The hypothermic patient

Concepts used in this chapter include: Thermoregulation:- Thermoregulation refers to the body’s sophisticated, multi-system regulation of core body temperature. This hierarchical system extends from highly thermo-sensitive neurons in the preoptic region of the brain proximate to the rostral hypothalamus, down to the brain stem and spinal cord. Coupled with receptors in the skin and spine, both central and peripheral information on body temperature is integrated to inform and activate the homeostatic mechanisms which maintain our core temperature at 37oC.1 Body heat is lost through the skin, via respiration and excretions. The skin is perhaps the most important organ in regulating heat loss. Hyporthermia:- Hypothermia is defined as core body temperature less than 350C and is the result of imbalance between the body’s heat production and heat loss mechanisms. Hypothermia may be accidental, or induced for clinical benefit i.e: neurological protection (therapeutic hypothermia). External environmental conditions are the most common cause of accidental hypothermia, but not the only causes of hypothermia in humans. Other causes include metabolic imbalance; trauma; neurological and infectious disease; and exposure to toxins such as organophosphates. Therapeutic Hypothermia:- In some circumstances, hypothermia can be induced to protect neurological functioning as a result of the associated decrease in cerebral metabolism and energy consumption. Reduction in the extent of degenerative processes associated with periods of ischaemia such as excitotoxic cascade; apoptotic and necrotic cell death; microglial activation; oxidative stress and inflammation associated with ischaemia are averted or minimised.2 Mild hypothermia is the only effective treatment confirmed clinically for improving the neurological outcomes of patient’s comatose following cardiac arrest.3

Detecting Symbian OS malware through static function call analysis

Smartphones become very critical part of our lives as they offer advanced capabilities with PC-like functionalities. They are getting widely deployed while not only being used for classical voice-centric communication. New smartphone malwares keep emerging where most of them still target Symbian OS. In the case of Symbian OS, application signing seemed to be an appropriate measure for slowing down malware appearance. Unfortunately, latest examples showed that signing can be bypassed resulting in new malware outbreak. In this paper, we present a novel approach to static malware detection in resource-limited mobile environments. This approach can be used to extend currently used third-party application signing mechanisms for increasing malware detection capabilities. In our work, we extract function calls from binaries in order to apply our clustering mechanism, called centroid. This method is capable of detecting unknown malwares. Our results are promising where the employed mechanism might find application at distribution channels, like online application stores. Additionally, it seems suitable for directly being used on smartphones for (pre-)checking installed applications.

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.

Soft power in China : public diplomacy through communication [Review]

Review of Soft Power in China: Public diplomacy through communication, edited by J IAN WANG, New York, Palgrave Macmillan, 2011, US$89 (hard), 220 pp

Modelling the flow of juice through a mill

A juice flow model has been developed to estimate the juice expression at the four nips of a sixroller mill. An extended volumetric theory was applied to determine the juice expressed at each nip. The model was applied to a first and final mill, using typical mill settings and an empirical equation to estimate reabsorption. Results of using the model for typical heavy-duty pressure feeder settings show that most of the juice is expressed at the pressure feeder nip. Since the pressure feeders are remote from the mill, a significant portion of the juice is expressed before the bagasse enters the mill.

Design approaches for promoting beneficial indoor environments in healthcare facilities : a review

As a result of growing evidence regarding the effects of environmental characteristics on the health and wellbeing of people in healthcare facilities (HCFs), more emphasis is being placed on, and more attention being paid to, the consequences of design choices in HCFs. Therefore, we have critically reviewed the implications of key indoor physical design parameters, in relation to their potential impact on human health and wellbeing. In addition, we discussed these findings within the context of the relevant guidelines and standards for the design of HCFs. A total of 810 abstracts, which met the inclusion criteria, were identified through a Pubmed search, and these covered journal articles, guidelines, books, reports and monographs in the studied area. Of these, 231 full publications were selected for this review. According to the literature, the most beneficial design elements were: single-bed patient rooms, safe and easily cleaned surface materials, sound-absorbing ceiling tiles, adequate and sufficient ventilation, thermal comfort, natural daylight, control over temperature and lighting, views, exposure and access to nature, and appropriate equipment, tools and furniture. The effects of some design elements, such as lighting (e.g. artificial lighting levels) and layout (e.g. decentralized versus centralized nurses’ stations), on staff and patients vary, and “the best design practice” for each HCF should always be formulated in co-operation with different user groups and a multi-professional design team. The relevant guidelines and standards should also be considered in future design, construction and renovations, in order to produce more favourable physical indoor environments in HCFs.

