be an important instrument in reducing the incidence of smoking, but should be combined with other mechanisms such as mandating smoke-free environments and antismoking education. Our results strongly support the targeting of antismoking campaigns towards teenagers.

Changing parental high risk behaviour in the reduction of SIDS : the imperative of translational research

Objectives To investigate the factors associated with sudden infant death syndrome (SIDS) from birth to age 2 years, whether recent advice has been followed, whether any new risk factors have emerged, and the specific circumstances in which SIDS occurs while cosleeping (infant sharing the same bed or sofa with an adult or child). Design Four year population based case-control study. Parents were interviewed shortly after the death or after the reference sleep (within 24 hours) of the two control groups. Setting South west region of England (population 4.9 million, 184 800 births). Participants 80 SIDS infants and two control groups weighted for age and time of reference sleep: 87 randomly selected controls and 82 controls at high risk of SIDS (young, socially deprived, multiparous mothers who smoked). Results The median age at death (66 days) was more than three weeks less than in a study in the same region a decade earlier. Of the SIDS infants, 54% died while cosleeping compared with 20% among both control groups. Much of this excess may be explained by a significant multivariable interaction between cosleeping and recent parental use of alcohol or drugs (31% v 3% random controls) and the increased proportion of SIDS infants who had coslept on a sofa (17% v 1%). One fifth of SIDS infants used a pillow for the last sleep (21% v 3%) and one quarter were swaddled (24% v 6%). More mothers of SIDS infants than random control infants smoked during pregnancy (60% v 14%), whereas one quarter of the SIDS infants were preterm (26% v 5%) or were in fair or poor health for the last sleep (28% v 6%). All of these differences were significant in the multivariable analysis regardless of which control group was used for comparison. The significance of covering the infant’s head, postnatal exposure to tobacco smoke, dummy use, and sleeping in the side position has diminished although a significant proportion of SIDS infants were still found prone (29% v 10%). Conclusions Many of the SIDS infants had coslept in a hazardous environment. The major influences on risk, regardless of markers for socioeconomic deprivation, are amenable to change and specific advice needs to be given, particularly on use of alcohol or drugs before cosleeping and cosleeping on a sofa.

Case-control study on risk factors of esophageal cancer

Objective: To explore the influencing factors of esophageal cancer in the trunk basin of Dawen river , Shandong province. Methods: A case- control study was carried out: 195 living cases of diagnosed esophageal cancer and 195 controls were matched by age and sex and surveyed by a unified inventory. Results: T he following items could rises the risk of esophageal cancer : hard dry diet, smoke homemade cigarettes, alcohol consumption> 500 ml/ day, relatives with tumor in history ( OR = 51850, OR = 161 158, OR = 111 513, OR = 11 827, respectively ) . While drinking tea may have protective effect against esophageal cancer ( OR = 01 311). Conclusion: The high incidence of esophageal cancer in the area is relative not only to the environment and dietary factors, but also to the family history of esophageal cancer.

The role of inflammation in the pathogenesis of non-small cell lung cancer

The link between chronic immune activation and tumorigenesis is well established. Compelling evidence has accumulated that histologic assessment of infiltration patterns of different host immune response components in non-small cell lung cancer specimens helps identify different prognostic patient subgroups. This review provides an overview of recent insights gained in the understanding of the role played by chronic inflammation in lung carcinogenesis. The usefulness of quantification of different populations of lymphocytes, natural killer cells, macrophages, and mast cells within the tumor microenvironment in non-small cell lung cancer is also discussed. In particular, the importance of assessment of inflammatory cell microlocalization within both the tumor islet and surrounding stromal components is emphasized. Copyright © 2010 by the International Association for the Study of Lung Cancer.

Influence of kaolinite/carbon black hybridization on combustion and thermal decomposition behaviors of NR composites

A series of NR composites filled with modified kaolinite (MK), carbon black (CB) and the hybrid fillercontained MK and CB, were prepared by melt blending. The microstructure, combustion and thermaldecomposition behaviors of NR composites were characterized by TEM, XRD, infrared spectroscopy, conecalorimeter test (CCT) and thermal-gravimetric analysis (TG). The results show that the filler hybridizationcan improve the dispensability and shape of the kaolinite sheets in the rubber matrix and change theinterface bond between kaolinite particles and rubber molecules. NR-3 filled by 10 phr MK and 40 phr CBhas the lowest heat release rate (HRR), mass loss rate (MLR), total heat release (THR), smoke productionrate (SPR) and the highest char residue among all the NR composites. Therefore, the hybridization ofthe carbon black particles with the kaolinite particles can effectively improve the thermal stability andcombustion properties of NR composites.

