A physiological study to determine the mechanism of carbon dioxide clearance during apnoea when using transnasal humidified rapid insufflation ventilatory exchange (THRIVE).

Clinical observations suggest that compared with standard apnoeic oxygenation, transnasal humidified rapid-insufflation ventilatory exchange using high-flow nasal oxygenation reduces the rate of carbon dioxide accumulation in patients who are anaesthetised and apnoeic. This suggests that active gas exchange takes place, but the mechanisms by which it may occur have not been described. We used three laboratory airway models to investigate mechanisms of carbon dioxide clearance in apnoeic patients. We determined flow patterns using particle image velocimetry in a two-dimensional model using particle-seeded fluorescent solution; visualised gas clearance in a three-dimensional printed trachea model in air; and measured intra-tracheal turbulence levels and carbon dioxide clearance rates using a three-dimensional printed model in air mounted on a lung simulator. Cardiogenic oscillations were simulated in all experiments. The visualisation experiments indicated that gaseous mixing was occurring in the trachea. With no cardiogenic oscillations applied, mean (SD) carbon dioxide clearance increased from 0.29 (0.04) ml.min-1 to 1.34 (0.14) ml.min-1 as the transnasal humidified rapid-insufflation ventilatory exchange flow rate was increased from 20 l.min-1 to 70 l.min-1 (p = 0.0001). With a cardiogenic oscillation of 20 ml.beat-1 applied, carbon dioxide clearance increased from 11.9 (0.50) ml.min-1 to 17.4 (1.2) ml.min-1 as the transnasal humidified rapid-insufflation ventilatory exchange flow rate was increased from 20 l.min-1 to 70 l.min-1 (p = 0.0014). These findings suggest that enhanced carbon dioxide clearance observed under apnoeic conditions with transnasal humidified rapid-insufflation ventilatory exchange, as compared with classical apnoeic oxygenation, may be explained by an interaction between entrained and highly turbulent supraglottic flow vortices created by high-flow nasal oxygen and cardiogenic oscillations.

Differences between endogenous attention to spatial locations and sensory modalities.

Vibell et al. (J Cogn Neurosci 19:109-120, 2007) reported that endogenously attending to a sensory modality (vision or touch) modulated perceptual processing, in part, by the relative speeding-up of neural activation (i.e., as a result of prior entry). However, it was unclear whether it was the fine temporal discrimination required by the temporal-order judgment task that was used, or rather, the type of attentional modulation (spatial locations or sensory modalities) that was responsible for the shift in latencies that they observed. The present study used a similar experimental design to evaluate whether spatial attention would also yield similar latency effects suggestive of prior entry in the early visual P1 potentials. Intriguingly, while the results demonstrate similar neural latency shifts attributable to spatial attention, they started at a somewhat later stage than seen in Vibell et al.'s study. These differences are consistent with different neural mechanisms underlying attention to a specific sensory modality versus to a spatial location.

Visually Induced Inhibition of Return Affects the Integration of Auditory and Visual Information.

Multisensory integration (MSI) and exogenous spatial attention can both speedup responses to perceptual events. Recently, it has been shown that audiovisual integration at exogenously attended locations is reduced relative to unattended locations. This effect was observed at short cue-target intervals (200-250 ms). At longer intervals, however, the initial benefits of exogenous shifts of spatial attention at the cued location are often replaced by response time (RT) costs (also known as Inhibition of Return, IOR). Given these opposing cueing effects at shorter versus longer intervals, we decided to investigate whether MSI would also be affected by IOR. Uninformative exogenous visual spatial cues were presented between 350 and 450 ms prior to the onset of auditory, visual, and audiovisual targets. As expected, IOR was observed for visual targets (invalid cue RT < valid cue RT). For auditory and audiovisual targets, neither IOR nor any spatial cueing effects were observed. The amount of relative multisensory response enhancement and race model inequality violation was larger for uncued as compared with cued locations indicating that IOR reduces MSI. The results are discussed in the context of changes in unisensory signal strength at cued as compared with uncued locations.

Experimental and computational investigation of the trajectories of blood drops ejected from the nose.

