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Sample records for adjusted ventilatory assist

  1. Neurally adjusted ventilatory assist: a ventilation tool or a ventilation toy?

    Science.gov (United States)

    Verbrugghe, Walter; Jorens, Philippe G

    2011-03-01

    Mechanical ventilation has, since its introduction into clinical practice, undergone a major evolution from controlled ventilation to various modes of assisted ventilation. Neurally adjusted ventilatory assist (NAVA) is the newest development. The implementation of NAVA requires the introduction of a catheter to measure the electrical activity of the diaphragm (EA(di)). NAVA relies, opposite to conventional assisted ventilation modes, on the EA(di) to trigger the ventilator breath and to adjust the ventilatory assist to the neural drive. The amplitude of the ventilator assist is determined by the instantaneous EA(di) and the NAVA level set by the clinician. The NAVA level amplifies the EA(di) signal and determines instantaneous ventilator assist on a breath-to-breath basis. Experimental and clinical data suggest superior patient-ventilator synchrony with NAVA. Patient-ventilator asynchrony is present in 25% of mechanically ventilated patients in the intensive care unit and may contribute to patient discomfort, sleep fragmentation, higher use of sedation, development of delirium, ventilator-induced lung injury, prolonged mechanical ventilation, and ultimately mortality. With NAVA, the reliance on the EA(di) signal, together with an intact ventilatory drive and intact breathing reflexes, allows integration of the ventilator in the neuro-ventilatory coupling on a higher level than conventional ventilation modes. The simple monitoring of the EA(di) signal alone may provide the clinician with important information to guide ventilator management, especially during the weaning process. Although, until now, little evidence proves the superiority of NAVA on clinically relevant end points, it seems evident that patient populations (eg, COPD and small children) with major patient-ventilator asynchrony may benefit from this new ventilatory tool.

  2. 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 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 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.

  3. 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.

  4. Neurally adjusted ventilatory assist improves patient–ventilator interaction in infants as compared with conventional ventilation.

    Science.gov (United States)

    Bordessoule, Alice; Emeriaud, Guillaume; Morneau, Sylvain; Jouvet, Philippe; Beck, Jennifer

    2012-08-01

    Neurally adjusted ventilatory assist (NAVA) is a mode of ventilation controlled by the electrical activity of the diaphragm (Edi). The aim was to evaluate patient-ventilator interaction in infants during NAVA as compared with conventional ventilation. Infants were successively ventilated with NAVA, pressure control ventilation (PCV), and pressure support ventilation (PSV). Edi and ventilator pressure (Pvent) waveforms were compared and their variability was assessed by coefficients of variation. Ten patients (mean age 4.3 ± 2.4 mo and weight 5.9 ± 2.2 kg) were studied. In PCV and PSV, 4 ± 4.6% and 6.5 ± 7.7% of the neural efforts failed to trigger the ventilator. This did not occur during NAVA. Trigger delays were shorter with NAVA as compared with PCV and PSV (93 ± 20 ms vs. 193 ± 87 ms and 135 ± 29 ms). During PCV and PSV, the ventilator cycled off before the end of neural inspiration in 12 ± 13% and 21 ± 19% of the breaths (0 ± 0% during NAVA). During PCV and PSV, 24 ± 11% and 25 ± 9% of the neural breath cycle was asynchronous with the ventilator as compared with 11 ± 3% with NAVA. A large variability was observed for Edi in all modes, which was transmitted into Pvent during NAVA (coefficient of variation: 24 ± 8%) and not in PCV (coefficient of variation 2 ± 1%) or PSV (2 ± 2%). NAVA improves patient-ventilator interaction and delivers adequate ventilation with variable pressure in infants.

  5. New Setting of Neurally Adjusted Ventilatory Assist during Noninvasive Ventilation through a Helmet.

    Science.gov (United States)

    Cammarota, Gianmaria; Longhini, Federico; Perucca, Raffaella; Ronco, Chiara; Colombo, Davide; Messina, Antonio; Vaschetto, Rosanna; Navalesi, Paolo

    2016-12-01

    Compared to pneumatically controlled pressure support (PSP), neurally adjusted ventilatory assist (NAVA) was proved to improve patient-ventilator interactions, while not affecting comfort, diaphragm electrical activity (EAdi), and arterial blood gases (ABGs). This study compares neurally controlled pressure support (PSN) with PSP and NAVA, delivered through two different helmets, in hypoxemic patients receiving noninvasive ventilation for prevention of extubation failure. Fifteen patients underwent three (PSP, NAVA, and PSN) 30-min trials in random order with both helmets. Positive end-expiratory pressure was always set at 10 cm H2O. In PSP, the inspiratory support was set at 10 cm H2O above positive end-expiratory pressure. NAVA was adjusted to match peak EAdi (EAdipeak) during PSP. In PSN, the NAVA level was set at maximum matching the pressure delivered during PSP by limiting the upper pressure. The authors assessed patient comfort, EAdipeak, rates of pressurization (i.e., airway pressure-time product [PTP] of the first 300 and 500 ms after the initiation of patient effort, indexed to the ideal pressure-time products), and measured ABGs. PSN significantly increased comfort to (median [25 to 75% interquartile range]) 8 [7 to 8] and 9 [8 to 9] with standard and new helmets, respectively, as opposed to both PSP (5 [5 to 6] and 7 [6 to 7]) and NAVA (6 [5 to 7] and 7 [6 to 8]; P < 0.01 for all comparisons). Regardless of the interface, PSN also decreased EAdipeak (P < 0.01), while increasing PTP of the first 300 ms from the onset of patient effort, indexed to the ideal PTP (P < 0.01) and PTP of the first 500 ms from the onset of patient effort, indexed to the ideal PTP (P < 0.001). ABGs were not different among trials. When delivering noninvasive ventilation by helmet, compared to PSP and NAVA, PSN improves comfort and patient-ventilator interactions, while not ABGs. (Anesthesiology 2016; 125:1181-9).

  6. Ventilation distribution measured with EIT at varying levels of pressure support and Neurally Adjusted Ventilatory Assist in patients with ALI.

    Science.gov (United States)

    Blankman, Paul; Hasan, Djo; van Mourik, Martijn S; Gommers, Diederik

    2013-06-01

    The purpose of this study was to compare the effect of varying levels of assist during pressure support (PSV) and Neurally Adjusted Ventilatory Assist (NAVA) on the aeration of the dependent and non-dependent lung regions by means of Electrical Impedance Tomography (EIT). We studied ten mechanically ventilated patients with Acute Lung Injury (ALI). Positive-End Expiratory Pressure (PEEP) and PSV levels were both 10 cm H₂O during the initial PSV step. Thereafter, we changed the inspiratory pressure to 15 and 5 cm H₂O during PSV. The electrical activity of the diaphragm (EAdi) during pressure support ten was used to define the initial NAVA gain (100 %). Thereafter, we changed NAVA gain to 150 and 50 %, respectively. After each step the assist level was switched back to PSV 10 cm H₂O or NAVA 100 % to get a new baseline. The EIT registration was performed continuously. Tidal impedance variation significantly decreased during descending PSV levels within patients, whereas not during NAVA. The dorsal-to-ventral impedance distribution, expressed according to the center of gravity index, was lower during PSV compared to NAVA. Ventilation contribution of the dependent lung region was equally in balance with the non-dependent lung region during PSV 5 cm H₂O, NAVA 50 and 100 %. Neurally Adjusted Ventilatory Assist ventilation had a beneficial effect on the ventilation of the dependent lung region and showed less over-assistance compared to PSV in patients with ALI.

  7. 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

  8. Increased diaphragmatic contribution to inspiratory effort during neurally adjusted ventilatory assistance versus pressure support: an electromyographic study.

    Science.gov (United States)

    Cecchini, Jérôme; Schmidt, Matthieu; Demoule, Alexandre; Similowski, Thomas

    2014-11-01

    Neurally adjusted ventilatory assist (NAVA), regulated exclusively by the electromyographic activity (EA) of the diaphragm (EAdi), could affect the distribution of neural drive to the various inspiratory muscles. The objective of this study was to compare EAdi, EA of the scalene (EAscal), and EA of the alae nasi (EAan), according to the ventilatory mode and assist level in 12 mechanically ventilated patients. Seven assist levels of pressure support ventilation (PSV) and NAVA were sequentially applied. EAdi, EAscal, and EAan were quantified and expressed as a percentage of their maximum values. The relative contributions of extradiaphragmatic muscles to inspiratory efforts were assessed by calculating EAscal/EAdi and EAan/EAdi ratios. Three assist levels for each of the two ventilatory modes that resulted in EAdi values of 80 to 100%, 60 to 80%, and 40 to 60% were assigned to three groups (N1, N2, and N3). Results are expressed as median and interquartile range. EA of inspiratory muscles decreased during PSV and NAVA (P PSV in N1 and N3 (65% [62 to 64] and 27% [18 to 34] in NAVA vs. 90% [81 to 100] and 49% [40 to 55] in PSV, P = 0.007). Altogether, EAscal/EAdi and EAan/EAdi ratios were lower in NAVA than PSV (0.7 [0.6 to 0.7] and 0.7 [0.6 to 0.8] in NAVA vs. 0.9 [0.8 to 1.1] and 0.9 [0.7 to 1.1] in PSV, P PSV both reduced extradiaphragmatic inspiratory muscle activity, in proportion to the level of assistance. Compared with PSV, NAVA resulted in a predominant contribution of the diaphragm to inspiratory effort.

  9. Neurally adjusted ventilatory assist as an alternative to pressure support ventilation in adults: a French multicentre randomized trial.

    Science.gov (United States)

    Demoule, A; Clavel, M; Rolland-Debord, C; Perbet, S; Terzi, N; Kouatchet, A; Wallet, F; Roze, H; Vargas, F; Guerin, C; Dellamonica, J; Jaber, S; Brochard, L; Similowski, T

    2016-11-01

    Neurally adjusted ventilatory assist (NAVA) is a ventilatory mode that tailors the level of assistance delivered by the ventilator to the electromyographic activity of the diaphragm. The objective of this study was to compare NAVA and pressure support ventilation (PSV) in the early phase of weaning from mechanical ventilation. A multicentre randomized controlled trial of 128 intubated adults recovering from acute respiratory failure was conducted in 11 intensive care units. Patients were randomly assigned to NAVA or PSV. The primary outcome was the probability of remaining in a partial ventilatory mode (either NAVA or PSV) throughout the first 48 h without any return to assist-control ventilation. Secondary outcomes included asynchrony index, ventilator-free days and mortality. In the NAVA and PSV groups respectively, the proportion of patients remaining in partial ventilatory mode throughout the first 48 h was 67.2 vs. 63.3 % (P = 0.66), the asynchrony index was 14.7 vs. 26.7 % (P < 0.001), the ventilator-free days at day 7 were 1.0 day [1.0-4.0] vs. 0.0 days [0.0-1.0] (P < 0.01), the ventilator-free days at day 28 were 21 days [4-25] vs. 17 days [0-23] (P = 0.12), the day-28 mortality rate was 15.0 vs. 22.7 % (P = 0.21) and the rate of use of post-extubation noninvasive mechanical ventilation was 43.5 vs. 66.6 % (P < 0.01). NAVA is safe and feasible over a prolonged period of time but does not increase the probability of remaining in a partial ventilatory mode. However, NAVA decreases patient-ventilator asynchrony and is associated with less frequent application of post-extubation noninvasive mechanical ventilation. clinicaltrials.gov Identifier: NCT02018666.

  10. Application of Selective Bronchial Intubation versus Neurally Adjusted Ventilatory Assist in the Management of Unilateral Pulmonary Interstitial Emphysema: An Illustrative Case and the Literature Review

    OpenAIRE

    Lee, Shing-yan Robert

    2017-01-01

    In the treatment of left-sided pulmonary interstitial emphysema (PIE) in a 23-week neonate, we used two ventilatory strategies: selective bronchial intubation from day 10 to 15 and neurally adjusted ventilatory assist (NAVA) from day 18 to 26. We compared the effects and adverse effects of these two strategies. On selective bronchial intubation, desaturation was frequent. Fentanyl infusion was required. There was an episode of carbon dioxide retention coupled with hypotension. On NAVA, the ne...

  11. 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

  12. Effects of propofol on patient-ventilator synchrony and interaction during pressure support ventilation and neurally adjusted ventilatory assist.

    Science.gov (United States)

    Vaschetto, Rosanna; Cammarota, Gianmaria; Colombo, Davide; Longhini, Federico; Grossi, Francesca; Giovanniello, Andrea; Della Corte, Francesco; Navalesi, Paolo

    2014-01-01

    Evaluating the physiologic effects of varying depths of propofol sedation on patient-ventilator interaction and synchrony during pressure support ventilation and neurally adjusted ventilatory assist. Prospective crossover randomized controlled trial. University hospital ICU. Fourteen intubated patients mechanically ventilated for acute respiratory failure. Six 25-minute trials randomly performed applying both pressure support ventilation and neurally adjusted ventilatory assist during wakefulness and with two doses of propofol, administered by Target Control Infusion, determining light (1.26 ± 0.35 μg/mL) and deep (2.52 ± 0.71 μg/mL) sedation, as defined by the bispectral index and Ramsay Sedation Scale. We measured electrical activity of the diaphragm to assess neural drive and calculated its integral over time during 1 minute (∫electrical activity of the diaphragm/min) to estimate diaphragm energy expenditure (effort), arterial blood gases, airway pressure, tidal volume and its coefficient of variation, respiratory rate, neural timing components, and calculated the ineffective triggering index. Increasing the depth of sedation did not cause significant modifications of respiratory timing, while determined a progressive significant decrease in neural drive (with both modes) and effort (in pressure support ventilation only). In pressure support ventilation, the difference in ineffective triggering index between wakefulness and light sedation was negligible (from 5.9% to 7.6%, p = 0.97); with deep sedation, however, ineffective triggering index increased up to 21.8% (p ventilator interactions. In pressure support ventilation, deep propofol sedation increased asynchronies, while light sedation did not. Propofol reduced the respiratory drive, while breathing timing was not significantly affected. Gas exchange and breathing pattern were also influenced by propofol infusion to an extent that varied with the depth of sedation and the mode of ventilation.

  13. Patient-ventilator synchrony in Neurally Adjusted Ventilatory Assist (NAVA) and Pressure Support Ventilation (PSV): a prospective observational study.

    Science.gov (United States)

    Yonis, Hodane; Crognier, Laure; Conil, Jean-Marie; Serres, Isabelle; Rouget, Antoine; Virtos, Marie; Cougot, Pierre; Minville, Vincent; Fourcade, Olivier; Georges, Bernard

    2015-08-08

    Weaning from mechanical ventilation is associated with the presence of asynchronies between the patient and the ventilator. The main objective of the present study was to demonstrate a decrease in the total number of patient-ventilator asynchronies in invasively ventilated patients for whom difficulty in weaning is expected by comparing neurally adjusted ventilatory assist (NAVA) and pressure support ventilation (PSV) ventilatory modes. We performed a prospective, non-randomized, non-interventional, single-center study. Thirty patients were included in the study. Each patient included in the study benefited in an unpredictable way from both modes of ventilation, NAVA or PSV. Patients were successively ventilated for 23 h in NAVA or in PSV, and then they were ventilated for another 23 h in the other mode. Demographic, biological and ventilatory data were collected during this period. The two modes of ventilatory support were compared using the non-parametric Wilcoxon test after checking for normal distribution by the Kolmogorov-Smirnov test. The groups were compared using the chi-square test. The median level of support was 12.5 cmH2O (4-20 cmH2O) in PSV and 0.8 cmH2O/μvolts (0.2-3 cmH2O/μvolts) in NAVA. The total number of asynchronies per minute in NAVA was lower than that in PSV (0.46 vs 1, p PSV (1.73 vs 3.36, p PSV (0.19 vs 0.71, p = 0.038). However, there was a higher percentage of double triggering in NAVA compared with PSV (0.76 vs 0.71, p = 0.046). The total number of asynchronies in NAVA is lower than that in PSV. This finding reflects improved patient-ventilator interaction in NAVA compared with the PSV mode, which is consistent with previous studies. Our study is the first to analyze patient-ventilator asynchronies in NAVA and PSV on such an important duration. The decrease in the number of asynchronies in NAVA is due to reduced ineffective efforts and auto-triggering.

  14. A randomized clinical trial of neurally adjusted ventilatory assist versus conventional weaning mode in patients with COPD and prolonged mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Kuo NY

    2016-05-01

    Full Text Available Nai-Ying Kuo,1,2 Mei-Lien Tu,1,3 Tsai-Yi Hung,1 Shih-Feng Liu,4 Yu-Hsiu Chung,4 Meng-Chih Lin,4 Chao-Chien Wu41Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital; 2Kaohsiung Medical University; 3Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan; 4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanBackground: Patient-ventilator asynchrony is a common problem in mechanically ventilated patients; the problem is especially obvious in COPD. Neutrally adjusted ventilatory assist (NAVA can improve patient-ventilator asynchrony; however, the effect in COPD patients with prolonged mechanical ventilation is still unknown. The goals of this study are to evaluate the effect of NAVA and conventional weaning mode in patients with COPD during prolonged mechanical ventilation.Methods: The study enrolled a total of 33 COPD patients with ventilator dependency for more than 21 days in the weaning center. A diaphragm electrical activity (Edi catheter was inserted in patients within 24 hours after admission to the respiratory care center, and patients were randomly allocated to NAVA or conventional group. A spontaneous breathing trial was performed every 24 hours. The results correlated with the clinical parameters.Results: There were significantly higher asynchrony incidence rates in the whole group after using Edi catheter (before vs post-Edi catheter insertion =60.6% vs 87.9%, P<0.001. Asynchrony index: before vs post-Edi catheter insertion =7.4%±8.5% vs 13.2%±13.5%, P<0.01. Asynchrony incidence: NAVA vs conventional =0% vs 84.2%, P<0.001. Asynchrony index: NAVA vs conventional =0 vs 11.9±11.2 (breath %, P<0.001. The most common asynchrony events were ineffective trigger and delayed trigger. Conclusion: Compared to conventional mode, NAVA mode can significantly enhance

  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. A randomized clinical trial of neurally adjusted ventilatory assist versus conventional weaning mode in patients with COPD and prolonged mechanical ventilation.

    Science.gov (United States)

    Kuo, Nai-Ying; Tu, Mei-Lien; Hung, Tsai-Yi; Liu, Shih-Feng; Chung, Yu-Hsiu; Lin, Meng-Chih; Wu, Chao-Chien

    2016-01-01

    Patient-ventilator asynchrony is a common problem in mechanically ventilated patients; the problem is especially obvious in COPD. Neutrally adjusted ventilatory assist (NAVA) can improve patient-ventilator asynchrony; however, the effect in COPD patients with prolonged mechanical ventilation is still unknown. The goals of this study are to evaluate the effect of NAVA and conventional weaning mode in patients with COPD during prolonged mechanical ventilation. The study enrolled a total of 33 COPD patients with ventilator dependency for more than 21 days in the weaning center. A diaphragm electrical activity (Edi) catheter was inserted in patients within 24 hours after admission to the respiratory care center, and patients were randomly allocated to NAVA or conventional group. A spontaneous breathing trial was performed every 24 hours. The results correlated with the clinical parameters. There were significantly higher asynchrony incidence rates in the whole group after using Edi catheter (before vs post-Edi catheter insertion =60.6% vs 87.9%, Ppatient-ventilator interaction in COPD patients with prolonged mechanical ventilation in respiratory care center.

  17. 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).

  18. Effects of neurally adjusted ventilatory assist on air distribution and dead space in patients with acute exacerbation of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Sun, Qin; Liu, Ling; Pan, Chun; Zhao, Zhanqi; Xu, Jingyuan; Liu, Airan; Qiu, Haibo

    2017-06-02

    Neurally adjusted ventilatory assist (NAVA) could improve patient-ventilator interaction; its effects on ventilation distribution and dead space are still unknown. The aim of this study was to evaluate the effects of varying levels of assist during NAVA and pressure support ventilation (PSV) on ventilation distribution and dead space in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Fifteen mechanically ventilated patients with AECOPD were included in the study. The initial PSV levels were set to 10 cmH2O for 10 min. Thereafter, the ventilator mode was changed to NAVA for another 10 min with the same electrical activity of the diaphragm as during PSV. Furthermore, the ventilation mode was switched between PSV and NAVA every 10 min in the following order: PSV 5 cmH2O; NAVA 50%; PSV 15 cmH2O; and NAVA 150% (relative to the initial NAVA support level). Ventilation distribution in the lung was evaluated in percentages in regions of interest (ROI) of four anteroposterior segments of equal height (ROI1 to ROI4 represents ventral, mid-ventral, mid-dorsal, and dorsal, respectively). Blood gases, ventilation distribution (electrical impedance tomography), diaphragm activity (B-mode ultrasonography), and dead space fraction (PeCO2 and PaCO2) were measured. The trigger and cycle delays were lower during NAVA than during PSV. The work of trigger was significantly lower during NAVA compared to PSV. The diaphragm activities based on ultrasonography were higher during NAVA compared to the same support level during PSV. The ventilation distribution in ROI4 increased significantly (P space fraction compared to the corresponding support level of PSV. NAVA was superior to PSV in AECOPD for increasing ventilation distribution in ROI4 and reducing dead space. Clinicaltrials.gov, NCT02289573 . Registered on 12 November 2014.

  19. 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.

  20. 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.

  1. Mask proportional assist vs pressure support ventilation in patients in clinically stable condition with chronic ventilatory failure.

    Science.gov (United States)

    Porta, Roberto; Appendini, Lorenzo; Vitacca, Michele; Bianchi, Luca; Donner, Claudio F; Poggi, Roberta; Ambrosino, Nicolino

    2002-08-01

    To compare the short-term physiologic effects of mask pressure support ventilation (PSV) and proportional assist ventilation (PAV) in patients in clinically stable condition with chronic ventilatory failure (CVF). Randomized, controlled physiologic study. Lung function units of two pulmonary rehabilitation centers. Eighteen patients with CVF caused by COPD (11 patients) and restrictive chest wall diseases (RCWDs) [7 patients]. Assessment of breathing pattern and minute ventilation (E), respiratory muscles and lung mechanics, and patient/ventilator interaction during both unassisted and assisted ventilation. After baseline assessment during spontaneous breathing (SB), mask PSV and PAV were randomly applied at the patient's comfort, with the addition of the same level of continuous positive airway pressure (2 cm H2O or 4 cm H2O in all patients), for 30 min each, with a 20-min interval of SB between periods of assisted ventilation. A longer time was spent to set PAV than PSV (663 +/- 179 s and 246 +/- 58 s, respectively; p variation coefficient, 16.3% +/- 10.5% vs 11.6% +/- 7.7%, respectively; p ventilator interaction between ventilatory modes.

  2. 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...

  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. 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...

  5. 75 FR 41430 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... an increase in fresh apple imports during the August-December 2009/2010 marketing season. Instead, it... (No. 2010017) for trade adjustment assistance (TAA) for apples that was filed by the Minnesota Apple... that petitions must demonstrate, using data for the most recent, full marketing year or full official...

  6. 75 FR 59684 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-09-28

    ... (No. 2011017) for trade adjustment assistance for apples filed under the fiscal year (FY) 2011 program..., full marketing year or full official marketing season, a greater than 15- percent decline in at least... increase in imports of like or directly competitive articles, during the same marketing period, contributed...

  7. 75 FR 23667 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-05-04

    ... national average price of apples compared to the average of the 3 preceding marketing years. The petition... review of a petition, for trade adjustment assistance by the Michigan Agricultural Cooperative Marketing Association on behalf of apple producers in Michigan. A public hearing to review the merits of the petition...

  8. 75 FR 41431 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-07-16

    ... (No. 2010009) for trade adjustment assistance (TAA) for apples that was filed by the Michigan Agricultural Cooperative Marketing Association and accepted for review by USDA on May 4, 2010. SUPPLEMENTARY...) states that petitions must demonstrate, using data for the most recent, full marketing year or full...

  9. 76 FR 65213 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    Science.gov (United States)

    2011-10-20

    ... Adjustment Assistance and Alternative Trade Adjustment Assistance; FLEXTRONICS International USA, INC... of the Trade Act of 1974 as amended. AND All workers of Flextronics International USA, Inc...; FLEXTRONICS International USA, Inc., Infrastructure Division, Foothill Ranch, CA In accordance with Section...

  10. 76 FR 72979 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance...

    Science.gov (United States)

    2011-11-28

    ... Worker Adjustment Assistance and Alternative Trade Adjustment Assistance Petitions have been filed with... Sports (Company). 81003 BNY Mellon (Workers)....... Pawtucket, RI......... 10/24/11 10/20/11 81004 Pace...

  11. 76 FR 61744 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance...

    Science.gov (United States)

    2011-10-05

    ...). 80439 Yahoo Inc. (Workers) Hillsboro, OR...... 09/15/11 09/15/11 80440 Bank Of America Scranton, PA... Worker Adjustment Assistance and Alternative Trade Adjustment Assistance Petitions have been filed with... the workers are eligible to apply for adjustment assistance under Title II, Chapter 2, of the Act. The...

  12. 76 FR 4612 - Community Trade Adjustment Assistance Program Fiscal Year 2010 Annual Report

    Science.gov (United States)

    2011-01-26

    ... entrepreneurship by implementing economic gardening, business development, instructional technical assistance, and... Economic Development Administration Community Trade Adjustment Assistance Program Fiscal Year 2010 Annual Report AGENCY: Economic Development Administration, Commerce ACTION: Notice. SUMMARY: This report is...

  13. 76 FR 22147 - Solicitation for Grant Applications (SGA); Trade Adjustment Assistance Community College and...

    Science.gov (United States)

    2011-04-20

    ... Employment & Training Administration Solicitation for Grant Applications (SGA); Trade Adjustment Assistance... Administration (ETA), Labor. ACTION: Notice: Amendment to SGA/DFA PY 10-03. SUMMARY: The Employment and Training... funds and Solicitation for Grant Applications (SGA) for the Trade Adjustment Assistance Community...

  14. 77 FR 28901 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance; Lexis...

    Science.gov (United States)

    2012-05-16

    ... Adjustment Assistance; Lexis Nexis, a Subsidiary of Reed Elsevier, Quality & Metrics Department, Including Employees Located Throughout the United States Who Report to Miamisburg, OH; Lexis Nexis, a Subsidiary of... Worker Adjustment Assistance on February 3, 2012, applicable to workers of Lexis Nexis, Quality & Metrics...

  15. Impact of ventilatory modes on the breathing variability in mechanically ventilated infants.

    Directory of Open Access Journals (Sweden)

    Florent eBAUDIN

    2014-11-01

    Full Text Available Objectives: Reduction of breathing variability is associated with adverse outcome. During mechanical ventilation, the variability of ventilatory pressure is dependent on the ventilatory mode. During neurally adjusted ventilatory assist (NAVA, the support is proportional to electrical activity of diaphragm (EAdi, which reflects the respiratory center output. The variability of EAdi is therefore translated into a similar variability in pressures. Contrastingly, conventional ventilatory modes deliver less variable pressures. The impact of the mode on the patient’s own respiratory drive is less clear. This study aims to compare the impact of NAVA, pressure-control (PCV and pressure-support ventilation (PSV on the respiratory drive patterns in infants. We hypothesized that on NAVA, EAdi variability resembles most the endogenous respiratory drive pattern seen in a control group.Methods: EAdi was continuously recorded in 10 infants ventilated successively on NAVA (5 hours, PCV (30 min, and PSV (30 min. During the last 10 minutes of each period, the EAdi variability pattern was assessed using non-rhythmic to rhythmic index (NRR. These variability profiles were compared to the pattern of a control group of 11 spontaneously breathing and non-intubated infants.Results: In control infants, NRR was higher as compared to mechanically ventilated infants (p<0.001, and NRR pattern was relatively stable over time. While the temporal stability of NRR was similar in NAVA and controls, the NRR profile was less stable during PCV. PSV exhibited an intermediary pattern. Perspectives: Mechanical ventilation impacts the breathing variability in infants. NAVA produces EAdi pattern resembling most that of control infants. NRR can be used to characterize respiratory variability in infants. Larger prospective studies are necessary to understand the differential impact of the ventilatory modes on the cardio-respiratory variability and to study their impact on clinical

  16. 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...

  17. 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...

  18. 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.

  19. 77 FR 23288 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-04-18

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

  20. 76 FR 50269 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    Science.gov (United States)

    2011-08-12

    ... of eligibility to apply for trade adjustment assistance benefits and such supply or production is...,112; STK, LLC, Lemon Furnace, Pennsylvania. TA-W-80,112A; STK, LLC, Coconut Creek, Florida. TA-W-80...

  1. 77 FR 28901 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance; Novartis...

    Science.gov (United States)

    2012-05-16

    ... Adjustment Assistance; Novartis Pharmaceuticals Corporation, Primary Care Business Unit (Sales) Division... of Novartis Pharmaceuticals Corporation, Primary Care Business Unit (Sales) Division, East Hanover... Corporation, Primary Care Business Unit (Sales) Division, East Hanover, New in sales of pharmaceuticals. The...

  2. Bedside adjustment of proportional assist ventilation to target a predefined range of respiratory effort.

    Science.gov (United States)

    Carteaux, Guillaume; Mancebo, Jordi; Mercat, Alain; Dellamonica, Jean; Richard, Jean-Christophe M; Aguirre-Bermeo, Hernan; Kouatchet, Achille; Beduneau, Gaetan; Thille, Arnaud W; Brochard, Laurent

    2013-09-01

    During proportional assist ventilation with load-adjustable gain factors, peak respiratory muscle pressure can be estimated from the peak airway pressure and the percentage of assistance (gain). Adjusting the gain can, therefore, target a given level of respiratory effort. This study assessed the clinical feasibility of titrating proportional assist ventilation with load-adjustable gain factors with the goal of targeting a predefined range of respiratory effort. Prospective, multicenter, clinical observational study. Intensive care departments at five university hospitals. Patients were included after meeting simple criteria for assisted mechanical ventilation. Patients were ventilated in proportional assist ventilation with load-adjustable gain factors. The peak respiratory muscle pressure, estimated in cm H2O as (peak airway pressure-positive end-expiratory pressure)×[(100-gain)/gain], was calculated from a grid at the bedside. The gain adjustment algorithm was defined to target a peak respiratory muscle pressure between 5 and 10 cm H2O. Additional recommendations were available in case of hypoventilation or hyperventilation. Fifty-three patients were enrolled. Median time spent under proportional assist ventilation with load-adjustable gain factors was 3 days (interquartile range, 1-5). Gain was adjusted 1.0 (0.7-1.8) times per day, according to the peak respiratory muscle pressure target range in 91% of cases and because of hypoventilation or hyperventilation in 9%. Thirty-four patients were ventilated with proportional assist ventilation with load-adjustable gain factors until extubation, which was successful in 32. Eighteen patients required volume assist-controlled reventilation because of clinical worsening and need for continuous sedation. One patient was intolerant to proportional assist ventilation with load-adjustable gain factors. This first study assessing the clinical feasibility of titrating proportional assist ventilation with load-adjustable

  3. 76 FR 2720 - Trade Adjustment Assistance Program; Designation of Certifying Officers

    Science.gov (United States)

    2011-01-14

    ..., as amended, to provide assistance to domestic workers adversely affected in their employment by certain types of foreign trade. The Trade and Globalization Adjustment Assistance Act of 2009 amended the Trade Act of 1974, expanded TAA coverage to more workers and firms, including workers and firms in the...

  4. 78 FR 25481 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-05-01

    ... Stop). 82602 Wells Fargo Bank (Workers).. Beaverton, OR 03/26/13 03/25/13 82603 GE Ravenna Lamp... Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment... is to determine whether the workers are eligible to apply for adjustment assistance under Title II...

  5. 77 FR 62260 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-10-12

    ... those produced/supplied by the workers' firm; (B) there has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance In accordance with Section 223 of...

