Search

Background: Air conditioners (AC) have become indispensable in the contemporary World. However, their effects on respiratory health need to be explored further using dynamic and static lung functions. Objectives: The objectives were: 1. To evaluate and compare dynamic parameters (FEV1, FVC, FEV1/FVC, PEFR, and FEF25-75) in AC users and non-users of Bengaluru. 2. To evaluate and compare airway resistance and specific airway conductance as additional parameters. Materials and Methods: After applying ATS-ERS criteria for lung disorders, 30 AC users and non-users of Bengaluru, aged 18-40 yrs were assessed using body plethysmography. A significant association of restrictive pattern was seen in AC users (9 AC users out of 60 participants, Chi-square 8.37, P = 0.0038) having an Odd's ratio of 26.95 (CI: 1.4876 to 488.3558, Z = 2.229, P = 0.0258). Airway resistance (Raw) was comparable in both groups further indicating a non-obstructive pathology. Conclusion: AC users had a significant decrease in flow rates (PEFR and FEF25-75) as well as an association with restrictive lung disorder suggesting the need for proper ventilation and hygiene. It is crucial to develop policies to maintain indoor air quality. [ABSTRACT FROM AUTHOR]

BACKGROUND: Intermittent intrapulmonary deflation is an airway clearance technique that generates negative pressure during expiratory phases. This technology is intended to reduce air trapping by delaying the onset of air-flow limitation during exhalation. The objective of this study was to compare the short-term effect of intermittent intrapulmonary deflation versus positive expiratory pressure (PEP) therapy on trapped gas volume and vital capacity (VC) in patients with COPD. METHODS: We designed a randomized crossover study in which the participants with COPD received a 20-min session of both intermittent intrapulmonary deflation and PEP therapy on separate days and in random order. Lung volumes were measured via body plethysmography and helium dilution techniques, and spirometric outcomes were reviewed before and after each therapy. The trapped gas volume was estimated via functional residual capacity (FRC), residual volume (RV), and by the difference between FRC obtained through body plethysmography and helium dilution. Each participant also performed 3 VC maneuvers, from total lung capacity to RV with both devices. RESULTS: Twenty participants with COPD (mean ± SD ages 67 ± 8 y; FEV1 48.1 ± 17.0%) were recruited. There was no difference between the devices in FRC or trapped gas volume. However, the RV decreased more during intermittent intrapulmonary deflation compared with PEP. The intermittent intrapulmonary deflation mobilized a larger expiratory volume than PEP during the VC maneuver (mean difference 389 mL, 95% CI 128-650 mL; P = .003). CONCLUSIONS: The RV decreased after intermittent intrapulmonary deflation compared with PEP, but this effect was not captured by other estimates of hyperinflation. Although the expiratory volume obtained during the VC maneuver with intermittent intrapulmonary deflation was greater than that obtained with PEP, the clinical importance as well as the long-term effects remain to be determined. [ABSTRACT FROM AUTHOR]

Copyright of Polish Journal of Allergology / Alergologia Polska is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Few studies have examined the link between short-term exposure to air pollutants and atrial fibrillation (AF) episodes. This study aims to examine the association of hourly criteria air pollutants with AF episodes. We employ a smart device-based photoplethysmography technology to screen AF from 2018 to 2021. Hourly concentrations of six criteria air pollutants are matched to the onset hour of AF for each participant. We adopt a time-stratified case-crossover design to capture the acute effects of air pollutants on AF episodes, using conditional logistic regression models. Subgroup analyses are conducted by age, gender, and season. A total of 11,906 episodes of AF are identified in 2976 participants from 288 Chinese cities. Generally, the strongest associations of air pollutants are present at lag 18–24 h, with positive and linear exposure-response relationships. For an interquartile range increase in inhalable particles, fine particles, nitrogen dioxide, and carbon monoxide, the odds ratio (OR) of AF is 1.19 [95% confidential interval (CI): 1.03, 1.37], 1.38 (95%CI: 1.14, 1.67), 1.60 (95%CI: 1.16, 2.20) and 1.48 (95%CI: 1.19, 1.84), respectively. The estimates are robust to the adjustment of co-pollutants, and they are larger in females, older people, and in cold seasons. There are insignificant associations for sulfur dioxide and ozone. This nationwide case-crossover study demonstrates robust evidence of significant associations between hourly exposure to air pollutants and the onset of AF episodes, which underscores the importance of ongoing efforts to further improve air quality as an effective target for AF prevention. [ABSTRACT FROM AUTHOR]

