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Plant secondary metabolites in Tetrapleuratetraptera fruit meal (TTFM) could be exploited as natural safe feed additives alternative to non- nutritive chemical and antibiotics to enhance rumen fermentation and feed utilization efficiency with negative oxidative stress. The study investigated the responses of West African Dwarf (WAD) rams to the diets containing varying levels of supplemental Tetrapleura tetraptera fruit meal on the oxidative status and thermo-physiological parameters. Thirty five (35) WAD rams with an average live weight of 13.20±0.2 kg were used in a completely randomized design for 140 days. Five concentrate diets containing varying levels (0, 0.5, 1.0, 1.5 and 2.0 %) of TTFM were formulated while Panicum maximum was fed as a basal diet. The rectal temperature, pulse rate and respiratory rate were measured at two week intervals while blood was collected through jugular veins at the onset and at the end of feeding trial to determine oxidative status parameters in terms of superoxide dismutase (SOD), glutathione peroxidase, thiobarbituric acid reactive substance (TBARS).Data collected were subjected to one way Analysis of Variance (ANOVA). No significant difference observed (p>0.05) in the rectal temperature while the pulse rate and breathing rate increased significantly (p

Competitive indoor climbing has increased in popularity at the youth, collegiate, and Olympic levels. A critical aspect for improving performance is characterizing the physiologic response to different climbing strategies (e.g., work/rest patterns, pacing) and techniques (e.g., body position and movement) relative to location on climbing wall with spatially varying characteristics (e.g., wall inclinations, position of foot/hand holds). However, this response is not well understood due to the limited capabilities of climbing-specific measurement and assessment tools. In this study, we developed a novel method to examine time-resolved sensor-based measurements of multiple personal biometrics at different microlocations (finely spaced positions; MLs) along a climbing route. For the ML-specific biometric system (MLBS), we integrated continuous data from wearable biometric sensors and smartphone-based video during climbing, with a customized visualization and analysis system to determine three physiologic parameters (heart rate, breathing rate, ventilation rate) and one body movement parameter (hip acceleration), which are automatically time-matched to the corresponding video frame to determine ML-specific biometrics. Key features include: (1) biometric sensors that are seamlessly embedded in the fabric of an athletic compression shirt, and do not interfere with climbing performance, (2) climbing video, and (3) an interactive graphical user interface to rapidly visualize and analyze the time-matched biometrics and climbing video, determine timing sequence between the biometrics at key events, and calculate summary statistics. To demonstrate the capabilities of MLBS, we examined the relationship between changes in ML-specific climbing characteristics and changes in the physiologic parameters. Our study demonstrates the ability of MLBS to determine multiple time-resolved biometrics at different MLs, in support of developing and assessing different climbing strategies and training methods to help improve performance.

Study objectives: Unobtrusive monitoring of sleep and sleep disorders in children presents challenges. We investigated the possibility of using Ultra-Wide band (UWB) radar to measure sleep in children. Methods: Thirty-two children scheduled to undergo a clinical polysomnography participated; their ages ranged from 2 months to 14 years. During the polysomnography, the children's body movements and breathing rate were measured by an UWB-radar. A total of 38 features were calculated from the motion signals and breathing rate obtained from the raw radar signals. Adaptive boosting was used as machine learning classifier to estimate sleep stages, with polysomnography as gold standard method for comparison. Results: Data of all participants combined, this study achieved a Cohen's Kappa coefficient of 0.67 and an overall accuracy of 89.8% for wake and sleep classification, a Kappa of 0.47 and an accuracy of 72.9% for wake, rapid-eye-movement (REM) sleep, and non-REM sleep classification, and a Kappa of 0.43 and an accuracy of 58.0% for wake, REM sleep, light sleep and deep sleep classification. Conclusion: Although the current performance is not sufficient for clinical use yet, UWB radar is a promising method for non-contact sleep analysis in children.

Waterless transportation for live grouper is a novel mode of transport that not only saves money, but also lowers wastewater pollution. Technical obstacles remain, however, in achieving intelligent monitoring and a greater survival rate. During live grouper waterless transportation, the stress response is a key indicator that affects the survival life-span of the grouper. Studies based on breathing rate analysis have demonstrated that among many stress response parameters, breathing rate is the most direct parameter to reflect the intensity. Conventional measurement methods, which set up sensors on the gills of groupers, interfere with the normal breathing of living aquatic products and are complex in system design. We designed a new breathing monitoring system based on a completely non-destructive approach. The system allows the real-time monitoring of living aquatic products’ breathing rate by simply placing the millimeter wave radar on the inner wall of the incubator and facing the gills. The system we developed can detect more parameters in the future, and can replace the existing system to simplify the study of stress responses.

This work proposes a computational algorithm which extracts the frequency, timings and signal segments corresponding to respiratory phases, through buccal and nasal acoustic signal processing. The proposal offers a computational solution for medical applications which require on-site or remote patient monitoring and evaluation of pulmonary pathologies, such as coronavirus disease 19 (COVID-19). The state of the art presents a few respiratory evaluation proposals through buccal and nasal acoustic signals. Most proposals focus on respiratory signals acquired by a medical professional, using stethoscopes and electrodes located on the thorax. In this case the signal acquisition process is carried out through the use of a low cost and easy to use mask, which is equipped with strategically positioned and connected electret microphones, to maximize the proposed algorithm’s performance. The algorithm employs signal processing techniques such as signal envelope detection, decimation, fast Fourier transform (FFT) and detection of peaks and time intervals via estimation of local maxima and minima in a signal’s envelope. For the validation process a database of 32 signals of different respiratory modes and frequencies was used. Results show a maximum average error of 2.23% for breathing rate, 2.81% for expiration time and 3.47% for inspiration time.

Objectives. Inspiratory, hemodynamic and metabolic changes occur in laparoscopic surgery depending on pneumoperitoneum and patient position. This study aims to evaluate the effects of intra-abdominal pressure increase based on CO2 pneumoperitoneum in laparoscopic operations on hemodynamic parameters and respiratory dynamics and satisfaction of surgeon and operative view.Materials and Methods. A total of 116 consecutive, prospective, ASA class I–III cases aged 18–70 years undergoing laparoscopic cholecystectomy were enrolled in this study. Data of 104 patients were analysed. Patients were divided into two groups as the group Low Pressure (n=53) and the group Standard Pressure (>13 mmHg) (Group SP) (n=51). In this study administration of general anesthesia used total intravenous anaesthesia in both groups. All groups had standard and TOF monitorization applied. The anaesthesia methods used in both groups were recorded. Before, during and after peritoneal insufflation, the peroperative ventilation parameters and hemodynamic parameters were recorded. The adequacy of pneumoperitoneum, gastric and the operative view were evaluated by the operating surgeon and recorded.Results. The peripheral oxygen saturation showed no significant difference between the low and standard pressure pneumoperitoneum in view of tidal volume, respiratory rate, end tidal CO2, mean and peak inspiratory pressure, and minute ventilation values. In terms of hemodynamics, when values just after intubation and before extubation were compared, it was observed that in the LP group systolic, diastolic and mean blood pressure values were higher. In terms of heart rate, no significant difference was observed in determined periods between groups. There was no significant difference between the groups in terms of surgical satisfaction and vision.Conclusion. Low pressure pneumoperitoneum provides effective respiratory mechanics and stable hemodynamics for laparoscopic cholecystectomy. It also provides the surgeon with sufficient space for hand manipulations. Anaesthetic method, TIVA and neuromuscular blockage provided good surgery vision with low pressure pneumoperitoneum.