  6. 77 FR 70480 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-11-26

    ... (Company). 82107 Sub Zero and Wolf, Inc. Madison, WI 10/23/12 10/02/12 (Workers). 82108 Axa Equitable..., Certifying Officer, Office of Trade Adjustment Assistance. Appendix Date of Date of TA-W Subject firm... Jose, CA 10/22/12 10/18/12 One-Stop). 82101 BT Americas (Company)...... EL Segundo, CA........ 10/22/12...

  7. 75 FR 52987 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-08-30

    ... Weyerhaeuser (Union)....... Sweet Home, OR........ 08/13/10 08/11/10 74516 CCI (Company) Rancho Santa 08/13/10... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR..., to FOIA Disclosure Officer, Office of Trade Adjustment Assistance (ETA), U.S. Department of Labor...

  8. 76 FR 19468 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-04-07

    ... Park, IL....... February 14, 2010. Diagnostics Division, Leased Workers Advanced Clinical Services, etc... cases, the investigation revealed that the eligibility criteria for worker adjustment assistance have... met. TA-W No. Subject firm Location Impact date 74,911 Emerson Network Power, Bannock-burn, IL...

  9. 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...

  10. 75 FR 71462 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-11-23

    ... (Workers). 74822 Bank of America (State/ Los Angeles, CA.... 11/03/10 10/28/10 One-Stop). 74823 Hartford... Worker Adjustment Assistance Petitions have been filed with the Secretary of Labor under Section 221(a... of each of the investigations is to determine whether the workers are eligible to apply for...

  11. 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...

  12. 76 FR 30393 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-05-25

    ... Electronic Data Systems (EDS) Wake Forest, North Carolina TA-W-74,530E Hewlett Packard Company Human... overall servicing operation and were impacted by the shift in human resource services to Panama... Adjustment Assistance TA-W-74,530 Hewlett Packard Company Human Resources Division Including Workers Whose...

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

    Science.gov (United States)

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

    2009-01-01

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

  14. Impact of prolonged assisted ventilation on diaphragmatic efficiency: NAVA versus PSV.

    Science.gov (United States)

    Di Mussi, Rosa; Spadaro, Savino; Mirabella, Lucia; Volta, Carlo Alberto; Serio, Gabriella; Staffieri, Francesco; Dambrosio, Michele; Cinnella, Gilda; Bruno, Francesco; Grasso, Salvatore

    2016-01-05

    Prolonged controlled mechanical ventilation depresses diaphragmatic efficiency. Assisted modes of ventilation should improve it. We assessed the impact of pressure support ventilation versus neurally adjusted ventilator assist on diaphragmatic efficiency. Patients previously ventilated with controlled mechanical ventilation for 72 hours or more were randomized to be ventilated for 48 hours with pressure support ventilation (n =12) or neurally adjusted ventilatory assist (n = 13). Neuro-ventilatory efficiency (tidal volume/diaphragmatic electrical activity) and neuro-mechanical efficiency (pressure generated against the occluded airways/diaphragmatic electrical activity) were measured during three spontaneous breathing trials (0, 24 and 48 hours). Breathing pattern, diaphragmatic electrical activity and pressure time product of the diaphragm were assessed every 4 hours. In patients randomized to neurally adjusted ventilator assist, neuro-ventilatory efficiency increased from 27 ± 19 ml/μV at baseline to 62 ± 30 ml/μV at 48 hours (p <0.0001) and neuro-mechanical efficiency increased from 1 ± 0.6 to 2.6 ± 1.1 cmH2O/μV (p = 0.033). In patients randomized to pressure support ventilation, these did not change. Electrical activity of the diaphragm, neural inspiratory time, pressure time product of the diaphragm and variability of the breathing pattern were significantly higher in patients ventilated with neurally adjusted ventilatory assist. The asynchrony index was 9.48 [6.38- 21.73] in patients ventilated with pressure support ventilation and 5.39 [3.78- 8.36] in patients ventilated with neurally adjusted ventilatory assist (p = 0.04). After prolonged controlled mechanical ventilation, neurally adjusted ventilator assist improves diaphragm efficiency whereas pressure support ventilation does not. ClinicalTrials.gov study registration: NCT02473172, 06/11/2015.

  15. 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

  16. 77 FR 77217 - Fiscal Year 2012 Annual Report to Congress on the Trade Adjustment Assistance for Firms Program

    Science.gov (United States)

    2012-12-31

    ... firm eligibility--provided under the Trade and Globalization Adjustment Assistance Act of 2009 (TGAAA... program effectively targeted small and medium-sized firms in FY 2012. TAACs provided technical assistance...-assisted firms. It should be noted that TAAF clients are operating in the same economic environment as...

  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

    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

  18. 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

  19. Ventilatory strategies in trauma patients

    Directory of Open Access Journals (Sweden)

    Shubhangi Arora

    2014-01-01

    Full Text Available Lung injury in trauma patients can occur because of direct injury to lung or due to secondary effects of injury elsewhere for example fat embolism from a long bone fracture, or due to response to a systemic insult such as; acute respiratory distress syndrome (ARDS secondary to sepsis or transfusion related lung injury. There are certain special situations like head injury where the primary culprit is not the lung, but the brain and the ventilator strategy is aimed at preserving the brain tissue and the respiratory system takes a second place. The present article aims to delineate the strategies addressing practical problems and challenges faced by intensivists dealing with trauma patients with or without healthy lungs. The lung protective strategies along with newer trends in ventilation are discussed. Ventilatory management for specific organ system trauma are highlighted and their physiological base is presented.

  20. Ventilatory responses to imagined exercise.

    Science.gov (United States)

    Gallego, J; Denot-Ledunois, S; Vardon, G; Perruchet, P

    1996-11-01

    We studied whether the ventilatory responses to imagined exercise are influenced by automatic processes. Twentynine athletes produced mental images of a sport event with successive focus on the environment, the preparation, and the exercise. Mean breathing frequency increased from 15 to 22 breaths/min. Five participants reported having voluntarily controlled breathing, two of them during preparation. Twenty participants reported that their breathing pattern changed during the experiment: 11 participants were unable to correctly report on the direction of changes in frequency, and 13 incorrectly reported changes in amplitude. This finding suggests that these changes were not voluntary in most participants and may therefore reveal automatic forebrain influences on exercise hyperpnea. However, these changes may also reflect nonspecific processes (e.g., arousal) different from those occurring during actual exercise.

  1. 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 problems than singletons (M = 2.64, SD = 0.23; F(1, 156) = 5.75, b = 0.78, P problems (M = 1.37, SE = 0.33; F(1, 222) = 2.65, P = 0.05) than premature twins (M = 2.32, SE = 0.32, b = 0.95, P adjustment than singletons in this developmental period. This research is based on a collaborative research effort supported by University of Minnesota Agriculture Experiment Station Project Number MN-52-107, a University of Minnesota

  2. 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

  3. 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…

  4. 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...

  5. 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.

  6. 76 FR 54797 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance...

    Science.gov (United States)

    2011-09-02

    ... public hearing, provided such request is filed in writing with the Director, Office of Trade Adjustment... Wiring Harness Division. (State/One-Stop) 80353 The HON Company Owensboro, KY......... 08/10/11 08/09/11...

  7. 75 FR 2491 - Trade Adjustment Assistance for Firms Program Fiscal Year 2009 Annual Report

    Science.gov (United States)

    2010-01-15

    ... supply chain management strategy, integration, analysis, and efficiency training/coaching/mentoring.../cost studies/quoting/cost Employee training study Design software estimating supply chain management... petitions and Adjustment Proposals, the Economic Development Administration (EDA) experienced challenges in...

  8. 78 FR 61396 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-10-03

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

  9. 77 FR 62263 - Investigations Regarding Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-10-12

    ... hearing, provided such request is filed in writing with the Director, Office of Trade Adjustment... 09/26/12 Transactional Group (State/ One-Stop). 82011 Winzen Film, Inc. (Workers) Sulphur Springs, TX...

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

    NARCIS (Netherlands)

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

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

  11. 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) ...

  12. 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.

  13. Continuous Flow Ventilatory Support (Clinical Experience

    Directory of Open Access Journals (Sweden)

    Pavol Török

    2006-01-01

    Full Text Available Background. The world literature contains no reports on the clinical application of continuous flow ventilatory support by an insufflation catheter. Despite the use of different forms of ventilatory support, disconnection of patients from artificial ventilation is unsuccessful in 10—30% of cases despite the fact that the clinical and biochemical criteria are met.Objective: to discuss the efficiency of the new ventilation regime — continuous flow ventilatory support in the clinical setting.Methods: continuous flow ventilatory support with an original licensed multi-jet insufflation catheter or a terminal one-orifice catheter nasally inserted into the trachea was applied to 70 patients. It was used in a subgroup of 64 patients with chronic obstructive lung disease (COLD due to the occurrence of global respiratory insufficiency caused by infectious complications and in a group of 6 patients as a ventilatory regime for their disconnection from long-term artificial ventilation, whose disconnection other ventilatory regimens being used were unsuccessful.Results. None patient with COLD should be intubated, and just 30 minutes after the initiation of ventilatory support with a multi-jet catheter, there were decreases in the mean respiration rate from 33±2.8 to 27±2.5 cycles/min and in paCo2 from 11.9±1.7 to 10.8±1.6 kPa and an increase in paCo2 from 5.7±1.1 to 6.8±1.3 kPa at FiO2 =0.3. Within 24 hours after the initiation of ventilatory support, blood gas levels changed in response to the values typical of partial respiratory insufficiency. The spontaneous ventilation rate decreased to 20±2.2, paCO2 reduced to 6.4±1.2  kPa  and  pO2 continuously  increased  up  to  the  value  8.9±1.4  kPa  (FiO2 =0.3  at  hour  24  of  ventilatory  support. Ventilatory support lasted an average of 5 days. Statistical comparison of the study parameters showed a significant improvement (p<0.05 just 6 hours after ventilatory support and a

  14. Defining obstructive ventilatory defect in 2015

    African Journals Online (AJOL)

    2015-10-08

    Oct 8, 2015 ... obstructive pulmonary disease (COPD) is constantly increasing worldwide including African countries. (1, 2). These two chronic diseases, often having in com- mon an obstructive ventilatory defect (OVD), should be diagnosed more accurately by using spirometry (3, 4). However, there is no clear consensus ...

  15. 20 CFR 410.430 - Ventilatory studies.

    Science.gov (United States)

    2010-04-01

    ...-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.430 Ventilatory... minute. The reported maximum voluntary ventilation (MVV) or maximum breathing capacity (MBC) and 1-second forced expiratory volume (FEV1) should represent the largest of at least three attempts. The MVV or the...

  16. 24 CFR 570.401 - Community adjustment and economic diversification planning assistance.

    Science.gov (United States)

    2010-04-01

    ... development; (5) Preparation for and conduct of initial community outreach activities to begin involving local...: Director, Office of Technical Assistance, room 7214, 451 Seventh Street, SW., Washington, DC 20410. Each... sheet, signed and dated by a person authorized to represent and contractually or otherwise commit the...

  17. 78 FR 73886 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-12-09

    ... investigation resulting in-- (A) An affirmative determination of serious injury or threat thereof under section..., Inc., Corporate Accounting Greenwood Village, November 6, 2012. and Finance Administration. CO. The... the following cases, the investigation revealed that the eligibility criteria for worker adjustment...

  18. 76 FR 39131 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance...

    Science.gov (United States)

    2011-07-05

    ... public hearing, provided such request is filed in writing with the Director, Office of Trade Adjustment... submit written comments regarding the subject matter of the investigations to the Director, Office of... 80228 CNA Insurance (State/One- Chicago, IL 06/13/11 06/10/11 Stop). 80229 Neff Motivation, Inc...

  19. 75 FR 67771 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-11-03

    .... 73,935 Pratt-Read Corporation Shelton, CT April 15, 2009. 74,482 Airolite, LLC, Marietta, OH.... Galva, IL an Ohio Corporation, Bob Evans Farms, Inc., a Delaware Corporation. 74,646 American Municipal Marietta, OH......... Power. ] Determinations Terminating Investigations of Petitions for Worker Adjustment...

  20. 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.

  1. 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 PCO2 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 PCO2 (PETCO2). 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); PETCO2 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 (groups, demonstrating STM. There were no significant differences between groups

  2. Ventilatory Efficiency in Children and Adolescents Born Extremely Preterm

    Science.gov (United States)

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

    2017-01-01

    Purpose: Children and adolescents born extremely preterm (EP) have lower dynamic lung volumes and gas transfer capacity than subjects born at term. Most studies also report lower aerobic capacity. We hypothesized that ventilatory efficiency was poorer and that breathing patterns differed in EP−born compared to term−born individuals. Methods: Two area−based cohorts of participants born with gestational age ≤28 weeks or birth weight ≤1000 g in 1982−85 (n = 46) and 1991–92 (n = 35) were compared with individually matched controls born at term. Mean ages were 18 and 10 years, respectively. The participants performed an incremental treadmill exercise test to peak oxygen uptake with data averaged over 20 s intervals. For each participant, the relationship between exhaled minute ventilation (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. PMID:28751866

  3. 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.

  4. Early post-partum adjustment and admission to parenting services in Victoria, Australia after assisted conception.

    Science.gov (United States)

    Hammarberg, K; Rowe, H J R; Fisher, J R W

    2009-11-01

    Higher rates of admission to residential early parenting services (REPSs) after assisted conception compared with spontaneous conception have been reported. The aim of this study was to characterize early post-partum psychological functioning and the rate of, and risks factors for, admission to REPSs in women conceiving with assisted reproductive technology (ART) in Australia. A consecutive cohort of women who had conceived through ART was recruited systematically in early pregnancy. At 3 months post-partum, participants completed postal questionnaires which included a new measure of the degree of difficulty involved in conceiving, the Burden of Infertility and Treatment (BIT) scale. Of 166 women who participated, 8% had already been admitted to a REPS within 3 months, which is a higher rate compared with other women in the first 12 months (5%). Compared with community samples of new mothers, there was no difference in rate of depression. A higher proportion reported dysregulated infant behaviours (P < 0.0001) and a smaller proportion was breast feeding exclusively (P < 0.0001). Greater difficulty conceiving (higher BIT score) was associated with lower maternal confidence. Clinical care of the increasing group of women who conceive with ART should include explicit assessment of early post-partum psychological functioning and early intervention if difficulties in managing infant behaviour are reported.

  5. A risk-adjusted financial model to estimate the cost of a video-assisted thoracoscopic surgery lobectomy programme.

    Science.gov (United States)

    Brunelli, Alessandro; Tentzeris, Vasileios; Sandri, Alberto; McKenna, Alexandra; Liew, Shan Liung; Milton, Richard; Chaudhuri, Nilanjan; Kefaloyannis, Emmanuel; Papagiannopoulos, Kostas

    2016-05-01

    To develop a clinically risk-adjusted financial model to estimate the cost associated with a video-assisted thoracoscopic surgery (VATS) lobectomy programme. Prospectively collected data of 236 VATS lobectomy patients (August 2012-December 2013) were analysed retrospectively. Fixed and variable intraoperative and postoperative costs were retrieved from the Hospital Accounting Department. Baseline and surgical variables were tested for a possible association with total cost using a multivariable linear regression and bootstrap analyses. Costs were calculated in GBP and expressed in Euros (EUR:GBP exchange rate 1.4). The average total cost of a VATS lobectomy was €11 368 (range €6992-€62 535). Average intraoperative (including surgical and anaesthetic time, overhead, disposable materials) and postoperative costs [including ward stay, high dependency unit (HDU) or intensive care unit (ICU) and variable costs associated with management of complications] were €8226 (range €5656-€13 296) and €3029 (range €529-€51 970), respectively. The following variables remained reliably associated with total costs after linear regression analysis and bootstrap: carbon monoxide lung diffusion capacity (DLCO) 0.05) in 86% of the samples. A hypothetical patient with COPD and DLCO less than 60% would cost €4270 more than a patient without COPD and with higher DLCO values (€14 793 vs €10 523). Risk-adjusting financial data can help estimate the total cost associated with VATS lobectomy based on clinical factors. This model can be used to audit the internal financial performance of a VATS lobectomy programme for budgeting, planning and for appropriate bundled payment reimbursements. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  6. Adaptive support and pressure support ventilation behavior in response to increased ventilatory demand.

    Science.gov (United States)

    Jaber, Samir; Sebbane, Mustapha; Verzilli, Daniel; Matecki, Stefan; Wysocki, Marc; Eledjam, Jean-Jacques; Brochard, Laurent

    2009-03-01

    Dual-control modes of ventilation adapt the pressure delivery to keep a volume target in response to changes in respiratory mechanics, but they may respond poorly to changes in ventilatory demand. Adaptive support ventilation (ASV), a complex minute volume-targeted pressure-regulated ventilation, was compared to adaptive pressure ventilation (APV), a dual-mode in which the pressure level is adjusted to deliver a preset tidal volume, and to pressure support ventilation (PSV) when facing an increase in ventilatory demand. A total of 14 intensive care unit patients being weaned off mechanical ventilation were included in this randomized crossover study. The effect of adding a heat-and-moisture exchanger to augment circuit dead space was assessed with a same fixed level of ASV, PSV, and APV. Arterial blood gases, ventilator response, and patient respiratory effort parameters were evaluated at the end of the six periods. Adding dead space significantly increased minute ventilation and PaCO2 values with the three modes. Indexes of respiratory effort (pressure-time index of respiratory muscles and work of breathing) increased with all ventilatory modes after dead-space augmentation. This increase was significantly greater with APV than with PSV or ASV (P ventilator.

  7. 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.

  8. 76 FR 5811 - Adjusted Federal Medical Assistance Percentage (FMAP) Rate for the First Quarter of Fiscal Year...

    Science.gov (United States)

    2011-02-02

    ... unemployment rate from the calendar quarter ending before July 1, 2010 to the calendar quarter ending before... last two quarters of the extended recession adjustment period, and changed the look back period for calculating the unemployment adjustment for those quarters, which will be addressed in a future Notice. DATES...

  9. 76 FR 32204 - Adjusted Federal Medical Assistance Percentage (FMAP) Rates for the Second and Third Quarters of...

    Science.gov (United States)

    2011-06-03

    ... period, and changed the look back period for calculating the unemployment adjustment for those quarters... rate from decreasing due to a lower unemployment rate from the calendar quarter ending before July 1... of the extended recession adjustment period, and changed the look back period for calculating the...

  10. 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

  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. An unusual cause of ventilatory failure in motor neurone disease

    Directory of Open Access Journals (Sweden)

    Epaminondas Markos Valsamis, MB BChir, MA (Cantab, MRCS

    2017-01-01

    Full Text Available A patient previously diagnosed with motor neurone disease (MND and gastrostomy-fed was under surveillance for ventilatory decline via our respiratory centre. At a planned review she was found to be hypercapnic, which would usually prompt an offer of non-invasive ventilation for home use. However, she was alkalotic and not acidotic as we might expect. Her serum potassium was checked urgently and confirmed as low. It was established that the community team had prescribed a feeding regime with insufficient potassium. Correction of hypokalaemia resolved her ventilatory failure. This case demonstrates the importance of co-ordinated care in the management of patients with MND.

  13. An unusual cause of ventilatory failure in motor neurone disease.

    Science.gov (United States)

    Valsamis, Epaminondas Markos; Smith, Ian; De Sousa, Adri

    2017-01-01

    A patient previously diagnosed with motor neurone disease (MND) and gastrostomy-fed was under surveillance for ventilatory decline via our respiratory centre. At a planned review she was found to be hypercapnic, which would usually prompt an offer of non-invasive ventilation for home use. However, she was alkalotic and not acidotic as we might expect. Her serum potassium was checked urgently and confirmed as low. It was established that the community team had prescribed a feeding regime with insufficient potassium. Correction of hypokalaemia resolved her ventilatory failure. This case demonstrates the importance of co-ordinated care in the management of patients with MND.

  14. Influences of lung parenchyma density and thoracic fluid on ventilatory EIT measurements

    NARCIS (Netherlands)

    Kunst, P. W.; Vonk Noordegraaf, A.; Straver, B.; Aarts, R. A.; Tesselaar, C. D.; Postmus, P. E.; de Vries, P. M.

    1998-01-01

    Ventilatory impedance changes can be measured by electrical impedance tomography (EIT). Several studies have pointed out that the ventilatory-induced impedance change measured over the lungs shows a linear relationship with tidal volume. However, EIT measures the ventilatory impedance changes

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

    African Journals Online (AJOL)

    EL-HAKIM

    Egypt J Pediatr Allergy Immunol 2012;10(1):33-37. 33. Ventilatory functions response to breathing training versus aerobic training in asthmatic children. INTRODUCTION ... as anxiety, light headedness, and fatigue4. Many previous ... Objective: To compare the effects of a program of breathing training and aerobic training ...

  16. 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, ...

  17. Ventilatory Function and Cigarette Smoking in Cement Handlers in ...

    African Journals Online (AJOL)

    Introduction: Occupational exposure to dust and cigarette smoking play important roles in the pathogenesis of lung diseases, particularly in developing countries. To determine the effects of outdoor cement dust exposure and cigarette smoking on lung health, we compared ventilatory function in cement handlers (smokers ...

  18. 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 ...

  19. Endogenous Opioids and Ventilatory Adaptation to Prolonged Hypoxia in Goats,

    Science.gov (United States)

    1984-06-25

    the rise in arterial PCO 2 with .- gA. IV. 10 long-term acclimatization in goats and attributed it to. augmented production of CO2 by the rumen of the...proposed that, with prolonged hypoxia, partial non-respiratory compensation for metabolic acidosis in the central nervous system acts to decrease ventilatory

  20. 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 ...

  1. Outcomes of pharmacist-assisted management of antiretroviral therapy in patients with HIV infection: A risk-adjusted analysis.

    Science.gov (United States)

    Nevo, Ofir Noah; Lesko, Catherine R; Colwell, Bradford; Ballard, Craig; Cole, Stephen R; Mathews, W Christopher

    2015-09-01

    The impact of pharmacist-assisted management (PAM) of pharmacotherapy for patients with human immunodeficiency virus (HIV) infection was investigated. A retrospective cohort analysis was conducted to evaluate antiretroviral therapy (ART) outcomes in treatment-naive patients initiated on ART at an HIV clinic. Eligible patients enrolled in the clinic during the period 1999-2013 were classified into two groups: those referred to a clinic-based HIV pharmacist for initiation of ART (the PAM group) and those managed by a primary care provider (the control group). The primary study objective was the median time to viral suppression; secondary objectives included the durability of response to the first ART regimen. Relative hazards for the events of interest were estimated using a marginal structural Cox proportional hazards model and Kaplan-Meier curves, with inverse probability weights used to control for selection and confounding bias. Patients referred for PAM services (n = 819) typically had higher baseline viral loads and lower CD4+ cell counts than those in the control group (n = 436). The likelihood of viral suppression during the first two years after ART initiation was significantly higher in the PAM group versus the control group (hazard ratio, 1.37; 95% confidence interval, 1.18-1.59; p 0.05). In treatment-naive patients, suppression of HIV viral load occurred earlier when pharmacists assisted with initiating ART than when ART was initiated without that assistance. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  2. Minocycline blocks glial cell activation and ventilatory acclimatization to hypoxia.

    Science.gov (United States)

    Stokes, Jennifer A; Arbogast, Tara E; Moya, Esteban A; Fu, Zhenxing; Powell, Frank L

    2017-04-01

    Ventilatory acclimatization to hypoxia (VAH) is the time-dependent increase in ventilation, which persists upon return to normoxia and involves plasticity in both central nervous system respiratory centers and peripheral chemoreceptors. We investigated the role of glial cells in VAH in male Sprague-Dawley rats using minocycline, an antibiotic that inhibits microglia activation and has anti-inflammatory properties, and barometric pressure plethysmography to measure ventilation. Rats received either minocycline (45mg/kg ip daily) or saline beginning 1 day before and during 7 days of chronic hypoxia (CH, PiO2  = 70 Torr). Minocycline had no effect on normoxic control rats or the hypercapnic ventilatory response in CH rats, but minocycline significantly (P minocycline administration during only the last 3 days of CH did not reverse VAH. Microglia and astrocyte activation in the nucleus tractus solitarius was quantified from 30 min to 7 days of CH. Microglia showed an active morphology (shorter and fewer branches) after 1 h of hypoxia and returned to the control state (longer filaments and extensive branching) after 4 h of CH. Astrocytes increased glial fibrillary acidic protein antibody immunofluorescent intensity, indicating activation, at both 4 and 24 h of CH. Minocycline had no effect on glia in normoxia but significantly decreased microglia activation at 1 h of CH and astrocyte activation at 24 h of CH. These results support a role for glial cells, providing an early signal for the induction but not maintenance of neural plasticity underlying ventilatory acclimatization to hypoxia.NEW & NOTEWORTHY The signals for neural plasticity in medullary respiratory centers underlying ventilatory acclimatization to chronic hypoxia are unknown. We show that chronic hypoxia activates microglia and subsequently astrocytes. Minocycline, an antibiotic that blocks microglial activation and has anti-inflammatory properties, also blocks astrocyte activation in respiratory

  3. [Ventilatory function in patients with silicosis or coal workers' pneumoconiosis].

    Science.gov (United States)

    Brhel, Petr; Petrovová, Markéta; Lorenzová, Dana

    2015-12-01

    The aim of the study was to determine ventilatory function in a group of patients with silicosis and coal workers pneumoconisos (CWP) newly granted as occupational disease. The authors have undertaken the analysis of all cases of occupational silicosis and CWP which were diagnosed in men in the South Moravia region. Information on ventilatory function, chest symptoms, age, working and smoking history was collected during the medical surveys, including spirometry testing and chest radiography. Diagnosis was based on history of occupational exposure to coal or silica dust, chest x-ray findings, using International Labour Office classification. In the years 1997-2014, 116 occupational silicosis and coal workers´ pneumoconiosis have been notified. There were diagnosed 42 cases of simple and 17 cases of complicated silicosis, 40 cases of the simple and 17 cases of complicated CWP. Duration of exposure to respiratory hazards, smoking history and prevalence of ventilatory impairment were not significantly different between these groups. The mean age of persons at diagnosing occupational disease was 61.0 (SD 11.2) years, the mean duration of exposure to respirable dust was 24.7 (SD 10.2) years. Abnormal spirometry results were detected in 51.7% of pneumoconiotics--8.6% with restrictive, 11.2% with obstructive, and 31.9 with mixed impairment. The prevalence of ventilatory function impairment was found to be significantly associated with chronic obstructive pulmonary disease and age. Testing of ventilatory function has an important role in the evaluation of lung disease in employees exposed to various respirable hazards. Although such testing was not useful for diagnosing silicosis or CWP, it was important for evaluating compensation amount for occupational disease in 51.7% pneumoconiotic patiens.

  4. 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].

  5. Polycythemia and high levels of erythropoietin in blood and brain blunt the hypercapnic ventilatory response in adult mice.

    Science.gov (United States)

    Menuet, Clément; Khemiri, Hanan; de la Poëze d'Harambure, Théodora; Gestreau, Christian

    2016-05-15

    Changes in arterial Po2, Pco2, and pH are the strongest stimuli sensed by peripheral and central chemoreceptors to adjust ventilation to the metabolic demand. Erythropoietin (Epo), the main regulator of red blood cell production, increases the hypoxic ventilatory response, an effect attributed to the presence of Epo receptors in both carotid bodies and key brainstem structures involved in integration of peripheral inputs and control of breathing. However, it is not known whether Epo also has an effect on the hypercapnic chemoreflex. In a first attempt to answer this question, we tested the hypothesis that Epo alters the ventilatory response to increased CO2 levels. Basal ventilation and hypercapnic ventilatory response (HCVR) were recorded from control mice and from two transgenic mouse lines constitutively expressing high levels of human Epo in brain only (Tg21) or in brain and plasma (Tg6), the latter leading to polycythemia. To tease apart the potential effects of polycythemia and levels of plasma Epo in the HCVR, control animals were injected with an Epo analog (Aranesp), and Tg6 mice were treated with the hemolytic agent phenylhydrazine after splenectomy. Ventilatory parameters measured by plethysmography in conscious mice were consistent with data from electrophysiological recordings in anesthetized animals and revealed a blunted HCVR in Tg6 mice. Polycythemia alone and increased levels of plasma Epo blunt the HCVR. In addition, Tg21 mice with an augmented level of cerebral Epo also had a decreased HCVR. We discuss the potential implications of these findings in several physiopathological conditions. Copyright © 2016 the American Physiological Society.

  6. 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...

  7. 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 support and CPR was significantly increased in the group with manual resuscitator without 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.

  8. 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.

  9. 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

  10. Coupling of EIT with computational lung modeling for predicting patient-specific ventilatory responses.

    Science.gov (United States)

    Roth, Christian J; Becher, Tobias; Frerichs, Inéz; Weiler, Norbert; Wall, Wolfgang A

    2017-04-01

    Providing optimal personalized mechanical ventilation for patients with acute or chronic respiratory failure is still a challenge within a clinical setting for each case anew. In this article, we integrate electrical impedance tomography (EIT) monitoring into a powerful patient-specific computational lung model to create an approach for personalizing protective ventilatory treatment. The underlying computational lung model is based on a single computed tomography scan and able to predict global airflow quantities, as well as local tissue aeration and strains for any ventilation maneuver. For validation, a novel "virtual EIT" module is added to our computational lung model, allowing to simulate EIT images based on the patient's thorax geometry and the results of our numerically predicted tissue aeration. Clinically measured EIT images are not used to calibrate the computational model. Thus they provide an independent method to validate the computational predictions at high temporal resolution. The performance of this coupling approach has been tested in an example patient with acute respiratory distress syndrome. The method shows good agreement between computationally predicted and clinically measured airflow data and EIT images. These results imply that the proposed framework can be used for numerical prediction of patient-specific responses to certain therapeutic measures before applying them to an actual patient. In the long run, definition of patient-specific optimal ventilation protocols might be assisted by computational modeling.NEW & NOTEWORTHY In this work, we present a patient-specific computational lung model that is able to predict global and local ventilatory quantities for a given patient and any selected ventilation protocol. For the first time, such a predictive lung model is equipped with a virtual electrical impedance tomography module allowing real-time validation of the computed results with the patient measurements. First promising results

  11. Source of human ventilatory chaos: lessons from switching controlled mechanical ventilation to inspiratory pressure support in critically ill patients.

    Science.gov (United States)

    Mangin, Laurence; Fiamma, Marie-Noëlle; Straus, Christian; Derenne, Jean-Philippe; Zelter, Marc; Clerici, Christine; Similowski, Thomas

    2008-04-30

    Ventilatory flow measured at the airway opening in humans exhibits a complex dynamics that has the features of chaos. Currently available data point to a neural origin of this feature, but the role of respiratory mechanics has not been specifically assessed. In this aim, we studied 17 critically ill mechanically ventilated patients during a switch form an entirely machine-controlled assistance mode (assist-controlled ventilation ACV) to a patient-driven mode (inspiratory pressure support IPS). Breath-by-breath respiratory variability was assessed with the coefficient of variation of tidal volume, total cycle time, inspiratory time, expiratory time, mean inspiratory flow, duty cycle. The detection of chaos was performed with the noise titration technique. When present, chaos was characterized with numerical indexes (correlation dimension, irregularity; largest Lyapunov exponent, sensitivity to initial conditions). Expectedly, the coefficients of variations of the respiratory variables were higher during IPS than during ACV. During ACV, noise titration failed to detect nonlinearities in 12 patients who did not exhibit signs of spontaneous respiratory activity. This indicates that the mechanical properties of the respiratory system were not sufficient to produce ventilatory chaos in the presence of a nonlinear command (ventilator clock). A positive noise limit was found in the remaining 5 cases, but these patients exhibited signs of active expiratory control (highly variable expiratory time, respiratory frequency higher than the set frequency). A positive noise limit was also observed in 16/17 patients during IPS (pmechanics, if any.

