Contribution of stretch to the change of activation properties of muscle fibers in the diaphragm at the transition from fetal to neonatal life

The transition from fetal to postnatal life involves clearance of liquid from the lung and airways, and rapid formation of a functional residual capacity. Despite the importance of the diaphragm in this process, the impact of birth on the mechanical and functional activity of its muscle fibers is not known. This study determined the contractile characteristics of individual “skinned” diaphragm fibers from 70 days (0.47) gestation to after birth in sheep. Based on differential sensitivity to the divalent ions calcium (Ca²⁺) and strontium (Sr²⁺), all fibers in the fetal diaphragm were classified as “fast,” whereas fibers from the adult sheep diaphragm exhibited a “hybrid” phenotype where both “fast” and “slow” characteristics were present within each single fiber. Transition to the hybrid phenotype occurred at birth, was evident after only 40 min of spontaneous breathing, and could be induced by simple mechanical stretch of diaphragm fibers from near-term fetuses (∼147 days gestation). Both physical stretch of isolated fibers, and mechanical ventilation of the fetal diaphragm in situ, significantly increased sensitivity to Ca²⁺ and Sr²⁺, maximum force generating capacity, and decreased passive tension in near-term and preterm fetuses; however, only fibers from near-term fetuses showed a complete transition to a “hybrid” activation profile. These findings suggest that stretch associated with the transition from a liquid to air-filled lung at birth induces physical changes of proteins determining the activation and elastic properties of the diaphragm. These changes may allow the diaphragm to meet the increased mechanical demands of breathing immediately after birth.

A family-sized greenhouse for a remote mountain region of Nepal

Food security is a significant issue in the remote, high altitude areas of Nepal. Malnutrition is common because the harsh climate restricts production and access to fresh food. Humla is a province in north-west Nepal where the severe weather conditions and limited arable land restrict the growing season of vegetables to only 4-5 months a year. Passive solar greenhouses are a technology that can be used to extend the growing period of vegetables. For the greenhouse to be effective in Humla, the design must be appropriate to the climatic conditions, available resources and the social requirements of the community. This paper describes the design and evaluation of a family-sized solar greenhouse proposed for Humla. Three solar greenhouses built in other high altitude areas have initially been reviewed to see what techniques might be replicated in Humla. The thermal performance of the proposed family-sized greenhouse has been predicted using the solar simulation software, TRNSYS, and compared against an existing design in the area. The proposed design was found to be superior and average night-time temperatures in the coldest month were predicted to be approximately 7°C higher. Overheating was controlled in the hottest month by shading and natural ventilation.

Recommendations for improved data processing from expired gas analysis indirect calorimetry

There is currently no universally recommended and accepted method of data processing within the science of indirect calorimetry for either mixing chamber or breath-by-breath systems of expired gas analysis. Exercise physiologists were first surveyed to determine methods used to process oxygen consumption ([OV0312]O 2) data, and current attitudes to data processing within the science of indirect calorimetry. Breath-by-breath datasets obtained from indirect calorimetry during incremental exercise were then used to demonstrate the consequences of commonly used time, breath and digital filter post-acquisition data processing strategies. Assessment of the variability in breath-by-breath data was determined using multiple regression based on the independent variables ventilation (VE), and the expired gas fractions for oxygen and carbon dioxide, FEO 2 and FECO2, respectively. Based on the results of explanation of variance of the breath-by-breath [OV0312]O2 data, methods of processing to remove variability were proposed for time-averaged, breath-averaged and digital filter applications. Among exercise physiologists, the strategy used to remove the variability in sequential [OV0312]O2 measurements varied widely, and consisted of time averages (30 sec [38%], 60 sec [18%], 20 sec [11%], 15 sec [8%]), a moving average of five to 11 breaths (10%), and the middle five of seven breaths (7%). Most respondents indicated that they used multiple criteria to establish maximum [OV0312]O 2 ([OV0312]O2max) including: the attainment of age-predicted maximum heart rate (HRmax) [53%], respiratory exchange ratio (RER) >1.10 (49%) or RER >1.15 (27%) and a rating of perceived exertion (RPE) of >17, 18 or 19 (20%). The reasons stated for these strategies included their own beliefs (32%), what they were taught (26%), what they read in research articles (22%), tradition (13%) and the influence of their colleagues (7%). The combination of VE, FEO 2 and FECO2 removed 96-98% of [OV0312]O2 breath-by-breath variability in incremental and steady-state exercise [OV0312]O2 data sets, respectively. Correction of residual error in [OV0312]O2 datasets to 10% of the raw variability results from application of a 30-second time average, 15-breath running average, or a 0.04 Hz low cut-off digital filter. Thus, we recommend that once these data processing strategies are used, the peak or maximal value becomes the highest processed datapoint. Exercise physiologists need to agree on, and continually refine through empirical research, a consistent process for analysing data from indirect calorimetry.

