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Sample records for adjusted ventilatory assist

  1. [Successful weaning and extubation in the premature newborn using neurally adjusted ventilatory assist].

    Science.gov (United States)

    García-Muñoz Rodrigo, F; Rivero Rodríguez, S; Florido Rodríguez, A; Martín Cruz, F G; Díaz Pulido, R

    2015-01-01

    Invasive and non-invasive ventilation of the preterm newborn may be associated with local and systemic complications due to mechanical trauma to lung tissues and their inflammatory response. A key objective of any type of mechanical ventilation, therefore, is to reduce its duration and the side effects related to it. Neurally Adjusted Ventilatory Assist (NAVA) may improve synchronization between patient and ventilator and optimize the gas volume delivered to the lungs, according to the patient needs, eventually reducing volu- and biotrauma. Two preterm babies with severe respiratory distress syndrome are presented, who were successfully weaned and extubated with the help of this ventilatory system. Further studies are needed to assess whether short-term benefits are reflected in better outcomes in the long run. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  2. Neurally adjusted ventilatory assist (NAVA) mode as an adjunct diagnostic tool in congenital central hypoventilation syndrome

    International Nuclear Information System (INIS)

    Rahmani, A.; Rehman, N.U.; Chedid, F.

    2013-01-01

    A full term female newborn was admitted to the neonatal intensive care unit (NICU) for continuous observation of apnea. Infant was noted to have apnea while asleep requiring intubation and mechanical ventilation. A video EEG was performed which demonstrated normal awake background without any seizure activity. Neurally adjusted ventilatory assist (NAVA) demonstrated the absence of electrical activity of the diaphragm (Edi) when the patient was in quiet phase of sleep. This finding on NAVA monitor raised the suspicion of central hypoventilation syndrome (CCHS) which was confirmed by genetic identification of the PHOX2B mutation. (author)

  3. Neurally adjusted ventilatory assist (NAVA) mode as an adjunct diagnostic tool in congenital central hypoventilation syndrome.

    Science.gov (United States)

    Rahmani, Aiman; Ur Rehman, Naveed; Chedid, Fares

    2013-02-01

    A full term female newborn was admitted to the neonatal intensive care unit (NICU) for continuous observation of apnea. Infant was noted to have apnea while asleep requiring intubation and mechanical ventilation. A video EEG was performed which demonstrated normal awake background without any seizure activity. Neurally adjusted ventilatory assist (NAVA) demonstrated the absence of electrical activity of the diaphragm (Edi) when the patient was in quiet phase of sleep. This finding on NAVA monitor raised the suspicion of central hypoventilation syndrome (CCHS) which was confirmed by genetic identification of the PHOX2B mutation.

  4. Neurally adjusted ventilatory assist and proportional assist ventilation both improve patient-ventilator interaction.

    Science.gov (United States)

    Schmidt, Matthieu; Kindler, Felix; Cecchini, Jérôme; Poitou, Tymothée; Morawiec, Elise; Persichini, Romain; Similowski, Thomas; Demoule, Alexandre

    2015-02-25

    The objective was to compare the impact of three assistance levels of different modes of mechanical ventilation; neurally adjusted ventilatory assist (NAVA), proportional assist ventilation (PAV), and pressure support ventilation (PSV) on major features of patient-ventilator interaction. PSV, NAVA, and PAV were set to obtain a tidal volume (VT) of 6 to 8 ml/kg (PSV₁₀₀, NAVA₁₀₀, and PAV₁₀₀) in 16 intubated patients. Assistance was further decreased by 50% (PSV₅₀, NAVA₅₀, and PAV₅₀) and then increased by 50% (PSV₁₅₀, NAVA₁₅₀, and PAV₁₅₀) with all modes. The three modes were randomly applied. Airway flow and pressure, electrical activity of the diaphragm (EAdi), and blood gases were measured. VT, peak EAdi, coefficient of variation of VT and EAdi, and the prevalence of the main patient-ventilator asynchronies were calculated. PAV and NAVA prevented the increase of VT with high levels of assistance (median 7.4 (interquartile range (IQR) 5.7 to 10.1) ml/kg and 7.4 (IQR, 5.9 to 10.5) ml/kg with PAV₁₅₀ and NAVA₁₅₀ versus 10.9 (IQR, 8.9 to 12.0) ml/kg with PSV₁₅₀, P PAV than with PSV at level₁₀₀ and level₁₅₀. The coefficient of variation of VT was higher with NAVA and PAV (19 (IQR, 14 to 31)% and 21 (IQR 16 to 29)% with NAVA₁₀₀ and PAV₁₀₀ versus 13 (IQR 11 to 18)% with PSV₁₀₀, P PAV and NAVA than with PSV (P PAV and PSV (P PAV and NAVA both prevent overdistention, improve neuromechanical coupling, restore the variability of the breathing pattern, and decrease patient-ventilator asynchrony in fairly similar ways compared with PSV. Further studies are needed to evaluate the possible clinical benefits of NAVA and PAV on clinical outcomes. Clinicaltrials.gov NCT02056093 . Registered 18 December 2013.

  5. Clinical review: Update on neurally adjusted ventilatory assist - report of a round-table conference

    Science.gov (United States)

    2012-01-01

    Conventional mechanical ventilators rely on pneumatic pressure and flow sensors and controllers to detect breaths. New modes of mechanical ventilation have been developed to better match the assistance delivered by the ventilator to the patient's needs. Among these modes, neurally adjusted ventilatory assist (NAVA) delivers a pressure that is directly proportional to the integral of the electrical activity of the diaphragm recorded continuously through an esophageal probe. In clinical settings, NAVA has been chiefly compared with pressure-support ventilation, one of the most popular modes used during the weaning phase, which delivers a constant pressure from breath to breath. Comparisons with proportional-assist ventilation, which has numerous similarities, are lacking. Because of the constant level of assistance, pressure-support ventilation reduces the natural variability of the breathing pattern and can be associated with asynchrony and/or overinflation. The ability of NAVA to circumvent these limitations has been addressed in clinical studies and is discussed in this report. Although the underlying concept is fascinating, several important questions regarding the clinical applications of NAVA remain unanswered. Among these questions, determining the optimal NAVA settings according to the patient's ventilatory needs and/or acceptable level of work of breathing is a key issue. In this report, based on an investigator-initiated round table, we review the most recent literature on this topic and discuss the theoretical advantages and disadvantages of NAVA compared with other modes, as well as the risks and limitations of NAVA. PMID:22715815

  6. Clinical review: Update on neurally adjusted ventilatory assist--report of a round-table conference.

    Science.gov (United States)

    Terzi, Nicolas; Piquilloud, Lise; Rozé, Hadrien; Mercat, Alain; Lofaso, Frédéric; Delisle, Stéphane; Jolliet, Philippe; Sottiaux, Thierry; Tassaux, Didier; Roesler, Jean; Demoule, Alexandre; Jaber, Samir; Mancebo, Jordi; Brochard, Laurent; Richard, Jean-Christophe Marie

    2012-06-20

    Conventional mechanical ventilators rely on pneumatic pressure and flow sensors and controllers to detect breaths. New modes of mechanical ventilation have been developed to better match the assistance delivered by the ventilator to the patient's needs. Among these modes, neurally adjusted ventilatory assist (NAVA) delivers a pressure that is directly proportional to the integral of the electrical activity of the diaphragm recorded continuously through an esophageal probe. In clinical settings, NAVA has been chiefly compared with pressure-support ventilation, one of the most popular modes used during the weaning phase, which delivers a constant pressure from breath to breath. Comparisons with proportional-assist ventilation, which has numerous similarities, are lacking. Because of the constant level of assistance, pressure-support ventilation reduces the natural variability of the breathing pattern and can be associated with asynchrony and/or overinflation. The ability of NAVA to circumvent these limitations has been addressed in clinical studies and is discussed in this report. Although the underlying concept is fascinating, several important questions regarding the clinical applications of NAVA remain unanswered. Among these questions, determining the optimal NAVA settings according to the patient's ventilatory needs and/or acceptable level of work of breathing is a key issue. In this report, based on an investigator-initiated round table, we review the most recent literature on this topic and discuss the theoretical advantages and disadvantages of NAVA compared with other modes, as well as the risks and limitations of NAVA.

  7. Non-invasive ventilation with neurally adjusted ventilatory assist in newborns.

    Science.gov (United States)

    Stein, Howard; Beck, Jennifer; Dunn, Michael

    2016-06-01

    Neurally adjusted ventilatory assist (NAVA) is a mode of ventilation in which both the timing and degree of ventilatory assist are controlled by the patient. Since NAVA uses the diaphragm electrical activity (Edi) as the controller signal, it is possible to deliver synchronized non-invasive NAVA (NIV-NAVA) regardless of leaks and to monitor continuously patient respiratory pattern and drive. Advantages of NIV-NAVA over conventional modes include improved patient-ventilator interaction, reliable respiratory monitoring and self-regulation of respiratory support. In theory, these characteristics make NIV-NAVA an ideal mode to provide effective, appropriate non-invasive support to newborns with respiratory insufficiency. NIV-NAVA has been successfully used clinically in neonates as a mode of ventilation to prevent intubation, to allow early extubation, and as a novel way to deliver nasal continuous positive airway pressure. The use of NAVA in neonates is described with an emphasis on studies and clinical experience with NIV-NAVA. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Neurally adjusted ventilatory assist increases respiratory variability and complexity in acute respiratory failure.

    Science.gov (United States)

    Schmidt, Matthieu; Demoule, Alexandre; Cracco, Christophe; Gharbi, Alexandre; Fiamma, Marie-Noëlle; Straus, Christian; Duguet, Alexandre; Gottfried, Stewart B; Similowski, Thomas

    2010-03-01

    Neurally adjusted ventilatory assist (NAVA) is a partial ventilatory support mode where positive pressure is provided in relation to diaphragmatic electrical activity (EAdi). Central inspiratory activity is normally not monotonous, but it demonstrates short-term variability and complexity. The authors reasoned that NAVA should produce a more "natural" or variable breathing pattern than other modes. This study compared respiratory variability and complexity during pressure support ventilation (PSV) and NAVA. Flow and EAdi were recorded during routine PSV (tidal volume approximately 6-8 ml/kg) and four NAVA levels (1-4 cm H2O/microVEAdi) in 12 intubated patients. Breath-by-breath variability of flow and EAdi-related variables was quantified by the coefficient of variation (CV) and autocorrelation analysis. Complexity of flow and EAdi was described using noise titration, largest Lyapunov exponent, Kolmogorov-Sinai entropy, and three-dimensional phase portraits. Switching from PSV to NAVA increased the CV and decreased the autocorrelation for most flow-related variables in a dose-dependent manner (P Kolmogorov-Sinai entropy for flow were greater during NAVA than PSV and increased with NAVA level (P Kolmogorov-Sinai entropy for EAdi were not influenced by ventilator mode. Compared with PSV, NAVA increases the breathing pattern variability and complexity of flow, whereas the complexity of EAdi is unchanged. Whether this improves clinical outcomes remains to be determined.

  9. Case report: Non-invasive neurally adjusted ventilatory assist in a newborn with unilateral diaphragmatic paralysis.

    Science.gov (United States)

    Roosens, Sander; Derriks, Frank; Cools, Filip

    2016-11-01

    Diaphragmatic paralysis is a rare cause of respiratory distress in the newborn. In this paper, a patient with unilateral phrenic nerve injury after traumatic delivery is presented. The child inadequately responded to standard respiratory supportive measures. Non-invasive neurally adjusted ventilatory assist (NIV-NAVA®), providing an optimally synchronized respiratory support proportional to the effort of the patient, resulted in prompt clinical and biological improvement of the patient's respiratory condition. NAVA is a relatively new mode of ventilation in neonatal care. In this case of unilateral diaphragmatic paralysis, it provided an alternative strategy of non-invasive respiratory support avoiding prolonged mechanical ventilation. Pediatr Pulmonol. 2016;51:E37-E39. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. Absence of inspiratory laryngeal constrictor muscle activity during nasal neurally adjusted ventilatory assist in newborn lambs.

    Science.gov (United States)

    Hadj-Ahmed, Mohamed Amine; Samson, Nathalie; Bussières, Marie; Beck, Jennifer; Praud, Jean-Paul

    2012-07-01

    In nonsedated newborn lambs, nasal pressure support ventilation (nPSV) can lead to an active glottal closure in early inspiration, which can limit lung ventilation and divert air into the digestive system, with potentially deleterious consequences. During volume control ventilation (nVC), glottal closure is delayed to the end of inspiration, suggesting that it is reflexly linked to the maximum value of inspiratory pressure. Accordingly, the aim of the present study was to test whether inspiratory glottal closure develops at the end of inspiration during nasal neurally adjusted ventilatory assist (nNAVA), an increasingly used ventilatory mode where maximal pressure is also reached at the end of inspiration. Polysomnographic recordings were performed in eight nonsedated, chronically instrumented lambs, which were ventilated with progressively increasing levels of nPSV and nNAVA in random order. States of alertness, diaphragm, and glottal muscle electrical activity, tracheal pressure, Spo(2), tracheal Pet(CO(2)), and respiratory inductive plethysmography were continuously recorded. Although phasic inspiratory glottal constrictor electrical activity appeared during nPSV in 5 of 8 lambs, it was never observed at any nNAVA level in any lamb, even at maximal achievable nNAVA levels. In addition, a decrease in Pco(2) was neither necessary nor sufficient for the development of inspiratory glottal constrictor activity. In conclusion, nNAVA does not induce active inspiratory glottal closure, in contrast to nPSV and nVC. We hypothesize that this absence of inspiratory activity is related to the more physiological airway pressurization during nNAVA, which tightly follows diaphragm electrical activity throughout inspiration.

  11. Neurally adjusted ventilatory assist compared to other forms of triggered ventilation for neonatal respiratory support.

    Science.gov (United States)

    Rossor, Thomas E; Hunt, Katie A; Shetty, Sandeep; Greenough, Anne

    2017-10-27

    Effective synchronisation of infant respiratory effort with mechanical ventilation may allow adequate gas exchange to occur at lower peak airway pressures, potentially reducing barotrauma and volutrauma and development of air leaks and bronchopulmonary dysplasia. During neurally adjusted ventilatory assist ventilation (NAVA), respiratory support is initiated upon detection of an electrical signal from the diaphragm muscle, and pressure is provided in proportion to and synchronous with electrical activity of the diaphragm (EADi). Compared to other modes of triggered ventilation, this may provide advantages in improving synchrony. Primary• To determine whether NAVA, when used as a primary or rescue mode of ventilation, results in reduced rates of bronchopulmonary dysplasia (BPD) or death among term and preterm newborn infants compared to other forms of triggered ventilation• To assess the safety of NAVA by determining whether it leads to greater risk of intraventricular haemorrhage (IVH), periventricular leukomalacia, or air leaks when compared to other forms of triggered ventilation Secondary• To determine whether benefits of NAVA differ by gestational age (term or preterm)• To determine whether outcomes of cross-over trials performed during the first two weeks of life include peak pressure requirements, episodes of hypocarbia or hypercarbia, oxygenation index, and the work of breathing SEARCH METHODS: We performed searches of the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cohrane Library; MEDLINE via Ovid SP (January 1966 to March 2017); Embase via Ovid SP (January 1980 to March 2017); the Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host (1982 to March 2017); and the Web of Science (1985 to 2017). We searched abstracts from annual meetings of the Pediatric Academic Societies (PAS) (2000 to 2016); meetings of the European Society of Pediatric Research (published in Pediatric Research); and meetings of the

  12. 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

  13. Neurally adjusted ventilatory assist decreases ventilator-induced lung injury and non-pulmonary organ dysfunction in rabbits with acute lung injury

    NARCIS (Netherlands)

    Brander, Lukas; Sinderby, Christer; Lecomte, François; Leong-Poi, Howard; Bell, David; Beck, Jennifer; Tsoporis, James N.; Vaschetto, Rosanna; Schultz, Marcus J.; Parker, Thomas G.; Villar, Jesús; Zhang, Haibo; Slutsky, Arthur S.

    2009-01-01

    OBJECTIVE: To determine if neurally adjusted ventilatory assist (NAVA) that delivers pressure in proportion to diaphragm electrical activity is as protective to acutely injured lungs (ALI) and non-pulmonary organs as volume controlled (VC), low tidal volume (Vt), high positive end-expiratory

  14. Neurally adjusted ventilatory assist (NAVA) in preterm newborn infants with respiratory distress syndrome-a randomized controlled trial.

    Science.gov (United States)

    Kallio, Merja; Koskela, Ulla; Peltoniemi, Outi; Kontiokari, Tero; Pokka, Tytti; Suo-Palosaari, Maria; Saarela, Timo

    2016-09-01

    Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator synchrony during invasive ventilation and leads to lower peak inspiratory pressures (PIP) and oxygen requirements. The aim of this trial was to compare NAVA with current standard ventilation in preterm infants in terms of the duration of invasive ventilation. Sixty infants born between 28 + 0 and 36 + 6 weeks of gestation and requiring invasive ventilation due to neonatal respiratory distress syndrome (RDS) were randomized to conventional ventilation or NAVA. The median durations of invasive ventilation were 34.7 h (quartiles 22.8-67.9 h) and 25.8 h (15.6-52.1 h) in the NAVA and control groups, respectively (P = 0.21). Lower PIPs were achieved with NAVA (P = 0.02), and the rapid reduction in PIP after changing the ventilation mode to NAVA made following the predetermined extubation criteria challenging. The other ventilatory and vital parameters did not differ between the groups. Frequent apneas and persistent pulmonary hypertension were conditions that limited the use of NAVA in 17 % of the patients randomized to the NAVA group. Similar cumulative doses of opiates were used in both groups (P = 0.71). NAVA was a safe and feasible ventilation mode for the majority of preterm infants suffering from RDS, but the traditional extubation criteria were not clinically applicable during NAVA. • NAVA improves patient-ventilator synchrony during invasive ventilation. • Lower airway pressures and oxygen requirements are achieved with NAVA during invasive ventilation in preterm infants by comparison with conventional ventilation. What is new: • Infants suffering from PPHN did not tolerate NAVA in the acute phase of their illness. • The traditional extubation criteria relying on inspiratory pressures and spontaneous breathing efforts were not clinically applicable during NAVA.

  15. Combined use of Neurally Adjusted Ventilatory Assist (NAVA) and Vertical Expandable Prostethic Titanium Rib (VEPTR) in a patient with Spondylocostal dysostosis and associated bronchomalacia.

    Science.gov (United States)

    Pons-Odena, Martí; Verges, Alba; Arza, Natalia; Cambra, Francisco José

    2017-02-14

    Jarcho-Levin syndrome is a rare disorder characterised by defects in vertebral and costal segmentation of varying severity. Respiratory complications are the main cause of death or severe comorbidity due to a restrictive rib cage. A 3 months old infant with Spondylocostal dysostosis and associated bronchomalacia experiencing severe asynchrony during the weaning process is reported. The Neurally Adjusted Ventilatory Assist (NAVA) mode was used to improve adaptation to mechanical ventilation after Vertical Expandable Prosthetic Titanium Ribs (VEPTRs) were implanted. The synchrony achieved with the NAVA mode allowed a decrease of the sedoanalgesia he received. A follow-up CT scan showed a reduction in the volume of the posterobasal atelectasis. The evolution of this patient suggests that the combined use of VEPTR for thoracic expansion and ventilation using NAVA can favour the global improvement. This mode could be an option to consider in selected patients with difficult weaning from mechanical ventilation in paediatric intensive care units. 2017 BMJ Publishing Group Ltd.

  16. 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).

  17. Assessing the Response to Inhaled Albuterol by Monitoring Patient Effort-Related Trends With a Servo-I Ventilator in Neurally Adjusted Ventilatory Assist Mode: A Case Presentation.

    Science.gov (United States)

    Snow, Timothy Matthew; Brinck, Matthew J

    2015-12-01

    Infants with chronic lung disease tend to be difficult to care for due to the heterogeneous nature of both their disease and the treatments required. Multiple types of medications, treatments, and nursing interventions are often needed to attain clinical success, and it is frequently difficult to discern which are effective versus the ones that offer no benefit. This article presents a case study that chronicles the care of an infant with chronic lung disease treated with albuterol. An innovative form of ventilation with monitoring of the electrical activity of the diaphragm with a special sensor-embedded catheter is used to assess the effectiveness of albuterol administration. This case study presents the monitoring of the effectiveness of albuterol in an infant with chronic lung disease measuring the electrical activity of the diaphragm catheter (Edi) and the various monitoring systems on the Servo-i ventilator in Neurally Adjusted Ventilatory Assist (NAVA) Mode. The clinicians followed various respiratory trends monitored by the Servo-i ventilator after albuterol dosing to document the clinical utility of using albuterol in this infant. The monitoring provided by NAVA showed an improvement in both lung mechanics and clinical condition immediately after albuterol administration. The infant had a positive response to albuterol dosing that subsequently led to reduced length of stay, reduced costs, and reduced family anxiety. This type of monitoring could help nurses and clinicians discern whether a given treatment or medication was effective. This method of clinical monitoring could provide a means to assess clinical utility of respiratory medications, treatments, and nursing interventions in certain populations of neonates and infants. The impact of objective monitoring on required sedation, weight gain, ventilator days, length of hospitalization, and overall hospital costs are other possible areas for future research.

  18. Cough and ventilatory adjustments evoked by aerosolised capsaicin and distilled water (fog) in man.

    Science.gov (United States)

    Lavorini, Federico; Pantaleo, Tito; Geri, Pietro; Mutolo, Donatella; Pistolesi, Massimo; Fontana, Giovanni A

    2007-06-15

    Airway receptors mediate cough and ventilatory adjustments. Simultaneous assessment of cough sensory-motor components and changes in breathing pattern may provide insights into the receptor(s) prevailingly stimulated by inhaled irritants. Nineteen subjects inhaled capsaicin and fog up to threshold concentrations for cough. Cough intensity, respiratory sensations and changes in breathing pattern induced by the two irritants were compared. Capsaicin and fog cough threshold values did not correlate. Coughing induced by both agents was preceded by qualitatively similar sensations and by significant increases in minute ventilation and respiratory drive due to selective increases in tidal volume (Pfog and capsaicin cough threshold values suggests differences in the neural mechanisms activated. The selective increase in tidal volume suggests prevailing involvement of rapidly adapting receptors. The stronger sensations evoked by capsaicin may contribute to the higher cough frequency observed with this agent.

  19. Ventilatory assistance and respiratory muscle activity. 2: Simulation with an adaptive active ("aa" or "a-squared") model lung.

    Science.gov (United States)

    Mecklenburgh, J S; Mapleson, W W

    1998-04-01

    The aim of this study was to develop a lung model which adapted its active simulation of spontaneous breathing to the ventilatory assistance it received--an "aa" or "a-squared" lung model. The active element required was the waveform of negative pressure (pmus), which is equivalent to respiratory muscle activity. This had been determined previously in 12 healthy volunteers and comprised a contraction phase, relaxation phase and expiratory pause. Ventilatory assistance had shortened the contraction and relaxation phases without changing their shape, and lengthened the pause phase to compensate. In this study, the contraction and relaxation phases could be adequately represented by two quadratic equations, in addition to a third to provide a smooth transition. Therefore, the adaptive element required was the prediction of the duration of the contraction phase. The best predictive variables were flow at the end of contraction or peak mouth pressure. Determination of either of these allowed adjustment of the "standard" waveform to the level of assistance produced by an "average" ventilator, in a manner that matched the mean response of 12 healthy conscious subjects.

  20. [Risk factors for presence of complications of the mechanical ventilatory assistance in the newborn].

    Science.gov (United States)

    Tapia-Rombo, Carlos Antonio; Domínguez-Martínez, Rosalba; Saucedo-Zavala, Victor Joel; Cuevas-Urióstegui, Maria Luisa

    2004-01-01

    The mechanical ventilatory assistance (MVA) is a procedure that is used very often in the neonatal intensive care units but its use its linked to a lot of complications. The objective of this study was to determine the risk factors for the presence of complications of the MVA in the newborns infants. One hundred thirty five medical records from January 98 to June 2000 of newborns that had been discharged by amelioration or death were reviewed retrospectively. All of them had been received MVA; twenty medical record were excluded. They were divided in two groups: group A, neonates that had presented complications during MVA, composed of 40 patients (cases) and B, neonates with MVA, but that had not presented complications due to the procedure of 75 patients (controls). In group A there were 39 preterm neonates and in B, 58 preterm neonates, the rest were term neonates. It was used descriptive and inferential statistics. Odds ratio (OR) and multivariate analysis were used to study risk factors with confidence interval (CI) of 95%. Statistical significance was considered at p newborn patients critically ill, with low birth weight, low gestational age, with RDS, who need more ventilatory support will be more liable to have complications and, as consequence, the mortality will be increased. For this reason it is essential a close monitoring of this group of patients for not over supporting them in IOF, PIP and cycles, thus avoiding as far as possible, the complications of the MVA.

  1. Does Trade Adjustment Assistance Make a Difference?

    OpenAIRE

    Kara M. Reynolds; John S. Palatucci

    2008-01-01

    Background: The U.S. Trade Adjustment Assistance (TAA) program provides workers who have lost their jobs due to increased trade with income support and training, job search, and relocation benefits. This paper uses the most recent data collected by the Department of Labor on TAA beneficiaries to provide one of the first evaluations of the effectiveness of the Trade Adjustment Assistance program. Using propensity score matching techniques, we find that the TAA program is of dubious value in te...

  2. 75 FR 45092 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-02

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS) today accepted and began a review of a petition for trade adjustment assistance filed under... technical assistance and cash benefits. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for...

  3. 7 CFR 1580.303 - Adjustment assistance payments.

    Science.gov (United States)

    2010-01-01

    ..., DEPARTMENT OF AGRICULTURE TRADE ADJUSTMENT ASSISTANCE FOR FARMERS § 1580.303 Adjustment assistance payments... payment may assign their rights to such payment in accordance with 7 CFR part 1404 or successor...

  4. 75 FR 49886 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-16

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS) today accepted and began a review of a petition for trade adjustment assistance filed under... INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA by phone: (202) 720-0638...

  5. 75 FR 43140 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-23

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS) today accepted and began a review of a petition for trade adjustment assistance [[Page 43141... for free technical assistance and cash benefits. FOR FURTHER INFORMATION CONTACT: Trade Adjustment...

  6. 75 FR 49458 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-13

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS) today accepted and began a review of a petition for trade adjustment assistance filed under... and cash benefits. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program...

  7. 75 FR 48642 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-11

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS) today accepted and began a review of a petition for trade adjustment assistance filed under... benefits. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA...

  8. 75 FR 43485 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-26

    ... Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service, USDA. ACTION: Notice... petition for trade adjustment assistance filed under the FY 2011 Program by three wool producers on behalf... cash benefits. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Staff, FAS...

  9. [Risk factors associated to complications of the mechanical ventilatory assistance in the premature newborn].

    Science.gov (United States)

    Tapia-Rombo, Carlos Antonio; Rodríguez-Jiménez, Gustavo; Ballesteros-del Olmo, Julio César; Cuevas-Urióstegui, María Luisa

    2009-01-01

    To determine risk factors associated with the presence of complications with mechanical ventilatory support (MVS) in the preterm infants (PI). One hundred thirty medical records of PI that had been discharged by amelioration or death were reviewed retrospectively. They were divided in two groups: group A, PI that had presented complications during MVS (cases) and B, PI with MVS, but that had not presented complications due to the procedure (controls). Statistical significance was considered at p < 0.05. The significative risk factors in the multivariate analysis reached significance for the associated of complications: gestational age (32 weeks or less), orotracheal reintubations three o more times, cycles of 60 per minute or more at the third day of being had initiate the MVS, and the symptomatic patent ductus arteriosus (PDA), all with p < 0.05. It will be necessary to impact more on the cycles level to diminish him below 60 per minute to the third day when it is feasible, to make the smallest reintubations number, to correct quickly the PDA when it is symptomatic, to avoid this way as much as possible, the complications of the MVS.

  10. Trade Adjustment Assistance for Firms: Economic, Program, and Policy Issues

    National Research Council Canada - National Science Library

    Hornbeck, J. F

    2007-01-01

    .... This report focuses on the trade adjustment assistance (TAA) program for firms, which provides technical assistance to help them develop strategies to remain competitive in the changing international economy...

  11. 75 FR 62760 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-10-13

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS), certified a petition (No. 2011015) for trade adjustment assistance (TAA) for blueberries... average. This conforms to the eligibility requirements stipulated in Subtitle C of Title I of the Trade...

  12. 75 FR 41432 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS) has certified a petition (No. 2010005) for trade adjustment assistance (TAA) for shrimp that... stipulated in Subtitle C of Title I of the Trade Act of 2002 (Pub. L. 107-210). Individual shrimp producers...

  13. 75 FR 41431 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS) has denied a petition (No. 2010009) for trade adjustment assistance (TAA) for apples that... the Trade Act of 2002 (Pub. L. 107-210) states that petitions must demonstrate, using data for the...

  14. 75 FR 61121 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-10-04

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS), certified two petitions (petition nos. 2011002 and 2011022) for trade adjustment assistance.... This conforms to the eligibility requirements stipulated in Subtitle C of Title I of the Trade Act of...

  15. 75 FR 63437 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-10-15

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS) has denied a petition (No. 2011032) for trade adjustment assistance (TAA) for blueberries... qualify under the program, Subtitle C of Title I of the Trade Act of 2002 (Pub. L. 107-210) states that...

  16. 75 FR 62759 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-10-13

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS), denied a petition (No. 2011019) for trade adjustment assistance (TAA) for Tilapia filed... INFORMATION: To qualify under the program, Subtitle C of Title I of the Trade Act of 2002 (Pub. L. 107-210...

  17. 75 FR 41430 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... Service (FAS) has denied a petition (No. 2010017) for trade adjustment assistance (TAA) for apples that was filed by the Minnesota Apple Growers Association, Inc. (MAGA) and accepted for review by USDA on... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers...

  18. 75 FR 23227 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-05-03

    ... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers... Service (FAS), today accepted a petition, and began a review of a petition, for trade adjustment... in cash receipts for lilies compared to the average of the 3 preceding marketing years. If a...

  19. 75 FR 41433 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... Service (FAS) has certified a petition (No. 2010003) for trade adjustment assistance (TAA) for asparagus that was filed by the National Asparagus Council and accepted for review by USDA on May 3, 2010... of asparagus during January-December 2009 contributed importantly to a greater than 15-percent...

  20. 75 FR 63437 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-10-15

    ... (No. 2011016) for trade adjustment assistance (TAA) for northeast multi-species fish filed under the... to demonstrate that an increase in imports of like or directly competitive articles, during the same... previous 3-year period. However, the import data provided for the same time period showed a 5.8-percent...

  1. 7 CFR 1580.301 - Application for trade adjustment assistance.

    Science.gov (United States)

    2010-01-01

    ... supporting financial data, such as financial statements, balance sheets, and reports prepared for or provided... financial data, such as financial statements, balance sheets, and reports prepared for or provided to the...) Certification that adjustment assistance payments have not exceeded the $10,000 limitation for the Federal...

  2. 75 FR 41430 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... #0; #0;Notices #0; Federal Register #0; #0; #0;This section of the FEDERAL REGISTER contains documents other than rules #0;or proposed rules that are applicable to the public. Notices of hearings #0... trade adjustment assistance (TAA) for apples that was filed by the New York Apple Association and...

  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

  4. Noninvasive ventilation–neurally adjusted ventilator assist for management of acute exacerbation of chronic obstructive pulmonary disease

    Science.gov (United States)

    Hadda, Vijay; Shah, Tajamul Hussain; Madan, Karan; Mohan, Anant; Khilnani, Gopi C; Guleria, Randeep

    2018-01-01

    Patient–ventilator asynchrony is common with noninvasive ventilation (NIV) used for management of acute exacerbation of chronic obstructive pulmonary disease (COPD). Neurally adjusted ventilator assist (NAVA) is a mode of ventilatory support which can minimize the patient–ventilator asynchrony. Delivering NIV with NAVA (NIV–NAVA) during acute exacerbation of COPD seems a logical approach and may be useful in reducing patient–ventilator asynchrony. However, there are no published reports which describe the use of NIV–NAVA for management of acute exacerbation of COPD. We describe the successful management of a 56-year-old gentleman presenting to the emergency department of our hospital with acute exacerbation of COPD with hypercapnic respiratory failure with NIV–NAVA. PMID:29319038

  5. Noninvasive ventilation–neurally adjusted ventilator assist for management of acute exacerbation of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Vijay Hadda

    2018-01-01

    Full Text Available Patient–ventilator asynchrony is common with noninvasive ventilation (NIV used for management of acute exacerbation of chronic obstructive pulmonary disease (COPD. Neurally adjusted ventilator assist (NAVA is a mode of ventilatory support which can minimize the patient–ventilator asynchrony. Delivering NIV with NAVA (NIV–NAVA during acute exacerbation of COPD seems a logical approach and may be useful in reducing patient–ventilator asynchrony. However, there are no published reports which describe the use of NIV–NAVA for management of acute exacerbation of COPD. We describe the successful management of a 56-year-old gentleman presenting to the emergency department of our hospital with acute exacerbation of COPD with hypercapnic respiratory failure with NIV–NAVA.

  6. Assisting Older Persons With Adjusting to Hearing Aids.

    Science.gov (United States)

    Lane, Kari R; Clark, M Kathleen

    2016-02-01

    This intervention study tested the feasibility and initial effect of Hearing Aid Reintroduction (HEAR) to assist persons aged 70 to 85 years adjust to hearing aids. Following this 30-day intervention, hearing aid use increased between 1 and 8 hr per day with 50% of participants able to wear them for at least 4 hr. Hearing aid satisfaction improved from not satisfied to satisfied overall. The study demonstrated that HEAR is feasible and could improve hearing aid use of a substantial number of older persons who had previously failed to adjust to their hearing aids and had given up. However, further testing among a larger and more diverse population is needed to better understand the effectiveness and sustainability of the intervention. © The Author(s) 2014.

  7. Laser-assisted voice adjustment (LAVA) in transsexuals.

    Science.gov (United States)

    Orloff, Lisa A; Mann, Andrea P; Damrose, John F; Goldman, Stephen N

    2006-04-01

    The objective of this study was to evaluate results of laser-assisted voice adjustment (LAVA) surgery in male-to-female (MTF) transsexual patients with androphonia. The authors conducted a prospective case-control study of MTFs who underwent CO2 laser vocal fold vaporization between 1997 and 2003. Thirty-one patients were self-referred for voice feminization. Pre- and postoperative evaluations were completed. Patients' voices were recorded to obtain Fo before and after surgery. Voice Handicap Index (VHI) questionnaires were completed by post-LAVA patients. A panel of blinded listeners identified patients as male or female based on samples of connected speech recorded over the telephone. Mean follow-up (23 weeks) revealed pitch increases averaging 26 Hz. Self-evaluations revealed increases in voice femininity, congruity with self-image, and satisfaction. However, the evaluations also showed decreased vocal quality, loudness, and vocal range. Mean VHI was consistent with VHI scores associated with Reinke's edema. Six of 10 patients were consistently perceived as female. LAVA provides a conservative treatment for androphonia. Postoperative voice therapy may optimize outcomes.

  8. 75 FR 1345 - Solicitation of Applications for the Community Trade Adjustment Assistance Program

    Science.gov (United States)

    2010-01-11

    ... of 2009, Congress enacted the Trade and Globalization Adjustment Assistance Act of 2009, which in... by trade competition. This notice announces general policies and application requirements for the... regions for growth and success in the worldwide economy. The Trade and Globalization Adjustment Assistance...

  9. 76 FR 50268 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-08-12

    ... Adjustment Assistance TA-W-73,218 International Business Machines Corporation, ITD Business Unit, Division 7... Reporting to Armonk, NY TA-W-73,218A International Business Machines Corporation, Web Strategy and... Adjustment Assistance on May 14, 2010, applicable to workers of International Business Machines Corporation...

  10. 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... certified under the Act as eligible to apply for adjustment assistance. From time to time the agency issues... determinations and redeterminations and to issue certifications of eligibility of groups of workers to apply for...

  11. Hand-assisted laparoscopic surgery (HALS) is associated with less-restrictive ventilatory impairment and less risk for pulmonary complication than open laparotomy in thoracoscopic esophagectomy.

    Science.gov (United States)

    Oshikiri, Taro; Yasuda, Takashi; Kawasaki, Kentaro; Harada, Hitoshi; Oyama, Masato; Hasegawa, Hiroshi; Ohara, Tadayuki; Sendo, Hiroyoshi; Nakamura, Tetsu; Fujino, Yasuhiro; Tominaga, Masahiro; Kakeji, Yoshihiro

    2016-02-01

    Esophagectomy with extended lymphadenectomy improves prognosis but it is associated with high morbidity and mortality. The thoracoscopic approach is associated with fewer pulmonary complications. Abdominal wall injury greatly affects pulmonary function and complication rates during the acute postoperative phase. In this study we aimed to compare the incidence of pulmonary complications and respiratory recovery after thoracoscopic esophagectomy in the prone position with hand-assisted laparoscopic surgery (HALS) versus open laparotomy (OL). This was a case-matched control study of patients with esophageal cancer who underwent thoracoscopic esophagectomy in the prone position. Thirty-two patients in the HALS group and 32 patients in the OL group were selected by the use of propensity score matching. Operative outcomes and perioperative changes in respiratory function were compared. There was no operative mortality in either group. Estimated blood loss was less in the HALS group (P < .001). The incidence of postoperative pneumonia was 6.2% (4/64) overall; it was less in the HALS group (0%) than in the OL group (12.5%) (P = .016). There were no differences in preoperative vital capacity (VC) and percent predicted vital capacity (%VC). Each parameter, including the ratio of the postoperative to preoperative %VC (%VC ratio), reached its nadir on postoperative day 7 in both groups but was greater in the HALS group (VC, 2.91 ± 0.68 L vs 2.53 ± 0.53 L, P = .018; %VC, 90.62 ± 16.92% vs 78.91 ± 16.65%, P = .007; %VC ratio, 80.90 ± 9.87% vs 72.09 ± 11.95%, P = .002). At 1 and 3 months, respiratory recovery was seen in both groups but more so in the HALS group. At 6 months, further respiratory recovery was seen in both groups, without any significant intergroup differences. During the acute phase after thoracoscopic esophagectomy in the prone position, HALS is associated with less-restrictive ventilatory impairment, fewer subsequent pulmonary

  12. 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...

  13. 13 CFR 307.6 - Economic Adjustment Assistance post-approval requirements.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Economic Adjustment Assistance post-approval requirements. 307.6 Section 307.6 Business Credit and Assistance ECONOMIC DEVELOPMENT... § 302.18 of this chapter: (a) Strategy Grants shall comply with the applicable provisions of part 303 of...

  14. 75 FR 23226 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-05-03

    ... assistance by the National Asparagus Council on behalf of asparagus producers in California, Michigan, and Washington. The Administrator will determine within 40 days whether or not increasing imports of asparagus contributed importantly to a greater than 15 percent decrease in the quantity of production of asparagus...

  15. 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.

  16. 76 FR 4614 - Trade Adjustment Assistance for Firms Program Fiscal Year 2010 Annual Report

    Science.gov (United States)

    2011-01-26

    ... Globalization Adjustment Assistance Act (TGAAA) of 2009, which was included as subtitle I (letter ``I'') of... U.S. businesses develop strategies to compete in the global economy. In general, the program provides cost-sharing technical assistance to eligible businesses to create and implement targeted business...

  17. Extension Education Drives Economic Stimulus through Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    Neibergs, J. Shannon; Mahnken, Curtis; Moore, Danna L.; Kemper, Nathan P.; Nelson, John Glenn, III; Rainey, Ron; Hipple, Patricia

    2015-01-01

    Trade Adjustment Assistance for Farmers (TAAF) is a national multifaceted USDA program that provided technical and financial assistance to farmers and fishermen adversely affected by import competition. This article describes how Extension was successfully mobilized to deliver the TAAF program to 10,983 producers across the nation using innovative…

  18. 75 FR 2491 - Trade Adjustment Assistance for Firms Program Fiscal Year 2009 Annual Report

    Science.gov (United States)

    2010-01-15

    ...: Notice. SUMMARY: The Secretary of Commerce is directed by Section 1866 of the Trade and Globalization... business recovery plans, which are known as Adjustment Proposals under Section 252 of the Trade Act, and... certification. (8) The number of firms that received assistance developing business recovery plans (Adjustment...

  19. 76 FR 59170 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance...

    Science.gov (United States)

    2011-09-23

    ... 15th day of September 2011. Michael Jaffe, Certifying Officer, Office of Trade Adjustment Assistance... Jackson, MI 09/09/11 09/08/11 PCT International (State/ One-Stop). [FR Doc. 2011-24469 Filed 9-22-11; 8:45...

  20. 77 FR 14832 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-03-13

    ... Massachusetts Mutual Life Enfield, CT......... January 24, 2011. Insurance Company, USIG B & T and Technology... trade adjustment assistance for workers by (TA-W) number issued during the period of February 20, 2012... 222(a)(2)(A) (increased imports) of the Trade Act have been met. TA-W No. Subject firm Location Impact...

  1. 76 FR 2718 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-01-14

    .../10 75020 John Hancock Life Insurance Milwaukee, WI......... 12/21/10 12/17/10 Company (Company..., DC, this 30th day of December 2010. Michael W. Jaffe, Certifying Officer, Office of Trade Adjustment Assistance. ] Appendix--TAA Petitions Instituted Between 12/20/10 and 12/23/10 Date of Date of TA-W Subject...

  2. 76 FR 81987 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-12-29

    ..., Personal Insurance Division, Tele- Workers to this Location. 81,085 Western United Life Spokane, WA........ February 13, 2010. Assurance Company, Global Life Holdings, LLC, Insurance Administration, etc. 81,091... trade adjustment assistance for workers by (TA-W) number issued during the period of December 12, 2011...

  3. 76 FR 4612 - Community Trade Adjustment Assistance Program Fiscal Year 2010 Annual Report

    Science.gov (United States)

    2011-01-26

    ... Trade and Globalization Adjustment Assistance Act (TGAAA) of 2009, which was included as subtitle I... Design (LEED) program. The business incubator for biomedical, life science and biotechnology start-ups... Corporation to build a roadway for improved access to the Triangle North Franklin Business Park. The grantee...

  4. 78 FR 52975 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-08-27

    ... Adjustment Assistance Homeward Residential, Inc. a Subsidiary of Ocwen Loan Servicing, LLC Including On-Site... Reported through American Mortgage Servicing, Inc., Power Reo Management Services, Inc., and Stratus Asset... Stratus Asset Management Addison, Texas; Homeward Residential, Inc. a Subsidiary of Ocwen Loan Servicing...

  5. 76 FR 2711 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-01-14

    ... Employment and Training Administration Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance TA-W-71,054 Apria Healthcare Including On-Site Leased Workers from Corporate Employment... Including On-Site Leased Workers from Corporate Employment Resources, Inc., D/B/A Corestaff and Leafstone...

  6. 75 FR 77666 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-12-13

    ..., Information Technology Department. 74,629 West Dermatology Medical Redlands, CA....... August 30, 2009.......... May 11, 2009. Inc. Negative Determinations for Worker Adjustment Assistance In the following cases... date 74,718 SecurAmerica, Workers On- Winston-Salem, NC.. Site at Dell Products LP. 74,930 Hotels.com...

  7. 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 IWS...

  8. 76 FR 58045 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    Science.gov (United States)

    2011-09-19

    ... Division of Trade Adjustment Assistance to issue a certification of eligibility to apply for Alternative... Information Management, Inc., Boston, MA: May 17, 2010 TA-W-80,268; Cadmus Journal Services, Inc., Ephrata, PA...) have not been met. TA-W-80,323; Allen Family Foods, Inc., Cordova, MD The workers' firm does not...

  9. 75 FR 26796 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-05-12

    ...] [FR Doc No: 2010-11271] DEPARTMENT OF LABOR Employment and Training Administration Investigations... Trade Adjustment Assistance, Employment and Training Administration, has instituted investigations... Mercury of Winchester, KY........ 04/19/10 04/15/10 Winchester, Inc. (Company). 73956 Siemens IT Solutions...

  10. 77 FR 27084 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-05-08

    ... to determine whether the workers are eligible to apply for adjustment assistance under Title II.../11/12 (Workers). 81498 Journal Register Company Mt. Clemens, MI........ 04/16/12 03/22/12 (State/One... PA, FL, 04/19/12 04/17/12 TX, KS, CO, & OR-- follow-up email will specify, WA. 81521 Journal Register...

