Intrarater Reliability of Muscle Strength and Hamstring to Quadriceps Strength Imbalance Ratios During Concentric, Isometric, and Eccentric Maximal Voluntary Contractions Using the Isoforce Dynamometer.

Science.gov (United States)

Mau-Moeller, Anett; Gube, Martin; Felser, Sabine; Feldhege, Frank; Weippert, Matthias; Husmann, Florian; Tischer, Thomas; Bader, Rainer; Bruhn, Sven; Behrens, Martin

2017-08-17

To determine intrasession and intersession reliability of strength measurements and hamstrings to quadriceps strength imbalance ratios (H/Q ratios) using the new isoforce dynamometer. Repeated measures. Exercise science laboratory. Thirty healthy subjects (15 females, 15 males, 27.8 years). Coefficient of variation (CV) and intraclass correlation coefficients (ICC) were calculated for (1) strength parameters, that is peak torque, mean work, and mean power for concentric and eccentric maximal voluntary contractions; isometric maximal voluntary torque (IMVT); rate of torque development (RTD), and (2) H/Q ratios, that is conventional concentric, eccentric, and isometric H/Q ratios (Hcon/Qcon at 60 deg/s, 120 deg/s, and 180 deg/s, Hecc/Qecc at -60 deg/s and Hiso/Qiso) and functional eccentric antagonist to concentric agonist H/Q ratios (Hecc/Qcon and Hcon/Qecc). High reliability: CV 0.90; moderate reliability: CV between 10% and 20%, ICC between 0.80 and 0.90; low reliability: CV >20%, ICC Strength parameters: (a) high intrasession reliability for concentric, eccentric, and isometric measurements, (b) moderate-to-high intersession reliability for concentric and eccentric measurements and IMVT, and (c) moderate-to-high intrasession reliability but low intersession reliability for RTD. (2) H/Q ratios: (a) moderate-to-high intrasession reliability for conventional ratios, (b) high intrasession reliability for functional ratios, (c) higher intersession reliability for Hcon/Qcon and Hiso/Qiso (moderate to high) than Hecc/Qecc (low to moderate), and (d) higher intersession reliability for conventional H/Q ratios (low to high) than functional H/Q ratios (low to moderate). The results have confirmed the reliability of strength parameters and the most frequently used H/Q ratios.

Characteristics of rain penetration through a gravity ventilator used for natural ventilation.

Science.gov (United States)

Kim, Taehyeung; Lee, Dong Ho; Ahn, Kwangseog; Ha, Hyunchul; Park, Heechang; Piao, Cheng Xu; Li, Xiaoyu; Seo, Jeoungyoon

2008-01-01

Gravity ventilators rely simply on air buoyancy to extract air and are widely used to exhaust air contaminants and heat from workplaces using minimal energy. They are designed to maximize the exhaust flow rate, but the rain penetration sometimes causes malfunctioning. In this study, the characteristics of rain penetration through a ventilator were examined as a preliminary study to develop a ventilator with the maximum exhaust capacity while minimizing rain penetration. A model ventilator was built and exposed to artificial rain and wind. The paths, intensities and amounts of penetration through the ventilator were observed and measured in qualitative and quantitative fashions. In the first phase, the pathways and intensities of rain penetration were visually observed. In the second phase, the amounts of rain penetration were quantitatively measured under the different configurations of ventilator components that were installed based on the information obtained in the first-phase experiment. The effects of wind speed, grill direction, rain drainage width, outer wall height, neck height and leaning angle of the outer wall from the vertical position were analyzed. Wind speed significantly affected rain penetration. Under the low crosswind conditions, the rain penetration intensities were under the limit of detection. Under the high crosswind conditions, grill direction and neck height were the most significant factors in reducing rain penetration. The installation of rain drainage was also important in reducing rain penetration. The experimental results suggest that, with proper configurations of its components, a gravity ventilator can be used for natural ventilation without significant rain penetration problems.

Field and Laboratory Testing of Approaches to Smart Whole-House Mechanical Ventilation Control

Energy Technology Data Exchange (ETDEWEB)

Martin, Eric [Florida Solar Energy Center, Cocoa, FL (United States); Fenaughty, Karen [Florida Solar Energy Center, Cocoa, FL (United States); Parker, Danny [Florida Solar Energy Center, Cocoa, FL (United States); Lubliner, Michael [Washington State Univ., Pullman, WA (United States); Howard, Luke [Washington State Univ., Pullman, WA (United States)

2018-01-15

Whole-house mechanical ventilation is a critical component to a comprehensive strategy for good indoor air quality (IAQ). However, due to lack of integration with standard heating and cooling systems, and perceptions from a portion of the homebuilding industry about risks related to increased energy use, increased cost, and decreased comfort, voluntary and code-required adoption varies amongst regions. Smart ventilation controls (SVC) balance energy consumption, comfort, and IAQ by optimizing mechanical ventilation operation to reduce the heating and/or cooling loads, improve management of indoor moisture, and maintain IAQ equivalence according to ASHRAE 62.2.

Field and Laboratory Testing of Approaches to Smart Whole-House Mechanical Ventilation Control

Energy Technology Data Exchange (ETDEWEB)

Martin, Eric [Florida Solar Energy Center, Cocoa, FL (United States); Fenaughty, Karen [Florida Solar Energy Center, Cocoa, FL (United States); Parker, Danny [Florida Solar Energy Center, Cocoa, FL (United States); Lubiner, Michael [Washington State Univ., Pullman, WA (United States); Howard, Luke [Washington State Univ., Pullman, WA (United States)

2018-01-29

Whole-house mechanical ventilation is a critical component to a comprehensive strategy for good indoor air quality (IAQ). However, due to lack of integration with standard heating and cooling systems, and perceptions from a portion of the homebuilding industry about risks related to increased energy use, increased cost, and decreased comfort, voluntary and code-required adoption varies among regions. Smart ventilation controls (SVC) balance energy consumption, comfort, and IAQ by optimizing mechanical ventilation operation to reduce the heating and/or cooling loads, improve management of indoor moisture, and maintain IAQ equivalence according to ASHRAE 62.2.

Application of mid-frequency ventilation in an animal model of lung injury: a pilot study.

Science.gov (United States)

Mireles-Cabodevila, Eduardo; Chatburn, Robert L; Thurman, Tracy L; Zabala, Luis M; Holt, Shirley J; Swearingen, Christopher J; Heulitt, Mark J

2014-11-01

Mid-frequency ventilation (MFV) is a mode of pressure control ventilation based on an optimal targeting scheme that maximizes alveolar ventilation and minimizes tidal volume (VT). This study was designed to compare the effects of conventional mechanical ventilation using a lung-protective strategy with MFV in a porcine model of lung injury. Our hypothesis was that MFV can maximize ventilation at higher frequencies without adverse consequences. We compared ventilation and hemodynamic outcomes between conventional ventilation and MFV. This was a prospective study of 6 live Yorkshire pigs (10 ± 0.5 kg). The animals were subjected to lung injury induced by saline lavage and injurious conventional mechanical ventilation. Baseline conventional pressure control continuous mandatory ventilation was applied with V(T) = 6 mL/kg and PEEP determined using a decremental PEEP trial. A manual decision support algorithm was used to implement MFV using the same conventional ventilator. We measured P(aCO2), P(aO2), end-tidal carbon dioxide, cardiac output, arterial and venous blood oxygen saturation, pulmonary and systemic vascular pressures, and lactic acid. The MFV algorithm produced the same minute ventilation as conventional ventilation but with lower V(T) (-1 ± 0.7 mL/kg) and higher frequency (32.1 ± 6.8 vs 55.7 ± 15.8 breaths/min, P ventilation and MFV for mean airway pressures (16.1 ± 1.3 vs 16.4 ± 2 cm H2O, P = .75) even when auto-PEEP was higher (0.6 ± 0.9 vs 2.4 ± 1.1 cm H2O, P = .02). There were no significant differences in any hemodynamic measurements, although heart rate was higher during MFV. In this pilot study, we demonstrate that MFV allows the use of higher breathing frequencies and lower V(T) than conventional ventilation to maximize alveolar ventilation. We describe the ventilatory or hemodynamic effects of MFV. We also demonstrate that the application of a decision support algorithm to manage MFV is feasible. Copyright © 2014 by Daedalus Enterprises.

Voluntary activation of the trapezius muscle in cases with neck/shoulder pain compared to healthy controls

DEFF Research Database (Denmark)

Bech, Katrine Tholstrup; Larsen, Camilla Marie; Sjøgaard, Gisela

2017-01-01

Subjects reporting neck/shoulder pain have been shown to generate less force during maximal voluntary isometric contractions (MVC) of the shoulder muscles compared to healthy controls. This has been suggested to be caused by a pain-related decrease in voluntary activation (VA) rather than lack of...

Changes in voluntary activation assessed by transcranial magnetic stimulation during prolonged cycling exercise.

Directory of Open Access Journals (Sweden)

Marc Jubeau

Full Text Available Maximal central motor drive is known to decrease during prolonged exercise although it remains to be determined whether a supraspinal deficit exists, and if so, when it appears. The purpose of this study was to evaluate corticospinal excitability and muscle voluntary activation before, during and after a 4-h cycling exercise. Ten healthy subjects performed three 80-min bouts on an ergocycle at 45% of their maximal aerobic power. Before exercise and immediately after each bout, neuromuscular function was evaluated in the quadriceps femoris muscles under isometric conditions. Transcranial magnetic stimulation was used to assess voluntary activation at the cortical level (VATMS, corticospinal excitability via motor-evoked potential (MEP and intracortical inhibition by cortical silent period (CSP. Electrical stimulation of the femoral nerve was used to measure voluntary activation at the peripheral level (VAFNES and muscle contractile properties. Maximal voluntary force was significantly reduced after the first bout (13 ± 9%, P<0.01 and was further decreased (25 ± 11%, P<0.001 at the end of exercise. CSP remained unchanged throughout the protocol. Rectus femoris and vastus lateralis but not vastus medialis MEP normalized to maximal M-wave amplitude significantly increased during cycling. Finally, significant decreases in both VATMS and VAFNES (∼ 8%, P<0.05 and ∼ 14%, P<0.001 post-exercise, respectively were observed. In conclusion, reductions in VAFNES after a prolonged cycling exercise are partly explained by a deficit at the cortical level accompanied by increased corticospinal excitability and unchanged intracortical inhibition. When comparing the present results with the literature, this study highlights that changes at the cortical and/or motoneuronal levels depend not only on the type of exercise (single-joint vs. whole-body but also on exercise intensity and/or duration.

Maximal Voluntary Activation of the Elbow Flexors Is under Predicted by Transcranial Magnetic Stimulation Compared to Motor Point Stimulation Prior to and Following Muscle Fatigue

Directory of Open Access Journals (Sweden)

Edward W. J. Cadigan

2017-09-01

Full Text Available Transcranial magnetic (TMS and motor point stimulation have been used to determine voluntary activation (VA. However, very few studies have directly compared the two stimulation techniques for assessing VA of the elbow flexors. The purpose of this study was to compare TMS and motor point stimulation for assessing VA in non-fatigued and fatigued elbow flexors. Participants performed a fatigue protocol that included twelve, 15 s isometric elbow flexor contractions. Participants completed a set of isometric elbow flexion contractions at 100, 75, 50, and 25% of maximum voluntary contraction (MVC prior to and following fatigue contractions 3, 6, 9, and 12 and 5 and 10 min post-fatigue. Force and EMG of the bicep and triceps brachii were measured for each contraction. Force responses to TMS and motor point stimulation and EMG responses to TMS (motor evoked potentials, MEPs and Erb's point stimulation (maximal M-waves, Mmax were also recorded. VA was estimated using the equation: VA% = (1−SITforce/PTforce × 100. The resting twitch was measured directly for motor point stimulation and estimated for both motor point stimulation and TMS by extrapolation of the linear regression between the superimposed twitch force and voluntary force. MVC force, potentiated twitch force and VA significantly (p < 0.05 decreased throughout the elbow flexor fatigue protocol and partially recovered 10 min post fatigue. VA was significantly (p < 0.05 underestimated when using TMS compared to motor point stimulation in non-fatigued and fatigued elbow flexors. Motor point stimulation compared to TMS superimposed twitch forces were significantly (p < 0.05 higher at 50% MVC but similar at 75 and 100% MVC. The linear relationship between TMS superimposed twitch force and voluntary force significantly (p < 0.05 decreased with fatigue. There was no change in triceps/biceps electromyography, biceps/triceps MEP amplitudes, or bicep MEP amplitudes throughout the fatigue protocol at

Ankle voluntary movement enhancement following robotic-assisted locomotor training in spinal cord injury.

Science.gov (United States)

Varoqui, Deborah; Niu, Xun; Mirbagheri, Mehdi M

2014-03-31

In incomplete spinal cord injury (iSCI), sensorimotor impairments result in severe limitations to ambulation. To improve walking capacity, physical therapies using robotic-assisted locomotor devices, such as the Lokomat, have been developed. Following locomotor training, an improvement in gait capabilities-characterized by increases in the over-ground walking speed and endurance-is generally observed in patients. To better understand the mechanisms underlying these improvements, we studied the effects of Lokomat training on impaired ankle voluntary movement, known to be an important limiting factor in gait for iSCI patients. Fifteen chronic iSCI subjects performed twelve 1-hour sessions of Lokomat training over the course of a month. The voluntary movement was qualified by measuring active range of motion, maximal velocity peak and trajectory smoothness for the spastic ankle during a movement from full plantar-flexion (PF) to full dorsi-flexion (DF) at the patient's maximum speed. Dorsi- and plantar-flexor muscle strength was quantified by isometric maximal voluntary contraction (MVC). Clinical assessments were also performed using the Timed Up and Go (TUG), the 10-meter walk (10MWT) and the 6-minute walk (6MWT) tests. All evaluations were performed both before and after the training and were compared to a control group of fifteen iSCI patients. After the Lokomat training, the active range of motion, the maximal velocity, and the movement smoothness were significantly improved in the voluntary movement. Patients also exhibited an improvement in the MVC for their ankle dorsi- and plantar-flexor muscles. In terms of functional activity, we observed an enhancement in the mobility (TUG) and the over-ground gait velocity (10MWT) with training. Correlation tests indicated a significant relationship between ankle voluntary movement performance and the walking clinical assessments. The improvements of the kinematic and kinetic parameters of the ankle voluntary movement

Omnidirectional ventilated acoustic barrier

Science.gov (United States)

Zhang, Hai-long; Zhu, Yi-fan; Liang, Bin; Yang, Jing; Yang, Jun; Cheng, Jian-chun

2017-11-01

As an important problem in acoustics, sound insulation finds applications in a great variety of situations. In the existing schemes, however, there has always been a trade-off between the thinness of sound-insulating devices and their ventilating capabilities, limiting their potentials in the control of low-frequency sound in high ventilation environments. Here, we design and experimentally implement an omnidirectional acoustic barrier with a planar profile, subwavelength thickness ( 0.18 λ ), yet high ventilation. The proposed mechanism is based on the interference between the resonant scattering of discrete states and the background scattering of continuous states which induces a Fano-like asymmetric transmission profile. Benefitting from the binary-structured design of the coiled unit and hollow pipe, it maximally simplifies the design and fabrication while ensuring the ventilation for all the non-resonant units with open tubes. The simulated and measured results agree well, showing the effectiveness of our proposed mechanism to block low frequency sound coming from various directions while allowing 63% of the air flow to pass. We anticipate our design to open routes to design sound insulators and to enable applications in traditionally unattainable cases such as those calling for noise reduction and cooling simultaneously.

[Air quality control systems: heating, ventilating, and air conditioning (HVAC)].

Science.gov (United States)

Bellucci Sessa, R; Riccio, G

2004-01-01

After a brief illustration of the principal layout schemes of Heating, Ventilating, and Air Conditioning (HVAC), the first part of this paper summarizes the standards, both voluntary and compulsory, regulating HVAC facilities design and installation with regard to the question of Indoor Air Quality (IAQ). The paper then examines the problem of ventilation systems maintenance and the essential hygienistic requirements in whose absence HVAC facilities may become a risk factor for people working or living in the building. Lastly, the paper deals with HVAC design strategies and methods, which aim not only to satisfy comfort and air quality requirements, but also to ensure easy and effective maintenance procedures.

Effect of voluntary vs. artificial activation on the relationship of muscle torque to speed

Science.gov (United States)

Dudley, Gary A.; Harris, Robert T.; Duvoisin, Marc R.; Hather, Bruce M.; Buchanan, Paul

1990-01-01

The suggestion by Phillips and Petrofsky (1980) and Wickiewicz et al. (1984) that artificial activation of the knee extensor muscles should result in greater relative changes in torque than those evident with maximal voluntary activation is examined by investigating the speed-torque relationship of the right knee extensor muscle group in eight human subjects in whom activation was achieved by 'maximal' voluntary effort or by electrical stimulation. Torque was measured at a specific knee angle during isokinetic concentric or eccentric actions at velocities between 0.17 and 3.66 rad/s and during isometric actions. It is shown that, with artificial activation, the relative changes in both eccentric and concentric torque were greater as the speed increased; the speed-torque relationship was independed of the extent of activation and was similar to that of an isolated muscle. On the other hand, activation by the central nervous system during maximal effort depended on the speed and the type of muscle action performed.

Ventilation on demand (VOD) projects : Vale Inco Ltd.

Energy Technology Data Exchange (ETDEWEB)

Allen, C.L. [Vale Inco Ltd., Sudbury, ON (Canada)

2008-07-01

This paper presented a dynamic ventilation on Demand (VOD) system that is in the developmental stages at Vale Inco. The VOD addresses the need to minimize ventilation costs associated with mining at depth. The physical components of the system are in the process of being tested at Vale Inco's mine sites in Sudbury, Ontario, where the company operates 6 base metal mines that vary in depth from 1200 metres to 2400 metres. Two pilot projects are simultaneously testing the physical components of the VOD system at Coleman and Creighton mines. A Scope of Work is also being finalized in which the architecture of the system is being optimized for testing a prototype dynamic VOD installation. The primary ventilation systems at the mines were described along with future ventilation requirements and air flow regulations with reference to both conventional and automated regulators. The development of the VOD system involved software development, computer networking, electrical planning, PLC programming and accurate ventilation modeling. The common objective was to reduce ventilation cost and increase production in the mine by maximizing the efficiency of the ventilation system. This will be accomplished through communication training and following safety standards and protocols. 7 refs., 2 tabs., 6 figs.

Percent voluntary inactivation and peak force predictions with the interpolated twitch technique in individuals with high ability of voluntary activation

International Nuclear Information System (INIS)

Herda, Trent J; Walter, Ashley A; Hoge, Katherine M; Stout, Jeffrey R; Costa, Pablo B; Ryan, Eric D; Cramer, Joel T

2011-01-01

The purpose of this study was to examine the sensitivity and peak force prediction capability of the interpolated twitch technique (ITT) performed during submaximal and maximal voluntary contractions (MVCs) in subjects with the ability to maximally activate their plantar flexors. Twelve subjects performed two MVCs and nine submaximal contractions with the ITT method to calculate percent voluntary inactivation (%VI). Additionally, two MVCs were performed without the ITT. Polynomial models (linear, quadratic and cubic) were applied to the 10–90% VI and 40–90% VI versus force relationships to predict force. Peak force from the ITT MVC was 6.7% less than peak force from the MVC without the ITT. Fifty-eight percent of the 10–90% VI versus force relationships were best fit with nonlinear models; however, all 40–90% VI versus force relationships were best fit with linear models. Regardless of the polynomial model or the contraction intensities used to predict force, all models underestimated the actual force from 22% to 28%. There was low sensitivity of the ITT method at high contraction intensities and the predicted force from polynomial models significantly underestimated the actual force. Caution is warranted when interpreting the % VI at high contraction intensities and predicted peak force from submaximal contractions

The influence of sodium bicarbonate on maximal force and rates of force development in the triceps surae and brachii during fatiguing exercise.

Science.gov (United States)

Siegler, Jason C; Mudie, Kurt; Marshall, Paul

2016-11-01

What is the central question of this study? Does metabolic alkalosis in humans, induced by sodium bicarbonate, affect rates of skeletal muscle fatigue differentially in muscle groups composed predominately of slow- and fast-twitch fibres? What is the main finding and its importance? Sodium bicarbonate exhibited no effect on the fatigue profile observed between triceps surae and brachii muscle groups during and after 2 min of tetanic stimulation. For the first time in exercising humans, we have profiled the effect of sodium bicarbonate on the voluntary and involuntary contractile characteristics of muscle groups representative of predominately slow- and fast-twitch fibres. The effect of metabolic alkalosis on fibre-specific maximal force production and rates of force development (RFD) has been investigated previously in animal models, with evidence suggesting an improved capacity to develop force rapidly in fast- compared with slow-twitch muscle. We have attempted to model in vivo the fatigue profile of voluntary and involuntary maximal force and RFD in the triceps surae and brachii after sodium bicarbonate (NaHCO 3 ) ingestion. In a double-blind, three-way repeated-measures design, participants (n = 10) ingested either 0.3 g kg -1 NaHCO 3 (ALK) or equivalent calcium carbonate (PLA) prior to 2 min of continuous (1 Hz) supramaximal stimulation (300 ms at 40 Hz) of the triceps surae or brachii, with maximal voluntary efforts (maximal voluntary torque) coupled with direct muscle stimulation also measured at baseline, 1 and 2 min. Metabolic alkalosis was achieved in both ALK trials but was not different between muscle groups. Regardless of the conditions, involuntary torque declined nearly 60% in the triceps brachii (P < 0.001) and ∼30% in the triceps surae (P < 0.001). In all trials, there was a significant decline in normalized involuntary RFD (P < 0.05). Maximal voluntary torque declined nearly 28% but was not different between conditions (P < 0

Efficacy of respiratory muscle training in weaning of mechanical ventilation in patients with mechanical ventilation for 48hours or more: A Randomized Controlled Clinical Trial.

Science.gov (United States)

Sandoval Moreno, L M; Casas Quiroga, I C; Wilches Luna, E C; García, A F

2018-02-02

To evaluate the efficacy of respiratory muscular training in the weaning of mechanical ventilation and respiratory muscle strength in patients on mechanical ventilation of 48hours or more. Randomized controlled trial of parallel groups, double-blind. Ambit: Intensive Care Unit of a IV level clinic in the city of Cali. 126 patients in mechanical ventilation for 48hours or more. The experimental group received daily a respiratory muscle training program with treshold, adjusted to 50% of maximal inspiratory pressure, additional to standard care, conventional received standard care of respiratory physiotherapy. MAIN INTEREST VARIABLES: weaning of mechanical ventilation. Other variables evaluated: respiratory muscle strength, requirement of non-invasive mechanical ventilation and frequency of reintubation. intention-to-treat analysis was performed with all variables evaluated and analysis stratified by sepsis condition. There were no statistically significant differences in the median weaning time of the MV between the groups or in the probability of extubation between groups (HR: 0.82 95% CI: 0.55-1.20 P=.29). The maximum inspiratory pressure was increased in the experimental group on average 9.43 (17.48) cmsH20 and in the conventional 5.92 (11.90) cmsH20 (P=.48). The difference between the means of change in maximal inspiratory pressure was 0.46 (P=.83 95%CI -3.85 to -4.78). respiratory muscle training did not demonstrate efficacy in the reduction of the weaning period of mechanical ventilation nor in the increase of respiratory muscle strength in the study population. Registered study at ClinicalTrials.gov (NCT02469064). Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Stable tooth contacts in intercuspal occlusion makes for utilities of the jaw elevators during maximal voluntary clenching.

Science.gov (United States)

Wang, X-R; Zhang, Y; Xing, N; Xu, Y-F; Wang, M-Q

2013-05-01

Data are inconsistent concerning whether the level of the surface electromyographic (SEMG) activity of jaw-closing muscles increases when biting forces elevated during maximal voluntary clenching (MVC). In this study, T-Scan III system and BioEMG III system were used to record bite force, occlusal contacts and SEMG activity of the anterior temporalis (TA) and of the masseter muscles (MM) simultaneously. Recordings were obtained from 16 healthy young adult males during different conditions: (i) a fast MVC from resting position to intercuspal position (ICP); (ii) mandibular movements from ICP to protrusive or lateral edge-to-edge positions with teeth in contact with biting; (iii) a fast MVC in protrusive and lateral edge-to-edge positions. A higher level of SEMG activity was associated with a higher bite force during occluding movements (P < 0.05). However, during fast MVC from rest to ICP, the largest number of occlusal contacts was achieved and distributed more symmetrically, the highest level of biting force was obtained, but the SEMG activity of the jaw elevator muscles was reduced compared with its maximum level (P < 0.05). This phenomenon was not observed during the fast MVC in protrusive or lateral edge-to-edge positions. The present results that a lower SEMG activity was associated with the largest number of occlusal contacts and the highest level of bite force during centric MVC demonstrated a complex integration of jaw-closing muscles when a stable occlusion is present. © 2013 Blackwell Publishing Ltd.

Effects of contraction duration on low-frequency fatigue in voluntary and electrically induced exercise of quadriceps muscle in humans.

Science.gov (United States)

Ratkevicius, A; Skurvydas, A; Povilonis, E; Quistorff, B; Lexell, J

1998-04-01

The aims of this study were to investigate if low-frequency fatigue (LFF) dependent on the duration of repeated muscle contractions and to compare LFF in voluntary and electrically induced exercise. Male subjects performed three 9-min periods of repeated isometric knee extensions at 40% maximal voluntary contraction with contraction plus relaxation periods of 30 plus 60 s, 15 plus 30 s and 5 plus 10 s in protocols 1, 2 and 3, respectively. The same exercise protocols were repeated using feedback-controlled electrical stimulation at 40% maximal tetanic torque. Before and 15 min after each exercise period, knee extension torque at 1, 7, 10, 15, 20, 50 and 100 Hz was assessed. During voluntary exercise, electromyogram root mean square (EMGrms) of the vastus lateralis muscle was evaluated. The 20-Hz torque:100-Hz torque (20:100 Hz torque) ratio was reduced more after electrically induced than after voluntary exercise (P exercise, the decrease in 20:100 Hz torque ratio was gradually (P exercise, the decrease in 20:100 Hz torque ratio and the increase in EMGrms were greater in protocol 1 (P exercise and that the electrically induced exercise produced a more pronounced LFF compared to voluntary exercise of submaximal intensity. It is suggested that compensatory recruitment of faster-contracting motor units is an additional factor affecting the severity of LFF during voluntary exercise.

