Transpulmonary thermodilution for hemodynamic measurements in severely burned children

Abstract Introduction Monitoring of hemodynamic and volumetric parameters after severe burns is of critical importance. Pulmonary artery catheters, however, have been associated with many risks. Our aim was to show the feasibility of continuous monitoring with minimally invasive transpulmonary thermodilution (TPTD) in severely burned pediatric patients. Methods This prospective cohort study was conducted in patients with severe burns over 40% of the total body surface area (TBSA) who were admitted to the hospital within 96 hours after sustaining the injury. TPTD measurements were performed using the PiCCO system (Pulsion Medical Systems, Munich, Germany). Cardiac Index (CI), Intrathoracic Blood Volume Index (ITBVI) (Stewart-Hamilton equation), Extravascular Lung Water Index (EVLWI) and Systemic Vascular Resistance Index (SVRI) measurements were recorded twice daily. Statistical analysis was performed using one-way repeated measures analysis of variance with the post hoc Bonferroni test for intra- and intergroup comparisons. Results Seventy-nine patients with a mean age (±SD) of 9 ± 5 years and a mean TBSA burn (±SD) of 64% ± 20% were studied. CI significantly increased compared to level at admission and was highest 3 weeks postburn. ITBVI increased significantly starting at 8 days postburn. SVRI continuously decreased early in the perioperative burn period. EVLWI increased significantly starting at 9 days postburn. Young children (0 to 5 years old) had a significantly increased EVLWI and decreased ITBVI compared to older children (12 to 18 years old). EVLWI was significantly higher in patients who did not survive burn injury. Conclusions Continuous PiCCO measurements were performed for the first time in a large cohort of severely burned pediatric patients. The results suggest that hyperdynamic circulation begins within the first week after burn injury and continues throughout the entire intensive care unit stay

Electrochemically controlled growth and positioning of suspended collagen membranes

Two independently recognized in vitro polymer aggregation variables, electric field and pH, can be used in concert to produce suspended membranes from solutions of type I collagen monomers, without need of a supporting substrate. A collagen network film can form at the alkalineacidic pH interface created during the normal course of water electrolysis with parallel plate electrodes, and the anchoring location can be controlled by adjusting the bulk electrolyte pH. Electrosynthesized films remain intact upon drying and rehydration and function as ion separation membranes even in submillimeter channels. This approach could benefit lab-on-a-chip technologies for rational placement of membranes in microfluidic devices

Advanced Optical Diagnostics for Ice Crystal Cloud Measurements in the NASA Glenn Propulsion Systems Laboratory

A light extinction tomography technique has been developed to monitor ice water clouds upstream of a direct connected engine in the Propulsion Systems Laboratory (PSL) at NASA Glenn Research Center (GRC). The system consists of 60 laser diodes with sheet generating optics and 120 detectors mounted around a 36-inch diameter ring. The sources are pulsed sequentially while the detectors acquire line-of-sight extinction data for each laser pulse. Using computed tomography algorithms, the extinction data are analyzed to produce a plot of the relative water content in the measurement plane. To target the low-spatial-frequency nature of ice water clouds, unique tomography algorithms were developed using filtered back-projection methods and direct inversion methods that use Gaussian basis functions. With the availability of a priori knowledge of the mean droplet size and the total water content at some point in the measurement plane, the tomography system can provide near real-time in-situ quantitative full-field total water content data at a measurement plane approximately 5 feet upstream of the engine inlet. Results from ice crystal clouds in the PSL are presented. In addition to the optical tomography technique, laser sheet imaging has also been applied in the PSL to provide planar ice cloud uniformity and relative water content data during facility calibration before the tomography system was available and also as validation data for the tomography system. A comparison between the laser sheet system and light extinction tomography resulting data are also presented. Very good agreement of imaged intensity and water content is demonstrated for both techniques. Also, comparative studies between the two techniques show excellent agreement in calculation of bulk total water content averaged over the center of the pipe

Predictor species: Improving assessments of rare species occurrence by modeling environmental co-responses

Designing an effective conservation strategy requires understanding where rare species are located. Because rare species can be difficult to find, ecologists often identify other species called conservation surrogates that can help inform the distribution of rare species. Species distribution models typically rely on environmental data when predicting the occurrence of species, neglecting the effect of species\u27 co-occurrences and biotic interactions. Here, we present a new approach that uses Bayesian networks to improve predictions by modeling environmental co-responses among species. For species from a European peat bog community, our approach consistently performs better than single-species models and better than conventional multi-species approaches that include the presence of nontarget species as additional independent variables in regression models. Our approach performs particularly well with rare species and when calibration data are limited. Furthermore, we identify a group of “predictor species” that are relatively common, insensitive to the presence of other species, and can be used to improve occurrence predictions of rare species. Predictor species are distinct from other categories of conservation surrogates such as umbrella or indicator species, which motivates focused data collection of predictor species to enhance conservation practices

The importance of accurate muscle modelling for biomechanical analyses: a case study with a lizard skull

Computer-based simulation techniques such as multi-body dynamics analysis are becoming increasingly popular in the field of skull mechanics. Multi-body models can be used for studying the relationships between skull architecture, muscle morphology and feeding performance. However, to be confident in the modelling results, models need to be validated against experimental data, and the effects of uncertainties or inaccuracies in the chosen model attributes need to be assessed with sensitivity analyses. Here, we compare the bite forces predicted by a multi-body model of a lizard (Tupinambis merianae) with in vivo measurements, using anatomical data collected from the same specimen. This subject-specific model predicts bite forces that are very close to the in vivo measurements and also shows a consistent increase in bite force as the bite position is moved posteriorly on the jaw. However, the model is very sensitive to changes in muscle attributes such as fibre length, intrinsic muscle strength and force orientation, with bite force predictions varying considerably when these three variables are altered. We conclude that accurate muscle measurements are crucial to building realistic multi-body models and that subject-specific data should be used whenever possible.Flora Gröning, Marc E. H. Jones, Neil Curtis, Anthony Herrel, Paul O'Higgins, Susan E. Evans and Michael J. Faga

