WorldWideScience

Sample records for adjusted ventilatory assist

  1. A prospective crossover comparison of neurally adjusted ventilatory assist and pressure-support ventilation in a pediatric and neonatal intensive care unit population.

    LENUS (Irish Health Repository)

    Breatnach, Cormac

    2012-02-01

    OBJECTIVE: To compare neurally adjusted ventilatory assist ventilation with pressure-support ventilation. DESIGN: Prospective, crossover comparison study. SETTING: Tertiary care pediatric and neonatal intensive care unit. PATIENTS: Sixteen ventilated infants and children: mean age = 9.7 months (range = 2 days-4 yrs) and mean weight = 6.2 kg (range = 2.4-13.7kg). INTERVENTIONS: A modified nasogastric tube was inserted and correct positioning was confirmed. Patients were ventilated in pressure-support mode with a pneumatic trigger for a 30-min period and then in neurally adjusted ventilatory assist mode for up to 4 hrs. MEASUREMENTS AND MAIN RESULTS: Data collected for comparison included activating trigger (neural vs. pneumatic), peak and mean airway pressures, expired minute and tidal volumes, heart rate, respiratory rate, pulse oximetry, end-tidal CO2 and arterial blood gases. Synchrony was improved in neurally adjusted ventilatory assist mode with 65% (+\\/-21%) of breaths triggered neurally vs. 35% pneumatically (p < .001) and 85% (+\\/-8%) of breaths cycled-off neurally vs. 15% pneumatically (p = .0001). The peak airway pressure in neurally adjusted ventilatory assist mode was significantly lower than in pressure-support mode with a 28% decrease in pressure after 30 mins (p = .003) and 32% decrease after 3 hrs (p < .001). Mean airway pressure was reduced by 11% at 30 mins (p = .13) and 9% at 3 hrs (p = .31) in neurally adjusted ventilatory assist mode although this did not reach statistical significance. Patient hemodynamics and gas exchange remained stable for the study period. No adverse patient events or device effects were noted. CONCLUSIONS: In a neonatal and pediatric intensive care unit population, ventilation in neurally adjusted ventilatory assist mode was associated with improved patient-ventilator synchrony and lower peak airway pressure when compared with pressure-support ventilation with a pneumatic trigger. Ventilating patients in this new mode

  2. Neurally adjusted ventilatory assist during weaning from respiratory support in a case of guillain-barré syndrome.

    Science.gov (United States)

    Dugernier, Jonathan; Bialais, Emilie; Reychler, Gregory; Vinetti, Marco; Hantson, Philippe

    2015-04-01

    We report a case of Guillain-Barré syndrome complicated by respiratory failure requiring mechanical ventilation. Neurally adjusted ventilatory assist (NAVA) allowed proper patient-ventilator synchronization by pressure support proportional to the electrical activity of the diaphragm (Edi). Prolonged ventilation with NAVA seems feasible in patients with neuromuscular impairment, but the weaning process conducted by a continuous monitoring of Edi for pressure support titration needed to be assessed in a Guillain-Barré syndrome patient. Beginning on day 12 after hospital admission, the patient was ventilated with NAVA for 8 d. The NAVA level (pressure support per unit of Edi) was decreased from 1.2 cm H2O/μV to zero over the 8-d period. A simultaneous decrease in the tidal volume/Edi ratio was interpreted as a sign of recovery. A spontaneous breathing trial was successfully performed on day 20, followed by decannulation 4 d later. In conclusion, NAVA should be further investigated in patients with Guillain-Barré syndrome, particularly during the weaning period. Copyright © 2015 by Daedalus Enterprises.

  3. Clinical assessment of auto-positive end-expiratory pressure by diaphragmatic electrical activity during pressure support and neurally adjusted ventilatory assist.

    Science.gov (United States)

    Bellani, Giacomo; Coppadoro, Andrea; Patroniti, Nicolò; Turella, Marta; Arrigoni Marocco, Stefano; Grasselli, Giacomo; Mauri, Tommaso; Pesenti, Antonio

    2014-09-01

    Auto-positive end-expiratory pressure (auto-PEEP) may substantially increase the inspiratory effort during assisted mechanical ventilation. Purpose of this study was to assess whether the electrical activity of the diaphragm (EAdi) signal can be reliably used to estimate auto-PEEP in patients undergoing pressure support ventilation and neurally adjusted ventilatory assist (NAVA) and whether NAVA was beneficial in comparison with pressure support ventilation in patients affected by auto-PEEP. In 10 patients with a clinical suspicion of auto-PEEP, the authors simultaneously recorded EAdi, airway, esophageal pressure, and flow during pressure support and NAVA, whereas external PEEP was increased from 2 to 14 cm H2O. Tracings were analyzed to measure apparent "dynamic" auto-PEEP (decrease in esophageal pressure to generate inspiratory flow), auto-EAdi (EAdi value at the onset of inspiratory flow), and IDEAdi (inspiratory delay between the onset of EAdi and the inspiratory flow). The pressure necessary to overcome auto-PEEP, auto-EAdi, and IDEAdi was significantly lower in NAVA as compared with pressure support ventilation, decreased with increase in external PEEP, although the effect of external PEEP was less pronounced in NAVA. Both auto-EAdi and IDEAdi were tightly correlated with auto-PEEP (r = 0.94 and r = 0.75, respectively). In the presence of auto-PEEP at lower external PEEP levels, NAVA was characterized by a characteristic shape of the airway pressure. In patients with auto-PEEP, NAVA, compared with pressure support ventilation, led to a decrease in the pressure necessary to overcome auto-PEEP, which could be reliably monitored by the electrical activity of the diaphragm before inspiratory flow onset (auto-EAdi).

  4. 神经电活动辅助通气模式对患者睡眠质量的影响%Effect of neurally adjusted ventilatory assist modes on sleep quality of patients

    Institute of Scientific and Technical Information of China (English)

    潘红; 李国宏; 朱艳萍; 黄琴红

    2015-01-01

    目的 探讨压力支持通气(PSV)模式和神经电活动辅助通气(NAVA)模式对重症患者睡眠质量的影响.方法 筛选2013年10月20日至2014年2月28日东南大学附属中大医院重症医学科内有自主呼吸的机械通气患者,排除了颅脑疾病、中枢神经系统疾病、慢性精神疾病患者.研究分为两个连续的3h时段:11 pm~2 am为第一时段,3 am~6 am为第二时段,2 am~3 am为洗脱期.10 pm将起始通气模式随机分配为PSV模式或NAVA模式,2 am更换通气模式(即第一时段为PSV模式的改用NAVA模式;第一时段为NAVA模式的改用PSV模式).机械通气参数由临床医师设置:FiO2≤60%,PS使得VT:6~8 ml/kg,RR<35次/min,SPO2≥90%,NAVA吸气触发灵敏度:0.5 mV.采用脑电双频指数持续监测机械通气患者的睡眠.提取11 pm~2 am(第一时段)和3 am~6 am(第二时段)机械通气患者的睡眠数据进行分析.结果 NAVA模式下重症患者的总睡眠时间明显长于PSV模式下重症患者的总睡眠时间[(159±13) min vs (147±31) min,F=5.655,P=0.030];睡眠效率提高[(89±8)% vs (82±17)%,F=5.655,P=0.030].非快速眼球运动睡眠的第1、2期睡眠时间基本一致[(105±37) min vs (115±37) min,F=0.022,P=0.883];慢波睡眠无明显改变,差异无统计学意义[67 min(23~79) vs 31 min(4~56),U=26.5,W=71.5,P=0.215].PSV模式和NAVA模式下均未监测到快速眼球运动睡眠.结论 机械通气患者睡眠效率低、慢波睡眠缩短、快速眼球运动睡眠丧失,遭受严重的睡眠剥夺.NAVA模式下重症患者的睡眠质量优于PSV模式下重症患者的睡眠质量.%Objective To compare the effects of pressure support ventilation (PSV) and neurally adjusted ventilatory assist (NAVA) modes on sleep quality in critically ill patients with mechanical ventilation.Methods Comparative crossover study in 9 mechanically ventilated adult patients.NAVA and PSV were delivered in a randomized order using a closed

  5. 75 FR 59681 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-09-28

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Farmers Program Review Committee, comprised of representatives from USDA's Office of the Chief Economist... adjustment assistance in FY 2011. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for...

  6. 75 FR 59683 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-09-28

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... for Farmers Program Review Committee, comprised of representatives from USDA's Office of the Chief... assistance in FY 2011. FOR FURTHER INFORMATION, CONTACT: Trade Adjustment Assistance for Farmers...

  7. 75 FR 59685 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-09-28

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... analyzed by USDA's Economic Research Service and reviewed by the Trade Adjustment Assistance for Farmers... assistance in FY 2011. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program...

  8. 75 FR 23667 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-05-04

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... site for the Trade Adjustment Assistance for Farmers program. The URL is...

  9. 75 FR 63437 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-10-15

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Farmers Program Review Committee, comprised of representatives from USDA's Office of the Chief Economist... CONTACT: Trade Adjustment Assistance for Farmers Program Staff, Office of Trade Programs, FAS, USDA,...

  10. 75 FR 59682 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-09-28

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... analyzed by USDA's Economic Research Service and reviewed by the Trade Adjustment Assistance for Farmers... Adjustment Assistance for Farmers Program Staff, Office of Trade Programs, FAS, USDA, or by phone at...

  11. 75 FR 43140 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-23

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... assistance and cash benefits. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Staff... ; or visit the TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . Dated: July 14, 2010....

  12. 75 FR 45092 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-02

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service.... FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA by... TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . Dated: July 21, 2010. John D....

  13. 75 FR 48931 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-12

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA by phone... Farmers' Web site: www.fas.usda.gov/itp/taa . Dated: July 30, 2010. John D. Brewer, Administrator,...

  14. 75 FR 43485 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-26

    ...; ] DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY...: Trade Adjustment Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by e-mail: tradeadjustment@fas.usda.gov ; or visit the TAA for Farmers' Web site:...

  15. 75 FR 49458 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-13

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service.... FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA by... TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa . Dated: August 3, 2010. Suzanne...

  16. 75 FR 49886 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-16

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA by phone: (202) 720-0638 or (202) 690- 0633; or by e-mail at: tradeadjustment@fas.usda.gov ; or visit ] the TAA for Farmers' Web...

  17. 75 FR 48642 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-11

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Adjustment Assistance for Farmers Program Staff, FAS, USDA by phone: (202) 720-0638 or (202) 690- 0633; or by e-mail at: tradeadjustment@fas.usda.gov ; or visit the TAA for Farmers' Web site:...

  18. 75 FR 41432 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Farmers Review Committee, comprised of representatives from USDA's Office of the Chief Economist, Farm... Farmers' Program Should Contact: USDA, Farm Service Agency (at your local service center). FOR...

  19. 75 FR 41433 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... TAA for Farmers Review Committee, comprised of representatives from USDA's Office of the Chief... eligible for cash benefits. Producers Certified as Eligible For TAA for Farmers' Program Should...

  20. 75 FR 41431 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Economic Research Service and reviewed by the TAA for Farmers Review Committee, comprised of... Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by...

  1. 75 FR 42375 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-21

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by e-mail: tradeadjustment@fas.usda.gov ; or visit the TAA for Farmers' Web site: http://www.fas.usda.gov/itp/taa ....

  2. 75 FR 41430 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ...; ] DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY... Economic Research Service and reviewed by the TAA for Farmers Review Committee, comprised of... Assistance for Farmers Staff, FAS, USDA, by phone: (202) 720-0638, or (202) 690-0633; or by...

  3. Metabolic acidosis and ventilatory response

    NARCIS (Netherlands)

    Langbroek, Aart Jan Mattheüs

    1988-01-01

    In terrestrial vertebrates lung ventilation is nescessary to accmplish exchange of oxygen (O2) and carbon dioxide (CO2) between the gas phase (lung alveoli) and the fluid phase (the blood flowing through the lung capillaries). The ventilatory control system adjusts the arterial carbon dioxide tensio

  4. Metabolic acidosis and ventilatory response

    NARCIS (Netherlands)

    Langbroek, Aart Jan Mattheüs

    1988-01-01

    In terrestrial vertebrates lung ventilation is nescessary to accmplish exchange of oxygen (O2) and carbon dioxide (CO2) between the gas phase (lung alveoli) and the fluid phase (the blood flowing through the lung capillaries). The ventilatory control system adjusts the arterial carbon dioxide

  5. 75 FR 59683 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-09-28

    ... (No. 2011020) for trade adjustment assistance for coffee filed under the fiscal year (FY) 2011 program by the Kona Coffee Farmers Association. The petition was accepted for review by USDA on July 21, 2010... following factors: national average price, quantity of production, value of production, or cash...

  6. 75 FR 59684 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-09-28

    ... (No. 2011001) for trade adjustment assistance for coffee filed under the fiscal year (FY) 2011 program by 100% Puerto Rico Coffee Export Board, Inc. The petition was accepted for review by USDA on July 21... one of the following factors: national average price, quantity of production, value of production,...

  7. 75 FR 61121 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-10-04

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Economic Research Service and reviewed by the TAA for Farmers Program Review Committee, comprised of... program in order to be eligible for cash benefits. Producers Certified As Eligible For TAA For...

  8. 75 FR 62760 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-10-13

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... analyzed by USDA's Economic Research Service and reviewed by the TAA for Farmers Program Review Committee... CERTIFIED AS ELIGIBLE FOR TAA FOR FARMERS CONTACT: Your local USDA Farm Service Agency county office....

  9. 75 FR 41434 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service... Crawfish Farmers Association and accepted for review by USDA on May 3, 2010. SUPPLEMENTARY INFORMATION: To... and reviewed by the TAA for Farmers Review Committee, comprised of representatives from USDA's...

  10. 75 FR 23226 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-05-03

    ... 15 percent decrease in the quantity of production of asparagus compared to the average of the 3..., and began a review of a petition, for trade adjustment assistance by the National Asparagus Council on behalf of asparagus producers in California, Michigan, and Washington. The Administrator will determine...

  11. Lung protection during non-invasive synchronized assist versus volume control in rabbits

    National Research Council Canada - National Science Library

    Mirabella, Lucia; Grasselli, Giacomo; Haitsma, Jack J; Zhang, Haibo; Slutsky, Arthur S; Sinderby, Christer; Beck, Jennifer

    2014-01-01

    .... For this, we used non-invasive Neurally Adjusted Ventilatory Assist (NIV-NAVA), with the hypothesis that liberation of upper airways and the ventilator's integration with lung protective reflexes would be equally lung protective...

  12. 24 CFR 1000.320 - How is Formula Current Assisted Stock adjusted for local area costs?

    Science.gov (United States)

    2010-04-01

    ... § 1000.320 How is Formula Current Assisted Stock adjusted for local area costs? There are two adjustment... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false How is Formula Current Assisted Stock adjusted for local area costs? 1000.320 Section 1000.320 Housing and Urban Development...

  13. Ventilatory chaos is impaired in carotid atherosclerosis.

    Directory of Open Access Journals (Sweden)

    Laurence Mangin

    Full Text Available Ventilatory chaos is strongly linked to the activity of central pattern generators, alone or influenced by respiratory or cardiovascular afferents. We hypothesized that carotid atherosclerosis should alter ventilatory chaos through baroreflex and autonomic nervous system dysfunctions. Chaotic dynamics of inspiratory flow was prospectively evaluated in 75 subjects undergoing carotid ultrasonography: 27 with severe carotid stenosis (>70%, 23 with moderate stenosis (<70%, and 25 controls. Chaos was characterized by the noise titration method, the correlation dimension and the largest Lyapunov exponent. Baroreflex sensitivity was estimated in the frequency domain. In the control group, 92% of the time series exhibit nonlinear deterministic chaos with positive noise limit, whereas only 68% had a positive noise limit value in the stenoses groups. Ventilatory chaos was impaired in the groups with carotid stenoses, with significant parallel decrease in the noise limit value, correlation dimension and largest Lyapunov exponent, as compared to controls. In multiple regression models, the percentage of carotid stenosis was the best in predicting the correlation dimension (p<0.001, adjusted R(2: 0.35 and largest Lyapunov exponent (p<0.001, adjusted R(2: 0.6. Baroreflex sensitivity also predicted the correlation dimension values (p = 0.05, and the LLE (p = 0.08. Plaque removal after carotid surgery reversed the loss of ventilatory complexity. To conclude, ventilatory chaos is impaired in carotid atherosclerosis. These findings depend on the severity of the stenosis, its localization, plaque surface and morphology features, and is independently associated with baroreflex sensitivity reduction. These findings should help to understand the determinants of ventilatory complexity and breathing control in pathological conditions.

  14. 77 FR 23288 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-04-18

    ... March 14, 2011. Scientific Milwaukee, LLC, Molecular Biology Reagents Division. 81,426 Dixtal Medical..., Emporia, VA March 13, 2011. Campbell Foundry. Negative Determinations for Worker Adjustment Assistance...

  15. 7 CFR 4279.175 - Domestic lamb industry adjustment assistance program set aside.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Domestic lamb industry adjustment assistance program... GUARANTEED LOANMAKING Business and Industry Loans § 4279.175 Domestic lamb industry adjustment assistance... National Office to fund loans to lamb processors for real estate purchases and improvements;...

  16. 38 CFR 36.4412 - Annual adjustments to the aggregate amount of assistance available.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Annual adjustments to the aggregate amount of assistance available. 36.4412 Section 36.4412 Pensions, Bonuses, and Veterans' Relief... Specially Adapted Housing § 36.4412 Annual adjustments to the aggregate amount of assistance available....

  17. 13 CFR 307.3 - Use of Economic Adjustment Assistance Investments.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Use of Economic Adjustment Assistance Investments. 307.3 Section 307.3 Business Credit and Assistance ECONOMIC DEVELOPMENT... “Strategy Grant”), or to fund a Project implementing such a CEDS (an “Implementation Grant”). (a) Strategy...

  18. 75 FR 23227 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-05-03

    ... lilies contributed importantly to a greater than 15 percent decrease in cash receipts for lilies compared... apply to the Farm Service Agency for technical assistance at no cost and cash benefits. FOR...

  19. 75 FR 28780 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-05-24

    ... in the national average price, or quantity of production, or value of production, or cash receipts... production, or cash receipts for the agricultural commodity specified in the petition, compared to the... Agriculture (USDA) provides technical assistance and cash benefits to eligible producers of raw...

  20. 75 FR 11513 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-03-11

    ... value of production, or cash receipts for the commodity specified in the petition compared to the... the national average price, or quantity of production, or value of production, or cash receipts for.... Under this program, the U.S. Department of Agriculture (USDA) provides technical assistance and...

  1. 75 FR 51978 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-24

    ... decrease in the average annual price of tilapia, quantity of production, value of production, or cash receipts, compared to the average of the three preceding marketing years. If a determination is affirmative... for free technical assistance and cash benefits. FOR FURTHER INFORMATION CONTACT: Trade...

  2. 75 FR 7039 - Investigations Regarding Certifications of Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-02-16

    ... adjustment assistance under Title II, Chapter 2, of the Act. The investigations will further relate, as......... 01/13/10 11/01/09 73267 Johnston Supply, Inc. Ashland, OH 01/13/10 12/31/09 (Comp). 73268...

  3. European Globalisation Adjustment Fund-Assistance in the Labour Market

    Directory of Open Access Journals (Sweden)

    Ramona Mariana CALINICA

    2016-12-01

    Full Text Available The intensification of globalization and through intense manifestation of the effects on recent economic and financial crisis, employment market has been affected, and at European Union level was considered increasingly necessary granting support for counter of the negative effects of the two phenomena on this market. European Globalisation Adjustment Fund is designed for a rapid reintegration of fired workers and increase of the employment potential of the workforce, after mass dismissals linked to the two phenomena mentioned above.

  4. 75 FR 2491 - Trade Adjustment Assistance for Firms Program Fiscal Year 2009 Annual Report

    Science.gov (United States)

    2010-01-15

    ... Adjustment Assistance Centers' goal is to help U.S. firms increase profitability and retain employees while.../customer diversification server improvement bar coding brand recognition/ CRM and PM software financial... customer communication government procurement enhance testing and marketing/advertising tools...

  5. 78 FR 3031 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-01-15

    ... Adjustment Assistance TA-W-81,739, HEWLETT-PACKARD COMPANY, PERSONAL PRINTING SYSTEMS (PPS), FORMERLY KNOWN... PRINTING SYSTEMS (PPS), INK JET & WEB SERVICES (IWS), WORLD WIDE DESIGN GROUP, VANCOUVER, WA; TA-W-81,739B, HEWLETT-PACKARD COMPANY, PERSONAL PRINTING SYSTEMS (PPS), SUPPLY CHAIN OPERATIONS (FORMERLY KNOWN AS...

  6. 24 CFR 570.401 - Community adjustment and economic diversification planning assistance.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Community adjustment and economic... Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES COMMUNITY DEVELOPMENT...

  7. 76 FR 68219 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    Science.gov (United States)

    2011-11-03

    ... firm or subdivision have contributed importantly to such workers' separation or threat of separation...' separation or threat of separation. In order for the Division of Trade Adjustment Assistance to issue a...,455; LA Darling Company, LLC, Corning, AR: September 19, 2010. The following certifications have been...

  8. 76 FR 2720 - Trade Adjustment Assistance Program; Designation of Certifying Officers

    Science.gov (United States)

    2011-01-14

    ... certain types of foreign trade. The Trade and Globalization Adjustment Assistance Act of 2009 amended the... service sector; made benefits available to workers whose jobs have been off-shored to any country, as... earlier access to training. Workers become eligible for program benefits only if the worker group is...

  9. 78 FR 780 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-01-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR... adjustment assistance under Title II, Chapter 2, of the Act. The investigations will further relate, as...). 82175 Philips Healthcare (Workers) Highland Heights, OH... 11/27/12 11/16/12 82176 RockTenn...

  10. 75 FR 49533 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-08-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR... adjustment assistance under Title II, Chapter 2, of the Act. The investigations will further relate, as.../10 LLC (State/One-Stop). MI. 74435 Philips Lighting Union, NJ......... 07/28/10 07/21/10...

  11. 78 FR 48471 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-08-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR... to determine whether the workers are eligible to apply for adjustment assistance under Title II...). Jonesboro, AR......... 07/05/13 07/03/13 82876 Philips Respironics (State/ Wallingford, CT..........

  12. 77 FR 29366 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-05-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR... to determine whether the workers are eligible to apply for adjustment assistance under Title II... (Company). 81526 Philips Healthcare/ Murrysville, PA....... 04/23/12 03/15/12 Respironics (Workers)....

  13. 78 FR 69883 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-11-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR... to determine whether the workers are eligible to apply for adjustment assistance under Title II...). 83163 Osram Sylvania (State/One- Luquillo, PR 10/22/13 10/21/13 Stop). 83164 Philips Lumileds...

  14. 78 FR 781 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-01-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR... to determine whether the workers are eligible to apply for adjustment assistance under Title II... International, Buena Park, CA......... 12/12/12 12/11/12 Esterline Corporation (Company). 82244 Philips...

  15. 78 FR 28636 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-05-15

    ... Trade Commission as a member of a domestic industry in an investigation resulting in-- (A) An... Management, Global Tech, Citi Shared, Leased Workers. 82,558 Abbott Diabetes Care, Abbott, Langhorne, PA... for Worker Adjustment Assistance In the following cases, the investigation revealed that...

  16. Examining Differences in Psychological Adjustment Problems among Children Conceived by Assisted Reproductive Technologies

    Science.gov (United States)

    Shelton, Katherine H.; Boivin, Jacky; Hay, Dale; van den Bree, Marianne B. M.; Rice, Frances J.; Harold, Gordon T.; Thapar, Anita

    2009-01-01

    The aim of this study was to examine whether there was variation in levels of psychological adjustment among children conceived through Assisted Reproductive Technologies using the parents' gametes (homologous), sperm donation, egg donation, embryo donation and surrogacy. Information was provided by parents about the psychological functioning of…

  17. 75 FR 7041 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-02-16

    ... Trade Adjustment Assistance. Appendix Subject firm Date of Date of TA-W (petitioners) Location.... North Wilkesboro, NC... 01/21/10 01/08/10 (Comp). 73320 Rio Tinto Services, Inc. South Jordan, UT... Elkins, WV 01/22/10 01/21/10 Group (Comp). 73334 GBR Systems Ltd (State). Chester, CT 01/22/10...

  18. 75 FR 68623 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-11-08

    ... substantial interest in the subject matter of the investigations may request a public hearing, provided such... regarding the subject matter of the investigations to the Director, Division of Trade Adjustment Assistance... Antenna Systems, Albion, MI 10/22/10 10/18/10 Inc. (Company). 74766 Rocon Manufacturing Rochester,...

  19. 77 FR 28901 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance; Lexis...

    Science.gov (United States)

    2012-05-16

    ... Adjustment Assistance; Lexis Nexis, a Subsidiary of Reed Elsevier, Quality & Metrics Department, Including... Reed Elsevier, Quality & Metrics Department, Including Employees Located Throughout the United States... report wages under the parent company, Reed Elsevier. The amended notice applicable to TA-W-80,205 and...

  20. Efeitos da tosse manualmente assistida sobre a mecânica do sistema respiratório de pacientes em suporte ventilatório total Effects of manually assisted coughing on respiratory mechanics in patients requiring full ventilatory support

    Directory of Open Access Journals (Sweden)

    Katia de Miranda Avena

    2008-06-01

    Full Text Available OBJETIVO: A tosse manualmente assistida (TMA consiste na compressão vigorosa do tórax no início da expiração espontânea ou da fase expiratória da ventilação mecânica. Tendo em vista a utilização rotineira da TMA na unidade de terapia intensiva, a proposta deste estudo foi analisar os efeitos dessa técnica no comportamento da mecânica do sistema respiratório de pacientes submetidos a suporte ventilatório total. MÉTODOS: Foram estudados 16 pacientes intubados, sedados e submetidos à ventilação mecânica controlada, sem participação interativa com o ventilador. A mecânica do sistema respiratório e a saturação periférica de oxigênio foram mensuradas antes e após a aplicação de TMA e após a aspiração traqueal. Foram realizadas 10 aplicações bilaterais da técnica por paciente, com intervalos de 3 ciclos respiratórios entre cada aplicação. RESULTADOS: Os dados evidenciaram a diminuição da pressão resistiva e da resistência do sistema respiratório e aumento da saturação periférica de oxigênio após a aplicação da TMA associada à aspiração traqueal. Não foram evidenciadas alterações das pressões de pico, platô e complacência do sistema respiratório após a aplicação da TMA. CONCLUSÕES: A TMA foi capaz de alterar a mecânica do sistema respiratório, mais especificamente aumentando as forças resistivas através do deslocamento de secreção. A técnica pode ser considerada eficaz e segura para pacientes em pós-operatório imediato. A associação entre TMA e aspiração traqueal mostrou-se benéfica, alcançando os objetivos propostos: deslocamento e remoção de secreção das vias aéreas.OBJECTIVE: Manually assisted coughing (MAC consists of a vigorous thrust applied to the chest at the beginning of a spontaneous expiration or of the expiratory phase of mechanical ventilation. Due to routine use of MAC in intensive care units, the objective of this study was to assess the effects of MAC

  1. 76 FR 5811 - Adjusted Federal Medical Assistance Percentage (FMAP) Rate for the First Quarter of Fiscal Year...

    Science.gov (United States)

    2011-02-02

    ... HUMAN SERVICES Adjusted Federal Medical Assistance Percentage (FMAP) Rate for the First Quarter of... 2009 (Pub. L. 111-5) for Adjustments to the First Quarter of Fiscal Year 2011 Federal Medical... quarter of Fiscal Year 2011 (FY11) as required under Section 5001 of the American Recovery...

  2. Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: A systematic review.

    Science.gov (United States)

    Gourounti, Kleanthi

    2016-01-01

    The aim of this review was to examine studies describing the psychological stress and adjustment in pregnancy after an assisted reproductive technology (ART) treatment. A systematic search of the electronic databases was performed. This review considered only quantitative, primary studies in the English language, published during the period 2000-2014 and relevant to the objective. The population of interest was previously infertile pregnant women. Outcome variables were general anxiety, depressive symptoms, pregnancy-specific anxiety, quality of life, self-esteem, pregnancy attitudes and adjustment, and maternal-fetal attachment. Twenty studies met the inclusion and methodological criteria and were included in the review. The review revealed that compared to women who conceive naturally or to general norms, women who conceive after an in vitro fertilization treatment had greater pregnancy-specific anxiety, poorer quality of life, either the same or less depressive symptomatology, the same level of self-esteem, more positive attitudes toward pregnancy demands, and higher levels of maternal-fetal attachment. However, the evidence regarding the general anxiety levels in pregnancy after an ART treatment was inconclusive. Methodological limitations and differences across studies may explain the inconsistencies in their findings regarding the impact of ART. This review provides an insight into psychological reactions and adjustment in pregnancy after an ART treatment.

  3. Leg strength is associated with ventilatory efficiency in older women.

    Science.gov (United States)

    Gonzales, J U; Tucker, S H; Kalasky, M J; Proctor, D N

    2012-07-01

    The aim of the present study was to determine if leg function is associated with ventilatory efficiency during exercise in healthy older adults. 24 women and 18 men aged 60-80 years performed treadmill exercise to fatigue for calculation of ventilatory efficiency using the ratio of ventilation to carbon dioxide at the anaerobic threshold (VE/VCO₂@AT). On a separate day, participants performed leg strength testing and graded single-leg knee extension exercise. The VE/VCO₂@AT was higher in women than men (33±3 vs. 30±3; p=0.03). After adjustment for age and VO(₂max), leg strength (knee extensor isometric force) was inversely associated with VE/VCO₂@AT in women (r= - 0.44, p=0.03) while no relationships were found for men. Strength-matched women and men had similar VE/VCO₂@AT indicating that the correlation between leg strength and VE/VCO₂@AT was strength- but not sex-specific. During knee extensor exercise, women with lower leg strength had increased VE/VCO₂ slope across 0-15 W as compared to higher strength women (38±8 vs. 31±3; p<0.05), while no differences were found for men. These results find leg strength to be associated with ventilatory responses to exercise in healthy older women, a finding that might be related to lower leg strength in women than men.

  4. Ventilatory support in facioscapulohumeral muscular dystrophy.

    NARCIS (Netherlands)

    Wohlgemuth, M.; Kooi, E.L. van der; Kesteren, R.G. van; Maarel, S.M. van der; Padberg, G.W.A.M.

    2004-01-01

    Respiratory insufficiency due to respiratory muscle weakness is a common complication of many neuromuscular diseases. The prevalence of respiratory failure in facioscapulohumeral muscular dystrophy (FSHD) is unknown. The authors identified 10 FSHD patients on nocturnal ventilatory support at home,

  5. Evaluation of ventilatory therapy for acid aspiration.

    Science.gov (United States)

    Flint, L; Gosdin, G; Carrico, C J

    1975-10-01

    Aspiration of hydrochloric acid in experimental animals results in severe, progressive hypoxia which is due to intrapulmonary shunting and depressed cardiac output. This preparation is useful therefore in studying the therapy of hypoxia. Mongrel dogs were subjected to acid aspiration and the effects of several ventilatory patterns on intrapulmonary shunt fractions and lung water accumulation observed. The combination of large tidal volumes (30 c.c. per kilogram) with positive end-expiratory pressure was effective in preventing intrapulmonary shunting and other ventilatory patterns were ineffective. Pulmonary edema uniformly followed acid aspiration and was not affected by ventilatory therapy. When ventilatory therapy was delayed for 4 hours, the progression of shunting apparently was limited, but the existing shunt was not reduced.

  6. Newborn ventilatory response to maternal chronic hypercapnia.

    Science.gov (United States)

    DeLuca, L; Holzman, I; Gibbs, K

    2012-10-01

    This is a case of a neonate born with a respiratory acidosis with a compensatory metabolic alkalosis. This case demonstrates placental physiology of gas exchange as well as the blunted ventilatory response in the neonate from chronic hypercapnia.

  7. Twins conceived using assisted reproduction: parent mental health, family relationships and child adjustment at middle childhood.

    Science.gov (United States)

    Anderson, Kayla N; Koh, Bibiana D; Connor, Jennifer J; Koerner, Ascan F; Damario, Mark; Rueter, Martha A

    2014-10-10

    Compared with singletons, what is the parent mental health, parent-child and couple relationship satisfaction, and child adjustment of 6- to 12-year-old assisted reproduction technology (ART) twins and their families? There are no differences between 6- and 12-year-old ART twin and singleton families in parent mental health or family relationships; however, twins had significantly fewer behavior and attention problems than singletons in middle childhood. When ART twins are younger than 5 years old, parents have more mental health difficulties and poorer parent-child relationship quality, and no differences have been found in ART twin and singletons' psychosocial adjustment. However, studies have only examined the implications of ART twin status in families with infant and toddler aged children. A cross-sectional study of 300 6-12-year-old ART children (n = 124 twins and n = 176 singletons) from 206 families at a reproductive endocrinology clinic in the USA. Patients from one clinic with a child born between 1998 and 2004 were invited to participate in an online survey (82% recruitment rate). Participants provided information on each 6- to 12-year-old ART child in the family, and responded to questions on parent mental health, family relationships and child adjustment. There were no differences in parent mental health or family relationships in families with 6- to 12-year-old ART twins versus singletons. However, twins (M = 2.40, SE = 0.35) had significantly fewer behavior problems than singletons (M = 3.47, SE = 0.36; F(1, 201) = 4.54, b = 1.08, P family demographics are representative of US ART patients, patients are from one US clinic. Responses also are from one family member and may be subject to social desirability biases. Additionally, our data did not include identification of monozygotic and dizygotic twins. Studies on infant and toddler ART twins suggest these families have parents with more mental health difficulties and lower parent-child relationship

  8. Does infertility history affect the emotional adjustment of couples undergoing assisted reproduction? the mediating role of the importance of parenthood.

    Science.gov (United States)

    Moura-Ramos, Mariana; Gameiro, Sofia; Canavarro, Maria Cristina; Soares, Isabel; Almeida-Santos, Teresa

    2016-05-01

    The emotional adjustment of couples undergoing assisted reproductive technology (ART) treatments has been widely studied; however, it remains unclear whether infertility history contributes to couples' adjustment. This study examined the impact of infertility history (duration of infertility and number of previous ART treatment cycles) on the emotional adjustment of couples undergoing an ART cycle and the mediating effect of importance of parenthood on that association. In this cross-sectional study, 70 infertile couples (70 women and 70 men) completed self-report questionnaires assessing emotional adjustment and infertility stress during the hormonal stimulation phase of an ART cycle. Path models accounting for the dyadic nature of the data examined the direct and indirect effects (by affecting representations about parenthood and childlessness) of infertility history on emotional adjustment. The number of previous cycles affected men's, but not women's, emotional adjustment by affecting the representations on the importance of parenthood and of childlessness. Duration of infertility had the opposite effect, as couples with longer infertility reported heightened importance of parenthood, which negatively affected their emotional adjustment. Infertility history was associated with emotional adjustment in men and women, although these associations were complex. The results suggest that progression through treatment is harder for those men and women who attribute higher importance to being parents, which is aggravated by longer infertility. What is already known about the subject? Infertility is an unexpected and stressful life event Assisted reproductive treatments (ART) are emotionally demanding What does this study add? The influence of infertility history on adjustment is mediated by the importance of parenthood Men and women are affected by their past history of infertility differently. © 2015 The Authors. British Journal of Health Psychology published by John

  9. Dislocated Workers. An Early Look at the NAFTA Transitional Adjustment Assistance Program. Report to the Chairman, Employment, Housing and Aviation Subcommittee, Committee on Government Operations, House of Representatives.

    Science.gov (United States)

    General Accounting Office, Washington, DC. Health, Education, and Human Services Div.

    The General Accounting Office reviewed the Department of Labor's (DOL) implementation of the North American Free Trade Agreement Transitional Adjustment Assistance (NAFTA-TAA) program to see whether the DOL had corrected the shortcomings of the original Trade Adjustment Assistance (TAA) program. (An earlier study had shown that the TAA program had…

  10. 13 CFR 307.2 - Criteria for Economic Adjustment Assistance Investments.

    Science.gov (United States)

    2010-01-01

    ... Assistance Investments. 307.2 Section 307.2 Business Credit and Assistance ECONOMIC DEVELOPMENT... targeted economic sectors through use of tools that: (1) Help develop and implement a CEDS; (2) Expand the capacity of public officials and economic development organizations to work effectively with businesses;...

  11. An Illustration to Assist in Comparing and Remembering Several Multiplicity Adjustment Methods

    Science.gov (United States)

    Hasler, Mario

    2017-01-01

    There are many well-known or new methods to adjust statistical tests for multiplicity. This article provides an illustration helping lecturers or consultants to remember the differences of three important multiplicity adjustment methods and to explain them to non-statisticians.

  12. 75 FR 57514 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-09-21

    ... Worker from Express Personnel Services, etc. 74,550 Artisans, Inc Glen Flora, WI...... August 20, 2009...,246 Bank of America, Card State College, PA... Customer Assistance Division. 74,290 Supermedia...

  13. 76 FR 4614 - Trade Adjustment Assistance for Firms Program Fiscal Year 2010 Annual Report

    Science.gov (United States)

    2011-01-26

    ... economy. In general, the program provides cost-sharing technical assistance to eligible businesses to... Program is to help U.S. firms regain competitiveness in the global economy. Import-impacted...

  14. 78 FR 61396 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-10-03

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment... International Banking Center (State/One-Stop). ] BILLING CODE 4510-FN-P...

  15. Factors affecting the decline of ventilatory function in chronic bronchitis

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, A.H.; Barter, C.E.; O' Connell, J.M.; Huggins, R.

    1985-10-01

    Ninety six middle aged male patients with chronic bronchitis with relatively well preserved ventilatory function who were resident in Queensland, New South Wales, or Victoria took part in a prospective study to determine the relationship of various factors to the rate of decline of the Forced Expiratory Volume (FEV1). Thirty of the subjects withdrew, leaving 66 to be followed for four to six years. The mean rate of decline of the Forced Expiratory Volume (FEV1) was 58.6 ml/year. The subjects ventilatory responses to bronchodilator and to methacholine were significantly related to each other and to sputum eosinophilia. With a linear model for the data on 57 patients who had methacholine and skin tests the rate of decline of the FEV1 was found, after adjustment had been made for other variables, to be significantly related to state of residence, current smoking, response to bronchodilator, age, and occupational exposure to dust. Response to bronchodilator was interchangeable with response to methacholine. When data from all 66 subjects were introduced into the model, in addition to the five significant individual variables (FEV1/VC% X response to bronchodilator) was significantly related to the rate of decline of the FEV1. Of these prognostic indices, response to bronchodilator was independent of the initial FEV1, FEV/VC%, and FEV1% predicted. The difference between states, which was not explained by differences due to sampling or withdrawal of subjects, was due to a low rate of decline in Queensland.

  16. Home mechanical ventilatory support in patients with restrictive ventilatory disorders : A 48-year experience

    NARCIS (Netherlands)

    Duiverman, ML; Bladder, G; Meinesz, AF; Wijkstra, PJ

    2006-01-01

    We performed a retrospective analysis to the effects of negative pressure ventilation (NPV), tracheal intermittent positive pressure ventilation (TIPPV), and nasal intermittent positive pressure ventilation (NIPPV, volume or pressure-controlled ventilatory mode), in 114 patients with restrictive ven

  17. Measurement of ventilatory threshold by respiratory frequency.

    Science.gov (United States)

    Nabetani, Teru; Ueda, Takeshi; Teramoto, Keisuke

    2002-06-01

    This study was conducted to assess whether respiratory frequency can be used as a valid parameter for estimating ventilatory threshold and for examining differences in exercise modes such as a cycle ergometer and a treadmill. 24 men and 12 women performed an incremental exercise test to exhaustion on a cycle ergometer and on a treadmill. Oxygen uptake, carbon dioxide output, pulmonary ventilation, ventilatory frequency, and heart rate were measured continuously every 30 sec. during the test. Three different and independent reviewers detected the ventilatory threshold point and break point of respiratory rate, which were then compared. Analysis indicated that (1) ventilatory threshold was well correlated with break point of respiratory rate for both cycle (r=.88, pcycle) or 88% (treadmill) of break point of respiratory rate. (2) The regression equation for treadmill exercise was more accurate than that for cycling, but the detected data samples were smaller. The break point of respiratory rate was more easily detected for the cycle ergometer test 33 of 36 subjects) than for the treadmill test (only 15 of 36). The cycle ergometer test identified the break point of respiratory rate more easily than did the treadmill test. (3) There was an association between physical fitness and whether the break point of respiratory rate was detectable, and the more fit the subject (above average), the more likely the break point was to be undetected. Our study demonstrates that the break point of respiratory rate is closely associated with ventilatory threshold and that the cycle ergometer test is more conducive than the treadmill test to the detectability of break point of respiratory rate.

  18. 77 FR 22340 - Section 8 Housing Assistance Payments Program-Annual Adjustment Factors, Fiscal Year 2012

    Science.gov (United States)

    2012-04-13

    ... Statistics Consumer Price Index (CPI) survey. These factors are applied at Housing Assistance Payment (HAP... no need to differentiate the AAF by use. A separate Federal Register Notice will be published that.... There are three categories of Section 8 programs that use the AAFs: Category 1--The Section 8...

  19. 78 FR 30322 - Section 8 Housing Assistance Payments Program-Annual Adjustment Factors, Fiscal Year 2013

    Science.gov (United States)

    2013-05-22

    ... Statistics Consumer Price Index (CPI) survey. These factors are applied at Housing Assistance Payment (HAP... there is no need to differentiate the AAF by use. A separate Federal Register Notice will be published... program. There are three categories of Section 8 programs that use the AAFs: Category 1: The Section 8...

  20. 76 FR 13231 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-03-10

    ... investigation resulting in-- (A) An affirmative determination of serious injury or threat thereof under section... Loom; Leased Workers Spherion. 74,902 Abbott Diabetes Care, Inc., Alameda, CA November 18, 2009. Leased... Assistance In the following cases, the investigation revealed that the eligibility criteria for...

  1. 76 FR 4730 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-01-26

    ... the report submitted to the President by the International Trade Commission under section 202(f)(1... Assistance In the following cases, the investigation revealed that the eligibility criteria for worker...Drive Systems, Ogdensburg, NY Inc., TTI Turner Technology Instruments, Inc.; Leased Workers...

  2. 75 FR 6688 - Section 8 Housing Assistance Payments Program-Renewal Funding Annual Adjustment Factors, Fiscal...

    Science.gov (United States)

    2010-02-10

    ... Adjustment Factors (AAFs). SUMMARY: The Consolidated Appropriations Act, 2010 (Pub. L. 111-117), directs HUD... Survey (ACS) data on the ratio of utilities to rents.\\2\\ The CEX data used to decompose the contract rent...-rent ratio used in the formula comes from 2007 ACS median rent and utility costs. \\1\\ CPI indexes...

  3. 78 FR 66783 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-11-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment.../13 (Workers). 83130 Harte Hanks Shoppers Inc. Brea, CA 10/17/13 09/30/13 (State/One-Stop)....

  4. When Parents Divorce: Assisting Teens to Adjust through a Group Approach.

    Science.gov (United States)

    Studer, Jeannine R.; Allton, Judith A.

    1996-01-01

    Addresses factors that contribute to the adjustment difficulties of children and adolescents when their parents divorce. Gender issues, custody, age, parenting style, visitation patterns, socioeconomic considerations, the support system, family size, and the reconstituted family are all discussed. Describes a model for an effective support group…

  5. Ventilatory Efficiency in Children and Adolescents Born Extremely Preterm.

    Science.gov (United States)

    Hestnes, Julie; Hoel, Hedda; Risa, Ole J; Romstøl, Hanna O; Røksund, Ola; Frisk, Bente; Thorsen, Einar; Halvorsen, Thomas; Clemm, Hege H

    2017-01-01

    Purpose: Children and adolescents born extremely preterm (EP) have lower dynamic lung volumes and gas transfer capacity than subjects born at term. Most studies also report lower aerobic capacity. We hypothesized that ventilatory efficiency was poorer and that breathing patterns differed in EP-born compared to term-born individuals. Methods: Two area-based cohorts of participants born with gestational age ≤28 weeks or birth weight ≤1000 g in 1982-85 (n = 46) and 1991-92 (n = 35) were compared with individually matched controls born at term. Mean ages were 18 and 10 years, respectively. The participants performed an incremental treadmill exercise test to peak oxygen uptake with data averaged over 20 s intervals. For each participant, the relationship between exhaled minute ventilation ([Formula: see text]E) and carbon dioxide output ([Formula: see text]CO2) was described by a linear model, and the relationship between tidal volume (VT) and [Formula: see text]E by a quadratic model. Multivariate regression analyses were done with curve parameters as dependent variables, and the categories EP vs. term-born, sex, age, height, weight and forced expiratory volume in 1 s (FEV1) as independent variables. Results: In adjusted analyses, the slope of the [Formula: see text]E-[Formula: see text]CO2 relationship was significantly steeper in the EP than the term-born group, whereas no group difference was observed for the breathing pattern, which was related to FEV1 only. Conclusion: EP-born participants breathed with higher [Formula: see text]E for any given CO2 output, indicating lower ventilatory efficiency, possibly contributing to lower aerobic capacity. The breathing patterns did not differ between the EP and term-born groups when adjusted for FEV1.

  6. Ventilatory Efficiency in Children and Adolescents Born Extremely Preterm

    Directory of Open Access Journals (Sweden)

    Julie Hestnes

    2017-07-01

    Full Text Available Purpose: Children and adolescents born extremely preterm (EP have lower dynamic lung volumes and gas transfer capacity than subjects born at term. Most studies also report lower aerobic capacity. We hypothesized that ventilatory efficiency was poorer and that breathing patterns differed in EP−born compared to term−born individuals.Methods: Two area−based cohorts of participants born with gestational age ≤28 weeks or birth weight ≤1000 g in 1982−85 (n = 46 and 1991–92 (n = 35 were compared with individually matched controls born at term. Mean ages were 18 and 10 years, respectively. The participants performed an incremental treadmill exercise test to peak oxygen uptake with data averaged over 20 s intervals. For each participant, the relationship between exhaled minute ventilation (V˙E and carbon dioxide output (V˙CO2 was described by a linear model, and the relationship between tidal volume (VT and V˙E by a quadratic model. Multivariate regression analyses were done with curve parameters as dependent variables, and the categories EP vs. term−born, sex, age, height, weight and forced expiratory volume in 1 s (FEV1 as independent variables.Results: In adjusted analyses, the slope of the V˙E−V˙CO2 relationship was significantly steeper in the EP than the term-born group, whereas no group difference was observed for the breathing pattern, which was related to FEV1 only.Conclusion: EP-born participants breathed with higher V˙E for any given CO2 output, indicating lower ventilatory efficiency, possibly contributing to lower aerobic capacity. The breathing patterns did not differ between the EP and term−born groups when adjusted for FEV1.

  7. Ventilatory efficiency during exercise in healthy subjects.

    Science.gov (United States)

    Sun, Xing-Guo; Hansen, James E; Garatachea, Nuria; Storer, Thomas W; Wasserman, Karlman

    2002-12-01

    When evaluating dyspnea in patients with heart or lung disease it is useful to measure the quantity of ventilation needed to eliminate metabolically produced CO2 (i.e., the ventilatory efficiency). Mathematically, the relationship between ventilation (VE) and CO2 output is determined by the arterial CO2 pressure and the physiologic dead space-tidal volume ratio. We decided to determine how age, sex, size, fitness, and the type of ergometer influenced ventilatory efficiency in normal subjects. Three methods were compared for expressing this relationship: (1) the VE versus CO2 output slope below the ventilatory compensation point, commonly used by cardiologists for estimating the severity of heart failure; (2) the VE/CO2 output ratio at the anaerobic threshold, commonly used by pulmonologists; and (3) the lowest VE/CO2 output ratio during exercise, the latter parameter not previously reported. We studied 474 healthy adults, between 17 and 78 years of age during incremental cycle and treadmill cardiopulmonary exercise tests at three test sites, correcting the total VE for the equipment dead space. The lowest VE/CO2 output ratio was insignificantly different from the ratio at the anaerobic threshold, less variable than that for the slope relationship, and unaffected by the site, ergometer, and gas exchange measurement systems. The regression equation for the lowest VE/CO2 output ratio was 27.94 + 0.108 x age + (0.97 = F, 0.0 = M) - 0.0376 x height, where age is in years and height is in centimeters. We conclude that the lowest VE/CO2 output ratio is the preferred noninvasive method to estimate ventilatory inefficiency.

  8. Long-term survival rates of gravity-assisted, adjustable differential pressure valves in infants with hydrocephalus.

    Science.gov (United States)

    Gebert, Anna-Felicitas; Schulz, Matthias; Schwarz, Karin; Thomale, Ulrich-Wilhelm

    2016-05-01

    OBJECTIVE The use of adjustable differential pressure valves with gravity-assisted units in shunt therapy of children with hydrocephalus was reported to be feasible and promising as a way to avoid chronic overdrainage. In this single-center study, the authors' experiences in infants, who have higher rates of shunt complications, are presented. METHODS All data were collected from a cohort of infants (93 patients [37 girls and 56 boys], less than 1 year of age [mean age 4.1 ± 3.1 months]) who received their first adjustable pressure hydrocephalus shunt as either a primary or secondary implant between May 2007 and April 2012. Rates of valve and shunt failure were recorded for a total of 85 months until the end of the observation period in May 2014. RESULTS During a follow-up of 54.2 ± 15.9 months (range 26-85 months), the Kaplan-Meier rate of shunt survival was 69.2% at 1 year and 34.1% at 85 months; the Kaplan-Meier rate of valve survival was 77.8% at 1 year and 56% at 85 months. Survival rates of the shunt were significantly inferior if the patients had previous shunt surgery. During follow-up, 44 valves were exchanged in cases of infection (n = 19), occlusion (n = 14), dysfunction of the adjustment unit (n = 10), or to change the gravitational unit (n = 1). CONCLUSIONS Although a higher shunt complication rate is observed in infant populations compared with older children, reasonable survival rates demonstrate the feasibility of using this sophisticated valve technology. The gravitational unit of this valve is well tolerated and its adjustability offers the flexible application of opening pressure in an unpredictable cohort of patients. This may adequately address overdrainage-related complications from early in treatment.

  9. A necklace sonar with adjustable scope range for assisting the visually impaired.

    Science.gov (United States)

    Villamizar, Luz H; Gualdron, Mauricio; Gonzalez, Fabio; Aceros, Juan; Rizzo-Sierra, Carlos V

    2013-01-01

    A sonar based device with tactile feedback was developed to improve the mobility and independence of visually impaired individuals. It features a transceiver/receiver, a potentiometer, a microcontroller, a rechargeable polymer lithium ion battery, and a Nokia Cell phone vibrator. All components are commercially available and housed in a custom acrylic package with 86 mm × 34 mm × 12 mm in dimension, and 120 grms in weight. Additionally, the device features an adjustable detection scheme for user customization of distance range, and a tactile feedback system that avoids interference with auditory sensory information. The device was tested for its navigational efficacy in an artificial indoor environment, and in a live outdoor setting. Ten subjects (9 males and 1 female), with a mean age of 35 years-old (range: 17 to 52) were presented with a series of navigational tasks resulting in considerable reduction of head, shoulder, chest, and arms collisions during their locomotion. We conclude that this device greatly improves the mobility and safety of visually impaired individuals.

  10. Psychosocial adjustment during the transition to parenthood of Portuguese couples who conceived spontaneously or through assisted reproductive technologies.

    Science.gov (United States)

    Gameiro, Sofia; Moura-Ramos, Mariana; Canavarro, Maria Cristina; Soares, Isabel

    2010-06-01

    We examined the psychosocial adjustment of 35 Portuguese couples who conceived through Assisted Reproductive Technologies (ART) and 31 couples with a spontaneous conception during their transition to parenthood (pregnancy and 4 months postpartum). Couples completed self-report questionnaires regarding their perceptions of pregnancy and parenthood, psychological distress, quality of life, marital relationship, and parenting stress. Compared with parents who conceived spontaneously, parents who conceived through ART perceived pregnancy as being more risky and demanding, reported a decrease in their psychological quality of life, and ART fathers only perceived themselves as being more competent than fathers who conceived spontaneously. Healthcare professionals should be aware of need of couples in their efforts to adapt to the individual and relational challenges associated with the transition to parenthood.

  11. Mass Law Predicts Hyperbolic Hypoxic Ventilatory Response

    Science.gov (United States)

    Severinghaus, John W.

    The hyperbolic hypoxic ventilatory response vs PaO2, HVRp, is interpreted as relecting a mass hyperbolic relationship of cytochrome PcO2 to cytochrome potential Ec, offset 32 torr by the constant diffusion gradient between arterial blood and cytochrome in CB at its constant metabolic rate dot VO_2 . Ec is taken to be a linear function of redox reduction and CB ventilatory drive. As Ec rises in hypoxia, the absolute potentials of each step in the citric acid cycle rises equally while the potential drop across each step remains constant because flux rate remains constant. A hypothetic HVRs ( dot VE vs SaO2) response curve computed from these assumptions is strikingly non linear. A hypothetic HVRp calculated from an assumed linear HVRs cannot be fit to the observed hyperbolic increase of ventilation in response to isocapnic hypoxia at PO2 less than 40 torr. The incompatibility of these results suggest that in future studies HVRs will not be found to be linear, especially below 80% SaO2 and HVRp will fail to be accurately hyperbolic.