Tunnel Ventilation Control Using Reinforcement Learning Methodology

Science.gov (United States)

Chu, Baeksuk; Kim, Dongnam; Hong, Daehie; Park, Jooyoung; Chung, Jin Taek; Kim, Tae-Hyung

The main purpose of tunnel ventilation system is to maintain CO pollutant concentration and VI (visibility index) under an adequate level to provide drivers with comfortable and safe driving environment. Moreover, it is necessary to minimize power consumption used to operate ventilation system. To achieve the objectives, the control algorithm used in this research is reinforcement learning (RL) method. RL is a goal-directed learning of a mapping from situations to actions without relying on exemplary supervision or complete models of the environment. The goal of RL is to maximize a reward which is an evaluative feedback from the environment. In the process of constructing the reward of the tunnel ventilation system, two objectives listed above are included, that is, maintaining an adequate level of pollutants and minimizing power consumption. RL algorithm based on actor-critic architecture and gradient-following algorithm is adopted to the tunnel ventilation system. The simulations results performed with real data collected from existing tunnel ventilation system and real experimental verification are provided in this paper. It is confirmed that with the suggested controller, the pollutant level inside the tunnel was well maintained under allowable limit and the performance of energy consumption was improved compared to conventional control scheme.

Assessment of dynamic mechanical properties of the respiratory system during high-frequency oscillatory ventilation*.

Science.gov (United States)

Dellacà, Raffaele L; Zannin, Emanuela; Ventura, Maria L; Sancini, Giulio; Pedotti, Antonio; Tagliabue, Paolo; Miserocchi, Giuseppe

2013-11-01

1) To investigate the possibility of estimating respiratory system impedance (Zrs, forced oscillation technique) by using high-amplitude pressure oscillations delivered during high-frequency oscillatory ventilation; 2) to characterize the relationship between Zrs and continuous distending pressure during an increasing/decreasing continuous distending pressure trial; 3) to evaluate how the optimal continuous distending pressure identified by Zrs relates to the point of maximal curvature of the deflation limb of the quasi-static pressure-volume curve. Prospective laboratory animal investigation. Experimental medicine laboratory. Eight New Zealand rabbits. The rabbits were ventilated with high-frequency oscillatory ventilation. Zrs was measured while continuous distending pressure was increased and decreased between 2 and 26 cm H2O in 1-minute steps of 4 cm H2O. At each step, a low-amplitude (6 cm H2O) sinusoidal signal was alternated with a high-amplitude (18 cm H2O) asymmetric high-frequency oscillatory ventilation square pressure waveform. Pressure-volume curves were determined at the end of the continuous distending pressure trial. All measurements were repeated after bronchoalveolar lavage. Zrs was estimated from flow and pressure measured at the inlet of the tracheal tube and expressed as resistance (Rrs) and reactance (Xrs). Linear correlation between the values, measured by applying the small-amplitude sinusoidal signal and the ventilator waveform, was good for Xrs (r = 0.95 ± 0.04) but not for Rrs (r = 0.60 ± 0.34). Following lavage, the Xrs-continuous distending pressure curves presented a maximum on the deflation limb, identifying an optimal continuous distending pressure that was, on average, 1.1 ± 1.7 cm H2O below the point of maximal curvature of the deflation limb of the pressure-volume curves. Xrs can be accurately measured during high-frequency oscillatory ventilation without interrupting ventilation and/or connecting additional devices. An optimal

Effects of voluntary and automatic control of center of pressure sway during quiet standing.

Science.gov (United States)

Ueta, Kozo; Okada, Yohei; Nakano, Hideki; Osumi, Michihiro; Morioka, Shu

2015-01-01

The authors investigated the effects of voluntary and automatic control on the spatial variables (envelope area, maximal amplitude, and root mean square [RMS]) of center of pressure (COP) displacement during quiet standing and identified differences in their postural control strategies (mean velocity [MV], mean power frequency [MPF], and power density). COP data were recorded under relaxed (experimental control), still (voluntary control), and dual (automatic control) conditions. RMS was significantly lower in the still and dual conditions than in the relaxed condition. MV, MPF, and power density were significantly higher in the still condition than in the dual condition. These results indicate that both voluntary and automatic control decrease the spatial variables of COP displacement; however, their postural control strategies are different.

LONG-LASTING SUPERNORMAL CONDUCTION-VELOCITY AFTER SUSTAINED MAXIMAL ISOMETRIC CONTRACTION IN HUMAN MUSCLE

NARCIS (Netherlands)

VANDERHOEVEN, JH; VANWEERDEN, TW; ZWARTS, MJ

Local muscle fatigue (1 min maximal voluntary contraction) and recovery were studied by means of surface and invasive EMG on elbow flexors to record the changes in muscle fiber conduction velocity (MFCV), median power frequency (MPF), integrated EMG (IEMG), and force. The main finding was a

Ventilation

DEFF Research Database (Denmark)

Nielsen, Toke Rammer; Svendsen, Sv Aa Højgaard

1999-01-01

The note concerns ventilation in residential buildings. Describes components in ventilation systems, electric energy consumption and different ventilation systems with heat exchanger.......The note concerns ventilation in residential buildings. Describes components in ventilation systems, electric energy consumption and different ventilation systems with heat exchanger....

The influence of mechanical ventilation on physiological parameters in ball pythons (Python regius).

Science.gov (United States)

Jakobsen, Sashia L; Williams, Catherine J A; Wang, Tobias; Bertelsen, Mads F

2017-05-01

Mechanical ventilation is widely recommended for reptiles during anesthesia, and while it is well-known that their low ectothermic metabolism requires much lower ventilation than in mammals, very little is known about the influence of ventilation protocol on the recovery from anesthesia. Here, 15 ball pythons (Python regius) were induced and maintained with isoflurane for 60min at one of three ventilation protocols (30, 125, or 250mlmin -1 kg -1 body mass) while an arterial catheter was inserted, and ventilation was then continued on 100% oxygen at the specified rate until voluntary extubation. Mean arterial blood pressure and heart rate (HR) were measured, and arterial blood samples collected at 60, 80, 180min and 12 and 24h after intubation. In all three groups, there was evidence of a metabolic acidosis, and snakes maintained at 30mlmin -1 kg -1 experienced an additional respiratory acidosis, while the two other ventilation protocols resulted in normal or low arterial PCO 2 . In general, normal acid-base status was restored within 12h in all three protocols. HR increased by 143±64% during anesthesia with high mechanical ventilation (250mlmin -1 kg -1 ) in comparison with recovered values. Recovery times after mechanical ventilation at 30, 125, or 250mlmin -1 kg -1 were 289±70, 126±16, and 68±7min, respectively. Mild overventilation may result in a faster recovery, and the associated lowering of arterial PCO 2 normalised arterial pH in the face of metabolic acidosis. Copyright © 2017 Elsevier Inc. All rights reserved.

: ventilators for noninvasive ventilation

OpenAIRE

Fauroux , Brigitte; Leroux , Karl; Desmarais , Gilbert; Isabey , Daniel; Clément , Annick; Lofaso , Frédéric; Louis , Bruno

2008-01-01

International audience; The aim of the present study was to evaluate the performance characteristics of all the ventilators proposed for home noninvasive positive-pressure ventilation in children in France. The ventilators (one volume-targeted, 12 pressure-targeted and four dual) were evaluated on a bench which simulated six different paediatric ventilatory patterns. For each ventilator, the quality of the inspiratory and expiratory trigger and the ability to reach and maintain the preset pre...

The Effect of Voluntary Ventilation on Acid-base Responses to a Moo Duk Tkow Form.

Science.gov (United States)

Hetzler, Ronald K.; And Others

1989-01-01

Results are reported from a study that investigated the acid-base and lactate reponses to voluntary integration of breathing and exercise movements during beginning level form Ki Cho I, performed at competitive intensities. Findings suggest that respiratory compensation does not occur and that respiratory acidosis may contribute to metabolic…

Variation in Definition of Prolonged Mechanical Ventilation.

Science.gov (United States)

Rose, Louise; McGinlay, Michael; Amin, Reshma; Burns, Karen Ea; Connolly, Bronwen; Hart, Nicholas; Jouvet, Philippe; Katz, Sherri; Leasa, David; Mawdsley, Cathy; McAuley, Danny F; Schultz, Marcus J; Blackwood, Bronagh

2017-10-01

Consistency of definitional criteria for terminology applied to describe subject cohorts receiving mechanical ventilation within ICU and post-acute care settings is important for understanding prevalence, risk stratification, effectiveness of interventions, and projections for resource allocation. Our objective was to quantify the application and definition of terms for prolonged mechanical ventilation. We conducted a scoping review of studies (all designs except single-case study) reporting a study population (adult and pediatric) using the term prolonged mechanical ventilation or a synonym. We screened 5,331 references, reviewed 539 full-text references, and excluded 120. Of the 419 studies (representing 38 countries) meeting inclusion criteria, 297 (71%) reported data on a heterogeneous subject cohort, and 66 (16%) included surgical subjects only (46 of those 66, 70% cardiac surgery). Other studies described COPD (16, 4%), trauma (22, 5%), neuromuscular (17, 4%), and sepsis (1, 0.2%) cohorts. A total of 741 terms were used to refer to the 419 study cohorts. The most common terms were: prolonged mechanical ventilation (253, 60%), admission to specialized unit (107, 26%), and long-term mechanical ventilation (79, 19%). Some authors (282, 67%) defined their cohorts based on duration of mechanical ventilation, with 154 studies (55%) using this as the sole criterion. We identified 37 different durations of ventilation ranging from 5 h to 1 y, with > 21 d being the most common (28 of 282, 7%). For studies describing a surgical cohort, minimum ventilation duration required for inclusion was ≥ 24 h for 20 of 66 studies (30%). More than half of all studies (237, 57%) did not provide a reason/rationale for definitional criteria used, with only 28 studies (7%) referring to a consensus definition. We conclude that substantial variation exists in the terminology and definitional criteria for cohorts of subjects receiving prolonged mechanical ventilation. Standardization of

Voluntary euthanasia.

Science.gov (United States)

Brewin, Thurstan B

1986-05-10

Brewin comments upon James Rachels' The End of Life (Oxford University Press; 1986) and Voluntary Euthanasia (Peter Owen; 1986), a compilation edited by A.B. Downing and B. Smoker that is an expanded version of a 1969 work by Britain's Voluntary Euthanasia Society. Rachels maintains that it is illogical to distinguish between active and passive euthanasia. In Voluntary Euthanasia, 17 contributors argue the pros and cons of the issue. The Voluntary Euthanasia Society proposes that mentally competent persons be allowed by law to request euthanasia, either when taken ill or by advance directive. Brewin says he is almost but not quite convinced by the arguments for legalized voluntary euthanasia. He is concerned about the "slippery slope," the uncertainties of prognosis and quality of life judgments, the pressures to which the terminally ill or aged might be subjected, and the potentially negative impact of euthanasia on the physician patient relationship.

Blood lactate clearance after maximal exercise depends on active recovery intensity.

Science.gov (United States)

Devlin, J; Paton, B; Poole, L; Sun, W; Ferguson, C; Wilson, J; Kemi, O J

2014-06-01

High-intensity exercise is time-limited by onset of fatigue, marked by accumulation of blood lactate. This is accentuated at maximal, all-out exercise that rapidly accumulates high blood lactate. The optimal active recovery intensity for clearing lactate after such maximal, all-out exercise remains unknown. Thus, we studied the intensity-dependence of lactate clearance during active recovery after maximal exercise. We constructed a standardized maximal, all-out treadmill exercise protocol that predictably lead to voluntary exhaustion and blood lactate concentration>10 mM. Next, subjects ran series of all-out bouts that increased blood lactate concentration to 11.5±0.2 mM, followed by recovery exercises ranging 0% (passive)-100% of the lactate threshold. Repeated measurements showed faster lactate clearance during active versus passive recovery (P40%>passive recovery, Pexercise clears accumulated blood lactate faster than passive recovery in an intensity-dependent manner, with maximum clearance occurring at active recovery of 80% of lactate threshold.

Comparison between electrically evoked and voluntary isometric contractions for biceps brachii muscle oxidative metabolism using near-infrared spectroscopy.

Science.gov (United States)

Muthalib, Makii; Jubeau, Marc; Millet, Guillaume Y; Maffiuletti, Nicola A; Nosaka, Kazunori

2009-09-01

This study compared voluntary (VOL) and electrically evoked isometric contractions by muscle stimulation (EMS) for changes in biceps brachii muscle oxygenation (tissue oxygenation index, DeltaTOI) and total haemoglobin concentration (DeltatHb = oxygenated haemoglobin + deoxygenated haemoglobin) determined by near-infrared spectroscopy. Twelve men performed EMS with one arm followed 24 h later by VOL with the contralateral arm, consisting of 30 repeated (1-s contraction, 1-s relaxation) isometric contractions at 30% of maximal voluntary contraction (MVC) for the first 60 s, and maximal intensity contractions thereafter (MVC for VOL and maximal tolerable current at 30 Hz for EMS) until MVC decreased approximately 30% of pre-exercise MVC. During the 30 contractions at 30% MVC, DeltaTOI decrease was significantly (P < 0.05) greater and DeltatHb was significantly (P < 0.05) lower for EMS than VOL, suggesting that the metabolic demand for oxygen in EMS is greater than VOL at the same torque level. However, during maximal intensity contractions, although EMS torque (approximately 40% of VOL) was significantly (P < 0.05) lower than VOL, DeltaTOI was similar and tHb was significantly (P < 0.05) lower for EMS than VOL towards the end, without significant differences between the two sessions in the recovery period. It is concluded that the oxygen demand of the activated biceps brachii muscle in EMS is comparable to VOL at maximal intensity.

Does hip joint positioning affect maximal voluntary contraction in the gluteus maximus, gluteus medius, tensor fasciae latae and sartorius muscles?

Science.gov (United States)

Bernard, J; Beldame, J; Van Driessche, S; Brunel, H; Poirier, T; Guiffault, P; Matsoukis, J; Billuart, F

2017-11-01

Minimally invasive total hip arthroplasty (THA) is presumed to provide functional and clinical benefits, whereas in fact the literature reveals that gait and posturographic parameters following THA do not recover values found in the general population. There is a significant disturbance of postural sway in THA patients, regardless of the surgical approach, although with some differences between approaches compared to controls: the anterior and anterolateral minimally invasive approaches seem to be more disruptive of postural parameters than the posterior approach. Electromyographic (EMG) study of the hip muscles involved in surgery [gluteus maximus (GMax), gluteus medius (GMed), tensor fasciae latae (TFL), and sartorius (S)] could shed light, the relevant literature involves discordant methodologies. We developed a methodology to assess EMG activity during maximal voluntary contraction (MVC) of the GMax, GMed, TFL and sartorius muscles as a reference for normalization. A prospective study aimed to assess whether hip joint positioning and the learning curve on an MVC test affect the EMG signal during a maximal voluntary contraction. Hip positioning and the learning curve on an MVC test affect EMG signal during MVC of GMax, GMed, TFL and S. Thirty young asymptomatic subjects participated in the study. Each performed 8 hip muscle MVCs in various joint positions recorded with surface EMG sensors. Each MVC was performed 3 times in 1 week, with the same schedule every day, controlling for activity levels in the preceding 24h. EMG activity during MVC was expressed as a ratio of EMG activity during unipedal stance. Non-parametric tests were applied. Statistical analysis showed no difference according to hip position for abductors or flexors in assessing EMG signal during MVC over the 3 sessions. Hip abductors showed no difference between abduction in lateral decubitus with hip straight versus hip flexed: GMax (19.8±13.7 vs. 14.5±7.8, P=0.78), GMed (13.4±9.0 vs. 9.9±6

Validation of a Maximal Incremental Skating Test Performed on a Slide Board: Comparison With Treadmill Skating.

Science.gov (United States)

Piucco, Tatiane; Diefenthaeler, Fernando; Soares, Rogério; Murias, Juan M; Millet, Guillaume Y

2017-11-01

To investigate the criterion validity of a maximal incremental skating test performed on a slide board (SB). Twelve subelite speed skaters performed a maximal skating test on a treadmill and on a SB. Gas exchange threshold (GET), respiratory compensation point (RCP), and maximal variables were determined. Oxygen uptake ([Formula: see text]) (31.0 ± 3.2 and 31.4 ± 4.1 mL·min -1 ·kg -1 ), percentage of maximal [Formula: see text] ([Formula: see text]) (66.3 ± 4 and 67.7 ± 7.1%), HR (153 ± 14 and 150 ±12 bpm), and ventilation (59.8 ± 11.8 and 57.0 ± 10.7 L·min -1 ) at GET, and [Formula: see text] (42.5 ± 4.4 and 42.9 ± 4.8 mL·min -1 ·kg -1 ), percentage of [Formula: see text] (91.1 ± 3.3 and 92.4 ± 2.1%), heart rate (HR) (178 ± 9 and 178 ± 6 bpm), and ventilation (96.5 ± 19.2 and 92.1 ± 12.7 L·min -1 ) at RCP were not different between skating on a treadmill and on a SB. [Formula: see text] (46.7 ± 4.4 vs 46.4 ±6.1 mL·min -1 ·kg -1 ) and maximal HR (195 ± 6 vs 196 ± 10 bpm) were not significantly different and correlated (r = .80 and r = .87, respectively; P  .8) with athletes' best times on 1500 m. The incremental skating test on a SB was capable to distinguish maximal ([Formula: see text] and HR) and submaximal ([Formula: see text], % [Formula: see text], HR, and ventilation) parameters known to determine endurance performance. Therefore, the SB test can be considered as a specific and practical alternative to evaluate speed skaters.

Ventilator-driven xenon ventilation studies

International Nuclear Information System (INIS)

Chilcoat, R.T.; Thomas, F.D.; Gerson, J.I.

1984-01-01

A modification of a common commercial Xe-133 ventilation device is described for mechanically assisted ventilation imaging. The patient's standard ventilator serves as the power source controlling the ventilatory rate and volume during the xenon study, but the gases in the two systems are not intermixed. This avoids contamination of the ventilator with radioactive xenon. Supplemental oxygen and positive end-expiratory pressure (PEEP) are provided if needed. The system can be converted quickly for conventional studies with spontaneous respiration

Comparing two methods to record maximal voluntary contractions and different electrode positions in recordings of forearm extensor muscle activity: Refining risk assessments for work-related wrist disorders.

Science.gov (United States)

Dahlqvist, Camilla; Nordander, Catarina; Granqvist, Lothy; Forsman, Mikael; Hansson, Gert-Åke

2018-01-01

Wrist disorders are common in force demanding industrial repetitive work. Visual assessment of force demands have a low reliability, instead surface electromyography (EMG) may be used as part of a risk assessment for work-related wrist disorders. For normalization of EMG recordings, a power grip (hand grip) is often used as maximal voluntary contraction (MVC) of the forearm extensor muscles. However, the test-retest reproducibility is poor and EMG amplitudes exceeding 100% have occasionally been recorded during work. An alternative MVC is resisted wrist extension, which may be more reliable. To compare hand grip and resisted wrist extension MVCs, in terms of amplitude and reproducibility, and to examine the effect of electrode positioning. Twelve subjects participated. EMG from right forearm extensors, from four electrode pairs, was recorded during MVCs, on three separate occasions. The group mean EMG amplitudes for resisted wrist extension were 1.2-1.7 times greater than those for hand grip. Resisted wrist extension showed better reproducibility than hand grip. The results indicate that the use of resisted wrist extension is a more accurate measurement of maximal effort of wrist extensor contractions than using hand grip and should increase the precision in EMG recordings from forearm extensor muscles, which in turn will increase the quality of risk assessments that are based on these.

Demand Controlled Ventilation and Classroom Ventilation

Energy Technology Data Exchange (ETDEWEB)

Fisk, William J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mendell, Mark J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Davies, Molly [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Eliseeva, Ekaterina [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Faulkner, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hong, Tienzen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sullivan, Douglas P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2012-05-01

This document summarizes a research effort on demand controlled ventilation and classroom ventilation. The research on demand controlled ventilation included field studies and building energy modeling.

Demand controlled ventilation and classroom ventilation

Energy Technology Data Exchange (ETDEWEB)

Fisk, William J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mendell, Mark J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Davies, Molly [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Eliseeva, Ekaterina [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Faulkner, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hong, Tienzen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sullivan, Douglas P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2014-01-06

This document summarizes a research effort on demand controlled ventilation and classroom ventilation. The research on demand controlled ventilation included field studies and building energy modeling.

Comparative study of the thermal and power performances of a semi-transparent photovoltaic façade under different ventilation modes

International Nuclear Information System (INIS)

Peng, Jinqing; Lu, Lin; Yang, Hongxing; Ma, Tao

2015-01-01

Highlights: • A ventilated photovoltaic double-skin façade (PV-DSF) using semi-transparent a-Si was reported. • The impact of different ventilation modes on the power performance of PV-DSF was studied experimentally. • The SHGCs and U-values of PV-DSFs under different ventilation modes were calculated and compared. • An optimum operating strategy was proposed for this PV-DSF to achieve the best energy efficiency. - Abstract: This paper studied the thermal and power performances of a ventilated photovoltaic façade under different ventilation modes, and appropriate operation strategies for different weather conditions were proposed accordingly to maximize its energy conversion efficiency. This ventilated PV double-skin façade (PV-DSF) consists of an outside layer of semi-transparent amorphous silicon (a-Si) PV laminate, an inward-openable window and a 400 mm airflow cavity. Before installation, the electrical characteristics under standard testing conditions (STC) and the temperature coefficients of the semi-transparent PV module were tested and determined in the laboratory. Field measurements were carried out to investigate the impact of different ventilation modes, namely, ventilated, buoyancy-driven ventilated and non-ventilated, on the thermal and power performances of this PV-DSF. The results show that the ventilated PV-DSF provides the lowest average solar heat gain coefficient (SHGC) and the non-ventilated PV-DSF provides the best thermal insulation performance. In terms of power performance, the energy output of the ventilated PV-DSF is greater than those of the buoyancy-driven ventilated and non-ventilated PV-DSFs by 1.9% and 3%, respectively, due to its much lower operating temperature. Based on the experimental results, a conclusion was drawn that the ventilation design can not only reduce the heat gain of PV-DSF but also improve the energy conversion efficiency of PV modules by bringing down their operating temperature. In addition, an optimum

Anaesthesia ventilators

Directory of Open Access Journals (Sweden)

Rajnish K Jain

2013-01-01

Full Text Available Anaesthesia ventilators are an integral part of all modern anaesthesia workstations. Automatic ventilators in the operating rooms, which were very simple with few modes of ventilation when introduced, have become very sophisticated with many advanced ventilation modes. Several systems of classification of anaesthesia ventilators exist based upon various parameters. Modern anaesthesia ventilators have either a double circuit, bellow design or a single circuit piston configuration. In the bellows ventilators, ascending bellows design is safer than descending bellows. Piston ventilators have the advantage of delivering accurate tidal volume. They work with electricity as their driving force and do not require a driving gas. To enable improved patient safety, several modifications were done in circle system with the different types of anaesthesia ventilators. Fresh gas decoupling is a modification done in piston ventilators and in descending bellows ventilator to reduce th incidence of ventilator induced volutrauma. In addition to the conventional volume control mode, modern anaesthesia ventilators also provide newer modes of ventilation such as synchronised intermittent mandatory ventilation, pressure-control ventilation and pressure-support ventilation (PSV. PSV mode is particularly useful for patients maintained on spontaneous respiration with laryngeal mask airway. Along with the innumerable benefits provided by these machines, there are various inherent hazards associated with the use of the ventilators in the operating room. To use these workstations safely, it is important for every Anaesthesiologist to have a basic understanding of the mechanics of these ventilators and breathing circuits.

Anaesthesia ventilators.

Science.gov (United States)

Jain, Rajnish K; Swaminathan, Srinivasan

2013-09-01

Anaesthesia ventilators are an integral part of all modern anaesthesia workstations. Automatic ventilators in the operating rooms, which were very simple with few modes of ventilation when introduced, have become very sophisticated with many advanced ventilation modes. Several systems of classification of anaesthesia ventilators exist based upon various parameters. Modern anaesthesia ventilators have either a double circuit, bellow design or a single circuit piston configuration. In the bellows ventilators, ascending bellows design is safer than descending bellows. Piston ventilators have the advantage of delivering accurate tidal volume. They work with electricity as their driving force and do not require a driving gas. To enable improved patient safety, several modifications were done in circle system with the different types of anaesthesia ventilators. Fresh gas decoupling is a modification done in piston ventilators and in descending bellows ventilator to reduce th incidence of ventilator induced volutrauma. In addition to the conventional volume control mode, modern anaesthesia ventilators also provide newer modes of ventilation such as synchronised intermittent mandatory ventilation, pressure-control ventilation and pressure-support ventilation (PSV). PSV mode is particularly useful for patients maintained on spontaneous respiration with laryngeal mask airway. Along with the innumerable benefits provided by these machines, there are various inherent hazards associated with the use of the ventilators in the operating room. To use these workstations safely, it is important for every Anaesthesiologist to have a basic understanding of the mechanics of these ventilators and breathing circuits.

Anaesthesia ventilators

Science.gov (United States)

Jain, Rajnish K; Swaminathan, Srinivasan

2013-01-01

Anaesthesia ventilators are an integral part of all modern anaesthesia workstations. Automatic ventilators in the operating rooms, which were very simple with few modes of ventilation when introduced, have become very sophisticated with many advanced ventilation modes. Several systems of classification of anaesthesia ventilators exist based upon various parameters. Modern anaesthesia ventilators have either a double circuit, bellow design or a single circuit piston configuration. In the bellows ventilators, ascending bellows design is safer than descending bellows. Piston ventilators have the advantage of delivering accurate tidal volume. They work with electricity as their driving force and do not require a driving gas. To enable improved patient safety, several modifications were done in circle system with the different types of anaesthesia ventilators. Fresh gas decoupling is a modification done in piston ventilators and in descending bellows ventilator to reduce th incidence of ventilator induced volutrauma. In addition to the conventional volume control mode, modern anaesthesia ventilators also provide newer modes of ventilation such as synchronised intermittent mandatory ventilation, pressure-control ventilation and pressure-support ventilation (PSV). PSV mode is particularly useful for patients maintained on spontaneous respiration with laryngeal mask airway. Along with the innumerable benefits provided by these machines, there are various inherent hazards associated with the use of the ventilators in the operating room. To use these workstations safely, it is important for every Anaesthesiologist to have a basic understanding of the mechanics of these ventilators and breathing circuits. PMID:24249886

Evaluation of ventilators for mouthpiece ventilation in neuromuscular disease.

