Ventilatory Response to Hypercapnia as Experimental Model to Study Effects of Oxycodone on Respiratory Depression.

BACKGROUND: Opioid analgesics used to treat pain can cause respiratory depression. However, this effect has not been extensively studied, and life-threatening, opioid-induced respiratory depression remains difficult to predict. We tested the ventilatory response to hypercapnia for evaluating the pharmacodynamic effect of a drug on respiratory depression. METHODS: We conducted a randomized, placebo-controlled, double-blind, crossover study on 12 healthy adult males. Subjects received 2 treatments (placebo and immediate-release oxycodone 30 mg) separated by a 24-hour washout period. Subjects inhaled a mixture of 7% carbon dioxide, 21% oxygen, and 72% nitrogen for 5 minutes to assess respiratory depression. Minute ventilation, respiratory rate, tidal volume, flow rate, end-tidal CO2, and oxygen saturation were recorded continuously at pre-dose and 30, 60, 120, and 180 minutes post-dose. The primary endpoint was the effect on the ventilatory response to hypercapnia at 60 minutes post-dose, as assessed by the slope of the linear relationship between minute ventilation and end-tidal CO2. RESULTS: At 60 minutes post-dose, subjects had a mean slope of 2.4 in the oxycodone crossover period, compared to 0.1 in the placebo period (mean difference, 2.3; 95% CI: 0.2 to 4.5; p = 0.035). Statistical significance was likewise achieved at the secondary time points (30, 120, and 180 minutes post-dose, p <0.05). CONCLUSIONS: This model for testing ventilatory response to hypercapnia discriminated the effect of 30 mg of oxycodone vs. placebo for up to 3 hours after a single dose. It may serve as a method to predict the relative effect of a drug on respiratory depression.

Efficiency of Electropumping in Nanochannels.

Electropumping has been shown to be an effective means of inducing a net positive flow in fluids confined within planar nanochannels and carbon nanotubes. In this Letter, we investigate the efficiency of electropumping relative to Couette and Poiseuille flows. We apply a spatially uniform rotating electric field to a fluid confined in a functionalized nanochannel that couples the water's permanent dipole moment resulting in a net positive flow. We then induce a net positive flow in nanochannels for Couette and Poiseuille flows, matching volume flow rates to allow a direct comparison of average power dissipation per unit volume between all flow types. We show that while electropumping is less efficient than Couette flow, it is 4 orders of magnitude more efficient than Poiseuille flow. This suggests that, rather than being a mere novelty, electropumping is a far more energetically efficient means of transporting water compared to conventional pressure driven pumping.

Inducing a Net Positive Flow of Water in Functionalized Concentric Carbon Nanotubes Using Rotating Electric Fields.

Electropumping has shown great potential as an effective means of inducing a net positive flow of water in confined channels. In this paper we present the first nonequilibrium molecular dynamics study and continuum based numerical solutions that demonstrate an effective net positive flow between concentric carbon nanotubes (CNT) using electropumping. We apply a spatially uniform rotating electric field that couples to the water's permanent dipole moment. Taking advantage of the coupling between the spin angular momentum and the linear momentum we break the symmetry of the channel radius by functionalizing the inner CNT's outer surface with carboxyl groups to induce a net positive flow. We also show that our results for concentric nanotubes are consistent with our previous work where we demonstrated that an increase in functionalization beyond an optimal point in a single walled carbon nanotube resulted in a decrease in positive net flow. We then numerically solve the coupled hydrodynamic momentum equations to show that the nonequilibrium molecular dynamics results are consistent with the continuum theory.

The geometry of high angle of attack maneuvers and the implications for Gy-induced neck injuries.

INTRODUCTION: Modern super agile fighter aircraft have significantly expanded maneuverability envelopes, often involving very high angles of attack (AOA) in the post-stall region. One such maneuver is the high AOA velocity vector roll. The geometry of this flight maneuver is such that during the roll there is a significant lateral C load imposed on the unrestrained head-neck complex of the pilot. METHODS: A mathematical analysis of the geometric relationship determining the magnitude of +/- Gy acceleration during high AOA maneuvering was conducted. This preliminary mathematical model is able to predict the Gy load imposed on the head-neck complex of the pilot for a given set of flight maneuver parameters. RESULTS: The analysis predicts that at an AOA of 700 and with a roll rate of 100 degrees x s(-1), the lateral G developed will be approximately 3.5 Gy. Increasing the roll rate increases the lateral G component: at 200 degrees x s(-1) the Gy, load is more than 6 Gy. CONCLUSIONS: There are serious potential implications of super agile maneuvers on the neck of the pilot. The G environment experienced by the pilot of super agile aircraft is increasingly multiaxial, involving +/- Gx, +/- Gy, and +/- Gz. The level of lateral G developed during these dynamic flight maneuvers should not be underestimated, as such G loads can potentially lead to neck injuries. While aircraft become ever more capable, a full understanding of the biodynamic effects on the pilot while exploiting the agility of the aircraft still needs to be developed.

In defense of data.

Getting better health care information into the hands of people who need it is our business at Ingenix. Our company has been in the news as a result of the New York attorney general's investigation into the healthcare industry's use of actual physician billed charge data to determine a "reasonable and customary" amount to pay a physician when consumers choose doctors outside their health plan's network of care providers. We believe that the issue of how to calculate out-of-network charges and reimbursement is an important one, but we also believe that it is a small part of a larger issue: improving the healthcare system by improving the quality and quantity of information available to its participants.