  12. Re-engineering ventilatory support to decrease days and improve resource utilization.

    Science.gov (United States)

    Kirton, O C; DeHaven, C B; Hudson-Civetta, J; Morgan, J P; Windsor, J; Civetta, J M

    1996-09-01

    The objective of this study was to describe the development of a cost-effective ventilatory strategy using a portable microprocessor-controlled respiratory monitor (Bicore CP-100; Allied Healthcare Products, Riverside, CA.) Until recently, clinicians have had to accept the uncertainties of clinical judgment, which unfortunately, often biased the patient to a prolonged ventilatory course to avoid extubation failures, necessitating reintubation. Over a 4-year period, the authors attempted to re-engineer the process of ventilatory support based on measured work of breathing (WOB), including physiologic (WOBPhys), imposed (WOBImp) and total (WOBTot). The authors made 90 determinations of WOB in 31 patients. The coefficient of determination (i2) of WOBTot, with the breathing frequency was 0.35, with tidal volume was 0.10, and with the rapid shallow breathing index (f/V(tau)) was 0.23; therefore, the authors discarded them as reliable inferences. Of 27 patients ventilated for > 2 days with satisfactory blood gases, but with breathing frequency > 30 breaths/minute, 6 had WOBTot < 0.8 J/L and were extubated successfully. In 21 patients, WOBTot was elevated to 1.6 +/- 0.83 J/L, WOBImp was 1.1 +/- 0.64 J/L, approximately twice the WOBPhys (0.5 +/- 0.26 J/L), a normal value. Extubation was successful in 20 of those 21 patients. This approach was extended to the spontaneous breathing pre-extubation trial. In addition, the ventilator was adjusted so that the patient sustained a WOBTot of 0.6 to 1 J/L during the ventilatory support. This evolution was tracked for 18 months in a series of 838 trauma intensive care unit patients. Average duration of ventilation decreased from 8.2 to 4.2 days (49%; p < 0.01). This translated into approximately 2400 decreased ventilator days per year. Objective measurement to guide the adequacy of ventilatory support and interpret apparent clinical weaning failures decreased total ventilatory time by 50%, permitting extubation in nearly 20% of

  13. Quantifying the ventilatory control contribution to sleep apnoea using polysomnography.

    Science.gov (United States)

    Terrill, Philip I; Edwards, Bradley A; Nemati, Shamim; Butler, James P; Owens, Robert L; Eckert, Danny J; White, David P; Malhotra, Atul; Wellman, Andrew; Sands, Scott A

    2015-02-01

    Elevated loop gain, consequent to hypersensitive ventilatory control, is a primary nonanatomical cause of obstructive sleep apnoea (OSA) but it is not possible to quantify this in the clinic. Here we provide a novel method to estimate loop gain in OSA patients using routine clinical polysomnography alone. We use the concept that spontaneous ventilatory fluctuations due to apnoeas/hypopnoeas (disturbance) result in opposing changes in ventilatory drive (response) as determined by loop gain (response/disturbance). Fitting a simple ventilatory control model (including chemical and arousal contributions to ventilatory drive) to the ventilatory pattern of OSA reveals the underlying loop gain. Following mathematical-model validation, we critically tested our method in patients with OSA by comparison with a standard (continuous positive airway pressure (CPAP) drop method), and by assessing its ability to detect the known reduction in loop gain with oxygen and acetazolamide. Our method quantified loop gain from baseline polysomnography (correlation versus CPAP-estimated loop gain: n=28; r=0.63, ppolysomnography, enabling identification of likely responders to therapies targeting ventilatory control.

  14. OBESITY: CHALLENGES TO VENTILATORY CONTROL DURING EXERCISE A BRIEF REVIEW

    Science.gov (United States)

    Babb, Tony G.

    2013-01-01

    Obesity is a national health issue in the US. Among the many physiological changes induced by obesity, it also presents a unique challenge to ventilatory control during exercise due to increased metabolic demand of moving larger limbs, increased work of breathing due to extra weight on the chest wall, and changes in breathing mechanics. These challenges to ventilatory control in obesity can be inconspicuous or overt among obese adults but for the most part adaptation of ventilatory control during exercise in obesity appears remarkably unnoticed in the majority of obese people. In this brief review, the changes to ventilatory control required for maintaining normal ventilation during exercise will be examined, especially the interaction between respiratory neural drive and ventilation. Also, gaps in our current knowledge will be discussed. PMID:23707540

  15. Influence of menstrual phase on ventilatory response to submaximal ...

    African Journals Online (AJOL)

    To determine whether an increase in respiratory drive, due to elevated ... menstrual phases, persists throughout prolonged submaximal exercise and potentially ... the change in ventilatory parameters (minute ventilation (VE), respiratory rate ...

  16. Postural and ventilatory functions of intercostal muscles.

    Science.gov (United States)

    Duron, B

    1973-01-01

    During spontaneous breathing, the interchondral muscles present a pattern of activity similar to that of the diaphragm. The external intercostals and most of the internal intercostals generally show electrical discharges not related to ventilatory rhythm. Studies of the electrical responses of these muscles in experimental variations of their length show that the external and internal intercostals are readily activated by this category of reflexes while the diaphragm and the interchondrals are not. Bilateral multisegmental sections of spinal dorsal roots do not affect the respiratory activity of the diaphragm and of the interchondral muscles; on the contrary, all types of activity - spontaneous or reflex - disappear from the intercostals. Electrical stimulation of appropriate points in the bulbar pyramids in decerebrate cats can activate at the same time different intercostals and leg muscles without modifying the rhythmic inspiratory activity of the diaphragm and the interchondrals. In preparations with chronically implanted electrodes, the intercostals muscles are chiefly involved in posture. These results fit very well with our histological findings which disclose a much greater density of muscle spindles in external intercostals than in the diaphragm or in the interchondral muscles.

  17. Resting and exercise ventilatory chemosensitivity across the menstrual cycle.

    Science.gov (United States)

    Macnutt, Meaghan J; De Souza, Mary Jane; Tomczak, Simone E; Homer, Jenna L; Sheel, A William

    2012-03-01

    We hypothesized that resting and exercise ventilatory chemosensitivity would be augmented in women when estrogen and progesterone levels are highest during the luteal phase of the menstrual cycle. Healthy, young females (n = 10; age = 23 ± 5 yrs) were assessed across one complete cycle: during early follicular (EF), late follicular (LF), early luteal, and mid-luteal (ML) phases. We measured urinary conjugates of estrogen and progesterone daily. To compare values of ventilatory chemosensitivity and day-to-day variability of measures between sexes, males (n = 10; age = 26 ± 7 yrs) were assessed on 5 nonconsecutive days during a 1-mo period. Resting ventilation was measured and hypoxic chemosensitivity assessed using an isocapnic hypoxic ventilatory response (iHVR) test. The hypercapnic ventilatory response was assessed using the Read rebreathing protocol and modified rebreathing tests. Participants completed submaximal cycle exercise in normoxia and hypoxia. We observed a significant effect of menstrual-cycle phase on resting minute ventilation, which was elevated in the ML phase relative to the EF and LF phases. Compared with males, resting end-tidal CO(2) was reduced in females during the EF and ML phases but not in the LF phase. We found that iHVR was unaffected by menstrual-cycle phase and was not different between males and females. The sensitivity to chemical stimuli was unaffected by menstrual-cycle phase, meaning that any hormone-mediated effect is of insufficient magnitude to exceed the inherent variation in these chemosensitivity measures. The ventilatory recruitment threshold for CO(2) was generally lower in women, which is suggestive of a hormonally related lowering of the ventilatory recruitment threshold. We detected no effect of menstrual-cycle phase on submaximal exercise ventilation and found that the ventilatory response to normoxic and hypoxic exercise was quantitatively similar between males and females. This suggests that feed-forward and feed

  18. Defining obstructive ventilatory defect in 2015

    Directory of Open Access Journals (Sweden)

    Zied Affes

    2015-10-01

    Full Text Available Introduction: There is no clear consensus as to what constitutes an obstructive ventilatory defect (OVD: Is it FEV1/FVC

  19. Brain neuropeptides in central ventilatory and cardiovascular regulation in trout.

    Directory of Open Access Journals (Sweden)

    Jean-Claude eLe Mével

    2012-10-01

    Full Text Available Many neuropeptides and their G-protein coupled receptors (GPCRs are present within the brain area involved in ventilatory and cardiovascular regulation but only a few mammalian studies have focused on the integrative physiological actions of neuropeptides on these vital cardio-respiratory regulations. Because both the central neuroanatomical substrates that govern motor ventilatory and cardiovascular output and the primary sequence of regulatory peptides and their receptors have been mostly conserved through evolution, we have developed a trout model to study the central action of native neuropeptides on cardio-ventilatory regulation. In the present review, we summarize the most recent results obtained using this non-mammalian model with a focus on PACAP, VIP, tachykinins, CRF, urotensin-1, CGRP, angiotensin-related peptides, urotensin-II, NPY, and PYY. We propose hypotheses regarding the physiological relevance of the results obtained.

  20. 77 FR 77217 - Fiscal Year 2012 Annual Report to Congress on the Trade Adjustment Assistance for Firms Program

    Science.gov (United States)

    2012-12-31

    ... economically distressed U.S. businesses develop strategies to compete in the global economy. Through a... provides cost-sharing technical assistance to help eligible businesses create and implement targeted... mission of the TAAF program is to help U.S. firms regain competitiveness in the global economy....

  1. Effects of Breathing Resistance on Resting Ventilatory Sensitivity to CO2

    Science.gov (United States)

    2014-08-12

    BREATHING RESISTANCE ON RESTING VENTILATORY SENSITIVITY TO CO2 Authors: B. Shykoff, Ph.D...June 2013 - Feb 2014 4. TITLE AND SUBTITLE (U) EFFECTS OF BREATHING RESISTANCE ON RESTING VENTILATORY SENSITIVITY TO CO2 5a...the respiratory muscles by optimizing for their loading, ventilatory response to CO2 may be damped when resistance to breathing increases. This has

  2. Ventilatory response during exercise among chronic Chagas cardiopathy patients

    Directory of Open Access Journals (Sweden)

    Fátima Palha de Oliveira

    Full Text Available CONTEXT AND OBJECTIVE: The change in slope of the VE/VCO2 curve with time during exercise (VE/VCO2 slope has been recommended as a parameter for analyzing the ventilatory response during exercise among patients with heart failure of different etiologies. The aim of this work was to evaluate the ventilatory response among patients with chronic Chagas cardiopathy. METHODS: Forty-eight patients, divided into four groups according to the Los Andes clinical/hemodynamic classification, were studied. They were also classified according to peak oxygen uptake (peak VO2 for a second analysis. The results from the patients were compared with results from a control group consisting of 21 healthy male volunteers (no Chagas disease. Exercise was performed on a cycle ergometer with loads increasing at the rate of 12.5 watts/min, and exercise duration was symptom-limited. Gas concentration and flow rate data were fed into a computer, which produced a real-time report on ventilatory and gas exchange parameters (breath-by-breath. The ventilatory parameters of VE/VCO2 slope and VE/VCO2 ratio computed at different times of the test were adopted. RESULTS: Although there were no significant differences in VE/VCO2 ratio and VE/VCO2 slope when patients were grouped using the Los Andes clinical/hemodynamic classification, these parameters varied significantly when peak VO2 was used to define patient groups. CONCLUSION: Our results indicate that progressive deterioration in ventilatory response among chronic Chagas cardiopathy patients during exercise is more evident when the functional capacity (peak VO2 is reduced, than when changes are related to the Los Andes classification.

  3. Ibuprofen Blunts Ventilatory Acclimatization to Sustained Hypoxia in Humans.

    Directory of Open Access Journals (Sweden)

    Kemal Erdem Basaran

    Full Text Available Ventilatory acclimatization to hypoxia is a time-dependent increase in ventilation and the hypoxic ventilatory response (HVR that involves neural plasticity in both carotid body chemoreceptors and brainstem respiratory centers. The mechanisms of such plasticity are not completely understood but recent animal studies show it can be blocked by administering ibuprofen, a nonsteroidal anti-inflammatory drug, during chronic hypoxia. We tested the hypothesis that ibuprofen would also block the increase in HVR with chronic hypoxia in humans in 15 healthy men and women using a double-blind, placebo controlled, cross-over trial. The isocapnic HVR was measured with standard methods in subjects treated with ibuprofen (400 mg every 8 hrs or placebo for 48 hours at sea level and 48 hours at high altitude (3,800 m. Subjects returned to sea level for at least 30 days prior to repeating the protocol with the opposite treatment. Ibuprofen significantly decreased the HVR after acclimatization to high altitude compared to placebo but it did not affect ventilation or arterial O2 saturation breathing ambient air at high altitude. Hence, compensatory responses prevent hypoventilation with decreased isocapnic ventilatory O2-sensitivity from ibuprofen at this altitude. The effect of ibuprofen to decrease the HVR in humans provides the first experimental evidence that a signaling mechanism described for ventilatory acclimatization to hypoxia in animal models also occurs in people. This establishes a foundation for the future experiments to test the potential role of different mechanisms for neural plasticity and ventilatory acclimatization in humans with chronic hypoxemia from lung disease.

  4. Data on respiratory variables in critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+).

    Science.gov (United States)

    Georgopoulos, Dimitris; Xirouchaki, Nectaria; Tzanakis, Nikolaos; Younes, Magdy

    2016-09-01

    The data show respiratory variables in 108 critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+) after at least 36 h on passive mechanical ventilation. PAV+ was continued for 48 h until the patients met pre-defined criteria either for switching to controlled modes or for breathing without ventilator assistance. Data during passive mechanical ventilation and during PAV+ are reported. Data are acquired from the whole population, as well as from patients with and without acute respiratory distress syndrome. The reported variables are tidal volume, driving pressure (ΔP, the difference between static end-inspiratory plateau pressure and positive end-expiratory airway pressure), respiratory system compliance and resistance, and arterial blood gasses. The data are supplemental to our original research article, which described individual ΔP in these patients and examined how it related to ΔP when the same patients were ventilated with passive mechanical ventilation using the currently accepted lung-protective strategy "Driving pressure during assisted mechanical ventilation. Is it controlled by patient brain?" [1].

  5. Data on respiratory variables in critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+

    Directory of Open Access Journals (Sweden)

    Dimitris Georgopoulos

    2016-09-01

    Full Text Available The data show respiratory variables in 108 critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+ after at least 36 h on passive mechanical ventilation. PAV+ was continued for 48 h until the patients met pre-defined criteria either for switching to controlled modes or for breathing without ventilator assistance. Data during passive mechanical ventilation and during PAV+ are reported. Data are acquired from the whole population, as well as from patients with and without acute respiratory distress syndrome. The reported variables are tidal volume, driving pressure (ΔP, the difference between static end-inspiratory plateau pressure and positive end-expiratory airway pressure, respiratory system compliance and resistance, and arterial blood gasses. The data are supplemental to our original research article, which described individual ΔP in these patients and examined how it related to ΔP when the same patients were ventilated with passive mechanical ventilation using the currently accepted lung-protective strategy “Driving pressure during assisted mechanical ventilation. Is it controlled by patient brain?” [1].

  6. Efficacy of a Ventilatory Training Mask to Improve Anaerobic and Aerobic Capacity in Reserve Officers' Training Corps Cadets.

    Science.gov (United States)

    Sellers, John H; Monaghan, Taylor P; Schnaiter, Jessica A; Jacobson, Bert H; Pope, Zachary K

    2016-04-01

    The purpose of this study was to examine the efficacy of a ventilatory training mask to improve anaerobic and aerobic fitness in reserve officers' training corps (ROTC) cadets. Seventeen ROTC cadets from a Midwest university completed pre- and postassessments consisting of anthropometry, a 30-second Wingate Anaerobic Test (WAnT), and a maximal aerobic capacity test (V[Combining Dot Above]O2max). A 6-week intervention training period was used during which time participants completed their mandatory physical training (PT) sessions. Participants were randomly assigned to either the experimental group (MASK; n = 9) or the control group (CON; n = 8). The ventilatory training masks were adjusted to simulate an altitude of 2,750 m. There was no significant effect (p ≤ 0.05) between groups on fatigue index, anaerobic capacity, peak power, V[Combining Dot Above]O2max, or time to exhaustion. These results suggest that the use of the ventilatory training mask during mandatory PT did not elicit superior aerobic or anaerobic adaptations in ROTC cadets. Therefore, it is recommended that more established simulated altitude training methods be used when incorporating intermittent hypoxic training.

  7. Tissue Functioning and Remodeling in the Circulatory and Ventilatory Systems

    CERN Document Server

    Thiriet, Marc

    2013-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. Volume 5 is devoted to cells, tissues, and organs of the cardiovascular and ventilatory systems with an emphasis on mechanotransduction-based regulation of flow. The blood vessel wall is a living tissue that quickly reacts to loads applied on it by the flowing blood. In any segment of a blood vessel, the endothelial and smooth muscle cells can sense unusual time variations in small-magnitude wall shear stress and large-amplitude wall stretch generated by abnormal hemodynamic stresses. These cells respond with a short-time scale (from seconds to hours) to adapt the vessel caliber. Since such adaptive cell activities can be described using mathematical models, a key objective of this volume is to identify the mesoscopic agents and nanoscopic mediators required to derive adequate mathematical models...

  8. Ventilatory Function in Young Adults and Dietary Antioxidant Intake

    Directory of Open Access Journals (Sweden)

    Vanessa Garcia-Larsen

    2015-04-01

    Full Text Available Dietary antioxidants may protect against poor ventilatory function. We assessed the relation between ventilatory function and antioxidant components of diet in young Chileans. Forced expiratory volume in 1 s (FEV1, forced vital capacity (FVC, and the ratio FEV1/FVC were measured in 1232 adults aged 22–28 years, using a Vitalograph device. Dietary intake was ascertained with a food frequency questionnaire (FFQ designed for this study, from which nutrient and flavonoid intakes were estimated. Dietary patterns were derived with Principal Component Analysis (PCA. After controlling for potential confounders, dietary intake of total catechins was positively associated with FVC (Regression coefficient (RC of highest vs. lowest quintile of intake 0.07; 95% CI 0.01 to 0.15; p per trend 0.006. Total fruit intake was related to FVC (RC of highest vs. lowest quintile 0.08; 95% CI 0.003 to 0.15; p per trend 0.02. Intake of omega 3 fatty acids was associated with a higher FEV1 (RC for highest vs. lowest quintile 0.08; 95% CI 0.01 to 0.15 L; p per trend 0.02 and with FVC 0.08 (RC in highest vs. lowest quintile of intake 0.08, 95% CI 0.001 to 0.16; p per trend 0.04. Our results show that fresh fruits, flavonoids, and omega 3 fatty acids may contribute to maintain ventilatory function.

  9. The ventilatory effect of external oscillation.

    Science.gov (United States)

    Isabey, D; Piquet, J

    1989-01-01

    High frequency ventilation (HFV) may be achieved by external oscillation (external HFV) applied around the chest wall (HFCWO) in large animals and humans, or over the entire body (HFBSO) in small animals, instead of being applied via the trachea (internal HFV). We present a synthesis of the results obtained with external HFV in both normal and bronchoconstricted subjects. Whereas external and internal HFV were found to be equivalent in terms of gas exchange in normal rats, external HFV was found to have a beneficial effect in bronchoconstricted rabbits, but internal HFV did not. From the frequency-oscillatory tidal volume relationship determined in normocapnic rabbits, HFBSO at 5 Hz was found to be the optimal frequency at which to ventilate with tidal volumes close to the dead space volume, and which was also shown to be the optimal volume to obtain normocapnia. Moreover, 5 Hz oscillations (HFCWO) at 20 ml and 40 ml superimposed on tidal breathing accelerated nitrogen washout, i.e., gas exchange in normal humans. Unfortunately, only oscillations with much smaller volumes (5-10 ml) were obtainable in COPD patients. Nevertheless, they produced a clear change in breathing pattern associated with a slight improvement in gas exchange and a potentially positive effect on inspiratory muscle fatigue. These results support the concept that non-invasive external HFV technique may be of use in assisting ventilation in bronchoconstricted subjects and may possibly replace conventional controlled ventilation, at least in subjects with high lung compliance, such as babies, neonates and normal adults.

  10. Ventilatory responses when altering stride frequency at a constant oxygen uptake.

    Science.gov (United States)

    McMurray, R G; Smith, L G

    1985-10-01

    Ten women completed a slow walk (SW), fast walk (FW) and a slow run (R) on a motor driven treadmill to evaluate the effect of varying stride frequency on ventilatory responses. The treadmill grade was adjusted during the walks such that the oxygen uptake was the same as during running at 0% grade. Stride frequencies averaged 59, 69 and 80 strides/min for the SW, FW and R, respectively. Oxygen uptake was similar for all three trials (1.78 L/min); as were heart frequencies (154.6 beats/min). Mean blood pressure was unaffected by changing stride frequency. Minute ventilation was similar for all three trials (ca. 47.3 L/min). Significant differences in respiratory frequency were observed (SW = 33.2, FW = 35.4, R = 37.2 breaths/min). Tidal volumes were significantly greater during the slow walk (1417 ml) than either the fast walk (1331 ml) or the run (1301 ml). CO2 output was significantly greater during the run compared to either of the walking trials. End-tidal CO2 was 38.6 mm Hg during the slow walk and was significantly reduced during the fast walk (36.3) and run (36.0). The results suggest the existence of a mild hypocapnia during the fast walk and running exercise. These results further suggest that variations in ventilatory patterns exist during walking and running that are not totally accountable by blood pressure or CO2 and may be related to extra-metabolic stimuli.

  11. Interaction between the ventilatory and cerebrovascular responses to hypo- and hypercapnia at rest and during exercise

    National Research Council Canada - National Science Library

    Shigehiko Ogoh; Naoyuki Hayashi; Masashi Inagaki; Philip N. Ainslie; Tadayoshi Miyamoto

    2008-01-01

    ... ) via limiting changes in brain [H + ] modulates ventilatory control. It remains unclear, however, how exercise-induced alterations in respiratory chemoreflex might influence cerebral blood flow (CBF...

  12. Synthesis of cobalt-containing mesoporous catalysts using the ultrasonic-assisted "pH-adjusting" method: Importance of cobalt species in styrene oxidation

    Science.gov (United States)

    Li, Baitao; Zhu, Yanrun; Jin, Xiaojing

    2015-01-01

    Cobalt-containing SBA-15 and MCM-41 (Co-SBA-15 and Co-MCM-41) mesoporous catalysts were prepared via ultrasonic-assisted "pH-adjusting" technique in this study. Their physiochemical structures were comprehensively characterized and correlated with catalytic activity in oxidation of styrene. The nature of cobalt species depended on the type of mesoporous silica as well as pH values. The different catalytic performance between Co-SBA-15 and Co-MCM-41 catalysts originated from cobalt species. Cobalt species were homogenously incorporated into the siliceous framework of Co-SBA-15 in single-site Co(II) state, while Co3O4 particles were loaded on Co-MCM-41 catalysts. The styrene oxidation tests showed that the single-site Co(II) state was more beneficial to the catalytic oxidation of styrene. The higher styrene conversion and benzaldehyde selectivity over Co-SBA-15 catalysts were mainly attributed to single-site Co(II) state incorporated into the framework of SBA-15. The highest conversion of styrene (34.7%) with benzaldehyde selectivity of 88.2% was obtained over Co-SBA-15 catalyst prepared at pH of 7.5, at the mole ratio of 1:1 (styrene to H2O2) at 70 °C.

  13. Periodic cardiovascular and ventilatory activity during midazolam sedation.

    Science.gov (United States)

    Galletly, D C; Williams, T B; Robinson, B J

    1996-04-01

    We have examined the effects of sedation with midazolam 0.1 mg kg-1 and reversal with flumazenil 0.5 mg on beat-to-beat heart rate (HR) variability (HRV), systolic arterial pressure (SAP), finger photoplethysmograph amplitude (PLA) and impedence pneumography in eight volunteers. With the onset of sedation there was a small decrease in SAP and increase in HR (ns). Spectral analysis of the HR time series showed reductions in the proportion of power in the high (> 0.15 Hz) frequency "ventilatory" band consistent with midazolam causing vagolysis. During sedation, low frequency (midazolam sedation were reversed by administration of flumazenil.

  14. IMPACT OF SMOKING ON ADULTS LUNG AGE AND VENTILATORY FUNCTION

    Directory of Open Access Journals (Sweden)

    Omar Farouk Helal

    2014-04-01

    Full Text Available Background: Although a large body of evidence exists on the effect of smoking on lung age and pulmonary function, much less attention has been dedicated to using these effects as an effective strategy in smoking cessation. Objective: The present study was carried out to investigate the impact of smoking on lung age and ventilatory function in adult Saudi in order to use these effects in a future strategy for smoking cessation. Methods: Eighty one smoker students with their mean age 23.88 ± 2.7 years were enrolled in this study. Every student performed a ventilatory function tests in order to measure lung age, forced vital capacity (FVC, forced expiratory volume at the end of the first second (FEV1, FEV1/FVC ratio and peak expiratory flow rate PEFR. Results: The result showed significant deterioration in the mean value of FEV1, PEFR and the estimated lung age and a non-significant difference in the mean values of FVC. Conclusion: Smoking has a significant effect on ventilaroty function and deteriorating estimated lung age.

  15. Origin of the unique ventilatory apparatus of turtles.

    Science.gov (United States)

    Lyson, Tyler R; Schachner, Emma R; Botha-Brink, Jennifer; Scheyer, Torsten M; Lambertz, Markus; Bever, G S; Rubidge, Bruce S; de Queiroz, Kevin

    2014-01-01

    The turtle body plan differs markedly from that of other vertebrates and serves as a model system for studying structural and developmental evolution. Incorporation of the ribs into the turtle shell negates the costal movements that effect lung ventilation in other air-breathing amniotes. Instead, turtles have a unique abdominal-muscle-based ventilatory apparatus whose evolutionary origins have remained mysterious. Here we show through broadly comparative anatomical and histological analyses that an early member of the turtle stem lineage has several turtle-specific ventilation characters: rigid ribcage, inferred loss of intercostal muscles and osteological correlates of the primary expiratory muscle. Our results suggest that the ventilation mechanism of turtles evolved through a division of labour between the ribs and muscles of the trunk in which the abdominal muscles took on the primary ventilatory function, whereas the broadened ribs became the primary means of stabilizing the trunk. These changes occurred approximately 50 million years before the evolution of the fully ossified shell.

  16. Ventilatory Efficiency in Children and Adolescents: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Paloma Lopes Francisco Parazzi

    2015-01-01

    Full Text Available Introduction. The index of ventilatory efficiency (VE/VCO2 obtained by the progressive exercise test has been considered the gold standard in the prognosis of adults with heart failure, but few studies have evaluated this approach in children. Objective. To verify the scientific evidence about the VE/VCO2 in pediatric and adolescents patients. Methods. A systematic literature review was carried out using the key words VE/VCO2, children, and adolescents using the PEDro and PubMed/MedLine databases. Clinical trials published from 1987 to 2014, including children, adolescents, and young adults up to 25 years, addressing the VE/VCO2 index as a method of evaluation, monitoring, and prognosis were considered. Results. Initially, 95 articles were found; 12 were excluded as the title/abstract did not contain the VE/VCO2 index or because they included patients greater than 25 years of age. From the remaining 83, 58 were repeated between the databases. The final sample consisted of 32 studies including healthy children and children with respiratory and other diseases. Conclusion. There are few studies involving cardiorespiratory assessment by ventilatory efficiency. The studies highlight the fact that high VE/VCO2 values are associated with a worse prognosis of patients due to the relationship with the decrease in pulmonary perfusion and cardiac output.

  17. An experimental randomized study of six different ventilatory modes in a piglet model with normal lungs

    DEFF Research Database (Denmark)

    Nielsen, J B; Sjöstrand, U H; Henneberg, S W

    1991-01-01

    A randomized study of 6 ventilatory modes was made in 7 piglets with normal lungs. Using a Servo HFV 970 (prototype system) and a Servo ventilator 900 C the ventilatory modes examined were as follows: SV-20V, i.e. volume-controlled intermittent positive-pressure ventilation (IPPV); SV-20VIosc, i...

  18. Assessment of ventilatory neuromuscular drive in patients with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    L.R.A. Bittencourt

    1998-04-01

    Full Text Available The presence of abnormalities of the respiratory center in obstructive sleep apnea (OSA patients and their correlation with polysomnographic data are still a matter of controversy. Moderately obese, sleep-deprived OSA patients presenting daytime hypersomnolence, with normocapnia and no clinical or spirometric evidence of pulmonary disease, were selected. We assessed the ventilatory control and correlated it with polysomnographic data. Ventilatory neuromuscular drive was evaluated in these patients by measuring the ventilatory response (VE, the inspiratory occlusion pressure (P.1 and the ventilatory pattern (VT/TI, TI/TTOT at rest and during submaximal exercise, breathing room air. These analyses were also performed after inhalation of a hypercapnic mixture of CO2 (DP.1/DPETCO2, DVE/DPETCO2. Average rest and exercise ventilatory response (VE: 12.2 and 32.6 l/min, respectively, inspiratory occlusion pressure (P.1: 1.5 and 4.7 cmH2O, respectively, and ventilatory pattern (VT/TI: 0.42 and 1.09 l/s; TI/TTOT: 0.47 and 0.46 l/s, respectively were within the normal range. In response to hypercapnia, the values of ventilatory response (DVE/DPETCO2: 1.51 l min-1 mmHg-1 and inspiratory occlusion pressure (DP.1/DPETCO2: 0.22 cmH2O were normal or slightly reduced in the normocapnic OSA patients. No association or correlation between ventilatory neuromuscular drive and ventilatory pattern, hypersomnolence score and polysomnographic data was found; however a significant positive correlation was observed between P.1 and weight. Our results indicate the existence of a group of normocapnic OSA patients who have a normal awake neuromuscular ventilatory drive at rest or during exercise that is partially influenced by obesity

  19. Intracellular Signaling Mediators in the Circulatory and Ventilatory Systems

    CERN Document Server

    Thiriet, Marc

    2013-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to phenomenological models of nano- and microscopic events in a corrector scheme of regulated mechanisms when the vessel lumen caliber varies markedly. Therefore, investigation of flows of blood and air in physiological conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning. Volume 4 is devoted to major sets of intracellular mediators that transmit signals upon stimulation of cell-surface receptors.  Activation of...

  20. Control of Cell Fate in the Circulatory and Ventilatory Systems

    CERN Document Server

    Thiriet, Marc

    2012-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to nano- and microscopic events in a corrector scheme of regulated mechanisms. Therefore, investigation of flows of blood and air in physiological conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning. Volumes 1 and 2 are devoted to cell organization and fate, as well as activities that are autoregulated and/or controlled by the cell environment. Volume 1 examined cellular features that allow adaptation to env...

  1. ADJUSTMENT FACTORS AND ADJUSTMENT STRUCTURE

    Institute of Scientific and Technical Information of China (English)

    Tao Benzao

    2003-01-01

    In this paper, adjustment factors J and R put forward by professor Zhou Jiangwen are introduced and the nature of the adjustment factors and their role in evaluating adjustment structure is discussed and proved.

  2. Convexity Adjustments

    DEFF Research Database (Denmark)

    M. Gaspar, Raquel; Murgoci, Agatha

    2010-01-01

    of particular importance to practitioners: yield convexity adjustments, forward versus futures convexity adjustments, timing and quanto convexity adjustments. We claim that the appropriate way to look into any of these adjustments is as a side effect of a measure change, as proposed by Pelsser (2003...

  3. Abnormalities of the Ventilatory Equivalent for Carbon Dioxide in Patients with Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Lee Ingle

    2012-01-01

    Full Text Available Introduction. The relation between minute ventilation (VE and carbon dioxide production (VCO2 can be characterised by the instantaneous ratio of ventilation to carbon dioxide production, the ventilatory equivalent for CO2 (VEqCO2. We hypothesised that the time taken to achieve the lowest VEqCO2 (time to VEqCO2 nadir may be a prognostic marker in patients with chronic heart failure (CHF. Methods. Patients and healthy controls underwent a symptom-limited, cardiopulmonary exercise test (CPET on a treadmill to volitional exhaustion. Results. 423 patients with CHF (mean age 63±12 years; 80% males and 78 healthy controls (62% males; age 61±11 years were recruited. Time to VEqCO2 nadir was shorter in patients than controls (327±204 s versus 514±187 s; =0.0001. Univariable predictors of all-cause mortality included peak oxygen uptake (2=53.0, VEqCO2 nadir (2=47.9, and time to VEqCO2 nadir (2=24.0. In an adjusted Cox multivariable proportional hazards model, peak oxygen uptake (2=16.7 and VEqCO2 nadir (2=17.9 were the most significant independent predictors of all-cause mortality. Conclusion. The time to VEqCO2 nadir was shorter in patients with CHF than in normal subjects and was a predictor of subsequent mortality.

  4. [Noninvasive ventilation: efficacy of a new ventilatory mode in patients with obesity-hypoventilation syndrome].

    Science.gov (United States)

    Couillard, A; Pepin, J-L; Rabec, C; Cuvelier, A; Portmann, A; Muir, J-F

    2015-03-01

    Noninvasive ventilation is recommended to correct the nocturnal hypoventilation and relieve the symptoms of patients with the obesity-hypoventilation syndrome (OHS). The benefits of fixed pressure ventilation (S/T technology) are recognized but limited on account of the variability of nocturnal ventilatory requirements. The new technique AVAPS-AE (automatic EPAP) allows adjustment of the pressure according to the volume currently targeted. Its efficacy has not yet been evaluated. Our objectives are to evaluate firstly, whether AVAPS-AE optimizes the benefits of S/T technology on sleep architecture and quality, secondly, whether these benefits are associated with an improvement in gas exchange, symptoms, exercise tolerance, level of physical activity and quality of life of patients with OHS. In this multicenter trial, 60 newly diagnosed patients with OHS will be randomized to the control (S/T) and trial (AVAPS-AE) groups. A standardized titration procedure will be followed for the calibration of the ventilators. Functional evaluations (polysomnography, blood gases, impedance measurements and walking tests), questionnaires (physical activity, quality of life, quality of sleep and daytime somnolence) visual scales (fatigue, headaches) and a recording of activity will be undertaken after two months of ventilation. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  5. Obesity: challenges to ventilatory control during exercise--a brief review.

    Science.gov (United States)

    Babb, Tony G

    2013-11-01

    Obesity is a national health issue in the US. Among the many physiological changes induced by obesity, it also presents a unique challenge to ventilatory control during exercise due to increased metabolic demand of moving larger limbs, increased work of breathing due to extra weight on the chest wall, and changes in breathing mechanics. These challenges to ventilatory control in obesity can be inconspicuous or overt among obese adults but for the most part adaptation of ventilatory control during exercise in obesity appears remarkably unnoticed in the majority of obese people. In this brief review, the changes to ventilatory control required for maintaining normal ventilation during exercise will be examined, especially the interaction between respiratory neural drive and ventilation. Also, gaps in our current knowledge will be discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Improvement of ventilatory function by spa therapy in patients with intractable asthma.

    Directory of Open Access Journals (Sweden)

    Tanizaki,Yoshiro

    1986-02-01

    Full Text Available Twenty-five patients with intractable asthma had swimming training in a hot spring pool for 3 months. The subjects were divided into three groups according to their clinical symptoms and ages. Changes of ventilatory function during swimming training were observed in in each group. The ventilatory function test revealed that free swimming training in a hot spring pool for 30 min did not induce bronchoconstriction in any of the groups. The values of ventilatory parameters such as FEV 1.0%, %PEFR, %V50 and %V25 were improved after the 3-month swimming training. The improvement of ventilatory parameters, especially %MMF, %V50 and %V25, by the training was most remarkable in the type II asthma group. The percent increase in %MMF, %V50 and %V25 was highest in patients more than 61 years of age, and higher in patients aged 40 to 60 years than in younger patients.

  7. Ventilatory pattern and associated episodic hypoxaemia in the late postoperative period in the general surgical ward

    DEFF Research Database (Denmark)

    Rosenberg, J; Rasmussen, G I; Wøjdemann, K R;

    1999-01-01

    Episodic oxygen desaturation is frequent in the late postoperative period and seems most pronounced on the second and third postoperative nights. However, the ventilatory pattern has not been described systematically during this period. We studied the ventilatory pattern and associated arterial...... oxygenation using the Edentrace II equipment (impedance pneumography and pulse oximetry) on the second and third postoperative nights in 28 patients undergoing major abdominal surgery. Ventilatory disturbances were common and included periods of hypopnoea, and obstructive, central and mixed apnoeas. Overall...... disturbances. Overall, 23% (0-100) of the hypopnoeas and 7% (0-100) of the apnoeas were associated with episodic hypoxaemia. In conclusion, ventilatory disturbances were common in the late postoperative period in the general surgical ward and often associated with episodes of oxygen desaturation....

  8. Neonatal maturation of the hypercapnic ventilatory response and central neural CO2 chemosensitivity.

    Science.gov (United States)

    Putnam, Robert W; Conrad, Susan C; Gdovin, M J; Erlichman, Joseph S; Leiter, J C

    2005-11-15

    The ventilatory response to CO2 changes as a function of neonatal development. In rats, a ventilatory response to CO2 is present in the first 5 days of life, but this ventilatory response to CO2 wanes and reaches its lowest point around postnatal day 8. Subsequently, the ventilatory response to CO2 rises towards adult levels. Similar patterns in the ventilatory response to CO2 are seen in some other species, although some animals do not exhibit all of these phases. Different developmental patterns of the ventilatory response to CO2 may be related to the state of development of the animal at birth. The triphasic pattern of responsiveness (early decline, a nadir, and subsequent achievement of adult levels of responsiveness) may arise from the development of several processes, including central neural mechanisms, gas exchange, the neuromuscular junction, respiratory muscles and respiratory mechanics. We only discuss central neural mechanisms here, including altered CO2 sensitivity of neurons among the various sites of central CO2 chemosensitivity, changes in astrocytic function during development, the maturation of electrical and chemical synaptic mechanisms (both inhibitory and excitatory mechanisms) or changes in the integration of chemosensory information originating from peripheral and multiple central CO2 chemosensory sites. Among these central processes, the maturation of synaptic mechanisms seems most important and the relative maturation of synaptic processes may also determine how plastic the response to CO2 is at any particular age.

  9. Classic conditioning of the ventilatory responses in rats.

    Science.gov (United States)

    Nsegbe, E; Vardon, G; Perruchet, P; Gallego, J

    1997-10-01

    Recent authors have stressed the role of conditioning in the control of breathing, but experimental evidence of this role is still sparse and contradictory. To establish that classic conditioning of the ventilatory responses can occur in rats, we performed a controlled experiment in which a 1-min tone [conditioned stimulus (CS)] was paired with a hypercapnic stimulus [8.5% CO2, unconditioned stimulus (US)]. The experimental group (n = 9) received five paired CS-US presentations, followed by one CS alone to test conditioning. This sequence was repeated six times. The control group (n = 7) received the same number of CS and US, but each US was delivered 3 min after the CS. We observed that after the CS alone, breath duration was significantly longer in the experimental than in the control group and mean ventilation was significantly lower, thus showing inhibitory conditioning. This conditioning may have resulted from the association between the CS and the inhibitory and aversive effects of CO2. The present results confirmed the high sensitivity of the respiratory controller to conditioning processes.

  10. Evaluation of criteria for discontinuing mechanical ventilatory support.

    Science.gov (United States)

    Millbern, S M; Downs, J B; Jumper, L C; Modell, J H

    1978-12-01

    Thirty-three patients who required short-term postoperative mechanical ventilatory support were studied to compare different criteria established to initiate weaning from mechanical ventilation. Intermittent mandatory ventilation criteria (i.e., decreasing mechanical respirator rate as long as the arterial (pHa) remains above 7.35) and conventional criteria (ie, vital capacity greater than 15 ml/kg and peak negative pressure greater than 20 cm H2O) were compared to determine which would more rapidly predict a patient's ability to sustain total spontaneous respiration. All patients were eventually weaned from mechanical ventilation and had their tracheas extubated. Twenty-one patients maintained a pHa of greater than 7.35 during total spontaneous ventilation before they would, or could, meet conventional criteria for initiating a trial of spontaneous respiration (P less than .001). Seven patients simultaneously met both criteria for maintaining total spontaneous ventilation and the remaining five patients met conventional criteria before intermittent mandatory ventilation criteria. In the latter group, the pHa decreased below 7.35 during spontaneous respiration but in only one patient did it fall below 7.30. Our findings suggest that a patient's ability to maintain a pHa of greater than 7.35 while decreasing the frequency of mechanical ventilator breaths is more accurate than peak negative pressure and vital capacity for predicting ability to sustan adequate spontaneous respiration.

  11. Occurrence of respiratory symptoms in persons with restrictive ventilatory impairment compared with persons with chronic obstructive pulmonary disease: The PLATINO study.

    Science.gov (United States)

    Nonato, Nívia L; Nascimento, Oliver A; Padilla, Rogelio P; de Oca, Maria M; Tálamo, Carlos; Valdivia, Gonzalo; Lisboa, Carmen; López, Maria V; Celli, Bartolomé; Menezes, Ana Maria B; Jardim, José R

    2015-08-01

    Patients with chronic obstructive pulmonary disease (COPD) usually complain of symptoms such as cough, sputum, wheezing, and dyspnea. Little is known about clinical symptoms in individuals with restrictive ventilatory impairment. The aim of this study was to compare the prevalence and type of respiratory symptoms in patients with COPD to those reported by individuals with restrictive ventilatory impairment in the Proyecto Latinoamericano de Investigacion en Obstruccion Pulmonar study. Between 2002 and 2004, individuals ≥40 years of age from five cities in Latin America performed pre and post-bronchodilator spirometry and had their respiratory symptoms recorded in a standardized questionnaire. Among the 5315 individuals evaluated, 260 (5.1%) had a restrictive spirometric diagnosis (forced vital capacity (FVC) < lower limit of normal (LLN) with forced expiratory volume in the first second to forced vital capacity ratio (FEV1/FVC) ≥ LLN; American Thoracic Society (ATS)/European Respiratory Society (ERS) 2005) and 610 (11.9%) were diagnosed with an obstructive pattern (FEV1/FVC < LLN; ATS/ERS 2005). Patients with mild restriction wheezed more ((30.8%) vs. (17.8%); p < 0.028). No difference was seen in dyspnea, cough, and sputum between the two groups after adjusting for severity stage. The health status scores for the short form 12 questionnaire were similar in restricted and obstructed patients for both physical (48.4 ± 9.4 vs. 48.3 ± 9.8) and mental (50.8 ± 10.6 vs. 50.0 ± 11.5) domains. Overall, respiratory symptoms are not frequently reported by patients with restricted and obstructed patterns as defined by spirometry. Wheezing was more frequent in patients with restricted pattern compared with those with obstructive ventilatory defect. However, the prevalence of cough, sputum production, and dyspnea are not different between the two groups when adjusted by the same severity stage. © The Author(s) 2015.

  12. The influence of aerobic fitness status on ventilatory efficiency in patients with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Danilo M.L. Prado

    2015-01-01

    Full Text Available OBJECTIVE: To test the hypotheses that 1 coronary artery disease patients with lower aerobic fitness exhibit a lower ventilatory efficiency and 2 coronary artery disease patients with lower initial aerobic fitness exhibit greater improvements in ventilatory efficiency with aerobic exercise training. METHOD: A total of 123 patients (61.0±0.7 years with coronary artery disease were divided according to aerobic fitness status into 3 groups: group 1 (n = 34, peak VO217.5 and 24.5 ml/kg/min. All patients performed a cardiorespiratory exercise test on a treadmill. Ventilatory efficiency was determined by the lowest VE/VCO2 ratio observed. The exercise training program comprised moderate-intensity aerobic exercise performed 3 times per week for 3 months. Clinicaltrials.gov: NCT02106533 RESULTS: Before intervention, group 1 exhibited both lower peak VO2 and lower ventilatory efficiency compared with the other 2 groups (p<0.05. After the exercise training program, group 1 exhibited greater improvements in aerobic fitness and ventilatory efficiency compared with the 2 other groups (group 1: ▵ = -2.5±0.5 units; group 2: ▵ = -0.8±0.3 units; and group 3: ▵ = -1.4±0.6 units, respectively; p<0.05. CONCLUSIONS: Coronary artery disease patients with lower aerobic fitness status exhibited lower ventilatory efficiency during a graded exercise test. In addition, after 3 months of aerobic exercise training, only the patients with initially lower levels of aerobic fitness exhibited greater improvements in ventilatory efficiency.

  13. Metabolic interpretation of ventilatory parameters during maximal effort test and their applicability to sports

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Barreto Martins

    2007-09-01

    Full Text Available One important tool for producing specifi c and individualized training intensities is to determine ventilatory threshold (VT, respiratory compensation point (RCP and maximal oxygen uptake (VO2max by means of maximum effort testing. However, in order to be able to interpret these data in a wide-ranging manner, it is also important to understand the metabolic responses that occur during the test as the systems transporting and utilizing O2 and producing CO2 adjust. This review article presents an overview of the metabolic responses that take place during a hypothetical maximum effort test, and the applicability of the fi gures thus obtained to the training of athletes. ABSTRACT A determinação das velocidades atingidas no limiar ventilatório (LV, ponto de compensação respiratório (PCR e consumo máximo de O2 (VO2max através de um teste de esforço máximo, é uma ferramenta importante para a aplicação de intensidades de treinamento específicas e individualizadas. Mas para poder interpretar os dados de uma forma abrangente, também é importante o entendimento das respostas metabólicas presentes no ajuste dos sistemas de transporte e utilização de O2 e produção de CO2 durante a realização do teste. Esta revisão apresenta um panorama das respostas metabólicas que acontecem durante a realização de um teste de esforço máximo hipotético, e a aplicabilidade dos valores obtidos no treinamento de atletas.

  14. Chiropractic Adjustment

    Science.gov (United States)

    ... syndrome) A certain type of stroke (vertebral artery dissection) after neck manipulation Don't seek chiropractic adjustment ... Chiropractic treatment. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015. Shekelle P, et al. Spinal ...

  15. Noninvasive Ventilatory Correction as an Adjunct to an Experimental Systemic Reperfusion Therapy in Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Kristian Barlinn

    2010-01-01

    Full Text Available Background. Obstructive sleep apnea (OSA is a common condition in patients with acute ischemic stroke and associated with early clinical deterioration and poor functional outcome. However, noninvasive ventilatory correction is hardly considered as a complementary treatment option during the treatment phase of acute ischemic stroke. Summary of Case. A 55-year-old woman with an acute middle cerebral artery (MCA occlusion received intravenous tissue plasminogen activator (tPA and enrolled into a thrombolytic research study. During tPA infusion, she became drowsy, developed apnea episodes, desaturated and neurologically deteriorated without recanalization, re-occlusion or intracerebral hemorrhage. Urgent noninvasive ventilatory correction with biphasic positive airway pressure (BiPAP reversed neurological fluctuation. Her MCA completely recanalized 24 hours later. Conclusions. Noninvasive ventilatory correction should be considered more aggressively as a complementary treatment option in selected acute stroke patients. Early initiation of BiPAP can stabilize cerebral hemodynamics and may unmask the true potential of other therapies.

  16. Diaphragm paralysis causing ventilatory failure in an adult with the rigid spine syndrome.

    Science.gov (United States)

    Efthimiou, J; McLelland, J; Round, J; Gribbin, H R; Loh, L; Spiro, S G

    1987-12-01

    A syndrome consisting of a rigid spine and myopathy predominantly affecting proximal limb muscles has been previously described in children, and as with most neuromuscular disorders, the respiratory muscles appear to be affected only at an advanced stage in the disease. We describe an adult male with this syndrome who presented with ventilatory failure caused by severe respiratory muscle weakness and who demonstrated profound nocturnal arterial oxygen desaturation, particularly during rapid eye movement sleep. Treatment with negative pressure ventilation initially resulted in only modest improvements in symptoms, blood gas tensions, and nocturnal desaturation. The cause of this only partial improvement was upper airway obstruction provoked by the mode of ventilatory support used. After tracheostomy there was a dramatic and sustained improvement in symptoms and blood gas tensions and complete abolition of nocturnal arterial oxygen desaturation. This is the first report of an adult with the rigid spine syndrome presenting with ventilatory failure and cor pulmonale due to severe respiratory muscle weakness.

  17. Periaqueductal gray matter modulates the hypercapnic ventilatory response.

    Science.gov (United States)

    Lopes, Luana T; Patrone, Luis G A; Bícego, Kênia C; Coimbra, Norberto C; Gargaglioni, Luciane H

    2012-08-01

    The periaqueductal gray (PAG) is a midbrain structure directly involved in the modulation of defensive behaviors. It has direct projections to several central nuclei that are involved in cardiorespiratory control. Although PAG stimulation is known to elicit respiratory responses, the role of the PAG in the CO(2)-drive to breathe is still unknown. The present study assessed the effect of chemical lesion of the dorsolateral and dorsomedial and ventrolateral/lateral PAG (dlPAG, dmPAG, and vPAG, respectively) on cardiorespiratory and thermal responses to hypercapnia. Ibotenic acid (IBO) or vehicle (PBS, Sham group) was injected into the dlPAG, dmPAG, or vPAG of male Wistar rats. Rats with lesions outside the dlPAG, dmPAG, or vPAG were considered as negative controls (NC). Pulmonary ventilation (VE: ), mean arterial pressure (MAP), heart rate (HR), and body temperature (Tb) were measured in unanesthetized rats during normocapnia and hypercapnic exposure (5, 15, 30 min, 7 % CO(2)). IBO lesioning of the dlPAG/dmPAG caused 31 % and 26.5 % reductions of the respiratory response to CO(2) (1,094.3 ± 115 mL/kg/min) compared with Sham (1,589.5 ± 88.1 mL/kg/min) and NC groups (1,488.2 ± 47.7 mL/kg/min), respectively. IBO lesioning of the vPAG caused 26.6 % and 21 % reductions of CO(2) hyperpnea (1,215.3 ± 108.6 mL/kg/min) compared with Sham (1,657.3 ± 173.9 mL/kg/min) and NC groups (1,537.6 ± 59.3). Basal VE: , MAP, HR, and Tb were not affected by dlPAG, dmPAG, or vPAG lesioning. The results suggest that dlPAG, dmPAG, and vPAG modulate hypercapnic ventilatory responses in rats but do not affect MAP, HR, or Tb regulation in resting conditions or during hypercapnia.

  18. Influence of locomotor muscle afferent inhibition on the ventilatory response to exercise in heart failure.

    Science.gov (United States)

    Olson, Thomas P; Joyner, Michael J; Eisenach, John H; Curry, Timothy B; Johnson, Bruce D

    2014-02-01

    What is the central question of this study? Patients with heart failure often develop ventilatory abnormalities at rest and during exercise, but the mechanisms underlying these abnormalities remain unclear. This study investigated the influence of inhibiting afferent neural feedback from locomotor muscles on the ventilatory response during exercise in heart failure patients. What is the main finding and its importance? Our results suggest that inhibiting afferent feedback from locomotor muscle via intrathecal opioid administration significantly reduces the ventilatory response to exercise in heart failure patients. Patients with heart failure (HF) develop ventilatory abnormalities at rest and during exercise, but the mechanism(s) underlying these abnormalities remain unclear. We examined whether the inhibition of afferent neural feedback from locomotor muscles during exercise reduces exercise ventilation in HF patients. In a randomized, placebo-controlled design, nine HF patients (age, 60 ± 2 years; ejection fraction, 27 ± 2%; New York Heart Association class 2 ± 1) and nine control subjects (age, 63 ± 2 years) underwent constant-work submaximal cycling (65% peak power) with intrathecal fentanyl (impairing the cephalad projection of opioid receptor-sensitive afferents) or sham injection. The hypercapnic ventilatory response was measured to determine whether cephalad migration of fentanyl occurred. There were no differences in hypercapnic ventilatory response within or between groups in either condition. Despite a lack of change in ventilation, tidal volume or respiratory rate, HF patients had a mild increase in arterial carbon dioxide (P(aCO(2)) and a decrease in oxygen (P(aO(2)); P rate at rest. In response to fentanyl during exercise, HF patients had a reduction in ventilation (63 ± 6 versus 44 ± 3 l min(-1), P rate (30 ± 1 versus 26 ± 2 breaths min(-1), P increased P(aCO(2)) (37.3 ± 0.9 versus 43.5 ± 1.1 mmHg, P exercise in HF patients.

  19. Respiratory muscle training with normocapnic hyperpnea improves ventilatory pattern and thoracoabdominal coordination, and reduces oxygen desaturation during endurance exercise testing in COPD patients

    Directory of Open Access Journals (Sweden)

    Bernardi E

    2015-09-01

    Full Text Available Eva Bernardi,1 Luca Pomidori,1 Faisy Bassal,1 Marco Contoli,2 Annalisa Cogo11Biomedical Sport Studies Center, University of Ferrara, Ferrara, 2Respiratory Section, Department of Medical Sciences, University of Ferrara, Cona (FE, ItalyBackground: Few data are available about the effects of respiratory muscle training with normocapnic hyperpnea (NH in COPD. The aim is to evaluate the effects of 4 weeks of NH (Spirotiger® on ventilatory pattern, exercise capacity, and quality of life (QoL in COPD patients.Methods: Twenty-six COPD patients (three females, ages 49–82 years, were included in this study. Spirometry and maximal inspiratory pressure, St George Respiratory Questionnaire, 6-minute walk test, and symptom-limited endurance exercise test (endurance test to the limit of tolerance [tLim] at 75%–80% of peak work rate up to a Borg Score of 8–9/10 were performed before and after NH. Patients were equipped with ambulatory inductive plethysmography (LifeShirt® to evaluate ventilatory pattern and thoracoabdominal coordination (phase angle [PhA] during tLim. After four supervised sessions, subjects trained at home for 4 weeks – 10 minutes twice a day at 50% of maximal voluntary ventilation. The workload was adjusted during the training period to maintain a Borg Score of 5–6/10.Results: Twenty subjects completed the study. After NH, maximal inspiratory pressure significantly increased (81.5±31.6 vs 91.8±30.6 cmH2O, P<0.01; exercise endurance time (+150 seconds, P=0.04, 6-minute walk test (+30 meters, P=0.03, and QoL (-8, P<0.01 all increased. During tLim, the ventilatory pattern changed significantly (lower ventilation, lower respiratory rate, higher tidal volume; oxygen desaturation, PhA, and dyspnea Borg Score were lower for the same work intensity (P<0.01, P=0.02, and P<0.01, respectively; one-way ANOVA. The improvement in tidal volume and oxygen saturation after NH were significantly related (R2=0.65, P<0.01.Conclusion: As

  20. Using Thorax Expansion to Detect a Ventilatory Inflection Point in the Field.

    Science.gov (United States)

    Heyde, C; Mahler, H; Gollhofer, A; Roecker, K

    2016-01-01

    Assessing an individual's physical fitness can usually be achieved through evaluating lactate or ventilatory thresholds. Unfortunately, the detection of ventilatory thresholds still requires uncomfortable mass flow sensors and a laboratory setting. Therefore, this study aimed to evaluate a ventilatory inflection point (VIP) derived from thorax expansion as a useful surrogate to assess an individual's physical fitness under field conditions. 348 and 107 ramp tests have been selected respectively to examine validity and retest variability of VIP. The individual anaerobic threshold (IAT) determined by means of blood lactate sampling was used as reliable rationale for evaluation. Calibrated respiratory inductance plethysmography (RIP) was utilized to derive ventilation from thorax expansion during the ramp test. An automated software routine was applied to detect the VIP. Speed, heart rate and ventilation at the VIP correlated significantly to corresponding values at IAT (r=0.840, 0.876, 0.933). Non-systematic differences between repeated testing ranged within ±1.15 km·h(-1), ±8.74 b·min(-1) and ±12.69 l·min(-1) (±1.96 SD). The timing of VIP is not solely dependent on the aerobic capacity and might instead quantify an individual's physical fitness in terms of the efficiency of the compensative and supportive ventilatory response during increased exercise intensities. © Georg Thieme Verlag KG Stuttgart · New York.