  12. Peak oxygen uptake and ventilatory anaerobic threshold in fibromyalgia.

    Science.gov (United States)

    Valim, Valéria; Oliveira, Leda M; Suda, Alina L; Silva, Luciana E; Faro, Mário; Neto, Turíbio L Barros; Feldman, Daniel; Natour, Jamil

    2002-02-01

    To compare maximum oxygen uptake and anaerobic threshold in patients with fibromyalgia (FM) and healthy sedentary controls matched by sex, age, weight, and body mass index. Fifty women with FM aged 18-60 years and 50 healthy sedentary controls were studied. All were submitted to a maximum treadmill incremental test. Expired gas, ventilatory anaerobic threshold, and maximum oxygen uptake (VO2max) were evaluated. The influence of FM on quality of life was evaluated by questionnaires: the Fibromyalgia Impact Questionnaire and the Medical Outcomes Study Short-Form (SF-36). In patients with FM, the anaerobic threshold and peak oxygen uptake were significantly reduced. Maximum heartbeat rate was significantly lower in FM, indicating submaximum effort. Linear regression data showed a correlation between peak VO2 and the "Role-physical" domain of the SF-36. No such correlations were noted with anaerobic threshold. These results confirm the hypothesis of lower physical fitness in patients with FM. Considering that patients with FM do not achieve a maximum effort, ventilatory anaerobic threshold should be considered as a better fitness index than VO2max.

  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

    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...

  14. 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.

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

    DEFF Research Database (Denmark)

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

    1999-01-01

    Episodic oxygen desaturation is frequent in the late postoperative period and seems most pronounced on the second and third postoperative nights. However, the ventilatory pattern has not been described systematically during this period. We studied the ventilatory pattern and associated arterial...... oxygenation using the Edentrace II equipment (impedance pneumography and pulse oximetry) on the second and third postoperative nights in 28 patients undergoing major abdominal surgery. Ventilatory disturbances were common and included periods of hypopnoea, and obstructive, central and mixed apnoeas. Overall......, 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...

  16. 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

  17. 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...

  18. 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...

  19. Withdrawal of Ventilatory Support at Home on Hospice.

    Science.gov (United States)

    Unger, Kenneth M

    2016-08-01

    When ventilatory support is withdrawn in an intensive care unit (ICU), the place of death for most patients is the hospital. However, the majority of terminally ill patients prefer to die at home. Few articles have addressed taking adult mechanically ventilated patients home from the ICU for withdrawal of ventilatory support (WVS). To determine the outcomes of a protocol-driven program of WVS in the home under hospice care. A retrospective chart review of 14 consecutive patients who had WVS at home. All subjects were mechanically ventilated ICU patients referred to hospice with a request for WVS to be performed in the patient's home. A protocol/checklist guided care. Medical records were reviewed to obtain demographic and medical information, particularly for duration of mechanical ventilation, the use of premedication, level of consciousness at the time of WVS, symptoms following WVS, pharmacologic measures used for symptom control after WVS, and survival time after WVS. At the time of WVS, five patients were awake or arousable and nine were stuporous or comatose. Ten patients required no medication before WVS; only four required medications for symptom control after WVS. Median survival after WVS was 18.15 hours. In all cases, symptomatic control was judged to be excellent. Successful WVS and a natural death at home is possible with logistic support from the hospice organization and the expertise of the hospice team, guided by a comprehensive protocol/checklist. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2015-08-01

    Patients with chronic obstructive pulmonary disease (COPD) usually complain of symptoms such as cough, sputum, wheezing, and dyspnea. Little is known about clinical symptoms in individuals with restrictive ventilatory impairment. The aim of this study was to compare the prevalence and type of respiratory symptoms in patients with COPD to those reported by individuals with restrictive ventilatory impairment in the Proyecto Latinoamericano de Investigacion en Obstruccion Pulmonar study. Between 2002 and 2004, individuals ≥40 years of age from five cities in Latin America performed pre and post-bronchodilator spirometry and had their respiratory symptoms recorded in a standardized questionnaire. Among the 5315 individuals evaluated, 260 (5.1%) had a restrictive spirometric diagnosis (forced vital capacity (FVC) mental (50.8 ± 10.6 vs. 50.0 ± 11.5) domains. Overall, respiratory symptoms are not frequently reported by patients with restricted and obstructed patterns as defined by spirometry. Wheezing was more frequent in patients with restricted pattern compared with those with obstructive ventilatory defect. However, the prevalence of cough, sputum production, and dyspnea are not different between the two groups when adjusted by the same severity stage. © The Author(s) 2015.

  1. [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.

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

    Science.gov (United States)

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

    2015-03-01

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

  3. 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)

  4. Red Spinach Extract Increases Ventilatory Threshold during Graded Exercise Testing

    Directory of Open Access Journals (Sweden)

    Angelique N. Moore

    2017-10-01

    Full Text Available Background: We examined the acute effect of a red spinach extract (RSE (1000 mg dose; ~90 mg nitrate (NO 3 − on performance markers during graded exercise testing (GXT. Methods: For this randomized, double-blind, placebo (PBO-controlled, crossover study, 15 recreationally-active participants (aged 23.1 ± 3.3 years; BMI: 27.2 ± 3.7 kg/m2 reported >2 h post-prandial and performed GXT 65–75 min post-RSE or PBO ingestion. Blood samples were collected at baseline (BL, pre-GXT (65–75 min post-ingestion; PRE, and immediately post-GXT (POST. GXT commenced with continuous analysis of expired gases. Results: Plasma concentrations of NO 3 − increased PRE (+447 ± 294%; p < 0.001 and POST (+378 ± 179%; p < 0.001 GXT with RSE, but not with PBO (+3 ± 26%, −8 ± 24%, respectively; p > 0.05. No effect on circulating nitrite (NO 2 − was observed with RSE (+3.3 ± 7.5%, +7.7 ± 11.8% PRE and POST, respectively; p > 0.05 or PBO (−0.5 ± 7.9%, −0.2 ± 8.1% PRE and POST, respectively; p > 0.05. When compared to PBO, there was a moderate effect of RSE on plasma NO 2 − at PRE (g = 0.50 [−0.26, 1.24] and POST g = 0.71 [−0.05, 1.48]. During GXT, VO2 at the ventilatory threshold was significantly higher with RSE compared to PBO (+6.1 ± 7.3%; p < 0.05, though time-to-exhaustion (−4.0 ± 7.7%; p > 0.05 and maximal aerobic power (i.e., VO2 peak; −0.8 ± 5.6%; p > 0.05 were non-significantly lower with RSE. Conclusions: RSE as a nutritional supplement may elicit an ergogenic response by delaying the ventilatory threshold.

  5. 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.

  6. Clinical predictors of ventilatory threshold achievement in patients with claudication.

    Science.gov (United States)

    Farah, Breno Q; Ritti-Dias, Raphael M; Cucato, Gabriel G; Menêses, Annelise L; Gardner, Andrew W

    2015-03-01

    Ventilatory threshold (VT) is considered a clinically important marker of cardiovascular function in several populations, including patients with claudication, because it is related to walking capacity and hemodynamics. The purpose of this study was to identify clinical predictors for VT achievement in patients with intermittent claudication. One hundred and seventy-seven (n = 177) patients with intermittent claudication performed a progressive graded cardiopulmonary treadmill test until maximal claudication pain. Oxygen uptake (V˙O2) was continuously measured during the test, and afterwards, VT was visually detected. Clinical characteristics, demographic data, comorbid conditions, and cardiovascular risk factors were obtained. Patients who achieved and did not achieve VT were compared, as well as the workload that VT occurred in the former group. VT was achieved in 134 patients (76%), and the mean V˙O2 at VT for these patients was 10.8 ± 2.4 mL·kg(-1)·min(-1). Patients who did not achieve VT presented lower ankle brachial index (ABI), claudication onset time, peak walking time, and V˙O2peak, and the proportion of women was higher compared with patients who achieved VT (P achieve VT, and these patients were mostly women and those with greater severity of disease. Moreover, in those who reached VT, the predictors of poor VT were female sex, high body mass index, low peak walking time, and low ABI.

  7. Delayed acclimatization of the ventilatory threshold in healthy trekkers.

    Science.gov (United States)

    Myers, Stephen D; Biccard, Bruce M; Chan, Colin; Imray, Christopher H E; Wright, Alexander D; Pattinson, Kyle T S

    2008-01-01

    To test the hypothesis that acclimatization to high altitude results in an improvement of the ventilatory threshold (VT). Eight lowlanders underwent cardiopulmonary exercise testing with a cycle ergometer to determine VT and peak oxygen uptake (Vo2peak) in Coventry, United Kingdom (altitude: 80 m), on arrival in leh, india (altitude: 3500 m), and after 12 days of acclimatization that included a 5-day high altitude trek up to 4770 m. Vo2peak fell on arrival at 3500 m and remained depressed at 12 days. VT was depressed on arrival at high altitude and was further depressed at 12 days. VT as a proportion of the Vo2peak was decreased on arrival at high altitude, and after acclimatization, this relationship was further decreased. Individuals who are sedentary or not participating in regular physical training appear to require a longer period of acclimatization than trained athletes. With the increasing numbers participating in high-altitude trekking and charity climbs of peaks, such as Mt. Kilimanjaro, this information has clinically significant practical implications for those leading or acting as medical advisors.

  8. 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 o...

  9. Increased ventilatory response to carbon dioxide in COPD patients following vitamin C administration

    Directory of Open Access Journals (Sweden)

    Sara E. Hartmann

    2015-09-01

    Full Text Available Patients with chronic obstructive pulmonary disease (COPD have decreased ventilatory and cerebrovascular responses to hypercapnia. Antioxidants increase the ventilatory response to hypercapnia in healthy humans. Cerebral blood flow is an important determinant of carbon dioxide/hydrogen ion concentration at the central chemoreceptors and may be affected by antioxidants. It is unknown whether antioxidants can improve the ventilatory and cerebral blood flow response in individuals in whom these are diminished. Thus, we aimed to determine the effect of vitamin C administration on the ventilatory and cerebrovascular responses to hypercapnia during healthy ageing and in COPD. Using transcranial Doppler ultrasound, we measured the ventilatory and cerebral blood flow responses to hyperoxic hypercapnia before and after an intravenous vitamin C infusion in healthy young (Younger and older (Older subjects and in moderate COPD. Vitamin C increased the ventilatory response in COPD patients (mean (95% CI 1.1 (0.9–1.1 versus 1.5 (1.1–2.0 L·min−1·mmHg−1, p0.05 or Older (1.3 (1.0–1.7 versus 1.3 (1.0–1.7 L·min−1·mmHg−1, p>0.05 healthy subjects. Vitamin C did not affect the cerebral blood flow response in the young or older healthy subjects or COPD subjects (p>0.05. Vitamin C increases the ventilatory but not cerebrovascular response to hyperoxic hypercapnia in patients with moderate COPD.

  10. Ventilatory responses to hypercapnia and hypoxia after 6 h passive hyperventilation in humans

    Science.gov (United States)

    Ren, Xiaohui; Robbins, Peter A

    1999-01-01

    Acute exposure to hypoxia stimulates ventilation and induces hypocapnia. Long-term exposure to hypoxia generates changes in respiratory control known as ventilatory acclimatization to hypoxia. The object of this study was to investigate the degree to which the hyperventilation and hypocapnia can induce the changes known as ventilatory acclimatization to hypoxia, in the absence of the primary hypoxic stimulus itself.Three 6 h protocols were each performed on twelve healthy volunteers: (1) passive hypocapnic hyperventilation, with end-tidal CO2 pressure (PET,CO2) held 10 Torr below the eupnoeic value; (2) passive eucapnic hyperventilation, with PET,CO2 maintained eucapnic; (3) control.Ventilatory responses to acute hypercapnia and hypoxia were assessed before and half an hour after each protocol.The presence of prior hypocapnia, but not prior hyperventilation, caused a reduction in air-breathing PET,CO2 (P hyperventilation, but not prior hypocapnia, caused an increase in the ventilatory sensitivity to CO2 (P hyperventilation: (i) the left shift of the VE-PET,CO2 relationship is due to alkalosis and not to hyperventilation; (ii) the increase in slope of the VE-PET,CO2 relationship is due to the hyperventilation and not the alkalosis; and (iii) ventilatory sensitivity to hypoxia is unaltered. PMID:9882758

  11. 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 (FEV1 = 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)/CO2 output ([Formula: see text]CO2) 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]O2), higher [Formula: see text]E/[Formula: see text]CO2 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 (DLCO) to a key clinical outcome (poor exercise tolerance) in COPD patients with only modest spirometric abnormalities.

  12. Ventilatory demand and dynamic hyperinflation induced during ADL-based tests in Chronic Obstructive Pulmonary Disease patients

    Directory of Open Access Journals (Sweden)

    Karoliny dos Santos

    2016-01-01

    Full Text Available ABSTRACT Background Airflow limitation frequently leads to the interruption of activities of daily living (ADL in patients with Chronic Obstructive Pulmonary Disease (COPD. These patients commonly show absence of ventilatory reserve, reduced inspiratory reserve volume, and dynamic hyperinflation (DH. Objective To investigate ventilatory response and DH induced by three ADL-based protocols in COPD patients and compare them to healthy subjects. Method Cross-sectional study. COPD group: 23 patients (65±6 years, FEV1 37.2±15.4%pred; control group: 14 healthy subjects (64±4 years matched for age, sex, and body mass index. Both groups performed all three tests: Glittre-ADL test; an activity test that involved moving objects on a shelf (TSHELF; and a modified shelf protocol isolating activity with upper limbs (TSHELF-M. Ventilatory response and inspiratory capacity were evaluated. Results Baseline ventilatory variables were similar between groups (p>0.05. The ventilatory demand increased and the inspiratory capacity decreased significantly at the end of the tests in the COPD group. Ventilatory demand and DH were higher (p0.05 and ventilatory demand increased at the end of the tests (p<0.05 but to a lower extent than the COPD group. Conclusion The TSHELF induces similar ventilatory responses to the Glittre-ADL test in COPD patients with higher ventilatory demand and DH. In contrast, the ventilatory response was attenuated in the TSHELF-M, suggesting that squatting and bending down during the Glittre-ADL test could trigger significant ventilatory overload.

  13. Chemosensitivity, Cardiovascular Risk, and the Ventilatory Response to Exercise in COPD.

    Science.gov (United States)

    Stickland, Michael K; Fuhr, Desi P; Edgell, Heather; Byers, Brad W; Bhutani, Mohit; Wong, Eric Y L; Steinback, Craig D

    2016-01-01

    COPD is associated with elevated cardiovascular risk and a potentiated ventilatory response to exercise. Enhanced carotid chemoreceptor (CC) activity/sensitivity is present in other clinical conditions, has been shown to contribute to sympathetic vasoconstrictor outflow, and is predictive of mortality. CC activity/sensitivity, and the resulting functional significance, has not been well examined in COPD. We hypothesized that CC activity/sensitivity would be elevated in COPD, and related to increased pulse wave velocity (a marker of CV risk) and the ventilatory response to exercise. 30 COPD patients and 10 healthy age-matched controls were examined. Participants performed baseline cardiopulmonary exercise and pulmonary function testing. CC activity was later evaluated by the drop in ventilation with breathing 100% O2, and CC sensitivity was then assessed by the ventilatory response to hypoxia (ΔVE/ΔSpO2). Peripheral arterial stiffness was subsequently evaluated by measurement of pulse wave velocity (PWV) using applanation tonometry while the subjects were breathing room air, and then following chemoreceptor inhibition by breathing 100% O2 for 2 minutes. CC activity, CC sensitivity, PWV and the ventilatory response to exercise were all increased in COPD relative to controls. CC sensitivity was related to PWV; however, neither CC activity nor CC sensitivity was related to the ventilatory response to exercise in COPD. CC inhibition by breathing 100% O2 normalized PWV in COPD, while no effect was observed in controls. CC activity and sensitivity are elevated in COPD, and appear related to cardiovascular risk; however, CC activity/sensitivity does not contribute to the potentiated ventilatory response to exercise.

  14. Validity of the modified conconi test for determining ventilatory threshold during on-water rowing.

    Science.gov (United States)

    Cabo, Jorge Villamil; Martinez-Camblor, Pablo; Del Valle, Miguel

    2011-01-01

    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). Key pointsThe Modified Conconi test for on-water rowing is a simple and non-invasive method for the determination of anaerobic threshold for on-water rowing.The modified Conconi protocol for rowing was also shown to be a valid protocol for the calculation of the second ventilatory threshold

  15. 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 ...

  16. Ventilatory function during exercise in multiple sclerosis and impact of training intervention: cross-sectional and randomized controlled trial.

    Science.gov (United States)

    Hansen, D; Wens, I; Keytsman, C; Verboven, K; Dendale, P; Eijnde, B O

    2015-10-01

    Patients with MS (pwMS) often experience resting ventilatory anomalies. Ventilatory function during exercise and impact of long-term training intervention remains however uncertain. The aim of this study was to examine the ventilatory function during exercise and impact of a 6-month training intervention in pwMS. Combination of a cross-sectional (part 1) and randomized controlled trial (part 2). University rehabilitation facility. Caucasian patients with MS and healthy controls. In part 1, the ventilatory function during submaximal endurance exercise was compared between pwMS (N.=37) and healthy participants (N.=15). In part 2, pwMS were then randomly assigned to a 6-month training intervention (N.=16) or usual care (N.=11). Following training intervention, ventilatory function during exercise was re-evaluated. Despite comparable relative exercise testing intensities between groups in part 1, significantly elevated steady-state exercise dead space/tidal volume ratio, O2 uptake and CO2 output equivalent, end-tidal O2 pressure, ratings of perceived exertion and lowered end-tidal CO2 pressure and O2 pulse was observed in pwMS (Ptraining intervention, ventilatory dysfunction remained present during endurance exercise (P>0.05). Patients with MS experience a ventilatory dysfunction during endurance exercise, which is related to worse exercise tolerance. This ventilatory anomaly remains present after long-term training intervention. Patients with MS experience ventilatory dysfunction during exercise. This dysfunction is related to exercise tolerance and ratings of perceived exertion. Long-term exercise training did not remediate this ventilatory dysfunction. The systematic examination of the pulmonary/cardiovascular system at rest and during exercise is recommended in MS.

  17. The Talk Test and its relationship with the ventilatory and lactate thresholds.

    Science.gov (United States)

    Quinn, Timothy J; Coons, Benjamin A

    2011-08-01

    In this study, we wished to determine the relationship between the Talk Test physiological and perceptual indicators and variables measured at the ventilatory and lactate thresholds, and if the Talk Test indicators were associated with a typical exercise prescription. Fifteen participants (13 males and 2 females; age 18-35 years) underwent a treadmill lactate threshold test followed by a VO2max (maximal oxygen consumption) test in which the ventilatory threshold was determined. On a separate day, a Talk Test was administered in which participants read a passage during exercise and rated speaking comfort: "comfortable" (+Talk Test), "not sure" (+/-Talk Test), or "not able to speak comfortably" (-Talk Test). Exercise prescriptions based on 65% and 80% of heart rate reserve and VO2 reserve were determined. Lactate threshold values were significantly higher than those at the ventilatory threshold (P ACSM exercise intensity guidelines. Therefore, the Talk Test can be used in this population to prescribe exercise, and Talk Test data are more strongly related to physiological and perceptual variables corresponding to the lactate threshold than to the ventilatory threshold.

  18. 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

    Cardiovascular and ventilatory responses to electrically induced dynamic exercise were investigated in eight healthy young males with afferent neural influence from the legs blocked by epidural anaesthesia (25 ml 2% lidocaine) at L3-L4. This caused cutaneous sensory anaesthesia below T8-T9 and co...

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Ventilatory and hemodynamic management of potential organ donors: an observational survey.

    Science.gov (United States)

    Mascia, Luciana; Bosma, Karen; Pasero, Daniela; Galli, Tamara; Cortese, Gerardo; Donadio, Pierpaolo; Bosco, Riccardo

    2006-02-01

    To determine the current standard ventilatory and cardiovascular management in potential organ donors. Prospective, multiple-center, observational survey. A total of 15 intensive care units in 13 hospitals in Piedmont, Italy. A total of 34 brain-dead patients enrolled in 6 months. Demographics and reasons for lung transplant exclusion were recorded. Ventilatory and hemodynamic variables were compared before and after confirmation of brain death. A total of 23 potential donors were ineligible for lung donation based on pulmonary status and age. Of the 11 eligible lung donors, only two donated the lungs because five had Pao2/Fio2 ratios of tests were performed with apneic oxygenation after disconnection from the ventilator in all cases; tracheal suction was performed with an open circuit in eight cases, and no recruitment maneuvers were performed. Crystalloid infusion was increased after diagnosis of brain death from 187 +/- 151 to 275 +/- 158 mL/hr (p < .05), and central venous pressure increased from 6 +/- 3 to 7 +/- 3 mm Hg (p < .05). Inotropic support was used in 24 donors (70%). Five of 11 potential lung donors (45%) had a Pao2/Fio2 ratio of <300, making them ineligible for lung donation. After the diagnosis of brain death, ventilatory management remained the same, no maneuvers for prevention of derecruitment of the lung were performed, and cardiovascular management was modified to optimize peripheral organ perfusion. These data represent the current standard of care for ventilatory management of potential organ donors and may be suboptimal in preserving lung function.

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

    Directory of Open Access Journals (Sweden)

    Laura M. T. Neves

    2014-03-01

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

  2. The Effect Of Salinity Stress On Buccal Ventilatory Rate In The ...

    African Journals Online (AJOL)

    The Effect Of Salinity Stress On Buccal Ventilatory Rate In The African Lungfish, Protopterus annectens Owen. AI Okafor, LO Chukwu, LO Chukwu. Abstract. No Abstract. Animal Research International Vol. 2 (1) 2005 pp. 252-254. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL ...

  3. 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

  4. Ventilatory inhomogeneity determined from multiple-breath washouts during sustained microgravity on Spacelab SLS-1

    Science.gov (United States)

    Prisk, G. Kim; Guy, Harold J. B.; Elliott, Ann R.; Paiva, Manuel; West, John B.

    1995-01-01

    We used multiple-breath N2 washouts (MBNW) to study the homogeneity of ventilation in four normal humans (mean age 42.5 yr) before, during, and after 9 days of exposure to microgravity on Spacelab Life Sciences-1. Subjects performed 20-breath MBNW at tidal volumes of approximately 700 ml and 12-breath MBNW at tidal volumes of approximately 1,250 ml. Six indexes of ventilatory inhomogeneity were derived from data from (1) distribution of specific ventilation (SV) from mixed-expired and (2) end-tidal N2, (3) change of slope of N2 washout (semilog plot) with time, (4) change of slope of normalized phase III of successive breaths, (5) anatomic lead dead space, and (6) Bohr dead space. Significant ventilatory inhomogeneity was seen in the standing position at normal gravity (1 G). When we compared standing 1 G with microgravity, the distributions of SV became slightly narrower, but the difference was not significant. Also, there were no significant changes in the change of slope of the N2 washout, change of normalized phase III slopes, or the anatomic and Bohr dead spaces. By contrast, transition from the standing to supine position in 1 G resulted in significantly broader distributions of SV and significantly greater changes in the changes in slope of the N2 washouts, indicating more ventilatory inhomogeneity in that posture. Thus these techniques can detect relatively small changes in ventilatory inhomogeneity. We conclude that the primary determinants of ventilatory inhomogeneity during tidal breathing in the upright posture are not gravitational in origin.

  5. 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.

  6. 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.

  7. Salary adjustments

    CERN Multimedia

    HR Department

    2008-01-01

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

  8. 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

  9. Intermittent hypercapnic hypoxia during sleep does not induce ventilatory long-term facilitation in healthy males.

    Science.gov (United States)

    Deacon, Naomi L; McEvoy, R Doug; Stadler, Daniel L; Catcheside, Peter G

    2017-09-01

    Intermittent hypoxia-induced ventilatory neuroplasticity is likely important in obstructive sleep apnea pathophysiology. Although concomitant CO2 levels and arousal state critically influence neuroplastic effects of intermittent hypoxia, no studies have investigated intermittent hypercapnic hypoxia effects during sleep in humans. Thus the purpose of this study was to investigate if intermittent hypercapnic hypoxia during sleep induces neuroplasticity (ventilatory long-term facilitation and increased chemoreflex responsiveness) in humans. Twelve healthy males were exposed to intermittent hypercapnic hypoxia (24 × 30 s episodes of 3% CO2 and 3.0 ± 0.2% O2) and intermittent medical air during sleep after 2 wk washout period in a randomized crossover study design. Minute ventilation, end-tidal CO2, O2 saturation, breath timing, upper airway resistance, and genioglossal and diaphragm electromyograms were examined during 10 min of stable stage 2 sleep preceding gas exposure, during gas and intervening room air periods, and throughout 1 h of room air recovery. There were no significant differences between conditions across time to indicate long-term facilitation of ventilation, genioglossal or diaphragm electromyogram activity, and no change in ventilatory response from the first to last gas exposure to suggest any change in chemoreflex responsiveness. These findings contrast with previous intermittent hypoxia studies without intermittent hypercapnia and suggest that the more relevant gas disturbance stimulus of concomitant intermittent hypercapnia frequently occurring in sleep apnea influences acute neuroplastic effects of intermittent hypoxia. These findings highlight the need for further studies of intermittent hypercapnic hypoxia during sleep to clarify the role of ventilatory neuroplasticity in the pathophysiology of sleep apnea.NEW & NOTEWORTHY Both arousal state and concomitant CO2 levels are known modulators of the effects of intermittent hypoxia on

  10. Restrictive ventilatory insufficiency and lung injury induced by ischemia/reperfusion of the pancreas in rats.

    Science.gov (United States)

    Chen, C F; Chen, H T; Wang, D; Li, J P; Fong, Y

    2008-09-01

    Ischemia/reperfusion injury (I/R) of the rat pancreas induces acute pancreatitis with a systemic inflammatory response syndrome. Activated inflammatory cells sequestered in the lung and the proteases released from the inflammatory pancreas both induce acute lung injury. Ischemia was induced by clamping the gastroduodenal artery and the splenic artery for 2 hours to induce ischemia of the pancreas, followed by reperfusion for 6 hours. We then observed lung function parameters, such as weight changes, compliance, functional residual capacity (FRC), and respiratory work. This protocol resulted in elevation in the blood concentrations of nitric oxide (P lung compliance (Cchord), but significant increases in respiratory work. The lung weight/body weight ratio also increased significantly. I/R of the pancreas induced lung injury and restrictive ventilatory insufficiency. Inflammatory responses in the lung tissues induced by oxidative stress and nitrosative stress may be major factors inducing lung injury and a restrictive type of ventilatory insufficiency.

  11. Ventilatory and metabolic responses of burrowing owls, Athene cunicularia, to moderate and extreme hypoxia: analysis of the hypoxic ventilatory threshold vs. hemoglobin oxygen affinity relationship in birds.

    Science.gov (United States)

    Kilgore, Delbert L; Boggs, Dona F; Kilgore, Trevor J; Colby, Conrad; Williams, Burl R; Bavis, Ryan W

    2008-06-01

    We measured ventilation, oxygen consumption and blood gases in burrowing owls (Athene cunicularia) breathing moderate and extreme hypoxic gas mixtures to determine their hypoxic ventilatory threshold (HVT) and to assess if they, like other birds and mammals, exhibit a relationship between HVT and hemoglobin O2 affinity (P(50)) of their blood. An earlier report of an attenuated ventilatory responsiveness of this species to hypoxia was enigmatic given the low O2 affinity (high P(50)) of burrowing owl hemoglobin. In the current study, burrowing owls breathing 11% and 9% O2 showed a significantly elevated total ventilation. The arterial partial pressure of oxygen (PaO2) at which ventilation is elevated above normoxic values in burrowing owls was 58 mm Hg. This threshold value conforms well to expectations based on the high P(50) of their hemoglobin and the HVT vs. P(50) relationship for birds developed in this study. Correcting for phylogenetic relatedness in the multi-species analysis had no effect on the HVT vs. P(50) relationship. Also, because burrowing owls in this study did not show a hypometabolic response at any level of hypoxia (even at 9% O2); HVT described in terms of percent change in oxygen convection requirement is identical to that based on ventilation alone.

  12. 24 CFR 886.312 - Rent adjustments.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Rent adjustments. 886.312 Section... Program for the Disposition of HUD-Owned Projects § 886.312 Rent adjustments. (a) Limits. Housing assistance payments will be made in amounts commensurate with contract rent adjustments under this paragraph...

  13. 24 CFR 5.611 - Adjusted income.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Adjusted income. 5.611 Section 5... Serving Persons with Disabilities: Family Income and Family Payment; Occupancy Requirements for Section 8 Project-Based Assistance Family Income § 5.611 Adjusted income. Adjusted income means annual income (as...

  14. 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.

  15. Contributions of central and peripheral chemoreceptors to the ventilatory response to CO2/H+

    OpenAIRE

    Forster, H. V.; Smith, C A

    2010-01-01

    The major objective of this review is to evaluate existing information and reach conclusions regarding whether there is interaction between Pco2/H+ stimulation of carotid (peripheral) and intracranial (central) chemoreceptors. Interaction is defined as a ventilatory response to simultaneous changes in the degree of Pco2/H+ stimulation of both chemoreceptors that is greater (hyperadditive) or less (hypoadditive) than the sum of the responses when stimulation of each set of chemoreceptors is in...

  16. 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.

  17. Relationship between resting ventilatory chemosensitivity and maximal oxygen uptake in moderate hypobaric hypoxia.

    Science.gov (United States)

    Ogawa, Takeshi; Hayashi, Keiji; Ichinose, Masashi; Nishiyasu, Takeshi

    2007-10-01

    This study tested the hypothesis that the extent of the decrement in (.)Vo(2max) and the respiratory response seen during maximal exercise in moderate hypobaric hypoxia (H; simulated 2,500 m) is affected by the hypoxia ventilatory and hypercapnia ventilatory responses (HVR and HCVR, respectively). Twenty men (5 untrained subjects, 7 long distance runners, 8 middle distance runners) performed incremental exhaustive running tests in H and normobaric normoxia (N) condition. During the running test, (.)Vo(2), pulmonary ventilation (Ve) and arterial oxyhemoglobin saturation (Sa(O(2))) were measured, and in two ventilatory response tests performed during N, a rebreathing method was used to evaluate HVR and HCVR. Mean HVR and HCVR were 0.36 +/- 0.04 and 2.11 +/- 0.2 l.min(-1).mmHg(-1), respectively. HVR correlated significantly with the percent decrements in (.)Vo(2max) (%d(.)Vo(2max)), Sa(O(2)) [%dSa(O(2)) = (N-H).N(-1).100], and (.)Ve/(.)Vo(2) seen during H condition. By contrast, HCVR did not correlate with any of the variables tested. The increment in maximal Ve between H and N significantly correlated with %d(.)Vo(2max). Our findings suggest that O(2) chemosensitivity plays a significant role in determining the level of exercise hyperventilation during moderate hypoxia; thus, a higher O(2) chemosensitivity was associated with a smaller drop in (.)Vo(2max) and Sa(O(2)) under those conditions.

  18. Changes in Ventilatory Response to Exercise in Trained Athletes: Respiratory Physiological Benefits Beyond Cardiovascular Performance.

    Science.gov (United States)

    di Paco, Adriano; Dubé, Bruno-Pierre; Laveneziana, Pierantonio

    2017-05-01

    The beneficial impact of an 8-month competitive season on the ventilatory profile response to exercise in soccer players has never been evaluated. Ventilatory profile (evaluated by determining individual tidal volume [VT] relative to minute ventilation [VE] inflection points during exercise) and metabolic responses to incremental exercise were evaluated in 2 professional soccer teams before and after an 8-month competitive season. No differences between teams in anthropometric characteristics or in resting cardiopulmonary variables, included oxygen uptake (VO2) and heart rate (HR), before and during the competitive season were found. At iso-speed, there were overall improvements in carbon dioxide output (VCO2), VE/VO2, VE/VCO2, VE and respiratory frequency (fR) during the season. The VT/VE inflection points 1 and 2 occurred with greater exercise time, HR, VO2, VCO2, VE and VT during the competitive season. Despite very high baseline performance and a negligible improvement in VO2, an 8-month competitive season improved ventilatory profile response to exercise in elite athletes. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Body Mass Index-Dependent Ventilatory Parameters From Respiratory Inductive Plethysmography During 6-Minute Walk Test.

