Exercise-induced respiratory muscle work: Effects on blood flow, fatigue and performance

This is the post print version of this article. The official published version can be obtained from the link below.In healthy subjects, heavy intensity endurance exercise places substantial demands on the respiratory muscles as breathing frequency, ventilation and the work of breathing rise over time. In the highly trained subject working at high absolute work rates, the ventilatory demand often causes varying degrees of expiratory flow limitation, sometimes accompanied by lung hyperinflation and, therefore, increased elastic work of breathing. Time-dependant increases in effort perceptions for both dyspnea and limb discomfort accompany these increased ventilatory demands. Similar responses to endurance exercise but at much lower exercise intensities also occur in patients with COPD and CHF. Note that these responses significantly influence exercise performance times in both health and disease. This effect was demonstrated by the marked reductions in the rate of rise of effort perceptions and the enhanced exercise performance times elicited by unloading the respiratory muscles using pressure support ventilation or proportional assist mechanical ventilation. In healthy fit subjects, unloading the inspiratory work of breathing by about one half increased performance by an average of 14% (Harms et al. 2000), and in CHF and COPD patients performance time more than doubled with respiratory muscle unloading (O’Donnell et al. 2001). Why are effort perceptions of limb discomfort markedly reduced and exercise performance increased when the respiratory muscles are unloaded? Our hypothesis is shown in Fig. 1

A Survey of Current Rotorcraft Propulsion Health Monitoring Technologies

A brief review is presented on the state-of-the-art in rotorcraft engine health monitoring technologies including summaries on current practices in the area of sensors, data acquisition, monitoring and analysis. Also, presented are guidelines for verification and validation of Health Usage Monitoring System (HUMS) and specifically for maintenance credits to extend part life. Finally, a number of new efforts in HUMS are summarized as well as lessons learned and future challenges. In particular, gaps are identified to supporting maintenance credits to extend rotorcraft engine part life. A number of data sources were consulted and include results from a survey from the HUMS community, Society of Automotive Engineers (SAE) documents, American Helicopter Society (AHS) papers, as well as references from Defence Science & Technology Organization (DSTO), Civil Aviation Authority (CAA), and Federal Aviation Administration (FAA)

A spread spectrum approach to time-domain near-infrared diffuse optical imaging using inexpensive optical transceiver modules

We introduce a compact time-domain system for near-infrared spectroscopy using a spread spectrum technique. The proof-of-concept single channel instrument utilises a low-cost commercially available optical transceiver module as a light source, controlled by a Kintex 7 field programmable gate array (FPGA). The FPGA modulates the optical transceiver with maximum-length sequences at line rates up to 10Gb/s, allowing us to achieve an instrument response function with full width at half maximum under 600ps. The instrument is characterised through a set of detailed phantom measurements as well as proof-of-concept in vivo measurements, demonstrating performance comparable with conventional pulsed time-domain near-infrared spectroscopy systems

Social and interactional practices for disseminating current awareness information in an organisational setting.

Current awareness services are designed to keep users informed about recent developments based around user need profiles. In organisational settings, they may operate through both electronic and social interactions aimed at delivering information that is relevant, pertinent and current. Understanding these interactions can reveal the tensions in current awareness dissemination and help inform ways of making services more effective and efficient. We report an in-depth, observational study of electronic current awareness use within a large London law firm. The study found that selection, re-aggregation and forwarding of information by multiple actors gives rise to a complex sociotechnical distribution network. Knowledge management staff act as a layer of “intelligent filters” sensitive to complex, local information needs; their distribution decisions address multiple situational relevance factors in a situation fraught with information overload and restrictive time-pressures. Their decisions aim to optimise conflicting constraints of recall, precision and information quantity. Critical to this is the use of dynamic profile updates which propagate back through the network through formal and informal social interactions. This supports changes to situational relevance judgements and so allows the network to ‘self-tune’. These findings lead to design requirements, including that systems should support rapid assessment of information items against an individual’s interests; that it should be possible to organise information for different subsequent uses; and that there should be back-propagation from information consumers to providers, to tune the understanding of their information needs

Implementation of the Combined--Nonlinear Condensation Transformation

We discuss several applications of the recently proposed combined nonlinear-condensation transformation (CNCT) for the evaluation of slowly convergent, nonalternating series. These include certain statistical distributions which are of importance in linguistics, statistical-mechanics theory, and biophysics (statistical analysis of DNA sequences). We also discuss applications of the transformation in experimental mathematics, and we briefly expand on further applications in theoretical physics. Finally, we discuss a related Mathematica program for the computation of Lerch's transcendent.Comment: 23 pages, 1 table, 1 figure (Comput. Phys. Commun., in press

