Induction of oscillatory ventilation pattern using dynamic modulation of heart rate through a pacemaker

For disease states characterized by oscillatory ventilation, an ideal dynamic therapy would apply a counteracting oscillation in ventilation. Modulating respiratory gas transport through the circulation might allow this. We explore the ability of repetitive alternations in heart rate, using a cardiac pacemaker, to elicit oscillations in respiratory variables and discuss the potential for therapeutic exploitation. By incorporating acute cardiac output manipulations into an integrated mathematical model, we observed that a rise in cardiac output should yield a gradual rise in end-tidal CO2 and, subsequently, ventilation. An alternating pattern of cardiac output might, therefore, create oscillations in CO2 and ventilation. We studied the effect of repeated alternations in heart rate of 30 beats/min with periodicity of 60 s, on cardiac output, respiratory gases, and ventilation in 22 subjects with implanted cardiac pacemakers and stable breathing patterns. End-tidal CO2 and ventilation developed consistent oscillations with a period of 60 s during the heart rate alternations, with mean peak-to-trough relative excursions of 8.4 +/- 5.0% (P < 0.0001) and 24.4 +/- 18.8% (P < 0.0001), respectively. Furthermore, we verified the mathematical prediction that the amplitude of these oscillations would depend on those in cardiac output (r = 0.59, P = 0.001). Repetitive alternations in heart rate can elicit reproducible oscillations in end-tidal CO2 and ventilation. The size of this effect depends on the magnitude of the cardiac output response. Harnessed and timed appropriately, this cardiorespiratory mechanism might be exploited to create an active dynamic responsive pacing algorithm to counteract spontaneous respiratory oscillations, such as those causing apneic breathing disorders.     

A fortuitous syncope. The pitfalls of integrated bipolar defibrillator leads

Myopotential oversensing in implantable defibrillators causing inhibition of pacing and inappropriate therapies is well described. Current literature is dominated by reports of diaphragmatic muscle as the source of such far-field oversensing. Those reporting pectoral muscle sources were invariably due to unipolar sensing circuits, incorrect DF-1 connections or inappropriate programming. We report an interesting case of pectoral muscle myopotential oversensing causing inhibition of bradycardia pacing leading to presyncope and syncope.     

Biobanking of Fresh-Frozen Human Adenocarcinomatous and Normal Colon Tissues: Which Parameters Influence RNA Quality?

Medical research projects become increasingly dependent on biobanked tissue of high quality because the reliability of gene expression is affected by the quality of extracted RNA. Hence, the present study aimed to determine if clinical, surgical, histological, and molecular parameters influence RNA quality of normal and tumoral frozen colonic tissues. RNA Quality Index (RQI) was evaluated on 241 adenocarcinomas and 115 matched normal frozen colon tissues collected between October 2006 and December 2012. RQI results were compared to patients’ age and sex, tumor site, kind of surgery, anastomosis failure, adenocarcinoma type and grade, tumor cell percentage, necrosis extent, HIF-1α and cleaved caspase-3 immunohistochemistry, and BRAF, KRAS and microsatellites status. The RQI was significantly higher in colon cancer tissue than in matched normal tissue. RQI from left-sided colonic cancers was significantly higher than RQI from right-sided cancers. The RNA quality was not affected by ischemia and storage duration. According to histological control, 7.9% of the samples were unsatisfactory because of inadequate sampling. Biobanked tumoral tissues with RQI ≥5 had lower malignant cells to stromal cells ratio than samples with RQI <5 (p <0.05). Cellularity, necrosis extent and mucinous component did not influence RQI results. Cleaved caspase-3 and HIF-1α immunolabelling were not correlated to RQI. BRAF, KRAS and microsatellites molecular status did not influence RNA quality. Multivariate analysis revealed that the tumor location, the surgical approach (laparoscopy versus open colectomy) and the occurrence of anastomotic leakage were the only parameters influencing significantly RQI results of tumor samples. We failed to identify parameter influencing RQI of normal colon samples. These data suggest that RNA quality of colonic adenocarcinoma biospecimens is determined by clinical and surgical parameters. More attention should be paid during the biobanking procedure of right-sided colon cancer or laparoscopic colectomy specimen. Histological quality control remains essential to control sampling accuracy.     

Biochar amendment to soils with contrasting organic matter level: effects on N mineralization and biological soil properties

Four biochar types, produced by slow pyrolysis of poultry litter (PL) and pine chips (P) at 400 or 500 °C, were added to two adjacent soils with contrasting soil organic matter (SOM) content (8.9 vs. 16.1 g C kg^?1). The N mineralization rate was determined during 14‐week incubations and assessments were made of the microbial biomass C, dehydrogenase activity, and the microbial community structure (PLFA‐extraction). The addition of PL biochars increased the net N mineralization (i.e., compared to the control treatment) in both soils, while for treatments with P biochars net N immobilization was observed in both soils. Increasing the pyrolysis temperature of both feedstock types led to a decrease in net N mineralization. The ratio of Bacterial to Fungal PLFA biomarkers also increased with addition of biochars, and particularly in the case of the 500 °C biochars. Next to feedstock type and pyrolysis temperature, SOM content clearly affected the assessed soil biological parameters, viz. net N mineralization or immobilization, MBC and dehydrogenase activity were all greater in the H soil. This might be explained by an increased chance of physical contact between the microbial community activated by SOM mineralization upon incubation and discrete biochar particles. However, when considering the H soil's double C and N content, these responses were disproportionally small, which may be partly due to the L soil's, somewhat more labile SOM. Nonetheless, increasing SOM content and microbial biomass and activity generally appears to result in greater mineralization of biochar. Additionally, higher N mineralization after PL addition to the H soil with lower pH than the L soil can be due to the liming effect of the PL biochars.     

Fouling in reverse osmosis (RO) membrane in water recovery from secondary effluent: a review

Reverse osmosis (RO) is the most preferable process for water recovery from secondary effluent (SE) because of its higher rejection of impurities with lower associated cost and higher quality of product. Fouling still is a major challenge during the water recovery due to higher contaminant loadings in SE and high rejection capability of this membrane. The presence of suspended solids, colloidal and organic matters, and high level of biological activities in SE further elevate fouling potentiality. This review was performed to identify major foulants causing hindrance in sustainable application of reverse osmosis and to present available pre-treatment options for these foulants. There are four fouling types present in RO namely; bio-fouling, inorganic/scaling, organic, and particulate fouling. Among them; bio-fouling is less understood but dominant since the pre-treatment options are not well developed. Other fouling mechanisms have been overcome by well developed pre-treatments. The major foulants for RO are dissolved and macromolecular organic substances, sparingly soluble inorganic compounds, colloidal and suspended particles, and micro-organisms. Some of these potential fouling water quality parameters (PFWQPs) are interrelated with each others such as electrical conductivity is a surrogate measure of total dissolved solids with established stable relationship. Most of these PFWQPs such as total suspended solids, turbidity, chemical oxygen demand can be removed by conventional pre-treatment; some such as colloidal particles and micro-organisms by modern options and even others such as endocrine disrupting compounds, pharmaceutical and personal care products are still challenging for current pre-treatments. These foulants need to be identified properly to integrate appropriate pre-treatments for minimizing fouling potentiality to increase water recovery at minimal costs.