Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography

To present a novel algorithm for estimating recruitable alveolar collapse and hyperdistension based on electrical impedance tomography (EIT) during a decremental positive end-expiratory pressure (PEEP) titration. Technical note with illustrative case reports. Respiratory intensive care unit. Patients with acute respiratory distress syndrome. Lung recruitment and PEEP titration maneuver. Simultaneous acquisition of EIT and X-ray computerized tomography (CT) data. We found good agreement (in terms of amount and spatial location) between the collapse estimated by EIT and CT for all levels of PEEP. The optimal PEEP values detected by EIT for patients 1 and 2 (keeping lung collapse < 10%) were 19 and 17 cmH(2)O, respectively. Although pointing to the same non-dependent lung regions, EIT estimates of hyperdistension represent the functional deterioration of lung units, instead of their anatomical changes, and could not be compared directly with static CT estimates for hyperinflation. We described an EIT-based method for estimating recruitable alveolar collapse at the bedside, pointing out its regional distribution. Additionally, we proposed a measure of lung hyperdistension based on regional lung mechanics.

Recruitment maneuver in experimental acute lung injury: The role of alveolar collapse and edema

Objective: In acute lung injury, recruitment maneuvers have been used to open collapsed lungs and set positive end-expiratory pressure, but their effectiveness may depend on the degree of lung injury. This study uses a single experimental model with different degrees of lung injury and tests the hypothesis that recruitment maneuvers may have beneficial or deleterious effects depending on the severity of acute lung injury. We speculated that recruitment maneuvers may worsen lung mechanical stress in the presence of alveolar edema. Design: Prospective, randomized, controlled experimental study. Setting: University research laboratory. Subjects: Thirty-six Wistar rats randomly divided into three groups (n = 12 per group). Interventions: In the control group, saline was intraperitoneally injected, whereas moderate and severe acute lung injury animals received paraquat intraperitoneally (20 mg/kg [moderate acute lung injury] and 25 mg/kg [severe acute lung injury]). After 24 hrs, animals were further randomized into subgroups (n = 6/each) to be recruited (recruitment maneuvers: 40 cm H(2)O continuous positive airway pressure for 40 secs) or not, followed by 1 hr of protective mechanical ventilation (tidal volume, 6 mL/kg; positive end-expiratory pressure, 5 cm H(2)O). Measurements and Main Results: Only severe acute lung injury caused alveolar edema. The amounts of alveolar collapse were similar in the acute lung injury groups. Static lung elastance, viscoelastic pressure, hyperinflation, lung, liver, and kidney cell apoptosis, and type 3 procollagen and interleukin-6 mRNA expressions in lung tissue were more elevated in severe acute lung injury than in moderate acute lung injury. After recruitment maneuvers, static lung elastance, viscoelastic pressure, and alveolar collapse were lower in moderate acute lung injury than in severe acute lung injury. Recruitment maneuvers reduced interleukin-6 expression with a minor detachment of the alveolar capillary membrane in moderate acute lung injury. In severe acute lung injury, recruitment maneuvers were associated with hyperinflation, increased apoptosis of lung and kidney, expression of type 3 procollagen, and worsened alveolar capillary injury. Conclusions: In the presence of alveolar edema, regional mechanical heterogeneities, and hyperinflation, recruitment maneuvers promoted a modest but consistent increase in inflammatory and fibrogenic response, which may have worsened lung function and potentiated alveolar and renal epithelial injury. (Crit Care Med 2010; 38: 2207-2214)

Collapse and Color Changes in Grapefruit Juice Powder as Affected by Water Activity, Glass Transition, and Addition of Carbohydrate Polymers

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Killer Whales and Marine Mammal Trends in The North Pacific—A Re-Examination of Evidence for Sequential Megafauna Collapse and the Prey-Switching Hypothesis

Springer et al. (2003) contend that sequential declines occurred in North Pacific populations of harbor and fur seals, Steller sea lions, and sea otters. They hypothesize that these were due to increased predation by killer whales, when industrial whaling’s removal of large whales as a supposed primary food source precipitated a prey switch. Using a regional approach, we reexamined whale catch data, killer whale predation observations, and the current biomass and trends of potential prey, and found little support for the prey-switching hypothesis. Large whale biomass in the Bering Sea did not decline as much as suggested by Springer et al., and much of the reduction occurred 50–100 yr ago, well before the declines of pinnipeds and sea otters began; thus, the need to switch prey starting in the 1970s is doubtful. With the sole exception that the sea otter decline followed the decline of pinnipeds, the reported declines were not in fact sequential. Given this, it is unlikely that a sequential megafaunal collapse from whales to sea otters occurred. The spatial and temporal patterns of pinniped and sea otter population trends are more complex than Springer et al. suggest, and are often inconsistent with their hypothesis. Populations remained stable or increased in many areas, despite extensive historical whaling and high killer whale abundance. Furthermore, observed killer whale predation has largely involved pinnipeds and small cetaceans; there is little evidence that large whales were ever a major prey item in high latitudes. Small cetaceans (ignored by Springer et al.) were likely abundant throughout the period. Overall, we suggest that the Springer et al. hypothesis represents a misleading and simplistic view of events and trophic relationships within this complex marine ecosystem.