Science.gov (United States)

Khirani, Sonia; Ramirez, Adriana; Delord, Vincent; Leroux, Karl; Lofaso, Frédéric; Hautot, Solène; Toussaint, Michel; Orlikowski, David; Louis, Bruno; Fauroux, Brigitte

2014-09-01

Daytime mouthpiece ventilation is a useful adjunct to nocturnal noninvasive ventilation (NIV) in patients with neuromuscular disease. The aims of the study were to analyze the practice of mouthpiece ventilation and to evaluate the performance of ventilators for mouthpiece ventilation. Practice of mouthpiece ventilation was assessed by a questionnaire, and the performance of 6 home ventilators with mouthpiece ventilation was assessed in a bench test using 24 different conditions per ventilator: 3 mouthpieces, a child and an adult patient profile, and 4 ventilatory modes. Questionnaires were obtained from 30 subjects (mean age 33 ± 11 y) using NIV for 12 ± 7 y. Fifteen subjects used NIV for > 20 h/day, and 11 were totally ventilator-dependent. The subject-reported benefits of mouthpiece ventilation were a reduction in dyspnea (73%) and fatigue (93%) and an improvement in speech (43%) and eating (27%). The bench study showed that none of the ventilators, even those with mouthpiece ventilation software, were able to deliver mouthpiece ventilation without alarms and/or autotriggering in each condition. Alarms and/or ineffective triggering or autotriggering were observed in 135 of the 198 conditions. The occurrence of alarms was more common with a large mouthpiece without a filter compared to a small mouthpiece with a filter (P ventilator. Subjects are satisfied with mouthpiece ventilation. Alarms are common with home ventilators, although less common in those with mouthpiece ventilation software. Improvements in home ventilators are needed to facilitate the expansion of mouthpiece ventilation. Copyright © 2014 by Daedalus Enterprises.

Effects of Acupuncture Therapy on the EMG Activity of the Rectus Femoris and Tibialis Anterior during Maximal Voluntary Isometric Contraction in College Students

Directory of Open Access Journals (Sweden)

Se In Jang

2017-12-01

Full Text Available Acupuncture has been increasingly used in the treatment of muscle damage associated with sports activities. However, studies on the immediate effects of one-time acupuncture on the muscles of athletes are clearly lacking. Thus, this study aimed to examine the effects of acupuncture therapy on the maximal voluntary isometric contraction (MVIC electromyography (EMG of the rectus femoris and tibialis anterior muscles. This study was conducted among 20 healthy male college students who had no musculoskeletal disease. The participants were subjected to 3 different experimental conditions and subsequently grouped based on these conditions: real acupuncture, sham acupuncture, and control. A 7-day washout period was implemented to avoid any transient effects on the physiological and psychological conditions of the participants. Subsequently, an electromyogram patch was attached on the most developed area in the middle of the origin and insertion of the rectus femoris and tibialis anterior muscles. The percent MVIC, which was used to standardize the signal from the electromyogram, was determined, and the maximal value from the MVIC of the rectus femoris and tibialis anterior muscles was measured. The MVIC EMG activities of both femoris (F = 6.633, p = 0.003 and tibialis anterior (F = 5.216, p = 0.008 muscles were significantly different among all groups. Accordingly, the results of a posthoc test showed that the real acupuncture group had higher MVIC EMG activities in the femoris (p = 0.002 and tibialis anterior (p = 0.006 muscles compared with the control group. These results suggest that treatment with real acupuncture resulted in significantly higher MVIC EMG activities of the rectus femoris and tibialis anterior muscles than the other treatments. Hence, acupuncture may be helpful in the improvement of muscle strength among athletes in the physical fitness field.

Ventilation and ventilation/perfusion ratios

International Nuclear Information System (INIS)

Valind, S.O.

1989-01-01

The thesis is based on five different papers. The labelling of specific tracer compounds with positron emitting radionuclides enables a range of structural, physiological and biochemical parameters in the lung to be measured non-invasively, using positron emission tomography. This concept affords a unique opportunity for in vivo studies of different expressions of pulmonary pathophysiology at the regional level. The present thesis describes the application of positron emission tomography to the measurements of ventilation and ventilation/perfusion ratios using inert gas tracers, neon-19 and nitrogen-13 respectively. The validity of the methods applied was investigated with respect to the transport of inert gas tracers in the human lung. Both ventilation and the ventilation/perfusion ratio may be obtained with errors less than 10 % in the normal lung. In disease, however, errors may increase in those instances where the regional ventilation is very low or the intra-regional gas flow distribution is markedly nonuniform. A 2-3 fold increase in ventilation was demonstrated in normal nonsmoking subjects going from ventral to dorsal regions in the supine posture. These large regional differences could be well explained by the intrinsic elastic properties of lung tissue, considering the gravitational gradient in transpulmonary pressure. In asymptomatic smokers substantial regional ventilatroy abnormalities were found whilst the regional gas volume was similar in smokers and nonsmokers. The uncoupling between ventilation and gas volume probably reflects inflammatory changes in the airways. The regional differences in dV/dt/dQ/dt were relatively small and blood flow was largely matched to ventilation in the supine posture. However, small regions of lung with very low ventilation, unmatched by blood flow commonly exists in the most dependent parts of the lung in both smokers and nonsmokers. (29 illustrations, 7 tables, 113 references)

Voluntary muscle activation improves with power training and is associated with changes in gait speed in mobility-limited older adults

DEFF Research Database (Denmark)

Hvid, Lars G; Strotmeyer, Elsa S; Skjødt, Mathias

2016-01-01

Incomplete voluntary muscle activation may contribute to impaired muscle mechanical function and physical function in older adults. Exercise interventions have been shown to increase voluntary muscle activation, although the evidence is sparse for mobility-limited older adults, particularly...... in association with physical function. This study examined the effects of 12weeks of power training on outcomes of voluntary muscle activation and gait speed in mobility-limited older adults from the Healthy Ageing Network of Competence (HANC) study. We included 37 older men and women with a usual gait speed...... in TG (r=0.67, pactivation is improved in mobility-limited older adults following 12-weeks of progressive power training, and is associated with improved maximal gait speed. Incomplete voluntary muscle activation should be considered one of the key mechanisms...

Respiratory training during rehabilitation of acute organic fluorine-poisoned patients treated by non-invasive positive pressure ventilation.

Science.gov (United States)

Liu, L; Liu, D Z; Wang, Q P; Zhu, Z L; Li, H M; Lu, X Y

2017-01-01

This paper aimed to analyze the effects of respiratory training on pulmonary function during the rehabilitation period for acute organic fluorine-poisoned patients treated by non-invasive positive pressure ventilation (NIPPV). Sixty-two acute organic fluorine-poisoned patients admitted to the Xinxiang Central Hospital, Xinxiang City, China, from May 2012 to March 2016 were selected and randomly divided into an observation group and a control group, with 31 cases in each. Both groups received NIPPV. The patients in the control group exercised daily, while the patients in the observation group received contracting lips-abdominal breathing training. The therapeutic effects, pulmonary ventilation function, serum levels of α-antitrypsin1 (α-AT1), surfactant protein D (SP-D), neutrophil elastase (NE), transforming growth factor beta 1 (TGF-β1), and quality of life were analyzed and compared between the two groups both before and after the administration of treatment. The total effective rate of the observation group was 93.55%, which was significantly higher when compared with the control group (74.19%) (P less than 0.05). The levels of forced expiratory volume in one second (FEV1), FEV1/FVC ratio, vital capacity (VC), carbon monoxide diffusion capacity (DLco), and maximal voluntary ventilation (MVV) of the observation group were better when compared with the control group and had statistical significance (P less than 0.05). Before treatment, the serum levels of α-AT1, SP-D, NE, and TGF-β1, and quality of life had no statistical significance in either group (P>0.05); after treatment, these indexes and the quality of life for the observation group were significantly higher when compared with the control group, with statistical significance (P less than 0.05). The respiratory training in acute organic fluorine-poisoned patients treated by NIPPV can improve the serum indexes, dilute toxicity, and recover pulmonary function, which play key roles in improving the

Neuromuscular function of the quadriceps muscle during isometric maximal, submaximal and submaximal fatiguing voluntary contractions in knee osteoarthrosis patients.

Directory of Open Access Journals (Sweden)

Anett Mau-Moeller

Full Text Available Knee osteoarthrosis (KOA is commonly associated with a dysfunction of the quadriceps muscle which contributes to alterations in motor performance. The underlying neuromuscular mechanisms of muscle dysfunction are not fully understood. The main objective of this study was to analyze how KOA affects neuromuscular function of the quadriceps muscle during different contraction intensities.The following parameters were assessed in 20 patients and 20 healthy controls: (i joint position sense, i.e. position control (mean absolute error, MAE at 30° and 50° of knee flexion, (ii simple reaction time task performance, (iii isometric maximal voluntary torque (IMVT and root mean square of the EMG signal (RMS-EMG, (iv torque control, i.e. accuracy (MAE, absolute fluctuation (standard deviation, SD, relative fluctuation (coefficient of variation, CV and periodicity (mean frequency, MNF of the torque signal at 20%, 40% and 60% IMVT, (v EMG-torque relationship at 20%, 40% and 60% IMVT and (vi performance fatigability, i.e. time to task failure (TTF at 40% IMVT.Compared to the control group, the KOA group displayed: (i significantly higher MAE of the angle signal at 30° (99.3%; P = 0.027 and 50° (147.9%; P < 0.001, (ii no significant differences in reaction time, (iii significantly lower IMVT (-41.6%; P = 0.001 and tendentially lower RMS-EMG of the rectus femoris (-33.7%; P = 0.054, (iv tendentially higher MAE of the torque signal at 20% IMVT (65.9%; P = 0.068, significantly lower SD of the torque signal at all three torque levels and greater MNF at 60% IMVT (44.8%; P = 0.018, (v significantly increased RMS-EMG of the vastus lateralis at 20% (70.8%; P = 0.003 and 40% IMVT (33.3%; P = 0.034, significantly lower RMS-EMG of the biceps femoris at 20% (-63.6%; P = 0.044 and 40% IMVT (-41.3%; P = 0.028 and tendentially lower at 60% IMVT (-24.3%; P = 0.075 and (vi significantly shorter TTF (-51.1%; P = 0.049.KOA is not only associated with a deterioration of IMVT

Moving from voluntary euthanasia to non-voluntary euthanasia: equality and compassion.

Science.gov (United States)

Amaraskekara, Kumar; Bagaric, Mirko

2004-09-01

The recent Dutch law legalising active voluntary euthanasia will reignite the euthanasia debate. An illuminating method for evaluating the moral status of a practice is to follow the implications of the practice to its logical conclusion. The argument for compassion is one of the central arguments in favour of voluntary active euthanasia. This argument applies perhaps even more forcefully in relation to incompetent patients. If active voluntary euthanasia is legalised, arguments based on compassion and equality will be directed towards legalising active non-voluntary euthanasia in order to make accelerated termination of death available also to the incompetent. The removal of discrimination against the incompetent has the potential to become as potent a catch-cry as the right to die. However, the legalisation of non-voluntary euthanasia is undesirable. A review of the relevant authorities reveals that there is no coherent and workable "best interests" test which can be invoked to decide whether an incompetent patient is better off dead. This provides a strong reason for not stepping onto the slippery path of permitting active voluntary euthanasia.

The slack test does not assess maximal shortening velocity of muscle fascicle in human.

Science.gov (United States)

Hager, Robin; Dorel, Sylvain; Nordez, Antoine; Rabita, Giuseppe; Couturier, Antoine; Hauraix, Hugo; Duchateau, Jacques; Guilhem, Gaël

2018-06-14

The application of a series of extremely high accelerative motor-driven quick releases while muscles contract isometrically (i.e. slack test) has been proposed to assess unloaded velocity in human muscle. This study aimed to measure gastrocnemius medialis fascicle (V F ) and tendinous tissues shortening velocity during motor-driven quick releases performed at various activation levels to assess the applicability of the slack test method in human. Maximal fascicle shortening velocity and joint velocity recorded during quick releases and during fast contraction without external load (ballistic condition) were compared. Gastrocnemius medialis fascicle behaviour was investigated from 25 participants using high-frame rate ultrasound during quick releases performed at various activation levels (from 0% to 60% of maximal voluntary isometric torque) and ballistic contractions. Unloaded joint velocity calculated using the slack test method increased whereas V F decreased with muscle activation level (P≤0.03). Passive and low-level quick releases elicited higher V F values (≥ 41.4±9.7 cm.s -1 ) compared to ballistic condition (36.3±8.7 cm.s -1 ), while quick releases applied at 60% of maximal voluntary isometric torque produced the lowest V F These findings suggest that initial fascicle length, complex fascicle-tendon interactions, unloading reflex and motor-driven movement pattern strongly influence and limit the shortening velocity achieved during the slack test. Furthermore, V F elicited by quick releases is likely to reflect substantial contributions of passive processes. Therefore, the slack test is not appropriate to assess maximal muscle shortening velocity in vivo. © 2018. Published by The Company of Biologists Ltd.

Bench performance of ventilators during simulated paediatric ventilation.

Science.gov (United States)

Park, M A J; Freebairn, R C; Gomersall, C D

2013-05-01

This study compares the accuracy and capabilities of various ventilators using a paediatric acute respiratory distress syndrome lung model. Various compliance settings and respiratory rate settings were used. The study was done in three parts: tidal volume and FiO2 accuracy; pressure control accuracy and positive end-expiratory pressure (PEEP) accuracy. The parameters set on the ventilator were compared with either or both of the measured parameters by the test lung and the ventilator. The results revealed that none of the ventilators could consistently deliver tidal volumes within 1 ml/kg of the set tidal volume, and the discrepancy between the delivered volume and the volume measured by the ventilator varied greatly. The target tidal volume was 8 ml/kg, but delivered tidal volumes ranged from 3.6-11.4 ml/kg and the volumes measured by the ventilator ranged from 4.1-20.6 ml/kg. All the ventilators maintained pressure within 20% of the set pressure, except one ventilator which delivered pressures of up to 27% higher than the set pressure. Two ventilators maintained PEEP within 10% of the prescribed PEEP. The majority of the readings were also within 10%. However, three ventilators delivered, at times, PEEPs over 20% higher. In conclusion, as lung compliance decreases, especially in paediatric patients, some ventilators perform better than others. This study highlights situations where ventilators may not be able to deliver, nor adequately measure, set tidal volumes, pressure, PEEP or FiO2.

Anaesthesia ventilators

OpenAIRE

Jain, Rajnish K; Swaminathan, Srinivasan

2013-01-01

Anaesthesia ventilators are an integral part of all modern anaesthesia workstations. Automatic ventilators in the operating rooms, which were very simple with few modes of ventilation when introduced, have become very sophisticated with many advanced ventilation modes. Several systems of classification of anaesthesia ventilators exist based upon various parameters. Modern anaesthesia ventilators have either a double circuit, bellow design or a single circuit piston configuration. In the bello...

[Anesthesia ventilators].

Science.gov (United States)

Otteni, J C; Beydon, L; Cazalaà, J B; Feiss, P; Nivoche, Y

1997-01-01

To review anaesthesia ventilators in current use in France by categories of ventilators. References were obtained from computerized bibliographic search. (Medline), recent review articles, the library of the service and personal files. Anaesthesia ventilators can be allocated into three groups, depending on whether they readminister expired gases or not or allow both modalities. Contemporary ventilators provide either constant volume ventilation, or constant pressure ventilation, with or without a pressure plateau. Ventilators readministering expired gases after CO2 absorption, or closed circuit ventilators, are either of a double- or a single-circuit design. Double-circuit ventilators, or pneumatical bag or bellows squeezers, or bag-in-bottle or bellows-in-bottle (or box) ventilators, consist of a primary, or driving circuit (bottle or box) and a secondary or patient circuit (including a bag or a bellows or membrane chambers). Bellows-in-bottle ventilators have either standing bellows ascending at expiration, or hanging bellows, descending at expiration. Ascending bellows require a positive pressure of about 2 cmH2O throughout exhalation to allow the bellows to refill. The expired gas volume is a valuable indicator for leak and disconnection. Descending bellows generate a slight negative pressure during exhalation. In case of leak or disconnection they aspirate ambient air and cannot act therefore as an indicator for integrity of the circuit and the patient connection. Closed circuit ventilators with a single-circuit (patient circuit) include a insufflating device consisting either in a bellows or a cylinder with a piston, operated by a electric or pneumatic motor. As the hanging bellows of the double circuit ventilators, they generate a slight negative pressure during exhalation and aspirate ambient air in case of leak or disconnection. Ventilators not designed for the readministration of expired gases, or open circuit ventilators, are generally stand

Ventilation systems

International Nuclear Information System (INIS)

Gossler

1980-01-01

The present paper deals with - controlled area ventilation systems - ventilation systems for switchgear-building and control-room - other ventilation systems for safety equipments - service systems for ventilation systems. (orig./RW)

Measuring voluntary quadriceps activation: Effect of visual feedback and stimulus delivery.

Science.gov (United States)

Luc, Brittney A; Harkey, Matthew H; Arguelles, Gabrielle D; Blackburn, J Troy; Ryan, Eric D; Pietrosimone, Brian

2016-02-01

Quadriceps voluntary activation, assessed via the superimposed burst technique, has been extensively studied in a variety of populations as a measure of quadriceps function. However, a variety of stimulus delivery techniques have been employed, which may influence the level of voluntary activation as calculated via the central activation ratio (CAR). The purpose was to determine the effect of visual feedback, stimulus delivery, and perceived discomfort on maximal voluntary isometric contraction (MVIC) peak torque and the CAR. Quadriceps CAR was assessed in 14 individuals on two days using three stimulus delivery methods; (1) manual without visual feedback, (2) manual with visual feedback, and (3) automated with visual feedback. MVIC peak torque and the CAR were not different between the automated with visual feedback (MVIC=3.25, SE=0.14Nm/kg; CAR=88.63, SE=1.75%) and manual with visual feedback (MVIC=3.26, SE=0.13Nm/kg, P=0.859; CAR=89.06, SE=1.70%, P=0.39) stimulus delivery methods. MVIC (2.99, SE=0.12Nm/kg) and CAR (85.32, SE=2.10%) were significantly lower using manual without visual feedback compared to manual with visual feedback and automated with visual feedback (CAR P<0.001; MVIC P<0.001). Perceived discomfort was lower in the second session (P<0.05). Utilizing visual feedback ensures participant MVIC, and may provide a more accurate assessment of quadriceps voluntary activation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Tidal ventilation distribution during pressure-controlled ventilation and pressure support ventilation in post-cardiac surgery patients.

Science.gov (United States)

Blankman, P; VAN DER Kreeft, S M; Gommers, D

2014-09-01

Inhomogeneous ventilation is an important contributor to ventilator-induced lung injury. Therefore, this study examines homogeneity of lung ventilation by means of electrical impedance tomography (EIT) measurements during pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) using the same ventilation pressures. Twenty mechanically ventilated patients were studied after cardiac surgery. On arrival at the intensive care unit, ventilation distribution was measured with EIT just above the diaphragm for 15 min. After awakening, PCV was switched to PSV and EIT measurements were again recorded. Tidal impedance variation, a measure of tidal volume, increased during PSV compared with PCV, despite using the same ventilation pressures (P = 0.045). The distribution of tidal ventilation to the dependent lung region was more pronounced during PSV compared with PCV, especially during the first half of the inspiration. An even distribution of tidal ventilation between the dependent and non-dependent lung regions was seen during PCV at lower tidal volumes (tidal volumes (≥ 8 ml/kg). In addition, the distribution of tidal ventilation was predominantly distributed to the dependent lung during PSV at low tidal volumes. In post-cardiac surgery patients, PSV showed improved ventilation of the dependent lung region due to the contribution of the diaphragm activity, which is even more pronounced during lower assist levels. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Mechanical Ventilation

Science.gov (United States)

... ventilation is a life support treatment. A mechanical ventilator is a machine that helps people breathe when ... to breathe enough on their own. The mechanical ventilator is also called a ventilator , respirator, or breathing ...

Drainage of pleural effusion improves diaphragmatic function in mechanically ventilated patients.

Science.gov (United States)

Umbrello, Michele; Mistraletti, Giovanni; Galimberti, Andrea; Piva, Ilaria R; Cozzi, Ottavia; Formenti, Paolo

2017-03-01

Pleural effusion adversely affects the pressuregenerating capacity of the diaphragm. It uncouples the lung and chest wall, which may result in diaphragmatic dysfunction. Information on the effects of effusion drainage on diaphragmatic function is limited, but several studies report relief of dyspnoea after drainage, which was attributed to improved diaphragmatic mechanics, even if this issue was never formally addressed. To investigate the effect of drainage of unilateral pleural effusion on diaphragmatic function. In a prospective twostep protocol (at baseline and after drainage of effusion), we conducted a spontaneous breathing trial in fourteen critically ill, mechanically ventilated patients undergoing pressure support ventilation. We used ultrasonography of the ipsilateral hemidiaphragm to evaluate and record respiratory displacement and thickening during tidal and maximal breathing efforts. We recorded and analysed airway pressures, respiratory system compliance, vital capacity, indices of respiratory effort and arterial blood gases. After drainage of the effusion, the respiratory rate decreased and tidal volume increased, but haemodynamic parameters were unaffected and oxygenation levels showed a non-significant increase. Drainage was associated with significant decreases in indices of respiratory drive and the maximal pressure generated by the respiratory muscles, as well as an increased compliance of the respiratory system. Diaphragmatic displacement and thickening significantly increased after drainage. We found there was a significant correlation between the volume of the effusion drained and the increase in tidal diaphragmatic thickening. Drainage of a unilateral pleural effusion during weaning from mechanical ventilation improves diaphragmatic contractile activity and respiratory system performance.

Seasonal Temperature Variations controlling Cave Ventilation Processes in Cueva Larga, Puerto Rico

Science.gov (United States)

Winter, A.; Vieten, R.; Warken, S. F.; Schrӧder-Ritzrau, A.; Miller, T. E.; Scholz, D.

2016-12-01

Two years of monthly monitoring result in much better understanding of ventilation processes in caves. Cueva Larga, a tropical cave in Puerto Rico is 1440 m long with a large main passage (about 116,000 m3). Cave air pCO2 in the main passage varied seasonally, between 600 ppm in winter and 1800 ppm in summer. The seasonal variability in cave pCO2 made it possible to estimate a cave air exchange time of 36±5 days and a winter ventilation rate of 3,200±800 m3/day for the main cave passage. Calculations of virtual temperature and differences between cave and surface temperature show that the seasonal temperature cycle is the main driver of the alternation between a well-ventilated winter mode and a near-stagnant summer mode. The winter mode is characterized by a positive buoyancy contrast at night leading to maximal cave ventilation, while during summer ventilation is at a minimum. Between winter and summer, a transitional mode of partial cave ventilation is observed. On shorter time scales (diurnal to weekly), cave pCO2 is also influenced by atmospheric pressure but this variation is one order of magnitude lower than the seasonal pCO2 change. The cave morphology of Cueva Larga including its large volume, tubular shape and the obstructed cave entrance geometry are important boundary conditions for the observed ventilation patterns. Our findings emphasize that cave systems with varying morphology have to be studied individually in order to correctly describe ventilation processes.

Support for Voluntary Euthanasia with No Logical Slippery Slope to Non-Voluntary Euthanasia.

Science.gov (United States)

Daskal, Steven

2018-01-01

This paper demonstrates that acceptance of voluntary euthanasia does not generate commitment to either non-voluntary euthanasia or euthanasia on request. This is accomplished through analysis of John Keown's and David Jones's slippery slope arguments, and rejection of their view that voluntary euthanasia requires physicians to judge patients as better off dead. Instead, voluntary euthanasia merely requires physicians to judge patients as within boundaries of appropriate deference. This paper develops two ways of understanding and defending voluntary euthanasia on this model, one focused on the independent value of patients' autonomy and the other on the evidence of well-being provided by patients' requests. Both avoid the purported slippery slopes and both are independently supported by an analogy to uncontroversial elements of medical practice. Moreover, the proposed analyses of voluntary euthanasia suggest parameters for the design of euthanasia legislation, both supporting and challenging elements of existing laws in Oregon and the Netherlands.

Displacement ventilation

DEFF Research Database (Denmark)

Kosonen, Risto; Melikov, Arsen Krikor; Mundt, Elisabeth

The aim of this Guidebook is to give the state-of-the art knowledge of the displacement ventilation technology, and to simplify and improve the practical design procedure. The Guidebook discusses methods of total volume ventilation by mixing ventilation and displacement ventilation and it gives...... insights of the performance of the displacement ventilation. It also shows practical case studies in some typical applications and the latest research findings to create good local micro-climatic conditions....

Battery life of portable home ventilators: effects of ventilator settings.

Science.gov (United States)

Falaize, Line; Leroux, Karl; Prigent, Hélène; Louis, Bruno; Khirani, Sonia; Orlikowski, David; Fauroux, Brigitte; Lofaso, Frédéric

2014-07-01

The battery life (BL) of portable home ventilator batteries is reported by manufacturers. The aim of this study was to evaluate the effects of ventilator mode, breathing frequency, PEEP, and leaks on the BL of 5 commercially available portable ventilators. The effects of the ventilator mode (volume controlled-continuous mandatory ventilation [VC-CMV] vs pressure support ventilation [PSV]), PEEP 5 cm H2O, breathing frequency (10, 15, and 20 breaths/min), and leaks during both volume-targeted ventilation and PSV on the BL of 5 ventilators (Elisée 150, Monnal T50, PB560, Vivo 50, and Trilogy 100) were evaluated. Each ventilator was ventilated with a test lung at a tidal volume of 700 ml and an inspiratory time of 1.2 s in the absence of leaks. Switching from PSV to VC-CMV or the addition of PEEP did not significantly change ventilator BL. The increase in breathing frequency from 10 to 20 breaths/min decreased the BL by 18 ± 11% (P = .005). Leaks were associated with an increase in BL during the VC-CMV mode (18 ± 20%, P = .04) but a decrease in BL during the PSV mode (-13 ± 15%, P = .04). The BL of home ventilators depends on the ventilator settings. BL is not affected by the ventilator mode (VC-CMV or PSV) or the addition of PEEP. BL decreases with an increase in breathing frequency and during leaks with a PSV mode, whereas leaks increase the duration of ventilator BL during VC-CMV. Copyright © 2014 by Daedalus Enterprises.