  1. An experimental randomized study of six different ventilatory modes in a piglet model with normal lungs

    DEFF Research Database (Denmark)

    Nielsen, J B; Sjöstrand, U H; Henneberg, S W

    1991-01-01

    -controlled intermittent positive-pressure ventilation; and SV-20P denotes pressure-controlled intermittent positive-pressure ventilation. With all modes of ventilation a PEEP of 7.5 cm H2O was used. In the abbreviations used, the number denotes the ventilatory frequency in breaths per minute (bpm). HFV indicates that all...

  2. Do regression-based computer algorithms for determining the ventilatory threshold agree?

    Science.gov (United States)

    Ekkekakis, Panteleimon; Lind, Erik; Hall, Eric E; Petruzzello, Steven J

    2008-07-01

    The determination of the ventilatory threshold has been a persistent problem in research and clinical practice. Several computerized methods have been developed to overcome the subjectivity of visual methods but it remains unclear whether different computerized methods yield similar results. The purpose of this study was to compare nine regression-based computerized methods for the determination of the ventilatory threshold. Two samples of young and healthy volunteers (n = 30 each) participated in incremental treadmill protocols to volitional fatigue. The ventilatory data were averaged in 20-s segments and analysed with a computer program. Significant variance among methods was found in both samples (Sample 1: F = 11.50; Sample 2: F = 11.70, P < 0.001 for both). The estimates of the ventilatory threshold ranged from 2.47 litres.min(-1) (71% VO2max) to 3.13 litres.min(-1) (90% VO2max) in Sample 1 and from 2.37 litres.min(-1) (67% VO2max) to 3.03 litres.min(-1) (83% VO2max) in Sample 2. The substantial differences between methods challenge the practice of relying on any single computerized method. A standardized protocol, likely based on a combination of methods, might be necessary to increase the methodological consistency in both research and clinical practice.

  3. Evidence that ventilatory rhythmogenesis in the frog involves two distinct neuronal oscillators

    Science.gov (United States)

    Wilson, R J A; Vasilakos, K; Harris, M B; Straus, C; Remmers, J E

    2002-01-01

    In Rana catesbeiana the upper airways are used for two distinct yet highly coordinated ventilatory behaviours: buccal ventilation and lung inflation cycles. How these behaviours are generated and coordinated is unknown. The purpose of this study was to identify putative rhythmogenic brainstem loci involved in these ventilatory behaviours. We surveyed the isolated postmetamorphic brainstem to determine sites where local depolarization, produced by microinjecting the non-NMDA glutamate receptor agonist, AMPA, augmented the ventilatory motor patterns. Two sites were identified: a caudal site, at the level of cranial nerve (CN) X, where AMPA injections caused increased buccal burst frequency but abolished lung bursts, and a rostral site, between the levels of CN VIII and IX, where injections increased the frequency of both types of ventilatory bursts. These two sites were further examined using GABA microinjections to locally inhibit cells. GABA injected into the caudal site suppressed the buccal rhythm but the lung rhythm continued, albeit at a different frequency. When GABA was injected into the rostral site the lung bursts were abolished but the buccal rhythm continued. When the two sites were physically separated by transection, both rostral and caudal brainstem sections were capable of rhythmogenesis. The results suggest the respiratory network within the amphibian brainstem is composed of at least two distinct but interacting oscillators, the buccal and lung oscillators. These putative oscillators may provide a promising experimental model for studying coupled oscillators in vertebrates. PMID:11956343

  4. Respiratory muscle endurance is limited by lower ventilatory efficiency in post-myocardial infarction patients

    Directory of Open Access Journals (Sweden)

    Laura M. T. Neves

    2014-03-01

    Full Text Available Background: Reduced respiratory muscle endurance (RME contributes to increased dyspnea upon exertion in patients with cardiovascular disease. Objective: The objective was to characterize ventilatory and metabolic responses during RME tests in post-myocardial infarction patients without respiratory muscle weakness. Method: Twenty-nine subjects were allocated into three groups: recent myocardial infarction group (RG, n=9, less-recent myocardial infarction group (LRG, n=10, and control group (CG, n=10. They underwent two RME tests (incremental and constant pressure with ventilatory and metabolic analyses. One-way ANOVA and repeated measures one-way ANOVA, both with Tukey post-hoc, were used between groups and within subjects, respectively. Results: Patients from the RG and LRG presented lower metabolic equivalent and ventilatory efficiency than the CG on the second (50± 06, 50± 5 vs. 42± 4 and third part (50± 11, 51± 10 vs. 43± 3 of the constant pressure RME test and lower metabolic equivalent during the incremental pressure RME test. Additionally, at the peak of the incremental RME test, RG patients had lower oxygen uptake than the CG. Conclusions : Post-myocardial infarction patients present lower ventilatory efficiency during respiratory muscle endurance tests, which appears to explain their inferior performance in these tests even in the presence of lower pressure overload and lower metabolic equivalent.

  5. Physician attitudes towards ventilatory support for spinal muscular atrophy type 1 in Australasia

    NARCIS (Netherlands)

    Geevasinga, Nimeshan; Ryan, Monique M.

    2007-01-01

    Without ventilatory support, premature death from respiratory insufficiency is virtually universal in infants with spinal muscular atrophy type 1 (SMA1). With mechanical ventilation, however, long-term survival has been reported from numerous international centres. We aimed to characterize physician

  6. Salary adjustments

    CERN Multimedia

    HR Department

    2008-01-01

    In accordance with decisions taken by the Finance Committee and Council in December 2007, salaries are adjusted with effect from 1 January 2008. Scale of basic salaries and scale of stipends paid to fellows (Annex R A 5 and R A 6 respectively): increased by 0.71% with effect from 1 January 2008. As a result of the stability of the Geneva consumer price index, the following elements do not increase: a)\tFamily Allowance, Child Allowance and Infant Allowance (Annex R A 3); b)\tReimbursement of education fees: maximum amounts of reimbursement (Annex R A 4.01) for the academic year 2007/2008. Related adjustments will be applied, wherever applicable, to Paid Associates and Students. As in the past, the actual percentage increase of each salary position may vary, due to the application of a constant step value and rounding effects. Human Resources Department Tel. 73566

  7. Salary adjustments

    CERN Multimedia

    HR Department

    2008-01-01

    In accordance with decisions taken by the Finance Committee and Council in December 2007, salaries are adjusted with effect from 1 January 2008. Scale of basic salaries and scale of stipends paid to fellows (Annex R A 5 and R A 6 respectively): increased by 0.71% with effect from 1 January 2008. As a result of the stability of the Geneva consumer price index, following elements do not increase: a) Family Allowance, Child Allowance and Infant Allowance (Annex R A 3). b) Reimbursement of education fees: maximum amounts of reimbursement (Annex R A 4.01) for the academic year 2007/2008. Related adjustments will be implemented, wherever applicable, to Paid Associates and Students. As in the past, the actual percentage increase of each salary position may vary, due to the application of a constant step value and the rounding effects. Human Resources Department Tel. 73566

  8. Employment Assistance: Strategic Adjustment of Rural Poverty Reduction Should Be Orientation%就业援助是农村扶贫战略调整的应有取向

    Institute of Scientific and Technical Information of China (English)

    周毕芬

    2012-01-01

    本文分析了我国农村扶贫战略先后经历的从救济式扶贫、区域开发式扶贫,向整村推进扶贫、最低生活保障制度扶贫的转变的局限性,认为当前农村扶贫战略应朝就业援助方向调整,并提出从“上游”、“中游”、“下游”三个维度实施就业援助政策措施.%China's rural poverty alleviation strategy has undergone the relief-type approach, regional development-oriented aid, the whole village to promote poverty alleviation, and minimum life guarantee system change of poverty alleviation. This paper analyzed the limitation of the traditional above poverty eradication strategies, thinks that the current rural poverty alleviation strategy toward employment assistance direction should be adjusted, and put forward from "upstream", "middle" and "downstream" three dimensions implementation employment assistance policy measures.

  9. 24 CFR 886.312 - Rent adjustments.

    Science.gov (United States)

    2010-04-01

    ... levels of such expenses in comparable assisted and unassisted housing in the area to ensure that... assisted and comparable unassisted units. Contract rents may be adjusted upward or downward as may be...) Comparability between assisted and unassisted units. Notwithstanding any other provisions of this...

  10. Influence of Inspiratory Muscle Training on Ventilatory Efficiency and Cycling Performance in Normoxia and Hypoxia

    Science.gov (United States)

    Salazar-Martínez, Eduardo; Gatterer, Hannes; Burtscher, Martin; Naranjo Orellana, José; Santalla, Alfredo

    2017-01-01

    The aim of this study was to analyse the influence of inspiratory muscle training (IMT) on ventilatory efficiency, in normoxia and hypoxia, and to investigate the relationship between ventilatory efficiency and cycling performance. Sixteen sport students (23.05 ± 4.7 years; 175.11 ± 7.1 cm; 67.0 ± 19.4 kg; 46.4 ± 8.7 ml·kg−1·min−1) were randomly assigned to an inspiratory muscle training group (IMTG) and a control group (CG). The IMTG performed two training sessions/day [30 inspiratory breaths, 50% peak inspiratory pressure (Pimax), 5 days/week, 6-weeks]. Before and after the training period subjects carried out an incremental exercise test to exhaustion with gas analysis, lung function testing, and a cycling time trial test in hypoxia and normoxia. Simulated hypoxia (FiO2 = 16.45%), significantly altered the ventilatory efficiency response in all subjects (p < 0.05). Pimax increased significantly in the IMTG whereas no changes occurred in the CG (time × group, p < 0.05). Within group analyses showed that the IMTG improved ventilatory efficiency (VE/VCO2 slope; EqCO2VT2) in hypoxia (p < 0.05) and cycling time trial performance [WTTmax (W); WTTmean (W); PTF(W)] (p < 0.05) in hypoxia and normoxia. Significant correlations were not found in hypoxia nor normoxia found between ventilatory efficiency parameters (VE/VCO2 slope; LEqCO2; EqCO2VT2) and time trial performance. On the contrary the oxygen uptake efficiency slope (OUES) was highly correlated with cycling time trial performance (r = 0.89; r = 0.82; p < 0.001) under both conditions. Even though no interaction effect was found, the within group analysis may suggest that IMT reduces the negative effects of hypoxia on ventilatory efficiency. In addition, the data suggest that OUES plays an important role in submaximal cycling performance. PMID:28337149

  11. Poikilocapnic hypoxic ventilatory response in humans during 0.85 MAC isoflurane anesthesia.

    Science.gov (United States)

    Sjögren, D; Sollevi, A; Ebberyd, A; Lindahl, S G

    1994-02-01

    Ventilatory responses to hypoxia (HVR) were investigated using poikilocapnic conditions (i.e. end-tidal CO2's allowed to seek it's own level) in 15 cardio-pulmonary healthy patients who were first studied awake and then at 0.85 MAC isoflurane. The influence of hypercapnia (HyperCapnic Ventilatory Response, HCVR) was also elucidated. Pneumotachography, capnography and airway occlusion pressures at 0.1 s (P degree 0.1) were used before and during both mild hypoxia (end-tidal O2 tension 8.7 kPa) and hypercapnia achieved by an inspired CO2 concentration of 5%. HCVR was attenuated by 60% during anesthesia (P awake state, five of the 15 patients decreased HVR during hypoxia as compared with during normoxia. This resulted in a VE that on average increased by 0.6 l.min-1 (P MAC isoflurane.

  12. Influence of gender on ventilatory efficiency during exercise in young children.

    Science.gov (United States)

    Guerrero, Laura; Naranjo, José; Carranza, M Dolores

    2008-11-01

    In this study, we assessed the ventilatory response in 84 children (46 males: age 8.1 +/- 1.0 years, body mass 34.2 +/- 7.9 kg, height 1.32 +/- 0.16 m; 38 females: age 8.0 +/- 0.8 years, body mass 31.7 +/- 8.7 kg, height 1.31 +/- 0.08 m) during a cycle ergometer test to determine if there was an influence of gender on ventilatory efficiency. The test commenced at 25 W and increased by 10 W every minute. Expired air was collected through a face mask and analysed breath by breath. The ventilatory anaerobic threshold was determined according to gas exchange methods and we focused our attention on the analysis of carbon dioxide production (VCO(2)), ventilation (V(E)), the ratio V(E)/VCO(2) and its slope. Differences between the sexes at maximal power output were strongly significant for V(E) and VCO(2) (P = 0.0001 and P = 0.0004 respectively) and moderately significant for the V(E)/VCO(2) ratio (P = 0.05). The slope of V(E) versus VCO(2) was 30.8 +/- 4.2 for males and 29.4 +/- 3.2 for females, with no difference between the sexes (P = 0.1). In conclusion, although the peak values of V(E) and VCO(2) were significantly different between the sexes, there were no such differences in ventilatory efficiency during a maximal incremental test expressed as the slope of V(E)/VCO(2), at least in young children.

  13. Withdrawal of ventilatory support outside the intensive care unit: guidance for practice

    OpenAIRE

    Laddie, Joanna; Craig, Finella; Brierley, Joe; Kelly, Paula; Bluebond-Langner, Myra

    2014-01-01

    Objective To review the work of one tertiary paediatric palliative care service in facilitating planned withdrawal of ventilatory support outside the intensive care setting, with the purpose of developing local guidance for practice. Methods Retrospective 10-year (2003–2012) case note review of intensive care patients whose parents elected to withdraw ventilation in another setting. Demographic and clinical data revealed common themes and specific incidents relevant to local guideline develop...

  14. Cardiac Resynchronization Therapy Reduces Metaboreflex Contribution to the Ventilatory Response in Heart Failure Population

    Directory of Open Access Journals (Sweden)

    Jérémie Jaussaud

    2012-01-01

    Full Text Available Background. Metaboreflex overactivation has been proprosed to explain exaggerated hyperventilation in heart failure population. We investigated the metaboreflex activation after cardiac resynchronization therapy (CRT. Methods. 10 heart failure patients (mean left ventricular ejection fraction (LVEF 27±4% schedulded for CRT implantation were prospectively studied. At baseline and after 6 month follow up two maximal cardiopulmonary exercise tests with and without regional circulatory occlusion (RCO during recovery were performed. RCO was achieved by inflation of bilateral upper thigh tourniquets 30 mmHg above peak systolic blood pressure during 3 minutes after peak exercise. Metaboreflex contribution to the ventilatory response was assessed as the difference in ventilatory data at the third minute during recovery between the two tests (Δ. Results. Patients had enhanced VE/VCO2 slope (40±9 and an evident metaboreflex contribution to the high ventilatory response (ΔVE: 3±4 L/min; =0.05, ΔRR: 4.5±4/min; =0.003 and ΔVE/VCO2: 5.5±4; =0.007. 6 months after CRT implantation, NYHA class, LVEF, peak VO2 and VE/VCO2 were significantly improved (1.4±0.5; <0.001, 42±7%; <0.001, 16.5±3 mL/kg/min; =0.003; 33±10; =0.01. Metaboreflex contribution to VE, RR, and VE/VCO2 was reduced compared with baseline (=0.08, =0.01 and =0.4 resp.. Conclusion. 6 months after CRT metaboreflex contribution to the ventilatory response is reduced.

  15. Management of Ventilatory Insufficiency in Neuromuscular Patients Using Mechanical Ventilator Supported by the Korean Government.

    Science.gov (United States)

    Kang, Seong-Woong; Choi, Won Ah; Cho, Han Eol; Lee, Jang Woo; Park, Jung Hyun

    2016-06-01

    Since 2001, financial support has been provided for all patients with neuromuscular disease (NMD) who require ventilatory support due to the paralysis of respiratory muscles in Korea. The purpose of this study was to identify ventilator usage status and appropriateness in these patients. We included 992 subjects with rare and incurable NMD registered for ventilator rental fee support. From 21 February 2011 to 17 January 2013, ventilator usage information, regular follow-up observation, and symptoms of chronic hypoventilation were surveyed by phone. Home visits were conducted for patients judged by an expert medical team to require medical examination. Abnormal ventilatory status was assessed by respiratory evaluation. Chronic respiratory insufficiency symptoms were reported by 169 of 992 subjects (17%), while 565 subjects (57%) did not receive regular respiratory evaluation. Ventilatory status was abnormal in 102 of 343 home-visit subjects (29.7%). Although 556 subjects (56%) reported 24-hour ventilator use, only 458 (46%) had an oxygen saturation monitoring device, and 305 (31%) performed an airstacking exercise. A management system that integrates ventilator usage monitoring, counselling and advice, and home visits for patients who receive ventilator support could improve the efficiency of the ventilator support project.

  16. [Respiratory symptoms and obstructive ventilatory disorder in Tunisian woman exposed to biomass].

    Science.gov (United States)

    Kwas, H; Rahmouni, N; Zendah, I; Ghedira, H

    2017-04-01

    In some Tunisian cities, especially semi-urbanized, the exposure to the smoke produced during combustion of the biomass, main source of pollution of indoor air, remains prevalent among non-smoking women. To assess the relationship between exposure to biomass smoke and the presence of obstructive ventilatory disorder in the non-smoking women in semi-urban areas of Tunisia. Cross etiological study, using a questionnaire, including 140 non-smoking women responsible for cooking and/or exposed during heating by traditional means with objective measurement of their respiratory functions. We found 81 women exposed to biomass for a period of≥20 hours-years and 59 unexposed women. Exposed women reported more respiratory symptoms namely exertional dyspnea and/or chronic cough than unexposed. Of the 140 women, 14 women have an FEV/FEV6biomass. We found a correlation between respiratory symptoms and obstructive ventilatory disorder in exposed women. The air pollution inside the home during the traditional activities of cooking and/or heating is a respiratory risk factor for non-smoking women over the age of 30 years. Exposure to biomass smoke can cause chronic respiratory symptoms and persistent obstructive ventilatory disorder that can consistent with COPD. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Different ventilatory responses to progressive maximal exercise test performed with either the arms or legs

    Directory of Open Access Journals (Sweden)

    Renata R. T. Castro

    2011-01-01

    Full Text Available OBJECTIVE: This study aimed to compare respiratory responses, focusing on the time-domain variability of ventilatory components during progressive cardiopulmonary exercise tests performed on cycle or arm ergometers. METHODS: The cardiopulmonary exercise tests were conducted on twelve healthy volunteers on either a cycle ergometer or an arm ergometer following a ramp protocol. The time-domain variabilities (the standard deviations and root mean squares of the successive differences of the minute ventilation, tidal volume and respiratory rate were calculated and normalized to the number of breaths. RESULTS: There were no significant differences in the timing of breathing throughout the exercise when the cycle and arm ergometer measurements were compared. However, the arm exercise time-domain variabilities for the minute ventilation, tidal volume and respiratory rate were significantly greater than the equivalent values obtained during leg exercise. CONCLUSION: Although the type of exercise does not influence the timing of breathing when dynamic arm and leg exercises are compared, it does influence time-domain ventilatory variability of young, healthy individuals. The mechanisms that influence ventilatory variability during exercise remain to be studied.

  18. Body temperature depression and peripheral heat loss accompany the metabolic and ventilatory responses to hypoxia in low and high altitude birds.

    Science.gov (United States)

    Scott, Graham R; Cadena, Viviana; Tattersall, Glenn J; Milsom, William K

    2008-04-01

    The objectives of this study were to compare the thermoregulatory, metabolic and ventilatory responses to hypoxia of the high altitude bar-headed goose with low altitude waterfowl. All birds were found to reduce body temperature (T(b)) during hypoxia, by up to 1-1.5 degrees C in severe hypoxia. During prolonged hypoxia, T(b) stabilized at a new lower temperature. A regulated increase in heat loss contributed to T(b) depression as reflected by increases in bill surface temperatures (up to 5 degrees C) during hypoxia. Bill warming required peripheral chemoreceptor inputs, since vagotomy abolished this response to hypoxia. T(b) depression could still occur without bill warming, however, because vagotomized birds reduced T(b) as much as intact birds. Compared to both greylag geese and pekin ducks, bar-headed geese required more severe hypoxia to initiate T(b) depression and heat loss from the bill. However, when T(b) depression or bill warming were expressed relative to arterial O(2) concentration (rather than inspired O(2)) all species were similar; this suggests that enhanced O(2) loading, rather than differences in thermoregulatory control centres, reduces T(b) depression during hypoxia in bar-headed geese. Correspondingly, bar-headed geese maintained higher rates of metabolism during severe hypoxia (7% inspired O(2)), but this was only partly due to differences in T(b). Time domains of the hypoxic ventilatory response also appeared to differ between bar-headed geese and low altitude species. Overall, our results suggest that birds can adjust peripheral heat dissipation to facilitate T(b) depression during hypoxia, and that bar-headed geese minimize T(b) and metabolic depression as a result of evolutionary adaptations that enhance O(2) transport.

  19. Cost-effectiveness analysis of a low-cost bubble CPAP device in providing ventilatory support for neonates in Malawi - a preliminary report.

    Science.gov (United States)

    Chen, Ariel; Deshmukh, Ashish A; Richards-Kortum, Rebecca; Molyneux, Elizabeth; Kawaza, Kondwani; Cantor, Scott B

    2014-11-25

    A low-cost bubble continuous positive airway pressure (bCPAP) device has been shown to be an excellent clinical alternative to nasal oxygen for the care of neonates with respiratory difficulty. However, the delivery of bCPAP requires more resources than the current routine care using nasal oxygen. We performed an economic evaluation to determine the cost-effectiveness of a low-cost bCPAP device in providing ventilatory support for neonates in Malawi. We used patient-level clinical data from a previously published non-randomized controlled study. Economic data were based on the purchase price of supplies and equipment, adjusted for shelf life, as well as hospital cost data from the World Health Organization. Costs and benefits were discounted at 3%. The outcomes were measured in terms of cost, discounted life expectancy, cost/life year gained and net benefits of using bCPAP or nasal oxygen. The incremental cost-effectiveness ratio and incremental net benefits determined the value of one intervention compared to the other. Subgroup analysis on several parameters (birth weight categories, diagnosis of respiratory distress syndrome, and comorbidity of sepsis) was conducted to evaluate the effect of these parameters on the cost-effectiveness. Nasal oxygen therapy was less costly (US$29.29) than the low-cost bCPAP device ($57.78). Incremental effectiveness associated with bCPAP was 6.78 life years (LYs). In the base case analysis, the incremental cost-effectiveness ratio for bCPAP relative to nasal oxygen therapy was determined to be $4.20 (95% confidence interval, US$2.29-US$16.67) per LY gained. The results were highly sensitive for all tested subgroups, particularly for neonates with birth weight 1- cost effective. The bCPAP is a highly cost-effective strategy in providing ventilatory support for neonates in Malawi.

  20. 24 CFR 891.645 - Adjustment of utility allowances.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Adjustment of utility allowances... Handicapped-Section 8 Assistance § 891.645 Adjustment of utility allowances. In connection with adjustments of contract rents as provided in § 891.640(a), the requirements for the adjustment of utility...

  1. 24 CFR 886.112 - Rent adjustments.

    Science.gov (United States)

    2010-04-01

    ... Adjustment Factor most recently published by HUD in the Federal Register in accordance with 24 CFR part 888... unassisted housing in the area to ensure that adjustments in the Contract Rents shall not result in material differences between the rents charged for assisted and comparable unassisted units. Contract Rents may...

  2. Comparative determination of ventilatory efficiency from constant load and incremental exercise testing.

    Science.gov (United States)

    Algul, S; Ugur, F A; Ayar, A; Ozcelik, O

    2017-08-15

    The analysis of the relationships between minute ventilation (VE) to CO2 output (VCO2), referred to as ventilatory efficiency, in response to incremental exercise testing, is considered a useful index for assessing the presence and severity of cardiopulmonary and metabolic diseases. The effects of constant load exercise testing performed at work intensity associated with anaerobic threshold (AT) and respiratory compensation points (RCP), on the accurate measurements of ventilatory efficiency are not well known. The aim of this present study was to investigate the reliability of the VE/VCO2 ratio obtained from constant load exercise tests performed with two important metabolic rates (at the AT and RCP) and compare it to that of those of incremental exercise tests. A total of 20 young male (20.8±0.4 yr) subjects initially performed an incremental exercise test and then two constant load exercise tests, on different days. Respiratory and pulmonary gas exchange variables were used to estimate AT and RCP. A paired t-test was used to analyse data. AT and RCP (average) occurred the at 60% and at 71% of peak O2 uptake, respectively. The lowest VE/VCO2 ratio recorded within the first 2 minutes of constant load exercise tests with a work load of AT (26.4±0.3) and RCP (26.7±0.5) was not statistically different from the lowest ratio obtained from the incremental exercise tests (26.0±0.7). In the constant load exercise test, despite the different metabolic rates, the increase in ventilation corresponded closely with the increase in CO2 production, reflecting an optimal ventilation and perfusion ratio. Clinicians should consider the constant load exercise test work load associated with AT and RCP as it provides a meaningful lowest value for ventilatory efficiency.

  3. Effects of aging and training status on ventilatory response during incremental cycling exercise.

    Science.gov (United States)

    Lenti, Mauro; De Vito, Giuseppe; Scotto di Palumbo, Alessandro; Sbriccoli, Paola; Quattrini, Filippo M; Sacchetti, Massimo

    2011-05-01

    The aim of this study was to examine the effect of aging and training status on ventilatory response during incremental cycling exercise. Eight young (24 ± 5 years) and 8 older (64 ± 3 years) competitive cyclists together with 8 young (27 ± 4 years) and 8 older (63 ± 2 years) untrained individuals underwent a continuous incremental cycling test to exhaustion to determine ventilatory threshold (VT), respiratory compensation point (RCP), and maximal oxygen uptake (VO₂max). In addition, the isocapnic buffering (IB) phase was calculated together with the hypocapnic hyperventilation. Ventilatory threshold occurred at similar relative exercise intensities in all groups, whereas RCP was recorded at higher intensities in young and older cyclists compared to the untrained subjects. The IB phase, reported as the difference between VT and RCP and expressed either in absolute (ml·min⁻¹·kg⁻¹ VO₂) or in relative terms, was greater (p < 0.01) in both young and older trained cyclists than in untrained subjects, who were also characterized by a lower exercise capacity. Isocapnic buffering was particularly small in the older untrained volunteers. Although young untrained and older trained subjects had a similar level of VO₂max, older athletes exhibited a larger IB. In addition, a higher absolute but similar relative IB was observed in young vs. older cyclists, despite a higher VO₂max in the former. In conclusion, the present study shows that aging is associated with a reduction of the IB phase recorded during an incremental exercise test. Moreover, endurance training induces adaptations that result in an enlargement of the IB phase independent of age. This information can be used for the characterization and monitoring of the physiological adaptations induced by endurance training.

  4. Basilar artery blood flow velocity and the ventilatory response to acute hypoxia in mountaineers.

    Science.gov (United States)

    Jansen, Gerard F A; Kagenaar, Dick A; Basnyat, Buddha; Odoom, Joseph A

    2002-10-23

    Hypoxic ventilatory response is higher in successful extreme-altitude climbers than in controls. We hypothesized that these climbers have lower brainstem blood flow secondary to hypoxia which may possibly cause retention of medullary CO(2) and greater ventilatory drive. Using transcranial Doppler, basilar artery blood flow velocity (Vba) was measured at sea level in 7 extreme-altitude climbers and 10 controls in response to 10 min sequential exposures to inspired oxygen fractions (FI(O(2))) of 0.21 (baseline), 0.13, 0.11, 0.10, 0.09, 0.08 and 0.07. Sa(O(2)) was higher in climbers at FI(O(2)) of 0.11 (P<0.05), 0.08 and 0.07 (both P<0.0001). Expired ventilation (VE) increased more (n.s.), and PET(CO(2)) decreased more (n.s.) in the climbers than in controls. Vba did not significantly change in both groups at FI(O(2)) of 0.13-0.09. At FI(O(2)) of 0.08 and 0.07, Vba decreased 21% (P<0.03) and 27% (P<0.01), respectively, in climbers, and increased 29% (P<0.01) and 27% (P<0.01), respectively, in controls. The conflicting effects of hypoxia and hypocapnia on both medullary blood flow and ventilatory drive thus balance out, giving climbers a greater drive and higher Sa(O(2)), despite lower PET(CO(2)) and lower brain stem blood flow.

  5. The effects of acute L-carnitine administration on ventilatory breakpoint and exercise performanceduring incremental exercise

    Directory of Open Access Journals (Sweden)

    Mojtaba Kaviani

    2009-01-01

    Full Text Available (Received 31 October, 2009 ; Accepted 10 March, 2010AbstractBackground and purpose: Many athletes adopt nutritional manipulations to improve their performance. Among the substances generally consumed is carnitine (L-trimethyl-3-hydroxy-ammoniobutanoate which has been used by athletes as an ergogenic aid, due to its role in the transport of long-chain fatty acids across mitochondrial membranes. Nutritional supplements containing carbohydrates, proteins, vitamins, and minerals have been widely used in various sporting fields to provide a boost to the recommended daily allowance. The aim of this study is to investigate the effects of acute L-carnitine administration on ventilatory breakpoint, an exercise performance during incremental exercise.Materials and methods: This study was double-blind, randomized and crossover in design. The subjects were 12 randomly selected active male physical education students, 21.75±0.64 years old, with a mean body mass index (BMI of 23.7±0.94kg/m2, divided into 2 groups. They received orally either 2g of L-carnitine dissolved in 200 ml of water, plus 6 drops of lemon juice or a placebo (6 ml lemon juice dissolved in 200 ml of water 90 minutes before they began to exercise on a treadmill. They performed a modified protocol of Conconi test to exhaustion. One-way analysis of variance with repeated measurements was used for data analysis.Results: The results showed that exercise performance improved in LC group (2980±155 meter compared with placebo group (2331±51 meter. Furthermore, no significant difference was found in ventilatory breakpoint between the two groups.Conclusion: This finding indicates that administration of L- Carnitine, 90 minutes prior to exercise may improve performance; despite the ventilatory breakpoint as one of the anaerobic system indices that had no effect. J Mazand Univ Med Sci 2009; 19(73: 43-50 (Persian.

  6. Anaerobic threshold assessment through the ventilatory method during roller-ski skating testing: right or wrong?

    Science.gov (United States)

    Fabre, Nicolas; Bortolan, Lorenzo; Pellegrini, Barbara; Zerbini, Livio; Mourot, Laurent; Schena, Federico

    2012-02-01

    This study aimed at questioning the validity of the ventilatory method to determine the anaerobic threshold (respiratory compensation point [RCP]) during an incremental roller-ski skating test to exhaustion. Nine elite crosscountry skiers were evaluated. The skiers carried out an incremental roller-ski test on a treadmill with the V2 skating technique. Ventilatory parameters were continuously collected breath by breath, thanks to a portable gas exchange measurement system. Poling signal was obtained using instrumented ski poles. For each stage, ventilatory and poling signals were synchronized and averaged. The poor coefficient of interobserver reliability for the time at RCP confirmed the great difficulty felt by the 3 blinded reviewers for the RCP determination. Moreover, the reviewer agreed with the impossibility of determining RCP in 4 of the 9 skiers. There was no significant difference between breathing frequency (Bf) and poling frequency (Pf) during the last 8 stages. However, it seems that the differences observed during the first stages arose from the use of either a strictly 1:1 or a 1:2 Bf to Pf ratio when the exercise intensity was still moderate. So, even if there were significant differences between the frequencies, the Bf was strictly subordinate to the Pf during the entire test. In the same way, the normalized tidal volume and peak poling forces curves were superposable. These findings showed that when the upper body is mainly involved in the propulsion, the determinants of the ventilation are strictly dependent on the poling pattern during an incremental test to exhaustion. Thus, during roller-ski skating, the determination of RCP must be used cautiously because too much depending on mechanical factors.

  7. Higher ventilatory responses during and after passive walking-like leg movement in older individuals.

    Science.gov (United States)

    Ogata, Hisayoshi; Fujimaru, Ikuyo; Yamada, Keiko; Kondo, Takaharu

    2013-11-08

    Minute ventilation (V · E) during walking has been shown to be higher in older individuals than in young individuals, but the mechanisms underlying the higher ventilatory response is unclear. Central command and peripheral neural reflex are important neural control mechanisms underlying ventilatory response during exercise. Passive leg movement has been used to exclude the influence of central command due to the lack of voluntary activation of muscles. The aim of the present study was to compare the ventilatory response during and after passive walking-like leg movement (PWM) in young and older individuals. Eight young subjects (20 ± 2 years) and seven older subjects (70 ± 1 years) participated in this study. Subjects spent 7 minutes in a quiet standing (QS) position. Thereafter, they performed 14-minute rhythmic PWM at 1 Hz and this was followed by 7 minutes of QS. V · E values during pre-PWM QS were calculated as 1-minute averages using data obtained between 5 and 6 minutes. V · E values at pre-PWM QS in the young and older groups were 8.4 ± 2.1 and 7.5 ± 1.2 l/minute, respectively. V · E values increased significantly at the first minute of PWM to 11.4 ± 2.2 and 10.4 ± 2.5 l/minute in the young and older groups, respectively (P <0.001). In the young group, V · E at the last minute of PWM (9.2 ± 2.0 l/minute) was not significantly different from that at pre-PWM QS due to a decline in V · E, whereas V · E at the last minute of PWM in the older group (9.4 ± 2.2 l/minute) was still significantly higher (P <0.01). On the other hand, V · E at the first minute of post-PWM QS (7.2 ± 1.8 l/minute) was significantly lower than that during pre-PWM QS in the young group (P <0.05) but not in the older group. Ventilatory response during and after PWM is higher in older individuals than in young individuals. This may be associated with a mechanism(s) other than central command. Our findings may explain part of the higher V · E response while walking in older

  8. Validity and Reliability of Ventilatory and Blood Lactate Thresholds in Well-Trained Cyclists

    Science.gov (United States)

    Pallarés, Jesús G.; Morán-Navarro, Ricardo; Ortega, Juan Fernando; Fernández-Elías, Valentín Emilio; Mora-Rodriguez, Ricardo

    2016-01-01

    Purpose The purpose of this study was to determine, i) the reliability of blood lactate and ventilatory-based thresholds, ii) the lactate threshold that corresponds with each ventilatory threshold (VT1 and VT2) and with maximal lactate steady state test (MLSS) as a proxy of cycling performance. Methods Fourteen aerobically-trained male cyclists (V˙O2max 62.1±4.6 ml·kg-1·min-1) performed two graded exercise tests (50 W warm-up followed by 25 W·min-1) to exhaustion. Blood lactate, V˙O2 and V˙CO2 data were collected at every stage. Workloads at VT1 (rise in V˙E/V˙O2;) and VT2 (rise in V˙E/V˙CO2) were compared with workloads at lactate thresholds. Several continuous tests were needed to detect the MLSS workload. Agreement and differences among tests were assessed with ANOVA, ICC and Bland-Altman. Reliability of each test was evaluated using ICC, CV and Bland-Altman plots. Results Workloads at lactate threshold (LT) and LT+2.0 mMol·L-1 matched the ones for VT1 and VT2, respectively (p = 0.147 and 0.539; r = 0.72 and 0.80; Bias = -13.6 and 2.8, respectively). Furthermore, workload at LT+0.5 mMol·L-1 coincided with MLSS workload (p = 0.449; r = 0.78; Bias = -4.5). Lactate threshold tests had high reliability (CV = 3.4–3.7%; r = 0.85–0.89; Bias = -2.1–3.0) except for DMAX method (CV = 10.3%; r = 0.57; Bias = 15.4). Ventilatory thresholds show high reliability (CV = 1.6%–3.5%; r = 0.90–0.96; Bias = -1.8–2.9) except for RER = 1 and V-Slope (CV = 5.0–6.4%; r = 0.79; Bias = -5.6–12.4). Conclusions Lactate threshold tests can be a valid and reliable alternative to ventilatory thresholds to identify the workloads at the transition from aerobic to anaerobic metabolism. PMID:27657502

  9. Unusual features in chronic inflammatory demyelinating polyneuropathy: Good outcome after prolonged ventilatory support

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    Sanjeev Jha

    2011-01-01

    Full Text Available Severe respiratory muscle paralysis and ventilatory failure is rare in chronic inflammatory demyelinating polyneuropathy (CIDP. We report a 14 year child who presented with respiratory failure, bulbar and multiple cranial nerves involvement along with bilateral phrenic nerve paralysis. He was diagnosed with CIDP after electrophysiological evaluation. He required AMBU ventilation for about 4 months (including domiciliary use, after which he recovered significantly. Along with several unusual features of CIDP, this report highlights good example of steady basic intensive care to save lives and rewarding outcome of prolonged respiratory support, provided by AMBU ventilation which is a rather primitive, but inexpensive device.

  10. Early life sensory ability-ventilatory responses of thornback ray embryos (Raja clavata) to predator-type electric fields.

    Science.gov (United States)

    Ball, Rachel Emma; Oliver, Matthew Kenneth; Gill, Andrew Bruce

    2016-07-01

    Predator avoidance is fundamental for survival and it can be particularly challenging for prey animals if physical movement away from a predatory threat is restricted. Many sharks and rays begin life within an egg capsule that is attached to the sea bed. The vulnerability of this sedentary life stage is exacerbated in skates (Rajidae) as the compulsory ventilatory activity of embryos makes them conspicuous to potential predators. Embryos can reduce this risk by mediating ventilatory activity if they detect the presence of a predator using an acute electrosense. To determine how early in embryonic life predator elicited behavioral responses can occur, the reactions of three different age groups (1/3 developed, 2/3 developed, and near hatching) of embryonic thornback rays Raja clavata were tested using predator-type electric field stimuli. Egg capsules were exposed to continuous or intermittent stimuli in order to assess varying predator-type encounter scenarios on the ventilatory behavior of different developmental stages. All embryos reacted with a "freeze response" following initial electric field (E-field) exposure, ceasing ventilatory behavior in response to predator presence, demonstrating electroreceptive functionality for the first time at the earliest possible stage in ontogeny. This ability coincided with the onset of egg ventilatory behavior and may represent an effective means to enhance survival. A continuous application of stimuli over time revealed that embryos can adapt their behavior and resume normal activity, whereas when presented intermittently, the E-field resulted in a significant reduction in overall ventilatory activity across all ages. Recovery from stimuli was significantly quicker in older embryos, potentially indicative of the trade-off between avoiding predation and adequate respiration. © 2015 Wiley Periodicals, Inc. Develop Neurobiol 76: 721-729, 2016. © 2015 Wiley Periodicals, Inc.

  11. Effects of low temperature on breathing pattern and ventilatory responses during hibernation in the golden-mantled ground squirrel.

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    Webb, Cheryl L; Milsom, William K

    2017-07-01

    During entrance into hibernation in golden-mantled ground squirrels (Callospermophilus lateralis), ventilation decreases as metabolic rate and body temperature fall. Two patterns of respiration occur during deep hibernation. At 7 °C body temperature (T b ), a breathing pattern characterized by episodes of multiple breaths (20.6 ± 1.9 breaths/episode) separated by long apneas or nonventilatory periods (T nvp ) (mean = 11.1 ± 1.2 min) occurs, while at 4 °C T b , a pattern in which breaths are evenly distributed and separated by a relatively short T nvp (0.5 ± 0.05 min) occurs. Squirrels exhibiting each pattern have similar metabolic rates and levels of total ventilation (0.2 and 0.23 ml O2/hr/kg and 0.11 and 0.16 ml air/min/kg, respectively). Squirrels at 7 °C T b exhibit a significant hypoxic ventilatory response, while squirrels at 4 °C T b do not respond to hypoxia at any level of O2 tested. Squirrels at both temperatures exhibit a significant hypercapnic ventilatory response, but the response is significantly reduced in the 4 °C T b squirrels. Carotid body denervation has little effect on the breathing patterns or on the hypercapnic ventilatory responses. It does reduce the magnitude and threshold for the hypoxic ventilatory response. Taken together the data suggest that (1) the fundamental rhythm generator remains functional at low temperatures; (2) the hypercapnic ventilatory response arises from central chemoreceptors that remain functional at very low temperatures; (3) the hypoxic ventilatory response arises from both carotid body and aortic chemoreceptors that are silenced at lower temperatures; and (4) there is a strong correlation between breathing pattern and chemosensitivity.

  12. Metabolic adaptations may counteract ventilatory adaptations of intermittent hypoxic exposure during submaximal exercise at altitudes up to 4000 m.

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    Martin Faulhaber

    Full Text Available Intermittent hypoxic exposure (IHE has been shown to induce aspects of altitude acclimatization which affect ventilatory, cardiovascular and metabolic responses during exercise in normoxia and hypoxia. However, knowledge on altitude-dependent effects and possible interactions remains scarce. Therefore, we determined the effects of IHE on cardiorespiratory and metabolic responses at different simulated altitudes in the same healthy subjects. Eight healthy male volunteers participated in the study and were tested before and 1 to 2 days after IHE (7 × 1 hour at 4500 m. The participants cycled at 2 submaximal workloads (corresponding to 40% and 60% of peak oxygen uptake at low altitude at simulated altitudes of 2000 m, 3000 m, and 4000 m in a randomized order. Gas analysis was performed and arterial oxygen saturation, blood lactate concentrations, and blood gases were determined during exercise. Additionally baroreflex sensitivity, hypoxic and hypercapnic ventilatory response were determined before and after IHE. Hypoxic ventilatory response was increased after IHE (p<0.05. There were no altitude-dependent changes by IHE in any of the determined parameters. However, blood lactate concentrations and carbon dioxide output were reduced; minute ventilation and arterial oxygen saturation were unchanged, and ventilatory equivalent for carbon dioxide was increased after IHE irrespective of altitude. Changes in hypoxic ventilatory response were associated with changes in blood lactate (r = -0.72, p<0.05. Changes in blood lactate correlated with changes in carbon dioxide output (r = 0.61, p<0.01 and minute ventilation (r = 0.54, p<0.01. Based on the present results it seems that the reductions in blood lactate and carbon dioxide output have counteracted the increased hypoxic ventilatory response. As a result minute ventilation and arterial oxygen saturation did not increase during submaximal exercise at simulated altitudes between 2000 m and 4000 m.

  13. Ventilatory responses of trained and untrained subjects during running and walking.

    Science.gov (United States)

    Berry, M J; Robergs, R A; Weyrich, A S; Puntenney, P J

    1988-10-01

    To investigate the influence of stride frequency on ventilation in different subject populations, the ventilatory responses to walking and running at similar metabolic loads were studied in 29 males. Ten of the males were well-trained, highly fit runners (HFR), ten were well-trained, highly fit cyclists (HFC), and nine were healthy low-fit males (LFM) who did not engage in any form of regular exercise. All subjects completed two separate exercise bouts, a level run and an uphill walk, at 90% of their ventilatory threshold. Stride frequency was found to increase by 49% between the walk and run trials. Minute ventilation (VE), tidal volume (VT), breathing frequency (f), end-tibial CO2 tension (PETCO2), end-tidal O2 tension (PETO2), and inspiratory time (TI) were all significantly different (P less than 0.05) between the walk and run trials for the HFR. Minute ventilation and expiratory time (TE) did not differ significantly between the walk and run trials for the HFC; however, VT, f, PETCO2, PETO2, and TI were significantly different. Only PETCO2 and TI were found to be significantly different between the walk and run trials for the LFM. These results suggest that stride frequency affects ventilation to varying degrees dependent upon the subject population and that the mechanisms for the hyperpnea of moderate exercise operating in each of these subject populations involve a complex interaction of many factors.

  14. Reduced suppression of CO2-induced ventilatory stimulation by endomorphins relative to morphine.

    Science.gov (United States)

    Czapla, Marc A; Zadina, James E

    2005-10-19

    Opioids are among the most effective analgesics, but a major limitation for their therapeutic usefulness is their induction of respiratory depression. Endomorphin-1 (EM1), in contrast to several other mu opioids, exhibits a threshold for respiratory depression that is well above its threshold for analgesia. Its effect on sensitivity to CO(2), however, remains unknown. Minute ventilation (V(E)) in 2, 4, and 6% CO(2) was measured before and after systemic administration of EM1, endomorphin-2 (EM2), DAMGO, and morphine in the conscious rat. EM1 and EM2 attenuated the hypercapnic ventilatory response (HCVR) only in high doses, while DAMGO and morphine diminished the HCVR in much lower doses. The ventilatory effects of high doses of all 4 agonists were blocked by the mu-opioid antagonist naloxone (0.4 mg/kg i.v.), but not by the peripherally restricted mu-opioid antagonist, methyl-naloxone (0.4 mg/kg i.v.). It was concluded that the endomorphins attenuated the HCVR only in large doses, well beyond the analgesic threshold, and did so through a centrally mediated mu-opioid mechanism.

  15. Behavioral, Ventilatory and Thermoregulatory Responses to Hypercapnia and Hypoxia in the Wistar Audiogenic Rat (WAR Strain.

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    Érica Maria Granjeiro

    Full Text Available We investigated the behavioral, respiratory, and thermoregulatory responses elicited by acute exposure to both hypercapnic and hypoxic environments in Wistar audiogenic rats (WARs. The WAR strain represents a genetic animal model of epilepsy.Behavioral analyses were performed using neuroethological methods, and flowcharts were constructed to illustrate behavioral findings. The body plethysmography method was used to obtain pulmonary ventilation (VE measurements, and body temperature (Tb measurements were taken via temperature sensors implanted in the abdominal cavities of the animals.No significant difference was observed between the WAR and Wistar control group with respect to the thermoregulatory response elicited by exposure to both acute hypercapnia and acute hypoxia (p>0.05. However, we found that the VE of WARs was attenuated relative to that of Wistar control animals during exposure to both hypercapnic (WAR: 133 ± 11% vs. Wistar: 243 ± 23%, p<0.01 and hypoxic conditions (WAR: 138 ± 8% vs. Wistar: 177 ± 8%; p<0.01. In addition, we noted that this ventilatory attenuation was followed by alterations in the behavioral responses of these animals.Our results indicate that WARs, a genetic model of epilepsy, have important alterations in their ability to compensate for changes in levels of various arterial blood gasses. WARs present an attenuated ventilatory response to an increased PaCO2 or decreased PaO2, coupled to behavioral changes, which make them a suitable model to further study respiratory risks associated to epilepsy.

  16. The midpoint between ventilatory thresholds approaches maximal lactate steady state intensity in amateur cyclists

    Science.gov (United States)

    Filho, DM Pessôa; Díaz, V; Benito, PJ; Álvarez-Sánchez, M; Zapico, AG; Calderón, FJ

    2016-01-01

    The aim was to determine whether the midpoint between ventilatory thresholds (MPVT) corresponds to maximal lactate steady state (MLSS). Twelve amateur cyclists (21.0 ± 2.6 years old; 72.2 ± 9.0 kg; 179.8 ± 7.5 cm) performed an incremental test (25 W·min-1) until exhaustion and several constant load tests of 30 minutes to determine MLSS, on different occasions. Using MLSS determination as the reference method, the agreement with five other parameters (MPVT; first and second ventilatory thresholds: VT1 and VT2; respiratory exchange ratio equal to 1: RER = 1.00; and Maximum) was analysed by the Bland-Altman method. The difference between workload at MLSS and VT1, VT2, RER=1.00 and Maximum was 31.1 ± 20.0, -86.0 ± 18.3, -63.6 ± 26.3 and -192.3 ± 48.6 W, respectively. MLSS was underestimated from VT1 and overestimated from VT2, RER = 1.00 and Maximum. The smallest difference (-27.5 ± 15.1 W) between workload at MLSS and MPVT was in better agreement than other analysed parameters of intensity in cycling. The main finding is that MPVT approached the workload at MLSS in amateur cyclists, and can be used to estimate maximal steady state. PMID:28090142

  17. Usefulness of lung perfusion scintigraphy before lung cancer resection in patients with ventilatory obstruction.

    Science.gov (United States)

    Mineo, Tommaso C; Schillaci, Orazio; Pompeo, Eugenio; Mineo, Davide; Simonetti, Giovanni

    2006-11-01

    The study was conducted to evaluate the efficacy of preoperative lung perfusion scintigraphy performed by planar acquisition and single-photon emission computed tomography (SPECT) in predicting postoperative pulmonary function of patients with resectable lung cancer and obstructive ventilatory defect. The study enrolled 39 patients (mean age, 67 +/- 2.1 years). All patients underwent preoperative and postoperative pulmonary function tests. Cut-off values for postoperative forced expiratory volume in 1 second (FEV1) were 65% of the predicted value for pneumonectomy and 45% for lobectomy. A semiquantitative analysis of planar and SPECT lung perfusion scintigraphy images was performed preoperatively to estimate postoperative predicted FEV1 (FEV1ppo). Relationships between FEV1ppo and measured postoperative FEV1 were tested by the Pearson correlation and Bland Altman agreement tests. Twenty-eight lobectomies and 11 pneumonectomies were performed. The FEV1ppo estimated by mean planar lung scintigraphy was 1.85 +/- 0.38 L, with a Pearson correlation coefficient to the measured FEV1 of 0.8632 (p lung scintigraphy and SPECT with FEV1 measured by spirometry. Both planar lung scintigraphy and SPECT can accurately predict postoperative FEV1 and can therefore be considered reliable tools in establishing operability of patients with lung cancer and ventilatory obstruction.

  18. CESAR: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure

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    Mugford Miranda

    2006-12-01

    Full Text Available Abstract Background An estimated 350 adults develop severe, but potentially reversible respiratory failure in the UK annually. Current management uses intermittent positive pressure ventilation, but barotrauma, volutrauma and oxygen toxicity can prevent lung recovery. An alternative treatment, extracorporeal membrane oxygenation, uses cardio-pulmonary bypass technology to temporarily provide gas exchange, allowing ventilator settings to be reduced. While extracorporeal membrane oxygenation is proven to result in improved outcome when compared to conventional ventilation in neonates with severe respiratory failure, there is currently no good evidence from randomised controlled trials to compare these managements for important clinical outcomes in adults, although evidence from case series is promising. Methods/Design The aim of the randomised controlled trial of Conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR is to assess whether, for patients with severe, but potentially reversible, respiratory failure, extracorporeal membrane oxygenation will increase the rate of survival without severe disability ('confined to bed' and 'unable to wash or dress' by six months post-randomisation, and be cost effective from the viewpoints of the NHS and society, compared to conventional ventilatory support. Following assent from a relative, adults (18–65 years with severe, but potentially reversible, respiratory failure (Murray score ≥ 3.0 or hypercapnea with pH Discussion Analysis will be based on intention to treat. A concurrent economic evaluation will also be performed to compare the costs and outcomes of both treatments.

  19. Excess ventilation and ventilatory constraints during exercise in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Teopompi, Elisabetta; Tzani, Panagiota; Aiello, Marina; Gioia, Maria Rosaria; Marangio, Emilio; Chetta, Alfredo

    2014-06-15

    We assessed the relationship between minute ventilation/carbon dioxide output (VE/VCO2) and ventilatory constraints during an incremental cardiopulmonary exercise testing (CPET) in patients with chronic obstructive pulmonary disease (COPD). Slope and intercept of the VE/VCO2 linear relationship, the ratios of inspiratory capacity/total lung capacity (IC/TLC) and of tidal volume (VT) over vital capacity (VTpeak/VC) and IC (VTpeak/IC) and over forced expiratory volume at 1st second (VTpeak/FEV1) at peak of exercise were measured in 52 COPD patients during a CPET. The difference peak-rest in end-tidal pressure of CO2 (PETCO2) was also measured. VE/VCO2 intercept showed a negative correlation with IC/TLC peak (pCOPD, VE/VCO2 slope and intercept provide complementary information on the ventilatory limitation to exercise, as assessed by changes in the end-expiratory lung volume and in tidal volume excursion.

  20. Contributors to fatigue in patients receiving mechanical ventilatory support: A descriptive correlational study.

    Science.gov (United States)

    Chlan, Linda L; Savik, Kay

    2015-10-01

    To describe levels of fatigue and explore clinical factors that might contribute to fatigue in critically ill patients receiving mechanical ventilation. Descriptive, correlational design. Sample was a sub-set of patients enrolled in a randomised clinical trial testing patient-directed music for anxiety self-management. Clinical factors included age, gender, length of ICU stay, length of ventilatory support, illness severity (APACHE III), and sedative exposure (sedation intensity and frequency). Descriptive statistics and mixed models were used to address the study objectives. Medical and surgical intensive care units in the Midwestern United States. Fatigue was measured daily via a 100-mm Visual Analogue Scale, up to 25 days. A sample of 80 patients (50% female) receiving ventilatory support for a median 7.9 days (range 1-46) with a mean age of 61.2 years (SD 14.8) provided daily fatigue ratings. ICU admission APACHE III was 61.5 (SD 19.8). Baseline mean fatigue ratings were 60.7 (SD 27.9), with fluctuations over time indicating a general trend upward. Mixed models analysis implicated illness severity (β(se(β))=.27(.12)) and sedation frequency (β(se(β))=1.2(.52)) as significant contributors to fatigue ratings. Illness severity and more frequent sedative administration were related to higher fatigue ratings in these mechanically ventilated patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Inductive plethysmography potential as a surrogate for ventilatory measurements during rest and moderate physical exercise

    Science.gov (United States)

    Cabiddu, Ramona; Pantoni, Camila B. F.; Mendes, Renata G.; Trimer, Renata; Catai, Aparecida M.; Borghi-Silva, Audrey

    2016-01-01

    Background: Portable respiratory inductive plethysmography (RIP) systems have been validated for ventilatory assessment during resting conditions and during incremental treadmill exercise. However, in clinical settings and during field-based exercise, intensity is usually constant and submaximal. A demonstration of the ability of RIP to detect respiratory measurements accurately during constant intensity conditions would promote and validate the routine use of portable RIP devices as an alternative to ergospirometry (ES), the current gold standard technique for ventilatory measures. Objective: To investigate the agreement between respiratory variables recorded by a portable RIP device and by ES during rest and constant intensity exercise. Method: Tidal volume (VT), respiratory rate (RR) and minute ventilation (VE) were concurrently acquired by portable RIP and ES in seven healthy male volunteers during standing rest position and constant intensity treadmill exercise. Results: Significant agreement was found between RIP and ES acquisitions during the standing rest position and constant intensity treadmill exercise for RR and during the standing rest position for VE. Conclusion: Our results suggest that portable RIP devices might represent a suitable alternative to ES during rest and during constant submaximal exercise. PMID:26982454

  2. Impaired ventilatory and thermoregulatory responses to hypoxic stress in newborn Phox2b heterozygous knockout mice

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    Nelina eRamanantsoa

    2011-09-01

    Full Text Available The Phox2b gene is necessary for the development of the autonomic nervous system, and especially, of respiratory neuronal circuits. In the present study, we examined the role of Phox2b in ventilatory and thermoregulatory responses to hypoxic stress, which are closely related in the postnatal period. Hypoxic stress was generated by strong thermal stimulus, combined or not with reduced inspired O2. To this end, we exposed 6-day-old Phox2b+/- pups and their wild-type littermates (Phox2b+/+ to hypoxia (10% O2 or hypercapnia (8% CO2 under thermoneutral (33°C or cold (26°C conditions. We found that Phox2b+/- pups showed less normoxic ventilation (VE in the cold than Phox2b+/+ pups. Phox2b+/- pups also showed lower oxygen consumption (VO2 in the cold, reflecting reduced thermogenesis and a lower body temperature. Furthermore, while the cold depressed ventilatory responses to hypoxia and hypercapnia in both genotype groups, this effect was less pronounced in Phox2b+/- pups. Finally, because serotonin (5-HT neurons are pivotal to respiratory and thermoregulatory circuits and depend on Phox2b for their differentiation, we studied 5-HT metabolism using high-pressure liquid chromatography, and found that it was altered in Phox2b+/- pups. We conclude that Phox2b haploinsufficiency alters the ability of newborns to cope with metabolic challenges, possibly due to 5-HT signaling impairments.

