Response: A Study of the Genesis, Nature, and Meaning of the Aural Imagery in Henry Vaughan\u27s Silex Scintillans

The traditional symbols of the Christian life of prayer are readily discoverable in Silex Scintillans, the poetic record of one man\u27s quest for God; they both constitute its deepest meaning and establish its proper context. It is, however, clear that the poet, Henry Vaughan, has embodied these universal symbols in patterns of his own arrangement. In this arrangement, the poetic imagery, which forms the patterns by which the symbolism is understood, is of exceptional importance to his poems in its inspiration, structure, effect, and meaning. The poet’s individual vision, communicated by his imagery, encompasses a world of marked Christian contrasts: the wonder of daybreak is contrasted with the mystery of night; the “quick” world with its affirmation of revival and resurrection is contrasted the world of sleep and death. And the world of his native Breconshire landscape is contrasted with reminiscences of the Scriptural Garden of Eden. The poetic images of these contrasts combine to communicate in a unique ·way the symbolism of the poet is spiritual experience although in recent years several important studies have dealt with Vaughen’s imagery, the authors have concentrated on his visual and have practically ignored the aural imagery. It will appear that this aural imagery is focal to a full understanding of Vaughan\u27s religious verse in that it adds meaning which is not conveyed by the visual image alone. It is my purpose, therefore, to examine Vaughan\u27s use of aural imagery in Silex Scintillans, the volume of religious poetry recognized as his most notable achievement, and thus to point the way to an appreciation of the part that aural imagery played in his poetic technique. Incidentally, by this means, we may· come to appreciate one of the ways in which Vaughan is different from other poets of his time

Computer simulation allows goal-oriented mechanical ventilation in acute respiratory distress syndrome

Introduction To prevent further lung damage in patients with acute respiratory distress syndrome ( ARDS), it is important to avoid overdistension and cyclic opening and closing of atelectatic alveoli. Previous studies have demonstrated protective effects of using low tidal volume ( VT), moderate positive end-expiratory pressure and low airway pressure. Aspiration of dead space ( ASPIDS) allows a reduction in VT by eliminating dead space in the tracheal tube and tubing. We hypothesized that, by applying goal-orientated ventilation based on iterative computer simulation, VT can be reduced at high respiratory rate and much further reduced during ASPIDS without compromising gas exchange or causing high airway pressure. Methods ARDS was induced in eight pigs by surfactant perturbation and ventilator-induced lung injury. Ventilator resetting guided by computer simulation was then performed, aiming at minimal VT, plateau pressure 30 cmH(2)O and isocapnia, first by only increasing respiratory rate and then by using ASPIDS as well. Results VT decreased from 7.2 +/- 0.5 ml/kg to 6.6 +/- 0.5 ml/kg as respiratory rate increased from 40 to 64 +/- 6 breaths/min, and to 4.0 +/- 0.4 ml/kg when ASPIDS was used at 80 +/- 6 breaths/min. Measured values of arterial carbon dioxide tension were close to predicted values. Without ASPIDS, total positive end-expiratory pressure and plateau pressure were slightly higher than predicted, and with ASPIDS they were lower than predicted. Conclusion In principle, computer simulation may be used in goal-oriented ventilation in ARDS. Further studies are needed to investigate potential benefits and limitations over extended study periods

Physiologic compliance in engineered small-diameter arterial constructs based on an elastomeric substrate.