    Science.gov (United States)

    Retory, Yann; de Picciotto, Carole; Niedzialkowski, Pauline; Petitjean, Michel; Bonay, Marcel

    2016-04-01

    Walking is part of obesity management. Assessment of ventilatory impairments and consequences for gait induced by obesity could be clinically helpful. We aimed to develop a method to accurately monitor ventilation with respiratory inductive plethysmography (RIP) in subjects with high body mass indices (BMIs) during a 6-min walk test (6MWT). 25 volunteers were divided into 2 groups based on BMI (30 kg/m2) and performed a 6MWT with a calibrated RIP. Ventilatory parameters (tidal volume [V(T)], inspiratory [T(I)] and expiratory [T(E)] times, V(T)/T(I) ratio, and T(I)/Ttot ratio) were determined after processing RIP signals with a custom-made algorithm designed to discriminate tissue motion artifacts and respiratory cycles in the time domain. Six-min walk distance and average speed by minute were collected. The number of artifacts removed by the algorithm used for artifact removal was higher for high-BMI subjects and was correlated to their individual values (r = 0.66, P exercise for V(T), T(I), and T(E) (P exercise as well as locomotor and ventilatory differences relative to BMI during the 6MWT. Thus, this system gives useful information from the 6MWT for clinicians who want to assess respiratory patterns of patients during this commonly used test. Copyright © 2016 by Daedalus Enterprises.

  20. [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.

  1. [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.

  2. Technological Change: Helping Workers Adjust.

    Science.gov (United States)

    Mowery, David C.

    1987-01-01

    Discusses some of the problems in employment shifts and unemployment caused by new technologies in offices and factories. Addresses the Job Training Partnership Act (Title III) which was established as the primary assistance vehicle for displaced workers. Calls for workers to receive sufficient time to adjust to technologies. (TW)

  3. 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...

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

    Science.gov (United States)

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

    2017-08-15

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

  5. Contributions of central and peripheral chemoreceptors to the ventilatory response to CO2/H+.

    Science.gov (United States)

    Forster, H V; Smith, C A

    2010-04-01

    The major objective of this review is to evaluate existing information and reach conclusions regarding whether there is interaction between P(CO(2))/H(+) stimulation of carotid (peripheral) and intracranial (central) chemoreceptors. Interaction is defined as a ventilatory response to simultaneous changes in the degree of Pco2/H(+) stimulation of both chemoreceptors that is greater (hyperadditive) or less (hypoadditive) than the sum of the responses when stimulation of each set of chemoreceptors is individually altered. Simple summation of the simultaneous changes in stimuli results in no interaction (i.e., additive interaction). Knowledge of the nature of central/peripheral interaction is crucial for determining the physiological significance of newer models of ventilatory control based on recent neuroanatomic observations of the circuitry of key elements of the ventilatory control system. In this review, we will propose that these two sets of receptors are not functionally separate but rather that they are dependent on one another such that the sensitivity of the medullary chemoreceptors is critically determined by input from the peripheral chemoreceptors and possibly other breathing-related reflex afferents as well. The short format of this minireview demands that we be somewhat selective in developing our ideas. We will briefly discuss the limitations of experiments used to study CO(2)/H(+) sensitivity and interaction to date, traditional views of the relative contributions of peripheral and central chemoreceptors to CO(2)/H(+) sensitivity, the evidence for and against different types of interaction, and the effect of tonic carotid chemoreceptor afferent activity on central control mechanisms.

  6. Altered breathing mechanics and ventilatory response during exercise in children born extremely preterm.

    Science.gov (United States)

    MacLean, J E; DeHaan, K; Fuhr, D; Hariharan, S; Kamstra, B; Hendson, L; Adatia, I; Majaesic, C; Lovering, A T; Thompson, R B; Nicholas, D; Thebaud, B; Stickland, M K

    2016-11-01

    Extreme preterm birth confers risk of long-term impairments in lung function and exercise capacity. There are limited data on the factors contributing to exercise limitation following extreme preterm birth. This study examined respiratory mechanics and ventilatory response during exercise in a large cohort of children born extremely preterm (EP). This cohort study included children 8-12 years of age who were born EP (≤28 weeks gestation) between 1997 and 2004 and treated in a large regionalised neonatal intensive care unit in western Canada. EP children were divided into no/mild bronchopulmonary dysplasia (BPD) (ie, supplementary oxygen or ventilation ceased before 36 weeks gestational age; n=53) and moderate/severe BPD (ie, continued supplementary oxygen or ventilation at 36 weeks gestational age; n=50). Age-matched control children (n=65) were born at full term. All children attempted lung function and cardiopulmonary exercise testing measurements. Compared with control children, EP children had lower airway flows and diffusion capacity but preserved total lung capacity. Children with moderate/severe BPD had evidence of gas trapping relative to other groups. The mean difference in exercise capacity (as measured by oxygen uptake (VO2)% predicted) in children with moderate/severe BPD was -18±5% and -14±5.0% below children with no/mild BPD and control children, respectively. Children with moderate/severe BPD demonstrated a potentiated ventilatory response and greater prevalence of expiratory flow limitation during exercise compared with other groups. Resting lung function did not correlate with exercise capacity. Expiratory flow limitation and an exaggerated ventilatory response contribute to respiratory limitation to exercise in children born EP with moderate/severe BPD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Long-term non-invasive ventilation to manage persistent ventilatory failure after COPD exacerbation.

    Science.gov (United States)

    Oscroft, Nicholas S; Quinnell, Timothy G; Shneerson, John M; Smith, Ian E

    2010-07-01

    Patients with ventilatory failure at discharge from hospital following an exacerbation of COPD (ECOPD) have increased work of breathing and reduced inspiratory muscle strength compared with those with a normal arterial carbon dioxide tension (PaCO(2)). They also have a significantly worse prognosis. Long-term non-invasive positive pressure ventilation (NIPPV) may offer a treatment strategy but benefits have not been established. We examined the outcomes of 35 patients, with a PaCO(2) >7.5 kPa and normal pH, following hospital admission with an ECOPD. Patients were initiated on long-term NIPPV. Our aims were to establish if NIPPV was tolerated and to describe the effects on ventilatory parameters. Daytime arterial blood gases and nocturnal ventilatory parameters improved significantly on NIPPV. Diurnal PaO(2), self-ventilating, rose from (mean (SD)) 7.3 (1.8) to 8.1 (0.9) kPa (P = 0.005) and PaCO(2) fell from 8.8 (1.3) to 7.3 (0.8) kPa (P

  8. 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.

  9. ventilatory support

    African Journals Online (AJOL)

    Kinfu Betemariam, Gebreyesus Hagos. Abstract. Background: Mechanical Ventilation is a supportive measure for patients who are in respiratory failure. Objective: Designed to identify the commonest pathology responsible for admission to the unit for mechanical respiratory support. Method: A prospective case study ...

  10. Response time and sensitivity of the ventilatory response to CO2 in unanesthetized intact dogs: central vs. peripheral chemoreceptors.

    Science.gov (United States)

    Smith, C A; Rodman, J R; Chenuel, B J A; Henderson, K S; Dempsey, J A

    2006-01-01

    We assessed the speed of the ventilatory response to square-wave changes in alveolar P(CO2) and the relative gains of the steady-state ventilatory response to CO2 of the central chemoreceptors vs. the carotid body chemoreceptors in intact, unanesthetized dogs. We used extracorporeal perfusion of the reversibly isolated carotid sinus to maintain normal tonic activity of the carotid body chemoreceptor while preventing it from sensing systemic changes in CO2, thereby allowing us to determine the response of the central chemoreceptors alone. We found the following. 1) The ventilatory response of the central chemoreceptors alone is 11.2 (SD = 3.6) s slower than when carotid bodies are allowed to sense CO2 changes. 2) On average, the central chemoreceptors contribute approximately 63% of the gain to steady-state increases in CO2. There was wide dog-to-dog variability in the relative contributions of central vs. carotid body chemoreceptors; the central exceeded the carotid body gain in four of six dogs, but in two dogs carotid body gain exceeded central CO2 gain. If humans respond similarly to dogs, we propose that the slower response of the central chemoreceptors vs. the carotid chemoreceptors prevents the central chemoreceptors from contributing significantly to ventilatory responses to rapid, transient changes in arterial P(CO2) such as those after periods of hypoventilation or hyperventilation ("ventilatory undershoots or overshoots") observed during sleep-disordered breathing. However, the greater average responsiveness of the central chemoreceptors to brain hypercapnia in the steady-state suggests that these receptors may contribute significantly to ventilatory overshoots once unstable/periodic breathing is fully established.

  11. Ventilatory responses to muscle metaboreflex activation in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Bruce, Richard M; Turner, Alice; White, Michael J

    2016-10-15

    Recent evidence indicates a role for group III/IV muscle afferents in reflex control of the human ventilatory response to exercise. Dyspnoea in chronic obstructive pulmonary disease (COPD) may be linked to this reflex response. This study shows that activation of the muscle metaboreflex causes a ventilatory response in COPD patients but not in healthy controls. This indicates abnormal involvement of muscle afferents in the control of ventilation in COPD which may be a contributing factor to exercise dyspnoea. Blockade of thin fibre muscle afferent feedback during dynamic exercise reduces exercise hyperpnoea in health and chronic obstructive pulmonary disease (COPD). Therefore, we hypothesised that activation of the muscle metaboreflex at rest would cause hyperpnoea. We evaluated the effect of muscle metaboreflex activation on ventilation, in resting COPD patients and healthy participants. Following a bout of rhythmic hand grip exercise, post exercise circulatory occlusion (PECO) was applied to the resting forearm to sustain activation of the muscle metaboreflex, in 18 COPD patients (FEV 1 /FVC ratio abnormally involved in the control of ventilation in COPD and may be a contributing factor to exercise dyspnoea. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

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

    Directory of Open Access Journals (Sweden)

    Érica Maria Granjeiro

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

  13. Fluoxetine augments ventilatory CO2 sensitivity in Brown Norway but not Sprague Dawley rats

    Science.gov (United States)

    Hodges, Matthew R.; Echert, Ashley E.; Puissant, Madeleine M.; Mouradian, Gary C.

    2013-01-01

    The Brown Norway (BN; BN/NHsdMcwi) rat exhibits a deficit in ventilatory CO2 sensitivity and a modest serotonin (5-HT) deficiency. Here, we tested the hypothesis that the selective serotonin reuptake inhibitor fluoxetine would augment CO2 sensitivity in BN but not Sprague Dawley (SD) rats. Ventilation during room air or 7 % CO2 exposure was measured before, during and after 3 weeks of daily injections of saline or fluoxetine (10 mg/kg/day) in adult male BN and SD rats. Fluoxetine had minimal effects on room air breathing in BN and SD rats (p>0.05), although tidal volume (VT) was reduced in BN rats (pfluoxetine on CO2 sensitivity in SD rats, but fluoxetine increased minute ventilation, breathing frequency and VT during hypercapnia in BN rats (pfluoxetine. Brain levels of biogenic amines were largely unaffected, but 5-HIAA and the ratio of 5-HIAA/5-HT were reduced (pfluoxetine increases ventilatory CO2 sensitivity in BN but not SD rats, further suggesting altered 5-HT system function may contribute to the inherently low CO2 sensitivity in the BN rat. PMID:23454023

  14. 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.

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

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    Emily S. Gillett

    2016-07-01

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

  16. 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.

  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. Mechanical ventilatory constraints during incremental cycle exercise in human pregnancy: implications for respiratory sensation

    Science.gov (United States)

    Jensen, Dennis; Webb, Katherine A; Davies, Gregory A L; O'Donnell, Denis E

    2008-01-01

    The aim of this study was to identify the physiological mechanisms of exertional respiratory discomfort (breathlessness) in pregnancy by comparing ventilatory (breathing pattern, airway function, operating lung volumes, oesophageal pressure (Poes)-derived indices of respiratory mechanics) and perceptual (breathlessness intensity) responses to incremental cycle exercise in 15 young, healthy women in the third trimester (TM3; between 34 and 38 weeks gestation) and again 4–5 months postpartum (PP). During pregnancy, resting inspiratory capacity (IC) increased (P respiratory muscle strength. This permitted greater tidal volume (VT) expansion throughout exercise in TM3, while preserving the relationship between contractile respiratory muscle effort (tidal Poes swing expressed as a percentage of maximum inspiratory pressure (PImax)) and thoracic volume displacement (VT expressed as a percentage of vital capacity) and between breathlessness and ventilation (V̇E). At the highest equivalent work rate (HEWR = 128 ± 5 W) in TM3 compared with PP: V̇E, tidal Poes/PImax and breathlessness intensity ratings increased by 10.2 l min−1 (P mechanical constraints on VT expansion (P respiratory muscle effort; (2) mechanical adaptations of the respiratory system, including recruitment of resting IC and increased bronchodilatation, accommodated the increased VT while preserving effort–displacement and breathlessness–V̇E relationships; and (3) dynamic mechanical ventilatory constraints contributed to respiratory discomfort near the limits of tolerance in late gestation. PMID:18687714

  19. T3 supplementation affects ventilatory timing & glucose levels in type 2 diabetes mellitus model.

    Science.gov (United States)

    Bollinger, Stephen S; Weltman, Nathen Y; Gerdes, A Martin; Schlenker, Evelyn H

    2015-01-01

    Type II diabetes mellitus (T2DM) can affect ventilation, metabolism, and fasting blood glucose levels. Hypothyroidism may be a comorbidity of T2DM. In this study T2DM was induced in 20 female Sprague Dawley rats using Streptozotocin (STZ) and Nicotinamide (N). One of experimental STZ/N groups (N=10 per group) was treated with a low dose of triiodothyronine (T3). Blood glucose levels, metabolism and ventilation (in air and in response to hypoxia) were measured in the 3 groups. STZ/N-treated rats increased fasting blood glucose compared to control rats eight days and 2 months post-STZ/N injections indicating stable induction of T2DM state. Treatments had no effects on ventilation, metabolism or body weight. After one month of T3 supplementation, there were no physiological indications of hyperthyroidism, but T3 supplementation altered ventilatory timing and decreased blood glucose levels compared to STZ/N rats. These results suggest that low levels of T3 supplementation could offer modest effects on blood glucose and ventilatory timing in this T2M model. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Postural control and ventilatory drive during voluntary hyperventilation and carbon dioxide rebreathing.

    Science.gov (United States)

    David, Pascal; Laval, David; Terrien, Jérémy; Petitjean, Michel

    2012-01-01

    The present study sought to establish links between hyperventilation and postural stability. Eight university students were asked to stand upright under two hyperventilation conditions applied randomly: (1) a metabolic hyperventilation induced by 5 min of hypercapnic-hyperoxic rebreathing (CO(2)-R); and, (2) a voluntary hyperventilation (VH) of 3 min imposed by a metronome set at 25 cycles per min. Recordings were obtained with eyes open, with the subjects standing on a force plate over 20-s periods. Ventilatory response, displacements in the centre of pressure in both the frontal and sagittal planes and fluctuations in the three planes of the ground reaction force were monitored in the time and frequency domains. Postural changes related to respiratory variations were quantified by coherence analysis. Myoelectric activities of the calf muscles were recorded using surface electromyography. Force plate measurements revealed a reduction in postural stability during both CO(2)-R and VH conditions, mainly in the sagittal plane. Coherence analysis provided evidence of a ventilatory origin in the vertical ground reaction force fluctuations during VH. Electromyographic analyses showed different leg muscles strategies, assuming the existence of links between the control of respiration and the control of posture. Our results suggest that the greater disturbing effects caused by voluntary hyperventilation on body balance are more compensated when respiration is under automatic control. These findings may have implications for understanding the organisation of postural and respiratory activities and suggest that stability of the body may be compromised in situations in which respiratory demand increases and requires voluntary control.

  1. 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

    Objective 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. Methods 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. Results 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 8cmH2O. 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. Conclusion 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. PMID:25028947

  2. Ventilatory Anaerobic Thresholds of Individuals Recovering from Traumatic Brain Injury Compared to Non-Injured Controls

    Science.gov (United States)

    Amonette, William E.; Mossberg, Kurt A.

    2012-01-01

    The purpose of this study was to compare the peak aerobic capacities and ventilatory anaerobic thresholds (VAT) of individuals with a traumatic brain injury (TBI) to age- and gender-matched controls. Methods Nineteen participants that previously suffered a mild to moderate TBI and 19 apparently healthy controls (CON) volunteered as subjects. TBI and CON were matched for age and gender and were similar in weight and BMI. Volunteers performed a maximal graded treadmill test to volitional failure where oxygen consumption (V̇O2), carbon dioxide production (V̇CO2), ventilation (V̇E), and heart rate (HR) were measured continuously. From metabolic and ventilatory data, VAT was measured using a previously described method. VAT and peak exercise responses of participants with a TBI were compared to CON. Results The V̇O2, and V̇CO2at VAT and peak exercise were lower for TBI compared to CON. V̇E was also lower for TBI at VAT and peak exercise. HR was lower for TBI at VAT; however, TBI had similar HR to CON at peak exercise. Conclusions The VAT and peak exercise capacities of participants with a TBI were below the metabolic demands of many routine daily activities. The data suggest that therapeutic interventions for individuals with a TBI should include targeted exercise prescriptions to improve cardiorespiratory fitness. PMID:22935575

  3. 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.

  4. Sickness absence and ventilatory capacity of workers exposed to sulphuric acid mist

    Science.gov (United States)

    Williams, M. K.

    1970-01-01

    Williams, M. K. (1970).Brit. J. industr. Med.,27, 61-66. Sickness absence and ventilatory capacity of workers exposed to sulphuric acid mist. The certified sickness absence and ventilatory capacity of men exposed to high concentrations of sulphuric acid mist in the Forming department of an electric accumulator factory, and in control departments, were investigated. The Forming men showed a slight excess of spells of respiratory disease, particularly bronchitis, but not of other disease. The excess of repiratory disease was due to an increased number of spells in men attacked rather than to an increase in the proportion of men attacked. The absence of a marked excess of lower respiratory tract disease might be due to large mist particle size. The forced expiratory volume over one second (F.E.V.1·0) and the forced vital capacity (F.V.C.) were measured in Forming men and in a control group at the beginning and end of the afternoon shifts on a Monday and Friday. Statistically significant decreases of both tests on both days could be attributed to circadian variation. Differences between the Forming and control departments in the mean changes of F.E.V.1·0 and F.V.C. during the shift were not significant. PMID:5418921

  5. Is the ventilatory threshold coincident with maximal fat oxidation during submaximal exercise in women?

    Science.gov (United States)

    Astorino, T A

    2000-09-01

    The purpose of this study was to detect the fraction of peak oxygen consumption (VO2peak) that elicits maximal rates of fat oxidation during submaximal treadmill exercise. It was hypothesized that this point would appear at a work rate just below the ventilatory threshold. subjects completed a protocol requiring them to exercise for 15 min on a treadmill at six different workloads, 25, 40, 55, 65, 75, and 85% VO2peak, over two separate visits. nine healthy, moderately-trained eumenorrheic females (age = 28.8+/-5.99 yrs, VO2peak = 47.20 +/-2.57 ml x kg(-1) x min(-1)) volunteered for the study. a one-way ANOVA with repeated measures was used to test for differences across exercise intensities in the metabolic variables (i.e. substrate oxidation, blood lactate concentration ([La-]), RER, and the contribution of fat to total energy expenditure). Following significant F ratios, post-hoc tests were used to detect differences between the means for various exercise intensities. Exercise at 75% VO2peak elicited the greatest rate of fat oxidation (4.75+/-0.49 kcal x min(-1)), and this intensity was coincident with the ventilatory threshold (76+/-7.41% VO2peak). Moreover, a significant difference (t(8) = -3.98, ppopulation has application in exercise prescription and refutes the belief that low-intensity exercise is preferred for fat metabolism.

  6. The hypoxic ventilatory response and ventilatory long-term facilitation are altered by time of day and repeated daily exposure to intermittent hypoxia

    Science.gov (United States)

    Gerst, David G.; Yokhana, Sanar S.; Carney, Laura M.; Lee, Dorothy S.; Badr, M. Safwan; Qureshi, Tabarak; Anthouard, Magalie N.

    2011-01-01

    This study examined whether time of day and repeated exposure to intermittent hypoxia have an impact on the hypoxic ventilatory response (HVR) and ventilatory long-term facilitation (vLTF). Thirteen participants with sleep apnea were exposed to twelve 4-min episodes of isocapnic hypoxia followed by a 30-min recovery period each day for 10 days. On days 1 (initial day) and 10 (final day) participants completed the protocol in the evening (PM); on the remaining days the protocol was completed in the morning (AM). The HVR was increased in the morning compared with evening on the initial (AM 0.83 ± 0.08 vs. PM 0.64 ± 0.11 l·min−1·%SaO2−1; P ≤ 0.01) and final days (AM 1.0 ± 0.08 vs. PM 0.81 ± 0.09 l·min−1·%SaO2−1; P ≤ 0.01, where %SaO2 refers to percent arterial oxygen saturation). Moreover, the magnitude of the HVR was enhanced following daily exposure to intermittent hypoxia in the morning (initial day 0.83 ± 0.08 vs. final day 1.0 ± 0.08 l·min−1·%SaO2−1; P ≤ 0.03) and evening (initial day 0.64 ± 0.11 vs. final day 0.81 ± 0.09 l·min−1·%SaO2−1; P ≤ 0.03). vLTF was reduced in the morning compared with the evening on the initial (AM 19.03 ± 0.35 vs. PM 22.30 ± 0.49 l/min; P ≤ 0.001) and final (AM 20.54 ± 0.32 vs. PM 23.11 ± 0.54 l/min; P ≤ 0.01) days. Following daily exposure to intermittent hypoxia, vLTF was enhanced in the morning (initial day 19.03 ± 0.35 vs. final day 20.54 ± 0.32 l/min; P ≤ 0.01). We conclude that the HVR is increased while vLTF is decreased in the morning compared with the evening in individuals with sleep apnea and that the magnitudes of these phenomena are enhanced following daily exposure to intermittent hypoxia. PMID:20724571

  7. 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.

  8. 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...

  9. An assessment of pulmonary function testing and ventilatory kinematics by optoelectronic plethysmography.

    Science.gov (United States)

    Layton, A M; Garber, C E; Basner, R C; Bartels, M N

    2011-09-01

    New advances in computer processing and imaging have allowed the development of innovative techniques to assess lung function. A promising methodology is optoelectronic plethysmography (OEP). OEP evaluates ventilatory kinematics through the use of infrared imaging. Markers are placed, and images read on the chest, back and abdomen of subjects. Currently, this system is used mainly in research settings, but in the future may have broad applicability to patient populations such as very young children, patients with neuromuscular disease and patients who cannot be tested with classical spirometry testing. This paper presents the history and development of OEP, along with a summary of the OEP methodology, a discussion of research findings and results to date, as well as application and limitations. © 2011 The Authors. Clinical Physiology and Functional Imaging © 2011 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

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

    DEFF Research Database (Denmark)

    Thomsen, Mikkel; Wang, Tobias; Bayley, Mark

    systems provide information on when gill ventilation is insufficient for oxygen uptake and hence initiate air-breathing. Here we investigate the ventilatory and cardiovascular responses to changes in either in the external media or internally in the blood in resting fish. We found ventilation in P......The air-breathing fish Pangasianodon hypophthalmus is abundant in the Mekong river system where it is also intensively cultured. In contrast to most other air-breathing fishes it has well developed gills as well as a highly traberculated swim bladder with a large surface area used for air...... suggested to form part of the oxygen-sensing stimulus in mammals (Chang et al. 2015) and we present the first evidence of this mechanism in fish....

  11. Ventilatory Responses to Hypercapnia during Wakefulness and Sleep in Obese Adolescents With and Without Obstructive Sleep Apnea Syndrome

    Science.gov (United States)

    Yuan, Haibo; Pinto, Swaroop J.; Huang, Jingtao; McDonough, Joseph M.; Ward, Michelle B.; Lee, Yin N.; Bradford, Ruth M.; Gallagher, Paul R.; Shults, Justine; Konstantinopoulou, Sophia; Samuel, John M.; Katz, Eliot S.; Hua, Shucheng; Tapia, Ignacio E.; Marcus, Carole L.

    2012-01-01

    Study Objectives: Abnormal ventilatory drive may contribute to the pathophysiology of the childhood obstructive sleep apnea syndrome (OSAS). Concomitant with the obesity epidemic, more adolescents are developing OSAS. However, few studies have specifically evaluated the obese adolescent group. The authors hypothesized that obese adolescents with OSAS would have a blunted hypercapnic ventilatory response (HCVR) while awake and blunted ventilatory responses to carbon dioxide (CO2) during sleep compared with obese and lean adolescents without OSAS. Design: CVR was measured during wakefulness. During nonrapid eye movement (NREM) and rapid eye movement (REM) sleep, respiratory parameters and genioglossal electromyogram were measured during CO2 administration in comparison with room air in obese adolescents with OSAS, obese control study participants, and lean control study participants. Setting: Sleep laboratory. Participants: Twenty-eight obese patients with OSAS, 21 obese control study participants, and 37 lean control study participants. Results: The obese OSAS and obese control groups had a higher HCVR compared with the lean control group during wakefulness. During both sleep states, all 3 groups had a response to CO2; however, the obese OSAS group had lower percentage changes in minute ventilation, inspiratory flow, inspiratory time, and tidal volume compared with the 2 control groups. There were no significance differences in genioglossal activity between groups. Conclusions: HCVR during wakefulness is increased in obese adolescents. Obese adolescents with OSAS have blunted ventilatory responses to CO2 during sleep and do not have a compensatory prolongation of inspiratory time, despite having normal CO2 responsivity during wakefulness. Central drive may play a greater role than upper airway neuromotor tone in adapting to hypercapnia. Citation: Yuan H; Pinto SJ; Huang J; McDonough JM; Ward MB; Lee YN; Bradford RM; Gallagher PR; Shults J; Konstantinopoulou S

  12. Orexinergic system in the locus coeruleus modulates the CO2 ventilatory response.

    Science.gov (United States)

    Vicente, Mariane C; Dias, Mirela B; Fonseca, Elisa M; Bícego, Kênia C; Gargaglioni, Luciane H

    2016-05-01

    The orexins are hypothalamic neuropeptides involved in an array of functions such as regulation of sleep/wake states and chemoreception to CO2/pH. The locus coeruleus (LC) is a chemosensitive site and expresses an extensive population of orexin receptor 1 (OX1R). We tested the hypothesis that OX1Rs located in the LC participate in the ventilatory response to hypercapnia in a vigilance state and diurnal cycle-dependent manner. For this, we performed unilateral injections of SB-334867 (OX1R antagonist, 5 mM) into the LC of male Wistar rats and evaluated the ventilatory response to 7 % CO2 during wakefulness and sleep in the dark and light phases of the diurnal cycle. Hypercapnia induced an increase in ventilation (V E) in all groups compared to normocapnic values. However, during the dark phase, but not in the light phase, SB-334867 injection promoted an attenuation of the hypercapnic chemoreflex during wakefulness (V E: vehicle, 1502.6 ± 100 mL kg(-1) min(-1) vs SB-334867, 1200.3 ± 70.0 mL kg(-1) min(-1)) but not during sleep (V E: vehicle, 1383.0 ± 113.9 vs SB-334687, 1287.6 ± 92.1 mL kg(-1) min(-1)), due to changes in tidal volume (V T). We suggest that projections of orexin-containing neurons to the LC contribute, via OX1Rs, to the hypercapnic chemoreflex during wakefulness in the dark phase.

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

    Directory of Open Access Journals (Sweden)

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

    2013-10-01

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

  14. Ventilatory anaerobic thresholds of individuals recovering from traumatic brain injury compared with noninjured controls.

    Science.gov (United States)

    Amonette, William E; Mossberg, Kurt A

    2013-01-01

    The purpose of this study was to compare the peak aerobic capacities and ventilatory anaerobic thresholds (VAT) of individuals with a traumatic brain injury (TBI) to age- and gender-matched controls. Nineteen participants that previously suffered a mild to moderate TBI and 19 apparently healthy controls volunteered as subjects. Traumatic brain injury and healthy controls were matched for age and gender and were similar in weight and body mass index. Volunteers performed a maximal graded treadmill test to volitional failure where oxygen consumption ((Equation is included in full-text article.)O2), carbon dioxide production ((Equation is included in full-text article.)CO2, ventilation ((Equation is included in full-text article.)E, and heart rate were measured continuously. From metabolic and ventilatory data, VAT was measured using a previously described method. VAT and peak exercise responses of participants with a TBI were compared with healthy controls. The (Equation is included in full-text article.)O2, and (Equation is included in full-text article.)CO2 at VAT and peak exercise were lower for TBI compared with healthy controls. (Equation is included in full-text article.)E was also lower for TBI at VAT and peak exercise. Heart rate was lower for TBI at VAT; however, TBI had similar heart rate to healthy controls at peak exercise. The VAT and peak exercise capacities of participants with a TBI were below the metabolic demands of many routine daily activities. The data suggest that therapeutic interventions for individuals with a TBI should include targeted exercise prescriptions to improve cardiorespiratory fitness.

  15. 42 years ago--development of the concepts of ventilatory and lactate threshold.

    Science.gov (United States)

    Hollmann, W

    2001-01-01

    At the Third Pan-American Congress of Sport Physicians in Chicago in 1959 we reported the physiological and clinical significance of the spiroergometric determination of the aerobic-anaerobic turnover point for judging the performance of sick and healthy persons for the first time. In this context a distinction was made between a ventilatory and a lactate-related (arterial blood) method of determination. We called the former method the 'point of optimal ventilatory efficiency (PoW)', and the latter one 'endurance performance limit'. In the 1950s the clinical spiroergometric examination of patients and athletes for the determination of the aerobic performance capacity was consistently based on the measurement of the maximal oxygen uptake. As entering the individual border area of the performance capacity of a patient with, for example, cardiopulmonary disease, can provoke accidents, we started to think about a criterion in connection with submaximal work in 1954. Determination of pyruvate and lactic acid in the venous blood did not prove to be a valid parameter. If the spiroergometric values were entered into a coordinate system the most striking similarities during increasing exercise would become evident between the curve of the minute ventilation and the curve of the arterial lactate. The findings were interpreted as follows: during lower grades of performance the oxygen demand in the working muscle cells was saturated, whereas in the case of increasing exercise intensity an additional anaerobic metabolism was necessary. We termed the maximal work load which was covered nearly completely aerobically as the PoW and designated heart frequency at this point as 'pulse endurance limit'. The determination of the parameter was derived in the coordinate system with a tangent to the curve of the minute ventilation as well as to the curve of the arterial lactate. The results of patients and athletes were first published in 1959.

  16. 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

  17. 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

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

    Science.gov (United States)

    May, Harold J.; Breme, Frederick J.

    1982-01-01

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

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

    Science.gov (United States)

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

    2017-03-01

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

  20. Relation of ventilatory impairment and of chronic mucus hypersecretion to mortality from obstructive lung disease and from all causes.

    Science.gov (United States)

    Lange, P; Nyboe, J; Appleyard, M; Jensen, G; Schnohr, P

    1990-08-01

    The relation of ventilatory impairment and chronic mucus hypersecretion to death from all causes and death from obstructive lung disease (chronic bronchitis, emphysema and asthma) was studied in 13,756 men and women randomly selected from the general population of the City of Copenhagen. During the 10 year follow up 2288 subjects died. In 164 subjects obstructive lung disease was considered to be an underlying or a contributory cause of death (obstructive lung disease related death); in 73 subjects it was considered to be the underlying cause of death (obstructive lung disease death). Forced expiratory volume in one second, expressed as a percentage of the predicted value (FEV1% pred), and the presence of chronic phlegm were used to characterise ventilatory function and chronic mucus hypersecretion respectively. For mortality analysis the proportional hazards regression model of Cox was used; it included age, sex, pack years, inhalation habit, body mass index, alcohol consumption, and the presence or absence of asthma, heart disease, and diabetes mellitus as confounding factors. By comparison with subjects with an FEV1 of 80% pred or more, subjects with an FEV1 below 40% pred had increased risk of dying from all causes (relative risk (RR) = 5.0 for women, 2.7 for men), a higher risk of obstructive lung disease related death (RR = 57 for women, 34 for men), and a higher risk of obstructive lung disease death (RR = 101 for women, 77 for men). Chronic mucus hypersecretion was associated with only a slightly higher risk of death from all causes (RR = 1.1 for women, 1.3 for men). The association between chronic mucus hypersecretion and obstructive lung disease death varied with the level of ventilatory function, being weak in subjects with normal ventilatory function (for an FEV1 of 80% pred the RR was 1.2), but more pronounced in subjects with reduced ventilatory function (for an FEV1 of 40% pred the RR was 4.2). A similar though statistically non-significant trend was

  1. 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.