  3. Heart rate deflection point relates to second ventilatory threshold in a tennis test.

    Science.gov (United States)

    Baiget, Ernest; Fernández-Fernández, Jaime; Iglesias, Xavier; Rodríguez, Ferran A

    2015-03-01

    The relationship between heart rate deflection point (HRDP) and the second ventilatory threshold (VT2) has been studied in continuous sports, but never in a tennis-specific test. The aim of the study was to assess the relationships between HRDP and the VT2, and between the maximal test performance and the maximal oxygen uptake ((Equation is included in full-text article.)) in an on-court specific endurance tennis test. Thirty-five high-level tennis players performed a progressive tennis-specific field test to exhaustion to determine HRDP, VT2, and (Equation is included in full-text article.). Ventilatory gas exchange parameters were continuously recorded by a portable telemetric breath-by-breath gas exchange measurement system. Heart rate deflection point was identified at the point at which the slope values of the linear portion of the time/heart rate (HR) relationship began to decline and was successfully determined in 91.4% of the players. High correlations (r = 0.79-0.96; p tennis test can be used to determine the VT2, and the BallfHRDP can be used as a practical performance variable to prescribe on-court specific aerobic training at or near VT2.

  4. Disorders of Sleep and Ventilatory Control in Prader-Willi Syndrome

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    Emily S. Gillett

    2016-07-01

    Full Text Available Prader-Willi syndrome (PWS is an imprinted genetic disorder conferred by loss of paternal gene expression from chromosome 15q11.2-q13. Individuals with PWS have impairments in ventilatory control and are predisposed toward sleep disordered breathing due to a combination of characteristic craniofacial features, obesity, hypotonia, and hypothalamic dysfunction. Children with PWS progress from failure to thrive during infancy to hyperphagia and morbid obesity during later childhood and onward. Similarly, the phenotype of sleep disordered breathing in PWS patients also evolves over time from predominantly central sleep apnea in infants to obstructive sleep apnea (OSA in older children. Behavioral difficulties are common and may make establishing effective therapy with continuous positive airway pressure (CPAP more challenging when OSA persists after adenotonsillectomy. Excessive daytime sleepiness (EDS is also common in patients with PWS and may continue after OSA is effectively treated. We describe here the characteristic ventilatory control deficits, sleep disordered breathing, and excessive daytime sleepiness seen in individuals with PWS. We review respiratory issues that may contribute to sudden death events in PWS patients during sleep and wakefulness. We also discuss therapeutic options for treating sleep disordered breathing including adenotonsillectomy, weight loss, and CPAP. Lastly, we discuss the benefits and safety considerations related to growth hormone therapy.

  5. The acute hypoxic ventilatory response under halothane, isoflurane, and sevoflurane anaesthesia in rats.

    Science.gov (United States)

    Karanovic, N; Pecotic, R; Valic, M; Jeroncic, A; Carev, M; Karanovic, S; Ujevic, A; Dogas, Z

    2010-03-01

    The relative order of potency of anaesthetic agents on the hypoxic ventilatory response has been tested in humans, but animal data are sparse. We examined the effects of 1.4, 1.6, 1.8, and 2.0 MAC halothane, isoflurane, and sevoflurane on phrenic nerve activity in euoxia (baseline) and during acute normocapnic hypoxia (inspired oxygen fraction 0.09) in adult male Sprague-Dawley rats. With halothane, all animals became apnoeic even in euoxia, and the hypoxic response was completely abolished at all anaesthetic levels. With isoflurane, 5 of 14 animals exhibited phrenic nerve activity in euoxia at 1.4 MAC and demonstrated a hypoxic response (302% of baseline activity), but all became apnoeic and lost the hypoxic response at higher doses. With sevoflurane, phrenic nerve activity and a hypoxic response was preserved in at least some animals at all doses (i.e. even the highest dose of 2.0 MAC). Similar to the rank order of potency previously observed in humans, the relative order of potency of depression of the hypoxic ventilatory response in rats was halothane (most depressive) > isoflurane > sevoflurane (p = 0.01 for differences between agents).

  6. 机械通气限度的评估%Estimation of Mechanical Ventilatory Limitation

    Institute of Scientific and Technical Information of China (English)

    Tony G.Babb

    2005-01-01

    The purpose of this study was to estimate mechanical ventilatory limitation during maximal exercise with the use of three methods for subjects with normal lung function (N=13) and subjects with mild (N=11),moderate (N=5), or severe (N=6) chronic airflow limitation (CAL, FEV1/FVC, 39% to 68%). To estimate mechanical ventilatory limitation, ventilation during maximal exercise (VEmax) was compared with the maximal voluntary ventilation (MVV), a calculated exercise ventilatory maximum (VEmaxCal), and the product of FEV1 times 37.5 (FEV1×37.5). All subjects performed graded cycle ergometry to volitional termination. There was a significant interaction between lung function and estimate method (P < 0.001). The mechanical ventilatory limitation indicated by VEmax/MVV (%) was elevated in only the subjects with severe CAL when compared with the subjects with normal lung function (83 vs 62%, P < 0.05). Vmax/VmaxCal (%) was greater in all GAL subjects and VEmax/FEV1×37.5 (%) was greater in the subjects with mild and severe CAL (P<0.05) when compared with the subjects with normal lung function. In subjects with mild and severe CAL, the mechanical ventilatory limitation indicated by VEmax/MVV was lower than indicated by VEmax/VEmax (P < 0.05) or VEmax/FEV1×37.5 (P <0.01). These data indicate that mechanical ventilatory limitation is greater when estimated by VEmax/VEmaxCal and VEmax/FEV1×37.5 than by the Vmax/MVV, especially for subjects with mild or moderate CAL. It is concluded that the estimation of mechanical ventilatory limitation is influenced by both the level of pulmonary function and the variable with which VEmax is compared.%本研究的目的是通过在最大运动量期间,用三种方法对正常者(n=13)及轻度(n=11)、中度(n=5)、重度(n=6)慢性空气流量受限者(CAL,FEV1/FVC,39%~68%)的机械通气限度进行评估.为了评估机械通气限度,将最大运动量时的通气量(VEmax)与最大的自主换气量(MVV)[即计算的运

  7. The von Hippel-Lindau Chuvash mutation in mice causes carotid-body hyperplasia and enhanced ventilatory sensitivity to hypoxia.

    Science.gov (United States)

    Slingo, Mary E; Turner, Philip J; Christian, Helen C; Buckler, Keith J; Robbins, Peter A

    2014-04-01

    The hypoxia-inducible factor (HIF) family of transcription factors coordinates diverse cellular and systemic responses to hypoxia. Chuvash polycythemia (CP) is an autosomal recessive disorder in humans in which there is impaired oxygen-dependent degradation of HIF, resulting in long-term systemic elevation of HIF levels at normal oxygen tensions. CP patients demonstrate the characteristic features of ventilatory acclimatization to hypoxia, namely, an elevated baseline ventilation and enhanced acute hypoxic ventilatory response (AHVR). We investigated the ventilatory and carotid-body phenotype of a mouse model of CP, using whole-body plethysmography, immunohistochemistry, and electron microscopy. In keeping with studies in humans, CP mice had elevated ventilation in euoxia and a significantly exaggerated AHVR when exposed to 10% oxygen, with or without the addition of 3% carbon dioxide. Carotid-body immunohistochemistry demonstrated marked hyperplasia of the oxygen-sensing type I cells, and the cells themselves appeared enlarged with more prominent nuclei. This hypertrophy was confirmed by electron microscopy, which also revealed that the type I cells contained an increased number of mitochondria, enlarged dense-cored vesicles, and markedly expanded rough endoplasmic reticulum. The morphological and ultrastructural changes seen in the CP mouse carotid body are strikingly similar to those observed in animals exposed to chronic hypoxia. Our study demonstrates that the HIF pathway plays a major role, not only in regulating both euoxic ventilatory control and the sensitivity of the response to hypoxia, but also in determining the morphology of the carotid body.

  8. A comparative evaluation of different supraglottic ventilatory devices during general anesthesia with controlled ventilation: A pilot study

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    Ahmed A. Abd El Aziz

    2014-10-01

    Conclusions: We concluded that the I-gel, PLMA and SLIPA are effective ventilatory devices during controlled ventilation, without major complications. I-gel offers advantage over PLMA and SLIPA in being less manipulation needed during placement, less air leak, less postoperative sore throat and less in blood stained to the device after its removal in comparison with PLMA and SLIPA.

  9. SIDS Family Adjustment Scale: A Method of Assessing Family Adjustment to Sudden Infant Death Syndrome.

    Science.gov (United States)

    May, Harold J.; Breme, Frederick J.

    1982-01-01

    Discusses Sudden Infant Death Syndrome (SIDS) and the family's resultant grief process. Explores SIDS as a family crisis, and by identifying the psychological factors or tasks pertinent to family adjustment, proposes a SIDS Family Adjustment Scale which assists in recognizing adaptive and maladaptive grief responses. (Author)

  10. Signaling at the cell surface in the circulatory and ventilatory systems

    CERN Document Server

    Thiriet, Marc

    2012-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to nano- and microscopic events in a corrector scheme of regulated mechanisms when the vessel lumen caliber varies markedly. Therefore, investigation of flows of blood and air in physiological conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning. Volume 3 is devoted to the set of mediators of the cell surface, especially ion and molecular carriers and catalytic receptors that, once liganded and activated, initiat...

  11. The Carotid Body Does Not Mediate the Acute Ventilatory Effects of Leptin.

    Science.gov (United States)

    Olea, E; Ribeiro, M J; Gallego-Martin, T; Yubero, S; Rigual, R; Masa, J F; Obeso, A; Conde, S V; Gonzalez, C

    2015-01-01

    Leptin is a hormone produced mostly in adipose tissue and playing a key role in the control of feeding and energy expenditure aiming to maintain a balance between food intake and metabolic activity. In recent years, it has been described that leptin might also contributes to control ventilation as the administration of the hormone reverses the hypoxia and hypercapnia commonly encountered in ob/ob mice which show absence of the functional hormone. In addition, it has been shown that the carotid body (CB) of the rat expresses leptin as well as the functional leptin-B receptor. Therefore, the possibility exists that the ventilatory effects of leptin are mediated by the CB chemoreceptors. In the experiments described below we confirm the stimulatory effect of leptin on ventilation, finding additionally that the CB does not mediate the instant to instant control of ventilation.

  12. Heat and moisture exchanger: importance of humidification in anaesthesia and ventilatory breathing system.

    Science.gov (United States)

    Parmar, Vandana

    2008-08-01

    Adequate humidification is vital to maintain homeostasis of the airway. Heat and moisture exchangers conserve some of the exhaled water, heat and return them to inspired gases. Many heat and moisture exchangers also perfom bacterial/viral filtration and prevent inhalation of small particles. Heat and moisture exchangers are also called condenser humidifier, artificial nose, etc. Most of them are disposable devices with exchanging medium enclosed in a plastic housing. For adult and paediatric age group different dead space types are available. Heat and moisture exchangers are helpful during anaesthesia and ventilatory breathing system. To reduce the damage of the upper respiratory tract through cooling and dehydration inspiratory air can be heated and humidified, thus preventing the serious complications.

  13. Ventilatory management of respiratory failure in patients with severe Guillain-Barré syndrome

    Directory of Open Access Journals (Sweden)

    Aggarwal A

    2003-04-01

    Full Text Available Guillain-Barré syndrome (GBS is the commonest peripheral neuropathy causing ventilatory failure, and 10-30% patients may require respiratory support. Records of 11 adult patients of GBS in respiratory failure, admitted to the Respiratory Intensive Care Unit (RICU of our institute for mechanical ventilation over a four-year period, were studied. Six patients received intravenous immunoglobulin. The median duration of mechanical ventilation was 38 days. Seven patients underwent tracheostomy. Four patients were ventilated for less than 2 weeks and 3 for more than 2 months each. Seven developed ventilator-associated pneumonia and/or sepsis. Three patients died in, and two shortly after discharge from RICU; all had systemic problems or complications of hospitalization.

  14. Immediate effect of suryanadi pranayama on pulmonary function (ventilatory volumes and capacities in healthy volunteers

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    Shravya Keerthi G, Hari Krishna Bandi, Suresh M, Mallikarjuna Reddy N

    2013-10-01

    Full Text Available Objectives: we found only effects of at least a short term practice extended over a period of a few days to weeks of pranayama (alternate nostril breathing rather than acute effects of unilateral right nostril breathing (suryanadi pranayama. Keeping this in mind the present study was designed to test the hypothesis that 10 min. of right nostril breathing have any immediate effect on ventilatory volumes and capacities in healthy volunteers. Methodology: Forced vital capacity (FVC, Forced expiratory volume in the first second (FEV1, Forced expiratory volume percent (FEV1/FVC%, Peak expiratory flow rate (PEFR, Forced expiratory flow25-75% (FEF25-75%, Maximum voluntary ventilation (MVV, Slow vital capacity (SVC, Expiratory reserve volume (ERV, Inspiratory reserve volume (IRV and Tidal volume (TV were recorded before and after Surya Nadi Pranayama. Results & Conclusion: There was a significant increase in FVC (p<0.0001, FEV1 (p<0.0007, PEFR (p<0.0001, FEF25-75% (p<0.0001, MVV (p<0.0001, SVC (p<0.0001, ERV (0.0006, IRV (p<0.0001 and TV (0.0055 after suryanadi pranayama. The immediate effect of suryanadi pranayama practice showed alleviation of ventilatory capacities and volumes. Any practice that increases PEFR and FEF25–75% is expected to retard the development of COPD’s. The increase in PEFR, vital capacities and flow rates by suryanadi pranayama practice obviously offers an increment in respiratory efficiency and it can be advocated to the patients of early bronchitis and as a preventive measure for COPD.

  15. Ventilatory support and pharmacological treatment of patients with central apnoea or hypoventilation during sleep

    Directory of Open Access Journals (Sweden)

    D. Pevernagie

    2007-12-01

    Full Text Available The concept of central sleep apnoea or hypoventilation encompasses hypercapnic central hypoventilation, such as obesity hypoventilation syndrome and eucapnic or hypocapnic central sleep apnoea. Among subjects with eucapnic or hypocapnic central sleep apnoea, several therapeutic options are available for those with Cheyne–Stokes respiration (CSR. CSR is frequent in patients with New York Heart Association stage III and IV chronic heart failure, and in various neurological disorders. In these patients, treatment modalities include optimising cardiac condition and drugs, such as theophylline, acetazolamide and/or oxygen. Ventilatory support, such as nasal continuous positive airway pressure (CPAP, bi-level pressure support, or adaptive servo-ventilation (ASV, has been shown to improve CSR in patients with cardiac failure; however, convincing evidence that nasal CPAP improves life expectancy in these patients is lacking. Nevertheless, the treatment of associated obstructive sleep-disordered breathing is indicated per se, as it may improve cardiac function. There is currently no proof that bi-level ventilation is superior to nasal CPAP. The few available studies that have focused on ASV have shown satisfactory control of CSR in cardiac failure patients. While ASV is not a first-line treatment choice, it appears to be superior to oxygen, CPAP and bi-level pressure ventilation in controlling the apnoea/hypopnea index and probably sleep fragmentation. As yet there are no data on mortality and, as such, firm conclusions cannot be drawn as to the role of ASV in the management of cardiac failure patients suffering from CSR. Obesity-related hypoventilation has increased dramatically over recent decades due to the epidemic increase in obesity in the developed countries. Obesity hypoventilation syndrome predisposes to the development of pulmonary hypertension and cor pulmonale. Noninvasive home ventilation is increasingly applied in obese patients with

  16. Cerebrovascular and ventilatory responses to acute normobaric hypoxia in girls and women.

    Science.gov (United States)

    Morris, Laura E; Flück, Daniela; Ainslie, Philip N; McManus, Ali M

    2017-08-01

    Physiological responses to hypoxia in children are incompletely understood. We aimed to characterize cerebrovascular and ventilatory responses to normobaric hypoxia in girls and women. Ten healthy girls (9.9 ± 1.7 years; mean ± SD; Tanner stage 1 and 2) and their mothers (43.9 ± 3.5 years) participated. Internal carotid (ICA) and vertebral artery (VA) velocity, diameter and flow (Duplex ultrasound) was recorded pre- and post-1 h of hypoxic exposure (FIO2 = 0.126;~4000 m) in a normobaric chamber. Ventilation (V˙E) and respiratory drive (VT/TI) expressed as delta change from baseline (∆%), and end-tidal carbon-dioxide (PETCO2) were collected at baseline (BL) and 5, 30 and 60 min of hypoxia (5/30/60 HYP). Heart rate (HR) and oxygen saturation (SpO2) were also collected at these time-points. SpO2 declined similarly in girls (BL-97%; 60HYP-80%, P girls (BL-687; 60HYP-912 mL·min(-1), P girls, 75:25%; women, 61:39%). The relative increase in V˙E peaked at 30HYP in both girls (27%, P girls, 41%; women, 27%, P's girls and women at 5HYP, remaining elevated above baseline in girls at 30 and 60 HYP, but declined back toward baseline in women. Girls elicit similar increases in gCBF and ventilatory parameters in response to acute hypoxia as women, though the pattern and contributions mediating these responses appear developmentally divergent. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  17. Ventilatory function assessment in safety pharmacology: optimization of rodent studies using normocapnic or hypercapnic conditions.

    Science.gov (United States)

    Goineau, Sonia; Rompion, Sonia; Guillaume, Philippe; Picard, Sandra

    2010-09-15

    Although the whole body plethysmography for unrestrained animals is the most widely used method to assess the respiratory risk of new drugs in safety pharmacology, non-appropriate experimental conditions may mask deleterious side effects of some substances. If stimulant or bronchodilatory effects can be easily evidenced in rodents under standard experimental conditions, i.e. normal air breathing and diurnal phase, drug-induced respiratory depression remains more difficult to detect. This study was aimed at comparing the responsiveness of Wistar rats, Duncan Hartley guinea-pigs or BALB/c mice to the respiratory properties of theophylline (50 or 100 mg/kg p.o.) or morphine (30 mg/kg i.p.) under varying conditions (100% air versus 5% CO2-enriched air, light versus dark day phase), in order to select the most appropriate experimental conditions to each species for safety airway investigations. Our results showed that under normocapnia the ventilatory depressant effects of morphine can be easily evidenced in mice, slightly observed in guinea-pigs and not detected in rats in any day phase. Slight hypercapnic conditions enhanced the responsiveness of rats to morphine but not that of guinea-pigs and importantly they did not blunt the airway responsiveness of rats to the stimulation and bronchodilation evoked by theophylline, the most widely used reference agent in safety pharmacology studies. In conclusion, hypercapnic conditions associated with the non-invasive whole body plethysmography should be considered for optimizing the assessment of both the ventilatory depressant potential of morphine-like substances or the respiratory stimulant effects of new drugs in the rat, the most extensively used species in rodent safety and toxicological investigations.

  18. Chronic overexpression of cerebral Epo improves the ventilatory response to acute hypoxia during the postnatal development.

    Science.gov (United States)

    Caravagna, Céline; Gasser, Edith M Schneider; Ballot, Orlane; Joseph, Vincent; Soliz, Jorge

    2015-08-01

    Clinicians observed that the treatment of premature human newborns for anemia with erythropoietin (Epo) also improved their respiratory autonomy. This observation is in line with our previous in vitro studies showing that acute and chronic Epo stimulation enhances fictive breathing of brainstem-spinal cord preparations of postnatal day 3-4 mice during hypoxia. Furthermore, we recently reported that the antagonization of the cerebral Epo (by using the soluble Epo receptor; sEpoR) significantly reduced the basal ventilation and the hypoxic ventilatory response of 10 days old mice. In this study, we used transgenic (Tg21) mice to investigate the effect of the chronic cerebral Epo overexpression on the modulation of the normoxic and hypoxic ventilatory drive during the post-natal development. Ventilation was evaluated by whole body plethysmography at postnatal ages 3 (P3), 7 (P7), 15 (P15) and 21 (P21). In addition Epo quantification was performed by RIA and mRNA EpoR was evaluated by qRT-PCR. Our results showed that compared to control animals the chronic Epo overexpression stimulates the hypoxic (but not the normoxic) ventilation assessed as VE/VO2 at the ages of P3 and P21. More interestingly, we observed that at P7 and P15 the chronic Epo stimulation of ventilation was attenuated by the down regulation of the Epo receptor in brainstem areas. We conclude that Epo, by stimulating ventilation in brainstem areas crucially helps tolerating physiological (e.g., high altitude) and/or pathological (e.g., respiratory disorders, prematurity, etc.) oxygen deprivation at postnatal ages.

  19. 24 CFR 891.785 - Adjustment of utility allowances.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Adjustment of utility allowances... Handicapped Families and Individuals-Section 162 Assistance § 891.785 Adjustment of utility allowances. In... adjustment of utility allowances provided in § 891.440 apply....

  20. Lvad pump speed increase is associated with increased peak exercise cardiac output and vo2, postponed anaerobic threshold and improved ventilatory efficiency.

    Science.gov (United States)

    Vignati, Carlo; Apostolo, Anna; Cattadori, Gaia; Farina, Stefania; Del Torto, Alberico; Scuri, Silvia; Gerosa, Gino; Bottio, Tomaso; Tarzia, Vincenzo; Bejko, Jonida; Sisillo, Erminio; Nicoli, Flavia; Sciomer, Susanna; Alamanni, Francesco; Paolillo, Stefania; Agostoni, Piergiuseppe

    2017-03-01

    Peak exercise cardiac output (CO) increase is associated with an increase of peak oxygen uptake (VO2), provided that arteriovenous O2 difference [Δ(Ca-Cv)O2] does not decrease. At anaerobic threshold, VO2, is related to CO. We tested the hypothesis that, in heart failure (HF) patients with left ventricular assistance device (LVAD), an acute increase of CO obtained through changes in LVAD pump speed is associated with peak exercise and anaerobic threshold VO2 increase. Fifteen of 20 patients bearing LVAD (Jarvik 2000) enrolled in the study successfully performed peak exercise evaluation. All patients had severe HF as shown by clinical evaluation, laboratory tests, echocardiography, spirometry with alveolar-capillary diffusion, and maximal cardiopulmonary exercise testing (CPET). CPETs with non-invasive CO measurements at rest and peak exercise were done on 2days at LVAD pump speed set randomly at 2 and 4. Increasing LVAD pump speed from 2 to 4 increased CO from 3.4±0.9 to 3.8±1.0L/min (ΔCO 0.4±0.6L/min, p=0.04) and from 5.3±1.3 to 5.9±1.4L/min (ΔCO 0.6±0.7L/min, pincreased from 788±169 to 841±152mL/min (ΔVO2 52±76mL/min, p=0.01) and from 568±116 to 619±124mL/min (ΔVO2 69±96mL/min, p=0.02) at peak exercise and at anaerobic threshold, respectively. Δ(Ca-Cv)O2 did not change significantly, while ventilatory efficiency improved (VE/VCO2 slope from 39.9±5.4 to 34.9±8.3, ΔVE/VCO2 -5.0±6.4, pincrease in CO with a higher LVAD pump speed is associated with increased peak VO2, postponed anaerobic threshold, and improved ventilatory efficiency. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Annual Adjustment Factors

    Data.gov (United States)

    Department of Housing and Urban Development — The Department of Housing and Urban Development establishes the rent adjustment factors - called Annual Adjustment Factors (AAFs) - on the basis of Consumer Price...

  2. Ventilatory and cardiovascular actions of centrally administered trout tachykinins in the unanesthetized trout.

    Science.gov (United States)

    Le Mével, Jean-Claude; Lancien, Frédéric; Mimassi, Nagi; Conlon, J Michael

    2007-09-01

    The brains of teleost fish contain members of the tachykinin family that are the products of orthologous genes expressed in mammalian nervous tissues, but little is known regarding the physiological effects of these peptides in their species of origin. The present study compares the central actions of trout neuropeptide gamma (NPgamma), substance P (SP) and neurokinin A (NKA) (5-250 pmol) on ventilatory and cardiovascular parameters in the unanesthetized rainbow trout Oncorhynchus mykiss. Intracerebroventricular (ICV) injection of NPgamma evoked a dose-dependent elevation of the ventilation rate (f(V)) but a reduction of the ventilation amplitude (V(AMP)) that was caused by a reduction of the magnitude of the adduction phase of the ventilatory signal. The net effect of NPgamma was to produce an hypoventilatory response since the total ventilation (V(TOT)) was significantly reduced. The minimum effective dose for a significant effect of NPgamma on f(V) and V(AMP) was 50 pmol. SP evoked a significant elevation of f(V), a concomitant depression of V(AMP), and a resultant decrease in V(TOT) but only at the highest dose (250 pmol). NKA was without action on f(V) but significantly decreased V(AMP) at only the highest dose tested. In this case also, the net effect of NKA was to reduce V(TOT). When injected centrally, none of the three peptides, at any dose tested, produced changes in heart rate or mean dorsal aortic blood pressure (P(DA)). Intra-arterial injection of the three tachykinins (250 pmol) produced a significant (P<0.05) increase in P(DA), but only SP and NKA induced concomitant bradycardia. None of the three peptides produced any change in f(V) or V(AMP). In conclusion, our results demonstrate that centrally injected tachykinins, particularly NPgamma, produce a strong hypoventilatory response in a teleost fish and so suggest that endogenous tachykinins may be differentially implicated in neuroregulatory control of ventilation.

  3. Ventilatory requirements of quadriceps resistance training in people with COPD and healthy controls

    Directory of Open Access Journals (Sweden)

    Houchen-Wolloff L

    2014-06-01

    Full Text Available Linzy Houchen-Wolloff,1 Carolyn J Sandland,1 Samantha L Harrison,1 Manoj K Menon,1 Mike D Morgan,1 Michael C Steiner,1 Sally J Singh1,21Centre for Exercise and Rehabilitation Science, Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK; 2Faculty of Health and Life Sciences, Coventry University, Coventry, UKBackground: It is proposed that resistance training (RT does not activate the cardiopulmonary system to the same extent as whole-body exercise. This is important for patients with chronic obstructive pulmonary disease (COPD who are ventilatory limited.Objective: The aim was to assess the ventilatory response to an isokinetic quadriceps RT program in people with COPD and healthy controls.Design: Observational.Registration number: ISRCTN22764439.Setting: Outpatient, university teaching hospital.Participants and outcome measures: People with COPD (n=14 and healthy controls (n=11 underwent breath-by-breath analysis of their ventilation during an RT session (five sets of 30 maximal knee extensions at 180°/sec. Subjects performed a maximal cycle ergometry test (CET at baseline. Peak ventilation (VE; L/min and oxygen consumption (VO2; mL/kg/min were collected. The same system measured VO2 and VE during the RT session. Parameters are presented as a percentage of the maximal CET. Isokinetic workload, symptom scores, heart rate (HR, and oxygen saturation were documented post-training.Results: People with COPD worked at higher percentages of their maximal capacity than controls (mean range between sets 1–5 for VO2 =49.1%–60.1% [COPD], 45.7%–51.43% [controls] and for VE =57.6%–72.2% [COPD], 49.8%–63.6% [controls], although this was not statistically significant (P>0.1 in all cases. In absolute terms, the difference between groups was only significant for actual VO2 on set 2 (P<0.05. Controls performed more isokinetic work than patients with COPD (P<0.05. Median Borg symptom scores after RT were the same in both groups (3

  4. Acute effects of different inspiratory efforts on ventilatory pattern and chest wall compartmental distribution in elderly women.

    Science.gov (United States)

    Muniz de Souza, Helga; Rocha, Taciano; Campos, Shirley Lima; Brandão, Daniella Cunha; Fink, James B; Aliverti, Andrea; de Andrade, Armele Dornelas

    2016-06-15

    It is not completely described how aging affect ventilatory kinematics and what are the mechanisms adopted by the elderly population to overcome these structural modifications. Given this, the aim was to evaluate the acute effects of different inspiratory efforts on ventilatory pattern and chest wall compartmental distribution in elderly women. Variables assessed included: tidal volume (Vt), total chest wall volume (Vcw), pulmonary rib cage (Vrcp%), abdominal rib cage (Vrca%) and abdominal compartment (Vab%) relative contributions to tidal volume. These variables were assessed during quiet breathing, maximal inspiratory pressure maneuver (MIP), and moderate inspiratory resistance (MIR; i.e., 40% of MIP). 22 young women (age: 23.9 ± 2.5 years) and 22 elderly women (age: 68.2 ± 5.0 years) participated to this study. It was possible to show that during quiet breathing, Vab% was predominant in elderly (pelderly (p=0.249). When MIP was imposed, both groups presented a predominance of Vrcp%. In conclusion, there are differences in abdominal kinematics between young and elderly women during different inspiratory efforts. In elderly, during moderate inspiratory resistance, the pattern is beneficial, deep, and slow. Although, during maximal inspiratory resistance, the ventilatory pattern seems to predict imminent muscle fatigue.

  5. Cerebrovascular and ventilatory responses to acute isocapnic hypoxia in healthy aging and lung disease: effect of vitamin C.

    Science.gov (United States)

    Hartmann, Sara E; Waltz, Xavier; Kissel, Christine K; Szabo, Lian; Walker, Brandie L; Leigh, Richard; Anderson, Todd J; Poulin, Marc J

    2015-08-15

    Acute hypoxia increases cerebral blood flow (CBF) and ventilation (V̇e). It is unknown if these responses are impacted with normal aging, or in patients with enhanced oxidative stress, such as (COPD). The purpose of the study was to 1) investigate the effects of aging and COPD on the cerebrovascular and ventilatory responses to acute hypoxia, and 2) to assess the effect of vitamin C on these responses during hypoxia. In 12 Younger, 14 Older, and 12 COPD, we measured peak cerebral blood flow velocity (V̄p; index of CBF), and V̇e during two 5-min periods of acute isocapnic hypoxia, under conditions of 1) saline-sham; and 2) intravenous vitamin C. Antioxidants [vitamin C, superoxide dismutase (SOD), glutathione peroxidase, and catalase], oxidative stress [malondialdehyde (MDA) and advanced protein oxidation product], and nitric oxide metabolism end products (NOx) were measured in plasma. Following the administration of vitamin C, vitamin C, SOD, catalase, and MDA increased, while NOx decreased. V̄p and V̇e sensitivity to hypoxia was reduced in Older by ∼60% (P 0.05). Vitamin C did not have an effect on the hypoxic V̇e response but selectively decreased the V̄p sensitivity in Younger only. These findings suggest a reduced integrative reflex (i.e., cerebrovascular and ventilatory) during acute hypoxemia in healthy older adults. Vitamin C does not appear to have a large influence on the cerebrovascular or ventilatory responses during acute hypoxia.

  6. Does amifostine reduce metabolic rate? Effect of the drug on gas exchange and acute ventilatory hypoxic response in humans.

    Science.gov (United States)

    Pandit, Jaideep J; Allen, Caroline; Little, Evelyn; Formenti, Federico; Harris, Adrian L; Robbins, Peter A

    2015-04-16

    Amifostine is added to chemoradiation regimens in the treatment of many cancers on the basis that, by reducing the metabolic rate, it protects normal cells from toxic effects of therapy. We tested this hypothesis by measuring the metabolic rate (by gas exchange) over 255 min in 6 healthy subjects, at two doses (500 mg and 1000 mg) of amifostine infused over 15 min at the start of the protocol. We also assessed the ventilatory response to six 1 min exposures to isocapnic hypoxia mid-protocol. There was no change in metabolic rate with amifostine as measured by oxygen uptake (p = 0.113). However in carbon dioxide output and respiratory quotient, we detected a small decline over time in control and drug protocols, consistent with a gradual change from carbohydrate to fat metabolism over the course of the relatively long study protocol. A novel result was that amifostine (1000 mg) increased the mean ± SD acute hypoxic ventilatory response from 12.4 ± 5.1 L/min to 20.3 ± 11.9 L/min (p = 0.045). In conclusion, any cellular protective effects of amifostine are unlikely due to metabolic effects. The stimulatory effect on hypoxic ventilatory responses may be due to increased levels of hypoxia inducible factor, either peripherally in the carotid body, or centrally in the brain.

  7. Does Amifostine Reduce Metabolic Rate? Effect of the Drug on Gas Exchange and Acute Ventilatory Hypoxic Response in Humans

    Directory of Open Access Journals (Sweden)

    Jaideep J. Pandit

    2015-04-01

    Full Text Available Amifostine is added to chemoradiation regimens in the treatment of many cancers on the basis that, by reducing the metabolic rate, it protects normal cells from toxic effects of therapy. We tested this hypothesis by measuring the metabolic rate (by gas exchange over 255 min in 6 healthy subjects, at two doses (500 mg and 1000 mg of amifostine infused over 15 min at the start of the protocol. We also assessed the ventilatory response to six 1 min exposures to isocapnic hypoxia mid-protocol. There was no change in metabolic rate with amifostine as measured by oxygen uptake (p = 0.113. However in carbon dioxide output and respiratory quotient, we detected a small decline over time in control and drug protocols, consistent with a gradual change from carbohydrate to fat metabolism over the course of the relatively long study protocol. A novel result was that amifostine (1000 mg increased the mean ± SD acute hypoxic ventilatory response from 12.4 ± 5.1 L/min to 20.3 ± 11.9 L/min (p = 0.045. In conclusion, any cellular protective effects of amifostine are unlikely due to metabolic effects. The stimulatory effect on hypoxic ventilatory responses may be due to increased levels of hypoxia inducible factor, either peripherally in the carotid body, or centrally in the brain.

  8. Heart rate response during a simulated Olympic boxing match is predominantly above ventilatory threshold 2: a cross sectional study.

    Science.gov (United States)

    de Lira, Claudio Andre Barbosa; Peixinho-Pena, Luiz Fernando; Vancini, Rodrigo Luiz; de Freitas Guina Fachina, Rafael Júlio; de Almeida, Alexandre Aparecido; Andrade, Marília Dos Santos; da Silva, Antonio Carlos

    2013-01-01

    The present study aimed to describe heart rate (HR) responses during a simulated Olympic boxing match and examine physiological parameters of boxing athletes. Ten highly trained Olympic boxing athletes (six men and four women) performed a maximal graded exercise test on a motorized treadmill to determine maximal oxygen uptake (52.2 mL · kg(-1) · min(-1) ± 7.2 mL · kg(-1) · min(-1)) and ventilatory thresholds 1 and 2. Ventilatory thresholds 1 and 2 were used to classify the intensity of exercise based on respective HR during a boxing match. In addition, oxygen uptake (V̇O2) was estimated during the match based on the HR response and the HR-V̇O2 relationship obtained from a maximal graded exercise test for each participant. On a separate day, participants performed a boxing match lasting three rounds, 2 minutes each, with a 1-minute recovery period between each round, during which HR was measured. In this context, HR and V̇O2 were above ventilatory threshold 2 during 219.8 seconds ± 67.4 seconds. There was an increase in HR and V̇O2 as a function of round (round 3 boxing practitioners and other athletes.

  9. Hypoxic ventilatory sensitivity in men is not reduced by prolonged hyperoxia (Predictive Studies V and VI)

    Science.gov (United States)

    Gelfand, R.; Lambertsen, C. J.; Clark, J. M.; Hopkin, E.

    1998-01-01

    Potential adverse effects on the O2-sensing function of the carotid body when its cells are exposed to toxic O2 pressures were assessed during investigations of human organ tolerance to prolonged continuous and intermittent hyperoxia (Predictive Studies V and VI). Isocapnic hypoxic ventilatory responses (HVR) were determined at 1.0 ATA before and after severe hyperoxic exposures: 1) continuous O2 breathing at 1.5, 2.0, and 2.5 ATA for 17.7, 9.0, and 5.7 h and 2) intermittent O2 breathing at 2.0 ATA (30 min O2-30 min normoxia) for 14.3 O2 h within 30-h total time. Postexposure curvature of HVR hyperbolas was not reduced compared with preexposure controls. The hyperbolas were temporarily elevated to higher ventilations than controls due to increments in respiratory frequency that were proportional to O2 exposure time, not O2 pressure. In humans, prolonged hyperoxia does not attenuate the hypoxia-sensing function of the peripheral chemoreceptors, even after exposures that approach limits of human pulmonary and central nervous system O2 tolerance. Current applications of hyperoxia in hyperbaric O2 therapy and in subsea- and aerospace-related operations are guided by and are well within these exposure limits.

  10. Ventilatory behaviors of the toad Bufo marinus revealed by coherence analysis

    Directory of Open Access Journals (Sweden)

    F. C. Coelho

    Full Text Available Breathing in amphibians is a remarkably complex behavior consisting of irregular breaths that may be taken singly or in bouts that are used to deflate and inflate the lungs. The valves at the two outlets of the buccal cavity (nares and glottis need to be finely controlled throughout the bout for the expression of these complex respiratory behaviors. In this study, we use a technique based on the calculation of the coherence spectra between respiratory variables (buccal pressure; narial airflow; and lung pressure. Coherence was also used to quantify the effects of chemoreceptor and pulmonary mechanoreceptor input on narial and glottal valve behavior on normoxic, hypoxic, and hypercapnic toads with both intact and bilaterally sectioned pulmonary vagi. We found a significant reduction in narial coherence in hypoxic vagotomized toads indicating that pulmonary mechanoreceptor feedback modulates narial opening duration. An unexpectedly high coherence between Pl and Pb during non-respiratory buccal oscillations in hypercapnic toads indicated more forceful use of the buccal pump. We concluded that the coherence function reveals behaviors that are not apparent through visual inspection of ventilatory time series.

  11. Respiratory mechanics and ventilatory control in overlap syndrome and obesity hypoventilation

    Science.gov (United States)

    2013-01-01

    The overlap syndrome of obstructive sleep apnoea (OSA) and chronic obstructive pulmonary disease (COPD), in addition to obesity hypoventilation syndrome, represents growing health concerns, owing to the worldwide COPD and obesity epidemics and related co-morbidities. These disorders constitute the end points of a spectrum with distinct yet interrelated mechanisms that lead to a considerable health burden. The coexistence OSA and COPD seems to occur by chance, but the combination can contribute to worsened symptoms and oxygen desaturation at night, leading to disrupted sleep architecture and decreased sleep quality. Alveolar hypoventilation, ventilation-perfusion mismatch and intermittent hypercapnic events resulting from apneas and hypopneas contribute to the final clinical picture, which is quite different from the “usual” COPD. Obesity hypoventilation has emerged as a relatively common cause of chronic hypercapnic respiratory failure. Its pathophysiology results from complex interactions, among which are respiratory mechanics, ventilatory control, sleep-disordered breathing and neurohormonal disturbances, such as leptin resistance, each of which contributes to varying degrees in individual patients to the development of obesity hypoventilation. This respiratory embarrassment takes place when compensatory mechanisms like increased drive cannot be maintained or become overwhelmed. Although a unifying concept for the pathogenesis of both disorders is lacking, it seems that these patients are in a vicious cycle. This review outlines the major pathophysiological mechanisms believed to contribute to the development of these specific clinical entities. Knowledge of shared mechanisms in the overlap syndrome and obesity hypoventilation may help to identify these patients and guide therapy. PMID:24256627

  12. Ventilatory responses to hypoxia nullify hypoxic tracheal constriction in awake dogs.

    Science.gov (United States)

    Sorkness, R L; Vidruk, E H

    1986-10-01

    Three awake dogs with chronic tracheostomies were used to study the effects of hypoxia (12% O2) on tracheal smooth muscle tone. Pressure changes within a water-filled cuff in an isolated portion of the cervical trachea reflected changes in tracheal tone. During spontaneous ventilation, hypoxia produced hyperventilation, but no significant change in tracheal tone. If hypocapnia was prevented with inspired CO2 during hypoxia, one of three dogs increased tracheal tone, and all dogs increased ventilation beyond that measured with hypoxia alone. When the awake dogs were ventilated mechanically to prevent changes in ventilation, hypoxia always increased tracheal tone. We made independent changes in ventilation and CO2 similar to the spontaneous responses to hypoxia to test these effects on tracheal tone. When the dogs were ventilated mechanically first with 2% CO2, and then with no CO2, the resulting drop in end-tidal CO2 always decreased tone. When the tidal volume on the ventilator was increased under hyperoxic, isocapnic conditions, tracheal tone always decreased. We conclude that the normal ventilatory response to hypoxia opposes the bronchoconstrictor effect of hypoxia, resulting in no net change in tracheal smooth muscle tone.

  13. POSTURAL CONTROL AFTER A PROLONGED TREADMILL RUN AT INDIVIDUAL VENTILATORY AND ANAEROBIC THRESHOLD

    Directory of Open Access Journals (Sweden)

    Laura Guidetti

    2011-09-01

    Full Text Available The objective of the study was to verify whether young males' balance was affected by 30min prolonged treadmill running (TR at individual ventilatory (IVT and anaerobic (IAT thresholds in recovery time. The VO2max, IAT and IVT during an incremental TR were determined. Mean displacement amplitude (Acp and velocity (Vcp of center of pressure were recorded before (pre and after (0min post; 5min post; and 10min post prolonged TR at IAT and IVT, through posturographic trials performed with eyes open (EO and closed (EC. Significant differences between IVT and IAT for Vcp, between EO and EC for Acp and Vcp, were observed. The IAT induced higher destabilizing effect when postural trials were performed with EC. The IVT intensity produced also a destabilizing effect on postural control immediately after exercise. An impairment of postural control after prolonged treadmill running exercise at IVT and IAT intensity was showed. However, destabilizing effect on postural control disappeared within 10min after IAT intensity and within 5min after IVT intensity

  14. Effects of a prior short simulated training session on the subsequent occurrence of ventilatory thresholds.

    Science.gov (United States)

    Guilhem, Gaël; Dorel, Sylvain; Hug, Francois

    2009-03-01

    The concept of ventilatory thresholds (VTs) has been shown to be particularly useful to prescribe exercise intensities, yet, to date no study has examined the effects of previous submaximal exercise (i.e. a simulated training session) on the subsequent occurrence of VTs. We designed the present study to test the hypothesis that a previous short simulated training session induces an earlier VTs occurrence. Thirteen trained subjects perfomed two classical incremental tests on a cycle ergometer. The two tests were separated by a time period of 2-5 days, and the second test was preceded by a 34-min simulated training session. The first and second VTs (VT(1) and VT(2), respectively) were detected and expressed in their corresponding values of time, V O(2), and power output. The simulated training session did not modify VT(1) occurrence. In contrast, VT(2) was influenced by the simulated training session, showing a significant earlier occurence when VT(2) was expressed in time [-42 (-72; -13)s] and in power output [-15 (-25; -5)W]. Maximal power tolerated (MPT) was also significantly reduced by the previous exercise [-17 (-27; -7)W]. As a consequence, training intensities based on power output (associated with VT(2) or in %MPT) would be overestimated (i.e. higher metabolic state) after a short period of training session. Thus, doubt is cast on the pertinence of using the power output (or running speed by extension) for prescription of exercise during prolonged training sessions.

  15. Initial indication of treatment in 60 patients with sleep obstructive ventilatory disturbance.

    Science.gov (United States)

    de Tarso Moura Borges, Paulo; Paschoal, Jorge Rizzato

    2005-01-01

    The author present a retrospective descriptive study of 60 patients with sleep obstructive ventilatory disturbance who have taken medical advice at the Centro Campinas de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço during a period of three years. All the patients have been examined after standardized protocol and decisions related to the treatment have been taken after systematic multidisciplinary discussion. clinical retrospective. The patients were distributed into two groups according to the proposal of surgical and non-surgical treatment. After so, they were studied according to the model of treatment proposed and the main propaedeutic findings: respiratory disturbance index (RDI), body mass index (BMI), cephalometric analysis and Müller maneuver. The main features were compared--isolated or in association--with the model of treatment proposed. Amongst several conclusions obtained, the most important were: surgical and non-surgical treatment were indicated almost in the same proportion for of snoring; surgical treatments were most indicated for snoring and Apnoea-Hipopnoea Syndrome, despite of its modality; RDI, BMI and cephalometric analysis and Müller maneuver had no influence at any therapeutic modality; the therapeutic decision was taken after standardized protocol and systematic multidisciplinary discussion, where each case was discussed individually.

  16. Double product break point estimates ventilatory threshold in individuals with type 2 diabetes.

    Science.gov (United States)

    Victor de Sousa, Caio; Sales, Marcelo Magalhães; Aguiar, Samuel da Silva; Boullosa, Daniel Alexandre; Rosa, Thiago Dos Santos; Baldissera, Vilmar; Simões, Herbert Gustavo

    2016-06-01

    [Purpose] To verify the identification of the anaerobic threshold through the double product breakpoint (DPBP) method for individuals with type 2 diabetes. [Subjects and Methods] Nine individuals with T2D (7 females; age=63.2 ± 8.9 y) and 10 non-diabetic (ND) (7 females; age=58.3 ± 7.8 y) performed an incremental exercise test on a cycle ergometer. Heart rate (HR), blood pressure (BP) and expired gas were measured at the end of each stage. The ventilatory threshold (VT) and DPBP were considered as the exercise intensities above which an over proportional increases in VE and DP were observed in relation to increasing workload. [Results] No differences were observed between the workloads, HR and VO2 corresponding to the AT identified respectively by VT and DPBP. For the T2D, strong correlations between VT and DBPB workloads (r=0.853), HR (r=0.714), and VO2 (r=0.863) were found. These relationships were similar to those found for the control group (r=0.923; r=0.881; and r=0.863, respectively). [Conclusion] These results demonstrate that the DPBP enables for the prediction of AT and correlated well the VT in both the T2D and ND participants.

  17. Prediction VO2max during cycle ergometry based on submaximal ventilatory indicators.

    Science.gov (United States)

    Nunes, Rodolfo Alkmim Moreira; Vale, Rodrigo Gomes de Souza; Simão, Roberto; de Salles, Belmiro Freitas; Reis, Victor Machado; Novaes, Jefferson da Silva; Miranda, Humberto; Rhea, Matthew R; Medeiros, Aldo da Cunha

    2009-09-01

    There are several equations to predict maximum oxygen consumption (VO2max) from ergometric test variables on different ergometers. However, a similar equation using ventilatory thresholds of ergospirometry in a submaximal test on a cycle ergometer is unavailable. The aim of the present study was to assess the accuracy of VO2max prediction models based on indicators of submaximal effort. Accordingly, 4,640 healthy, nonathlete women ages 20 years and older volunteered to be tested on a cycle ergometer using a maximum incremental protocol. The subjects were randomly assigned to 2 groups: group A (estimation) and group B (validation). From the independent variables of weight in kilograms, the second workload threshold (WT2), and heart rate of the second threshold (HRT2), it was possible to build a multiple linear regression model to predict maximal oxygen consumption (VO2max = 40.302 - 0.497 [Weight] - 0.001 [HRT2] + 0.239 [WT2] in mL O2/kg/min(-1); r = 0.995 and standard error of the estimate [SEE] = 0.68 mL O2/kg/min(-1)). The cross-validation method was used in group B with group A serving as the basis for building the model and the validation dataset. The results showed that, in healthy nonathlete women, it is possible to predict VO2max with a minimum of error (SEE = 1.00%) from submaximal indicators obtained in an incremental test.

  18. A new ventilatory threshold equation for aerobically trained men and women.

    Science.gov (United States)

    Malek, Moh H; Coburn, Jared W

    2009-04-01

    The purposes of the present study were to (i) modify previously published ventilatory threshold (VT) equations using the constant error (CE) values for aerobically trained individuals from a recent study; (ii) cross-validate the modified equations to determine their accuracy for estimating VT in aerobically trained individuals; (iii) derive a new non-exercise based equation for estimating VT in aerobically trained individuals if the modified equations are found to be inaccurate; and (iv) cross-validate the new VT equation using the Predicted REsidual Sum of Squares (PRESS) statistic and an independent sample of aerobically trained individuals. Two hundred and eight (n = 208) aerobically trained men and women (mean +/- SD: age = 38.8 +/- 10.4 year) performed a maximal incremental test on a cycle ergometer to determine the observed VT. The predicted VT values from seven published equations were compared with the observed VT by examining the CE, standard error of estimate, validity coefficient (r), and total error (TE). Cross-validation of the modified equations resulted in high %TE values. Therefore, a new VT equation was derived. Cross-validation of this equation on an independent sample of 72 subjects resulted in a low %TE value. The new model is recommended over previous models for estimating VT in aerobically trained individuals.

  19. Preliminary investigation into the ventilatory effects of midazolam in isoflurane-anaesthetised goats

    Directory of Open Access Journals (Sweden)

    George F. Stegmann

    2012-04-01

    Full Text Available The ventilatory effects of intravenous midazolam (MDZ were evaluated in isoflurane- anaesthetised goats. Eight female goats aged 2–3 years were fasted from food and water for 12 h. Anaesthesia was then induced using a face mask with isoflurane in oxygen, whilst the trachea was intubated with a cuffed tracheal tube and anaesthesia maintained with isoflurane at 1.5% end-tidal concentration. Ventilation was spontaneous. The goats were treated with either a saline placebo (PLC or MDZ intravenously at 0.2 mg/kg. Analysis of variance for repeated measures was used for the analysis of data. Significance was taken at the 0.05 level. Differences between treatments were not statistically significant (p > 0.05 for tidal volume, ventilation rate, tidal volume/kg (VT/kg and end-tidal carbon dioxide partial pressure. Within treatments, VT and VT/kg differed 5 min after MDZ administration; this was statistically significant (p < 0.05. The occurrence of apnoea in the MDZ-treated goats was statistically significant (p = 0.04 compared with the PLC treated goats. Intravenous MDZ at 0.2 mg/kg administered to isoflurane-anaesthetised goats may result in transient apnoea and a mild decrease in VT and VT/kg.

  20. Lack of correlation between the ventilatory response to CO2 and lung function impairment in myotonic dystrophy patients: evidence for a dysregulation at central level.

    Science.gov (United States)

    Poussel, Mathias; Thil, Catherine; Kaminsky, Pierre; Mercy, Magalie; Gomez, Emmanuel; Chaouat, Ari; Chabot, François; Chenuel, Bruno

    2015-05-01

    Myotonic dystrophy Type 1 (DM1) is the most common muscular dystrophy in adults. Respiratory failure is common but clinical findings support a dysregulation of the control of breathing at central level, furthermore contributing to alveolar hypoventilation independently of the severity of respiratory weakness. We therefore intended to study the relationship between the ventilatory response to CO2 and the impairment of lung function in DM1 patients. Sixty-nine DM1 patients were prospectively investigated (43.5 ± 12.7 years). Systematic pulmonary lung function evaluation including spirometry, plethysmography, measurements of respiratory muscle strength, arterial blood gas analysis and ventilatory response to CO2 were performed. Thirty-one DM1 patients (45%) presented a ventilatory restriction, 38 (55%) were hypoxaemic and 15 (22%) were hypercapnic. Total lung capacity decline was correlated to hypoxaemia (p = 0.0008) and hypercapnia (p = 0.0013), but not to a decrease in ventilatory response to CO2 (p = 0.194). Ventilatory response to CO2 was reduced to 0.85 ± 0.67 L/min/mmHg and not correlated to respiratory muscle weakness. Ventilatory response to CO2 was neither different among restricted/non-restricted patients (p = 0.2395) nor among normoxaemic/hypoxaemic subjects (p = 0.6380). The reduced ventilatory response to CO2 in DM1 patients appeared independent of lung function impairment and respiratory muscle weakness, suggesting a central cause of CO2 insensitivity.

  1. Gravity predominates over ventilatory pattern in the prevention of ventilator-associated pneumonia.

    Science.gov (United States)

    Li Bassi, Gianluigi; Marti, Joan Daniel; Saucedo, Lina; Rigol, Montserrat; Roca, Ignasi; Cabanas, Maria; Muñoz, Laura; Ranzani, Otavio Tavares; Giunta, Valeria; Luque, Nestor; Esperatti, Mariano; Gabarrus, Albert; Fernandez, Laia; Rinaudo, Mariano; Ferrer, Miguel; Ramirez, Jose; Vila, Jordi; Torres, Antoni

    2014-09-01

    In the semirecumbent position, gravity-dependent dissemination of pathogens has been implicated in the pathogenesis of ventilator-associated pneumonia. We compared the preventive effects of a ventilatory strategy, aimed at decreasing pulmonary aspiration and enhancing mucus clearance versus the Trendelenburg position. Prospective randomized animal study. Animal research facility, University of Barcelona, Spain. Twenty-four Large White-Landrace pigs. Pigs were intubated and on mechanical ventilation for 72 hours. Following surgical preparation, pigs were randomized to be positioned: 1) in semirecumbent/prone position, ventilated with a duty cycle (TITTOT) of 0.33 and without positive end-expiratory pressure (control); 2) as in the control group, positive end-expiratory pressure of 5 cm H2O and TITTOT to achieve a mean expiratory-inspiratory flow bias of 10 L/min (treatment); 3) in Trendelenburg/prone position and ventilated as in the control group (Trendelenburg). Following randomization, Pseudomonas aeruginosa was instilled into the oropharynx. Mucus clearance rate was measured through fluoroscopic tracking of tracheal markers. Microspheres were instilled into the subglottic trachea to assess pulmonary aspiration. Ventilator-associated pneumonia was confirmed by histological/microbiological studies. The mean expiratory-inspiratory flow in the treatment, control, and Trendelenburg groups were 10.7 ± 1.7, 1.8 ± 3.7 and 4.3 ± 2.8 L/min, respectively (p gravity-dependent translocation of oropharyngeal pathogens and development of ventilator-associated pneumonia. These findings further substantiate the primary role of gravity in the pathogenesis of ventilator-associated pneumonia.