A new era of wide-field submillimetre imaging: on-sky performance of SCUBA-2

SCUBA-2 is the largest submillimetre wide-field bolometric camera ever built. This 43 square arc-minute field-of-view instrument operates at two wavelengths (850 and 450 microns) and has been installed on the James Clerk Maxwell Telescope on Mauna Kea, Hawaii. SCUBA-2 has been successfully commissioned and operational for general science since October 2011. This paper presents an overview of the on-sky performance of the instrument during and since commissioning in mid-2011. The on-sky noise characteristics and NEPs of the 450 and 850 micron arrays, with average yields of approximately 3400 bolometers at each wavelength, will be shown. The observing modes of the instrument and the on-sky calibration techniques are described. The culmination of these efforts has resulted in a scientifically powerful mapping camera with sensitivities that allow a square degree of sky to be mapped to 10 mJy/beam rms at 850 micron in 2 hours and 60 mJy/beam rms at 450 micron in 5 hours in the best weather.Comment: 18 pages, 15 figures.SPIE Conference series 8452, Millimetre, Submillimetre and Far-infrared Detectors and Instrumentation for Astronomy VI 201

On the presence and functional significance of sympathetic premotor neurons with collateralized spinal axons in the rat

KEY POINTS: Spinally-projecting neurons of the rostral ventrolateral medulla (RVLM) determine sympathetic outflow to different territories of the body. Previous studies suggest the existence of RVLM neurons with distinct functional classes, such as neurons that target sympathetic nerves bound for functionally-similar tissue types (e.g. muscle vasculature). The existence of RVLM neurons with more general actions had not been critically tested. Using viral tracing, we show that a significant minority of RVLM neurons send axon collaterals to disparate spinal segments (T2 and T10 ). Furthermore, optogenetic activation of sympathetic premotor neurons projecting to lumbar spinal segments also produced activation of sympathetic nerves from rostral spinal segments that innervate functionally diverse tissues (heart and forelimb muscle). These findings suggest the existence of individual RVLM neurons for which the axons branch to drive sympathetic preganglionic neurons of more than one functional class and may be able to produce global changes in sympathetic activity. ABSTRACT: We investigate the extent of spinal axon collateralization of rat rostral ventrolateral medulla (RVLM) sympathetic premotor neurons and its functional consequences. In anatomical tracing experiments, two recombinant herpes viral vectors with retrograde tropism and expressing different fluorophores were injected into the intermediolateral column at upper thoracic and lower thoracic levels. Histological analysis revealed that ∼21% of RVLM bulbospinal neurons were retrogradely labelled by both vectors, indicating substantial axonal collateralization to disparate spinal segments. In functional experiments, another virus with retrograde tropism, a canine adenovirus expressing Cre recombinase, was injected into the left intermediolateral horn around the thoracolumbar junction, whereas a Cre-dependent viral vector encoding Channelrhodopsin2 under LoxP control was injected into the ipsilateral RVLM. In subsequent terminal experiments, blue laser light (473 nm × 20 ms pulses at 10 mW) was used to activate RVLM neurons that had been transduced by both vectors. Stimulus-locked activation, at appropriate latencies, was recorded in the following pairs of sympathetic nerves: forelimb and hindlimb muscle sympathetic fibres, as well as cardiac and either hindlimb muscle or lumbar sympathetic nerves. The latter result demonstrates that axon collaterals of lumbar-projecting RVLM neurons project to, and excite, both functionally similar (forelimb and hindlimb muscle) and functionally dissimilar (lumbar and cardiac) preganglionic neurons. Taken together, these findings show that the axons of a significant proportion of RVLM neurons collateralise widely within the spinal cord, and that they may excite preganglionic neurons of more than one functional class

No neurodevelopmental benefit of cerebral oximetry in the first randomised trial (SafeBoosC II) in preterm infants during the first days of life

Aim: Cerebral hypoxia has been associated with neurodevelopmental impairment. We studied whether reducing cerebral hypoxia in extremely preterm infants during the first 72 hours of life affected neurological outcomes at two years of corrected age. Methods: In 2012‐2013, the phase II randomised Safeguarding the Brains of our smallest Children trial compared visible cerebral near‐infrared spectroscopy (NIRS) monitoring in an intervention group and blinded NIRS monitoring in a control group. Cerebral hy oxia was significantly reduced in the intervention group. We followed up 115 survivors from eight European centres at two years of corrected age, by conducting a medical examination and assessing their neurodevelopment with the Bayley Scales of Infant and Toddler Development, Second or Third Edition, and the parental Ages and Stages Questionnaire (ASQ). Results: There were no differences between the intervention (n = 65) and control (n = 50) groups with regard to the mean mental developmental index (89.6 ± 19.5 versus 88.4 ± 14.7, p = 0.77), ASQ score (215 ± 58 versus 213 ± 58, p = 0.88) and the number of children with moderate‐to‐severe neurodevelopmental impairment (10 versus six, p = 0.58). Conclusions: Cerebral NIRS monitoring was not associated with long‐term benefits or harm with regard to neurodevelopmental outcome at two years of corrected age