  11. 75 FR 20385 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-04-19

    ... Regarding Eligibility To Apply for Worker Adjustment Assistance Dell Products LP, Winston-Salem (WS-1..., applicable to workers of Dell Products LP, Winston- Salem (WS-1) Division, including on-site leased workers... were employed on-site at the Winston-Salem, North Carolina location of Dell Products LP, Winston-Salem...

  12. 75 FR 71457 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-11-23

    ... Eligibility To Apply for Worker Adjustment Assistance TA-W-74,466 Hewlett Packard Company, Enterprise Business..., North America Logistics, and UPS Headquartered in Palo Alto, California, Teleworkers Across California and Workers On-Site In Roseville, California; TA-W-74,466A Hewlett Packard Company Enterprise Business...

  13. Timber harvesting, processing, and employment in the Northwest Economic Adjustment Initiative region: changes and economic assistance.

    Science.gov (United States)

    Terry L. Raettig; Harriet H. Christensen

    1999-01-01

    The Northwest economic adjustment initiative (NWEAI) provides economic assistance to a region including western Washington, western Oregon, and northern California. Timber harvests have fallen markedly in this region since 1990. The forest products industry is the largest manufacturing sector in the region, and employment has followed the downward trend in timber...

  14. 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

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

    OpenAIRE

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

    2015-01-01

    Objectives 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. Methods In ...

  16. Psychological adjustment in adolescents conceived by assisted reproduction techniques: a systematic review.

    Science.gov (United States)

    Ilioi, Elena Cristiana; Golombok, Susan

    2015-01-01

    Adolescence is a transitional time for identity formation and relationships with parents. While people born through assisted reproduction techniques (ART) appear to be well adjusted in childhood, it is unclear whether these findings carry into adolescence, and whether diverse ART have different psychological outcomes. This review summarizes what is known about the psychological adjustment and family relationships of the growing number of children born through ART who are reaching adolescence. The Pubmed, Web of Knowledge, PsycINFO and Scopus databases were searched systematically for peer reviewed papers focusing on adolescent psychological adjustment and parent-adolescent relationships in families created by ART. Key search inclusion criteria included all papers published in English relating to adolescents aged between 11 and 18 years. Seventeen publications with varied methodologies were identified by this review. Only papers relating to in vitro fertilization (IVF), egg donation and donor insemination were identified. Results were categorized according to ART that used the parents' own gametes (IVF) and those that involved reproductive donation (egg donation, and donor insemination). Compared with naturally conceived adolescents and standardized normative samples, adolescents born through all ARTs seemed to be equally well adjusted, and to have positive parent-adolescent relationships. Some differences were however identified based on the type of ART used. In particular, the sex of the parent and child, along with age and process of disclosure of the adolescent's conception were identified as key mediators of parent-adolescent relationships in families created by donor insemination. The studies in this review indicate that children born through ART have positive parent-adolescent relationships and are well adjusted, with some slight differences based on different ART. The generalizability of findings may be limited by the general low level of disclosure to

  17. Psychological adjustment in adolescents conceived by assisted reproduction techniques: a systematic review

    Science.gov (United States)

    Ilioi, Elena Cristiana; Golombok, Susan

    2015-01-01

    BACKGROUND Adolescence is a transitional time for identity formation and relationships with parents. While people born through assisted reproduction techniques (ART) appear to be well adjusted in childhood, it is unclear whether these findings carry into adolescence, and whether diverse ART have different psychological outcomes. This review summarizes what is known about the psychological adjustment and family relationships of the growing number of children born through ART who are reaching adolescence. METHODS The Pubmed, Web of Knowledge, PsycINFO and Scopus databases were searched systematically for peer reviewed papers focusing on adolescent psychological adjustment and parent–adolescent relationships in families created by ART. Key search inclusion criteria included all papers published in English relating to adolescents aged between 11 and 18 years. RESULTS Seventeen publications with varied methodologies were identified by this review. Only papers relating to in vitro fertilization (IVF), egg donation and donor insemination were identified. Results were categorized according to ART that used the parents' own gametes (IVF) and those that involved reproductive donation (egg donation, and donor insemination). Compared with naturally conceived adolescents and standardized normative samples, adolescents born through all ARTs seemed to be equally well adjusted, and to have positive parent–adolescent relationships. Some differences were however identified based on the type of ART used. In particular, the sex of the parent and child, along with age and process of disclosure of the adolescent's conception were identified as key mediators of parent–adolescent relationships in families created by donor insemination. CONCLUSIONS The studies in this review indicate that children born through ART have positive parent–adolescent relationships and are well adjusted, with some slight differences based on different ART. The generalizability of findings may be limited

  18. Actor and partner effects of coping on adjustment in couples undergoing assisted reproduction treatment

    Directory of Open Access Journals (Sweden)

    Aleksandra Kroemeke

    2017-06-01

    Full Text Available Background Infertility is a shared experience as it affects both partners. However, mutual dependencies between coping and adjustment at the couple level remain to be fully elucidated. The study attempted to address this issue using the Actor-Partner Interdependence Model (APIM to examine the actor effect (the extent to which an individual’s score on coping predicted their own level of depressive symptoms and life purpose and the partner effect (the extent to which an individual’s score on coping predicted the level of adjustment in the partner in couples undergoing assisted reproduction treatment (ART. Participants and procedure Coping strategies, depressive symptoms, and life purpose were assessed among 31 married couples (aged 27-38 years undergoing ART. The Brief COPE, CES-D, and PIL questionnaires were used. Data were analyzed by multilevel modeling (MLM. Results The results of MLM indicated that focus on positive and active coping had an actor effect with depressive symptoms and life purpose, respectively. The actor effect of evasive coping on depression was moderated by gender and significant only in women. The partner effect was demonstrated for evasive coping, social support seeking, and substance use – the first two were gender moderated and significant in men. Conclusions Coping efforts in the couple during infertility treatment are not only associated with the individual but also the partner’s adjustment to that situation. Although the focus on positive and active coping was associated with individual benefits, other coping strategies which have the function of a protective buffer may also result in the occurrence of side effects, especially in females.

  19. 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

  20. 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

  1. Conservative treatment for equinus deformity in children with cerebral palsy using an adjustable splint-assisted ankle-foot orthosis.

    Science.gov (United States)

    Chen, Wei; Liu, Xiaoyu; Pu, Fang; Yang, Yang; Wang, Lizhen; Liu, Hong; Fan, Yubo

    2017-10-01

    A novel splint, the assisting ankle-foot orthoses (AFO), was developed to provide adjustable sustained stretching to improve conservative treatment for equinus deformities in children with cerebral palsy (CP). The treatment effect was validated by follow-up visits. This study involved subjects between 2 and 12 years old, including 28 CP children treated with splint-assisted AFO correction, 30 CP children treated with static AFO correction, and 30 normal children with typical development (TD). Quantitative pedobarographic measurements were taken to evaluate the effect of splint-assisted AFO correction. The heel/forefoot ratio was introduced to indicate the degree of the equinus deformity during treatment. The results showed that the heel/forefoot ratios were 1.41 ± 0.26 for the TD children; 0.65 ± 0.41, 1.02 ± 0.44, and 1.24 ± 0.51 for the splint-assisted AFO correction before and after 6-month and 12-month treatments; 0.59 ± 0.37, 0.67 ± 0.44, and 0.66 ± 0.42 for the static AFO correction before and after 6-month and 12-month treatments. This study suggests that correction with the adjustable splint-assisted AFO is an effective treatment for equinus deformity in CP Children.

  2. 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…

  3. 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... capacity of public officials and economic development organizations to work effectively with businesses; (3..., development of Regional economies, or recovery from natural or other disasters; or (5) Encourage the...

  4. 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.

  5. Ventilatory management in neonates. Science or art?

    Science.gov (United States)

    Mariani, G L; Carlo, W A

    1998-03-01

    Conventional mechanical ventilation continues to be the standard mode of support for neonates with respiratory failure. Controversies regarding the selection of optimal ventilatory strategies still abound. A deep understanding of physiologic concepts as well as a critical appraisal of the literature is needed to optimize the ventilatory management of the newborn. Principles of gas exchange, pulmonary mechanics and control of breathing are reviewed in the context of their relevance during mechanical ventilation. The application of these concepts to the ventilatory strategies for the management of infants with respiratory distress is presented, and current controversies are emphasized.

  6. 76 FR 16446 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-03-23

    ... workers of the subject firm. The workers are engaged in the production of special effects and performance pigments. The review shows that on March 13, 2009, a certification of eligibility to apply for adjustment...

  7. 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.

  8. Time course evolution of ventilatory responses to inspiratory unloading in patients.

    Science.gov (United States)

    Viale, J P; Duperret, S; Mahul, P; Delafosse, B; Delpuech, C; Weismann, D; Annat, G

    1998-02-01

    Inspiratory muscle unloading decreases ventilatory drive. In this study, we examined the time course of this effect in patients with chronic obstructive pulmonary disease receiving two modes of ventilatory support: pressure support ventilation (PSV), during which each cycle was assisted, and biphasic positive airway pressure (BIPAP), set up in such a manner that one spontaneous breath took place between two consecutive pressure-assisted breaths. The first breath following the switch from spontaneous breathing to PSV was associated with an increase in tidal volume (VT) and a drop in mean transdiaphragmatic pressure (mean Pdi) and inspiratory work (WI) performed per liter but with unchanged values of esophageal occlusion pressure at 100 ms (Pes 0.1), diaphragmatic electrical activity (EMGdi), and WI performed by breath. The same phenomena were observed for the assisted breath of BIPAP as compared with the preceding spontaneous breath. During the subsequent breaths of PSV, Pes 0.1, EMGdi, and WI performed per breath decreased progressively up to the sixth to eighth breaths, and VT returned to pre-PSV values. We conclude that in patients with chronic obstructive pulmonary disease the decrease in ventilatory drive associated with PSV takes place from the first breath onwards but requires six to eight breaths to be fully achieved. During BIPAP, as a consequence of the kinetics of the PSV-induced downregulation of ventilatory drive, assisted breaths following spontaneous breaths are characterized by an enhanced inspiratory efficiency.

  9. 76 FR 4732 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-01-26

    ... DEPARTMENT OF LABOR Employment and Training Administration Investigations Regarding Certifications... Assistance, Employment and Training Administration, has instituted investigations pursuant to Section 221(a... Central Webster City, IA... 12/30/10 12/24/10 Vacuum Systems (Company). [FR Doc. 2011-1614 Filed 1-25-11...

  10. 77 FR 22340 - Section 8 Housing Assistance Payments Program-Annual Adjustment Factors, Fiscal Year 2012

    Science.gov (United States)

    2012-04-13

    ... of Housing, 202-708-3000, for questions relating to all other Section 8 programs; and Geoffrey Newton... AAFs differently. The specific application of the AAFs is determined by the law, the HAP contract, and... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5620-N-01] Section 8 Housing Assistance...

  11. 75 FR 16987 - Trade Adjustment Assistance; Merit Staffing of State Administration and Allocation of Training...

    Science.gov (United States)

    2010-04-02

    ... program, as provided in the Governor-Secretary Agreement. The Trade and Globalization Adjustment... introduced by Senator Max Baucus, and the actions of the Conference Committee as relevant legislative history..., pt. 1, at 119-120) as relevant legislative history. One commenter asserted that ``because Congress...

  12. 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…

  13. A Dynamic Localized Adjustable Force Field Method for Real-Time Assistive Non-Holonomic Mobile Robotics

    Directory of Open Access Journals (Sweden)

    Michael Gillham

    2015-10-01

    Full Text Available Providing an assistive navigation system that augments rather than usurps user control of a powered wheelchair represents a significant technical challenge. This paper evaluates an assistive collision avoidance method for a powered wheelchair that allows the user to navigate safely whilst maintaining their overall governance of the platform motion. The paper shows that by shaping, switching and adjusting localized potential fields we are able to negotiate different obstacles by generating a more intuitively natural trajectory, one that does not deviate significantly from the operator in the loop desired-trajectory. It can also be seen that this method does not suffer from the local minima problem, or narrow corridor and proximity oscillation, which are common problems that occur when using potential fields. Furthermore this localized method enables the robotic platform to pass very close to obstacles, such as when negotiating a narrow passage or doorway.

  14. Actor and partner effects of coping on adjustment in couples undergoing assisted reproduction treatment

    OpenAIRE

    Aleksandra Kroemeke; Ewelina Kubicka

    2017-01-01

    Background Infertility is a shared experience as it affects both partners. However, mutual dependencies between coping and adjustment at the couple level remain to be fully elucidated. The study attempted to address this issue using the Actor-Partner Interdependence Model (APIM) to examine the actor effect (the extent to which an individual’s score on coping predicted their own level of depressive symptoms and life purpose) and the partner effect (the extent to which an individual’s scor...

  15. Facilitating Family Life Review during a Relocation to Assisted Living: Exploring Contextual Impact on Family Adjustment.

    Science.gov (United States)

    O'Hora, Kendra A; Roberto, Karen A

    2017-12-14

    The purpose of this study was to explore how contextual aspects of participants' lives before and throughout relocation to assisted living (ALF) informed family experience of family life review (FLR). Fourteen families participated in a single FLR session within 6 months of the older adults' relocation. Semi-structured interviews, conducted one-month following the FLR session, were analyzed using the constant comparative method. Demographic and relational variables provided context for assessing how individual and family dynamics influenced the family relocation process. Techniques were used during the three phases of FLR (introduction, validation, consolidation) to encourage openness and mutual dialogue between family members. Health-related limitations challenged older adults' understanding and openness during the FLR. Mental health concerns linked to older adults' outlook on life, comfort in conversation during the FLR, and reflection of lifelong social ties. Family involvement and dynamics influenced how families communicated about their mutual narrative and the relocation transition. FLR is an adaptable intervention to assist older adults and their family during a transition to ALF. Although contextual challenges impacted how families experienced the FLR, they enjoyed FLR as a unifying event that promoted mutual understanding. The use of FLR facilitates enhanced understanding and communication during relocation. Older adults' health status as well as family dynamics need to be assessed prior to organizing a FLR to accommodate each families' unique needs.

  16. Respiratory symptoms and ventilatory functions among quarry ...

    African Journals Online (AJOL)

    Introduction: Workers in the quarry industries are exposed to hazards resulting from the inhalation of air borne particulates. The study determined the prevalence of respiratory symptoms and assessed ventilatory functions among quarry workers in Edo state, Nigeria Methods: Quarry workers (site workers and office workers) ...

  17. Respiratory symptoms and ventilatory function impairment among ...

    African Journals Online (AJOL)

    Methods: One hundred and forty (140) workers in a wood furniture factory in Kaduna, a city within the Savannah belt of Northern Nigeria, were studied for presence of respiratory symptoms and /or ventilatory function impairment using the MRC questionnaire on respiratory symptoms and an electronic Spirometer.

  18. Short-term modulation of the ventilatory response to exercise is preserved in obstructive sleep apnea.

    Science.gov (United States)

    Bernhardt, Vipa; Mitchell, Gordon S; Lee, Won Y; Babb, Tony G

    2017-02-01

    The ventilatory response to exercise can be transiently adjusted in response to environmentally (e.g., breathing apparatus) or physiologically altered conditions (e.g., respiratory disease), maintaining constant relative arterial P CO2 regulation from rest to exercise (Mitchell and Babb, 2006); this augmentation is called short-term modulation (STM) of the exercise ventilatory response. Obesity and/or obstructive sleep apnea could affect the exercise ventilatory response and the capacity for STM due to chronically increased mechanical and/or ventilatory loads on the respiratory system, and/or recurrent (chronic) intermittent hypoxia experienced during sleep. We hypothesized that: (1) the exercise ventilatory response is augmented in obese OSA patients compared with obese non-OSA adults, and (2) the capacity for STM with added dead space is diminished in obese OSA patients. Nine obese adults with OSA (age: 39±6 yr, BMI: 40±5kg/m 2 , AHI: 25±24 events/h [range 6-73], mean±SD) and 8 obese adults without OSA (age: 38±10 yr, BMI: 37±6kg/m 2 , AHI: 1±2) completed three, 20-min bouts of constant-load submaximal cycling exercise (8min rest, 6min at 10 and 30W) with or without added external dead space (200 or 400mL; 20min rest between bouts). Steady-state measurements were made of ventilation (V˙ E ) , oxygen consumption V˙ O2 ), carbon dioxide production (V˙ CO2 ), and end-tidal P CO2 (PET CO2 ). The exercise ventilatory response was defined as the slope of the V˙E-V˙ CO2 relationship (ΔV˙E/ΔV˙ CO2 ). In control (i.e. no added dead space), the exercise ventilatory response was not significantly different between non-OSA and OSA groups (ΔV˙E/ΔV˙ CO2 slope: 30.5±4.2 vs 30.5±3.8, p>0.05); PET CO2 regulation from rest to exercise did not differ between groups (p>0.05). In trials with added external dead space, ΔV˙E/ΔV˙ CO2 increased with increased dead space (p exercise remained small (exercise ventilatory response is not increased in obese OSA

  19. 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.

  20. Effect of forced breathing on ventilatory functions of the lung.

    Directory of Open Access Journals (Sweden)

    Joshi L

    1998-07-01

    Full Text Available Ventilatory functions were studied in 36 male and 35 female subjects (mean age 18.5 years, who underwent six weeks course in forced breathing. Ventilatory functions were studied in the form of Forced Vital Capacity (FVC, Forced Expiratory Volume at the end of one second as % of FVC (FEV1%, Maximum Voluntary Ventilation (MVV, Peak expiratory flow rate (PEFR and Breath Holding Time. Some of these ventilatory functions were found to be increased after a course of forced breathing.

  1. [Ventilatory dysfunction in motor neuron disease: when and how to act?].

    Science.gov (United States)

    Rocha, J Afonso; Miranda, M J

    2007-01-01

    Amyotrophic lateral sclerosis is a devastating progressive neurodegenerative disorder, involving motor neurons in the cerebral cortex, brainstem and spinal cord. Mean duration of survival from the time of diagnosis is around 15 months, being pulmonary complications and respiratory failure responsible for more than 85% of deaths. Albeit the inevitability of respiratory failure and short-term death, standardized intervention protocols have been shown to significantly delay the need for invasive ventilatory support, thus prolonging survival and enhancing quality of life. The authors present an intervention protocol based on clinical progression and respiratory parameters. Decisions regarding initiation of non-invasive positive pressure ventilation (NIPPV) and mechanically assisted coughing, depend on development of symptoms of hypoventilation and on objective deterioration of respiratory parameters especially in what concerns bulbar muscle function. These include maximum inspiratory capacity (MIC), difference between MIC and vital capacity (MIC-VC), and assisted peak cough flow (PCF). These standardized protocols along with patient and caregivers education, allow for improved quality of life, prolonged survival and delay or eventually prevent the need for tracheotomy and invasive ventilatory support. Supplemental oxygen should be avoided in these patients, since it precludes use of oxymetry as feedback for titrating NIPPV and MAC, and is associated with decreased ventilatory drive and aggravated hypercapnia.

  2. Novel Control Scheme of Power Assisted Wheelchair for Preventing Overturn (Part I)-Adjustment of Assisted Torque and Performance Evaluation From Field Test-

    Science.gov (United States)

    Seki, Hirokazu; Hata, Naoki; Koyasu, Yuichi; Hori, Yoichi

    Aged people and disabled people who have difficulty in walking are increasing. As one of mobility support, significance of power assisted wheelchair which assists driving force using electric motors and spreads their living areas has been enhanced. However, the increased driving force often causes a dangerous overturn of wheelchair. In this paper, control method to prevent power assisted wheelchair from overturning is proposed. It is found the front wheels rising is caused by magnitude and rapid increase of assisted torque. Therefore, feedforward control method to limit the assisted torque by tuning its magnitude or time constant is proposed. In order to emphasize safety and feeling of security, these methods make the front wheels no rise. The effectiveness of the proposed method is verified by the practical experiments and field test based performance evaluation using many trial subjects.

  3. Ventilatory physiology of children and adolescents with anxiety disorders.

    Science.gov (United States)

    Pine, D S; Coplan, J D; Papp, L A; Klein, R G; Martinez, J M; Kovalenko, P; Tancer, N; Moreau, D; Dummit, E S; Shaffer, D; Klein, D F; Gorman, J M

    1998-02-01

    Abnormalities in ventilatory physiology have been noted in adults with panic disorder. We tested the hypothesis that abnormalities in ventilatory physiology differentiate children and adolescents with anxiety disorders from psychiatrically healthy children. Ventilatory physiology was monitored with a canopy apparatus during room-air breathing and 15 minutes of carbon dioxide exposure in 33 children and adolescents comprising 18 probands with an anxiety disorder and 15 psychiatrically healthy children. During room-air breathing, probands had significantly larger minute ventilation, larger tidal volumes, and more variable breathing patterns than healthy comparisons, but the groups did not differ in end-tidal carbon dioxide or respiratory rate. During carbon dioxide challenge, probands exhibited larger minute ventilation and respiratory rate responses relative to comparisons. These findings on the association between ventilatory physiology and anxiety disorders in children and adolescents are consistent with results from studies of adults with panic disorder.

  4. Noninvasive Positive Pressure Ventilatory Support Begins During Sleep.

    Science.gov (United States)

    Bach, John R

    2017-12-01

    The goal of sleep doctors has been to titrate away apneas and hypopneas using noninvasive ventilation, a term that has become synonymous with continuous positive airway pressure and bilevel positive airway pressure at the lowest effective bilevel settings. It is now time to appreciate noninvasive ventilatory support as an alternative to invasive mechanical ventilation. This article discusses mechanisms of action, two paradigms, and ancillary techniques for noninvasive ventilatory support. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Effects of theophylline on ventilatory response to hypoxic challenge.

    OpenAIRE

    Milerad, J

    1987-01-01

    The respiratory and arousal responses to mild hypoxia during quiet sleep were studied using inductive plethysmography and transcutaneous gas electrodes in 11 apnoeic infants before and after the administration of oral theophylline (3 mg/kg). Theophylline changed the ventilatory response to a more biphasic pattern--that is, ventilation decreased after an initial increase. The relative ventilatory slope (defined as the decrease in transcutaneous carbon dioxide tension (PCO2) in relation to the ...

  6. VBS RTK GPS-ASSISTED SELF-CALIBRATION BUNDLE ADJUSTMENT FOR AERIAL TRIANGULATION OF FIXED-WING UAS IMAGES FOR UPDATING TOPOGRAPHIC MAPS

    Directory of Open Access Journals (Sweden)

    SHIH-HONG CHIO

    Full Text Available Unmanned Aircraft Systems (UASs can collect high resolution and high quality images for local mapping. If the highly accurate GPS flying trajectory of a UAS is collected, it can support bundle adjustment aerial triangulation (AT of UAS images and reduce the demands on ground control points (GCPs. This study installs a Trimble BD970 GNSS OEM on a fixed-wing UAS for capturing highly accurate GPS data by using a Virtual Base Station (VBS RTK GPS technique for AT. Meanwhile, the GPS antenna-camera offset is resolved by stripwise linear drift parameters introduced in GPS observation equations, while performing bundle adjustment for AT. Additionally, self-calibration bundle adjustment is used in VBS RTK GPS-assisted AT to solve incomplete camera parameters calibrated by a close-range photogrammetric approach. The results show that the AT accuracy of fixed-wing UAS images collected with a 24 mm focal-length Canon EOS 5D Mark II camera at a flying height of 550 m above ground level is 0.21 m in planimetry and 0.22 m in height using two cross strips with two full GCPs at each corner of the block. The RMSE of check points from stereoscopic viewing can reach 0.27 m in planimetry and 0.24 m in height. The test results show that the accuracy of VBS RTK GPS-assisted bundle adjustment with self-calibration for the AT of fixed-wing UAS image can be used for updating local 1/5000 topographic maps in Taiwan.

  7. 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].

  8. 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].

  9. 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

  10. Adjusting the chlorhexidine content of calcium phosphate coatings by electrochemically assisted co-deposition from aqueous solutions.

    Science.gov (United States)

    Scharnweber, D; Flössel, M; Born, R; Worch, H

    2007-02-01

    Currently, a number of strategies to create either biologically active or antimicrobial surfaces of biomaterials are being developed and commercially applied. However, for metallic implants in contact with bone, both osteomyelitis and a fast and stable long-term fixation of implants are challenges to be overcome, especially in the case of bad bone quality. Therefore, the present work aims to develop compound coatings of calcium phosphate phases (CPP) and chlorhexidine (CHD) that combine bioactive properties with a strategy to prevent initial bacterial adhesion and thus offer a possible solution to the two major problems of implant surgery mentioned above. Using electrochemically assisted deposition of CPP on samples of Ti6Al4V together with the pH-dependent solubility of CHD, the preparation of coatings with a wide range of CHD concentrations (150 ng/cm(2) to 65 microg/cm(2)) from electrolytes with CHD concentrations between 50 and 200 microM was possible, thus allowing the adaptation of implant surface properties to different surgical and patient situations. Detailed SEM and FTIR analysis showed that coatings are formed by a co-deposition process of both phases and that CHD interacts with the deposition and transformation of CPP in the coating. For high CHD contents, coatings consist of CHD crystals coated by nano-crystalline hydroxyapatite.

  11. 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.

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

    African Journals Online (AJOL)

    Objectives. To determine whether an increase in respiratory drive, due to elevated progesterone and oestrogen concentration during various menstrual phases, persists throughout prolonged submaximal exercise and potentially contributes to fatigue. Furthermore, to determine whether the difference in the ventilatory ...

  13. Ventilatory functions response to breathing training versus aerobic ...

    African Journals Online (AJOL)

    Background: There is worldwide public interest in physical therapies for asthma. Objective: To compare the effects of a program of breathing training and aerobic training on ventilatory functions in children with bronchial asthma. Methods: Forty asthmatic children from both genders (22 boys and 18 girls) were recruited to ...

  14. Ventilatory support of the newborn | Ahmed | Nigerian Journal of ...

    African Journals Online (AJOL)

    ... monitoring and re- evaluation. This article is intended to present an overview of the embryology of the respiratory system, pulmonary physiology in the newborn, the principles of oxygen therapy and mechanical ventilation. It also discusses the complications that can follow. Key words: Ventilatory support, oxygen delivery, ...

  15. Defining obstructive ventilatory defect in 2015 | Affes | Libyan ...

    African Journals Online (AJOL)

    % vs. 78+17%) and FVC (71+15% vs. 93+19%). Conclusion: The frequency of OVD much depends on the criteria used for its definition. Keywords: obstructive ventilatory defect; FEV1/FVC; fixed threshold; lower limit of normal; spirometry; ...

  16. Ventilatory functions response to breathing training versus aerobic ...

    African Journals Online (AJOL)

    EL-HAKIM

    Ventilatory functions response to breathing training versus aerobic training in asthmatic children. INTRODUCTION. Pharmacologic therapy remains the primary mode of treatment for patients with asthma and despite recent advances in pharmacological intervention, there is worldwide public interest in physical therapies for ...

  17. 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.

  18. 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.

  19. P ET CO2 e SpO2 permitem ajuste ventilatório adequado em pacientes obesos mórbidos P ET CO2 y SpO2 permiten ajuste de ventilación adecuada en pacientes obesos mórbidos P ET CO2 and SpO2 allow adequate ventilatory adjustment in morbidly obese patients

    Directory of Open Access Journals (Sweden)

    Fábio Ely Martins Benseñor

    2004-08-01

    O2 mayor que 95%. No se utilizó PEEP. A través de monitor respiratorio CO2SMO Plus, se midió espacios muertos fisiológico, alveolar y de vías aéreas (VD phy, VD alv y VD aw y el volumen corriente alveolar (VT alv. Muestras de sangre arterial y venoso central permitieron calcular PaO2/FIO2 y VD phy/VT. Los datos fueron comparados y analizados por ANOVA (p BACKGROUND AND OBJECTIVES: Ventilation strategies for anesthesia in morbidly obese patients have been investigated, but an agreement has not been achieved yet. This study aimed at clinically evaluating ventilation adjustments based on oximetry and capnography readings in these patients during anesthesia. METHODS: Consent was obtained from the Institutional Ethics Committee and from patients. Smokers and respiratory or cardiac disease patients were excluded. Eleven patients with Body Mass Index (BMI of 59.2 ± 8.3 undergoing gastroplasty under general anesthesia were studied (Group O, with a control group (NO composed of 8 non-obese patients (BMI 20.2 ± 3.9 submitted to gastrectomy. Ventilator was adjusted to keep P ET CO2 below 40 mmHg and SpO2 above 95%. PEEP was not used. Through a CO2SMO Plus respiratory monitor, airway, alveolar and physiologic dead spaces (respectively VD aw, VD phy and VD alv, as well as alveolar tidal volume (TV alv were measured. Arterial and central venous blood samples were used to calculate PaO2/FIO2 and VD phy/TV relationships. Data were compared and evaluated by ANOVA (p < 0.05. RESULTS: Tidal volume was 4.2 ± 0.4 mL.kg-1 in Group O and 7.9 ± 2.3 mL.kg-1 in Group NO for measured weight, and 11.5 ± 1.8 mL.kg-1 in Group O and 6.6 ± 1.1 mL.kg-1 in Group NO for ideal weight. PaO2 was lower and TV alv was higher in Group O (p < 0.008 and 0.0001, respectively. No difference was found in PaCO2, VD phy, VD alv and VD aw. CONCLUSIONS: SpO2 and P ET CO2 seem to assure adequate ventilation, which can be achieved in morbidly obese patients with tidal volumes adjusted to ideal weight.

  20. 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...

  1. Ventilatory sensitivity to mild asphyxia: prone versus supine sleep position

    OpenAIRE

    Galland, B; Bolton, D; Taylor, B; Sayers, R; Williams, S

    2000-01-01

    AIMS—To compare the effects of prone and supine sleep position on the main physiological responses to mild asphyxia: increase in ventilation and arousal.
METHODS—Ventilatory and arousal responses to mild asphyxia (hypercapnia/hypoxia) were measured in 53 healthy infants at newborn and 3 months of age, during quiet sleep (QS) and active sleep (AS), and in supine and prone sleep positions. The asphyxial test mimicked face down rebreathing by slowly altering the inspired air: C...

  2. Model-based characterization of ventilatory stability using spontaneous breathing

    OpenAIRE

    Nemati, Shamim; Edwards, Bradley A.; Sands, Scott A.; Berger, Philip J.; Wellman, Andrew; Verghese, George C.; Malhotra, Atul; Butler, James P.

    2011-01-01

    Cyclic ventilatory instabilities are widely attributed to an increase in the sensitivity or loop gain of the chemoreflex feedback loop controlling ventilation. A major limitation in the conventional characterization of this feedback loop is the need for labor-intensive methodologies. To overcome this limitation, we developed a method based on trivariate autoregressive modeling using ventilation, end-tidal Pco2 and Po2; this method provides for estimation of the overall “loop gain” of the resp...

  3. Determination of ventilatory threshold through quadratic regression analysis.

    Science.gov (United States)

    Gregg, Joey S; Wyatt, Frank B; Kilgore, J Lon

    2010-09-01

    Ventilatory threshold (VT) has been used to measure physiological occurrences in athletes through models via gas analysis with limited accuracy. The purpose of this study is to establish a mathematical model to more accurately detect the ventilatory threshold using the ventilatory equivalent of carbon dioxide (VE/VCO2) and the ventilatory equivalent of oxygen (VE/Vo2). The methodology is primarily a mathematical analysis of data. The raw data used were archived from the cardiorespiratory laboratory in the Department of Kinesiology at Midwestern State University. Procedures for archived data collection included breath-by-breath gas analysis averaged every 20 seconds (ParVoMedics, TrueMax 2400). A ramp protocol on a Velotron bicycle ergometer was used with increased work at 25 W.min beginning with 150 W, until volitional fatigue. The subjects consisted of 27 healthy, trained cyclists with age ranging from 18 to 50 years. All subjects signed a university approved informed consent before testing. Graphic scatterplots and statistical regression analyses were performed to establish the crossover and subsequent dissociation of VE/Vo2 to VE/VCO2. A polynomial trend line along the scatterplots for VE/VO2 and VE/VCO2 was used because of the high correlation coefficient, the coefficient of determination, and trend line. The equations derived from the scatterplots and trend lines were quadratic in nature because they have a polynomial degree of 2. A graphing calculator in conjunction with a spreadsheet was used to find the exact point of intersection of the 2 trend lines. After the quadratic regression analysis, the exact point of VE/Vo2 and VE/VCO2 crossover was established as the VT. This application will allow investigators to more accurately determine the VT in subsequent research.

  4. Predictive value of ventilatory inflection points determined under field conditions.

    Science.gov (United States)

    Heyde, Christian; Mahler, Hubert; Roecker, Kai; Gollhofer, Albert

    2016-01-01

    The aim of this study was to evaluate the predictive potential provided by two ventilatory inflection points (VIP1 and VIP2) examined in field without using gas analysis systems and uncomfortable facemasks. A calibrated respiratory inductance plethysmograph (RIP) and a computerised routine were utilised, respectively, to derive ventilation and to detect VIP1 and VIP2 during a standardised field ramp test on a 400 m running track on 81 participants. In addition, average running speed of a competitive 1000 m run (S1k) was observed as criterion. The predictive value of running speed at VIP1 (SVIP1) and the speed range between VIP1 and VIP2 in relation to VIP2 (VIPSPAN) was analysed via regression analysis. VIPSPAN rather than running speed at VIP2 (SVIP2) was operationalised as a predictor to consider the covariance between SVIP1 and SVIP2. SVIP1 and VIPSPAN, respectively, provided 58.9% and 22.9% of explained variance in regard to S1k. Considering covariance, the timing of two ventilatory inflection points provides predictive value in regard to a competitive 1000 m run. This is the first study to apply computerised detection of ventilatory inflection points in a field setting independent on measurements of the respiratory gas exchange and without using any facemasks.

  5. Benefits of Manometer in Non-Invasive Ventilatory Support.

    Science.gov (United States)

    Lacerda, Rodrigo Silva; de Lima, Fernando Cesar Anastácio; Bastos, Leonardo Pereira; Fardin Vinco, Anderson; Schneider, Felipe Britto Azevedo; Luduvico Coelho, Yves; Fernandes, Heitor Gomes Costa; Bacalhau, João Marcus Ramos; Bermudes, Igor Matheus Simonelli; da Silva, Claudinei Ferreira; da Silva, Luiza Paterlini; Pezato, Rogério

    2017-12-01

    Introduction Effective ventilation during cardiopulmonary resuscitation (CPR) is essential to reduce morbidity and mortality rates in cardiac arrest. Hyperventilation during CPR reduces the efficiency of compressions and coronary perfusion. Problem How could ventilation in CPR be optimized? The objective of this study was to evaluate non-invasive ventilator support using different devices. The study compares the regularity and intensity of non-invasive ventilation during simulated, conventional CPR and ventilatory support using three distinct ventilation devices: a standard manual resuscitator, with and without airway pressure manometer, and an automatic transport ventilator. Student's t-test was used to evaluate statistical differences between groups. P values manometer when compared with the manual resuscitator with manometer support (MS) group or automatic ventilator (AV) group. The study recommends for ventilatory support the use of a manual resuscitator equipped with MS or AVs, due to the risk of reduction in coronary perfusion pressure and iatrogenic thoracic injury during hyperventilation found using manual resuscitator without manometer. Lacerda RS , de Lima FCA , Bastos LP , Vinco AF , Schneider FBA , Coelho YL , Fernandes HGC , Bacalhau JMR , Bermudes IMS , da Silva CF , da Silva LP , Pezato R . Benefits of manometer in non-invasive ventilatory support. Prehosp Disaster Med. 2017;32(6):615-620.

  6. Exercise training effects on hypoxic and hypercapnic ventilatory responses in mice selected for increased voluntary wheel running.

    Science.gov (United States)

    Kelly, Scott A; Rezende, Enrico L; Chappell, Mark A; Gomes, Fernando R; Kolb, Erik M; Malisch, Jessica L; Rhodes, Justin S; Mitchell, Gordon S; Garland, Theodore

    2014-02-01

    What is the central question of this study? We used experimental evolution to determine how selective breeding for high voluntary wheel running and exercise training (7-11 weeks) affect ventilatory chemoreflexes of laboratory mice at rest. What is the main finding and its importance? Selective breeding, although significantly affecting some traits, did not systematically alter ventilation across gas concentrations. As with most human studies, our findings support the idea that endurance training attenuates resting ventilation. However, little evidence was found for a correlation between ventilatory chemoreflexes and the amount of individual voluntary wheel running. We conclude that exercise 'training' alters respiratory behaviours, but these changes may not be necessary to achieve high levels of wheel running. Ventilatory control is affected by genetics, the environment and gene-environment and gene-gene interactions. Here, we used an experimental evolution approach to test whether 37 generations of selective breeding for high voluntary wheel running (genetic effects) and/or long-term (7-11 weeks) wheel access (training effects) alter acute respiratory behaviour of mice resting in normoxic, hypoxic and hypercapnic conditions. As the four replicate high-runner (HR) lines run much more than the four non-selected control (C) lines, we also examined whether the amount of exercise among individual mice was a quantitative predictor of ventilatory chemoreflexes at rest. Selective breeding and/or wheel access significantly affected several traits. In normoxia, HR mice tended to have lower mass-adjusted rates of oxygen consumption and carbon dioxide production. Chronic wheel access increased oxygen consumption and carbon dioxide production in both HR and C mice during hypercapnia. Breathing frequency and minute ventilation were significantly reduced by chronic wheel access in both HR and C mice during hypoxia. Selection history, while significantly affecting some traits

  7. Control of breathing and ventilatory acclimatization to hypoxia in deer mice native to high altitudes.

    Science.gov (United States)

    Ivy, C M; Scott, G R

    2017-12-01

    We compared the control of breathing and heart rate by hypoxia between high- and low-altitude populations of Peromyscus mice, to help elucidate the physiological specializations that help high-altitude natives cope with O 2 limitation. Deer mice (Peromyscus maniculatus) native to high altitude and congeneric mice native to low altitude (Peromyscus leucopus) were bred in captivity at sea level. The F1 progeny of each population were raised to adulthood and then acclimated to normoxia or hypobaric hypoxia (12 kPa, simulating hypoxia at ~4300 m) for 5 months. Responses to acute hypoxia were then measured during stepwise reductions in inspired O 2 fraction. Lowlanders exhibited ventilatory acclimatization to hypoxia (VAH), in which hypoxia acclimation enhanced the hypoxic ventilatory response, made breathing pattern more effective (higher tidal volumes and lower breathing frequencies at a given total ventilation), increased arterial O 2 saturation and heart rate during acute hypoxia, augmented respiratory water loss and led to significant growth of the carotid body. In contrast, highlanders did not exhibit VAH - exhibiting a fixed increase in breathing that was similar to hypoxia-acclimated lowlanders - and they maintained even higher arterial O 2 saturations in hypoxia. However, the carotid bodies of highlanders were not enlarged by hypoxia acclimation and were similar in size to those of normoxic lowlanders. Highlanders also maintained consistently higher heart rates than lowlanders during acute hypoxia. Our results suggest that highland deer mice have evolved high rates of alveolar ventilation and respiratory O 2 uptake without the significant enlargement of the carotid bodies that is typical of VAH in lowlanders, possibly to adjust the hypoxic chemoreflex for life in high-altitude hypoxia. © 2017 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

  8. [Structural adjustment, cultural adjustment?].

    Science.gov (United States)

    Dujardin, B; Dujardin, M; Hermans, I

    2003-12-01

    Over the last two decades, multiple studies have been conducted and many articles published about Structural Adjustment Programmes (SAPs). These studies mainly describe the characteristics of SAPs and analyse their economic consequences as well as their effects upon a variety of sectors: health, education, agriculture and environment. However, very few focus on the sociological and cultural effects of SAPs. Following a summary of SAP's content and characteristics, the paper briefly discusses the historical course of SAPs and the different critiques which have been made. The cultural consequences of SAPs are introduced and are described on four different levels: political, community, familial, and individual. These levels are analysed through examples from the literature and individual testimonies from people in the Southern Hemisphere. The paper concludes that SAPs, alongside economic globalisation processes, are responsible for an acute breakdown of social and cultural structures in societies in the South. It should be a priority, not only to better understand the situation and its determining factors, but also to intervene and act with strategies that support and reinvest in the social and cultural sectors, which is vital in order to allow for individuals and communities in the South to strengthen their autonomy and identify.

  9. 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

    , the median (range) respiratory disturbance index (apnoeas + hypopnoeas per h) was 12 (0-121), with the patients spending 6% (0-65%) of the night in some kind of ventilatory disturbance. It was not possible from pre-operative snoring habits to predict patients who developed postoperative ventilatory...

  10. 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

    2014-11-07

    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.

  11. Ventilatory muscle strength, diaphragm thickness and pulmonary function in world-class powerlifters.

    Science.gov (United States)

    Brown, Peter I; Venables, Heather K; Liu, Hymsuen; de-Witt, Julie T; Brown, Michelle R; Faghy, Mark A

    2013-11-01

    Resistance training activates the ventilatory muscles providing a stimulus similar to ventilatory muscle training. We examined the effects of elite powerlifting training upon ventilatory muscle strength, pulmonary function and diaphragm thickness in world-class powerlifters (POWER) and a control group (CON) with no history of endurance or resistance training, matched for age, height and body mass. Body composition was assessed using single-frequency bioelectrical impedance. Maximal static volitional inspiratory (P(I,max)) and expiratory (P(E,max)) mouth pressures, diaphragm thickness (T(di)) derived from ultrasound measurements and pulmonary function from maximal flow volume loops were measured. There were no differences in physical characteristics or pulmonary function between groups. P(I,max) (22 %, P powerlifters improve ventilatory muscle strength and increases diaphragm size. Whole-body resistance training may be an appropriate training mode to attenuate the effects of ventilatory muscle weakness experienced with ageing and some disease states.

  12. Convexity Adjustments

    DEFF Research Database (Denmark)

    M. Gaspar, Raquel; Murgoci, Agatha

    2010-01-01

    A convexity adjustment (or convexity correction) in fixed income markets arises when one uses prices of standard (plain vanilla) products plus an adjustment to price nonstandard products. We explain the basic and appealing idea behind the use of convexity adjustments and focus on the situations...

  13. 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

  14. 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...

  15. 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...