Early-life changes to lung and gut microbiota have been linked to alterations in immune responses that may lead to pulmonary diseases later in life. Associations between early-life microbiota, germ-free status, lung gene expression, lung development and function are not well described. In this study, we compare early-life lung gene transcription under germ-free and different perinatal microbial exposures, and analyze with a predetermined focus on lung capacity and lung surfactant. We also analyze the later-in-life physiological measures of breathing patterns and lung surfactant function between the germ-free, gnotophoric and gnotobiotic offspring. To achieve this, we kept pregnant BALB/c germ-free mice in separate germ-free isolators until exposure to either A: no exposure (GF), B: Bifidobacterium animalis ssp. Lactis (BI04) or C: full cecum content harvested from other female SPF mice (Cecum). Subsequently, perinatally exposed offspring were used for the analyses. Lung tissue transcriptomics analysis was done at postnatal day 10 (PNday10) at the first phase of lung alveolar development. Head-out plethysmography for breathing pattern analysis was performed on the siblings at PNday23 followed by lung surfactant collection. The function of the collected lung surfactant was then analyzed ex vivo using the constrained drop surfactometer. Our results show that lung transcriptomics had differentially expressed genes related to surfactant turnover between groups and sex at PNday10. They also show that the GF and BI04 animals had lower respiratory rate than Cecum mice, or compared to agematched specific pathogen-free (SPF) reference animals. We also see changes in lung surfactant function ex vivo. The overall conclusions are that 10-day-old GF mice do not have a markedly different lung gene transcription compared to gnotophoric or gnotobiotic mice, but genes related to surfactant metabolism are among the few differentially expressed genes. We show here for the first time that early-life microbiome status correlates with early-life surfactant-gene transcription and to later-in-life lung surfactant function and associated respiratory-rate changes in mice. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to compare body composition (BC) measurements obtained by three widely used BC measuring methods, air displacement plethysmography (ADP), bioelectrical impedance analysis (BIA) and dual‐energy X‐ray absorptiometry (DXA), in Chinese children and adolescents by sex and different BMI categories. Methods: We used three BC measuring methods to evaluate healthy Chinese children and adolescents aged 5–17 years with BMI categories ranging from underweight to obese. Fat mass (FM, kg), fat mass percentage (FMP, %), fat‐free mass (FFM, kg) and appendicular skeletal muscle mass (ASM, kg) were measured by DXA, BIA and ADP on the same day within 1 h. Results: A total of 172 Chinese children and adolescents were included in this study. The agreements for FM, FFM and ASM estimated by the three methods were excellent or good at the population level (intraclass correlation coefficient > 0.850, P < 0.05). However, ADP or BIA estimated lower body fat content and higher FFM than DXA (P < 0.001 for all). Moreover, the precise estimates significantly varied across BMI categories. In addition, the limit of agreements was wide, and the differences might not be clinically acceptable at the individual level. Conclusions: Body fat and FFM obtained by the three commonly used methods were highly correlated, but systematically different and influenced by BMI. This study provided a basis for mutual reference of measurements between three widely used methods. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the mechanoreflex control of respiration and circulation in patients with chronic obstructive pulmonary disease (COPD). Methods: Twenty-eight patients with moderate-to-severe COPD (mean ± SD: 67.0 ± 7.9 yr, 10 women) and 14 age- and sex-matched controls (67.9 ± 2.6 yr, 7 women) participated in the study. Their dominant knee was passively moved to stimulate mechanoreceptors, whereas vastus lateralis surface electrical activity checked active contractions. A differential pressure flowmeter, an electrocardiogram, and a servo-controlled finger photoplethysmograph acquired cardiorespiratory data. To gain insight into the mechanoreflex arc, we further analyzed reduced/oxidized glutathione ratio and mechanoreceptor-related gene expression in a vastus lateralis biopsy of additional nine patients (63.9 ± 8.1 yr, 33% women) and eight controls (62.9 ± 9.1 yr, 38% women). Results: Patients with COPD had a greater peak respiratory frequency response (COPD: Δ = 3.2 ± 2.3 vs Controls: 1.8 ± 1.2 cycles per minute, P = 0.036) and a smaller peak tidal volume response to passive knee movement than controls. Ventilation, heart rate, stroke volume, and cardiac output peak responses, and total peripheral resistance nadir response, were unaltered by COPD. In addition, patients had a diminished glutathione ratio (COPD: 13.3 ± 3.8 vs controls: 20.0 ± 5.5 a.u., P = 0.015) and an augmented brain-derived neurotrophic factor expression (COPD: 2.0 ± 0.7 vs controls: 1.1 ± 0.4 a.u., P = 0.002) than controls. Prostaglandin E receptor 4, cyclooxygenase 2, and Piezo1 expression were similar between groups. Conclusions: Respiratory frequency response to mechanoreceptors activation is increased in patients with COPD. This abnormality is possibly linked to glutathione redox imbalance and augmented brain-derived neurotrophic factor expression within locomotor muscles, which could increase mechanically sensitive afferents' stimulation and sensitivity. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate whether a reduction in daily sedentary behavior (SB) improves insulin sensitivity in adults with metabolic syndrome in 6 months, without adding intentional exercise training. Methods: Sixty-four sedentary inactive middle-age adults with overweight and metabolic syndrome (mean (SD) age, 58 (7) yr; mean (SD) body mass index, 31.6 (4.3) kg·m−2; 27 men) were randomized into intervention and control groups. The 6-month individualized behavioral intervention supported by an interactive accelerometer and a mobile application aimed at reducing daily SB by 1 h compared with baseline. Insulin sensitivity by hyperinsulinemic euglycemic clamp, body composition by air displacement plethysmography, and fasting blood samples were analyzed before and after the intervention. SB and physical activity were measured with hip-worn accelerometers throughout the intervention. Results: SB decreased by 40 (95% confidence interval, 17–65) min·d−1, and moderate-to-vigorous physical activity increased by 20 (95% confidence interval, 11–28) min·d−1 on average in the intervention group with no significant changes in these outcomes in the control group. After 6 months, fasting plasma insulin decreased (~1 mU·L−1) in the intervention group compared with the control group (time–group, P = 0.0081), but insulin sensitivity did not change in either group. The changes in body mass or adiposity did not differ between groups. Among all participants, the changes in SB and body mass correlated inversely with the change in insulin sensitivity (r = −0.31, −0.44; P = 0.025, 0.0005, respectively). Conclusions: An intervention aimed at reducing daily SB resulted in slightly decreased fasting insulin, but had no effects on insulin sensitivity or body adiposity. However, as the change in insulin sensitivity associated with the changes in SB and body mass, multifaceted interventions targeting to weight loss are likely to be beneficial in improving whole-body insulin sensitivity. [ABSTRACT FROM AUTHOR]

The link between Compulsive Sexual Behavior (CSB) and atypical sexual interests is elusive. This study aimed to provide preliminary insights into the relationship between both aspects. The study sample comprised 61 self-identified straight men. CSB was measured through a composite self-report index assessing symptoms of CSB, whereas sexual interests –atypical and normophilic– were assessed objectively through penile plethysmography. The CSB index had small, non-significant correlation with greater sexual response to different sexual stimuli (r general sexual responsiveness=.127 [95% CI: −.137,.384]). In terms of overall sexual interest, increased scores on the CSB index had small, non-significant correlation with a higher preference for younger sexual stimuli (r = −.098 [95% CI: −.499,.215]) and persuasive sex (r =.10 [95% CI: −.168,.316]). Finally, CSB had a moderate correlation with sexual response when presented with stimuli depicting "female toddler coercive" (r =.27 [95% CI: −.083,.544]). We conclude that our findings do not support the hypotheses that CSB is significantly related to an increased arousability across sexual stimuli. The study findings also suggest that CSB may be, to a small degree, predisposed to experience sexual attraction toward children. Given the preliminary nature of the study, these conclusions warrant further research. Alternative explanations for the study findings related to the particular components of CSB that may be related to typical and atypical sexual interests are also considered. [ABSTRACT FROM AUTHOR]

This study presents an ear-mounted photoplethysmography (PPG) system that is designed to detect mental stress. Mental stress is a prevalent condition that can negatively impact an individual's health and well-being. Early detection and treatment of mental stress are crucial for preventing related illnesses and maintaining overall wellness. The study used data from 14 participants that were collected in a controlled environment. The participants were subjected to stress-inducing tasks such as the Stroop color–word test and mathematical calculations. The raw PPG signal was then preprocessed and transformed into scalograms using continuous wavelet transform (CWT). A convolutional neural network classifier was then used to classify the transformed signals as stressed or non-stressed. The results of the study show that the PPG system achieved high levels of accuracy (92.04%) and F1-score (90.8%). Furthermore, by adding white Gaussian noise to the raw PPG signals, the results were improved even more, with an accuracy of 96.02% and an F1-score of 95.24%. The proposed ear-mounted device shows great promise as a reliable tool for the early detection and treatment of mental stress, potentially revolutionizing the field of mental health and well-being. [ABSTRACT FROM AUTHOR]

Preserved ratio impaired spirometry (PRISm) is defined by reduced FEV1 with a preserved FEV1/FVC ratio; some individuals with PRISm can also have restrictive ventilatory abnormality. The aim of this study was to clarify clinical features of restrictive and non-restrictive PRISm. In total, 11,246 participants (mean, 49.1 years; range, 35–65 years) from five healthcare centres were included in this study. We evaluated baseline characteristics of participants with restrictive PRISm (FEV1/FVC ≥ 0.7, FEV1 < 80% and FVC < 80%) and non-restrictive PRISm (FEV1/FVC ≥ 0.7, FEV1 < 80% and FVC ≥ 80%), and airflow obstruction (FEV1/FVC < 0.7). We examined the longitudinal risk of developing airflow obstruction by comparing spirometry results at baseline and 5 years post-baseline among 2141 participants. Multivariate analysis demonstrated that a history of asthma or smoking could constitute an independent risk factor for non-restrictive PRISm, and that non-restrictive PRISm was independently associated with the risk of developing airflow obstruction. In contrast, female sex, advanced age, and high BMI, but not history of asthma or smoking, were risk factors for restrictive PRISm. Restrictive PRISm was not associated with the development of airflow obstruction. In conclusion, our results indicate that PRISm can be categorized according to the presence or absence of restrictive abnormality. Non-restrictive PRISm, which does not meet the conventional criteria of obstructive and restrictive ventilatory abnormalities, may be a precursor of chronic obstructive pulmonary disease and merits increased monitoring. [ABSTRACT FROM AUTHOR]