Utility of an alternative bicycle commute route of lower proximity to motorised traffic in decreasing exposure to ultra-fine particles, respiratory symptoms and airway inflammation - a structured exposure experiment

Background: Bicycle commuting in an urban environment of high air pollution is known as a potential health risk, especially for susceptible individuals. While risk management strategies aimed to reduce motorised traffic emissions exposure have been suggested, limited studies have assessed the utility of such strategies in real-world circumstances. Objectives: The potential of reducing exposure to ultrafine particles (UFP; < 0.1 µm) during bicycle commuting by lowering interaction with motorised traffic was investigated with real-time air pollution and acute inflammatory measurements in healthy individuals using their typical, and an alternative to their typical, bicycle commute route. Methods: Thirty-five healthy adults (mean ± SD: age = 39 ± 11 yr; 29% female) each completed two return trips of their typical route (HIGH) and a pre-determined altered route of lower interaction with motorised traffic (LOW; determined by the proportion of on-road cycle paths). Particle number concentration (PNC) and diameter (PD) were monitored in real-time in-commute. Acute inflammatory indices of respiratory symptom incidence, lung function and spontaneous sputum (for inflammatory cell analyses) were collected immediately pre-commute, and one and three hours post-commute. Results: LOW resulted in a significant reduction in mean PNC (1.91 x e4 ± 0.93 x e4 ppcc vs. 2.95 x e4 ± 1.50 x e4 ppcc; p ≤ 0.001). Besides incidence of in-commute offensive odour detection (42 vs. 56 %; p = 0.019), incidence of dust and soot observation (33 vs. 47 %; p = 0.038) and nasopharyngeal irritation (31 vs. 41 %; p = 0.007), acute inflammatory indices were not significantly associated to in-commute PNC, nor were these indices reduced with LOW compared to HIGH. Conclusions: Exposure to PNC, and the incidence of offensive odour and nasopharyngeal irritation, can be significantly reduced when utilising a strategy of lowering interaction with motorised traffic whilst bicycle commuting, which may bring important benefits for both healthy and susceptible individuals.

Management of heterogeneous UAVs through a capability framework of UAV’s functional autonomy

An increased interest in utilising groups of Unmanned Aerial Vehicles (UAVs) with heterogeneous capabilities and autonomy is presenting the challenge to effectively manage such during missions and operations. This has been the focus of research in recent years, moving from a traditional UAV management paradigm of n-to-1 (n operators for one UAV, with n being at least two operators) toward 1-to-n (one operator, multiple UAVs). This paper has expanded on the authors’ previous work on UAV functional capability framework, by incorporating the concept of Functional Level of Autonomy (F-LOA) with two configurations: The lower F-LOA configuration contains sufficient information for the operator to generate solutions and make decisions to address perturbation events. Alternatively, the higher F-LOA configuration presents information reflecting on the F-LOA of the UAV, allowing the operator to interpret solutions and decisions generated autonomously, and decide whether to veto from this decision.

Understanding Indigenous Australian women’s social and emotional wellbeing and wellness through yarning

This paper explores Indigenous Australian women’s understanding of wellness, through the lens of social and emotional wellbeing. The authors use a “yarning” approach to explore how wellness is important to Indigenous women who live in North Brisbane (Australia). They discuss the benefits of yarning and its strength as a methodology for conducting research and building activism within Indigenous Australian communities. They argue that, for Indigenous Australian women, wellness is linked to a sense of wholeness and strongly related to the feeling of connection that women get from meeting together and having time for women’s business. They describe the way that their research project developed into a community summit focused on Indigenous women’s wellness.