Hemodynamic effects of dobutamine after cardiopulmonary bypass in children

The synthetic inotropic agent, dobutamine, has reportedly increased cardiac output in adults after cardiopulmonary bypass with minimal side effects. Its use in children, after surgical correction of congenital heart disease, was tested by infusing the drug at 1, 4, 7, and 10 micrograms/kg x min in 11 children. While significant increases in cardiac index above control (23, 23, and 16% at 4, 7, and 10 micrograms/kg x min, respectively) were observed, this was achieved at the expense of significant increases in heart rate (15, 24, and 10%). This increase in heart rate (47% in one child) necessitated discontinuing the infusion in 4 subjects. There were also significant increases in systolic and mean blood pressure with no change in stroke volume or peripheral vascular resistance. The authors conclude that in children, dobutamine is an effective inotropic agent acting principally by stimulating beta 1-receptors in the myocardium producing a predominantly chronotropic effect without significant changes in peripheral vascular resistance. Given the intrinsically higher heart rate of children, the levels of tachycardia produced by the drug in some instances reach unacceptable levels and as such, may make dopabutamine unsuitable for use in children after cardiopulmonary bypass.     

Behavioral effects of spinal cord transection in the developing rat

Albino rats, 0, 9, 12, 15, 18, 21 or greater than 90 days of age, were given a mid-thoracic spinal cord transection. Evaluation of responses of the hindlimbs to a variety of behavioral tasks was begun on the day of surgery and at intervals throughout the postoperative survival period (up to 300 days). Two investigators, independently and without knowledge of the animals' ages or survival times, rated the response data. Histological study showed all transections to be complete. Large differences in behavior are observed when animals trasected at the neonatal stage (0-4 days of age) are compared with animals transected at the weanling stage (21-26 days of age)37. Results of the present investigation indicate a critical period near 15 days of age; animals lesioned prior to this age (0, 9, 12 days of age) show response development and recovery similar to the neonatally lesioned animal, whereas those animals lesioned at a later age (18, 21, greater than 90 days of age) show little recovery and are behaviorally similar to the weanling transected animal. In animals lesioned prior to the fifteenth postnatal day, postural responses appear depressed for a brief period but recover rapidly while most responses of animals in the older groups are depressed for longer periods and never attain the degree of recovery characteristic of the neonatally transected animal. Finally, like the neonatally transected animal, rats lesioned on the ninth and twelfth postnatal day develop certain responses at appropriate times relative to normal response development. If, however, these responses are mature and supraspinal control is present at the time of lesioning, they appear to be permanently depressed and fail to recover.     

Continuous epidural analgesia in the obstetric patient: a feasibility study using a mechanical infusion pump

Eleven patients in uncomplicated labour received a continuous infusion of 0-125 or 0-25% bupivacaine solutions into the epidural space, using a simple rotary pump. Maternal and umbilical cord venous plasma bupivacaine levels were measured and were found to be within safe limits for mother and baby. Incidence of complications were noted.     

Towards sustainable mobility behavior: research challenges for location-aware information and communication technology

Private transport accounts for a large amount of total CO₂ emissions, thus significantly contributing to global warming. Tools that actively support people in engaging in a more sustainable life-style without restricting their mobility are urgently needed. How can location-aware information and communication technology (ICT) enable novel interactive and participatory approaches that help people in becoming more sustainable? In this survey paper, we discuss the different aspects of this challenge from a technological and cognitive engineering perspective, based on an overview of the main information processes that may influence mobility behavior. We review the state-of-the-art of research with respect to various ways of influencing mobility behavior (e.g., through providing real-time, user-specific, and location-based feedback) and suggest a corresponding research agenda. We conclude that future research has to focus on reflecting individual goals in providing personal feedback and recommendations that take into account different motivational stages. In addition, a long-term and large-scale empirical evaluation of such tools is necessary.     