VENTILATION MODEL

International Nuclear Information System (INIS)

V. Chipman

2002-01-01

The purpose of the Ventilation Model is to simulate the heat transfer processes in and around waste emplacement drifts during periods of forced ventilation. The model evaluates the effects of emplacement drift ventilation on the thermal conditions in the emplacement drifts and surrounding rock mass, and calculates the heat removal by ventilation as a measure of the viability of ventilation to delay the onset of peak repository temperature and reduce its magnitude. The heat removal by ventilation is temporally and spatially dependent, and is expressed as the fraction of heat carried away by the ventilation air compared to the fraction of heat produced by radionuclide decay. One minus the heat removal is called the wall heat fraction, or the remaining amount of heat that is transferred via conduction to the surrounding rock mass. Downstream models, such as the ''Multiscale Thermohydrologic Model'' (BSC 2001), use the wall heat fractions as outputted from the Ventilation Model to initialize their postclosure analyses

Are there benefits or harm from pressure targeting during lung-protective ventilation?

Science.gov (United States)

MacIntyre, Neil R; Sessler, Curtis N

2010-02-01

Mechanically, breath design is usually either flow/volume-targeted or pressure-targeted. Both approaches can effectively provide lung-protective ventilation, but they prioritize different ventilation parameters, so their responses to changing respiratory-system mechanics and patient effort are different. These different response behaviors have advantages and disadvantages that can be important in specific circumstances. Flow/volume targeting guarantees a set minute ventilation but sometimes may be difficult to synchronize with patient effort, and it will not limit inspiratory pressure. In contrast, pressure targeting, with its variable flow, may be easier to synchronize and will limit inspiratory pressure, but it provides no control over delivered volume. Skilled clinicians can maximize benefits and minimize problems with either flow/volume targeting or pressure targeting. Indeed, as is often the case in managing complex life-support devices, it is operator expertise rather than the device design features that most impacts patient outcomes.

Postactivation potentiation biases maximal isometric strength assessment.

Science.gov (United States)

Lima, Leonardo Coelho Rabello; Oliveira, Felipe Bruno Dias; Oliveira, Thiago Pires; Assumpção, Claudio de Oliveira; Greco, Camila Coelho; Cardozo, Adalgiso Croscato; Denadai, Benedito Sérgio

2014-01-01

Postactivation potentiation (PAP) is known to enhance force production. Maximal isometric strength assessment protocols usually consist of two or more maximal voluntary isometric contractions (MVCs). The objective of this study was to determine if PAP would influence isometric strength assessment. Healthy male volunteers (n = 23) performed two five-second MVCs separated by a 180-seconds interval. Changes in isometric peak torque (IPT), time to achieve it (tPTI), contractile impulse (CI), root mean square of the electromyographic signal during PTI (RMS), and rate of torque development (RTD), in different intervals, were measured. Significant increases in IPT (240.6 ± 55.7 N·m versus 248.9 ± 55.1 N·m), RTD (746 ± 152 N·m·s(-1) versus 727 ± 158 N·m·s(-1)), and RMS (59.1 ± 12.2% RMSMAX  versus 54.8 ± 9.4% RMSMAX) were found on the second MVC. tPTI decreased significantly on the second MVC (2373 ± 1200 ms versus 2784 ± 1226 ms). We conclude that a first MVC leads to PAP that elicits significant enhancements in strength-related variables of a second MVC performed 180 seconds later. If disconsidered, this phenomenon might bias maximal isometric strength assessment, overestimating some of these variables.

The empirical slippery slope from voluntary to non-voluntary euthanasia.

Science.gov (United States)

Lewis, Penney

2007-01-01

This article examines the evidence for the empirical argument that there is a slippery slope between the legalization of voluntary and non-voluntary euthanasia. The main source of evidence in relation to this argument comes from the Netherlands. The argument is only effective against legalization if it is legalization which causes the slippery slope. Moreover, it is only effective if it is used comparatively-to show that the slope is more slippery in jurisdictions which have legalized voluntary euthanasia than it is in jurisdictions which have not done so. Both of these elements are examined comparatively.

Patient-Ventilator Dyssynchrony

Directory of Open Access Journals (Sweden)

Elvira-Markela Antonogiannaki

2017-11-01

Full Text Available In mechanically ventilated patients, assisted mechanical ventilation (MV is employed early, following the acute phase of critical illness, in order to eliminate the detrimental effects of controlled MV, most notably the development of ventilator-induced diaphragmatic dysfunction. Nevertheless, the benefits of assisted MV are often counteracted by the development of patient-ventilator dyssynchrony. Patient-ventilator dyssynchrony occurs when either the initiation and/or termination of mechanical breath is not in time agreement with the initiation and termination of neural inspiration, respectively, or if the magnitude of mechanical assist does not respond to the patient’s respiratory demand. As patient-ventilator dyssynchrony has been associated with several adverse effects and can adversely influence patient outcome, every effort should be made to recognize and correct this occurrence at bedside. To detect patient-ventilator dyssynchronies, the physician should assess patient comfort and carefully inspect the pressure- and flow-time waveforms, available on the ventilator screen of all modern ventilators. Modern ventilators offer several modifiable settings to improve patient-ventilator interaction. New proportional modes of ventilation are also very helpful in improving patient-ventilator interaction.

Initial mechanical ventilator settings and lung protective ventilation in the ED.

Science.gov (United States)

Wilcox, Susan R; Richards, Jeremy B; Fisher, Daniel F; Sankoff, Jeffrey; Seigel, Todd A

2016-08-01

Mechanical ventilation with low tidal volumes has been shown to improve outcomes for patients both with and without acute respiratory distress syndrome. This study aims to characterize mechanically ventilated patients in the emergency department (ED), describe the initial ED ventilator settings, and assess for associations between lung protective ventilation strategies in the ED and outcomes. This was a multicenter, prospective, observational study of mechanical ventilation at 3 academic EDs. We defined lung protective ventilation as a tidal volume of less than or equal to 8 mL/kg of predicted body weight and compared outcomes for patients ventilated with lung protective vs non-lung protective ventilation, including inhospital mortality, ventilator days, intensive care unit length of stay, and hospital length of stay. Data from 433 patients were analyzed. Altered mental status without respiratory pathology was the most common reason for intubation, followed by trauma and respiratory failure. Two hundred sixty-one patients (60.3%) received lung protective ventilation, but most patients were ventilated with a low positive end-expiratory pressure, high fraction of inspired oxygen strategy. Patients were ventilated in the ED for a mean of 5 hours and 7 minutes but had few ventilator adjustments. Outcomes were not significantly different between patients receiving lung protective vs non-lung protective ventilation. Nearly 40% of ED patients were ventilated with non-lung protective ventilation as well as with low positive end-expiratory pressure and high fraction of inspired oxygen. Despite a mean ED ventilation time of more than 5 hours, few patients had adjustments made to their ventilators. Copyright © 2016 Elsevier Inc. All rights reserved.

Relation between Peak Power Output in Sprint Cycling and Maximum Voluntary Isometric Torque Production.

Science.gov (United States)

Kordi, Mehdi; Goodall, Stuart; Barratt, Paul; Rowley, Nicola; Leeder, Jonathan; Howatson, Glyn

2017-08-01

From a cycling paradigm, little has been done to understand the relationships between maximal isometric strength of different single joint lower body muscle groups and their relation with, and ability to predict PPO and how they compare to an isometric cycling specific task. The aim of this study was to establish relationships between maximal voluntary torque production from isometric single-joint and cycling specific tasks and assess their ability to predict PPO. Twenty male trained cyclists participated in this study. Peak torque was measured by performing maximum voluntary contractions (MVC) of knee extensors, knee flexors, dorsi flexors and hip extensors whilst instrumented cranks measured isometric peak torque from MVC when participants were in their cycling specific position (ISOCYC). A stepwise regression showed that peak torque of the knee extensors was the only significant predictor of PPO when using SJD and accounted for 47% of the variance. However, when compared to ISOCYC, the only significant predictor of PPO was ISOCYC, which accounted for 77% of the variance. This suggests that peak torque of the knee extensors was the best single-joint predictor of PPO in sprint cycling. Furthermore, a stronger prediction can be made from a task specific isometric task. Copyright © 2017 Elsevier Ltd. All rights reserved.

Demand Controlled Ventilation in a Combined Ventilation and Radiator System

OpenAIRE

Hesaraki, Arefeh; Holmberg, Sture

2013-01-01

With growing concerns for efficient and sustainable energy treatment in buildings there is a need for balanced and intelligent ventilation solutions. This paper presents a strategy for demand controlled ventilation with ventilation radiators, a combined heating and ventilation system. The ventilation rate was decreased from normal requirements (per floor area) of 0.375 l·s-1·m-2 to 0.100 l·s-1·m-2 when the residence building was un-occupied. The energy saving potential due to decreased ventil...

[Lung protective ventilation. Ventilatory modes and ventilator parameters].

Science.gov (United States)

Schädler, Dirk; Weiler, Norbert

2008-06-01

Mechanical ventilation has a considerable potential for injuring the lung tissue. Therefore, attention has to be paid to the proper choice of ventilatory mode and settings to secure lung-protective ventilation whenever possible. Such ventilator strategy should account for low tidal volume ventilation (6 ml/kg PBW), limited plateau pressure (30 to 35 cm H2O) and positive end-expiratory pressure (PEEP). It is unclear whether pressure controlled or volume controlled ventilation with square flow profile is beneficial. The adjustment of inspiration and expiration time should consider the actual breathing mechanics and anticipate the generation of intrinsic PEEP. Ventilatory modes with the possibility of supporting spontaneous breathing should be used as soon as possible.

Variable mechanical ventilation.

Science.gov (United States)

Fontela, Paula Caitano; Prestes, Renata Bernardy; Forgiarini, Luiz Alberto; Friedman, Gilberto

2017-01-01

To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique. Search, selection, and analysis of all original articles on variable ventilation, without restriction on the period of publication and language, available in the electronic databases LILACS, MEDLINE®, and PubMed, by searching the terms "variable ventilation" OR "noisy ventilation" OR "biologically variable ventilation". A total of 36 studies were selected. Of these, 24 were original studies, including 21 experimental studies and three clinical studies. Several experimental studies reported the beneficial effects of distinct variable ventilation strategies on lung function using different models of lung injury and healthy lungs. Variable ventilation seems to be a viable strategy for improving gas exchange and respiratory mechanics and preventing lung injury associated with mechanical ventilation. However, further clinical studies are necessary to assess the potential of variable ventilation strategies for the clinical improvement of patients undergoing mechanical ventilation.

Mine ventilation engineering

Energy Technology Data Exchange (ETDEWEB)

Hall, C.J.

1981-01-01

This book on mine ventilation covers psychometrics, airflow through roadways and ducts, natural ventilation, fans, instruments, ventilation surveys, auxiliary ventilation, air quality, and planning and economics.

Meeting Residential Ventilation Standards Through Dynamic Control of Ventilation Systems

OpenAIRE

Sherman, Max H.

2011-01-01

Existing ventilation standards, including American Society of Heating, Refrigerating, and Air-conditioning Engineers (ASHRAE) Standard 62.2, specify continuous operation of a defined mechanical ventilation system to provide minimum ventilation, with time-based intermittent operation as an option. This requirement ignores several factors and concerns including: other equipment such as household exhaust fans that might incidentally provide ventilation, negative impacts of ventilation when outd...

Ventilator-Related Adverse Events: A Taxonomy and Findings From 3 Incident Reporting Systems.

Science.gov (United States)

Pham, Julius Cuong; Williams, Tamara L; Sparnon, Erin M; Cillie, Tam K; Scharen, Hilda F; Marella, William M

2016-05-01

In 2009, researchers from Johns Hopkins University's Armstrong Institute for Patient Safety and Quality; public agencies, including the FDA; and private partners, including the Emergency Care Research Institute and the University HealthSystem Consortium (UHC) Safety Intelligence Patient Safety Organization, sought to form a public-private partnership for the promotion of patient safety (P5S) to advance patient safety through voluntary partnerships. The study objective was to test the concept of the P5S to advance our understanding of safety issues related to ventilator events, to develop a common classification system for categorizing adverse events related to mechanical ventilators, and to perform a comparison of adverse events across different adverse event reporting systems. We performed a cross-sectional analysis of ventilator-related adverse events reported in 2012 from the following incident reporting systems: the Pennsylvania Patient Safety Authority's Patient Safety Reporting System, UHC's Safety Intelligence Patient Safety Organization database, and the FDA's Manufacturer and User Facility Device Experience database. Once each organization had its dataset of ventilator-related adverse events, reviewers read the narrative descriptions of each event and classified it according to the developed common taxonomy. A Pennsylvania Patient Safety Authority, FDA, and UHC search provided 252, 274, and 700 relevant reports, respectively. The 3 event types most commonly reported to the UHC and the Pennsylvania Patient Safety Authority's Patient Safety Reporting System databases were airway/breathing circuit issue, human factor issues, and ventilator malfunction events. The top 3 event types reported to the FDA were ventilator malfunction, power source issue, and alarm failure. Overall, we found that (1) through the development of a common taxonomy, adverse events from 3 reporting systems can be evaluated, (2) the types of events reported in each database were related

Ventilator-Related Adverse Events: A Taxonomy and Findings From 3 Incident Reporting Systems

Science.gov (United States)

Pham, Julius Cuong; Williams, Tamara L; Sparnon, Erin M; Cillie, Tam K; Scharen, Hilda F; Marella, William M

2016-01-01

BACKGROUND: In 2009, researchers from Johns Hopkins University's Armstrong Institute for Patient Safety and Quality; public agencies, including the FDA; and private partners, including the Emergency Care Research Institute and the University HealthSystem Consortium (UHC) Safety Intelligence Patient Safety Organization, sought to form a public-private partnership for the promotion of patient safety (P5S) to advance patient safety through voluntary partnerships. The study objective was to test the concept of the P5S to advance our understanding of safety issues related to ventilator events, to develop a common classification system for categorizing adverse events related to mechanical ventilators, and to perform a comparison of adverse events across different adverse event reporting systems. METHODS: We performed a cross-sectional analysis of ventilator-related adverse events reported in 2012 from the following incident reporting systems: the Pennsylvania Patient Safety Authority's Patient Safety Reporting System, UHC's Safety Intelligence Patient Safety Organization database, and the FDA's Manufacturer and User Facility Device Experience database. Once each organization had its dataset of ventilator-related adverse events, reviewers read the narrative descriptions of each event and classified it according to the developed common taxonomy. RESULTS: A Pennsylvania Patient Safety Authority, FDA, and UHC search provided 252, 274, and 700 relevant reports, respectively. The 3 event types most commonly reported to the UHC and the Pennsylvania Patient Safety Authority's Patient Safety Reporting System databases were airway/breathing circuit issue, human factor issues, and ventilator malfunction events. The top 3 event types reported to the FDA were ventilator malfunction, power source issue, and alarm failure. CONCLUSIONS: Overall, we found that (1) through the development of a common taxonomy, adverse events from 3 reporting systems can be evaluated, (2) the types of

Human versus Computer Controlled Selection of Ventilator Settings: An Evaluation of Adaptive Support Ventilation and Mid-Frequency Ventilation

Directory of Open Access Journals (Sweden)

Eduardo Mireles-Cabodevila

2012-01-01

Full Text Available Background. There are modes of mechanical ventilation that can select ventilator settings with computer controlled algorithms (targeting schemes. Two examples are adaptive support ventilation (ASV and mid-frequency ventilation (MFV. We studied how different clinician-chosen ventilator settings are from these computer algorithms under different scenarios. Methods. A survey of critical care clinicians provided reference ventilator settings for a 70 kg paralyzed patient in five clinical/physiological scenarios. The survey-derived values for minute ventilation and minute alveolar ventilation were used as goals for ASV and MFV, respectively. A lung simulator programmed with each scenario’s respiratory system characteristics was ventilated using the clinician, ASV, and MFV settings. Results. Tidal volumes ranged from 6.1 to 8.3 mL/kg for the clinician, 6.7 to 11.9 mL/kg for ASV, and 3.5 to 9.9 mL/kg for MFV. Inspiratory pressures were lower for ASV and MFV. Clinician-selected tidal volumes were similar to the ASV settings for all scenarios except for asthma, in which the tidal volumes were larger for ASV and MFV. MFV delivered the same alveolar minute ventilation with higher end expiratory and lower end inspiratory volumes. Conclusions. There are differences and similarities among initial ventilator settings selected by humans and computers for various clinical scenarios. The ventilation outcomes are the result of the lung physiological characteristics and their interaction with the targeting scheme.

Ventilation models

Science.gov (United States)

Skaaret, Eimund

Calculation procedures, used in the design of ventilating systems, which are especially suited for displacement ventilation in addition to linking it to mixing ventilation, are addressed. The two zone flow model is considered and the steady state and transient solutions are addressed. Different methods of supplying air are discussed, and different types of air flow are considered: piston flow, plane flow and radial flow. An evaluation model for ventilation systems is presented.

Noninvasive ventilation.

Science.gov (United States)

Rabatin, J T; Gay, P C

1999-08-01

Noninvasive ventilation refers to the delivery of assisted ventilatory support without the use of an endotracheal tube. Noninvasive positive pressure ventilation (NPPV) can be delivered by using a volume-controlled ventilator, a pressure-controlled ventilator, a bilevel positive airway pressure ventilator, or a continuous positive airway pressure device. During the past decade, there has been a resurgence in the use of noninvasive ventilation, fueled by advances in technology and clinical trials evaluating its use. Several manufacturers produce portable devices that are simple to operate. This review describes the equipment, techniques, and complications associated with NPPV and also the indications for both short-term and long-term applications. NPPV clearly represents an important addition to the techniques available to manage patients with respiratory failure. Future clinical trials evaluating its many clinical applications will help to define populations of patients most apt to benefit from this type of treatment.

Contextualizing ethics: ventilators, H1N1 and marginalized populations.

Science.gov (United States)

Silva, Diego S; Nie, Jason X; Rossiter, Kate; Sahni, Sachin; Upshur, Ross E G

2010-01-01

If the H1N1 pandemic worsens, there may not be enough ventilated beds to care for all persons with respiratory failure. To date, researchers who explicitly discuss the ethics of intensive care unit admission and the allocation of ventilators during an influenza pandemic have based criteria predominantly on the principles of utility and efficiency, that is, promoting actions that maximize the greatest good for the greatest number of people. However, haphazardly applying utility and efficiency potentially disadvantages marginalized populations who might be at increased risk of severe reactions to H1N1. In Canada, Aboriginals represent 3% of Canadians, yet 11% of H1N1 cases requiring hospitalization involve Aboriginal persons. Aboriginal persons suffer from high rates of obesity due to socio-economic inequalities. Obesity is also a risk factor for severe H1N1 reactions. Yet, since obesity is found to increase the duration of stay in ventilated beds and a long stay is not considered an optimal use of ventilators, applying the principles of utility and efficiency may magnify existing social inequalities. Although promoting utility and efficiency is important, other ethical principles, such as equity and need, require thoughtful consideration and implementation. Furthermore, since public resources are being used to address a public health hazard, the viewpoints of the public, and specifically stakeholders who will be disproportionately affected, should inform decision-makers. Finally, giving attention to the needs and rights of marginalized populations means that ventilators should not be allocated based on criteria that exacerbate the social injustices faced by these groups of people.

Cardiorespiratory Coordination in Repeated Maximal Exercise

Directory of Open Access Journals (Sweden)

Sergi Garcia-Retortillo

2017-06-01

Full Text Available Increases in cardiorespiratory coordination (CRC after training with no differences in performance and physiological variables have recently been reported using a principal component analysis approach. However, no research has yet evaluated the short-term effects of exercise on CRC. The aim of this study was to delineate the behavior of CRC under different physiological initial conditions produced by repeated maximal exercises. Fifteen participants performed 2 consecutive graded and maximal cycling tests. Test 1 was performed without any previous exercise, and Test 2 6 min after Test 1. Both tests started at 0 W and the workload was increased by 25 W/min in males and 20 W/min in females, until they were not able to maintain the prescribed cycling frequency of 70 rpm for more than 5 consecutive seconds. A principal component (PC analysis of selected cardiovascular and cardiorespiratory variables (expired fraction of O2, expired fraction of CO2, ventilation, systolic blood pressure, diastolic blood pressure, and heart rate was performed to evaluate the CRC defined by the number of PCs in both tests. In order to quantify the degree of coordination, the information entropy was calculated and the eigenvalues of the first PC (PC1 were compared between tests. Although no significant differences were found between the tests with respect to the performed maximal workload (Wmax, maximal oxygen consumption (VO2 max, or ventilatory threshold (VT, an increase in the number of PCs and/or a decrease of eigenvalues of PC1 (t = 2.95; p = 0.01; d = 1.08 was found in Test 2 compared to Test 1. Moreover, entropy was significantly higher (Z = 2.33; p = 0.02; d = 1.43 in the last test. In conclusion, despite the fact that no significant differences were observed in the conventionally explored maximal performance and physiological variables (Wmax, VO2 max, and VT between tests, a reduction of CRC was observed in Test 2. These results emphasize the interest of CRC

Predicting the lung compliance of mechanically ventilated patients via statistical modeling

International Nuclear Information System (INIS)

Ganzert, Steven; Kramer, Stefan; Guttmann, Josef

2012-01-01

To avoid ventilator associated lung injury (VALI) during mechanical ventilation, the ventilator is adjusted with reference to the volume distensibility or ‘compliance’ of the lung. For lung-protective ventilation, the lung should be inflated at its maximum compliance, i.e. when during inspiration a maximal intrapulmonary volume change is achieved by a minimal change of pressure. To accomplish this, one of the main parameters is the adjusted positive end-expiratory pressure (PEEP). As changing the ventilator settings usually produces an effect on patient's lung mechanics with a considerable time delay, the prediction of the compliance change associated with a planned change of PEEP could assist the physician at the bedside. This study introduces a machine learning approach to predict the nonlinear lung compliance for the individual patient by Gaussian processes, a probabilistic modeling technique. Experiments are based on time series data obtained from patients suffering from acute respiratory distress syndrome (ARDS). With a high hit ratio of up to 93%, the learned models could predict whether an increase/decrease of PEEP would lead to an increase/decrease of the compliance. However, the prediction of the complete pressure–volume relation for an individual patient has to be improved. We conclude that the approach is well suitable for the given problem domain but that an individualized feature selection should be applied for a precise prediction of individual pressure–volume curves. (paper)

The deflation limb of the pressure-volume relationship in infants during high-frequency ventilation.

Science.gov (United States)

Tingay, David G; Mills, John F; Morley, Colin J; Pellicano, Anastasia; Dargaville, Peter A

2006-02-15

The importance of applying high-frequency oscillatory ventilation with a high lung volume strategy in infants is well established. Currently, a lack of reliable methods for assessing lung volume limits clinicians' ability to achieve the optimum volume range. To map the pressure-volume relationship of the lung during high-frequency oscillatory ventilation in infants, to determine at what point ventilation is being applied clinically, and to describe the relationship between airway pressure, lung volume, and oxygenation. In 12 infants, a partial inflation limb and the deflation limb of the pressure-volume relationship were mapped using a quasi-static lung volume optimization maneuver. This involved stepwise airway pressure increments to total lung capacity, followed by decrements until the closing pressure of the lung was identified. Lung volume and oxygen saturation were recorded at each airway pressure. Lung volume was measured using respiratory inductive plethysmography. A distinct deflation limb could be mapped in each infant. Overall, oxygenation and lung volume were improved by applying ventilation on the deflation limb. Maximal lung volume and oxygenation occurred on the deflation limb at a mean airway pressure of 3 and 5 cm H(2)O below the airway pressure approximating total lung capacity, respectively. Using current ventilation strategies, all infants were being ventilated near the inflation limb. It is possible to delineate the deflation limb in infants receiving high-frequency oscillatory ventilation; in doing so, greater lung volume and oxygenation can be achieved, often at lower airway pressures.

Human response to ductless personalized ventilation coupled with displacement ventilation

DEFF Research Database (Denmark)

Dalewski, Mariusz; Veselý, Michal; Melikov, Arsen K.

2012-01-01

A human subject experiment was carried out to investigate the extent to which ductless personalized ventilation (DPV) in conjunction with displacement ventilation can improve perceived air quality (PAQ) and thermal comfort at elevated room air temperature in comparison with displacement ventilation...... alone. The experimental conditions comprised displacement ventilation alone (room air temperature of 23 °C, 26 °C, 29 °C) and DPV with displacement ventilation (26 °C, 29 °C), both operating at supply air temperatures 3, 5 or 6K lower than room air temperature, as well as mixing ventilation (23 °C, 3 K......). During one hour exposure participants answered questionnaires regarding PAQ and thermal comfort. PAQ was significantly better with DPV than without DPV at the same background conditions. Thermal comfort improved when DPV was used. Combining DPV with displacement ventilation showed the potential...

Industrial ventilation

Science.gov (United States)

Goodfellow, H. D.

Industrial ventilation design methodology, using computers and using fluid dynamic models, is considered. It is noted that the design of a ventilation system must be incorporated into the plant design and layout at the earliest conceptual stage of the project. A checklist of activities concerning the methodology for the design of a ventilation system for a new facility is given. A flow diagram of the computer ventilation model shows a typical input, the initialization and iteration loop, and the output. The application of the fluid dynamic modeling techniques include external and internal flow fields, and individual sources of heat and contaminants. Major activities for a ventilation field test program are also addressed.

