Spatiotemporal Aeration and Lung Injury Patterns Are Influenced by the First Inflation Strategy at Birth.

Ineffective aeration during the first inflations at birth creates regional aeration and ventilation defects, initiating injurious pathways. This study aimed to compare a sustained first inflation at birth or dynamic end-expiratory supported recruitment during tidal inflations against ventilation without intentional recruitment on gas exchange, lung mechanics, spatiotemporal regional aeration and tidal ventilation, and regional lung injury in preterm lambs. Lambs (127 ± 2 d gestation), instrumented at birth, were ventilated for 60 minutes from birth with either lung-protective positive pressure ventilation (control) or as per control after either an initial 30 seconds of 40 cm H2O sustained inflation (SI) or an initial stepwise end-expiratory pressure recruitment maneuver during tidal inflations (duration 180 s; open lung ventilation [OLV]). At study completion, molecular markers of lung injury were analyzed. The initial use of an OLV maneuver, but not SI, at birth resulted in improved lung compliance, oxygenation, end-expiratory lung volume, and reduced ventilatory needs compared with control, persisting throughout the study. These changes were due to more uniform inter- and intrasubject gravity-dependent spatiotemporal patterns of aeration (measured using electrical impedance tomography). Spatial distribution of tidal ventilation was more stable after either recruitment maneuver. All strategies caused regional lung injury patterns that mirrored associated regional volume states. Irrespective of strategy, spatiotemporal volume loss was consistently associated with up-regulation of early growth response-1 expression. Our results show that mechanical and molecular consequences of lung aeration at birth are not simply related to rapidity of fluid clearance; they are also related to spatiotemporal pressure-volume interactions within the lung during inflation and deflation.

Intratracheal atomized surfactant provides similar outcomes as bolus surfactant in preterm lambs with respiratory distress syndrome.

BACKGROUND: Aerosolization of exogenous surfactant remains a challenge. This study is aimed to evaluate the efficacy of atomized poractant alfa (Curosurf) administered with a novel atomizer in preterm lambs with respiratory distress syndrome. METHODS: Twenty anaesthetized lambs, 127 ± 1 d gestational age, (mean ± SD) were instrumented before birth and randomized to receive either (i) positive pressure ventilation without surfactant (Control group), (ii) 200 mg/kg of bolus instilled surfactant (Bolus group) at 10 min of life or (iii) 200 mg/kg of atomized surfactant (Atomizer group) over 60 min from 10 min of life. All lambs were ventilated for 180 min with a standardized protocol. Lung mechanics, regional lung compliance (electrical impedance tomography), and carotid blood flow (CBF) were measured with arterial blood gas analysis. RESULTS: Dynamic compliance and oxygenation responses were similar in the Bolus and Atomizer groups, and both better than Control by 180 min (all P < 0.05; two-way ANOVA). Both surfactant groups demonstrated more homogeneous regional lung compliance throughout the study period. There were no differences in CBFConclusion:In a preterm lamb model, atomized surfactant resulted in similar gas exchange and mechanics as bolus administration. This study suggests evaluation of supraglottic atomization with this system when noninvasive support is warranted.

Multifrequency Oscillatory Ventilation in the Premature Lung: Effects on Gas Exchange, Mechanics, and Ventilation Distribution.

BACKGROUND: Despite the theoretical benefits of high-frequency oscillatory ventilation (HFOV) in preterm infants, systematic reviews of randomized clinical trials do not confirm improved outcomes. The authors hypothesized that oscillating a premature lung with multiple frequencies simultaneously would improve gas exchange compared with traditional single-frequency oscillatory ventilation (SFOV). The goal of this study was to develop a novel method for HFOV, termed "multifrequency oscillatory ventilation" (MFOV), which relies on a broadband flow waveform more suitable for the heterogeneous mechanics of the immature lung. METHODS: Thirteen intubated preterm lambs were randomly assigned to either SFOV or MFOV for 1 h, followed by crossover to the alternative regimen for 1 h. The SFOV waveform consisted of a pure sinusoidal flow at 5 Hz, whereas the customized MFOV waveform consisted of a 5-Hz fundamental with additional energy at 10 and 15 Hz. Per standardized protocol, mean pressure at airway opening ((Equation is included in full-text article.)) and inspired oxygen fraction were adjusted as needed, and root mean square of the delivered oscillatory volume waveform (Vrms) was adjusted at 15-min intervals. A ventilatory cost function for SFOV and MFOV was defined as (Equation is included in full-text article.), where Wt denotes body weight. RESULTS: Averaged over all time points, MFOV resulted in significantly lower VC (246.9 ± 6.0 vs. 363.5 ± 15.9 ml mmHg kg) and (Equation is included in full-text article.)(12.8 ± 0.3 vs. 14.1 ± 0.5 cm H2O) compared with SFOV, suggesting more efficient gas exchange and enhanced lung recruitment at lower mean airway pressures. CONCLUSION: Oscillation with simultaneous multiple frequencies may be a more efficient ventilator modality in premature lungs compared with traditional single-frequency HFOV.