In species that are subject to brood parasitism, individuals often vary in their responses to parasitic eggs, with some rejecting the eggs while others do not. While some factors, such as host age (breeding experience), the degree of egg matching and the level of perceived risk of brood parasitism have been shown to influence host decisions, much of the variation remains unexplained. The host personality hypothesis suggests that personality traits of the host influence its response to parasitic eggs, but few studies have tested this. We investigated the relationship between two personality traits (exploration and neophobia) and a physiological trait (breathing rate) of the host, and egg-rejection behaviour in a population of Daurian redstarts Phoenicurus auroreus in northeast China. We first show that exploratory behaviour and the response to a novel object are repeatable for individual females and strongly covary, indicating distinct personality types. We then show that fast-exploring and less neophobic hosts were more likely to reject parasitic eggs than slow-exploring and more neophobic hosts. Variation in breathing rate—a measure of the stress-response—did not affect rejection behaviour. Our results demonstrate that host personality, along the bold-shy continuum, predicts the responses to parasitic eggs in Daurian redstarts, with bold hosts being more likely to reject parasitic eggs.

Long-term sedentary behavior severely increases the risk of developing diseases and syndromes. Cardiovascular and skeletal muscle issues, higher blood pressure and cholesterol levels are among this long list of consequences. Although a great effort was devoted to fight sedentary behaviors by means of public health strategies and the employment of wearable devices, an effective and flexible technology enabling reliable worker monitoring still does not exist. This contribution is aimed to provide an advanced solution based on microwave radars for monitoring the sitting time and recognizing a worker's proper physical activities. The adoption of the radar technology is required to provide the unobtrusive wellness sensing while enabling advanced activity and vital signs monitoring. The proposed radar sensor is able to monitor the worker's breathing activity during his worktime and track his position by preserving the individual privacy in a safe and cost-effective way. Moreover, by exploiting the human micro-Doppler signature, it recognizes different activities such as standing up, sitting down and physical exercise. The basic principles of the radar sensing and processing in health care are illustrated whereas the detection of different activities is experimentally demonstrated, highlighting the potential and the advanced features of the proposed solution.

The present paper proposes the design of a sleep monitoring platform. It consists of an entire sleep monitoring system based on a smart glove sensor called UpNEA worn during the night for signals acquisition, a mobile application, and a remote server called AeneA for cloud computing. UpNEA acquires a 3-axis accelerometer signal, a photoplethysmography (PPG), and a peripheral oxygen saturation (SpO2) signal from the index finger. Overnight recordings are sent from the hardware to a mobile application and then transferred to AeneA. After cloud computing, the results are shown in a web application, accessible for the user and the clinician. The AeneA sleep monitoring activity performs different tasks: sleep stages classification and oxygen desaturation assessment; heart rate and respiration rate estimation; tachycardia, bradycardia, atrial fibrillation, and premature ventricular contraction detection; and apnea and hypopnea identification and classification. The PPG breathing rate estimation algorithm showed an absolute median error of 0.5 breaths per minute for the 32 s window and 0.2 for the 64 s window. The apnea and hypopnea detection algorithm showed an accuracy (Acc) of 75.1%, by windowing the PPG in one-minute segments. The classification task revealed 92.6% Acc in separating central from obstructive apnea, 83.7% in separating central apnea from central hypopnea and 82.7% in separating obstructive apnea from obstructive hypopnea. The novelty of the integrated algorithms and the top-notch cloud computing products deployed, encourage the production of the proposed solution for home sleep monitoring.

Impedance pneumography (ImP) is widely used for respiratory rate (RR) monitoring. However, ImP-derived RRs can be imprecise. The aim of this study was to develop a signal quality index (SQI) for the ImP signal, and couple it with a RR algorithm, to improve RR monitoring. An SQI was designed which identifies candidate breaths and assesses signal quality using: the variation in detected breath durations, how well peaks and troughs are defined, and the similarity of breath morphologies. The SQI categorises 32 s signal segments as either high or low quality. Its performance was evaluated using two critical care datasets. RRs were estimated from high-quality segments using a RR algorithm, and compared with reference RRs derived from manual annotations. The SQI had a sensitivity of 77.7 %, and specificity of 82.3 %. RRs estimated from segments classified as high quality were accurate and precise, with mean absolute errors of 0.21 and 0.40 breaths per minute (bpm) on the two datasets. Clinical monitor RRs were significantly less precise. The SQI classified 34.9 % of real-world data as high quality. In conclusion, the proposed SQI accurately identifies high-quality segments, and RRs estimated from those segments are precise enough for clinical decision making. This SQI may improve RR monitoring in critical care. Further work should assess it with wearable sensor data.

This work explores the use of a commodity ultra-wideband (UWB) radar based device to detect breathing rate for health monitoring applications. Health monitoring devices observe physiological signals to detect medical conditions. We focus on capturing the small mechanical movements caused by breathing. This is traditionally done via a strain gauge worn around the chest or stomach, but these systems limit user movement. Contactless systems provide a unique design that allows free user movement by eliminating all direct contact with the user. Additionally, these systems have the potential to support full health monitoring in a Smart Built Environment (SBE). In this work, a comparative evaluation is performed on a commodity UWB radar based device, the Walabot, to determine the accuracy and possible health monitoring applications. Based on results from a systematic review, six research challenges were identified: (1) high cost, functional limitations based on the user's (2) location, (3) orientation, and (4) movement, (5) dependency on system hardware placement, and (6) vulnerabilities in signal processing methods. A comparative evaluation was designed to test the Walabot against a medical grade wearable system in the context of these research challenges. The data was processed using two breathing rate derivation techniques: Fast Fourier Transformation (FFT) and Peak Detection. Results suggest great potential for the Walabot coupled with the FFT technique. However, the system requires further testing to address all of the research challenges. Overall, this work provides important steps toward using the Walabot in health monitoring applications. Master of Science The goal of research in the field of health monitoring is to gather medical information about a user by constantly collecting physiological signals emitted by their body. Four physiological signals are deemed the "vital signs" because they provide information about the overall health of the patient. These vital signs are heart rate, breathing rate, temperature and blood pressure. Breathing rate is an important vital sign that, when monitored closely, can indicate the oncoming of dangerous health conditions and events. The act of breathing causes the chest to expand and contract. This movement can be captured by placing a strain gauge around a user's chest and analyzing fluctuation in strain readings. However, this is not practical for health monitoring applications because this system is uncomfortable to wear and the accuracy of the system is heavily dependent on the user's ability to wear the chest band constantly and correctly. Capturing this signal without any direct user contact would eliminate the user's discomfort and provide better reliability. This can be done by several methods, but the focus of this work is on systems that capture chest movements using ultra-wideband (UWB) radar. In this work, a specific UWB radar based device, called the Walabot, is tested against a standard strain gauge system to determine if it has health monitoring applications. Other radar based devices that aim to detect breathing rate are limited by their high cost and inaccuracies in signal processing techniques. The functionality of the devices are also dependent on the user's location and body orientation relative to the system, any user movement and the placement of the system itself. The study in this work was designed to determine the Walabot accuracy when the data is processed by two common breathing rate derivation methods. Results showed that the Walabot is cost effective and flexible in terms of user location and system placement. Overall, this work demonstrates the potential of the Walabot as a breathing rate monitor.