  2. Isoflurane anaesthesia (0.6 MAC) and hypoxic ventilatory responses in humans.

    Science.gov (United States)

    Sjögren, D; Sollevi, A; Ebberyd, A; Lindahl, S G

    1995-01-01

    In order to evaluate the difference between poikilo-capnic (no CO2 added to inspired gas) and iso-capnic (CO2 added to keep end-tidal CO2 constant) hypoxic ventilatory responses (HVR) awake and during 0.6 MAC isoflurane anaesthesia, seven cardio-pulmonary healthy patients were investigated. Pneumotachography and capnography were used before and during hypoxia (end-tidal O2 tension approx. 7 kPa). In the awake state, poikilo-capnic hypoxic challenges resulted in an increased HVR as indicated by a VE that on average increased by 1.4 +/- 1.0 (mean +/- s.d.) l.min-1, whereas the iso-capnic hypoxic challenges resulted in a VE increase that was 4.7 +/- 2.3 l.min-1 on average. In the anaesthetized state, the corresponding value during poikilocapnia was 1.3 +/- 0.8 l.min-1 (88% of the awake responses, n.s.) and during iso-capnia 2.3 +/- 1.4 l.min-1 (49% of the awake, P Awake HVR was achieved by greater tidal volumes during poikilocapnia as well as during isocapnic challenges, while respiratory rates were unchanged. In the anaesthetized state, during poikilocapnia, however, HVR was mediated by an increased respiratory rate, (from 17.5 +/- 1.7 breath.min-1 to 20.2 +/- 2.2) and during isocapnia by a combination of increased rate (from 17.1 +/- 1.9 breath.min-1 to 19.1 +/- 1.8) and tidal volume (from 496 +/- 80 to 560 +/- 83 ml). It is concluded that poikilocapnic HVR is maintained at 0.6 MAC isoflurane whereas iso-capnic HVR is depressed by 50%.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Predicting Heart Rate at the Ventilatory Threshold for Aerobic Exercise Prescription in Persons With Chronic Stroke.

    Science.gov (United States)

    Boyne, Pierce; Buhr, Sarah; Rockwell, Bradley; Khoury, Jane; Carl, Daniel; Gerson, Myron; Kissela, Brett; Dunning, Kari

    2015-10-01

    Treadmill aerobic exercise improves gait, aerobic capacity, and cardiovascular health after stroke, but a lack of specificity in current guidelines could lead to underdosing or overdosing of aerobic intensity. The ventilatory threshold (VT) has been recommended as an optimal, specific starting point for continuous aerobic exercise. However, VT measurement is not available in clinical stroke settings. Therefore, the purpose of this study was to identify an accurate method to predict heart rate at the VT (HRVT) for use as a surrogate for VT. A cross-sectional design was employed. Using symptom-limited graded exercise test (GXT) data from 17 subjects more than 6 months poststroke, prediction methods for HRVT were derived by traditional target HR calculations (percentage of HRpeak achieved during GXT, percentage of peak HR reserve [HRRpeak], percentage of age-predicted maximal HR, and percentage of age-predicted maximal HR reserve) and by regression analysis. The validity of the prediction methods was then tested among 8 additional subjects. All prediction methods were validated by the second sample, so data were pooled to calculate refined prediction equations. HRVT was accurately predicted by 80% HRpeak (R, 0.62; standard deviation of error [SDerror], 7 bpm), 62% HRRpeak (R, 0.66; SDerror, 7 bpm), and regression models that included HRpeak (R, 0.62-0.75; SDerror, 5-6 bpm). Derived regression equations, 80% HRpeak and 62% HRRpeak, provide a specific target intensity for initial aerobic exercise prescription that should minimize underdosing and overdosing for persons with chronic stroke. The specificity of these methods may lead to more efficient and effective treatment for poststroke deconditioning.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A114).

  4. Associative conditioning with leg cycling and inspiratory resistance enhances the early exercise ventilatory response in humans.

    Science.gov (United States)

    Turner, Duncan; Stewart, Jamie D

    2004-12-01

    Repeated trials of hypercapnic exercise [deltaPET CO2 = 7 (1) mmHg] augment the increase in inspired minute ventilation and tidal volume (V(T)) in the early phase of subsequent trials of unencumbered exercise alone. The increase in V(T) in the first 20 s of exercise was correlated to the increase in V(T) evoked during hypercapnic exercise trials, suggesting that the evoked increase in V(T) during conditioning may be a factor in mediating associative conditioning. To test this hypothesis, inspiratory resistive loading (IRL) was employed to evoke an increase in V(T) [deltaV(T) = 0.4 (0.1) I(BTPS)] during conditioning exercise trials [IRL + EX; deltaP(ET)CO2 = 2 (l) mmHg]. IRL + EX associative conditioning elicited a significant augmentation of the early minute ventilation (+46%) and V(T) (+100%) responses to subsequent unencumbered exercise. The latter was correlated to the evoked increase in V(T) during associative conditioning with IRL + EX. The results support the hypothesis that an evoked increase in V(T) during associative conditioning could be a factor in eliciting long-term modulation of minute ventilation in subsequent unencumbered exercise. The results further indicated that the modulation of ventilation early in exercise is not due to sensitisation to repeated trials of either IRL or exercise alone. Associative conditioning may shape the ventilatory response to exercise through a process of motor learning. Data are presented as mean (SEM) unless otherwise stated.

  5. Maternal hypoxic ventilatory response, ventilation, and infant birth weight at 4,300 m.

    Science.gov (United States)

    Moore, L G; Brodeur, P; Chumbe, O; D'Brot, J; Hofmeister, S; Monge, C

    1986-04-01

    To test the hypothesis that increased hypoxic ventilatory responsiveness (HVR) raised maternal ventilation and arterial oxygenation during high-altitude pregnancy and related to the birth weight of the offspring, we studied 21 residents of Cerro de Pasco, Peru (4,300 m), while eight of them were 36 +/- 0 wk pregnant and 15 of them 13 +/- 0 wk postpartum. HVR was low in the nonpregnant women (mean +/- SE shape parameter A = 23 +/- 8) but increased nearly fourfold with pregnancy (A = 87 +/- 17). The increase in HVR appeared to account for the 25% rise in resting ventilation with pregnancy (delta VE observed = 2.4 +/- 0.7 l/min BTPS vs. delta VE predicted from delta HVR = 2.6 +/- 1.7 l/min BTPS, P = NS). Hyperoxia decreased ventilation in the pregnant women (P less than 0.01) to levels similar to those measured when nonpregnant. The increased ventilation of pregnancy raised arterial O2 saturation (SaO2) from 83 +/- 1 to 87 +/- 0%, and SaO2 was correlated positively with HVR in the pregnant women. The rise in SaO2 compensated for a 0.9 g/100 ml decrease in hemoglobin concentration to preserve arterial O2 content at levels present when nonpregnant. Cardiac output in the 36th wk of pregnancy did not differ significantly from values measured postpartum. The increase in HVR correlated positively with infant birth weight. An increase in HVR may be an important contributor to increased maternal ventilation with pregnancy and infant birth weight at high altitude.

  6. Noninvasive Ventilatory Correction in Patients With Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Tsivgoulis, Georgios; Alexandrov, Andrei V; Katsanos, Aristeidis H; Barlinn, Kristian; Mikulik, Robert; Lambadiari, Vaia; Bonakis, Anastasios; Alexandrov, Anne W

    2017-08-01

    Even though current guidelines suggest that noninvasive ventilatory correction (NIVC) could be considered for acute ischemic stroke patients with obstructive sleep apnea, available evidence is conflicting, with no adequately powered randomized clinical trial being available to date. We conducted a systematic review and meta-analysis of all available literature data evaluating the effect of NIVC on neurological improvement (based on decrease in National Institutes of Health Stroke Scale score), vascular events (recurrent stroke, transient ischemic attack, myocardial infarction and unstable angina), and mortality during the follow-up period. We identified 4 randomized clinical trials and 1 prospectively matched observational cohort, comprising a total of 389 patients (59.8% males, mean age: 64.4 years). The risk of both performance and detection bias was considered high in most of the included randomized clinical trials because of the lack of blinding in participants, personnel and/or outcome assessors. The mean decrease in National Institutes of Health Stroke Scale scores during the first (≤30) days of acute ischemic stroke was found to be greater in NIVC-treated patients in comparison to controls (standardized mean difference, 0.38; 95% confidence interval, 0.11-0.66; P=0.007). However, no significant differences were detected between NIVC-treated acute ischemic stroke patients and controls on both the risk of vascular events (risk ratio, 0.53; 95% confidence interval, 0.25-1.14; P=0.11) and mortality (risk ratio, 0.71; 95% confidence interval, 0.37-1.36; P=0.30). No evidence of heterogeneity (I(2)=0%; P for Cochran Q>0.50) or publication bias were detected in all analyses. NIVC seems to be associated with greater short-term neurological improvement in acute ischemic stroke patients with obstructive sleep apnea. This finding deserves further investigation within the settings of an adequately powered, sham-control, randomized clinical trial. © 2017 American Heart

  7. The Effects of a Duathlon Simulation on Ventilatory Threshold and Running Economy

    Directory of Open Access Journals (Sweden)

    Nathaniel T. Berry, Laurie Wideman, Edgar W. Shields, Claudio L. Battaglini

    2016-06-01

    Full Text Available Multisport events continue to grow in popularity among recreational, amateur, and professional athletes around the world. This study aimed to determine the compounding effects of the initial run and cycling legs of an International Triathlon Union (ITU Duathlon simulation on maximal oxygen uptake (VO2max, ventilatory threshold (VT and running economy (RE within a thermoneutral, laboratory controlled setting. Seven highly trained multisport athletes completed three trials; Trial-1 consisted of a speed only VO2max treadmill protocol (SOVO2max to determine VO2max, VT, and RE during a single-bout run; Trial-2 consisted of a 10 km run at 98% of VT followed by an incremental VO2max test on the cycle ergometer; Trial-3 consisted of a 10 km run and 30 km cycling bout at 98% of VT followed by a speed only treadmill test to determine the compounding effects of the initial legs of a duathlon on VO2max, VT, and RE. A repeated measures ANOVA was performed to determine differences between variables across trials. No difference in VO2max, VT (%VO2max, maximal HR, or maximal RPE was observed across trials. Oxygen consumption at VT was significantly lower during Trial-3 compared to Trial-1 (p = 0.01. This decrease was coupled with a significant reduction in running speed at VT (p = 0.015. A significant interaction between trial and running speed indicate that RE was significantly altered during Trial-3 compared to Trial-1 (p < 0.001. The first two legs of a laboratory based duathlon simulation negatively impact VT and RE. Our findings may provide a useful method to evaluate multisport athletes since a single-bout incremental treadmill test fails to reveal important alterations in physiological thresholds.

  8. Differences in Ventilatory Threshold for Exercise Prescription in Outpatient Diabetic and Sarcopenic Obese Subjects

    Directory of Open Access Journals (Sweden)

    Gian Pietro Emerenziani

    2016-01-01

    Full Text Available Aim of the study was to examine cardiorespiratory parameters at individual ventilatory threshold (IVT and peak exercise capacity (V˙O2peak in outpatient diabetic and sarcopenic obese subjects. Seventeen obese subjects (BMI: 36.6±4.1 kg·m−1 and sixteen SO subjects (BMI: 37.0±7.3 kg·m−1 were compared with sixteen T2DM subjects (BMI: 37.7±5.6 kg·m−1. All groups performed an incremental exercise test on a treadmill according to their physical ability. V˙O2peak, %HRmax, and maximal metabolic equivalent (METmax were evaluated at maximal effort. Moreover, V˙O2ivt, %V˙O2peak, %HRmax, %HRR, ΔHR, and METivt were assessed at IVT. No significant differences were found in any physiological parameters at maximal effort (V˙O2peak, %HRmax, and METmax in all groups. On the contrary, V˙O2ivt, %V˙O2peak, %HRmax, %HRR, ΔHR, and METivt were significantly lower in T2DM subjects as compared to OB and SO subjects at IVT (p<0.05. Our results show that while at maximal effort there are no differences among groups, at IVT the physiological parameters are lower in T2DM subjects than in OB and SO subjects. Therefore, due to the differences observed in the groups, we suggest usng the IVT as a useful parameter to prescribe aerobic exercise in obese with sarcopenia or diabetes mellitus conditions.

  9. Relationship between double product break point, lactate threshold, and ventilatory threshold in cardiac patients.

    Science.gov (United States)

    Omiya, Kazuto; Itoh, Haruki; Harada, Naomi; Maeda, Tomoko; Tajima, Akihiko; Oikawa, Keiko; Koike, Akira; Aizawa, Tadanori; Fu, Long-Tai; Osada, Naohiko

    2004-03-01

    A double product break point (DPBP) occurs simultaneously with both ventilatory threshold (VT) and lactate threshold (LT) in normal subjects. We sought to determine whether a DPBP also occurs in cardiac patients and to investigate correlations between DPBP, VT and LT (study 1). We also evaluated a non-invasive DPBP measurement system that determined blood pressure automatically by the cuff method (study 2). Study 1 comprised 15 patients [8 men and 7 women, mean (SD) age 47.7 (11.1) years] who performed cardiopulmonary exercise tests on a cycle ergometer. The double product was defined as the product of heart rate and direct systolic blood pressure. Arterial blood samples were obtained for measurement of lactate, pyruvate, pH, and norepinephrine levels. VT was determined by gas analysis, and LT was determined as the lactate/pyruvate ratio. DPBPs were detected in all 15 patients. Double product slopes above the DPBP were significantly greater than those below the DPBP (286.2 vs 98.5/W, P<0.001). The lactate/pyruvate ratio increased, arterial pH decreased, and plasma norepinephrine concentration increased above the DPBP. DPBP had strong positive correlations with VT ( r=0.93) and LT ( r=0.95). Study 2 comprised 65 cardiac patients. The DPBP was detected in 89.2% of patients and correlated closely with VT. We conclude that DPBP occurs near VT and LT in cardiac patients during incremental exercise, that the noninvasive DPBP measurement method is comparable to the invasive method, and that DPBP may be as useful an index of exercise intensity in patients with cardiac disease as VT or LT.

  10. ADJUSTABLE CHIP HOLDER

    DEFF Research Database (Denmark)

    2009-01-01

    An adjustable microchip holder for holding a microchip is provided having a plurality of displaceable interconnection pads for connecting the connection holes of a microchip with one or more external devices or equipment. The adjustable microchip holder can fit different sizes of microchips with ...

  11. Benchmarking Judgmentally Adjusted Forecasts

    NARCIS (Netherlands)

    Ph.H.B.F. Franses (Philip Hans); L.P. de Bruijn (Bert)

    2017-01-01

    textabstractMany publicly available macroeconomic forecasts are judgmentally adjusted model-based forecasts. In practice, usually only a single final forecast is available, and not the underlying econometric model, nor are the size and reason for adjustment known. Hence, the relative weights given

  12. Benchmarking judgmentally adjusted forecasts

    NARCIS (Netherlands)

    Ph.H.B.F. Franses (Philip Hans); L.P. de Bruijn (Bert)

    2015-01-01

    markdownabstractMany publicly available macroeconomic forecasts are judgmentally-adjusted model-based forecasts. In practice usually only a single final forecast is available, and not the underlying econometric model, nor are the size and reason for adjustment known. Hence, the relative weights

  13. Benchmarking judgmentally adjusted forecasts

    NARCIS (Netherlands)

    Ph.H.B.F. Franses (Philip Hans); L.P. de Bruijn (Bert)

    2015-01-01

    markdownabstractMany publicly available macroeconomic forecasts are judgmentally-adjusted model-based forecasts. In practice usually only a single final forecast is available, and not the underlying econometric model, nor are the size and reason for adjustment known. Hence, the relative weights give

  14. Dental Assistants

    Science.gov (United States)

    ... Z INDEX | OOH SITE MAP | EN ESPAÑOL Healthcare > Dental Assistants PRINTER-FRIENDLY EN ESPAÑOL Summary What They ... of workers and occupations. What They Do -> What Dental Assistants Do About this section Assistants prepare and ...

  15. Surgical Assisting

    Science.gov (United States)

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  16. New modes of assisted mechanical ventilation.

    Science.gov (United States)

    Suarez-Sipmann, F

    2014-05-01

    Recent major advances in mechanical ventilation have resulted in new exciting modes of assisted ventilation. Compared to traditional ventilation modes such as assisted-controlled ventilation or pressure support ventilation, these new modes offer a number of physiological advantages derived from the improved patient control over the ventilator. By implementing advanced closed-loop control systems and using information on lung mechanics, respiratory muscle function and respiratory drive, these modes are specifically designed to improve patient-ventilator synchrony and reduce the work of breathing. Depending on their specific operational characteristics, these modes can assist spontaneous breathing efforts synchronically in time and magnitude, adapt to changing patient demands, implement automated weaning protocols, and introduce a more physiological variability in the breathing pattern. Clinicians have now the possibility to individualize and optimize ventilatory assistance during the complex transition from fully controlled to spontaneous assisted ventilation. The growing evidence of the physiological and clinical benefits of these new modes is favoring their progressive introduction into clinical practice. Future clinical trials should improve our understanding of these modes and help determine whether the claimed benefits result in better outcomes.

  17. Hemodynamic and ventilatory response to different levels of hypoxia and hypercapnia in carotid body-denervated rats

    Directory of Open Access Journals (Sweden)

    João Paulo J. Sabino

    2013-01-01

    Full Text Available OBJECTIVE: Chemoreceptors play an important role in the autonomic modulation of circulatory and ventilatory responses to changes in arterial O2 and/or CO2. However, studies evaluating hemodynamic responses to hypoxia and hypercapnia in rats have shown inconsistent results. Our aim was to evaluate hemodynamic and respiratory responses to different levels of hypoxia and hypercapnia in conscious intact or carotid body-denervated rats. METHODS: Male Wistar rats were submitted to bilateral ligature of carotid body arteries (or sham-operation and received catheters into the left femoral artery and vein. After two days, each animal was placed into a plethysmographic chamber and, after baseline measurements of respiratory parameters and arterial pressure, each animal was subjected to three levels of hypoxia (15, 10 and 6% O2 and hypercapnia (10% CO2. RESULTS: The results indicated that 15% O2 decreased the mean arterial pressure and increased the heart rate (HR in both intact (n = 8 and carotid body-denervated (n = 7 rats. In contrast, 10% O2did not change the mean arterial pressure but still increased the HR in intact rats, and it decreased the mean arterial pressure and increased the heart rate in carotid body-denervated rats. Furthermore, 6% O2 increased the mean arterial pressure and decreased the HR in intact rats, but it decreased the mean arterial pressure and did not change the HR in carotid body-denervated rats. The 3 levels of hypoxia increased pulmonary ventilation in both groups, with attenuated responses in carotid body-denervated rats. Hypercapnia with 10% CO2 increased the mean arterial pressure and decreased HR similarly in both groups. Hypercapnia also increased pulmonary ventilation in both groups to the same extent. CONCLUSION: This study demonstrates that the hemodynamic and ventilatory responses varied according to the level of hypoxia. Nevertheless, the hemodynamic and ventilatory responses to hypercapnia did not depend on the

  18. Partial ventilatory support modalities in acute lung injury and acute respiratory distress syndrome-a systematic review.

    Directory of Open Access Journals (Sweden)

    Sarah M McMullen

    Full Text Available PURPOSE: The efficacy of partial ventilatory support modes that allow spontaneous breathing in patients with acute lung injury (ALI and acute respiratory distress syndrome (ARDS is unclear. The objective of this scoping review was to assess the effects of partial ventilatory support on mortality, duration of mechanical ventilation, and both hospital and intensive care unit (ICU lengths of stay (LOS for patients with ALI and ARDS; the secondary objective was to describe physiologic effects on hemodynamics, respiratory system and other organ function. METHODS: MEDLINE (1966-2009, Cochrane, and EmBase (1980-2009 databases were searched using common ventilator modes as keywords and reference lists from retrieved manuscripts hand searched for additional studies. Two researchers independently reviewed and graded the studies using a modified Oxford Centre for Evidence-Based Medicine grading system. Studies in adult ALI/ARDS patients were included for primary objectives and pre-clinical studies for supporting evidence. RESULTS: Two randomized controlled trials (RCTs were identified, in addition to six prospective cohort studies, one retrospective cohort study, one case control study, 41 clinical physiologic studies and 28 pre-clinical studies. No study was powered to assess mortality, one RCT showed shorter ICU length of stay, and the other demonstrated more ventilator free days. Beneficial effects of preserved spontaneous breathing were mainly physiological effects demonstrated as improvement of gas exchange, hemodynamics and non-pulmonary organ perfusion and function. CONCLUSIONS: The use of partial ventilatory support modalities is often feasible in patients with ALI/ARDS, and may be associated with short-term physiological benefits without appreciable impact on clinically important outcomes.

  19. Family Adjustment to Aphasia

    Science.gov (United States)

    ... Public / Speech, Language and Swallowing / Disorders and Diseases Family Adjustment to Aphasia Richard S. was a senior manager ... It also presents a great challenge to the family. There may be tension among family members and ...

  20. Remotely Adjustable Hydraulic Pump

    Science.gov (United States)

    Kouns, H. H.; Gardner, L. D.

    1987-01-01

    Outlet pressure adjusted to match varying loads. Electrohydraulic servo has positioned sleeve in leftmost position, adjusting outlet pressure to maximum value. Sleeve in equilibrium position, with control land covering control port. For lowest pressure setting, sleeve shifted toward right by increased pressure on sleeve shoulder from servovalve. Pump used in aircraft and robots, where hydraulic actuators repeatedly turned on and off, changing pump load frequently and over wide range.

  1. A quick and easy method of measuring the hypercapnic ventilatory response in patients with COPD.

    Science.gov (United States)

    Nickol, Annabel H; Dunroy, Helen; Polkey, Michael I; Simonds, Anita; Cordingley, Jeremy; Corfield, Douglas R; Morrell, Mary J

    2009-02-01

    Hypercapnic ventilatory response (HCVR) techniques have not previously been adequately validated in patients with chronic obstructive pulmonary disease (COPD). We have tested the hypothesis that end-tidal PCO(2) may be used to test the HCVR in COPD during non-steady-state rebreathing, despite the fact that large (arterial-end-tidal) PCO(2) differences (P(a-et)CO(2)) exist during air breathing. Eight patients and 11 healthy volunteers underwent steady-state HCVR testing and non-steady-state rebreathing HCVR testing, using Pa and PetCO(2). In COPD patients, PetCO(2) was lower than PaCO(2) by a constant amount throughout steady-state HCVR, but equalised with PaCO(2) during non-steady-state HCVR. Consequently there were no differences in HCVR slope using either method (steady-state p=0.91; rebreathing p=0.73), or HCVR intercept in rebreathing (p=0.68) whether PaCO(2) or PetCO(2) was used. The steady-state HCVR intercept using PetCO(2) was greater than that using PaCO(2) (p=0.02). In healthy volunteers PetCO(2) equalised with PaCO(2) during steady-state HCVR, but was progressively greater than PaCO(2) during non-steady-state. Consequently, there was no difference in HCVR slope (p=0.21) or intercept (p=0.46) whether PaCO(2) or PetCO(2) was used. During non-steady-state there was a P(a-et)CO(2) difference in slope (p=0.03) and intercept (p=0.04). In COPD patients non-steady-state HCVR using PetCO(2) is well tolerated, which is as accurate as PaCO(2). HCVR slope may be derived using PetCO(2) during steady-state testing, though there may be errors in intercept compared to use of PaCO(2). In healthy volunteers PetCO(2) may be used to estimate PaCO(2) during steady-state but not rebreathing HCVR.

  2. Weighted triangulation adjustment

    Science.gov (United States)

    Anderson, Walter L.

    1969-01-01

    The variation of coordinates method is employed to perform a weighted least squares adjustment of horizontal survey networks. Geodetic coordinates are required for each fixed and adjustable station. A preliminary inverse geodetic position computation is made for each observed line. Weights associated with each observed equation for direction, azimuth, and distance are applied in the formation of the normal equations in-the least squares adjustment. The number of normal equations that may be solved is twice the number of new stations and less than 150. When the normal equations are solved, shifts are produced at adjustable stations. Previously computed correction factors are applied to the shifts and a most probable geodetic position is found for each adjustable station. Pinal azimuths and distances are computed. These may be written onto magnetic tape for subsequent computation of state plane or grid coordinates. Input consists of punch cards containing project identification, program options, and position and observation information. Results listed include preliminary and final positions, residuals, observation equations, solution of the normal equations showing magnitudes of shifts, and a plot of each adjusted and fixed station. During processing, data sets containing irrecoverable errors are rejected and the type of error is listed. The computer resumes processing of additional data sets.. Other conditions cause warning-errors to be issued, and processing continues with the current data set.

  3. Weighted triangulation adjustment

    Science.gov (United States)

    Anderson, Walter L.

    1969-01-01

    The variation of coordinates method is employed to perform a weighted least squares adjustment of horizontal survey networks. Geodetic coordinates are required for each fixed and adjustable station. A preliminary inverse geodetic position computation is made for each observed line. Weights associated with each observed equation for direction, azimuth, and distance are applied in the formation of the normal equations in-the least squares adjustment. The number of normal equations that may be solved is twice the number of new stations and less than 150. When the normal equations are solved, shifts are produced at adjustable stations. Previously computed correction factors are applied to the shifts and a most probable geodetic position is found for each adjustable station. Pinal azimuths and distances are computed. These may be written onto magnetic tape for subsequent computation of state plane or grid coordinates. Input consists of punch cards containing project identification, program options, and position and observation information. Results listed include preliminary and final positions, residuals, observation equations, solution of the normal equations showing magnitudes of shifts, and a plot of each adjusted and fixed station. During processing, data sets containing irrecoverable errors are rejected and the type of error is listed. The computer resumes processing of additional data sets.. Other conditions cause warning-errors to be issued, and processing continues with the current data set.

  4. Chest radiographs fail to detect right ventricular enlargement and right atrial enlargement in patients with a pure restrictive ventilatory impairment.

    Science.gov (United States)

    Shivkumar, K; Ravi, K; Henry, J W; Eichenhorn, M S; Stein, P D

    1994-08-01

    The validity of measurements of the cardiac silhouette on chest radiographs for the evaluation of right ventricular enlargement and right atrial enlargement in patients with a pure restrictive ventilatory impairment was investigated in 19 patients. The forced vital capacity (FVC) percent predicted in these patients was 59 +/- 12 percent (mean +/- SD) (range, 29 to 79 percent). Right ventricular enlargement, by two-dimensional echocardiography, was defined as a right ventricular area > 20.4 cm2 and right atrial enlargement was defined as a right atrial area > 15.3 cm2. Chest radiographic measurements in the posteroanterior (PA) projection included distance from the midline to the farthest point of the right border of the cardiac silhouette, transverse cardiac diameter, and cardiothoracic ratio. Measurements in the lateral projection included the lateral horizontal transverse diameter, ventral portion of the lateral broad diameter, and obliteration of the retrosternal space. Neither the right ventricular area nor the right atrial area correlated with any of these radiographic measurements. There were no differences in these chest radiographic measurements among patients with normal right ventricular and right atrial dimensions, patients with right ventricular enlargement, and patients with right atrial enlargement. We conclude, therefore, that PA and lateral chest radiographs do not reliably detect right ventricular enlargement or right atrial enlargement in patients with a pure restrictive ventilatory impairment.

  5. Neonatal stress affects the aging trajectory of female rats on the endocrine, temperature, and ventilatory responses to hypoxia.

    Science.gov (United States)

    Fournier, Sébastien; Gulemetova, Roumiana; Baldy, Cécile; Joseph, Vincent; Kinkead, Richard

    2015-04-01

    Human and animal studies on sleep-disordered breathing and respiratory regulation show that the effects of sex hormones are heterogeneous. Because neonatal stress results in sex-specific disruption of the respiratory control in adult rats, we postulate that it might affect respiratory control modulation induced by ovarian steroids in female rats. The hypoxic ventilatory response (HVR) of adult female rats exposed to neonatal maternal separation (NMS) is ∼30% smaller than controls (24), but consequences of NMS on respiratory control in aging female rats are unknown. To address this issue, whole body plethysmography was used to evaluate the impact of NMS on the HVR (12% O2, 20 min) of middle-aged (MA; ∼57 wk old) female rats. Pups subjected to NMS were placed in an incubator 3 h/day for 10 consecutive days (P3 to P12). Controls were undisturbed. To determine whether the effects were related to sexual hormone decline or aging per se, experiments were repeated on bilaterally ovariectomized (OVX) young (∼12 wk old) adult female rats. OVX and MA both reduced the HVR significantly in control rats but had little effect on the HVR of NMS females. OVX (but not aging) reduced the anapyrexic response in both control and NMS animals. These results show that hormonal decline decreases the HVR of control animals, while leaving that of NMS female animals unaffected. This suggests that neonatal stress alters the interaction between sex hormone regulation and the development of body temperature, hormonal, and ventilatory responses to hypoxia.

  6. Effect of jute dust exposure on ventilatory function and the pertinence of cough and smoking to the response.

    Science.gov (United States)

    Chattopadhyay, B P; Alams, J; Gangopadhyay, P K; Saiyed, H N

    1995-06-01

    The ventilatory capacity of 32 men exposed to jute dust in the jute industry, was estimated at the beginning and end of shifts on the first day and last day of a working week. A detailed occupational, clinical and smoking history was recorded and a more detailed questionnaire on respiratory symptoms was completed prior to the pulmonary function tests. The presence of a productive cough among workers was noted. A mean decrease of forced expiratory volume at one second (FEV1) was observed among workers according to processes, concentration of dust exposure and smoking habit on the first day and last day of the week. The mean difference of values was observed in most of the comparisons but only a few were statistically significant. Low mean values of FEV1 were observed in workers having high dust exposure, a smoking history and productive cough in comparison to the low dust exposure group, non-smokers and workers without cough symptoms. The significant deterioration of FEV1 was found between before shift and after shift values of the low dust exposed group of workers who had a cough and smoking history. The relevance of these factors on the ventilatory function is observed and discussed.

  7. Drenagem venosa assistida através da utilização controlada de vácuo no reservatório venoso do oxigenador Assisted venous drainage using an adjustable vacuum system: a clinical study

    Directory of Open Access Journals (Sweden)

    Luiz Fernando CANÊO

    1999-04-01

    Full Text Available Nas operações minimamente invasivas o uso de cânula de menor calibre facilita a realização dos procedimentos cirúrgicos, mas, por outro lado, a drenagem venosa pode ser prejudicada. O emprego de vácuo no reservatório venoso do oxigenador é uma maneira simples e de baixo custo na correção do problema. O objetivo deste trabalho é apresentar nossa experiência com um dispositivo que permite além da utilização do vácuo, a sua regulagem conforme a necessidade específica do paciente e cânula empregada. Esse dispositivo consiste de uma válvula reguladora de vácuo, um filtro para a retenção de líquidos do ar aspirado e um manômetro eletrônico de pressão negativa. Os testes de bancada evidenciaram eficiência e segurança na aplicação da pressão negativa no oxigenador até 250 mmHg em temperaturas de até 40oC. O estudo clínico consistiu, inicialmente, na aplicação em 11 pacientes com esternotomia total. Posteriormente, foi utilizado em esternotomias parciais para tratamento da doença isolada da valva aórtica em 5 casos (L invertido e 4 casos de atriosseptoplastia. Esse dispositivo permitiu a utilização de cânulas de diâmetros menores que as cânulas únicas convencionais, variando de 32 a 26 Fr, com a utilização de pressões negativas de 62,40 ± 11,69 mmHg com drenagem venosa satisfatória, sem evidências indiretas de hemólise. O dispositivo por nós idealizado permitiu a drenagem venosa assistida com a utilização de vácuo de forma controlada, segura e eficiente.The use of small cannulae improves surgical field visualization in minimally invasive cardiac surgery, but may compromise the venous drainage. Vacuum assisted venous drainage is a simple and nonexpensive solution to this problem. We report our clinical experience using a device consisting of a negative pressure regulator, a vacuum line filter and an electronic manometer. The safety and efficacy of this CPB system was first tested in vitro, applying a

  8. Assistive Technology

    Science.gov (United States)

    ... Page Resize Text Printer Friendly Online Chat Assistive Technology Assistive technology (AT) is any service or tool that helps ... be difficult or impossible. For older adults, such technology may be a walker to improve mobility or ...

  9. Auto Adjusting Astronomical Telescope

    Directory of Open Access Journals (Sweden)

    Rohit R. Ghalsasi

    2014-04-01

    Full Text Available Astronomical telescope is powerful and basic tool for star or celestial observation. Here we proposed integrated system using Raspberry Pi for auto adjusting astronomical telescope. This integrated circuit helps to control stellar monitoring, stellar targeting, and tracking functions of telescope. Astro compass gives the direction of the celestial objects.

  10. Psychological Adjustment and Homosexuality.

    Science.gov (United States)

    Gonsiorek, John C.

    In this paper, the diverse literature bearing on the topic of homosexuality and psychological adjustment is critically reviewed and synthesized. The first chapter discusses the most crucial methodological issue in this area, the problem of sampling. The kinds of samples used to date are critically examined, and some suggestions for improved…

  11. 7 CFR 1580.302 - Technical assistance and services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Technical assistance and services. 1580.302 Section... SERVICE, DEPARTMENT OF AGRICULTURE TRADE ADJUSTMENT ASSISTANCE FOR FARMERS § 1580.302 Technical assistance... may apply for and receive information and technical assistance from the Extension Service that will...

  12. Assistive Technologies

    Science.gov (United States)

    Auat Cheein, Fernando A., Ed.

    2012-01-01

    This book offers the reader new achievements within the Assistive Technology field made by worldwide experts, covering aspects such as assistive technology focused on teaching and education, mobility, communication and social interactivity, among others. Each chapter included in this book covers one particular aspect of Assistive Technology that…

  13. Oxygenation Threshold Derived from Near-Infrared Spectroscopy: Reliability and Its Relationship with the First Ventilatory Threshold

    Science.gov (United States)

    Jaspers, Richard T.; Blokland, Ilse J.; Achterberg, Chantal; Visser, Jurrian M.; den Uil, Anne R.; Hofmijster, Mathijs J.; Levels, Koen; Noordhof, Dionne A.; de Haan, Arnold; de Koning, Jos J.; van der Laarse, Willem J.; de Ruiter, Cornelis J.

    2016-01-01

    Background Near-infrared spectroscopy (NIRS) measurements of oxygenation reflect O2 delivery and utilization in exercising muscle and may improve detection of a critical exercise threshold. Purpose First, to detect an oxygenation breakpoint (Δ[O2HbMb-HHbMb]-BP) and compare this breakpoint to ventilatory thresholds during a maximal incremental test across sexes and training status. Second, to assess reproducibility of NIRS signals and exercise thresholds and investigate confounding effects of adipose tissue thickness on NIRS measurements. Methods Forty subjects (10 trained male cyclists, 10 trained female cyclists, 11 endurance trained males and 9 recreationally trained males) performed maximal incremental cycling exercise to determine Δ[O2HbMb-HHbMb]-BP and ventilatory thresholds (VT1 and VT2). Muscle haemoglobin and myoglobin O2 oxygenation ([HHbMb], [O2HbMb], SmO2) was determined in m. vastus lateralis. Δ[O2HbMb-HHbMb]-BP was determined by double linear regression. Trained cyclists performed the maximal incremental test twice to assess reproducibility. Adipose tissue thickness (ATT) was determined by skinfold measurements. Results Δ[O2HbMb-HHbMb]-BP was not different from VT1, but only moderately related (r = 0.58–0.63, p<0.001). VT1 was different across sexes and training status, whereas Δ[O2HbMb-HHbMb]-BP differed only across sexes. Reproducibility was high for SmO2 (ICC = 0.69–0.97), Δ[O2HbMb-HHbMb]-BP (ICC = 0.80–0.88) and ventilatory thresholds (ICC = 0.96–0.99). SmO2 at peak exercise and at occlusion were strongly related to adipose tissue thickness (r2 = 0.81, p<0.001; r2 = 0.79, p<0.001). Moreover, ATT was related to asymmetric changes in Δ[HHbMb] and Δ[O2HbMb] during incremental exercise (r = -0.64, p<0.001) and during occlusion (r = -0.50, p<0.05). Conclusion Although the oxygenation threshold is reproducible and potentially a suitable exercise threshold, VT1 discriminates better across sexes and training status during maximal stepwise

  14. Heart rate response during a simulated Olympic boxing match is predominantly above ventilatory threshold 2: a cross sectional study

    Directory of Open Access Journals (Sweden)

    de Lira CA

    2013-07-01

    Full Text Available Claudio Andre Barbosa de Lira,1 Luiz Fernando Peixinho-Pena,2 Rodrigo Luiz Vancini1,2 Rafael Júlio de Freitas Guina Fachina,3,4 Alexandre Aparecido de Almeida,2 Marília dos Santos Andrade,2 Antonio Carlos da Silva2 1Setor de Fisiologia Humana e do Exercício, Universidade Federal de Goiás (UFG, Câmpus Jataí, Jataí, GO, Brazil; 2Departamento de Fisiologia, Universidade Federal de São Paulo (UNIFESP, São Paulo, SP, Brazil; 3Departamento de Ciência do Esporte, Faculdade de Educação Física (FEF, Universidade Estadual de Campinas (UNICAMP, Campinas, Brazil; 4Confederação Brasileira de Basketball (CBB, Rio de Janeiro, Brazil Abstract: The present study aimed to describe heart rate (HR responses during a simulated Olympic boxing match and examine physiological parameters of boxing athletes. Ten highly trained Olympic boxing athletes (six men and four women performed a maximal graded exercise test on a motorized treadmill to determine maximal oxygen uptake (52.2 mL · kg-1 · min-1 ± 7.2 mL · kg-1 · min-1 and ventilatory thresholds 1 and 2. Ventilatory thresholds 1 and 2 were used to classify the intensity of exercise based on respective HR during a boxing match. In addition, oxygen uptake (VO2 was estimated during the match based on the HR response and the HR-VO2 relationship obtained from a maximal graded exercise test for each participant. On a separate day, participants performed a boxing match lasting three rounds, 2 minutes each, with a 1-minute recovery period between each round, during which HR was measured. In this context, HR and VO2 were above ventilatory threshold 2 during 219.8 seconds ± 67.4 seconds. There was an increase in HR and VO2 as a function of round (round 3 < round 2 < round 1, P < 0.0001.These findings may direct individual training programs for boxing practitioners and other athletes. Keywords: heart rate, physiological profile, intermittent exercise, combat sports, boxing

  15. Ventilatory long-term facilitation is evident after initial and repeated exposure to intermittent hypoxia in mice genetically depleted of brain serotonin.

    Science.gov (United States)

    Hickner, Stephen; Hussain, Najaah; Angoa-Perez, Mariana; Francescutti, Dina M; Kuhn, Donald M; Mateika, Jason H

    2014-02-01

    Our study was designed to determine if central nervous system (CNS) serotonin is required for the induction of ventilatory long-term facilitation (LTF) in intact, spontaneously breathing mice. Nineteen tryptophan hydroxylase 2-deficient (Tph2(-/-)) mice, devoid of serotonin in the CNS, and their wild-type counterparts (Tph2(+/+)) were exposed to intermittent hypoxia each day for 10 consecutive days. The ventilatory response to intermittent hypoxia was greater in the Tph2(+/+) compared with the Tph2(-/-) mice (1.10 ± 0.10 vs. 0.77 ± 0.01 ml min(-1)·percent(-1) oxygen; P ≤ 0.04). Ventilatory LTF, caused by increases in breathing frequency, was evident in Tph2(+/+) and Tph2(-/-) mice following exposure to intermittent hypoxia each day; however, the magnitude of the response was greater in the Tph2(+/+) compared with the Tph2(-/-) mice (1.11 ± 0.02 vs. 1.05 ± 0.01 normalized to baseline on each day; P ≤ 0.01). The magnitude of ventilatory LTF increased significantly from the initial to the finals days of the protocol in the Tph2(-/-) (1.06 ± 0.02 vs. 1.11 ± 0.03 normalized to baseline on the initial days; P ≤ 0.004) but not in the Tph2(+/+) mice. This enhanced response was mediated by increases in tidal volume. Body temperature and metabolic rate did not account for differences in the magnitude of ventilatory LTF observed between groups after acute and repeated daily exposure to intermittent hypoxia. We conclude that ventilatory LTF, after acute exposure to intermittent hypoxia, is mediated by increases in breathing frequency and occurs in the absence of serotonin, although the magnitude of the response is diminished. This weakened response is enhanced following repeated daily exposure to intermittent hypoxia, via increases in tidal volume, to a similar magnitude evident in Tph2(+/+) mice. Thus the magnitude of ventilatory LTF following repeated daily exposure to intermittent hypoxia is not dependent on the presence of CNS serotonin.

  16. Housing Assistance

    Directory of Open Access Journals (Sweden)

    Emma Baker

    2013-07-01

    Full Text Available In Australia, an increasing number of households face problems of access to suitable housing in the private market. In response, the Federal and State Governments share responsibility for providing housing assistance to these, mainly low-income, households. A broad range of policy instruments are used to provide and maintain housing assistance across all housing tenures, for example, assisting entry into homeownership, providing affordability assistance in the private rental market, and the provision of socially owned and managed housing options. Underlying each of these interventions is the premise that secure, affordable, and appropriate housing provides not only shelter but also a number of nonshelter benefits to individuals and their households. Although the nonshelter outcomes of housing are well acknowledged in Australia, the understanding of the nonshelter outcomes of housing assistance is less clear. This paper explores nonshelter outcomes of three of the major forms of housing assistance provided by Australian governments—low-income mortgage assistance, social housing, and private rent assistance. It is based upon analysis of a survey of 1,353 low-income recipients of housing assistance, and specifically measures the formulation of health and well-being, financial stress, and housing satisfaction outcomes across these three assistance types. We find clear evidence that health, finance, and housing satisfaction outcomes are associated with quite different factors for individuals in these three major housing assistance types.

  17. Ventricular assist device

    Science.gov (United States)

    VAD; RVAD; LVAD; BVAD; Right ventricular assist device; Left ventricular assist device; Biventricular assist device; Heart pump; Left ventricular assist system; LVAS; Implantable ventricular assist device

  18. Comparison of heart rate deflection and ventilatory threshold during a field cross-country roller-skiing test.

    Science.gov (United States)

    Fabre, Nicolas; Passelergue, Philippe; Bouvard, Marc; Perrey, Stéphane

    2008-11-01

    This study was to assess whether the point of deflection from linearity of heart rate (HRd) could be an accurate predictor of ventilatory threshold (VT2) during a specific cross-country roller-skiing (RS) test. Ten well-trained cross-country skiers performed a maximal and incremental RS test in the field and a standardized maximal and incremental treadmill running (TR) test in the laboratory. Values of oxygen uptake (VO2) and heart rate (HR) were continuously recorded during all exercises by a portable breath-by-breath gas exchange measurement system and a wireless Polar monitoring system, respectively. The VT2 and HRd points were individually determined by visual analysis during RS. Maximal VO2 (VO2 max) and HR were higher (p cross-country coaches and skiers to evaluate and control specific aerobic training loads.

  19. Metric adjusted skew information

    DEFF Research Database (Denmark)

    Hansen, Frank

    2008-01-01

    establish a connection between the geometrical formulation of quantum statistics as proposed by Chentsov and Morozova and measures of quantum information as introduced by Wigner and Yanase and extended in this article. We show that the set of normalized Morozova-Chentsov functions describing the possible...... quantum statistics is a Bauer simplex and determine its extreme points. We determine a particularly simple skew information, the "¿-skew information," parametrized by a ¿ ¿ (0, 1], and show that the convex cone this family generates coincides with the set of all metric adjusted skew informations.......We extend the concept of Wigner-Yanase-Dyson skew information to something we call "metric adjusted skew information" (of a state with respect to a conserved observable). This "skew information" is intended to be a non-negative quantity bounded by the variance (of an observable in a state...

  20. Fiscal adjustment in Brazil

    Directory of Open Access Journals (Sweden)

    Fabiana Rocha

    2003-03-01

    Full Text Available Two questions are addressed in this paper. The first one is the determination of periods of fiscal consolidation and fiscal stimulus. The second one is the importance of the composition of fiscal adjustments for their success, defined as a declining debt to GDP ratio. We, characterize 1994 and 1999 as points of fiscal consolidation. The 1994 consolidation can not be considered successful since after that period the debt to GDP ratio has grown continuously. The adjustment can be characterized as a type 2 adjustment (Alesina and Perotti (1997 in the sense that cuts were made mainly in public investment, while government wages and transfers remained almost unchanged. This type of adjustment usually has a low likelihood of being a success.Duas questões são tratadas neste artigo. A primeira é a determinação dos períodos de consolidação fiscal e estímulo fiscal. A segunda questão é a importância da composição dos ajustamentos fiscais para o seu sucesso, definido como um declínio na razo dívida/PIB. Nós, caracterizamos 1994 e 1999 como pontos de consolidação fiscal. A consolidação de 1994 não pode ser considerada um sucesso pois nos anos seguintes a razão dívida/PIB cresceu continuamente. O ajustamento pode ser considerado como um ajustamento do tipo 2 (Alesina and Perotti, 1997 no sentido de que foram feitos cortes principalmente no investimento público, enquanto os salários e transferências permaneceram praticamente inalterados. Este tipo de ajustamento geralmente tem uma baixa probabilidade de sucesso.

  1. [Parameters of oxygen uptake and carbon dioxide output ventilatory efficiency during exercise are index of circulatory function in normal subjects].

    Science.gov (United States)

    Sun, Xingguo; Wang, Guizhi; Lyu, Jing; Tan, Xiaoyue; William, W Stringer; Karlman, Wasserman

    2014-12-01

    To observe oxygen uptake efficiency plateau (OUEP, i.e.highest V˙O2/V˙E) and carbon dioxide output efficiency (lowest V˙E/V˙CO2) parameter changes during exercise in normal subjects. Five healthy volunteers performed the symptom limited maximal cardiopulmonary exercise test (CPET) at Harbor-UCLA Medical Center. V˙O2/V˙E and V˙E/V˙CO2 were determined by both arterial and central venous catheters. After blood gas analysis of arterial and venous sampling at the last 30 seconds of every exercise stage and every minute of incremental loading, the continuous parameter changes of hemodynamics, pulmonary ventilation were monitored and oxygen uptake ventilatory efficiency (V˙O2/V˙E and V˙E/V˙CO2) was calculated. During CPET, as the loading gradually increased, cardiac output, heart rate, mixed venous oxygen saturation, arteriovenous oxygen difference, minute ventilation, minute alveolar ventilation, tidal volume, alveolar ventilation and pulmonary ventilation perfusion ratio increased near-linearly (P change (P > 0.05); stroke volume, respiratory rate, arterial partial pressure of carbon dioxide, arterial blood hydrogen ion concentration and dead space ventilation ratio significantly changed none-linearly (compare resting state P exercise increased from 30.9 ± 3.3 at resting state to the highest plateau 46.0 ± 4.7 (P exercise. The V˙E/V˙CO2 during exercise decreased from the resting state (39.2 ± 6.5) to the minimum value (24.2 ± 2.4) after AT for a few minutes (P > 0.05 vs.earlier stage), then gradually increased after the ventilatory compensation point (P exercise. Cardiac and lung function as well as metabolism change during CPET is synchronous.In the absence of pulmonary limit, appearing before and after anaerobic threshold, OUEP and lowest V˙E/V˙CO2 could be used as reliable parameters representing the circulatory function.

  2. Association of toxic and essential metals with atopy markers and ventilatory lung function in women and men

    Energy Technology Data Exchange (ETDEWEB)

    Pizent, Alica [Institute for Medical Research and Occupational Health, Zagreb (Croatia)], E-mail: apizent@imi.hr; Macan, Jelena; Jurasovic, Jasna; Varnai, Veda Marija; Milkovic-Kraus, Sanja; Kanceljak-Macan, Bozica [Institute for Medical Research and Occupational Health, Zagreb (Croatia)

    2008-02-15

    The association of age, smoking, alcohol, superoxide dismutase (SOD), glutathione peroxidase (GPx), blood lead (BPb) and cadmium (BCd) levels, and serum levels of copper (SCu), zinc (SZn) and selenium (SSe) with atopic status and ventilatory function was examined in the groups of 166 women and 50 men with no occupational exposure to metals or other xenobiotics. Markers of atopy included serum total IgE, skin prick test (SPT) to common inhalatory allergens, non-specific nasal reactivity (NNR) and non-specific bronchial reactivity (NBR). Parameters of ventilatory function included forced vital capacity (FVC) and forced expiratory volume in the first second (FEV{sub 1}). Significantly higher BPb, SZn, IgE and prevalence of positive SPT, and lower SCu and NNR was found in men than in women. Fifteen women taking female sex hormones (HT) had significantly higher SCu than women without HT. Regression models showed significant inverse associations between IgE and SCu (P = 0.021) and NNR and SCu (P = 0.044) in women. When excluding women with HT, the association of SCu and total IgE became of borderline significance (P = 0.051), association between SCu and NNR disappeared, and significant positive association between total IgE and BPb emerged (P = 0.046). In men, significant inverse association was found between positive SPT and SSe, and between NBR and SSe. A decrease in FVC% and FEV{sub 1}% was associated with an increase in smoking intensity (P < 0.001) and a decrease in SZn (P = 0.043 and P = 0.053, respectively). These results were observed at the levels of the metals comparable to those in general populations worldwide. The observed differences between men and women may partly be explained by different levels of relevant toxic and essential metals, and their combination. The role of female HT in associations of atopy markers and SCu should be further investigated.

  3. Association of ADAM33 gene polymorphism and arginase activity with susceptibility to ventilatory impairment in wood dust-exposed workers.

    Science.gov (United States)

    Saad-Hussein, A; Thabet, E H; Taha, M M; Shahy, E M; Mahdy-Abdallah, H

    2016-09-01

    ADAM33 represents an important gene of susceptibility for lung function impairment. This work aimed to evaluate the association between genetic polymorphism of ADAM33 at four single nucleotide polymorphisms (T1, T2, S1, and Q1) and arginase activity with respiratory functions impairment in wood workers. The study was done to compare ventilatory functions and arginase activity of 82 wood workers and 81 controls. Genotyping was determined by using the polymerase chain restriction fragment length polymorphism method. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and peak expiratory flow rate (PEF) of the workers were significantly reduced compared with the controls. T1 single nucleotide polymorphism (SNP) was associated with obvious decline in the FEV1, FVC, and PEF in wood workers, while T2 SNP was associated with decline in FEV1 and PEF. A significant increase in arginase activity was found in T2 and S1 SNPs of the exposed workers. Increase in duration of exposure was correlated with the decline in ventilatory functions. This inverse correlation was significant for pulmonary function indices in AA and GG genotypes of T1 and T2, respectively. Moreover, significance was detected for FVC and FEV1 in AA and GA genotypes of S1 and Q1. A positive correlation between arginase activity and duration of exposure was found to be significant in GG genotype of S1 SNP. An association between ADAM33 gene polymorphism and impaired lung functions was detected in wood dust-exposed workers. Arginase activity may play an associated important role in increasing this impairment in wood workers.

  4. Anesthetic management of robot-assisted thoracoscopic thymectomy

    Directory of Open Access Journals (Sweden)

    Anil Karlekar

    2016-01-01

    Full Text Available Myasthenia gravis (MG is a rare disorder involving neuromuscular junction. In conjunction with medical therapy, thymectomy is a known modality of treatment of MG and has shown to increase the probability of remission and overall symptomatic improvement. For minimally invasive thymectomy, video-.assisted thoracoscopic surgery has been the preferred surgical approach till recently. The robotic surgical procedure must necessarily bring new challenges to the anesthesiologists to effectively meet the specific requirements of the technique. At present, there is a paucity of literature regarding the anesthetic concerns of robotic assisted thymectomy, patient in question specifically posed a challenge since different maneuvers and techniques had to be tried to obtain optimum surgical conditions with stable ventilatory and hemodynamic parameters. Concerns of patient positioning and hemodynamic monitoring have also been discussed.

  5. Influence of the ventilatory mode on acute adverse effects and facial thermography after noninvasive ventilation.

    Science.gov (United States)

    Pontes, Suzy Maria Montenegro; Melo, Luiz Henrique de Paula; Maia, Nathalia Parente de Sousa; Nogueira, Andrea da Nóbrega Cirino; Vasconcelos, Thiago Brasileiro; Pereira, Eanes Delgado Barros; Bastos, Vasco Pinheiro Diógenes; Holanda, Marcelo Alcantara

    2017-01-01

    To compare the incidence and intensity of acute adverse effects and the variation in the temperature of facial skin by thermography after the use of noninvasive ventilation (NIV). We included 20 healthy volunteers receiving NIV via oronasal mask for 1 h. The volunteers were randomly divided into two groups according to the ventilatory mode: bilevel positive airway pressure (BiPAP) or continuous positive airway pressure (CPAP). Facial thermography was performed in order to determine the temperature of the face where it was in contact with the mask and of the nasal dorsum at various time points. After removal of the mask, the volunteers completed a questionnaire about adverse effects of NIV. The incidence and intensity of acute adverse effects were higher in the individuals receiving BiPAP than in those receiving CPAP (16.1% vs. 5.6%). Thermographic analysis showed a significant cooling of the facial skin in the two regions of interest immediately after removal of the mask. The more intense acute adverse effects occurred predominantly among the participants in whom the decrease in the mean temperature of the nasal dorsum was lower (14.4% vs. 7.2%). The thermographic visual analysis of the zones of cooling and heating on the face identified areas of hypoperfusion or reactive hyperemia. The use of BiPAP mode was associated with a higher incidence and intensity of NIV-related acute adverse effects. There was an association between acute adverse effects and less cooling of the nasal dorsum immediately after removal of the mask. Cutaneous thermography can be an additional tool to detect adverse effects that the use of NIV has on facial skin. Comparar a incidência e a intensidade de efeitos adversos agudos e a variação da temperatura da pele da face através da termografia após a aplicação de ventilação não invasiva (VNI). Foram incluídos 20 voluntários sadios, de ambos os gêneros, submetidos à VNI com máscara oronasal por 1 h e divididos aleatoriamente em

  6. 13 CFR 107.1540 - Distributions by Licensee-Prioritized Payments and Adjustments.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Distributions by Licensee-Prioritized Payments and Adjustments. 107.1540 Section 107.1540 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS INVESTMENT COMPANIES SBA Financial Assistance for Licensees...