  16. Developmental hyperoxia alters CNS mechanisms underlying hypoxic ventilatory depression in neonatal rats.

    Science.gov (United States)

    Hill, Corey B; Grandgeorge, Samuel H; Bavis, Ryan W

    2013-12-01

    Newborn mammals exhibit a biphasic hypoxic ventilatory response (HVR), but the relative contributions of carotid body-initiated CNS mechanisms versus central hypoxia on ventilatory depression during the late phase of the HVR are not well understood. Neonatal rats (P4-5 or P13-15) were treated with a nonselective P2 purinergic receptor antagonist (pyridoxalphosphate-6-azophenyl-2',4'-disulfonic acid, or PPADS; 125mgkg(-1), i.p.) to pharmacologically denervate the peripheral chemoreceptors. At P4-5, rats reared in normoxia showed a progressive decline in ventilation during a 10-min exposure to 12% O2 (21-28% decrease from baseline). No hypoxic ventilatory depression was observed in the older group of neonatal rats (i.e., P13-15), suggesting that the contribution of central hypoxia to hypoxic ventilatory depression diminishes with age. In contrast, rats reared in moderate hyperoxia (60% O2) from birth exhibited no hypoxic ventilatory depression at either age studied. Systemic PPADS had no effect on the ventilatory response to 7% CO2, suggesting that the drug did not cross the blood-brain barrier. These findings indicate that (1) CNS hypoxia depresses ventilation in young, neonatal rats independent of carotid body activation and (2) hyperoxia alters the development of CNS pathways that modulate the late phase of the hypoxic ventilatory response. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Analysis of Hypoxic and Hypercapnic Ventilatory Response in Healthy Volunteers

    Science.gov (United States)

    Lin, Ling; Sharifi, Husham; Rico, Tom; Andlauer, Olivier; Aran, Adi; Bloomrosen, Efrat; Faraco, Juliette; Fang, Han; Mignot, Emmanuel

    2017-01-01

    Introduction A previous study has suggested that the Human Leukocyte Antigen (HLA) allele DQB1*06:02 affects hypoxic ventilatory response (HVR) but not hypercapnic ventilatory response (HCVR) in an Asian population. The current study evaluated the relationship in Caucasians and Asians. In addition we assessed whether gender or polymorphisms in genes participating in the control of breathing affect HVR and HCVR. Methods A re-breathing system was used to measure HVR and HCVR in 551 young adults (56.8% Caucasians, 30% Asians). HLA-DQB1*06:02 and tagged polymorphisms and coding variants in genes participating in breathing (PHOX2B, GPR4 and TASK2/KCNK5) were analyzed. The associations between HVR/HCVR and HLA-DQB1*06:02, genetic polymorphisms, and gender were evaluated using ANOVA or frequentist association testing with SNPTEST. Results HVR and gender are strongly correlated. HCVR and gender are not. Mean HVR in women was 0.276±0.168 (liter/minute/%SpO2) compared to 0.429±0.266 (liter/minute/%SpO2) in men, pHVR in men). Women had lower baseline minute ventilation (8.08±2.36 l/m vs. 10.00±3.43l/m, pHVR or HCVR. Genetic analysis revealed point wise, uncorrected significant associations between two TASK2/KCNK5 variants (rs2815118 and rs150380866) and HCVR. Conclusions This is the largest study to date reporting the relationship between gender and HVR/ HCVR and the first study assessing the association between genetic polymorphisms in humans and HVR/HCVR. The data suggest that gender has a large effect on hypoxic breathing response. PMID:28045995

  18. Analysis of Hypoxic and Hypercapnic Ventilatory Response in Healthy Volunteers.

    Science.gov (United States)

    Goldberg, Shmuel; Ollila, Hanna Maria; Lin, Ling; Sharifi, Husham; Rico, Tom; Andlauer, Olivier; Aran, Adi; Bloomrosen, Efrat; Faraco, Juliette; Fang, Han; Mignot, Emmanuel

    2017-01-01

    A previous study has suggested that the Human Leukocyte Antigen (HLA) allele DQB1*06:02 affects hypoxic ventilatory response (HVR) but not hypercapnic ventilatory response (HCVR) in an Asian population. The current study evaluated the relationship in Caucasians and Asians. In addition we assessed whether gender or polymorphisms in genes participating in the control of breathing affect HVR and HCVR. A re-breathing system was used to measure HVR and HCVR in 551 young adults (56.8% Caucasians, 30% Asians). HLA-DQB1*06:02 and tagged polymorphisms and coding variants in genes participating in breathing (PHOX2B, GPR4 and TASK2/KCNK5) were analyzed. The associations between HVR/HCVR and HLA-DQB1*06:02, genetic polymorphisms, and gender were evaluated using ANOVA or frequentist association testing with SNPTEST. HVR and gender are strongly correlated. HCVR and gender are not. Mean HVR in women was 0.276±0.168 (liter/minute/%SpO2) compared to 0.429±0.266 (liter/minute/%SpO2) in men, pHVR in men). Women had lower baseline minute ventilation (8.08±2.36 l/m vs. 10.00±3.43l/m, pHVR or HCVR. Genetic analysis revealed point wise, uncorrected significant associations between two TASK2/KCNK5 variants (rs2815118 and rs150380866) and HCVR. This is the largest study to date reporting the relationship between gender and HVR/ HCVR and the first study assessing the association between genetic polymorphisms in humans and HVR/HCVR. The data suggest that gender has a large effect on hypoxic breathing response.

  19. An evaluation of peak inspiratory pressure, tidal volume, and ventilatory frequency during ventilation with a neonatal self-inflating bag resuscitator.

    Science.gov (United States)

    Bassani, Mariana Almada; Filho, Francisco Mezzacappa; de Carvalho Coppo, Maria Regina; Martins Marba, Sérgio Tadeu

    2012-04-01

    Although the self-inflating bag is widely used in the hospital setting, variability of delivered ventilatory parameters is usually high, which might result in both hypoventilation and lung injury. The aims of this study were to assess possible sources of the high variability and to evaluate the adequacy of obtained values in relation to the recommended values for neonatal resuscitation. This was an experimental study in which 172 health professionals (physicians, resident physicians, physiotherapists, nurses, and nursing technicians) who work with neonatal intensive care manually ventilated a test lung (adjusted to simulate the lungs of an intubated term newborn) with a self-inflating bag in 5 different handling techniques, using 10, 5, 4, 3, and 2 fingers. Delivered values of peak inspiratory pressure (PIP), tidal volume (V(T)), and ventilatory frequency (f) were compared, taking into account the different handling modalities and professions by analysis of variance for repeated measures. Chi-square, the Friedman test and the Fisher exact tests were performed to compare the delivered and standard values. PIP and V(T) were significantly affected by the handling technique, with higher values for a greater number of fingers used for ventilation. Profession also influenced V(T) and f significantly: physiotherapists tended to deliver higher volumes and lower rates. Nevertheless, we observed high variability of all studied ventilatory parameters and overall inadequacy of obtained values. Most volunteers delivered excessive pressures and volumes at insufficient ventilatory frequency. Delivered values seem to depend on operators' individual and professional differences, as well as on the number of fingers used to compress the bag. However, from the clinical point of view, it is important to point out the high occurrence of inadequate delivered values, regardless of handling technique and profession.

  20. 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.

  1. Ventilatory Threshold, Running Economy and Distance Running Performance of Trained Athletes.

    Science.gov (United States)

    Powers, Scott K.; And Others

    1983-01-01

    In an attempt to identify physiological factors that account for success in distance running, researchers evaluated relationships among ventilatory threshold, running economy, and distance running performance. Subjects were trained male runners with similar maximal aerobic power. (Authors/PP)

  2. Chiropractic Adjustment

    Science.gov (United States)

    ... Results Chiropractic adjustment can be effective in treating low back pain, although much of the research done shows only a modest benefit — similar to the results of more conventional treatments. Some studies suggest that spinal manipulation also may ...

  3. Chiropractic Adjustment

    Science.gov (United States)

    ... How you prepare No special preparation is required before a chiropractic adjustment. Chiropractic treatment may require a series of visits to your chiropractor. Ask your care provider about the frequency of visits and be ...

  4. Disharmony between wake- and respiration-promoting activities: effects of modafinil on ventilatory control in rodents

    OpenAIRE

    Terada, Jiro; Fukushi, Isato; Takeda, Kotaro; Hasebe, Yohei; Pokorski, Mieczyslaw; Tatsumi, Koichiro; Okada, Yasumasa

    2016-01-01

    Background Modafinil is a wake-promoting drug and has been widely used for daytime sleepiness in patients with narcolepsy and other sleep disorders. A recent case series reported that daily oral modafinil alleviated hypercapnic respiratory failure in patients with COPD. However, the precise action of modafinil on respiration such as hypercapnic and/or hypoxic ventilatory responses remains unclear. The aim of this study is to clarify the effect of modafinil on the ventilatory control. Methods ...

  5. Possibilities of bronchography in diagnosis of ventilatory failure in chronic pulmonary diseases

    International Nuclear Information System (INIS)

    Sharov, V.B.

    1982-01-01

    Ventilatory disorders have been studied in 187 patients by means of X-ray examination of the respiratory tract and its functional changes with the help of improved method of aspiration bronchography. The data obtained permit to distinguish the causes of ventilatory function disorders (obstructive and restrictive alterations) and the process spreading (diffuse or regional character). Timely detection of these lesions could help to avoid undesirable consequences in the treatment of patients

  6. Time course of air hunger mirrors the biphasic ventilatory response to hypoxia.

    Science.gov (United States)

    Moosavi, S H; Banzett, R B; Butler, J P

    2004-12-01

    Determining response dynamics of hypoxic air hunger may provide information of use in clinical practice and will improve understanding of basic dyspnea mechanisms. It is hypothesized that air hunger arises from projection of reflex brain stem ventilatory drive ("corollary discharge") to forebrain centers. If perceptual response dynamics are unmodified by events between brain stem and cortical awareness, this hypothesis predicts that air hunger will exactly track ventilatory response. Thus, during sustained hypoxia, initial increase in air hunger would be followed by a progressive decline reflecting biphasic reflex ventilatory drive. To test this prediction, we applied a sharp-onset 20-min step of normocapnic hypoxia and compared dynamic response characteristics of air hunger with that of ventilation in 10 healthy subjects. Air hunger was measured during mechanical ventilation (minute ventilation = 9 +/- 1.4 l/min; end-tidal Pco(2) = 37 +/- 2 Torr; end-tidal Po(2) = 45 +/- 7 Torr); ventilatory response was measured during separate free-breathing trials in the same subjects. Discomfort caused by "urge to breathe" was rated every 30 s on a visual analog scale. Both ventilatory and air hunger responses were modeled as delayed double exponentials corresponding to a simple linear first-order response but with a separate first-order adaptation. These models provided adequate fits to both ventilatory and air hunger data (r(2) = 0.88 and 0.66). Mean time constant and time-to-peak response for the average perceptual response (0.36 min(-1) and 3.3 min, respectively) closely matched corresponding values for the average ventilatory response (0.39 min(-1) and 3.1 min). Air hunger response to sustained hypoxia tracked ventilatory drive with a delay of approximately 30 s. Our data provide further support for the corollary discharge hypothesis for air hunger.

  7. Analysis of Hypoxic and Hypercapnic Ventilatory Response in Healthy Volunteers.

    Directory of Open Access Journals (Sweden)

    Shmuel Goldberg

    Full Text Available A previous study has suggested that the Human Leukocyte Antigen (HLA allele DQB1*06:02 affects hypoxic ventilatory response (HVR but not hypercapnic ventilatory response (HCVR in an Asian population. The current study evaluated the relationship in Caucasians and Asians. In addition we assessed whether gender or polymorphisms in genes participating in the control of breathing affect HVR and HCVR.A re-breathing system was used to measure HVR and HCVR in 551 young adults (56.8% Caucasians, 30% Asians. HLA-DQB1*06:02 and tagged polymorphisms and coding variants in genes participating in breathing (PHOX2B, GPR4 and TASK2/KCNK5 were analyzed. The associations between HVR/HCVR and HLA-DQB1*06:02, genetic polymorphisms, and gender were evaluated using ANOVA or frequentist association testing with SNPTEST.HVR and gender are strongly correlated. HCVR and gender are not. Mean HVR in women was 0.276±0.168 (liter/minute/%SpO2 compared to 0.429±0.266 (liter/minute/%SpO2 in men, p<0.001 (55.4% higher HVR in men. Women had lower baseline minute ventilation (8.08±2.36 l/m vs. 10.00±3.43l/m, p<0.001, higher SpO2 (98.0±1.3% vs. 96.6±1.7%, p<0.001, and lower EtCO2 (4.65±0.68% vs. 4.82±1.02%, p = 0.025. One hundred and two (18.5% of the participants had HLA-DQB1*06:02. No association was seen between HLA-DQB1*06:02 and HVR or HCVR. Genetic analysis revealed point wise, uncorrected significant associations between two TASK2/KCNK5 variants (rs2815118 and rs150380866 and HCVR.This is the largest study to date reporting the relationship between gender and HVR/ HCVR and the first study assessing the association between genetic polymorphisms in humans and HVR/HCVR. The data suggest that gender has a large effect on hypoxic breathing response.

  8. Ventilatory inefficiency in major depressive disorder: a potential adjunct for cardiac risk stratification in depressive disorders?

    Science.gov (United States)

    Donath, Lars; Puta, Christian; Boettger, Silke; Mueller, Hans Josef; Faude, Oliver; Meyer, Tim; Bär, Karl-Jürgen; Gabriel, Holger H W

    2010-08-16

    Cardiopulmonary exercise testing (CPET) provides insights into ventilatory, cardiac and metabolic dysfunction in heart and lung diseases and might play a role in cardiac risk stratification in major depressive disorder (MDD). The VE/VCO(2)-slope indicates ventilatory efficiency and has been applied to stratify the cardiac risk in heart failure (HF). Therefore, the current study was conducted to evaluate and classify ventilatory efficiency and its relationship to physical fitness and disease severity in MDD. Exhaustive incremental exercise testing was completed by 15 female MDD patients and pair matched controls. The ventilatory threshold (VT) and the VE/VCO(2)-slope were assessed. Statistical analyses were conducted by means of MANOVAs and follow-up univariate ANOVAs. In patients with MDD, significant different relative work rates and oxygen uptakes at the VT in comparison to healthy controls were observed. Furthermore, we found an increased VE/VCO(2)-slope in depressed patients. We additionally report an inverse relationship between the VE/VCO(2)-slope and peak power output as well as peak oxygen uptake solely in patients. We did not observe any association of assessed parameters with disease severity. CPET measures indicate ventilatory inefficiency in patients with MDD. The elevated VE/VCO(2)-slope indicates that patients with MDD need to ventilate significantly more to a given amount of developing CO(2). Further investigations are needed to verify the application of the ventilatory classification system to stratify cardiovascular risk in depressive disorder. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  9. 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.

  10. Breathing pattern and ventilatory control in chronic tetraplegia.

    Science.gov (United States)

    Spungen, Ann M; Bauman, William A; Lesser, Marvin; McCool, F Dennis

    2009-01-01

    Blunted ventilatory responses to carbon dioxide indicate that respiratory control is impaired when ventilation is stimulated in individuals with tetraplegia; however, respiratory control during resting breathing has not been extensively studied in this population. Our objective was to evaluate respiratory control and sigh frequency during resting breathing in persons with tetraplegia. A prospective, two-group comparative study was performed. Breathing pattern was assessed in ten outpatients with chronic tetraplegia and eight age- and gender-matched able-bodied controls. Subjects were noninvasively monitored for 1 h, while seated and at rest. Tidal volume (V(T)) was calculated from the sum of the anteroposterior displacements of the rib cage and abdomen and the axial displacement of the chest wall. Inspiratory time (T(I)), V(T), and the ratio of V(T) to inspiratory time (V(T)/T(I)) were calculated breath by breath. A sigh was defined as any breath greater than two or more times an individual's mean V(T). Minute ventilation, V(T)/T(I), and sigh frequency were reduced in tetraplegia compared with controls (5.24 +/- 1.15 vs. 7.16 +/- 1.29 L/min, P tetraplegia: R = 0.88; P = 0.001 and control: R = 0.70; P tetraplegia. These findings extend prior observations of disordered respiratory control during breathing stimulated by CO(2) in tetraplegia to resting breathing.

  11. Ventilatory response of the newborn infant to mild hypoxia.

    Science.gov (United States)

    Cohen, G; Malcolm, G; Henderson-Smart, D

    1997-09-01

    The transition from an immature (biphasic) to a mature (sustained hyperpneic) response to a brief period of sustained hypoxia is believed to be well advanced by postnatal day 10 for newborn infants. However, a review of the supporting evidence convinced us that this issue warranted further, more systematic investigation. Seven healthy term infants aged 2 days to 8 weeks were studied. The ventilatory response (VR) elicited by 5 min breathing of 15% O2 was measured during quiet sleep. Arterial SaO2 (pulse oximeter) and minute ventilation (expressed as a change from control, delta V'i) were measured continuously. Infants were wrapped in their usual bedding and slept in open cots at room temperature (23 degrees-25 degrees). Infants aged 2-3 days exhibited predominantely a sustained hypopnea during the period of hypoxia (delta V'i = -2% at 1 min, -13% at 5 min). At 8 weeks of age, the mean response was typically biphasic (delta V'i = +9% at 1 min, -4% at 5 min). This age-related difference between responses was statistically significant (two-way ANOVA by time and age-group; interaction P < 0.05). These data reveal that term infants studied under ambient conditions during defined quiet sleep may exhibit an immature VR to mild, sustained hypoxia for at least 2 months after birth. This suggests that postnatal development of the O2 chemoreflex is slower than previously thought.

  12. Current methods of non-invasive ventilatory support for neonates.

    Science.gov (United States)

    Mahmoud, Ramadan A; Roehr, Charles Christoph; Schmalisch, Gerd

    2011-09-01

    Non-invasive ventilatory support can reduce the adverse effects associated with intubation and mechanical ventilation, such as bronchopulmonary dysplasia, sepsis, and trauma to the upper airways. In the last 4 decades, nasal continuous positive airway pressure (CPAP) has been used to wean preterm infants off mechanical ventilation and, more recently, as a primary mode of respiratory support for preterm infants with respiratory insufficiency. Moreover, new methods of respiratory support have been developed, and the devices used to provide non-invasive ventilation (NIV) have improved technically. Use of NIV is increasing, and a variety of equipment is available in different clinical settings. There is evidence that NIV improves gas exchange and reduces extubation failure after mechanical ventilation in infants. However, more research is needed to identify the most suitable devices for particular conditions; the NIV settings that should be used; and whether to employ synchronized or non-synchronized NIV. Furthermore, the optimal treatment strategy and the best time for initiation of NIV remain to be identified. This article provides an overview of the use of non-invasive ventilation (NIV) in newborn infants, and the clinical applications of NIV. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Ventilatory gas exchange and early response to cardiac resynchronization therapy.

    Science.gov (United States)

    Kim, Chul-Ho; Olson, Lyle J; Shen, Win K; Cha, Yong-Mei; Johnson, Bruce D

    2015-11-01

    Cardiac resynchronization therapy (CRT) is an accepted intervention for chronic heart failure (HF), although approximately 30% of patients are non-responders. The purpose of this study was to determine whether exercise respiratory gas exchange obtained before CRT implantation predicts early response to CRT. Before CRT implantation, patients were assigned to either a mild-moderate group (Mod G, n = 33, age 67 ± 10 years) or a moderate-severe group (Sev G, n = 31, age 67 ± 10 years), based on abnormalities in exercise gas exchange. Severity of impaired gas exchange was based on a score from the measures of VE/VCO(2) slope, resting PETCO(2) and change of PETCO(2) from resting to peak. All measurements were performed before and 3 to 4 months after CRT implantation. Although Mod G did not have improved gas exchange (p > 0.05), Sev G improved significantly (p 0.05), yet Sev G showed significantly improved RVSP, by 23% (50 ± 14 vs 42 ± 12 mm Hg, p Heart Association class (p 0.05). No significant changes were observed in brain natriuretic peptide in either group post-CRT. Based on pre-CRT implantation ventilatory gas exchange, subjects with the most impaired values appeared to have more improvement post-CRT, possibly associated with a decrease in RVSP. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  14. Duchenne muscular dystrophy: life prolongation by noninvasive ventilatory support.

    Science.gov (United States)

    Villanova, Marcello; Brancalion, Beatrice; Mehta, Anokhi D

    2014-07-01

    American, Japanese, and Canadian centers have demonstrated that noninvasive intermittent positive pressure ventilatory support (NVS) can be used continuously and in the long-term by people with Duchenne muscular dystrophy as a definitive alternative to tracheostomy mechanical ventilation. The aim of this study was to report this for the first time in Europe. In this study, more than 300 patients with Duchenne muscular dystrophy were followed. End-tidal carbon dioxide, oxyhemoglobin saturation, and vital capacity were measured at each visit. Of the 300 patients, 79 used NVS for 8 hrs or more per day and 20 of these became continuously dependent on NVS. A total of 20 patients have continuously depended on NVS for survival, for a total of 336 patient-years, up to 16 yrs in one case. Nocturnal NVS was begun for symptomatic hypoventilation when the vital capacity had decreased to a mean of 831 ± 173 ml, and continuous dependence on NVS was necessary when the vital capacity had decreased below 297 ± 113 ml. Noninvasive respiratory management can prolong survival without resorting to tracheotomy and without hospitalization.

  15. Very low pressures drive ventilatory flow in chimaeroid fishes.

    Science.gov (United States)

    Dean, Mason N; Summers, Adam P; Ferry, Lara A

    2012-05-01

    Chimaera (Holocephali) are cartilaginous fishes with flexible operculi rather than external gill slits, suggesting ventilation occurs in a manner different from other fishes. We examined holocephalan ventilation morphology, behavior, and performance by anatomical investigations, high-speed video, and in vivo pressure measurements from the buccal and parabranchial cranial cavities in Hydrolagus colliei and Callorhinchus callorynchus. Ventilatory modes ranged from quiet resting breathing to rapid "active" breathing, yet external cranial movements-excepting the passive movement of the opercular flap-were always extremely subtle, and pressures generated were one to two orders of magnitude lower than those of other fishes. To explain ventilation with such minimal pressure generation and cranial motion, we propose an "accordion" model, whereby rostrocaudal movement of the visceral arches drives pressure differentials, albeit with little lateral or ventral movement. Chimaeroids have comparatively large oropharyngeal cavities, which can move fluid with a smaller linear dimension change than the comparatively smaller cavities of other fishes. Orobranchial pressures are often less than parabranchial pressures, suggesting flow in the "wrong" direction; however, the long gill curtains of chimaeroids may passively restrict backflow. We suggest that constraints on holocephalan jaw and hyoid movements were compensated for evolutionarily by novel visceral arch mechanics and kinematics. Copyright © 2011 Wiley-Liss, Inc.

  16. Reduced hypoxic ventilatory response in newborn mice knocked-out for the progesterone receptor.

    Science.gov (United States)

    Potvin, Catherine; Rossignol, Orlane; Uppari, NagaPraveena; Dallongeville, Arnaud; Bairam, Aida; Joseph, Vincent

    2014-11-01

    Recent studies showed that progesterone stimulates the hypoxic ventilatory response and may reduce apnoea frequency in newborn rats, but so far we still do not know by what mechanisms and whether endogenous progesterone might contribute to respiratory control in neonates. We therefore determined the role of the nuclear progesterone receptor (PR; member of the steroid receptor superfamily) by using wild-type (WT) and PR knock-out (PRKO) mice at postnatal days (P) 1, 4 and 10. We measured the hypoxic ventilatory response (14 and 12% O2, 20 min each) and apnoea frequency in both male and female mice by using whole-body plethysmography. In response to hypoxia, WT male mice had a marked hypoxic ventilatory response at P1 and P10, but not at P4. At P1 and P10, PRKO male mice had a lower hypoxic ventilatory response than WT males. Wild-type female mice had a marked hypoxic ventilatory response at P10, but not at P1 and P4. At P1 and P10, PRKO female mice had a lower hypoxic ventilatory response than WT females. In basal conditions, apnoea frequency was similar in WT and PRKO mice at P1, P4 and P10. During hypoxia, apnoea frequency was higher in WT male mice compared with PRKO male mice and WT female mice at P1. We conclude that PR is a key contributor to the hypoxic ventilatory response in newborn mice, but PR deletion does not increase the frequency of apnoea during normoxia or hypoxia. © 2014 The Authors. Experimental Physiology © 2014 The Physiological Society.

  17. 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.

  18. The effect of sub-lethal doses of dieldrin on the ventilatory and cardiac activity in two species of shrimps.

    Science.gov (United States)

    Lawrence, V; Young, R E; Mansingh, A

    1986-01-01

    The effect of dieldrin on the heart and ventilatory activity in the shrimps Macrobranchium faustinum and Macrobrachium amazonicum was studied over 4 and 7 day exposure periods, respectively. In M. faustinum, ventilatory rate increased by 43% and heart rate by 14.4%. In M. amazonicum, the ventilatory and heart rates decreased by 21 and 6%, respectively. In M. amazonicum ventilatory reversal frequency, an index of respiratory stress, was 6.7 times higher than the control values. All the changes, except for M. amazonicum heart rate were significant at the 0.01 level of probability.

  19. User Experience of an Innovative Mobile Health Program to Assist in Insulin Dose Adjustment: Outcomes of a Proof-of-Concept Trial.

    Science.gov (United States)

    Ding, Hang; Fatehi, Farhad; Russell, Anthony W; Karunanithi, Mohan; Menon, Anish; Bird, Dominique; Gray, Leonard C

    2017-12-20

    Many patients with diabetes require insulin therapy to achieve optimal glycemic control. Initiation and titration of insulin often require an insulin dose adjustment (IDA) program, involving frequent exchange of blood glucose levels (BGLs) and insulin prescription advice between the patient and healthcare team. This process is time consuming with logistical barriers. To develop an innovative mobile health (m-Health) mobile-based IDA program (mIDA) and evaluate the user adherence and experience through a proof-of-concept trial. In the program, an m-Health system was designed to be integrated within a clinical IDA service, comprising a Bluetooth-enabled glucose meter, smartphone application, and clinician portal. Insulin-requiring patients with type-2 diabetes mellitus and stable BGL were recruited to use the m-Health system to record and exchange BGL entries, insulin dosages, and clinical messages for 2 weeks. The user experience was evaluated by a Likert scale questionnaire. Nine participants, aged 58 ± 14 years (mean ± SD), completed the trial with average daily records of 3.1 BGL entries and 1.2 insulin dosage entries. The participants recognized the potential value of the clinical messages. They felt confident about managing their diabetes and were positive regarding ease of use and family support of the system, but disagreed that there were no technical issues. Finally, they were satisfied with the program and would continue to use it if possible. The m-Health system for IDA showed promising levels of adherence, usability, perception of usefulness, and satisfaction. Further research is required to assess the feasibility and cost-effectiveness of using this system in outpatient settings.

  20. A comparison of ventilatory prostate movement in four treatment positions

    International Nuclear Information System (INIS)

    Dawson, Laura A.; Litzenberg, Dale W.; Brock, Kristy K.; Sanda, Martin; Sullivan, Molly; Sandler, Howard M.; Balter, James M.

    2000-01-01

    Purpose: To ensure target coverage during radiotherapy, all sources of geometric uncertainty in target position must be considered. Movement of the prostate due to breathing has not traditionally been considered in prostate radiotherapy. The purpose of this study is to report the influence of patient orientation and immobilization on prostate movement due to breathing. Methods and Materials: Four patients had radiopaque markers implanted in the prostate. Fluoroscopy was performed in four different positions: prone in alpha cradle, prone with an aquaplast mold, supine on a flat table, and supine with a false table under the buttocks. Fluoroscopic movies were videotaped and digitized. Frames were analyzed using 2D-alignment software to determine the extent of movement of the prostate markers and the skeleton for each position during normal and deep breathing. Results: During normal breathing, maximal movement of the prostate markers was seen in the prone position (cranial-caudal [CC] range: 0.9-5.1 mm; anterior-posterior [AP] range: up to 3.5 mm). In the supine position, prostate movement during normal breathing was less than 1 mm in all directions. Deep breathing resulted in CC movements of 3.8-10.5 mm in the prone position (with and without an aquaplast mold). This range was reduced to 2.0-7.3 mm in the supine position and 0.5-2.1 mm with the use of the false table top. Deep breathing resulted in AP skeletal movements of 2.7-13.1 mm in the prone position, whereas AP skeletal movements in the supine position were negligible. Conclusion: Ventilatory movement of the prostate is substantial in the prone position and is reduced in the supine position. The potential for breathing to influence prostate movement, and thus the dose delivered to the prostate and normal tissues, should be considered when positioning and planning patients for conformal irradiation

  1. 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.

  2. Relationship between the prognostic value of ventilatory efficiency and age in patients with heart failure.

    Science.gov (United States)

    Kato, Yuko; Suzuki, Shinya; Uejima, Tokuhisa; Semba, Hiroaki; Nagayama, Osamu; Hayama, Etsuko; Arita, Takuto; Yagi, Naoharu; Kano, Hiroto; Matsuno, Shunsuke; Otsuka, Takayuki; Oikawa, Yuji; Kunihara, Takashi; Yajima, Junji; Yamashita, Takeshi

    2018-01-01

    Background Ventilatory efficiency decreases with age. This study aimed to investigate the prognostic significance and cut-off value of the minute ventilation/carbon dioxide production (VE/VCO 2 ) slope according to age in patients with heart failure. Methods and results We analysed 1501 patients with heart failure from our observational cohort who performed maximal symptom-limited cardiopulmonary exercise testing and separated them into three age groups (≤55 years, 56-70 years and ≥71 years) in total and according to the three ejection fraction categories defined by European Society of Cardiology guidelines. The endpoint was set as heart failure events, hospitalisation for heart failure or death from heart failure. The VE/VCO 2 slope increased with age. During the median follow-up period of 4 years, 141 heart failure (9%) events occurred. In total, univariate Cox analyses showed that the VE/VCO 2 slope (cont.) was significantly related to heart failure events, while on multivariate analysis, the prognostic significance of the VE/VCO 2 slope (cont.) was poor, accompanied by a significant interaction with age ( P age in not only the total but also the sub-ejection fraction categories. Multivariate analyses with a stepwise method adjusted for estimated glomerular filtration rate, peak oxygen consumption, atrial fibrillation and brain natriuretic peptide, showed that the predictive value of the binary VE/VCO 2 slope separated by the cut-off value varied according to age. There was a tendency for the prognostic significance to increase with age irrespective of ejection fraction. Conclusion The prognostic significance and cut-off value of the VE/VCO 2 slope may increase with advancing age.

  3. 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

  4. 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

  5. Shaft adjuster

    Science.gov (United States)

    Harry, Herbert H.

    1989-01-01

    Apparatus and method for the adjustment and alignment of shafts in high power devices. A plurality of adjacent rotatable angled cylinders are positioned between a base and the shaft to be aligned which when rotated introduce an axial offset. The apparatus is electrically conductive and constructed of a structurally rigid material. The angled cylinders allow the shaft such as the center conductor in a pulse line machine to be offset in any desired alignment position within the range of the apparatus.

  6. Adjustable collimator

    International Nuclear Information System (INIS)

    Carlson, R.W.; Covic, J.; Leininger, G.

    1981-01-01

    In a rotating fan beam tomographic scanner there is included an adjustable collimator and shutter assembly. The assembly includes a fan angle collimation cylinder having a plurality of different length slots through which the beam may pass for adjusting the fan angle of the beam. It also includes a beam thickness cylinder having a plurality of slots of different widths for adjusting the thickness of the beam. Further, some of the slots have filter materials mounted therein so that the operator may select from a plurality of filters. Also disclosed is a servo motor system which allows the operator to select the desired fan angle, beam thickness and filter from a remote location. An additional feature is a failsafe shutter assembly which includes a spring biased shutter cylinder mounted in the collimation cylinders. The servo motor control circuit checks several system conditions before the shutter is rendered openable. Further, the circuit cuts off the radiation if the shutter fails to open or close properly. A still further feature is a reference radiation intensity monitor which includes a tuning-fork shaped light conducting element having a scintillation crystal mounted on each tine. The monitor is placed adjacent the collimator between it and the source with the pair of crystals to either side of the fan beam

  7. Ventilatory response to hypercarbia in newborns of smoking and substance-misusing mothers.

    Science.gov (United States)

    Ali, Kamal; Wolff, Kim; Peacock, Janet L; Hannam, Simon; Rafferty, Gerrard F; Bhat, Ravindra; Greenough, Anne

    2014-07-01

    Infants of mothers who smoked (S) or substance misused (SM) during pregnancy have an increased risk of sudden infant death syndrome (SIDS). To test the hypothesis that infants of S and SM mothers compared with infants of non-substance-misusing, nonsmoking mothers (control subjects) would have a reduced ventilatory response to hypercarbia and that any reduction would be greater in the SM infants. Infants were assessed before maternity/neonatal unit discharge. Maternal and infant urine samples were obtained and tested for cotinine, cannabinoids, opiates, amphetamines, methadone, cocaine, and benzodiazepines. Respiratory flow and Vt were measured using a pneumotachograph inserted into a face mask placed over the infant's mouth and nose. The ventilatory responses to three levels of inspired carbon dioxide (0 [baseline], 2, and 4% CO2) were assessed. Twenty-three SM, 34 S, and 22 control infants were assessed. The birth weight of the control subjects was higher than the SM and S infants (P = 0.017). At baseline, SM infants had a higher respiratory rate (P = 0.003) and minute volume (P = 0.007) compared with control subjects and S infants. Both the SM and S infants had a lower ventilatory response to 2% (P ventilatory response to CO2 was lower in the SM infants compared with the S infants (P = 0.009). These results are consistent with infants of smoking mothers and substance misuse/smoking mothers having a dampened ventilatory response to hypercarbia, which is particularly marked in the latter group.

  8. Emphysema on Thoracic CT and Exercise Ventilatory Inefficiency in Mild-to-Moderate COPD.

    Science.gov (United States)

    Jones, Joshua H; Zelt, Joel T; Hirai, Daniel M; Diniz, Camilla V; Zaza, Aida; O'Donnell, Denis E; Neder, J Alberto

    2017-04-01

    There is growing evidence that emphysema on thoracic computed tomography (CT) is associated with poor exercise tolerance in COPD patients with only mild-to-moderate airflow obstruction. We hypothesized that an excessive ventilatory response to exercise (ventilatory inefficiency) would underlie these abnormalities. In a prospective study, 19 patients (FEV 1 = 82 ± 13%, 12 Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 1) and 26 controls underwent an incremental exercise test. Ventilatory inefficiency was assessed by the ventilation ([Formula: see text]E)/CO 2 output ([Formula: see text]CO 2 ) nadir. Pulmonary blood flow (PBF) in a submaximal test was calculated by inert gas rebreathing. Emphysema was quantified as % of attenuation areas below 950 HU. Patients typically presented with centrilobular emphysema (76.8 ± 10.1% of total emphysema) in the upper lobes (upper/total lung ratio = 0.82 ± 0.04). They had lower peak oxygen uptake ([Formula: see text]O 2 ), higher [Formula: see text]E/[Formula: see text]CO 2 nadir, and greater dyspnea scores than controls (p exercise (p exercise (r = -0.69) (p exercise ventilatory efficiency in mild-to-moderate COPD. Exercise ventilatory inefficiency links structure (emphysema) and function (D L CO) to a key clinical outcome (poor exercise tolerance) in COPD patients with only modest spirometric abnormalities.

  9. Acute ventilatory failure complicating obesity hypoventilation: update on a 'critical care syndrome'.

    Science.gov (United States)

    BaHammam, Ahmed

    2010-11-01

    Obesity can result in serious complications, including obesity hypoventilation syndrome (OHS). OHS patients may present with acute-on-chronic ventilatory failure, necessitating acute care management. The purpose of this review is to discuss the recent literature on acute ventilatory failure in OHS patients. Obese persons can develop acute hypercapnic respiratory failure and sleep hypoventilation due to disorders in lung mechanics, ventilatory drive, and neurohormonal and neuromodulators of breathing. Although there are no clearly defined predictors for OHS patients who are likely to develop acute hypercapnic respiratory failure, most such patients are middle-aged (mid-50s), morbidly obese, and have daytime hypercapnia, hypoxemia, and low serum pH values. Immediate ventilatory support, without sleep study confirmation, is necessary in most such patients. Patients with respiratory acidemia (pH care unit monitoring. Noninvasive application of bilevel positive airway pressure therapy is the recommended initial ventilatory support under close monitoring. Prompt initiation of noninvasive positive pressure ventilation reduces the need for invasive mechanical ventilation and rapidly improves the levels of blood gases. Obese patients with sleep hypoventilation have an increased risk of acute hypercapnic respiratory failure. Early diagnosis and implementation of noninvasive positive pressure ventilation is recommended for these patients.

  10. 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.

  11. 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...... ventilatory modes. Also the mean airway pressures were lower with the HFV modes 8-9 cm H2O compared to 11-14 cm H2O for the other modes. The gas distribution was evaluated by N2 wash-out and a modified lung clearance index. All modes showed N2 wash-out according to a two-compartment model. The SV-20P mode had...

  12. High-flow nasal cannula: transient fashion or new method of non-invasive ventilatory assistance?

    Science.gov (United States)

    Mosca, F; Colnaghi, M; Agosti, M; Fumagalli, M

    2012-10-01

    Respiratory failure in the premature infants remains a difficult challenge. An alternative to the use of nasal continuous positive airway pressure (NCPAP) as a non-invasive modality to support respiratory distress in premature infants has been the recent introduction of high flow nasal cannula (HFNC) devices in many neonatal units. There has been increased use of HFNC presumably because of anecdotal reports and experience that it is easy to use, and well tolerated by the infants, while experiencing decreased nasal septumerosion. The paucity of evidence regarding its efficacy and safety, would support a caution approach to the use of HFNC. Particular concern has focused on the imprecise regulation and generation of pressure that may occur at higher flows especially in the smallest of infants.

  13. 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

    ventilatory modes. Also the mean airway pressures were lower with the HFV modes 8-9 cm H2O compared to 11-14 cm H2O for the other modes. The gas distribution was evaluated by N2 wash-out and a modified lung clearance index. All modes showed N2 wash-out according to a two-compartment model. The SV-20P mode had...... the fastest wash-out, but the HFV-60 and HFV-20 ventilatory modes also showed a faster N2 wash-out than the others.(ABSTRACT TRUNCATED AT 250 WORDS)...

  14. 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

  15. Use of laryngeal mask airway for prolonged ventilatory support in a preterm newborn.

    Science.gov (United States)

    Fernández-Jurado, Ma Isabel; Fernández-Baena, Mariano

    2002-05-01

    We present the case report of a preterm, low weight newborn with dysmorphic features and micrognathia in whom a laryngeal mask airway was inserted and maintained for 44 h for ventilatory support after several failed intubations. No complications associated with laryngeal mask airway use were apparent.

  16. Disharmony between wake- and respiration-promoting activities: effects of modafinil on ventilatory control in rodents.

    Science.gov (United States)

    Terada, Jiro; Fukushi, Isato; Takeda, Kotaro; Hasebe, Yohei; Pokorski, Mieczyslaw; Tatsumi, Koichiro; Okada, Yasumasa

    2016-11-14

    Modafinil is a wake-promoting drug and has been widely used for daytime sleepiness in patients with narcolepsy and other sleep disorders. A recent case series reported that daily oral modafinil alleviated hypercapnic respiratory failure in patients with COPD. However, the precise action of modafinil on respiration such as hypercapnic and/or hypoxic ventilatory responses remains unclear. The aim of this study is to clarify the effect of modafinil on the ventilatory control. We investigated the hypothesis that modafinil enhances resting ventilation as well as the stimulatory ventilatory responses to hypercapnia and hypoxia. We addressed the issue by examining minute ventilation, respiratory rate and volume components using plethysmography, combined with a concurrent EEG monitoring of the level of wakefulness before and after administration of modafinil in two doses of 100 mg/kg and 200 mg/kg in unanesthetized mice. In addition, we monitored the effect of the lower dose of modafinil on mice locomotor activity in a freely moving condition by video-recording. Wakefulness, locomotor activity and variability of the breathing pattern in tidal volume were promoted by both doses of modafinil. Neither dose of modafinil increased the absolute values of resting ventilation or promoted the ventilatory responses to hypercapnia and hypoxia. Rather, higher dose of modafinil slightly suppressed respiratory rate in room air condition. Modafinil is conducive to the state of wakefulness but does not augment resting ventilation or the hyperventilatory responses to chemical stimuli in unanesthetized rodents.

  17. Ventilatory and Cardiovascular Regulation in the Air-Breathing Fish Pangasianodon Hypophthalmus

    DEFF Research Database (Denmark)

    Thomsen, Mikkel; Wang, Tobias; Bayley, Mark

    bradycardia and a post air-breathing tachycardia as well as a hypercarbic bradycardia. Furthermore, we document that injections of lactate ions in the blood at physiological concentrations induce a strong hypoxic ventilatory response in P. hypophthalmus independent of arterial pH. This mechanism was recently...

  18. Role of acid-sensing ion channels in hypoxia- and hypercapnia-induced ventilatory responses.

    Directory of Open Access Journals (Sweden)

    Neil D Detweiler

    Full Text Available Previous reports indicate roles for acid-sensing ion channels (ASICs in both peripheral and central chemoreception, but the contributions of ASICs to ventilatory drive in conscious, unrestrained animals remain largely unknown. We tested the hypotheses that ASICs contribute to hypoxic- and hypercapnic-ventilatory responses. Blood samples taken from conscious, unrestrained mice chronically instrumented with femoral artery catheters were used to assess arterial O2, CO2, and pH levels during exposure to inspired gas mixtures designed to cause isocapnic hypoxemia or hypercapnia. Whole-body plethysmography was used to monitor ventilatory parameters in conscious, unrestrained ASIC1, ASIC2, or ASIC3 knockout (-/- and wild-type (WT mice at baseline, during isocapnic hypoxemia and during hypercapnia. Hypercapnia increased respiratory frequency, tidal volume, and minute ventilation in all groups of mice, but there were no differences between ASIC1-/-, ASIC2-/-, or ASIC3-/- and WT. Isocapnic hypoxemia also increased respiratory frequency, tidal volume, and minute ventilation in all groups of mice. Minute ventilation in ASIC2-/- mice during isocapnic hypoxemia was significantly lower compared to WT, but there were no differences in the responses to isocapnic hypoxemia between ASIC1-/- or ASIC3-/- compared to WT. Surprisingly, these findings show that loss of individual ASIC subunits does not substantially alter hypercapnic or hypoxic ventilatory responses.

  19. 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...

  20. Acetazolamide Attenuates the Ventilatory Response to Arousal in Patients with Obstructive Sleep Apnea

    Science.gov (United States)

    Edwards, Bradley A.; Connolly, James G.; Campana, Lisa M.; Sands, Scott A.; Trinder, John A.; White, David P.; Wellman, Andrew; Malhotra, Atul

    2013-01-01

    Study Objectives: The magnitude of the post-apnea/hypopnea ventilatory overshoot following arousal may perpetuate subsequent respiratory events in obstructive sleep apnea (OSA) patients, potentially contributing to the disorder's severity. As acetazolamide can reduce apnea severity in some patients, we examined the effect of acetazolamide on the ventilatory response to spontaneous arousals in CPAP-treated OSA patients. Design: We assessed the ventilatory response to arousal in OSA patients on therapeutic CPAP before and after administration of acetazolamide for 7 days. Setting: Sleep research laboratory. Participants: 12 (7M/5F) CPAP-treated OSA patients. Interventions: Sustained-release acetazolamide 500 mg by mouth twice daily for one week. Measurements and Results: A blinded investigator identified spontaneous arousals (3-15 s) during NREM sleep. Breath-by-breath measurements of minute ventilation, end-tidal CO2, tidal volume, expiratory/inspiratory-time, and total breath duration were determined (4-s intervals) 32 s prior and 60 s following each arousal. Acetazolamide significantly increased resting ventilation (7.3 ± 0.2 L/min versus 8.2 ± 0.4 L/min; P Edwards BA; Connolly JG; Campana LM; Sands SA; Trinder JA; White DP; Wellman A; Malhotra A. Acetazolamide attenuates the ventilatory response to arousal in patients with obstructive sleep apnea. SLEEP 2013;36(2):281-285. PMID:23372276

  1. Effects of protein intake on pulmonary gas exchange and ventilatory drive in postoperative patients.

    Science.gov (United States)

    Delafosse, B; Bouffard, Y; Bertrand, O; Viale, J P; Annat, G; Motin, J

    1989-03-01

    The effects of different protein regimens on pulmonary gas exchange and ventilatory drive were examined in eight postoperative patients receiving inspiratory pressure support ventilation. They were studied during 60 consecutive hours, which included two 12-h periods of high protein intake (33%) of total caloric intake provided as protein), each of them being preceded and followed by a 12-h period of standard protein intake (14% of total caloric intake provided as protein). Throughout the study, total caloric intake was 1.5 times the predicted resting energy expenditure. Nitrogen was provided as a 24% branched chain amino acid (BCAA) solution during the period of standard protein intake. During the periods of high protein intake, it was provided as a 24% and a 41% BCAA solution. Pulmonary gas exchange was continuously measured during the second half of each period, with the use of a mass spectrometer system. Measurements of the ventilatory response to CO2 (FICO2 0, 1.5, and 3%) were achieved at the end of each dietary regimen. O2 consumption, CO2 production, respiratory quotient, minute ventilation, and PaCO2 were the same for the three protein regimens. Changing protein intake failed to affect the ventilatory response to CO2. The authors conclude that, in postoperative patients having inspiratory pressure support ventilation, the administration of a high protein intake does not affect the ventilatory drive and the pulmonary gas exchange.

  2. Spirometric evaluation of ventilatory function in adult male cigarette smokers in Sokoto metropolis.

    Science.gov (United States)

    Isah, Muhammad D; Makusidi, Muhammad A; Abbas, Aminu; Okpapi, Juliana U; Njoku, Chibueze H; Abba, Abdullahi A

    2017-01-01

    Cigarette smoking is a widespread social habit in Nigeria with extensive deleterious multisystemic effect. Ventilatory dysfunction is one of the cigarette smoking-related illnesses that affect the respiratory system. Spirometry is an investigative method that can be used for the early detection of ventilatory dysfunction even before the onset of the symptoms. A questionnaire adapted from the European Community Respiratory Health Survey was administered to collect demographic, clinical, and cigarette smoking data. Ventilatory function test was conducted using Clement Clarke (One Flow) Spirometer, version 1.3. The highest value of each ventilatory function index was chosen for analysis, and individual(s) with ventilatory dysfunction were subjected to post bronchodilator spirometry. For the purpose of this research, 150 participants who were currently cigarette smokers were enrolled, and 50 apparently healthy, age-matched individuals who were never smokers served as controls in the ratio of 3:1. Eighty percent of participants and 68% of controls were aged 40 years or below. The mean age of participants (34.27 ± 8.91 years) and the controls (35.08 ± 10.35 years) was not significantly different (P = 0.592). Similarly, there were no statistically significant differences between the mean anthropometric indices (weight: P = 0.663, height: P = 0.084, and body mass index: P = 0.099) of both participants and controls. The mean values of FEV1 (forced expiratory flow in one second) and FEV1/FVC (FVC=forced vital capacity) were lower in the participants compared to the controls, and this difference was statistically significant (P cigarette smoking and FEV1 (r = -0.237 and P = 0.004). Obstructive ventilatory defect was found among six study participants (4%) and two controls (4%). Cigarette smoking is associated with decline in ventilatory function test indices (FEV1 and FEV1/FVC) in adult males. Decline in FEV1 is directly related to pack

  3. Importance of ventricular rate after mode switching during low intensity exercise as assessed by clinical symptoms and ventilatory gas exchange.