BACKGROUND: Our aim in this study was to compare the blood gas changes, the malondialdehyde (MDA) and endogenous antiox-idant glutathione (GSH) levels in blood and lung tissues after ischemia/reperfusion, the histopathological damage in lung tissue in rats provided respiratory support with mechanical ventilation after translaryngeal intubation and tracheostomy. METHODS: Group 1 rats were provided mechanical ventilator support after translaryngeal intubation, Group 2 mechanical ventilator support after tracheostomy, and Group 3 was the control group where rats were only anesthetized. Three groups were compared for blood gas changes, MDA, GSH, and histopathological changes. RESULTS: Blood gas evaluation showed a more marked increase in pO2 values and decline in pCO2 values in Group 2 than Group 1 (p0.05). In terms of histopathological scoring, the damage score in Group 1 was higher than in Group 2 (p

Objective: The simple observation of breathing rate (BR) remains the first and often the most sensitive marker of acute respiratory dysfunction. In fact, there are evidences that drastic changes in BR are a predictive indicator of adverse events (i.e. cardiac arrest). The aim of this study is to develop a camera-based technology that may provide near-continuously estimation of BR considering the effect of respiration on videoPPG (vPPG). Approach: The technology has been tested in two different experimental settings, including controlled BR and more challenging scenarios with spontaneous breathing pattern. Video data were processed offline to derive the vPPG signal. The method derives respiration from beat-to-beat PPG rate and morphology changes in amplitude and width driven by the physiological relationships between vPPG and respiration. Moreover, respiratory-induced head movements were used as additional source of information for the vPPG system. A combination of these methods has been exploited to estimate the respiratory rate every 10 second. Main Results: According to the results, respiratory frequencies in the central range (0.2-0.4 Hz) may be estimated using vPPG system with low relative error, eR < 2 % and interquartile range of order IQR < 5 %. However, the vPPG system showed a drop in performance at respiratory range boundaries, around 0.1 Hz and 0.5 Hz. Significance: This camera-based technology can be used as ubiquitous BR monitoring system. However, vPPG-based systems should consider the effect of the BR in the estimation, mainly in applications where respiratory rate is out of the range 0.2-0.4 Hz.

Road accidents and victims provoked by drowsiness are a worldwide relevant social and economic problem. In EU, 25% of road accidents are related with fatigue. The relation between drowsiness and accidents is supported by scientific evidences that relate microsleep and other fatigue episodes with the loss of control of the vehicle. Nowadays there exist different technological approaches for drowsiness mitigating while driving, which try to reduce these accidents by detecting driver's physical condition and acting on the driver response. The techniques for mitigating accidents are based on algorithms of detection of physiological parameters that ensure drivers confidence and an appropriate use of the technology. The most frequently used non-invasive system are the cameras, which have been explored and used, mainly detecting eye movement and eyelid closure (PERCLOS). These systems have limitations due to artifacts and noise related to environmental and emotional conditions, which might lead to false positives. With the purpose of solving these shortcomings, the goal of the research is to develop a system capable of detecting the level of drowsiness based on the involuntary movements of the driver provoked by the respiration captured by means of cameras. In the current research, robustness in front of different types of users and circumstances has been explored. A system of reduced size automotive cameras of high dynamics is proposed to be used as breathing rate sensor. Images captured by these sensors will be processed to obtain the driver's chest/abdomen movement. These data will be analyzed in real time by a validated algorithm that interprets the movement and obtains the level of fatigue and drowsiness of the driver. A twofold "gold standard" is used to compare the robustness of the developed system. An experimental design has been developed in order to take into consideration different anthropometric characteristics, clothing types, user and vehicle movement and light conditions. The result will provide the boundary conditions of any system based on on-board cameras. These data will be used for building the algorithms to detect and interpret breathing patterns. The results show the capabilities of this approach and also permit to define the needs and requirements of the resulting technological developments. Language: en

Made available in DSpace on 2018-11-26T16:17:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-12-01 Natural Sciences and Engineering Research Council of Canada Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Fundação para o Desenvolvimento da UNESP (FUNDUNESP) The present study determined whether EEG and/or EMG recordings could be used to reliably define activity states in the Brazilian black and white tegu lizard (Tupinambis merianae) and then examined the interactive effects of temperature and activity states on strategies for matching O-2 supply and demand. In a first series of experiments, the rate of oxygen consumption (), breathing frequency (f (R)), heart rate (f (H)), and EEG and EMG (neck muscle) activity were measured in different sleep/wake states (sleeping, awake but quiet, alert, or moving). In general, metabolic and cardio-respiratory changes were better indictors of the transition from sleep to wake than were changes in the EEG and EMG. In a second series of experiments, the interactive effects of temperature (17, 27 and 37 A degrees C) and activity states on f (R), tidal volume (V (T)), the fraction of oxygen extracted from the lung per breath (FIO2-FEO2), f (H), and the cardiac O-2 pulse were quantified to determine the relative roles of each of these variables in accommodating changes in . The increases in oxygen supply to meet temperature- and activity-induced increases in oxygen demand were produced almost exclusively by increases in f (H) and f (R). Regression analysis showed that the effects of temperature and activity state on the relationships between f (H), f (R) and was to extend a common relationship along a single curve, rather than separate relationships for each metabolic state. For these lizards, the predictive powers of f (R) and f (H) were maximized when the effects of changes in temperature, digestive state and activity were pooled. However, the best r (2) values obtained were 0.63 and 0.74 using f (R) and f (H) as predictors of met abolic rate, respectively. Univ British Columbia, Dept Zool, Vancouver, BC V6T 1Z4, Canada Univ Estadual Paulista Rio Claro, Inst Nacl Ciencia & Tecnol Fisiol, Dept Zool, Rio Claro, SP, Brazil Brock Univ, Dept Biol Sci, St Catharines, ON L2S 3A1, Canada Univ Estadual Paulista Rio Claro, Inst Nacl Ciencia & Tecnol Fisiol, Dept Zool, Rio Claro, SP, Brazil

BACKGROUND: The purpose of this study is to detect the mortality predictive power of new Glasgow coma scale, age, and arterial pressure (GAP) scoring system in major trauma patients admitted to the emergency department (ED). METHODS: A total of 100 major trauma patients admitted to Uludag University Faculty of Medicine ED who were 18 years of age or more were included in the study. In this prospective study, revised trauma score (RTS), injury severity score (ISS), trauma-related ISS (TRISS), Mechanism, GAP (MGAP) and GAP scores of the patients were calculated. RESULTS: A significant positive correlation was established between ISS, TRISS, MGAP, and GAP in predicting in-hospital mortality (p

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:30:32Z No. of bitstreams: 0 Made available in DSpace on 2014-05-27T11:30:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-09-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) This study examined the distribution and orientation of gill O2 chemoreceptors in Oreochromis niloticus and their role in cardiorespiratory responses to graded hypoxia. Intact fish, and a group with the first gill arch excised (operated), were submitted to graded hypoxia and their cardiorespiratory responses (oxygen uptake - V̇O2, breathing frequency - fR, ventilatory stroke volume - VT, gill ventilation - V̇G, O2 extraction from the ventilatory current - EO2, and heart rate - fH) were compared. Their responses to bolus injections of NaCN into the bloodstream (internal) or ventilatory water stream (external) were also determined. The V̇O2 of operated fish was significantly lower at the deepest levels of hypoxia. Neither reflex bradycardia nor ventilatory responses were completely abolished by bilateral excision of the first gill arch. EO2 of the operated group was consistently lower than the intact group. The responses to internal and external NaCN included transient decreases in fH and increases in fR and Vamp (ventilation amplitude). These cardiorespiratory responses were attenuated but not abolished in the operated group, indicating that chemoreceptors are not restricted to the first gill arch, and are sensitive to oxygen levels in both blood and water. © 2013 Elsevier Inc. Department of Physiological Sciences Laboratory of Zoophysiology and Comparative Biochemistry Federal University of São Carlos (UFSCar), P.O. Box 676, Via Washington Luis, km 235, 13565-905 São Carlos, SP Department of Zoology and Botany São Paulo State University - UNESP/IBILCE, Rua Cristóvão Colombo, 2265, 15054-000 - São José do Rio Preto, SP National Institute of Science and Technology - Comparative Physiology (FAPESP/CNPq) Department of Zoology and Botany São Paulo State University - UNESP/IBILCE, Rua Cristóvão Colombo, 2265, 15054-000 - São José do Rio Preto, SP FAPESP: 10/03599-2