  7. 75 FR 42376 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-21

    ...% Puerto Rico Coffee Export Board, Inc. on behalf of coffee producers in Puerto Rico. The Administrator will determine within 40 days whether increasing imports of coffee contributed importantly to a greater than 15-percent decrease in the average annual price, production quantity, or production value...

  8. 75 FR 9087 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-03-01

    ...) Reflect the skills gained by the producer through the courses described in paragraph (c) of this section; and (2) Demonstrate how the producer will apply those skills to the circumstances of the producer. (e... certification from a certified public accountant or attorney, that relied upon information from a...

  9. 75 FR 62759 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-10-13

    ... data for the most recent, full marketing year or full official marketing season, a greater than 15... marketing period, contributed importantly to the decrease in one of the above factors for the agricultural..., Farm Service Agency, Agricultural Marketing Service, and FAS. After a review, the...

  10. 75 FR 41433 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... price, quantity of production, value of production, or cash receipts. According to the statute, it is... qualify under the program, Subtitle C of Title I of the Trade Act of 2002 (Pub. L. 107-210) states that...

  11. 75 FR 59684 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-09-28

    ...: national average price, quantity of production, value of production, or cash receipts. According to the... INFORMATION: To qualify under the program, Subtitle C of Title I of the Trade Act of 2002 (Pub. L. 107-210... value of wool production for 2009, when compared to the previous 3-year period. However, the import data...

  12. 75 FR 41430 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... average price, quantity of production, value of production, or cash receipts. According to the statute, it...: To qualify under the program, Subtitle C of Title I of the Trade Act of 2002 (Pub. L. 107-210) states...

  13. Trade Adjustment Assistant: Experiences of Six Trade-Impacted Communities

    Science.gov (United States)

    2001-08-01

    Mexico have contributed to their loss of employment. Once a TAA or NAFTA-TAA petition is approved covered workers must meet several tests regarding...used as a Workforce Development Center and a Business Resource Center. The second loan was made in March 2001, for $180,000 to La Mujer Obrera, an...the former Levi- Strauss plant and a $1.2 million grant to La Mujer Obrera, an advocacy group for dislocated women workers. Watsonville and El Paso

  14. Adjustment Criterion and Algorithm in Adjustment Model with Uncertain

    Directory of Open Access Journals (Sweden)

    SONG Yingchun

    2015-02-01

    Full Text Available Uncertainty often exists in the process of obtaining measurement data, which affects the reliability of parameter estimation. This paper establishes a new adjustment model in which uncertainty is incorporated into the function model as a parameter. A new adjustment criterion and its iterative algorithm are given based on uncertainty propagation law in the residual error, in which the maximum possible uncertainty is minimized. This paper also analyzes, with examples, the different adjustment criteria and features of optimal solutions about the least-squares adjustment, the uncertainty adjustment and total least-squares adjustment. Existing error theory is extended with new observational data processing method about uncertainty.

  15. Sustainable urban regime adjustments

    DEFF Research Database (Denmark)

    Quitzau, Maj-Britt; Jensen, Jens Stissing; Elle, Morten

    2013-01-01

    The endogenous agency that urban governments increasingly portray by making conscious and planned efforts to adjust the regimes they operate within is currently not well captured in transition studies. There is a need to acknowledge the ambiguity of regime enactment at the urban scale. This directs...... attention to the transformative implications of conscious strategic maneuvering by incumbent regime actors, when confronting regime structurations. This article provides insight to processes of regime enactment performed by local governments by applying a flow-oriented perspective on regime dynamics...

  16. Adjustable Reeds For Weaving

    Science.gov (United States)

    Farley, Gary L.

    1994-01-01

    Local characteristics of fabrics varied to suit special applications. Adjustable reed machinery proposed for use in weaving fabrics in various net shapes, widths, yarn spacings, and yarn angles. Locations of edges of fabric and configuration of warp and filling yarns varied along fabric to obtain specified properties. In machinery, reed wires mounted in groups on sliders, mounted on lengthwise rails in reed frame. Mechanisms incorporated to move sliders lengthwise, parallel to warp yarns, by sliding them along rails; move sliders crosswise by translating reed frame rails perpendicular to warp yarns; and crosswise by spreading reed rails within group. Profile of reed wires in group on each slider changed.

  17. Jordan Adjusted Human Development

    OpenAIRE

    Ababsa, Myriam

    2014-01-01

    Jordan Human Development Index (HDI) and Adjusted Human Development Index (IHDI) In 1990, the United Nations Development Programme designed a Human Development Index composed of life expectancy at birth, level of education and gross domestic product (GDP) per capita. In 2011, the UNDP ranked Jordan 95th out of 187 countries with a human development index of 0.698, up from 0.591 in 1990, making it the leading medium-range country for human development (fig. VIII.1). In 2010, the inequality adj...

  18. Adjusting to the Emergent

    DEFF Research Database (Denmark)

    Revsbæk, Line

    of ‘adjusting to the emergent’. Newcomer innovation is portrayed as carrying a variety of possible significations, such as unintentional innovation effects of newcomer’s proactive self-socializing behavior; an inspirational basis for designing innovation-generating employee induction; ‘resonant instances...... in standardized induction programs where newcomers are cast in roles as insecure novices needing to be “taught the ropes” of the organizational culture. Linked with this, it is suggested that the prevailing dichotomy of ‘newcomer assimilation’ versus ‘organizational accommodation’ is replaced with a notion...

  19. Continuously adjustable Pulfrich spectacles

    Science.gov (United States)

    Jacobs, Ken; Karpf, Ron

    2011-03-01

    A number of Pulfrich 3-D movies and TV shows have been produced, but the standard implementation has inherent drawbacks. The movie and TV industries have correctly concluded that the standard Pulfrich 3-D implementation is not a useful 3-D technique. Continuously Adjustable Pulfrich Spectacles (CAPS) is a new implementation of the Pulfrich effect that allows any scene containing movement in a standard 2-D movie, which are most scenes, to be optionally viewed in 3-D using inexpensive viewing specs. Recent scientific results in the fields of human perception, optoelectronics, video compression and video format conversion are translated into a new implementation of Pulfrich 3- D. CAPS uses these results to continuously adjust to the movie so that the viewing spectacles always conform to the optical density that optimizes the Pulfrich stereoscopic illusion. CAPS instantly provides 3-D immersion to any moving scene in any 2-D movie. Without the glasses, the movie will appear as a normal 2-D image. CAPS work on any viewing device, and with any distribution medium. CAPS is appropriate for viewing Internet streamed movies in 3-D.

  20. Measuring Ventilatory Activity with Structured Light Plethysmography (SLP Reduces Instrumental Observer Effect and Preserves Tidal Breathing Variability in Healthy and COPD

    Directory of Open Access Journals (Sweden)

    Marie-Cécile Niérat

    2017-05-01

    Full Text Available The use of a mouthpiece to measure ventilatory flow with a pneumotachograph (PNT introduces a major perturbation to breathing (“instrumental/observer effect” and suffices to modify the respiratory behavior. Structured light plethysmography (SLP is a non-contact method of assessment of breathing pattern during tidal breathing. Firstly, we validated the SLP measurements by comparing timing components of the ventilatory pattern obtained by SLP vs. PNT under the same condition; secondly, we compared SLP to SLP+PNT measurements of breathing pattern to evaluate the disruption of breathing pattern and breathing variability in healthy and COPD subjects. Measurements were taken during tidal breathing with SLP alone and SLP+PNT recording in 30 COPD and healthy subjects. Measurements included: respiratory frequency (Rf, inspiratory, expiratory, and total breath time/duration (Ti, Te, and Tt. Passing-Bablok regression analysis was used to evaluate the interchangeability of timing components of the ventilatory pattern (Rf, Ti, Te, and Tt between measurements performed under the following experimental conditions: SLP vs. PNT, SLP+PNT vs. SLP, and SLP+PNT vs. PNT. The variability of different ventilatory variables was assessed through their coefficients of variation (CVs. In healthy: according to Passing-Bablok regression, Rf, TI, TE and TT were interchangeable between measurements obtained under the three experimental conditions (SLP vs. PNT, SLP+PNT vs. SLP, and SLP+PNT vs. PNT. All the CVs describing “traditional” ventilatory variables (Rf, Ti, Te, Ti/Te, and Ti/Tt were significantly smaller in SLP+PNT condition. This was not the case for more “specific” SLP-derived variables. In COPD: according to Passing-Bablok regression, Rf, TI, TE, and TT were interchangeable between measurements obtained under SLP vs. PNT and SLP+PNT vs. PNT, whereas only Rf, TE, and TT were interchangeable between measurements obtained under SLP+PNT vs. SLP. However, most

  1. Adjusting to the Emergent

    DEFF Research Database (Denmark)

    Revsbæk, Line

    In her doctoral thesis Line Revsbaek explores newcomer innovation related to organizational entry processes in a changing organization. She introduces process philosophy and complexity theory to research on organizational socialization and newcomer innovation. The study challenges assumptions...... in standardized induction programs where newcomers are cast in roles as insecure novices needing to be “taught the ropes” of the organizational culture. Linked with this, it is suggested that the prevailing dichotomy of ‘newcomer assimilation’ versus ‘organizational accommodation’ is replaced with a notion...... of ‘adjusting to the emergent’. Newcomer innovation is portrayed as carrying a variety of possible significations, such as unintentional innovation effects of newcomer’s proactive self-socializing behavior; an inspirational basis for designing innovation-generating employee induction; ‘resonant instances...

  2. Adolescent Mothers' Adjustment to Parenting.

    Science.gov (United States)

    Samuels, Valerie Jarvis; And Others

    1994-01-01

    Examined adolescent mothers' adjustment to parenting, self-esteem, social support, and perceptions of baby. Subjects (n=52) responded to questionnaires at two time periods approximately six months apart. Mothers with higher self-esteem at Time 1 had better adjustment at Time 2. Adjustment was predicted by Time 2 variables; contact with baby's…

  3. Adolescent Mothers' Adjustment to Parenting.

    Science.gov (United States)

    Samuels, Valerie Jarvis; And Others

    1994-01-01

    Examined adolescent mothers' adjustment to parenting, self-esteem, social support, and perceptions of baby. Subjects (n=52) responded to questionnaires at two time periods approximately six months apart. Mothers with higher self-esteem at Time 1 had better adjustment at Time 2. Adjustment was predicted by Time 2 variables; contact with baby's…

  4. Relationships (II) of International Classification of High-resolution Computed Tomography for Occupational and Environmental Respiratory Diseases with ventilatory functions indices for parenchymal abnormalities.

    Science.gov (United States)

    Tamura, Taro; Suganuma, Narufumi; Hering, Kurt G; Vehmas, Tapio; Itoh, Harumi; Akira, Masanori; Takashima, Yoshihiro; Hirano, Harukazu; Kusaka, Yukinori

    2015-01-01

    The International Classification of High-Resolution Computed Tomography (HRCT) for Occupational and Environmental Respiratory Diseases (ICOERD) is used to screen and diagnose respiratory illnesses. Using univariate and multivariate analysis, we investigated the relationship between subject characteristics and parenchymal abnormalities according to ICOERD, and the results of ventilatory function tests (VFT). Thirty-five patients with and 27 controls without mineral-dust exposure underwent VFT and HRCT. We recorded all subjects' occupational history for mineral dust exposure and smoking history. Experts independently assessed HRCT using the ICOERD parenchymal abnormalities (Items) grades for well-defined rounded opacities (RO), linear and/or irregular opacities (IR), and emphysema (EM). High-resolution computed tomography showed that 11 patients had RO; 15 patients, IR; and 19 patients, EM. According to the multiple regression model, age and height had significant associations with many indices ventilatory functions such as vital capacity, forced vital capacity, and forced expiratory volume in 1 s (FEV1). The EM summed grades on the upper, middle, and lower zones of the right and left lungs also had significant associations with FEV1 and the maximum mid-expiratory flow rate. The results suggest the ICOERD notation is adequate based on the good and significant multiple regression modeling of ventilatory function with the EM summed grades.

  5. 24 CFR 880.609 - Adjustment of contract rents.

    Science.gov (United States)

    2010-04-01

    ... date of the contract in accordance with 24 CFR part 888. (b) Special additional adjustments. For all... CFR part 883 projects, by the Agency and HUD), to reflect increases in the actual and necessary... for assisted units and comparable unassisted units except to the extent that the differences...

  6. Assisted Living

    Science.gov (United States)

    ... if needs change. Assisted living costs less than nursing home care. It is still fairly expensive. Older people or their families usually pay for it. Health and long-term care insurance policies may cover ...

  7. Unusual Ventilatory Response to Exercise in Patient with Arnold-Chiari Type 1 Malformation after Posterior Fossa Decompression

    Science.gov (United States)

    Smith, Keely; Gomez-Rubio, Ana M.; Harris, Tomika S.; Brooks, Lauren E.

    2016-01-01

    We present a case of a 17-year-old Hispanic male with Arnold-Chiari Type 1 [AC-Type 1] with syringomyelia, status post decompression, who complains of exercise intolerance, headaches, and fatigue with exertion. The patient was found to have diurnal hypercapnia and nocturnal alveolar hypoventilation. Cardiopulmonary testing revealed blunting of the ventilatory response to the rise in carbon dioxide (CO2) resulting in failure of the parallel correlation between increased CO2 levels and ventilation; the expected vertical relationship between PETCO2 and minute ventilation during exercise was replaced with an almost horizontal relationship. No new pathology of the brainstem was discovered by MRI or neurological evaluation to explain this phenomenon. The patient was placed on continuous noninvasive open ventilation (NIOV) during the day and CPAP at night for a period of 6 months. His pCO2 level decreased to normal limits and his symptoms improved; specifically, he experienced less headaches and fatigue during exercise. In this report, we describe the abnormal response to exercise that patients with AC-Type 1 could potentially experience, even after decompression, characterized by the impairment of ventilator response to hypercapnia during exertion, reflecting a complete loss of chemical influence on breathing with no evidence of abnormality in the corticospinal pathway. PMID:27418995

  8. Ventilatory responses to exercise and CO2 after menopause in healthy women: effects of age and fitness.

    Science.gov (United States)

    Davenport, Margie H; Beaudin, Andrew E; Brown, Allison D; Leigh, Richard; Poulin, Marc J

    2012-10-15

    The extent to which aging affects respiratory control in postmenopausal women remains relatively unknown. In a cross-sectional study of 39 postmenopausal women (50-79 years), we examined the influence of age and fitness on the ventilatory responses to hypercapnia (HCVR; +8 mmHg) and exercise (ΔV˙(E)/ΔV˙CO2) above and below the anaerobic threshold (AT). Data were analyzed using the full cohort, by age (younger postmenopausal: YPM, 50-64 years; and older postmenopausal: OPM, 65-79 years) and fitness as per our previous work (Active: V˙O2max ≥90% age-predicted values; and Sedentary: V˙O2max fitness, was inversely related to ΔV˙(E)/ΔV˙CO2 above AT (YPM: 46.8±11.5; OPM: 34.8±6.9, p<0.01) which may be explained, at least in part, by age-related declines in lung function. HCVR and ΔV˙(E)/ΔV˙CO2 were not correlated.

  9. [Analysis in pulmonary ventilatory function from 100 patients with ano-rectal diseases caused by deficiency of qi].

    Science.gov (United States)

    Wang, W

    1999-03-01

    To explore the pathogenesis of ano-rectal diseases caused by deficiency of Qi, which is correlated with obstruction of pulmonary ventilation. The pulmonary ventilatory function was measured in 100 patients with the internal piles, the interno-external hemorrhoid and prolapse of rectum, the prolapse of anus was the principal symptom of them. Data from the 100 patients showed that 67% of them were diagnosed with the obstruction of pulmonary ventilation, the ratio was far less in the health control group. FEV 1.0 (mean +/- s) (2011.65 +/- 875) ml, MMF (1.84 +/- 1.24) L/s and PEF (2.34 +/- 1.51) L/s in male patients, (1551.54 +/- 514) ml, (1.57 +/- 0.62) L/s and (1.85 +/- 0.92) L/s in female patients, but those values were higher in the control than in the patients. The statistical analysis was performed and the difference was significant between patients and the control group (P < 0.01). The patients with ano-rectal diseases caused by deficiency of Qi accompanied with obstruction of pulmonary ventilation in different degree and varied sorts, it confirmed that the pathogenesis of ano-rectal diseases caused by deficiency of Qi is related with "sinking of pectoral Qi".

  10. The modified Dmax method is reliable to predict the second ventilatory threshold in elite cross-country skiers.

    Science.gov (United States)

    Fabre, Nicolas; Balestreri, Filippo; Pellegrini, Barbara; Schena, Federico

    2010-06-01

    This study was designed to evaluate, in elite cross-country skiers, the capacity of the DMAX lactate threshold method and its modified version (DMAX MOD) to accurately predict the second ventilatory threshold (VT2). Twenty-three elite cross-country skiers carried out an incremental roller-ski test on a motorized treadmill. Ventilation, heart rate (HR), and gas exchanges were continuously recorded during the test. Blood was sampled at the end of each 3-minute work stage for lactate concentration measurements. The VT2 was individually determined by visual analysis. The DMAX, DMAX MOD points also with the 4 mmol.L(-1) fixed lactate concentration value (4 mM) were determined by a computerized program. Paired t tests showed nonsignificant differences between HR at VT2 and HR at DMAX MOD, between HR at VT2 and HR at 4 mM, and between HR at DMAX MOD and HR at 4 mM. HR at DMAX was significantly lower than HR at VT2, DMAX MOD, and at 4 mM (pcross-country skiers.

  11. Unusual Ventilatory Response to Exercise in Patient with Arnold-Chiari Type 1 Malformation after Posterior Fossa Decompression

    Directory of Open Access Journals (Sweden)

    Keely Smith

    2016-01-01

    Full Text Available We present a case of a 17-year-old Hispanic male with Arnold-Chiari Type 1 [AC-Type 1] with syringomyelia, status post decompression, who complains of exercise intolerance, headaches, and fatigue with exertion. The patient was found to have diurnal hypercapnia and nocturnal alveolar hypoventilation. Cardiopulmonary testing revealed blunting of the ventilatory response to the rise in carbon dioxide (CO2 resulting in failure of the parallel correlation between increased CO2 levels and ventilation; the expected vertical relationship between PETCO2 and minute ventilation during exercise was replaced with an almost horizontal relationship. No new pathology of the brainstem was discovered by MRI or neurological evaluation to explain this phenomenon. The patient was placed on continuous noninvasive open ventilation (NIOV during the day and CPAP at night for a period of 6 months. His pCO2 level decreased to normal limits and his symptoms improved; specifically, he experienced less headaches and fatigue during exercise. In this report, we describe the abnormal response to exercise that patients with AC-Type 1 could potentially experience, even after decompression, characterized by the impairment of ventilator response to hypercapnia during exertion, reflecting a complete loss of chemical influence on breathing with no evidence of abnormality in the corticospinal pathway.

  12. Ventilatory responses to carbon dioxide at low and high levels of oxygen are elevated after episodic hypoxia in men compared with women.

    Science.gov (United States)

    Morelli, Chris; Badr, M Safwan; Mateika, Jason H

    2004-11-01

    We hypothesized that the acute ventilatory response to carbon dioxide in the presence of low and high levels of oxygen would increase to a greater extent in men compared with women after exposure to episodic hypoxia. Eleven healthy men and women of similar race, age, and body mass index completed a series of rebreathing trials before and after exposure to eight 4-min episodes of hypoxia. During the rebreathing trials, subjects initially hyperventilated to reduce the end-tidal partial pressure of carbon dioxide (PetCO2) below 25 Torr. Subjects then rebreathed from a bag containing a normocapnic (42 Torr), low (50 Torr), or high oxygen gas mixture (150 Torr). During the trials, PetCO2 increased while the selected level of oxygen was maintained. The point at which minute ventilation began to rise in a linear fashion as PetCO2 increased was considered to be the carbon dioxide set point. The ventilatory response below and above this point was determined. The results showed that the ventilatory response to carbon dioxide above the set point was increased in men compared with women before exposure to episodic hypoxia, independent of the oxygen level that was maintained during the rebreathing trials (50 Torr: men, 5.19 +/- 0.82 vs. women, 4.70 +/- 0.77 l x min(-1) x Torr(-1); 150 Torr: men, 4.33 +/- 1.15 vs. women, 3.21 +/- 0.58 l x min(-1) x Torr(-1)). Moreover, relative to baseline measures, the ventilatory response to carbon dioxide in the presence of low and high oxygen levels increased to a greater extent in men compared with women after exposure to episodic hypoxia (50 Torr: men, 9.52 +/- 1.40 vs. women, 5.97 +/- 0.71 l x min(-1) x Torr(-1); 150 Torr: men, 5.73 +/- 0.81 vs. women, 3.83 +/- 0.56 l x min(-1) x Torr(-1)). Thus we conclude that enhancement of the acute ventilatory response to carbon dioxide after episodic hypoxia is sex dependent.

  13. Adjustment computations spatial data analysis

    CERN Document Server

    Ghilani, Charles D

    2011-01-01

    the complete guide to adjusting for measurement error-expanded and updated no measurement is ever exact. Adjustment Computations updates a classic, definitive text on surveying with the latest methodologies and tools for analyzing and adjusting errors with a focus on least squares adjustments, the most rigorous methodology available and the one on which accuracy standards for surveys are based. This extensively updated Fifth Edition shares new information on advances in modern software and GNSS-acquired data. Expanded sections offer a greater amount of computable problems and their worked solu

  14. Metric-adjusted skew information

    DEFF Research Database (Denmark)

    Liang, Cai; Hansen, Frank

    2010-01-01

    We give a truly elementary proof of the convexity of metric-adjusted skew information following an idea of Effros. We extend earlier results of weak forms of superadditivity to general metric-adjusted skew information. Recently, Luo and Zhang introduced the notion of semi-quantum states on a bipa......We give a truly elementary proof of the convexity of metric-adjusted skew information following an idea of Effros. We extend earlier results of weak forms of superadditivity to general metric-adjusted skew information. Recently, Luo and Zhang introduced the notion of semi-quantum states...

  15. Convexity Adjustments for ATS Models

    DEFF Research Database (Denmark)

    Murgoci, Agatha; Gaspar, Raquel M.

    Practitioners are used to value a broad class of exotic interest rate derivatives simply by preforming for what is known as convexity adjustments (or convexity corrections). We start by exploiting the relations between various interest rate models and their connections to measure changes. As a re......Practitioners are used to value a broad class of exotic interest rate derivatives simply by preforming for what is known as convexity adjustments (or convexity corrections). We start by exploiting the relations between various interest rate models and their connections to measure changes....... As a result we classify convexity adjustments into forward adjustments and swaps adjustments. We, then, focus on affine term structure (ATS) models and, in this context, conjecture convexity adjustments should be related of affine functionals. In the case of forward adjustments, we show how to obtain exact...... formulas. Concretely for LIBOR in arrears (LIA) contracts, we derive the system of Riccatti ODE-s one needs to compute to obtain the exact adjustment. Based upon the ideas of Schrager and Pelsser (2006) we are also able to derive general swap adjustments useful, in particular, when dealing with constant...

  16. Hearing Assistive Technology

    Science.gov (United States)

    ... for the Public / Hearing and Balance Hearing Assistive Technology Hearing Assistive Technology: FM Systems | Infrared Systems | Induction ... Assistive Technology Systems Solutions What are hearing assistive technology systems (HATS)? Hearing assistive technology systems (HATS) are ...

  17. Efeito da obesidade na função ventilatória Impact of obesity on ventilatory function

    Directory of Open Access Journals (Sweden)

    Perran Boran

    2007-04-01

    Full Text Available OBJETIVO: Embora a obesidade tenha sido associada ao comprometimento grave da ventilação, a maior parte da população estudada constitui-se de adultos com obesidade mórbida. Nosso objetivo foi investigar os efeitos da obesidade leve na função ventilatória de pacientes pediátricos. MÉTODOS: Estudo transversal controlado que analisou 80 pacientes (M/F: 35/45 avaliados em nosso ambulatório, com queixa de sobrepeso, sem histórico de asma ou de outras atopias, comparando-os a um grupo controle com 50 crianças de peso normal controladas para a idade e para o sexo. A média de idade dos pacientes foi de 9,7±2,5 anos (7 a 15 anos. Todos os indivíduos foram submetidos a medições antropométricas e à espirometria. A capacidade vital forçada (CVF e o volume expiratório forçado no primeiro segundo (VEF1 foram usados como medidas da função ventilatória. RESULTADOS: Não houve diferenças significativas nas VEF1%, CVF% e VEF1%/CVF% por grupo de estudo (p > 0,05. Apenas três pacientes tiveram alterações obstrutivas relatadas em seus testes de função pulmonar (dois tiveram alterações moderadamente graves e um teve alterações obstrutivas leves. Não houve correlação entre os parâmetros da função pulmonar e as medidas antropométricas. CONCLUSÃO: Esses dados mostram que os parâmetros do teste da função pulmonar em crianças com obesidade leve foram semelhantes àqueles das crianças com peso normal. As medidas antropométricas não mostraram nenhum efeito significativo nas medições espirométricas das crianças, como ocorreu nos adultos.OBJECTIVE: Although obesity was found to be associated with severe impairment of ventilation, most of the study population has been morbidly obese adults. We aimed to explore the effects of mild obesity on ventilatory function in the pediatric age group. METHODS: In a cross-sectional controlled study, 80 patients (M/F: 35/45, who were evaluated in our outpatient clinic with the complaint

  18. Specificity of VO2MAX and the ventilatory threshold in free swimming and cycle ergometry: comparison between triathletes and swimmers.

    Science.gov (United States)

    Roels, B; Schmitt, L; Libicz, S; Bentley, D; Richalet, J-P; Millet, G

    2005-12-01

    To compare maximal heart rate (HRmax), maximal oxygen consumption (VO2MAX), and the ventilatory threshold (VT; %VO2MAX) during cycle ergometry and free swimming between swimmers and triathletes. Nine swimmers and ten triathletes completed an incremental swimming and cycling test to exhaustion. Whole body metabolic responses were determined in each test. The swimmers exhibited a significantly higher VO2MAX in swimming than in cycling (58.4 (5.6) v 51.3 (5.1) ml/kg/min), whereas the opposite was found in the triathletes (53.0 (6.7) v 68.2 (6.8) ml/kg/min). HRmax was significantly different in the maximal cycling and swimming tests for the triathletes (188.6 (7.5) v 174.8 (9.0) beats/min). In the maximal swimming test, HRmax was significantly higher in the swimmers than in the triathletes (174.8 (9.0) v 184.6 (9.7) beats/min). No significant differences were found for VT measured in swimming and cycling in the triathletes and swimmers. This study confirms that the exercise testing mode affects the VO2MAX value, and that swimmers have very specific training adaptations even compared with triathletes. This may be a function of acute physiological responses combined with the specialist training status of the different athletes influencing maximal cardiac output or oxygen extraction. In contrast, the different training regimens do not seem to influence the VT, as this variable did not differ between the two testing modes in either group.

  19. LACTATE AND VENTILATORY THRESHOLDS REFLECT THE TRAINING STATUS OF PROFESSIONAL SOCCER PLAYERS WHERE MAXIMUM AEROBIC POWER IS UNCHANGED

    Directory of Open Access Journals (Sweden)

    N Clark

    2003-03-01

    Full Text Available The aim of this study was to investigate maximum aerobic power (VO2 max and anaerobic threshold (AT as determinants of training status among professional soccer players. Twelve professional 1st team British male soccer players (age: 26.2 ± 3.3 years, height: 1.77 ± 0.05 m, body mass: 79.3 ± 9.4 kg agreed to participate in the study and provided informed consent. All subjects completed a combined test of anaerobic threshold (AT and maximum aerobic power on two occasions: Test 1 following 5 weeks of low level activity at the end of the off-season and Test 2 immediately following conclusion of the competitive season. AT was assessed as both lactate threshold (LT and ventilatory threshold (VT. There was no change in VO2 max between Test 1 and Test 2 (63.3 ± 5.8 ml·kg-1·min-1 vs. 62.1 ± 4.9 ml·kg-1·min-1 respectively, however, the duration of exercise tolerance (ET at VO2 max was significantly extended from Test 1 to Test 2 (204 ± 54 vs. 228 ± 68 s respectively (P<0.01. LT oxygen consumption was significantly improved in Test 2 versus Test 1 (P<0.01 VT was also improved (P<0.05. There was no significant difference in VO2 (ml·kg-1·min-1 corresponding to LT and VT. The results of this study show that VO2 max is a less sensitive indicator to changes in training status in professional soccer players than either LT or VT.

  20. Validity of electromyographic fatigue threshold as a noninvasive method for tracking changes in ventilatory threshold in college-aged men.

    Science.gov (United States)

    Kendall, Kristina L; Smith, Abbie E; Graef, Jennifer L; Walter, Ashley A; Moon, Jordan R; Lockwood, Christopher M; Beck, Travis W; Cramer, Joel T; Stout, Jeffrey R

    2010-01-01

    The submaximal electromyographic fatigue threshold test (EMG(FT)) has been shown to be highly correlated to ventilatory threshold (VT) as determined from maximal graded exercise tests (GXTs). Recently, a prediction equation was developed using the EMG(FT) value to predict VT. The aim of this study, therefore, was to determine if this new equation could accurately track changes in VT after high-intensity interval training (HIIT). Eighteen recreationally trained men (mean +/- SD; age 22.4 +/- 3.2 years) performed a GXT to determine maximal oxygen consumption rate (V(O2)peak) and VT using breath-by-breath spirometry. Participants also completed a discontinuous incremental cycle ergometer test to determine their EMGFT value. A total of four 2-minute work bouts were completed to obtain 15-second averages of the electromyographic amplitude. The resulting slopes from each successive work bout were used to calculate EMG(FT). The EMG(FT) value from each participant was used to estimate VT from the recently developed equation. All participants trained 3 days a week for 6 weeks. Training consisted of 5 sets of 2-minute work bouts with 1 minute of rest in between. Repeated-measures analysis of variance indicated no significant difference between actual and predicted VT values after 3 weeks of training. However, there was a significant difference between the actual and predicted VT values after 6 weeks of training. These findings suggest that the EMG(FT) may be useful when tracking changes in VT after 3 weeks of HIIT in recreationally trained individuals. However, the use of EMG(FT) to predict VT does not seem to be valid for tracking changes after 6 weeks of HIIT. At this time, it is not recommended that EMG(FT) be used to predict and track changes in VT.

  1. Mood Adjustment via Mass Communication.

    Science.gov (United States)

    Knobloch, Silvia

    2003-01-01

    Proposes and experimentally tests mood adjustment approach, complementing mood management theory. Discusses how results regarding self-exposure across time show that patterns of popular music listening among a group of undergraduate students differ with initial mood and anticipation, lending support to mood adjustment hypotheses. Describes how…

  2. Spousal Adjustment to Myocardial Infarction.

    Science.gov (United States)

    Ziglar, Elisa J.

    This paper reviews the literature on the stresses and coping strategies of spouses of patients with myocardial infarction (MI). It attempts to identify specific problem areas of adjustment for the spouse and to explore the effects of spousal adjustment on patient recovery. Chapter one provides an overview of the importance in examining the…

  3. A complete generalized adjustment criterion

    NARCIS (Netherlands)

    Perković, Emilija; Textor, Johannes; Kalisch, Markus; Maathuis, Marloes H.

    2015-01-01

    Covariate adjustment is a widely used approach to estimate total causal effects from observational data. Several graphical criteria have been developed in recent years to identify valid covariates for adjustment from graphical causal models. These criteria can handle multiple causes, latent confound

  4. Teaching Assistants.

    Science.gov (United States)

    Feinman, Jay M.

    1991-01-01

    A discussion of teaching assistants (TAs) in the law school looks at the TA's cognitive and affective roles and effective ways to use TAs to reinforce usual forms of learning in the large class; introduce a broadened range of materials, skills, and learning methods; and transform the large class experience. (MSE)

  5. Assistive Devices

    Science.gov (United States)

    ... a number of assistive devices. These are tools, products or types of equipment that help you perform tasks and activities. They may help you move around, see, communicate, eat, or get dressed. Some are high-tech tools, such as computers. Others are much simpler, ...

  6. Bayes linear covariance matrix adjustment

    CERN Document Server

    Wilkinson, Darren J

    1995-01-01

    In this thesis, a Bayes linear methodology for the adjustment of covariance matrices is presented and discussed. A geometric framework for quantifying uncertainties about covariance matrices is set up, and an inner-product for spaces of random matrices is motivated and constructed. The inner-product on this space captures aspects of our beliefs about the relationship between covariance matrices of interest to us, providing a structure rich enough for us to adjust beliefs about unknown matrices in the light of data such as sample covariance matrices, exploiting second-order exchangeability and related specifications to obtain representations allowing analysis. Adjustment is associated with orthogonal projection, and illustrated with examples of adjustments for some common problems. The problem of adjusting the covariance matrices underlying exchangeable random vectors is tackled and discussed. Learning about the covariance matrices associated with multivariate time series dynamic linear models is shown to be a...

  7. Parental Divorce and Children's Adjustment.

    Science.gov (United States)

    Lansford, Jennifer E

    2009-03-01

    This article reviews the research literature on links between parental divorce and children's short-term and long-term adjustment. First, I consider evidence regarding how divorce relates to children's externalizing behaviors, internalizing problems, academic achievement, and social relationships. Second, I examine timing of the divorce, demographic characteristics, children's adjustment prior to the divorce, and stigmatization as moderators of the links between divorce and children's adjustment. Third, I examine income, interparental conflict, parenting, and parents well-being as mediators of relations between divorce and children's adjustment. Fourth, I note the caveats and limitations of the research literature. Finally, I consider notable policies related to grounds for divorce, child support, and child custody in light of how they might affect children s adjustment to their parents divorce.

  8. The effects of high intensity exercise during pulmonary rehabilitation on ventilatory parameters in people with moderate to severe stable COPD: a systematic review

    Directory of Open Access Journals (Sweden)

    Osterling K

    2014-10-01

    Full Text Available Kristin Osterling,1 Kimbly MacFadyen,1 Robert Gilbert,2 Gail Dechman1 1School of Physiotherapy, 2School of Health Sciences, Dalhousie University, Halifax, NS, Canada Objective: The objective of this systematic review was to determine whether people with moderate to severe COPD who are participating in pulmonary rehabilitation and exercising at high intensity demonstrate the changes in ventilatory parameters that are associated with decreased dyspnea. Data sources: The authors searched EMBASE, The Cochrane Library, and CINAHL databases up to December 2013 for relevant randomized control trials, systematic reviews, and observational studies. References of identified studies were also screened. Study selection: Studies conducted in a pulmonary rehabilitation setting that included education and exercise were included. Symptom-limited, graded exercise testing that measured tidal volume, respiratory rate, minute ventilation, and inspiratory capacity was required. The studies that contained these keywords in the title or the abstract were selected for further evaluation of the text. Disagreements between reviewers were resolved by consensus. Four studies met these inclusion criteria. Data extraction: Quality assessment and data extraction were performed independently by two reviewers. Risk of bias and quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. Data synthesis: Participants in three studies trained at high intensity (70%–80% maximum workload, demonstrating statistically significant changes in tidal volume and respiratory rate. One study did not demonstrate positive ventilatory benefits; however, participants may not have met the desired training intensity. Two studies reported improvement in dyspnea at submaximal exercise intensities. One study noted an increased maximum workload with no significant change in dyspnea at peak exercise. Conclusion: People with moderate to severe, stable COPD were able

  9. Managing psychosocial adjustment to aphasia.

    Science.gov (United States)

    Müller, D

    1999-01-01

    This article argues for incorporating psychosocial adjustment into treatment plans for people with aphasia. It proposes that rehabilitation is a social rather than a medical construct and that by adopting a broad range of intervention strategies, more effective approaches to reintegration can be adopted. Outcome measures relating to self-esteem are judged to be central to evaluating the efficacy of treatment. The role of social factors in managing psychosocial adjustment are considered alongside individual and family approaches to counseling. It is concluded that clinicians need to broaden their treatment program to include psychosocial adjustment in rehabilitation.

  10. Adjustable Induction-Heating Coil

    Science.gov (United States)

    Ellis, Rod; Bartolotta, Paul

    1990-01-01

    Improved design for induction-heating work coil facilitates optimization of heating in different metal specimens. Three segments adjusted independently to obtain desired distribution of temperature. Reduces time needed to achieve required temperature profiles.

  11. Household Adjustments to Hurricane Katrina

    National Research Council Canada - National Science Library

    Meri Davlasheridze; Qin Fan

    2017-01-01

    This paper examines household adjustments to Hurricane Katrina by estimating the effects of Katrina-induced damages on changes in household demographics and income distributions in the Orleans Parish...

  12. Yuan Exchange Rate 'Properly Adjusted'

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

      The currency exchange rate was "properly adjusted" this year and takes into account effects on the country's neighbors and the world, Premier Wen Jiabao said at a regional meeting in Malaysia.……

  13. Time-adjusted variable resistor

    Science.gov (United States)

    Heyser, R. C.

    1972-01-01

    Timing mechanism was developed effecting extremely precisioned highly resistant fixed resistor. Switches shunt all or portion of resistor; effective resistance is varied over time interval by adjusting switch closure rate.

  14. Comparative evaluation of ventilatory function through pre and postoperative peak expiratory flow in patients submitted to elective upper abdominal surgery.

    Science.gov (United States)

    Scheeren, Caio Fernando Cavanus; Gonçalves, José Júlio Saraiva

    2016-01-01

    to evaluate the ventilatory function by Peak Expiratory Flow (PEF) in the immediate pre and postoperative periods of patients undergoing elective surgical procedures in the upper abdomen. we conducted a prospective cohort study including 47 patients admitted to the Hospital Regional de Mato Grosso do Sul from July to December 2014, who underwent elective surgeries of the upper abdomen, and submiited to spirometric evaluation and measurement of PEF immediately before and after surgery. of the 47 patients, 22 (46.8%) were male and 25 (53.20%) female. The mean preoperative PEF was 412.1±91.7, and postoperative, 331.0±87.8, indicating significant differences between the two variables. Men had higher PEF values than women, both in the pre and postoperative periods. There was a reasonable inverse correlation between age and decreased PEF. Both situations showed statistical significance (psexo masculino, e 25 (53,20%) do sexo feminino. A média do PFE pré-operatório foi 412,1±91,7, e do pós-operatório de 331,0±87,8, indicando diferenças significantes entre as duas variáveis. O sexo masculino apresentou maiores valores de PFE do que o feminino, tanto no pré-cirúrgico quanto no pós-cirúrgico. Observou-se razoável correlação inversamente proporcional entre as variáveis idade e diminuição do PFE. Ambas as situações mostraram significância estatística (p<0,001). O grupo composto por fumantes apresentou menores valores de PFE tanto no pré como no pós-operatório. O grupo composto por portadores de co-morbidades (HAS e/ou DM) apresentou menores valores de PFE tanto no pré como no pós-operatório (p=0,005). Em ambos os grupos, o pós-operatório determinou uma diminuição significativa do PFE (p<0,001). O tipo de cirurgia realizada e o tipo de anestesia não mostraram diferenças significantes em relação ao PFE. as variáveis mais implicadas na diminuição da função ventilatória, avaliadas através da PFE, foram: idade avançada, tabagismo e

  15. Perfil ventilatório dos pacientes submetidos a cirurgia de revascularização do miocárdio Ventilatory profile of patients undergoing CABG surgery

    Directory of Open Access Journals (Sweden)

    Katiane Tremarin Morsch

    2009-06-01

    Full Text Available OBJETIVO: Avaliar o perfil ventilatório, radiológico e clínico dos pacientes submetidos a cirurgia eletiva de revascularização do miocárdio em hospital de referência em cardiologia no sul do Brasil. MÉTODOS: A amostra foi composta por 108 indivíduos submetidos a cirurgia eletiva de revascularização do miocárdio no Instituto de Cardiologia do Rio Grande do Sul (IC-FUC, no período de abril de 2006 a fevereiro de 2007. A abordagem cirúrgica realizada foi a da esternotomia mediana e os enxertos foram com ponte de safena e/ou artéria mamária interna. Os volumes e capacidades pulmonares, bem como a presença de distúrbios ventilatórios, foram avaliados por meio da espirometria e a força muscular ventilatória da manovacuometria. As avaliações foram realizadas no período pré-operatório e no sexto dia de pós-operatório. RESULTADOS: Observou-se redução significativa do VEF1 e da CVF quando comparados os valores pré-operatórios com os do sexto dia de pós-operatório (POBJECTIVE: To assess the ventilatory, radiological and clinical profile of patients undergoing elective CABG in a cardiology reference hospital in South Brazil. METHODS: This study included 108 patients undergoing elective CABG surgery, in the period between April 2006 and February 2007 at the Cardiology Institute of Rio Grande do Sul (IC-FUC. The surgical procedure involved median sternotomy, and the saphenous vein and/or internal mammary artery were used for grafting. Lung volume and capacity, as well as the possible existence of ventilatory changes, were assessed by spirometry, and the ventilatory muscle strength was assessed using a vaccum manometer. All evaluations were performed on the preoperative period and on the sixth postoperative day. RESULTS: Preoperative levels of FEV1 and FVC were significantly reduced on the 6th postoperative day (P<0.001 when compared to the preoperative levels. A significant decrease of ventilatory muscle strength, expressed

  16. Adjusting to Chronic Health Conditions.

    Science.gov (United States)

    Helgeson, Vicki S; Zajdel, Melissa

    2017-01-03

    Research on adjustment to chronic disease is critical in today's world, in which people are living longer lives, but lives are increasingly likely to be characterized by one or more chronic illnesses. Chronic illnesses may deteriorate, enter remission, or fluctuate, but their defining characteristic is that they persist. In this review, we first examine the effects of chronic disease on one's sense of self. Then we review categories of factors that influence how one adjusts to chronic illness, with particular emphasis on the impact of these factors on functional status and psychosocial adjustment. We begin with contextual factors, including demographic variables such as sex and race, as well as illness dimensions such as stigma and illness identity. We then examine a set of dispositional factors that influence chronic illness adjustment, organizing these into resilience and vulnerability factors. Resilience factors include cognitive adaptation indicators, personality variables, and benefit-finding. Vulnerability factors include a pessimistic attributional style, negative gender-related traits, and rumination. We then turn to social environmental variables, including both supportive and unsupportive interactions. Finally, we review chronic illness adjustment within the context of dyadic coping. We conclude by examining potential interactions among these classes of variables and outlining a set of directions for future research.

  17. MCCB warm adjustment testing concept

    Science.gov (United States)

    Erdei, Z.; Horgos, M.; Grib, A.; Preradović, D. M.; Rodic, V.

    2016-08-01

    This paper presents an experimental investigation in to operating of thermal protection device behavior from an MCCB (Molded Case Circuit Breaker). One of the main functions of the circuit breaker is to assure protection for the circuits where mounted in for possible overloads of the circuit. The tripping mechanism for the overload protection is based on a bimetal movement during a specific time frame. This movement needs to be controlled and as a solution to control this movement we choose the warm adjustment concept. This concept is meant to improve process capability control and final output. The warm adjustment device design will create a unique adjustment of the bimetal position for each individual breaker, determined when the testing current will flow thru a phase which needs to trip in a certain amount of time. This time is predetermined due to scientific calculation for all standard types of amperages and complies with the IEC 60497 standard requirements.

  18. Tax Adjusted for Imported Equipment

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    @@ Ministry of Finance, Central Administration of Customs, and State Administration of Taxation of P.R. of China jointly issued a "Notice on the Lists Related to the Interim Provisions on the Adjustment of Import Tax Policy on Major Technical Equipment" (the Notice) on April 13rd to adjust the list of equipment catalog and merchandise attached to the "Interim Provisions on the Import Tax Policy on Major Technical Equipment", as well as the preferential scope and extent of the import tax on a number of major technical equipment.

  19. Adjustable chain trees for proteins

    DEFF Research Database (Denmark)

    Winter, Pawel; Fonseca, Rasmus

    2012-01-01

    A chain tree is a data structure for changing protein conformations. It enables very fast detection of clashes and free energy potential calculations. A modified version of chain trees that adjust themselves to the changing conformations of folding proteins is introduced. This results in much...

  20. An adjustable contracted CI method

    Institute of Scientific and Technical Information of China (English)

    王育彬; 甘正汀; 苏克和; 文振翼

    1999-01-01

    A new contracted CI scheme——adjustable contracted CI scheme——is presented and programed. The efficiency of this scheme is tested by some example calculations. The result shows that the application of the new scheme is flexible and the correlation energy loss is lower than that of the original externally contracted CI method.

  1. Adjustment or updating of models

    Indian Academy of Sciences (India)

    D J Ewins

    2000-06-01

    In this paper, first a review of the terminology used in the model adjustment or updating is presented. This is followed by an outline of the major updating algorithms cuurently available, together with a discussion of the advantages and disadvantages of each, and the current state-of-the-art of this important application and part of optimum design technology.

  2. 75 FR 25103 - Tree Assistance Program

    Science.gov (United States)

    2010-05-07

    ..., Conservation, and Energy Act of 2008 (the 2008 Farm Bill). TAP provides disaster assistance to eligible... which there were mortality losses in excess of 15 percent, after adjustment for normal mortality, are... authorized by the 2008 Farm Bill (Pub. L. 110-246). Sections 12033 and 15101 of the 2008 Farm Bill...

  3. Congenital anomalies after assisted reproductive technology

    DEFF Research Database (Denmark)

    Pinborg, Anja; Henningsen, Anna-Karina Aaris; Malchau, Sara Sofie

    2013-01-01

    Worldwide, more than 5 million children have been born after assisted reproductive technology (ART), and in many developed countries ART infants represent more than 1% of the birth cohorts. It is well known that ART children are at increased risk of congenital malformations even after adjustment ...

  4. Divergent cardio-ventilatory and locomotor effects of centrally and peripherally administered urotensin II and urotensin II-related peptides in the unanesthethized trout

    Directory of Open Access Journals (Sweden)

    Gilmer eVanegas

    2015-04-01

    Full Text Available The urotensin II (UII gene family consists of four paralogous genes called UII, UII-related peptide (URP, URP1 and URP2. UII and URP peptides exhibit the same cyclic hexapeptide core sequence (CFWKYC while the N- and C-terminal regions are variable. UII, URP1 and URP2 mRNAs are differentially expressed within the central nervous system of teleost fishes, suggesting that they may exert distinct functions. Although the cardiovascular, ventilatory and locomotor effects of UII have been described in teleosts, much less is known regarding the physiological actions of URPs. The goal of the present study was to compare the central and peripheral actions of picomolar doses (5-500 pmol of trout UII, URP1 and URP2 on cardio-ventilatory variables and locomotor activity in the unanesthetized trout. Compared to vehicle, intracerebroventricular injection of UII, URP1 and URP2 evoked a gradual increase in total ventilation (VTOT reaching statistical significance for doses of 50 and 500 pmol of UII and URP1 but for only 500 pmol of URP2. In addition, UII, URP1 and URP2 provoked an elevation of dorsal aortic blood pressure (PDA accompanied with tachycardia. All peptides caused an increase in locomotor activity (ACT, at a threshold dose of 5 pmol for UII and URP1, and 50 pmol for URP2. After intra-arterial (IA injection, and in contrast to their central effects, only the highest dose of UII and URP1 significantly elevated VTOT and ACT. UII produced a dose-dependent hypertensive effect with concomitant bradycardia while URP1 increased PDA and heart rate after injection of only the highest dose of peptide. URP2 did not evoke any cardio-ventilatory or locomotor effect after IA injection. Collectively, these findings support the hypothesis that endogenous UII, URP1 and URP2 in the trout brain may act as neurotransmitters and/or neuromodulators acting synergistically or differentially to control the cardio-respiratory and locomotor systems. In the periphery, the only

  5. 24 CFR 884.109 - Rent adjustments.

    Science.gov (United States)

    2010-04-01

    ... assisted and comparable unassisted units, as determined by HUD: Provided, however, That this limitation shall not be construed to prohibit differences in rents between assisted and comparable unassisted...

  6. Personal Assistant for onLine Services: Addressing human factors

    NARCIS (Netherlands)

    Lindenberg, J.; Nagata, S.F.; Neerincx, M.A.

    2003-01-01

    The Personal Assistant for onLine Services (PALS) project aims at substantially improving the user experience of mobile internet services. It focuses on a generic solution: a personal assistant, which attunes the interaction to the momentary user needs and use context (e.g. adjusting the

  7. 77 FR 12007 - Notice of Petitions by Firms tor Determination of Eligibility to Apply For Trade Adjustment...

    Science.gov (United States)

    2012-02-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE Economic Development Administration Notice of Petitions by Firms tor Determination of Eligibility to Apply For Trade Adjustment Assistance AGENCY: Economic Development Administration, Department of...

  8. Adjustable wheelchair and method for adjusting said adjustable wheelchair, and wheelchair assembly

    NARCIS (Netherlands)

    Oosterhuis, D.S.

    2013-01-01

    The invention relates to an adjustable wheelchair comprising: -a carriage; -two rear wheels; -at least one front wheel; -at least one footrest; -a sub-frame; -a seat; and -a backrest; wherein the two rear wheels, the at least one front wheel and the at least one footrest are mounted to the carriage,

  9. Cell and Tissue Organization in the Circulatory and Ventilatory Systems Volume 1 Signaling in Cell Organization, Fate, and Activity, Part A Cell Structure and Environment

    CERN Document Server

    Thiriet, Marc

    2011-01-01

    The volumes in this authoritative series present a multidisciplinary approach to modeling and simulation of flows in the cardiovascular and ventilatory systems, especially multiscale modeling and coupled simulations. The cardiovascular and respiratory systems are tightly coupled, as their primary function is to supply oxygen to and remove carbon dioxide from the body's cells. Because physiological conduits have deformable and reactive walls, macroscopic flow behavior and prediction must be coupled to nano- and microscopic events in a corrector scheme of regulated mechanisms. Therefore, investigation of flows of blood and air in physiological conduits requires an understanding of the biology, chemistry, and physics of these systems together with the mathematical tools to describe their functioning.  The present volume is devoted to cellular events that allow adaptation to environmental conditions, particularly mechanotransduction. It begins with cell organization and a survey of cell types in the vasculatur...

  10. The effect of combined glutamate receptor blockade in the NTS on the hypoxic ventilatory response in awake rats differs from the effect of individual glutamate receptor blockade.

    Science.gov (United States)

    Pamenter, Matthew E; Nguyen, Jetson; Carr, John A; Powell, Frank L

    2014-08-01

    Ventilatory acclimatization to hypoxia (VAH) increases the hypoxic ventilatory response (HVR) and causes persistent hyperventilation when normoxia is restored, which is consistent with the occurrence of synaptic plasticity in acclimatized animals. Recently, we demonstrated that antagonism of individual glutamate receptor types (GluRs) within the nucleus tractus solitarii (NTS) modifies this plasticity and VAH (J. Physiol. 592(8):1839-1856); however, the effects of combined GluR antagonism remain unknown in awake rats. To evaluate this, we exposed rats to room air or chronic sustained hypobaric hypoxia (CSH, PiO2 = 70 Torr) for 7-9 days. On the experimental day, we microinjected artificial cerebrospinal fluid (ACSF: sham) and then a "cocktail" of the GluR antagonists MK-801 and DNQX into the NTS. The location of injection sites in the NTS was confirmed by glutamate injections on a day before the experiment and with histology following the experiment. Ventilation was measured in awake, unrestrained rats breathing normoxia or acute hypoxia (10% O2) in 15-min intervals using barometric pressure plethysmography. In control (CON) rats, acute hypoxia increased ventilation; NTS microinjections of GluR antagonists, but not ACSF, significantly decreased ventilation and breathing frequency in acute hypoxia but not normoxia (P NTS significantly decreased ventilation in normoxia and breathing frequency in hypoxia. A persistent HVR after combined GluR blockade in the NTS contrasts with the effect of individual GluR blockade and also with results in anesthetized rats. Our findings support the hypotheses that GluRs in the NTS contribute to, but cannot completely explain, VAH in awake rats.

  11. Ventilatory and ECMO treatment of H1N1-induced severe respiratory failure: results of an Italian referral ECMO center

    Directory of Open Access Journals (Sweden)

    Giovannini Valtere

    2011-01-01

    Full Text Available Abstract Background Since the first outbreak of a respiratory illness caused by H1N1 virus in Mexico, several reports have described the need of intensive care or extracorporeal membrane oxygenation (ECMO assistance in young and often healthy patients. Here we describe our experience in H1N1-induced ARDS using both ventilation strategy and ECMO assistance. Methods Following Italian Ministry of Health instructions, an Emergency Service was established at the Careggi Teaching Hospital (Florence, Italy for the novel pandemic influenza. From Sept 09 to Jan 10, all patients admitted to our Intensive Care Unit (ICU of the Emergency Department with ARDS due to H1N1 infection were studied. All ECMO treatments were veno-venous. H1N1 infection was confirmed by PCR assayed on pharyngeal swab, subglottic aspiration and bronchoalveolar lavage. Lung pathology was evaluated daily by lung ultrasound (LUS examination. Results A total of 12 patients were studied: 7 underwent ECMO treatment, and 5 responded to protective mechanical ventilation. Two patients had co-infection by Legionella Pneumophila. One woman was pregnant. In our series, PCR from bronchoalveolar lavage had a 100% sensitivity compared to 75% from pharyngeal swab samples. The routine use of LUS limited the number of chest X-ray examinations and decreased transportation to radiology for CT-scan, increasing patient safety and avoiding the transitory disconnection from ventilator. No major complications occurred during ECMO treatments. In three cases, bleeding from vascular access sites due to heparin infusion required blood transfusions. Overall mortality rate was 8.3%. Conclusions In our experience, early ECMO assistance resulted safe and feasible, considering the life threatening condition, in H1N1-induced ARDS. Lung ultrasound is an effective mean for daily assessment of ARDS patients.

  12. Uncertainty-based Estimation of the Secure Range for ISO New England Dynamic Interchange Adjustment

    Energy Technology Data Exchange (ETDEWEB)

    Etingov, Pavel V.; Makarov, Yuri V.; Wu, Di; Hou, Zhangshuan; Sun, Yannan; Maslennikov, S.; Luo, Xiaochuan; Zheng, T.; George, S.; Knowland, T.; Litvinov, E.; Weaver, S.; Sanchez, E.