  2. 24 CFR 891.780 - Adjustment of rents.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Adjustment of rents. 891.780... and Individuals-Section 162 Assistance § 891.780 Adjustment of rents. (a) Contract rents. HUD will calculate contract rent adjustments based on the sum of the project's operating costs and debt service (as...

  3. 24 CFR 35.725 - Section 8 Rent adjustments.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Section 8 Rent adjustments. 35.725... § 35.725 Section 8 Rent adjustments. HUD may, subject to the availability of appropriations for Section... assistance, provide adjustments to the maximum monthly rents to cover the costs of evaluation for and...

  4. 24 CFR 891.640 - Adjustment of rents.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Adjustment of rents. 891.640... 8 Assistance § 891.640 Adjustment of rents. (a) Contract rents—(1) Adjustment based on approved budget. If the HAP contract provides, or has been amended to provide, that contract rents will be...

  5. Ventilatory responses to hypercapnia during wakefulness and sleep in obese adolescents with and without obstructive sleep apnea syndrome.

    Science.gov (United States)

    Yuan, Haibo; Pinto, Swaroop J; Huang, Jingtao; McDonough, Joseph M; Ward, Michelle B; Lee, Yin N; Bradford, Ruth M; Gallagher, Paul R; Shults, Justine; Konstantinopoulou, Sophia; Samuel, John M; Katz, Eliot S; Hua, Shucheng; Tapia, Ignacio E; Marcus, Carole L

    2012-09-01

    Abnormal ventilatory drive may contribute to the pathophysiology of the childhood obstructive sleep apnea syndrome (OSAS). Concomitant with the obesity epidemic, more adolescents are developing OSAS. However, few studies have specifically evaluated the obese adolescent group. The authors hypothesized that obese adolescents with OSAS would have a blunted hypercapnic ventilatory response (HCVR) while awake and blunted ventilatory responses to carbon dioxide (CO(2)) during sleep compared with obese and lean adolescents without OSAS. CVR was measured during wakefulness. During nonrapid eye movement (NREM) and rapid eye movement (REM) sleep, respiratory parameters and genioglossal electromyogram were measured during CO(2) administration in comparison with room air in obese adolescents with OSAS, obese control study participants, and lean control study participants. Sleep laboratory. Twenty-eight obese patients with OSAS, 21 obese control study participants, and 37 lean control study participants. The obese OSAS and obese control groups had a higher HCVR compared with the lean control group during wakefulness. During both sleep states, all 3 groups had a response to CO(2); however, the obese OSAS group had lower percentage changes in minute ventilation, inspiratory flow, inspiratory time, and tidal volume compared with the 2 control groups. There were no significance differences in genioglossal activity between groups. HCVR during wakefulness is increased in obese adolescents. Obese adolescents with OSAS have blunted ventilatory responses to CO(2) during sleep and do not have a compensatory prolongation of inspiratory time, despite having normal CO(2) responsivity during wakefulness. Central drive may play a greater role than upper airway neuromotor tone in adapting to hypercapnia.

  6. Relation of ventilatory impairment and of chronic mucus hypersecretion to mortality from obstructive lung disease and from all causes.

    OpenAIRE

    Lange, P; Nyboe, J; Appleyard, M; Jensen, G; Schnohr, P

    1990-01-01

    The relation of ventilatory impairment and chronic mucus hypersecretion to death from all causes and death from obstructive lung disease (chronic bronchitis, emphysema and asthma) was studied in 13,756 men and women randomly selected from the general population of the City of Copenhagen. During the 10 year follow up 2288 subjects died. In 164 subjects obstructive lung disease was considered to be an underlying or a contributory cause of death (obstructive lung disease related death); in 73 su...

  7. Serotonin nerve terminals in the dorsomedial medulla facilitate sympathetic and ventilatory responses to hemorrhage and peripheral chemoreflex activation.

    Science.gov (United States)

    Kung, Ling-Hsuan; Scrogin, Karie E

    2011-11-01

    Serotonin neurons of the caudal raphe facilitate ventilatory and sympathetic responses that develop following blood loss in conscious rats. Here, we tested whether serotonin projections to the caudal portion of the dorsomedial brain stem (including regions of the nucleus tractus solitarius that receive cardiovascular and chemosensory afferents) contribute to cardiorespiratory compensation following hemorrhage. Injections of the serotonin neurotoxin 5,7-dihydroxytryptamine produced >90% depletion of serotonin nerve terminals in the region of injection. Withdrawal of ∼21% of blood volume over 10 min produced a characteristic three-phase response that included 1) a normotensive compensatory phase, 2) rapid sympathetic withdrawal and hypotension, and 3) rapid blood pressure recovery accompanied by slower recovery of heart rate and sympathetic activity. A gradual tachypnea developed throughout hemorrhage, which quickly reversed with the advent of sympathetic withdrawal. Subsequently, breathing frequency and neural minute volume (determined by diaphragmatic electromyography) declined below baseline following termination of hemorrhage but gradually recovered over time. Lesioned rats showed attenuated sympathetic and ventilatory responses during early compensation and later recovery from hemorrhage. Both ventilatory and sympathetic responses to chemoreceptor activation with potassium cyanide injection were attenuated by the lesion. In contrast, the gain of sympathetic and heart rate baroreflex responses was greater, and low-frequency oscillations in blood pressure were reduced after lesion. Together, the data are consistent with the view that serotonin innervation of the caudal dorsomedial brain stem contributes to sympathetic compensation during hypovolemia, possibly through facilitation of peripheral chemoreflex responses.

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

    Directory of Open Access Journals (Sweden)

    F. C. Coelho

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

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

    Directory of Open Access Journals (Sweden)

    Coelho F. C.

    2003-01-01

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

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

    Science.gov (United States)

    Coelho, F C; Baker, T L; Smatresk, N J

    2003-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Laura Guidetti

    2011-09-01

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

  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. 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.

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

    Science.gov (United States)

    2013-01-01

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

  15. Components to the acid-base related ventilatory drives in the South American lungfish Lepidosiren paradoxa.

    Science.gov (United States)

    Amin-Naves, J; Giusti, H; Hoffmann, A; Glass, M L

    2007-01-15

    Lungfish are closely related to terrestrial vertebrates (tetrapoda). Like tetrapods, the South American lungfish (Lepidosiren paradoxa) has central chemoreceptors involved in regulation of acid-base status. However, no data were available on peripheral CO(2)/[H(+)] receptors. Therefore, we tested the hypothesis that such receptors exist by measuring the ventilatory responses during a 5h exposure to combined aquatic/gas phase hypercarbia 7% (approximately 49 mmHg). Normocarbic control ventilation was 22 ml BTPS kg(-1)h(-1), and hypercarbia increased ventilation to 175 ml BTPS kg(-1)h(-1) at 5h. This procedure was repeated with the modification that normocarbic mock CSF (pH 7.45; P(CO2) = 20.7 mmHg) was applied to superfuse the cerebral ventricular system during the last 2h of the experiment. This served to eliminate the hypercarbic stimulus to the central chemoreceptors, while possible responses from peripheral chemoreceptors would remain intact. Peripheral receptors were detected, since ventilation became reduced to 62 ml BTPS kg(-1)h(-1) (P<0.05), which exceeds the initial normocarbic control ventilation (P<0.05). Based on this, the peripheral contribution accounted for 20% of the total response to hypercarbia, similar to the contribution of these receptors in man.

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

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    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.

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

    Science.gov (United States)

    de Tarso Moura Borges, Paulo; Paschoal, Jorge Rizzato

    2005-01-01

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

  18. 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...

  19. Ventilatory Response to Hypercapnia Predicts Dementia with Lewy Bodies in Late-Onset Major Depressive Disorder.

    Science.gov (United States)

    Takahashi, Sho; Mizukami, Katsuyoshi; Arai, Tetsuaki; Ogawa, Ryoko; Kikuchi, Norihiro; Hattori, Satoshi; Darby, David; Asada, Takashi

    2016-01-01

    Studies have shown that developing major depressive disorder (MDD) at 50 years of age or older can predict dementia. Depression is particularly common in dementia with Lewy bodies (DLB), and occasionally occurs before the onset of extrapyramidal symptoms. Moreover, systemic autonomic dysfunction, including an abnormal ventilatory response to hypercapnia (VRH), is common in patients with DLB. Here, we aimed to determine whether the VRH is useful for distinguishing depression that is predictive of DLB from other types of MDD. Participants were 35 consecutive patients with first onset MDD at 50 years or older with bradykinesia. After diagnosing the clinical subtype of MDD according to DSM-IV criteria, each subject underwent a battery of psychological tests, autonomic examinations including VRH, brain magnetic resonance imaging, and 123I-meta-iodobenzylguanidine scintigraphy. Longitudinal follow-up showed that all 18 patients with abnormal VRH results developed DLB, whereas none of the 17 patients with normal VRH results converted to DLB within the study period (sensitivity: 100% , specificity: 100%). Additionally, over half of the DLB converters showed abnormalities on other autonomic examinations. For converters, the most common MDD subtype had psychotic and melancholic features simultaneously. The frequency of hypersensitivity to psychotropics was higher in converters than it was in non-converters. In the present study, patients with abnormal VRH results were very likely to develop DLB. Thus, for patients with late-onset MDD accompanied by bradykinesia, the VRH in combination with the clinical subtype of MDD or hypersensitivity to psychotropics may be useful for diagnosing prodromal DLB.

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

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    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.

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

    Science.gov (United States)

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

    2015-10-01

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

  2. 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.

  3. 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.

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

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    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.

  5. 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.

  6. Ventilatory response at the onset of voluntary exercise and passive movement in endurance runners.

    Science.gov (United States)

    Miyamura, M; Ishida, K; Hashimoto, I; Yuza, N

    1997-01-01

    The present study was performed to examine whether or not the ventilatory response at the onset of voluntary exercise and passive movement in endurance runners is the same as in untrained subjects. Twelve long-distance runners belonging to the varsity athletic club and 13 untrained subjects of our university participated as subjects in this study. Maximum oxygen uptake was significantly higher in the endurance runner group [mean (SD) 70.8 (4.7) ml.kg-1.min-1] than in the untrained group [49.8 (6.3) ml.kg-1.min-1]. Cardiorespiratory responses during voluntary exercise and passive movement of alternate flexion-extension of the right and left legs for about 15 s at a frequency of about 60 rpm, were determined by means of breath-by-breath techniques. Minute inspiratory ventilation (VI), tidal volume (VT), respiratory frequency (fb), cardiac output (Qc), stroke volume (SV) and heart rate (HR) increased significantly immediately at the onset of voluntary exercise and passive movement. The incremental rate for VI was greater than that for Qc. Average values and standard deviations of changes in VI were calculated as the difference between the mean of the first and second breath and the mean of five breaths preceding the exercise or movement. The rates obtained in voluntary exercise and passive movement in the endurance runner group [2.34 (0.82) and 1.72 (0.71 l.min-1), respectively] were significantly (P untrained group [4.16 (2.66) and 2.71 (1.56 l.min-1), respectively]. Also changes in VT and HR were significantly lower in the endurance group than in the untrained group with regard to both voluntary exercise and passive movement. The results suggest that the magnitude of cardiorespiratory responses at the onset of voluntary exercise and passive movement in humans is influenced by chronic endurance training for long periods.

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

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    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.

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

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    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. Breathing while altricial: the ontogeny of ventilatory chemosensitivity in red-winged blackbird (Agelaius phoeniceus) nestlings.

    Science.gov (United States)

    Dzialowski, Edward M; Sirsat, Tushar S; Sirsat, Sarah K G; Price, Edwin R

    2016-12-01

    Altricial bird species, like red-winged blackbirds, hatch at an immature state of functional maturity with limited aerobic capacity and no endothermic capacity. Over the next 10-12 days in the nest, red-winged blackbirds develop increased metabolic capacity before fledging. Although ontogeny of respiration has been described in precocial birds, ontogeny of ventilatory chemosensitivity is unknown in altricial species. Here we examined developmental changes in chemosensitivity of tidal volume (Vt), breathing frequency (ƒ), minute ventilation (V̇e), and whole animal oxygen consumption (V̇o2) from hatching to just before fledging in red-winged blackbirds on days 1, 3, 5, 7, and 9 posthatching (dph) in response to hypercapnia (2 and 4% CO2) and hypoxia (15 and 10% O2). Under control conditions, there was a developmental increase in V̇e with age due to increased Vt Hypercapnic and hypoxic chemosensitivities were present as early as 1 dph. In response to hypoxia, 1, 3, and 9 dph nestlings increased V̇e at 10% O2, by increasing ƒ with some change in Vt in younger animals. In contrast to early neonatal altricial mammals, the hypoxic response of nestling red-winged blackbirds was not biphasic. In response to hypercapnia, 3 dph nestlings increased V̇e by increasing both ƒ and Vt From 5 dph on, the hypercapnic increase in V̇e was accounted for by increased Vt and not ƒ. Chemosensitivity to O2 and CO2 matures early in nestling red-winged blackbirds, well before the ability to increase V̇o2 in response to cooling, and thus does not represent a limitation to the development of endothermy. Copyright © 2016 the American Physiological Society.

  10. Chest vibration redistributes intra-airway CO2 during tracheal insufflation in ventilatory failure.

    Science.gov (United States)

    Eckmann, D M; Gavriely, N

    1996-03-01

    To determine if high-frequency external chest wall vibration added to low flow intratracheal fresh gas insufflation alters the intra-airway CO2 distribution and the resistance to CO2 transport from the lungs. Prospective study. Experimental laboratory. Six adult anesthesized and paralyzed mongrel dogs (mean weight 24.3+/- 4.4 kg). Dogs were ventilated by three methods: a) intermittent positive pressure ventilation; b) intermittent positive pressure ventilation with tracheal insufflation of fresh gas (FIO2 of 0.4) flowing at 0.15 L/kg/min through a catheter positioned at the carina; and c) intermittent positive pressure ventilation with tracheal insufflation and with external high-frequency chest wall vibration of the dependent hemithorax. We measured arterial blood gas values as an index of global gas exchange, and intrapulmonary airway CO2 concentrations as an index of local gas exchange. Intra-airway CO2 concentrations along the axis of the airways were measured via a sampling catheter. Airway axial concentration profiles were constructed and resistances to gas transport were calculated from the measured data. Vibration increased intraluminal CO2 concentrations from 1.1% to 2.5% mouthward of the insufflation catheter tip. Peak resistance to CO2 transport decreased by 65% during vibration relative to the insufflation-only value. Vibration displaced peak transport resistance from second- to fourth-generation airways. Global gas exchange improves during ventilation by chest wall vibration with low flow insufflation. Local gas exchange in the central airways is also improved due to increased intraluminal mixing and CO2 elimination. This ventilation technique may confer therapeutic advantages over conventional mechanical ventilation in the treatment of ventilatory failure.

  11. Adjustable suture strabismus surgery

    Science.gov (United States)

    Nihalani, B R; Hunter, D G

    2011-01-01

    Surgical management of strabismus remains a challenge because surgical success rates, short-term and long-term, are not ideal. Adjustable suture strabismus surgery has been available for decades as a tool to potentially enhance the surgical outcomes. Intellectually, it seems logical that having a second chance to improve the outcome of a strabismus procedure should increase the overall success rate and reduce the reoperation rate. Yet, adjustable suture surgery has not gained universal acceptance, partly because Level 1 evidence of its advantages is lacking, and partly because the learning curve for accurate decision making during suture adjustment may span a decade or more. In this review we describe the indications, techniques, and published results of adjustable suture surgery. We will discuss the option of ‘no adjustment' in cases with satisfactory alignment with emphasis on recent advances allowing for delayed adjustment. The use of adjustable sutures in special circumstances will also be reviewed. Consistently improved outcomes in the adjustable arm of nearly all retrospective studies support the advantage of the adjustable option, and strabismus surgeons are advised to become facile in the application of this approach. PMID:21760626

  12. Theory of adaptive adjustment

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    Weihong Huang

    2000-01-01

    Full Text Available Conventional adaptive expectation as a mechanism of stabilizing an unstable economic process is reexamined through a generalization to an adaptive adjustment framework. The generic structures of equilibria that can be stabilized through an adaptive adjustment mechanism are identified. The generalization can be applied to a broad class of discrete economic processes where the variables interested can be adjusted or controlled directly by economic agents such as in cobweb dynamics, Cournot games, Oligopoly markets, tatonnement price adjustment, tariff games, population control through immigration etc.

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

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    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

  14. 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.

  15. 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.

  16. 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 ...

  17. University students' adjustment problems.

    Science.gov (United States)

    Cherian, V I; Cherian, L

    1998-06-01

    Considerable information is available on the adjustment problems of first-year university students in developed countries, but comparatively little is known about such problems in Asia and Africa. This study of a representative sample of 1257 first-year students conducted at the University of the North showed that 33 to 85% of the first-year students experienced various adjustment problems.

  18. 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.

  19. 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 < 0.001). Mucus clearance rate was 11.3 ± 9.9 mm/min in the Trendelenburg group versus 0.1 ± 1.0 in the control and 0.2 ± 1.0 in the 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

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

    Science.gov (United States)

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

    2016-06-01

    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. Key pointsDecrease in relative oxygen uptake at VT (ml·kg(-1)·min(-1)) during the final leg of a duathlon simulation, compared to a single-bout maximal run.We observed a decrease in running speed at VT during the final leg of a duathlon simulation; resulting in an

  1. Ventilatory response to progressive curarization in patients during light halothane, N2O in O2 anaesthesia.

    Science.gov (United States)

    Linko, K; Wirtavuori, K; Tammisto, T

    1984-06-01

    The effects of progressive curarization on spontaneous ventilation were studied in 23 patients during light halothane-nitrous oxide-oxygen anaesthesia. In 11 patients, in whom the end-expiratory CO2 concentration and evoked mechanical response were recorded, increasing curarization caused first a slow CO2 accumulation and later an abrupt ventilatory impairment at a twitch tension of between 5 and 50% of original muscle strength. In 12 patients, in whom the evoked integrated hypothenar EMG, spontaneous frontal EMG and mean frequency and amplitude of the EEG were recorded, the spontaneous frontal EMG and ventilation diminished within 3 min, following the first 5 mg dose of tubocurarine. At this stage muscle strength, indicated by the amplitude of the evoked EMG and the train-of-four ratio, was unchanged. Repeated 5 mg doses of tubocurarine caused an almost linear decrease in ventilation and an increase in end-tidal CO2 concentration without affecting the rate of breathing until the sudden impairment of ventilation that occurred usually after the fourth dose of tubocurarine. The EEG changes during curarization were minimal and no common trend was seen. The results suggest that tubocurarine may be given to anaesthetized patients in a dose which is too small to produce, using the evoked EMG, a detectable neuromuscular block, but is sufficient to cause ventilatory depression without a compensatory increase in the rate of breathing.

  2. Gel-mediated delivery of AAV1 vectors corrects ventilatory function in Pompe mice with established disease.

    Science.gov (United States)

    Mah, Cathryn S; Falk, Darin J; Germain, Sean A; Kelley, Jeffry S; Lewis, Melissa A; Cloutier, Denise A; DeRuisseau, Lara R; Conlon, Thomas J; Cresawn, Kerry O; Fraites, Thomas J; Campbell-Thompson, Martha; Fuller, David D; Byrne, Barry J

    2010-03-01

    Pompe disease is a muscular dystrophy that results in respiratory insufficiency. We characterized the outcomes of targeted delivery of recombinant adeno-associated virus serotype 1 (rAAV2/1) vector to diaphragms of Pompe mice with varying stages of disease progression. We observed significant improvement in diaphragm contractile strength in mice treated at 3 months of age that is sustained at least for 1 year and enhanced contractile strength in mice treated at 9 and 21 months of age, measured 3 months post-treatment. Ventilatory parameters including tidal volume/inspiratory time ratio, minute ventilation/expired CO2 ratio, and peak inspiratory airflow were significantly improved in mice treated at 3 months and tested at 6 months. Despite early improvement, mice treated at 3 months and tested at 1 year had diminished normoxic ventilation, potentially due to attenuation of correction over time or progressive degeneration of nontargeted accessory tissues. However, for all rAAV2/1-treated mice (treated at 3, 9, and 21 months, assayed 3 months later; treated at 3 months, assayed at 1 year), minute ventilation and peak inspiratory flows were significantly improved during respiratory challenge. These results demonstrate that gel-mediated delivery of rAAV2/1 vectors can significantly augment ventilatory function at initial and late phases of disease in a model of muscular dystrophy.

  3. 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.

  4. 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

  5. [Assisted cough--physiotherapy to improve expectoration of mucus].

    Science.gov (United States)

    Schmidt, I

    2008-03-01

    Pulmonary complications are the most common causes of mortality in patients with severe inspiratory and/or expiratory muscle weakness. An inspiratory tidal volume below 1500 ml and a peak cough flow below 160 L/min result in mucus retention and increase the risk of pneumonia. An intact cough function is pivotal for airway clearance during acute and chronic airway infections with increased mucus production as well as for protection against endotracheal aspirations. Effective cough requires that all of its phases work or are effectively supported. Non-invasive assistance of inspiration can be provided by manual hyperinflation, air stacking, glossopharyngeal breathing or mechanical insufflation. Safe and effective methods of expiration assistance include manual thorax and abdominal compression, manual self-assistance as well as mechanical insufflation-exsufflation. The use of these non-invasive inspiratory and expiratory muscle aids can decrease the risk of pulmonary complications in patients with severe ventilatory muscle weakness.

  6. 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.

  7. Clinical outcomes of patients requiring ventilatory support in Brazilian intensive care units: a multicenter, prospective, cohort study

    Science.gov (United States)

    2013-01-01

    Introduction Contemporary information on mechanical ventilation (MV) use in emerging countries is limited. Moreover, most epidemiological studies on ventilatory support were carried out before significant developments, such as lung protective ventilation or broader application of non-invasive ventilation (NIV). We aimed to evaluate the clinical characteristics, outcomes and risk factors for hospital mortality and failure of NIV in patients requiring ventilatory support in Brazilian intensive care units (ICU). Methods In a multicenter, prospective, cohort study, a total of 773 adult patients admitted to 45 ICUs over a two-month period requiring invasive ventilation or NIV for more than 24 hours were evaluated. Causes of ventilatory support, prior chronic health status and physiological data were assessed. Multivariate analysis was used to identifiy variables associated with hospital mortality and NIV failure. Results Invasive MV and NIV were used as initial ventilatory support in 622 (80%) and 151 (20%) patients. Failure with subsequent intubation occurred in 54% of NIV patients. The main reasons for ventilatory support were pneumonia (27%), neurologic disorders (19%) and non-pulmonary sepsis (12%). ICU and hospital mortality rates were 34% and 42%. Using the Berlin definition, acute respiratory distress syndrome (ARDS) was diagnosed in 31% of the patients with a hospital mortality of 52%. In the multivariate analysis, age (odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01 to 1.03), comorbidities (OR, 2.30; 95% CI, 1.28 to 3.17), associated organ failures (OR, 1.12; 95% CI, 1.05 to 1.20), moderate (OR, 1.92; 95% CI, 1.10 to 3.35) to severe ARDS (OR, 2.12; 95% CI, 1.01 to 4.41), cumulative fluid balance over the first 72 h of ICU (OR, 2.44; 95% CI, 1.39 to 4.28), higher lactate (OR, 1.78; 95% CI, 1.27 to 2.50), invasive MV (OR, 2.67; 95% CI, 1.32 to 5.39) and NIV failure (OR, 3.95; 95% CI, 1.74 to 8.99) were independently associated with hospital mortality

  8. Remotely Adjustable Hydraulic Pump

    Science.gov (United States)

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

    1987-01-01

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

  9. 38 CFR 21.268 - Employment adjustment allowance.

    Science.gov (United States)

    2010-07-01

    ... allowance. 21.268 Section 21.268 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS.... Chapter 31 Monetary Assistance Services § 21.268 Employment adjustment allowance. (a) General. A veteran... employment adjustment allowance for a period of two months at the full-time subsistence allowance rate for...

  10. Weighted triangulation adjustment

    Science.gov (United States)

    Anderson, Walter L.

    1969-01-01

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

  11. Adjustment disorder: epidemiology, diagnosis and treatment

    OpenAIRE

    Casey, Patricia R.

    2009-01-01

    Adjustment disorder was introduced into the psychiatric classification systems almost 30 years ago, although the concept was recognized for many years before that. In DSM-IV, six subtypes are described based on the predominant symptoms, but no further diagnostic criteria are offered to assist the clinician. These are common conditions, especially in primary care and in consultation liaison psychiatry, where the prevalence ranges from 11% to 18% and from 10% to 35%, respectively. Yet they are ...

  12. 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.

  13. 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

  14. Comparing four non-invasive methods to determine the ventilatory anaerobic threshold during cardiopulmonary exercise testing in children with congenital heart or lung disease

    NARCIS (Netherlands)

    Visschers, Naomi C A; Hulzebos, Erik H.|info:eu-repo/dai/nl/304818224; van Brussel, Marco|info:eu-repo/dai/nl/30481962X; Takken, Tim|info:eu-repo/dai/nl/184586674

    2015-01-01

    Background: The ventilatory anaerobic threshold (VAT) is an important method to assess the aerobic fitness in patients with cardiopulmonary disease. Several methods exist to determine the VAT; however, there is no consensus which of these methods is the most accurate. Objective: To compare four

  15. Comparison of ventilatory and haemodynamic effects of BIPAP and S-IMV/PSV for postoperative short-term ventilation in patients after coronary artery bypass grafting.

    Science.gov (United States)

    Kazmaier, S; Rathgeber, J; Buhre, W; Buscher, H; Busch, T; Mensching, K; Sonntag, H

    2000-10-01

    The aim of the present multiple cross-over study was to compare the effects of biphasic positive airway pressure (BIPAP) ventilation with synchronized intermittent mandatory ventilation combined with pressure support ventilation (S-IMV/PSV) in sedated and awake patients after coronary artery bypass grafting (CABG) surgery. Twenty-four patients with no evidence of preoperative respiratory dysfunction and an uncomplicated intraoperative course were investigated. The patients were randomly assigned to one of two groups starting with either BIPAP or S-IMV/PSV mode. Haemodynamic measurements and blood gas analyses were performed during sedation with 2.0 mg kg(-1) h(-1) propofol in the primary mode, after switching to the alternative ventilatory mode, and in the primary mode again. The same sequence of measurements was repeated in awake patients who had reached extubation criteria. In awake patients, PSV was performed instead of S-IMV. Statistical analysis of data was performed using non-parametric tests. Inspiratory peak pressure increased significantly during S-IMV/PSV in sedated patients in both groups. Other ventilatory parameters did not differ significantly between BIPAP and S-IMV/PSV in both groups. Similarly, haemodynamic parameters and blood-gas analyses did not vary with the ventilatory mode. Our results demonstrate that BIPAP ventilation has comparable effects on haemodynamics and pulmonary gas exchange compared with S-IMV/PSV and PSV when used for short-term ventilatory support in patients after cardiac surgery.

  16. Dental Assistants

    Science.gov (United States)

    ... State & Area Data Explore resources for employment and wages by state and area for dental assistants. Similar Occupations Compare the job duties, education, job growth, and pay of dental assistants with ...

  17. 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 ...

  18. Assistive Technologies

    Science.gov (United States)

    Auat Cheein, Fernando A., Ed.

    2012-01-01

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

  19. Adjustment of International Students.

    Science.gov (United States)

    Stafford, Thomas H., Jr.; And Others

    1980-01-01

    International students (N=747) completed a questionnaire to obtain information about their adjustment so that special services could be developed for them. Homesickness was their greatest area of concern, as well as housing, social relationships, the English language, and finances. (RC)

  20. Adjustment to Retirement

    NARCIS (Netherlands)

    van Solinge, H.; Krauss Withbourne, S.

    2016-01-01

    Retirement is an important life course event that marks the start of a new life stage in which work is no longer dominant. Thus, employees have to adjust to the significant life changes that accompany the transition and seek to achieve psychological comfort with their retirement life. This entry

  1. Rural to Urban Adjustment

    Science.gov (United States)

    Abramson, Jane A.

    Personal interviews with 100 former farm operators living in Saskatoon, Saskatchewan, were conducted in an attempt to understand the nature of the adjustment process caused by migration from rural to urban surroundings. Requirements for inclusion in the study were that respondents had owned or operated a farm for at least 3 years, had left their…

  2. Psychosocial adjustment following ostomy.

    Science.gov (United States)

    Follick, M J; Smith, T W; Turk, D C

    1984-01-01

    Ostomy patients have been identified as a chronic illness population frequently experiencing adjustment difficulties. The present study, based on the biopsychosocial model (Engel, 1977) of chronic illness, examined a range of post-surgical adjustment difficulties in a sample of 131 ostomy patients. The patient population reported experiencing a significant number of technical, emotional, social, marital/family, and sexual difficulties post-surgically. Technical difficulties were associated with impaired emotional, social, and marital/family functioning. Emotional difficulties were also associated with problematic social, marital/family adjustment, and impaired sexual functioning. Technical problems, emotional difficulties, and social problems were all associated with the patient's perception of having received inadequate preparatory information. Marital/family and sexual maladjustment, on the other hand, were associated with low levels of perceived social support. The results of this investigation are interpreted as supporting the biopsychosocial model of chronic illness, and the clinical implications of these findings are discussed as well as their relation to previous research on adjustment to stressful medical procedures.

  3. Environmentally Adjusted Elasticity Measures

    OpenAIRE

    Shaik, Saleem

    2005-01-01

    Here, using input, output and nitrogen pollution data related to one state, we propose to extend the elasticity concept to include environmental pollution treated as undesirable output to provide the environmentally adjusted elasticity measures for the period, 1936-1997 in a two-step procedure.

  4. Incisor adjustment in rabbits.

    Science.gov (United States)

    Brown, Cyndi

    2009-06-01

    Rabbit incisor teeth are open-rooted and, in healthy animals, grow continuously. Incisor adjustments are often necessary to maintain the health and well-being of rabbits with incisor malocclusion. This column will describe some techniques used to manage incisor malocclusion in the rabbit.

  5. Dorsomedial medullary 5-HT2 receptors mediate immediate onset of initial hyperventilation, airway dilation, and ventilatory decline during hypoxia in mice.

    Science.gov (United States)

    Kanamaru, Mitsuko; Homma, Ikuo

    2009-07-01

    The dorsomedial medulla oblongata (DMM) includes the solitary tract nucleus and the hypoglossal nucleus, to which 5-HT neurons project. Effects of 5-HT in the DMM on ventilatory augmentation and airway dilation are mediated via 5-HT2 receptors, which interact with the CO(2) drive. The interaction may elicit cycles between hyperventilation with airway dilation and hypoventilation with airway narrowing. In the present study, effects of 5-HT2 receptors in the DMM on hypoxic ventilatory and airway responses were investigated, while 5-HT release in the DMM was monitored. Adult male mice were anesthetized, and then a microdialysis probe was inserted into the DMM. The mice were placed in a double-chamber plethysmograph. After recovery from anesthesia, the mice were exposed to hypoxic gas (7% O(2) in N(2)) for 5 min with or without a 5-HT2 receptor antagonist (LY-53857) perfused in the DMM. 5-HT release in the DMM was increased by hypoxia regardless of the presence of LY-53857. Immediate onset and the peak of initial hypoxic hyperventilatory responses were delayed. Subsequent ventilatory decline and airway dilation during initial hypoxic hyperventilation were suppressed with LY-53857. These results suggest that 5-HT release increased by hypoxia acts on 5-HT2 receptors in the DMM, which contributes to the immediate onset of initial hypoxic hyperventilation, airway dilation, and subsequent ventilatory decline. Hypoxic ventilatory and airway responses mediated via 5-HT2 receptors in the DMM may play roles in immediate rescue and defensive adaptation for hypoxia and may be included in periodic breathing and the pathogenesis of obstructive sleep apnea.