Voluntary agreements in environmental policy

International Nuclear Information System (INIS)

Torvanger, Asbjoern

2001-01-01

A typically voluntary agreement is signed between the authorities and an industrial sector in order to reduce the emission of environmentally harmful substances. There are many different types of agreements. Voluntary agreements are not strictly voluntary, since in the background there is often some kind of ''threat'' about taxation or fees if the industry is unwilling to cooperate. This type of agreements has become popular in many OECD countries during the last decades. In Norway there are only a few agreements of this type. Experience with the use of voluntary agreements as well as research show that they are less cost-effective than market-based instruments such as taxes and quota systems. If there are great restrictions on the use of taxes and quota systems because of information- or measurement problems, or because these instruments are not politically acceptable, then voluntary agreements may be an interesting alternative. Thus, voluntary agreements are best used as a supplement to other instruments in some niche areas of the environmental policy. In some cases, voluntary agreements may be used between two countries or at a regional level, for example within the EU

Diffuse Ceiling Ventilation

DEFF Research Database (Denmark)

Zhang, Chen; Yu, Tao; Heiselberg, Per Kvols

with conventional ventilation systems (mixing or displacement ventilation), diffuse ceiling ventilation can significantly reduce or even eliminate draught risk in the occupied zone. Moreover, this ventilation system presents a promising opportunity for energy saving, because of the low pressure loss, extended free...

Diffuse ceiling ventilation

DEFF Research Database (Denmark)

Zhang, Chen

Diffuse ceiling ventilation is an innovative ventilation concept where the suspended ceiling serves as air diffuser to supply fresh air into the room. Compared with conventional ventilation systems, diffuse ceiling ventilation can significantly reduce or even eliminate draught risk due to the low...

Voluntary Service System (VSS)

Data.gov (United States)

Department of Veterans Affairs — Voluntary Service System (VSS) is a national-level application which replaced the site-based Voluntary Timekeeping System (VTK). VTK was used for many years at the...

Radioaerosol ventilation imaging in ventilator-dependent patients. Technical considerations

International Nuclear Information System (INIS)

Vezina, W.; Chamberlain, M.; Vinitski, S.; King, M.; Nicholson, R.; Morgan, W.K.

1985-01-01

The differentiation of pulmonary embolism (PE) from regional ventilatory abnormalities accompanied by reduced perfusion requires contemporary perfusion and ventilation studies. Distinguishing these conditions in ventilator-dependent patients is aided by administering a Tc-99m aerosol to characterize regional ventilation, and by performing a conventional Tc-99m MAA perfusion study. The technique uses a simple in-house constructed apparatus. Simple photographic techniques suffice, but computer subtraction of perfusion from the combined perfusion-ventilation image renders interpretation easier if aerosol administration follows perfusion imaging. Multiple defects can be examined in a single study. Excluding normal or near-normal perfusion studies, PE was thought to be present in eight of 16 patients after perfusion imaging alone, but in only one of eight after added aerosol imaging. Angiography confirmed the diagnosis in that patient. Of the eight patients who had abnormal perfusion but were thought unlikely to have PE from the perfusion study alone, two had normal ventilation, and subsequently were shown to have PE by angiography. Because angiography was only performed on patients who were thought to have a high probability of PE on sequential perfusion-ventilation imaging, the true incidence of PE may have been higher. Aerosol ventilation imaging is a useful adjunct to perfusion imaging in patients on ventilators. It requires an efficient delivery system, particularly if aerosol administration follows perfusion imaging, as it does in this study

Ventilation Model

International Nuclear Information System (INIS)

Yang, H.

1999-01-01

The purpose of this analysis and model report (AMR) for the Ventilation Model is to analyze the effects of pre-closure continuous ventilation in the Engineered Barrier System (EBS) emplacement drifts and provide heat removal data to support EBS design. It will also provide input data (initial conditions, and time varying boundary conditions) for the EBS post-closure performance assessment and the EBS Water Distribution and Removal Process Model. The objective of the analysis is to develop, describe, and apply calculation methods and models that can be used to predict thermal conditions within emplacement drifts under forced ventilation during the pre-closure period. The scope of this analysis includes: (1) Provide a general description of effects and heat transfer process of emplacement drift ventilation. (2) Develop a modeling approach to simulate the impacts of pre-closure ventilation on the thermal conditions in emplacement drifts. (3) Identify and document inputs to be used for modeling emplacement ventilation. (4) Perform calculations of temperatures and heat removal in the emplacement drift. (5) Address general considerations of the effect of water/moisture removal by ventilation on the repository thermal conditions. The numerical modeling in this document will be limited to heat-only modeling and calculations. Only a preliminary assessment of the heat/moisture ventilation effects and modeling method will be performed in this revision. Modeling of moisture effects on heat removal and emplacement drift temperature may be performed in the future

Displacement Ventilation

DEFF Research Database (Denmark)

Nielsen, Peter Vilhelm

Displacement ventilation is an interesting new type of air distribution principle which should be considered in connection with design of comfort ventilation in both smal1 and large spaces. Research activities on displacement ventilation are large all over the world and new knowledge of design...... methods appears continuously. This book gives an easy introduction to the basis of displacement ventilation and the chapters are written in the order which is used in a design procedure. The main text is extended by five appendices which show some of the new research activities taking place at Aalborg...

Trigger performance of mid-level ICU mechanical ventilators during assisted ventilation: a bench study.

Science.gov (United States)

Ferreira, Juliana C; Chipman, Daniel W; Kacmarek, Robert M

2008-09-01

To compare the triggering performance of mid-level ICU mechanical ventilators with a standard ICU mechanical ventilator. Experimental bench study. The respiratory care laboratory of a university-affiliated teaching hospital. A computerized mechanical lung model, the IngMar ASL5000. Ten mid-level ICU ventilators were compared to an ICU ventilator at two levels of lung model effort, three combinations of respiratory mechanics (normal, COPD and ARDS) and two modes of ventilation, volume and pressure assist/control. A total of 12 conditions were compared. Performance varied widely among ventilators. Mean inspiratory trigger time was ventilators. The mean inspiratory delay time (time from initiation of the breath to return of airway pressure to baseline) was longer than that for the ICU ventilator for all tested ventilators except one. The pressure drop during triggering (Ptrig) was comparable with that of the ICU ventilator for only two ventilators. Expiratory Settling Time (time for pressure to return to baseline) had the greatest variability among ventilators. Triggering differences among these mid-level ICU ventilators and with the ICU ventilator were identified. Some of these ventilators had a much poorer triggering response with high inspiratory effort than the ICU ventilator. These ventilators do not perform as well as ICU ventilators in patients with high ventilatory demand.

Isometric parameters in the monitoring of maximal strength, power, and hypertrophic resistance-training.

Science.gov (United States)

Peltonen, Heikki; Walker, Simon; Lähitie, Anuliisa; Häkkinen, Keijo; Avela, Janne

2018-02-01

This study monitored strength-training adaptations via isometric parameters throughout 2 × 10 weeks of hypertrophic (HYP I-II) or 10 weeks maximum strength (MS) followed by 10 weeks power (P) training with untrained controls. Trainees performed bilateral isometric leg press tests analyzed for peak force (maximal voluntary contraction (MVC)) and rate of force development (RFD) every 3.5 weeks. These parameters were compared with dynamic performance, voluntary and electrically induced isometric contractions, muscle activity, and cross-sectional area (CSA) in the laboratory before and after 10 and 20 weeks. RFD increased similarly during the first 7 weeks (HYP I, 44% ± 53%; MS, 48% ± 55%, P strength/power training, while MVC cannot distinguish between strength or muscle mass changes. Monitoring RFD provided important information regarding plateaus in RFD improvement, which were observed in dynamic explosive performances after HYP II compared with P.

Volume-Targeted Ventilation in the Neonate: Benchmarking Ventilators on an Active Lung Model.

Science.gov (United States)

Krieger, Tobias J; Wald, Martin

2017-03-01

Mechanically ventilated neonates have been observed to receive substantially different ventilation after switching ventilator models, despite identical ventilator settings. This study aims at establishing the range of output variability among 10 neonatal ventilators under various breathing conditions. Relative benchmarking test of 10 neonatal ventilators on an active neonatal lung model. Neonatal ICU. Ten current neonatal ventilators. Ventilators were set identically to flow-triggered, synchronized, volume-targeted, pressure-controlled, continuous mandatory ventilation and connected to a neonatal lung model. The latter was configured to simulate three patients (500, 1,500, and 3,500 g) in three breathing modes each (passive breathing, constant active breathing, and variable active breathing). Averaged across all weight conditions, the included ventilators delivered between 86% and 110% of the target tidal volume in the passive mode, between 88% and 126% during constant active breathing, and between 86% and 120% under variable active breathing. The largest relative deviation occurred during the 500 g constant active condition, where the highest output machine produced 147% of the tidal volume of the lowest output machine. All machines deviate significantly in volume output and ventilation regulation. These differences depend on ventilation type, respiratory force, and patient behavior, preventing the creation of a simple conversion table between ventilator models. Universal neonatal tidal volume targets for mechanical ventilation cannot be transferred from one ventilator to another without considering necessary adjustments.

Voluntary Environmental Governance Arrangements

NARCIS (Netherlands)

van der Heijden, J.

2012-01-01

Voluntary environmental governance arrangements have focal attention in studies on environmental policy, regulation and governance. The four major debates in the contemporary literature on voluntary environmental governance arrangements are studied. The literature falls short of sufficiently

Voluntary wheel running is beneficial to the amino acid profile of lysine-deficient rats.

Science.gov (United States)

Nagao, Kenji; Bannai, Makoto; Seki, Shinobu; Kawai, Nobuhiro; Mori, Masato; Takahashi, Michio

2010-06-01

Rats voluntarily run up to a dozen kilometers per night when their cages are equipped with a running wheel. Daily voluntary running is generally thought to enhance protein turnover. Thus, we sought to determine whether running worsens or improves protein degradation caused by a lysine-deficient diet and whether it changes the utilization of free amino acids released by proteolysis. Rats were fed a lysine-deficient diet and were given free access to a running wheel or remained sedentary (control) for 4 wk. Amino acid levels in plasma, muscle, and liver were measured together with plasma insulin levels and tissue weight. The lysine-deficient diet induced anorexia, skeletal muscle loss, and serine and threonine aminoacidemia, and it depleted plasma insulin and essential amino acids in skeletal muscle. Allowing rats to run voluntarily improved these symptoms; thus, voluntary wheel running made the rats less susceptible to dietary lysine deficiency. Amelioration of the declines in muscular leucine and plasma insulin observed in running rats could contribute to protein synthesis together with the enhanced availability of lysine and other essential amino acids in skeletal muscle. These results indicate that voluntary wheel running under lysine-deficient conditions does not enhance protein catabolism; on the contrary, it accelerates protein synthesis and contributes to the maintenance of muscle mass. The intense nocturnal voluntary running that characterizes rodents might be an adaptation of lysine-deficient grain eaters that allows them to maximize opportunities for food acquisition.

Plasma volume expansion does not increase maximal cardiac output or VO2 max in lowlanders acclimatized to altitude

DEFF Research Database (Denmark)

Calbet, José A L; Rådegran, Göran; Boushel, Robert Christopher

2004-01-01

liter of 6% dextran 70 (BV = 6.32 +/- 0.34 liters). PV expansion had no effect on Qmax, maximal O2 consumption (VO2), and exercise capacity. Despite maximal systemic O2 transport being reduced 19% due to hemodilution after PV expansion, whole body VO2 was maintained by greater systemic O2 extraction (P...... VO2 during exercise regardless of PV. Pulmonary ventilation, gas exchange, and acid-base balance were essentially unaffected by PV expansion. Sea......With altitude acclimatization, blood hemoglobin concentration increases while plasma volume (PV) and maximal cardiac output (Qmax) decrease. This investigation aimed to determine whether reduction of Qmax at altitude is due to low circulating blood volume (BV). Eight Danish lowlanders (3 females, 5...

Effect of voluntary physical activity initiated at age 7 months on skeletal hindlimb and cardiac muscle function in mdx mice of both genders.

Science.gov (United States)

Ferry, Arnaud; Benchaouir, Rachid; Joanne, Pierre; Peat, Rachel A; Mougenot, Nathalie; Agbulut, Onnik; Butler-Browne, Gillian

2015-11-01

The effects of voluntary activity initiated in adult mdx (C57BL/10ScSc-DMD(mdx) /J) mice on skeletal and cardiac muscle function have not been studied extensively. We studied the effects of 3 months of voluntary wheel running initiated at age 7 months on hindlimb muscle weakness, increased susceptibility to muscle contraction-induced injury, and left ventricular function in mdx mice. We found that voluntary wheel running did not worsen the deficit in force-generating capacity and the force drop after lengthening contractions in either mdx mouse gender. It increased the absolute maximal force of skeletal muscle in female mdx mice. Moreover, it did not affect left ventricular function, structural heart dimensions, cardiac gene expression of inflammation, fibrosis, or remodeling markers. These results indicate that voluntary activity initiated at age 7 months had no detrimental effects on skeletal or cardiac muscles in either mdx mouse gender. © 2015 Wiley Periodicals, Inc.

VENTILATION NEEDS DURING CONSTRUCTION

International Nuclear Information System (INIS)

C.R. Gorrell

1998-01-01

The purpose of this analysis is to determine ventilation needs during construction and development of the subsurface repository and develop systems to satisfy those needs. For this analysis, construction is defined as pre-emplacement excavation and development is excavation that takes place simultaneously with emplacement. The three options presented in the ''Overall Development and Emplacement Ventilation Systems'' analysis (Reference 5.5) for development ventilation will be applied to construction ventilation in this analysis as well as adding new and updated ventilation factors to each option for both construction and development. The objective of this analysis is to develop a preferred ventilation system to support License Application Design. The scope of this analysis includes: (1) Description of ventilation conditions; (2) Ventilation factors (fire hazards, dust control, construction logistics, and monitoring and control systems); (3) Local ventilation alternatives; (4) Global ventilation options; and (5) Evaluation of options

International Voluntary Renewable Energy Markets (Presentation)

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.

2012-06-01

This presentation provides an overview of international voluntary renewable energy markets, with a focus on the United States and Europe. The voluntary renewable energy market is the market in which consumers and institutions purchase renewable energy to match their electricity needs on a voluntary basis. In 2010, the U.S. voluntary market was estimated at 35 terawatt-hours (TWh) compared to 300 TWh in the European market, though key differences exist. On a customer basis, Australia has historically had the largest number of customers, pricing for voluntary certificates remains low, at less than $1 megawatt-hour, though prices depend on technology.

Ventilative Cooling

DEFF Research Database (Denmark)

Heiselberg, Per Kvols; Kolokotroni, Maria

This report, by venticool, summarises the outcome of the work of the initial working phase of IEA ECB Annex 62 Ventilative Cooling and is based on the findings in the participating countries. It presents a summary of the first official Annex 62 report that describes the state-of-the-art of ventil......This report, by venticool, summarises the outcome of the work of the initial working phase of IEA ECB Annex 62 Ventilative Cooling and is based on the findings in the participating countries. It presents a summary of the first official Annex 62 report that describes the state......-of-the-art of ventilative cooling potentials and limitations, its consideration in current energy performance regulations, available building components and control strategies and analysis methods and tools. In addition, the report provides twenty six examples of operational buildings using ventilative cooling ranging from...

46 CFR 111.103-1 - Power ventilation systems except machinery space ventilation systems.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Power ventilation systems except machinery space ventilation systems. 111.103-1 Section 111.103-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Power ventilation systems except machinery space ventilation systems. Each power ventilation system must...

78 FR 69793 - Voluntary Remedial Actions and Guidelines for Voluntary Recall Notices

Science.gov (United States)

2013-11-21

...'' and ``hard copy'' as possible forms of direct voluntary recall notice. Because firms often lack... formatting of a voluntary recall notice in the form of a press release should comport with the most current... transmitted using an electronic medium and in hard copy form. Acceptable forms of, and means for...

[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.

The voluntary offset - approaches and limitations

International Nuclear Information System (INIS)

2012-06-01

After having briefly presented the voluntary offset mechanism which aims at funding a project of reduction or capture of greenhouse gas emissions, this document describes the approach to be followed to adopt this voluntary offset, for individuals as well as for companies, communities or event organisations. It describes other important context issues (projects developed under the voluntary offset, actors of the voluntary offsetting market, market status, offset labels), and how to proceed in practice (definition of objectives and expectations, search for needed requirements, to ensure the meeting of requirements with respect to expectations). It addresses the case of voluntary offset in France (difficult implantation, possible solutions)

Ventilation effectiveness

CERN Document Server

Mathisen, Hans Martin; Nielsen, Peter V; Moser, Alfred

2004-01-01

Improving the ventilation effectiveness allows the indoor air quality to be significantly enhanced without the need for higher air changes in the building, thereby avoiding the higher costs and energy consumption associated with increasing the ventilation rates. This Guidebook provides easy-to-understand descriptions of the indices used to mesure the performance of a ventilation system and which indices to use in different cases.

Collateral ventilation quantification using xenon-enhanced dynamic dual-energy CT: Differences between canine and swine models of bronchial occlusion

Energy Technology Data Exchange (ETDEWEB)

Kim, Eun Ah; Goo, Jin Mo; Park, Sang Joon; Lee, Chang Hyun; Park, Chng Min [Dept. of Radiology, Seoul National University College of Medicine and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul (Korea, Republic of)

2015-06-15

The aim of this study was to evaluate whether the difference in the degree of collateral ventilation between canine and swine models of bronchial obstruction could be detected by using xenon-enhanced dynamic dual-energy CT. Eight mongrel dogs and six pigs underwent dynamic dual-energy scanning of 64-slice dual-source CT at 12-second interval for 2-minute wash-in period (60% xenon) and at 24-second interval for 3-minute wash-out period with segmental bronchus occluded. Ventilation parameters of magnitude (A value), maximal slope, velocity (K value), and time-to-peak (TTP) enhancement were calculated from dynamic xenon maps using exponential function of Kety model. A larger difference in A value between parenchyma was observed in pigs than in dogs (absolute difference, -33.0 +/- 5.0 Hounsfield units [HU] vs. -2.8 +/- 7.1 HU, p = 0.001; normalized percentage difference, -79.8 +/- 1.8% vs. -5.4 +/- 16.4%, p = 0.0007). Mean maximal slopes in both periods in the occluded parenchyma only decreased in pigs (all p < 0.05). K values of both periods were not different (p = 0.892) in dogs. However, a significant (p = 0.027) difference was found in pigs in the wash-in period. TTP was delayed in the occluded parenchyma in pigs (p = 0.013) but not in dogs (p = 0.892). Xenon-ventilation CT allows the quantification of collateral ventilation and detection of differences between canine and swine models of bronchial obstruction.

Collateral ventilation quantification using xenon-enhanced dynamic dual-energy CT: Differences between canine and swine models of bronchial occlusion

International Nuclear Information System (INIS)

Kim, Eun Ah; Goo, Jin Mo; Park, Sang Joon; Lee, Chang Hyun; Park, Chng Min

2015-01-01

The aim of this study was to evaluate whether the difference in the degree of collateral ventilation between canine and swine models of bronchial obstruction could be detected by using xenon-enhanced dynamic dual-energy CT. Eight mongrel dogs and six pigs underwent dynamic dual-energy scanning of 64-slice dual-source CT at 12-second interval for 2-minute wash-in period (60% xenon) and at 24-second interval for 3-minute wash-out period with segmental bronchus occluded. Ventilation parameters of magnitude (A value), maximal slope, velocity (K value), and time-to-peak (TTP) enhancement were calculated from dynamic xenon maps using exponential function of Kety model. A larger difference in A value between parenchyma was observed in pigs than in dogs (absolute difference, -33.0 +/- 5.0 Hounsfield units [HU] vs. -2.8 +/- 7.1 HU, p = 0.001; normalized percentage difference, -79.8 +/- 1.8% vs. -5.4 +/- 16.4%, p = 0.0007). Mean maximal slopes in both periods in the occluded parenchyma only decreased in pigs (all p < 0.05). K values of both periods were not different (p = 0.892) in dogs. However, a significant (p = 0.027) difference was found in pigs in the wash-in period. TTP was delayed in the occluded parenchyma in pigs (p = 0.013) but not in dogs (p = 0.892). Xenon-ventilation CT allows the quantification of collateral ventilation and detection of differences between canine and swine models of bronchial obstruction.

Liquid Ventilation

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Qutaiba A. Tawfic

2011-01-01

Full Text Available Mammals have lungs to breathe air and they have no gills to breath liquids. When the surface tension at the air-liquid interface of the lung increases, as in acute lung injury, scientists started to think about filling the lung with fluid instead of air to reduce the surface tension and facilitate ventilation. Liquid ventilation (LV is a technique of mechanical ventilation in which the lungs are insufflated with an oxygenated perfluorochemical liquid rather than an oxygen-containing gas mixture. The use of perfluorochemicals, rather than nitrogen, as the inert carrier of oxygen and carbon dioxide offers a number of theoretical advantages for the treatment of acute lung injury. In addition, there are non-respiratory applications with expanding potential including pulmonary drug delivery and radiographic imaging. The potential for multiple clinical applications for liquid-assisted ventilation will be clarified and optimized in future. Keywords: Liquid ventilation; perfluorochemicals; perfluorocarbon; respiratory distress; surfactant.

Abnormal ventilation scans in middle-aged smokers. Comparison with tests of overall lung function

International Nuclear Information System (INIS)

Barter, S.J.; Cunningham, D.A.; Lavender, J.P.; Gibellino, F.; Connellan, S.J.; Pride, N.B.

1985-01-01

The uniformity of regional ventilation during tidal breathing has been assessed using continuous inhalation of krypton-81m in 43 male, lifelong nonsmokers and 46 male, current cigarette smokers (mean daily consumption 24.1 cigarettes/day) between 44 and 61 yr of age and with mild or no respiratory symptoms. All subjects had normal chest radiographs. The results of the ventilation scans were compared with tests of overall lung function (spirometry, maximal expiratory flow-volume curves, and single-breath N2 test). Diffuse abnormalities of the ventilation scan were found in 19 (41%) of the 46 smokers but in none of the nonsmokers. Focal abnormalities were found in 7 smokers and 3 nonsmokers. Smokers showed the expected abnormalities in overall lung function (reduced FEV1 and VC, increased single-breath N2 slope, and closing volume), but in individual smokers there was only a weak relation between the severity of abnormality of overall lung function and an abnormal ventilation scan. Abnormal scans could be found when overall lung function was normal and were not invariably found when significant abnormalities in FEV1/VC or N2 slope were present. There was no relation between the presence of chronic expectoration and an abnormal scan. The prognostic significance of an abnormal ventilation scan in such smokers remains to be established

Nasal mask ventilation is better than face mask ventilation in edentulous patients.

Science.gov (United States)

Kapoor, Mukul Chandra; Rana, Sandeep; Singh, Arvind Kumar; Vishal, Vindhya; Sikdar, Indranil

2016-01-01

Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated. Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively evaluated. After induction of anesthesia and administration of neuromuscular blocker, lungs were ventilated with a standard anatomical face mask of appropriate size, using a volume controlled anesthesia ventilator with tidal volume set at 10 ml/kg. In case of inadequate ventilation, the mask position was adjusted to achieve best-fit. Inspired and expired tidal volumes were measured. Thereafter, the face mask was replaced by a nasal mask and after achieving best-fit, the inspired and expired tidal volumes were recorded. The difference in expired tidal volumes and airway pressures at best-fit with the use of the two masks and number of patients with inadequate ventilation with use of the masks were statistically analyzed. A total of 79 edentulous patients were recruited for the study. The difference in expiratory tidal volumes with the use of the two masks at best-fit was statistically significant (P = 0.0017). Despite the best-fit mask placement, adequacy of ventilation could not be achieved in 24.1% patients during face mask ventilation, and 12.7% patients during nasal mask ventilation and the difference was statistically significant. Nasal mask ventilation is more efficient than standard face mask ventilation in edentulous patients.

SUPRAGLOTTIC JET VENTILATION VERSUS CONVENTIONAL ENDOTRACHEAL VENTILATION IN MINOR LARYNGEAL SURGERIES

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Illendual Upendranath

2016-08-01

Full Text Available Any attempt at intubation will cause many cardiovascular responses and the major concern during this time is to attenuate the same. Similar response is seen during procedures on Larynx in microlaryngeal surgery which produces an intense cardiovascular stimulation during suspension laryngoscopy and intubation. AIM OF STUDY Supraglottic jet ventilation versus conventional endotracheal ventilation in minor laryngeal surgeries. To evaluate the haemodynamic response in supraglottic jet ventilation and conventional intubation in minor laryngeal surgeries. METHODS Patients were randomised to 2 Groups: 30 patients in each group; Group A - in whom supraglottic jet ventilation was planned and Group B - in whom endotracheal intubation was planned. RESULT The haemodynamic response in terms of increase in MAP and HR is significantly more with endotracheal intubation than with supraglottic jet ventilation. CONCLUSION Our study showed that supraglottic jet ventilation showed a better haemodynamic stability when compared to conventional endotracheal intubation in patients undergoing minor laryngeal surgeries. Statistical scores were also in favour of the patients treated with supraglottic jet ventilation based on the p values.

History of Mechanical Ventilation. From Vesalius to Ventilator-induced Lung Injury.

Science.gov (United States)

Slutsky, Arthur S

2015-05-15

Mechanical ventilation is a life-saving therapy that catalyzed the development of modern intensive care units. The origins of modern mechanical ventilation can be traced back about five centuries to the seminal work of Andreas Vesalius. This article is a short history of mechanical ventilation, tracing its origins over the centuries to the present day. One of the great advances in ventilatory support over the past few decades has been the development of lung-protective ventilatory strategies, based on our understanding of the iatrogenic consequences of mechanical ventilation such as ventilator-induced lung injury. These strategies have markedly improved clinical outcomes in patients with respiratory failure.

Recovery of voluntary and evoked muscle performance following intermittent-sprint exercise in the heat.