    2014-04-14

    The paper proposes an approach to estimate the secure range for dynamic interchange adjustment, which assists system operators in scheduling the interchange with neighboring control areas. Uncertainties associated with various sources are incorporated. The proposed method is implemented in the dynamic interchange adjustment (DINA) tool developed by Pacific Northwest National Laboratory (PNNL) for ISO New England. Simulation results are used to validate the effectiveness of the proposed method.

  13. Research Design in Marital Adjustment Studies.

    Science.gov (United States)

    Croake, James W.; Lyon, Rebecca S.

    1978-01-01

    The numerous marital adjustment studies which exist in the literature are confounded by basic design problems. Marital stability should be the baseline for data. It is then possible to discuss "happiness,""success,""adjustment," and "satisfaction." (Author)

  14. First Year Adjustment in the Secondary School.

    Science.gov (United States)

    Loosemore, Jean Ann

    1978-01-01

    This study investigated the relationship between adjustment to secondary school and 17 cognitive and noncognitive variables, including intelligence (verbal and nonverbal reasoning), academic achievement, extraversion-introversion, stable/unstable, social adjustment, endeavor, age, sex, and school form. (CP)

  15. Theory of Work Adjustment Personality Constructs.

    Science.gov (United States)

    Lawson, Loralie

    1993-01-01

    To measure Theory of Work Adjustment personality and adjustment style dimensions, content-based scales were analyzed for homogeneity and successively reanalyzed for reliability improvement. Three sound scales were developed: inflexibility, activeness, and reactiveness. (SK)

  16. Inspiratory-resistive loading increases the ventilatory response to arousal but does not reduce genioglossus muscle activity on the return to sleep.

    Science.gov (United States)

    Cori, Jennifer M; Nicholas, Christian L; Baptista, Shaira; Huynh, Ivan; Rochford, Peter D; O'Donoghue, Fergal J; Trinder, John A; Jordan, Amy S

    2012-09-01

    Arousals from sleep are thought to predispose to obstructive sleep apnea by causing hyperventilation and hypocapnia, which reduce airway dilator muscle activity on the return to sleep. However, prior studies of auditory arousals have not resulted in reduced genioglossus muscle activity [GG-electromyogram (EMG)], potentially because airway resistance prior to arousal was low, leading to a small ventilatory response to arousal and minimal hypocapnia. Thus we aimed to increase the ventilatory response to arousal by resistive loading prior to auditory arousal and determine whether reduced GG-EMG occurred on the return to sleep. Eighteen healthy young men and women were recruited. Subjects were instrumented with a nasal mask with a pneumotachograph, an epiglottic pressure catheter, and intramuscular GG-EMG electrodes. Mask CO(2) levels were monitored. Three- to 15-s arousals from sleep were induced with auditory tones after resting breathing (No-Load) or inspiratory-resistive loading (Load; average 8.4 cmH(2)O·l(-1)·s(-1)). Peak minute ventilation following arousal was greater after Load than No-Load (mean ± SE; 8.0 ± 0.6 vs. 7.4 ± 0.6 l/min, respectively). However, the nadir end tidal partial pressure of CO(2) did not differ between Load conditions (43.1 ± 0.6 and 42.8 ± 0.5 mmHg, respectively), and no period of reduced GG activity occurred following the return to sleep (GG-EMG baseline, minimum after Load and No-Load = 2.9 ± 1.2%, 3.1 ± 1.3%, and 3.0 ± 1.3% max, respectively). These findings indicate that the hyperventilation, which occurs following tone-induced arousal, is appropriate for the prevailing level of respiratory drive, because loading did not induce marked hypocapnia or lower GG muscle activity on the return to sleep. Whether similar findings occur following obstructive events in patients remains to be determined.

  17. Lack of additional effect of adjunct of assisted ventilation to pulmonary rehabilitation in mild COPD patients.

    Science.gov (United States)

    Bianchi, L; Foglio, K; Porta, R; Baiardi, R; Vitacca, M; Ambrosino, N

    2002-05-01

    Different modalities of assisted ventilation improve breathlessness and exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the effects of the addition of assisted ventilation during exercise training on the outcome of a structured pulmonary rehabilitation programme (PRP) in COPD patients. Thirty-three male patients with stable COPD (mean (SD) forced expiratory volume in 1 s (FEV1) 44 (16) % pred), without chronic ventilatory failure, undergoing a 6-week multidisciplinary outpatient PRP including exercise training, were randomised to training during either mask proportional assist ventilation (PAV: 18 patients) or spontaneous breathing (SB: 15 patients). Assessment included exercise tolerance, dyspnoea, leg fatigue, and health-related quality of life (HRQL). Five out of 18 patients (28%) in the PAV group dropped out due to lack of compliance with the equipment. Both groups showed significant post-PRP improvements in exercise tolerance (peak work rate difference: 20 (95% Cl 2.4-37.6) and 14 (3.8% CI to 24.2) W in PAV and SB group, respectively), dyspnoea and leg fatigue, but not in HRQL, without any significant difference between groups. It is concluded that with the modality and in the patients assessed in this study assisted ventilation during training sessions included in a multidisciplinary PRP was not well tolerated by all patients and gave no additional physiological benefit in comparison with exercise training alone.

  18. Work adjustments among the chronically ill.

    NARCIS (Netherlands)

    Baanders, A.N.; Andries, F.; Rijken, P.M.; Dekker, J.

    2001-01-01

    Work(place) adjustments can help the work capacity of persons with a chronic disease. This study aims to to quantify the presence of work adjustments among chronically ill workers in the Netherlands, and to investigate the extent to which the presence of work adjustments are related to the

  19. Do fair value adjustments influence dividend policy?

    NARCIS (Netherlands)

    Goncharov, I.; van Triest, S.

    2011-01-01

    We examine the impact of positive fair value adjustments on dividend policy. If fair value adjustments are transitory in nature and managers are able to assess their implications for future earnings, fair value adjustments in net income is expected to have no distribution consequences. However, posi

  20. Do fair value adjustments influence dividend policy?

    NARCIS (Netherlands)

    Goncharov, I.; van Triest, S.

    2011-01-01

    We examine the impact of positive fair value adjustments on dividend policy. If fair value adjustments are transitory in nature and managers are able to assess their implications for future earnings, fair value adjustments in net income is expected to have no distribution consequences. However,

  1. Capital adjustment patterns on Dutch pig farms

    NARCIS (Netherlands)

    Gardebroek, C.

    2004-01-01

    This paper develops a generalised adjustment cost framework that explicitly accounts for zero investments on Dutch pig farms. A farm-specific flexible adjustment cost function is used to account for differences in adjustment costs between farms. Using the Generalised Method of Moments the Euler equa

  2. Psychosocial adjustment to recurrent cancer.

    Science.gov (United States)

    Mahon, S M; Cella, D F; Donovan, M I

    1990-01-01

    This descriptive study of the perceptions and needs of people with recurrent malignancies asks three questions: How do patients describe the meaning of a recurrence of cancer? Do individuals perceive the diagnosis of recurrence and the initial diagnosis of cancer differently? What are the key psychosocial problems associated with recurrent cancer? The theoretical framework was based on Lazarus and Folkman's theory of stress, appraisal, and coping. Subjects completed the Impact of Event Scale (IES), the Psychosocial Adjustment to Illness Scale--Self-Report (PAIS), and a semistructured qualitative interview. The interview elicited perceptions of the event of recurrence and differences between the diagnosis of recurrence and the initial diagnosis. The convenience sample included 40 patients diagnosed with recurrent cancer within the last 30 days. Many subjects (78%) reported that the recurrence was more upsetting than the initial diagnosis. Scores on both the IES and the PAIS were high when compared to normative samples of patients with cancer suggesting that this sample of patients experienced a lot of psychological distress as well as problems at home, work, and in their social lives. These concerns often were unknown to caregivers. Although more research is needed, the authors propose that, with more accurate assessment, more effective intervention could be implemented and the quality of life improved for patients with recurrent cancer.

  3. Control of Adjustable Compliant Actuators

    Directory of Open Access Journals (Sweden)

    Berno J.E. Misgeld

    2014-05-01

    Full Text Available Adjustable compliance or variable stiffness actuators comprise an additional element to elastically decouple the actuator from the load and are increasingly applied to human-centered robotic systems. The advantages of such actuators are of paramount importance in rehabilitation robotics, where requirements demand safe interaction between the therapy system and the patient. Compliant actuator systems enable the minimization of large contact forces arising, for example, from muscular spasticity and have the ability to periodically store and release energy in cyclic movements. In order to overcome the loss of bandwidth introduced by the elastic element and to guarantee a higher range in force/torque generation, new actuator designs consider variable or nonlinear stiffness elements, respectively. These components cannot only be adapted to the walking speed or the patient condition, but also entail additional challenges for feedback control. This paper introduces a novel design method for an impedance-based controller that fulfills the control objectives and compares the performance and robustness to a classical cascaded control approach. The new procedure is developed using a non-standard positive-real Η2 controller design and is applied to a loop-shaping approach. Robust norm optimal controllers are designed with regard to the passivity of the actuator load-impedance transfer function and the servo control problem. Classical cascaded and positive-real Η2 controller designs are validated and compared in simulations and in a test bench using a passive elastic element of varying stiffness.

  4. Reexpansion Pulmonary Edema following Laparoscopy-Assisted Distal Gastrectomy for a Patient with Early Gastric Cancer: A Case Report

    Directory of Open Access Journals (Sweden)

    Kazuhito Yajima

    2012-01-01

    Full Text Available We report here a case of reexpansion pulmonary edema following laparoscopy-assisted distal gastrectomy (LADG for early gastric cancer. A 57-year-old Japanese woman with no preoperative comorbidity was diagnosed with early gastric cancer. The patient underwent LADG using the pneumoperitoneum method. During surgery, the patient was unintentionally subjected to single-lung ventilation for approximately 247 minutes due to intratracheal tube dislocation. One hour after surgery, she developed severe dyspnea and produced a large amount of pink frothy sputum. Chest radiography results showed diffuse ground-glass attenuation and alveolar consolidation in both lungs without cardiomegaly. A diagnosis of pulmonary edema was made, and the patient was immediately intubated and received ventilatory support with high positive end-expiratory pressure. The patient gradually recovered and was weaned from the ventilatory support on the third postoperative day. This case shows that single-lung ventilation may be a risk factor for reexpansion pulmonary edema during laparoscopic surgery with pneumoperitoneum.

  5. Ventilatory expired gas at constant-rate low-intensity exercise predicts adverse events and is related to neurohormonal markers in patients with heart failure.

    Science.gov (United States)

    Arena, Ross; MacCarter, Dean; Olson, Thomas P; Lalande, Sophie; Ceridon, Maile L; Olson, Lyle J; Johnson, Bruce

    2009-08-01

    Ventilatory efficiency (VE/VCO(2) ratio) and the partial pressure of end-tidal carbon dioxide (P(ET)CO(2)), obtained during moderate to high levels of physical exertion demonstrate prognostic value in heart failure (HF). The present investigation assesses the clinical utility of these variables during low-intensity exercise. One hundred and thirty subjects diagnosed with HF underwent a 2-minute, constant-rate treadmill session at 2 miles per hour. Both the VE/VCO(2) ratio and P(ET)CO(2) were recorded during exercise (30-second average) and their change (Delta) from rest. B-type and atrial natriuretic peptide (BNP and ANP) were also determined. Only P(ET)CO(2) and DeltaP(ET)CO(2) emerged from the multivariate Cox regression. Receiver operating characteristic curve analysis revealed the prognostic classification schemes were significant with thresholds of or=34 mm Hg (hazard ratio: 4.2, 95% CI: 2.2-8.0, P or=1 mm Hg (hazard ratio: 3.5, 95% CI: 1.9-6.6, P or=34 mm Hg had a significantly lower BNP (214.1 +/- 431.9 vs. 1110.5 +/- 1854.0 pg/mL, P=.005) and ANP (108.2 +/- 103.6 vs. 246.2 +/- 200.4 pg/mL, P exercise may provide insight into prognosis and cardiac stability.

  6. Comparison between two different modes of non-invasive ventilatory support in preterm newborn infants with respiratory distress syndrome mild to moderate: preliminary data

    Directory of Open Access Journals (Sweden)

    F. Ciuffini

    2014-08-01

    Full Text Available Despite of improved survival of premature infants, the incidence of long term pulmonary complications, mostly associated with ventilation-induced lung injury, remains high. Non invasive ventilation (NIV is able to reduce the adverse effects of mechanical ventilation. Although nasal continuous positive airway pressure (NCPAP is an effective mode of NIV, traumatic nasal complications and intolerance of the nasal interface are common. Recently high flow nasal cannula (HFNC is emerging as a better tolerated form of NIV, allowing better access to the baby’s face, which may improve nursing, feeding and bonding. HFNC may be effective in the treatment of some neonatal respiratory conditions while being more user-friendly for care-givers than conventional NCPAP. Limited evidence is available to support the specific role, efficacy and safety of HFNC in newborns and to demonstrate efficacy compared with NCPAP; some studies suggest a potential role for HFNC in respiratory care of the neonate as a distinct non invasive ventilatory support. We present the preliminary data of a randomized clinical trial; the aim of this study was to assess efficacy and safety of HFNC compared to NCPAP in preterm newborns with mild to moderate respiratory distress syndrome (RDS.

  7. A simplified approach to assess variations in Eustachian tubal ventilatory function by Bortnick-Miller apparatus in chronic otitis media cases (dry before surgery

    Directory of Open Access Journals (Sweden)

    Apoorva Kumar Pandey

    2011-01-01

    Full Text Available Aim: The aim of this study is to see the different functional gradings of Eustachian tube ventilatory function as assessed by Bortnick-Miller (B-M apparatus in chronically diseased middle ears (dry cases planned to undergo tympanoplasty and to correlate the results with the past experiences. Materials and Methods: This study consisted of 29 cases of chronic suppurative otitis media, inactive stage having central perforation. Tubal function was evaluated by B-M apparatus based on ability of tube assimilating the applied positive and negative pressure. Tubal opening pressure was noted after applying positive pressure while residual intratympanic pressure after 10 swallows was recorded after applying negative pressure. Results: This study revealed that results of tubal manometry in diseased ears cover a wide spectrum of normal function to partial/non-function. 51.72% of cases were able to equalize applied negative pressure, 41.39% partially equalizing, while 6.89% of cases were completely unable to equalize applied negative pressure. Conclusion: Our results of aspiration method with the help of BM apparatus explicitly suggest that tubal function in chronically diseased ears deviates from that of normal ears. It perpetually reflects that varied results of middle ear reconstructive surgeries could be anticipated in accordance with different tubal function gradings.

  8. The use of near infrared spectroscopy (NIRS) to determine the ventilatory threshold and the relation between skeletal muscle oxygenation and RPE

    Science.gov (United States)

    Tessmer, Kathryn Anne

    This study: (1) compared three (i.e., V-slope, Bhambhani et al., 1997, and Belardinelli et al., 1995) techniques of measuring the ventilatory threshold (VT), (2) examined the relation between OMNI RPE and muscle deoxygenation (MD), and (3) evaluated the impact of gender on MD and RPE. Subjects included 20 males and 13 females, aged 25-29 years. A commercial NIRS sensor (NIRS Micro-Run Man model # MRM-96) was placed over the right vastus lateralis and secured with an elastic wrap. Next, each subject underwent a progressive multistage cycle ergometer test to establish the VT using the V-slope method and NIRS methods. The V-slope (58.62 +/- 10.47% VO2peak), Bhambhani et al. 1997 (49.75 +/- 20.13% VO2peak), and Belardinelli et al. 1995 (60.87 +/- 10.15% VO2peak) methods did not result in different (F(2,49) = 2.77, p > 0.05) VT values. The following significant linear regression equation was generated (p = 0.016): OMNI RPE = 5.97 - (15.20)MD (R = -0.20, R 2 = 0.04, and SE = 2.76). The two-way ANOVA (gender x power output) conducted on OMNI RPE revealed a significant main effect for gender ( F(1,193) = 19.53, p cycle ergometer protocol.

  9. ForeignAssistance.gov

    Data.gov (United States)

    US Agency for International Development — ForeignAssistance.gov provides a view of U.S. Government foreign assistance funds across agencies and enables users to explore, analyze, and review aid investments...

  10. Assisted Vaginal Delivery

    Science.gov (United States)

    ... be needed. What are the risks for my baby if I have assisted vaginal delivery? Although the overall rate of injury to the baby as a result of assisted vaginal delivery is low, there still is a risk of ...

  11. Bias Adjusted Precipitation Threat Scores

    Directory of Open Access Journals (Sweden)

    F. Mesinger

    2008-04-01

    Full Text Available Among the wide variety of performance measures available for the assessment of skill of deterministic precipitation forecasts, the equitable threat score (ETS might well be the one used most frequently. It is typically used in conjunction with the bias score. However, apart from its mathematical definition the meaning of the ETS is not clear. It has been pointed out (Mason, 1989; Hamill, 1999 that forecasts with a larger bias tend to have a higher ETS. Even so, the present author has not seen this having been accounted for in any of numerous papers that in recent years have used the ETS along with bias "as a measure of forecast accuracy".

    A method to adjust the threat score (TS or the ETS so as to arrive at their values that correspond to unit bias in order to show the model's or forecaster's accuracy in extit{placing} precipitation has been proposed earlier by the present author (Mesinger and Brill, the so-called dH/dF method. A serious deficiency however has since been noted with the dH/dF method in that the hypothetical function that it arrives at to interpolate or extrapolate the observed value of hits to unit bias can have values of hits greater than forecast when the forecast area tends to zero. Another method is proposed here based on the assumption that the increase in hits per unit increase in false alarms is proportional to the yet unhit area. This new method removes the deficiency of the dH/dF method. Examples of its performance for 12 months of forecasts by three NCEP operational models are given.

  12. Efficient Adjustable Reflectivity Smart Window

    Energy Technology Data Exchange (ETDEWEB)

    D. Morgan Tench

    2005-12-01

    This project addressed the key technical issues for development of an efficient smart window based on reversible electrochemical transfer of silver between a mirror electrode and a localized counter electrode. Effort to provide uniform switching over large areas focused on use of a resistive transparent electrode innerlayer to increase the interelectrode resistance. An effective edge seal was developed in collaboration with adhesive suppliers and an electrochromic device manufacturer. Work to provide a manufacturable counter electrode focused on fabricating a dot matrix electrode without photolithography by electrodeposition of Pt nuclei on inherent active sites on a transparent oxide conductor. An alternative counter electrode based on a conducting polymer and an ionic liquid electrolyte was also investigated. Work in all of these areas was successful. Sputtered large-bandgap oxide innerlayers sandwiched between conductive indium tin oxide (ITO) layers were shown to provide sufficient cross-layer resistance (>300 ohm/cm{sup 2}) without significantly affecting the electrochemical properties of the ITO overlayer. Two edge seal epoxies, one procured from an epoxy manufacturer and one provided by an electrochromic device manufacturer in finished seals, were shown to be effective barriers against oxygen intrusion up to 80 C. The optimum density of nuclei for the dot matrix counter electrode was attained without use of photolithography by electrodeposition from a commercial alkaline platinum plating bath. Silver loss issues for cells with dot matrix electrodes were successfully addressed by purifying the electrolyte and adjusting the cell cycling parameters. More than 30K cycles were demonstrated for a REM cell (30-cm square) with a dot matrix counter electrode. Larger cells (30-cm square) were successfully fabricated but could not be cycled since the nucleation layers (provided by an outside supplier) were defective so that mirror deposits could not be produced.

  13. Adaptation and adjustment in children of transsexual parents.

    Science.gov (United States)

    White, Tonya; Ettner, Randi

    2007-06-01

    It is a relatively uncommon event that children find themselves in a situation with a parent who undergoes a transition from one sex to another. Unlike situations of divorce or a parent with a medical or major psychiatric disorder, it is unlikely that the children will know of other children who encounter similar situations. There is very little literature that describes the adjustment of these children and the nature of their relationships with their parents and peers. Such information would be beneficial for clinicians assisting children and families in this situation. To better delineate the adjustment of these children, we interviewed 27 parents of 55 children. The interview took place on average 6 years after the gender transition. The measures obtained included the parent and child relationships at present and also at the time of the transition. We also inquired about academic function, peer relationships and social stigma. The results found that children who were younger at the time of the parent's transition tended to have better relationships and less adjustment difficulties. In addition, parental conflict that continues after the transition period tends to reflect greater family conflict between the transitioned parent and their child.

  14. Precision Adjustable Liquid Regulator (ALR)

    Science.gov (United States)

    Meinhold, R.; Parker, M.

    2004-10-01

    A passive mechanical regulator has been developed for the control of fuel or oxidizer flow to a 450N class bipropellant engine for use on commercial and interplanetary spacecraft. There are several potential benefits to the propulsion system, depending on mission requirements and spacecraft design. This system design enables more precise control of main engine mixture ratio and inlet pressure, and simplifies the pressurization system by transferring the function of main engine flow rate control from the pressurization/propellant tank assemblies, to a single component, the ALR. This design can also reduce the thermal control requirements on the propellant tanks, avoid costly Qualification testing of biprop engines for missions with more stringent requirements, and reduce the overall propulsion system mass and power usage. In order to realize these benefits, the ALR must meet stringent design requirements. The main advantage of this regulator over other units available in the market is that it can regulate about its nominal set point to within +/-0.85%, and change its regulation set point in flight +/-4% about that nominal point. The set point change is handled actively via a stepper motor driven actuator, which converts rotary into linear motion to affect the spring preload acting on the regulator. Once adjusted to a particular set point, the actuator remains in its final position unpowered, and the regulator passively maintains outlet pressure. The very precise outlet regulation pressure is possible due to new technology developed by Moog, Inc. which reduces typical regulator mechanical hysteresis to near zero. The ALR requirements specified an outlet pressure set point range from 225 to 255 psi, and equivalent water flow rates required were in the 0.17 lb/sec range. The regulation output pressure is maintained at +/-2 psi about the set point from a P (delta or differential pressure) of 20 to over 100 psid. Maximum upstream system pressure was specified at 320 psi

  15. Ergonomic evaluation of the Apple Adjustable Keyboard

    Energy Technology Data Exchange (ETDEWEB)

    Tittiranonda, P.; Burastero, S.; Shih, M. [Lawrence Livermore National Lab., CA (United States); Rempel, D. [University of California Berkeley/San Francisco (United States). Ergonomics Laboratory

    1994-05-01

    This study presents an evaluation of the Apple Adjustable Keyboard based on subjective preference and observed joint angles during typing. Thirty five keyboard users were asked to use the Apple adjustable keyboard for 7--14 days and rate the various characteristics of the keyboard. Our findings suggest that the most preferred opening angles range from 11--20{degree}. The mean ulnar deviation on the Apple Adjustable keyboard is 11{degree}, compared to 16{degree} on the standard keyboard. The mean extension was decreased from 24{degree} to 16{degree} when using the adjustable keyboard. When asked to subjectively rate the adjustable keyboard in comparison to the standard, the average subject felt that the Apple Adjustable Keyboard was more comfortable and easier to use than the standard flat keyboard.

  16. A Quantitative Appraisal of Adjustment Lending

    OpenAIRE

    Bela Balassa

    1989-01-01

    This paper presents a quantitative analysis of adjustment programmes. This is done by charting changes in various performance indicators following the receipt of the first adjustment loan, and by further contrasting the results with those for the comparator group of countries that did not receive adjustment loans. It is found that the average decline in the GDP growth rate in the loan-recipient countries was less than in the comparator groups. Similar results were obtained in regard to per ca...

  17. The organization of anticipatory postural adjustments

    OpenAIRE

    Aruin Alexander S.

    2002-01-01

    Central control of posture is expressed through anticipatory and compensatory postural adjustments. Anticipatory postural adjustments (APAs) precede planned postural perturbations and minimize them with anticipatory corrections, while compensatory postural adjustments deal with actual perturbations of balance that occur as a result of suboptimal efficiency of anticipatory corrections. The process of generation of APAs is affected by three major factors: expected magnitude and direction of the...

  18. Evaluation of an adjustable epidemiologic information system.

    Directory of Open Access Journals (Sweden)

    Jiunn-Shyan Julian Wu

    Full Text Available BACKGROUND: In order to facilitate public health response and to achieve early control of infectious disease epidemics, an adjustable epidemiologic information system (AEIS was established in the Taiwan public health network in February 2006. METHODOLOGY/PRINCIPAL FINDINGS: The performance of AEIS for the period 2006 through 2008 was evaluated based on a number of response times (RT and the public health impact. After implementation of the system, the apparent overall shortened RT was mainly due to the shortening of personnel response time (PRT and the time needed to draft a new questionnaire that incurred as personnel-system interface (PSI; PRT dropped from a fluctuating range of 9.8 ∼28.8 days in the first four months to <10 days in the following months and remained low till 2008 (0.88±1.52 days. The PSIs for newly emerged infectious diseases were 2.6 and 3.4 person-hours for H5N1 in 2007 and chikungunya in 2008, respectively, a much improvement from 1142.5 person-hours for SARS in 2003. The duration of each rubella epidemic cluster was evaluated as public health impact and showed a shortening trend (p = 0.019 that concurred with the shortening of PRT from 64.8±47.3 to 25.2±38.2 hours per cluster (p<0.0001. CONCLUSIONS/SIGNIFICANCE: The first evaluation of the novel instrument AEIS that had been used to assist Taiwan's multi-level government for infectious diseases control demonstrated that it was well integrated into the existing public health infrastructure. It provided flexible tools and computer algorithms with friendly interface for timely data collection, integration, and analysis; as a result, it shortened RTs, filled in gaps of personnel lacking sufficient experiences, created a more efficient flow of response, and identified asymptomatic/mild cases early to minimize further spreading. With further development, AEIS is anticipated to be useful in the application of other acute public health events needing immediate

  19. USING R TO TEACH SEASONAL ADJUSTMENT

    Directory of Open Access Journals (Sweden)

    Pedro Costa Ferreira

    2017-03-01

    Full Text Available This article shows, using R software, how to seasonally adjust a time series using the X13-ARIMA-SEATS program and the seasonal package developed by Christoph Sax. In addition to presenting step-by-step seasonal adjustment, the article also explores how to analyze the program output and how to forecast the original and seasonally adjusted time series. A case study was proposed using the Brazilian industrial production. It was verified that the effect of Carnival, Easter and working days improved the seasonal adjustment when treated by the model.

  20. Development of Adjustable Grazing Incidence Optics

    Science.gov (United States)

    Reid, Paul B.; Davis, W.; Schwartz, D. A.; Trolier-McKinstry, S.; Wilke, R. H. T.

    2010-03-01

    We report on the development of adjustable grazing incidence optics. We are developing bimorph mirrors for high resolution (sub-arc second) imaging. Bimorph mirrors consist of a thin layer of piezo-electric material deposited on the back surface of a thin (material localizes the strain to the particular piezo "pixel.” Mirror figure errors are corrected (on-orbit) via induced localized deformations. We have successfully deposited a 1-micrometer thick layer of the piezo-electric material lead-zirconate-titanate (PZT) on thin glass mirrors. We report on the electrical and mechanical properties of the bimorph mirrors, and mirror requirements. We discuss finite element modeling of bimorph mirrors. In particular, we focus on how a difference in mirror mounting affects the influence functions ( the induced deformations). We are also developing the use of electrostrictive adjusters for moderate resolution (a few arc second) imaging. Electroplated nickel/cobalt full shells are mounted together using the adjusters. The adjusters are arrayed axially and tangentially between shells, with their adjustable dimension in the radial direction. Each shell is adjusted and fixed in place during mirror assembly, starting with the innermost shell. We review finite element modeling of the adjustable optics and the application of the adjustment system to correct manufacturing errors. We discuss initial tests using electrostrictive adjusters to change the shape of flat mirror segments. This work is supported by NASA Contract NNX09AE87G and a grant from the Gordon and Betty Moore Foundation.

  1. Marital conflict, divorce, and children's adjustment.

    Science.gov (United States)

    Kelly, J B

    1998-04-01

    This article summarizes current research on children's adjustment after separation and divorce, and then focuses on the contributions of marital conflict, marital violence, and hostile family environments to children's adjustment during marriage and after divorce. Children living in marriages with frequent and intense conflict are significantly more likely to have substantial adjustment problems before parental divorce and compromised parent-child relationships. These findings suggest that the deleterious effects of divorce per se have been overstated, with insufficient attention paid in the clinical and research literature to the damaging effects of highly troubled marriages on children's adjustment.

  2. Laser-assisted hatching in assisted reproduction.

    Science.gov (United States)

    Montag, M; van der Ven, H

    1999-09-01

    The use of a 1.48 um diode laser for assisted hatching was investigated in animal experimentation. Laser assisted hatching was offered to patients with advanced maternal age to evaluate a possible benefit. Using the Fertilase(r) system we investigated the impact of openings with different size in the zona of mouse embryos on the hatching process, as well as that of two openings. Laser-drilling was performed at the blastocyst stage to look for differences in timing and efficacy of hatching. The possible benefit of assisted hatching was studied in 24 couples with advanced maternal age (38.8+2.1 years) and compared to a control group (37.8+2.5 years) treated in the same time period but without assisted hatching. A certain diameter of a laser drilled opening in the zona pellucida is necessary for efficient hatching. When two openings are present in the zona, the embryo will use both openings for hatching and subsequently become trapped. Laser-drilling at th e expanded blastocyst stage causes an immediate collapse of treated blastocysts and the onset of hatching is retarded. Assisted hatching in 24 patients with advanced maternal age resulted in a significant increase (plaser to drill an opening into the zona pellucida provides a good alternate to conventionally applied techniques. The procedure is efficient and safe as long as it is applied properly. In a human in vitro fertilization program, selected patients will have a benefit form assisted hatching.

  3. Assistência ventilatória domiciliar em crianças: descrição de um programa Home ventilation of pediatric patients: description of a program

    Directory of Open Access Journals (Sweden)

    Tânia D. Resener

    2001-04-01

    Full Text Available OBJETIVO: o número de pacientes pediátricos dependentes de suporte ventilatório vem aumentando de maneira relevante nas últimas décadas. Essas crianças permanecem por longos períodos internadas, freqüentemente em unidades de terapia intensiva. Para minimizar as hospitalizações, tem sido dada ênfase à continuação da terapia ventilatória no domicílio. No presente trabalho descreve-se um programa de assistência ventilatória domiciliar desenvolvido na Alemanha, visando antever a possibilidade de adaptação à nossa realidade. CASUÍSTICA E METODOLOGIA: avaliou-se o programa de assistência ventilatória domiciliar da UTI-Pediátrica do Dr. von Haunersches Kinderklinik - Ludwig-Maximilians-Universität-München (Munique, Alemanha no período entre abril de 1997 e junho de 1998. RESULTADOS: o referido programa dá suporte a pacientes com idades entre 1 e 21 anos, sendo 11 do sexo masculino e 15 do feminino. Dos 26 pacientes, 15 apresentavam patologias neuromusculares, oito problemas ventilatórios de causa central e três doenças pulmonares obstrutivas. Doze crianças (46,2% eram ventiladas através de técnicas não-invasivas e 19 (73,1% necessitavam apenas de suporte ventilatório intermitente. CONCLUSÃO: o programa tem uma equipe multidisciplinar permanentemente responsável pelo tratamento de intercorrências. Os pacientes, em períodos pré-determinados, são submetidos a reavaliações da evolução da insuficiência respiratória. Essa organização do sistema faz com que paciente e familiares sintam-se seguros e é responsável pelo êxito do programa de assistência ventilatória no domicílio. Existe a necessidade de um grande esforço organizacional antes que possamos instituir programas semelhantes no Brasil.OBJECTIVE: to describe a German program for home ventilatory support, and to analyze the possibility of applying it in Brazil. MATERIALS AND METHODS: we assessed Dr. von Haunersches Kinderklinik’s Pediatric

  4. Effect of long duration exercise on the ratings of perceived exertion and perceived difficulty of walking and running at the ventilatory threshold.

    Science.gov (United States)

    Grego, F; Collardeau, M; Vallier, J M; Delignieres, D; Brisswalter, J

    2004-12-01

    The purpose of this study was to examine if the relationship between physiological changes classically observed with exercise duration and some subjective workload measures would be affected by the complexity of the locomotion mode (running vs racewalking). The study was conducted on 24 well trained subjects (12 long distance runners and 12 racewalkers) divided in 3 groups (runners, racewalkers and control). Energy cost of locomotion (C), heart rate (HR), minute ventilation (V(E)), lactate concentration [La], ratings of perceived exertion (RPE 6-20 scale) and ratings of perceived difficulty (RPD 1(-1)5 scale) were recorded during 2 10-min submaximal tests on a treadmill before and immediately after a 3 hour exercise (racewalking or running) conducted at the velocity ventilatory threshold (vVT). No significant variations in physiological parameters and perceived measures were observed in G(c). A significant increase (prunning (mean: +7.5%) at the end of exercise was observed. A significant interaction of locomotion mode and exercise duration was found on perceived exertion and perceived difficulty. In racewalkers RPD significantly increased with duration whereas no significant effect was found for RPE. Conversely a significant increase in RPE was found after 3 hours in runners without any significant change in RPD. This experiment suggests that, for a complex task, the classical relationship between RPE and metabolic load increase during prolonged exercise could be affected by changes in RPD. In this study, stability in RPE and increase in RPD observed in racewalkers may reflect an attentional focus dissociated from internal sensations and directed toward maintaining the required race walking gait.

  5. Divorcing Parents: Guidelines for Promoting Children's Adjustment.

    Science.gov (United States)

    Freeman, Kurt A.; Adams, Christina D; Drabman, Ronald S.

    1998-01-01

    There are measures that parents can take to help their children through the often distressing process of parental divorce. Describes the empirical literature regarding issues and factors relevant to children's adjustment to divorce. Provides practical guidelines and suggestions likely to help parents enhance their children's adjustment.…

  6. 7 CFR 1744.64 - Budget adjustment.

    Science.gov (United States)

    2010-01-01

    ... another source, requests a deficiency loan, or scales back the project. (b) RUS may make a budget... AGRICULTURE POST-LOAN POLICIES AND PROCEDURES COMMON TO GUARANTEED AND INSURED TELEPHONE LOANS Advance and... description of how the adjustment will affect loan purposes. RUS will not approve a budget adjustment...

  7. Parenting Styles and Adjustment in Gifted Children

    Science.gov (United States)

    Pilarinos, Vassiliki; Solomon, C. R.

    2017-01-01

    The present study examined the relationship between parenting styles and the psychosocial adjustment of 48 children aged 7 to 11 years, each of whom had been identified as gifted on the basis of a score of 130 or above on the Wechsler Intelligence Scale for Children--Fourth Edition. Parenting styles and child psychosocial adjustment were measured…

  8. Ergonomically Adjustable School Furniture for Male Students

    Science.gov (United States)

    Al-Saleh, Khalid S.; Ramadan, Mohamed Z.; Al-Ashaikh, Riyad A.

    2013-01-01

    The need for adjustability in school furniture, in order to accommodate the variation in anthropometric measures of different genders, cultures and ages is becoming increasingly important. Four chair-table combinations, different in dimensions, with adjustable chair seating heights and table heights were designed, manufactured and distributed to…

  9. Research on Adjust Time of Premium

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    By considering economic strength and economic profit of insurance company, this paper presents a concept-contact point, and gives premium expectation adjust time model which provides more practical significance for insurance company to make rational adjustment of premium. Finally, an illustration is given to show their application.

  10. Adjustment of the Internal Tax Scale

    CERN Multimedia

    2013-01-01

    In application of Article R V 2.03 of the Staff Regulations, the internal tax scale has been adjusted with effect on 1 January 2012. The new scale may be consulted via the CERN Admin e-guide.  The notification of internal annual tax certificate for the financial year 2012 takes into account this adjustment. HR Department (Tel. 73907)

  11. Policies facilitating firm adjustment to globalization

    OpenAIRE

    Hoekman, Bernard; Javorcik, Beata Smarzynska

    2004-01-01

    The authors focus on policies facilitating firm adjustment to globalization. They briefly review the effects of trade and investment liberalization on firms, focusing on within-industry effects. They postulate that governments' role in supporting the process is to (1) ensure that firms face "right" incentives to adjust, and (2) intervene in areas where market failures are present. Their ma...

  12. Adjusting to Retirement: Considerations for Counselors.

    Science.gov (United States)

    LaBauve, Bill J.; Robinson, Chester R.

    1999-01-01

    Examines retirement, while focusing on issues older adults face in adjusting to retirement, and suggests implications for counseling people who are making this transition. Discusses adjustment to retirement in terms of role, disengagement, activity, continuity, crisis, and compromise/negotiation theories. (Author/MKA)

  13. Cultural Distance Asymmetry in Expatriate Adjustment

    DEFF Research Database (Denmark)

    Selmer, Jan; Chiu, Randy K.; Shenkar, Oded

    2007-01-01

    Purpose - The current literature implicitly assumes a symmetric impact of cultural distance (CD) on expatriate adjustment. By using distance as a predictor of adjustment, the literature has rendered the direction of the flow irrelevant: a US expatriate in Germany is presumed to face the same hurd...

  14. Adjustment, Pollyannaism, and Attraction to Close Relationships

    Science.gov (United States)

    Scott, William A.; Peterson, Christopher

    1975-01-01

    The following two main hypotheses were tested: a) personal adjustment is associated with liking for close, personal relationships; and b) apparent adjustment is a manifestation of a test-taking style of favorable self-presentation. Data obtained from college students in three cultures tended to support the first interpretation best and the second…

  15. 76 FR 42140 - Rate Adjustment Remand

    Science.gov (United States)

    2011-07-18

    ... the plain meaning of the words ``due to'' in section 3622(d)(1)(E) requires a causal relationship... causal relationship between the amount of a requested adjustment and the exigent circumstances' impact on...'' phrase does not adequately express how close the relationship between the proposed adjustment and...

  16. 38 CFR 18.444 - Academic adjustments.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Academic adjustments. 18.444 Section 18.444 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED....444 Academic adjustments. (a) Academic requirements. A recipient shall make necessary modifications...

  17. Macroeconomic shocks and firms' labor adjustment

    DEFF Research Database (Denmark)

    Eriksson, Tor

    2013-01-01

    , but a brief discussion of cross-country differences and similarities in firmlevel labor adjustment is also provided. For Denmark, remarkable long-term stability in firms’ labor adjustment technologies is observed and the cross-country comparisons reveal striking similarities between countries with very...... diverse labor market institutions....

  18. Parenting Styles and Adjustment in Gifted Children

    Science.gov (United States)

    Pilarinos, Vassiliki; Solomon, C. R.

    2017-01-01

    The present study examined the relationship between parenting styles and the psychosocial adjustment of 48 children aged 7 to 11 years, each of whom had been identified as gifted on the basis of a score of 130 or above on the Wechsler Intelligence Scale for Children--Fourth Edition. Parenting styles and child psychosocial adjustment were measured…

  19. Religiousity, Spirituality and Adolescents' Self-Adjustment

    Science.gov (United States)

    Japar, Muhammad; Purwati

    2014-01-01

    Religiuosity, spirituality, and adolescents' self-adjustment. The objective of this study is to test the correlation among religiosity, spirituality and adolescents' self-adjustment. A quantitative approach was employed in this study. Data were collected from 476 junior high schools students of 13 State Junior High Schools and one Junior High…

  20. [Respiratory system elastance and resistance measured by proportional assist ventilation in patients with respiratory muscle weakness].

    Science.gov (United States)

    Oya, Yasushi; Ogawa, Masafumi; Kawai, Mitsuru

    2004-01-01

    Non-invasive ventilatory therapy has prolonged survival of myopathy patients with hypoventilation. Efficacy of non-invasive ventilation depends on both elastance and resistance of the respiratory system. Although these parameters are important in the prescription of respiratory management, conventional respiratory function test does not show the appropriate answer in patients with severe respiratory muscle weakness. In muscular dystrophy, muscle tends to be shortened due to its fibrosis, when muscle becomes atrophic and weak; fibrosis of respiratory muscle tissues presumably causes high thoracic elastance. We evaluated the total respiratory system elastance and resistance during proportional assist ventilation (PAV) in myopathy patients. In PAV with 100% assist, using BiPAP Vision ventilator, airway pressure exceeds 20 cmH2O or tidal volume exceeds 1.5 liter (run-away phenomenon) when the volume assist or the flow assist is higher than the individual elastance or the resistance, respectively. Twenty myopathy patients with ventilatory failure and 7 healthy controls were evaluated, including 7 patients with Duchenne muscular dystrophy (DMD), 2 patients with congenital myopathy (CM), 1 patient with limb-girdle muscular dystrophy (LG), 6 patients with myotonic dystrophy (MyD) and 4 patients with acid maltase deficiency (AMD). Seventeen patients used a nasal mask and 3 patients had a tracheostomy tube. Fifteen patients used a pressure-preset ventilator, and 3 patients used a volume-preset ventilator. In all patients with DMD, CM and LG, respiratory system elastance was higher than 20 (cmH2O/L) and than in all patients with AMD and MyD except 1 MyD patient. Follow-up measurement after half a or one year showed increase of respiratory system elastance in 2 DMD patients and 1 CM patient, but almost no change in 3 AMD patients. The elastance measured during PAV was consistent with the clinical impression of muscle shortening. One exceptional MyD patient showed extremely

  1. Cultural Distance Asymmetry in Expatriate Adjustment

    DEFF Research Database (Denmark)

    Selmer, Jan; Chiu, Randy K.; Shenkar, Oded

    2007-01-01

    of the assignment. Design/methodology/approach - Using a two-flow sample of US expatriates in Germany and German expatriates in the USA, we examine and compare the psychological and socio-cultural adjustment of each group of executives. Findings - Controlling for the length of assignment, we find that German...... expatriates in the USA were better adjusted, both socio-culturally and psychologically, than American expatriates in Germany. These results support the asymmetry hypothesis and call into question previous findings attesting to the relationship between CD and expatriate adjustment. Originality......Purpose - The current literature implicitly assumes a symmetric impact of cultural distance (CD) on expatriate adjustment. By using distance as a predictor of adjustment, the literature has rendered the direction of the flow irrelevant: a US expatriate in Germany is presumed to face the same hurdle...

  2. Assistance Focus: Africa (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2014-12-01

    The Clean Energy Solutions Center Ask an Expert service connects governments seeking policy information and advice with one of more than 30 global policy experts who can provide reliable and unbiased quick-response advice and information. The service is available at no cost to government agency representatives from any country and the technical institutes assisting them. This publication presents summaries of assistance provided to African governments, including the benefits of that assistance.

  3. Robot assisted laparoscopic radical prostatectomy: assistant's seniority has no influence on perioperative course.

    Science.gov (United States)

    Abu-Ghanem, Yasmin; Erlich, Tomer; Ramon, Jacob; Dotan, Zohar; Zilberman, Dorit E

    2016-11-09

    An experienced surgical team, in general, and the surgeon assistant in particular are believed to play a critical role in the operation's safety and success. We sought to explore whether the assistant's seniority influences perioperative course following robot assisted laparoscopic radical prostatectomy (RALP). We reviewed our prospective registry database of RALP cases performed by a single surgeon who during the study period was beyond his learning curve. The following parameters were documented and analyzed: patient's age, body mass index (BMI), associated comorbidities, previous abdominal surgeries, assistant's identity, total and skin-to-skin operative time (tOT, ssOT, respectively), estimated blood loss (EBL), immediate post-operative complications, length of stay (LOS), and prostate weight per final pathology report. Univariate analysis and Spearman's correlation test were used to evaluate whether the assistant's seniority influenced perioperative course. Between the years 2011-2015, 106 consecutive cases were retrieved and analyzed. Prostate weight was found to be associated with longer tOT (Spearman's ρ = 0.34, p < 0.001), ssOT (0.3, p < 0.01) and increased EBL (0.28, p < 0.01). Patient's age, BMI, associated comorbidities, and previous abdominal surgeries were found to have no influence on neither tOT, ssOT nor EBL. Three assistants' subgroups were identified (seniors, PGY 1-3, PGY 4-6). The assistant's seniority was found to have no influence on tOT, ssOT, EBL, immediate post-operative complications and LOS. Same results were obtained following prostate size adjustments. The assistant's seniority has no influence on perioperative course following RALP. Consequently, given a highly experienced primary surgeon, a less experienced assistant can be safely incorporated into this procedure.

  4. [Food assistance programs in Mexico, coverage and targeting].

    Science.gov (United States)

    Morales-Ruán, Ma del Carmen; Shamah-Levy, Teresa; Mundo-Rosas, Verónica; Cuevas-Nasu, Lucía; Romero-Martínez, Martín; Villalpando, Salvador; Rivera-Dommarco, Juan Ángel

    2013-01-01

    To describe the distribution of social food assistance programs in Mexico. Information about 36 150 households from the National Health and Nutrition Survey (ENSANUT 2012) was included. The distribution of the social assistance food programs by characteristics as rural/urban locality, country region, ethnicity, socioeconomic level and nutritional status was observed. At the national level, food assistance programs with the greater coverage are Oportunidades (reaching 18.8% of the population), Liconsa (milk distribution, 9.7%) and School Breakfasts (12.2%). The program that assists in the best way the target population is Oportunidades, where 75% of its beneficiaries belong to the "low" and "lower" socioeconomic levels, in contrast to Liconsa and School Breakfasts programs, where only 42% and 55% of the beneficiaries are in such levels, respectively. Current focus and application of the food assistance programs must be adjusted under the perspective of wellness, health and nutrition of the children population.

  5. Ventilatory-perfusory pulmonary scintigraphy as non invasive election procedure in patients with clinical suspicion of pulmonary thrombo emboli; Centelleografia pulmonar ventilatoria-perfusoria, como procedimiento no invasivo de eleccion en pacientes con sospecha clinica de tromboembolia pulmonar

    Energy Technology Data Exchange (ETDEWEB)

    Altamirano L, J

    2004-07-01

    30 patients were studied with suspicion of pulmonary thrombo emboli PTE, in a period of 9 months (January-September of 1992), 20 women and 10 men, with an age range of 26 to 88 years, average of 57.59 18.89. With respect to the clinical data, 24 presented breathing inadequacy (80%). 16 tachycardia (54%), 15 with thoracic pain (50%) and 4 with hemoptysis (13%). Of the cabinet studies, 12 presented electrocardiographic changes (IF, QIII, and TIII) (40%), 14 presented abnormalities in arterial gases. In the thorax tele, 8 presented abnormality; as spill, pneumonia, diaphragmatic elevation, etc. (26.6%) and of 14 the result was not reported (46 6%). They were carried out in all the patients, the ventilatory studies and perfusories in that order. A Siemens mark scintillation camera was used, with a collimator of low energy and of high resolution; the information was stored in a floppy disk, and later on they were printed in radiographic plaques of high resolution. The ventilatory study was carried out with 30 mCi of {sup 99m} Tc-DTPA, in radio aerosol form, emitted by a micro nebulizer, to which was applied a pressure of oxygen of 10 ml-min; during 10 to 15 minutes. They took projections antero, posterior, oblique antero left and right, oblique posterior left and right, each one with an acquisition of 150000 counts, or during 5 minutes. Later on and remaining the patient in supine position, was carried out the perfusory study, applying 3-4 mCi of {sup 99} Tc-MAA for endo venous via; they took the same projections that the ventilatory study, but with a density of information greater (500 000 counts each one). Both studies are printed in a radiographic plaque of high resolution, with which is interpreted and the study is filed. (Author)

  6. Role of Osmotic Adjustment in Plant Productivity

    Energy Technology Data Exchange (ETDEWEB)

    Gebre, G.M.

    2001-01-11

    Successful implementation of short rotation woody crops requires that the selected species and clones be productive, drought tolerant, and pest resistant. Since water is one of the major limiting factors in poplar (Populus sp.) growth, there is little debate for the need of drought tolerant clones, except on the wettest of sites (e.g., lower Columbia River delta). Whether drought tolerance is compatible with productivity remains a debatable issue. Among the many mechanisms of drought tolerance, dehydration postponement involves the maintenance of high leaf water potential due to, for example, an adequate root system. This trait is compatible with productivity, but requires available soil moisture. When the plant leaf water potential and soil water content decline, the plant must be able to survive drought through dehydration tolerance mechanisms, such as low osmotic potential or osmotic adjustment. Osmotic adjustment and low osmotic potential are considered compatible with growth and yield because they aid in the maintenance of leaf turgor. However, it has been shown that turgor alone does not regulate cell expansion or stomatal conductance and, therefore, the role of osmotic adjustment is debated. Despite this finding, osmotic adjustment has been correlated with grain yield in agronomic crop species, and gene markers responsible for osmotic adjustment are being investigated to improve drought tolerance in productive progenies. Although osmotic adjustment and low osmotic potentials have been investigated in several forest tree species, few studies have investigated the relationship between osmotic adjustment and growth. Most of these studies have been limited to greenhouse or container-grown plants. Osmotic adjustment and rapid growth have been specifically associated in Populus and black spruce (Picea mariuna (Mill.) B.S.P.) progenies. We tested whether these relationships held under field conditions using several poplar clones. In a study of two hybrid poplar

  7. Adjustment and mental health problem in prisoners

    Directory of Open Access Journals (Sweden)

    Sudhinta Sinha

    2010-01-01

    Full Text Available Background : "Crime" is increasing day by day in our society not only in India but also all over the world. In turn, the number of prisoners is also increasing at the same rate. They remain imprisoned for a long duration or in some cases for the whole life. Living in a prison for long time becomes difficult for all inmates. So they often face adjustment and mental health problems. Recent findings suggest that mental illness rate in prison is three times higher than in the general population. Objective: The aim of the present study was to investigate the adjustment and the mental health problem and its relation in the prisoners. Materials and Methods : In the present study, 37 male prisoners of district jail of Dhanbad District of Jharkhand were selected on purposive sampling basis. Each prisoner was given specially designed Performa - Personal Data Sheet, General Health Questionnaire-12 and Bell Adjustment Inventory. Appropriate statistical tools were used to analyze the data. Results: The results obtained showed poor adjustment in social and emotional areas on the adjustment scale. The study also revealed a significant association between adjustment and mental health problem in the prisoners. Conclusion: The prisoners were found to have poor social and emotional adjustment which has strong association with their mental health.

  8. Couples' patterns of adjustment to colon cancer.

    Science.gov (United States)

    Northouse, L L; Mood, D; Templin, T; Mellon, S; George, T

    2000-01-01

    The objectives for this longitudinal study were to: (a) compare colon cancer patients' and their spouses' appraisal of illness, resources, concurrent stress, and adjustment during the first year following surgery; (b) examine the influence of gender (male vs female) and role (patient vs spouse caregiver) on study variables; (c) assess the degree of correlation between patients' and spouses' adjustments; and (d) identify factors that affect adjustment to the illness. Fifty-six couples were interviewed at one week post diagnosis, and at 60 days and one year post surgery. Based on a cognitive-appraisal model of stress, the Smilkstein Stress Scale was used to measure concurrent stress; the Family APGAR, Social Support Questionnaire, and Dyadic Adjustment Scale were used to measure social resources; the Beck Hopelessness Scale and Mishel Uncertainty in Illness Scales were used to measure appraisal of illness; and the Brief Symptom Inventory and Psychosocial Adjustment to Illness Scale were used to measure psychosocial adjustment. Repeated Measures Analysis of Variance indicated that spouses reported significantly more emotional distress and less social support than patients. Gender differences were found, with women reporting more distress, more role problems, and less marital satisfaction, regardless of whether they were patient or spouse. Both patients and spouses reported decreases in their family functioning and social support, but also decreases in emotional distress over time. Moderately high autocorrelations and modest intercorrelations were found among and between patients' and spouses' adjustment scores over time. The strongest predictors of patients' role adjustment problems were hopelessness and spouses' role problems. The strongest predictors of spouses' role problems were spouses' own baseline role problems and level of marital satisfaction. Interventions need to start early in the course of illness, be family-focused, and identify the couples at risk of

  9. Assisted suicide and euthanasia.

    Science.gov (United States)

    van der Heide, Agnes

    2013-01-01

    Several countries have adopted laws that regulate physician assistance in dying. Such assistance may consist of providing a patient with a prescription of lethal medication that is self-administered by the patient, which is usually referred to as (physician) assistance in suicide, or of administering lethal medication to a patient, which is referred to as euthanasia. The main aim of regulating physician assistance in dying is to bring these practices into the open and to provide physicians with legal certainty. A key condition in all jurisdictions that have regulated either assistance in suicide or euthanasia is that physicians are only allowed to engage in these acts upon the explicit and voluntary request of the patient. All systems that allow physician assistance in dying have also in some way included the notion that physician assistance in dying is only accepted when it is the only means to address severe suffering from an incurable medical condition. Arguments against the legal regulation of physician assistance in dying include principled arguments, such as the wrongness of hastening death, and arguments that emphasize the negative consequences of allowing physician assistance in dying, such as a devaluation of the lives of older people, or people with chronic disease or disabilities. Opinion polls show that some form of accepting and regulating euthanasia and physician assistance in suicide is increasingly supported by the general population in most western countries. Studies in countries where physician assistance in dying is regulated suggest that practices have remained rather stable in most jurisdictions and that physicians adhere to the legal criteria in the vast majority of cases.

  10. A note on how to iterate adjustment

    Energy Technology Data Exchange (ETDEWEB)

    Wagschal, Jehudah J.; Yeivin, Yehuda [Hebrew University of Jerusalem, Racah Institute of Physics, Jerusalem (Israel)

    2002-08-01

    We study the elementary problem of adjusting a given parameter library by one measured response so that calculating the response with the adjusted library reproduces the measured value. We formulate the problem of the least-squares adjustment for non-linear responses, and offer a reasoned iteration scheme to solve it. A numerical example illustrates the success of the proposed procedure. Our scheme is identical to that suggested by Perey, and thus adds insight, offers justification, and also serves as a formal proof of the latter. (author)

  11. Structural Adjustment of Oasis Agriculture in Xinjiang

    Institute of Scientific and Technical Information of China (English)

    Lei Jun; Zhang Xiaolei

    2005-01-01

    Xinjiang's oasis agriculture has made enormous strides over past decades. Structural adjustment of oasis agriculture sector has promoted production diversification. Xinjiang's oasis agriculture sector is entering a new era. The era means more adjustments in oasis agricultural and rural economic structure so as to realize the sustainable development of agriculture. By summing and analyzing the main problems in Xinjinag's oasis agricultural structure,such as raising farmer's income, industry structure within agriculture, rural urbanization, pressure coming from market, agricultural environment degradation,puts forward the thinking, director and countermeasures to adjust oasis agricultural structure.