Blood expirated from the nose may leave a characteristic bloodstain at a crime scene which can provide important clues for reconstructing events during a violent assault. Little research has been done on the typical velocities, trajectories and size distribution that can be expected from expirated blood. An experimental fluid dynamics technique known as stereoscopic particle image velocimetry is used in this work to obtain the air velocity field inside and outside the nostrils during exhalation. A numerical model was then used to compute the trajectory of blood drops of 0.5 and 2 mm. The drops were tracked until ground plane impact below the nostril exit. Three heights were investigated, 1.5, 1.6 and 1.7 m. For an expiration flow rate of 32 l/min in vivo, there is a maximum exit velocity from the nostril of approximately 4 m/s, with a 0.5 m/s difference between nostrils. After the drops have traversed the distances investigated, drops of 0.5 and 2 mm in diameter from both nostrils are at a similar velocity. This implies that the gravitational acceleration after the drops leave the jet has the most influence on velocity. It is however shown that exit velocity does affect impact location. Drop size affects both impact location and impact velocity. An increase in height increases the distance traversed. Compared to the 2-mm drop, the 0.5 mm had a lower impact velocity, but its impact location in the ground plane was further from the nostril exit. Understanding the physics of expirated blood flight allows better interpretation of expirated stains at crime scenes.

Modelling Subarctic watershed dissolved organic carbon response to hydroclimatic regime.

Shifts in hydroclimatic regimes associated with global climate change may impact freshwater availability and quality. In high latitudes of the northern hemisphere, where vast quantities of carbon are stored terrestrially, explaining landscape-scale carbon (C) budgets and associated pollutant transfer is necessary for understanding the impact of changing hydroclimatic regimes. We used a dynamic modelling approach to simulate streamflow, DOC concentration, and DOC export in a northern Canadian catchment that has undergone notable climate warming, and will continue to for the remainder of this century. The Integrated Catchment model for Carbon (INCA-C) was successfully calibrated to a multi-year period (2012-2016) that represents a range in hydrologic conditions. The model was subsequently run over 30-year periods representing baseline and two future climate scenarios. Average discharge is predicted to decrease under an elevated temperature scenario (22-27 % of baseline) but increase (116-175 % of baseline) under an elevated temperature and precipitation scenario. In the latter scenario the nival hydroclimatic regime is expected to shift to a combined nival and pluvial regime. Average DOC flux over 30 years is predicted to decrease (24-27 % of baseline) under the elevated temperature scenario, as higher DOC concentrations are offset by lower runoff. Under the elevated temperature and precipitation scenario, results suggest an increase in carbon export of 64-81 % above baseline. These increases are attributed to greater connectivity of the catchment. The largest increase in DOC export is expected to occur in early winter. These predicted changes in DOC export, particularly under a climate that is warmer and wetter could be part of larger ecosystem change and warrant additional monitoring efforts in the region.

Microbial production of volatile sulphur compounds in the large intestine of pigs fed two different diets.

AIMS: To investigate the production of volatile sulphur compounds (VSC) in the segments of the large intestine of pigs and to assess the impact of diet on this production. METHODS AND RESULTS: Pigs were fed two diets based on either wheat and barley (STD) or wheat and dried distillers grains with solubles (DDGS). Net production of VSC and potential sulphate reduction rate (SRR) (sulphate saturated) along the large intestine were determined by means of in vitro incubations. The net production rate of hydrogen sulphide and potential SRR increased from caecum towards distal colon and were significantly higher in the STD group. Conversely, the net methanethiol production rate was significantly higher in the DDGS group, while no difference was observed for dimethyl sulphide. The number of sulphate-reducing bacteria and total bacteria were determined by quantitative PCR and showed a significant increase along the large intestine, whereas no diet-related differences were observed. CONCLUSION: VSC net production varies widely throughout the large intestine of pigs and the microbial processes involved in this production can be affected by diet. SIGNIFICANCE AND IMPACT OF THE STUDY: This first report on intestinal production of all VSC shows both spatial and dietary effects, which are relevant to both bowel disease- and odour mitigation research.

Assessment of dispersion of airborne particles of oral/nasal fluid by high flow nasal cannula therapy.