HIV knowledge and perceptions of risk in a young, urban, drug-using population.

BACKGROUND: Educational programs targeted towards youth to prevent HIV transmission are based on a model that increased knowledge equals reduced risk behaviour. This study explored HIV knowledge among a cohort of young drug users, and their perceptions of HIV risk acquisition. METHODS: Between September 2005 and August 2009, youth who used illegal drugs were recruited into a prospective cohort known as the at-risk youth study (ARYS) in Vancouver, Canada. Participants completed an 18 item HIV Knowledge Questionnaire (HIV-KQ-18) and responses were scored dichotomously (i.e., ≥15 indicating high knowledge and <15 indicating low knowledge). We compared high- and low-scoring youth using Pearson's chi-square test and logistic regression. We also examined youths' perceptions of risk for acquiring HIV compared to their peers. RESULTS: Of 589 youth recruited into ARYS, the mean age was 22 (interquartile range [IQR]: 20-24), 186 (31.6%) were female, and 143 (24.3%) were of Aboriginal ancestry. The median score on the HIV-KQ- 18 was 15 (IQR: 12-16). Internal reliability was high (Cronbach's α=0.82). The analyses demonstrated that youth with higher HIV knowledge were more likely to be older (adjusted odds ratio [AOR]=1.08, per year older p=0.031), completed high school (AOR=1.42, p=0.054), and engage in unprotected intercourse (AOR=1.73, p=0.023). The majority of respondents (77.6%) perceived themselves to be at lower risk for acquiring HIV in comparison to their peers. CONCLUSIONS: HIV knowledge scores of participants were surprisingly low for an urban Canadian setting as was their HIV risk perception. Higher HIV knowledge was not associated with reduced sexual risk behaviour. Results demonstrate that education programs are not reaching or impacting this high-risk population. Given the complex forces that promote HIV risk behaviour, prevention programs should be fully evaluated and must recognize the unique characteristics of drug-using youth and factors that drive risk among this population.

Modeling effects of Photoadaption on the Photosynthesis-Irradiance Curve

In this article, I analyse how photoadaption affects the photosynthesis-irradiance curve in phytoplankton. Four parameters are presumably affected by photoadaption: (1) the size of a photosynthetic unit; (2) the number of photosynthetic units per cell; (3) the average turnover time of a photosynthetic unit; and (4) the chlorophyll-specific absorption cross-section. Prezelin's well-known conceptual model of photoadaption deals with variation in size and number of photosynthetic units, but not with the other two parameters. Prezelin's model predicts that the photosynthesis-irradiance curve is differentially affected by variations in size or number of photosynthetic units. By contrast, my analysis shows that if photoadaptional variation in the turnover time is also accounted for, only the cellular chlorophyll concentration is relevant; variation in the size vs. number of photosynthetic units is immaterial. The photoadaptional response of the chlorophyll-specific absorption cross-section allows a simple description consistent with experimental data. I use this description to derive a single expression for the rate of photosynthesis as dependent on irradiance and the cellular chlorophyll concentration. This model for the photosynthesis-irradiance-curve accounts for the photoadaptional alterations of all four parameters. Copyright 1997 Academic Press Limited

Early reproduction and increased reproductive allocation in metal-adapted populations of the terrestrial isopod Porcellio scaber.

Organisms inhabiting metal-contaminated areas can be stressed by metal exposure and are possibly subject to selection, resulting in increased metal tolerance and changes in growth and/or reproduction characteristics. In a previous study it was found that in the terrestrial isopod Porcellio scaber, sampled from the vicinity of a zine smelter, the body size was small and the brood size was large compared to isopods from a reference area. To assess whether these differences were due to genetic differentiation between strains, isopods collected from a reference wood, a zinc smelter area and a lead mine were cultured on non-polluted food, while growth, reproduction and metal concentrations were studied in first and second laboratory generations. The isopods from the three populations differed in age and weight at first reproduction, although there were hardly any differences in growth. The females of the mine and the smelter population started to reproduce earlier, at a lower weight, which resulted in fewer young per female. However, reproductive allocation (=wight of young relative to the weight of the mother) was higher in mine and smelter isopods. We conclude that the isopods at the metal-contaminated sites have been selected for early reproduction and increased reproductive allocation. The results indicate that populations inhabiting metal-polluted sites have probably undergone evolutionary changes. This study showed that growth and reproduction characteristics of different populations under laboratory conditions may provide information on selection processes in the field.