NADPH Phagocyte Oxidase Knockout Mice Control Trypanosoma cruzi Proliferation, but Develop Circulatory Collapse and Succumb to Infection

(NO)-N-center dot is considered to be a key macrophage-derived cytotoxic effector during Trypanosoma cruzi infection. On the other hand, the microbicidal properties of reactive oxygen species (ROS) are well recognized, but little importance has been attributed to them during in vivo infection with T. cruzi. In order to investigate the role of ROS in T. cruzi infection, mice deficient in NADPH phagocyte oxidase (gp91(phox-/-) or phox KO) were infected with Y strain of T. cruzi and the course of infection was followed. phox KO mice had similar parasitemia, similar tissue parasitism and similar levels of IFN-gamma and TNF in serum and spleen cell culture supernatants, when compared to wild-type controls. However, all phox KO mice succumbed to infection between day 15 and 21 after inoculation with the parasite, while 60% of wild-type mice were alive 50 days after infection. Further investigation demonstrated increased serum levels of nitrite and nitrate (NOx) at day 15 of infection in phox KO animals, associated with a drop in blood pressure. Treatment with a NOS2 inhibitor corrected the blood pressure, implicating NOS2 in this phenomenon. We postulate that superoxide reacts with (NO)-N-center dot in vivo, preventing blood pressure drops in wild type mice. Hence, whilst superoxide from phagocytes did not play a critical role in parasite control in the phox KO animals, its production would have an important protective effect against blood pressure decline during infection with T. cruzi.

Extended spherical collapse and the accelerating universe

The influence of the shear stress and angular momentum on the nonlinear spherical collapse model is discussed in the framework of the Einstein–de Sitter and ΛCDM models. By assuming that the vacuum component is not clustering within the homogeneous nonspherical overdensities, we show how the local rotation and shear affect the linear density threshold for collapse of the nonrelativistic component (δc) and its virial overdensity (ΔV ). It is also found that the net effect of shear and rotation in galactic scale is responsible for higher values of the linear overdensity parameter as compared with the standard spherical collapse model (no shear and rotation)

Interacting bosons and fermions in three-dimensional optical lattice potentials

This thesis reports on the realization, characterization and analysis of ultracold bosonic and fermionic atoms in three-dimensional optical lattice potentials. Ultracold quantum gases in optical lattices can be regarded as ideal model systems to investigate quantum many-body physics. In this work interacting ensembles of bosonic 87Rb and fermionic 40K atoms are employed to study equilibrium phases and nonequilibrium dynamics. The investigations are enabled by a versatile experimental setup, whose core feature is a blue-detuned optical lattice that is combined with Feshbach resonances and a red-detuned dipole trap to allow for independent control of tunneling, interactions and external confinement. The Fermi-Hubbard model, which plays a central role in the theoretical description of strongly correlated electrons, is experimentally realized by loading interacting fermionic spin mixtures into the optical lattice. Using phase-contrast imaging the in-situ size of the atomic density distribution is measured, which allows to extract the global compressibility of the many-body state as a function of interaction and external confinement. Thereby, metallic and insulating phases are clearly identified. At strongly repulsive interaction, a vanishing compressibility and suppression of doubly occupied lattice sites signal the emergence of a fermionic Mott insulator. In a second series of experiments interaction effects in bosonic lattice quantum gases are analyzed. Typically, interactions between microscopic particles are described as two-body interactions. As such they are also contained in the single-band Bose-Hubbard model. However, our measurements demonstrate the presence of multi-body interactions that effectively emerge via virtual transitions of atoms to higher lattice bands. These findings are enabled by the development of a novel atom optical measurement technique: In quantum phase revival spectroscopy periodic collapse and revival dynamics of the bosonic matter wave field are induced. The frequencies of the dynamics are directly related to the on-site interaction energies of atomic Fock states and can be read out with high precision. The third part of this work deals with mixtures of bosons and fermions in optical lattices, in which the interspecies interactions are accurately controlled by means of a Feshbach resonance. Studies of the equilibrium phases show that the bosonic superfluid to Mott insulator transition is shifted towards lower lattice depths when bosons and fermions interact attractively. This observation is further analyzed by applying quantum phase revival spectroscopy to few-body systems consisting of a single fermion and a coherent bosonic field on individual lattice sites. In addition to the direct measurement of Bose-Fermi interaction energies, Bose-Bose interactions are proven to be modified by the presence of a fermion. This renormalization of bosonic interaction energies can explain the shift of the Mott insulator transition. The experiments of this thesis lay important foundations for future studies of quantum magnetism with fermionic spin mixtures as well as for the realization of complex quantum phases with Bose-Fermi mixtures. They furthermore point towards physics that reaches beyond the single-band Hubbard model.