Comparing mortality outcomes of major burns and toxic epidermal necrolysis in a tertiary burns centre

 Introduction
Our aim was to provide descriptive information to burn clinicians, who have extensive experience treating major burns and determining prognosis, as to whether significant differences in mortality exist between major burns injuries and the comparatively less common toxic epidermal necrolysis for a given age and total body surface area percentage.

Methods
Retrospective data was analyzed of all deceased patients admitted to the Victorian Adult Burns Service in Melbourne, Australia over a period of 10 years with greater than 30% total body surface area burned or greater than 30% total body surface area epidermal detachment in the case of toxic epidermal necrolysis. Retrospective data was also collected on all patients, survivors and deceased, with toxic epidermal necrolysis and these patients were matched with burns patients by age and % total body surface area burned. Comparisons in outcomes were performed with mortality being the primary variable of interest.

Results
Toxic epidermal necrolysis patients that died were older (median: 68.5 vs 57 yrs; P = 0.04), had a longer length of hospital stay (36.5 vs 0.8 days; P = 0.001) and significantly longer periods of mechanical ventilation (1404 vs 14.5 h; P = 0.011) than major burns patients that died. When toxic epidermal necrolysis patients were matched to major burns patients by age and total body surface area burned, there were no significant differences between the two groups with respect to mortality.

Conclusion
Palliative care approaches are more frequently administered at the time of presentation for major burns patients in comparison to toxic epidermal necrolysis patients. This may be due to a perception that if toxic epidermal necrolysis patients can survive their initial systemic injury, they are likely to survive, as opposed to major burns patients who often undergo extensive surgery and for whom other factors should be taken into account in the context of end-of-life decision making.

Chassis for pneumatic vehicle

A pneumatic vehicle is provided with a first sub-assembly with a chassis, part of the vehicle body, a pair of B-pillars, a pair of rear rails, wheels, an elongate aluminum compressed load bearing air tank oriented longitudinally in the chassis, side panels connected to the tank and the wheels, a heat exchanger to heat the compressed air, and an air motor driven by the heated, compressed air and connected to a wheel. A ventilation system has a restrictive solenoid valve for directing air to the heat exchanger. The air tank is provided with a carbon filament reinforced plastic layer, and a fiberglass and aramid-fiber layer. A second sub-assembly includes part of the vehicle body bonded to the first-sub-assembly using a structural adhesive, a pair of A-pillars, and a pair of roof rails. Seating includes inflatable components for adjustment.

Pneumatic powertrain for an automotive vehicle

A pneumatic vehicle is provided with a chassis, wheels, a compressed air tank, a heat exchanger to heat the compressed air, and an air motor driven by the heated air and connected to at least one wheel. A pneumatic vehicle is provided with a chassis, wheels, a compressed air tank, and an air motor driven by the compressed air and connected to a wheel. The vehicle also has a ventilation system for the passenger compartment, a heat exchanger, and a restrictive solenoid valve for directing ventilation system air to the heat exchanger. A pneumatic vehicle is provided with a chassis, wheels, an aluminum compressed air tank, a carbon filament reinforced plastic layer over the tank, a fiberglass and aramid-fiber layer over the carbon filament reinforced plastic layer, and an air motor driven by the compressed air and connected to at least one wheel.