    Science.gov (United States)

    Brunner-La Rocca, H P; Rickli, H; Weilenmann, D; Duru, F; Candinas, R

    2000-01-01

    Automatic mode switching from DDD(R) to DDI(R) or VVI(R) pacing modes has improved dual chamber pacing in patients at high risk for supraventricular tachyarrhythmias. However, little is known about the effect of ventricular pacing rate adaptation after mode switching. We conducted a single-blinded, crossover study in 15 patients (58 +/- 21 years) with a DDD pacemaker who had AV block and normal sinus node function to investigate the influence of pacing rate adaptation to intrinsic heart rate during low intensity exercise. Patients performed two tests (A/B) of low intensity treadmill exercise (0.5 W/kg) in randomized order. They initially walked for 6 minutes while paced in DDD mode. The pacing mode was then switched to VVI with a pacing rate of either 70 beats/min (test A) or matched to the intrinsic heart rate (95 +/- 11 beats/min test B). Respiratory gas exchange variables were determined and patients classified the effort before and after mode switching on a Borg scale from 6 to 20. Percentage changes of respiratory gas exchange measurements were significantly larger (O2 consumption: -8.2 +/- 5.0% vs. -0.6 +/- 7.2%; ventilatory equivalent of CO2 exhalation: 5.3 +/- 4.9% vs. 1.5 +/- 4.3%; respiratory exchange ratio: 7.0 +/- 2.2% vs. 3.5 +/- 3.0%; end-tidal CO2: -5.7 +/- 2.9% vs. -1.8 +/- 2.7%; all P higher (mean increase on Borg scale: 1.6 +/- 1.9 vs. 1.1 +/- 1.8, P = 0.07) after heart rate unadjusted than after adjusted mode switching. Mode switching from DDD to VVI pacing is better tolerated and gas exchange measurements are less influenced if ventricular pacing rate is adjusted to the level of physical activity. Thus, pacing rate adjustment should be considered as part of automatic mode switch algorithms.

  4. Central ventilatory and cardiovascular actions of trout gastrin-releasing peptide (GRP in the unanesthetized trout

    Directory of Open Access Journals (Sweden)

    Jean-Claude Le Mével

    2013-07-01

    Gastrin-releasing peptide (GRP, a neuropeptide initially isolated from porcine stomach, shares sequence similarity with bombesin. GRP and its receptors are present in the brains and peripheral tissues of several species of teleost fish, but little is known about the ventilatory and cardiovascular effects of this peptide in these vertebrates. The goal of this study was to compare the central and peripheral actions of picomolar doses of trout GRP on ventilatory and cardiovascular variables in the unanesthetized rainbow trout. Compared to vehicle, intracerebroventricular (ICV injection of GRP (1–50 pmol significantly elevated the ventilation rate (ƒV and the ventilation amplitude (VAMP, and consequently the total ventilation (VTOT. The maximum hyperventilatory effect of GRP (VTOT: +225%, observed at a dose of 50 pmol, was mostly due to its stimulatory action on VAMP (+170% rather than ƒV (+20%. In addition, ICV GRP (50 pmol produced a significant increase in mean dorsal aortic blood pressure (PDA (+35% and in heart rate (ƒH (+25%. Intra-arterial injections of GRP (5–100 pmol were without sustained effect on the ventilatory variables but produced sporadic and transient increases in ventilatory movement at doses of 50 and 100 pmol. At these doses, GRP elevated PDA by +20% but only the 50 pmol dose significantly increased HR (+15%. In conclusion, our study suggests that endogenous GRP within the brain of the trout may act as a potent neurotransmitter and/or neuromodulator in the regulation of cardio-ventilatory functions. In the periphery, endogenous GRP may act as locally-acting and/or circulating neurohormone with an involvement in vasoregulatory mechanisms.

  5. 13 CFR 315.16 - Adjustment proposal requirements.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Adjustment proposal requirements. 315.16 Section 315.16 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT... Firm in becoming more competitive in the global marketplace. For this purpose, Adjustment Assistance...

  6. The ventilatory response to hypoxia: how much is good for a mountaineer?

    OpenAIRE

    Milledge, J. S.

    1987-01-01

    Methods for measuring the ventilatory response to hypoxia (HVR) are reviewed. The criteria for success as a high altitude mountaineer are defined as freedom from acute mountain sickness (AMS) and ability to perform well at extreme altitude. The evidence for a brisk HVR being protective against AMS and associated with successful high altitude performance is reviewed. The contrary evidence of blunted HVR in high altitude residence and some elite climbers is discussed. The effect of a brisk HVR ...

  7. Ventilatory and chemoreceptor responses to hypercapnia in neonatal rats chronically exposed to moderate hyperoxia.

    Science.gov (United States)

    Bavis, Ryan W; Li, Ke-Yong; DeAngelis, Kathryn J; March, Ryan J; Wallace, Josefine A; Logan, Sarah; Putnam, Robert W

    2017-03-01

    Rats reared in hyperoxia hypoventilate in normoxia and exhibit progressive blunting of the hypoxic ventilatory response, changes which are at least partially attributed to abnormal carotid body development. Since the carotid body also responds to changes in arterial CO 2 /pH, we tested the hypothesis that developmental hyperoxia would attenuate the hypercapnic ventilatory response (HCVR) of neonatal rats by blunting peripheral and/or central chemoreceptor responses to hypercapnic challenges. Rats were reared in 21% O 2 (Control) or 60% O 2 (Hyperoxia) until studied at 4, 6-7, or 13-14days of age. Hyperoxia rats had significantly reduced single-unit carotid chemoafferent responses to 15% CO 2 at all ages; CO 2 sensitivity recovered within 7days after return to room air. Hypercapnic responses of CO 2 -sensitive neurons of the caudal nucleus tractus solitarius (cNTS) were unaffected by chronic hyperoxia, but there was evidence for a small decrease in neuronal excitability. There was also evidence for augmented excitatory synaptic input to cNTS neurons within brainstem slices. Steady-state ventilatory responses to 4% and 8% CO 2 were unaffected by developmental hyperoxia in all three age groups, but ventilation increased more slowly during the normocapnia-to-hypercapnia transition in 4-day-old Hyperoxia rats. We conclude that developmental hyperoxia impairs carotid body chemosensitivity to hypercapnia, and this may compromise protective ventilatory reflexes during dynamic respiratory challenges in newborn rats. Impaired carotid body function has less of an impact on the HCVR in older rats, potentially reflecting compensatory plasticity within the CNS. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. 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.

  9. Ventilatory efficiency and breathing pattern in world-class cyclists: A three-year observational study.

    Science.gov (United States)

    Salazar-Martínez, Eduardo; Terrados, Nicolás; Burtscher, Martin; Santalla, Alfredo; Naranjo Orellana, José

    2016-07-15

    The purpose of this three-year observational study was to analyze the ventilatory efficiency and breathing pattern in world-class professional cyclists. Twelve athletes (22.61±3.8years; 177.38±5.5cm; 68.96±5.5kg and VO2max 75.51±3.3mLkg(-1)min(-1)) were analyzed retrospectively. For each subject, respiratory and performance variables were recorded during incremental spiroergometry: oxygen uptake (VO2), carbon dioxide output (VCO2), pulmonary ventilation (VE), tidal volume (Vt), breathing frequency (fR), driving (Vt/Ti), timing (Ti/Ttot), peak power output (PPO) and maximum oxygen uptake (VO2max). Ventilatory efficiency (VE/VCO2 slope) was calculated from the beginning of exercise testing to the second ventilatory threshold (VT2). The VE/VCO2 slope was unaffected during the study period (24.63±3.07; 23.61±2:79; 24:89±2:61) with a low effect size (ES=0.04). The PPO improved significantly in the third year (365±33.74; 386.36±32.33; 415.00±24.15) (p<0.05). The breathing pattern variables, Vt/Ti and Ti/Ttot, did not change significantly over the three year period (ES=0.00; ES=0.03 respectively). These findings suggest that changes in cycling performance in world-class professional cyclists do not modify breathing variables related to the control of ventilatory efficiency. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Time Domains of the Hypoxic Ventilatory Response and Their Molecular Basis

    Science.gov (United States)

    Pamenter, Matthew E.; Powell, Frank L.

    2016-01-01

    Ventilatory responses to hypoxia vary widely depending on the pattern and length of hypoxic exposure. Acute, prolonged, or intermittent hypoxic episodes can increase or decrease breathing for seconds to years, both during the hypoxic stimulus, and also after its removal. These myriad effects are the result of a complicated web of molecular interactions that underlie plasticity in the respiratory control reflex circuits and ultimately control the physiology of breathing in hypoxia. Since the time domains of the physiological hypoxic ventilatory response (HVR) were identified, considerable research effort has gone toward elucidating the underlying molecular mechanisms that mediate these varied responses. This research has begun to describe complicated and plastic interactions in the relay circuits between the peripheral chemoreceptors and the ventilatory control circuits within the central nervous system. Intriguingly, many of these molecular pathways seem to share key components between the different time domains, suggesting that varied physiological HVRs are the result of specific modifications to overlapping pathways. This review highlights what has been discovered regarding the cell and molecular level control of the time domains of the HVR, and highlights key areas where further research is required. Understanding the molecular control of ventilation in hypoxia has important implications for basic physiology and is emerging as an important component of several clinical fields. PMID:27347896

  11. Humidification during high-frequency oscillation ventilation is affected by ventilator circuit and ventilatory setting.

    Science.gov (United States)

    Chikata, Yusuke; Imanaka, Hideaki; Onishi, Yoshiaki; Ueta, Masahiko; Nishimura, Masaji

    2009-08-01

    High-frequency oscillation ventilation (HFOV) is an accepted ventilatory mode for acute respiratory failure in neonates. As conventional mechanical ventilation, inspiratory gas humidification is essential. However, humidification during HFOV has not been clarified. In this bench study, we evaluated humidification during HFOV in the open circumstance of ICU. Our hypothesis is that humidification during HFOV is affected by circuit design and ventilatory settings. We connected a ventilator with HFOV mode to a neonatal lung model that was placed in an infant incubator set at 37 degrees C. We set a heated humidifier (Fisher & Paykel) to obtain 37 degrees C at the chamber outlet and 40 degrees C at the distal temperature probe. We measured absolute humidity and temperature at the Y-piece using a rapid-response hygrometer. We evaluated two types of ventilator circuit: a circuit with inner heating wire and another with embedded heating element. In addition, we evaluated three lengths of the inspiratory limb, three stroke volumes, three frequencies, and three mean airway pressures. The circuit with embedded heating element provided significantly higher absolute humidity and temperature than one with inner heating wire. As an extended tube lacking a heating wire was shorter, absolute humidity and temperature became higher. In the circuit with inner heating wire, absolute humidity and temperature increased as stroke volume increased. Humidification during HFOV is affected by circuit design and ventilatory settings.

  12. Influence of high-intensity interval training on ventilatory efficiency in trained athletes.

    Science.gov (United States)

    Salazar-Martínez, Eduardo; Santalla, Alfredo; Orellana, José Naranjo; Strobl, Jochen; Burtscher, Martin; Menz, Verena

    2018-04-01

    The aim of this study was to investigate the effects of 3 weeks high-intensity interval training (HIIT) on ventilatory efficiency (V E /VCO 2 slope) in endurance athletes. Sixteen male well-trained (67.72 ml kg min -1 ) athletes participated in this study. Each participant performed an incremental exercise test with gas analysis (i.e. V E , VO 2 ) and a 400 m running field test (T400m) before and after the 3 weeks intervention period. HIIT group (HIITG) performed 11 HIIT sessions consisting of four 4-min interval bouts at an exercise intensity of 90-95% of the VO 2max , separated by 4-min active recovery periods (work/rest ratio = 1:1). No significant differences were found in the parameters studied. Ventilatory efficiency (up to VT 2 and up to exhaustion) did not show any change in HIITG after training intervention (ES = 0.24 HIITG; ES = 0.21 CG). No significant changes were observed on ventilation (V Emax ; ES = 0.38). VO 2max and T400 m did not show a significant improvement after the training period (no interaction time × group, p athletes. Furthermore, they show the lack of relationship between ventilatory efficiency and sport performance. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Effect of chronic ethanol exposure on rat ventilatory responses to hypoxia and hypercapnia

    Directory of Open Access Journals (Sweden)

    João Paulo J. Sabino

    2014-01-01

    Full Text Available OBJECTIVE: The effect of chronic ethanol exposure on chemoreflexes has not been extensively studied in experimental animals. Therefore, this study tested the hypothesis that known ethanol-induced autonomic, neuroendocrine and cardiovascular changes coincide with increased chemoreflex sensitivity, as indicated by increased ventilatory responses to hypoxia and hypercapnia. METHODS: Male Wistar rats were subjected to increasing ethanol concentrations in their drinking water (first week: 5% v/v, second week: 10% v/v, third and fourth weeks: 20% v/v. At the end of each week of ethanol exposure, ventilatory parameters were measured under basal conditions and in response to hypoxia (evaluation of peripheral chemoreflex sensitivity and hypercapnia (evaluation of central chemoreflex sensitivity. RESULTS: Decreased respiratory frequency was observed in rats exposed to ethanol from the first until the fourth week, whereas minute ventilation remained unchanged. Moreover, we observed an increased tidal volume in the second through the fourth week of exposure. The minute ventilation responses to hypoxia were attenuated in the first through the third week but remained unchanged during the last week. The respiratory frequency responses to hypoxia in ethanol-exposed rats were attenuated in the second through the third week but remained unchanged in the first and fourth weeks. There was no significant change in tidal volume responses to hypoxia. With regard to hypercapnic responses, no significant changes in ventilatory parameters were observed. CONCLUSIONS: Our data are consistent with the notion that chronic ethanol exposure does not increase peripheral or central chemoreflex sensitivity.

  14. [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.

  15. Reproducibility of hypercapnic ventilatory response measurements with steady-state and rebreathing methods.

    Science.gov (United States)

    Mannée, Denise C; Fabius, Timon M; Wagenaar, Michiel; Eijsvogel, Michiel M M; de Jongh, Frans H C

    2018-01-01

    In this study, the hypercapnic ventilatory response (HCVR) was measured, defined as the ventilation response to carbon dioxide tension ( P CO 2 ). We investigated which method, rebreathing or steady-state, is most suitable for measurement of the HCVR in healthy subjects, primarily based on reproducibility. Secondary outcome parameters were subject experience and duration. 20 healthy adults performed a rebreathing and steady-state HCVR measurement on two separate days. Subject experience was assessed using numeric rating scales (NRS). The intraclass correlation coefficient (ICCs) of the sensitivity to carbon dioxide above the ventilatory recruitment threshold and the projected apnoea threshold were calculated to determine the reproducibility of both methods. The ICCs of sensitivity were 0.89 (rebreathing) and 0.56 (steady-state). The ICCs of the projected apnoea threshold were 0.84 (rebreathing) and 0.25 (steady-state). The steady-state measurement was preferred by 16 out of 20 subjects; the differences in NRS scores were small. The hypercapnic ventilatory response measured using the rebreathing setup provided reproducible results, while the steady-state method did not. This may be explained by high variability in end-tidal P CO 2 . Differences in subject experience between the methods are small.

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

    Science.gov (United States)

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

    2017-06-01

    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 > or equal to 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/FEV6 <70 % of which 13 are exposed to biomass. 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 be consistent with COPD. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. 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.

  18. The effect of music therapy on physiological signs of anxiety in patients receiving mechanical ventilatory support.

    Science.gov (United States)

    Korhan, Esra Akin; Khorshid, Leyla; Uyar, Mehmet

    2011-04-01

    The aim of this study was to investigate if relaxing music is an effective method of reducing the physiological signs of anxiety in patients receiving mechanical ventilatory support. Few studies have focused on the effect of music on physiological signs of anxiety in patients receiving mechanical ventilatory support. A study-case-control, experimental repeated measures design was used. Sixty patients aged 18-70 years, receiving mechanical ventilatory support and hospitalised in the intensive care unit, were taken as a convenience sample. Participants were randomised to a control group or intervention group, who received 60 minutes of music therapy. Classical music was played to patients using media player (MP3) and headphones. Subjects had physiological signs taken immediately before the intervention and at the 30th, 60th and 90th minutes of the intervention. Physiological signs of anxiety assessed in this study were mean systolic and diastolic blood pressure, pulse rate, respiratory rate and oxygen saturation in blood measured by pulse oxymetry. Data were collected over eight months in 2006-2007. The music group had significantly lower respiratory rates, and systolic and diastolic blood pressure, than the control group. This decrease improved progressively in the 30th, 60th and 90th minutes of the intervention, indicating a cumulative dose effect. Music can provide an effective method of reducing potentially harmful physiological responses arising from anxiety. As indicated by the results of this study, music therapy can be supplied to allay anxiety in patients receiving mechanical ventilation. Nurses may include music therapy in the routine care of patients receiving mechanical ventilation. © 2011 Blackwell Publishing Ltd.

  19. Primary peritoneal drainage for increasing ventilatory requirements in critically ill neonates with necrotizing enterocolitis.

    Science.gov (United States)

    Dzakovic, A; Notrica, D M; Smith, E O; Wesson, D E; Jaksic, T

    2001-05-01

    Primary peritoneal drainage (PPD) is an established therapy for premature neonates with necrotizing enterocolitis (NEC) and free intraperitoneal air. This study seeks to evaluate the efficacy of PPD in ill premature neonates with severe abdominal distension and increasing ventilatory requirements without free intraperitoneal air. Eleven neonates (gestational age, 27 +/- 0.59 weeks; age, 25 +/- 4.3 days; birth weight, 862 +/- 67 g) with NEC underwent bedside PPD under local anesthesia for rapid clinical deterioration characterized by severe abdominal distension and increasing ventilatory requirements. None showed radiographic evidence of free intraperitoneal air. Mean airway pressure (MAP) and oxygenation-index (OI) were analyzed 24 hours before, immediately before and 24 hours after surgery. The patients were followed up to discharge from hospital. Statistical analyses were performed using analysis of variance (ANOVA) for repeated measures. Mean airway pressure (MAP) showed a significant difference (P <.05) increasing from 7.1 +/- 0.75 cm H2O 24 hours before surgery to 11 +/- 1.3 cm H2O immediately before surgery and decreasing to 9.9 +/- 1.1 cm H2O 24 hours after drainage. Likewise, OI measured at the same time intervals showed significant differences (P <.05) deteriorating from 5 +/- 1.2 to 26 +/- 6.9 then improving to 13 +/- 3.5. A significant quadratic effect (P <.03) was evident for MAP and OI (ie, values significantly rose then fell). There were six 30-day survivors (55%), and 3 survived to discharge (27%). Of the long-term survivors, 2 required operative fistula closure, and 1 needed no further surgery. Bedside PPD for increasing ventilatory requirements and abdominal distension in critically ill neonates with nonperforated NEC is a simple technique that offers rapid stabilization, although ultimate mortality rate remains high. Copyright 2001 by W.B. Saunders Company.

  20. Mechanical ventilatory constraints during incremental exercise in healthy and cystic fibrosis children.

    Science.gov (United States)

    Borel, Benoit; Leclair, Erwan; Thevenet, Delphine; Beghin, Laurent; Gottrand, Frédéric; Fabre, Claudine

    2014-03-01

    To analyze breathing pattern and mechanical ventilatory constraints during incremental exercise in healthy and cystic fibrosis (CF) children. Thirteen healthy children and 6 children with cystic fibrosis volunteered to perform an incremental test on a treadmill. Exercise tidal flow/volume loops were plotted every minute within a maximal flow/volume loop (MFVL). Expiratory flow limitation (expFL expressed in %Vt) was evaluated and end-expiratory and end-inspiratory lung volumes (EELV and EILV) were estimated from expiratory reserve volume relative to vital capacity (ERV/FVC) and from inspiratory reserve volume relative to vital capacity (IRV/FVC). During the incremental exercise, expFL was first observed at 40% of maximal aerobic speed in both groups. At maximal exercise, 46% of healthy children and 83% of CF children presented expFL, without significant effect of cystic fibrosis on the severity of expFL. According to the two-way ANOVA results, both groups adopted similar breathing pattern and breathing strategies as no significant effect of CF has been revealed. But, according to one-way ANOVA results, a significant increase of ERV/FVC associated with a significant decrease of IRV/FVC from resting value shave been observed in healthy children at maximal exercise, but not in CF children. The hypothesis of this study was based on the assumption that mild cystic fibrosis could induce more frequent and more severe mechanical ventilatory constraints due to pulmonary impairment and breathing pattern disturbances. But, this study did not succeed to highlight an effect of mild cystic fibrosis on the mechanical ventilatory constraints (expFL and dynamic hyperinflation) that occur during an incremental exercise. This absence of effect could be due to the absence of an impact of the disease on spirometric data, breathing pattern regulation during exercise and breathing strategy. © 2013 Wiley Periodicals, Inc.

  1. EFFECT OF TIME OF DAY ON THE RELATIONSHIP BETWEEN LACTATE AND VENTILATORY THRESHOLDS: A BRIEF REPORT

    Directory of Open Access Journals (Sweden)

    Fadil Ozyener

    2002-12-01

    Full Text Available The purpose of this investigation was to study the effect of time of day on the relationship between lactate (LT and ventilatory thresholds (VT of pulmonary oxygen uptake (VO2. Seven moderately active male volunteers (26.3±3.0 years, 1.74±0.08 m, 76±5 kg performed a maximal incremental test (increases of 30 W every 2 min on a cycle ergometer on consecutive days at 0900 h, 1400h and 1900 h in a randomized fashion. The anaerobic threshold was determined using both ventilatory gas analysis and blood lactate measures. Each of the following variables was recorded both at VT and the LT; heart rate (HR, beats.min-1, minute ventilation (VE, L.min-1, respiratory exchange ratio (RER, time to threshold (Time, sec, oxygen uptake (VO2, ml.kg-1.min-1 and VO2 as a percentage of maximal oxygen uptake (%VO2max. The correlations between VT and LT variables analyzed by Pearson product moment correlations for each time of day. ANOVA was used to compare the data obtained at different times of the day. There were no significant differences for the data related to time of day either for ventilatory gas analysis or lactate measurements. The correlation coefficients between VT and LT variables were moderate to high (r=0.56-0.94 for time of day. However, the correlations for HR, VO2, and %VO2max (r=0.81-0.94 were slightly stronger compared with Time, VE and RER (r=0.56-0.88. It was concluded that, the data at VT and LT were not influenced by time of day

  2. VALIDITY OF THE MODIFIED CONCONI TEST FOR DETERMINING VENTILATORY THRESHOLD DURING ON-WATER ROWING

    Directory of Open Access Journals (Sweden)

    Jorge Villamil Cabo

    2011-12-01

    Full Text Available The objectives of this study were to design a field test based on the Conconi protocol to determine the ventilatory threshold of rowers and to test its reliability and validity. A group of sixteen oarsmen completed a modified Conconi test for on-water rowing. The reliability of the detection of the heart rate threshold was evaluated using heart rate breaking point in the Conconi test and retest. Heart rate threshold was detected in 88.8% of cases in the test-retest. The validity of the modified Conconi test was evaluated by comparing the heart rate threshold data acquired with that obtained in a ventilatory threshold test (VT2. No significant differences were found for the values of different intensity parameters i.e. heart rate (HR, oxygen consumption (VO2, stroke rate (SR and speed (S between the heart rate threshold and the ventilatory threshold, (170.9 ± 6.8 vs. 169.3 ± 6.4 beats·min-1; 42.0 ± 8.6 vs. 43.5 ± 8.3 ml·kg-1·min-1; 25.8 ± 3.3 vs. 27.0 ± 3.2 strokes·min-1 and 14.4 ± 0.8 vs. 14.6 ± 0.8 km·h-1. The differences in averages obtained in the Conconi test-retest were small with a low standard error of the mean. The reliability data between the Conconi test-retest showed low coefficients of variations (CV and high intraclass correlation coefficients (ICC. The total errors for the Conconi test-retest are low for the measured variables (1.31 HR, 0.87 VO2, 0.65 SR, and 0.1 S. The Bland- Altman's method for analysis validity showed a strong concordance according to the analyzed variables. We conclude that the modified Conconi test for on-water rowing is a valid and reliable method for the determination of the second ventilatory threshold (VT2.

  3. Cardiovascular and ventilatory responses to electrically induced cycling with complete epidural anaesthesia in humans

    DEFF Research Database (Denmark)

    Kjaer, M; Perko, G; Secher, N H

    1994-01-01

    with epidural anaesthesia [93 +/- 3 (rest) to 95 +/- 5 mmHg (exercise)]. As there is ample evidence for similar cardiovascular and ventilatory responses to electrically induced and voluntary exercise (Strange et al. 1993), the present results support the fact that the neural input from working muscle is crucial...... for the normal blood pressure response to exercise. Other haemodynamic and/or humoral mechanisms must operate in a decisive manner in the control of HR, CO and VE during dynamic exercise with large muscle groups....

  4. 7 CFR 1421.102 - Adjustment of basic loan rates.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Adjustment of basic loan rates. 1421.102 Section 1421...-MARKETING ASSISTANCE LOANS AND LOAN DEFICIENCY PAYMENTS FOR 2008 THROUGH 2012 Marketing Assistance Loans § 1421.102 Adjustment of basic loan rates. (a) Basic loan rates are established under § 1421.9 and will...

  5. Response of Preterm Infants to 2 Noninvasive Ventilatory Support Systems: Nasal CPAP and Nasal Intermittent Positive-Pressure Ventilation.

    Science.gov (United States)

    Silveira, Carmen Salum Thomé; Leonardi, Kamila Maia; Melo, Ana Paula Carvalho Freire; Zaia, José Eduardo; Brunherotti, Marisa Afonso Andrade

    2015-12-01

    Noninvasive ventilation (NIV) in preterm infants is currently applied using intermittent positive pressure (2 positive-pressure levels) or in a conventional manner (one pressure level). However, there are no studies in the literature comparing the chances of failure of these NIV methods. The aim of this study was to evaluate the occurrence of failure of 2 noninvasive ventilatory support systems in preterm neonates over a period of 48 h. A randomized, prospective, clinical study was conducted on 80 newborns (gestational age Ventilatory support failure was observed in 25 (62.5%) newborns treated with nasal CPAP and in 12 (30%) newborns treated with NIPPV, indicating an association between NIV failure and the absence of intermittent positive pressure (odds ratio [OR] 1.22, P newborns receiving nasal CPAP and 12.5% (OR 0.14) receiving NIPPV required invasive mechanical ventilation. Ventilatory support failure was significantly more frequent when nasal CPAP was used. Copyright © 2015 by Daedalus Enterprises.

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

    Science.gov (United States)

    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 O 2 /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 O 2 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.

  7. Assessing ventilatory control in infants at high risk of sleep disordered breathing: a study of infants with cleft lip and/or palate.

    Science.gov (United States)

    MacLean, Joanna E; Tan, Sara; Fitzgerald, Dominic A; Waters, Karen A

    2013-03-01

    Neonatal exposure to intermittent hypoxia results in altered ventilatory response to subsequent hypoxia in animal models. The effect of similar exposure in human infants is unknown. Our objective was to determine the impact of sleep disordered breathing (SDB) in early infancy on ventilatory response in infants. We recruited consecutive infants with cleft lip and/or palate (CL/P) to undergo ventilatory response testing using exposure to a hypoxic (15% O(2) ) gas mixture during sleep. This population is at high risk of SDB because of smaller airway caliber and abnormal palatal muscle attachments predisposing them to airway obstruction of ranging severity from birth. Ventilatory responses were compared between infants with a low apnea-hypopnea index (AHI; AHI pattern of ventilatory response to hypoxia differed between the two groups; infants with high AHI had an earlier ventilatory decline and a blunted maximal ventilatory response to hypoxia. Infants with a high AHI use a different strategy to augment ventilation in response to hypoxia; while infants with a low AHI initially increased respiratory rate, tidal volume was the first parameter to increase in infants with high AHI. These results demonstrate that SDB in infancy is associated with altered ventilatory response to hypoxia. Copyright © 2012 Wiley Periodicals, Inc.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. The effect of metabolic alkalosis on the ventilatory response in healthy subjects.

    Science.gov (United States)

    Oppersma, E; Doorduin, J; van der Hoeven, J G; Veltink, P H; van Hees, H W H; Heunks, L M A

    2018-02-01

    Patients with acute respiratory failure may develop respiratory acidosis. Metabolic compensation by bicarbonate production or retention results in posthypercapnic alkalosis with an increased arterial bicarbonate concentration. The hypothesis of this study was that elevated plasma bicarbonate levels decrease respiratory drive and minute ventilation. In an intervention study in 10 healthy subjects the ventilatory response using a hypercapnic ventilatory response (HCVR) test was assessed, before and after administration of high dose sodium bicarbonate. Total dose of sodiumbicarbonate was 1000 ml 8.4% in 3 days. Plasma bicarbonate increased from 25.2 ± 2.2 to 29.2 ± 1.9 mmol/L. With increasing inspiratory CO 2 pressure during the HCVR test, RR, V t , Pdi, EAdi and V E increased. The clinical ratio ΔV E /ΔP et CO 2 remained unchanged, but Pdi, EAdi and V E were significantly lower after bicarbonate administration for similar levels of inspired CO 2 . This study demonstrates that in healthy subjects metabolic alkalosis decreases the neural respiratory drive and minute ventilation, as a response to inspiratory CO 2 . Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Peinado, A B; Filho, Dm Pessôa; Díaz, V; Benito, P J; Álvarez-Sánchez, M; Zapico, A G; Calderón, F J

    2016-12-01

    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.

  11. Influence of music on the stress response in patients receiving mechanical ventilatory support: a pilot study.

    Science.gov (United States)

    Chlan, Linda L; Engeland, William C; Anthony, Anita; Guttormson, Jill

    2007-03-01

    Music is considered an ideal therapy for reducing stress in patients receiving mechanical ventilation. Previous studies of the effect of music on stress in such patients have focused solely on indirect markers of the stress response rather than on serum biomarkers. To explore the influence of music on serum biomarkers of the stress response in patients receiving ventilatory support. A convenience sample of 10 patients receiving mechanical ventilation was recruited from an 11-bed medical intensive care unit. Patients were randomly assigned to listen to music or to rest quietly for 60 minutes. Levels of corticotropin, cortisol, epinephrine, and norepinephrine were measured 4 times during the 60 minutes. The levels of the 4 biomarkers of the stress response did not differ significantly between patients who listened to music and patients who rested quietly, though the levels of corticotropin and cortisol showed interesting trends. Additional research is needed with a larger sample size to evaluate further the influence of music on biochemical markers of the stress response in patients receiving mechanical ventilatory support. In future studies, confounding factors such as endotracheal suctioning and administration of medications that influence the stress response should be controlled for.

  12. 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

    2016-03-15

    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. To investigate the agreement between respiratory variables recorded by a portable RIP device and by ES during rest and constant intensity exercise. 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. 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. Our results suggest that portable RIP devices might represent a suitable alternative to ES during rest and during constant submaximal exercise.

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

    Directory of Open Access Journals (Sweden)

    Ramona Cabiddu

    2016-01-01

    Full Text Available 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.

  14. Ventilatory weaning practices in intensive care units in the city of Cali.

    Science.gov (United States)

    Muñoz, Vilma; Calvo, Lucía; Ramírez, María Fernanda; Arias, Marcela; Villota, Mario; Wilches-Luna, Esther Cecilia; Soto, Rodolfo

    2014-01-01

    Early weaning from mechanical ventilation is one of the primary goals in managing critically ill patients. There are various techniques and measurement parameters for such weaning. The objective of this study was to describe the practices of ventilatory weaning in adult intensive care units in the city of Cali. A survey of 32 questions (some multiple choice) evaluating weaning practices was distributed to physiotherapists and respiratory therapists working in intensive care units, to be answered anonymously. The most common strategy for the parameter set was the combination of continuous positive airway pressure with pressure support (78%), with a large variability in pressure levels, the most common range being 6 to 8 cm H2O. The most common weaning parameters were as follows: tidal volume (92.6%), respiratory rate (93.3%) and oxygen saturation (90.4%). The most common waiting time for registration of the parameters was >15 minutes (40%). The measurements were preferably obtained from the ventilator display. The methods and measurement parameters of ventilatory weaning vary greatly. The most commonly used method was continuous positive airway pressure with more pressure support and the most commonly used weaning parameters were the measured tidal volume and respiratory rate.

  15. A simple method for estimating the ventilatory response to CO2 in infants.

    Science.gov (United States)

    Brady, J P; Durand, M; McCann, E

    1983-04-01

    We report a new noninvasive method for the estimation of CO2 response in uncooperative infants. By comparing the changes in inspired minus alveolar PO2 breathing air and 4% CO2, an indirect estimate of increase in alveolar ventilation can be obtained. This report is a comparison of 3 possible indirect methods: changes in inspired minus alveolar PCO2 (delta AIPCO2), changes in inspired minus alveolar PO2 (delta IAPO2), and changes in transcutaneous PO2 (TcPO2) with the standard steady-state method for ventilatory response to CO2. Twenty-one comparisons were made, 16 on 7 preterm infants, and 5 on an older child (at 2.5 and at 4 yr of age), with central hypoventilation syndrome. We found that changes in delta IAPO2 gave the best correlation with changes in minute ventilation (r = 0.83, p less than 0.001), that changes in delta AIPCO2 were less valid (r = 0.66, p less than 0.001), and that there was no correlation with changes in TcPO2. We conclude that changes in inspired PO2 minus alveolar PO2 can be used in uncooperative infants to estimate the ventilatory response to CO2.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Identifying ventilatory anaerobic threshold in children and adolescents: A literature review

    Directory of Open Access Journals (Sweden)

    Anselmo José Perez

    2012-04-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2012v14n3p343 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.

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

    Directory of Open Access Journals (Sweden)

    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. Ventilatory chemosensory drive is blunted in the mdx mouse model of Duchenne Muscular Dystrophy (DMD.

    Directory of Open Access Journals (Sweden)

    Matias Mosqueira

    Full Text Available Duchenne Muscular Dystrophy (DMD is caused by mutations in the DMD gene resulting in an absence of dystrophin in neurons and muscle. Respiratory failure is the most common cause of mortality and previous studies have largely concentrated on diaphragmatic muscle necrosis and respiratory failure component. Here, we investigated the integrity of respiratory control mechanisms in the mdx mouse model of DMD. Whole body plethysmograph in parallel with phrenic nerve activity recordings revealed a lower respiratory rate and minute ventilation during normoxia and a blunting of the hypoxic ventilatory reflex in response to mild levels of hypoxia together with a poor performance on a hypoxic stress test in mdx mice. Arterial blood gas analysis revealed low PaO2 and pH and high PaCO2 in mdx mice. To investigate chemosensory respiratory drive, we analyzed the carotid body by molecular and functional means. Dystrophin mRNA and protein was expressed in normal mice carotid bodies however, they are absent in mdx mice. Functional analysis revealed abnormalities in Dejours test and the early component of the hypercapnic ventilatory reflex in mdx mice. Together, these results demonstrate a malfunction in the peripheral chemosensory drive that would be predicted to contribute to the respiratory failure in mdx mice. These data suggest that investigating and monitoring peripheral chemosensory drive function may be useful for improving the management of DMD patients with respiratory failure.

  20. 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...

  1. The inspired sine-wave technique: A novel method to measure lung volume and ventilatory heterogeneity.

    Science.gov (United States)

    Bruce, Richard M; Phan, Phi Anh; Pacpaco, Edmund; Rahman, Najib M; Farmery, Andrew D

    2018-02-19

    What is the central question of this study? We present a new non-invasive medical technology, the inspired sine-wave technique, which involves inhalation of sinusoidally fluctuating concentrations of a tracer gas. The technique requires only passive patient cooperation and can monitor different cardiorespiratory variables, such as end-expired lung volume, ventilatory heterogeneity and pulmonary blood flow. What is the main finding and its importance? In this article, we demonstrate that the measurements of end-expired lung volume are repeatable and accurate, in comparison to whole-body plethysmography, and the technique is sensitive to the changes in ventilatory heterogeneity associated with advancing age. As such, it has the potential to provide clinically valuable information. The inspired sine-wave technique (IST) is a new method that can provide simple, non-invasive cardiopulmonary measurements. Over successive tidal breaths, the concentration of a tracer gas (i.e. nitrous oxide, N 2 O) is sinusoidally modulated in inspired air. Using a single-compartment tidal-ventilation lung model, the resulting amplitude/phase of the expired sine wave allows estimation of end-expired lung volume (ELV), pulmonary blood flow and three indices for ventilatory heterogeneity (VH; ELV 180 /FRC pleth , ELV 180 /FRC pred and ELV 60 /ELV 180 ). This investigation aimed to determine the repeatability and agreement of ELV with FRC pleth and, as normal ageing results in well-established changes in pulmonary structure and function, whether the IST estimates of ELV and VH are age dependent. Forty-eight healthy never-smoker participants (20-86 years) underwent traditional pulmonary function testing (e.g. spirometry, body plethysmography) and the IST test, which consisted of 4 min of quiet breathing through a face mask while inspired N 2 O concentrations were oscillated in a sine-wave pattern with a fixed mean (4%) and amplitude (3%) and a period of either 180 or 60 s. The ELV 180 /FRC

  2. Clinical factors associated with success of proportional assist ventilation in the acute phase of critical illness: pilot study.

    Science.gov (United States)

    Delgado, M; Zavala, E; Tomás, R; Fernandez, R

    2014-03-01

    Proportional assist ventilation plus (PAV+) applies pressure depending on the patient's inspiratory effort, automatically adjusting flow and volume assist to changes in respiratory mechanics. We aimed to assess the clinical factors associated with the success of PAV+ as first-line support in the acute phase of critical illness. A prospective cohort study was carried out. Mechanically ventilated patients>24h were switched from assist-control ventilation to PAV+ as soon as they regained spontaneous breathing activity. PAV+ was set to deliver the highest assistance. We compared patients in whom PAV+ succeeded versus those in whom it failed. PAV+ succeeded in 12 (63%) patients, but failed in 7 (37%) due to tachypnea (n=4), hypercapnia (n=2), and metabolic acidosis (n=1), but without statistical significance. Both groups had similar clinical parameters. On the day of inclusion, total work of breathing per breath was lower in the successful PAV+ group (WOBTOT: 0.95 [0.8-1.35] vs. 1.6 [1.4-1.8] J/L; P<.007). The area under the ROC curve was 0.89 ± 0.08 for WOBTOT. The best cut-off for predicting PAV+ success was WOBTOT<1.4 J/L (sensitivity: 1 [0.7-1], specificity: 0.6 [0.4-0.6], PPV: 0.7 [0.5-0.7], and NPV: 1 [0.6-1]). PAV+ proved feasible as first-line ventilatory support in 63% of the patients, mostly in individuals without extreme derangements in WOBTOT. Tachypnea and hypercapnia were the clinical factors associated with failure, though statistical significance was not reached. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  3. Cardiovascular and ventilatory responses to electrically induced cycling with complete epidural anaesthesia in humans

    DEFF Research Database (Denmark)

    Kjaer, M; Perko, G; Secher, N H

    1994-01-01

    and complete paralysis of the legs. Cycling was performed for 22.7 +/- 2.7 min (mean, SE) (fatigue) and oxygen uptake (VO2) increased to 1.90 +/- 0.13 1 min-1. Compared with voluntary exercise at the same VO2, increases in heart rate (HR) (135 +/- 7 vs. 130 +/- 9 beats min-1) and cardiac output (16.9 +/- 1...... with epidural anaesthesia [93 +/- 3 (rest) to 95 +/- 5 mmHg (exercise)]. As there is ample evidence for similar cardiovascular and ventilatory responses to electrically induced and voluntary exercise (Strange et al. 1993), the present results support the fact that the neural input from working muscle is crucial...... for the normal blood pressure response to exercise. Other haemodynamic and/or humoral mechanisms must operate in a decisive manner in the control of HR, CO and VE during dynamic exercise with large muscle groups....

  4. Dose dependent effect of progesterone on hypoxic ventilatory response in newborn rats.

    Science.gov (United States)

    Hichri, Oubeidallah; Laurin, Jean-C; Julien, Cécile A; Joseph, Vincent; Bairam, Aida

    2012-01-01

    The effect of progesterone as a respiratory stimulant in newborn subjects is less known than that in adults. This study investigated the dose-response curve (0, 2, 4, and 8 mg/kg, ip) of progesterone on ventilation in non-anesthetized newborn rats at 4- and 12-days old using plethysmography. Progesterone had no effects in the regulation of normoxic ventilation. However, it enhanced the response to moderate hypoxia (FiO(2) 12%, 20 min) in 4- but not in 12-days old pups. This response was similar between the dose of 4 and 8 mg/kg. These observations suggested that progesterone enhances in age- and dose-dependent manner the hypoxic ventilatory response in newborn rats.

  5. 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.

  6. 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 (pexercise, as assessed by changes in the end-expiratory lung volume and in tidal volume excursion. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. 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...

  8. Ventilatory Threshold may be a More Specific Measure of Aerobic Capacity than Peak Oxygen Consumption Rate in Persons with Stroke

    Science.gov (United States)

    Boyne, Pierce; Reisman, Darcy; Brian, Michael; Barney, Brian; Franke, Ava; Carl, Daniel; Khoury, Jane; Dunning, Kari

    2017-01-01

    Background After stroke, aerobic deconditioning can have a profound impact on daily activities. This is usually measured by the peak oxygen consumption rate achieved during exercise testing (VO2-peak). However, VO2-peak may be distorted by motor function. The oxygen uptake efficiency slope (OUES) and VO2 at the ventilatory threshold (VO2-VT) could more specifically assess aerobic capacity after stroke, but this has not been tested. Objectives To assess the differential influence of motor function on three measures of aerobic capacity (VO2-peak, OUES and VO2-VT) and to evaluate the inter-rater reliability of VO2-VT determination post-stroke. Methods Among 59 persons with chronic stroke, cross-sectional correlations with motor function (comfortable gait speed [CGS] and lower extremity Fugl-Meyer [LEFM]) were compared between the different aerobic capacity measures, after adjustment for covariates, in order to isolate any distorting effect of motor function. Reliability of VO2-VT determination between 3 raters was assessed with intra-class correlation (ICC). Results CGS was moderately correlated with VO2-peak (r=0.52, p<0.0001) and weakly correlated with OUES (r=0.41, p=0.002) and VO2-VT (r=0.37, p=0.01). LEFM was weakly correlated with VO2-peak (r=0.26, p=0.055) and very weakly correlated with OUES (r=0.19, p=0.17) and VO2-VT (r=0.14, p=0.31). Compared to VO2-peak, VO2-VT was significantly less correlated with CGS (r difference = -0.16, p=0.02). Inter-rater reliability of VO2-VT determination was high (ICC: 0.93, 95%CI: 0.89 to 0.96). Conclusions Motor dysfunction appears to artificially lower measured aerobic capacity. VO2-VT seemed to be less distorted than VO2-peak and had good inter-rater reliability, so it may provide more specific assessment of aerobic capacity post-stroke. PMID:27454553

  9. Lower hypoxic ventilatory response in smokers compared to non-smokers during abstinence from cigarettes.

    Science.gov (United States)

    Hildebrandt, Wulf; Sauer, Roland; Koehler, Ulrich; Bärtsch, Peter; Kinscherf, Ralf

    2016-11-24

    Carotid body O 2 -chemosensitivity determines the hypoxic ventilatory response (HVR) as part of crucial regulatory reflex within oxygen homeostasis. Nicotine has been suggested to attenuate HVR in neonates of smoking mothers. However, whether smoking affects HVR in adulthood has remained unclear and probably blurred by acute ventilatory stimulation through cigarette smoke. We hypothesized that HVR is substantially reduced in smokers when studied after an overnight abstinence from cigarettes i.e. after nicotine elimination. We therefore determined the isocapnic HVR of 23 healthy male smokers (age 33.9 ± 2.0 years, BMI 24.2 ± 0.5 kg m -2 , mean ± SEM) with a smoking history of >8 years after 12 h of abstinence and compared it to that of 23 healthy male non-smokers matched for age and BMI. Smokers and non-smokers were comparable with regard to factors known to affect isocapnic HVR such as plasma levels of glucose and thiols as well as intracellular levels of glutathione in blood mononuclear cells. As a new finding, abstinent smokers had a significantly lower isocapnic HVR (0.024 ± 0.002 vs. 0.037 ± 0.003 l min -1 % -1 BMI -1 , P = 0.002) compared to non-smokers. However, upon re-exposure to cigarettes the smokers' HVR increased immediately to the non-smokers' level. This is the first report of a substantial HVR reduction in abstinent adult smokers which appears to be masked by daily smoking routine and may therefore have been previously overlooked. A low HVR may be suggested as a novel link between smoking and aggravated hypoxemia during sleep especially in relevant clinical conditions such as COPD.