  12. Adjusting the inner-structure of polypyrrole nanoparticles through microemulsion polymerization

    Energy Technology Data Exchange (ETDEWEB)

    Liu Yang [Department of Chemistry, Northeast Normal University, Changchun, Jilin 130024 (China); Chu Ying [Department of Chemistry, Northeast Normal University, Changchun, Jilin 130024 (China)]. E-mail: chuying@nenu.edu.cn; Yang Likun [Department of Chemistry, Northeast Normal University, Changchun, Jilin 130024 (China)

    2006-08-01

    The inner-structure of polypyrrole (PPy) nanoparticles can be straightly adjusted by a simple alcohol-assisted microemulsion polymerization. The characteristic peaks of PPy in infrared spectroscopy (IR) confirm the formation of PPy. The morphology of PPy nanoparticles was characterized by transmission electron microscopy (TEM) and scanning electron microscopy (SEM). UV-vis and Raman spectra exhibit that the conjugation and order of PPy chains were improved directly in the presence of alcohols and adjusted by the alkyl unit of alcohols. These changes in the molecular structure lead to the improvement in the electrical conductivity of as-prepared PPy nanoparticles obviously.

  13. The choice of a 'Best' assisted history matching algorithm

    NARCIS (Netherlands)

    Hanea, R.G.; Przybysz-Jarnut, J.K.; Krymskaya, M.V.; Heemink, A.W.; Jansen, J.D.

    2010-01-01

    Computer-assisted history matching is the act of systematicalty adjusting a ‘prior’ reservoir model using measured data until its simulated production response closely reproduces the past behavior of the reservoir. Thereafler, the updated, ‘posterior’, model is expected to predict future reservoir b

  14. Steering and evasion assist

    NARCIS (Netherlands)

    Dang, T.; Desens, J.; Franke, U.; Gavrila, D.; Schäfers, L.; Ziegler, W.; Eskandarian, A.

    2012-01-01

    Steering and evasion assistance defines a new and future class of driver assistance systems to avoid an impending collision with other traffic participants. Dynamic and kinematic considerations reveal that an evasive steering maneuver has high potential for collision avoidance in many driving

  15. Medical Assisting Program Guide.

    Science.gov (United States)

    Georgia Univ., Athens. Dept. of Vocational Education.

    This guide presents the standard curriculum for technical institutes in Georgia. The curriculum addresses the minimum competencies for a medical assisting program. The program guide is designed to relate primarily to the development of those skills needed by individuals in the medical assisting field, such as medical law and ethics, typing,…

  16. Inheritance of Welfare Recipiency: An Intergenerational Study of Social Assistance Recipiency in Postwar Sweden.

    Science.gov (United States)

    Stenberg, Sten-Ake

    2000-01-01

    Study utilizes a longitudinal data set from Sweden to test hypotheses on the inheritance of welfare benefit recipiency as indicated by reliance on means-tested social assistance. A clear intergenerational effect was observed. Effect reflects a combination of social assistance in the family of origin, children's school adjustment, and parental…

  17. 29 CFR 90.22 - Dissemination of program knowledge and assistance to workers.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Dissemination of program knowledge and assistance to workers. 90.22 Section 90.22 Labor Office of the Secretary of Labor CERTIFICATION OF ELIGIBILITY TO APPLY FOR WORKER ADJUSTMENT ASSISTANCE Initiation and Conduct of Study With Respect to Workers in Industry Which is...

  18. 24 CFR 882.410 - Rent adjustments.

    Science.gov (United States)

    2010-04-01

    ... URBAN DEVELOPMENT (SECTION 8 HOUSING ASSISTANCE PROGRAMS, SECTION 202 DIRECT LOAN PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SECTION 8 MODERATE REHABILITATION PROGRAMS Special Procedures for Moderate...

  19. Marital Adjustment and Psychological Distress in Japan.

    Science.gov (United States)

    Li, Angela; Robustelli, Briana L; Whisman, Mark A

    2016-11-01

    This study was conducted to examine the association between marital adjustment and psychological distress in a large, probability sample of married adults in Japan (N = 710) from the Midlife Development in Japan (MIDJA) study. Results indicate that positive and negative dimensions of marital adjustment were significantly associated with dimensional and categorical measures of psychological distress. Furthermore, the associations between marital adjustment and psychological distress remained significant when statistically controlling for neuroticism, quality of friend and family relationships, and demographic variables. These results demonstrate that the well-established association between marital adjustment and psychological distress found in European-American countries is also found in Japan. Findings support continued research on marital functioning and psychological distress in East Asian countries.

  20. Risk-adjusted monitoring of survival times

    Energy Technology Data Exchange (ETDEWEB)

    Sego, Landon H.; Reynolds, Marion R.; Woodall, William H.

    2009-02-26

    We consider the monitoring of clinical outcomes, where each patient has a di®erent risk of death prior to undergoing a health care procedure.We propose a risk-adjusted survival time CUSUM chart (RAST CUSUM) for monitoring clinical outcomes where the primary endpoint is a continuous, time-to-event variable that may be right censored. Risk adjustment is accomplished using accelerated failure time regression models. We compare the average run length performance of the RAST CUSUM chart to the risk-adjusted Bernoulli CUSUM chart, using data from cardiac surgeries to motivate the details of the comparison. The comparisons show that the RAST CUSUM chart is more efficient at detecting a sudden decrease in the odds of death than the risk-adjusted Bernoulli CUSUM chart, especially when the fraction of censored observations is not too high. We also discuss the implementation of a prospective monitoring scheme using the RAST CUSUM chart.

  1. Annual adjustments to 2014 financial benefits

    CERN Multimedia

    2013-01-01

    In accordance with recommendations made by the Finance Committee and decisions taken by Council in December 2013, no adjustments have been made to basic salaries and stipends, subsistence allowances or family benefits as at 1 January 2014. HR Department

  2. Annual adjustments to 2016 financial benefits

    CERN Multimedia

    HR Department

    2016-01-01

    In accordance with recommendations made by the Finance Committee and decisions taken by the Council in December 2015, no adjustments have been made to basic salaries and stipends, subsistence allowances or family benefits as at 1 January 2016.  

  3. Continuity Adjustment for Control Charts for Attributes

    Institute of Scientific and Technical Information of China (English)

    L.K. Chan; T.K. Mak; B. Tao

    2003-01-01

    A unified approach is proposed for making a continuity adjustment on some control charts for attributes, e.g., np-chart and c-chart, through adding a uniform (0, 1) random observation to the conventional sample statistic (e.g., npi and ci). The adjusted sample statistic then has a continuous distribution. Consequently, given any Type I risk α (the probability that the sample statistic is on or beyond the control limits),control charts achieving the exact value of α can be readily constructed. Guidelines are given for when to use the continuity adjustment control chart, the conventional Shewhart control chart (with ±3 standard deviations control limits), and the control chart based on the exact distribution of the sample statistic before adjustment.

  4. Speed of adjustment: Evidence from Borsa Istanbul

    Directory of Open Access Journals (Sweden)

    Emrah Arioglu

    2014-06-01

    Full Text Available In this study, we investigate the speed of adjustment for leverage ratios of firms listed on Borsa Istanbul, in order to investigate the prediction of the trade-off theory, regarding capital structure rebalancing. For this purpose, we estimate the speed of adjustment by using Generalized Method of Moments system estimation technique. The results of this estimation suggest the speed of adjustment as approximately 29%. This significant speed of adjustment is consistent with the prediction of trade-off theory, which suggests that firms follow target capital structures and when the firms' leverage ratios deviate from these targets; they make financial decisions with the goal of closing the gap between the previous year's leverage and target leverage of the current period.

  5. Determinants of intercultural adjustment among expatriate spouses

    NARCIS (Netherlands)

    Ali, Anees; Van der Zee, K.I.; Sanders, G

    2003-01-01

    The adaptation of expatriate families to a host country seems crucial to successful fulfilment of international business assignments. The present study focused on personality, family characteristics and characteristics of expatriates' work life as determinants of the intercultural adjustment of expa

  6. Annual adjustments to 2015 financial benefits

    CERN Multimedia

    HR Department

    2015-01-01

    In accordance with recommendations made by the Finance Committee and decisions taken by Council in December 2014, no adjustments have been made to basic salaries and stipends, subsistence allowances or family benefits as at 1 January 2015.

  7. Annual adjustments to 2013 financial benefits

    CERN Multimedia

    2013-01-01

    In accordance with recommendations made by the Finance Committee and decisions taken by Council in December 2012, no adjustments have been made to basic salaries and stipends, subsistence allowances or family benefits as at 1 January 2013. HR Department

  8. Maintained inspiratory activity during proportional assist ventilation in surfactant-depleted cats early after surfactant instillation: phrenic nerve and pulmonary stretch receptor activity

    Directory of Open Access Journals (Sweden)

    Schaller Peter

    2006-03-01

    Full Text Available Abstract Background Inspiratory activity is a prerequisite for successful application of patient triggered ventilation such as proportional assist ventilation (PAV. It has recently been reported that surfactant instillation increases the activity of slowly adapting pulmonary stretch receptors (PSRs followed by a shorter inspiratory time (Sindelar et al, J Appl Physiol, 2005 [Epub ahead of print]. Changes in lung mechanics, as observed in preterm infants with respiratory distress syndrome and after surfactant treatment, might therefore influence the inspiratory activity when applying PAV early after surfactant treatment. Objective To investigate the regulation of breathing and ventilatory response in surfactant-depleted young cats during PAV and during continuous positive airway pressure (CPAP early after surfactant instillation in relation to phrenic nerve activity (PNA and the activity of PSRs. Methods Seven anesthetized, endotracheally intubated young cats were exposed to periods of CPAP and PAV with the same end-expiratory pressure (0.2–0.5 kPa before and after lung lavage and after surfactant instillation. PAV was set to compensate for 75% of the lung elastic recoil. Results Tidal volume and respiratory rate were higher with lower PaCO2 and higher PaO2 during PAV than during CPAP both before and after surfactant instillation (p Conclusion PSR activity and the control of breathing are maintained during PAV in surfactant-depleted cats early after surfactant instillation, with a higher ventilatory response and a lower breathing effort than during CPAP.

  9. Price Changes, Resource Adjustments and Rational Expectations

    DEFF Research Database (Denmark)

    Hoffmann, Kira

    This study investigates the relationship between the accuracy of managerial demand expectations, resource adjustment decisions and selling price changes. In line with rational expectation theory, it is argued that managers adjust resources and selling prices differently in response to expected...... that cost elasticity is higher when a demand decrease is expected among companies with similar exposure to demand uncertainty. Overall, this implies that managerial competences in predicting future demand significantly determines firms’ profitability; especially when demand uncertainty is high...

  10. Adjustable Fiber Optic Microwave Transversal Filters

    Science.gov (United States)

    Shadaram, Mehdi; Lutes, George F.; Logan, Ronald T.; Maleki, Lutfollah

    1994-01-01

    Microwave transversal filters implemented as adjustable tapped fiber optic delay lines developed. Main advantages of these filters (in comparison with conventional microwave transversal filters) are small size, light weight, no need for matching of radio-frequency impedances, no need for shielding against electromagnetic radiation at suboptical frequencies, no need for mechanical tuning, high stability of amplitude and phase, and active control of transfer functions. Weights of taps in fiber optic delay lines adjusted.

  11. Industrial Forecasts after Export Rebates Adjustment

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ On June 19, 2007, the Circular of the Ministry of Finance and the State Administration of Taxation concerning Lowering the Export Rebate Rates for Some Commodities was published, which finally proved the early rumor of tax rebate adjustment to be true.According to the Circular, the export rebate rates for some commodities have been adjusted upon approval of the State Council and the new rates have become in force since July 1, 2007.

  12. Measuring the human ventilatory and cerebral blood flow response to CO2: a technical consideration for the end-tidal-to-arterial gas gradient.

    Science.gov (United States)

    Tymko, Michael M; Hoiland, Ryan L; Kuca, Tomas; Boulet, Lindsey M; Tremblay, Joshua C; Pinske, Bryenna K; Williams, Alexandra M; Foster, Glen E

    2016-01-15

    Our aim was to quantify the end-tidal-to-arterial gas gradients for O2 (PET-PaO2) and CO2 (Pa-PETCO2) during a CO2 reactivity test to determine their influence on the cerebrovascular (CVR) and ventilatory (HCVR) response in subjects with (PFO+, n = 8) and without (PFO-, n = 7) a patent foramen ovale (PFO). We hypothesized that 1) the Pa-PETCO2 would be greater in hypoxia compared with normoxia, 2) the Pa-PETCO2 would be similar, whereas the PET-PaO2 gradient would be greater in those with a PFO, 3) the HCVR and CVR would be underestimated when plotted against PETCO2 compared with PaCO2, and 4) previously derived prediction algorithms will accurately target PaCO2. PETCO2 was controlled by dynamic end-tidal forcing in steady-state steps of -8, -4, 0, +4, and +8 mmHg from baseline in normoxia and hypoxia. Minute ventilation (V̇E), internal carotid artery blood flow (Q̇ICA), middle cerebral artery blood velocity (MCAv), and temperature corrected end-tidal and arterial blood gases were measured throughout experimentation. HCVR and CVR were calculated using linear regression analysis by indexing V̇E and relative changes in Q̇ICA, and MCAv against PETCO2, predicted PaCO2, and measured PaCO2. The Pa-PETCO2 was similar between hypoxia and normoxia and PFO+ and PFO-. The PET-PaO2 was greater in PFO+ by 2.1 mmHg during normoxia (P = 0.003). HCVR and CVR plotted against PETCO2 underestimated HCVR and CVR indexed against PaCO2 in normoxia and hypoxia. Our PaCO2 prediction equation modestly improved estimates of HCVR and CVR. In summary, care must be taken when indexing reactivity measures to PETCO2 compared with PaCO2. Copyright © 2016 the American Physiological Society.

  13. Robot-Assisted Navigation versus Computer-Assisted Navigation in Primary Total Knee Arthroplasty: Efficiency and Accuracy.

    Science.gov (United States)

    Clark, Tanner C; Schmidt, Frank H

    2013-01-01

    Background. Since the introduction of robot-assisted navigation in primary total knee arthroplasty (TKA), there has been little research conducted examining the efficiency and accuracy of the system compared to computer-assisted navigation systems. Objective. To compare the efficiency and accuracy of Praxim robot-assisted navigation (RAN) and Stryker computer-assisted navigation (CAN) in primary TKA. Methods. This was a retrospective study consisting of 52 patients who underwent primary TKA utilizing RAN and 29 patients utilizing CAN. The primary outcome measure was navigation time. Secondary outcome measures included intraoperative final mechanical axis alignment, intraoperative robot-assisted bone cut accuracy, tourniquet time, and hospitalization length. Results. RAN navigation times were, on average, 9.0 minutes shorter compared to CAN after adjustment. The average absolute intraoperative malalignment was 0.5° less in the RAN procedures compared to the CAN procedures after adjustment. Patients in the RAN group tended to be discharged 0.6 days earlier compared to patients in the CAN group after adjustment. Conclusions. Among patients undergoing TKA, there was decreased navigation time, decreased final malalignment, and decreased hospitalization length associated with the use of RAN when compared to CAN independent of age, BMI, and pre-replacement alignment.

  14. Dose Adjustment for Normal Eating: A Role for the Expert Patient?

    Directory of Open Access Journals (Sweden)

    Harold David McIntyre

    2014-04-01

    Full Text Available The Dose Adjustment for Normal Eating (DAFNE programme of intensive insulin therapy for type 1 diabetes provides a structured educational intervention to improve glycemic control, reduce hypoglycemia and improve quality of life. Enhancement of self-management skills is a key element of DAFNE and patients acquire detailed skills in insulin dose adjustment. Following DAFNE training, patients report improved confidence in their ability to manage their own insulin dosing, but generally still seek and require the assistance of health professionals when making substantial changes to their insulin regimens. Some DAFNE trained patients may be able to assist their peers in aspects of diabetes management within a group environment, but widespread introduction of the expert patient/peer educator role in the self-management of type 1 diabetes, in particular related to insulin dose management, would require formal and detailed evaluation, preferably in randomized controlled clinical trials, before being introduced into routine clinical practice.

  15. Weatherization Assistance Program Technical Assistance Center

    Energy Technology Data Exchange (ETDEWEB)

    Robert Adams

    2009-01-07

    The following is a synopsis of the major achievements attributed to the operation of the Weatherization Assistance Program Technical Assistance Center (WAPTAC) by the National Association for State Community Services Programs (NASCSP). During the past five years, the WAPTAC has developed into the premier source for information related to operating the Weatherization Assistance Program (WAP) at the state and local levels. The services provide through WAPTAC include both virtual technical support as well as hands-on training and instruction in classroom and in the field. The WAPTAC achieved several important milestones during its operation including the establishment of a national Weatherization Day now celebrated in most states, the implementation of a comprehensive Public Information Campaign (PIC) to raise the awareness of the Program among policy makers and the public, the training of more than 150 new state managers and staff as they assume their duties in state offices around the country, and the creation and support of a major virtual information source on the Internet being accessed by thousands of staff each month. The Weatherization Assistance Program Technical Assistance Center serves the Department of Energy's (DOE) Office of Weatherization and Intergovernmental Program as a valuable training and technical assistance resource for the network of 54 direct state grantees (50 states, District of Columbia and three Native American tribes) and the network of 900 local subgrantees (comprised of community action agencies, units of local government, and other non-profit organizations). The services provided through WAPTAC focus on standardizing and improving the daily management of the WAP. Staff continually identify policies changes and best practices to help the network improve its effectiveness and enhance the benefits of the Program for the customers who receive service and the federal and private investors. The operations of WAPTAC are separated into

  16. FEMA Hazard Mitigation Assistance Flood Mitigation Assistance (FMA) Data

    Data.gov (United States)

    Department of Homeland Security — This dataset contains closed and obligated projects funded under the following Hazard Mitigation Assistance (HMA) grant programs: Flood Mitigation Assistance (FMA)....

  17. The effect of accuracy motivation on anchoring and adjustment: do people adjust from provided anchors?

    Science.gov (United States)

    Simmons, Joseph P; LeBoeuf, Robyn A; Nelson, Leif D

    2010-12-01

    Increasing accuracy motivation (e.g., by providing monetary incentives for accuracy) often fails to increase adjustment away from provided anchors, a result that has led researchers to conclude that people do not effortfully adjust away from such anchors. We challenge this conclusion. First, we show that people are typically uncertain about which way to adjust from provided anchors and that this uncertainty often causes people to believe that they have initially adjusted too far away from such anchors (Studies 1a and 1b). Then, we show that although accuracy motivation fails to increase the gap between anchors and final estimates when people are uncertain about the direction of adjustment, accuracy motivation does increase anchor-estimate gaps when people are certain about the direction of adjustment, and that this is true regardless of whether the anchors are provided or self-generated (Studies 2, 3a, 3b, and 5). These results suggest that people do effortfully adjust away from provided anchors but that uncertainty about the direction of adjustment makes that adjustment harder to detect than previously assumed. This conclusion has important theoretical implications, suggesting that currently emphasized distinctions between anchor types (self-generated vs. provided) are not fundamental and that ostensibly competing theories of anchoring (selective accessibility and anchoring-and-adjustment) are complementary.

  18. Adjustable versus non-adjustable suture techniques for concomitant horizontal strabismus: a comparative study

    Directory of Open Access Journals (Sweden)

    Galton C. Vasconcelos

    2015-12-01

    Full Text Available ABSTRACT Purpose: To compare the surgical results of adjustable and non-adjustable horizontal strabismus surgery for concomitant horizontal strabismus. Methods: The charts of 231 patients, who underwent horizontal strabismus surgery, selected using probabilistic sampling, were retrospectively reviewed. Patients were divided into two groups according to the surgical technique used and strabismus type. The adjustable suture technique was used for 107 patients (Group 1, and non-adjustable or conventional surgery was performed in the remaining 124 patients (Group 2. Patients with esotropia (ET or exotropia (XT of 5 PD, syndromes, restrictive or paretic strabismus, reoperations, botulinum toxin injection, and patients postoperatively followed up for 50% was present in all subgroups. Significant differences between strabismus groups submitted to adjustable technique and non-adjustable on postoperative day 1 were observed (p=0.00 for ET and p=0.01 for XT and at the last visit for the XT group with a follow-up of at least 1 year (p=0.05. Conclusion: The adjustable suture technique produced a higher success rate than non-adjustable strabismus surgery for both ET and XT groups on postoperative day 1. For XT patients, the adjustable suture technique appears to produce better surgical results than non-adjustable surgery, when the surgical goal is long-lasting maintenance of a small hypercorrection.

  19. 10 CFR 455.122 - Applicant certifications for State grants for technical assistance, program assistance, and...

    Science.gov (United States)

    2010-01-01

    ... for State grants for technical assistance, program assistance, and marketing. Applications from States for financial assistance for technical assistance programs, program assistance, and marketing shall... expend, for technical assistance, program assistance, and marketing, more than 15 percent of the...

  20. Couples' adjustment to breast cancer and benign breast disease: a longitudinal analysis.

    Science.gov (United States)

    Northouse, L L; Templin, T; Mood, D; Oberst, M

    1998-01-01

    A comprehensive comparison of couples' adjustment to benign (n = 73 couples) and malignant breast disease (n = 58 couples) at the time of diagnosis and at two follow-up assessments at 60 days and 1 year is reported. Specific objectives were to: (a) compare the concurrent stress, resources, appraisal, and patterns of adjustment of couples in the benign and malignant groups; (b) compare the psychosocial responses of patients versus spouses; and (c) determine the amount of correspondence in levels of adjustment reported by patients and their husbands over time. Multiple instruments with reported reliability and validity were used to measure study variables: Smilkstein Stress Scale, Dyadic Adjustment Scale, Family APGAR, Social Support Questionnaire, Mishel Uncertainty in Illness Scale, Beck Hopelessness Scale, Brief Symptom Inventory, and Psychosocial Adjustment to Illness Scale. Mixed design analyses of covariance (ANCOVA) were used to assess differences between and among couples and examine changes in study variables over time. Significant differences were found in the resources, appraisal, and patterns of adjustment reported by couples in the benign and malignant groups. Couples facing breast cancer reported greater decreases in their marital and family functioning, more uncertain appraisals, and more adjustment problems associated with the illness. In addition, there was a high degree of correspondence between the levels of adjustment reported by women with breast cancer and their husbands over time. Couples who reported high distress or a high number of role problems at diagnosis were likely to remain highly distressed at 60 days and 1 year. Study findings underscore the importance of assisting couples, not just patients, to manage the adjustment difficulties associated with breast cancer.

  1. Ventilatory strategy during liver transplantation

    DEFF Research Database (Denmark)

    Sørensen, Henrik; Grocott, Hilary P; Niemann, Mads

    2014-01-01

    BACKGROUND: As measured by near infrared spectroscopy (NIRS), cerebral oxygenation (ScO2) may be reduced by hyperventilation in the anhepatic phase of liver transplantation surgery (LTx). Conversely, the brain may be subjected to hyperperfusion during reperfusion of the grafted liver. We investig......, this retrospective analysis suggests that attention to maintain a targeted EtCO2 would result in a more stable ScO2 during the operation....

  2. Identifying ventilatory anaerobic threshold in children and adolescents: A literature review. DOI: http://dx.doi.org/10.5007/1980-0037.2012v14n3p343

    Directory of Open Access Journals (Sweden)

    Luciana Carletti

    2012-05-01

    Full Text Available Ventilatory anaerobic threshold (VAT has been used in research to represent pulmonary function and submaximal performance capacity of children and adolescents. This study aimed to identify: a the group of children and adolescents that has been the main focus of research; b the criteria most commonly used to determine VAT; and c the main references that have been used to support the theoretical analysis. A literature search was conducted using LILACS, MEDLINE/PubMed, and SciELO. The search was limited to studies using VAT in their methodology, published between 2000 and 2010, in order to identify categories through content analysis. Descriptive statistics were used to analyze the data. Forty-five studies were found and distributed according to categories identified, as follows: severe exercise intolerance (23 [51%]; healthy subjects (6 [13%]; obese subjects and comparison of methodologies (4 [9%], each; O2 kinetics (3 [7%]; sports (2 [4%]; stunting, asthma, and effort perception (1 [2%], each. The main reference used is Beaver WL, Wasserman K, Whipp BJ (1986, cited in 24 (53% studies, and the main criterion for VAT determination is the V-slope method. In addition to this method, ventilatory equivalents for O2 and CO2 have been used, accounting for 37% (17 of cases. In conclusion, the dataindicate that VAT has been primarily used in rehabilitation studies including children and adolescents by the V-slope method.

  3. Robotic assisted laparoscopic colectomy.

    LENUS (Irish Health Repository)

    Pandalai, S

    2010-06-01

    Robotic surgery has evolved over the last decade to compensate for limitations in human dexterity. It avoids the need for a trained assistant while decreasing error rates such as perforations. The nature of the robotic assistance varies from voice activated camera control to more elaborate telerobotic systems such as the Zeus and the Da Vinci where the surgeon controls the robotic arms using a console. Herein, we report the first series of robotic assisted colectomies in Ireland using a voice activated camera control system.

  4. Society for Assisted Reproductive Technology

    Science.gov (United States)

    The Society for Assisted Reproductive Technology PATIENTS Patient Information What Is SART? Risks of IVF Third Party Reproduction A Patient's Guide to Assisted Reproductive Technology Frequently Asked ...

  5. Energetics of geostrophic adjustment in rotating flow

    Science.gov (United States)

    Juan, Fang; Rongsheng, Wu

    2002-09-01

    Energetics of geostrophic adjustment in rotating flow is examined in detail with a linear shallow water model. The initial unbalanced flow considered first falls tinder two classes. The first is similar to that adopted by Gill and is here referred to as a mass imbalance model, for the flow is initially motionless but with a sea surface displacement. The other is the same as that considered by Rossby and is referred to as a momentum imbalance model since there is only a velocity perturbation in the initial field. The significant feature of the energetics of geostrophic adjustment for the above two extreme models is that although the energy conversion ratio has a large case-to-case variability for different initial conditions, its value is bounded below by 0 and above by 1 / 2. Based on the discussion of the above extreme models, the energetics of adjustment for an arbitrary initial condition is investigated. It is found that the characteristics of the energetics of geostrophic adjustment mentioned above are also applicable to adjustment of the general unbalanced flow under the condition that the energy conversion ratio is redefined as the conversion ratio between the change of kinetic energy and potential energy of the deviational fields.

  6. Separate adjustment in close-range photogrammetry

    Science.gov (United States)

    Wang, X.; Clarke, T. A.

    Industrial manufacturing processes will increasingly require high-speed 3D measurement. If a photogrammetric measurement system is used, cameras will typically be pre-calibrated for interior orientation parameters. The conventional bundle adjustment may be computationally too expensive and other algorithms such as DLT or direct intersection can be used. However, these methods do not provide optimum solutions. In this paper, the separate adjustment method is introduced. This method is based on the separate least squares estimation (LSE) of both the camera exterior orientation parameters and the 3D co-ordinates of the object points. The same results as the bundle adjustment are produced but with a significantly lower computational load. This method is analogous to iterative solution algorithms such as Jacobi or Gauss-Seidel; however, the implementation is different. It is also similar to the successive application of resection and intersection under certain circumstances. The separate adjustment algorithm is described and compared with the bundle adjustment in terms of results, speed and memory requirements.

  7. Technical Assistance Plan (TAP)

    Science.gov (United States)

    A Technical Assistance Plan (TAP) enables community groups to retain the services of an independent technical advisor and to provide resources for a community group to help inform other community members about site decisions.

  8. Accessibility and assistive products

    Science.gov (United States)

    Rodríguez-Porrero, Cristina

    2009-01-01

    Introduction Accessibility and assistive products and technologies are needed to ensure the rights of persons with disabilities and older persons. Many developments have been implemented in laws, standards, markets and from the consumers perspective, at international, European and national levels. The real issue is that not all the potential users benefit from the use of assistive products or accessible measures. Discussion Innovative methods are needed to allow all potential users to have real advantage of assistive technologies and accessible and design for all facilities. Best practices will be presented and existing gaps and recommendations will be discussed. Cost-benefits aspects will also be presented. Conclusion In order to get advantages from opportunities of globalization, hard work and responsibilities of all stakeholders are needed, so that assistive products and accessibility reach a whole range of situations and environments and contribute to ensure quality of life in a society for all.

  9. [Assisted peritoneal dialysis].

    Science.gov (United States)

    Klarić, Dragan; Prkačin, Ingrid

    2014-04-01

    According to the National Registry of Renal Replacement Therapy (RRT), the incidence of chronic kidney disease (end-stage renal disease) and the need of RRT have declined in the last decade renal. One of the reasons for this tendency certainly is transplantation as the best choice. However, transplant procedure has limitations in elderly patients due to the number of comorbidities. This study was designed as retrospective analysis of outcomes in patients treated with peritoneal dialysis for a period of eleven years. Patients were divided into those who had been assisted or unassisted. Out of 100 patients treated with peritoneal dialysis (PD), 77 completed the treatment, including 26 assisted and 51 unassisted patients. Peritonitis was recorded in 20 assisted and 26 unassisted patients. Peritonitis was more common in unassisted patients, who were more frequently lost from PD. Assisted PD could be a good and safe choice of RRT in this special group of patients.

  10. Superfund Technical Assistance Grants

    Data.gov (United States)

    U.S. Environmental Protection Agency — This asset includes data related to the Superfund Technical Assistance Grant program, including grant number, award amounts, award dates, period of performance,...

  11. Financial Assistance Information

    Science.gov (United States)

    ... Other Sites: Genetic and Rare Diseases Information Center Financial Assistance Information The National Institutes of Health (NIH) ... area call 900-638-0742. Top of page Financial Aid for Medical Treatments Information on financial aid ...

  12. 78 FR 57129 - Notice of Petitions by Firms for Determination of Eligibility To Apply for Trade Adjustment...

    Science.gov (United States)

    2013-09-17

    ... Eligibility To Apply for Trade Adjustment Assistance Date accepted Firm name Firm address for Product(s) investigation York Imperial Plastics, Inc 718 Country Road, York, 9/9/2013 The firm manufactures plastic PA.... Unlimited Designs, Inc 780 North Warm Springs 9/10/2013 The firm manufactures Road (700 West),...

  13. 77 FR 74643 - Notice of Petitions by Firms for Determination of Eligibility To Apply for Trade Adjustment...

    Science.gov (United States)

    2012-12-17

    ... for Trade Adjustment Assistance AGENCY: Economic Development Administration, Department of Commerce.... Beecher and Myers Co., Inc 3753 Carlisle Road, Dover, 10/26/2012 Manufacturer of custom-cut PA 17315. wooden materials as well as provides edge banding, CNC routing, and light assembly services to...

  14. 75 FR 38139 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-07-01

    ... Services and Manpower. 73,936 ATI Wah Chang, Allegheny Albany, OR April 14, 2009. Technologies, Inc. 73,942...,989 United Auto Workers (UAW) Fenton, MO Local 136. 74,057 Specialty Minerals, Inc...... Franklin, VA...

  15. 78 FR 55757 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-09-11

    ... Processing (ADP)-- San Dimas, CA Corporate, Corporate Finance, Kforce, Inc. and Horizon Corporate Consultants...,966 Kohl's Department Stores, Inc., Milwaukee, WI....... August 7, 2012. Finance Department, Kforce..., Apex Systems, Horizon, etc. 82,828B Automatic Data Processing (ADP), San Dimas, CA Inc.,...

  16. 78 FR 49293 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-08-13

    ..., 2012. Finance Group, Midwest Staffing. 82,778 Energizer, Adecco Westlake, OH........ June 3, 2012 82,805 Citi, Corporate Finance for New York, NY........ June 11, 2012. Operations & Technology, Corporate Realty Services. 82,805A Citi, Corporate Finance for Fort Lauderdale, FL. June 11, 2012....

  17. 75 FR 5348 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-02-02

    ... 12/21/09 73156 American Spring Wire Kankakee, IL 12/28/09 12/17/09 Corporation (Wkrs). 73157 FCI USA... Construction Silver City, NV....... 12/29/09 12/23/09 Company (Wkrs). 73166 Gormac Products, Inc. Racine, WI 12... Carrollton, TX........ 12/30/09 12/16/09 Services, Inc. (Comp). 73184 Transguard Industries Angola, IN 12/30...

  18. 76 FR 77555 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-12-13

    ... date 80,306 Jem Sportswear, Inc., San Fernando, CA..... July 19, 2010. Affordable Staffing. 80,365... El Paso, TX July 12, 2010. 80,336 Dell Inc., Dell Financial Austin, TX July 18, 2010. Services...

  19. 78 FR 28634 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-05-15

    ..., PA....... January 30, 2012. Inc., Plants 18, 19 and 76, Owens- Brockway Packaging, Inc. 82,619..., MA..... Co., Inc., D.R. Plourde, Spherion, Ranstad, Sourceright. 82,638 New Mexico Farmers Markets..., Frostburg, MD. Specialty Business Unit, Xerox Business Services, LLC. 82,380 Red Rock Medical Billing...

  20. 76 FR 37154 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    Science.gov (United States)

    2011-06-24

    ... or a shift in production to Mexico or Canada) of the Trade Act have been met. None Affirmative...; Holcim (US), Inc., Catskill Plant, Holcim LTD, On-Site Leased Workers of Manpower, Catskill, NY: April 4...)(3)(A)(ii) of the Trade Act have been met. TA-W-80,092; Covidien, formerly Aspect Medical, R & MS...

  1. 77 FR 19719 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-04-02

    ..., TX January 23, 2011. Inc., Information Technology Helpdesk. 81,285 The Aftermarket Group, TAG... October 2, 2011. Holdings I, Inc.. 81,347 SenoRX, Bard Biopsy Irvine, CA February 16, 2011. Systems, Wages Reported under Bard Biopsy Sys., Select Staffing. 81,356 The W.E. Bassett Company, Shelton, CT February 8...

  2. 75 FR 5349 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-02-02

    ... appropriate, to the determination of the date on which total or partial separations began or threatened to...). 73098 Valspar Coatings (Wkrs).... High Point, NC........ 12/15/09 11/24/09 73099 Siemen Medical.../09 Processing/First Tennessee Bank (Rep). 73119 Crown Paper Box (Comp)..... Indianapolis, IN.........

  3. 75 FR 21359 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-04-23

    ... determination of market disruption or threat thereof under section 421(b)(1); or (C) An affirmative final...; Hanesbrands, Inc., Eden Textiles Operations Division, Forest City, NC: November 24, 2008. TA-W-72,989B; Hanesbrands, Inc., Eden Textiles Operations Division, Winston-Salem, NC: November 24, 2008. TA-W-72,989...

  4. 77 FR 42335 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-07-18

    ... determination of market disruption or threat thereof under section 421(b)(1); or (C) An affirmative final... Textiles LLC, Vernon, CT June 5, 2011. Job Pro. The following certifications have been issued. The...

  5. 78 FR 73886 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-12-09

    ... 202(b)(1); (B) An affirmative determination of market disruption or threat thereof under section 421(b...,191 Victor Innovative Textiles, LLC, Fall River, MA...... October 30, 2012. Victor Innovatex, Victor...

  6. 78 FR 8591 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-02-06

    ...,111 Carolina Precision Stratford, CT......... October 25, 2011. Plastics, Monroe Staffing. 82,168A... Seneca, SC December 3, 2011. Medical Devices, Kelly Services. 82,220 Netlist, Inc., Test Irvine,...

  7. 77 FR 16070 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-03-19

    ... date 81,041 Vanguard Pai Monroe, NC July 22, 2011. Lung, LLC. 81,184 C&M Wood Hesperia, CA February 13...., Roanoke, VA February 13, 2010. Sales Fulfillment Division, Kelly Services, Aerotek. 81,211 Solaicx, a... Payment Services (GBPS) inc. Kelly Services. 81,281 Time Warner Coudersport, PA. Entertainment Company,...

  8. 77 FR 17526 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-03-26

    ... TE Connectivity/Tyco Wilsonville, OR February 10, 2011. Electronics, CIS- Datacomm Division, Kelly...., Manufacturing Division, Monroe Staffing and Adecco. 81,336 Bureau Veritas, Taunton, MA February 14,...

  9. 75 FR 68621 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-11-08

    ... 16, 2009. Trimline, Accountemps, Kelly, Delta, and Connection. 74,275A Welch Allyn, Inc., Also..., Incorporated, Pleasant Pairie, WI August 30, 2009. Kelly Service. 74,682 Broadview Network Rye Brook, NY........... October 13, 2009. Inc.; Monroe Staffing Services, LLC and Photo Temps. The following certifications...

  10. 75 FR 28298 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-05-20

    ... Worldwide, Corporate IT Division, Leased Workers from Computer Merchant, LTD, White Plains, NY: September 30... Aerotek Commercial Staffing, Oak Park, MI: November 6, 2008. TA-W-73,028: TRW Automotive, Body Control...: Minnesota Industries, Chisholm, MN. TA-W-71,667: Fort Smith Express, Inc., Fort Smith, AR. TA-W-71,789:...

  11. 76 FR 21408 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-04-15

    ..... New York, NY November 22, 2009. 75,157 Smethport and Lauri Smethport, PA January 28, 2010. Toys, Patch... Milford, CT December 16, 2009. Limited, Former Workers from Dataviz, Inc. 75,077 Dama Jewelry Johnston,...

  12. 76 FR 7585 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-02-10

    .... Support Group; Including Virtual Workers Reporting to this Location. 74,871 International Business.... Storage Management, Teleworkers. 75,087A International Business Smyrna, GA........ December 22, 2009. Machines (IBM), Integrated Technology, Storage Management, Teleworkers. 75,087B International Business...

  13. 77 FR 67406 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-11-09

    ... Richmond & Roanoke, VA 10/15/12 10/12/12 Cross Blue Shield) (Workers). 82080 International Business...- Stop). 82091 T-Shirt International Inc. Culloden, WV 10/18/12 10/16/12 (Company). 82092 General...

  14. 75 FR 70294 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-11-17

    ...,, Working On-Site at Phoenix Life and Annuity Company. 73,988 International Business Armonk, NY March 1... International Business Lexington, KY......... June 10, 2009. Machines (IBM), Global Tech Serv., Server Systems, IC1, Storage, Backup. 74,316A International Business Cambridge, MA......... June 10, 2009....

  15. 78 FR 54487 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-09-04

    ... separated; (2) The public agency has acquired from a foreign country services like or directly competitive..., Greyhound Lines. 82,890 YP Southeast Advertising & Tucker, GA Publishing LLC, Customer Service Group, YP LLC...; and (3) One of the following must be satisfied: (A) Imports of articles or services like or...

  16. 75 FR 39046 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-07-07

    ... been met. TA-W No. Subject firm Location Impact date 72,851 General Motors Milford, MI October 20, 2008... Holdings Company. 73,176 Valeo Electrical Systems, Troy, MI December 8, 2008. Inc., Wiper Systems Division...., Aerospace Div., Purchasing Dept., Leased Workers Manpower International. The following certifications...

  17. 75 FR 51846 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-08-23

    ..., Inc., Emerson Electric Company. 73,975 CareFusion 209, Middleton, WI April 6, 2009. Incorporated.... Company. 73,689 General Motors Component Kokomo, IN February 15, 2010. Holdings, LLC, General Motors... 73,683 Contour Aerospace Everett, WA Corporation, a division of Vought Aircraft Industries....

  18. 76 FR 81987 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-12-29

    ... Aerospace Sidney, NY......... February 13, 2010. Corporation, Superior Technical Resource, Staffworks...... February 13, 2010. (Wackenhut) and Ozark Motor Lines, Working On- Site at Sanyo Manufacturing Corporation.... Corporation, QPS Employment Group. 81,111 Ametek National Controls West Chicago, IL... October 9,...

  19. 78 FR 52976 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-08-27

    ..., NY Services, LLC. 82,844 Unilever Manufacturing (US), Inc., Huntington, IN North America Ice Cream... Cambia Health Solutions, Inc., Salt Lake City, UT.. July 18, 2012. Claims Department. 82,937D...

  20. 76 FR 40400 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    Science.gov (United States)

    2011-07-08

    ..., MO. TA-W-80,118; PSC Industrial Outsourcing, LP, Kelso, WA. TA-W-80,126; Ryder Integrated Logistics... Partnership, Callejo, CA. TA-W-80,221; International Netherlands Group, ING, Windsor, CT. The following...

  1. 76 FR 20046 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-04-11

    ... 2010. Company, Travelers Companies, Inc.; Personal Insurance Div.; Customer Sales and Service. 75,234... Advanced Career Services. 75,159 BAE Systems, Land and Lemont Furnace, Armaments, U.S. Combat PA Systems... following must be satisfied: (A) Imports of articles or services like or directly competitive with articles...

  2. 75 FR 71457 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-11-23

    ... America, Global Parts Supply Chain Group, Including Leased Workers From QFLEX, North America Logistics... America Global Parts Supply Chain Group Including Leased Workers From QFLEX, North America Logistics, and... Global Parts Supply Chain Group Including Leased Workers From QFLEX, North America Logistics, and...

  3. 75 FR 70689 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-11-18

    ... LLC, MGD Consulting, Inc., Case Interactive LLC., and Sapphire Technologies, Highlands Ranch, Colorado..., InfoQuest Consulting Group, CCSI Inc., ICONMA LLC, MGD Consulting, Inc., Case Interactive LLC., and... Resources Inc., Real Soft, Inforquest Consulting Group, CCSI Inc., ICONMA LLC, MGD Consulting, Inc.,...

  4. 75 FR 16512 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-04-01

    ...., Real Soft, Inforquest Consulting Group, CCSI Inc., ICONMA LLC, MGD Consulting, Inc., Case Interactive... LLC, MGD Consulting, Inc., Case Interactive LLC., and Sapphire Technologies, Highlands Ranch, Colorado... Resources Inc., Real Soft, InfoQuest Consulting Group, CCSI Inc., ICONMA LLC, MGD Consulting, Inc.,...

  5. 78 FR 14360 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-03-05

    ... HP Global Functions Palo Alto, CA 02/13/13 02/12/13 (Company). 82453 Dell Financial Services LLC... Russell Brands LLC/ Alexander City, AL..... 02/13/13 02/12/13 Decorations (Company). 82458 REC Silicon...

  6. 78 FR 63496 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-10-24

    .... 83,019 Springs Global US, Inc., Lancaster, SC March 29, 2013. Grace Complex--Distribution Facility, Springs Global, Defender Industries. 83,022 The Spencer Turbine Company, Windsor, CT August 23, 2012..., Staffing Solutions. 83,071 Applied Discovery, Inc., Bellevue, WA August 26, 2012. Behind The Brand,...

  7. 77 FR 6588 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-02-08

    ... Brands, St. Louis, MO.. February 13, Inc., Interstate 2010. Brands Corp., Resources Global Int'l, Ranstad... Corp., Resources Global Int'l, Ranstad Finance, etc. 81,029B......... Hostess Brands, Peoria, IL..... February 13, Inc., Interstate 2010. Brands Corp., Resources Global Int'l, Ranstad Finance, etc....

  8. 77 FR 46122 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-08-02

    ... sales of the workers' firm; or (B) A loss of business by the workers' firm with the firm described in.... Industries, Inc.. 81,772 WellPoint, Inc., Sr. Indianapolis, IN...... July 2, 2011. Business Div. Claims Dept...., Cut and Sew Operations. 81,796 Adams Globalization, Austin, TX July 9, 2011. Transperfect...

  9. 77 FR 44682 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-07-30

    ... Adams Globalization, a Austin, TX 07/12/12 07/09/12 Division of Transperfect, IDTP Department (Workers). 81797 International Business Endicott, NY 07/13/12 07/12/12 Machines (IBM) (State/One- Stop). 81798...

  10. 76 FR 27084 - Section 8 Housing Assistance Payments Program-Renewal Funding Annual Adjustment Factors, Fiscal...

    Science.gov (United States)

    2011-05-10

    ... Appropriations Act, 2010 (Pub. L 111-117, approved, December 16, 2009), provides that: * * * the Secretary for... the Department of Defense and Full-Year Continuing Appropriations Act, 2011 (Pub. L 112-10, approved...) and American Community Survey (ACS) data on the ratio of utilities to rents.\\2\\ The CEX data used to...

  11. 75 FR 6685 - Section 8 Housing Assistance Payments Program-Contract Rent Annual Adjustment Factors, Fiscal...

    Science.gov (United States)

    2010-02-10

    ... Expenditure Survey (CEX) and American Community Survey (ACS) data on the ratio of utilities to rents.\\2\\ \\1....HUDUSER.org Survey Data Used to Produce Contract Rent AAFs In this publication, the rent and fuel and... AAFs. The utility- to-rent ratio used to produce Contract Rent AAFs comes from 2007 ACS median rent and...

  12. 76 FR 14421 - Section 8 Housing Assistance Payments Program-Contract Rent Annual Adjustment Factors (AAFs...

    Science.gov (United States)

    2011-03-16

    ... Survey (ACS) data on the ratio of utilities to rents.\\2\\ \\1\\ CPI indexes CUUSA103SEHA and CUSR0000SAH2... AAFs In this publication, the rent and fuel and utilities inflation factors for large metropolitan... produce Contract Rent AAFs comes from 2008 ACS median rent and utility costs. Geographic Areas Contract...

  13. 75 FR 20385 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-04-19

    ... Workers from Comforce Corporation, Adecco, Multax, Inconen, CTS, Hi-Tec, Woods, Ciber, Kelly Services..., Multax, Inconen, CTS, Hi-Tec, Woods, Ciber, Kelly Services, Analysts International Corp, Comsys, Filter..., Inconen, CTS, Hi-Tec, Woods, Ciber, Kelly Services, Analysts International Corp, Comsys, Filter...

  14. 76 FR 13664 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-03-14

    ... Software, Ciber, Inc., Engineering Technology Associates, Inc., TAC Transportation, the Bartech Group... Diamond Software, Ciber, Inc., Engineering Technology Associates, Inc., TAC Transportation, The...

  15. 76 FR 5833 - Amended Certification Regarding Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-02-02

    ... SERVICES, CIBER, UC4 AND ENVISIONS INCLUDING OFF-SITE WORKERS ACROSS THE UNITED STATES, MALVERN..., Collegiate, Cornelius Professional Services, Ciber, UC4 and Envisions, including off-site workers across...

  16. 78 FR 77498 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-12-23

    ... Technology Puerto Rico, Inc. Aguadilla, PR....... August 1, 2012. 83,132 Citibank, N.A., Enterprise New York... Citibank, N.A., Enterprise Tampa, FL October 11, 2012. Operations & Technology, Citi Procurement,...

  17. 78 FR 9943 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-02-12

    ... (Workers). 82358 YP Holdings LLC San Francisco, CA.... 01/22/13 01/17/13 (Workers). 82359 American Silk.../One-Stop). 82369 Energizer Battery Maryville, MO........ 01/25/13 01/17/13 (Company). BILLING...

  18. 78 FR 18366 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-03-26

    ............ February 5, 2013. Development and Engineering Organization. 82,369 Energizer Holdings, Inc., Staff Maryville, MO....... January 17, 2012. Management/SMX, Seaton Companies. 82,369A Energizer Holdings, Inc... been met. TA-W No. Subject firm Location Impact date 82,211 AGY Huntingdon, AGY Holding Huntingdon,...

  19. 77 FR 9970 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-02-21

    .... ] 81,266 Wells Manufacturing, L.P... Fond du Lac, WI....... January 24, 2011. 81,267 Kimball Electronics Tampa, Tampa, FL January 25, 2011. Inc., Kimball Electronics, Inc. The following certifications...

  20. 75 FR 11922 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-03-12

    .... June 9, 2008. TA-W-71,333; Marketing Alliance Group, American Display, Array Marketing, Optimum... Consultancy Services, Green Bay, WI. May 21, 2008. The following certifications have been issued. The...

  1. 77 FR 3505 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance...

    Science.gov (United States)

    2012-01-24

    ... date on which total or partial separations began or threatened to begin and the subdivision of the firm... Sunshine 368 Inc. (Workers) Corona, NY 01/04/12 12/25/11 81213 American Express (Workers). Salt Lake City...

  2. 77 FR 38666 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-06-28

    ... date on which total or partial separations began or threatened to begin and the subdivision of the firm.../12 (State/One-Stop). 81643 Frontier Aluminum (State/ Corona, CA 05/21/12 05/19/12 One-Stop). 81644...

  3. 75 FR 63147 - Solicitation of Applications for the Public Works, Economic Adjustment Assistance, and Global...

    Science.gov (United States)

    2010-10-14

    ... under EO 12372, applicants may contact their State's Single Point of Contact (SPOC). Names and addresses....whitehouse.gov/omb/grants/spoc.html . Section A.11. of Form ED-900 provides more information and...

  4. 77 FR 51067 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-08-23

    .../12 08/06/12 (Workers). 81860 Resolute Forest Products Catawba, SC........ 08/06/12 08/03/12 (Company...)... Langhorne, PA...... 08/08/12 08/07/12 81873 Legacy Custom Plastics Clearwater, FL..... 08/09/12 08/08/12 LLC... Custom Technology, Windsor, CT........ 08/09/12 08/09/12 Inc., Engineering Design and Drafting...

  5. 77 FR 8279 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-02-14

    ... separated; (2) The workers' firm is a Supplier or Downstream Producer to a firm that employed a group of...-- (A) The workers' firm is a supplier and the component parts it supplied to the firm described in... Group International Division. 81,138 Keystone Automotive Exeter, PA February 13, 2010. Operations,...

  6. 78 FR 34672 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-06-10

    ... separated, or are threatened to become totally or partially separated; (2) The workers' firm is a Supplier... service that was the basis for such certification; and (3) Either-- (A) The workers' firm is a supplier..., KY...... March 1, 2012. Manufacturing, LLC, Automotive Electronics and Interiors, Johnson...

  7. 77 FR 61029 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-10-05

    ... separated; (2) The workers' firm is a Supplier or Downstream Producer to a firm that employed a group of...-- (A) The workers' firm is a supplier and the component parts it supplied to the firm described in... date 81,916 Veolia ES Industrial Shreveport, LA........ Services, Inc. 81,917 Automotive...

  8. 75 FR 20392 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-04-19

    ... Vernon Hills, IL...... 03/11/10 03/10/10 Manufacturing (Wkrs). 73686 MWH Americas (Human Broomfield, CO........ 03/11/10 03/03/10 Resources (Wkrs). 73687 Somerset Plastics, Inc. Somerset, PA 03/11/10...

  9. 76 FR 7588 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-02-10

    ... 01/24/11 75137 John Crane, Inc. (Company). Cranston, RI 01/25/11 01/24/11 75138 Ashland Foundry and.../25/11 01/24/11 75140 Holland Consulting Enumclaw, WA 01/26/11 01/25/11 (Company). 75141 Wellpoint...

  10. 78 FR 70583 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-11-26

    ...., Corporate Greenwood Village, CO.... 11/07/13 11/06/13 Accounting and Finance Administration (Company). 83204...-Stop). 83210 Kinetic Concepts, Inc. Charlotte, NC 11/08/13 11/07/13 (Company). 83211 Creavey...

  11. 76 FR 17154 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-03-28

    ..., Corporate Chicago, IL January 18, 2010. Functions Finance; Chicago Metro Locations. 75,134 Veyance.... Probuild Holdings LLC; North East Division; NJ/PA Outside Sales, etc. 74,809 Diversey Equipment/Beta Santa...., Powertrain Operations Division, Corporate Office--Juneau Avenue. 75,000A Harley-Davidson Motor Franklin, WI...

  12. 78 FR 61390 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-10-03

    ... Department. 82,921 Staples, Inc., Human Resources Framingham, MA...... July 18, 2012. Services Division, BTHR......... August 1, 2012. Addison Group and Robert Half Accounting. 82,980 Sunrise Medical, Labor Max Staffing... date 82,959 Global Resource Services LLC....... Darrington, WA...... 83,013 Graymont St. Helens,...

  13. 75 FR 34178 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-06-16

    ..., Inc. (State/ One-Stop). 74142 World Color (Workers)... Schaumburg, IL..... 05/25/10 05/21/10. 74143 Providence Watch Cranston, RI....... 05/25/10 05/13/10. Hospital (Workers). 74144 Hoffmann La Roche...

  14. 75 FR 70699 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-11-18

    ........... Hospital. 74,595 Connect North America Presque Island, ME. U.S.A., Inc., Black Diamond Financial...,684 World Color (USA), LLC, Clarksville, TN.... Quad-Graphics, Inc. I hereby certify that...

  15. 77 FR 44679 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-07-30

    ... Washington, PA June 5, 2011. Global Relocation Services, Client Accounting Division, Accountemps and Quad. 81... Staffing. 81,770 Hartford Southington, CT June 29, 2011. Financial Services Group, Inc.,...

  16. 77 FR 29363 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-05-17

    .... Automotive Service Delivery Division, Accounting Services, PRO Unlimited. 81,349 Alcatel-Lucent USA, Inc., D..., Finance and Accounting Team. 81,449 RR Donnelley, A Subsidiary of RR Glen Mills, PA..... March 22, 2011... Service Delivery Division. 81,459P International Business Machines Southbury, CT...... March 29,...

  17. 77 FR 25199 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-04-27

    ... Lenox, IL........ November 25, 2011. Lenox Production Division, Cable Tie Division, Areotek, Inc. 81,425... separated; (2) The sales or production, or both, of such firm have decreased absolutely; and (3) One of the... separation and to the decline in the sales or production of such firm; or II. Section 222(a)(2)(B) all of...

  18. 75 FR 7043 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-02-16

    ... 01/27/10 01/25/10 73369 Key Energy (State)......... Houston, TX 01/27/10 01/22/10 73370 Thomson Reuters (Wkrs)..... Independence, OH...... 01/27/10 01/26/10 73371 The State Media Company Columbia, SC...

  19. 76 FR 50269 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-08-12

    ..., Concord, CA TA-W-73,158A Siemens Medical Solutions USA, Inc., Global Services/Supply Chain Management... information provided by Seimens reveals that workers of Global Services/Supply Chain Management, Malvern..., California facility (TA-W-73,158). Global Services/Supply Chain Management, Malvern, Pennsylvania supplies...

  20. 78 FR 25305 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-04-30

    ... L & W Supply, Inc., USG Pico Rivera, CA....... February 20, 2012. Corporation, Accounts Payable....), Tapfin, Manpower and Experis. 82,506Q Experian, Fraud Solutions, San Diego, CA......... February 26, 2012...