Although there is growing evidence that breathing is modulated by various motor and cognitive activities, the nature of breathing in musical performance has been little explored. The present study examined the temporal breath pattern in piano performance, aiming to elucidate how breath timing is related to musical organization/events and performance. In the experiments, the respiration of 15 professional and amateur pianists, playing 10 music excerpts in total (from four-octave C major scale, Hanon's exercise, J. S. Bach's Invention, Mozart's Sonatas, and Debussy's Clair de lune), was monitored by capnography. The relationship between breathing and musical characteristics was analyzed. Five major results were obtained. (1) Mean breath interval was shortened for excerpts in faster tempi. (2) Fluctuation of breath intervals was reduced for the pieces for finger exercise and those in faster tempi. Pianists showing large within-trial fluctuation also exhibited large inter-excerpt difference. (3) Inter-trial consistency of the breath patterns depended on the excerpts. Consistency was generally reduced for the excerpts that could be performed mechanically (i.e., pieces for finger exercise), but interestingly, one third of the participant showed consistent patterns for the simple scale, correlated with the ascending/descending sequences. (4) Pianists tended to exhale just after the music onsets, inhale at the rests, and inhibit inhale during the slur parts. There was correlation between breathing pattern and two-voice polyphonic structure for several participants. (5) Respiratory patterns were notably different among the pianists. Every pianist showed his or her own characteristic features commonly for various musical works. These findings suggest that breathing in piano performance depends not only on musical parameters and organization written in the score but also some pianist-dependent factors which might be ingrained to individual pianists.

Contains fulltext : 171220.pdf (Publisher’s version ) (Closed access) PURPOSE: To improve the outcome of the acute respiratory distress syndrome (ARDS), one needs to identify potentially modifiable factors associated with mortality. METHODS: The large observational study to understand the global impact of severe acute respiratory failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across five continents. A pre-specified secondary aim was to examine the factors associated with outcome. Analyses were restricted to patients (93.1 %) fulfilling ARDS criteria on day 1-2 who received invasive mechanical ventilation. RESULTS: 2377 patients were included in the analysis. Potentially modifiable factors associated with increased hospital mortality in multivariable analyses include lower PEEP, higher peak inspiratory, plateau, and driving pressures, and increased respiratory rate. The impact of tidal volume on outcome was unclear. Having fewer ICU beds was also associated with higher hospital mortality. Non-modifiable factors associated with worsened outcome from ARDS included older age, active neoplasm, hematologic neoplasm, and chronic liver failure. Severity of illness indices including lower pH, lower PaO2/FiO2 ratio, and higher non-pulmonary SOFA score were associated with poorer outcome. Of the 578 (24.3 %) patients with a limitation of life-sustaining therapies or measures decision, 498 (86.0 %) died in hospital. Factors associated with increased likelihood of limitation of life-sustaining therapies or measures decision included older age, immunosuppression, neoplasia, lower pH and increased non-pulmonary SOFA scores. CONCLUSIONS: Higher PEEP, lower peak, plateau, and driving pressures, and lower respiratory rate are associated with improved survival from ARDS. TRIAL REGISTRATION: ClinicalTrials.gov NCT02010073.

Arachidonic acid (AA) is a polyunsaturated fatty acid that is present in the phospholipids of the cell membranes of the body and is abundant in the brain. Exogenously administered AA has been shown to affect brain metabolism and to exhibit cardiovascular and neuroendocrine actions. However, little is known regarding its respiratory actions and/or central mechanism of its respiratory effects. Therefore, the present study was designed to investigate the possible effects of centrally injected AA on respiratory system and the mediation of the central cyclooxygenase (COX) to thromboxane A2 (TXA2) signaling pathway on AA-induced respiratory effects in anaesthetized rats. Intracerebroventricular (i.c.v.) administration of AA induced dose- and time-dependent increase in tidal volume, respiratory rates and respiratory minute ventilation and also caused an increase in partial oxygen pressure (pO2) and decrease in partial carbon dioxide pressure (pCO2) in male anaesthetized Sprague Dawley rats. I.c.v. pretreatment with ibuprofen, a non-selective COX inhibitor, completely blocked the hyperventilation and blood gases changes induced by AA. In addition, central pretreatment with different doses of furegrelate, a TXA2 synthesis inhibitor, also partially prevented AA-evoked hyperventilation and blood gases effects. These data explicitly show that centrally administered AA induces hyperventilation with increasing pO2 and decreasing pCO2 levels which are mediated by the activation of central COX to TXA(2) signaling pathway. (C) 2016 Elsevier B.V. All rights reserved.

Our goal is to develop countermeasures for pulmonary injury following unpredictable events such as radiological terrorism or nuclear accidents. We have previously demonstrated that captopril, an angiotensin converting enzyme (ACE) inhibitor, is more effective than losartan, an angiotensin type-1 receptor blocker, in mitigating radiation-pneumopathy in a relevant rodent model. In the current study we determined the dose modifying factors (DMFs) of captopril for mitigation of parameters of radiation pneumonitis. We used a whole animal model, irradiating 9-10-week-old female rats derived from a Wistar strain (WAG/RijCmcr) with a single dose of irradiation to the thorax of 11, 12, 13, 14 or 15 Gy. Our study develops methodology to measure DMFs for morbidity (survival) as well as physiological endpoints such as lung function, taking into account attrition due to lethal radiation-induced pneumonitis. Captopril delivered in drinking water (140-180 mg/m(2)/day, comparable with that given clinically) and started one week after irradiation has a DMF of 1.07-1.17 for morbidity up to 80 days (survival) and 1.21-1.35 for tachypnea at 42 days (at the peak of pneumonitis) after a single dose of ionizing radiation (X-rays). These encouraging results advance our goals, since DMF measurements are essential for drug labeling and comparison with other mitigators.

This study is to investigate the effects of slow breathing on heart rate variability (HRV) and arterial baroreflex sensitivity in essential hypertension. We studied 60 patients with essential hypertension and 60 healthy controls. All subjects underwent controlled breathing at 8 and 16 breaths per minute. Electrocardiogram, respiratory, and blood pressure signals were recorded simultaneously. We studied effects of slow breathing on heart rate, blood pressure and respiratory peak, high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio of HRV with traditional and corrected spectral analysis. Besides, we tested whether slow breathing was capable of modifying baroreflex sensitivity in hypertensive subjects. Slow breathing, compared with 16 breaths per minute, decreased the heart rate and blood pressure (all P

The aim of this study was to compare the effects of 3 different sedative-analgesic regimens in patients with intracranial mass lesions undergoing stereotactic brain biopsy. A 135 outpatients with American Society of Anesthesiologists I to II were divided into 3 groups: group A (n = 45) received a loading dose of IV alfentanil 7.5 microg/kg followed by infusion rate of 0.25 microg/kg/min; group F (n = 45) received a bolus dose of 1 microg/kg IV fentanyl and repeated as needed; and group R (n = 45) received infusion of 0.05 microg/kg/min remifentanil. Target level of sedation was 3 to 4 of the Ramsay Sedation Scale. Systolic and diastolic blood pressure, heart rate, respiratory rate, peripheric oxygen saturation (SpO2), and end-tidal carbon dioxide were recorded at different stages of the procedures. The patients in group F had significantly lower mean heart rate than those in groups A and R, but this was not in the limits of the bradycardia. The patients in group A had significantly lower mean SpO2 than those in the other groups, but mean SpO2 values did not drop below 94%. There were no significant differences in end-tidal carbon dioxide and respiratory rate values among the groups. Our results suggest that all 3 regimens have relatively similar hemodynamic and respiratory responses. The use of bolus fentanyl technique caused less hemodynamic stability. The continuous infusion technique of remifentanil or alfentanil provided better control on hemodynamic parameters.