BACKGROUND: Nasal High Flow (NHF) therapy delivers flows of heated humidified gases up to 60 LPM (litres per minute) via a nasal cannula. Particles of oral/nasal fluid released by patients undergoing NHF therapy may pose a cross-infection risk, which is a potential concern for treating COVID-19 patients. METHODS: Liquid particles within the exhaled breath of healthy participants were measured with two protocols: (1) high speed camera imaging and counting exhaled particles under high magnification (6 participants) and (2) measuring the deposition of a chemical marker (riboflavin-5-monophosphate) at a distance of 100 and 500 mm on filter papers through which air was drawn (10 participants). The filter papers were assayed with HPLC. Breathing conditions tested included quiet (resting) breathing and vigorous breathing (which here means nasal snorting, voluntary coughing and voluntary sneezing). Unsupported (natural) breathing and NHF at 30 and 60 LPM were compared. RESULTS: Imaging: During quiet breathing, no particles were recorded with unsupported breathing or 30 LPM NHF (detection limit for single particles 33 µm). Particles were detected from 2 of 6 participants at 60 LPM quiet breathing at approximately 10% of the rate caused by unsupported vigorous breathing. Unsupported vigorous breathing released the greatest numbers of particles. Vigorous breathing with NHF at 60 LPM, released half the number of particles compared to vigorous breathing without NHF.Chemical marker tests: No oral/nasal fluid was detected in quiet breathing without NHF (detection limit 0.28 µL/m3). In quiet breathing with NHF at 60 LPM, small quantities were detected in 4 out of 29 quiet breathing tests, not exceeding 17 µL/m3. Vigorous breathing released 200-1000 times more fluid than the quiet breathing with NHF. The quantities detected in vigorous breathing were similar whether using NHF or not. CONCLUSION: During quiet breathing, 60 LPM NHF therapy may cause oral/nasal fluid to be released as particles, at levels of tens of µL per cubic metre of air. Vigorous breathing (snort, cough or sneeze) releases 200 to 1000 times more oral/nasal fluid than quiet breathing (p < 0.001 with both imaging and chemical marker methods). During vigorous breathing, 60 LPM NHF therapy caused no statistically significant difference in the quantity of oral/nasal fluid released compared to unsupported breathing. NHF use does not increase the risk of dispersing infectious aerosols above the risk of unsupported vigorous breathing. Standard infection prevention and control measures should apply when dealing with a patient who has an acute respiratory infection, independent of which, if any, respiratory support is being used. CLINICAL TRIAL REGISTRATION: ACTRN12614000924651.

Development and comparison of SYBR Green quantitative real-time PCR assays for detection and enumeration of sulfate-reducing bacteria in stored swine manure.

AIMS: To develop and evaluate primer sets targeted to the dissimilatory sulfite reductase gene (dsrA) for use in quantitative real-time PCR detection of sulfate-reducing bacteria (SRB) in stored swine manure. METHODS AND RESULTS: Degenerate primer sets were developed to detect SRB in stored swine manure. These were compared with a previously reported primer set, DSR1F+ and DSR-R, for their coverage and ability to detect SRB communities in stored swine manure. Sequenced clones were most similar to Desulfovibrio sp. and Desulfobulbus sp., and these SRB populations differed within different manure ecosystems. Sulfur content of swine diets was shown to affect the population of Desulfobulbus-like Group 1 SRB in manure. CONCLUSIONS: The newly developed assays were able to enumerate and discern different groups of SRB, and suggest a richly diverse and as yet undescribed population of SRB in swine manure. SIGNIFICANCE AND IMPACT OF THE STUDY: The PCR assays described here provide improved and efficient molecular tools for quantitative detection of SRB populations. This is the first study to show population shifts of SRB in swine manure, which are a result of either the effects of swine diets or the maturity of the manure ecosystem.

Multisensory perception: beyond modularity and convergence.

Recent research on multisensory perception suggests a number of general principles for crossmodal integration and that the standard model in the field--feedforward convergence of information--must be modified to include a role for feedback projections from multimodal to unimodal brain areas.

A microfabricated fluorescence-activated cell sorter.

We have demonstrated a disposable microfabricated fluorescence-activated cell sorter (microFACS) for sorting various biological entities. Compared with conventional FACS machines, the microFACS provides higher sensitivity, no cross-contamination, and lower cost. We have used microFACS chips to obtain substantial enrichment of micron-sized fluorescent bead populations of differing colors. Furthermore, we have separated Escherichia coli cells expressing green fluorescent protein from a background of nonfluorescent E. coli cells and shown that the bacteria are viable after extraction from the sorting device. These sorters can function as stand-alone devices or as components of an integrated microanalytical chip.

The Development of Tactile Perception.

Touch is the first of our senses to develop, providing us with the sensory scaffold on which we come to perceive our own bodies and our sense of self. Touch also provides us with direct access to the external world of physical objects, via haptic exploration. Furthermore, a recent area of interest in tactile research across studies of developing children and adults is its social function, mediating interpersonal bonding. Although there are a range of demonstrations of early competence with touch, particularly in the domain of haptics, the review presented here indicates that many of the tactile perceptual skills that we take for granted as adults (e.g., perceiving touches in the external world as well as on the body) take some time to develop in the first months of postnatal life, likely as a result of an extended process of connection with other sense modalities which provide new kinds of information from birth (e.g., vision and audition). Here, we argue that because touch is of such fundamental importance across a wide range of social and cognitive domains, it should be placed much more centrally in the study of early perceptual development than it currently is.