The association between intraoperative nociception and increased patient's morbidity is well established. However, hemodynamic parameters, such as heart rate and blood pressure, may result in an inadequate monitor of nociception during surgery. Over the last two decades, different devices have been marketed to "reliably" detect intraoperative nociception. Since the direct measure of nociception is impractical during surgery, these monitors measures nociception surrogates such as sympathetic and parasympathetic nervous systems responses (heart rate variability, pupillometry, skin conductance), electroencephalographic changes, and muscular reflex arc. Each monitor carries its own advantages and disadvantages. The manuscript aims to give an overview of the most up-to-date information available in the literature on current nociceptor monitors available in clinical practice, with particular focus on their applications in pediatrics. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Taibah University Medical Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Yunpi-Xiefei-Huatan decoction (YXHD) is a traditional Chinese medicine that can improve asthma-related symptoms, including cough, phlegm in the throat, and shortness of breath. However, the YXHD mechanism on asthma has not yet been elucidated. The aim of this study is to investigate the effect of YXHD on airway inflammation, mucus hypersecretion, and autophagy modulation in asthma. The YXHD chemical constituents were observed and analyzed using high-performance liquid chromatography-mass spectrometry. Ovalbumin sensitization and stimulation were used to establish an asthma rat model. A total of 80 Sprague-Dawley (SD) rats were segmented into eight groups at random: a Normal (NC) group, a Model (Mod) group, a YXHD low-dose group (10 g/kg/d), a YXHD moderate-dose group (20 g/kg/d), a YXHD high-dose group (40 g/kg/d), a Rapamycin group (4 mg/kg/d), a 3-methyladenine (3-MA) group (15 mg/kg/d), and a Dexamethasone (DEX) group (0.5 mg/kg/d). Whole-body plethysmography (WBP) detection was used to evaluate airway hyperresponsiveness. An enzyme-linked immunosorbent assay (ELISA) was used to detect inflammatory factors in the peripheral blood. Inflammatory cells in the bronchoalveolar lavage fluid (BALF) were also counted. Pathological changes in the lung tissues were marked using hematoxylin and eosin (H&E) staining and periodic acid-Schiff (PAS) staining. The localization of MUC5AC and the co-localization of LC3B + MUC5AC were observed using immunofluorescence. The expressions of autophagy and the TGF-β3/Smad2/Smad3 pathway in the lung tissues were detected using a Western blot assay (WB) and qPCR, and the autophagosomes in the lung tissues were detected using a transmission electron microscope (TEM). Twenty signal peaks were identified using ultra-high performance liquid chromatography with quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) technology. The TGF-β3/Smad2/Smad3 signal pathway activation was induced using ovalbumin (OVA) exposure in the rats. The upregulated expression of autophagy, enhanced MUC5AC fluorescence and LC3B fluorescence, and their co-localized expression in the airway epithelium indicated inflammatory cell infiltration and excessive mucus secretion in the lungs. This resulted in airway hyper-responsiveness. The YXHD inhibited the activation of the TGF-β3/Smad2/Smad3 signaling pathway, and autophagy expression reduced inflammatory factors, abnormal mucus secretion, and airway hyperresponsiveness. The YXHD improved lung function, relieved lung inflammation, and inhibited airway mucus secretions in asthmatic rat models. Its mechanism may have been related to the blockage of the TGF-β3/Smad2/Smad3 signaling pathway and autophagy downregulation. [Display omitted] • YXHD inhibits TGF-β3/Smad2/Smad3 to alleviate asthma symptoms. • YXHD reduces airway inflammation and mucus hypersecretion in asthmatic rats. • Autophagy inhibition by YXHD contributes to its therapeutic effect. • YXHD's mechanism may involve downregulating autophagy-related genes. [ABSTRACT FROM AUTHOR]

The emergence of new synthetic opioids (NSOs) has added complexity to recreational opioid markets worldwide. While NSOs with diverse chemical structures have emerged, brorphine currently remains the only NSO with a piperidine benzimidazolone scaffold. However, the emergence of new generations of NSOs, including brorphine analogues, can be anticipated. This study explored the pharmaco-toxicological, opioid-like effect profile of brorphine alongside its non-brominated analogue (orphine) and three other halogenated analogues (fluorphine, chlorphine, iodorphine). In vitro , radioligand binding assays in rat brain tissue indicated that all analogues bind to the μ-opioid receptor (MOR) with nM affinity. While analogues with smaller-sized substituents showed the highest MOR affinity, further in vitro characterization via two cell-based (HEK 293T) MOR activation (β-arrestin 2 and mini-G αi recruitment) assays indicated that chlorphine, brorphine, and iodorphine were generally the most active MOR agonists. None of the compounds showed significant in vitro biased agonism compared to hydromorphone. In vivo , we investigated the effects of intraperitoneal (IP) administration of the benzimidazolones (0.01–15 mg/kg) on mechanical and thermal antinociception in male CD-1 mice. Chlorphine and brorphine overall induced the highest levels of antinociception. Furthermore, the effects on respiratory changes induced by a fixed dose (15 mg/kg IP) of the compounds were investigated using non-invasive plethysmography. Fluorphine-, chlorphine-, and brorphine-induced respiratory depressant effects were the most pronounced. For some compounds, pretreatment with naloxone (6 mg/kg IP) could not reverse respiratory depression. Taken together, brorphine-like piperidine benzimidazolones are opioid agonists that have the potential to cause substantial harm to users should they emerge as NSOs. This article is part of the Special Issue on "Novel Synthetic Opioids (NSOs)". • Analogues of brorphine have the potential to emerge as new synthetic opioids. • Piperidine benzimidazolones are μ-opioid receptor agonists in vitro. • Chlorphine and brorphine induced the highest levels of antinociception in vivo. • Fluorphine, chlorphine, and brorphine induced pronounced respiratory depression. • Non-opioid-mediated effects may contribute to some of the in vivo effects. [ABSTRACT FROM AUTHOR]

Safe anesthesia is achieved using objective methods that estimate the patient’s state during different phases of surgery. A patient’s state under anesthesia is characterized by three major aspects, which are linked to the main effects produced by each of the families of anesthetic agents administered: hypnosis, analgesia, and muscular relaxation. While quantification techniques designed to assess muscular relaxation under neuromuscular blocking agents have a relatively long history with a high degree of standardization and understanding (e.g., the train-of-four), the knowledge and techniques used to the depth of hypnosis assessment suffer from a lesser degree in both standardization and interpretation due to brain complexity. The problem of standardization and interpretation in the analgesia and nociception assessment increases since it involves more systems, the central nervous system, and the autonomic nervous system. This helps to explain why there are multiple a priori valid approaches to develop nociception monitoring from different interpretations and physiological bases of noxious stimuli processing. Thus, in this review, the current monitoring technologies clinically available for estimating a patient’s nociception under general anesthesia are described.

Abstract Objective To review the technical aspects of body composition assessment by dual-energy X-ray absorptiometry (DXA) and other methods based on the most recent scientific evidence. Materials and methods This Official Position is a result of efforts by the Scientific Committee of the Brazilian Association of Bone Assessment and Metabolism (Associação Brasileira de Avaliação Óssea e Osteometabolismo, ABRASSO) and health care professionals with expertise in body composition assessment who were invited to contribute to the preparation of this document. The authors searched current databases for relevant publications. In this first part of the Official Position, the authors discuss the different methods and parameters used for body composition assessment, general principles of DXA, and aspects of the acquisition and analysis of DXA scans. Conclusion Considering aspects of accuracy, precision, cost, duration, and ability to evaluate all three compartments, DXA is considered the gold-standard method for body composition assessment, particularly for the evaluation of fat mass. In order to ensure reliable, adequate, and reproducible DXA reports, great attention is required regarding quality control procedures, preparation, removal of external artifacts, imaging acquisition, and data analysis and interpretation.