  10. Relationship of hypoxic ventilatory response to exercise performance on Mount Everest.

    Science.gov (United States)

    Schoene, R B; Lahiri, S; Hackett, P H; Peters, R M; Milledge, J S; Pizzo, C J; Sarnquist, F H; Boyer, S J; Graber, D J; Maret, K H

    1984-06-01

    At very high altitude, exercise performance in the human sojourner may depend on a sufficient hypoxic ventilatory response (HVR). To study the relationship of HVR to exercise performance at high altitude, we studied HVR at sea level and 5,400 m and exercise ventilation at sea level, 5,400 m, and 6,300 m in nine members of the American Medical Research Expedition to Everest. The relationship of HVR between individuals was maintained when HVR was repeated after acclimatization to 5,400 m (P less than 0.05). There was a significant correlation in all subjects between HVR and ventilatory equivalent during exercise at sea level (r = 0.704, P less than 0.05). Subjects were then grouped into high (H) and low (L) HVR responders (ventilation increase to end-tidal PO2 of 40 Torr = 21.2 +/- 5.4 and 5.6 +/- 0.9 1 X min-1, respectively. At low and moderate levels of exercise, ventilation at sea level and after acclimatization to 6,300 m was higher in the high HVR group. At 6,300 m blood O2 saturation (Sao2%) decreased from rest to maximum exercise: H = 8.3 +/- 1.8%, L = 20.0 +/- 2.5% (P less than 0.01). HVR correlated inversely in all subjects with the decrease in Sao2 from rest to maximum exercise (P less than 0.05). Climbers with the highest HVR values reached and slept at higher altitudes. We conclude that the relative value of HVR in our group of climbers was not significantly altered after acclimatization; HVR predicts exercise ventilation at sea level and high altitude; the drop in Sao2% that occurs with exercise is inversely related to HVR; and sojourners with high HVR may perform better at extreme altitude.

  11. Evaluation of imaging of the ventilatory lung motion in pulmonary diseases

    International Nuclear Information System (INIS)

    Fujii, Tadashige; Kanai, Hisakata; Tanaka, Masao; Hirayama, Jiro; Handa, Kenjiro

    1988-01-01

    Using perfusion lung scintigram with 99m Tc-macroaggregated albumin at maximal expiration (E) and inspiration (I), images of the motion of the regional pulmonary areas and lung margins during ventilation ((E-I)/I) was obtained in patients with various respiratory diseases. The image of (E-I)/I consisted of positive and negative components. The former component visualized the motion of the regional pulmonary areas that corresponded with the ventilatory amplitude of the videodensigram. The sum of the positive component of (E-I)/I in both lungs correlated with the vital capacity (n = 50, r = 0.62). It was 163.5 ± 52.5 in cases with a vital capacity of more than 3.01, 94.1 ± 61.5 in primary lung cancer, 89.2 ± 44.7 in chronic obstructive lung diseases and 69.0 ± 27.5 in diffuse interstitial pneumonia. The distribution pattern of pulmonary perfusion and the positive component of (E-I)/I matched fairly in many cases, but did not match in some cases. The negative component of (E-I)/I demonstrated the ventilatory motion of the lung margin and its decreased activity was shown in cases with hypoventilation of various causes including pleural diseases. The sum of the negative component of (E-I)/I in the both lungs correlated with the vital capacity (n = 50, r = 0.44). These results suggest that this technique is useful to estimate the regional pulmonary ventilatioin and motion of the lung margins. (author)

  12. Determination of ventilatory liver movement via radiographic evaluation of diaphragm position

    International Nuclear Information System (INIS)

    Balter, James M.; Dawson, Laura A.; Kazanjian, Sahira; McGinn, Cornelius; Brock, Kristy K.; Lawrence, Theodore; Haken, Randall ten

    2001-01-01

    Purpose: To determine the accuracy of estimation of liver movement inferred by observing diaphragm excursion on radiographic images. Methods and Materials: Eight patients with focal liver cancer had platinum embolization microcoils implanted in their livers during catheterization of the hepatic artery for delivery of regional chemotherapy. These patients underwent fluoroscopy, during which normal breathing movement was recorded on videotape. Movies of breathing movement were digitized, and the relative projected positions of the diaphragm and coils were recorded. For 6 patients, daily radiographs were also acquired during treatment. Retrospective measurements of coil position were taken after the diaphragm was aligned with the superior portion of the liver on digitally reconstructed radiographs. Results: Coil movement of 4.9 to 30.4 mm was observed during normal breathing. Diaphragm position tracked inferior-superior coil displacement accurately (population σ 1.04 mm) throughout the breathing cycle. The range of coil movement was predicted by the range of diaphragm movement with an accuracy of 2.09 mm (σ). The maximum error observed measuring coil movement using diaphragm position was 3.8 mm for a coil 9.8 cm inferior to the diaphragm. However, the distance of the coil from the top of the diaphragm did not correlate significantly with the error in predicting liver excursion. Analysis of daily radiographs showed that the error in predicting coil position using the diaphragm as an alignment landmark was 1.8 mm (σ) in the inferior-superior direction and 2.2 mm in the left-right direction, similar in magnitude to the inherent uncertainty in alignment. Conclusions: This study demonstrated that the range of ventilatory movement of different locations within the liver is predicted by diaphragm position to an accuracy that matches or exceeds existing systems for ventilatory tracking. This suggests that the diaphragm is an acceptable anatomic landmark for radiographic

  13. 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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

    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% CO 2 -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.

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

    Science.gov (United States)

    Caravagna, Céline; Schneider Gasser, Edith M; 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. Copyright © 2015 ISDN. Published by Elsevier Ltd. All rights reserved.

  16. Electrical stimulation ventilatory feedback facilitates maintenance of a prolonged expiration pattern during exercise: A proof-of-concept study in healthy adults.

    Science.gov (United States)

    Yamahara, Jun; Ito, Kenichi; Nonaka, Koji

    2016-08-01

    This study aimed at verifying the safety and effects of electrical stimulation ventilatory feedback (ESVF) to provide feedback during expiration, which may assist with breathing control in patients with chronic obstructive pulmonary disease (COPD). Because this is a new therapy, we examined the feasibility of the therapy in healthy adults. The 23 healthy adult participants were randomized into two groups: a stimulation group that received ESVF and a placebo group with the ESVF device attached, but not activated. Sensory stimulation was provided at a frequency of 20 Hz and pulse duration of 200 μs. During breathing training, participants practiced a prolonged expiration pattern and were instructed to maintain the breathing pattern during exercise. A variety of parameters such as respiratory time from the gas analyzer monitor and quantitative load were measured during lower-extremity cycle ergometer exercise. The primary outcome was the expiratory to inspiratory time ratio, which was significantly higher in the stimulation group than in the placebo group, both during and after exercise. No side effects were reported during the use of electrical stimulation. Therefore, ESVF is safe and facilitates maintenance of a prolonged expiration pattern during and after exercise.

  17. 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 ...

  18. 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

  19. The breathing pattern and the ventilatory response to aquatic and aerial hypoxia and hypercarbia in the frog Pipa carvalhoi

    OpenAIRE

    Fonseca, Elisa M. [UNESP; da Silva, Glauber S. F.; Fernandes, Marcelo; Giusti, Humberto; Noronha-de-Souza, Carolina R. [UNESP; Glass, Mogens L.; Bicego, Kenia C. [UNESP; Gargaglioni, Luciane H. [UNESP

    2012-01-01

    Anuran amphibians are known to exhibit an intermittent pattern of pulmonary ventilation and to exhibit an increased ventilatory response to hypoxia and hypercarbia. However, only a few species have been studied to date. The aquatic frog Pipa carvalhoi inhabits lakes, ponds and marshes that are rich in nutrients but low in O-2. There are no studies of the respiratory pattern of this species and its ventilation during hypoxia or hypercarbia. Accordingly, the aim of the present study was to char...

  20. The breathing pattern and the ventilatory response to aquatic and aerial hypoxia and hypercarbia in the frog Pipa carvalhoi.

    Science.gov (United States)

    Fonseca, Elisa M; da Silva, Glauber S F; Fernandes, Marcelo; Giusti, Humberto; Noronha-de-Souza, Carolina R; Glass, Mogens L; Bícego, Kênia C; Gargaglioni, Luciane H

    2012-07-01

    Anuran amphibians are known to exhibit an intermittent pattern of pulmonary ventilation and to exhibit an increased ventilatory response to hypoxia and hypercarbia. However, only a few species have been studied to date. The aquatic frog Pipa carvalhoi inhabits lakes, ponds and marshes that are rich in nutrients but low in O(2). There are no studies of the respiratory pattern of this species and its ventilation during hypoxia or hypercarbia. Accordingly, the aim of the present study was to characterize the breathing pattern and the ventilatory response to aquatic and aerial hypoxia and hypercarbia in this species. With this purpose, pulmonary ventilation (V(I)) was directly measured by the pneumotachograph method during normocapnic normoxia to determine the basal respiratory pattern and during aerial and aquatic hypercarbia (5% CO(2)) and hypoxia (5% O(2)). Our data demonstrate that P. carvalhoi exhibits a periodic breathing pattern composed of single events (single breaths) of pulmonary ventilation separated by periods of apnea. The animals had an enhanced V(I) during aerial hypoxia, but not during aquatic hypoxia. This increase was strictly the result of an increase in the breathing frequency. A pronounced increase in V(I) was observed if the animals were simultaneously exposed to aerial and aquatic hypercarbia, whereas small or no ventilatory responses were observed during separately administered aerial or aquatic hypercarbia. P. carvalhoi primarily inhabits an aquatic environment. Nevertheless, it does not respond to low O(2) levels in water, although it does so in air. The observed ventilatory responses to hypercarbia may indicate that this species is similar to other anurans in possessing central chemoreceptors. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Breathing with your belly: abdominal exhalation, loco-ventilatory integration and size constraints on locomotion in small mammals.

    Science.gov (United States)

    Reilly, Stephen M; White, Thomas D

    2009-01-01

    In mammals, diaphragmatic contractions control inhalation while contraction of some thoracic hypaxial muscles and the transversus abdominis muscle contribute to exhalation. Additional thoracic hypaxial muscles are recruited as accessory ventilatory muscles to improve inhalation and exhalation during locomotion. However, the contribution of abdominal hypaxial muscles to resting and locomotor ventilation is little understood in mammals and loco-ventilatory integration has not been studied in small basal mammals. We show for the first time that all of the abdominal hypaxial muscles actively contribute to both resting and locomotory ventilation in mammals but in a size-dependent manner. In large opossums (Didelphis), hypaxial muscles exhibit uniform mild tonus during resting ventilation (pressurizing the gut to aid in exhalation) and shift to phasic bursts of activity during each exhalation during locomotion. Smaller opossums (Monodelphis) actively exhale by firing the abdominal hypaxial muscles at approximately 10Hz at both rest and at preferred locomotor speeds. Furthermore, the large opossums entrained ventilation to limb cycling as speed increased while the small opossums entrained limb cycling to the resting ventilation rate during locomotion. Differences in these species are related to size effects on the natural frequency of the ventilatory system and increasing resting ventilation rates at small size. Large mammals, with lower resting ventilation rates, can increase ventilatory rates during locomotion, while the high resting ventilation rates of small mammals limits their ability to increase ventilation rates during locomotion. We propose that increase in mammalian body size during the Cenozoic may have been an adaptation or exaptation to overcome size effects on ventilation frequency.

  2. Adjustment of macroeconomic imbalances

    Directory of Open Access Journals (Sweden)

    Georgeta Barbulescu

    2013-03-01

    Full Text Available The global financial and economic crisis was the factor that triggered the adjustment of macroeconomic imbalances accumulated in Romania. The current account deficit and budget deficit were two major structural imbalances that have created a high vulnerability for the economy and explained the extent of economic contraction in Romania during the economic crisis. This article identifies the main causes that lead to the need for fiscal adjustment both in the EU and in Romania, as well as main effects of adjustments in respect of their experience in recent years. The article deals with this topic, because the current topical debate in the field of fiscal adjustments implemented both in the EU and our country, and their need for economic activity aimed at economic recovery.

  3. Price adjustment clauses : report.

    Science.gov (United States)

    2012-10-01

    Price adjustment mechanisms exist to account for fluctuations in commodity or labor prices and have : been used for highway construction in 47 states. They are useful in stabilizing bid prices in times of : economic uncertainty and preventing default...

  4. 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.

  5. Static hyperinflation is associated with ventilatory limitation and exercise tolerance in adult cystic fibrosis.

    Science.gov (United States)

    Stevens, Daniel

    2018-01-13

    Lung hyperinflation is a potential mechanism limiting exercise tolerance. However, available data on the impact of static hyperinflation on exercise performance in adult cystic fibrosis are lacking. Furthermore, the relative contribution of both static and dynamic hyperinflation to exercise performance is unknown. The aim of this study was to determine the impact of static hyperinflation on exercise tolerance and lung dynamics in adult cystic fibrosis. Clinical data of 107 adult patients with cystic fibrosis, including pulmonary function, lung volumes and cardiopulmonary exercise from the Toronto Cystic Fibrosis database, were collected and analyzed. Patients were classified as having static hyperinflation with a residual volume to total lung capacity (RV/TLC) ratio of 30% or greater. Patients with static hyperinflation demonstrated a significant reduction in exercise performance [peak oxygen uptake (% predicted) 70 ± 17 vs 80 ± 17; P = .006] and were more likely to experience ventilatory limitation when exercising (Fisher's exact test P static hyperinflation [RV/TLC ratio (%)] and exercise performance [peak oxygen uptake (% predicted); r = -.38, P static hyperinflation to exercise performance [peak oxygen uptake (% predicted)] was greater than that of airway obstruction (forced expiratory volume in 1 second). Clinicians working with this patient group in a pulmonary rehabilitation or health care setting may wish to consider using measures of static hyperinflation as end points to determine program or treatment efficacy. © 2018 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Verbraecken, Johan; McNicholas, Walter T

    2013-11-20

    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.

  7. 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.

  8. A comparison of the ventilatory response of sleeping newborn lambs to step and progressive hypoxaemia.

    Science.gov (United States)

    Cohen, G; Malcolm, G; Henderson-Smart, D

    1997-01-01

    1. Slight variations in the rate at which hypoxaemia develops may significantly alter the ventilatory response (VR) elicited. Here we have developed a technique to compare the VRs elicited from sleeping newborn lambs by specific (step versus progressive), short-duration ( or = 9 days (10 +/- 0.3 days) were also compared. There was an upward shift in the position of step and progressive response curves of older lambs, reflecting primarily the increased vigour of the initial hyperpnoea elicited by step (delta Vi at 1 min = +20 +/- 4% at 4 days vs. +40 +/- 11% at 10 days) as well as progressive (delta Vi at 1 min = +6 +/- 2% at 4 days vs. +17 +/- 5% at 10 days) hypoxaemia. 5. Qualitatively different VRs may be elicited from the newborn, depending upon the specific hypoxaemic profile administered. Therefore, to evaluate the significance of VRs elicited in response to classical, steady-state hypoxia at different postnatal ages properly, the stimulus must be accurately described. PMID:9288688

  9. Hormonal imbalance in relation to exercise intolerance and ventilatory inefficiency in chronic heart failure.

    Science.gov (United States)

    Agapitou, Varvara; Dimopoulos, Stavros; Kapelios, Christos; Karatzanos, Eleftherios; Manetos, Christos; Georgantas, Andreas; Ntalianis, Argyrios; Terrovitis, John; Karga, Helen; Nanas, Serafim

    2013-04-01

    Skeletal muscle wasting is associated with altered catabolic/anabolic balance and poor prognosis in patients with chronic heart failure (CHF). This study evaluated catabolic and anabolic abnormalities in relation to disease severity in CHF patients. Forty-two stable CHF patients (34 men; aged 56±12 years, body mass index, 27±5 kg/m2) receiving optimal medical treatment underwent incremental symptom-limited cardiopulmonary exercise testing on a cycle ergometer. Blood samples were drawn within 10 days to determine serum cortisol, plasma adrenocorticotropin (ACTH), and serum dehydroepiandrosterone sulfate, insulin-like growth factor 1, growth hormone, and total testosterone in men. Patients with higher cortisol levels presented with impaired peak oxygen uptake (Vo2 peak: 18.3±3.9 vs. 14.2±3.7 ml/kg/min, phormones, whereas cortisol remained the only independent predictor of Ve/Vco2 slope (R2 = 0.133; F = 6.1; SE = 6.2; p = 0.02). Enhanced catabolic status is significantly associated with exercise intolerance, ventilatory inefficiency, and chronotropic incompetence in CHF patients, suggesting a significant contributing mechanism to their limited functional status. Copyright © 2013 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  10. Isoflurane and Ketamine Anesthesia have Different Effects on Ventilatory Pattern Variability in Rats

    Science.gov (United States)

    Chung, Augustine; Fishman, Mikkel; Dasenbrook, Elliot C.; Loparo, Kenneth A.; Dick, Thomas E.; Jacono, Frank J.

    2013-01-01

    We hypothesize that isoflurane and ketamine impact ventilatory pattern variability (VPV) differently. Adult Sprague-Dawley rats were recorded in a whole-body plethysmograph before, during and after deep anesthesia. VPV was quantified from 60-s epochs using a complementary set of analytic techniques that included constructing surrogate data sets that preserved the linear structure but disrupted nonlinear deterministic properties of the original data. Even though isoflurane decreased and ketamine increased respiratory rate, VPV as quantified by the coefficient of variation decreased for both anesthetics. Further, mutual information increased and sample entropy decreased and the nonlinear complexity index (NLCI) increased during anesthesia despite qualitative differences in the shape and period of the waveform. Surprisingly mutual information and sample entropy did not change in the surrogate sets constructed from isoflurane data, but in those constructed from ketamine data, mutual information increased and sample entropy decreased significantly in the surrogate segments constructed from anesthetized relative to unanesthetized epochs. These data suggest that separate mechanisms modulate linear and nonlinear variability of breathing. PMID:23246800

  11. Sleep disturbance at simulated altitude indicated by stratified respiratory disturbance index but not hypoxic ventilatory response.

    Science.gov (United States)

    Kinsman, Tahnee A; Townsend, Nathan E; Gore, Christopher J; Hahn, Allan G; Clark, Sally A; Aughey, Robert J; McKenna, Michael J; Hawley, John A; Chow, Chin-Moi

    2005-08-01

    At high altitudes, the clinically defined respiratory disturbance index (RDI) and high hypoxic ventilatory response (HVR) have been associated with diminished sleep quality. Increased RDI has also been observed in some athletes sleeping at simulated moderate altitude. In this study, we investigated relationships between the HVR of 14 trained male endurance cyclists with variable RDI and sleep quality responses to simulated moderate altitude. Blood oxygen saturation (SpO2%), heart rate, RDI, arousal rate, awakenings, sleep efficiency, rapid eye movement (REM) sleep, non-REM sleep stages 1, 2 and slow wave sleep as percentages of total sleep time (%TST) were measured for two nights at normoxia of 600 m and one night at a simulated altitude of 2,650 m. HVR and RDI were not significantly correlated with sleep stage, arousal rate or awakening response to nocturnal simulated altitude. SpO2 was inversely correlated with total RDI (r = -0.69, P = 0.004) at simulated altitude and with the change in arousal rate from normoxia (r = -0.65, P = 0.02). REM sleep response to simulated altitude correlated with the change, relative to normoxia, in arousal (r = -0.63, P = 0.04) and heart rate (r = -0.61, P = 0.04). When stratified, those athletes at altitude with RDI >20 h(-1) (n = 4) and those with sleep or arousal increase. However, the stratified RDI provides a basis for determining potential sleep disturbance in athletes at simulated moderate altitude.

  12. Heart rate variability to assess ventilatory threshold in ski-mountaineering.

    Science.gov (United States)

    Cassirame, Johan; Tordi, Nicolas; Fabre, Nicolas; Duc, Sébastien; Durand, Fabienne; Mourot, Laurent

    2015-01-01

    The capacity to predict the heart rate (HR) and speed at the first (VT1) and second (VT2) ventilatory thresholds was evaluated during an incremental ski-mountaineering test using heart rate variability (HRV). Nine skiers performed a field test to exhaustion on an alpine skiing track. VT1 and VT2 were individually determined by visual analysis from gas exchanges (VT1V and VT2V) and time-varying spectral HRV analysis (VT1fH, VT2fH and VT2H). VT1 could not be determined with the HRV methods used. On the contrary, the VT2 was determined in all skiers. No significant difference between HR and speed at VT2H and VT2V was observed (174.3 ± 5.6 vs. 174.3 ± 5.3 bpm, and 6.3 ± 0.9 and 6.3 ± 0.9 km h(-1), respectively). Strong correlations were obtained for HR (r = 0.91) and speed (r = 0.92) at VT2H and VT2V with small limits of agreement (±3.6 bpm for HR). Our results indicated that HRV enables determination of HR and speed at VT2 during a specific ski-mountaineering incremental test. These findings provide practical applications for skiers in order to evaluate and control specific training loads, at least when referring to VT2.

  13. Effects of 12-week overground walking training at ventilatory threshold velocity in type 2 diabetic women.

    Science.gov (United States)

    Belli, Taisa; Ribeiro, Luiz Fernando Paulino; Ackermann, Marco Aurélio; Baldissera, Vilmar; Gobatto, Claudio Alexandre; Galdino da Silva, Rozinaldo

    2011-09-01

    This study analyzed the effects of overground walking training at ventilatory threshold (VT) velocity on glycaemic control, body composition, physical fitness and lipid profile in DM2 women. Nineteen sedentary patients were randomly assigned to a control group (CG; n=10, 55.9±2.2 years) or a trained group (TG; n=9, 53.4±2.3 years). Both groups were subjected to anthropometric measures, a 12-h fasting blood sampling and a graded treadmill exercise test at baseline and after a 12-week period, during which TG followed a training program involving overground walking at VT velocity for 20-60min/session three times/week. Significant group×time interactions (P0.05) in fasting blood glucose, submaximal fitness parameters and lipid profile. Our results suggest that overground walking training at VT velocity improves long term glycaemic control, body composition and exercise capacity, attesting for the relevance of this parameter as an effective strategy for the exercise intensity prescription in DM2 population. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. Glutamate receptors in the nucleus tractus solitarius contribute to ventilatory acclimatization to hypoxia in rat.

    Science.gov (United States)

    Pamenter, Matthew E; Carr, J Austin; Go, Ariel; Fu, Zhenxing; Reid, Stephen G; Powell, Frank L

    2014-04-15

    When exposed to a hypoxic environment the body's first response is a reflex increase in ventilation, termed the hypoxic ventilatory response (HVR). With chronic sustained hypoxia (CSH), such as during acclimatization to high altitude, an additional time-dependent increase in ventilation occurs, which increases the HVR. This secondary increase persists after exposure to CSH and involves plasticity within the circuits in the central nervous system that control breathing. Currently these mechanisms of HVR plasticity are unknown and we hypothesized that they involve glutamatergic synapses in the nucleus tractus solitarius (NTS), where afferent endings from arterial chemoreceptors terminate. To test this, we treated rats held in normoxia (CON) or 10% O2 (CSH) for 7 days and measured ventilation in conscious, unrestrained animals before and after microinjecting glutamate receptor agonists and antagonists into the NTS. In normoxia, AMPA increased ventilation 25% and 50% in CON and CSH, respectively, while NMDA doubled ventilation in both groups (P e. acute hypoxia in CON and CSH, and normoxia in CSH. These results support our hypothesis that glutamate receptors in the NTS contribute to plasticity in the HVR with CSH. The mechanism underlying this synaptic plasticity is probably glutamate receptor modification, as in CSH rats the expression of phosphorylated NR1 and GluR1 proteins in the NTS increased 35% and 70%, respectively, relative to that in CON rats.

  15. 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. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  16. 24 CFR 982.520 - Regular tenancy: Special adjustment of rent to owner.

    Science.gov (United States)

    2010-04-01

    ..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SECTION 8 TENANT BASED ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM Rent and Housing Assistance Payment § 982.520 Regular tenancy: Special adjustment of rent to owner. (a...

  17. 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

  18. Sleep quality under mild hypoxia in men with low hypoxic ventilatory response.

    Science.gov (United States)

    Hoshikawa, Masako; Uchida, Sunao; Ganeko, Masashi; Sumitomo, Junya; Totoki, Masatsugu; Kojima, Takuto; Nakamura, Yukiko; Kawahara, Takashi

    2014-01-01

    The present study evaluated whether slow-wave sleep and whole-night delta power of the non-rapid eye movement (NREM) sleep electroencephalogram (EEG) decrease during sleep at a simulated altitude of 2000 m, and whether such changes related to measures of hypoxic ventilatory response (HVR). This study consisted of two parts; in the first, HVR was measured in 41 subjects and each seven subjects with the lowest or the highest HVR were selected for the subsequent sleep study. In the second part, polysomnogram, arterial oxygen saturation (SpO2) and respiratory events are recorded on the selected subjects under normoxic and hypoxic conditions. Hypoxia decreased SpO2 and increased respiratory disturbances for both groups. The low HVR group, but not the high HVR group, showed decreases in the whole-night delta power of NREM sleep EEG under hypoxia. On the other hand, two subjects in the high HVR group, who showed relatively high apnoea indices, also showed lower SpO2 nadirs and decreases in the whole-night delta power under hypoxia. These results suggest that acute hypoxia equivalent to that at a 2000 m altitude decreases slow-wave sleep in individuals that show low HVR. However, low HVR may not be the only, but one of some factors that decrease the whole-night delta power under hypoxia. Therefore, it was not sufficient to identify individuals likely to be susceptible to deteriorated sleep quality at a simulated altitude of 2000 m only using the HVR test. Other factors, which relate to respiratory instabilities, should be taken into consideration to identify them.

  19. Testosterone potentiates the hypoxic ventilatory response of adult male rats subjected to neonatal stress.

    Science.gov (United States)

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

    2014-05-01

    Neonatal stress disrupts development of homeostatic systems. During adulthood, male rats subjected to neonatal maternal separation (NMS) are hypertensive and show a larger hypoxic ventilatory response (HVR), with greater respiratory instability during sleep. Neonatal stress also affects sex hormone secretion; hypoxia increases circulating testosterone of NMS (but not control) male rats. Given that these effects of NMS are not observed in females, we tested the hypothesis that testosterone elevation is necessary for the stress-related increase of the HVR in adult male rats. Pups subjected to NMS were placed in an incubator for 3 h per day from postnatal day 3 to 12. Control pups remained undisturbed. Rats were reared until adulthood, and the HVR was measured by plethysmography (fractional inspired O2 = 0.12, for 20 min). We used gonadectomy to evaluate the effects of reducing testosterone on the HVR. Gonadectomy had no effect on the HVR of control animals but reduced that of NMS animals below control levels. Immunohistochemistry was used to quantify androgen receptors in brainstem areas involved in the HVR. Androgen receptor expression was generally greater in NMS rats than in control rats; the most significant increase was noted in the caudal region of the nucleus tractus solitarii. We conclude that the abnormal regulation of testosterone is important in stress-related augmentation of the HVR. The greater number of androgen receptors within the brainstem may explain why NMS rats are more sensitive to testosterone withdrawal. Based on the similarities of the cardiorespiratory phenotype of NMS rats and patients suffering from sleep-disordered breathing, these results provide new insight into its pathophysiology, especially sex-based differences in its prevalence. © 2014 The Authors. Experimental Physiology © 2014 The Physiological Society.

  20. Chronic intermittent hyperoxia alters the development of the hypoxic ventilatory response in neonatal rats.

    Science.gov (United States)

    Logan, Sarah; Tobin, Kristina E; Fallon, Sarah C; Deng, Kevin S; McDonough, Amy B; Bavis, Ryan W

    2016-01-01

    Chronic exposure to sustained hyperoxia alters the development of the respiratory control system, but the respiratory effects of chronic intermittent hyperoxia have rarely been investigated. We exposed newborn rats to short, repeated bouts of 30% O2 or 60% O2 (5 bouts h(-1)) for 4-15 days and then assessed their hypoxic ventilatory response (HVR; 10 min at 12% O2) by plethysmography. The HVR tended to be enhanced by intermittent hyperoxia at P4 (early phase of the HVR), but it was significantly reduced at P14-15 (primarily late phase of the HVR) compared to age-matched controls; the HVR recovered when individuals were returned to room air and re-studied as adults. To investigate the role of carotid body function in this plasticity, single-unit carotid chemoafferent activity was recorded in vitro. Intermittent hyperoxia tended to decrease spontaneous action potential frequency under normoxic conditions but, contrary to expectations, hypoxic responses were only reduced at P4 (not at P14) and only in rats exposed to higher O2 levels (i.e., intermittent 60% O2). Rats exposed to intermittent hyperoxia had smaller carotid bodies, and this morphological change may contribute to the blunted HVR. In contrast to rats exposed to intermittent hyperoxia beginning at birth, two weeks of intermittent 60% O2 had no effect on the HVR or carotid body size of rats exposed beginning at P28; therefore, intermittent hyperoxia-induced respiratory plasticity appears to be unique to development. Although both intermittent and sustained hyperoxia alter carotid body development and the HVR of rats, the specific effects and time course of this plasticity differs. Copyright © 2015 Elsevier B.V. All rights reserved.

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

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    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.

  2. VO2max, ventilatory and anaerobic thresholds in rhythmic gymnasts and young female dancers.

    Science.gov (United States)

    Baldari, C; Guidetti, L

    2001-06-01

    This study examines the fitness level of a rhythmic gymnasts group and a young female classical dancers group. Aerobic power (VO2max), individual ventilatory (IVT) and anaerobic thresholds (IAT) were assessed in 12 elite rhythmic gymnasts, eight elite ballet dancers and 12 sedentary female subjects in the same age range (13-16 yrs). The VO2max, IVT and IAT were assessed during a continuous incremental running treadmill test. At IVT and IAT the VO2max expressed in ml x kg(-1) x min(-1) was significantly different between the three groups of subjects. The highest values were found in gymnasts (30.8+/-2.6 for IVT and 43.8+/-3.5 for IAT) followed by the values of dancers (21.7+/-2.8 for IVT and 30.5+/-3.1 for IAT) and controls (15.6+/-2.0 for IVT and 20.6+/-1.7 for IAT). When the VO2max was expressed in percent of VO2max, the values at IAT were significantly different between all groups (gymnasts: 84.9+/-0.7; dancers: 64.0+/-4.1; controls: 59.7+/-2.4) while at IVT no difference was found between dancers and controls (45.6+/-4.1 and 45.2+/-16, respectively). At maximal effort VO2 was significantly higher both in gymnasts and dancers (51.7+/-4.4 and 47.5+/-3.0 ml x kg(-1) x min(-1), respectively), than in controls (34.5+/-2.5 ml x kg(-1) x min(-1)). Although VO2max was similar between gymnasts and dancers, VO2 values at NT and IAT were able to discriminate the higher level of fitness in gymnasts with respect to dancers.

  3. Ventilatory threshold during incremental running can be estimated using EMG shorts.

    Science.gov (United States)

    Tikkanen, Olli; Hu, Min; Vilavuo, Toivo; Tolvanen, Pekka; Cheng, Sulin; Finni, Taija

    2012-04-01

    The present study examined whether shorts with textile electromyographic (EMG) electrodes can be used to detect second ventilatory threshold (V(T2)) during incremental treadmill running. Thirteen recreationally active (REC) and eight endurance athletes were measured for EMG, heart rate, blood lactate and respiratory gases during VO(2max) test (3 min ramps, 1 km·h(-1) increments). V(T)(2), onset of blood lactate accumulation (OBLA) and EMG threshold (EMG(T)) were determined. In athletes, OBLA occurred at 56 ± 6 mL·kg(-1)·min(-1), V(T2) occurred at 59 ± 6 mL·kg(-1)·min(-1), and EMG(T) at 62 ± 6 mL·kg(-1)·min(-1) without significant differences between methods (analysis of variance: ANOVA). In REC participants, OBLA occurred at 40 ± 10 mL·kg(-1)·min(-1), V(T2) occurred at 43 ± 7 mL·kg(-1)·min(-1), and EMG(T) at 41 ± 9 mL·kg(-1)·min(-1) without significant differences between methods (ANOVA). For the entire group, correlation between EMG(T) and V(T2) was 0.86 (P < 0.001) and 0.84 (P < 0.001) between EMG(T) and OBLA. Limits of agreement between EMG(T) and V(T2) were narrower in athletes than in REC participants. Thus, it is concluded that estimation of V(T2) using EMG(T) in athletes is more valid than in REC participants. In practice, experienced runners could use online feedback from EMG garments to monitor whether their running intensity is near V(T2). © 2012 Institute of Physics and Engineering in Medicine

  4. Respiratory symptoms and ventilatory functions among quarry workers in Edo state, Nigeria.

    Science.gov (United States)

    Isara, Alphonsus Rukevwe; Adam, Vincent Yakubu; Aigbokhaode, Adesuwa Queen; Alenoghena, Innocent Osi

    2016-01-01

    Workers in the quarry industries are exposed to hazards resulting from the inhalation of air borne particulates. The study determined the prevalence of respiratory symptoms and assessed ventilatory functions among quarry workers in Edo state, Nigeria. Quarry workers (site workers and office workers) were interviewed using structured questionnaire. FEV1, FVC, FEV1/FVC and PEFR were measured using a KoKo Legend spirometer. A total of 113 quarry workers (76 exposure and 37 controls) were studied. The exposure group had significantly higher occurrence of chest tightness (35.5%) compared with 16.2% of the controls (p < 0.05). The occurrence of cough (23.7% versus 13.5%), sputum (21.1% versus 16.2%), and dyspnoea (7.9% versus 5.4%), were higher in exposure groups while wheeze (10.8% versus 10.5%) and nasal congestion (27.0% and 25.0%) were higher in the control groups. The mean (SD) FEV1, and FVC were significantly lower among the exposure compared with the control group; 2.77L (0.73) versus 3.14L (0.78), p < 0.05, and 3.48L (0.84) versus 3.89L (0.92), p < 0.05. In both groups, smokers had significantly lower mean (SD) FEV1, FVC and PEFR compared with non-smokers; 2.91L (0.77) versus 3.39L (0.69), p = 0.01, 3.61L (0.91) versus 4.26L (0.74), p < 0.05 and 6.56L (2.43) versus 7.98L (1.67), p < 0.05. Chronic exposure to quarry dust is associated with respiratory symptoms and reduced lung function indices among quarry workers. The enforcement of the use of PPEs and periodic evaluation the lung function status of quarry workers is advocated.

  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

    ABSTRACT Objective: 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). Methods: 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. Results: 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. Conclusions: 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. PMID:28538774

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

    Directory of Open Access Journals (Sweden)

    Suzy Maria Montenegro Pontes

    Full Text Available ABSTRACT Objective: 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. Methods: 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. Results: 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. Conclusions: 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.

  7. 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.

  8. A Simplified Approach for Estimating the Ventilatory and Respiratory Compensation Thresholds

    Directory of Open Access Journals (Sweden)

    Giancarlo Condello

    2014-06-01

    Full Text Available This study aimed to investigate whether ventilatory (VT and respiratory compensation (RCT thresholds could be derived from percentages of maximal running speed (Vmax. During the model building phase (1, VT & RCT of 31 competitive level athletes were identified with respiratory gas exchange. During the cross-validation phase (2, 20 subjects performed a treadmill test to identify Vmax and then they performed 30-min runs at velocities 2SE below or above the velocity at VT and RCT derived from (1, with measurement of blood lactate [BL], RPE, heart rate (HR, and speech comfort. Phase (1 revealed that VT and RCT were reached at 67 ± 9% and 84 ± 6% of Vmax. In (2 sustained running 2SE below VT (64% Vmax was associated with the ability to finish 30-min, with low and constant [BL] (~2.5 mmol.l-1, moderate RPE (~3.0-3.5, a small HR drift, and ability to speak comfortably. Conversely, running at 2SE above RCT (86% Vmax was associated with the inability to finish 30-min (18.5 ± 2.5 min to fatigue, increasing [BL] (end-exercise = 11.9 ± 0.9 mmol.l-1, high RPE (end-exercise = 8.9 ± 1.0, large HR drift (end-exercise = 98 ± 3% HRmax, and inability to speak comfortably. Simple percentages of Vmax (≤64% and ≥86% obtained from a treadmill test without gas exchange, may be useful for prescribing exercise training intensities.

  9. Circulatory and Ventilatory Power: Characterization in Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Viviane Castello-Simões

    2015-06-01

    Full Text Available Background: Circulatory power (CP and ventilatory power (VP are indices that have been used for the clinical evaluation of patients with heart failure; however, no study has evaluated these indices in patients with coronary artery disease (CAD without heart failure. Objective: To characterize both indices in patients with CAD compared with healthy controls. Methods: Eighty-seven men [CAD group = 42 subjects and healthy control group (CG = 45 subjects] aged 40–65 years were included. Cardiopulmonary exercise testing was performed on a treadmill and the following parameters were measured: 1 peak oxygen consumption (VO2, 2 peak heart rate (HR, 3 peak blood pressure (BP, 4 peak rate-pressure product (peak systolic HR x peak BP, 5 peak oxygen pulse (peak VO2/peak HR, 6 oxygen uptake efficiency (OUES, 7 carbon dioxide production efficiency (minute ventilation/carbon dioxide production slope, 8 CP (peak VO2 x peak systolic BP and 9 VP (peak systolic BP/carbon dioxide production efficiency. Results: The CAD group had significantly lower values for peak VO2 (p < 0.001, peak HR (p < 0.001, peak systolic BP (p < 0.001, peak rate-pressure product (p < 0.001, peak oxygen pulse (p = 0.008, OUES (p < 0.001, CP (p < 0.001, and VP (p < 0.001 and significantly higher values for peak diastolic BP (p = 0.004 and carbon dioxide production efficiency (p < 0.001 compared with CG. Stepwise regression analysis showed that CP was influenced by group (R2 = 0.44, p < 0.001 and VP was influenced by both group and number of vessels with stenosis after treatment (interaction effects: R2 = 0.46, p < 0.001. Conclusion: The indices CP and VP were lower in men with CAD than healthy controls.

  10. Comparison of ventilatory efficacy and airway dynamics between ProSeal laryngeal mask airway and endotracheal tube in adult patients during general anesthesia

    Directory of Open Access Journals (Sweden)

    Sudheesh Kannan

    2015-01-01

    Full Text Available Background and Aims: Studies have demonstrated minimal hemodynamic variation and postoperative complications with ProSeal laryngeal mask airway (PLMA compared to endotracheal tube (ETT. Hence, a study was conducted to compare the ventilatory parameters and airway dynamics required to maintain normocarbia and stable hemodynamics with PLMA and ETT. Material and Methods: A prospective, randomized, single blinded study was conducted on 60 patients aged 20-40 years of American society of anesthesiologists class I and II, divided into Group PLMA and Group ETT. Standard anesthesia protocol was instituted. Group PLMA received PLMA sizes as per manufacturer′s recommendations and group ETT received appropriate sized cuffed ETT. Patients were initially ventilated at 14 bpm, I:E ratio 1:2, tidal volume (Vt 6 ml/kg and later adjusted to maintain end tidal carbon dioxide (EtCO 2 between 35 and 40 mmHg. Peak airway pressure (Ppeak, compliance (Compl., Vt, airway resistance (R aw , hemodynamic parameters, oxygen saturation (SpO 2 and EtCO 2 were recorded throughout surgery. Postoperative complications if any, were noted. Results: Demographic parameters, R aw , EtCO 2 , SpO 2 were comparable between groups. Ppeak was lower and Vt needed to maintain EtCO 2 of 35-40 mmHg was lesser in Group PLMA. Compl was low for 5 min after insertion of PLMA. Heart rate was significantly reduced at 1 min post insertion; blood pressures were significantly lower upto 2 min after insertion and post removal in group PLMA. Incidence of cough was significantly lower in group PLMA. Conclusion: ProSeal laryngeal mask airway maintains adequate ventilation at lower Vts and minimal peak pressures, has lesser hemodynamic variations and lower incidence of postoperative cough compared to ETT.

  11. Adjustable continence balloons

    DEFF Research Database (Denmark)

    Kjær, Line; Fode, Mikkel; Nørgaard, Nis

    2012-01-01

    . Fourteen patients (12%) ended up with an artificial sphincter or a urethral sling. Sixty patients (63%) experienced no discomfort and 58 (61%) reported being dry or markedly improved. Overall, 50 patients (53%) reported being very or predominantly satisfied. Conclusions. Adjustable continence balloons seem...

  12. 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 direc...

  13. 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…

  14. 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 ...

  15. Assisted Living

    Science.gov (United States)

    Assisted living is for adults who need help with everyday tasks. They may need help with dressing, bathing, ... don't need full-time nursing care. Some assisted living facilities are part of retirement communities. Others are ...

  16. Serotonergic neurons in the nucleus raphé obscurus are not involved in the ventilatory and thermoregulatory responses to hypoxia in adult rats.

    Science.gov (United States)

    da Silva, Glauber S F; Giusti, Humberto; Castro, Olagide W; Garcia-Cairasco, Norberto; Gargaglioni, Luciane H; Branco, Luiz G S; Glass, Mogens L

    2013-06-15

    The medullary raphé is an important component of the central respiratory network, playing a key role in CO2 central chemoreception. However, its participation in hypoxic ventilatory responses is less understood. In the present study, we assessed the role of nucleus raphé obscurus (ROb), and specifically 5-HT neurons confined in the ROb, on ventilatory and thermoregulatory responses to hypoxia. Chemical lesions of the ROb were performed using either ibotenic acid (non-specific lesion; control animals received PBS) or anti-SERT-SAP (5-HT specific lesion; control animals received IgG-SAP). Ventilation (V˙E; whole body plethysmograph) and body temperature (Tb; data loggers) were measured during normoxia (21% O2, N2 balance) and hypoxia exposure (7% O2, N2 balance, 1h) in conscious adult rats. Ibotenic acid or anti-SERT-SAP-induced lesions did not affect baseline values of V˙E and Tb. Similarly, both lesion procedures did not alter the ventilatory or thermoregulatory responses to hypoxia. Although evidence in the literature suggests a role of the rostral medullary raphé in hypoxic ventilatory responses, under the present experimental conditions our data indicate that caudal medullary raphé (ROb) and its 5-HT neurons neither participate in the tonic maintenance of breathing nor in the ventilatory and thermal responses to hypoxia. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Assisted Living

    Science.gov (United States)

    ... it, too. Back to top What is the Cost for Assisted Living? Although assisted living costs less than nursing home ... Primarily, older persons or their families pay the cost of assisted living. Some health and long-term care insurance policies ...

  18. Accounts Assistant

    Indian Academy of Sciences (India)

    CHITRA

    (Not more than three months old). Annexure 1. Indian Academy of Sciences. C V Raman Avenue, Bengaluru 560 080. Application for the Post of: Accounts Assistant / Administrative Assistant Trainee / Assistant – Official Language. Implementation Policy / Temporary Copy Editor and Proof Reader / Social Media Manager. 1.

  19. Sleep-disordered breathing with nighttime hypocapnia relates to daytime enhanced ventilatory response to exercise in patients with heart disease.

