8 research outputs found
Apathy in Action: Baby Boomers\u27 Attitudes towards Product Placements in the Mass Media
Product placement, or the paid inclusion of branded products in to entertainment media, is a highly lucrative and popular practice. While much research has been done on the attitudes of college-aged individuals towards the practice of product placement, none had been conducted on any other populations’ attitudes towards product placements in media besides television and motion pictures. The current quantitatively-focused study employed a 23-question survey instrument to examine a baby boomer enumeration’s attitudes towards product placements in film, television, music videos, video games and internet web sites. Chi-square analysis, tests of correlation, ANOVA and simple means comparison were used to analyze the results. The majority of subjects approved of product placements in all media formats examined. When disapproval of product placements was voiced , it was towards the inclusion of alcohol or tobacco products in entertainment content aimed at children. Overall, the research in this study strengthened and extended the findings of previous studies to a baby boomer population
A mock circulation loop to test extracorporeal CO2 elimination setups
Background: Extracorporeal carbon dioxide removal (ECCO2R) is a promising yet
limited researched therapy for hypercapnic respiratory failure in acute respiratory
distress syndrome and exacerbated chronic obstructive pulmonary disease. Herein,
we describe a new mock circuit that enables experimental ECCO2R research without
animal models. In a second step, we use this model to investigate three experimental
scenarios of ECCO2R: (I) the influence of hemoglobin concentration on CO2 removal. (II)
a potentially portable ECCO2R that uses air instead of oxygen, (III) a low-flow ECCO2R
that achieves effective CO2 clearance by recirculation and acidification of the limited
blood volume of a small dual lumen cannula (such as a dialysis catheter).
Results: With the presented ECCO2R mock, CO2 removal rates comparable to previous
studies were obtained. The mock works with either fresh porcine blood or diluted
expired human packed red blood cells. However, fresh porcine blood was preferred
because of better handling and availability. In the second step of this work, hemoglobin
concentration was identified as an important factor for CO2 removal. In the second
scenario, an air-driven ECCO2R setup showed only a slightly lower CO2 wash-out than the
same setup with pure oxygen as sweep gas. In the last scenario, the low-flow ECCO2R,
the blood flow at the test membrane lung was successfully raised with a recirculation
channel without the need to increase cannula flow. Low recirculation ratios resulted in
increased efficiency, while high recirculation ratios caused slightly reduced CO2 removal
rates. Acidification of the CO2 depleted blood in the recirculation channel caused an
increase in CO2 removal rate.
Conclusions: We demonstrate a simple and cost effective, yet powerful, “in-vitro”
ECCO2R model that can be used as an alternative to animal experiments for many
research scenarios. Moreover, in our approach parameters such as hemoglobin level can
be modified more easily than in animal models
Comparison of Serial and Parallel Connections of Membrane Lungs against Refractory Hypoxemia in a Mock Circuit
Extracorporeal membrane oxygenation (ECMO) is an important rescue therapy method
for the treatment of severe hypoxic lung injury. In some cases, oxygen saturation and oxygen partial
pressure in the arterial blood are low despite ECMO therapy. There are case reports in which patients
with such instances of refractory hypoxemia received a second membrane lung, either in series or in
parallel, to overcome the hypoxemia. It remains unclear whether the parallel or serial connection
is more effective. Therefore, we used an improved version of our full-flow ECMO mock circuit to
test this. The measurements were performed under conditions in which the membrane lungs were
unable to completely oxygenate the blood. As a result, only the photometric pre- and post-oxygenator
saturations, blood flow and hemoglobin concentration were required for the calculation of oxygen
transfer rates. The results showed that for a pre-oxygenator saturation of 45% and a total blood flow of
10 L/min, the serial connection of two identical 5 L rated oxygenators is 17% more effective in terms
of oxygen transfer than the parallel connection. Although the idea of using a second membrane lung
if refractory hypoxia occurs is intriguing from a physiological point of view, due to the invasiveness
of the solution, further investigations are needed before this should be used in a wider clinical setting
Comparison of Circular and Parallel-Plated Membrane Lungs for Extracorporeal Carbon Dioxide Elimination
Extracorporeal carbon dioxide removal (ECCO2R) is an important technique to treat critical lung diseases such as exacerbated chronic obstructive pulmonary disease (COPD) and mild or
moderate acute respiratory distress syndrome (ARDS). This study applies our previously presented
ECCO2R mock circuit to compare the CO2 removal capacity of circular versus parallel-plated membrane lungs at different sweep gas flow rates (0.5, 2, 4, 6 L/min) and blood flow rates (0.3 L/min,
0.9 L/min). For both designs, two low-flow polypropylene membrane lungs (Medos Hilte 1000,
Quadrox-i Neonatal) and two mid-flow polymethylpentene membrane lungs (Novalung Minilung,
Quadrox-iD Pediatric) were compared. While the parallel-plated Quadrox-iD Pediatric achieved the
overall highest CO2 removal rates under medium and high sweep gas flow rates, the two circular
membrane lungs performed relatively better at the lowest gas flow rate of 0.5 L/min. The low-flow
Hilite 1000, although overall better than the Quadrox i-Neonatal, had the most significant advantage
at a gas flow of 0.5 L/min. Moreover, the circular Minilung, despite being significantly less efficient
than the Quadrox-iD Pediatric at medium and high sweep gas flow rates, did not show a significantly
worse CO2 removal rate at a gas flow of 0.5 L/min but rather a slight advantage. We suggest that
circular membrane lungs have an advantage at low sweep gas flow rates due to reduced shunting as
a result of their fiber orientation. Efficiency for such low gas flow scenarios might be relevant for
possible future portable ECCO2R devices
A Novel Mock Circuit to Test Full-Flow Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation (ECMO) has become an important therapeutic
approach in the COVID-19 pandemic. The development and research in this field strongly relies on
animal models; however, efforts are being made to find alternatives. In this work, we present a new
mock circuit for ECMO that allows measurements of the oxygen transfer rate of a membrane lung at
full ECMO blood flow. The mock utilizes a large reservoir of heparinized porcine blood to measure the
oxygen transfer rate of the membrane lung in a single passage. The oxygen transfer rate is calculated
from blood flow, hemoglobin value, venous saturation, and post-membrane arterial oxygen pressure.