Science.gov (United States)

Duffield, Rob; King, Monique; Skein, Melissa

2009-06-01

This study investigated the effects of hot conditions on the acute recovery of voluntary and evoked muscle performance and physiological responses following intermittent exercise. Seven youth male and six female team-sport athletes performed two sessions separated by 7 d, involving a 30-min exercise protocol and 60-min passive recovery in either 22 degrees C or 33 degrees C and 40% relative humidity. The exercise protocol involved a 20-s maximal sprint every 5 min, separated by constant-intensity exercise at 100 W on a cycle ergometer. Maximal voluntary contraction (MVC) and a resting evoked twitch (Pf) of the right knee extensors were assessed before and immediately following exercise and again 15, 30, and 60 min postexercise, and capillary blood was obtained at the same time points to measure lactate, pH, and HCO3. During and following exercise, core temperature, heart rate and rating of perceived exertion (RPE) were also measured. No differences (P=0.73 to 0.95) in peak power during repeated sprints were present between conditions. Postexercise MVC was reduced (Pheat (83+/-10 vs 74+/-11% recovered). Both heart rate and core temperature were significantly higher (Precovery in the heat. Capillary blood values did not differ between conditions at any time point, whereas sessional RPE was higher 60 min postexercise in the heat. The current data suggests that passive recovery in warm temperatures not only delays cardiovascular and thermal recovery, but may also slow the recovery of MVC and RPE.

Comparing Voluntary and Mandatory Gameplay

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Esther Kuindersma

2016-09-01

Full Text Available Gameplay is commonly considered to be a voluntary activity. Game designers generally believe that voluntary gameplay is essentially different from mandatory gameplay. Such a belief may be a challenge for serious games, as instruction is usually mandatory. The article describes the outcomes of two experiments on the impact of voluntariness on the learning effect and enjoyment of a serious game. In the first experiment freedom of choosing to play a serious game was studied, with participants who had volunteered to participate. The results suggested that, contrary to the opinion of many game designers, being required to play a serious game does not automatically take the fun out of the game. The second experiment had voluntary participants and mandatory participants, who had to participate as part of a homework assignment. The outcomes show that mandatory participants enjoyed the game as much as the voluntary participants, even if they had to play the game for a minimum required time. These studies indicate that mandatory gameplay does not reduce enjoyment and learning effect.

WE-AB-202-08: Feasibility of Single-Inhalation/Single-Energy Xenon CT for High-Resolution Imaging of Regional Lung Ventilation in Humans

International Nuclear Information System (INIS)

Pinkham, D; Schueler, E; Diehn, M; Mittra, E; Loo, B; Maxim, P; Negahdar, M; Yamamoto, T

2016-01-01

quantify regional lung ventilation volumetrically with high resolution using widely accessible radiologic equipment. Bill Loo and Peter Maxim are founders of TibaRay, Inc. Bill Loo is also a board member. Bill Loo and Peter Maxim have received research grants from Varian Medical Systems, Inc. and RaySearch Laboratory

WE-AB-202-08: Feasibility of Single-Inhalation/Single-Energy Xenon CT for High-Resolution Imaging of Regional Lung Ventilation in Humans

Energy Technology Data Exchange (ETDEWEB)

Pinkham, D; Schueler, E; Diehn, M; Mittra, E; Loo, B; Maxim, P [Stanford University School of Medicine, Palo Alto, California (United States); Negahdar, M [IBM Research Center, San Jose, California (United States); Yamamoto, T [University of California Davis Medical Center, Sacramento, CA (United States)

2016-06-15

quantify regional lung ventilation volumetrically with high resolution using widely accessible radiologic equipment. Bill Loo and Peter Maxim are founders of TibaRay, Inc. Bill Loo is also a board member. Bill Loo and Peter Maxim have received research grants from Varian Medical Systems, Inc. and RaySearch Laboratory.

Diaphragmatic reinnervation in ventilator-dependent patients with cervical spinal cord injury and concomitant phrenic nerve lesions using simultaneous nerve transfers and implantable neurostimulators.

Science.gov (United States)

Kaufman, Matthew R; Elkwood, Andrew I; Aboharb, Farid; Cece, John; Brown, David; Rezzadeh, Kameron; Jarrahy, Reza

2015-06-01

Patients who are ventilator dependent as a result of combined cervical spinal cord injury and phrenic nerve lesions are generally considered to be unsuitable candidates for diaphragmatic pacing due to loss of phrenic nerve integrity and denervation of the diaphragm. There is limited data regarding efficacy of simultaneous nerve transfers and diaphragmatic pacemakers in the treatment of this patient population. A retrospective review was conducted of 14 consecutive patients with combined lesions of the cervical spinal cord and phrenic nerves, and with complete ventilator dependence, who were treated with simultaneous microsurgical nerve transfer and implantation of diaphragmatic pacemakers. Parameters of interest included time to recovery of diaphragm electromyographic activity, average time pacing without the ventilator, and percent reduction in ventilator dependence. Recovery of diaphragm electromyographic activity was demonstrated in 13 of 14 (93%) patients. Eight of these 13 (62%) patients achieved sustainable periods (> 1 h/d) of ventilator weaning (mean = 10 h/d [n = 8]). Two patients recovered voluntary control of diaphragmatic activity and regained the capacity for spontaneous respiration. The one patient who did not exhibit diaphragmatic reinnervation remains within 12 months of initial treatment. Surgical intervention resulted in a 25% reduction (p nerve transfers and pacemaker implantation can result in reinnervation of the diaphragm and lead to successful ventilator weaning. Our favorable outcomes support consideration of this surgical method for appropriate patients who would otherwise have no alternative therapy to achieve sustained periods of ventilator independence. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Caffeine stimulates voluntary wheel running in mice without increasing aerobic capacity.

Science.gov (United States)

Claghorn, Gerald C; Thompson, Zoe; Wi, Kristianna; Van, Lindsay; Garland, Theodore

2017-03-01

The "energy drink" Red Bull and the "sports drink" Gatorade are often marketed to athletes, with claims that they cause performance gains. However, both are high in sugars, and also consumed by non-athletes. Few studies have addressed the effects of these drinks or their biologically active components in rodent exercise models. We used three experiments to test effects on both voluntary exercise behavior and maximal aerobic capacity in lines of mice known to differ in "athletic" traits. Mice from four replicate High Runner (HR) lines have been selectively bred for voluntary running on wheels, and run approximately three times as many revolutions per day as do mice from four non-selected Control (C) lines. HR mice also have higher endurance and maximal oxygen consumption (VO 2 max) during forced treadmill exercise. In Experiment 1, we tested the hypothesis that Gatorade or Red Bull might cause or allow mice to increase their voluntary wheel running. On days 5 and 6 of 6days of wheel access, as is used to select breeders, HR mice ran 3.3-fold more than C, and females ran 1.2-fold more than males, with no linetype by sex interaction. On day 7, mice were administered Gatorade, Red Bull or tap water. During the subsequent 19-hour period, Gatorade had no statistical effect on running, but Red Bull significantly increased distance run by both sexes and in both HR and C lines. The increase in distance run caused by Red Bull was attributable to time spent running, not an increase in mean (or maximum) speed. As previous studies have found that sucrose alone does not generally increase wheel running, we tested two other active ingredients in Red Bull, caffeine and taurine, in Experiment 2. With a similar testing protocol, caffeine alone and caffeine+taurine increased running by about half the magnitude of Red Bull. In Experiment 3, we tested the hypothesis that Red Bull or caffeine alone can increase physiological performance ability during aerobic exercise, measured as VO 2

Tri-maximal vs. bi-maximal neutrino mixing

International Nuclear Information System (INIS)

Scott, W.G

2000-01-01

It is argued that data from atmospheric and solar neutrino experiments point strongly to tri-maximal or bi-maximal lepton mixing. While ('optimised') bi-maximal mixing gives an excellent a posteriori fit to the data, tri-maximal mixing is an a priori hypothesis, which is not excluded, taking account of terrestrial matter effects

Potential risk for bacterial contamination in conventional reused ventilator systems and disposable closed ventilator-suction systems.

Science.gov (United States)

Li, Ya-Chi; Lin, Hui-Ling; Liao, Fang-Chun; Wang, Sing-Siang; Chang, Hsiu-Chu; Hsu, Hung-Fu; Chen, Sue-Hsien; Wan, Gwo-Hwa

2018-01-01

Few studies have investigated the difference in bacterial contamination between conventional reused ventilator systems and disposable closed ventilator-suction systems. The aim of this study was to investigate the bacterial contamination rates of the reused and disposable ventilator systems, and the association between system disconnection and bacterial contamination of ventilator systems. The enrolled intubated and mechanically ventilated patients used a conventional reused ventilator system and a disposable closed ventilator-suction system, respectively, for a week; specimens were then collected from the ventilator circuit systems to evaluate human and environmental bacterial contamination. The sputum specimens from patients were also analyzed in this study. The detection rate of bacteria in the conventional reused ventilator system was substantially higher than that in the disposable ventilator system. The inspiratory and expiratory limbs of the disposable closed ventilator-suction system had higher bacterial concentrations than the conventional reused ventilator system. The bacterial concentration in the heated humidifier of the reused ventilator system was significantly higher than that in the disposable ventilator system. Positive associations existed among the bacterial concentrations at different locations in the reused and disposable ventilator systems, respectively. The predominant bacteria identified in the reused and disposable ventilator systems included Acinetobacter spp., Bacillus cereus, Elizabethkingia spp., Pseudomonas spp., and Stenotrophomonas (Xan) maltophilia. Both the reused and disposable ventilator systems had high bacterial contamination rates after one week of use. Disconnection of the ventilator systems should be avoided during system operation to decrease the risks of environmental pollution and human exposure, especially for the disposable ventilator system. ClinicalTrials.gov PRS / NCT03359148.

Improving the Accuracy of Predicting Maximal Oxygen Consumption (VO2pk)

Science.gov (United States)

Downs, Meghan E.; Lee, Stuart M. C.; Ploutz-Snyder, Lori; Feiveson, Alan

2016-01-01

Maximal oxygen (VO2pk) is the maximum amount of oxygen that the body can use during intense exercise and is used for benchmarking endurance exercise capacity. The most accurate method to determineVO2pk requires continuous measurements of ventilation and gas exchange during an exercise test to maximal effort, which necessitates expensive equipment, a trained staff, and time to set-up the equipment. For astronauts, accurate VO2pk measures are important to assess mission critical task performance capabilities and to prescribe exercise intensities to optimize performance. Currently, astronauts perform submaximal exercise tests during flight to predict VO2pk; however, while submaximal VO2pk prediction equations provide reliable estimates of mean VO2pk for populations, they can be unacceptably inaccurate for a given individual. The error in current predictions and logistical limitations of measuring VO2pk, particularly during spaceflight, highlights the need for improved estimation methods.

Do new anesthesia ventilators deliver small tidal volumes accurately during volume-controlled ventilation?

Science.gov (United States)

Bachiller, Patricia R; McDonough, Joseph M; Feldman, Jeffrey M

2008-05-01

During mechanical ventilation of infants and neonates, small changes in tidal volume may lead to hypo- or hyperventilation, barotrauma, or volutrauma. Partly because breathing circuit compliance and fresh gas flow affect tidal volume delivery by traditional anesthesia ventilators in volume-controlled ventilation (VCV) mode, pressure-controlled ventilation (PCV) using a circle breathing system has become a common approach to minimizing the risk of mechanical ventilation for small patients, although delivered tidal volume is not assured during PCV. A new generation of anesthesia machine ventilators addresses the problems of VCV by adjusting for fresh gas flow and for the compliance of the breathing circuit. In this study, we evaluated the accuracy of new anesthesia ventilators to deliver small tidal volumes. Four anesthesia ventilator systems were evaluated to determine the accuracy of volume delivery to the airway during VCV at tidal volume settings of 100, 200, and 500 mL under different conditions of breathing circuit compliance (fully extended and fully contracted circuits) and lung compliance. A mechanical test lung (adult and infant) was used to simulate lung compliances ranging from 0.0025 to 0.03 L/cm H(2)O. Volumes and pressures were measured using a calibrated screen pneumotachograph and custom software. We tested the Smartvent 7900, Avance, and Aisys anesthesia ventilator systems (GE Healthcare, Madison, WI) and the Apollo anesthesia ventilator (Draeger Medical, Telford, PA). The Smartvent 7900 and Avance ventilators use inspiratory flow sensors to control the volume delivered, whereas the Aisys and Apollo ventilators compensate for the compliance of the circuit. We found that the anesthesia ventilators that use compliance compensation (Aisys and Apollo) accurately delivered both large and small tidal volumes to the airway of the test lung under conditions of normal and low lung compliance during VCV (ranging from 95.5% to 106.2% of the set tidal volume

Factors Predicting Ventilator Dependence in Patients with Ventilator-Associated Pneumonia

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Chia-Cheng Tseng

2012-01-01

Full Text Available Objectives. To determine risk factors associated with ventilator dependence in patients with ventilator-associated pneumonia (VAP. Study Design. A retrospective study was conducted at Chang Gung Memorial Hospital, Kaohsiung, from January 1, 2007 to January 31, 2008. Methods. This study evaluated 163 adult patients (aged ≥18 years. Eligibility was evaluated according to the criterion for VAP, Sequential Organ Failure Assessment (SOFA score, Acute Physiological Assessment and Chronic Health Evaluation II (APACHE II score. Oxygenation index, underlying comorbidities, septic shock status, previous tracheostomy status, and factors related to pneumonia were collected for analysis. Results. Of the 163 VAP patients in the study, 90 patients survived, yielding a mortality rate of 44.8%. Among the 90 surviving patients, only 36 (40% had been weaned off ventilators at the time of discharge. Multivariate logistic regression analysis was used to identify underlying factors such as congestive cardiac failure (P=0.009, initial high oxygenation index value (P=0.04, increased SOFA scores (P=0.01, and increased APACHE II scores (P=0.02 as independent predictors of ventilator dependence. Results from the Kaplan-Meier method indicate that initial therapy with antibiotics could increase the ventilator weaning rate (log Rank test, P<0.001. Conclusions. Preexisting cardiopulmonary function, high APACHE II and SOFA scores, and high oxygenation index were the strongest predictors of ventilator dependence. Initial empiric antibiotic treatment can improve ventilator weaning rates at the time of discharge.

Complications of mechanical ventilation

Directory of Open Access Journals (Sweden)

Drašković Biljana

2011-01-01

Full Text Available Mechanical ventilation of the lungs, as an important therapeutic measure, cannot be avoided in critically ill patients. However, when machines take over some of vital functions there is always a risk of complications and accidents. Complications associated with mechanical ventilation can be divided into: 1 airway-associated complications; 2 complications in the response of patients to mechanical ventilation; and 3 complications related to the patient’s response to the device for mechanical ventilation. Complications of artificial airway may be related to intubation and extubation or the endotracheal tube. Complications of mechanical ventilation, which arise because of the patient’s response to mechanical ventilation, may primarily cause significant side effects to the lungs. During the last two decades it was concluded that mechanical ventilation can worsen or cause acute lung injury. Mechanical ventilation may increase the alveolar/capillary permeability by overdistension of the lungs (volutrauma, it can exacerbate lung damage due to the recruitment/derecruitment of collapsed alveoli (atelectrauma and may cause subtle damages due to the activation of inflammatory processes (biotrauma. Complications caused by mechanical ventilation, beside those involving the lungs, can also have significant effects on other organs and organic systems, and can be a significant factor contributing to the increase of morbidity and mortality in critically ill of mechanically ventilated patients. Complications are fortunately rare and do not occur in every patient, but due to their seriousness and severity they require extensive knowledge, experience and responsibility by health-care workers.

Accuracy of tidal volume delivered by home mechanical ventilation during mouthpiece ventilation

Science.gov (United States)

Prigent, Helene; Falaize, Line; Leroux, Karl; Santos, Dante; Vaugier, Isabelle; Orlikowski, David; Lofaso, Frederic

2016-01-01

The aim of our study was to evaluate efficacy and reliability of currently available ventilators for mouthpiece ventilation (MPV). Five life-support home ventilators were assessed in a bench test using different settings simulating the specificities of MPV, such as intermittent circuit disconnection and presence of continuous leaks. The intermittent disconnection of the circuit caused relevant swings in the delivered tidal volume (VT), showing a VT overshoot during the disconnection periods and a VT decrease when the interface was reconnected to the test lung. The five ventilators showed substantial differences in the number of respiratory cycles necessary to reach a stable VT in the volume-controlled setting, ranging from 1.3 ± 0.6 to 7.3 ± 1.2 cycles. These differences were less accentuated in the volume-assisted setting (MPV-dedicated mode, when available). Our data show large differences in the capacity of the different ventilators to deal with the rapidly changing respiratory load features that characterize MPV, which can be further accentuated according to the used ventilator setting. The dedicated MPV modes allow improvement in the performance of ventilators only in some defined situations. This has practical consequences for the choice of the ventilator to be used for MPV in a specific patient. PMID:27146811

Analysis on ventilation pressure of fire area in longitudinal ventilation of underground tunnel

Science.gov (United States)

Li, Jiaxin; Li, Yanfeng; Feng, Xiao; Li, Junmei

2018-03-01

In order to solve the problem of ventilation pressure loss in the fire area under the fire condition, the wind pressure loss model of the fire area is established based on the thermodynamic equilibrium relation. The semi-empirical calculation formula is obtained by using the model experiment and CFD simulation. The validity of the formula is verified. The results show that the ventilation pressure loss in the fire zone is proportional to the convective heat release rate at the critical velocity, which is inversely proportional to the upstream ventilation velocity and the tunnel cross-sectional area. The proposed formula is consistent with the law of the tunnel fire test fitting formula that results are close, in contrast, the advantage lies in a clear theoretical basis and ventilation velocity values. The resistance of road tunnel ventilation system is calculated accurately and reliably, and then an effective emergency ventilation operation program is developed. It is necessary to consider the fire zone ventilation pressure loss. The proposed ventilation pressure loss formula can be used for design calculation after thorough verification.

Oral mask ventilation is more effective than face mask ventilation after nasal surgery.

Science.gov (United States)

Yazicioğlu, Dilek; Baran, Ilkay; Uzumcugil, Filiz; Ozturk, Ibrahim; Utebey, Gulten; Sayın, M Murat

2016-06-01

To evaluate and compare the face mask (FM) and oral mask (OM) ventilation techniques during anesthesia emergence regarding tidal volume, leak volume, and difficult mask ventilation (DMV) incidence. Prospective, randomized, crossover study. Operating room, training and research hospital. American Society of Anesthesiologists physical status I and II adult patients scheduled for nasal surgery. Patients in group FM-OM received FM ventilation first, followed by OM ventilation, and patients in group OM-FM received OM ventilation first, followed by FM ventilation, with spontaneous ventilation after deep extubation. The FM ventilation was applied with the 1-handed EC-clamp technique. The OM was placed only over the mouth, and the 1-handed EC-clamp technique was used again. A child's size FM was used for the OM ventilation technique, the mask was rotated, and the inferior part of the mask was placed toward the nose. The leak volume (MVleak), mean airway pressure (Pmean), and expired tidal volume (TVe) were assessed with each mask technique for 3 consecutive breaths. A mask ventilation grade ≥3 was considered DMV. DMV occurred more frequently during FM ventilation (75% with FM vs 8% with OM). In the FM-first sequence, the mean TVe was 249±61mL with the FM and 455±35mL with the OM (P=.0001), whereas in the OM-first sequence, it was 276±81mL with the FM and 409±37mL with the OM (P=.0001). Regardless of the order used, the OM technique significantly decreased the MVleak and increased the TVe when compared to the FM technique. During anesthesia emergence after nasal surgery the OM may offer an effective ventilation method as it decreases the incidence of DMV and the gas leak around the mask and provides higher tidal volume delivery compared with FM ventilation. Copyright © 2016 Elsevier Inc. All rights reserved.

Ventilation Effectiveness

DEFF Research Database (Denmark)

Mundt, M.; Mathisen, H. M.; Moser, M.

Improving the ventilation effectiveness allows the indoor air quality to be significantly enhanced without the need for higher air changes in the building, thereby avoiding the higher costs and energy consumption associated with increasing the ventilation rates. This Guidebook provides easy-to-un...

Clinical challenges in mechanical ventilation.

Science.gov (United States)

Goligher, Ewan C; Ferguson, Niall D; Brochard, Laurent J

2016-04-30

Mechanical ventilation supports gas exchange and alleviates the work of breathing when the respiratory muscles are overwhelmed by an acute pulmonary or systemic insult. Although mechanical ventilation is not generally considered a treatment for acute respiratory failure per se, ventilator management warrants close attention because inappropriate ventilation can result in injury to the lungs or respiratory muscles and worsen morbidity and mortality. Key clinical challenges include averting intubation in patients with respiratory failure with non-invasive techniques for respiratory support; delivering lung-protective ventilation to prevent ventilator-induced lung injury; maintaining adequate gas exchange in severely hypoxaemic patients; avoiding the development of ventilator-induced diaphragm dysfunction; and diagnosing and treating the many pathophysiological mechanisms that impair liberation from mechanical ventilation. Personalisation of mechanical ventilation based on individual physiological characteristics and responses to therapy can further improve outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Voluntary Disclosure and Risk Sharing

NARCIS (Netherlands)

Suijs, J.P.M.

2001-01-01

This paper analyzes the disclosure strategy of firms that face uncertainty regarding the investor's response to a voluntary disclosure of the firm's private information.This paper distinguishes itself from the existing disclosure literature in that firms do not use voluntary disclosures to separate

Nurses' role and care practices in decision-making regarding artificial ventilation in late stage pulmonary disease.

Science.gov (United States)

Jerpseth, Heidi; Dahl, Vegard; Nortvedt, Per; Halvorsen, Kristin

2017-11-01

Decisions regarding whether or not to institute mechanical ventilation during the later stages of chronic obstructive pulmonary disease is challenging both ethically, emotionally and medically. Caring for these patients is a multifaceted process where nurses play a crucial role. Research question and design: We have investigated how nurses experienced their own role in decision-making processes regarding mechanical ventilation in later stages of chronic obstructive pulmonary disease and how they consider the patients' role in these processes. We applied a qualitative approach, with six focus-group interviews of nurses (n = 26). Ethical considerations: The Regional Committees for Medical and Health Research Ethics approved the study. Voluntary informed consent was obtained. The nurses found themselves operating within a cure-directed treatment culture wherein they were unable to stand up for the caring values. They perceived their roles and responsibilities in decision-making processes regarding mechanical ventilation to patients as unclear and unsatisfactory. They also experienced inadequate interdisciplinary cooperation. Lack of communication skills, the traditional hierarchical hospital culture together with operating in a medical-orientated treatment culture where caring values is rated as less important might explain the nurses' absence in participation in the decision about mechanical ventilation. To be able to advocate for the patients' and their own right to be included in decision-making processes, nurses need an awareness of their own responsibilities. This requires personal courage, leadership who are capable of organising common interpersonal meetings and willingness on the part of the physicians to include and value the nurses' participation in decision-making processes.

Reduced Cognitive-Motor Interference on Voluntary Balance Control in Older Tai Chi Practitioners.

Science.gov (United States)

Varghese, Rini; Hui-Chan, Christina W Y; Bhatt, Tanvi

2016-01-01

Recent dual-task studies suggest that Tai Chi practitioners displayed better control of standing posture and maintained a quicker response time of postural muscle activation during a stepping down activity. Whether this effect extends to voluntary balance control, specifically the limits of excursion of the center of pressure, remains to be examined. The purpose of this study was to evaluate the cognitive-motor interference pattern by examining the effects of a concurrently performed cognitive task on attention of voluntary balance control in older adults who are long-term practitioners of Tai Chi. Ten older Tai Chi practitioners and 10 age-matched nonpractitioners performed a voluntary balance task that required them to shift their weight to reach a preset target in the forward and backward directions, with (single task, ST) and without (dual task, DT) a secondary cognitive task, which was the counting backward task. The counting backward task required the individual to compute and verbalize a series of arithmetic differences between a given pair of randomly generated numbers. The cognitive task was also performed independently (cognitive-ST). All trials were performed in a random order. Balance outcomes included reaction time, movement velocity, and maximal excursion of the center of pressure provided by the NeuroCom system. Cognitive outcome was the number of correct responses generated within the 8-second trial during the ST and DT conditions. Outcome variables were analyzed using a 2-factor, group by task, analysis of variance. DT costs for the variables were calculated as the relative difference between ST and DT conditions and were compared between the 2 groups using independent t tests. Tai Chi practitioners displayed shorter reaction times (P older nonpractitioners for both directions; however, no difference was found between the maximal excursions of the 2 groups. Cost analyses revealed that reaction time and cognitive costs were significantly lower in

Ventilation of uranium mines

International Nuclear Information System (INIS)

Francois, Y.; Pradel, J.; Zettwoog, P.; Dumas, M.

1975-01-01

In the first part of the paper the authors describe the ventilation of French mines in terms of the primary ventilation system, which brings the outside air close to the working places using the overall structure of the mine to form the airways, and the secondary ventilation system, which is for the distribution of the primary air or for the ventilation of the development drifts and blind tunnels. Brief mention is made of the French regulations on the ventilation of mines in general and uranium mines in particular. The authors describe the equipment used and discuss the installed capacities and air flow per man and per working place. The difficulties encountered in properly ventilating various types of working places are mentioned, such as sublevel development drifts, reinforced stopes, and storage chambers with an artificial crown. The second part of the paper is devoted to computer calculations of the primary ventilation system. It is explained why the Commissariat a l'energie atomique has found it necessary to make these calculations. Without restating the mathematical theories underlying the methods employed, the authors demonstrate how simple measuring instruments and a small-size computer can be used to solve the ventilation problems arising in French mines. Emphasis is given to the layout of the ventilation system and to air flow and negative pressure measurements at the base of the mine. The authors show how calculations can be applied to new heading operations, a change in resistance, the replacement or addition of a ventilator, and a new air inlet or outlet. The authors come to the conclusion that since ventilation is at present the most reliable way of avoiding the pollution of mines, a thorough knowledge of the capabilities in this respect can often help improve working conditions. Despite the progress made, however, constant surveillance of the ventilation systems in uranium mines by a separate team with no responsibility for production problems is

Ventilation of uranium mines

International Nuclear Information System (INIS)

Francois, Y.; Pradel, J.; Zettwoog, P.; Dumas, M.