From exposure to effect: a comparison of modeling approaches to chemical carcinogenesis.

Standardized long-term carcinogenicity tests aim to reveal the relationship between exposure to a chemical and occurrence of a carcinogenic response. The analysis of such tests may be facilitated by the use of mathematical models. To what extent current models actually achieve this purpose is difficult to evaluate. Various aspects of chemically induced carcinogenesis are treated by different modeling approaches, which proceed very much in isolation of each other. With this paper we aim to provide for the non-mathematician a comprehensive and critical overview of models dealing with processes involved in chemical carcinogenesis. We cover the entire process of carcinogenesis, from exposure to effect. We succinctly summarize the biology underlying the models and emphasize the relationship between model assumptions and model formulations. The use of mathematics is restricted as far as possible with some additional information relegated to boxes.

Analysis of bioassays with time-varying concentrations.

In the analysis of ecotoxicological bioassays the concentration of the test compounds is assumed to be constant. In many situations this assumption is questionable, as various processes may cause a substantial decline in the concentration during exposure. This leads to difficulties in the estimation of parameters that characterise the toxicity of the test compound. As a solution to this problem, time-varying concentrations are often replaced by their mean values for the estimation of toxicity parameters. However, Monte-Carlo simulations show that this approach results in biased estimates of the toxicity parameters. As an alternative approach, we propose models to estimate one important toxicity parameter, the no effect concentration, in situations where the concentration of the compound varies in time. These models are extensions of the DEBtox model (Kooijman and Bedaux, 1996) which is based on biological assumptions about toxicokinetics and toxic effects. We also propose a new approach for the estimation of toxicity parameters for strongly accumulating non-metabolisable compounds. This approach does not require any kinetics assumption. Computer simulation and experimental data confirm the relevance of the different proposals.

Comparative kinetics of embryo development.

A model of embryo energetics was fitted to data from the literature for species as different as snails and mammals. The model is based on assumptions about energy uptake, storage and utilization. It describes the animal by two state variables: volume and energy storage. Embryo weight is taken to be proportional to volume, yolk weight to energy storage, and respiration rate to storage utilization rate. The fits were good, with minor deviations occurring only in the early phases of development. For altricial birds, good model fits were obtained, but the parameter values markedly differed from those of other species. We hypothesized that, due to an increase in energy utilization towards hatching, the temperature of the embryo increases. As a result, metabolic processes are accelerated. When this was taken into account, parameter values were obtained that correspond better with those of other animals.

Models on butterfly protandry: virgin females are at risk to die.

Current models on protandry in butterflies assume that females are mated instantaneously upon eclosion. However, for most butterfly species this assumption is not realistic. In this paper a model is formulated in which the mating rate depends on both male and female density. Given the female presence curve, protandry is an evolutionarily stable strategy (ESS) for males. The evolutionarily stable amount of protandry decreases with increasing death rate and decreasing encounter rate. Given the male presence curve, protandry also is an ESS for females. However, male and female ESS are not identical; moreover, in the present model a simultaneous ESS does not exist. Protandry critically depends on the assumption that females mate only once, whereas males are capable of multiple mating. If females too are capable of multiple mating, absence of protandry is the ESS for males as well as females. The model predicts that protandry depends on population density: protandry should be more pronounced in populations with high density than in populations with low density. Protandry also depends on sex ratio. It becomes more pronounced when the proportion of males among emerging adults increases.

The embedded tumour: host physiology is important for the evaluation of tumour growth.

The growth potential of a tumour can significantly depend on host features such as age, cell proliferation rates and caloric intake. Although this is widely known, existing mathematical models for tumour growth do not account for it. We therefore developed a new model for tumour growth, starting from a mathematical framework that describes the host's physiology. The resulting tumour-in-host model allowed us to study the implications of various specific interactions between the energetics of tumour and host. The model accounts for the influence of both age and feeding regimen of the host organism on the behaviour of a tumour. Concerning the effects of a tumour on its host, it explains why tumour-mediated body-weight loss is often more dramatic than expected from the energy demands of the tumour. We also show how the model can be applied to study enhanced body-weight loss in presence of cachectic factors. Our tumour-in-host model thus appears a proper tool to unite a wide range of phenomena in tumour-host interactions.