Urban heat island and wind flow characteristics of a tropical city

 Urban Heat Island (UHI) has become a growing concern to the quality of densely built urban environments, particularly in tropical cities. Wind speed has widely been reported to have decreased the intensity of heat island effect in urban areas. The cooling effect of the wind helps to mitigate the adverse effects of heat island on the micro climate and human thermal comfort. This paper investigates the existence of heat island in Muar, one of the fast growing cities in southern part of Malaysia and its possible causes, and then examines the effects of different urban geometry on the wind flow. The results of this study indicate that the chaotic development in Muar has caused reduced ventilation in urban canyons. The heat island intensity in the city center was recorded as 4. °C during the day and 3.2. °C during the night. Investigation of various urban geometry modifications showed that step up configuration was the most effective geometry as it can distribute the wind evenly allowing the wind to reach even the leeward side of each building. © 2014 Elsevier Ltd.

Occupant behaviour simulation for cellular offices in early design stages - Architectural and modelling considerations

Building simulation is most useful and most difficult in early design stages. Most useful since the optimisation potential is large and most difficult because input data are often not available at the level of resolution required for simulation software. The aim of this paper is to addresses this difficulty, by analysing the predominantly qualitative information in early stages of an architectural design process in search for indicators towards quantitative simulation input. The discussion in this paper is focused on cellular offices. Parameters related to occupancy, the use of office equipment, night ventilation, the use of lights and blinds are reviewed based on simulation input requirements, architectural considerations in early design stages and occupant behaviour considerations in operational stages. A worst and ideal case scenario is suggested as a generic approach to model occupant behaviour in early design stages when more detailed information is not available. Without actually predicting specific occupant behaviour, this approach highlights the magnitude of impact that occupants can have on comfort and building energy performance and it matches the level of resolution of available architectural information in early design stages. This can be sufficient for building designers to compare the magnitude of impact of occupants with other parameters in order to inform design decisions. Potential indicators in early design stages towards the ideal or worst case scenario are discussed.

Chassis for pneumatic vehicle

A pneumatic vehicle is provided with a first sub-assembly with a chassis, part of the vehicle body, a pair of B-pillars, a pair of rear rails, wheels, an elongate aluminum compressed load bearing air tank oriented longitudinally in the chassis, side panels connected to the tank and the wheels, a heat exchanger to heat the compressed air, and an air motor driven by the heated, compressed air and connected to a wheel. A ventilation system has a restrictive solenoid valve for directing air to the heat exchanger. The air tank is provided with a carbon filament reinforced plastic layer, and a fiberglass and aramid-fiber layer. A second sub-assembly includes part of the vehicle body bonded to the first-sub-assembly using a structural adhesive, a pair of A-pillars, and a pair of roof rails. Seating includes inflatable components for adjustment.

Investigating and understanding CO2 levels in school classrooms

 It is a reported fact that a high CO2 concentration is a problem in school classrooms. However, the mere reporting of such results stops short of investigating causes; understanding is often missing. Steady-state results are often used in situations where changes occur frequently, such as varying student numbers, opening and closing classroom doors and windows and changing weather conditions. We revisit the mass balance model commonly used to predict or track CO2 concentrations in enclosed spaces as these factors change over time under varying conditions. This has prompted the study in several classrooms of actual air exchange rates, student exhalation rates, room volumes and ventilation design. In these cases, student numbers, room ventilation conditions (open and closed doors), room volume and the CO2 concentration have been recorded throughout the day. By fitting the model equation to the data, unknown parameters such as actual air change rates and CO2 exhalation rates per student can be determined. Having verified that the data can be modelled, we can predict behaviour in other cases such as a realistic rate of CO2 increase. This allows designers to size classrooms and ventilation systems to achieve a desired CO2 characteristic for known usages while saving energy.

The association between critical illness and changes in bone turnover in adults: a systematic review

Critical illness may lead to altered bone turnover and associated adverse health outcomes. This systematic review found moderate evidence for a positive association between critical illness and increased bone turnover. Prospective cohort studies that identify the extent and risk factors for critical illness related bone loss are required.