1975-01-01

In the first part of the paper the authors describe the ventilation of French mines in terms of the primary ventilation system, which brings the outside air close to the working places using the overall structure of the mine to form the airways, and the secondary ventilation system, which is for the distribution of the primary air or for the ventilation of the development drifts and blind tunnels. Brief mention is made of the French regulations on the ventilation of mines in general and uranium mines in particular. The authors describe the equipment used and discuss the installed capacities and air flow per man and per working place. The difficulties encountered in properly ventilating various types of working places are mentioned, such as sub-level development drifts, reinforced stopes, and storage chambers with an artificial crown. The second part of the paper is devoted to computer calculations of the primary ventilation system. It is explained why the Commissariat a l'energie atomique has found it necessary to make these calculations. Without restating the mathematical theories underlying the methods employed, the authors demonstrate how simple measuring instruments and a small-size computer can be used to solve the ventilation problems arising in French mines. Emphasis is given to the layout of the ventilation system and to air flow and negative pressure measurements at the base of the mine. The authors show how calculations can be applied to new heading operations, a change in resistance, the replacement or addition of a ventilator, and a new air inlet or outlet. The authors come to the conclusion that since ventilation is at present the most reliable way of avoiding the pollution of mines, a thorough knowledge of the capabilities in this respect can often help improve working conditions. Despite the progress made, however, constant surveillance of the ventilation systems in uranium mines by a separate team with no responsibility for production problems is

Operant Variability and Voluntary Action

Science.gov (United States)

Neuringer, Allen; Jensen, Greg

2010-01-01

A behavior-based theory identified 2 characteristics of voluntary acts. The first, extensively explored in operant-conditioning experiments, is that voluntary responses produce the reinforcers that control them. This bidirectional relationship--in which reinforcer depends on response and response on reinforcer--demonstrates the functional nature…

Performance evaluation of ventilation radiators

International Nuclear Information System (INIS)

Myhren, Jonn Are; Holmberg, Sture

2013-01-01

A ventilation radiator is a combined ventilation and heat emission unit currently of interest due to its potential for increasing energy efficiency in exhaust-ventilated buildings with warm water heating. This paper presents results of performance tests of several ventilation radiator models conducted under controlled laboratory conditions. The purpose of the study was to validate results achieved by Computational Fluid Dynamics (CFD) in an earlier study and identify possible improvements in the performance of such systems. The main focus was on heat transfer from internal convection fins, but comfort and health aspects related to ventilation rates and air temperatures were also considered. The general results from the CFD simulations were confirmed; the heat output of ventilation radiators may be improved by at least 20% without sacrificing ventilation efficiency or thermal comfort. Improved thermal efficiency of ventilation radiators allows a lower supply water temperature and energy savings both for heating up and distribution of warm water in heat pumps or district heating systems. A secondary benefit is that a high ventilation rate can be maintained all year around without risk for cold draught. -- Highlights: ► Low temperature heat emitters are currently of interest due to their potential for increasing energy efficiency. ► A ventilation radiator is a combined ventilation and heat emission unit which can be adapted to low temperature heating systems. ► We examine how ventilation radiators can be made to be more efficient in terms of energy consumption and thermal comfort. ► Current work focuses on heat transfer mechanisms and convection fin configuration of ventilation radiators

Local muscle metabolic demand induced by neuromuscular electrical stimulation and voluntary contractions at different force levels: a NIRS study

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Makii Muthalib

2016-06-01

Full Text Available Functional Muscle metabolic demand during contractions evoked by neuromuscular electrical stimulation (NMES has been consistently documented to be greater than voluntary contractions (VOL at the same force level (10-50% maximal voluntary contraction-MVC. However, we have shown using a near-infrared spectroscopy (NIRS technique that local muscle metabolic demand is similar between NMES and VOL performed at MVC levels, thus controversy exists. This study therefore compared biceps brachii muscle metabolic demand (tissue oxygenation index-TOI and total hemoglobin volume-tHb during a 10s isometric contraction of the elbow flexors between NMES (stimulation frequency of 30Hz and current level to evoke 30% MVC and VOL at 30% MVC (VOL-30%MVC and MVC (VOL-MVC level in 8 healthy men (23-33-y. Greater changes in TOI and tHb induced by NMES than VOL-30%MVC confirm previous studies of a greater local metabolic demand for NMES than VOL at the same force level. The same TOI and tHb changes for NMES and VOL-MVC suggest that local muscle metabolic demand and intramuscular pressure were similar between conditions. In conclusion, these findings indicate that NMES induce a similar local muscle metabolic demand as that of maximal VOL.

Local Muscle Metabolic Demand Induced by Neuromuscular Electrical Stimulation and Voluntary Contractions at Different Force Levels: A NIRS Study.

Science.gov (United States)

Muthalib, Makii; Kerr, Graham; Nosaka, Kazunori; Perrey, Stephane

2016-06-13

Functional Muscle metabolic demand during contractions evoked by neuromuscular electrical stimulation (NMES) has been consistently documented to be greater than voluntary contractions (VOL) at the same force level (10-50% maximal voluntary contraction-MVC). However, we have shown using a near-infrared spectroscopy (NIRS) technique that local muscle metabolic demand is similar between NMES and VOL performed at MVC levels, thus controversy exists. This study therefore compared biceps brachii muscle metabolic demand (tissue oxygenation index-TOI and total hemoglobin volume-tHb) during a 10s isometric contraction of the elbow flexors between NMES (stimulation frequency of 30Hz and current level to evoke 30% MVC) and VOL at 30% MVC (VOL-30%MVC) and MVC (VOL-MVC) level in 8 healthy men (23-33-y). Greater changes in TOI and tHb induced by NMES than VOL-30%MVC confirm previous studies of a greater local metabolic demand for NMES than VOL at the same force level. The same TOI and tHb changes for NMES and VOL-MVC suggest that local muscle metabolic demand and intramuscular pressure were similar between conditions. In conclusion, these findings indicate that NMES induce a similar local muscle metabolic demand as that of maximal VOL.

Design Principles for Hybrid Ventilation

DEFF Research Database (Denmark)

Heiselberg, Per

For many years mechanical and natural ventilation systems have developed separately. Naturally, the next step in this development is the development of ventilation concepts that utilize and combine the best features from each system to create a new type of ventilation system -Hybrid Ventilation. ....... The hybrid ventilation concepts, design challenges and - principles are discussed and illustrated by four building examples....

A mathematical model for carbon dioxide elimination: an insight for tuning mechanical ventilation.

Science.gov (United States)

Pomprapa, Anake; Schwaiberger, David; Lachmann, Burkhard; Leonhardt, Steffen

2014-01-01

The aim is to provide better understanding of carbon dioxide (CO2) elimination during ventilation for both the healthy and atelectatic condition, derived in a pressure-controlled mode. Therefore, we present a theoretical analysis of CO2 elimination of healthy and diseased lungs. Based on a single-compartment model, CO2 elimination is mathematically modeled and its contours were plotted as a function of temporal settings and driving pressure. The model was validated within some level of tolerance on an average of 4.9% using porcine dynamics. CO2 elimination is affected by various factors, including driving pressure, temporal variables from mechanical ventilator settings, lung mechanics and metabolic rate. During respiratory care, CO2 elimination is a key parameter for bedside monitoring, especially for patients with pulmonary disease. This parameter provides valuable insight into the status of an atelectatic lung and of cardiopulmonary pathophysiology. Therefore, control of CO2 elimination should be based on the fine tuning of the driving pressure and temporal ventilator settings. However, for critical condition of hypercapnia, airway resistance during inspiration and expiration should be additionally measured to determine the optimal percent inspiratory time (%TI) to maximize CO2 elimination for treating patients with hypercapnia.

Design Procedure for Hybrid Ventilation

DEFF Research Database (Denmark)

Heiselberg, Per; Tjelflaat, Per Olaf

Mechanical and natural ventilation systems have developed separately during many years. The natural next step in this development is development of ventilation concepts that utilises and combines the best features from each system into a new type of ventilation system - Hybrid Ventilation....... Buildings with hybrid ventilation often include other sustainable technologies and an energy optimisation requires an integrated approach in the design of the building and its mechanical systems. Therefore, the hybrid ventilation design procedure differs from the design procedure for conventional HVAC....... The first ideas on a design procedure for hybrid ventilation is presented and the different types of design methods, that is needed in different phases of the design process, is discussed....

Numerical investigation on the gas entrainment rate on ventilated supercavity body

Directory of Open Access Journals (Sweden)

WuGang Yang

2016-12-01

Full Text Available The supercavitation technique provides a means of significantly increasing the velocity of an underwater vehicle. This technique involves essentially the creation of stable supercavity shape. The method of artificial ventilation is most effective for generating and dominating the supercavity. This paper focuses on the numerical simulation of flow field around three-dimensional body. The method is based on the multiphase computational fluid dynamics model combined with the turbulence model and the full cavity model. The fundamental similarity parameters of ventilated supercavity flows that include cavitation number, Froude number Fr, entrainment rate CQ, and drag coefficient Cx are all investigated numerically in the case of steady flow and gravity field. We discuss the following simulations results in three parts: (1 the variations of the cavitation number and the supercavity’s relative diameter with entrainment rate; (2 the drag coefficient versus the cavitation number; and (3 deformation of supercavity axis caused by gravitational effect for three different fixed three Froude numbers. In the full paper, we give the comparison results of the drag reduction ratio among numerical simulation and experiment conducted in hydrodynamic tunnel and towing tank, respectively. We summarize our discussion of gravitational effect on the axis deformation of supercavity as follows: in the case of smaller Froude number, the inclination of the cavity axis increases monotonously with increasing horizontal length and reaches its maximal value at the end of supercavity; this deformation can be almost completely negligible when the Froude number Fr is larger than 7.0. The comparisons with the experimental data in the hydrodynamic tunnel and the towing tank indicate that the present method is effective for predicting the flows around ventilated supercavity; that the numerical results is in good agreement with the experimental ones and that the maximal value of the

Estudo eletromiográfico do músculo masseter durante o apertamento dentário e mastigação habitual em adultos com oclusão dentária normal Electromyographic study of the masseter muscle during maximal voluntary clenching and habitual chewing in adults with normal occlusion

Directory of Open Access Journals (Sweden)

Adriana Rahal

2009-01-01

Full Text Available OBJETIVO: Analisar a diferença entre os lados na atividade eletromiográfica do masseter em indivíduos adultos com oclusão dentária normal. MÉTODOS: Foram avaliados 30 indivíduos saudáveis entre 21 e 30 anos e realizou-se eletromiografia de superfície nos músculos masseteres direito e esquerdo, durante apertamento em máxima intercuspidação e mastigação habitual com uva passa. Foram computados os valores médios dos três apertamentos dentários e dos 15 segundos da mastigação habitual para cada indivíduo. Foram considerados para a análise: o lado de maior valor e o de menor valor eletromiográfico. RESULTADOS: Durante o apertamento dentário, a diferença média entre os dois lados foi de 20,0 microvolts (μV com intervalo de confiança (95% entre 14,0 e 26,0 μV e durante a mastigação habitual, a diferença média entre os dois lados foi de 10,3 μV com intervalo de confiança (95% entre 6,7 e 13,8 μV. CONCLUSÃO: Houve diferença estatisticamente significante entre os lados, com relação entre eles de 24% para o apertamento dentário e de 27% para a mastigação habitual, em indiv duos adultos saudáveis.PURPOSE: To analyze the difference between both sides of the face during the electromyographic activity of the masseter muscle in adults with normal occlusion. METHODS: Thirty healthy individuals with ages ranging from 21 to 30 years old were selected. Surface electromyography was performed on right and left masseter muscles during maximal voluntary clenching and habitual chewing with raisins. The mean values of three teeth clenching and fifteen seconds of habitual chewing were calculated for each subject. The analysis considered the sides with higher and lower electromyographic activity. RESULTS: During maximal voluntary clenching, the mean difference between sides was 20.0 microvolts (μV, with confidence interval (95% between 14.0 and 26.0 μV. During habitual chewing, the mean difference between sides was 10.3 �

Trends in mechanical ventilation: are we ventilating our patients in the best possible way?

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Raffaele L. Dellaca’

2017-06-01

To learn how mechanical ventilation developed in recent decades and to provide a better understanding of the actual technology and practice. To learn how and why interdisciplinary research and competences are necessary for providing the best ventilation treatment to patients. To understand which are the most relevant technical limitations in modern mechanical ventilators that can affect their performance in delivery of the treatment. To better understand and classify ventilation modes. To learn the classification, benefits, drawbacks and future perspectives of automatic ventilation tailoring algorithms.

Standardization of pulmonary ventilation technique using volume-controlled ventilators in rats with congenital diaphragmatic hernia

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Rodrigo Melo Gallindo

Full Text Available OBJECTIVE: To standardize a technique for ventilating rat fetuses with Congenital Diaphragmatic Hernia (CDH using a volume-controlled ventilator. METHODS: Pregnant rats were divided into the following groups: a control (C; b exposed to nitrofen with CDH (CDH; and c exposed to nitrofen without CDH (N-. Fetuses of the three groups were randomly divided into the subgroups ventilated (V and non-ventilated (N-V. Fetuses were collected on day 21.5 of gestation, weighed and ventilated for 30 minutes using a volume-controlled ventilator. Then the lungs were collected for histological study. We evaluated: body weight (BW, total lung weight (TLW, left lung weight (LLW, ratios TLW / BW and LLW / BW, morphological histology of the airways and causes of failures of ventilation. RESULTS: BW, TLW, LLW, TLW / BW and LLW / BW were higher in C compared with N- (p 0.05. The morphology of the pulmonary airways showed hypoplasia in groups N- and CDH, with no difference between V and N-V (p <0.05. The C and N- groups could be successfully ventilated using a tidal volume of 75 ìl, but the failure of ventilation in the CDH group decreased only when ventilated with 50 ìl. CONCLUSION: Volume ventilation is possible in rats with CDH for a short period and does not alter fetal or lung morphology.

The growing role of noninvasive ventilation in patients requiring prolonged mechanical ventilation.

Science.gov (United States)

Hess, Dean R

2012-06-01

For many patients with chronic respiratory failure requiring ventilator support, noninvasive ventilation (NIV) is preferable to invasive support by tracheostomy. Currently available evidence does not support the use of nocturnal NIV in unselected patients with stable COPD. Several European studies have reported benefit for high intensity NIV, in which setting of inspiratory pressure and respiratory rate are selected to achieve normocapnia. There have also been studies reporting benefit for the use of NIV as an adjunct to exercise training. NIV may be useful as an adjunct to airway clearance techniques in patients with cystic fibrosis. Accumulating evidence supports the use of NIV in patients with obesity hypoventilation syndrome. There is considerable observational evidence supporting the use of NIV in patients with chronic respiratory failure related to neuromuscular disease, and one randomized controlled trial reported that the use of NIV was life-prolonging in patients with amyotrophic lateral sclerosis. A variety of interfaces can be used to provide NIV in patients with stable chronic respiratory failure. The mouthpiece is an interface that is unique in this patient population, and has been used with success in patients with neuromuscular disease. Bi-level pressure ventilators are commonly used for NIV, although there are now a new generation of intermediate ventilators that are portable, have a long battery life, and can be used for NIV and invasive applications. Pressure support ventilation, pressure controlled ventilation, and volume controlled ventilation have been used successfully for chronic applications of NIV. New modes have recently become available, but their benefits await evidence to support their widespread use. The success of NIV in a given patient population depends on selection of an appropriate patient, selection of an appropriate interface, selection of an appropriate ventilator and ventilator settings, the skills of the clinician, the

VENTILATION TECHNOLOGY SYSTEMS ANALYSIS

Science.gov (United States)

The report gives results of a project to develop a systems analysis of ventilation technology and provide a state-of-the-art assessment of ventilation and indoor air quality (IAQ) research needs. (NOTE: Ventilation technology is defined as the hardware necessary to bring outdoor ...

Using a Ventilation Controller to Optimize Residential Passive Ventilation For Energy and Indoor Air Quality

Energy Technology Data Exchange (ETDEWEB)

Turner, William [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2014-08-01

One way to reduce the energy impact of providing residential ventilation is to use passive and hybrid systems. However, these passive and hybrid (sometimes called mixed-mode) systems must still meet chronic and acute health standards for ventilation. This study uses a computer simulation approach to examine the energy and indoor air quality (IAQ) implications of passive and hybrid ventilation systems, in 16 California climate zones. Both uncontrolled and flow controlled passive stacks are assessed. A new hybrid ventilation system is outlined that uses an intelligent ventilation controller to minimise energy use, while ensuring chronic and acute IAQ standards are met. ASHRAE Standard 62.2-2010 – the United States standard for residential ventilation - is used as the chronic standard, and exposure limits for PM_2.5, formaldehyde and NO₂ are used as the acute standards.The results show that controlled passive ventilation and hybrid ventilation can be used in homes to provide equivalent IAQ to continuous mechanical ventilation, for less use of energy.

Performance comparison of 15 transport ventilators.

Science.gov (United States)

Chipman, Daniel W; Caramez, Maria P; Miyoshi, Eriko; Kratohvil, Joseph P; Kacmarek, Robert M

2007-06-01

Numerous mechanical ventilators are designed and marketed for use in patient transport. The complexity of these ventilators differs considerably, but very few data exist to compare their operational capabilities. Using bench and animal models, we studied 15 currently available transport ventilators with regard to their physical characteristics, gas consumption (duration of an E-size oxygen cylinder), battery life, ease of use, need for compressed gas, ability to deliver set ventilation parameters to a test lung under 3 test conditions, and ability to maintain ventilation and oxygenation in normal and lung-injured sheep. Most of the ventilators tested were relatively simple to operate and had clearly marked controls. Oxygen cylinder duration ranged from 30 min to 77 min. Battery life ranged from 70 min to 8 hours. All except 3 of the ventilators were capable of providing various F(IO2) values. Ten of the ventilators had high-pressure and patient-disconnect alarms. Only 6 of the ventilators were able to deliver all settings as specifically set on the ventilator during the bench evaluation. Only 4 of the ventilators were capable of maintaining ventilation, oxygenation, and hemodynamics in both the normal and the lung-injured sheep. Only 2 of the ventilators met all the trial targets in all the bench and animal tests. With many of the ventilators, certain of the set ventilation parameters were inaccurate (differed by > 10% from the values from a cardiopulmonary monitor). The physical characteristics and high gas consumption of some of these ventilators may render them less desirable for patient transport.

46 CFR 45.131 - Ventilators.

Science.gov (United States)

2010-10-01

... 46 Shipping 2 2010-10-01 2010-10-01 false Ventilators. 45.131 Section 45.131 Shipping COAST GUARD....131 Ventilators. (a) Ventilators passing through superstructures other than enclosed superstructures must have coamings of steel or equivalent material at the freeboard deck. (b) Ventilators in position 1...

Ventilation area measured with eit in order to optimize peep settings in mechanically ventilated patients

NARCIS (Netherlands)

Blankman, P; Groot Jebbink, E; Preis, C; Bikker, I.; Gommers, D.

2012-01-01

INTRODUCTION. Electrical Impedance Tomography (EIT) is a non-invasive imaging technique, which can be used to visualize ventilation. Ventilation will be measured by impedance changes due to ventilation. OBJECTIVES. The aim of this study was to optimize PEEP settings based on the ventilation area of

Burrowing as a novel voluntary strength training method for mice : A comparison of various voluntary strength or resistance exercise methods

NARCIS (Netherlands)

Roemers, P; Mazzola, P N; De Deyn, P P; Bossers, W J; van Heuvelen, M J G; van der Zee, E A

2018-01-01

BACKGROUND: Voluntary strength training methods for rodents are necessary to investigate the effects of strength training on cognition and the brain. However, few voluntary methods are available. NEW METHOD: The current study tested functional and muscular effects of two novel voluntary strength

Pedagogical Aspects of Voluntary School Work

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Mária Jármai Erzsébet

2015-03-01

Full Text Available The economic importance of voluntary work has been exceedingly appreciated in the last few decades. This is not surprising at all, because it is highly profitable according to the related estimated data. There are 115,9 million people doing voluntary work only in Europe, which means that they would create the world's 7th biggest economy with EUR 282 billion value creation if they formed an individual state. The organizations know that voluntary work has several advantages apart from the economic benefits. It is profitable both for the society and for the individuals as well. Several researches have proven that voluntary work positively influences the development of the personality, because the key-competencies - such as: co-operation, empathy, solidarity, conflict handling, problem solving, etc. - expected in the labor market can be improved.

Numerical study on the thermal performance of a ventilated facade with PCM

International Nuclear Information System (INIS)

Gracia, Alvaro de; Navarro, Lidia; Castell, Albert; Cabeza, Luisa F.

2013-01-01

A new type of ventilated facade (VF) with macro-encapsulated phase change material (PCM) in its air cavity is presented in this paper. Two identical house-like cubicles located in Puigverd de Lleida (Spain) were monitored during 2012, and in one of them, the VF with PCM was implemented in the south wall. The versatility of the facade allows the system to reduce both heating and cooling loads. During winter, the PCM increases the heat storage capacity of the system exposed to solar radiation and during summer the system can be used as a cold storage unit or as a night free cooling device. From the experimental winter campaign, important net electrical energy savings were registered due to the use of the VF. On the other hand, no net energy savings were achieved during summer due to excessive use of mechanical ventilation. In this paper, an own developed numerical model, based on finite control volume approach, was validated against experimental data and it is used to select the operational schedule of both solidification and melting processes in order to achieve net electrical energy savings. During the mild summer period the system presents a net energy supply of 2.49 MJ/day. This value would be increased by 61.6% if a wooden structure would have been used instead of the current metallic structure. Moreover, the high hysteresis of the PCM limits strongly the potential of the system in supplying cooling during the severe summer period. -- Highlights: • Numerical study of the thermal performance of a ventilated facade with PCM. • The study considers cooling purposes. • Operational schedule and use of fans during solidification of PCM optimization. • Net energy supply of 2.49 MJ/day during mild summer from the ventilated facade. • Storage efficiency would maximize with more mechanical ventilation during less time

Alleviation of Motor Impairments in Patients with Cerebral Palsy: Acute Effects of Whole-body Vibration on Stretch Reflex Response, Voluntary Muscle Activation and Mobility

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Anne Krause

2017-08-01

Full Text Available IntroductionIndividuals suffering from cerebral palsy (CP often have involuntary, reflex-evoked muscle activity resulting in spastic hyperreflexia. Whole-body vibration (WBV has been demonstrated to reduce reflex activity in healthy subjects, but evidence in CP patients is still limited. Therefore, this study aimed to establish the acute neuromuscular and kinematic effects of WBV in subjects with spastic CP.Methods44 children with spastic CP were tested on neuromuscular activation and kinematics before and immediately after a 1-min bout of WBV (16–25 Hz, 1.5–3 mm. Assessment included (1 recordings of stretch reflex (SR activity of the triceps surae, (2 electromyography (EMG measurements of maximal voluntary muscle activation of lower limb muscles, and (3 neuromuscular activation during active range of motion (aROM. We recorded EMG of m. soleus (SOL, m. gastrocnemius medialis (GM, m. tibialis anterior, m. vastus medialis, m. rectus femoris, and m. biceps femoris. Angular excursion was recorded by goniometry of the ankle and knee joint.ResultsAfter WBV, (1 SOL SRs were decreased (p < 0.01 while (2 maximal voluntary activation (p < 0.05 and (3 angular excursion in the knee joint (p < 0.01 were significantly increased. No changes could be observed for GM SR amplitudes or ankle joint excursion. Neuromuscular coordination expressed by greater agonist–antagonist ratios during aROM was significantly enhanced (p < 0.05.DiscussionThe findings point toward acute neuromuscular and kinematic effects following one bout of WBV. Protocols demonstrate that pathological reflex responses are reduced (spinal level, while the execution of voluntary movement (supraspinal level is improved in regards to kinematic and neuromuscular control. This facilitation of muscle and joint control is probably due to a reduction of spasticity-associated spinal excitability in favor of giving access for greater supraspinal input during voluntary motor

Krypton ventilation imaging using dual-energy CT in chronic obstructive pulmonary disease patients: initial experience.

Science.gov (United States)

Hachulla, Anne-Lise; Pontana, François; Wemeau-Stervinou, Lidwine; Khung, Suonita; Faivre, Jean-Baptiste; Wallaert, Benoit; Cazaubon, Jean-François; Duhamel, Alain; Perez, Thierry; Devos, Patrick; Remy, Jacques; Remy-Jardin, Martine

2012-04-01

To evaluate the tolerance and level of enhancement achievable after inhalation of stable krypton. This study was approved by the institutional review board and the local ethics committee. Written informed consent was obtained from all subjects. The study was planned as a Fleming two-stage design, enabling one to assess the effectiveness of a newer treatment or technique on a small number of patients. At the end of each stage, the results are computed, and the trial can be stopped if the effectiveness is less than a minimum success rate or greater than an expected success rate. After informed consent was obtained, a total of 32 patients (ie, two successive series of 16 patients each) with severe emphysema underwent a dual-source, dual-energy chest computed tomographic (CT) examination after inhalation of a mixture of stable krypton (80%) and oxygen (20%), with reconstruction of diagnostic and ventilation images. For each patient, two regions of interest were selected on a diagnostic image, one in a region of severe emphysema (presumed to be poorly ventilated or not ventilated) and a second one in a region devoid of structural abnormalities (presumed to be normally ventilated), with measurements of attenuation values on the corresponding ventilation image. All examinations were successfully performed, without adverse effects. Differences in attenuation between normal lung and emphysematous areas were found in 28 patients (88%; 95% confidence interval: 71%, 96.5%). The maximal level of attenuation within normal lung was 18.5 HU. Krypton attenuation difference between normal and emphysematous lung was significant, with a median value of 51.8% (P krypton and its excellent clinical tolerance makes this gas eligible for ventilation CT examinations. © RSNA, 2012.

Natural Ventilation in Atria

DEFF Research Database (Denmark)

Svidt, Kjeld; Heiselberg, Per; Hendriksen, Ole Juhl

This case study comprises a monitoring programme as well as a Computational Fluid Dynamics (CFD) analysis of a natural ventilated atrium. The purpose has been to analyse the performance of a typical natural ventilation system in Denmark under both summer and winter conditions.......This case study comprises a monitoring programme as well as a Computational Fluid Dynamics (CFD) analysis of a natural ventilated atrium. The purpose has been to analyse the performance of a typical natural ventilation system in Denmark under both summer and winter conditions....

Ventilation practices in subarachnoid hemorrhage: a cohort study exploring the use of lung protective ventilation.