Daily impaired detachment and short-term effects of impaired sleep quality on next-day commuting near-accidents – an ambulatory diary study

This study investigated the short-term effects of daily recovery, that is, impaired psychological detachment from work and various actigraphical indicators of sleep quality, on near-accidents when commuting to work the next morning. Furthermore, the mediating effect of actigraphically assessed sleep quality on the relationship between impaired psychological detachment from work and near-accidents when commuting to work was analysed. Fifty-six full-time employees of a Swiss assurance company participated in the one-week study. Multilevel analyses revealed that impaired detachment was highly related to a decrease in sleep duration. Furthermore, impaired daily recovery processes, such as impaired psychological detachment from work and disturbed sleep quality, were related to commuting near-accidents. Impaired sleep quality mediated the effect of impaired psychological detachment from work on these near-accidents. Our results show that occupational safety interventions should address both impaired psychological detachment from work and sleep quality in order to prevent near accidents when commuting to work.

Practitioner Summary: Commuting accidents occur frequently and have detrimental effects on employees, organisations and society. This study shows that daily lack of recovery, that is, impaired psychological detachment and impaired sleep quality, is related to near-accidents when commuting to work the next morning. Primary prevention of commuting accidents should therefore address daily lack of recovery.     

A study of material flow systems (input/output) in high-bay warehouses

A method of planning and designing product sorting systems in warehousing is described. The theoretical background of the analytical models and simulation modelling is given. A calculation of the capacity of elements for joining and dividing for different priorities of material flow is described. New parameters are introduced in the formula for calculating the average number of unit loads in a system for joining, in the direction of the slave flow and for a simple analytical model for joining material flows with two different priorities with an exponential distribution of inter-arrival time. Simulation results are obtained using the GPSS/FON simulation language. Some characteristic results, used in the process of planning and design of two new distribution centres in Belgrade, are shown.     

Asynchronous collision integrators: Explicit treatment of unilateral contact with friction and nodal restraints

This article presents asynchronous collision integrators and a simple asynchronous method treating nodal restraints. Asynchronous discretizations allow individual time step sizes for each spatial region, improving the efficiency of explicit time stepping for finite element meshes with heterogeneous element sizes. The article first introduces asynchronous variational integration being expressed by drift and kick operators. Linear nodal restraint conditions are solved by a simple projection of the forces that is shown to be equivalent to RATTLE. Unilateral contact is solved by an asynchronous variant of decomposition contact response. Therein, velocities are modified avoiding penetrations. Although decomposition contact response is solving a large system of linear equations (being critical for the numerical efficiency of explicit time stepping schemes) and is needing special treatment regarding overconstraint and linear dependency of the contact constraints (for example from double‐sided node‐to‐surface contact or self‐contact), the asynchronous strategy handles these situations efficiently and robust. Only a single constraint involving a very small number of degrees of freedom is considered at once leading to a very efficient solution. The treatment of friction is exemplified for the Coulomb model. Special care needs the contact of nodes that are subject to restraints. Together with the aforementioned projection for restraints, a novel efficient solution scheme can be presented. The collision integrator does not influence the critical time step. Hence, the time step can be chosen independently from the underlying time‐stepping scheme. The time step may be fixed or time‐adaptive. New demands on global collision detection are discussed exemplified by position codes and node‐to‐segment integration. Numerical examples illustrate convergence and efficiency of the new contact algorithm. Copyright © 2013 The Authors. International Journal for Numerical Methods in Engineering published by John Wiley & Sons, Ltd.     

Sparsity-driven reconstruction for FDOT with anatomical priors

In this paper we propose a method based on (2, 1)-mixed-norm penalization for incorporating a structural prior in FDOT image reconstruction. The effect of (2, 1)-mixed-norm penalization is twofold: first, a sparsifying effect which isolates few anatomical regions where the fluorescent probe has accumulated, and second, a regularization effect inside the selected anatomical regions. After formulating the reconstruction in a variational framework, we analyze the resulting optimization problem and derive a practical numerical method tailored to (2, 1)-mixed-norm regularization. The proposed method includes as particular cases other sparsity promoting regularization methods such as l(1)-norm penalization and total variation penalization. Results on synthetic and experimental data are presented.