Carbon dioxide insufflation deflects airborne particles from an open surgical wound model.

BACKGROUND: Surgical site infections remain a significant burden on healthcare systems and may benefit from new countermeasures. AIM: To assess the merits of open surgical wound CO2 insufflation via a gas diffuser to reduce airborne contamination, and to determine the distribution of CO2 in and over a wound. METHODS: An experimental approach with engineers and clinical researchers was employed to measure the gas flow pattern and motion of airborne particles in a model of an open surgical wound in a simulated theatre setting. Laser-illuminated flow visualizations were performed and the degree of protection was quantified by collecting and characterizing particles deposited in and outside the wound cavity. FINDINGS: The average number of particles entering the wound with a diameter of <5µm was reduced 1000-fold with 10L/min CO2 insufflation. Larger and heavier particles had a greater penetration potential and were reduced by a factor of 20. The degree of protection was found to be unaffected by exaggerated movements of hands in and out of the wound cavity. The steady-state CO2 concentration within the majority of the wound cavity was >95% and diminished rapidly above the wound to an atmospheric level (∼0%) at a height of 25mm. CONCLUSION: Airborne particles were deflected from entering the wound by the CO2 in the cavity akin to a protective barrier. Insufflation of CO2 may be an effective means of reducing intraoperative infection rates in open surgeries.

Vision and touch in ageing: crossmodal selective attention and visuotactile spatial interactions.

We investigated whether ageing affects crossmodal selective attention (the ability to focus on a relevant sensory modality and ignore an irrelevant modality) and the spatial constraints on such selective processing. Three groups of 24 participants were tested: Young (19-25 years), Young-Old (65-72 years) and Old-Old (76-92 years). The participants had to judge the elevation of vibrotactile targets (upper/index finger and lower/thumb), presented randomly to either hand while ignoring concurrent visual distractors. In a second task, the role of the target and distractor modalities was reversed. Crossmodal selective attention was assessed by comparing performance in the presence versus absence of distractors. Spatial constraints on selective attention were also investigated by comparing the effect of distractors presented on the same versus opposite side as the target. When attending to touch, the addition of visual distractors had a significantly larger effect on error rates in both of the older groups as compared to the Young group. This indicates that ageing has a detrimental effect on crossmodal selective attention. In all three age groups, performance was impaired when the target and distractor were presented at incongruent as compared to congruent elevations in both tasks. This congruency effect was modulated by the relative spatial location of the target and distractor in certain conditions for the Young and the Young-Old group. That is, participants in the two younger age groups found it harder to attend selectively to targets in one modality, when distractor stimuli came from the same side rather than from the opposite side. However, no significant spatial modulation was found in the Old-Old group. This suggests that ageing may also compromise spatial aspects of crossmodal selective attention.

Crossmodal attention.

Most selective attention research has considered only a single sensory modality at a time, but in the real world, our attention must be coordinated crossmodally. Recent studies reveal extensive crossmodal links in attention across the various modalities (i.e. audition, vision, touch and proprioception). Attention typically shifts to a common location across the modalities, despite the vast differences in their initial coding of space. These spatial synergies in attention can be maintained even when receptors are realigned across the modalities by changes in posture. Some crossmodal integration can arise preattentively. The mechanisms underlying these crossmodal links can be examined in a convergent manner by integrating behavioural studies of normal subjects and brain-damaged patients with neuroimaging and neurophysiological studies.

Visuotactile temporal order judgments in ageing.

We report an experiment on the effects of ageing on crossmodal temporal perception. Young (mean age = 21.7 years) and old (mean age = 75.1 years) participants were presented with pairs of visual and vibrotactile stimuli to either hand and required to make unspeeded temporal order judgments (TOJs) regarding which sensory modality appeared to have been presented first. The stimulus onset asynchrony (SOA) between the two stimuli was varied using the method of constant stimuli. Temporal precision, as indexed by the just noticeable difference (JND), was better (i.e., JNDs were lower) when the stimuli were presented from different positions (M = 101 ms) rather than from the same position (M = 120 ms), as has been demonstrated previously. Additionally, older observers required more time (i.e., their JNDs were larger) to accurately perceive the temporal order (M = 131 ms) as compared to younger observers (M = 98 ms). Our results confirm that ageing deleteriously affects crossmodal temporal processing even when the spatial confound inherent in previous research has been ruled out.