RationaleThe relationship between respiratory function at hospital discharge and the severity of later respiratory disease in extremely low gestational age neonates is not well defined.ObjectivesTo test the hypothesis that tidal breathing measurements near the time of hospital discharge differ between extremely premature infants with bronchopulmonary dysplasia (BPD) or respiratory disease in the first year of life and those without these conditions.MethodsStudy subjects were part of the PROP (Prematurity and Respiratory Outcomes Program) study, a longitudinal cohort study of infants born at less than 29 gestational weeks followed from birth to 1 year of age. Respiratory inductance plethysmography was used for tidal breathing measurements before and after inhaled albuterol 1 week before anticipated hospital discharge. Infants were breathing spontaneously and were receiving less than or equal to 1 L/min nasal cannula flow at 21% to 100% fraction of inspired oxygen. A survey of respiratory morbidity was administered to caregivers at 3, 6, 9, and 12 months corrected age to assess for respiratory disease. We compared tidal breathing measurements in infants with and without BPD (oxygen requirement at 36 wk) and with and without respiratory disease in the first year of life. Measurements were also performed in a comparison cohort of term infants.ResultsA total of 765 infants survived to 36 weeks postmenstrual age, with research-quality tidal breathing data in 452 out of 564 tested (80.1%). Among these 452 infants, the rate of postdischarge respiratory disease was 65.7%. Compared with a group of 18 term infants, PROP infants had abnormal tidal breathing patterns. However, there were no clinically significant differences in tidal breathing measurements in PROP infants who had BPD or who had respiratory disease in the first year of life compared with those without these diagnoses. Bronchodilator response was not significantly associated with respiratory disease in the first year of life.ConclusionsExtremely premature infants receiving less than 1 L/min nasal cannula support at 21% to 100% fraction of inspired oxygen have tidal breathing measurements that differ from term infants, but these measurements do not differentiate those preterm infants who have BPD or will have respiratory disease in the first year of life from those who do not. Clinical trial registered with www.clinicaltrials.gov (NCT01435187).

Several new psychoactive substances (NPS) are responsible for intoxication involving the cardiovascular and respiratory systems. Among NPS, synthetic cannabinoids (SCs) provoked side effects in humans characterized by tachycardia, arrhythmias, hypertension, breathing difficulty, apnoea, myocardial infarction, and cardiac arrest. Therefore, the present study investigated the cardio-respiratory (MouseOx Plus; EMKA electrocardiogram (ECG) and plethysmography TUNNEL systems) and vascular (BP-2000 systems) effects induced by 1-naphthalenyl (1-pentyl-1H-indol-3-yl)-methanone (JWH-018; 0.3–3–6 mg/kg) and Δ9-tetrahydrocannabinol (Δ9-THC; 0.3–3–6 mg/kg), administered in awake CD-1 male mice. The results showed that higher doses of JWH-018 (3–6 mg/kg) induced deep and long-lasting bradycardia, alternated with bradyarrhythmia, spaced out by sudden episodes of tachyarrhythmias (6 mg/kg), and characterized by ECG electrical parameters changes, sustained bradypnea, and systolic and transient diastolic hypertension. Otherwise, Δ9-THC provoked delayed bradycardia (minor intensity tachyarrhythmias episodes) and bradypnea, also causing a transient and mild hypertensive effect at the tested dose range. These effects were prevented by both treatment with selective CB1 (AM 251, 6 mg/kg) and CB2 (AM 630, 6 mg/kg) receptor antagonists and with the mixture of the antagonists AM 251 and AM 630, even if in a different manner. Cardio-respiratory and vascular symptoms could be induced by peripheral and central CB1 and CB2 receptors stimulation, which could lead to both sympathetic and parasympathetic systems activation. These findings may represent a starting point for necessary future studies aimed at exploring the proper antidotal therapy to be used in SCs-intoxicated patient management. [ABSTRACT FROM AUTHOR]

Recent epidemiological findings link asthma to adverse cardiovascular responses. Yet, the precise cardiovascular impacts of asthma have been challenging to disentangle from the potential cardiovascular effects caused by asthma medication. The purpose of this study was to determine the impacts of allergic airways disease alone on cardiovascular function in an experimental model. Female Wistar rats were intranasally sensitized and then challenged once per week for 5 weeks with saline vehicle or a mixture of environmental allergens (ragweed, house dust mite, and Aspergillus fumigatus). Ventilatory and cardiovascular function, measured using double-chamber plethysmography and implantable blood pressure (BP) telemetry and cardiovascular ultrasound, respectively, were assessed before sensitization and after single and final allergen challenge. Responses to a single 0.5 ppm ozone exposure and to the cardiac arrhythmogenic agent aconitine were also assessed after final challenge. A single allergen challenge in sensitized rats increased tidal volume and specific airways resistance in response to provocation with methacholine and increased bronchoalveolar lavage fluid (BALF) eosinophils, neutrophils, lymphocytes, cytokines interleukin (IL)-4, IL-5, IL-10, IL-1β, tumor necrosis factor-α, and keratinocyte chemoattract-growth-related oncogene characteristic of allergic airways responses. Lung responses after final allergen challenge in sensitized rats were diminished, although ozone exposure increased BALF IL-6, IL-13, IL-1 β, and interferon-γ and modified ventilatory responses only in the allergen group. Final allergen challenge also increased systolic and mean arterial BP, stroke volume, cardiac output, end-diastolic volume, sensitivity to aconitine-induced cardiac arrhythmia, and cardiac gene expression with lesser effects after a single challenge. These findings demonstrate that allergic airways responses may increase cardiovascular risk in part by altering BP and myocardial function and by causing cardiac electrical instability. [ABSTRACT FROM AUTHOR]

Objective: The goal was to compare Speckle plethysmography (SPG) and Photoplethysmography (PPG) with non-invasive finger Arterial Pressure (fiAP) regarding Pulse Wave Morphology (PWM) and Pulse Arrival Time (PAT). Methods: Healthy volunteers (n = 8) were connected to a Non-Invasive Blood Pressure (NIBP) monitor providing fiAP pulse wave and PPG from a clinical transmission-mode SpO2 finger clip. Biopac recorded 3-lead ECG. A camera placed at a 25 cm distance recorded a video stream (100 fps) of a finger illuminated by a laser diode at 639 nm. A chest belt (Polar) monitored respiration. All signals were recorded simultaneously during episodes of spontaneous breathing and paced breathing. Analysis: Post-processing was performed in Matlab to obtain SPG and analyze the SPG, PPG and fiAP mean absolute deviations (MADs) on PWM, plus PAT modulation. Results: Across 2599 beats, the average fiAP MAD with PPG was 0.17 (0–1) and with SPG 0.09 (0–1). PAT derived from ECG–fiAP correlated as follows: 0.65 for ECG–SPG and 0.67 for ECG–PPG. Conclusion: Compared to the clinical NIBP monitor fiAP reference, PWM from an experimental camera-derived non-contact reflective-mode SPG setup resembled fiAP significantly better than PPG from a simultaneously recorded clinical transmission-mode finger clip. For PAT values, no significant difference was found between ECG–SPG and ECG–PPG compared to ECG–fiAP. [ABSTRACT FROM AUTHOR]

Background: The evidence that dynamic variables predict fluid responsiveness in young children is limited by conflicting research results. Methods: Sixty patients, 1–3 years of age, undergoing major neurosurgery, received 10 mL/kg of Ringer's solution over 10 min after anesthesia induction. Respiratory variation in aortic blood flow peak velocity (∆Vpeak), plethysmographic variability index (PVI), FloTrac/Vigileo‐derived stroke volume variation (SVV), dynamic arterial elastance (Eadyn), and pulse pressure variation (PPV) were measured before and following fluid loading. An increase in the cardiac index (CI) of ≥10% following fluid loading identified fluid "responders." Results: Twenty‐six patients (43.3%) were fluid responders. Baseline ∆Vpeak was an excellent predictor of a CI increase following fluid loading with an area under the receiver operating characteristic curve (AUROC) of 0.982 (p < 0.001). The PVI showed fair diagnostic accuracy for CI‐fluid responsiveness (AUROC 0.775, p < 0.001). Baseline ∆Vpeak and PVI cutoff values were 9.6% and 15%, respectively. PPV, SVV, and Eadyn were not predictors or were poor predictors for CI‐fluid responsiveness (AUROC 0.669, 0.653, and 0.533, respectively). Conclusion: Volume‐based PVI and ∆Vpeak showed acceptable reliability for fluid responsiveness prediction in young children undergoing major neurosurgery, whereas pressure‐based SVV using FloTrac/Vigileo, Eadyn, and PPV did not. [ABSTRACT FROM AUTHOR]