Effect of chest compressions only during experimental basic life support on alveolar collapse and recruitment

AIM: The importance of ventilatory support during cardiac arrest and basic life support is controversial. This experimental study used dynamic computed tomography (CT) to assess the effects of chest compressions only during cardiopulmonary resuscitation (CCO-CPR) on alveolar recruitment and haemodynamic parameters in porcine model of ventricular fibrillation. MATERIALS AND METHODS: Twelve anaesthetized pigs (26+/-1kg) were randomly assigned to one of the following groups: (1) intermittent positive pressure ventilation (IPPV) both during basic life support and advanced cardiac life support, or (2) CCO during basic life support and IPPV during advanced cardiac life support. Measurements were acquired at baseline prior to cardiac arrest, during basic life support, during advanced life support, and after return of spontaneous circulation (ROSC), as follows: dynamic CT series, arterial and central venous pressures, blood gases, and regional organ blood flow. The ventilated and atelectatic lung area was quantified from dynamic CT images. Differences between groups were analyzed using the Kruskal-Wallis test, and a p<0.05 was considered statistically significant. RESULTS: IPPV was associated with cyclic alveolar recruitment and de-recruitment. Compared with controls, the CCO-CPR group had a significantly larger mean fractional area of atelectasis (p=0.009), and significantly lower PaO(2) (p=0.002) and mean arterial pressure (p=0.023). The increase in mean atelectatic lung area observed during basic life support in the CCO-CPR group remained clinically relevant throughout the subsequent advanced cardiac life support period and following ROSC, and was associated with prolonged impaired haemodynamics. No inter-group differences in myocardial and cerebral blood flow were observed. CONCLUSION: A lack of ventilation during basic life support is associated with excessive atelectasis, arterial hypoxaemia and compromised CPR haemodynamics. Moreover, these detrimental effects remain evident even after restoration of IPPV.

Why fisheries collapse and what to do about it.

With the collapse of fisheries in many parts of the world causing widespread economic harm, attention is focused on a possible cause and remedy of fishery collapse. Economic theory for managing a renewable resource, such as a fishery, leads to an ecologically unstable equilibrium as difficult to maintain as balancing a marble on top of a dome. A fishery should be managed for ecological stability instead--in the analogy, as easy to maintain as keeping a marble near the base of a bowl. The goal of ecological stability is achieved if the target stock is above that producing maximum sustainable yield and harvested at less than the maximum sustainable yield. The cost of managing for ecological stability, termed "natural insurance," is low if the fishery is sufficiently productive. This cost is shown to pay for itself over the long term in a variable and uncertain environment. An ecologically stable target stock may be attained either with annually variable quotas following current practice or, preferably, through a market mechanism whereby fish are taxed at dockside if caught when the stock was below target and are untaxed otherwise. In this regulatory environment, the goal of maximizing short-term revenue coincides with the goal of ecological stability, thereby also maximizing long-term revenue. This new approach to fishery management is illustrated with the recently collapsed Newfoundland fishing industry. The Newfoundland cod fishery is expected to rebuild to an ecologically stable level in about 9 years and thereafter support an annual harvest of about 75% of the 1981-1990 average.

The finest of the wheat: hymns new and old, for missionary and revival meetings, and Sabbath-schools.

Vol. 1: 13th ed.

Narratives of remarkable conversions and revival incidents: including a review of revivals, from the day of Pentecost to the great awakening in the last century--conversions of eminent persons--instances of remarkable conversions and answers to prayer--an account of the rise and progress of the great awakening of 1857-'8.

Imperfect: 1st prelim. leaf wanting, p. xi mutilated.

An impartial and succinct history of the rise, declension and revival of the church of Christ; from the birth of our Saviour to the present time ...

Shoemaker 12731.