The Complex Interplay Between Multisensory Integration and Perceptual Awareness.

The integration of information has been considered a hallmark of human consciousness, as it requires information being globally available via widespread neural interactions. Yet the complex interdependencies between multisensory integration and perceptual awareness, or consciousness, remain to be defined. While perceptual awareness has traditionally been studied in a single sense, in recent years we have witnessed a surge of interest in the role of multisensory integration in perceptual awareness. Based on a recent IMRF symposium on multisensory awareness, this review discusses three key questions from conceptual, methodological and experimental perspectives: (1) What do we study when we study multisensory awareness? (2) What is the relationship between multisensory integration and perceptual awareness? (3) Which experimental approaches are most promising to characterize multisensory awareness? We hope that this review paper will provoke lively discussions, novel experiments, and conceptual considerations to advance our understanding of the multifaceted interplay between multisensory integration and consciousness.

Modulation of pain via expectation of its location.

BACKGROUND: The spatial precision of expectancy effects on pain is unclear. We hypothesized that expecting nociceptive stimuli at particular skin sites would have an analgesic effect on nociceptive stimuli presented between them (middle zone). METHODS: Laser stimuli (evoking pin-prick pain) were delivered to three discrete skin zones on the forearm, under two conditions. During 'Localization', participants' expectation of stimuli was spatially divided between two locations (expected stimuli in only the outer two skin zones): pain intensity and stimulus location were judged. During 'No-localization' (control condition), participants had no expectation concerning stimulus location; only pain intensity was rated. Additional experiments assessed the importance of the actual location on the forearm by: shifting all skin zones proximally towards the elbow (control for joint proximity, Experiment 2); adding a fourth zone distally (control for interaction between joint proximity and enhanced distal inhibition, Experiment 3). RESULTS: All experiments demonstrated spatially specific pain modulation, but only Experiment 2 (near elbow) supported our hypothesis: middle zone pain intensity was significantly lower (p = 0.02) during Localization than No-localization. Experiment 1 (near wrist) found reduced pain intensity during Localization only for the distal zone (p = 0.04). Experiment 3 confirmed this effect: reduced pain during Localization occurred only for the most distal zone (p = 0.046). CONCLUSION: Expecting a painful stimulus in non-adjacent skin sites has spatially specific effects on pain modulation, but this reflects an interaction between the expected location of stimulation and the actual location. This suggests a more complex connection between somatotopic maps and nociceptive modulation than previously thought; several distinct mechanisms likely contribute.

An Experimental and Numerical Investigation of CO2 Distribution in the Upper Airways During Nasal High Flow Therapy.

Nasal high flow (NHF) therapy is used to treat a variety of respiratory disorders to improve patient oxygenation. A CO2 washout mechanism is believed to be responsible for the observed increase in oxygenation. In this study, experimentally validated Computational Fluid Dynamics simulations of the CO2 concentration within the upper airway during unassisted and NHF assisted breathing were undertaken with the aim of exploring the existence of this washout mechanism. An anatomically accurate nasal cavity model was generated from a CT scan and breathing was reproduced using a Fourier decomposition of a physiologically measured breath waveform. Time dependent CO2 profiles were obtained at the entrance of the trachea in the experimental model, and were used as simulation boundary conditions. Flow recirculation features were observed in the anterior portion of the nasal cavity upon application of the therapy. This causes the CO2 rich gas to vent from the nostrils reducing the CO2 concentration in the dead space and lowering the inspired CO2 volume. Increasing therapy flow rate increases the penetration depth within the nasal cavity of the low CO2 concentration gas. A 65% decrease in inspired CO2 was observed for therapy flow rates ranging from 0 to 60 L min(-1) supporting the washout mechanism theory.

Attention and the crossmodal construction of space.

Traditional studies of spatial attention consider only a single sensory modality at a time (e.g. just vision, or just audition). In daily life, however, our spatial attention often has to be coordinated across several modalities. This is a non-trivial problem, given that each modality initially codes space in entirely different ways. In the last five years, there has been a spate of studies on crossmodal attention. These have demonstrated numerous crossmodal links in spatial attention, such that attending to a particular location in one modality tends to produce corresponding shifts of attention in other modalities. The spatial coordinates of these crossmodal links illustrate that the internal representation of external space depends on extensive crossmodal integration. Recent neuroscience studies are discussed that suggest possible brain mechanisms for the crossmodal links in spatial attention.