Work at height is considered a high-risk task due to the exposure of personnel to non-daily or natural factors for the human being, such as changes in temperature, position and limited displacement, which might affect the person's metabolism. In Colombia, over the years, this activity has represented a significant number of accidents and deaths. In order to be able to detect a possible eventuality or issue with the worker at height, this project proposed and developed an IoT prototype system to monitor biological variables, such as, heart rate and blood oxygen level, and variables of protection for the worker, such as the securing of the carabiner on the line of life and the height at which the worker is positioned. In the materials and methods section, the system architecture and its connections are explained. To measure heart rate and blood oxygen level, the plethysmography technique is selected, a high-resolution barometer is selected to measure the worker's height, and a pressure sensor is selected to measure carabiner securing. This section also explains the development of electronic instrumentation and the connection of the different modules to guarantee the acquisition of information and its sending to the cloud. The results of the characterization of the prototype indicated errors of 3.56% for the heart rate, 1.1% for the blood oxygen level and 10% for the carabiner securing measurement. As a conclusion the IoT system was designed, implemented and verified for the proposed variables. The system allows real-time measurements and connectivity between physical variables and the cloud. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Kineanthropometry & Human Performance is the property of Brazilian Journal of Kineanthropometry & Human Performance and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To examine the intermethods agreement of dual-energy X-ray absorptiometry (DXA) and foot-to-foot bioelectrical impedance analysis (BIA) to assess the percentage of body fat (%BF) in young male athletes using air-displacement plethysmography (ADP) as the reference method. Methods: Standard measurement protocols were carried out in 104 athletes (40 swimmers, 37 footballers, and 27 cyclists, aged 12-14 y). Results: Age-adjusted %BF ADP and %BF BIA were significantly higher in swimmers than footballers. ADP correlates better with DXA than with BIA (r = .84 vs r = .60, P < .001). %BF was lower when measured by DXA and BIA than ADP (P < .001), and the bias was higher when comparing ADP versus BIA than ADP versus DXA. The intraclass correlation coefficients between DXA and ADP showed a good to excellent agreement (r = .67-.79), though it was poor when BIA was compared with ADP (r = .26-.49). The ranges of agreement were wider when comparing BIA with ADP than DXA with ADP. Conclusion: DXA and BIA seem to underestimate %BF in young male athletes compared with ADP. Furthermore, the bias significantly increases with %BF in the BIA measurements. At the individual level, BIA and DXA do not seem to predict %BF precisely compared with ADP in young athletic populations. [ABSTRACT FROM AUTHOR]

Few investigations have evaluated the validity of current body composition technology among racially and ethnically diverse populations. This study assessed the validity of common body composition methods in a multi-ethnic sample stratified by race and ethnicity. One hundred and ten individuals (55 % female, age: 26·5 (sd 6·9) years) identifying as Asian, African American/Black, Caucasian/White, Hispanic, Multi-racial and Native American were enrolled. Seven body composition models (dual-energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), two bioelectrical impedance devices (BIS, IB) and three multi-compartment models) were evaluated against a four-compartment criterion model by assessing total error (TE) and standard error of the estimate. For the total sample, measures of % fat and fat-free mass (FFM) from multi-compartment models were all excellent to ideal (% fat: TE = 0·94–2·37 %; FFM: TE = 0·72–1·78 kg) compared with the criterion. % fat measures were very good to excellent for DXA, ADP and IB (TE = 2·52–2·89 %) and fairly good for BIS (TE = 4·12 %). For FFM, single device estimates were good (BIS; TE = 3·12 kg) to ideal (DXA, ADP, IB; TE = 1·21–2·15 kg). Results did not vary meaningfully between each race and ethnicity, except BIS was not valid for African American/Black, Caucasian/White and Multi-racial participants for % fat (TE = 4·3–4·9 %). The multi-compartment models evaluated can be utilised in a multi-ethnic sample and in each individual race and ethnicity to obtain highly valid results for % fat and FFM. Estimates from DXA, ADP and IB were also valid. The BIS may demonstrate greater TE for all racial and ethnic cohorts and results should be interpreted cautiously. [ABSTRACT FROM AUTHOR]

Depth-based plethysmography (DPG) for the measurement of respiratory parameters is a mobile and cost-effective alternative to spirometry and body plethysmography. In addition, natural breathing can be measured without a mouthpiece, and breathing mechanics can be visualized. This paper aims at showing further improvements for DPG by analyzing recent developments regarding the individual components of a DPG measurement. Starting from the advantages and application scenarios, measurement scenarios and recording devices, selection algorithms and location of a region of interest (ROI) on the upper body, signal processing steps, models for error minimization with a reference measurement device, and final evaluation procedures are presented and discussed. It is shown that ROI selection has an impact on signal quality. Adaptive methods and dynamic referencing of body points to select the ROI can allow more accurate placement and thus lead to better signal quality. Multiple different ROIs can be used to assess breathing mechanics and distinguish patient groups. Signal acquisition can be performed quickly using arithmetic calculations and is not inferior to complex 3D reconstruction algorithms. It is shown that linear models provide a good approximation of the signal. However, further dependencies, such as personal characteristics, may lead to non-linear models in the future. Finally, it is pointed out to focus developments with respect to single-camera systems and to focus on independence from an individual calibration in the evaluation. [ABSTRACT FROM AUTHOR]

This study aimed to compare in rats the cardiometabolic and cellular adaptative responses to 8 weeks of high-intensity interval training (HIIT) performed in a single (1xHIIT) or three shorter daily sessions (3xHIIT). Male Wistar rats were assigned to untrained (n = 10), 1xHIIT (n = 10), and 3xHIIT (n = 10) groups. Both HIIT groups performed 15 min of a treadmill run five times per week for 8 weeks. The 1xHIIT performed single daily sessions of 15 min, and the 3xHIIT performed three daily sessions of 5 min with an interval of 4 h between sessions. Resting VO2 and VO2max were measured using a metabolic chamber; blood pressure and heart rate were measured by plethysmography; body composition was estimated by DEXA; Glucose and insulin tolerance tests were performed; after euthanasia, hearts, gastrocnemius, and visceral fat were harvested for analysis of cardiac function, histology, and morphology. Mitochondrial densities of the gastrocnemius and left ventricle muscles were determined by electron microscopy. 3xHIIT induced similar positive adaptative responses to 1xHIIT on resting VO2 and VO2max, cardiac function, and mitochondria density. 3xHIIT was superior to 1xHIIT in reducing visceral fat weight and adipocyte size and improving insulin tolerance. Multiple short daily bouts of HIIT may be superior to single HIIT daily sessions in improving cardiometabolic and cellular adaptations in rats. [ABSTRACT FROM AUTHOR]