  6. Different Determinants of Ventilatory Inefficiency at Different Stages of Reduced Ejection Fraction Chronic Heart Failure Natural History.

    Science.gov (United States)

    Mezzani, Alessandro; Giordano, Andrea; Komici, Klara; Corrà, Ugo

    2017-05-09

    It is not known whether determinants of ventilation (VE)/volume of exhaled carbon dioxide (VCO2) slope during incremental exercise may differ at different stages of reduced ejection fraction chronic heart failure natural history. VE/VCO2 slope was fitted up to lowest VE/VCO2 ratio, that is, a proxy of the VE/perfusion ratio devoid of nonmetabolic stimuli to ventilatory drive. VE/VCO2 slope tertiles were generated from our database (failure patients with repeated tests yielding VE/VCO2 slopes in 2 different tertiles were selected. Determinants of VE/VCO2 slope changes across tertile pairs 1 versus 2, 2 versus 3, and 1 versus 3 were assessed by exploring changes in VE and VCO2 at lowest VE/VCO2 and those in VE/work rate (W) and VCO2/W slope. Resting and peak cardiac output (CO) were calculated as VO2/estimated arteriovenous O2 difference and the CO/W slope analyzed. Notwithstanding a progressively lower W with increasing tertile, VE at lowest VE/VCO2 and VE/W slope were significantly higher in tertiles 2 and 3 versus tertile 1. Conversely, VCO2 at lowest VE/VCO2 and CO/W slope significantly decreased across tertiles, whereas VCO2/W slope did not. Difference (Δ) in VE/W slope between tertiles accounted for 71% of ΔVE/VCO2 slope variance, with ΔVCO2/W slope explaining an additional 26% (model r=0.99; r2=0.97; Pslope with ΔCO/W slope. Ventilatory overactivation is the predominant cause of VE/VCO2 slope increase at initial stages of chronic heart failure, whereas hemodynamic impairment plays an additional role at more-advanced pathophysiological stages. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  7. [Pulmonary mechanics, oxygenation index, and alveolar ventilation in patients with two controlled ventilatory modes. A comparative crossover study].

    Science.gov (United States)

    Castañón-González, Jorge A; León-Gutiérrez, Marco Antonio; Gallegos-Pérez, Humberto; Pech-Quijano, Jorge; Martínez-Gutíerrez, Miguel; Olvera-Chávez, Alfredo

    2003-01-01

    To compare in a crossover study pulmonary mechanics, oxigenation index (PaO(2)/FiO(2)), and partial pressure of CO(2) in arterial blood (PaCO(2)) in patients with mechanical ventilation in two controlled ventilatory modes. Intensive care unit of a university affiliated hospital. Prospective crossover clinical trial. A total 114 consecutive patients were admitted to the intensive care unit (ICU) under controlled mechanical ventilation with SaO(2) >90% and FiO(2) ventilated with tidal volume (Vt) of 7 ml/kg, respiratory rate (RR) 14/min, inspiratory-expiratory ratio 1:2 (I:E), PEEP 5 cm H(2)O, and FiO(2) 0.4. After 15 min of mechanical ventilation, pulmonary mechanics, oxygenation index (OI), and PaCO(2) were measured and registered, and ventilatory mode was switched to PC mode in group I and to VC in group II, maintaining the same ventilator settings. Pulmonary mechanics, OI, and PaCO(2) were again registered after 15 min of ventilation. Peak inspiratory pressure (PIP) was higher in VC than in PC (31.5 vs 26 cm H(2)O), which resulted in a significant increase in transpulmonary pressure amplitude difference (DP) (25 vs 19 cm H(2)O). Mean airway pressure (MAP) and OI were lower in VC than in PC (11.5 vs 12 cm H(2)O, and 198.5 vs 215, respectively). Dynamic compliance (DynC) was lower in VC than in PC (20 vs 26 ml/cm H(2)O), p ventilator settings in the same patient, PC and not VC ventilation decreases PIP (which results in smaller transpulmonary pressure amplitude difference), increases MAP, and DynC and improves the oxygenation index.

  8. Housing Assistance

    Directory of Open Access Journals (Sweden)

    Emma Baker

    2013-07-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  10. Metric adjusted skew information

    DEFF Research Database (Denmark)

    Hansen, Frank

    2008-01-01

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

  11. Sustainable urban regime adjustments

    DEFF Research Database (Denmark)

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

    2013-01-01

    The endogenous agency that urban governments increasingly portray by making conscious and planned efforts to adjust the regimes they operate within is currently not well captured in transition studies. There is a need to acknowledge the ambiguity of regime enactment at the urban scale. This directs...... attention to the transformative implications of conscious strategic maneuvering by incumbent regime actors, when confronting regime structurations. This article provides insight to processes of regime enactment performed by local governments by applying a flow-oriented perspective on regime dynamics......, inspired by Actor-Network Theory to demonstrate that regime incumbent actors can induce gradual regime adjustments at the urban scale. This is done through a case study of an urban development project, where the Municipality of Egedal in Denmark has successfully promoted energy efficient buildings through...

  12. Adjustable Autonomy Testbed

    Science.gov (United States)

    Malin, Jane T.; Schrenkenghost, Debra K.

    2001-01-01

    The Adjustable Autonomy Testbed (AAT) is a simulation-based testbed located in the Intelligent Systems Laboratory in the Automation, Robotics and Simulation Division at NASA Johnson Space Center. The purpose of the testbed is to support evaluation and validation of prototypes of adjustable autonomous agent software for control and fault management for complex systems. The AA T project has developed prototype adjustable autonomous agent software and human interfaces for cooperative fault management. This software builds on current autonomous agent technology by altering the architecture, components and interfaces for effective teamwork between autonomous systems and human experts. Autonomous agents include a planner, flexible executive, low level control and deductive model-based fault isolation. Adjustable autonomy is intended to increase the flexibility and effectiveness of fault management with an autonomous system. The test domain for this work is control of advanced life support systems for habitats for planetary exploration. The CONFIG hybrid discrete event simulation environment provides flexible and dynamically reconfigurable models of the behavior of components and fluids in the life support systems. Both discrete event and continuous (discrete time) simulation are supported, and flows and pressures are computed globally. This provides fast dynamic simulations of interacting hardware systems in closed loops that can be reconfigured during operations scenarios, producing complex cascading effects of operations and failures. Current object-oriented model libraries support modeling of fluid systems, and models have been developed of physico-chemical and biological subsystems for processing advanced life support gases. In FY01, water recovery system models will be developed.

  13. 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.

  14. 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.

  15. 75 FR 9087 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-03-01

    ... business of fishing on the person's annual Federal income tax return for the taxable year that most closely... by the Department. (c) In the case of death, incompetency, disappearance, or dissolution of a...

  16. 75 FR 48931 - Trade Adjustment Assistance for Farmers

    Science.gov (United States)

    2010-08-12

    ... the Maine State Pomological Society on behalf of apple producers in Maine. The Administrator will... marketing years. If the determination is affirmative, producers who produce and market apples in Maine will...

  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. 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...

  19. 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

  20. Adjustable Reeds For Weaving

    Science.gov (United States)

    Farley, Gary L.

    1994-01-01

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

  1. 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.

  2. 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

  3. 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

  4. The Coupling of Peripheral Blood Pressure and Ventilatory Responses during Exercise in Young Adults with Cystic Fibrosis.

    Directory of Open Access Journals (Sweden)

    Erik H Van Iterson

    Full Text Available Cystic fibrosis (CF is commonly recognized as a pulmonary disease associated with reduced airway function. Another primary symptom of CF is low exercise capacity where ventilation and gas-exchange are exacerbated. However, an independent link between pathophysiology of the pulmonary system and abnormal ventilatory and gas-exchange responses during cardiopulmonary exercise testing (CPET has not been established in CF. Complicating this understanding, accumulating evidence suggests CF demonstrate abnormal peripheral vascular function; although, the clinical implications are unclear. We hypothesized that compared to controls, relative to total work performed (WorkTOT, CF would demonstrate increased ventilation accompanied by augmented systolic blood pressure (SBP during CPET.16 CF and 23 controls (age: 23±4 vs. 27±4 years, P = 0.11; FEV1%predicted: 73±14 vs. 96±5, P<0.01 participated in CPET. Breath-by-breath oxygen uptake ([Formula: see text], ventilation ([Formula: see text], and carbon dioxide output ([Formula: see text] were measured continuously during incremental 3-min stage step-wise cycle ergometry CPET. SBP was measured via manual sphygmomanometry. Linear regression was used to calculate [Formula: see text] slope from rest to peak-exercise.Compared to controls, CF performed less WorkTOT during CPET (90±19 vs. 43±14 kJ, respectively, P<0.01. With WorkTOT as a covariate, peak [Formula: see text] (62±8 vs. 90±4 L/min, P = 0.76, [Formula: see text] (1.8±0.3 vs. 2.7±0.1 L/min, P = 0.40, and SBP (144±13 vs. 152±6 mmHg, P = 0.88 were similar between CF and controls, respectively; whereas CF demonstrated increased [Formula: see text] slope (38±4 vs. 28±2, P = 0.02 but lower peak [Formula: see text] versus controls (22±5 vs. 33±4 mL/kg/min, P<0.01. There were modest-to-moderate correlations between peak SBP with [Formula: see text] (r = 0.30, [Formula: see text] (r = 0.70, and [Formula: see text] (r = 0.62 in CF.These data suggest

  5. Erythropoietin does not have effects on the ventilatory and pulmonary vascular response to acute hypoxia in men and women.

    Science.gov (United States)

    Berendsen, Remco R; Lindeman, Rob C; Boom, Merel; Aarts, Leon P H J; van Dorp, Eveline L A; Teppema, Luc J

    2016-07-13

    Sustained and chronic hypoxia lead to a rise in pulmonary ventilation (hypoxic ventilatory response, HVR) and to an increase in pulmonary vascular resistance (hypoxic pulmonary vasoconstriction, HPV). In this study, we examined the effect of a clinical intravenous dose of recombinant human erythropoietin (rHuEPO,50 IU kg(-1) ) on the isocapnic HVR and HPV in 7 male and 7 female subjects by exposing them to hypoxia for 20 min (end-tidal PO2  ∼ 50 mmHg) while measuring their ventilation and estimating pulmonary arterial pressure from the maximal velocity of the regurgitant jet over the tricuspid valve during systole (ΔPmax) with echocardiography. In placebo, after 5 and 20 min, men responded with a rise in ventilation by 0.0056 and 0.0023 l/min/kg/%SpO2 , respectively, indicating the presence of hypoxic ventilatory depression. In women, the rise in ventilation was 0.0067 and 0.0047 l/min/kg/%SpO2 , respectively. In both sexes, EPO did not alter these responses significantl . In placebo, mean ΔPmax rose by 6.1 ± 0.7 mmHg in men P = 0.035) and by 8.4 ± 1.4 mmHg in women (P = 0.020) during the hypoxic exposure whereby women had a ∼5 mmHg lower end-tidal PCO2 . EPO did not alter these responses: in men a rise in ΔPmax by 7.5 ± 1.1 mmHg (NS vs. placebo) and in women by 9.7 ± 2.2 mmHg (NS vs. placebo). We conclude that women tended to have a greater HPV in placebo and that a clinical dose of EPO has no effect on the HVR and HPV in either sex This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. 24 CFR 982.519 - Regular tenancy: Annual adjustment of rent to owner.

    Science.gov (United States)

    2010-04-01

    ... of rent to owner. 982.519 Section 982.519 Housing and Urban Development Regulations Relating to... Rent and Housing Assistance Payment § 982.519 Regular tenancy: Annual adjustment of rent to owner. (a) When rent is adjusted. At each annual anniversary date of the HAP contract, the PHA must adjust the...

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

  8. Adjusting to the Emergent

    DEFF Research Database (Denmark)

    Revsbæk, Line

    of ‘adjusting to the emergent’. Newcomer innovation is portrayed as carrying a variety of possible significations, such as unintentional innovation effects of newcomer’s proactive self-socializing behavior; an inspirational basis for designing innovation-generating employee induction; ‘resonant instances......In her doctoral thesis Line Revsbaek explores newcomer innovation related to organizational entry processes in a changing organization. She introduces process philosophy and complexity theory to research on organizational socialization and newcomer innovation. The study challenges assumptions......’ 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...

  9. 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-Jr, 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.

  10. Is there a beneficial effect difference between age, gender, and different cardiac pathology groups of exercise training at ventilatory threshold in cardiac patients?

    Science.gov (United States)

    Temfemo, Abdou; Chlif, Mehdi; Mandengue, Samuel Honoré; Lelard, Thierry; Choquet, Dominique; Ahmaidi, Said

    2011-01-01

    Research on cardiac rehabilitation has raised interesting methods and effects without however establishing the share of the profits according to age, sex and cardiac pathology. Yet today, this disease with various pathologies strikes people of all ages and both sexes, and the recommended rehabilitation exercise intensity is often the ventilatory threshold. The aim of this study was to compare benefits of a training program at ventilatory threshold according to age, gender and cardiac pathology. One hundred and eighty eight cardiac patients, of whom 62 had coronary artery bypass surgery, 22 artery angioplasty, 54 myocardial infarction and 50 valve replacements, aged 31-82 years, performed spirometric and cardiopulmonary exercise tests before and after a training program. This program consisted of exercise on a cycloergometer for three sessions of 45 min per week for eight weeks at heart rates attenuated at ventilatory threshold (V(Th)) obtained during a cardiopulmonary exercise test conducted before the training period. Peak heart rate, peak aerobic power, and peak oxygen uptake determined at V(Th) increased during the training period in all groups of subjects. Men and adult groups had higher absolute values compared to women and elderly groups. No difference was observed in cardiac pathology groups. Similar improvements of aerobic capacities were observed in age, gender and cardiac pathology groups. A training program conducted at personalised V(Th) significantly improves the aerobic physical capacities of all cardiac patients, and inducessimilar benefits whatever the age, gender or cardiac pathology.

  11. Muscular, cardiac, ventilatory and metabolic dysfunction in patients with multiple sclerosis: Implications for screening, clinical care and endurance and resistance exercise therapy, a scoping review.

    Science.gov (United States)

    Wens, Inez; Eijnde, Bert O; Hansen, Dominique

    2016-08-15

    In the treatment of multiple sclerosis (MS), exercise training is now considered a cornerstone. However, most clinicians tend to focus on neurologic deficits only, and thus prefer to prescribe rehabilitation programs specifically to counteract these deficits. However, the present comprehensive review shows that patients with MS (pwMS) also experience significant muscular, cardiac, ventilatory and metabolic dysfunction, which significantly contribute, next to neurologic deficits, to exercise intolerance. In addition, these anomalies also might increase the risk for frequent hospitalization and morbidity and can reduce life expectancy. Unfortunately, the impact of exercise intervention on these anomalies in pwMS are mostly unknown. Therefore, it is suggested that pwMS should be screened systematically for muscular, cardiac, ventilatory and metabolic function during exercise testing. The detection of such anomalies should lead to adaptations and optimisation of exercise training prescription and clinical care/medical treatment of pwMS. In addition, future studies should focus on the impact of exercise intervention on muscular, cardiac, ventilatory and metabolic (dys)function in pwMS, to contribute to improved treatment and care. Copyright © 2016. Published by Elsevier B.V.

  12. Hemodynamic and ventilatory effects of manual respiratory physiotherapy techniques of chest clapping, vibration, and shaking in an animal model.

    Science.gov (United States)

    Wong, W P; Paratz, J D; Wilson, K; Burns, Y R

    2003-09-01

    Chest clapping, vibration, and shaking were studied in 10 physiotherapists who applied these techniques on an anesthetized animal model. Hemodynamic variables (such as heart rate, blood pressure, pulmonary artery pressure, and right atrial pressure) were measured during the application of these techniques to verify claims of adverse events. In addition, expired tidal volume and peak expiratory flow rate were measured to ascertain effects of these techniques. Physiotherapists in this study applied chest clapping at a rate of 6.2 +/- 0.9 Hz, vibration at 10.5 +/- 2.3 Hz, and shaking at 6.2 +/- 2.3 Hz. With the use of these rates, esophageal pressure swings of 8.8 +/- 5.0, 0.7 +/- 0.3, and 1.4 +/- 0.7 mmHg resulted from clapping, vibration, and shaking respectively. Variability in rates and "forces" generated by these techniques was physiotherapy experience and layers of towel used explained approximately 79% of the variance in clapping force (P = 0.004), whereas age and clinical experience explained >80% of variance in shaking force (P = 0.003). Application of these techniques by physiotherapists was found to have no significant effects on hemodynamic and most ventilatory variables in this study. From this study, we conclude that chest clapping, vibration, and shaking 1). can be consistently performed by physiotherapists; 2). are significantly related to physiotherapists' characteristics, particularly clinical experience; and 3). caused no significant hemodynamic effects.

  13. 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.

  14. Influence of skeletal muscle mass on ventilatory and hemodynamic variables during exercise in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Costa Ricardo Vivacqua Cardoso

    2003-01-01

    Full Text Available OBJECTIVE: To assess the influence of skeletal muscle mass on ventilatory and hemodynamic variables during exercise in patients with chronic heart failure (CHF. METHODS: Twenty-five male patients underwent maximum cardiopulmonary exercise testing on a treadmill with a ramp protocol and measurement of the skeletal muscle mass of their thighs by using magnetic resonance imaging. The clinically stable, noncachectic patients were assessed and compared with 14 healthy individuals (S paired by age and body mass index, who underwent the same examinations. RESULTS: Similar values of skeletal muscle mass were found in both groups (CHF group: 3863 ± 874 g; S group: 3743 ± 540 g; p = 0.32. Significant correlations of oxygen consumption in the anaerobic threshold (CHF: r = 0.39; P= 0.02 and S: r = 0.14; P = 0.31 and of oxygen pulse also in the anaerobic threshold (CHF: r = 0.49; P = 0.01 and S: r =0.12; P = 0.36 were found only in the group of patients with chronic heart failure. CONCLUSION: The results obtained indicate that skeletal muscle mass may influence the capacity of patients with CHF to withstand submaximal effort, due to limitations in their physical condition, even maintaining a value similar to that of healthy individuals. This suggests qualitative changes in the musculature.

  15. [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".

  16. Effects of patient-directed music intervention on anxiety and sedative exposure in critically ill patients receiving mechanical-ventilatory support: a randomized clinical trial

    Science.gov (United States)

    Chlan, Linda L.; Weinert, Craig R.; Heiderscheit, Annie; Tracy, Mary Fran; Skaar, Debra J.; Guttormson, Jill L.; Savik, Kay

    2013-01-01

    Context Alternatives to sedative medications are needed to reduce anxiety in mechanically ventilated patients. Music is an integrative therapy without adverse effects that may alleviate the anxiety associated with ventilatory support. Objective To test whether patient-directed, self-initiated music listening can reduce anxiety and sedative exposure during ventilatory support in critically ill patients as compared with 2 control conditions. Design, Setting, and Patients Randomized, controlled trial that enrolled 373 ICU patients from the Minneapolis-St. Paul area receiving acute mechanical-ventilatory support for respiratory failure between September 2006 and March 2011. Patients were Caucasian (86%), female (52%), with mean age 59 (SD 14), APACHE III 63 (SD 21.6), on protocol 5.7 (SD 6.4) days. Intervention Patients (1) self-initiated music listening (patient-directed music; PDM) with preferred selections tailored by a music therapist whenever desired while receiving ventilatory support, (2) self-initiated use of noise-abating headphones (HP), or (3) received usual ICU care (UC). Main Outcome Measures Daily assessments of anxiety (100-mm visual analog scale) and two aggregate measure of sedative exposure (sedation intensity and sedation frequency). Results Mixed-models analysis showed that PDM patients had decreased levels of anxiety compared with the UC group of −19.5 (p=.003). By the fifth study day anxiety was reduced by 36.5% in PDM patients. The interaction between treatment and time showed PDM significantly reduced both measures of sedative exposure. PDM reduced sedation intensity by −.18 (−.36, −.004) points per day and frequency by −.21 (−.37, −.05) points per day compared to UC (p = .05, .01 respectively). PDM reduced sedation frequency by −.18 (−.36, −.004) points per day compared to HP (p = .04). By the fifth study day, PDM patients received two fewer sedative doses (reduction of 38%) and had a reduction of 36% in sedation intensity

  17. Psychological adjustment to twins after infertility.

    Science.gov (United States)

    Klock, Susan C

    2004-08-01

    The birth of twins and other multiples is physically and emotionally stressful. The increase in the use of the assisted reproductive technologies has lead to an exponential increase in the rates of twins and triplets in the US. Whereas the medical complications of twins and other multiples has been well studied, the psychological and social implications of these events has not. Very little empirical research has been conducted to assess the differential impact of twins, as compared to singletons, on maternal adjustment, postpartum depression and marital functioning. In addition, assessment of infant health, disposition and behavior and its relation to maternal adjustment is lacking. The birth of twins after a period of infertility complicates the clinical picture and the impact of infertility on subsequent parental adjustment is only beginning to be understood. Although research suggests that infertile couples often desire multiples, the experience of parenting multiples after infertility has not been studied. Research on fertile couples indicate that: (i) approximately 10% of women develop postpartum depression and; (ii) marital adjustment declines after the birth of the first child. Because of the unique demands of parenting multiples, it is hypothesized that mothers of twins who have a history of infertility would be at increased risk for depression and marital decline. Descriptive studies of these families support this view, although additional studies are needed to determine the degree and extent of the problem. Additionally, variables such as, prepregnancy adjustment, equitable division of child-care tasks and perceived social support should be studied to determine if they buffer against the expected effects.

  18. 43 CFR 12.91 - Later disallowances and adjustments.

    Science.gov (United States)

    2010-10-01

    ... Section 12.91 Public Lands: Interior Office of the Secretary of the Interior ADMINISTRATIVE AND AUDIT REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Uniform Administrative Requirements for Grants and... and adjustments. The closeout of a grant does not affect: (a) The Federal agency's right to disallow...

  19. 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

  20. Impact of training at ventilatory threshold on cardiopulmonary and functional capacity in overweight patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Danilo Takashi Aoike

    2012-06-01

    Full Text Available INTRODUCTION: Chronic kidney disease (CKD and obesity are both associated with reduced physical capacity. The potential benefit of aerobic training on physical capacity has been recognized. The exercise intensity can be established using different methods mostly subjective or indirect. Ventilatory threshold (VT is a direct and objective method that allows prescribing exercise intensity according to individual capacity. OBJECTIVES: To evaluate the impact of aerobic training at VT intensity on cardiopulmonary and functional capacities in CKD patients with excess of body weight. METHODS: Ten CKD patients (eight men, 49.7 ± 10.1 years; BMI 30.4 ± 3.5 kg/m², creatinine clearance 39.4 ± 9.8 mL/min/1.73 m² underwent training on a treadmill three times per week during 12 weeks. Cardiopulmonary capacity (ergoespirometry, functional capacity and clinical parameters were evaluated. RESULTS: At the end of 12 weeks, VO2PEAK increased by 20%, and the speed at VO2PEAK increased by 16%. The training resulted in improvement in functional capacity tests, such as six-minute walk test (9.2%, two-minute step test (20.3%, arm curl test (16.3%, sit and stand test (35.7%, and time up and go test (15.3%. In addition, a decrease in systolic and diastolic blood pressures was observed despite no change in body weight, sodium intake and antihypertensive medication. CONCLUSION: Aerobic exercise performed at VT intensity improved cardipulmonary and functional capacities of overweight CKD patients. Additional benefit on blood pressure was observed. These results suggest that VT can be effectively applied for prescribing exercise intensity in this particular group of patients.

  1. Do gender differences exist in the ventilatory response to progressive exercise in males and females of average fitness?

    Science.gov (United States)

    Kilbride, Emma; McLoughlin, Paul; Gallagher, Charles G; Harty, Helen R

    2003-08-01

    Gender differences in lung volumes and flow rates, and in respiratory control have been documented previously. How these gender differences affect exercise responses in normal subjects is less clear, particularly as many studies involved highly fit subjects. This study aimed to investigate potential gender differences occurring during progressive exercise in healthy males and females of average fitness. Fourteen males and ten females of mean (SD) age 23 (0.35) years completed a progressive exercise test to exhaustion on a cycle ergometer, with a ramp increase of 15 W min(-1) (female) or 20 W min(-1) (male). All females were studied during the follicular phase of their menstrual cycle. Cardiorespiratory variables were measured, breath by breath, and values were compared at rest, at 40 W, at physiologically equivalent workloads below, at and above the gas exchange threshold and at peak oxygen uptake (VO(2peak)). Mean VO(2peak) (SEM) was 32.4 (2.01) ml kg(-1) min(-1) for the females and 41.9 (1.80) ml kg(-1) min(-1) for the males. Females had a significantly lower end-tidal partial CO(2) pressure at rest and throughout exercise. Increases in exercise minute ventilation were achieved by a significantly greater tidal volume in males, whereas females adopted a significantly greater breathing frequency. Ratings of respiratory discomfort were significantly greater in the male group at physiologically equivalent workloads compared to the female group. This study shows gender differences exist in the ventilatory and sensory response to progressive exercise in untrained subjects. Further work is required to ascertain if these effects are altered during the luteal phase of the menstrual cycle.

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

    Directory of Open Access Journals (Sweden)

    N Clark

    2003-03-01

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

  3. An investigation into the relationship between heart rate variability and the ventilatory threshold in healthy moderately trained males.

    Science.gov (United States)

    Grannell, Andrew; De Vito, Giuseppe

    2017-05-04

    During incremental exercise, heart rate variability (HRV) has been shown to display distinct stabilization and inflection points, which have been used to indirectly detect the ventilatory threshold (VT). Ten moderately trained males (26·5 ± 5·9 years: VO2peak 48·7 ± 4·1 ml min(-1 ) kg(-1) ) performed an incremental test on a cycle ergometer until volitional exhaustion with both R-R intervals and respiratory indices recorded. HRV was quantified using both nonlinear (Poincare plot; short-term variability SD1) and spectral analysis of the R-R intervals (high-frequency component; HFp). The VT was identified using the V-slope method. The relationship between HRV parameters and the VT was assessed using both a paired t-test and Pearson's product correlation. In addition, Bland and Altman plots were used to quantify the mean difference along with a 95% confidence interval. When expressed as the corresponding heart rate values, both the SD1 and the HFp stabilization points revealed a strong (r = 0·86 and 0·087, respectively) correlation with the VT. However, only for SD1 this relationship was different to the VT (t-test). The Bland-Altman plots supported these findings showing wide limits of agreement present for SD1 and the VT whilst the relationship between HFp and the VT revealed narrower limits. There does not appear to be a relationship present between the VT and the SD1 stabilization point in moderately trained healthy males, whereas the HFp stabilization point revealed a strong relationship with the VT when expressed as heart rate. © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  4. Psychological adjustment to chronic disease.

    Science.gov (United States)

    de Ridder, Denise; Geenen, Rinie; Kuijer, Roeline; van Middendorp, Henriët

    2008-07-19

    This Review discusses physiological, emotional, behavioural, and cognitive aspects of psychological adjustment to chronic illness. Reviewing the reports of the past decade, we identify four innovative and promising themes that are relevant for understanding and explaining psychological adjustment. In particular, the emphasis on the reasons why people fail to achieve a healthy adjustment has shifted to the identification of factors that help patients make that adjustment. To promote psychological adjustment, patients should remain as active as is reasonably possible, acknowledge and express their emotions in a way that allows them to take control of their lives, engage in self-management, and try to focus on potential positive outcomes of their illness. Patients who can use these strategies have the best chance of successfully adjusting to the challenges posed by a chronic illness.

  5. 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....

  6. Adjustment computations spatial data analysis

    CERN Document Server

    Ghilani, Charles D

    2011-01-01

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

  7. 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…

  8. Convexity Adjustments for ATS Models

    DEFF Research Database (Denmark)

    Murgoci, Agatha; Gaspar, Raquel M.

    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...

  9. 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…

  10. [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.

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

    Science.gov (United States)

    Scheeren, Caio Fernando Cavanus; Gonçalves, José Júlio Saraiva

    2016-01-01

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

  12. Adjusted Clinical Groups: a patient classification system through risk adjustment

    OpenAIRE

    Sicras-Mainar, Antonio; Dirección de Planificación, Badalona Serveis Assistencials. Barcelona, España. Médico doctor en Medicina, especialista en Salud Pública.; Navarro-Artieda, Ruth; Hospital Germans Trías i Pujol. Badalona, Barcelona, España. médica especialista en Documentación Médica.

    2014-01-01

    Adjusted Clinical Groups (ACG) are risk adjustment systems that classify people according to their age, sex and medical conditions, these people have a similar consumption of health resources over a given period of time. They were developed by Starfield and Weiner (Johns Hopkins University, USA, 1991), and their objective is to measure the degree of illness among patients based on the levels of comorbidity. Their main applications are: a) the evaluation of the efficiency in the use of hea...

  13. 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 .

  14. 77 FR 61423 - Notice of Adjustment of Statewide Per Capita Impact Indicator

    Science.gov (United States)

    2012-10-09

    ... SECURITY Federal Emergency Management Agency Notice of Adjustment of Statewide Per Capita Impact Indicator... statewide per capita impact indicator under the Public Assistance program for disasters declared on or after... indicator under the Public Assistance program to reflect changes in the Consumer Price Index for All Urban...

  15. 76 FR 63936 - Notice of Adjustment of Statewide Per Capita Impact Indicator

    Science.gov (United States)

    2011-10-14

    ... SECURITY Federal Emergency Management Agency Notice of Adjustment of Statewide Per Capita Impact Indicator... statewide per capita impact indicator under the Public Assistance program for disasters declared on or after... indicator under the Public Assistance program to reflect changes in the Consumer Price Index for All Urban...

  16. 75 FR 62135 - Notice of Adjustment of Statewide Per Capita Impact Indicator

    Science.gov (United States)

    2010-10-07

    ... SECURITY Federal Emergency Management Agency Notice of Adjustment of Statewide Per Capita Impact Indicator... statewide per capita impact indicator under the Public Assistance program for disasters declared on or after... indicator under the Public Assistance program to reflect changes in the Consumer Price Index for All Urban...

  17. 75 FR 62135 - Notice of Adjustment of Countywide Per Capita Impact Indicator

    Science.gov (United States)

    2010-10-07

    ... SECURITY Federal Emergency Management Agency Notice of Adjustment of Countywide Per Capita Impact Indicator... countywide per capita impact indicator under the Public Assistance program for disasters declared on or after... the countywide per capita impact indicator under the Public Assistance program to reflect annual...

  18. Normal Stress or Adjustment Disorder?

    Science.gov (United States)

    ... and symptoms of an adjustment disorder can include: Anxiety Poor school or work performance Relationship problems Sadness Thoughts of suicide Worry Trouble sleeping If you're dealing with a stressful situation in your life, try ...

  19. Normal Stress or Adjustment Disorder?

    Science.gov (United States)

    ... Lifestyle Stress management What's the difference between normal stress and an adjustment disorder? Answers from Daniel K. Hall-Flavin, M.D. Stress is a normal psychological and physical reaction to ...

  20. Household Adjustments to Hurricane Katrina

    National Research Council Canada - National Science Library

    Meri Davlasheridze; Qin Fan

    2017-01-01

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

  1. 76 FR 63936 - Notice of Adjustment of Countywide Per Capita Impact Indicator

    Science.gov (United States)

    2011-10-14

    ... SECURITY Federal Emergency Management Agency Notice of Adjustment of Countywide Per Capita Impact Indicator... countywide per capita impact indicator under the Public Assistance program for disasters declared on or after...-wide per capita indicator to evaluate the impact of the disaster at the county level. FEMA will adjust...

