Microscale mechanisms of gas exchange in fruit tissue.

* Gas-filled intercellular spaces are considered the predominant pathways for gas transport through bulky plant organs such as fruit. Here, we introduce a methodology that combines a geometrical model of the tissue microstructure with mathematical equations to describe gas exchange mechanisms involved in fruit respiration. * Pear (Pyrus communis) was chosen as a model system. The two-dimensional microstructure of cortex tissue was modelled based on light microscopy images. The transport of O(2) and CO(2) in the intercellular space, cell wall network and cytoplasm was modelled using diffusion laws, irreversible thermodynamics and enzyme kinetics. * In silico analysis showed that O(2) transport mainly occurred through intercellular spaces and less through the intracellular liquid, while CO(2) was transported at equal rates in both phases. Simulations indicated that biological variation of the apparent diffusivity appears to be caused by the random distribution of cells and intercellular spaces in tissue. Temperature does not affect modelled gas exchange properties; it rather acts on the respiration metabolism. * This modelling approach provides, for the first time, detailed information about gas exchange mechanisms at the microscopic scale in bulky plant organs, such as fruit, and can be used to study conditions of anoxia.

A quality improvement project to improve admission temperatures in very low birth weight infants.

OBJECTIVE: To review the results of a quality improvement (QI) project to improve admission temperatures of very low birth weight inborn infants. STUDY DESIGN: The neonatal intensive care unit at Lucile Packard Children's Hospital underwent a QI project to address hypothermic preterm newborns by staff education and implementing processes such as polyethylene wraps and chemical warming mattresses. We performed retrospective chart review of all inborn infants with birth weight <1500 g during the 18 months prior to (n=134) and 15 months after (n=170) the implementation period. Temperatures were compared between periods. Multivariable logistic regression was used to account for potential confounding variables. We compared mortality rates and grade 3 or 4 intraventricular hemorrhage rates between periods. RESULT: The mean temperature rose from 35.4 to 36.2 degrees C (P<0.0001) after the QI project. The improvement was consistent and persisted over a 15-month period. After risk adjustment, the strongest predictor of hypothermia was being born in the period before implementation of the QI project (odds ratio 8.12, 95% confidence interval 4.63, 14.22). Although cesarean delivery was a strong risk factor for hypothermia prior to the project, it was no longer significant after the project. There was no significant difference in death or intraventricular hemorrhage detected between periods. CONCLUSION: There was a significant improvement in admission temperatures after a QI project, which persisted beyond the initial implementation period. Although there was no difference in mortality or intraventricular hemorrhage rates, we did not have sufficient power to detect small differences in these outcomes.