    Science.gov (United States)

    Fukuma, Nagaharu; Hayashi, Hiroko; Sugaya, Juri; Aida, Tomohiro; Kato, Masatoshi; Kato, Kazuyo; Kato, Yuko; Takahashi, Hiroshi; Mizuno, Kyoichi

    2012-01-01

    Sleep-disordered breathing (SDB) induces nighttime disturbance of arterial gases, such as carbon dioxide. However, it is still unclear whether nighttime SDB-related gas abnormality is related to respiratory dysregulation in daytime. Therefore, we examined the relationship between the arterial partial pressure of carbon dioxide (PaCO(2)) at nighttime and the respiratory response to exercise in daytime. Eighteen men (age, mean ± SD; 55 ± 11 years) with heart disease underwent multichannel respiratory monitoring through the night with transdermal measurement of PaCO(2) (PtcCO(2)) reflecting PaCO(2) and a cardiopulmonary exercise test in daytime. The ventilatory equivalent (VE)/carbon dioxide production (VCO(2)) slope as an index of ventilatory response to exercise and peak oxygen consumption (VO(2)) were obtained with a cardiopulmonary exercise test. Of the 18 patients, 10 patients had obstructive SDB, 5 had central SDB, and 3 patients did not have SDB. The mean apnea-hypopnea index was 21 ± 17. Minimum nighttime saturation of O(2) was positively correlated with peak VO(2), but not with VE/VCO(2). Nighttime PtcCO(2) was not correlated with peak VO(2) but was negatively correlated with the VE/VCO(2) slope of the daytime cardiopulmonary exercise test (r=-0.53). Nighttime lowering of PaCO(2) in SDB is related to an abnormal ventilatory response to exercise testing in the daytime. This finding suggests that nighttime hyperventilation in SDB alters both nighttime and daytime pathophysiological conditions in patients with heart disease.

  20. Breathing pattern and ventilatory chemosensitivity of the 1-day old Muscovy duck (Cairina moschata) in relation to its metabolic demands.

    Science.gov (United States)

    Mortola, Jacopo P; Toro-Velasquez, Paula Andrea

    2014-01-01

    Adult birds have a ventilatory equivalent (pulmonary ventilation-oxygen consumption ratio, V˙ E/ [Formula: see text] ) lower than mammals because of the superior gas exchange efficiency of their respiratory apparatus. In particular, adult Muscovy ducks (Cairina moschata) have been reported to have an extraordinary low ventilatory equivalent (~14mL STPD·mL BTPS(-1)). We asked if similar high efficiency was already apparent in duck hatchlings. Breathing pattern and V˙E were measured by the barometric technique and [Formula: see text] by an open-flow methodology in 1-day old Muscovy duck hatchlings (N=21); same measurements were performed on chicken hatchlings (N=21) for purpose of comparison. During air breathing V˙E/ [Formula: see text] was slightly, yet significantly, lower in ducklings (20.8) than in chicks (25.3), mostly because of a lower breathing frequency (f). The hatchlings of both species (N=14 per group) responded to inspired hypoxia (15 or 10% O2) or hypercapnia (2 or 4% CO2) with a clear hyperventilation; however, in ducklings the hypercapnic hyperventilation was smaller than in chicks because of a smaller increase in tidal volume and lower f. We conclude that duck and chicken hatchlings just a few hours old have the high ventilatory efficiency typical of birds, although possibly not as high as their adults. The low f and blunted V˙E response to hypercapnia of the newborn duck could be related to the aquatic habitat of the species. In such a case, it would mean that these characteristics are genetic traits, the phenotypic expression of which does not require diving experience. © 2013.

  1. 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 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.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.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.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.

  2. Influence of estrous cycle hormonal fluctuations and gonadal hormones on the ventilatory response to hypoxia in female rats.

    Science.gov (United States)

    Marques, Danuzia A; de Carvalho, Débora; da Silva, Glauber S F; Szawka, Raphael E; Anselmo-Franci, Janete A; Bícego, Kênia C; Gargaglioni, Luciane H

    2017-10-01

    Sex hormones may influence many physiological processes. Recently, we demonstrated that hormonal fluctuations of cycling female rats do not affect respiratory parameters during hypercapnia. However, it is still unclear whether sex hormones and hormonal fluctuations that occur during the estrous cycle can affect breathing during a hypoxic challenge. Our study aimed to evaluate respiratory, metabolic, and thermal responses to hypoxia in female rats on different days of the estrous cycle (proestrus, estrus, metestrus, and diestrus) and in ovariectomized rats that received replacement with oil (OVX), estradiol (OVX + E 2 ), or a combination of estradiol and progesterone (OVX + E 2 P). Ventilation (V E ), tidal volume (V T ), respiratory frequency (fR), oxygen consumption (VO 2 ), and V E /VO 2 were not different during the estrous cycle in normoxia or hypoxia. Body temperature (Tb) was higher during estrus, but decreased similarly in all groups during hypoxia. Compared with intact females in estrus, gonadectomized rats also had lower Tb in normoxia, but not in hypoxia. OVX rats experienced a significant drop in the ventilatory response to hypoxia, but hormonal replacement did not restore values to the levels of an intact animal. Our data demonstrate that the different phases of the estrous cycle do not alter ventilation during normoxia and hypoxia, but OVX animals display lower ventilatory responses to hypoxia compared with ovary-intact rats. Because estradiol and progesterone replacement did not cause significant differences in ventilation, our findings suggest that a yet-to-be-defined non-steroidal ovarian hormone is likely to stimulate the ventilatory responses to hypoxia in females.

  3. 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

  4. Ventilatory-perfusory pulmonary scintigraphy as non invasive election procedure in patients with clinical suspicion of pulmonary thrombo emboli

    International Nuclear Information System (INIS)

    Altamirano L, J.

    2004-01-01

    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 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 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)

  5. Impaired Ventilatory and Thermoregulatory Responses to Hypoxic Stress in Newborn Phox2b Heterozygous Knock-Out Mice

    OpenAIRE

    Ramanantsoa, Nelina; Matrot, Boris; Vardon, Guy; Lajard, Anne-Marie; Voituron, Nicolas; Dauger, Stéphane; Denjean, André; Hilaire, Gérard; Gallego, Jorge

    2011-01-01

    The Phox2b genesis 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...

  6. Automatic temperature adjustment apparatus

    Science.gov (United States)

    Chaplin, James E.

    1985-01-01

    An apparatus for increasing the efficiency of a conventional central space heating system is disclosed. The temperature of a fluid heating medium is adjusted based on a measurement of the external temperature, and a system parameter. The system parameter is periodically modified based on a closed loop process that monitors the operation of the heating system. This closed loop process provides a heating medium temperature value that is very near the optimum for energy efficiency.

  7. 78 FR 24236 - Notice of Availability of Funds and Solicitation for Grant Applications for Trade Adjustment...

    Science.gov (United States)

    2013-04-24

    ... benefit from the TAACCCT program once education and training programs are developed and implemented. The... Solicitation for Grant Applications for Trade Adjustment Assistance Community College and Career Training... Trade Adjustment Assistance Community College and Career Training (TAACCCT) grant program. The TAACCCT...

  8. 75 FR 51978 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-24

    ... 3 tilapia producers on behalf of tilapia producers in Arkansas. The Administrator will determine within 40 days whether increasing imports of tilapia contributed importantly to a greater than 15-percent decrease in the average annual price of tilapia, quantity of production, value of production, or cash...

  9. 75 FR 11513 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-03-11

    ... national average price, or quantity of production, or value of production, or cash receipts for the... petition is completed in accordance with 7 CFR part 1580.201, a notice of acceptance of the petition will... contributed importantly to a greater than 15 percent decrease in the national average price, or quantity of...

  10. 75 FR 28780 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-05-24

    ... contributed importantly to a greater than 15 percent decrease in the national average price, or quantity of... notice of acceptance will be published in the Federal Register, initiating a review to verify whether or... contributed importantly to a greater than 15 percent decrease in the national average price, or quantity of...

  11. 75 FR 9087 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-03-01

    ... marketing year for which data are available and the three preceding marketing years. FAS will first review... training must be at least 16 hours so that important information is covered that helps producers make the... was filed, compared to the county price for the 3 preceding marketing years. The interim rule...

  12. 75 FR 49458 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-13

    ... the Fiscal Year 2011 program by the Wild Blueberry Commission of Maine on behalf of blueberry... blueberries contributed importantly to a greater than 15-percent decrease in the average annual price of blueberries compared to the average of the three preceding marketing years. If a determination is affirmative...

  13. 75 FR 42376 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-21

    ..., or production value of coffee compared to the average of the 3 preceding marketing years. If the... the FY 2011 Program by 100% 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...

  14. 75 FR 23667 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-05-04

    ... Agricultural Cooperative Marketing Association on behalf of apple producers in Michigan. A public hearing to... AGENCY: Foreign Agricultural Service, USDA. ACTION: Notice of public hearings. The Administrator today... determine within 40 days whether or not increasing imports of apple juice contributed to a greater than 15...

  15. 75 FR 41434 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE... petitions must demonstrate, using data for the most recent, full marketing year or official marketing season... competitive, during the same marketing period, contributed importantly to the decrease in one of the above...

  16. 75 FR 41430 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE... that petitions must demonstrate, using data for the most recent, full marketing year or full official marketing season, a greater than 15- percent decline in at least one of the following factors: national...

  17. 75 FR 41433 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE... petitions must demonstrate, using data for the most recent, full marketing year or full official marketing... competitive, during the same marketing period, contributed importantly to the decrease in one of the above...

  18. 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 treatment groups (p = 0.002). In the control group, we recovered 1.35% ± 1.24% of the instilled microspheres per gram of tracheal secretions, whereas 0.22% ± 0.25% and 0.97% ± 1.44% were recovered in the treatment and Trendelenburg groups, respectively (p = 0.031). Ventilator-associated pneumonia developed in 66.67%, 85.71%, and 0% of the animals in the control, treatment, and Trendelenburg groups (p pneumonia. These findings further substantiate the primary role of gravity in the pathogenesis of

  19. Relationship between the talk test and ventilatory thresholds in well-trained cyclists.

    Science.gov (United States)

    Rodríguez-Marroyo, Jose A; Villa, José G; García-López, Juan; Foster, Carl

    2013-07-01

    The aim of this study was to extend the range of populations where the Talk Test (TT) might be used as a marker of physiologic thresholds. Eighteen highly trained cyclists underwent 2 incremental tests. One test included measurement of respiratory gas exchange to determine the ventilatory (VT) and respiratory compensation thresholds (RCTs). On a separate day, a TT was performed using the same exercise protocol. During TT, subjects read a standard paragraph at the end of each stage. The first stage at which the cyclists could not talk comfortably and could definitely not talk were referred to as the equivocal (EQ) and the negative stages (NEG), respectively. There were no significant differences in workload, heart rate, lactate, and rating of perceived exertion between VT (3.7 ± 0.4 W kg, 150 ± 10 b min, 1.6 ± 0.3 mm L, and 4.1 ± 1.4, respectively) vs. EQ (3.6 ± 0.4 W kg, 148 ± 12 b min, 1.3 ± 0.5 mm L, and 3.8 ± 1.2, respectively) and RCT (5.3 ± 0.4 W kg, 177 ± 7 b min, 4.0 ± 0.9 mm L, and 7.2 ± 1.0, respectively) vs. NEG (5.3 ± 0.5 W kg, 176 ± 10 b min, 4.2 ± 1.3 mm L, and 6.8 ± 1.5, respectively). We found significant relationships (p < 0.01) between VT and EQ and RCT and NEG for workload (r = 0.86 and 0.94, respectively), heart rate (r = 0.79 and 0.92, respectively), and rating of perceived exertion (r = 0.79 and 0.88, respectively). In conclusion, the present study showed that the EQ and NEG stages of TT can be used as a simple and practical surrogate of the VT and RCT in highly trained cyclists.

  20. Convexity Adjustments for ATS Models

    DEFF Research Database (Denmark)

    Murgoci, Agatha; Gaspar, Raquel M.

    . 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...

  1. Downhole adjustable bent assemblies

    International Nuclear Information System (INIS)

    Askew, W.E.

    1992-01-01

    This patent describes downhole adjustable apparatus for creating a bend angle in order to affect the inclination of a drilled borehole. It comprises an upper tubular member having an upper portion and a lower portion; lower tubular member having an upper portion and a lower portion; one of the portions being received within the other for relative rotational movement about an axis that is inclined with respect to the the longitudinal axes of the members, whereby in a first rotational position the longitudinal axes have one geometrical relationship, and in a second rotational position the longitudinal axes have a second, different geometrical relationship

  2. Primary length standard adjustment

    Science.gov (United States)

    Ševčík, Robert; Guttenová, Jana

    2007-04-01

    This paper deals with problems and techniques connected with primary length standard adjusting, which includes disassembling of the device and by use of the secondary laser with collimated beam and diffraction laws successively reassembling of the laser. In the reassembling process the device was enhanced with substituting the thermal grease cooling of cold finger by copper socket cooler. This improved external cooling system enables more effective cooling of molecular iodine in the cell, which allows better pressure stability of iodine vapor and easier readjustment of the system.

  3. Impaired Ventilatory and Thermoregulatory Responses to Hypoxic Stress in Newborn Phox2b Heterozygous Knock-Out Mice

    Science.gov (United States)

    Ramanantsoa, Nelina; Matrot, Boris; Vardon, Guy; Lajard, Anne-Marie; Voituron, Nicolas; Dauger, Stéphane; Denjean, André; Hilaire, Gérard; Gallego, Jorge

    2011-01-01

    The Phox2b genesis 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. PMID:21977017

  4. Chronic hypoxia modulates NMDA-mediated regulation of the hypoxic ventilatory response in an amphibian, Bufo marinus.

    Science.gov (United States)

    McAneney, Jessica; Gheshmy, Afshan; Uthayalingam, Sarangan; Reid, Stephen G

    2006-08-01

    This study examined whether a hypoxia-tolerant amphibian, the Cane toad, undergoes mammalian-like ventilatory acclimatisation to hypoxia (VAH) and whether chronic hypoxia (CH) alters NMDA-mediated regulation of the acute hypoxic ventilatory response (HVR). Toads were exposed to 10 days of CH (10% O2) followed by acute hypoxic breathing trials or an intra-arterial injection of NaCN. Trials were conducted before and after i.p. treatment with an NMDA-receptor channel blocker (MK801). CH blunted the acute HVR but did not alter resting breathing. MK801 did not alter resting ventilation. In control animals, MK801 augmented breathing frequency (fR) during acute hypoxia by increasing the number of breaths per episode. This effect was attenuated following CH although MK801 did enhance the number of episodes per minute during acute hypoxia. MK801 enhanced the fR response to NaCN in both groups. The results indicate that CH did not produce mammalian-like VAH (i.e. increased resting ventilation and an augmented acute HVR) but did alter MK801-sensitive regulation of breathing pattern and the acute HVR.

  5. Ventilatory responses of children to changes in deadspace volume. Studies using the T-piece (Mapleson F) system.

    Science.gov (United States)

    Charlton, A J; Lindahl, S G; Hatch, D J

    1985-06-01

    Twelve patients (4.3-25.3 kg) undergoing minor surgical procedures were investigated during halothane anaesthesia with spontaneous breathing through a modified T-piece (Mapleson F) with an apparatus deadspace that could be changed from 2 ml (VDsmall) to 16 ml (VDlarge). Immediately following the switch from VDsmall to Vlarge ETCO2 (mean +/- 1 SD) increased from 6.89 +/- 1.09% to 7.61 +/- 1.14% (ns) then gradually decreased during a 10-min period. The initial plateau of FlCO2 (mean +/- 1 SD) with VDlarge was 0.74 +/- 0.34%, but gradually decreased to 0.63 +/- 0.25% after 10 min. This was achieved by an increase in VE (P less than 0.05 by 2 min). After 10 min VE had increased by more than 40% (P less than 0.01) as a result of an increase in VT (mean +/- 1 SD) of 14.6 +/- 6.5 ml. After 10 min of VDlarge ventilation, VA and VCO2 were maintained at VDsmall values. The adequate ventilatory response to the large deadspace was seen in all patients, but the ventilatory efficiency, as judged by VD/VT and VENCO2 ratios, was reduced significantly in the children weighing less than 10 kg.

  6. Mechanical ventilation with heated humidifiers: measurements of condensed water mass within the breathing circuit according to ventilatory settings

    International Nuclear Information System (INIS)

    Schena, E; Saccomandi, P; Cappelli, S; Silvestri, S

    2013-01-01

    Heated wire humidifiers (HWHs) are widely used to heat and humidify gases during mechanical ventilation. The control strategy implemented on commercial HWHs, based on maintaining constant gas temperature at the chamber outlet, shows weaknesses: humidifying performances depend on environmental temperature and ventilatory settings, and often condensation occurs. Herein, we analyzed in vitro HWH performances focusing on the condensation amount according to ventilatory settings. We used a physical model to define the parameters which mainly influence the HWH performances. In order to investigate the influence of minute volume (MV) and frequency rate (f r ) on condensation, the other influencing parameters were kept constant during experiments, and we introduced a novel approach to estimate the condensation. The method, based on measuring the condensed vapor mass (Δm), provided more objective information than the visual-based scale used in previous studies. Thanks to both the control of other influencing factors and the accurate Δm measures, the investigation showed the Δm increase with MV and f r . Substantial condensation after 7 h of ventilation and the influence of MV and f r on Δm (i.e., Δm = 3 g at MV = 1.5 L min −1 and f r = 8 bpm and Δm = 9.4 g at MV = 8 L min −1 and f r = 20 bpm) confirm the weaknesses of 'single-point temperature' control strategies. (paper)

  7. Glittre-ADL Multiple Tasks Induce Similar Dynamic Hyperinflation With Different Metabolic and Ventilatory Demands in Patients With COPD.

    Science.gov (United States)

    Gulart, Aline Almeida; Munari, Anelise Bauer; Tressoldi, Caroline; Dos Santos, Karoliny; Karloh, Manuela; Mayer, Anamaria Fleig

    2017-11-01

    This cross-sectional study compared the physiological responses and dynamic hyperinflation (DH) of the Glittre-ADL test (TGlittre) and its specific tasks in patients with chronic obstructive pulmonary disease (COPD). Thirty patients with COPD performed the TGlittre. The individual tasks included stand up and sit down (TSS); climb up and down stairs (TSTAIRS); walk on a flat surface (TWALK); and move objects onto and off a shelf (TSHELF). While performing these tasks, the physiological responses were evaluated and inspiratory capacity measured before and immediately after the tests. All physiological variables and inspiratory capacity were different at the end of the TGlittre and its tasks compared with baseline (P .05), which were the tasks with the greatest physiological requirement, whereas the TSS represented the lowest metabolic, cardiovascular, and ventilatory demands among TGlittre's tasks. DH did not differ significantly among TGlittre's tasks. TWALK and TSHELF were the tasks that resulted in greater physiological overload, whereas TSS induced the lowest metabolic and ventilatory demands. Despite this, DH did not differ among the TGlittre's tasks in patients with COPD.

  8. Description of Peripheral Muscle Strength Measurement and Correlates of Muscle Weakness in Patients Receiving Prolonged Mechanical Ventilatory Support

    Science.gov (United States)

    Chlan, Linda L.; Tracy, Mary Fran; Guttormson, Jill; Savik, Kay

    2015-01-01

    Background Intensive Care Unit Acquired Weakness (ICUAW) is a frequent complication of critical illness due to immobility and prolonged mechanical ventilatory support. Objectives To describe daily peripheral muscle strength measurement in ventilated patients and explore relationships among factors that influence ICUAW. Methods Peripheral muscle strength of 120 ventilated ICU patients (mean age 59.8 ± 15.1; 51% female; APACHE III 61.3 ± 20.7; ICU stay 10.6 ± 8.6 days) was measured daily using a standardized hand grip dynamometry protocol. Three grip measurements for each hand were recorded in pounds-force; the mean of these three assessments was used in the analysis. Correlates of ICUAW were analyzed with mixed models to explore their relationship to grip strength (age, gender, illness severity, length of ventilatory support, medications). Results Median baseline grip strength was variable yet diminished (7.7; 0-102) with either a pattern of diminishing grip strength or maintenance of the baseline low grip strength over time. Controlling for days on protocol, female gender [β = −10.4(2.5); p = dynamometry, a marker for peripheral muscle strength. Hand dynamometry is a reliable method to measure muscle strength in cooperative ICU patients and can be used in future research to ultimately develop interventions to prevent ICUAW. PMID:26523017

  9. Adjustment disorder: current perspectives

    Directory of Open Access Journals (Sweden)

    Zelviene P

    2018-01-01

    Full Text Available Paulina Zelviene, Evaldas Kazlauskas Department of Clinical and Organizational Psychology, Vilnius University, Vilnius, Lithuania Abstract: Adjustment disorder (AjD is among the most often diagnosed mental disorders in clinical practice. This paper reviews current status of AjD research and discusses scientific and clinical issues associated with AjD. AjD has been included in diagnostic classifications for over 50 years. Still, the diagnostic criteria for AjD remain vague and cause difficulties to mental health professionals. Controversies in definition resulted in the lack of reliable and valid measures of AjD. Epidemiological data on prevalence of AjD is scarce and not reliable because prevalence data are biased by the diagnostic algorithm, which is usually developed for each study, as no established diagnostic standards for AjD are available. Considerable changes in the field of AjD could follow after the release of the 11th edition of International Classification of Diseases (ICD-11. A new AjD symptom profile was introduced in ICD-11 with 2 main symptoms as follows: 1 preoccupation and 2 failure to adapt. However, differences between the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and ICD-11 AjD diagnostic criteria could result in diverse research findings in the future. The best treatment approach for AjD remains unclear, and further treatment studies are needed to provide AjD treatment guidelines to clinicians. Keywords: adjustment disorder, review, diagnosis, prevalence, treatment, DSM, ICD

  10. 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.

  11. 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.

  12. 24 CFR 982.519 - Regular tenancy: Annual adjustment of rent to owner.

    Science.gov (United States)

    2010-04-01

    ..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SECTION 8 TENANT BASED ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM Rent and Housing Assistance Payment § 982.519 Regular tenancy: Annual adjustment of rent to owner. (a... rent to owner will only be increased for housing assistance payments covering months commencing on the...

  13. 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......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......) that vanishes for observables commuting with the state. We show that the skew information is a convex function on the manifold of states. It also satisfies other requirements, proposed by Wigner and Yanase, for an effective measure-of-information content of a state relative to a conserved observable. We...

  14. Adjusting to the Emergent

    DEFF Research Database (Denmark)

    Revsbæk, Line

    In her doctoral thesis Line Revsbæk 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...... 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......’ of newcomers enacting the organizational emergent. The study throws light on the informal socialization in work-related interactions between newcomers and veterans and reveals professional relational histories, as well as the relationship between veteran coworker and hiring manager, to be important aspects...

  15. VO2max and ventilatory threshold of trained cyclists are not affected by 28-day L-arginine supplementation.

    Science.gov (United States)

    Sunderland, Kyle L; Greer, Felicia; Morales, Jacobo

    2011-03-01

    The ergogenic effect of L-arginine on an endurance-trained population is not well studied. The few studies that have investigated L-arginine on this population have not been conducted in a laboratory setting or measured aerobic variables. The purpose of the current study is to determine if 28 days of L-arginine supplementation in trained male cyclists affects VO2max and ventilatory threshold (VT). Eighteen (18) endurance-trained male cyclists (mean ± SD, age: 36.3 ± 7.9 years; height: 182.4 ± 4.6 cm; and body mass: 79.5 ± 4.7 kg) performed a graded exercise test (GXT; 50 W + 25 W·min) before and after 28 days of supplementation with L-arginine (ARG; 2 × 6 g·d) or placebo (PLA; cornstarch). The GXT was conducted on the subject's own bicycle using the RacerMate CompuTrainer (Seattle, WA, USA). VO2 was continuously recorded using the ParvoMedics TrueOne 2400 metabolic cart (Salt Lake City, UT, USA) and VT was established by plotting the ventilatory equivalent for O2 (VE/VO2) and the ventilatory equivalent for CO2 (VE/VCO2) and identifying the point at which VE/VO2 increases with no substantial changes in VE/VCO2. L-arginine supplementation had no effect from initial VO2max (PL, 58.7 ± 7.1 ml·kg·min; ARG, 63.5 ± 7.3 ml·kg·min) to postsupplement VO2max (PL, 58.9 ± 6.0 ml·kg·min; ARG, 63.2 ± 7.2 ml·kg·min). Also, no effect was seen from initial VT (PL, 75.7 ± 4.6% VO2max; ARG, 76.0 ± 5.3% VO2max) to postsupplement VT (PL, 74.3 ± 8.1% VO2max; ARG, 74.2 ± 6.4% VO2max). These results indicate that L-arginine does not impact VO2max or VT in trained male cyclists.

  16. 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

  17. 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…

  18. Improved Ventilatory Efficiency with Locomotor Muscle Afferent Inhibition is Strongly Associated with Leg Composition in Heart Failure.

    Science.gov (United States)

    Keller-Ross, Manda L; Johnson, Bruce D; Carter, Rickey E; Joyner, Michael J; Eisenach, John H; Curry, Timothy B; Olson, Thomas P

    2016-01-01

    Skeletal muscle atrophy contributes to increased afferent feedback (group III and IV) and may influence ventilatory control (high VE/VCO2 slope) in heart failure (HF). This study examined the influence of muscle mass on the change in VE/VCO2 with afferent neural block during exercise in HF. 17 participants [9 HF (60±6 yrs) and 8 controls (CTL) (63±7 yrs, mean±SD)] completed 3 sessions. Session 1: dual energy x-ray absorptiometry and graded cycle exercise to volitional fatigue. Sessions 2 and 3: 5 min of constant-work cycle exercise (65% of peak power) randomized to lumbar intrathecal injection of fentanyl (afferent blockade) or placebo. Ventilation (VE) and gas exchange (oxygen consumption, VO2; carbon dioxide production, VCO2) were measured. Peak work and VO2 were lower in HF (pLeg fat was greater in HF (34.4±3.0 and 26.3±1.8%) and leg muscle mass was lower in HF (63.0±2.8 and 70.4±1.8%, respectively, pleg muscle mass (r2=0.58, pleg fat mass (r2=0.73, pleg muscle mass had the greatest improvement in VE/VCO2 with afferent blockade with leg fat mass being the only predictor for the improvement in VE/VCO2 slope. Both leg muscle mass and fat mass are important contributors to ventilatory abnormalities and strongly associated to improvements in VE/VCO2 slope with locomotor afferent inhibition in HF. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Effects of pressure support ventilation mode on emergence time and intra-operative ventilatory function: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Xavier Capdevila

    Full Text Available We tested the hypothesis that pressure-support ventilation (PSV allows a reduction in emergence time and laryngeal mask airway (LMA removal time after general anesthesia compared to volume-controlled mechanical ventilation (CMV. Because spontaneous breathing (SB is often used with LMA under general anesthesia, patients were allocated randomly to three groups (CMV, SB and PSV. Thirty-six consecutive ASA I-II patients scheduled for knee arthroscopic surgery under general anesthesia with a LMA and breathing throughout the ventilator circuit were included. Hemodynamic and ventilatory variables were recorded before and 10-min after general anesthesia-induction, at the surgical incision, at the end of anaesthetic drugs infusion and when the patient was totally awake (which defines emergence time. LMA removal time, drug consumption were recorded at the end of the surgical procedure. Leak fraction around the LMA was also evaluated. LMA removal time was significantly higher in the CMV-group (18 ± 6 min compared to both SB (8 ± 4 min and PSV (7 ± 4 min, P < 0.05 groups as well as for emergence time: CMV-group (32 ± 12 min, SB (17 ± 7 min and PSV (13 ± 6 min, P < 0.05 groups. Total propofol consumption was significantly lower in the PSV-group (610 ± 180 mg than in both CMV (852 ± 330 mg and SB (734 ± 246 mg, P < 0.05 groups. Air leaks around the LMA was significantly higher in the CMV-group than in the SB and PSV groups (16% vs 3% and 7%, all P<0.05. In conclusion, in knee arthroscopic surgery, in comparison to CMV, PSV use during general anesthesia in unparalyzed patients decreases LMA removal time, propofol consumption and leaks around LMA while improving ventilatory variables without adverse effects.Controlled-Trials.com ISRCTN17382426.

  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. 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 bipartite system and proved superadditivity of the Wigner-Yanase-Dyson skew informations for such states. We extend this result to the general metric-adjusted skew information. We finally show that a recently introduced extension to parameter values 1 information is a special case...... of (unbounded) metric-adjusted skew information....

  2. Adrenaline release evokes hyperpnoea and an increase in ventilatory CO2 sensitivity during hypoglycaemia: a role for the carotid body.

    Science.gov (United States)

    Thompson, Emma L; Ray, Clare J; Holmes, Andrew P; Pye, Richard L; Wyatt, Christopher N; Coney, Andrew M; Kumar, Prem

    2016-08-01

    Hypoglycaemia is counteracted by release of hormones and an increase in ventilation and CO2 sensitivity to restore blood glucose levels and prevent a fall in blood pH. The full counter-regulatory response and an appropriate increase in ventilation is dependent on carotid body stimulation. We show that the hypoglycaemia-induced increase in ventilation and CO2 sensitivity is abolished by preventing adrenaline release or blocking its receptors. Physiological levels of adrenaline mimicked the effect of hypoglycaemia on ventilation and CO2 sensitivity. These results suggest that adrenaline, rather than low glucose, is an adequate stimulus for the carotid body-mediated changes in ventilation and CO2 sensitivity during hypoglycaemia to prevent a serious acidosis in poorly controlled diabetes. Hypoglycaemia in vivo induces a counter-regulatory response that involves the release of hormones to restore blood glucose levels. Concomitantly, hypoglycaemia evokes a carotid body-mediated hyperpnoea that maintains arterial CO2 levels and prevents respiratory acidosis in the face of increased metabolism. It is unclear whether the carotid body is directly stimulated by low glucose or by a counter-regulatory hormone such as adrenaline. Minute ventilation was recorded during infusion of insulin-induced hypoglycaemia (8-17 mIU kg(-1)  min(-1) ) in Alfaxan-anaesthetised male Wistar rats. Hypoglycaemia significantly augmented minute ventilation (123 ± 4 to 143 ± 7 ml min(-1) ) and CO2 sensitivity (3.3 ± 0.3 to 4.4 ± 0.4 ml min(-1)  mmHg(-1) ). These effects were abolished by either β-adrenoreceptor blockade with propranolol or adrenalectomy. In this hypermetabolic, hypoglycaemic state, propranolol stimulated a rise in P aC O2, suggestive of a ventilation-metabolism mismatch. Infusion of adrenaline (1 μg kg(-1)  min(-1) ) increased minute ventilation (145 ± 4 to 173 ± 5 ml min(-1) ) without altering P aC O2 or pH and enhanced ventilatory CO2 sensitivity (3

  3. Perfectionsism, Coping, and Emotional Adjustment.

    Science.gov (United States)

    Rice, Kenneth G.; Lapsley, Daniel K.

    2001-01-01

    Undergraduates (N=204) completed three scales of the student adaptation to college questionnaire. Measures of coping and emotional adjustment revealed differences among the three groups of students labeled adaptive, maladaptive, and non-perfectionists. Perfectionism and coping predicted emotional adjustment but coping as a moderator or mediator in…

  4. 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…

  5. Transnasal humidified rapid insufflation ventilatory exchange for oxygenation of children during apnoea: a prospective randomised controlled trial.

    Science.gov (United States)

    Riva, T; Pedersen, T H; Seiler, S; Kasper, N; Theiler, L; Greif, R; Kleine-Brueggeney, M

    2018-03-01

    Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) comprises the administration of heated, humidified, and blended air/oxygen mixtures via nasal cannula at rates of ≥2 litres kg -1  min -1 . The aim of this randomized controlled study was to evaluate the length of the safe apnoea time using THRIVE with two different oxygen concentrations (100% vs 30% oxygen) compared with standard low-flow 100% oxygen administration. Sixty patients, aged 1-6 yr, weighing 10-20 kg, undergoing general anaesthesia for elective surgery, were randomly allocated to receive one of the following oxygen administration methods during apnoea: 1) low-flow 100% oxygen at 0.2 litres kg -1  min -1 ; 2) THRIVE 100% oxygen at 2 litres kg -1  min -1 ; and 3) THRIVE 30% oxygen at 2 litres kg -1  min -1 . Primary outcome was time to desaturation to 95%. Termination criteria included SpO 2 decreased to 95%, transcutaneous CO 2 increased to 65 mmHg, or apnoea time of 10 min. The median (interquartile range) [range] apnoea time was 6.9 (5.7-7.8) [2.8-10.0] min for low-flow 100% oxygen, 7.6 (6.2-9.1) [5.2-10.0] min for THRIVE 100% oxygen, and 3.0 (2.4-3.7) [0.2-5.3] min for THRIVE 30% oxygen. No significant difference was detected between apnoea times with low-flow and THRIVE 100% oxygen administration (P=0.15). THRIVE with 30% oxygen demonstrated significantly shorter apnoea times (Prate of transcutaneous CO 2 increase was 0.57 (0.49-0.63) [0.29-8.92] kPa min -1 without differences between the 3 groups (P=0.25). High-flow 100% oxygen (2 litres kg -1  min -1 ) administered via nasal cannulas did not extend the safe apnoea time for children weighing 10-20 kg compared with low-flow nasal cannula oxygen (0.2 litres kg -1  min -1 ). No ventilatory effect was observed with THRIVE at 2.0 litres kg -1  min -1 . NCT02979067. Copyright © 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  6. Addition of non-invasive ventilatory support to combined aerobic and resistance training improves dyspnea and quality of life in heart failure patients: a randomized controlled trial.

    Science.gov (United States)

    Bittencourt, Hugo Souza; Cruz, Cristiano Gonçalves; David, Bruno Costa; Rodrigues, Erenaldo; Abade, Camille Magalhães; Junior, Roque Aras; Carvalho, Vitor Oliveira; Dos Reis, Francisco Borges Faria; Gomes Neto, Mansueto

    2017-11-01

    To test the hypothesis that combined aerobic and resistance training and non-invasive ventilatory support result in additional benefits compared with combined aerobic and resistance training alone in heart failure patients. A randomized, single-blind, controlled study. Cardiac rehabilitation center. A total of 46 patients with New York Heart Association class II/III heart failure were randomly assigned to a 10-week program of combined aerobic and resistance training, plus non-invasive ventilatory support ( n = 23) or combined aerobic and resistance training alone ( n = 23). Before and after intervention, results for the following were obtained: 6-minute walk test, forced vital capacity, forced expiratory volume at one second, maximal inspiratory muscle pressure, and maximal expiratory muscle pressure, with evaluation of dyspnea by the London Chest Activity of Daily Living scale, and quality of life with the Minnesota Living With Heart Failure questionnaire. Of the 46 included patients, 40 completed the protocol. The combined aerobic and resistance training plus non-invasive ventilatory support, as compared with combined aerobic and resistance training alone, resulted in significantly greater benefit for dyspnea (mean change: 4.8 vs. 1.3, p = 0.004), and quality of life (mean change: 19.3 vs. 6.8, p = 0.017 ). In both groups, the 6-minute walk test improved significantly (mean change: 45.7 vs. 44.1, p = 0.924), but without a statistically significant difference. Non-invasive ventilatory support combined with combined aerobic and resistance training provides additional benefits for dyspnea and quality of life in moderate heart failure patients. ClinicalTrials.gov identifier: NCT02384798. Registered 03 April 2015.

  7. Assessment of two novel ventilatory surrogates for use in the delivery of gated/tracked radiotherapy for non-small cell lung cancer

    International Nuclear Information System (INIS)

    Hughes, Simon; McClelland, James; Tarte, Segolene; Lawrence, David; Ahmad, Shahreen; Hawkes, David; Landau, David

    2009-01-01

    Background: In selected patients with NSCLC the therapeutic index of radical radiotherapy can be improved with gating/tracking technology. Both techniques require real-time information on target location. This is often derived from a surrogate ventilatory signal. We assessed the correlation of two novel surrogate ventilatory signals with a spirometer-derived signal. The novel signals were obtained using the VisionRT stereoscopic camera system. The VisionRT-Tracked-Point (VRT-TP) signal was derived from tracking a point located midway between the umbilicus and xiphisternum. The VisionRT-Surface-Derived-Volume (VRT-SDV) signal was derived from 3D body surface imaging of the torso. Both have potential advantages over the current surrogate signals. Methods: Eleven subjects with NSCLC were recruited. Each was positioned as for radiotherapy treatment, and then instructed to breathe in five different modes: normal, abdominal, thoracic, deep and shallow breathing. Synchronous ventilatory signals were recorded for later analysis. The signals were analysed for correlation across all modes of breathing, and phase shifts. The VRT-SDV was also assessed for its ability to determine the mode of breathing. Results: Both novel respiratory signals showed good correlation (r > 0.80) with spirometry in 9 of 11 subjects. For all subjects the correlation with spirometry was better for the VRT-SDV signal than for the VRT-TP signal. Only one subject displayed a phase shift between the VisionRT-derived signals and spirometry. The VRT-SDV signal could also differentiate between different modes of breathing. Unlike the spirometer-derived signal, neither VisionRT-derived signal was subject to drift. Conclusion: Both the VRT-TP and VRT-SDV signals have potential applications in ventilatory-gated and tracked radiotherapy. They can also be used as a signal for sorting 4DCT images, and to drive 4DCT single- and multiple-parameter motion models.

  8. Effectiveness of transnasal humidified rapid-insufflation ventilatory exchange versus traditional preoxygenation followed by apnoeic oxygenation in delaying desaturation during apnoea: A preliminary study

    Directory of Open Access Journals (Sweden)

    Sunil Rajan

    2018-01-01

    Full Text Available Background and Aims: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE during apnoea has shown to delay desaturation. The primary objective was to compare time to desaturate to 200 mmHg even at 12 min of apnoea with a significant rise in PaCO2along with fall in pH after 6 min. Conclusion: During apnoeic periods time to desaturate to <90% was significantly prolonged with use of THRIVE.

  9. 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.

  10. Foreign assistance

    International Nuclear Information System (INIS)

    1991-07-01

    This paper reports that providing energy assistance to developing countries remains a relatively low priority of the Agency for International Development. AID is helping some developing countries meet their energy needs, but this assistance varies substantially because of the agency's decentralized structure. Most AID energy funding has gone to a handful of countries-primarily Egypt and Pakistan. With limited funding in most other countries, AID concentrates on providing technical expertise and promoting energy policy reforms that will encourage both energy efficiency and leverage investment by the private sector and other donors. Although a 1989 congressional directive to pursue a global warming initiative has had a marginal impact on the agency's energy programming, many AID energy programs, including those directed at energy conservation, help address global warming concerns

  11. Obstructive sleep apnea (OSA) does not affect ventilatory and perceptual responses to exercise in morbidly obese subjects.

    Science.gov (United States)

    Innocenti Bruni, Giulia; Gigliotti, Francesco; Scano, Giorgio

    2012-09-30

    We have tested the hypothesis that high mass loading effects and obstructive sleep apnea (OSA) constrain the ventilatory response to exercise in morbidly obese subjects as compared to their counterparts without OSA. Fifteen obese patients with (8) and without OSA and 12 lean healthy subjects performed incremental cycle exercise. The functional evaluation included ventilation, oxygen uptake, carbon dioxide production, end-expiratory-lung-volumes (EELV), inspiratory capacity, heart rate, dyspnea and leg effort (by a modified Borg scale). Changes in ventilation and dyspnea per unit changes in work rate and metabolic variables were similar in the three groups. Breathing pattern and heart rate increased from rest to peak exercise similarly in the three groups. Leg effort was the prevailing symptom for stopping exercise in most subjects. In conclusion, OSA does not limit exercise capacity in morbidly obese subjects. Ventilation contributes to exertional dyspnea similarly as in lean subjects and in obese patients regardless of OSA. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. 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.

  13. [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".

  14. Human corticotropin-releasing hormone and thyrotropin-releasing hormone modulate the hypercapnic ventilatory response in humans.

    Science.gov (United States)

    Schulz, R; Nink, M; Werner, G S; Andreas, S; Kreuzer, H; Beyer, J; Lehnert, H

    1996-11-01

    Human corticotropin-releasing hormone (hCRH) and thyrotropin-releasing hormone (TRH) are known to stimulate ventilation after i.v. administration in humans. In a placebo-controlled, single-blind study we aimed to clarify if both peptides act by altering central chemosensitivity. Two subsequent CO2-rebreathing tests were performed in healthy young volunteers. During the first test 0.9% NaCl was given i.v.; during the second test 200 micrograms of hCRH (n = 12) or 400 micrograms of TRH (n = 6) was administered i.v. Nine subjects received 0.9% NaCl i.v. during both rebreathing manoeuvres. The CO2-response curves for the two tests were compared within the same subject. In the hCRH group a marked parallel shift of the CO2-response curve to the left was observed after hCRH (P < 0.01). The same effect occurred following TRH but was less striking (P = 0.05). hCRH and TRH caused a reduction in the CO2 threshold. The CO2-response curves in the control group were nearly identical. The results indicate an additive effect of both releasing hormones on the hypercapnic ventilatory response in humans, presumably independent of central chemosensitivity.

  15. 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; Mosquera, Ricardo A

    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.

  16. Ventilatory effects of hypercapnic end-tidal PCO2 clamps during aerobic exercise of varying intensity.

    Science.gov (United States)

    Essfeld, D; Hoffmann, U; Stegemann, J

    1990-01-01

    Nine subjects performed a sequence of sustained and randomised changes between 40 W and 100 W on a cycle ergometer while the end-tidal PO2 was kept close to 17.3 kPa (130 mm Hg) by means of a dynamic forcing technique (reference experiment). In a second series inspiratory CO2 was additionally manipulated so as to hold end-tidal PCO2 (PETCO2) near 6.5 kPa (49 mm Hg; 'CO2-clamp' experiment). By this forcing PETCO2 oscillations were attenuated and more evenly distributed over the frequency range. Ventilation (VT) responded to this manoeuvre with an upward trend that could not be ascribed to a slow CO2-response component, changes in metabolic rate or a dissociation of end-tidal and arterial PCO2. VT differences between reference and CO2-clamp experiments were abolished within a 3-min period following the termination of the external CO2 control. The present results suggest that the CO2-H+ stimulus plays a major role in adjusting ventilation when exercise intensity is decreased. The underlying CO2 effect appears to be neither additive nor bi-directionally symmetrical.

  17. 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.

  18. Normal Stress or Adjustment Disorder?

    Science.gov (United States)

    ... disorder is a type of stress-related mental illness that can affect your feelings, thoughts and behaviors. Signs and symptoms of an adjustment disorder can include: Anxiety Poor school or work performance Relationship problems Sadness ...

  19. Electronic gaming and psychosocial adjustment.

    Science.gov (United States)

    Przybylski, Andrew K

    2014-09-01

    The rise of electronic games has driven both concerns and hopes regarding their potential to influence young people. Existing research identifies a series of isolated positive and negative effects, yet no research to date has examined the balance of these potential effects in a representative sample of children and adolescents. The objective of this study was to explore how time spent playing electronic games accounts for significant variation in positive and negative psychosocial adjustment using a representative cohort of children aged 10 to 15 years. A large sample of children and adolescents aged 10 to 15 years completed assessments of psychosocial adjustment and reported typical daily hours spent playing electronic games. Relations between different levels of engagement and indicators of positive and negative psychosocial adjustment were examined, controlling for participant age and gender and weighted for population representativeness. Low levels (3 hours daily) of game engagement was linked to key indicators of psychosocial adjustment. Low engagement was associated with higher life satisfaction and prosocial behavior and lower externalizing and internalizing problems, whereas the opposite was found for high levels of play. No effects were observed for moderate play levels when compared with non-players. The links between different levels of electronic game engagement and psychosocial adjustment were small (Games consistently but not robustly associated with children's adjustment in both positive and negative ways, findings that inform policy-making as well as future avenues for research in the area. Copyright © 2014 by the American Academy of Pediatrics.

  20. [Pressure support ventilation and proportional assist ventilation during weaning from mechanical ventilation].

    Science.gov (United States)

    Aguirre-Bermeo, H; Bottiroli, M; Italiano, S; Roche-Campo, F; Santos, J A; Alonso, M; Mancebo, J

    2014-01-01

    To compare tolerance, duration of mechanical ventilation (MV) and clinical outcomes during weaning from MV in patients subjected to either pressure support ventilation (PSV) or proportional assist ventilation (PAV). A prospective, observational study was carried out. Intensive Care Unit. A total of 40 consecutive subjects were allocated to either the PSV or the PAV group until each group contained 20 patients. Patients were included in the study when they met the criteria to begin weaning and the attending physician decided to initiate the weaning process. The physician selected the modality and set the ventilatory parameters. None. Demographic data, respiratory mechanics, ventilatory parameters, duration of MV, and clinical outcomes (reintubation, tracheostomy, mortality). Baseline characteristics were similar in both groups. No significant differences were observed between the PSV and PAV groups in terms of the total duration of MV (10 [5-18] vs. 9 [7-19] days; P=.85), reintubation (5 [31%] vs. 3 [19%]; P=.69), or mortality (4 [20%] vs. 5 [25%] deaths; P=1). Eight patients (40%) in the PSV group and 6 patients (30%) in the PAV group (P=.74) required a return to volume assist-control ventilation due to clinical deterioration. Tolerance, duration of MV and clinical outcomes during weaning from mechanical ventilation were similar in PSV and PAV. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  1. Assisted Vaginal Delivery

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Assisted Vaginal Delivery Home For Patients Search FAQs Assisted Vaginal Delivery ... Delivery FAQ192, February 2016 PDF Format Assisted Vaginal Delivery Labor, Delivery, and Postpartum Care What is assisted ...