A trigger-substrate model for smiling during an automated formative quiz: engagement is the substrate, not frustration

INTRODUCTION: Automated tutoring systems aim to respond to the learner’s cognitive state in order to maintain engagement. The end-user’s state might be inferred by interactive timings, bodily movements or facial expressions. Problematic computerized stimuli are known to cause smiling during periods of frustration. METHODS: Forty-four seated, healthy participants (age range 18-35, 18 male) used a handheld trackball to answer a computer-presented, formative, 3-way multiple choice geography quiz, with 9 questions, lasting a total of 175 seconds. Frontal facial videos (10 Hz) were collected with a webcam and processed for facial expressions by CrowdEmotion using a pattern recognition algorithm. Interactivity was recorded by a keystroke logger (Inputlog 5.2). Subjective responses were collected immediately after each quiz using a panel of visual analogue scales (VAS). RESULTS: Smiling was fie-fold enriched during the instantaneous feedback segments of the quiz, and this was correlated with VAS ratings for engagement but not with happiness or frustration. Nevertheless, smiling rate was significantly higher after wrong answers compared to correct ones, and frustration was correlated with the number of questions answered incorrectly. CONCLUSION: The apparent disconnect between the increased smiling during incorrect answers but the lack of correlation between VAS frustration and smiles suggests a trigger-substrate model where engagement is the permissive substrate, while the noises made by the quiz after wrong answers may be the trigger

What’s Sex (Composition) Got to Do with It? The Importance of Sex Composition of Gangs for Female and Male Members’ Offending and Victimization

Sex composition of groups has been theorized in organizational sociology and found in prior work to structure female and male members’ behaviors and experiences. Peer group and gang literature similarly finds that the sex gap in offending varies across groups of differing sex ratios. Drawing on this and other research linking gang membership, offending, and victimization, we examine whether sex composition of gangs is linked to sex differences in offending in this sample, further assess whether sex composition similarly structures females’ and males’ victimization experiences, and if so, why. Self-report data from gang members in a multi-site, longitudinal study of 3,820 youths are employed. Results support previous findings about variations in member delinquency by both sex and sex composition of the gang and also indicate parallel variations in members’ victimization. These results are further considered within the context of facilitating effects such as gender dynamics, gang characteristics, and normative orientation

Structure and assembly of the S-layer determine virulence in C. difficile

Many bacteria and archaea possess a cell surface layer – S-layer – made of a 2D protein array that covers the entire cell. As the outermost component of the cell envelope, S-layers play crucial roles in many aspects of cell physiology. Importantly, many clinically relevant bacterial pathogens possess a distinct S-layer that forms an initial interface with the host, making it a potential target for development of species-specific antimicrobials. Targeted therapeutics are particularly important for antibiotic resistant pathogens such as Clostridioides difficile, the most frequent cause of hospital acquired diarrhea, which relies on disruption of normal microbiota through antibiotic usage. Despite the ubiquity of S-layers, only partial structural information from a very limited number of species is available and their function and organization remains poorly understood. Here we report the first complete atomic level structure and in situ assembly model of an S-layer from a bacterial pathogen and reveal its role in disease severity. SlpA, the main C. difficile S-layer protein, assembles through tiling of triangular prisms abutting the cell wall, interlocked by distinct ridges facing the environment. This forms a tightly packed array, unlike the more porous S-layer models previously described. We report that removing one of the SlpA ridge features dramatically reduces disease severity, despite being dispensable for overall SlpA structure and S-layer assembly. Remarkably, the effect on disease severity is independent of toxin production and bacterial colonization within the mouse model of disease. Our work combines X-ray and electron crystallography to reveal a novel S-layer organization in atomic detail, highlighting the need for multiple technical approaches to obtain structural information on these paracrystalline arrays. These data also establish a direct link between specific structural elements of S-layer and virulence for the first time, in a crucial paradigm shift in our understanding of C. difficile disease, currently largely attributed to the action of potent toxins. This work highlights the crucial role of S-layers in pathogenicity and the importance of detailed structural information for providing new therapeutic avenues, targeting the S-layer. Understanding the interplay between S-layer and other virulence factors will further enhance our ability to tackle pathogens carrying an S-layer. We anticipate that this work provides a solid basis for development of new, C. difficile-specific therapeutics, targeting SlpA structure and S-layer assembly to reduce the healthcare burden of these infections.

Design, development and validity testing of the Gang Affiliation Risk Measure (GARM)

This study aimed to create a measure of risk for gang affiliation, for use in the UK. A pilot stage invited gang affiliated and non-gang affiliated participants between the ages of 16–25 years to retrospectively self-report on 58 items of risk exposure at the age of 11 years. Based on performance of these items, a 26-item measure was developed and administered to a main study sample (n=185) of gang affiliated and non-gang affiliated participants. Categorical Principal Component Analysis was applied to data, yielding a single-factor solution (historic lack of safety and current perception of threat). A 15-item gang affiliation risk measure (GARM) was subsequently created. The GARM demonstrated good internal consistency, construct validity and discriminative ability. Items from the GARM were then transformed to read prospectively, resulting in a test measure for predictive purposes (T-GARM). The T-GARM requires further validation regarding its predictive utility and generalisability. However, this study has resulted in the first measure of gang affiliation, with promising results