The effect of breathing hypoxic gas (15% FIO₂) on physiological and behavioral outcomes during simulated driving in healthy subjects

AbstractHypoxia is mainly caused by cardiopulmonary disease or high‐altitude exposure. We used a driving simulator to investigate whether breathing hypoxic gas influences driving behaviors in healthy subjects. Fifty‐two healthy subjects were recruited in this study, approved by the Science and Engineering Ethical Committee. During simulated driving experiments, driving behaviors, breathing frequency, oxygen saturation (SpO2), and heart rate variability (HRV) were analyzed. Each subject had four driving sessions; a 10‐min practice and three 20‐min randomized interventions: normoxic room air (21% FIO2) and medical air (21% FIO2) and hypoxic air (equal to 15% FIO2), analyzed by repeated measures ANOVA. Driving behaviors and HRV frequency domains showed no significant change. Heart rate (HR; p &lt; 0.0001), standard deviation of the RR interval (SDRR; p = 0.03), short‐term HRV (SD1; p &lt; 0.0001), breathing rate (p = 0.01), and SpO2 (p &lt; 0.0001) were all significantly different over the three gas interventions. Pairwise comparisons showed HR increased during hypoxic gas exposure compared to both normoxic interventions, while SDRR, SD1, breathing rate, and SpO2 were lower. Breathing hypoxic gas (15% FiO2, equivalent to 2710 m altitude) may not have a significant impact on driving behavior in healthy subjects. Furthermore, HRV was negatively affected by hypoxic gas exposure while driving suggesting further research to investigate the impact of breathing hypoxic gas on driving performance for patients with autonomic dysfunction.</jats:p

Integration and Autonomy in Organizational Governance: A Comparative Study of Two Government-Owned Railways in Hong Kong

This article identifies the patterns of integration and autonomy in organizational governance in two government-owned railways in Hong Kong in relation to relevant external and internal actors from the government, market and civil society. The Kowloon Canton Railway Corporation, a government department turned into a statutory corporation, and the Mass Transit Railway Corporation Limited, a statutory corporation turned into a listed company, are both profitable enterprises. They have been subjected to similar macro-governance influences (mainly political and policy changes), but their patterns of integration and autonomy with relevant actors in organizational governance are not the same. The historical variations in the integration-autonomy patterns, notably an increased tendency for government intervention, as well as major differences between the two railways in their relationships with market and civil society actors, can often be explained by three interrelated factors, namely, political conditions, community expectations and performance. Copyright Springer Science + Business Media, LLC 2006Integration, Autonomy, Governance, Statutory bodies, Government-owned enterprises, Organizational governance, Public transport, Railways,

Serum markers CASA, CEA, CYFRA 21-1, MSA, NSE, TPA and TPS in lung cancer

Serum CASA, CEA, CYFRA 21-1, NSE, MSA, TPA, and TPS were determined in patients with lung cancer (LC), benign lung disease (BL), and healthy control (HC) donors. Using predefined cutpoints, the cytokeratin-related markers TPA, TPS, and CYFRA showed the highest sensitivity in non-small cell lung cancer (TPA; 69%, TPS 63%, CYFRA 54%), while NSE gave the highest sensitivity in small cell lung cancer (50%), indicating that these markers may be most appropriate in monitoring the course of disease and the patients response to therapy. Receiver-operator analysis was performed to compare assays at the same specificity. At high specificities (295%), CYFRA was significantly better than all assays except CASA in the LC vs. HC and LC vs. non-infectious BL comparisons (

Global Health in Preconception, Pregnancy and Postpartum Alliance: development of an international consumer and community involvement framework.

Background: The goal of the Global Health in Preconception, Pregnancy and Postpartum (HiPPP) Alliance, comprising consumers and leading international multidisciplinary academics and clinicians, is to generate research and translation priorities and build international collaboration around healthy lifestyle and obesity prevention among women across the reproductive years. In doing so, we actively seek to involve consumers in research, implementation and translation initiatives. There are limited frameworks specifically designed to involve women across the key obesity prevention windows before (preconception), during and after pregnancy (postpartum). The aim of this paper is to outline our strategy for the development of the HiPPP Consumer and Community (CCI) Framework, with consumers as central to co-designed, co-implemented and co-disseminated research and translation. Method: The development of the framework involved three phases: In Phase 1, 21 Global HiPPP Alliance members participated in a CCI workshop to propose and discuss values and approaches for framework development; Phase 2 comprised a search of peer-reviewed and grey literature for existing CCI frameworks and resources; and Phase 3 entailed collaboration with consumers (i.e., members of the public with lived experience of weight/lifestyle issues in preconception, pregnancy and postpartum) and international CCI experts to workshop and refine the HiPPP CCI Framework (guided by Phases 1 and 2). Results: The HiPPP CCI Framework's values and approaches identified in Phases 1-2 and further refined in Phase 3 were summarized under the following five key principles: 1. Inclusive, 2. Flexible, 3. Transparent, 4. Equitable, and 5. Adaptable. The HiPPP Framework describes values and approaches for involving consumers in research initiatives from design to translation that focus on improving healthy lifestyles and preventing obesity specifically before, during and after pregnancy; importantly it takes into consideration common barriers to partnering in obesity research during perinatal life stages, such as limited availability associated with family caregiving responsibilities. Conclusion: The HiPPP CCI Framework aims to describe approaches for implementing meaningful CCI initiatives with women in preconception, pregnancy and postpartum periods. Evaluation of the framework is now needed to understand how effective it is in facilitating meaningful involvement for consumers, researchers and clinicians, and its impact on research to improve healthy lifestyle outcomes