Compliance mismatch is a significant challenge to long-term patency in small-diameter bypass grafts because it causes intimal hyperplasia and ultimately graft occlusion. Current engineered grafts are typically stiff with high burst pressure but low compliance and low elastin expression. We postulated that engineering small arteries on elastomeric scaffolds under dynamic mechanical stimulation would result in strong and compliant arterial constructs. This study compares properties of engineered arterial constructs based on biodegradable polyester scaffolds composed of either rigid poly(lactide-co-glycolide) (PLGA) or elastomeric poly(glycerol sebacate) (PGS). Adult baboon arterial smooth muscle cells (SMCs) were cultured in vitro for 10 days in tubular, porous scaffolds. Scaffolds were significantly stronger after culture regardless of material, but the elastic modulus of PLGA constructs was an order of magnitude greater than that of porcine carotid arteries and PGS constructs. Deformation was elastic in PGS constructs and carotid arteries but plastic in PLGA constructs. Compliance of arteries and PGS constructs were equivalent at pressures tested. Altering scaffold material from PLGA to PGS significantly decreased collagen content and significantly increased insoluble elastin content in constructs without affecting soluble elastin concentration in the culture medium. PLGA constructs contained no appreciable insoluble elastin. This research demonstrates that: (1) substrate stiffness directly affects in vitro tissue development and mechanical properties; (2) rigid materials likely inhibit elastin incorporation into the extracellular matrix of engineered arterial tissues; and (3) grafts with physiologic compliance and significant elastin content can be engineered in vitro after only days of cell culture

Dead space and CO2 elimination related to pattern of inspiratory gas delivery in ARDS patients

Introduction: The inspiratory flow pattern influences CO2 elimination by affecting the time the tidal volume remains resident in alveoli. This time is expressed in terms of mean distribution time (MDT), which is the time available for distribution and diffusion of inspired tidal gas within resident alveolar gas. In healthy and sick pigs, abrupt cessation of inspiratory flow (that is, high end-inspiratory flow (EIF)), enhances CO2 elimination. The objective was to test the hypothesis that effects of inspiratory gas delivery pattern on CO2 exchange can be comprehensively described from the effects of MDT and EIF in patients with acute respiratory distress syndrome (ARDS). Methods: In a medical intensive care unit of a university hospital, ARDS patients were studied during sequences of breaths with varying inspiratory flow patterns. Patients were ventilated with a computer-controlled ventilator allowing single breaths to be modified with respect to durations of inspiratory flow and postinspiratory pause (T-P), as well as the shape of the inspiratory flow wave. From the single-breath test for CO2, the volume of CO2 eliminated by each tidal breath was derived. Results: A long MDT, caused primarily by a long TP, led to importantly enhanced CO2 elimination. So did a high EIF. Effects of MDT and EIF were comprehensively described with a simple equation. Typically, an efficient and a less-efficient pattern of inspiration could result in +/- 10% variation of CO2 elimination, and in individuals, up to 35%. Conclusions: In ARDS, CO2 elimination is importantly enhanced by an inspiratory flow pattern with long MDT and high EIF. An optimal inspiratory pattern allows a reduction of tidal volume and may be part of lung-protective ventilation

Carbon dioxide rebreathing with the anaesthetic conserving device, AnaConDa

The anaesthetic conserving device (ACD) AnaConDa was developed to allow the reduced use of inhaled agents by conserving exhaled agent and allowing rebreathing. Elevated has been observed in patients when using this ACD, despite tidal volume compensation for the larger apparatus dead space. The aim of the present study was to determine whether CO2, like inhaled anaesthetics, adsorbs to the ACD during expiration and returns to a test lung during the following inspiration. The ACD was attached to an experimental test lung. Apparent dead space by the single-breath test for CO2 and the amount of CO2 adsorbed to the carbon filter of the ACD was measured with infrared spectrometry. Apparent dead space was 230 ml larger using the ACD compared with a conventional heat and moisture exchanger (internal volumes 100 and 50 ml, respectively). Varying CO2 flux to the test lung (85375 ml min(1)) did not change the measured dead space nor did varying respiratory rate (1224 bpm). The ACD contained 3.3 times more CO2 than the predicted amount present in its internal volume of 100 ml. Our measurements show a CO2 reservoir effect of 180 ml in excess of the ACD internal volume. This is due to adsorption of CO2 in the ACD during expiration and return of CO2 during the following inspiration