  2. 78 FR 64232 - Notice of Adjustment of Statewide Per Capita Impact Indicator

    Science.gov (United States)

    2013-10-28

    ... SECURITY Federal Emergency Management Agency Notice of Adjustment of Statewide Per Capita Impact Indicator... statewide per capita impact indicator under the Public Assistance program for disasters declared on or after... INFORMATION: 44 CFR 206.48 provides that FEMA will adjust the statewide per capita impact indicator under the...

  3. 77 FR 61011 - Notice of Adjustment of Countywide Per Capita Impact Indicator

    Science.gov (United States)

    2012-10-05

    ... SECURITY Federal Emergency Management Agency Notice of Adjustment of Countywide Per Capita Impact Indicator... countywide per capita impact indicator under the Public Assistance program for disasters declared on or after... capita indicator to evaluate the impact of the disaster at the county level. FEMA will adjust the...

  4. 78 FR 64231 - Notice of Adjustment of Countywide Per Capita Impact Indicator

    Science.gov (United States)

    2013-10-28

    ... SECURITY Federal Emergency Management Agency Notice of Adjustment of Countywide Per Capita Impact Indicator... countywide per capita impact indicator under the Public Assistance program for disasters declared on or after... capita indicator to evaluate the impact of the disaster at the county level. FEMA will adjust the...

  5. 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

  6. Effects of patient-directed music intervention on anxiety and sedative exposure in critically ill patients receiving mechanical ventilatory support: a randomized clinical trial.

    Science.gov (United States)

    Chlan, Linda L; Weinert, Craig R; Heiderscheit, Annie; Tracy, Mary Fran; Skaar, Debra J; Guttormson, Jill L; Savik, Kay

    2013-06-12

    Alternatives to sedative medications, such as music, may alleviate the anxiety associated with ventilatory support. To test whether listening to self-initiated patient-directed music (PDM) can reduce anxiety and sedative exposure during ventilatory support in critically ill patients. Randomized clinical trial that enrolled 373 patients from 12 intensive care units (ICUs) at 5 hospitals in the Minneapolis-St Paul, Minnesota, area receiving acute mechanical ventilatory support for respiratory failure between September 2006 and March 2011. Of the patients included in the study, 86% were white, 52% were female, and the mean (SD) age was 59 (14) years. The patients had a mean (SD) Acute Physiology, Age and Chronic Health Evaluation III score of 63 (21.6) and a mean (SD) of 5.7 (6.4) study days. Self-initiated PDM (n = 126) with preferred selections tailored by a music therapist whenever desired while receiving ventilatory support, self-initiated use of noise-canceling headphones (NCH; n = 122), or usual care (n = 125). Daily assessments of anxiety (on 100-mm visual analog scale) and 2 aggregate measures of sedative exposure (intensity and frequency). Patients in the PDM group listened to music for a mean (SD) of 79.8 (126) (median [range], 12 [0-796]) minutes/day. Patients in the NCH group wore the noise-abating headphones for a mean (SD) of 34.0 (89.6) (median [range], 0 [0-916]) minutes/day. The mixed-models analysis showed that at any time point, patients in the PDM group had an anxiety score that was 19.5 points lower (95% CI, -32.2 to -6.8) than patients in the usual care group (P = .003). By the fifth study day, anxiety was reduced by 36.5% in PDM patients. The treatment × time interaction showed that PDM significantly reduced both measures of sedative exposure. Compared with usual care, the PDM group had reduced sedation intensity by -0.18 (95% CI, -0.36 to -0.004) points/day (P = .05) and had reduced frequency by -0.21 (95% CI, -0.37 to -0.05) points/day (P

  7. [Adjustment disorder during military service].

    Science.gov (United States)

    Kamrowska, Anna; Florkowski, Antoni

    2008-01-01

    Adjustment disorders in soldiers of mandatory military service are one of most frequent causes of early military discharges. Their occurrence brings about economic, social and medical consequences. The analysis of reasons and circumstances for adjustment disorders in solders of mandatory military service accepted by Medical Military Boards as unfit for military service. Studies included 91 cases of soldiers of mandatory military service hospitalised at the Psychiatry Clinical Department of Psychiatry in 10th Clinical Military Hospital in Bydgoszcz for the occurrence of symptoms of adjustment disorder acc. to criteria ICD-10 and certified by Medical Military Boards. The examined soldiers were at the age of 19-24, and the period of their military service ranged from one week to three months. To evaluate statistical correlations chi-square test (chi2) was used. Before the call-up, more than a half of the soldiers revealing symptoms of adjustment disorder lived in the country or in big urban agglomerations. Those soldiers had primary or vocational education certificates and every third was brought up in one-parent family. In the tested population of soldiers there was found a statistical relation between the appearance of adjustment disorders and the education of soldiers' mothers, parents' diseases and factors impeding their military service. Factors conducive to adjustment disorders under conditions of mandatory military service in the studies carried out included: education of soldiers' mothers, raised difficulties while serving in the army and parents' diseases.

  8. 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

  9. Fiscal Adjustment in IMF-Supported Adjustment Programmes: The ...

    African Journals Online (AJOL)

    Fiscal adjustment is an essential element of macro-economic stability and economic growth. Given that economic growth is the most powerful weapon in the fight for higher living standards, poor growth performance in African countries, has been a challenge to economists, policy makers and international development ...

  10. GPU Parallel Bundle Block Adjustment

    Directory of Open Access Journals (Sweden)

    ZHENG Maoteng

    2017-09-01

    Full Text Available To deal with massive data in photogrammetry, we introduce the GPU parallel computing technology. The preconditioned conjugate gradient and inexact Newton method are also applied to decrease the iteration times while solving the normal equation. A brand new workflow of bundle adjustment is developed to utilize GPU parallel computing technology. Our method can avoid the storage and inversion of the big normal matrix, and compute the normal matrix in real time. The proposed method can not only largely decrease the memory requirement of normal matrix, but also largely improve the efficiency of bundle adjustment. It also achieves the same accuracy as the conventional method. Preliminary experiment results show that the bundle adjustment of a dataset with about 4500 images and 9 million image points can be done in only 1.5 minutes while achieving sub-pixel accuracy.

  11. Acculturation, personality, and psychological adjustment.

    Science.gov (United States)

    Ahadi, Stephan A; Puente-Díaz, Rogelio

    2011-12-01

    Two studies investigated relationships between traditional indicators of acculturation, cultural distance, acculturation strategies, and basic dimensions of personality as they pertain to psychological adjustment among Hispanic students. Although personality characteristics have been shown to be important determinants of psychological well-being, acculturation research has put less emphasis on the role of personality in the well-being of immigrants. Hierarchical regression analysis showed that basic dimensions of personality such as extraversion and neuroticism were strongly related to psychological adjustment. Acculturation strategies did not mediate the effect of personality variables, but cultural resistance made a small, independent contribution to the explanation of some aspects of negative psychological adjustment. The implications of the results were discussed.

  12. Bicultural Efficacy and College Adjustment.

    Science.gov (United States)

    Coleman, Hardin L. K.; And Others

    The retention of ethnic minorities is a major problem in American colleges and universities. This study deals with the factors that affect adjustment to college and, in particular, to achievement of "bicultural efficacy" for this group. Bicultural efficacy is defined as an individual's expectations that he or she can (or cannot) manage the stress…

  13. 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...

  14. 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...

  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. Comparing four non-invasive methods to determine the ventilatory anaerobic threshold during cardiopulmonary exercise testing in children with congenital heart or lung disease.

    Science.gov (United States)

    Visschers, Naomi C A; Hulzebos, Erik H; van Brussel, Marco; Takken, Tim

    2015-11-01

    The ventilatory anaerobic threshold (VAT) is an important method to assess the aerobic fitness in patients with cardiopulmonary disease. Several methods exist to determine the VAT; however, there is no consensus which of these methods is the most accurate. To compare four different non-invasive methods for the determination of the VAT via respiratory gas exchange analysis during a cardiopulmonary exercise test (CPET). A secondary objective is to determine the interobserver reliability of the VAT. CPET data of 30 children diagnosed with either cystic fibrosis (CF; N = 15) or with a surgically corrected dextro-transposition of the great arteries (asoTGA; N = 15) were included. No significant differences were found between conditions or among testers. The RER = 1 method differed the most compared to the other methods, showing significant higher results in all six variables. The PET-O2 method differed significantly on five of six and four of six exercise variables with the V-slope method and the VentEq method, respectively. The V-slope and the VentEq method differed significantly on one of six exercise variables. Ten of thirteen ICCs that were >0.80 had a 95% CI > 0.70. The RER = 1 method and the V-slope method had the highest number of significant ICCs and 95% CIs. The V-slope method, the ventilatory equivalent method and the PET-O2 method are comparable and reliable methods to determine the VAT during CPET in children with CF or asoTGA. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  17. Adjunctive dexmedetomidine therapy in the intensive care unit: a retrospective assessment of impact on sedative and analgesic requirements, levels of sedation and analgesia, and ventilatory and hemodynamic parameters.

    Science.gov (United States)

    MacLaren, Robert; Forrest, Laurel K; Kiser, Tyree H

    2007-03-01

    To determine if adjunctive dexmedetomidine therapy in intensive care patients alters requirements for and levels of sedation and analgesia, and to describe hemodynamic and ventilatory parameters. Retrospective, noncontrolled, descriptive study of clinical practice. Four intensive care units (ICUs; medical, surgical, neurosurgical, or burn) in a university-affiliated medical center. Forty patients who were already receiving sustained use of propofol, lorazepam, or fentanyl when dexmedetomidine was started. Medical records were identified by searching the pharmacy database for patients who had received continuous-infusion dexmedetomidine from January 2000-January 2003 while in one of the four ICUs. Primary end points were discontinuation or dosage reduction of other sedatives or fentanyl from the hour before to 6 hours after starting dexmedetomidine. Other outcomes included levels of sedation and analgesia before and after dexmedetomidine and description of ventilatory and hemodynamic parameters. The initial dexmedetomidine rate of 0.4 +/- 0.25 microg/kg/hour changed minimally through 47.4 +/- 61.1 infusion hours. At 6 hours, 11 of 13 patients receiving propofol, 14 of 23 receiving lorazepam, and 4 of 30 receiving fentanyl had the respective agent discontinued. With dexmedetomidine, the hourly rates and cumulative daily doses were reduced only for propofol. Adequate sedation occurred at rates of 64.6% and 47.9% during the 24-hour periods before and after dexmedetomidine was started, respectively (p=0.001). Four and 12 patients had severe agitation before and after, respectively (p=0.05). One and 12 patients had severe pain before and after, respectively (p=0.02). Nine patients experienced hypotension or bradycardia. Twenty-two patients were successfully extubated within 24 hours of starting dexmedetomidine. Adjunctive dexmedetomidine reduces sedative requirements but does not alter analgesic requirements. However, dexmedetomidine was associated with enhanced

  18. 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)

  19. Congenital anomalies after assisted reproductive technology

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  20. Hydrodynamic characterisation of ventricular assist devices

    NARCIS (Netherlands)

    Vandenberghe, S; Segers, P; Meyns, B; Verdonck, P

    A new mock circulatory system (MCS) was designed to evaluate and characterise the hydraulic performance of ventricular assist devices (VADs). The MCS consists of a preload section and a multipurpose afterload section, with an adjustable compliance chamber (C) and peripheral resistor (Rd as principal

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

    NARCIS (Netherlands)

    Oosterhuis, D.S.

    2013-01-01

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

  2. Homelessness Assistance and Resources

    Science.gov (United States)

    ... Email Updates Need Housing Assistance? Home Homelessness Assistance Homelessness Assistance Programs CoC CoC Program Page NOFAs Laws, ... VI UT VT VA WA WV WI WY Homelessness Declines in Most Communities of the U.S. with ...

  3. Adjustment in the World Economy

    OpenAIRE

    Paul Krugman

    1987-01-01

    There is a widespread view that world payments imbalances can be remedied through increased demand in surplus countries and reduced demand in deficit countries, without any need for real exchange rate changes. In fact shifts in demand and real exchange rate adjustment are necessary couplets, not substitutes. The essential reason for this complementarity is that a much higher fraction of a marginal dollar of US than of foreign spending falls on US output. As a result, a redistribution of world...

  4. Personal Assistant for onLine Services: Addressing human factors

    NARCIS (Netherlands)

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

    2003-01-01

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

  5. 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.

  6. 78 FR 68025 - Notice of Petitions by Firms for Determination of Eligibility To Apply for Trade Adjustment...

    Science.gov (United States)

    2013-11-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE... for Trade Adjustment Assistance AGENCY: Economic Development Administration, Department of Commerce..., Inc 201 Daktronics Drive, 11/06/2013 The firm manufactures Brookings, SD 57006. electronic sign...

  7. 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 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.

  8. 24 CFR 882.410 - Rent adjustments.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Rent adjustments. 882.410 Section... Policies § 882.410 Rent adjustments. (a) Annual and special adjustments. Contract Rents will be adjusted as... schedule of Contract Rents, provided that the unit is in decent, safe, and sanitary condition and that the...

  9. 12 CFR 19.240 - Inflation adjustments.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Inflation adjustments. 19.240 Section 19.240... PROCEDURE Civil Money Penalty Inflation Adjustments § 19.240 Inflation adjustments. (a) The maximum amount... Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note) as follows: ER10NO08.001 (b) The...

  10. Adjusting to University: The Hong Kong Experience

    Science.gov (United States)

    Yau, Hon Keung; Sun, Hongyi; Cheng, Alison Lai Fong

    2012-01-01

    Students' adjustment to the university environment is an important factor in predicting university outcomes and is crucial to their future achievements. University support to students' transition to university life can be divided into three dimensions: academic adjustment, social adjustment and psychological adjustment. However, these…

  11. Noogenic psychological characteristics and adjustment

    Directory of Open Access Journals (Sweden)

    Robert Masten

    2005-02-01

    Full Text Available The present article is concerned with noogenic personality characteristics of adolescents involved in military training in relation to psychic and psychosomatic symptoms. A selected sample of 107 conscripts was questioned regarding their psychical and psychosomatic symptoms in the first and in the sixth month of their military training. They were also questioned regarding personal meaning of life, as well as regarding their values and attitudes toward the army. Individuals maintaining their personal meaning of life, have less psychical and psychosomatic symptoms after coming to army than the others. The findings do not support the hypothesis that after five months of military training the number of symptoms decreases. In most participants the symptoms mostly remained at the same level after five months of training, for one third of respondents the number of symptoms increased significantly. In 9 % of military recruits number of symptoms decreased. The evaluation of differences in the number of symptoms between two assessments showed, that personal meaning, values and attitudes toward army discriminate the groups with different levels of adjustment to military service. Participants with the same level of symptoms after five months are less hedonistic, have more positive attitudes toward army and higher rates on meaning scales. The data are interpreted in the context of theory that adjustment to stressing life events is mediated by noogenic personality characteristics.

  12. Ventilatory changes during the use of heat and moisture exchangers in patients submitted to mechanical ventilation with support pressure and adjustments in ventilation parameters to compensate for these possible changes: a self-controlled intervention study in humans.

    Science.gov (United States)

    Lucato, Jeanette Janaina Jaber; Cunha, Thiago Marraccini Nogueira da; Reis, Aline Mela Dos; Picanço, Patricia Salerno de Almeida; Barbosa, Renata Cléia Claudino; Liberali, Joyce; Righetti, Renato Fraga

    2017-01-01

    To evaluate the possible changes in tidal volume, minute volume and respiratory rate caused by the use of a heat and moisture exchanger in patients receiving pressure support mechanical ventilation and to quantify the variation in pressure support required to compensate for the effect caused by the heat and moisture exchanger. Patients under invasive mechanical ventilation in pressure support mode were evaluated using heated humidifiers and heat and moisture exchangers. If the volume found using the heat and moisture exchangers was lower than that found with the heated humidifier, an increase in pressure support was initiated during the use of the heat and moisture exchanger until a pressure support value was obtained that enabled the patient to generate a value close to the initial tidal volume obtained with the heated humidifier. The analysis was performed by means of the paired t test, and incremental values were expressed as percentages of increase required. A total of 26 patients were evaluated. The use of heat and moisture exchangers increased the respiratory rate and reduced the tidal and minute volumes compared with the use of the heated humidifier. Patients required a 38.13% increase in pressure support to maintain previous volumes when using the heat and moisture exchanger. The heat and moisture exchanger changed the tidal and minute volumes and respiratory rate parameters. Pressure support was increased to compensate for these changes.

  13. 78 FR 64523 - Notice of Maximum Amount of Assistance Under the Individuals and Households Program

    Science.gov (United States)

    2013-10-29

    ... SECURITY Federal Emergency Management Agency Notice of Maximum Amount of Assistance Under the Individuals... gives notice of the maximum amount for assistance under the Individuals and Households Program for... annually adjust the maximum amount for assistance provided under the Individuals and Households Program...

  14. 75 FR 62136 - Notice of Maximum Amount of Assistance Under the Individuals and Households Program

    Science.gov (United States)

    2010-10-07

    ... SECURITY Federal Emergency Management Agency Notice of Maximum Amount of Assistance Under the Individuals... gives notice of the maximum amount for assistance under the Individuals and Households Program for... annually adjust the maximum amounts for assistance provided under the Individuals and Households (IHP...

  15. Neighborhood Assets and Adolescent Adjustment

    Directory of Open Access Journals (Sweden)

    Alfredo Oliva Delgado

    2011-12-01

    Full Text Available This paper presents the results of a study analyzing the relationship between some dimensions or developmental assets in the neighborhood, as measured by the Scale for the Assessment of Developmental Assets in the Neighborhood, and adjustment and life satisfaction of adolescent boys and girls. The sample consisted of 2400 adolescents (1068 boys and 1332 girls between ages 12 and 17 who were secondary students in public and private schools in Western Andalusia. The results showed significant relationships between most dimensions of the scale (youth empowerment, attachment to neighbourhood safety and social control and internalizing and externalizing problems, substance use and life satisfaction of participants. Moreover, the data provide evidence about the external validity of the scale used in the study. From the results some suggestions for intervention in the community environment are extracted.

  16. Research Design in Marital Adjustment Studies.

    Science.gov (United States)

    Croake, James W.; Lyon, Rebecca S.

    1978-01-01

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

  17. Communication and Empathy in Marital Adjustment.

    Science.gov (United States)

    Elliott, Marianne Weeks

    1982-01-01

    This study examines relationships between measures of empathy, communication, and marital adjustment and seeks information descriptive of the nature of empathy and of communication of maritally adjusted and maritally maladjusted couples. (CT)

  18. 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

  19. The ventilatory anaerobic threshold is related to, but is lower than, the critical power, but does not explain exercise tolerance at this workrate.

    Science.gov (United States)

    Okudan, N; Gökbel, H

    2006-03-01

    The aim of the present study was to investigate the relationships between critical power (CP), maximal aerobic power and the anaerobic threshold and whether exercise time to exhaustion and work at the CP can be used as an index in the determination of endurance. An incremental maximal cycle exercise test was performed on 30 untrained males aged 18-22 years. Lactate analysis was carried out on capillary blood samples at every 2 minutes. From gas exchange parameters and heart rate and lactate values, ventilatory anaerobic thresholds, heart rate deflection point and the onset of blood lactate accumulation were calculated. CP was determined with linear work-time method using 3 loads. The subjects exercised until they could no longer maintain a cadence above 24 rpm at their CP and exercise time to exhaustion was determined. CP was lower than the power output corresponding to VO2max, higher than the power outputs corresponding to anaerobic threshold. CP was correlated with VO2max and anaerobic threshold. Exercise time to exhaustion and work at CP were not correlated with VO2max and anaerobic threshold. Because of the correlations of the CP with VO2max and anaerobic threshold and no correlation of exercise time to exhaustion and work at the CP with these parameters, we conclude that exercise time to exhaustion and work at the CP cannot be used as an index in the determination of endurance.

  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. 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

  2. Adjustment to College in Students with ADHD

    Science.gov (United States)

    Rabiner, David L.; Anastopoulos, Arthur D.; Costello, Jane; Hoyle, Rick H.; Swartzwelder, H. Scott

    2008-01-01

    Objective: To examine college adjustment in students reporting an ADHD diagnosis and the effect of medication treatment on students' adjustment. Method: 1,648 first-semester freshmen attending a public and a private university completed a Web-based survey to examine their adjustment to college. Results: Compared with 200 randomly selected control…

  3. 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,

  4. 24 CFR 884.109 - Rent adjustments.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Rent adjustments. 884.109 Section... RENTAL HOUSING PROJECTS Applicability, Scope and Basic Policies § 884.109 Rent adjustments. (a) Funding... Contract Rent adjustments under this paragraph, up to the maximum amount authorized under the Contract...

  5. 24 CFR 886.112 - Rent adjustments.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Rent adjustments. 886.112 Section... for Projects With HUD-Insured and HUD-Held Mortgages § 886.112 Rent adjustments. This section applies to adjustments of the dollar amount stated in the Contract as the Maximum Unit Rent. It does not...

  6. 12 CFR 1780.80 - Inflation adjustments.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Inflation adjustments. 1780.80 Section 1780.80... 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...

  7. 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…

  8. Correlates of Children's Social Adjustment following Divorce.

    Science.gov (United States)

    Pett, Marjorie G.

    1982-01-01

    Interviewed randomly selected custodial parents (N=206). Custodial parents also completed a social adjustment scale on the criterion measure of children's adjustment. Results showed the most significant factor related to children's social adjustment was a positive relationship to the custodial parent. (Author/RC)

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    Kazuhito Yajima

    2012-01-01

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

  11. 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...

  12. Assisted Reproductive Technology (ART)

    Science.gov (United States)

    ... Cancel Close Email Share Dialog × 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, ...

  13. Glacial Isostatic Adjustment in Antarctica

    Science.gov (United States)

    Whitehouse, P. L.

    2014-12-01

    In order to determine the distribution of present-day ice mass change across the Antarctic Ice Sheet it is first necessary to remove the geodetic signal of past ice mass change. This signal arises due to the ongoing process of Glacial Isostatic Adjustment (GIA), which has traditionally been estimated by modelling the response of the Earth system to ice-sheet changes during a glacial cycle. Reconstructions of ice-sheet change are typically based on field observations relating to past ice extent and thickness, although a more recent approach has involved the use of ice-sheet models, and even coupled ice-sheet - GIA models, to reconstruct the ice-sheet history in areas where field constraints are sparse. Both methods have their limitations and in this presentation I will highlight the advantages of each and compare recently-published models to assess our current state of knowledge in the field of Antarctic GIA. I will also briefly discuss the motivation behind active areas of model development, which include the consideration of lateral variations in Earth structure and feedbacks between solid Earth, ice sheet and ocean processes. Finally, I will assess the suitability of the various data sets that are used to constrain or test Antarctic GIA models, and I will explain how combinations of data are being used to isolate the GIA signal independently of traditional modelling assumptions. Despite the clear benefits of this approach for the purposes of quantifying present-day ice mass change, it is still crucial to be able to model how GIA processes will evolve in the future. The motivation for this goal is provided by recent modelling studies, which suggest that GIA processes will be modified by, and are capable of influencing, the future dynamics of the Antarctic Ice Sheet.

  14. 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.

  15. 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.

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

    Science.gov (United States)

    2010-04-01

    ... of rent to owner. 982.520 Section 982.520 Housing and Urban Development Regulations Relating to... Rent and Housing Assistance Payment § 982.520 Regular tenancy: Special adjustment of rent to owner. (a... the rent to owner to reflect increases in the actual and necessary costs of owning and maintaining the...

  17. 76 FR 47605 - Notice of Proposed Information Collection: Comment Request; Annual Adjustment Factors (AAF) Rent...

    Science.gov (United States)

    2011-08-05

    ... (AAF) Rent Increase Requirement AGENCY: Office of the Assistant Secretary for Housing, HUD. ACTION...) Rent Increase Requirement. OMB Control Number, if applicable: 2502-0507, an extension of currently... section 8 contracts that utilize the AAF as the method of rent adjustment provide this information which...

  18. 76 FR 3926 - Notice of Funding Opportunity and Solicitation for Grant Application (SGA) for Trade Adjustment...

    Science.gov (United States)

    2011-01-21

    ... (SGA) for Trade Adjustment Assistance Community College and Career Training Grants Program AGENCY: Employment and Training Administration, Labor. ACTION: Notice of Solicitation for Grant Applications (SGA). Funding Opportunity Number: SGA/DFA PY 10-03. SUMMARY: Through this notice, the Department of Labor's...

  19. 78 FR 24236 - Notice of Availability of Funds and Solicitation for Grant Applications for Trade Adjustment...

    Science.gov (United States)

    2013-04-24

    ... Applications for Trade Adjustment Assistance Community College and Career Training Grants AGENCY: Employment and Training Administration, Labor. ACTION: Notice of Solicitation for Grant Applications. Funding Opportunity Number: SGA/DFA PY-12-10. SUMMARY: The U.S. Department of Labor (the Department) announces the...

  20. Effects of hydralazine on mouth occlusion pressure and ventilatory response to hypercapnia in patients with chronic obstructive pulmonary disease and pulmonary hypertension.

    Science.gov (United States)

    Corriveau, M L; Shepard, J W; Dolan, G F

    1987-01-01

    Hydralazine has been shown to increase minute ventilation (VE) in patients with chronic obstructive pulmonary disease and pulmonary hypertension. The mechanism by which hydralazine produces this effect has not been defined. We investigated the effects of orally administered hydralazine on hypercapnic ventilatory response (delta VE/delta PaCO2) and central respiratory drive (delta P0.1/delta PaCO2) as well as the effects on hemodynamics, ventilation, and gas exchange in 10 male patients (mean age, 59 +/- 2 yr). The patients had a severe degree of chronic air-flow obstruction (FEV1, 1.07 +/- 0.08 L) and mild pulmonary hypertension (mean pulmonary artery pressure, 25 +/- 4 mm Hg). After hydralazine, the slope of delta VE/delta PaCO2 increased by 177% (p less than 0.005), and the slope of delta P0.1/delta PaCO2 increased by 145% (p less than 0.05). Resting ventilation increased from 14.8 +/- 1.0 to 17.1 +/- 1.4 L/min (p less than 0.02), primarily as a result of increased respiratory frequency. After hydralazine, PaO2 increased from 66 +/- 4 to 70 +/- 3 mm Hg (p less than 0.05) at rest and from 54 +/- 3 to 59 +/- 3 mm Hg (p less than 0.02) during exercise. PaCO2 decreased from 46 +/- 3 to 42 +/- 3 mm Hg (p less than 0.001) at rest and from 50 +/- 3 to 45 +/- 3 mm Hg (p less than 0.001) during exercise. No change was seen in the dead space to tidal volume ratio or the degree of venous admixture. Mean pulmonary artery pressure and total pulmonary resistance both at rest and during exercise were unchanged after hydralazine.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Are first ventilatory threshold and 6-minute walk test heart rate interchangeable? A pilot study in healthy elderlies and cardiac patients.

    Science.gov (United States)

    Morard, M D; Bosquet, L; Laroche, D; Joussain, C; Besson, D; Deley, G; Casillas, J M; Gremeaux, V

    2015-04-01

    Heart rate (HR) at the ventilatory threshold (VT) is often used to prescribe exercise intensity in cardiac rehabilitation. Some studies have reported no significant difference between HR at VT and HR measured at the end of a 6-min walk test (6-MWT) in cardiac patients. The aim of this work was to assess the potential equivalence between those parameters at the individual level. Three groups of subjects performed a stress test and a 6-MWT: 22 healthy elderlies (GES, 77 ± 3.7 years), 10 stable coronary artery disease (CAD) patients (GMI, 50.9 ± 4.2 years) and 30 patients with chronic heart failure (GHF, 63.3 ± 10 years). We analyzed the correlation, mean bias, 95% confidence interval (95% CI) of the mean bias and the magnitude of the bias between 6-MWT-HR and VT-HR. There was a significant difference between 6-MWT and VT-HR in GHF (99.1 ± 8.8 vs 91.6 ± 18.6 bpm, P=0.016) but not in GES and GMI. The correlation between those 2 parameters was high for GMI (r=0.78, P30%) in GES and GHF and acceptable in GMI (8-12%). 6-MWT-HR and VT-HR do not appear interchangeable at the individual level in healthy elderlies and CHF patients. In CAD patients, further larger studies and/or the development of other walk tests could help in confirming the interest of a training prescription based on walking performance, after an exhaustive study of their cardiometabolic requirements. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  2. Adaptation and adjustment in children of transsexual parents.

    Science.gov (United States)

    White, Tonya; Ettner, Randi

    2007-06-01

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

  3. Evaluation of an adjustable epidemiologic information system.

    Directory of Open Access Journals (Sweden)

    Jiunn-Shyan Julian Wu

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

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

    Science.gov (United States)

    Kelly, J B

    1998-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Tânia D. Resener

    2001-04-01

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

  6. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Altamirano L, J

    2004-07-01

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

  8. Axion-Assisted Electroweak Baryogenesis

    CERN Document Server

    Craig, Nathaniel

    2010-01-01

    We consider a hidden-valley gauge sector, G, with strong coupling scale Lambda~TeV and CP-violating topological parameter, theta, as well as a new axion degree of freedom which adjusts theta to near zero in the current universe. If the G-sector couples to the Standard Model via weak-scale states charged under both, then in the early universe it is possible for the CP-violation due to theta (which has not yet been adjusted to zero by the hidden axion) to feed in to the SM and drive efficient baryogenesis during the electroweak (EW) phase transition, independent of the effectively small amount of CP violation present in the SM itself. While current constraints on both the new axion and charged states are easily satisfied, we argue that the LHC can investigate the vast majority of parameter space where EW-baryogenesis is efficiently assisted, while the hidden axion should comprise a significant fraction of the dark matter density. In the supersymmetric version, the ``messenger'' matter communicating between the ...

  9. Turning assistive machines into assistive robots

    Science.gov (United States)

    Argall, Brenna D.

    2015-01-01

    For decades, the potential for automation in particular, in the form of smart wheelchairs to aid those with motor, or cognitive, impairments has been recognized. It is a paradox that often the more severe a person's motor impairment, the more challenging it is for them to operate the very assistive machines which might enhance their quality of life. A primary aim of my lab is to address this confound by incorporating robotics autonomy and intelligence into assistive machines turning the machine into a kind of robot, and offloading some of the control burden from the user. Robots already synthetically sense, act in and reason about the world, and these technologies can be leveraged to help bridge the gap left by sensory, motor or cognitive impairments in the users of assistive machines. This paper overviews some of the ongoing projects in my lab, which strives to advance human ability through robotics autonomy.

  10. 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…

  11. 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 ...

  12. Consistent Occupational Preferences and Academic Adjustment

    Science.gov (United States)

    Walsh, W. Bruce; And Others

    1976-01-01

    A study explored the differences in academic adjustment variables between students who made congruent, incongruent, and undecided college major choices as measured by the Vocational Preference Inventory. Findings suggest that students in the congruent female and male groups tend to be more academically adjusted than those in the undecided male…

  13. Kuk's Model Adjusted for Protection and Efficiency

    Science.gov (United States)

    Su, Shu-Ching; Sedory, Stephen A.; Singh, Sarjinder

    2015-01-01

    In this article, we adjust the Kuk randomized response model for collecting information on a sensitive characteristic for increased protection and efficiency by making use of forced "yes" and forced "no" responses. We first describe Kuk's model and then the proposed adjustment to Kuk's model. Next, by means of a simulation…

  14. 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…

  15. 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…

  16. 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)

  17. 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.

  18. 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)

  19. Adjustment, Pollyannaism, and Attraction to Close Relationships

    Science.gov (United States)

    Scott, William A.; Peterson, Christopher

    1975-01-01

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

  20. 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,…

  1. 75 FR 4098 - Utility Allowance Adjustments

    Science.gov (United States)

    2010-01-26

    ... URBAN DEVELOPMENT Utility Allowance Adjustments AGENCY: Office of the Chief Information Officer, HUD... are required to advise the Secretary of the need for and request of a new utility allowance for... lists the following information: Title of Proposal: Utility Allowance Adjustments. OMB Approval Number...