Background: Central venous pressure (CVP) readings are affected by several factors. The need to test the technology of noninvasive or minimal invasive monitoring during liver surgery to guide fluids intake is the focus of this trial. Adult hepatic patients undergoing elective open liver resection were randomized into transesophageal Doppler (TED, n = 20) or plethysmography variability index (PVI, n = 20). PVI blinded to anesthetist in TED group (gp) and vice versa. During dissection, crystalloids were restricted to keep corrected flow time (FTc) parameter of TED < 330 msec or PVI > 14%, otherwise infused at 6 ml/kg/h. Following resection, colloids infused if FTc < 330 msec or PVI > 14% despite crystalloids infusion. Primary aim is to compare TED-corrected flow time (FTc, msec) parameter to PVI (%) for guiding intravenous fluids during liver resection. Secondary to study their correlations and each parameter effect on blood loss and consumption, morbidity and intensive care unit (ICU) stay. Results: It is presented as median [IQ]. Volumes of crystalloids and colloids guided by FTc and PVI were not different (p = 0.3, p = 0.1, respectively) despite negligible correlations. Normovolemic existed during dissection despite 2 h of fluids restriction. FTc was 327 (320–341) msec, PVI was 11.50 (11.00–14.00) %, and CVP in TED gp 11.00 (10.00–12.00) vs. 9.00 (9.00–11.50) mmHg in PVI gp, p = 0.2. Blood loss was 1500 (475–2000) ml in TED vs. 950 (675–1925) in PVI, p = 0.5. Patients' % in need for blood transfusion and volumes in TED vs. PVI gps were similar: red blood cells: 30%, 350 (350–350) vs. 40%, 525 (350–700) ml, and p = 0.2. Plasma is 20%, 200 (200–300) vs. 40%, and 400 (200–400) ml, p = 0.3. There was no difference in nausea, vomiting, or ICU stay, (p > 0.05). Conclusions: Volume of fluids guided by PVI was not different from that by TED, despite lack of correlation. Transfusion-free dissection was possible for a significant number of patients with normovolemia. Trial registration: PACTR201808140151322 (www.pactr.org) [ABSTRACT FROM AUTHOR]

Summary: Background: Early‐life exposure to tobacco is associated with obesity, but the most susceptible developmental periods are unknown. Objective: To explore windows of susceptibility in a cohort of 568 mother–child pairs. Methods: We measured seven measures of tobacco exposure (five self‐reported and two biomarkers) spanning from pre‐conception to age 5 years. Mothers self‐reported active smoking (pre‐conception, 17 weeks, and delivery) and household smokers (5 and 18 months postnatally). Cotinine was measured in maternal urine (27 weeks) and child urine (5 years). Adiposity (fat mass percentage) was measured at birth and 5 years via air displacement plethysmography. Using a multiple informant approach, we tested whether adiposity (5 years) and changes in adiposity (from birth to 5 years) differed by the seven measures of tobacco exposure. Results: The associations may depend on timing. For example, only pre‐conception (β = 3.1%; 95% CI: 1.0–5.1) and late gestation (β = 4.0%; 95% CI: 0.4–7.6) exposures influenced adiposity accretion from birth to 5 years (p for interaction = 0.01). Early infancy exposure was also associated with 1.7% higher adiposity at 5 years (95% CI: 0.1–3.2). Mid‐pregnancy and early childhood exposures did not influence adiposity. Conclusions: Pre‐conception, late gestation, and early infancy exposures to tobacco may have the greatest impact on childhood adiposity. [ABSTRACT FROM AUTHOR]

To evaluate the acute effects of expiratory positive airway pressure (EPAP) on exercise tolerance, dyspnea, leg discomfort, and breathing pattern in patients with COPD. Fifteen patients with COPD were assessed with the following three different protocols: EPAP of 7.5 cmH2O used during a constant cycle ergometer exercise test (Protocol-1); EPAP of 7.5 cmH2O used for 15 minutes before the test (Protocol-2); and a sham system without pressure used for 15 minutes before the test (Protocol-3). Dyspnea and leg discomfort were assessed using Borg scale, whereas breathing pattern by optoelectronic plethysmography. Statistical analyses were performed using generalized estimating equations and Bonferroni tests (α = 5%), considering the protocols (1, 2, and 3) and moment (resting and the end of exercise). Exercise tolerance was lower in protocol 1: 108 ± 45 seconds compared to protocols 2: 187 ± 99 seconds (p=.011) and 3: 183 ± 101 seconds (p=.021). No difference was observed between protocols 2 and 3 (p>.999). Dyspnea in protocol 1: 7.0 ± 2.08 was higher than protocols 2: 4.10 ± 2.45 (p=.001) and 3: 3.90 ± 2.21 (p<.001), but no differences were observed between protocols 2 and 3 (p>.999). No significant difference was observed for leg discomfort among the protocols (p=.137). There were no statistically significant differences for most variables of breathing pattern among the protocols. A reduction on exercise tolerance and an increase in dyspnea were found with EPAP of 7.5 cm H2O during a constant cycle ergometer exercise test in patients with COPD. [ABSTRACT FROM AUTHOR]

Elevated circulating platelet-derived extracellular vesicles (pEVs) have been associated with arterial hypertension. The role of hypertension-mediated organ damage (HMOD) to induce EV release is still unknown. We studied the micro- and macro-vascular changes (retinal vascular density and pulse wave velocity), endothelial function (flow-mediated vasodilation of brachial artery and finger plethysmography), and assessed the psychosocial status (anxiety and depression) in hypertensive patients to determine their relationship with EV release. Pulse wave velocity showed a significant positive correlation with pEVs (r = 0.33; p = 0.01). Systolic blood pressure (SBP) negatively correlated with retinal vascularity. The superficial retinal vascular plexus density in the whole image showed a significant negative correlation with 24 h SBP (r = −0.38, p < 0.01), day-SBP (r = −0.35, p = 0.01), and night-SBP (r = −0.27, p = 0.04). pEVs did not show significant associations with microvascular damage (retinal vascular density), endothelial function (flow-mediated vasodilation of brachial artery and finger plethysmography), or psychosocial status (anxiety and depression). Our results indicate that the pEV levels were associated with macrovascular damage measured by PWV, whereas no significant association between pEVs and microvascular damage, endothelial function, or emotional status could be detected. The potential utility of pEV in clinical practice in the context of HMOD may be limited to macrovascular changes. [ABSTRACT FROM AUTHOR]

Background. Lung volumes can be measured by body plethysmography (BP), by inert gas dilution during a single-breath or multiple breaths and by radiographic methods based on chest roentgenogram or CT scanning. Our objective was to analyze the concordance between several methods including a new pressure-derived method (PDM) in a variety of pulmonary conditions. Methods. We recruited four groups of adult volunteers at the chronic obstructive pulmonary disease and tobacco clinic of a respiratory referral hospital: patients with lung bullae, with obstructive lung diseases, with restrictive lung diseases and healthy controls; all subjects underwent lung volume measurements according to ATS/ERS standards in random order with each method and then CT scanning. Differences among groups were estimated by Kruskal–Wallis tests. Concordance correlation coefficients (CCC) and Bland–Altman plots were performed. Results. Sixty-two patients were studied including 15 with lung bullae, 14 with obstructive lung diseases, 12 with restrictive lung disease and 21 healthy subjects. Highest concordance was obtained between BP and CT scanning (CCC 0.95, mean difference −0.35 l) and the lowest, with TLC-DLCOsb (CCC 0.65, difference −1.05 l). TLC measured by BP had a moderate concordance with the PDM (CCC = 0.91, mean difference −0.19 l). The PDM on the other hand had the lowest intra-test repeatability (2.7%) of all tested methods. Conclusions. Lung volumes measured by BP and CT had high concordance in the scenario of varied pulmonary conditions including lung bullae, restrictive and obstructive diseases. The new PDM device, had low intra-test variability, and was easy to perform, with a reasonable concordance with BP. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) is a known complication after major abdominal surgery. Use of the usual functional AKI biomarkers for detection shows delayed results, and so, the use of cell cycle arrest biomarker was proposed. The aim of the present study was to assess the arrest biomarker as an early tool for AKI prediction in major abdominal surgery. After receiving approval from the Ethics Committee and taking informed written consent, a prospective randomized study was conducted. Forty adult patients were scheduled for major abdominal surgery. Patients were randomly categorized using closed-envelope technique into two equal groups (25 patients each): the control group (20 patients) with intraoperative standard fluid therapy and the goal-directed fluid therapy (GDT) (20 patients) using plethysmography. Urinary cycle arrest biomarkers were measured at 4 and 12 h after ICU admission. The mean value of the arrest biomarkers showed a significant increase in the control group only at 4 h period (p = 0.017). Moreover, there was a statistically significant increase in the number of positive patients in the control group at 4 h period only (p = 0.044). Urine arrest biomarkers were higher in AKI patients than in the non-AKI ones at 4 h (p = 0.003) and 12 h (p = 0.004). The arrest biomarker AUROC values at 4 and 12 h were 0.887 and 0.875, respectively. From these results, we concluded that cell cycle arrest biomarkers can predict AKI after major abdominal surgery. In addition, AKI incidence showed no difference between the control group and the GDT group. [ABSTRACT FROM AUTHOR]