Laser-to-radar sensing redundancy for resilient perception in adverse environmental conditions

This paper presents an approach to promote the integrity of perception systems for outdoor unmanned ground vehicles (UGV) operating in challenging environmental conditions (presence of dust or smoke). The proposed technique automatically evaluates the consistency of the data provided by two sensing modalities: a 2D laser range finder and a millimetre-wave radar, allowing for perceptual failure mitigation. Experimental results, obtained with a UGV operating in rural environments, and an error analysis validate the approach.

Perception Quality Evaluation with Visual and Infrared Cameras in Challenging Environmental Conditions

This work aims to contribute to the reliability and integrity of perceptual systems of unmanned ground vehicles (UGV). A method is proposed to evaluate the quality of sensor data prior to its use in a perception system by utilising a quality metric applied to heterogeneous sensor data such as visual and infrared camera images. The concept is illustrated specifically with sensor data that is evaluated prior to the use of the data in a standard SIFT feature extraction and matching technique. The method is then evaluated using various experimental data sets that were collected from a UGV in challenging environmental conditions, represented by the presence of airborne dust and smoke. In the first series of experiments, a motionless vehicle is observing a ’reference’ scene, then the method is extended to the case of a moving vehicle by compensating for its motion. This paper shows that it is possible to anticipate degradation of a perception algorithm by evaluating the input data prior to any actual execution of the algorithm.

Visual metrics for the evaluation of sensor data quality in outdoor perception

This paper proposes an experimental study of quality metrics that can be applied to visual and infrared images acquired from cameras onboard an unmanned ground vehicle (UGV). The relevance of existing metrics in this context is discussed and a novel metric is introduced. Selected metrics are evaluated on data collected by a UGV in clear and challenging environmental conditions, represented in this paper by the presence of airborne dust or smoke. An example of application is given with monocular SLAM estimating the pose of the UGV while smoke is present in the environment. It is shown that the proposed novel quality metric can be used to anticipate situations where the quality of the pose estimate will be significantly degraded due to the input image data. This leads to decisions of advantageously switching between data sources (e.g. using infrared images instead of visual images).

Visual metrics for the evaluation of sensor data quality in outdoor perception

This paper proposes an experimental study of quality metrics that can be applied to visual and infrared images acquired from cameras onboard an unmanned ground vehicle (UGV). The relevance of existing metrics in this context is discussed and a novel metric is introduced. Selected metrics are evaluated on data collected by a UGV in clear and challenging environmental conditions, represented in this paper by the presence of airborne dust or smoke.

Towards discrimination of challenging conditions for UGVs with visual and infrared sensors

This work aims to contribute to reliability and integrity in perceptual systems of autonomous ground vehicles. Information theoretic based metrics to evaluate the quality of sensor data are proposed and applied to visual and infrared camera images. The contribution of the proposed metrics to the discrimination of challenging conditions is discussed and illustrated with the presence of airborne dust and smoke.

Sensor Data Integrity : Multi-Sensor Perception for Unmanned Ground Vehicles

This document describes large, accurately calibrated and time-synchronised datasets, gathered in controlled environmental conditions, using an unmanned ground vehicle equipped with a wide variety of sensors. These sensors include: multiple laser scanners, a millimetre wave radar scanner, a colour camera and an infra-red camera. Full details of the sensors are given, as well as the calibration parameters needed to locate them with respect to each other and to the platform. This report also specifies the format and content of the data, and the conditions in which the data have been gathered. The data collection was made in two different situations of the vehicle: static and dynamic. The static tests consisted of sensing a fixed ’reference’ terrain, containing simple known objects, from a motionless vehicle. For the dynamic tests, data were acquired from a moving vehicle in various environments, mainly rural, including an open area, a semi-urban zone and a natural area with different types of vegetation. For both categories, data have been gathered in controlled environmental conditions, which included the presence of dust, smoke and rain. Most of the environments involved were static, except for a few specific datasets which involve the presence of a walking pedestrian. Finally, this document presents illustrations of the effects of adverse environmental conditions on sensor data, as a first step towards reliability and integrity in autonomous perceptual systems.