  2. 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...

  3. 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.

  4. 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...

  5. A randomized pilot study comparing the role of PEEP, O2flow, and high-flow air for weaning of ventilatory support in very low birth weight infants.

    Science.gov (United States)

    Yang, Chang-Yo; Yang, Mei-Chin; Chu, Shih-Ming; Chiang, Ming-Chou; Lien, Reyin

    2017-09-06

    There is a lack of evidence to guide step-wise weaning of positive pressure respiratory support for premature infants. This study sought to compare the efficacy of three weaning protocols we designed to facilitate weaning of very low birth weight (VLBW, less than 1500 g) preterm infants from nasal continuous positive airway pressure (NCPAP) support. This was a prospective, randomized, controlled trial of VLBW preterm infants who received positive pressure ventilatory support in our neonatal intensive care unit (NICU) from April 2008 through March 2009. When these infants were weaned to CPAP as their last step of respiratory support, they would be randomly assigned to one of the following three groups as their further weaning methods (M): (M1) CPAP group, (M2) O 2 flow group, and (M3) air flow group. The time period they needed to wean off any kind of respiratory support, as well as the likelihood of developing relevant prematurity related morbidities, were compared among patients using different weaning modalities. 181 patients were enrolled in the study. Their gestational age (GA) and birth weight (BW) were 29.1 ± 2.5, 28.7 ± 2.4, 28.7 ± 2.4 (mean ± SD) weeks and 1142 ± 232, 1099 ± 234, 1083 ± 219 g, in M1, M2 and M3, respectively. The time (period) needed to wean off support was 16.0 ± 10.0 days (M1), 11.6 ± 6.4 days (M2), and 15.0 ± 8.9 days (M3), respectively (p = .033). Incidence of retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD) were both significantly higher in the O 2 flow group (p = .048). Although using low oxygen flow significantly shortens CPAP weaning time, it may increase risks of BPD and ROP, both known to be related to oxygen toxicity. Unless the infant has BPD and is O 2 -dependent, clinicians should consider using air flow or just splinting with no support at all when weaning NCPAP. Copyright © 2017. Published by Elsevier B.V.

  6. Role of Osmotic Adjustment in Plant Productivity

    Energy Technology Data Exchange (ETDEWEB)

    Gebre, G.M.

    2001-01-11

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

  7. Adjustment and mental health problem in prisoners

    Directory of Open Access Journals (Sweden)

    Sudhinta Sinha

    2010-01-01

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

  8. Training Teaching Assistants.

    Science.gov (United States)

    Rava, Susan

    1987-01-01

    Washington University's (Missouri) Department of Romance Languages and Literature requires its graduate teaching assistants to take a one-semester pedagogy course to ensure their competence and effectiveness as teaching assistants. The course features seminars in which goals, expectations, and learning theories are discussed and practice teaching…

  9. Agricultural Disaster Assistance

    Science.gov (United States)

    2005-08-29

    ineligible for crop insurance, and include mushrooms, floriculture , ornamental nursery, Christmas tree crops , turfgrass sod, aquaculture, and ginseng. Trees...federal crop insurance, the noninsured assistance program and emergency disaster loans. Since 1988, Congress regularly has made supplemental financial...assistance available to farmers and ranchers on an ad-hoc basis, primarily in the form of direct crop disaster payments and emergency livestock

  10. Federal disaster assistance programs

    Science.gov (United States)

    William J. Patterson

    1995-01-01

    The Robert T. Stafford Disaster Relief and Emergency Assistance Act—Public Law 93-288, as amended—is designed to provide support and assistance to citizens, state, and local government from catastrophic disasters and emergencies. The law provides support in three distinct phases, including preparedness in avoiding or minimizing the effect of a disaster, response...

  11. Service water assistance program

    Energy Technology Data Exchange (ETDEWEB)

    Munchausen, J.H. [EPRI Plant Support Engineering, Charlotte, NC (United States)

    1995-09-01

    The Service Water Assistance Program was developed to provide utility service water system engineers with a mechanism to quickly and efficiently address service water issues. Since its inception, its ability to assist utilities has resulted in a reduction in the operations and maintenance costs associated with service water systems and has provided a medium for EPRI awareness of industry service water issues.

  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. Social Assistance: Theoretical Underpinnings

    African Journals Online (AJOL)

    user

    Minas Hiruy. 90. Reflections: Social assistance: theoretical underpinnings. Minas Hiruy. 1. Key words: marginalized community, social assistance, social welfare, MDGs, development. The case of the marginalized and how society regarded or responded to the same has played a significant part in shaping human history ...

  14. A pair of diopter-adjustable eyeglasses for presbyopia correction

    Science.gov (United States)

    Wang, Lihui; Cassinelli, Alvaro; Oku, Hiromasa; Ishikawa, Masatoshi

    2014-09-01

    We describe and demonstrate a pair of diopter-adjustable eyeglasses aimed to correct presbyopia; the glasses provide a tunable optical power in the whole surface of the lens cell, eliminating the optical distortion typical of bifocal/trifocal or progressive glasses. The wearer can actively control the optical power by a simple sliding gesture on the bridge of the glasses, so that presbyopic vision can be interactively corrected. Results from a preliminary experiment showed that a presbyopia sufferer could clearly observe near and far objects under the assistant accommodation of the glasses. Designing a truly wearable system poses some challenges - none of them theoretical - so the system should be feasible in the near future.

  15. 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…

  16. Couples' patterns of adjustment to colon cancer.

    Science.gov (United States)

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

    2000-01-01

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

  17. 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...

  18. 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.

  19. Ventilatory strategy during liver transplantation

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: As measured by near infrared spectroscopy (NIRS), cerebral oxygenation (ScO2) may be reduced by hyperventilation in the anhepatic phase of liver transplantation surgery (LTx). Conversely, the brain may be subjected to hyperperfusion during reperfusion of the grafted liver. We investig...

  20. Ventilatory disorders in heart failure

    NARCIS (Netherlands)

    Güder, G.

    2017-01-01

    Introduction: Chronic obstructive pulmonary disease (COPD), heart failure (HF) or both syndromes are the most common reasons for dyspnea in the elderly. Currently there is no standard to diagnose COPD and multiple definitions (fixed ratio [GOLD], lower limit of normal [LLN]) are discussed. Further,

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

    Directory of Open Access Journals (Sweden)

    Schaller Peter

    2006-03-01

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

  2. Identifying ventilatory anaerobic threshold in children and adolescents: A literature review. DOI: http://dx.doi.org/10.5007/1980-0037.2012v14n3p343

    Directory of Open Access Journals (Sweden)

    Luciana Carletti

    2012-05-01

    Full Text Available Ventilatory anaerobic threshold (VAT has been used in research to represent pulmonary function and submaximal performance capacity of children and adolescents. This study aimed to identify: a the group of children and adolescents that has been the main focus of research; b the criteria most commonly used to determine VAT; and c the main references that have been used to support the theoretical analysis. A literature search was conducted using LILACS, MEDLINE/PubMed, and SciELO. The search was limited to studies using VAT in their methodology, published between 2000 and 2010, in order to identify categories through content analysis. Descriptive statistics were used to analyze the data. Forty-five studies were found and distributed according to categories identified, as follows: severe exercise intolerance (23 [51%]; healthy subjects (6 [13%]; obese subjects and comparison of methodologies (4 [9%], each; O2 kinetics (3 [7%]; sports (2 [4%]; stunting, asthma, and effort perception (1 [2%], each. The main reference used is Beaver WL, Wasserman K, Whipp BJ (1986, cited in 24 (53% studies, and the main criterion for VAT determination is the V-slope method. In addition to this method, ventilatory equivalents for O2 and CO2 have been used, accounting for 37% (17 of cases. In conclusion, the dataindicate that VAT has been primarily used in rehabilitation studies including children and adolescents by the V-slope method.

  3. Adjustment problems and residential care environment

    National Research Council Canada - National Science Library

    Jan Sebastian Novotný

    2015-01-01

    .... The paper analyzes of the presence of adjustment problems among adolescents from institutional care environment and compares this results with a population of adolescents who grew up in a family. Methods...

  4. Annual adjustments to 2013 financial benefits

    CERN Document Server

    2013-01-01

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

  5. Annual adjustments to 2014 financial benefits

    CERN Multimedia

    2013-01-01

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

  6. Conflict adjustment devoid of perceptual selection.

    Science.gov (United States)

    Wendt, Mike; Luna-Rodriguez, Aquiles; Kiesel, Andrea; Jacobsen, Thomas

    2013-09-01

    Task performance suffers when an aspect of a stimulus is associated with an incorrect response, thereby evoking cognitive conflict. Such impairment is reduced after recent or frequent conflict occurrence, suggesting attentional adjustment. We examined adjustment to conflict evoked by a temporarily irrelevant S-R rule when participants frequently switched between two semantic classification tasks by manipulating the proportion of conflict trials in one of them. Controlling stimulus-specific presentation frequencies, we found reduced conflict effects under conditions of a higher proportion of conflict trials in the task to which the manipulation was applied, whereas there was no such effect in the other task. Additional analyses demonstrated task-specificity regarding trial-to-trial conflict adjustment. Because conflict was evoked in the absence of perceptually distinct target and distractor stimulus features, these adjustment effects cannot be attributed to perceptual selection. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Marital Adjustment and Psychological Distress in Japan

    Science.gov (United States)

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

    2016-01-01

    This study was conducted to examine the association between marital adjustment and psychological distress in a large, probability sample of married adults in Japan (N = 710) from the Midlife Development in Japan (MIDJA) study. Results indicate that positive and negative dimensions of marital adjustment were significantly associated with dimensional and categorical measures of psychological distress. Furthermore, the associations between marital adjustment and psychological distress remained significant when statistically controlling for neuroticism, quality of friend and family relationships, and demographic variables. These results demonstrate that the well-established association between marital adjustment and psychological distress found in European-American countries is also found in Japan. Findings support continued research on marital functioning and psychological distress in East Asian countries. PMID:28082761

  8. 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...

  9. 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.

  10. 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.  

  11. How patients experience progressive loss of visual function: a model of adjustment using qualitative methods.

    Science.gov (United States)

    Hayeems, R Z; Geller, G; Finkelstein, D; Faden, R R

    2005-05-01

    People with retinitis pigmentosa (RP) experience functional and psychological challenges as they adjust to progressive loss of visual function. The authors aimed to understand better the process of adjusting to RP in light of the emotional suffering associated with this process. Adults with RP were recruited from the Foundation Fighting Blindness and the Wilmer Eye Institute in Baltimore. Focus groups and semistructured interviews addressed the process of adjusting to RP and were audiotaped and transcribed. The transcripts were analysed qualitatively in order to generate a model of adjustment. A total of 43 individuals participated. It was found that, on diagnosis, people with RP seek to understand its meaning in their lives. Mastering the progressive functional implications associated with RP is contingent upon shifting personal identity from a sighted to a visually impaired person. In this sample, six participants self identified as sighted, 10 self identified as in transition, and 27 self identified as visually impaired. This adjustment process can be understood in terms of a five stage model of behaviour change. The proposed model presents one way to understand the process of adjusting to RP and could assist ophthalmologists in meeting their moral obligation to lessen patients' suffering, which arises in the course of their adjustment to progressive loss of visual function.

  12. 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.

  13. Labour demand adjustment: Does foreign ownership matter?

    OpenAIRE

    Dhyne, Emmanuel; Fuss, Catherine; Claude MATHIEU

    2010-01-01

    This paper examines whether multinational companies differ in their employment adjustment from domestic firms, on the basis of a panel of Belgian firms for the period 1997-2007. We focus on incumbent firms as, in general, they account for the largest fraction of net employment creation, especially among multinational firms (MNFs). We obtain structural estimates of adjustment cost parameters for blue-collar workers and white-collar workers, domestic firms, and MNFs. We find evidence of convex,...

  14. Adjustable Fiber Optic Microwave Transversal Filters

    Science.gov (United States)

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

    1994-01-01

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

  15. Towards Adjustable Autonomy for the Real World

    OpenAIRE

    Pynadath, D. V.; Scerri, P.; Tambe, M

    2011-01-01

    Adjustable autonomy refers to entities dynamically varying their own autonomy, transferring decision-making control to other entities (typically agents transferring control to human users) in key situations. Determining whether and when such transfers-of-control should occur is arguably the fundamental research problem in adjustable autonomy. Previous work has investigated various approaches to addressing this problem but has often focused on individual agent-human interactions. Unfortunately...

  16. Simultaneous vs sequential adjustments in a duopoly

    Science.gov (United States)

    Ibrahim, Adyda; Karim, Sharmila; Zaibidi, Nerda Zura

    2014-12-01

    In a duopoly situation, two firms can move towards the equilibrium point either sequentially or simultaneously. In the case of equal costs and equal initial outputs, numerical results in this paper show the effect of simultaneous adjustment and sequential adjustment on the length of time it takes for a firm to reach the Cournot equilibrium, and the total profit accumulated up until reaching the equilibrium point.

  17. 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)....

  18. 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.

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

    Science.gov (United States)

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

    2010-12-01

    Increasing accuracy motivation (e.g., by providing monetary incentives for accuracy) often fails to increase adjustment away from provided anchors, a result that has led researchers to conclude that people do not effortfully adjust away from such anchors. We challenge this conclusion. First, we show that people are typically uncertain about which way to adjust from provided anchors and that this uncertainty often causes people to believe that they have initially adjusted too far away from such anchors (Studies 1a and 1b). Then, we show that although accuracy motivation fails to increase the gap between anchors and final estimates when people are uncertain about the direction of adjustment, accuracy motivation does increase anchor-estimate gaps when people are certain about the direction of adjustment, and that this is true regardless of whether the anchors are provided or self-generated (Studies 2, 3a, 3b, and 5). These results suggest that people do effortfully adjust away from provided anchors but that uncertainty about the direction of adjustment makes that adjustment harder to detect than previously assumed. This conclusion has important theoretical implications, suggesting that currently emphasized distinctions between anchor types (self-generated vs. provided) are not fundamental and that ostensibly competing theories of anchoring (selective accessibility and anchoring-and-adjustment) are complementary. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  20. Assisted Reproductive Technology (ART)

    Science.gov (United States)

    ... com/wp-content/uploads/2016/04/third-party-reproduction-booklet.pdf (PDF - 902 KB) [top] American Society for Reproductive Medicine. (2015). Assisted reproductive technologies: A guide for patients . Retrieved May ...

  1. Superfund Technical Assistance Grants

    Data.gov (United States)

    U.S. Environmental Protection Agency — This asset includes data related to the Superfund Technical Assistance Grant program, including grant number, award amounts, award dates, period of performance,...

  2. Accessibility and assistive products

    Science.gov (United States)

    Rodríguez-Porrero, Cristina

    2009-01-01

    Introduction Accessibility and assistive products and technologies are needed to ensure the rights of persons with disabilities and older persons. Many developments have been implemented in laws, standards, markets and from the consumers perspective, at international, European and national levels. The real issue is that not all the potential users benefit from the use of assistive products or accessible measures. Discussion Innovative methods are needed to allow all potential users to have real advantage of assistive technologies and accessible and design for all facilities. Best practices will be presented and existing gaps and recommendations will be discussed. Cost-benefits aspects will also be presented. Conclusion In order to get advantages from opportunities of globalization, hard work and responsibilities of all stakeholders are needed, so that assistive products and accessibility reach a whole range of situations and environments and contribute to ensure quality of life in a society for all.

  3. 78 FR 61390 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-10-03

    ... Department. 82,921 Staples, Inc., Human Resources Framingham, MA...... July 18, 2012. Services Division, BTHR......... August 1, 2012. Addison Group and Robert Half Accounting. 82,980 Sunrise Medical, Labor Max Staffing... date 82,959 Global Resource Services LLC....... Darrington, WA...... 83,013 Graymont St. Helens, OR...

  4. 76 FR 40400 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    Science.gov (United States)

    2011-07-08

    ..., MO. TA-W-80,118; PSC Industrial Outsourcing, LP, Kelso, WA. TA-W-80,126; Ryder Integrated Logistics..., OH. TA-W-80,131; Invensys Operations Management, Irvine, CA. TA-W-80,170; Getty Images, Los Angles...

  5. 76 FR 43350 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

    Science.gov (United States)

    2011-07-20

    ... Trade Act have been met. TA-W-80,178; Chelsea House, Inc., Gastonia, NC: May 12, 2010. TA-W-80,183; Century Furniture, LLC, Hickory, NC: November 19, 2010. TA-W-80,211; Ringo B.D., Inc., Passaic, NJ: June 1...

  6. 76 FR 58044 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-09-19

    ... Carolina. The workers cut fabric for upholstered household goods. The notice was published in the Federal... production and were impacted by an increase in imports of upholstered household goods. Accordingly, the...

  7. 76 FR 183 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-01-03

    ... requested under the Freedom of Information Act. Requests may be submitted by fax, courier services, or mail...). 74964 RR Donnelley (Company).. Crawfordsville, IN...... 12/07/10 12/01/10 74965 Ross Sand Casting...

  8. 76 FR 24914 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-05-03

    ... CSC, Managed Services New York, NY February 14, 2010. Sector Division Working at Client Sites in New... 30, 2009. Inc. 75,003 Velsicol Chemical, LLC, Memphis, TN December 15, 2009. True Specialties Corp..., Austin, TX November 1, 2009. SQA Engineering, VCS and VCS-One Group. 74,810A Symantec Corporation...

  9. 75 FR 34173 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-06-16

    ... Division, Duncan, OK: February 17, 2009 TA-W-73,092: Sun Microsystems, Inc., Oracle Corporation, Netbeans...-W-73,427: Haldex Hydraulics Corporation, Statesville Location, Leased Workers Onin Staffing and... Controls Division, Airpax Corporation, Cambridge, MD: March 25, 2010 TA-W-73,854: MSA, Englewood-Fall...

  10. 75 FR 76487 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-12-08

    ... Smurfit-Stone Container Jefferson, OH....... Corporation, Container Division. 74,626 Newell Window Athens... International Business Endicott, NY........ Machines (IBM), Global Technology Services Delivery, Band 7 Oracle...

  11. 75 FR 68623 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-11-08

    ... (Petitioners) Location institution petition 74723 Oracle America, Inc. (State/ Broomfield, CO........ 10/18/10..., NY 10/19/10 10/15/10 Corporation (State/One- Stop). 74739 Chapman Data Services Dallas, TX 10/19/10 10/08/10 (Company). 74740 Bekaert Corporation Vista, CA 10/19/10 10/14/10 (Company). 74741 Seneca...

  12. 76 FR 50269 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-08-12

    ..., Concord, CA TA-W-73,158A Siemens Medical Solutions USA, Inc., Global Services/Supply Chain Management... information provided by Seimens reveals that workers of Global Services/Supply Chain Management, Malvern..., California facility (TA-W-73,158). Global Services/Supply Chain Management, Malvern, Pennsylvania supplies...

  13. 77 FR 67400 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-11-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR...) the Department of Labor herein presents summaries of determinations regarding eligibility to apply for.../Premium Audit/ Reviewers. 82,051A Hartford Financial Services Clinton, NY October 3, 2011. Group, Inc...

  14. 77 FR 17524 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-03-26

    ... metric services. The acquisition of these services from Manila, Philippines contributed importantly to... metric services from Manila, Philippines. The amended notice applicable to TA-W-80,502 is hereby issued...

  15. 76 FR 50267 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-08-12

    ... Employment and Training Administration Amended Certification Regarding Eligibility To Apply for Worker... Corporation, Conestoga Rovers and Associates, Phillips Engineering, Rockwell Engineering, Excel Logistics, and... Associates, Phillips Engineering, Rockwell Engineering, Excel Logistics, and American Food and Vending. The...

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

    Science.gov (United States)

    2011-01-26

    ... employment decreased by 10 percent, and average productivity increased by 11 percent. The Bureau of Labor... generally applied to all certified firms. However, BLS' productivity measures relate output to the labor... $10.3 million, average employment was 73, and average productivity was $140,977 (sales per employee...

  17. 75 FR 20393 - Investigations Regarding Certifications of Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-04-19

    ...). 73747 Payroll Solutions/Synergy North Las Vegas, NV... 03/19/10 03/17/10 (Wkrs). 73748 Commercial.../08/10 (Wkrs). 73751 RHealth, LLC (STATE)....... Memphis, TN 03/19/10 03/17/10 73752 Industrial Metal...

  18. 75 FR 75699 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-12-06

    .... Industrial Controls Division; Leased Workers from Manpower Professional. 74,855 Electrolux Homecare... Impact date 73,747 Synergy Solutions of Maine, Fort Kent, ME. LLC. 74,366 Ryder Truck Rental, Inc.... 74,779 Exel-Owens Corning, Chem/ Heath, OH. Industrial. Determinations Terminating Investigations of...

  19. 78 FR 12794 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-02-25

    ... Knoxville, TN...... November 19, 2011. Corporation (IBC), Hostess Brands, Inc., Stinson Industrial.... Petsche Company, Arlington, TX......... January 29, 2012. Randstad and Synergy Services Corporation. 82...

  20. 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...

  1. 75 FR 49529 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-08-13

    ... Sedona Staffing. 73,771 Technicolor Video Cassette Detroit, MI March 1, 2009. of Michigan, Thomson, Home... Ballefontaine, OH. 74,190 Dyrsmith, LLC, DBA Auburn, CA. Precision-works Manufacturing. 74,360 CR Compressors...

  2. 77 FR 38663 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-06-28

    ... Clemens, MI...... March 22, 2011. Composing Department, A Division of Journal Register Company. 81,539 Respironics, Inc., Philips Murrysville, PA........ April 25, 2011. Healthcare, Finance and Accounting, Philips...

  3. 77 FR 29366 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-05-17

    ... (Company). 81526 Philips Healthcare/ Murrysville, PA....... 04/23/12 03/15/12 Respironics (Workers). 81527...). 81538 State Journal Register Springfield, IL....... 04/26/12 04/25/12 (State/One-Stop). 81539 Philips Healthcare/ Murrysville, PA....... 04/26/12 04/25/12 Respironic (Workers). 81540 Rock Creek Athletics, Inc...

  4. 77 FR 54931 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-09-06

    ... 202(b)(1); ] (B) An affirmative determination of market disruption or threat thereof under section 421... the petition be withdrawn. ] TA-W number Subject firm Location Impact date 81,886 Monroe Gray, dba...

  5. 77 FR 38661 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-06-28

    ... determination of market disruption or threat thereof under section 421(b)(1); or (C) An affirmative final....... Gray, ME April 26, 2011. The following certifications have been issued. The requirements of Section 222...

  6. 77 FR 40639 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-07-10

    ..., Service, Sony Supply Chain Solutions, Selectremedy, Staffmark, etc. 81,423A Sony Electronics, Inc., San... System Des Des Moines, IA........ April 6, 2011. Moines, Health Information Management Department, Iowa... produced or services supplied by such firm have increased; (B) Imports of articles like or directly...

  7. 78 FR 66783 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-11-06

    ... Abbott Laboratories (State/ Temecula, CA 09/30/13 09/27/13 One-Stop). 83127 Robert Bosch Tool Corp..., IN....... 10/17/13 09/30/13 Operations (Company). 83140 Dresser-Rand (Workers)..... Painted Post, NY...

  8. 78 FR 55759 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-09-11

    ... York, NY....... 08/19/13 08/16/13 One-Stop). 83005 Mars Petcare US, Joplin, MO......... 08/19/13 08/16/13 Incorporated (State/One- Stop). 83006 Mersen USA Bn Corp, Bay Bay City, MI....... 08/20/13 08/19... Solutions & Mason, OH 08/19/13 08/16/13 Services, Inc., Billing & Collections Dept (State/One-Stop). 83000...

  9. 78 FR 14360 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-03-05

    ...-Stop). 82443 NXP Semiconductors (Company) San Jose, CA 02/12/13 02/11/13 82444 MacDermid Printing........ 02/13/13 02/11/13 (Company). 82456 NXP Semiconductors (Company) Cary, NC 02/13/13 02/12/13 82457...).. Baltimore, MD 02/14/13 02/13/13 82463 BP Solar (State/One-Stop)... Frederick, MD 02/14/13 02/13/13 82464...

  10. 78 FR 40512 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-07-05

    ...-5428, 200 Constitution Avenue NW., Washington, DC 20210. Signed at Washington, DC, this 26th day of... (Apple Inc) (Workers). Austin, TX 06/18/13 06/11/13 82818 Propex Operating Company, Nashville, GA...

  11. 75 FR 7040 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-02-16

    ... Fashions, Montgomery, PA........ 01/07/10 01/06/10 LLC (Comp). 73222 Weyerhaeuser Longview Castle Rock, WA... 73225 Custom Hoists (Union)...... Hayesville, OH........ 01/07/10 01/05/10 73226 Freedom Communications... (State). 73233 Local Insight Yellow Pages Hudson, OH 01/08/10 01/07/10 (Wkrs). 73234 Gerber Technology...

  12. 75 FR 38144 - Investigations Regarding Certifications of Eligibility To Apply For Worker Adjustment Assistance

    Science.gov (United States)

    2010-07-01

    ... 06/08/10 06/04/10 (State/One-Stop). 74207 Wendy Fashions, Inc. New York, NY 06/08/10 05/18/10...). 74212 Freedom Communications Marysville, CA........ 06/09/10 06/08/10 (State/One-Stop). 74213 Intel...). 74216 Prudential Financial Dubuque, IA 06/09/10 06/08/10 (Workers). 74217 Honeywell Technology Phoenix...

  13. 75 FR 16987 - Trade Adjustment Assistance; Merit Staffing of State Administration and Allocation of Training...

    Science.gov (United States)

    2010-04-02

    ... methodology by which the Department allocates training funds to the States. (The TGAAA uses the term... 236(a)(2) also established a methodology for distributing TAA training funds based on a formula to be.... Some of the commenters questioning our authority asserted that requiring the use of merit staff runs...

  14. 78 FR 31593 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-05-24

    ... following must be satisfied: (A) There has been a shift by the workers' firm to a foreign country in the... workers' firm; (B) there has been an acquisition from a foreign country by the workers' firm of articles... references the impact date for all workers of such determination. The following certifications have been...

  15. 78 FR 4459 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-01-22

    ... the workers' firm to a foreign country in the production of articles or supply of services like or... from a foreign country by the workers' firm of articles/services that are like or directly competitive... foreign country) of section 222 have not been met. ] TA-W No. Subject firm Location Impact date 81,935 ING...

  16. 76 FR 28813 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-05-18

    ... those produced/supplied by the workers' firm; (B) there has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... foreign country) of section 222 have not been met. TA-W No. Subject firm Location Impact date 74,725...

  17. 78 FR 54487 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-09-04

    ... the workers' firm to a foreign country in the production of articles or supply of services like or... from a foreign country by the workers' firm of articles/services that are like or directly competitive... workers cannot be covered by more than one certification at a time. TA-W No. Subject firm Location Impact...

  18. 78 FR 18368 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-03-26

    ... those produced/supplied by the workers' firm; (B) There has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... workers cannot be covered by more than one certification at a time. TA-W No. Subject firm Location Impact...

  19. 75 FR 63509 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-10-15

    ... the workers' firm to a foreign country in the production of articles or supply of services like or... from a foreign country by the workers' firm of articles/services that are like or directly competitive... workers cannot be covered by more than one certification at a time. TA-W No. Subject firm Location Impact...

  20. 77 FR 61029 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-10-05

    ... the workers' firm to a foreign country in the production of articles or supply of services like or... from a foreign country by the workers' firm of articles/services that are like or directly competitive... workers cannot be covered by more than one certification at a time. TA-W No. Subject firm Location Impact...

  1. 78 FR 41955 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-07-12

    ... those produced/supplied by the workers' firm; (B) There has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... Employment and Training Administration Notice of Determinations Regarding Eligibility to Apply for Worker...

  2. 77 FR 63874 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-10-17

    ... those produced/supplied by the workers' firm; (B) there has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... services to a foreign country) of section 222 have not been met. TA-W No. Subject firm Location Impact date...

  3. 77 FR 64356 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-10-19

    ... the workers' firm to a foreign country in the production of articles or supply of services like or... from a foreign country by the workers' firm of articles/services that are like or directly competitive... foreign country) of section 222 have not been met. TA-W No. Subject firm Location Impact date 81,834...

  4. 77 FR 3501 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-01-24

    ... following must be satisfied: (A) There has been a shift by the workers' firm to a foreign country in the... workers' firm; (B) There has been an acquisition from a foreign country by the workers' firm of articles... references the impact date for all workers of such determination. The following certifications have been...

  5. 77 FR 17526 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-03-26

    ... those produced/supplied by the workers' firm; (B) There has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker...

  6. 76 FR 30974 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-05-27

    ...) One of the following must be satisfied: (A) There has been a shift by the workers' firm to a foreign... produced/supplied by the workers' firm; (B) There has been an acquisition from a foreign country by the... determination references the impact date for all workers of such determination. The following certifications...

  7. 77 FR 23509 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-04-19

    ...) One of the following must be satisfied: (A) There has been a shift by the workers' firm to a foreign... produced/supplied by the workers' firm; (B) There has been an acquisition from a foreign country by the... each determination references the impact date for all workers of such determination. The following...

  8. 75 FR 77666 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2010-12-13

    ... the workers' firm to a foreign country in the production of articles or supply of services like or... from a foreign country by the workers' firm of articles/services that are like or directly competitive... at a time. TA-W No. Subject firm Location Impact date 74,718 SecurAmerica, Workers On- Winston-Salem...

  9. 78 FR 28628 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-05-15

    ... those produced/supplied by the workers' firm; (B) There has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... services to a foreign country) of section 222 have not been met. TA-W No. Subject firm Location Impact date...

  10. 78 FR 47779 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-08-06

    ... those produced/supplied by the workers' firm; (B) there has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker...

  11. 77 FR 13352 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-03-06

    ... the workers' firm to a foreign country in the production of articles or supply of services like or... from a foreign country by the workers' firm of articles/services that are like or directly competitive... foreign country) of section 222 have not been met. ] TA-W No. Subject firm Location Impact date 80,454 TMI...

  12. 78 FR 37587 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-06-21

    ... those produced/supplied by the workers' firm; (B) there has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker...

  13. 76 FR 32228 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-06-03

    ... those produced/supplied by the workers' firm; (B) there has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker...

  14. 78 FR 52976 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-08-27

    ... those produced/supplied by the workers' firm; (B) there has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. TA-W No. Subject firm Location... Employment and Training Administration Notice of Determinations Regarding Eligibility to Apply for Worker...

  15. 76 FR 16448 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-03-23

    ... those produced/supplied by the workers' firm; (B) There has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker...

  16. 77 FR 19719 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-04-02

    ... those produced/supplied by the workers' firm; (B) There has been an acquisition from a foreign country... determination references the impact date for all workers of such determination. The following certifications... Employment and Training Administration Notice of Determinations Regarding Eligibility To Apply for Worker...

  17. 76 FR 2713 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-01-14

    ... the workers' firm to a foreign country in the production of articles or supply of services like or... from a foreign country by the workers' firm of articles/services that are like or directly competitive... foreign country) of section 222 have not been met. ] TA-W No. Subject firm Location Impact date 73,857 The...

  18. 78 FR 1253 - Notice of Determinations Regarding Eligibility to Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2013-01-08

    ... the workers' firm to a foreign country in the production of articles or supply of services like or... from a foreign country by the workers' firm of articles/services that are like or directly competitive... services to a foreign country) of section 222 have not been met. TA-W No. Subject firm Location Impact date...

  19. 77 FR 16070 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2012-03-19

    ... the workers' firm to a foreign country in the production of articles or supply of services like or... from a foreign country by the workers' firm of articles/services that are like or directly competitive... foreign country) of section 222 have not been met. TA-W No. Subject firm Location Impact date 81,187...

  20. 76 FR 2716 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Science.gov (United States)

    2011-01-14

    ... the workers' firm to a foreign country in the production of articles or supply of services like or... from a foreign country by the workers' firm of articles/services that are like or ] directly.... TA-W No. Subject firm Location Impact date 74,841 PSB Industries, Inc., Leased Workers from Erie, PA...