Measuring breathing rates without a mouthpiece is of interest in clinical settings. Electrocardiogram devices and, more recently, optoelectronic plethysmography (OEP) methods can estimate breathing rates with only a few electrodes or motion-capture markers placed on the patient. This study estimated and compared the accuracy and reliability of three non-invasive devices: an OEP system with 12 markers, an electrocardiogram device and the conventional spirometer. Using the three devices simultaneously, we recorded 72 six-minute epochs on supine subjects. Our results show that the OEP system has a very low limit of agreement and a bias lower than 0.4% compared with the spirometer, indicating that these devices can be used interchangeably. We observed comparable results for electrocardiogram devices. The OEP system facilitates breathing rate measurements and offers a more complete chest-lung volume analysis that can be easily associated with heart rate analysis without any synchronisation process, for useful features for clinical applications and intensive care. [ABSTRACT FROM AUTHOR]

Background: Morbidity from undiagnosed atrial fibrillation (AF) may be preventable with early detection. Many consumer wearables contain optical photoplethysmography (PPG) sensors to measure pulse rate. PPG-based software algorithms that detect irregular heart rhythms may identify undiagnosed AF in large populations using wearables, but minimizing false-positive detections is essential.Methods: We performed a prospective remote clinical trial to examine a novel PPG-based algorithm for detecting undiagnosed AF from a range of wrist-worn devices. Adults aged ≥22 years in the United States without AF, using compatible wearable Fitbit devices and Android or iOS smartphones, were included. PPG data were analyzed using a novel algorithm that examines overlapping 5-minute pulse windows (tachograms). Eligible participants with an irregular heart rhythm detection (IHRD), defined as 11 consecutive irregular tachograms, were invited to schedule a telehealth visit and were mailed a 1-week ambulatory ECG patch monitor. The primary outcome was the positive predictive value of the first IHRD during ECG patch monitoring for concurrent AF.Results: A total of 455 699 participants enrolled (median age 47 years, 71% female, 73% White) between May 6 and October 1, 2020. IHRDs occurred for 4728 (1%) participants, and 2070 (4%) participants aged ≥65 years during a median of 122 (interquartile range, 110-134) days at risk for an IHRD. Among 1057 participants with an IHRD notification and subsequent analyzable ECG patch monitor, AF was present in 340 (32.2%). Of the 225 participants with another IHRD during ECG patch monitoring, 221 had concurrent AF on the ECG and 4 did not, resulting in an IHRD positive predictive value of 98.2% (95% CI, 95.5%-99.5%). For participants aged ≥65 years, the IHRD positive predictive value was 97.0% (95% CI, 91.4%-99.4%).Conclusions: A novel PPG software algorithm for wearable Fitbit devices exhibited a high positive predictive value for concurrent AF and identified participants likely to have AF on subsequent ECG patch monitoring. Wearable devices may facilitate identifying individuals with undiagnosed AF.Registration: URL: https://www.Clinicaltrials: gov; Unique identifier: NCT04380415. [ABSTRACT FROM AUTHOR]

To compare the effect of unsupported arm elevation (UAE) in different planes on chest wall volumes, thoracoabdominal asynchrony (TAA), ventilatory demands, dyspnea, and arm fatigue in patients with chronic obstructive pulmonary disease (COPD) and healthy subjects. Twenty-one patients with COPD and healthy-matched subjects performed UAE in shoulder flexion, scaption, abduction, and resting. Pulmonary total and regional chest wall volumes (VRCp), abdominal rib cage volume, abdominal volume, TAA, and ventilatory demands during arm positions were measured using optoelectronic plethysmography. In both groups, VRCp and TAA were significantly affected during UAEs compared with the resting position. The healthy subjects had significantly decreased VRCp (L) (p < 0.05) during scaption (0.14 ± 0.07) and abduction (0.15 ± 0.06) than during flexion (0.18 ± 0.07) and no significantly different TAA between UAEs. The COPD group had no significantly different VRCp between UAEs, had significantly increased TAA (p < 0.05) during scaption (31.1°±9.5°) and abduction (32.3°±9.9°) than during flexion (29.7°±9.1°); and had significantly worse VRCp (p = 0.007), TAA (p = 0.0001), ventilatory demands (p < 0.05), dyspnea ((p = 0.03), and arm fatigue (p = 0.002). In patients with COPD, UAE in different planes similarly restricted the upper chest wall volume. Shoulder scaption and abduction significantly impaired TAA, ventilation, dyspnea, and arm fatigue compared with flexion. These results may help to select the appropriate UAE during physical activities. [ABSTRACT FROM AUTHOR]

Anesthesia drug overdose hazards and lack of gold standards in anesthesia monitoring lead to an urgent need for accurate anesthesia drug detection. To investigate the PPG waveform features affected by anesthesia drugs and develop a machine-learning classifier with high anesthesia drug sensitivity. This study used 64 anesthesia and non-anesthesia patient data (32 cases each), extracted from Queensland and MIMIC-II databases, respectively. The key waveform features (total area, rising time, width 75%, 50%, and 25%) were extracted from 16,310 signal recordings (5-s duration). Discriminant analysis, support vector machine (SVM), and K-nearest neighbor (KNN) were evaluated by splitting the dataset into halve training (11 patients, 8570 segments) and halve testing dataset (11 patients, 7740 segments). Significant differences exist between PPG waveform features of anesthesia and non-anesthesia groups (p < 0.05) except total area feature (p > 0.05). The KNN classifier achieved 91.7% (AUC = 0.95) anesthesia detection accuracy with the highest sensitivity (0.88) and specificity (0.90) as compared to other classifiers. Kohen's kappa also shows almost perfect agreement (0.79) with the KNN classifier. The KNN classifier trained with significant PPG features has the potential to be used as a reliable, non-invasive, and low-cost method for the detection of anesthesia drugs for depth analysis during surgical operations and postoperative monitoring. [ABSTRACT FROM AUTHOR]

Background: Persistent symptoms after acute coronavirus-disease-2019 (COVID-19) are common, and there is no significant correlation with the severity of the acute disease. In long-COVID (persistent symptoms >4 weeks after acute COVID-19), respiratory symptoms are frequent, but lung function testing shows only mild changes that do not explain the symptoms. Although COVID-19 may lead to an impairment of the peripheral nervous system and skeletal muscles, respiratory muscle function has not been examined in this setting. Methods: In this study, we assessed the severity of dyspnea (NYHA-function class) in long-COVID patients and analyzed its association with body mass index (BMI), FEV1, forced vital capacity, other parameters of body plethysmography, diffusing capacity for carbon monoxide (DLCO), arterial blood gases, and inspiratory muscle function, assessed by airway occlusion pressure (P0.1) and maximal inspiratory pressure (PImax) in two respiratory clinics in Germany between Oct 2020 and Aug 2021. Results: A total of 116 patients were included in the study. The mean age was 50.2 ± 14.5 years; BMI, 26.7 ± 5.87 kg/m2; NYHA class I, 19%; II, 27%; III, 41%; and IV, 14%. While lung function values and computed tomography or conventional X-ray of the chest were in the normal range, inspiratory muscle function was markedly impaired. P01 was elevated to 154 ± 83%predicted and PImax was reduced to 41 ± 25%predicted. PImax reduction was strongly associated with the severity of dyspnea but independent of BMI, time after acute COVID-19 and most of the other parameters. Conclusions: This study shows that in long-COVID patients, respiratory symptoms may be mainly caused by reduced inspiratory muscle strength. Assessment of PImax and P0.1 might better explain dyspnea than classical lung function tests and DLCO. A prospective study is needed to confirm these results. [ABSTRACT FROM AUTHOR]