  2. 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

  3. Ventilatory response to hypercapnia and hypoxia after extensive lesion of medullary serotonergic neurons in newborn conscious piglets.

    Science.gov (United States)

    Penatti, E M; Berniker, A V; Kereshi, B; Cafaro, C; Kelly, M L; Niblock, M M; Gao, H G; Kinney, H C; Li, A; Nattie, E E

    2006-10-01

    Acute inhibition of serotonergic (5-HT) neurons in the medullary raphé (MR) using a 5-HT(1A) receptor agonist had an age-dependent impact on the "CO(2) response" of piglets (33). Our present study explored the effect of chronic 5-HT neuron lesions in the MR and extra-raphé on the ventilatory response to hypercapnia and hypoxia in piglets, with possible implications on the role of 5-HT in the sudden infant death syndrome. We established four experimental groups. Group 1 (n = 11) did not undergo any treatment. Groups 2, 3, and 4 were injected with either vehicle or the neurotoxin 5,7-dihydroxytryptamine in the cisterna magna during the first week of life (group 2, n = 9; group 4, n = 11) or second week of life (group 3, n = 10). Ventilation was recorded in response to 5% CO(2) (all groups) and 12% O(2) (group 2) during wakefulness and sleep up to postnatal day 25. Surprisingly, the piglets did not reveal changes in their CO(2) sensitivity during early postnatal development. Overall, considerable lesions of 5-HT neurons (up to 65% decrease) in the MR and extra-raphé had no impact on the CO(2) response, regardless of injection time. Postlesion raphé plasticity could explain why we observed no effect. 5,7-Dihydroxytryptamine-treated males, however, did present a lower CO(2) response during sleep. Hypoxia significantly altered the frequency during sleep in lesioned piglets. Further studies are necessary to elucidate the role of plasticity, sex, and 5-HT abnormalities in sudden infant death syndrome.

  4. Increases in .VO2max with "live high-train low" altitude training: role of ventilatory acclimatization.

    Science.gov (United States)

    Wilhite, Daniel P; Mickleborough, Timothy D; Laymon, Abigail S; Chapman, Robert F

    2013-02-01

    The purpose of this study was to estimate the percentage of the increase in whole body maximal oxygen consumption (.VO(2max)) that is accounted for by increased respiratory muscle oxygen uptake after altitude training. Six elite male distance runners (.VO(2max) = 70.6 ± 4.5 ml kg(-1) min(-1)) and one elite female distance runner (.VO(2max)) = 64.7 ml kg(-1) min(-1)) completed a 28-day "live high-train low" training intervention (living elevation, 2,150 m). Before and after altitude training, subjects ran at three submaximal speeds, and during a separate session, performed a graded exercise test to exhaustion. A regression equation derived from published data was used to estimate respiratory muscle .VO(2) (.VO(2RM)) using our ventilation (.VE) values. .VO(2RM) was also estimated retrospectively from a larger group of distance runners (n = 22). .VO(2max) significantly (p altitude (196 ± 59 ml min(-1)), while (.VE) at .VO(2max) also significantly (p altitude (201 ± 36 ml min(-1)), along with a 10.8 ± 2.1 l min(-1) increase in (.VE), thus requiring an estimated 27 % of Δ .VO(2max) Our data suggest that a substantial portion of the improvement in .VO(2max) with chronic altitude training goes to fuel the respiratory muscles as opposed to the musculature which directly contributes to locomotion. Consequently, the time-course of decay in ventilatory acclimatization following return to sea-level may have an impact on competitive performance.

  5. Parietal pleural invasion/adhesion of subpleural lung cancer: Quantitative 4-dimensional CT analysis using dynamic-ventilatory scanning

    Energy Technology Data Exchange (ETDEWEB)

    Sakuma, Kotaro, E-mail: ksakuma@ohara-hp.or.jp [Department of Radiology, Ohara General Hospital, 6-11 Omachi, Fukushima City, Fukushima 960-8611 (Japan); Department of Radiology and Nuclear Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima 960-1295 (Japan); Yamashiro, Tsuneo, E-mail: clatsune@yahoo.co.jp [Department of Radiology, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215 (Japan); Moriya, Hiroshi, E-mail: hrshmoriya@gmail.com [Department of Radiology, Ohara General Hospital, 6-11 Omachi, Fukushima City, Fukushima 960-8611 (Japan); Murayama, Sadayuki, E-mail: sadayuki@med.u-ryukyu.ac.jp [Department of Radiology, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215 (Japan); Ito, Hiroshi, E-mail: h-ito@fmu.ac.jp [Department of Radiology and Nuclear Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima 960-1295 (Japan)

    2017-02-15

    Highlights: • 4DCT can be used for assessment of pleural invasion/adhesion by lung cancer. • Quantitative 4DCT indices of lung cancer and adjacent structures are described. • An automatic analysis of pleural invasion/adhesion would be developed in the future. - Abstract: Purpose: Using 4-dimensional dynamic-ventilatory scanning by a 320-row computed tomography (CT) scanner, we performed a quantitative assessment of parietal pleural invasion and adhesion by peripheral (subpleural) lung cancers. Methods: Sixteen patients with subpleural lung cancer underwent dynamic-ventilation CT during free breathing. Neither parietal pleural invasion nor adhesion was subsequently confirmed by surgery in 10 patients, whereas the other 6 patients were judged to have parietal pleural invasion or adhesion. Using research software, we tracked the movements of the cancer and of an adjacent structure such as the rib or aorta, and converted the data to 3-dimensional loci. The following quantitative indices were compared by the Mann-Whitney test: cross-correlation coefficient between time curves for the distances moved from the inspiratory frame by the cancer and the adjacent structure, the ratio of the total movement distances (cancer/adjacent structure), and the cosine similarities between the inspiratory and expiratory vectors (from the cancer to the adjacent structure) and between vectors of the cancer and of the adjacent structure (from inspiratory to expiratory frames). Results: Generally, the movements of the loci of the lung cancer and the adjacent structure were similar in patients with parietal pleural invasion/adhesion, while they were independent in patients without. There were significant differences in all the parameters between the two patient groups (cross-correlation coefficient and the movement distance ratio, P < 0.01; cosine similarities, P < 0.05). Conclusion: These observations suggest that quantitative indices by dynamic-ventilation CT can be utilized as a

  6. Hyperadditive Ventilatory Response Arising from Interaction between the Carotid Chemoreflex and the Muscle Mechanoreflex in Healthy Humans.

    Science.gov (United States)

    Silva, Talita M; Aranda, Liliane C; Paula-Ribeiro, Marcelle; Oliveira, Diogo M; Medeiros, Wladimir Musetti; Vianna, Lauro C; Nery, Luiz E; Silva, Bruno M

    2018-03-22

    Physical exercise potentiates the carotid chemoreflex control of ventilation (VE). Hyperadditive neural interactions may partially mediate the potentiation. However, some neural interactions remain incompletely explored. As the potentiation occurs even during low-intensity exercise, we tested the hypothesis that the carotid chemoreflex and the muscle mechanoreflex could interact in a hyperadditive fashion. Fourteen young healthy subjects inhaled, randomly, in separate visits, 12% O 2 to stimulate the carotid chemoreflex, and 21% O 2 as control. A rebreathing circuit maintained isocapnia. During gases administration, subjects either remained at rest (i.e., normoxic and hypoxic rest) or the muscle mechanoreflex was stimulated, via passive knee movement (i.e., normoxic and hypoxic movement). Surface muscle electrical activity did not increase during the passive movement, confirming the absence of active contractions. Hypoxic rest and normoxic movement similarly increased VE [change (mean {plus minus} SEM) = 1.24 {plus minus} 0.72 vs. 0.73 {plus minus} 0.43 L/min, respectively; P = 0.46], but hypoxic rest only increased tidal volume (Vt) and normoxic movement only increased breathing frequency (BF). Hypoxic movement induced greater VE and mean inspiratory flow (Vt/Ti) increase than the sum of hypoxic rest and normoxic movement isolated responses (VE change: hypoxic movement = 3.72 {plus minus} 0.81 vs. sum = 1.96 {plus minus} 0.83 L/min, P = 0.01; Vt/Ti change: hypoxic movement = 0.13 {plus minus} 0.03 vs. sum = 0.06 {plus minus} 0.03 L/s, P = 0.02). Moreover, hypoxic movement increased both Vt and BF. Collectively, the results indicate the carotid chemoreflex and the muscle mechanoreflex interacted mediating a hyperadditive ventilatory response in healthy humans.

  7. Experiences with assisted peritoneal dialysis in China.

    Science.gov (United States)

    Xu, Rong; Zhuo, Min; Yang, Zhikai; Dong, Jie

    2012-01-01

    About half the patients on peritoneal dialysis (PD) in China need to be assisted by family members or home assistants. We explored whether these patients have a higher risk for peritonitis and death compared with self-care PD patients. We prospectively followed 313 incident PD patients until death or censoring. This cohort was divided into assisted and self-care PD groups according to the independence of bag exchange. Data on baseline demographics, Charlson comorbidity index, biochemistry, and residual renal function were recorded during the first 3 - 6 months. The outcome variables were first episode of peritonitis and all-cause mortality. Of the 313 patients in this cohort study, 122 needed assistance in performing bag exchanges (86 from a family member, 36 from a home assistant); the remaining 191 patients did not need assistance. During a follow-up period averaging 44.5 months, 122 patients developed a first episode of peritonitis, and 135 patients died. Compared with patients having a family assistant, those with a home assistant had similar peritonitis-free and survival times, but a higher risk of mortality after adjustments for variables such as age, sex, Charlson comorbidity score, hemoglobin, serum albumin, and residual renal function. Furthermore, compared with self-care patients, assisted patients overall had a similar peritonitis-free time, but a higher risk of mortality, even after adjusting for covariates. Based on our single-center experience in China, we conclude that assisted PD is a good option for patients with poor self-care ability. This result provides evidence for recruiting patients who need assistance to PD programs in China.

  8. Self-adjusting assembly jig

    Science.gov (United States)

    Haaser, M. J.

    1973-01-01

    Jig adjusts for thermal expansion and contraction to hold parts being joined under constant pressure and in correct alignment during entire joining operation. Jig is simple and easy to use, durable and maintenance free. Several methods may be used to join parts of many sizes and shapes.

  9. Kinematic adjustments to seismic recordings

    Energy Technology Data Exchange (ETDEWEB)

    Telegin, A.N.; Levii, N.V.; Volovik, U.M.

    1981-01-01

    The introduction of kinematic adjustments by adding the displaced blocks is studied theoretically and in test seismograms. The advantage to this method resulting from the weight variation in the trace is demonstrated together with its kinematic drawback. A variation on the displaced block addition method that does not involve realignment of the travel time curves and that has improved amplitude characteristics is proposed.

  10. 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...

  11. Adjustment or updating of models

    Indian Academy of Sciences (India)

    Department of Mechanical Engineering, Imperial College of Science, .... It is first necessary to decide upon the level of accuracy, or correctness which is sought from the adjustment of the initial model, and this will be heavily influenced by the eventual application of the ..... reviewing the degree of success attained.

  12. Inspiratory Muscle Training Is Associated With Improved Inspiratory Muscle Strength, Resting Cardiac Output, and the Ventilatory Efficiency of Exercise in Patients With a Fontan Circulation.

    Science.gov (United States)

    Laohachai, Karina; Winlaw, David; Selvadurai, Hiran; Gnanappa, Ganesh Kumar; d'Udekem, Yves; Celermajer, David; Ayer, Julian

    2017-08-21

    Patients with a Fontan circulation have reduced exercise capacity and respiratory muscle strength. Inspiratory muscle training (IMT) improves exercise capacity and quality of life in adults with heart failure. We assessed whether 6 weeks of a home-based program of IMT improves inspiratory muscle strength and the ventilatory efficiency of exercise in adolescent patients with a Fontan circulation. Twenty-three adolescent participants (aged 16±2 years) with a Fontan circulation underwent 6 weeks of IMT for 30 minutes daily. Respiratory muscle strength (maximal inspiratory pressure and expiratory pressure), lung function, and exercise capacity (cardiopulmonary exercise testing) were assessed. Fourteen of 23 participants also underwent exercise cardiac magnetic resonance imaging to examine the effects of IMT on cardiac output and systemic and pulmonary blood flow. Six weeks of IMT improved maximal inspiratory pressure by 36±24 cm H 2 O (61±46%) with no change in maximal expiratory pressure. Ventilatory efficiency of exercise improved after 6 weeks of IMT (from 34.2±7.8 to 32.2±5.6, P =0.04). In those who underwent exercise cardiac magnetic resonance imaging, IMT increased resting cardiac output (from 4.2±1.2 to 4.5±1.0 L/min, P =0.03) and ejection fraction (from 50.1±4.3 to 52.8±6.1%, P =0.03). Six weeks of IMT is associated with improved inspiratory muscle strength, ventilatory efficiency of exercise, and resting cardiac output in young Fontan patients. IMT may be a simple beneficial addition to the current management of Fontan patients, potentially reducing exercise intolerance and long-term morbidity and mortality. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  13. Activation of opioid μ-receptors in the commissural subdivision of the nucleus tractus solitarius abolishes the ventilatory response to hypoxia in anesthetized rats.

    Science.gov (United States)

    Zhang, Zhenxiong; Zhuang, Jianguo; Zhang, Cancan; Xu, Fadi

    2011-08-01

    : The commissural subnucleus of the nucleus tractus solitarius (comNTS) is a key region in the brainstem responsible for the hypoxic ventilatory response (HVR) because it contains the input terminals of the carotid chemoreceptor. Because opioids inhibit the HVR via activating central μ-receptors that are expressed abundantly in the comNTS, the authors of the current study asked whether activating local μ-receptors attenuated the carotid body-mediated HVR. : To primarily stimulate the carotid body, brief hypoxia (100% N2) and hypercapnia (15% CO2) for 10 s and/or intracarotid injection of NaCN (10 μg/100 μl) were performed in anesthetized and spontaneously breathing rats. These stimulations were repeated after: (1) microinjecting three doses of μ-receptor agonist [d-Ala2, N-Me-Phe4, Gly-ol]-Enkephalin (DAMGO) (approximately 3.5 nl) into the comNTS; (2) carotid body denervation; and (3) systemic administration of DAMGO (300 μg/kg) without and with previous intracomNTS injection of d-Phe-Cys-Tyr-d-Trp-Arg-Thr-Pen-Thr-NH2, a μ-receptor antagonist. : Study results showed that DAMGO at 0.25 and 2.5, but not 0.025 mM, caused a similar decrease in baseline ventilation (approximately 12%). DAMGO at 0.25 mM largely reduced (64%) the HVR, whereas DAMGO at 2.5 mM abolished the HVR (and the VE response to NaCN) and moderately attenuated (31%) the hypercapnic ventilatory response. Interestingly, similar HVR abolition and depression of the hypercapnic ventilatory response were observed after carotid body denervation. Blocking comNTS μ-receptors by d-Phe-Cys-Tyr-d-Trp-Arg-Thr-Pen-Thr-NH2 significantly attenuated the HVR depression by systemic DAMGO with little change in the DAMGO modulatory effects on baseline ventilation and the hypercapnic ventilatory response. : The data suggest that opioids within the comNTS, via acting on μ-receptors, are able to abolish the HVR by affecting the afferent pathway of the carotid chemoreceptor.

  14. Birth-Order Complementarity and Marital Adjustment.

    Science.gov (United States)

    Vos, Cornelia J. Vanderkooy; Hayden, Delbert J.

    1985-01-01

    Tested the influence of birth-order complementarity on marital adjustment among 327 married women using the Spanier Dyadic Adjustment Scale (1976). Birth-order complementarity was found to be unassociated with marital adjustment. (Author/BL)

  15. Feasibility of telemetric ICP-guided valve adjustments for complex shunt therapy.

    Science.gov (United States)

    Freimann, Florian Baptist; Schulz, Matthias; Haberl, Hannes; Thomale, Ulrich-Wilhelm

    2014-04-01

    The advances in shunt valve technology towards modern adjustable differential pressure (DP) valves and adjustable gravitational assisted valves result in an increasing complexity of therapeutical options. Modern telemetric intracranial pressure (ICP) sensors may be helpful in their application for diagnostic purposes in shunt therapy. We present our first experiences on telemetric ICP-guided valve adjustments in cases with the combination of an adjustable DP valve and adjustable gravitational unit. Four consecutive cases were evaluated in a retrospective review who had received a proGAV adjustable, gravitational assisted DP valve with secondary in-line implantation of an adjustable shunt assistant (proSA), together with a telemetric ICP sensor (Neurovent-P-tel) between December 2010 and June 2012 in our institution. The measured ICP values and the corresponding valve adjustments were analyzed in correlation with the clinical course and the cranial imaging of the patients. No surgery-related complications were observed after implantation of the proSA and the telemetric ICP sensor additional to the proGAV. ICP values could actively be influenced by adjustments of the respective valve units. An increase of the position depending resistance of the proSA resulted in significant attenuated negative ICP values for the standing position, while adjustments of the proGAV could be detected not only in a supine position but also in a standing position. A clinical improvement could be achieved in all cases. The combination of adjustability in the differential pressure valve and the gravitational unit reveals a complex combination which may be difficult to adapt only according to clinical information. Telemetric ICP-guided valve adjustments seem to be a promising tool as an objective measure according to different body positions. Further investigations are needed to select the patients for these costly implants.

  16. Stress, Social Support and Adjustment.

    Science.gov (United States)

    1982-03-01

    provided advice and assistance in conducting this project. we wish to thank especially Eric Gunderson, James LaRocco, Ross Vickers and Harold Ward...accounting for a great variety of volitional behaviors such as drinking (Schlegel et al., 1977), family planning (Davidson & Jaccard , 1979), drug use...1976. Cobb, S. Social support as a moderator of life stress. Psychosomatic Medicine, 1976, 38, 300-314. Davidson, A., & Jaccard , J. Variables that

  17. 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 (pvalores 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 (pvalores 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 presença de comorbidades.

  18. Sex-specific effects of daily gavage with a mixed progesterone and glucocorticoid receptor antagonist on hypoxic ventilatory response in newborn rats.

    Science.gov (United States)

    Fournier, Stéphanie; Doan, Van Diep; Joseph, Vincent

    2012-01-01

    We tested the hypothesis that daily gavage with mifepristone, a mixed progesterone/glucocorticoid receptor antagonist would alter hypoxic ventilatory response (HVR) in newborn male and female rats. Rats were treated with mifepristone (40µg/g/day), or vehicle between postnatal days 3-12, and used at 10-12 days of age to record baseline ventilatory and metabolic values using whole body plethysmography. HVR was tested by exposing the animals to 14% and 12% O(2) for 20 minutes each. HVR was enhanced by mifepristone treatment, mainly due to an effect on tidal volume that remained higher in mifepristone treated rats during both levels of hypoxic exposure. This effect was sex-specific being apparent only in male rats. In Vehicle treated rats, HVR was higher in females than in males, which was also due to a higher tidal volume in hypoxia (at 14 and 12% O(2)). We conclude that the activity of the progesterone and/or glucocorticoid receptors modulates respiratory control in rat pups, and that these effects are different in males and females.

  19. Rationale and study design for an individualized perioperative open lung ventilatory strategy (iPROVE): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Ferrando, Carlos; Soro, Marina; Canet, Jaume; Unzueta, Ma Carmen; Suárez, Fernando; Librero, Julián; Peiró, Salvador; Llombart, Alicia; Delgado, Carlos; León, Irene; Rovira, Lucas; Ramasco, Fernando; Granell, Manuel; Aldecoa, César; Diaz, Oscar; Balust, Jaume; Garutti, Ignacio; de la Matta, Manuel; Pensado, Alberto; Gonzalez, Rafael; Durán, M Eugenia; Gallego, Lucia; Del Valle, Santiago García; Redondo, Francisco J; Diaz, Pedro; Pestaña, David; Rodríguez, Aurelio; Aguirre, Javier; García, Jose M; García, Javier; Espinosa, Elena; Charco, Pedro; Navarro, Jose; Rodríguez, Clara; Tusman, Gerardo; Belda, Francisco Javier

    2015-04-27

    Postoperative pulmonary and non-pulmonary complications are common problems that increase morbidity and mortality in surgical patients, even though the incidence has decreased with the increased use of protective lung ventilation strategies. Previous trials have focused on standard strategies in the intraoperative or postoperative period, but without personalizing these strategies to suit the needs of each individual patient and without considering both these periods as a global perioperative lung-protective approach. The trial presented here aims at comparing postoperative complications when using an individualized ventilatory management strategy in the intraoperative and immediate postoperative periods with those when using a standard protective ventilation strategy in patients scheduled for major abdominal surgery. This is a comparative, prospective, multicenter, randomized, and controlled, four-arm trial that will include 1012 patients with an intermediate or high risk for postoperative pulmonary complications. The patients will be divided into four groups: (1) individualized perioperative group: intra- and postoperative individualized strategy; (2) intraoperative individualized strategy + postoperative continuous positive airway pressure (CPAP); (3) intraoperative standard ventilation + postoperative CPAP; (4) intra- and postoperative standard strategy (conventional strategy). The primary outcome is a composite analysis of postoperative complications. The Individualized Perioperative Open-lung Ventilatory Strategy (iPROVE) is the first multicenter, randomized, and controlled trial to investigate whether an individualized perioperative approach prevents postoperative pulmonary complications. Registered on 5 June 2014 with identification no. NCT02158923 .

  20. Reduced hypoxic ventilatory response with preserved blood oxygenation in yoga trainees and Himalayan Buddhist monks at altitude: evidence of a different adaptive strategy?

    Science.gov (United States)

    Bernardi, Luciano; Passino, Claudio; Spadacini, Giammario; Bonfichi, Maurizio; Arcaini, Luca; Malcovati, Luca; Bandinelli, Gabriele; Schneider, Annette; Keyl, Cornelius; Feil, Paul; Greene, Richard E; Bernasconi, Carlo

    2007-03-01

    Yoga induces long-term changes in respiratory function and control. We tested whether it represents a successful strategy for high-altitude adaptation. We compared ventilatory, cardiovascular and hematological parameters in: 12 Caucasian yoga trainees and 12 control sea-level residents, at baseline and after 2-week exposure to high altitude (Pyramid Laboratory, Nepal, 5,050 m), 38 active lifestyle high-altitude natives (Sherpas) and 13 contemplative lifestyle high-altitude natives with practice of yoga-like respiratory exercises (Buddhist monks) studied at 5,050 m. At baseline, hypoxic ventilatory response (HVR), red blood cell count and hematocrit were lower in Caucasian yoga trainees than in controls. After 14 days at altitude, yoga trainees showed similar oxygen saturation, blood pressure, RR interval compared to controls, but lower HVR (-0.44 +/- 0.08 vs. -0.98 +/- 0.21 l/min/m/%SaO(2), P monks was lower than in Sherpas (-0.23 +/- 0.05 vs. -0.63 +/- 0.09 l/min/m/%SaO(2), P monks as compared to Sherpas. In conclusion, Caucasian subjects practicing yoga maintain a satisfactory oxygen transport at high altitude, with minimal increase in ventilation and with reduced hematological changes, resembling Himalayan natives. Respiratory adaptations induced by the practice of yoga may represent an efficient strategy to cope with altitude-induced hypoxia.

  1. Adjusting ability and sensibility for an accident

    International Nuclear Information System (INIS)

    Rozental, J.J.

    1998-01-01

    Adjusting ability (technical competence) and sensibility (consciousness) are the two most important priorities any staff member of any organization should bear in mind while acting during a nuclear or radiological emergency. The discussion is aimed at the national authorities of states which do not have a major nuclear power reactor programme, and especially at the IAEA and WHO: although a decade has gone by, the lessons from the radiological accident in Goiania have not been fully learned. The events which unravelled in the fall of 1987 took the population of the city of Goiania completely by surprise: they did not comprehend what had happened and failed to grasp what measures needed to be taken, a situation which precipitated a very complex psychological reaction, coupled with discrimination. To ensure the safety of radiation sources and nuclear installations, national and international organizations should direct their efforts towards educating and training staff in developing countries who work with ionizing radiation and promoting organizational capacity. This should be done first, by improving safety qualitatively so as to better control the uses of radioactive materials in medicine, agriculture, industry and research, and secondly, by assisting countries without a major nuclear power reactor programme to develop an objective and realistic emergency response training programme. (author)

  2. 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

  3. 12 CFR 1780.80 - Inflation adjustments.

    Science.gov (United States)

    2010-01-01

    ... DEVELOPMENT RULES OF PRACTICE AND PROCEDURE RULES OF PRACTICE AND PROCEDURE Civil Money Penalty Inflation Adjustments § 1780.80 Inflation adjustments. The maximum amount of each civil money penalty within OFHEO's jurisdiction is adjusted in accordance with the Federal Civil Penalties Inflation Adjustment Act of 1990, as...

  4. 12 CFR 19.240 - Inflation adjustments.

    Science.gov (United States)

    2010-01-01

    ... PROCEDURE Civil Money Penalty Inflation Adjustments § 19.240 Inflation adjustments. (a) The maximum amount of each civil money penalty within the OCC's jurisdiction is adjusted in accordance with the Federal Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note) as follows: ER10NO08.001 (b) The...

  5. 78 FR 55056 - Notice of Petitions by Firms for Determination of Eligibility To Apply for Trade Adjustment...

    Science.gov (United States)

    2013-09-09

    ... vehicles such as military transport and civilian first responder utility vehicles. Nedza International Inc... DEPARTMENT OF COMMERCE Economic Development Administration Notice of Petitions by Firms for Determination of Eligibility To Apply for Trade Adjustment Assistance AGENCY: Economic Development...

  6. 77 FR 12007 - Notice of Petitions by Firms tor Determination of Eligibility to Apply For Trade Adjustment...

    Science.gov (United States)

    2012-02-28

    ... 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 Commerce. ACTION: Notice and Opportunity for Public Comment. Pursuant to Section...

  7. Tritium-assisted fusion breeders

    International Nuclear Information System (INIS)

    Greenspan, E.; Miley, G.H.

    1983-08-01

    This report undertakes a preliminary assessment of the prospects of tritium-assisted D-D fuel cycle fusion breeders. Two well documented fusion power reactor designs - the STARFIRE (D-T fuel cycle) and the WILDCAT (Cat-D fuel cycle) tokamaks - are converted into fusion breeders by replacing the fusion electric blankets with 233 U producing fission suppressed blankets; changing the Cat-D fuel cycle mode of operation by one of the several tritium-assisted D-D-based modes of operation considered; adjusting the reactor power level; and modifying the resulting plant cost to account for the design changes. Three sources of tritium are considered for assisting the D-D fuel cycle: tritium produced in the blankets from lithium or from 3 He and tritium produced in the client fission reactors. The D-D-based fusion breeders using tritium assistance are found to be the most promising economically, especially the Tritium Catalyzed Deuterium mode of operation in which the 3 He exhausted from the plasma is converted, by neutron capture in the blanket, into tritium which is in turn fed back to the plasma. The number of fission reactors of equal thermal power supported by Tritium Catalyzed Deuterium fusion breeders is about 50% higher than that of D-T fusion breeders, and the profitability is found to be slightly lower than that of the D-T fusion breeders

  8. Adjustable extender for instrument module

    International Nuclear Information System (INIS)

    Sevec, J.B.; Stein, A.D.

    1975-01-01

    A blank extender module used to mount an instrument module in front of its console for repair or test purposes has been equipped with a rotatable mount and means for locking the mount at various angles of rotation for easy accessibility. The rotatable mount includes a horizontal conduit supported by bearings within the blank module. The conduit is spring-biased in a retracted position within the blank module and in this position a small gear mounted on the conduit periphery is locked by a fixed pawl. The conduit and instrument mount can be pulled into an extended position with the gear clearing the pawl to permit rotation and adjustment of the instrument

  9. Insomnia as an expression of obstructive sleep apnea syndrome--the effect of treatment with nocturnal ventilatory support.

    Science.gov (United States)

    Mendes, M Saldanha; dos Santos, J Moutinho

    2015-01-01

    Obstructive sleep apnea syndrome (OSAS) and insomnia often coexist, and it is estimated that nearly half of those who suffer from the former report symptoms of the latter. The fact that these patients have no other causes of insomnia indicates that it is a sign of OSAS. The aim of the study is to evaluate the effectiveness of nocturnal ventilatory support (NVS) in the treatment of insomnia secondary to OSAS. In order to conduct the retrospective study, the authors reviewed the medical records of patients with insomnia and OSAS that had received NVS. Patients with psychiatric disorders, sleep movement disorders, psycho-physiological insomnia, circadian rhythm sleep disorders, inadequate sleep hygiene, use and abuse of hypnotic agents, stimulants, antidepressants, anxiolytics and alcohol, were excluded. For the selected patients, the effects of NVS in terms of clinical signs and symptoms of insomnia, apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS) score, and number of sleep hours were analyzed, before and after treatment with NVS. After reviewing 1241 medical records, 56 patients were selected, with a mean age of 60.9±10.0 years. Twenty-two (39.3%) suffered from intermediate insomnia, 19 (33.9%) had initial insomnia, eight (14.3%) had the mixed type, and seven patients (12.5%) had terminal insomnia. The majority of patients (n=48; 85.7%) were treated with auto-titrating continuous positive airway pressure (APAP). Forty-four patients (78.6%) overcame insomnia; insomnia symptoms persisted in nine (16.1%), and three (5.4%) patients abandoned during the medical follow-up. There was an association between the type of insomnia and its resolution and, in percentage terms patients with the mixed type did not manage to overcome insomnia symptoms (75%). There was a statistically significant difference between patients that overcame insomnia and those who did not in terms of the average time which elapsed between the initiation of treatment with NVS and compliance

  10. Adjustable link for kinematic mounting systems

    Science.gov (United States)

    Hale, L.C.

    1997-07-01

    An adjustable link for kinematic mounting systems is disclosed. The adjustable link is a low-cost, passive device that provides backlash-free adjustment along its single constraint direction and flexural freedom in all other directions. The adjustable link comprises two spheres, two sockets in which the spheres are adjustable retain, and a connection link threadly connected at each end to the spheres, to provide a single direction of restraint and to adjust the length or distance between the sockets. Six such adjustable links provide for six degrees of freedom for mounting an instrument on a support. The adjustable link has applications in any machine or instrument requiring precision adjustment in six degrees of freedom, isolation from deformations of the supporting platform, and/or additional structural damping. The damping is accomplished by using a hollow connection link that contains an inner rod and a viscoelastic separation layer between the two. 3 figs.

  11. NORD's Patient Assistance Programs

    Science.gov (United States)

    ... ctx@rarediseases.org Fax: 1-203-517-0978 Cushing’s Disease | Accepting Applications Medical Assistance Co-Pay Assistance Premium Assistance Medication Assistance Contact: 1-855-864-4018 Email: cushings@rarediseases.org Fax: 1-203-517-0978 Cutaneuos ...

  12. Adjustments to amputation and an artificial limb in lower limb amputees.

    Science.gov (United States)

    Sinha, Richa; van den Heuvel, Wim J A; Arokiasamy, Perianayagam

    2014-04-01

    Positive adjustments to amputation and an artificial limb play important roles in the rehabilitation process. To study the different facets of adjustments to amputation and an artificial limb in lower limb amputees and to assess the possible role of different background and amputation-related factors that could potentially influence these adjustments. Cross-sectional. Adult unilateral and non-congenital lower limb amputees (n = 368) met the inclusion/exclusion criteria. Face-to-face interviews were conducted using structured questionnaires including patient's background, amputation and the Trinity Amputation and Prosthesis Experience Scales. Amputees were on average satisfied with the functioning of the prosthesis, moderately psychosocially adjusted and not restricted in performing functional and social activities, except for athletic activities. Age, employment, daily use of prosthesis and assistive device use were the most important factors associated with adjustments to amputation and prosthesis, followed by gender, co-morbidity and amputation level. Evaluation of employment status and measures to curb unemployment through vocational rehabilitation and providing assistance for placement should be intrinsic to the rehabilitation programme. Future studies are envisaged to understand the underlying factors determining the extent of daily use of prosthesis and the reasons for the use of assistive devices by the amputees. Clinical relevance Proper appraisal and measures to alleviate employment and co-morbidity, related issues, routine evaluation of daily use of prosthesis and providing appropriate gait training might facilitate immediate and long-term adjustment.

  13. 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...

  14. Hyperoxia-induced developmental plasticity of the hypoxic ventilatory response in neonatal rats: contributions of glutamate-dependent and PDGF-dependent mechanisms.

    Science.gov (United States)

    Bavis, Ryan W; DeAngelis, Kathryn J; Horowitz, Terry C; Reedich, Lisa M; March, Ryan J

    2014-01-15

    Rats reared in hyperoxia exhibit a sustained (vs. biphasic) hypoxic ventilatory response (HVR) at an earlier age than untreated, Control rats. Given the similarity between the sustained HVR obtained after chronic exposure to developmental hyperoxia and the mature HVR, it was hypothesized that hyperoxia-induced plasticity and normal maturation share common mechanisms such as enhanced glutamate and nitric oxide signaling and diminished platelet-derived growth factor (PDGF) signaling. Rats reared in 21% O2 (Control) or 60% O2 (Hyperoxia) from birth until 4-5 days of age were studied after intraperitoneal injection of drugs targeting these pathways. Hyperoxia rats receiving saline showed a sustained HVR to 12% O2, but blockade of NMDA glutamate receptors (MK-801) restored the biphasic HVR typical of newborn rats. Blockade of PDGF-β receptors (imatinib) had no effect on the pattern of the HVR in Hyperoxia rats, although it attenuated ventilatory depression during the late phase of the HVR in Control rats. Neither nitric oxide synthase inhibitor used in this study (nNOS inhibitor I and l-NAME) altered the pattern of the HVR in Control or Hyperoxia rats. Drug-induced changes in the biphasic HVR were not correlated with changes in metabolic rate. Collectively, these results suggest that developmental hyperoxia hastens the transition from a biphasic to sustained HVR by upregulating glutamate-dependent mechanisms and downregulating PDGF-dependent mechanisms, similar to the changes underlying normal postnatal maturation of the biphasic HVR. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Role of nitric oxide-containing factors in the ventilatory and cardiovascular responses elicited by hypoxic challenge in isoflurane-anesthetized rats.

    Science.gov (United States)

    Mendoza, James P; Passafaro, Rachael J; Baby, Santhosh M; Young, Alex P; Bates, James N; Gaston, Benjamin; Lewis, Stephen J

    2014-06-01

    Exposure to hypoxia elicits changes in mean arterial blood pressure (MAP), heart rate, and frequency of breathing (fR). The objective of this study was to determine the role of nitric oxide (NO) in the cardiovascular and ventilatory responses elicited by brief exposures to hypoxia in isoflurane-anesthetized rats. The rats were instrumented to record MAP, heart rate, and fR and then exposed to 90 s episodes of hypoxia (10% O2, 90% N2) before and after injection of vehicle, the NO synthase inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME), or the inactive enantiomer D-NAME (both at 50 μmol/kg iv). Each episode of hypoxia elicited a decrease in MAP, bidirectional changes in heart rate (initial increase and then a decrease), and an increase in fR. These responses were similar before and after injection of vehicle or D-NAME. In contrast, the hypoxia-induced decreases in MAP were attenuated after administration of L-NAME. The initial increases in heart rate during hypoxia were amplified whereas the subsequent decreases in heart rate were attenuated in L-NAME-treated rats. Finally, the hypoxia-induced increases in fR were virtually identical before and after administration of L-NAME. These findings suggest that NO factors play a vital role in the expression of the cardiovascular but not the ventilatory responses elicited by brief episodes of hypoxia in isoflurane-anesthetized rats. Based on existing evidence that NO factors play a vital role in carotid body and central responses to hypoxia in conscious rats, our findings raise the novel possibility that isoflurane blunts this NO-dependent signaling. Copyright © 2014 the American Physiological Society.

  16. No evidence of a role for neuronal nitric oxide synthase in the nucleus tractus solitarius in ventilatory responses to acute or chronic hypoxia in awake rats

    Science.gov (United States)

    Pamenter, Matthew E.; Go, Ariel; Fu, Zhenxing

    2015-01-01

    When exposed to a hypoxic environment, the body's first response is a reflex increase in ventilation, termed the hypoxic ventilatory response (HVR). With chronic sustained hypoxia (CSH), such as during acclimatization to high altitude, an additional time-dependent increase in ventilation occurs, which increases the HVR and is termed ventilatory acclimatization to hypoxia (VAH). This secondary increase persists after exposure to CSH and involves plasticity within the circuits in the central nervous system that control breathing. The mechanisms of HVR plasticity are currently poorly understood. We hypothesized that changes in neuronal nitric oxide synthase (nNOS) activity or expression in the nucleus tractus solitarius contribute to this plasticity and underlie VAH in rats. To test this, we treated rats held in normoxia or 10% O2 (CSH, PiO2 = 70 Torr) for 7–9 days and measured ventilation in conscious, unrestrained animals before and after microinjecting the general NOS antagonist L-NG-Nitroarginine methyl ester into the nucleus tractus solitarius (NTS) or systemically injecting the nNOS-specific antagonist S-methyl-l-thiocitrulline. Localization of injection sites in the NTS was confirmed by histology following the experiment. We found that 1) neither NTS-specific nor systemic nNOS antagonism had any effect on hypoxia-mediated changes in breathing or metabolism (P > 0.05), but 2) nNOS protein expression was increased in the middle and caudal NTS by CSH. A persistent HVR after nNOS blockade in the NTS contrasts with results in awake mice, and our findings do not support the hypotheses that nNOS in the NTS contribute to the HVR or VAH in awake rats. PMID:25571988

  17. Assessing Marital Adjustment and Satisfaction: A Review.

    Science.gov (United States)

    Burnett, Paul

    1987-01-01

    Evaluated five instruments of marital adjustment and satisfaction: Marital Adjustment Test, Dyadic Adjustment Scale, Marital Satisfaction Index, Marital Satisfaction Scale, and the Kansas Marital Satisfaction Scale. Discusses studies evaluating psychometric properties of each instrument. Recommends the Marital Satisfaction Index for assessing…

  18. 7 CFR 2201.30 - Adjustments.

    Science.gov (United States)

    2010-01-01

    ... adjustment does not adversely affect the interest of the Federal Government in the Assets or Collateral of... 7 Agriculture 15 2010-01-01 2010-01-01 false Adjustments. 2201.30 Section 2201.30 Agriculture... TELEVISION LOAN GUARANTEE PROGRAM-PROGRAM REGULATIONS Loan Guarantees § 2201.30 Adjustments. (a) The Board...

  19. 7 CFR 1744.64 - Budget adjustment.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in a budget account, the borrower may request RUS's approval of a budget adjustment to use funds from another...

  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. 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.

  2. Potential adjustments to climate change

    International Nuclear Information System (INIS)

    Arthur, L.M.

    1990-01-01

    There are three basic approaches to the problem of climate change: prevention through reduction of greenhouse gas emissions, repair of damages by offsetting the effects of the gases, or learning to live with the climatic changes. Delaying greenhouse warming does not seem possible, at least not without substantial, unsupportable costs. A number of strategies to counter the effects of increasing concentrations of greenhouse gases have been proposed, but few have been given serious attention. Alternatives include additions of particulate matter to the atmosphere, altering land use to change the earth's reflectivity, cultivating carbon-eating organisms in the ocean, and injecting sulfur dioxide into the stratosphere to absorb visible sunlight. A contrasting response to the aggravated greenhouse effect is to require the world to adjust. Before potential adaptation strategies can be identified, regional and sectoral impacts of climate change must be understood, but few studies to date are convincing. It is suggested that the best response may be to delay any action on climatic warming, except in those cases where action can be justified on the basis of immediate or non-climate related benfits. 10 refs

  3. Factors influencing adjustment to a colostomy in Chinese patients: a cross-sectional study.

    Science.gov (United States)

    Hu, Ailing; Pan, Yunfeng; Zhang, Meifen; Zhang, June; Zheng, Meichun; Huang, Manrong; Ye, Xinmei; Wu, Xianrong

    2014-01-01

    We evaluated persons living with a colostomy in order to characterize and describe relationships among adjustment, self-care ability, and social support. One hundred twenty-nine colostomy patients from 5 hospitals in Guangzhou, capital city of the Guangdong province, were recruited by convenience sampling. Cross-sectional data were collected from a survey that included demographic and pertinent clinical data related to their ostomy. The survey also incorporated Chinese language versions of the Ostomy Adjustment Scale, Exercise of Self-Care Agency Scale, and Perceived Social Support Scale. These scales were used to measure the levels and degrees of adjustment, self-care ability, and social support of colostomy patients. Respondents completed the survey during outpatient clinics visit after creation of a colostomy. Scores from the Ostomy Adjustment Scale revealed that 96.9% of colostomy patients reported low to moderate adjustment (128.6 ± 19.38) to their stoma. Self-care ability and social support of patients were positively correlated with the adjustment level (R = 0.33, R = 0.21). Several factors, including being a housewife, paying medical expense by oneself, inability to manage the ostomy without assistance, and not participating in an ostomy support group, were associated with a lower level of adjustment (P antipathy toward the ostomy significantly contributed to lower levels of adjustment to the stoma (P < .01). Overall adjustment to a colostomy was moderate. Self-care ability and social support associated with having a colostomy positively influenced adjustment. Adjustment was also influenced by occupation, health insurance provider, and ability to care for the stoma without requiring assistance.

  4. Adjustable magnification anamorphic beam expander

    Science.gov (United States)

    Escobar, S. R.

    1990-08-01

    A visible laser diode package is proposed to substitute a Krpton-Ion laser for alignment purposes. The proposed system uses 5 Melles Griot AR coated stock lenses. Tests performed to the optics reveal some undesirable properties, such as, astigmatism and spherical aberration; however, the interference pattern and star test reveals what seems to be a good quality wavefront. The interference fringes seem to be very good, but there still is a small presence of a comalike aberration at the fringes extreme. The star test revealed the system to be about 3 times diffraction limited. The system has yet to be tested in an alignment situation. As for now, it is ready to be tested with some minor alignment adjustments necessary for a good wavefront quality. A safety memo was written for testing the prototype system at the alignment lab. The initial laser diode system alignment method suggested, uses a reverse alignment procedure. In this procedure, the expected output (30 mm diameter beam) is input into the system output and alignment is performed by moving the components until the desired system input is found; an elliptical beam with 1 mm in the horizontal axis and 4 mm in the vertical axis. Once this reverse alignment procedure is completed the laser diode is placed at the system input. Fine alignment is done with the help of shear plate interference patterns in both, the 1 mm axis and 4 mm axis. The proposed final opto-mechanical packaging of this system is formed with squared adapter plates that are connected by means of four support rods where the center of the plate becomes the optical axis. These components are commercially available and provide high mechanical stability.

  5. 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.

  6. Automatic adjustment of astrochronologic correlations

    Science.gov (United States)

    Zeeden, Christian; Kaboth, Stefanie; Hilgen, Frederik; Laskar, Jacques

    2017-04-01

    Here we present an algorithm for the automated adjustment and optimisation of correlations between proxy data and an orbital tuning target (or similar datasets as e.g. ice models) for the R environment (R Development Core Team 2008), building on the 'astrochron' package (Meyers et al.2014). The basis of this approach is an initial tuning on orbital (precession, obliquity, eccentricity) scale. We use filters of orbital frequency ranges related to e.g. precession, obliquity or eccentricity of data and compare these filters to an ensemble of target data, which may consist of e.g. different combinations of obliquity and precession, different phases of precession and obliquity, a mix of orbital and other data (e.g. ice models), or different orbital solutions. This approach allows for the identification of an ideal mix of precession and obliquity to be used as tuning target. In addition, the uncertainty related to different tuning tie points (and also precession- and obliquity contributions of the tuning target) can easily be assessed. Our message is to suggest an initial tuning and then obtain a reproducible tuned time scale, avoiding arbitrary chosen tie points and replacing these by automatically chosen ones, representing filter maxima (or minima). We present and discuss the above outlined approach and apply it to artificial and geological data. Artificial data are assessed to find optimal filter settings; real datasets are used to demonstrate the possibilities of such an approach. References: Meyers, S.R. (2014). Astrochron: An R Package for Astrochronology. http://cran.r-project.org/package=astrochron R Development Core Team (2008). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0, URL http://www.R-project.org.