The aim of the present study is to evaluate the analgesic activity, patient satisfaction, and side effect profile of different concentrations of levobupivacaine plus fentanyl administered through thoracic epidural patient-controlled analgesia in patients undergoing thoracotomy. The study included 60 patients who were randomly divided into three groups. At the end of the surgery, group I (n = 20) received 0.125% levobupivacaine plus 3 mg fentanyl, group II received 0.1% levobupivacaine plus 3 mg fentanyl, and group III received 0.05% levobupivacaine plus 3 mg fentanyl via an epidural catheter placed at the level of T10-11 or T11-12. For all groups, the patient-controlled analgesia device was programmed to deliver a loading dose of 14 μl at an infusion rate of 4 μl/h, and a bolus dose of 2 μl/h, with a locked out interval of 15 minutes and 60 μl of a 4-hour limit. The following parameters were evaluated at 5, 10, 15, 20, 30, and 40 minutes and at 1, 2, 4, 8, 16, and 24 hours after admission to the intensive care unit, at which nausea and vomiting scales, Visual Analog Scale I-II, Ramsay sedation scale, Bromage scale, pupil diameter, arterial blood pressure, heart rate, respiratory rate, and SpO2 were measured and recorded. Any side effect was also documented. As the result of the evaluation, visual Analog Scale I-II scores, patient satisfaction scores, mean arterial blood pressure, and heart rate significantly differed in group I as compared with groups II and III. No side effects were encountered except mild nausea, which was seen in group III and did not require treatment. Motor blockage, pupil size, respiratory rate, and SpO2 were not monitored in any of the patients in all groups. In conclusion, our study suggested that the use of 0.125% levobupivacaine, together with 3 mg/mL fentanyl, constitutes a good combination, and can be used safely without causing hemodynamic change and motor block. Copyright © 2012, Taiwan Society of Anesthesiologists.

The aim of the present study was to confirm whether feeding influences the resting breathing rate and to observe possible alterations in blood gas and pH levels produced by feeding in unanesthetized sloths (Bradypus variegatus). Five adult male sloths (4.1 +/- 0.6 kg) were placed daily in an experimental chair for a period of at least 4 h for sitting adaptation. Five measurements were made for each sloth. However, the sloths one, two and five were studied once and the sloths three and four were studied twice. Breathing rate was determined with an impedance meter and the output signal was digitized. Arterial blood samples were collected for blood gas analysis with a BGE electrolytes analyzer and adjusted for the animal's body temperature and hemoglobin content. The data are reported as mean +/- SD and were collected during the resting period (8:00-10:00 h) and during the feeding period (16:00-18:00 h). The mean breathing rate increased during mastication of ymbahuba leaves (rest: 5.0 +/- 1, feeding: 10 +/- 1 bpm). No significant alterations were observed in arterial pH (rest: 7.42 +/- 0.05, feeding: 7.45 +/- 0.03), PCO2 (rest: 35.2 +/- 5.3, feeding: 33.3 +/- 4.4 mmHg) or PO2 (rest: 77.5 +/- 8.2, feeding: 78.4 +/- 5.2 mmHg) levels. These results indicate that in unanesthetized sloths 1) feeding evokes an increase in breathing rate without a significant change in arterial pH, PCO2 or PO2 levels, and 2) the increase in breathing rate produced by feeding probably is due to the act of mastication.

The study focuses on psychological and physical effects of stress while performing community garden activities of various intensity levels. The aim of this study was to determine the psychological and physical effects in adults with (case group) and without (control group) mental disabilities. Salivary α-amylase (sAA) levels and the stress response scale (SRS-18) were used for the psychological analysis (n = 42). For physical assessment (n = 13), electrocardiogram (ECG), surface electromyogram (sEMG), and respiration rate were continuously measured while performing the activities using a multichannel telemetry system. The results showed that following the activities, the case group exhibited decreasing sAA levels while control group exhibited increasing sAA levels. However, both groups exhibited lower SRS-18 results following the activities. Compared with the control group, the case group had a significantly lower increase in the ratio of the heart rate (IRHR) (5.5%) during low-intensity work (filling pots with soil), but a significantly higher IRHR (16.7%) during high-intensity work (turning over soil). The case group experienced significantly higher levels of fatigue during high-intensity work (digging) than during the rest condition. These findings indicate that appropriate workload allocation, according to health, is necessary in the community garden setting because reducing the intensity of work assignments for people with mental disabilities will reduce their physical stress.

BMC medical informatics and decision making 14, 37 (2014). doi:10.1186/1472-6947-14-37, Published by BioMed Central, London

Oral anticoagulant therapy effectively prevents thromboem-bolism and its major complication is hemorrhage. Themajority of life-threatening hemorrhagic events associatedwith warfarin use consists of intracranial, intraabdominal andmost frequently, gastrointestinal bleeding (1,2). Hemorrhagiccomplications have been identified in soft tissue (includingwounds, 21%), gastrointestinal tract (15%), urinary tract(15%), nose and pharynx (35%), intracranial (4%), thorax(3%), joints (0.5%), intraocular (2%), and retroperitoneum(1%) (1).We describe a patient with wa rfarin toxicity suffering fromhypovolemic shock due to a large hematoma in his back.Although there are a large number of patients withhematomae in soft tissues, the specific location of the presentcase resulting in shock is unique and worth reporting.

This paper presents the preliminary results of our work in detecting respiration using Doppler Radar in the 2.7 GHz operating band. We demonstrate the capability of Doppler Radar in capturing breathing patterns under various breathing forms such as normal breathing, fast breathing, as well as different rate of inhale and exhale. From the captured signals, respiration rate was obtained using Fast Fourier Transform and validated. The proposed approach could potentially be used in number of applications involving breathing rate and breathing pattern analysis via non-contact methods. Refereed/Peer-reviewed

IMPORTANCE: Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination.OBJECTIVE: To evaluate and, as needed, update definitions for sepsis and septic shock.PROCESS: A task force (n = 19) with expertise in sepsis pathobiology, clinical trials, and epidemiology was convened by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. Definitions and clinical criteria were generated through meetings, Delphi processes, analysis of electronic health record databases, and voting, followed by circulation to international professional societies, requesting peer review and endorsement (by 31 societies listed in the Acknowledgment).KEY FINDINGS FROM EVIDENCE SYNTHESIS: Limitations of previous definitions included an excessive focus on inflammation, the misleading model that sepsis follows a continuum through severe sepsis to shock, and inadequate specificity and sensitivity of the systemic inflammatory response syndrome (SIRS) criteria. Multiple definitions and terminologies are currently in use for sepsis, septic shock, and organ dysfunction, leading to discrepancies in reported incidence and observed mortality. The task force concluded the term severe sepsis was redundant.RECOMMENDATIONS: Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. For clinical operationalization, organ dysfunction can be represented by an increase in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score of 2 points or more, which is associated with an in-hospital mortality greater than 10%. Septic shock should be defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. Patients with septic shock can be clinically identified by a vasopressor requirement to maintain a mean arterial pressure of 65 mm Hg or greater and serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%. In out-of-hospital, emergency department, or general hospital ward settings, adult patients with suspected infection can be rapidly identified as being more likely to have poor outcomes typical of sepsis if they have at least 2 of the following clinical criteria that together constitute a new bedside clinical score termed quickSOFA (qSOFA): respiratory rate of 22/min or greater, altered mentation, or systolic blood pressure of 100 mm Hg or less.CONCLUSIONS AND RELEVANCE: These updated definitions and clinical criteria should replace previous definitions, offer greater consistency for epidemiologic studies and clinical trials, and facilitate earlier recognition and more timely management of patients with sepsis or at risk of developing sepsis.