Objectives. Clinical assessment of skin perfusion informs prognosis in critically ill patients. Video camera monitoring could provide an objective, continuous method to monitor skin perfusion. In this prospective, interventional study of healthy volunteers, we tested whether video camera-derived photoplethysmography imaging and colour measurements could detect drug-induced skin perfusion changes. Approach. We monitored the lower limbs of 30 volunteers using video cameras while administering phenylephrine (a vasoconstrictor) and glyceryl trinitrate (a vasodilator). We report relative pixel intensity changes from baseline, as absolute values are sensitive to environmental factors. The primary outcome was the pre- to peak- infusion green channel amplitude change in the pulsatile PPGi waveform component. Secondary outcomes were pre-to-peak changes in the photoplethysmographic imaging waveform baseline, skin colour hue and skin colour saturation. Main results. The 30 participants had a median age of 29 years (IQR 25–34), sixteen (53%) were male. A 34.7% (p = 0.0001) mean decrease in the amplitude of the pulsatile photoplethysmographic imaging waveform occurred following phenylephrine infusion. A 30.7% (p = 0.000004) mean increase occurred following glyceryl trinitrate infusion. The photoplethysmographic imaging baseline decreased with phenylephrine by 2.1% (p = 0.000 02) and increased with glyceryl trinitrate by 0.5% (p = 0.026). Skin colour hue changed in opposite direction with phenylephrine (−0.0013, p = 0.0002) and glyceryl trinitrate (+0.0006, p = 0.019). Skin colour saturation decreased with phenylephrine by 0.0022 (p = 0.0002), with no significant change observed with glyceryl trinitrate (+0.0005, p = 0.21). Significance. Drug-induced vasoconstriction and vasodilation are associated with detectable changes in photoplethysmographic imaging waveform parameters and skin hue. Our findings suggest video cameras have great potential for continuous, contactless skin perfusion monitoring. [ABSTRACT FROM AUTHOR]

Standardized exercise therapy programs in pulmonary rehabilitation have been shown to improve physical performance and lung function parameters in post-acute COVID-19 patients. However, it has not been investigated if these positive effects are equally beneficial for both sexes. The purpose of this study was to analyze outcomes of a pulmonary rehabilitation program with respect to sex differences, in order to identify sex-specific pulmonary rehabilitation requirements. Data of 233 post-acute COVID-19 patients (40.4% females) were analyzed before and after a three-week standardized pulmonary rehabilitation program. Lung function parameters were assessed using body-plethysmography and functional exercise capacity was measured by the Six-Minute Walk Test. At post-rehabilitation, females showed a significantly smaller improvement in maximal inspiration capacity and forced expiratory volume (F=5.86, ω2=.02; p<0.05) than males. Exercise capacity improvements between men and women did not differ statistically. Females made greater progress towards reference values of exercise capacity (T(231)=−3.04; p<0.01) and forced expiratory volume in the first second (T(231)=2.83; p<0.01) than males. Sex differences in the improvement of lung function parameters seem to exist and should be considered when personalizing standardized exercise therapies in pulmonary rehabilitation. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study on the effectiveness of spirometry and forced oscillation technique in reducing thoracic compliance. Topics mentioned include the measurement of impedance to air flow due to airway resistance and respiratory system compliance, some limitations associated with spirometry, and the influence of chest restriction on total lung capacity.

Spirometry can play a critical role as a gold standard in the diagnosis and treatment of patients with chronic obstructive pulmonary disease (COPD). While the criteria for diagnosis have advanced over time, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) standard of the forced expiratory volume in 1 second/forced vital capacity ratio &lt;0.7 remains the most universally employed metric. However, spirometry cannot be utilized in all situations, and test execution can be difficult for some patients, often showing normal values in the early diagnosis of COPD. Therefore, research on new diagnostic methods is underway. Techniques include whole-body plethysmography for measurement of residual volume and inspiratory capacity and airway resistance, diffusing capacity of carbon monoxide or nitric oxide, impulse oscillometry, infrared time-offlight depth image sensor, diaphragm ultrasonography, which can enable early diagnosis and multifaceted assessment of patients with COPD.

Assessing growth quality in preterm infants present challenges, particularly with the use of the standard fat-free mass measurement. We report here a moderate correlation between indirect skeletal muscle mass measurements using the D3-creatine dilution method and fat-free mass measured with air-displacement plethysmography. Skeletal muscle mass could serve as an indicator of growth quality., Competing Interests: Declaration of Competing Interest The Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD102554; A.A.S.) and The Academy of Nutrition and Dietetics Dietitians in Nutrition Support Practice Group (M.L.J.). W.J.E. is listed as coinventor on the granted patents for the D3-creatine dilution method, but do not own or derive any income from the intellectual property. The other authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: To determine whether Opto-Electronic Plethysmography (OEP) can distinguish Exercise-Induced Bronchoconstriction (EIB) breathing patterns by comparing individuals with and without EIB, and between broncho-constriction and recovery. Breathing pattern was quantified in terms of regional contribution, breathing timing, and the phase between chest sub-compartments which indicates the synchronization in movement of the different sub-compartments., Methods: Individuals ( n  = 47) reporting no respiratory symptoms and no history of any respiratory disease or disorder were assumed to have a healthy breathing pattern. Of 38 participants reporting respiratory symptoms during exercise, and/or a previous diagnosis of asthma or EIB, 10 participants had a positive result to the Eucapnic Voluntary Hyperpnea test, defined as a fall of at least 10% in FEV 1 from baseline at two consecutive time points and were classified into the EIB group. OEP data was obtained from 89 markers and an 11-camera motion capture system operating at 100 Hz as follows: pre- and post-EVH challenge, and post-inhaler in participants who experienced a bronchoconstriction, and 2) for the healthy group during tidal breathing., Results: RCpRCa-Phase (upper versus lower ribcage), RCaS-Phase (lower ribcage versus shoulders), and RCpS-Phase (upper ribcage versus shoulders) differed between bronchoconstriction and rest in athletes with EIB and rest in healthy participants ( p  < 0.05), in all cases indicating greater asynchrony post-bronchoconstriction, and later movement of the abdominal ribcage (RCa) post-bronchoconstriction. RCpS-Phase was different ( p  < 0.05) between all conditions (rest, post-bronchoconstriction, and post-inhaler) in EIB., Conclusions: OEP can characterize and distinguish EIB-associated breathing patterns compared to rest and individuals without EIB at rest.

Hypertension constitutes a significant risk factor for the development of many coronary artery diseases. In recent years, the advancement of technology and artificial intelligence has led to significant research and breakthroughs in wearable devices that can monitor blood pressure (BP). These devices offer continuous, real-time BP readings, facilitating the early detection and prevention of hypertension. Detailed research was conducted via the PubMed and Scopus databases, using the following keywords: Wearable devices AND Hypertension AND Monitoring. The research was made in the articles from 2017 and subsequently. The aim of the present review is to highlight the benefits of advanced wearable devices, such as smartwatches equipped with BP tracking, inflatable cuffs, finger and wrist monitors, as well as patch and skin-compatible sensors, which provide individuals with the possibility of detecting BP at any time, while also preventing hypertension disease. Finally, wearable devices develop a telehealth connection between patient and physician. However, they ought to be adhered to by particular protocols that attest to their accuracy., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sinou et al.)