Extreme weather and climate in Europe

This report describes the current scientific knowledge of extreme weather and climate events in Europe for the following variables: temperature, precipitation, hail, and drought (with the following types of drought: meteorological, hydrological and soil moisture). The content summarises key literature drawn from peer reviewed journals and other sources (business and government reports), and builds upon the synthesised results presented in international assessments such as IPCC reports. It describes the recorded observations and modelled projections for extreme events including definitions, frequency, trends, spatial and temporal distribution. The report also presents an overview of the indices used to characterise extreme events as well as their main uses, before going on to describe the datasets where they are recorded, and provides information on the strengths and weaknesses of the indices and the datasets. Extra consideration is given to indices that are relevant to socio-economic impacts resulting from climate change and relevant statistical techniques for analysing extreme events. Observed changes in global climate and extreme events provide the context to the changes in extreme events observed in Europe, which are described for much of the 20th century. Modelled projections of extreme events are also given, under different emissions scenarios and time horizons, including results from regional models covering the European domain, such as EURO-CORDEX. The report is written for climate scientists, climate researchers and experts who use climate information in a professional role. There are four case studies (Appendix 2) which provide an anatomy of different recent European extreme weather/climate events including meteorological impacts and synoptic context. Observed global temperature trends show the number of warm extremes has increased and number of cool extremes has decreased over the last 100 years, and the length and frequency of summer heat waves has increased during the last century. In Europe these trends are most pronounced in the last 40 years although regional variations exist. For Europe, 2014 was the warmest year on record, although it had fewer hot days than recent years. Under future climate change with continued warming, the number of heat waves is projected to increase, along with their duration and intensity. Under all emissions scenarios, summers like the hot summer experienced in 2003 will become commonplace by the 2040s. The global trend in precipitation is generally for wetter conditions over the 20th century although changes are less temporally and spatially coherent than those observed for temperature. The general trend in precipitation for Europe in the 20th century is of increases over northern Europe and decreases over southern Europe. Extreme precipitation is becoming more intense and more frequent in Europe, especially in central and eastern Europe in winter, often resulting in greater and more frequent flooding. Since 1950 winter wet spells increased in duration in northern Europe and reduced in southern Europe, while summer wet spells became shorter in northern and eastern Europe. An increasing proportion of total rainfall is observed to fall on heavy rainfall days. Extreme precipitation (including short intense convective or longer duration frontal types) demonstrates complex variability and lacks a robust spatial pattern. Climate models project that events currently considered extreme are expected to occur more frequently in the future. For example a 1-in-20 year annual maximum daily precipitation amount is likely to become a 1-in-5 to 1-in-15 year event by the end of the 21st century in many parts of Europe. There are few ground based hail observation networks, so satellite measurements and weather models are used to identify hail forming conditions. In Europe most extreme hail events occur in the summer over Central Europe and the Alps where convective energy is greatest. Intense hail events are linked to increases in convective energy in the atmosphere observed over the last 30 years. Hailstorm projection studies, although limited to France, northern Italy and Germany, show increases in the convective conditions that lead to hail and some areas show a rise in damage days although this is not statistically significant. Recent severe droughts include Italy (1997-2002), the Baltic countries 2005-2009, the European heatwave of summer 2003, and the widespread European drought of 2011. The 1950s were prone to long, intense, Europe-wide meteorological and hydrological droughts. In northern and eastern Europe the highest drought frequency and severity was from the early 1950s to the mid-1970s. Southern and Western Europe (especially the Mediterranean) show the highest drought frequency and severity since 1990. There has been a small but continuous increase of the European areas prone to drought from the 1980s to the early 2010s. Regional climate models project a decrease in summer precipitation until 2100 of 17%. Dry periods are expected to occur 3 times more often at the end of this century and to last longer by 1 to 3 days compared to the period of 1971-2000. There is significant uncertainty associated with future projections of drought, with climate variability being the dominant source of uncertainty in observed and projected soil moisture drough

Clinical use of cerebral oximetry in extremely preterm infants is feasible

Introduction: The research programme Safeguarding the Brains of our smallest Children (SafeBoosC) aims to test the benefits and harms of cerebral near-infrared spectroscopy (NIRS) oximetry in infants born before 28 weeks of gestation. In a phase II trial, infants will be randomised to visible cerebral NIRS oximetry with pre-specified treatment guidelines compared to standard care with blinded NIRS-monitoring. The primary outcome is duration multiplied with the extent outside the normal range of regional tissue oxygen saturation of haemoglobin (rStO2) of 55 to 85% in percentage hours (burden). This study was a pilot of the Visible ­Oximetry Group. Material and methods: This was an observational study including ten infants. Results: The median gestational age was 26 weeks + three days, and the median start-up time was 133 minutes after delivery. The median recording time was 69.7 hours, mean rStO2 was 64.2 ± 4.5%, median burden of hyper- and hy­poxia was 30.3% hours (range 2.8-112.3). Clinical staff responded to an out of range value 29 times – only once to values above 85%. In comparison, there were 83 periods of more than ten minutes with an rStO2 below 55% and four episodes with an rStO2 above 85%. These periods accounted for 72% of the total hypoxia burden. A total of 18 of the 29 interventions were adjustments of FiO2 which in 13 of the 18 times resulted in an out-of-range SpO2. Two infants suffered second-degree burns from the sensor. Five infants died. In all cases, this was unrelated to NIRS monitoring and treatment. Conclusion: The intervention of early cerebral NIRS monitoring proved feasible, but prolonged periods of hypoxia went untreated. Thus, a revision of the treatment guideline and an alarm system is required