Before the next measuring sequence, the blood is regenerated to a venous condition with a sweep
gas of nitrogen and carbon dioxide. The presented mock was applied to investigate the effect of a
recirculation loop on the oxygen transfer rate of an ECMO setup. The recirculation loop caused a
significant increase in post-membrane arterial oxygen pressure (paO2
). The effect was strongest for
the highest recirculation flow. This was attributed to a smaller boundary layer on gas fibers due to
the increased blood velocity. However, the increase in paO2 did not translate to significant increases
in the oxygen transfer rate because of the minor significance of physically dissolved oxygen for gas
transfer. In conclusion, our results regarding a new ECMO mock setup demonstrate that recirculation
loops can improve ECMO performance, but not enough to be clinically relevant
A Novel Mock Circuit to Test Full-Flow Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation (ECMO) has become an important therapeutic approach in the COVID-19 pandemic. The development and research in this field strongly relies on animal models; however, efforts are being made to find alternatives. In this work, we present a new mock circuit for ECMO that allows measurements of the oxygen transfer rate of a membrane lung at full ECMO blood flow. The mock utilizes a large reservoir of heparinized porcine blood to measure the oxygen transfer rate of the membrane lung in a single passage. The oxygen transfer rate is calculated from blood flow, hemoglobin value, venous saturation, and post-membrane arterial oxygen pressure. Before the next measuring sequence, the blood is regenerated to a venous condition with a sweep gas of nitrogen and carbon dioxide. The presented mock was applied to investigate the effect of a recirculation loop on the oxygen transfer rate of an ECMO setup. The recirculation loop caused a significant increase in post-membrane arterial oxygen pressure (paO2). The effect was strongest for the highest recirculation flow. This was attributed to a smaller boundary layer on gas fibers due to the increased blood velocity. However, the increase in paO2 did not translate to significant increases in the oxygen transfer rate because of the minor significance of physically dissolved oxygen for gas transfer. In conclusion, our results regarding a new ECMO mock setup demonstrate that recirculation loops can improve ECMO performance, but not enough to be clinically relevant
Personalized management of elderly patients with rectal cancer: Expert recommendations of the European Society of Surgical Oncology, European Society of Coloproctology, International Society of Geriatric Oncology, and American College of Surgeons Commission on Cancer.
With an expanding elderly population and median rectal cancer detection age of 70 years, the prevalence of rectal cancer in elderly patients is increasing. Management is based on evidence from younger patients, resulting in substandard treatments and poor outcomes. Modern management of rectal cancer in the elderly demands patient-centered treatment, assessing frailty rather than chronological age. The heterogeneity of this group, combined with the limited available data, impedes drafting evidence-based guidelines. Therefore, a multidisciplinary task force convened experts from the European Society of Surgical Oncology, European Society of Coloproctology, International Society of Geriatric Oncology and the American College Surgeons Commission on Cancer, with the goal of identifying the best practice to promote personalized rectal cancer care in older patients. A crucial element for personalized care was recognized as the routine screening for frailty and geriatrician involvement and personalized care for frail patients. Careful patient selection and improved surgical and perioperative techniques are responsible for a substantial improvement in rectal cancer outcomes. Therefore, properly selected patients should be considered for surgical resection. Local excision can be utilized when balancing oncologic outcomes, frailty and life expectancy. Watch and wait protocols, in expert hands, are valuable for selected patients and adjuncts can be added to improve complete response rates. Functional recovery and patient-reported outcomes are as important as oncologic-specific outcomes in this age group. The above recommendations and others were made based on the best-available evidence to guide the personalized treatment of elderly patients with rectal cancer