This article investigates the possibility of extracting gastric motility (GM) information from finger photoplethysmographic (PPG) signals non-invasively. Now-a-days measuring GM is a challenging task because of invasive and complicated clinical procedures involved. It is well-known that the PPG signal acquired from finger consists of information related to heart rate and respiratory rate. This thread is taken further and effort has been put here to find whether it is possible to extract GM information from finger PPG in an easier way and without discomfort to the patients. Finger PPG and GM (measured using Electrogastrogram, EGG) signals were acquired simultaneously at the rate of 100 Hz from eight healthy subjects for 30 min duration in fasting and postprandial states. In this study, we process the finger PPG signal and extract a slow wave that is analogous to actual EGG signal. To this end, we chose two advanced signal processing approaches: first, we perform discrete wavelet transform (DWT) to separate the different components, since PPG and EGG signals are non-stationary in nature. Second, in the frequency domain, we perform cross-spectral and coherence analysis using autoregressive (AR) spectral estimation method in order to compare the spectral details of recorded PPG and EGG signals. In DWT, a lower frequency oscillation (?0.05 Hz) called slow wave was extracted from PPG signal which looks similar to the slow wave of GM in both shape and frequency in the range (0-0.1953) Hz. Comparison of these two slow wave signals was done by normalized cross-correlation technique. Cross-correlation values are found to be high (range 0.68-0.82, SD 0.12, R = 1.0 indicates exact agreement, p

Midazolam has only sedative properties. However, dexmedetomidine has both analgesic and sedative properties that may prolong the duration of sensory and motor block obtained with spinal anesthesia. This study was designed to compare intravenous dexmedetomidine with midazolam and placebo on spinal block duration, analgesia, and sedation in patients undergoing transurethral resection of the prostate. In this double-blind randomized placebo-controlled trial, 75 American Society of Anesthesiologists' I and II patients received dexmedetomidine 0.5 mu g center dot A kg(-1), midazolam 0.05 mg center dot A kg(-1), or saline intravenously before spinal anesthesia with bupivacaine 0.5% 15 mg (n = 25 per group). The maximum upper level of sensory block and sensory and motor regression times were recorded. Postoperative analgesic requirements and sedation were also recorded. Sensory block was higher with dexmedetomidine (T 4.6 +/- A 0.6) than with midazolam (T 6.4 +/- A 0.9; P < 0.001) or saline (T 6.4 +/- A 0.8; P < 0.001). Time for sensory regression of two dermatomes was 145 +/- A 26 min in the dexmedetomidine group, longer (P < 0.001) than in the midazolam (106 +/- A 39 min) or the saline (97 +/- A 27 min) groups. Duration of motor block was similar in all groups. Dexmedetomidine also increased the time to first request for postoperative analgesia (P < 0.01 compared with midazolam and saline) and decreased analgesic requirements (P < 0.05). The maximum Ramsay sedation score was greater in the dexmedetomidine and midazolam groups than in the saline group (P < 0.001). Intravenous dexmedetomidine, but not midazolam, prolonged spinal bupivacaine sensory blockade. It also provided sedation and additional analgesia.

Objective: Almost half of the patients with septic shock develop acute lung injury (ALI). The understanding why some patients do and others do not develop ALI is limited. The objective of this study was to test the hypothesis that delayed treatment of septic shock is associated with the development of ALI. Design: Observational cohort study. Setting. Medical intensive care unit in a tertiary medical center. Patients: Prospectively identified patients with septic shock who did not have ALI at the outset, excluding those who denied research authorization. Measurements and Main Results. High frequency cardio-respiratory monitoring, arterial gas analysis, and portable chest radiographs were reviewed to identify the timing of ALI development. Risk factors present before ALI development were identified by review of electronic medical records and analyzed in univariate and multivariate analyses. Seventy-one of 160 patients (44%) developed ALI at a median of 5 (range 2-94) hours after the onset of septic shock. Multivariate logistic regression analysis identified the following predictors of ALI development: delayed goal-directed resuscitation (odds ratio [OR] 3.55, 95% confidence interval [CI] 1.52-8.63, p =.004), delayed antibiotics (OR 2.39, 95% Cl 1.06 -5.59, p =.039), transfusion (OR 2.75, 95% CI 1.22-6.37, p =.016), alcohol abuse (OR 2.09, 95% Cl.88-5.10, p = 0.098), recent chemotherapy (OR 6.47, 95% Cl 1.99-24.9, p = 0.003), diabetes mellitus (OR.44, 95% CI.17-1.07, p =.076), and baseline respiratory rate (OR 2.03 per SO, 95% CI 1.38-3.08, P

Erythropoietin (EPO) is a hematopoietic factor, which is produced primarily by the adult kidney in response to tissue hypoxia. There is strong evidence that EPO may also be synthesized in the brain and act as a neuroprotector or neuromodulator in the central nervous system. The present study investigated the effect of centrally administered EPO on cardiovascular and respiratory parameters in anaesthetized rats. The animals were anaesthetized with ketamine (70 mg/kg) and xylazine (10 mg/kg) mixture. EPO at doses of 0.06, 0.12, 0.25 and 0.50 IU/5 μl or 0.9% saline as a control were injected intracerebroventricularly and blood pressure, heart rate, respiratory rate, tidal volume and minute ventilation were recorded. Following the administration of EPO, there was a significant increase in blood pressure, heart and respiratory rates, tidal volume and minute ventilation which were time and dose dependant. In order to investigate whether these effects of centrally injected EPO was caused by the diffusion of the drug to the periphery, the highest dose EPO (0.5 IU) in the present study, was injected intravenously but intravenously injected EPO showed no significant effect in these parameters. In conclusion, our findings showed that centrally injected erythropoietin caused pressor and tachycardic response, an increase in respiratory frequency and volume in anaesthetized rats. Moreover intravenous injection of the highest dose of EPO used in the study caused no effect suggesting a central mechanism of action for the agent. Hence, one can hypothesize that erythropoietin may play a role in the central regulation of cardiovascular and respiratory system as a neuromodulator or neuromediator.