Sterilization of lung matrices by supercritical carbon dioxide

Lung engineering is a potential alternative to transplantation for patients with end-stage pulmonary failure. Two challenges critical to the successful development of an engineered lung developed from a decellularized scaffold include (i) the suppression of resident infectious bioburden in the lung matrix, and (ii) the ability to sterilize decellularized tissues while preserving the essential biological and mechanical features intact. To date, the majority of lungs are sterilized using high concentrations of peracetic acid (PAA) resulting in extracellular matrix (ECM) depletion. These mechanically altered tissues have little to no storage potential. In this study, we report a sterilizing technique using supercritical carbon dioxide (ScCO(2)) that can achieve a sterility assurance level 10(−6) in decellularized lung matrix. The effects of ScCO(2) treatment on the histological, mechanical, and biochemical properties of the sterile decellularized lung were evaluated and compared with those of freshly decellularized lung matrix and with PAA-treated acellular lung. Exposure of the decellularized tissue to ScCO(2) did not significantly alter tissue architecture, ECM content or organization (glycosaminoglycans, elastin, collagen, and laminin), observations of cell engraftment, or mechanical integrity of the tissue. Furthermore, these attributes of lung matrix did not change after 6 months in sterile buffer following sterilization with ScCO(2), indicating that ScCO(2) produces a matrix that is stable during storage. The current study's results indicate that ScCO(2) can be used to sterilize acellular lung tissue while simultaneously preserving key biological components required for the function of the scaffold for regenerative medicine purposes

Enhanced imaging of microcalcifications in digital breast tomosynthesis through improved image-reconstruction algorithms

PURPOSE: We develop a practical, iterative algorithm for image-reconstruction in under-sampled tomographic systems, such as digital breast tomosynthesis (DBT). METHOD: The algorithm controls image regularity by minimizing the image total $p$-variation (TpV), a function that reduces to the total variation when $p=1.0$ or the image roughness when $p=2.0$. Constraints on the image, such as image positivity and estimated projection-data tolerance, are enforced by projection onto convex sets (POCS). The fact that the tomographic system is under-sampled translates to the mathematical property that many widely varied resultant volumes may correspond to a given data tolerance. Thus the application of image regularity serves two purposes: (1) reduction of the number of resultant volumes out of those allowed by fixing the data tolerance, finding the minimum image TpV for fixed data tolerance, and (2) traditional regularization, sacrificing data fidelity for higher image regularity. The present algorithm allows for this dual role of image regularity in under-sampled tomography. RESULTS: The proposed image-reconstruction algorithm is applied to three clinical DBT data sets. The DBT cases include one with microcalcifications and two with masses. CONCLUSION: Results indicate that there may be a substantial advantage in using the present image-reconstruction algorithm for microcalcification imaging.Comment: Submitted to Medical Physic

Method and system for aligning fibers during electrospinning

A method and system are provided for aligning fibers in an electrospinning process. A jet of a fiberizable material is directed towards an uncharged collector from a dispensing location that is spaced apart from the collector. While the fiberizable material is directed towards the collector, an elliptical electric field is generated via the electrically charged dispenser and an oppositely-charged control location. The field spans between the dispensing location and the control location that is within line-of-sight of the dispensing location, and impinges upon at least a portion of the collector. Various combinations of numbers and geometries of dispensers, collectors, and electrodes can be used

The effects of stereo shift angle, geometric magnification and display zoom on depth measurements in digital stereomammography

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134800/1/mp7615.pd

Joint Registration and Limited-Angle Reconstruction of Digital Breast Tomosynthesis

Digital breast tomosynthesis (DBT), an emerging imaging modality, provides a pseudo-3D image of the breast. Algorithms to aid the human observer process these large datasets involve two key tasks: reconstruction and registration. Previous studies separated these steps, solving each task independently. This can be effective if reconstructing using a complete set of data, e.g., in cone beam CT, assuming that only simple deformations exist. However, for ill-posed limited-angle problems such as DBT, estimating the deformation is complicated by the significant artefacts associated with DBT reconstructions, leading to severe inaccuracies in the registration. In this paper, we present an innovative algorithm, which combines reconstruction of a pair of temporal DBT acquisitions with their simultaneous registration. Using various computational phantoms and in vivo DBT simulations, we show that, compared to the conventional sequential method, jointly estimating image intensities and transformation parameters gives superior results with respect to reconstruction fidelity and registration accuracy