  7. Partnership for Prescription Assistance

    Science.gov (United States)

    ... may use our name without our permission. The Partnership for Prescription Assistance will help you find the ... Events Blog Facebook Twitter Start living better. The Partnership for Prescription Assistance helps qualifying patients without prescription ...

  8. Assisted Reproductive Technology (ART)

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print Assisted Reproductive Technology (ART) ART refers to treatments and procedures that ... American Society for Reproductive Medicine. (2015). Assisted reproductive technologies: A guide for patients . Retrieved May 31, 2016, ...

  9. Institutionalizing Security Force Assistance

    National Research Council Canada - National Science Library

    Binetti, Michael R

    2008-01-01

    .... It looks at the manner in which security assistance guidance is developed and executed. An examination of national level policy and the guidance from senior military and civilian leaders highlights the important role of Security Force Assistance...

  10. 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...

  11. Assisted delivery with forceps

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000509.htm Assisted delivery with forceps To use the sharing features on ... called vacuum assisted delivery . When is a Forceps Delivery Needed? Even after your cervix is fully dilated ( ...

  12. Vacuum-assisted delivery

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000514.htm Vacuum-assisted delivery To use the sharing features on this page, ... through the birth canal. When is Vacuum-assisted Delivery Needed? Even after your cervix is fully dilated ( ...

  13. 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.

  14. 24 CFR 883.308 - Adjustments to reflect changes in terms of financing.

    Science.gov (United States)

    2010-04-01

    ... Housing and Urban Development (Continued) OFFICE OF THE ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING... DIRECT LOAN PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE... AGENCIES Definitions and Other Requirements § 883.308 Adjustments to reflect changes in terms of financing...

  15. Submaximal cardiopulmonary thresholds on a robotics-assisted tilt table, a cycle and a treadmill: a comparative analysis.

    Science.gov (United States)

    Saengsuwan, Jittima; Nef, Tobias; Laubacher, Marco; Hunt, Kenneth J

    2015-11-10

    The robotics-assisted tilt table (RATT), including actuators for tilting and cyclical leg movement, is used for rehabilitation of severely disabled neurological patients. Following further engineering development of the system, i.e. the addition of force sensors and visual bio-feedback, patients can actively participate in exercise testing and training on the device. Peak cardiopulmonary performance parameters were previously investigated, but it also important to compare submaximal parameters with standard devices. The aim of this study was to evaluate the feasibility of the RATT for estimation of submaximal exercise thresholds by comparison with a cycle ergometer and a treadmill. 17 healthy subjects randomly performed six maximal individualized incremental exercise tests, with two tests on each of the three exercise modalities. The ventilatory anaerobic threshold (VAT) and respiratory compensation point (RCP) were determined from breath-by-breath data. VAT and RCP on the RATT were lower than the cycle ergometer and the treadmill: oxygen uptake (V'O2) at VAT was [mean (SD)] 1.2 (0.3), 1.5 (0.4) and 1.6 (0.5) L/min, respectively (p < 0.001); V'O2 at RCP was 1.7 (0.4), 2.3 (0.8) and 2.6 (0.9) L/min, respectively (p = 0.001). High correlations for VAT and RCP were found between the RATT vs the cycle ergometer and RATT vs the treadmill (R on the range 0.69-0.80). VAT and RCP demonstrated excellent test-retest reliability for all three devices (ICC from 0.81 to 0.98). Mean differences between the test and retest values on each device were close to zero. The ventilatory equivalent for O2 at VAT for the RATT and cycle ergometer were similar and both were higher than the treadmill. The ventilatory equivalent for CO2 at RCP was similar for all devices. Ventilatory equivalent parameters demonstrated fair-to-excellent reliability and repeatability. It is feasible to use the RATT for estimation of submaximal exercise thresholds: VAT and RCP on the RATT were lower than the

  16. TREE AGE AS ADJUSTMENT FACTOR TO NDVI

    OpenAIRE

    Elias Fernando Berra; Denise Cybis Fontana; Tatiana Mora Kuplich

    2018-01-01

    ABSTRACT This study aimed to increase satellite-derived Normalized Difference Vegetation Index (NDVI) sensitivity to biophysical parameters changes with aid of a forest age-based adjustment factor. This factor is defined as a ratio between stand age and age of rotation, which value multiplied by Landsat-5/TM-derived NDVI generated the so-called adjusted index NDVI_a. Soil Adjusted Vegetation Index (SAVI) was also calculated. The relationship between these vegetation indices (VI) with Eucalypt...

  17. 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…

  18. A Digital Game for International Students' Adjustment

    Science.gov (United States)

    Bisadi, Maryam; Chua, Alton Y. K; Keong, Lee Chu

    2013-01-01

    Although digital games have been developed for various subject areas, little attention has been focused on using digital games to address international students' adjustment issues. For this reason, this paper endeavors to explore the use of a digital game in facilitating international students acquire adjustment-related information. Specifically,…

  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. Family Adjustment Measure: Scale Construction and Validation

    Science.gov (United States)

    Daire, Andrew P.; Dominguez, Vanessa N.; Carlson, Ryan G.; Case-Pease, Jenene

    2014-01-01

    We administered the Family Adjustment Measure to 368 parents of children with special needs to identify positive adjustment. We randomly split the sample to conduct exploratory factor analysis ("n" = 194) and confirmatory factor analysis ("n" = 174). Results indicated four possible subscales and that explain 51% of the variance.

  1. 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)

  2. Fiscal adjustments and asset price movements

    OpenAIRE

    Athanasios Tagkalakis

    2009-01-01

    This paper examines the links between asset price movements and fiscal adjustments. Our findings suggest that a pick up in asset prices increases the probability of initiating a fiscal adjustment, but it does not necessarily lead to a sustainable correction of fiscal imbalances. However, higher real equity prices increase the probability of success.

  3. 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....

  4. Psychological Separation and Adjustment to College.

    Science.gov (United States)

    Lapsley, Daniel K.; And Others

    1989-01-01

    Examined relationship between psychological separation and adjustment to college in freshmen (N=130) and upperclassmen (N=123). Found freshmen showed more psychological dependencies on parents than upperclassmen; separation appeared more strongly related to personal/emotional adjustment, particularly functional and emotional independence from…

  5. Psychologica and social adjustment to blindness: Understanding ...

    African Journals Online (AJOL)

    Psychologica and social adjustment to blindness: Understanding from two groups of blind people in Ilorin, Nigeria. ... Background: Blindness can cause psychosocial distress leading to maladjustment if not mitigated. Maladjustment is a secondary burden that further reduces quality of life of the blind. Adjustment is often ...

  6. Correlational indicators of psychosocial adjustment among senior ...

    African Journals Online (AJOL)

    There was a significant joint contribution of the independent variables (sense of coherence, optimism and self-efficacy) to the prediction of psychosocial adjustment. This suggested that the three independent variables combined accounted for 30.4% (Adj.R2= .304) variation in the prediction of psychosocial adjustment.

  7. Premium adjustment: actuarial analysis on epidemiological models ...

    African Journals Online (AJOL)

    Premium adjustment: actuarial analysis on epidemiological models. DEA Omorogbe, SO Edobor. Abstract. In this paper, we analyse insurance premium adjustment in the context of an epidemiological model where the insurer's future financial liability is greater than the premium from patients. In this situation, it becomes ...

  8. 24 CFR 886.112 - Rent adjustments.

    Science.gov (United States)

    2010-04-01

    ... to adjustments of the dollar amount stated in the Contract as the Maximum Unit Rent. It does not... increased amounts commensurate with Contract Rent adjustments up to the maximum annual amount of housing... written request for a rent increase submitted by the owner and properly supported by substantiating...

  9. 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…

  10. 14 CFR Appendix - Example of SIFL Adjustment

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Example of SIFL Adjustment Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) POLICY STATEMENTS... taxes for rate purposes. Pt. 399, Subpt. C, Example Example of SIFL Adjustment [Methodology for...

  11. Adjustment Following Disability: Representative Case Studies.

    Science.gov (United States)

    Heinemann, Allen W.; Shontz, Franklin C.

    1984-01-01

    Examined adjustment following physical disability using the representative case method with two persons with quadriplegia. Results highlighted the importance of previously established coping styles as well as the role of the environment in adjustment. Willingness to mourn aided in later growth. (JAC)

  12. relationship between parenting styles and marital adjustment

    African Journals Online (AJOL)

    PROF. BARTH EKWEME

    The relationship between permissive parenting style and marital adjustment was also very low, positive and insignificant. There was a low, positive and significant joint relationship between the parenting styles and marital adjustment of married teachers in secondary schools in Obio/Akpor Local Government Area of Rivers ...

  13. 10 CFR 905.34 - Adjustment provisions.

    Science.gov (United States)

    2010-01-01

    ... continue to take place based on existing contract/marketing criteria principles. ... 10 Energy 4 2010-01-01 2010-01-01 false Adjustment provisions. 905.34 Section 905.34 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.34 Adjustment...

  14. Theatre Practice and Social Adjustment in Nigeria

    African Journals Online (AJOL)

    Nneka Umera-Okeke

    Media Sociology Lecturer. Department of Theatre and Film Studies ... the recent call for all-inclusive processes of adjustments in favour of local processes to drive social and economic development. ... materials which would have provided dependable social relations and basis for adequate adjustment. You do not “try new ...

  15. Academic Adjustment Amongst First Year Undergraduate Students ...

    African Journals Online (AJOL)

    A successful academic adjustment of first year students to the university will enable them complete their studies. The work examines the academic adjustment amongst first year students in Anambra State University, Uli (ANSU). Two research questions and two null hypotheses guided to study. Stratified random sampling ...

  16. psychosocial adjustment to epilepsy among nigerians

    African Journals Online (AJOL)

    comparison criteria, results indicated that “poorly seizure controlled epileptics” reported more adjustment difficulties in all the five ... Unemployed epileptic group reported more emotional, vocational, and financial adjustment difficulties than the employed ... and EEG considerations by either a consultant Neurologist or a.

  17. 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 hurdle...... 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...

  18. 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.

  19. 75 FR 33379 - Railroad Cost Recovery Procedures-Productivity Adjustment; Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2010-06-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Surface Transportation Board Railroad Cost Recovery Procedures--Productivity Adjustment; Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board. ] ACTION: Notice and request for comments...

  20. 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.

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

    Science.gov (United States)

    Ciuffini, F; Pietrasanta, C; Lavizzari, A; Musumeci, S; Gualdi, C; Sortino, S; Colnaghi, M; Mosca, F

    2014-08-31

    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).

  2. Restoring Functional Status: A Long-Term Case Report of Severe Lung and Ventilatory Muscle Pump Dysfunction Involving Recurrent Bacterial Pneumonias

    Science.gov (United States)

    Sobush, Dennis C.; Laatsch, Linda; Lipchik, Randolph J.

    2012-01-01

    Background and Purpose Prolonged mechanical ventilation contributes to immobility and deconditioning making efforts to safely discontinue ventilator support desirable. This case report documents how implementing physical therapy treatment interventions, based on the Guide to Physical Therapist Practice, can help to restore a person's functional status even after multiple years of mechanical ventilation dependency. Case Description A patient (female; aged 63 years) with severe restrictive and obstructive ventilatory impairment has survived 34 recurrent pneumonias involving 6 bacterial pathogens while being mechanically ventilated at home. A 3-year study was approved and informed consent obtained for a home exercise program of resistive extremity and inspiratory muscle training along with exercise reconditioning. Tolerable distances walked, maximal inspiratory and expiratory pressures, hours spent on versus off mechanical ventilation, activities performed within and around her home, and community excursions taken were charted. Outcomes Daily time tolerated off the ventilator improved from less than one to 12 hours, distance walked in 6 minutes increased 33%, and maximal inspiratory and expiratory pressures improved 62% and 9.6% respectively. These improvements made out-of-home social excursions possible. Discussion and Conclusions This patient's functional status improved following multiple physical therapy interventions dictated by the evaluation of initial physical therapy examination findings according to the Guide to Physical Therapist Practice. Long term mechanical ventilator dependency in the home environment did not exclude this patient from achieving clinically significant gains in functional status even when having severe restrictive and obstructive ventilator impairment. PMID:22833704

  3. Restoring functional status: a long-term case report of severe lung and ventilatory muscle pump dysfunction involving recurrent bacterial pneumonias.

    Science.gov (United States)

    Sobush, Dennis C; Laatsch, Linda; Lipchik, Randolph J

    2012-06-01

    Prolonged mechanical ventilation contributes to immobility and deconditioning making efforts to safely discontinue ventilator support desirable. This case report documents how implementing physical therapy treatment interventions, based on the Guide to Physical Therapist Practice, can help to restore a person's functional status even after multiple years of mechanical ventilation dependency. A patient (female; aged 63 years) with severe restrictive and obstructive ventilatory impairment has survived 34 recurrent pneumonias involving 6 bacterial pathogens while being mechanically ventilated at home. A 3-year study was approved and informed consent obtained for a home exercise program of resistive extremity and inspiratory muscle training along with exercise reconditioning. Tolerable distances walked, maximal inspiratory and expiratory pressures, hours spent on versus off mechanical ventilation, activities performed within and around her home, and community excursions taken were charted. Daily time tolerated off the ventilator improved from less than one to 12 hours, distance walked in 6 minutes increased 33%, and maximal inspiratory and expiratory pressures improved 62% and 9.6% respectively. These improvements made out-of-home social excursions possible. This patient's functional status improved following multiple physical therapy interventions dictated by the evaluation of initial physical therapy examination findings according to the Guide to Physical Therapist Practice. Long term mechanical ventilator dependency in the home environment did not exclude this patient from achieving clinically significant gains in functional status even when having severe restrictive and obstructive ventilator impairment.

  4. Cross-Cultural Adjustment of Chinese Students in Japan: School Adjustment and Educational Support

    OpenAIRE

    Li, Yuan Xiang; Sano, Hideki; Ahn, Ruth

    2013-01-01

    This study investigates Chinese immigrant students‘ cross-cultural and school adjustment issues in Japanese schools. Using a quantitative method, a survey which collected students‘ demographic information, cross-cultural adjustment, and school adjustment questions was administered to 143 Chinese junior high and high school students in Tokyo and Kanagawa Prefecture. The study found the following. First, three factors were identified to be significant in the students‘ cross-cultural adjustment:...

  5. 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

  6. 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.

  7. 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. © 2013 Elsevier B.V. All rights reserved.

  8. Cross-Cultural Adjustment of Chinese Students in Japan: School Adjustment and Educational Support

    Science.gov (United States)

    Li, Yuan Xiang; Sano, Hideki; Ahn, Ruth

    2013-01-01

    This study investigates Chinese immigrant students' cross-cultural and school adjustment issues in Japanese schools. Using a quantitative method, a survey which collected students' demographic information, cross-cultural adjustment, and school adjustment questions was administered to 143 Chinese junior high and high school students in Tokyo and…

  9. Postnatal follow-up of the oxygenation index, arterial to alveolar oxygen tension ratio and alveolar arterial oxygen tension difference values in neonates with the respiratory distress syndrome treated with conventional ventilatory support.

    Science.gov (United States)

    Atanasov, A; Despotova-Toleva, L

    1997-01-01

    Recent development of sophisticated intensive care technique for use in newborn infants with the respiratory distress syndrome (RDS) has resulted in changes in the therapeutic strategies and moved the problem of neonatal survival into the realm of new therapeutic realities. At present, the mechanical ventilation methods form an integral part of the intensive care strategy of infants with RDS. They have come to the forefront of infant care because of their successful use in ventilatory support and children survival where other therapeutic modalities have failed. The present prospective observational longitudinal study was designed to assess the real-time convenience, reliability and accuracy of the changes in the oxygenation index (OI), arterial-to-alveolar oxygen tension ratio (a/A PO2) and alveolar-arterial oxygen gradient (A-a)DO2 in ventilator-dependent neonates with RDS, to analyze their feasibility and potential information yield in oxygen inhalation therapy as well as their prognostic implications and predictive value. Twenty neonates with RDS, heralded by respiratory failure which necessitated the initiation of oxygen inhalation therapy and ventilatory support within 24 hours of birth, were enrolled in the study. Ten of the infants survived and the remaining ten died. OI, (a/A PO2) and (A-a)DO2 were followed up sequentially and thoroughly analyzed as the primary outcome measures of the study. The indices were calculated on the basis of the complete monitoring of the ventilatory equipment parameters and acid-base status carried out on an hourly basis. Our results show that: 1. The combination of three indexes (OI, (a/A)PO2 and (A-a)DO2 we propose is a useful discriminating predictor of neonatal lung maturity reflecting arterial blood gas status in ventilator-dependent neonates with RDS. 2. The indices detect the efficacy of the modern conventional ventilatory support with real-time convenience and reliable accuracy forming the cornerstone of clinical decision

  10. 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

  11. Competition for Assistance Agreements

    Science.gov (United States)

    It is EPA policy to promote competition in the award of assistance agreements to the maximum extent practicable.When assistance agreements are awarded competitively, it is EPA policy that the competitive process be fair and open & that no applicant receive

  12. Assistive Technology (Moldinclud)

    OpenAIRE

    Luján Mora, Sergio

    2011-01-01

    Slides of the seminar "Assistive Technology" taught at the Institul de Stat de Instruire Continua (Chisinau, Moldova) in november 2011. Transparencias del seminario "Assistive Technology" impartido en el Institul de Stat de Instruire Continua (Chisinau, Moldavia) en noviembre 2011. Tempus project: MOLDINCLUD, Teaching Training Centre for Inclusive Education (TEMPUS 158980-2009).

  13. Price Changes, Resource Adjustments and Rational Expectations

    DEFF Research Database (Denmark)

    Hoffmann, Kira

    a decrease in prices through managers that anticipated the drop in demand and proactively lower selling prices and cut resources. Moreover, this study provides evidence for the moderating effect of managerial forecast accuracy on the relationship between demand uncertainty and cost elasticity. Findings show......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...... compared to unexpected demand shocks. The association is tested using the empirical concept of cost stickiness. Cost stickiness arises as a consequence of asymmetric resource or price adjustments. Resource and price adjustments are termed asymmetric if the magnitude of change is different for increases...

  14. 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.

  15. 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.  

  16. 76 FR 67500 - Postal Service Price Adjustment

    Science.gov (United States)

    2011-11-01

    ... provides an overview, a discussion of any necessary adjustments to the billing determinants for the four... that its January 2012 prices for these parcels will be provided in a notice filed later this fall. Id...

  17. 78 FR 70080 - Market Dominant Price Adjustment

    Science.gov (United States)

    2013-11-22

    ... comments otherwise subject to a filing date that falls during a lapse in appropriations if they are... adjustments to the billing determinants for the four quarters ending FY 2013, quarter 3, and an explanation of...

  18. Adjustment to Divorce Through Transactional Analysis

    Science.gov (United States)

    Morris, James D.; Prescott, Mary R.

    1976-01-01

    Transactional Analysis in a group facilitates adjustment to divorce. Two case histories highlight the value of TA in conceptualizing the problem areas of each individual and the changes during group therapy. (Author)

  19. Determinants of intercultural adjustment among expatriate spouses

    NARCIS (Netherlands)

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

    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

  20. Atopic diseases in twins born after assisted reproduction

    DEFF Research Database (Denmark)

    Jäderberg, Ida; Thomsen, Simon F; Kyvik, Kirsten Ohm

    2012-01-01

    Jäderberg I, Thomsen SF, Kyvik KO, Skytthe A, Backer V. Atopic diseases in twins born after assisted reproduction. Paediatric and Perinatal Epidemiology 2012; 26: 140-145. We examined the risk of atopic diseases in twins born after assisted reproduction. Data on atopic diseases and assisted...... reproduction in 9694 twin pairs, 3-20 years of age, from the Danish Twin Registry were collected via multidisciplinary questionnaires. The risk of atopic diseases in twins born after assisted reproduction was compared with the risk in twins born after spontaneous conception using logistic regression...... and variance components analysis. Children born after assisted reproduction did not have a different risk of atopic outcomes (adjusted odds ratios [95% confidence intervals] for asthma: 0.95 [0.85, 1.07], P = 0.403; hay fever: 1.01 [0.86, 1.18], P = 0.918; and atopic dermatitis: 1.02 [0.81, 1.11], P = 0...

  1. [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.

  2. Effect of prenatal exposure to fine particulate matter on ventilatory lung function of preschool children of non-smoking mothers.

    Science.gov (United States)

    Jedrychowski, Wieslaw A; Perera, Frederica P; Maugeri, Umberto; Mroz, Elzbieta; Klimaszewska-Rembiasz, Maria; Flak, Elzbieta; Edwards, Susan; Spengler, John D

    2010-09-01

    Impaired fetal development is associated with a number of adult chronic diseases and it is believed that these associations arise as a result of the phenomenon of prenatal programming, which involves persisting changes in structure and function of various body organs caused by ambient factors during critical and vulnerable periods of early development. The main goal of the study was to assess the association between lung function in early childhood and prenatal exposure to fine particulate matter (PM(2.5)), which represents a wide range of chemical compounds potentially hazardous for fetal development. Among pregnant women recruited prenatally to the study, personal measurements of PM(2.5) were performed over 48 h in the second trimester of pregnancy. After delivery, infants were followed for 5 years; the interviewers visited participants in their homes to record children's respiratory symptoms every 3 months in the child's first 2 years of life and every 6 months thereafter. In the fifth year of the follow-up, children were invited for standard lung function testing of levels of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV(1)) and forced expiratory volume in 0.5 s (FEV(0.5)). There were 176 children of non-smoking mothers, who performed at least two acceptable spirometry measurements. Multivariable linear regression showed a significant deficit of FVC at the highest quartile of PM(2.5) exposure (beta coefficient = -91.9, P = 0.008), after adjustment for covariates (age, gender, birthweight, height and wheezing). Also FEV(1) level in children was inversely correlated with prenatal exposure to PM(2.5), and the average FEV(1) deficit amounted to 87.7 mL (P = 0.008) at the higher level of exposure. Although the effect of PM(2.5) exposure on FEV(0.5) was proportionally weaker (-72.7, P = 0.026), it was also statistically significant. The lung function level was inversely and significantly associated with the wheezing recorded over the follow

  3. 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

  4. Laparoscopy-Assisted Appendectomy via the patent umbilical ring ...

    African Journals Online (AJOL)

    Umbilical hernia aswell as acute appendicitis are two of the most common problems seen by paediatric surgeons, although rarely simultaneously. When detected the operative approach is adjusted. We perform the a laparoscopically assisted appendectomy trough through the an excised umbilical hernia sac opening.

  5. 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)....

  6. Role of video-assisted thoracoscopy in patients with ovarian cancer and pleural effusion.

    Science.gov (United States)

    Cohen-Mouly, Sandra; Badia, Alain; Bats, Anne-Sophie; Barthes, Françoise; Bensaïd, Chérazade; Riquet, Marc; Lécuru, Fabrice

    2009-12-01

    To evaluate the feasibility of video-assisted thoracoscopy (VAT) for staging advanced ovarian cancer, to measure the performance of preoperative computed tomography (CT) for diagnosing pleural metastases, to assess the correlation between pleural and abdominal involvement, and to measure the impact of VAT on patient management. We retrospectively evaluated 16 VAT procedures in 15 patients with advanced ovarian malignancies and pleural effusions. The reason for VAT was either to evaluate unilateral or bilateral pleural effusions (n = 15) or to evaluate pleural metastases after neoadjuvant chemotherapy (n = 1). Preoperative CT was performed routinely, and findings were compared with those of VAT. The rates of involvement of the hepatic pedicle, mesentery, and right side of the diaphragm were compared with the rate of pleural involvement. The right side of the chest was examined 12 times; and the left side, 4 times. There were no complications; 1 procedure was stopped because of ventilatory intolerance. Video-assisted thoracoscopy identified metastases smaller than 1 cm in 5 patients and larger than 1 cm in 2 additional patients; there was no evidence of pleural involvement in 6 patients. Computed tomography had 14% sensitivity and 25% specificity for pleural status determination, using VAT biopsy as the reference standard. Pleural involvement did not correlate with involvement of the hepatic pedicle, mesentery, or right side of the diaphragm. Video-assisted thoracoscopy performs better than CT for evaluating pleural involvement in ovarian cancer. Video-assisted thoracoscopy supplies accurate data on thoracic involvement, which does not seem predictable from the peritoneal involvement. Video-assisted thoracoscopy may impact patient management.

  7. 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.

  8. Insomnia as an expression of obstructive sleep apnea syndrome – the effect of treatment with nocturnal ventilatory support

    Directory of Open Access Journals (Sweden)

    M. Saldanha Mendes

    2015-07-01

    Full Text Available Introduction: Obstructive sleep apnea syndrome (OSAS and insomnia often coexist, and it is estimated that nearly half of those who suffer from the former report symptoms of the latter. The fact that these patients have no other causes of insomnia indicates that it is a sign of OSAS. Objective: The aim of the study is to evaluate the effectiveness of nocturnal ventilatory support (NVS in the treatment of insomnia secondary to OSAS. Materials and methods: In order to conduct the retrospective study, the authors reviewed the medical records of patients with insomnia and OSAS that had received NVS. Patients with psychiatric disorders, sleep movement disorders, psycho-physiological insomnia, circadian rhythm sleep disorders, inadequate sleep hygiene, use and abuse of hypnotic agents, stimulants, antidepressants, anxiolytics and alcohol, were excluded. For the selected patients, the effects of NVS in terms of clinical signs and symptoms of insomnia, apnea–hypopnea index (AHI, Epworth Sleepiness Scale (ESS score, and number of sleep hours were analyzed, before and after treatment with NVS. Results: After reviewing 1241 medical records, 56 patients were selected, with a mean age of 60.9 ± 10.0 years. Twenty-two (39.3% suffered from intermediate insomnia, 19 (33.9% had initial insomnia, eight (14.3% had the mixed type, and seven patients (12.5% had terminal insomnia. The majority of patients (n = 48; 85.7% were treated with auto-titrating continuous positive airway pressure (APAP. Forty-four patients (78.6% overcame insomnia; insomnia symptoms persisted in nine (16.1%, and three (5.4% patients abandoned during the medical follow-up. There was an association between the type of insomnia and its resolution and, in percentage terms patients with the mixed type did not manage to overcome insomnia symptoms (75%.There was a statistically significant difference between patients that overcame insomnia and those who did not in terms of the

  9. 78 FR 32464 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-05-30

    ... determination of market disruption or threat thereof under section 421(b)(1); or (C) an affirmative final... Nippon Sanso, Electronics Division, Aerotek, Apple One, etc. 82,610 Cooper Bussmann LLC, Ellisville, MO... City, IA..... February 16, 2013. Products, Inc., Electrolux Major Appliances, Electrolux North America...

  10. 75 FR 62425 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-10-08

    ... thereof under section 421(b)(1); or (C) An affirmative final determination of material injury or threat...- Pacific LLC, Wood and Fiber Supply Organization. 74,562 Nextrx, Inc., Express Plano, TX August 24, 2009... 24, 2009. Fruit of the Loom, Distribution Center 2. 74,577 MedRisk, Inc., Leased King of Prussia, PA...

  11. 75 FR 39046 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-07-07

    .... 73,869 iLevel by Weyerhaeuser, Greenwood Village, CO April 6, 2009. iLevel Marketing and Sales...., Mobile, AL. Mobile Division. 74,084 Tenaris Global Services Houston, TX. (USA) Corporation. 74,220...

  12. 78 FR 766 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-01-04

    ..., 2011. Services (ACS) Portfolio and Operations. 82,064 AT&T Services, Inc., Hoover and Mobile, AL... Lattice Semiconductor Hillsboro, OR........ November 2, 2011. Corporation, Corporate Marketing Department...

  13. 75 FR 5148 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-02-01

    ... Technology (State). 73150 Manchester Grand Hyatt San Diego, CA......... 12/28/09 12/17/09 (State). 73151... Air Cruisers Company (Comp) Liberty, MS 12/28/09 12/21/09 73156 American Spring Wire Kankakee, IL 12.../09 12/11/09 73180 Protingent Staffing (State) Redmond, WA 12/29/09 12/04/09 73181 Advanced Technology...

  14. 78 FR 61395 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-10-03

    ... (State/One-Stop). 83057 Alpha Wire and Cable (State/ Leominster, MA........ 09/05/13 08/29/13 One-Stop..., Ref: WARN 07/13/13 (State/One- Stop). 83062 Micron Technology Manassas Manassas, VA 09/06/13 08/28/13...

  15. 75 FR 24748 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-05-05

    ..., Sanitation Division, Leased Workers of Mancan, Inc., Big Prairie, OH: May 28, 2008. TA-W-72,270: Nielsen..., Skyware Global, Smithfield, NC: August 14, 2008. TA-W-72,218: SOMA Networks, Inc., San Francisco, CA... Corp., Network Maintenance Operations Center, Falls Church, VA. TA-W-72,899: Weatherford International...

  16. 78 FR 69880 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-11-21

    ... certifications have been issued. The date following the company name and location of each determination... Northridge, CA...... August 20, 2012. Support, Henry Elliott & Company, Inc. 83,008CC Quest Diagnostics, IT.... Support, HCL America, Iconma LLC, Idea Solutions, etc. 83,008EE Quest Diagnostics, IT Mason, OH August 20...

  17. 75 FR 21359 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-04-23

    ..., Ltd, Falconer, NY: June 10, 2008. TA-W-71,290; Unison Engine Components, General Electric Aviation...-W-72,670; Ericsson, Inc., Tek Systems, Vedior North America LLC, etc, Research Triangle Park, NC...

  18. 75 FR 15738 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-03-30

    .../05/10 03/01/10 73639 Bimbo Bakeries USA, Inc. Houston, TX 03/05/10 01/28/10 (Comp). 73640 Wacker..., LLC La Vergne, TN......... 03/05/10 03/04/10 (Comp). 73645 Bimbo Bakeries USA, Inc. Montebello, CA...

  19. 76 FR 76183 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-12-06

    ..., Experis, Die Tech Services, Probuss, Inc., The Bartech Group, And Metro Engineering Of Grand Rapids, Inc... Section 223 of the Trade Act of 1974, as amended (``Act''), 19 U.S.C. 2273, the Department of Labor issued... shows that workers leased from ManpowerGroup, Experis, Die Tech Services, ProBusS, Inc., The Bartech...

  20. 78 FR 52981 - Investigations Regarding Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-08-27

    ...-Stop). 82943 Pepperidge Farm Aiken, SC 07/30/13 07/30/13 (Company). 82944 Cubic Simulation Orlando, FL... (State/ One-Stop). 82951 ABB, Inc. (Company).... St. Louis, MO 08/01/13 07/30/13 82952 Verizon Business...

  1. Pre- and Post- Wage Differences of Trade Adjustment Assistance Job Training Participants in Arkansas

    Science.gov (United States)

    Gordon, Kimberley Hall

    2012-01-01

    A number of costs are associated with the implementation of trade agreements not the least of which is the cost to the American workforce. The information age ushered in an era of globalization unlike anything the world economy had experienced before. As countries raced forward to dominate emerging markets and grow market share, millions of…

  2. 76 FR 5834 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-02-02

    ... Transcriptionist, Work from Home. 74,972 CEVA Logistics, U.S., Jacksonville, FL..... December 6, 2009. Inc... Dubuque, IA November 30, 2009. Technologies, Inc., Sleep Innovation. Negative Determinations for Worker...

  3. 78 FR 14360 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-03-05

    .... The petitions filed in this case are available for inspection at the Office of the Director, Office of..., MA........ 02/12/13 02/11/13 LLC (Company). 82446 Ohio Gravure Technologies Miamisburg, OH..., Round Rock, TX......... 02/13/13 02/12/13 Operations Organization (State/One-Stop). 82454 Laserwords...

  4. 75 FR 75699 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-12-06

    ... Impact date 73,747 Synergy Solutions of Maine, Fort Kent, ME. LLC. 74,366 Ryder Truck Rental, Inc., Auburn Hills, MI. Fleet Management Solutions Division. 74,668 Communication Cable Company.. Malvern, PA...

  5. 75 FR 76491 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-12-08

    ... Aerospace (Union)...... Kent, WA 11/16/10 11/10/10 74879 Xella Aircrete North Adel, GA 11/16/10 11/15/10... 11/16/10 (Company). 74887 Winchester Electronics Rock Hill, SC......... 11/17/10 11/16/10 (Company...

  6. 75 FR 34175 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-06-16

    ... domestic industry in an investigation resulting in-- (A) An affirmative determination of serious injury or... TA-W-73,906: Ocean Beauty Seafoods, LLC, Los Angeles, CA: April 10, 2009 TA-W-72,246: Greenheck Fan...: Oakley Industries Sub Assembly Division, Incorporated, Leased Workers QPS Companies, Belvidere, IL...

  7. 75 FR 56141 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-09-15

    ... Electronics Lynchburg, VA May 27, 2009. Corporation, Leased Workers from Alpha Omega, Kelly Services, and Man... Services, Dallas, TX May 24, 2009. Inc., Xerox Corporation, Workers of ACS Application Management Services...

  8. 75 FR 49529 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-08-13

    ... date 72,362 P.M. Kelly, Inc., Realty Ashland, ME September 18, 2008. Road. 72,653 Da-Tech Corporation... Precision Custom Coatings. Totowa, NJ. 72,917 Circuit City, Inc., Bethlehem, PA. Bethlehem Distribution.... Subject firm Location Impact date 73,998 Dupont Performance Fremont, CA. Coatings, On-Site at New United...

  9. 76 FR 16448 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-03-23

    ... 31, 2010. Company, Chesterfield, Inc., Leased Workers from ETS Staffing. 75,161C Continental Coatings... date 75,269 Evergreen Solar, Inc., 112 Devens, MA February 11, 2010. Barnum Road; Leased Workers...

  10. 76 FR 50269 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    Science.gov (United States)

    2011-08-12

    ...' industry (i.e., conditions within the industry are adverse). Affirmative Determinations for Worker... the Trade Act have been met. TA-W-80,032; NL Fashion, Inc., New York, New York: February 27, 2010. TA... firm does not have a significant number of workers 50 years of age or older. TA-W-80,032; NL Fashion...

  11. 77 FR 17526 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-03-26

    ... identified by name by the International Trade Commission as a member of a domestic industry in an... Services. 81,162 Kennametal, Inc., Greenfield, MA April 1, 2011. JSCL Division. 81,324 CSB Fashion Inc..... New York, NY February 10, 2011. 81,337 Fu Sing Fashion, Inc Brooklyn, NY February 12, 2011. 81,374...

  12. 78 FR 19533 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-04-01

    ... Constitution Avenue NW., Washington, DC 20210. Signed at Washington, DC, this 20th day of March 2013. Michael W.../13 03/13/13 (Workers). 82559 Kimberly-Clark Corporation-- Belmont, MI 03/14/13 03/12/13 Jackson...

  13. 75 FR 28657 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-05-21

    .../26/10 04/21/10. 73990 Trinity North American Fort Worth, TX........ 04/26/10 04/23/10. Freight Car.... 73992 BP Solar (State/One-Stop).. Frederick, MD......... 04/26/10 04/23/10. 73993 Springer Science and...

  14. 75 FR 70294 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-11-17

    .... 74,316E International Business Research Triangle June 10, 2009. Machines (IBM), Global Park, NC. Tech... AColumbia Gorge Aluminum, Golden Northwest Aluminum Holding Co. 74,152A Northwest Aluminum Company, The Dalles, OR Golden Northwest Aluminum Holding Co. The investigation revealed that the criteria under...

  15. 75 FR 34178 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-06-16

    ..., TN...... 05/25/10 05/21/10. (Company). 74149 Hartford Financial Hartford, CT....... 05/26/10 04/29/10... (Petitioners) Location institution petition 74132 DuPont Performance Nederland, TX...... 05/24/10 05/20/10. Polymers Hypalon Unit (Company). 74133 Time Sensitive Circuits, Amesbury, MA....... 05/24/10 05/20/10. Inc...

  16. 78 FR 2291 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-01-10

    .../12 12/18/12 (Company). 82300 UBS Financial Services Weehawken, NJ 12/28/12 12/27/12 (Workers). 82301... (Workers)... St. Louis, MO 12/17/12 12/14/12 82260 HB Smith Company Inc. (State/ Westfield, MA 12/17/12 12...-Stop). 82262 Cequent Performance Goshen, IN 12/17/12 12/14/12 Products, Inc. (Union). 82263 American...

  17. 78 FR 28641 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-05-15

    ... New Mexico Farmers Markets Rio Rancho, NM 04/09/13 03/18/13 (State/One-Stop). 82639 Agilent... Salem, VA 04/11/13 04/10/13 Inc. (Company). 82649 Cigna Health I Life Tampa, FL 04/12/13 04/11/13 Insurance Company (Workers). BILLING CODE 4510-FN-P ...

  18. 75 FR 10325 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-03-05

    .../19/10] Date of Date of TA-W Subject firm (petitioners) Location institution petition 73461 Nationwide Insurance (Wkrs). Columbus, OH 02/16/10 02/10/10 73462 Fantasy Activewear, Inc. Vernon, CA 02/16/10 02/04/10... Lincoln, NE 02/18/10 02/11/10 Life) (Wkrs). 73507 Inventurus Knowledge Indiana, PA 02/19/10 02/05/10...

  19. 78 FR 49293 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-08-13

    ... Corporation, Transactional New Hope, MN........ May 14, 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...

  20. 77 FR 67400 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-11-09

    ... Financial Services Simsbury, CT October 3, 2011. Group, Inc., Corporate/ Finance/Controllers/ Accounting Operations. 82,049A Hartford Financial Services Hartford, CT October 3, 2011. Group, Inc., Corporate/ Finance...

  1. 77 FR 13352 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-03-06

    .... Services Group, Inc., Corporate/Finance/ Controllers. 81,213 American Express Travel Phoenix, AZ February.... Corporate Resources, Aerotek, Dysis and Tek. 81,254 BT North America, Network Atlanta, GA February 13, 2010... February 7, 2011. Services Group, Inc., Corporate/EIT/Consumer. The following certifications have been...

  2. 78 FR 61392 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-10-03

    ..., Hartford, CT. Inc., Corporate/Finance/ Controllers. The following determinations terminating investigations... Staffing, Employee Management, CBS Personnel, etc. 82,977 Pall Corporation, Finance Port Washington, NY..., Greensboro, NC. Finance Department, Novartis AG, ProUnlimited. 82,984 The Berry Company, LLC Rochester, NY...

  3. 78 FR 55757 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-09-11

    ... Automatic Data Processing (ADP)-- San Dimas, CA Corporate, Corporate Finance, Kforce, Inc. and Horizon Corporate Consultants, Inc. 82,828A Automatic Data Processing (ADP), San Dimas, CA Added Value Services...,966 Kohl's Department Stores, Inc., Milwaukee, WI....... August 7, 2012. Finance Department, Kforce...

  4. 77 FR 44682 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-07-30

    .... (Company). 81796 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...

  5. 77 FR 46122 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-08-02

    ... loss of business by the workers' firm with the firm described in paragraph (2) contributed importantly... WellPoint, Inc., Sr. Indianapolis, IN...... July 2, 2011. Business Div. Claims Dept., UI Wages Well.... 81,796 Adams Globalization, Austin, TX July 9, 2011. Transperfect Translations, IDTP Department...

  6. 78 FR 54487 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-09-04

    ... International, Inc., Imaging Lexington, KY........ September 11, 2012. Services and Solutions, Embedded Systems... 202(b)(1); (B) An affirmative determination of market disruption or threat thereof under section 421(b...

  7. 75 FR 54184 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-09-03

    ... National Emblem, Inc... Carson, CA February 12, 2009. 73,632 Simclar Interconnect Ozark, MO March 1, 2009... date 73,561 Musashi Auto Parts Battle Creek, MI...... February 23, 2009. Michigan, Inc., Musashi...

  8. 75 FR 52982 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-08-30

    ...., Torrance, CA May 6, 2009. Manufacturing Division. 74,112 Edwards Vacuum, Inc., Tewksbury, MA May 17, 2009...... Burbank, CA November 17, 2008. 73,165 James Hamilton Silver City, NM December 23, 2008. Construction...

  9. 75 FR 57984 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-09-23

    ... Cambridge, OH......... 09/08/10 09/07/10 (Workers). 74606 Watson Laboratories, Inc. Carmel, NY 09/10/10 09... Galt Temp Agency Burlington, MA........ 09/10/10 09/03/10 (State/One-Stop). 74614 IBM Global Services...

  10. 76 FR 2145 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-01-12

    ... 202(b)(1); (B) An affirmative determination of market disruption or threat thereof under section 421(b... Angeles, CA October 9, 2009. Baby Hay, The Big Citizen Division. 74,942 Harris Corporation, Pottstown, PA...

  11. 75 FR 3932 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-01-25

    ..., Industrial Staffing, Elk Grove Village, IL: May 20, 2008. TA-W-70,916; Agilent Technologies, Digital Test... Division, Leased Workers from Furst Staffing, Stockton, IL: June 5, 2008. TA-W-71,259; Cooper Tools, Inc., Cooper Power Tools Division, Cooper Industries, Dayton, OH: June 22, 2009. TA-W-72,093; Atlantic Guest...

  12. 75 FR 20393 - Investigations Regarding Certifications of Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-04-19

    .... 73745 Zumtobel Lighting Inc. Garfield, NJ 03/19/10 03/17/10 (UAW). 73746 Price Water House Coopers New... (STATE). 73749 Assembly and Test Shelton, CT 03/19/10 03/17/10 Worldwide, Inc. (STATE). 73750 General...

  13. 75 FR 32221 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-06-07

    .... TA-W-72,742: Cooper Standard Automotive, Bowling Green Hose Fluids Division, Bowling Green, OH...-Patient Pay Management Center, Indianapolis, IN: March 1, 2009. TA-W-73,611: PricewaterhouseCoopers, LLP...-73,623: LSI Corporation, Test and Product Engineering Group, Fort Collins, CO: March 3, 2009. [[Page...

  14. 75 FR 30068 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-05-28

    ... Fabricator, Addis, LA: December 22, 2008 TA-W-73,167: Veeco Process Equipment, Inc., Mechanical Process... Company, Waterford, MI: July 8, 2008 TA-W-71,759: Meridian Automotive Systems, Inc., Shelbyville, IN: July...-73,545: TG California Automotive Sealing Inc., Toyoda Gosei Co., Leased Workers from Aerotek...

  15. 76 FR 2716 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-01-14

    ... determination of serious injury or threat thereof under section 202(b)(1); (B) An affirmative determination of... material injury or threat thereof under section 705(b)(1)(A) or 735(b)(1)(A) of the Tariff Act of 1930 (19...,841 PSB Industries, Inc., Leased Workers from Erie, PA......... November 3, 2009. Career Concepts...

  16. 77 FR 71637 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-12-03

    ... investigation resulting in-- (A) An affirmative determination of serious injury or threat thereof under section...)(1); or (C) An affirmative final determination of material injury or threat thereof under section 705......... July 31, 2011. Inc., Spherion. 81,967 OMCO Machining Concepts, Winchester, IN........ August 13, 2011...

  17. 76 FR 58044 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-09-19

    ... Employment and Training Administration Amended Certification Regarding Eligibility To Apply for Worker..., KLAUSSNER CORPORATE SERVICES, INC., ALSO KNOWN AS KLAUSSNER OF IOWA, A DIVISION OF KLAUSSNER FURNITURE..., Plant 33, Asheboro, North Carolina, and Klaussner Corporate Services, Inc., also known as Klaussner of...

  18. 77 FR 28901 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance; The UBS...

    Science.gov (United States)

    2012-05-16

    ... Employment and Training Administration Amended Certification Regarding Eligibility To Apply for Worker... UBS-GLB (Americas), Inc., Formerly Known as Brinson Partners, Inc., Corporate Center Division, Group... known as UBS Financial Services, Inc., and/or UBS-GLB (Americas), Inc., ] Corporate Center Division...

  19. 76 FR 66328 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    Science.gov (United States)

    2011-10-26

    ...)(3)(A)(ii) of the Trade Act have been met. TA-W-80,331; Sloan Transportation Products, Holland, MI...; Phoenix Trim Works, Inc., Williamsport, PA: August 20, 2011 TA-W-80,422; Coastal Lumber Company... certification at a time. TA-W-80,427; Coastal Lumber Company, Hopwood, PA I hereby certify that the...

  20. 76 FR 66756 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    Science.gov (United States)

    2011-10-27

    ... the Trade Act have been met. TA-W-80,331; Sloan Transportation Products, Holland, MI: July 22, 2010 TA... Works, Inc., Williamsport, PA: August 20, 2011 TA-W-80,422; Coastal Lumber Company, Buckhannon, WV... certification at a time. TA-W-80,427; Coastal Lumber Company, Hopwood, PA I hereby certify that the...