Aim: To analyze the correlation of the Poincaré plot descriptors of RR intervals with standard measures of heart rate variability (HRV) and spontaneous baroreflex sensitivity (BRS). A physiological model of changing respiratory rates from 6 to 15 breaths/min provided a wide range of RR intervals for analysis. Material and methods: Beat-to-beat finger blood pressure, ECG, and respiratory curves were recorded noninvasively in 15 young healthy volunteers (19-25 years old; 7 females) breathing for 5 min at 4 different respiratory rates of 6, 9, 12, and 15 breaths/ min. Four descriptors of the Poincaré plot (SD1, SD2, S, and SD2/SD1), time and frequency domain HRV, and spontaneous BRS (cross-correlation method) were calculated for each 5-min recording. Results: The values of SD1 characterizing short-term HRV, SD2 describing long-term HRV, and S measuring total HRV were significantly correlated with BRS and time and frequency domain measures of short, long, and total HRV. The LF/ HF significantly correlated with SD2 and SD2/SD1 representing the balance between long- and short-term HRV. None of the Poincaré plot descriptors was correlated with the mean RR interval. The increased respiratory rate caused a significant reduction of BRS, measures of total and long-term HRV, and an increase of HF that peaked at 12 breaths/min. Conclusions: The descriptors of the Poincaré plot of RR intervals are significantly correlated with measures of BRS and time and frequency domain HRV, but not with heart rate. A faster respiratory rate reduces long-term HRV measures and temporarily increases HF.

A physiologically based pharmacokinetic (PB/PK) model has been developed in advanced computer simulation language (ACSL) to describe blood and tissue concentration-time profiles of the C(±)P(-) stereoisomers of soman after inhalation, subcutaneous and intravenous exposures at low (0.8-1.0 × LD50), medium (2-3 × LD50) and high (6 × LD50) levels of soman challenge in three species (rat, guinea pig, marmoset). Allometric formulae were used to compute the compartment volumes, blood flow rates, tidal volume and respiratory rate based upon total animal weight. Blood/tissue partition coefficients for soman, initial carboxylesterase and acetylcholinesterase levels and the rate constants for interactions between soman and these enzymes were species-dependent and were obtained from in vitro measurements reported in the literature. The model incorporated arterial and venous blood, lung, kidney, liver, richly perfused, poorly perfused and fat tissue compartments as well as subcutaneous and nasal exposure site compartments. First-order absorption from linearly filled soman deposits into metabolizing exposure site compartments was employed to model subcutaneous and inhalation exposures. The model was validated by comparing the predicted and observed values for C(±)P(-)-soman in arterial blood at various times following exposure and by regression analysis. Sensitivity analysis was used to determine the effects of perturbations in the model parameters on the time-course of arterial C(-)P(-)-soman concentrations for different exposure routes. In our evaluation of 28 datasets, predicted values were generally within 95% confidence limits of the observed values, and regression coefficients comparing predicted and observed data were greater than 0.85 for 95% of the intravenous and subcutaneous datasets and 25% of the inhalation datasets. We conclude that the model predicts the soman toxicokinetics for doses ≥1 × LD50 for intravenous and subcutaneous exposures and inhalation exposures of 8 min or less sufficiently well to allow its use in the modeling of bioscavenger protection. © 2006 Springer-Verlag.

A physiologically based pharmacokinetic (PB/PK) model has been developed in advanced computer simulation language (ACSL) to describe blood and tissue concentration-time profiles of the C(±)P(-) stereoisomers of soman after inhalation, subcutaneous and intravenous exposures at low (0.8-1.0 × LD50), medium (2-3 × LD50) and high (6 × LD50) levels of soman challenge in three species (rat, guinea pig, marmoset). Allometric formulae were used to compute the compartment volumes, blood flow rates, tidal volume and respiratory rate based upon total animal weight. Blood/tissue partition coefficients for soman, initial carboxylesterase and acetylcholinesterase levels and the rate constants for interactions between soman and these enzymes were species-dependent and were obtained from in vitro measurements reported in the literature. The model incorporated arterial and venous blood, lung, kidney, liver, richly perfused, poorly perfused and fat tissue compartments as well as subcutaneous and nasal exposure site compartments. First-order absorption from linearly filled soman deposits into metabolizing exposure site compartments was employed to model subcutaneous and inhalation exposures. The model was validated by comparing the predicted and observed values for C(±)P(-)-soman in arterial blood at various times following exposure and by regression analysis. Sensitivity analysis was used to determine the effects of perturbations in the model parameters on the time-course of arterial C(-)P(-)-soman concentrations for different exposure routes. In our evaluation of 28 datasets, predicted values were generally within 95% confidence limits of the observed values, and regression coefficients comparing predicted and observed data were greater than 0.85 for 95% of the intravenous and subcutaneous datasets and 25% of the inhalation datasets. We conclude that the model predicts the soman toxicokinetics for doses ≥1 × LD50 for intravenous and subcutaneous exposures and inhalation exposures of 8 min or less sufficiently well to allow its use in the modeling of bioscavenger protection. © 2006 Springer-Verlag.

OBJETIVO: o objetivo deste estudo foi determinar o efeito do posicionamento em prono na estabilidade cardiorrespiratória de prematuros, durante o desmame da ventilação mecânica e na evolução do desmame ventilatório. MÉTODO: de janeiro a dezembro de 1999, uma amostra de 42 prematuros, com peso de nascimento menor que 2.000 g, em ventilação mecânica na primeira semana de vida, foram, no início do desmame, randomizados em dois grupos: supino (n = 21), e prono (n = 21). A freqüência cardíaca, freqüência respiratória, saturação de oxigênio e parâmetros ventilatórios foram avaliados a cada hora. A duração e as complicações do desmame também foram avaliadas. RESULTADOS: em ambos os grupos, a média da idade gestacional foi de 29 semanas, a maioria dos pacientes foi de muito baixo peso ao nascimento, com síndrome do desconforto respiratório, e a mediana da duração do desmame foi de 2 dias. Não houve diferença entre os grupos na freqüência respiratória, na freqüência cardíaca e na saturação de oxigênio; entretanto, episódios de dessaturação foram mais freqüentes em supino (p = 0,009). No grupo prono, os parâmetros ventilatórios foram diminuídos mais rapidamente, e a necessidade de reintubação foi menos freqüente (4% x 33%). Não houve efeitos adversos da posição prona. CONCLUSÃO: aesses resultados sugerem que a posição prona é segura e benéfica durante o desmame da ventilação mecânica, e pode contribuir para o sucesso do desmame em prematuros. OBJECTIVE: the purpose of this study was to determine the effects of prone positioning on cardiorespiratory stability and weaning outcome of preterm infants during weaning from mechanical ventilation. METHOD: from January to December 1999, a sample of 42 preterm infants, with birthweight < 2,000 g, mechanically ventilated in the first week of life, were randomly divided, in the beginning of the weaning process, in two groups according to the position: supine position (n = 21) or prone position (n = 21). Heart rate, respiratory rate, transcutaneous oxygen saturation and ventilatory parameters were recorded every one hour. Length of the weaning process and complications were also assessed. RESULTS: in both groups the mean gestational age was 29 weeks, most of the patients presented very low birthweight and respiratory distress syndrome. The mean length of the weaning process was 2 days. There were no differences between the groups regarding respiratory rate, heart rate and transcutaneous oxygen saturation, however, oxygen desaturation episodes were more frequent in supine position (p = 0.009). Ventilatory parameters decreased faster and reintubation was less frequent in the prone group (4% versus 33%). No adverse effects of prone positioning were observed. CONCLUSION: these results suggest that prone position is a safe and beneficial procedure during the weaning from mechanical ventilation and may contribute to weaning success in preterm infants.

Objective: Spa therapy is commonly used in the treatment of daily chronic diseases practice, but its benefits are still the subjects of discussion. This study investigates possible effects of a combined spa and physical therapy program on pain and hemodynamic responses in various chronic diseases. Methods: The pain intensity and hemodynamic responses of 472 patients involved in a spa and physical therapy program were studied retrospectively. Assessment criteria were pain [Visual Analog Scale (VAS)] and hemodynamic responses (heart rate, blood pressure, respiratory rate). Assessments took place before, immediately after treatment, and after completion of the spa program (before discharge). Results: The patients with ankle arthrosis, fibromyalgia and cervical disc herniation reported the highest VAS score before treatment program (P < 0.05). After the therapy program, VAS scores were seen to decrease compared to before treatment (P < 0.05). The patients with osteoarthritis of the hip (1.3 ± 1.2) and soft tissue rheumatism (1.3 ± 1.2) had the lowest VAS score before discharge compared to patients with other pathologies (P < 0.05). No statistically significant differences were detected between both sexes in terms of pain improvement (P > 0.05). On discharge, all hemodynamic responses decreased significantly compared to before and immediately after initiation of the therapy program (P < 0.01). Conclusion: To decrease pain and high blood pressure without hemodynamic risk, a combined of spa and physical therapy program may help to decrease pain and improve hemodynamic response in patients with irreversible pathologies. © 2005 Elsevier Ltd. All rights reserved.

End-expiratory air trapping due to obstructive airway disease can be estimated through the measurement of intrinsic positive end-expiratory pressure PEEPi. The influence of breathing-frequency and use of expiratory muscles on PEEPi were measured in 10 normal and 10 chronic bronchitic patients (COPD). Insignificant control values of PEEPi increased to measurable values at high breathing rate in normal subjects. Control values were higher in COPD patients and increased at fast breathing rate. When corrected for the use of expiratory muscles according to simultaneous gastric pressure drop, PEEPi decreased in COPD, but still increased at high rate. We conclude that modifying the respiratory rate can increase PEEPi values independently of the severity of airway obstruction and the use of expiratory muscles. Before estimating the pathological value of a PEEPi measurement or evaluating the effects of a treatment, we always need to know the simultaneous breathing frequency.

Local lymph node activation and increased total serum IgE levels are suggested to be predictive parameters of airway hypersensitivity caused by low molecular weight (LMW) chemicals. Whether increases of total serum IgE are indicative of actual induction of specific airway reactions (morphological and functional) after inhalation challenge was examined in the present study. In Brown Norway (BN) and Wistar rats, serum IgE concentrations were examined following topical exposure of chemicals with known diverse sensitization potential in humans: trimellitic anhydride (TMA), a dermal and respiratory sensitizer; dinitrochlorobenzene (DNCB), a dermal sensitizer with no known potential to cause respiratory allergy; and methyl salicylate, a skin irritant devoid of sensitizing properties. Functional and histopathological changes in the respiratory tract were examined after subsequent inhalatory challenge with these chemicals. Of the three tested chemicals, only topical exposure to TMA resulted in a significant increase in total serum IgE concentrations in the high-IgE-responding BN rat. Upon subsequent inhalatory challenge of these rats, TMA induced specific airway reactions which included a sharp decrease in respiratory rate during challenge, followed by an increase in breathing rate with a concomitant decrease in tidal volume 24 and 48 h after inhalatory challenge, and histopathological changes in the larynx and lungs of animals necropsied 48 h after challenge. Interestingly, despite low IgE levels, TMA induced histopathological changes in the larynx and lungs of Wistar rats too. Laryngeal changes were also observed in Wistar rats upon sensitization and challenge with DNCB. These data suggest that increased total serum IgE after topical sensitization is associated with immediate-type specific airway reactivity after inhalation challenge in BN rats and thus may be a valuable parameter in testing for respiratory sensitization potential of LMW compounds. Histopathological examination upon subsequent inhalation challenge of sensitized low-IgE-responders may provide information on other allergic inflammatory airway reactions.

CASEOUS lymphadenitis (CLA) is a chronic disease of sheep and goats, characterised by the formation of suppurative abscesses in lymph nodes, caused by infection with the facultative anaerobe Corynebacterium pseudotuberculosis. Infection is transmitted in the discharges from ruptured lymph nodes of affected animals. The disease causes significant economic impact on the small ruminant industry through decreased meat yield, damaged wool and leather, decreased reproductive efficiency, culling of affected animals, and mortality due to the internal lesions (Blood and others 1989, Gilmour 1991, Williamson 2001). The clinical diagnosis depends on the presence of enlarged superficial lymph nodes and caseous, greenish pus; diagnosis is confirmed by the isolation and identification of C pseudotuberculosis (Blood and others 1989, Davis 1990, Williamson 2001). Rifamycin (3-4-methyl-1-piperazinyliminomethyl) is a clinically useful macrolide antibiotic produced by the Grampositive bacterium Amycolatopsis mediterranei. It is primarily used against Mycobacterium tuberculosis and Mycobacterium leprae, the causative agents of tuberculosis and leprosy, respectively (Lal and Lal 1994). Rifamycin SV has been shown to have in vitro activity against equine C pseudotuberculosis (Wilson and others 1988, Kohn and others 1993). However, it may cause hepatotoxicity and acute renal failure (Thornsbery and others 1983, Frank 1990, Molavi 1990, Plumb 1999), and thus it should be used with caution in patients with preexisting hepatic and renal dysfunction. There is no information about the adverse effects of the rifamycins in sheep. Resistance to the rifamycins can develop quickly, and the antibiotic is therefore most often used in combination with other antimicrobials (Thornsbery and others 1983, Davis 1990). This short communication describes a study of the efficacy of rifamycin SV, given in combination with a depot formulation of oxytetracycline, a broad-spectrum antibacterial agent with activity against a wide range of Gram-positive and Gram-negative bacteria, including obligate anaerobes (Barragry 1994), in sheep with naturally occurring CLA.

International audience; This paper investigates breathing profiles in eleven female speakers (subjects) when talking successively with the same two females (partners). Breathing kinematics of the two inter-locutors was recorded synchronously by means of two Induct-ance Plethysmographs. In order to understand the implication of breathing in dialogue, we analyzed changes in breathing pauses according to the main dialogue events (listening, back-channels, turns start and turns continuation). Breathing and syllable rates were also compared among partners and sub-jects. The duration of inhalations and related pauses was re-duced before a turn continuation in comparison to a turn start. The delay between speech offset in a breathing cycle and the onset of the next inhalation increased when a speaker and a listener swap roles as compared to a speaker who continued the turn. This was observed for both partners and subjects. The partners differed in their breathing and articulation rates but the two rates were not clearly correlated. In agreement with previous works, the current study shows that breathing kine-matics is strongly linked to dialogue events. However, it doesn't show any clear effect of partner on speaker's breath-ing. This last result is discussed relative to methodological as-pects.

Photoplethysmography (PPG) is typically used to extract cardiac-related information like heart rate and cardiac output, though extra-cardiac information like respiratory rate can also be extracted from PPG. The aim of the current study is to advance this approach further and investigate existence of gastric-related activity in PPG. To this end, we consider pulse rate variability (PRV), which provides information analogous to heart rate variability (HRV). Finger PPG and electrogastrography (EGG) signals were recorded from 8 healthy volunteers in fasting and postprandial state for 30 minutes. Peak-to-peak interval (PPI) analysis shows that the power of high frequency (HF) component in fasting and postprandial state changes significantly. The power ratio (PR), which is the ratio between powers of low frequency band (LF, 0.04-0.15 Hz) to that of high frequency band (HF, 0.15-0.4 Hz) and the EGG power were calculated in fasting and postprandial state. PR was positively correlated with EGG power (r = 0.46; P< 0.05). PR indicates the balancing sympathovagal modulation and vagal nervous activity. The significance of this study is that PR from PRV analysis could be used as a tool for diagnosing gastric system instead of the present invasive/cumbersome methods.