Science.gov (United States)

Marhong, Jonathan D; Ferguson, Niall D; Singh, Jeffrey M

2014-10-01

Acute respiratory distress syndrome (ARDS) is common following aneurysmal subarachnoid hemorrhage (SAH), but the influence of mechanical ventilator settings on its development is unclear. We sought to determine adherence to lung protective thresholds in ventilated patients with SAH and describe the association between ventilator settings and subsequent development of ARDS. We conducted a retrospective cohort study of consecutive patients receiving mechanical ventilation within 72 h of SAH at a single academic center. Ventilator settings and blood gas data were collected twice daily for the first 7 days of ventilation along with ICU and hospital outcomes. Lung protective ventilation was defined as follows: tidal volume ≤8 mL/kg of predicted body weight, positive end-expiratory pressure (PEEP) ≥5 cm H(2)O, and peak or plateau pressure ≤30 cm H(2)O. The development of ARDS was ascertained retrospectively by PaO(2)/FiO(2) ≤300 with new bilateral lung opacities on chest X-ray within one day of hypoxemia. We identified 62 patients who underwent early mechanical ventilation following SAH. PS and Continuous Positive Airway Pressure were common ventilator modes with a median tidal volume of 7.8 mL/kg [interquartile range 6.8-8.8], median peak pressure of 14 cm H(2)O [IQR 12-17], and median PEEP of 5 cm H(2)O [IQR 5-6]. Adherence to tidal volumes ≤8 mL/kg was seen in 64 % of all observations and peak pressures protective criteria were seen in 58 % of all observations. Thirty-one patients (50 %) were determined to have ARDS. ARDS patients were more frequently ventilated with a peak pressure >30 cm H(2)O (11.3 % of ARDS ventilation days vs. 0 % of non-ARDS ventilation days; p mechanical ventilation frequently breathe spontaneously, generating tidal volumes above usual protective thresholds regardless of meeting ARDS criteria. In patients with SAH, the presence of an additional ARDS risk factor should prompt close screening for the development of ARDS and

Comparison of 4-Dimensional Computed Tomography Ventilation With Nuclear Medicine Ventilation-Perfusion Imaging: A Clinical Validation Study

International Nuclear Information System (INIS)

Vinogradskiy, Yevgeniy; Koo, Phillip J.; Castillo, Richard; Castillo, Edward; Guerrero, Thomas; Gaspar, Laurie E.; Miften, Moyed; Kavanagh, Brian D.

2014-01-01

Purpose: Four-dimensional computed tomography (4DCT) ventilation imaging provides lung function information for lung cancer patients undergoing radiation therapy. Before 4DCT-ventilation can be implemented clinically it needs to be validated against an established imaging modality. The purpose of this work was to compare 4DCT-ventilation to nuclear medicine ventilation, using clinically relevant global metrics and radiologist observations. Methods and Materials: Fifteen lung cancer patients with 16 sets of 4DCT and nuclear medicine ventilation-perfusion (VQ) images were used for the study. The VQ-ventilation images were acquired in planar mode using Tc-99m-labeled diethylenetriamine-pentaacetic acid aerosol inhalation. 4DCT data, spatial registration, and a density-change-based model were used to compute a 4DCT-based ventilation map for each patient. The percent ventilation was calculated in each lung and each lung third for both the 4DCT and VQ-ventilation scans. A nuclear medicine radiologist assessed the VQ and 4DCT scans for the presence of ventilation defects. The VQ and 4DCT-based images were compared using regional percent ventilation and radiologist clinical observations. Results: Individual patient examples demonstrate good qualitative agreement between the 4DCT and VQ-ventilation scans. The correlation coefficients were 0.68 and 0.45, using the percent ventilation in each individual lung and lung third, respectively. Using radiologist-noted presence of ventilation defects and receiver operating characteristic analysis, the sensitivity, specificity, and accuracy of the 4DCT-ventilation were 90%, 64%, and 81%, respectively. Conclusions: The current work compared 4DCT with VQ-based ventilation using clinically relevant global metrics and radiologist observations. We found good agreement between the radiologist's assessment of the 4DCT and VQ-ventilation images as well as the percent ventilation in each lung. The agreement lessened when the data were

Voluntary suppression of hyperthermia-induced hyperventilation mitigates the reduction in cerebral blood flow velocity during exercise in the heat.

Science.gov (United States)

Tsuji, Bun; Honda, Yasushi; Ikebe, Yusuke; Fujii, Naoto; Kondo, Narihiko; Nishiyasu, Takeshi

2015-04-15

Hyperthermia during prolonged exercise leads to hyperventilation, which can reduce arterial CO2 pressure (PaCO2 ) and, in turn, cerebral blood flow (CBF) and thermoregulatory response. We investigated 1) whether humans can voluntarily suppress hyperthermic hyperventilation during prolonged exercise and 2) the effects of voluntary breathing control on PaCO2 , CBF, sweating, and skin blood flow. Twelve male subjects performed two exercise trials at 50% of peak oxygen uptake in the heat (37°C, 50% relative humidity) for up to 60 min. Throughout the exercise, subjects breathed normally (normal-breathing trial) or they tried to control their minute ventilation (respiratory frequency was timed with a metronome, and target tidal volumes were displayed on a monitor) to the level reached after 5 min of exercise (controlled-breathing trial). Plotting ventilatory and cerebrovascular responses against esophageal temperature (Tes) showed that minute ventilation increased linearly with rising Tes during normal breathing, whereas controlled breathing attenuated the increased ventilation (increase in minute ventilation from the onset of controlled breathing: 7.4 vs. 1.6 l/min at +1.1°C Tes; P flow velocity (MCAV) with rising Tes, but controlled breathing attenuated those reductions (estimated PaCO2 -3.4 vs. -0.8 mmHg; MCAV -10.4 vs. -3.9 cm/s at +1.1°C Tes; P = 0.002 and 0.011, respectively). Controlled breathing had no significant effect on chest sweating or forearm vascular conductance (P = 0.67 and 0.91, respectively). Our results indicate that humans can voluntarily suppress hyperthermic hyperventilation during prolonged exercise, and this suppression mitigates changes in PaCO2 and CBF. Copyright © 2015 the American Physiological Society.

Interfaces and ventilator settings for long-term noninvasive ventilation in COPD patients

Directory of Open Access Journals (Sweden)

Callegari J

2017-06-01

Full Text Available Jens Callegari,1 Friederike Sophie Magnet,1 Steven Taubner,1 Melanie Berger,2 Sarah Bettina Schwarz,1 Wolfram Windisch,1 Jan Hendrik Storre3,4 1Department of Pneumology, Cologne-Merheim Hospital, Kliniken der Stadt Koeln, Witten/Herdecke University Hospital, 2Department of Pneumology, Malteser Hospital St Hildegardis, Cologne, 3Department of Pneumology, University Medical Hospital, Freiburg, 4Department of Intensive Care, Sleep Medicine and Mechanical Ventilation, Asklepios Fachkliniken Munich-Gauting, Gauting, Germany Introduction: The establishment of high-intensity (HI noninvasive ventilation (NIV that targets elevated PaCO2 has led to an increase in the use of long-term NIV to treat patients with chronic hypercapnic COPD. However, the role of the ventilation interface, especially in more aggressive ventilation strategies, has not been systematically assessed.Methods: Ventilator settings and NIV compliance were assessed in this prospective cross-sectional monocentric cohort study of COPD patients with pre-existing NIV. Daytime ­arterialized blood gas analyses and lung function testing were also performed. The primary end point was the distribution among study patients of interfaces (full-face masks [FFMs] vs nasal masks [NMs] in a real-life setting.Results: The majority of the 123 patients studied used an FFM (77%, while 23% used an NM. Ventilation settings were as follows: mean ± standard deviation (SD inspiratory positive airway pressure (IPAP was 23.2±4.6 mbar and mean ± SD breathing rate was 16.7±2.4/minute. Pressure support ventilation (PSV mode was used in 52.8% of patients, while assisted pressure-controlled ventilation (aPCV was used in 47.2% of patients. Higher IPAP levels were associated with an increased use of FFMs (IPAP <21 mbar: 73% vs IPAP >25 mbar: 84%. Mean compliance was 6.5 hours/day, with no differences between FFM (6.4 hours/day and NM (6.7 hours/day users. PaCO2 assessment of ventilation quality revealed

Behovstyret ventilation

DEFF Research Database (Denmark)

Afshari, Alireza; Heiselberg, Per; Reinhold, Claus

2010-01-01

I en nylig afsluttet undersøgelse er der udført en række målinger på otte udvalgte børneinstitutioner. Fire af disse med mekanisk ventilation og fire med naturlig ventilation. Formålet er at udvide den erfaringsbaserede viden om funktionen af naturlige og mekaniske ventilationsløsninger i...

Rethinking voluntary euthanasia.

Science.gov (United States)

Stoyles, Byron J; Costreie, Sorin

2013-12-01

Our goal in this article is to explicate the way, and the extent to which, euthanasia can be voluntary from both the perspective of the patient and the perspective of the health care providers involved in the patient's care. More significantly, we aim to challenge the way in which those engaged in ongoing philosophical debates regarding the morality of euthanasia draw distinctions between voluntary, involuntary, and nonvoluntary euthanasia on the grounds that drawing the distinctions in the traditional manner (1) fails to reflect what is important from the patient's perspective and (2) fails to reflect the significance of health care providers' interests, including their autonomy and integrity.

Mechanical ventilator - infants

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/007240.htm Mechanical ventilator - infants To use the sharing features on this page, please enable JavaScript. A mechanical ventilator is a machine that assists with breathing. ...

Comparison between conventional and protective one-lung ventilation for ventilator-assisted thoracic surgery.

Science.gov (United States)

Ahn, H J; Kim, J A; Yang, M; Shim, W S; Park, K J; Lee, J J

2012-09-01

Recent papers suggest protective ventilation (PV) as a primary ventilation strategy during one-lung ventilation (OLV) to reduce postoperative pulmonary morbidity. However, data regarding the advantage of the PV strategy in patients with normal preoperative pulmonary function are inconsistent, especially in the case of minimally invasive thoracic surgery. Therefore we compared conventional OLV (VT 10 ml/kg, FiO2 1.0, zero PEEP) to protective OLV (VT 6 ml/kg, FiO2 0.5, PEEP 5 cmH2O) in patients with normal preoperative pulmonary function tests undergoing video-assisted thoracic surgery. Oxygenation, respiratory mechanics, plasma interleukin-6 and malondialdehyde levels were measured at baseline, 15 and 60 minutes after OLV and 15 minutes after restoration of two-lung ventilation. PaO2 and PaO2/FiO2 were higher in conventional OLV than in protective OLV (PProtective ventilation did not provide advantages over conventional ventilation for video-assisted thoracic surgery in this group of patients with normal lung function.

Ventilation of nuclear facilities

International Nuclear Information System (INIS)

1982-01-01

In this work an examination is made of ventilation problems in nuclear installations, of the fuel cycle or the handling of radioactive compounds. The study covers the detection of radioactive aerosols, purification, iodine trapping, ventilation equipment and its maintenance, engineering, safety of ventilation, fire efficiency, operation, regulations and normalization [fr

Newer nonconventional modes of mechanical ventilation

Directory of Open Access Journals (Sweden)

Preet Mohinder Singh

2014-01-01

Full Text Available The conventional modes of ventilation suffer many limitations. Although they are popularly used and are well-understood, often they fail to match the patient-based requirements. Over the years, many small modifications in ventilators have been incorporated to improve patient outcome. The ventilators of newer generation respond to patient′s demands by additional feedback systems. In this review, we discuss the popular newer modes of ventilation that have been accepted in to clinical practice. Various intensive care units over the world have found these modes to improve patient ventilator synchrony, decrease ventilator days and improve patient safety. The various modes discusses in this review are: Dual control modes (volume assured pressure support, volume support, Adaptive support ventilation, proportional assist ventilation, mandatory minute ventilation, Bi-level airway pressure release ventilation, (BiPAP, neurally adjusted ventilatory assist and NeoGanesh. Their working principles with their advantages and clinical limitations are discussed in brief.

Liquid ventilation.

Science.gov (United States)

Sarkar, Suman; Paswan, Anil; Prakas, S

2014-01-01

Human have lungs to breathe air and they have no gills to breath liquids like fish. When the surface tension at the air-liquid interface of the lung increases as in acute lung injury, scientists started to think about filling the lung with fluid instead of air to reduce the surface tension and facilitate ventilation. Liquid ventilation (LV) is a technique of mechanical ventilation in which the lungs are insufflated with an oxygenated perfluorochemical liquid rather than an oxygen-containing gas mixture. The use of perfluorochemicals, rather than nitrogen as the inert carrier of oxygen and carbon dioxide offers a number of advantages for the treatment of acute lung injury. In addition, there are non-respiratory applications with expanding potential including pulmonary drug delivery and radiographic imaging. It is well-known that respiratory diseases are one of the most common causes of morbidity and mortality in intensive care unit. During the past few years several new modalities of treatment have been introduced. One of them and probably the most fascinating, is of LV. Partial LV, on which much of the existing research has concentrated, requires partial filling of lungs with perfluorocarbons (PFC's) and ventilation with gas tidal volumes using conventional mechanical ventilators. Various physico-chemical properties of PFC's make them the ideal media. It results in a dramatic improvement in lung compliance and oxygenation and decline in mean airway pressure and oxygen requirements. No long-term side-effect reported.

Learning about ventilators

Science.gov (United States)

... medlineplus.gov/ency/patientinstructions/000458.htm Learning about ventilators To use the sharing features on this page, ... fixed or changed. How Does Being on a Ventilator Feel? A person receives medicine to remain comfortable ...

Factors that affect voluntary vaccination of children in Japan.

Science.gov (United States)

Shono, Aiko; Kondo, Masahide

2015-03-10

Some important vaccinations are not included in the routine childhood immunization schedule in Japan. Voluntary vaccinations are usually paid as an out-of-pocket expense. Low voluntary vaccination coverage rates and high target disease incidence are assumed to be a consequence of voluntary vaccination. Therefore, this study aimed to explore factors associated with voluntary vaccination patterns in children. We conducted an online survey of 1243 mothers from a registered survey panel who had at least one child 2 months to <3 years of age. The voluntary vaccination mainly correlated positively with annual household income and mothers' positive opinions about voluntary vaccinations, but negatively with number of children. Financial support, especially for low income households and households with more than one child, may motivate parents to vaccinate their children. Communication is also an important issue. More opportunities for education and information about voluntary vaccinations should be provided to mothers without distinguishing between voluntary and routine vaccination. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of sevoflurane on ventilator induced lung injury in a healthy lung experimental model.

Science.gov (United States)

Romero, A; Moreno, A; García, J; Sánchez, C; Santos, M; García, J

2016-01-01

Ventilator-induced lung injury (VILI) causes a systemic inflammatory response in tissues, with an increase in IL-1, IL-6 and TNF-α in blood and tissues. Cytoprotective effects of sevoflurane in different experimental models are well known, and this protective effect can also be observed in VILI. The objective of this study was to assess the effects of sevoflurane in VILI. A prospective, randomized, controlled study was designed. Twenty female rats were studied. The animals were mechanically ventilated, without sevoflurane in the control group and sevoflurane 3% in the treated group (SEV group). VILI was induced applying a maximal inspiratory pressure of 35 cmH2O for 20 min without any positive end-expiratory pressure for 20 min (INJURY time). The animals were then ventilated 30 min with a maximal inspiratory pressure of 12 cmH2O and 3 cmH2O positive end-expiratory pressure (time 30 min POST-INJURY), at which time the animals were euthanized and pathological and biomarkers studies were performed. Heart rate, invasive blood pressure, pH, PaO2, and PaCO2 were recorded. The lung wet-to-dry weight ratio was used as an index of lung edema. No differences were found in the blood gas analysis parameters or heart rate between the 2 groups. Blood pressure was statistically higher in the control group, but still within the normal clinical range. The percentage of pulmonary edema and concentrations of TNF-α and IL-6 in lung tissue in the SEV group were lower than in the control group. Sevoflurane attenuates VILI in a previous healthy lung in an experimental subclinical model in rats. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Forced vital capacity and not central chemoreflex predicts maximal hyperoxic breath-hold duration in elite apneists.

Science.gov (United States)

Bain, Anthony R; Barak, Otto F; Hoiland, Ryan L; Drvis, Ivan; Bailey, Damian M; Dujic, Zeljko; Mijacika, Tanja; Santoro, Antoinette; DeMasi, Daniel K; MacLeod, David B; Ainslie, Philip N

2017-08-01

The determining mechanisms of a maximal hyperoxic apnea duration in elite apneists have remained unexplored. We tested the hypothesis that maximal hyperoxic apnea duration in elite apneists is related to forced vital capacity (FVC) but not the central chemoreflex (for CO 2 ). Eleven elite apneists performed a maximal dry static-apnea with prior hyperoxic (100% oxygen) pre-breathing, and a central chemoreflex test via a hyperoxic re-breathing technique (hyperoxic-hypercapnic ventilatory response: HCVR); expressed as the increase in ventilation (pneumotachometry) per increase in arterial CO 2 tension (PaCO 2 ; radial artery). FVC was assessed using standard spirometry. Maximal apnea duration ranged from 807 to 1262s (mean=1034s). Average HCVR was 2.0±1.2Lmin -1 mmHg -1 PaCO 2 . The hyperoxic apnea duration was related to the FVC (r 2 =0.45, p0.05). These findings were interpreted to suggest that during a hyperoxic apnea, a larger initial lung volume prolongs the time before reaching intolerable discomfort associated with pending lung squeeze, while CO 2 sensitivity has little impact. Copyright © 2017 Elsevier B.V. All rights reserved.

The Client's Perspective on Voluntary Stuttering.

Science.gov (United States)

Byrd, Courtney T; Gkalitsiou, Zoi; Donaher, Joe; Stergiou, Erin

2016-08-01

Voluntary stuttering is a strategy that has been suggested for use in the clinical literature but has minimal empirical data regarding treatment outcomes. The purpose of the present study is to explore client perspectives regarding the impact of the use of this strategy on the affective, behavioral, and cognitive components of stuttering. The present study used an original survey designed to explore the intended purpose. A total of 206 adults who stutter were included in the final data corpus. Responses were considered with respect to the type of voluntary stuttering the participants reportedly produced and the location of use. A client perceives significantly greater affective, behavioral, and cognitive benefits from voluntary stuttering when the production is closely matched to the client's actual stutter and when it is used outside the clinical environment. To enhance client perception of associated benefits, clinicians should encourage use of voluntary stuttering that closely matches the client's own stuttering. Clinicians should also facilitate practice of voluntary stuttering outside of the therapy room. Finally, clinicians should be aware that clients, at least initially, may not perceive any benefits from the use of this strategy.

Bilevel vs ICU ventilators providing noninvasive ventilation: effect of system leaks: a COPD lung model comparison.

Science.gov (United States)

Ferreira, Juliana C; Chipman, Daniel W; Hill, Nicholas S; Kacmarek, Robert M

2009-08-01

Noninvasive positive-pressure ventilation (NPPV) modes are currently available on bilevel and ICU ventilators. However, little data comparing the performance of the NPPV modes on these ventilators are available. In an experimental bench study, the ability of nine ICU ventilators to function in the presence of leaks was compared with a bilevel ventilator using the IngMar ASL5000 lung simulator (IngMar Medical; Pittsburgh, PA) set at a compliance of 60 mL/cm H(2)O, an inspiratory resistance of 10 cm H(2)O/L/s, an expiratory resistance of 20 cm H(2)O/ L/s, and a respiratory rate of 15 breaths/min. All of the ventilators were set at 12 cm H(2)O pressure support and 5 cm H(2)O positive end-expiratory pressure. The data were collected at baseline and at three customized leaks. At baseline, all of the ventilators were able to deliver adequate tidal volumes, to maintain airway pressure, and to synchronize with the simulator, without missed efforts or auto-triggering. As the leak was increased, all of the ventilators (except the Vision [Respironics; Murrysville, PA] and Servo I [Maquet; Solna, Sweden]) needed adjustment of sensitivity or cycling criteria to maintain adequate ventilation, and some transitioned to backup ventilation. Significant differences in triggering and cycling were observed between the Servo I and the Vision ventilators. The Vision and Servo I were the only ventilators that required no adjustments as they adapted to increasing leaks. There were differences in performance between these two ventilators, although the clinical significance of these differences is unclear. Clinicians should be aware that in the presence of leaks, most ICU ventilators require adjustments to maintain an adequate tidal volume.

Voluntary sway and rapid orthogonal transitions of voluntary sway in young adults, and low and high fall-risk older adults.

Science.gov (United States)

Tucker, Murray G; Kavanagh, Justin J; Morrison, Steven; Barrett, Rod S

2009-10-01

Falls amongst older people have been linked to reduced postural stability and slowed movement responses. The objective of this study was to examine differences in postural stability and the speed of response between young adults, low fall-risk older adults, and high fall-risk older adults during voluntary postural sway movements. Twenty-five young adults (25+/-4 years), and 32 low fall-risk (74+/-5 years), and 16 high fall-risk (79+/-7 years) older adults performed voluntary sway and rapid orthogonal transitions of voluntary sway between the anterior-posterior and medial-lateral directions. Measures included reaction and movement time and the amplitudes of the centre of pressure, centre of mass, and the separation distance between the centre of pressure and centre of mass. Both fall-risk groups compared to the young had slower reaction and movement time, greater centre of pressure and/or centre of mass amplitude in the orthogonal (non-target) direction during voluntary sway, and reduced anterior-posterior and medial-lateral separation between the centre of pressure and centre of mass during voluntary sway and orthogonal transitions. High compared to low fall-risk individuals had slower reaction and movement time, increased non-target centre of mass amplitude during voluntary sway, and reduced medial-lateral centre of pressure and centre of mass separation during voluntary sway and orthogonal transitions. Age-related deterioration of postural control resulted in slower reactive responses and reduced control of the direction of body movement during voluntary sway and orthogonal transitions. Slower postural reaction and movement time and reduced medial-lateral control of the centre of mass during voluntary sway movements are associated with increased fall-risk in community-living older people.

Maximal metabolic rates during voluntary exercise, forced exercise, and cold exposure in house mice selectively bred for high wheel-running.

Science.gov (United States)

Rezende, Enrico L; Chappell, Mark A; Gomes, Fernando R; Malisch, Jessica L; Garland, Theodore

2005-06-01

Selective breeding for high wheel-running activity has generated four lines of laboratory house mice (S lines) that run about 170% more than their control counterparts (C lines) on a daily basis, mostly because they run faster. We tested whether maximum aerobic metabolic rates (V(O2max)) have evolved in concert with wheel-running, using 48 females from generation 35. Voluntary activity and metabolic rates were measured on days 5+6 of wheel access (mimicking conditions during selection), using wheels enclosed in metabolic chambers. Following this, V(O2max) was measured twice on a motorized treadmill and twice during cold-exposure in a heliox atmosphere (HeO2). Almost all measurements, except heliox V(O2max), were significantly repeatable. After accounting for differences in body mass (S running speeds on the treadmill. However, running speeds and V(O2max) during voluntary exercise were significantly higher in S lines. Nevertheless, S mice never voluntarily achieved the V(O2max) elicited during their forced treadmill trials, suggesting that aerobic capacity per se is not limiting the evolution of even higher wheel-running speeds in these lines. Our results support the hypothesis that S mice have genetically higher motivation for wheel-running and they demonstrate that behavior can sometimes evolve independently of performance capacities. We also discuss the possible importance of domestication as a confounding factor to extrapolate results from this animal model to natural populations.

Air Distribution and Ventilation Effectiveness in a room with Floor/Ceiling Heating and Mixing/Displacement Ventilation

DEFF Research Database (Denmark)

Wu, Xiaozhou; Fang, Lei; Olesen, Bjarne W.

2014-01-01

vertical air temperature differences and air velocities for different hybrid systems are less than 3 C and 0.2 m/s when supply air temperature is 19 C, air change rate is 4.2 h-1, and heated surface temperature of floor/ceiling heating system is 25 C. Ventilation effectiveness of mixing ventilation system...... combined with floor/ceiling heating systems is approximately equal to 1.0, and ventilation effectiveness of displacement ventilation system combined with floor/ceiling heating systems ranges from 1.0 to 1.2. The floor/ceiling heating systems combined with mixing ventilation system have more uniform indoor...... air distribution but smaller ventilation effectiveness compared with the floor/ceiling heating systems combined with displacement ventilation system. With regard to the building heat loss increased by non-uniform indoor air distribution and small ventilation effectiveness, there should be an optimal...

Intraoperative mechanical ventilation strategies in patients undergoing one-lung ventilation: a meta-analysis.

Science.gov (United States)

Liu, Zhen; Liu, Xiaowen; Huang, Yuguang; Zhao, Jing

2016-01-01

Postoperative pulmonary complications (PPCs), which are not uncommon in one-lung ventilation, are among the main causes of postoperative death after lung surgery. Intra-operative ventilation strategies can influence the incidence of PPCs. High tidal volume (V T) and increased airway pressure may lead to lung injury, while pressure-controlled ventilation and lung-protective strategies with low V T may have protective effects against lung injury. In this meta-analysis, we aim to investigate the effects of different ventilation strategies, including pressure-controlled ventilation (PCV), volume-controlled ventilation (VCV), protective ventilation (PV) and conventional ventilation (CV), on PPCs in patients undergoing one-lung ventilation. We hypothesize that both PV with low V T and PCV have protective effects against PPCs in one-lung ventilation. A systematic search (PubMed, EMBASE, the Cochrane Library, and Ovid MEDLINE; in May 2015) was performed for randomized trials comparing PCV with VCV or comparing PV with CV in one-lung ventilation. Methodological quality was evaluated using the Cochrane tool for risk. The primary outcome was the incidence of PPCs. The secondary outcomes included the length of hospital stay, intraoperative plateau airway pressure (Pplateau), oxygen index (PaO2/FiO2) and mean arterial pressure (MAP). In this meta-analysis, 11 studies (436 patients) comparing PCV with VCV and 11 studies (657 patients) comparing PV with CV were included. Compared to CV, PV decreased the incidence of PPCs (OR 0.29; 95 % CI 0.15-0.57; P < 0.01) and intraoperative Pplateau (MD -3.75; 95 % CI -5.74 to -1.76; P < 0.01) but had no significant influence on the length of hospital stay or MAP. Compared to VCV, PCV decreased intraoperative Pplateau (MD -1.46; 95 % CI -2.54 to -0.34; P = 0.01) but had no significant influence on PPCs, PaO2/FiO2 or MAP. PV with low V T was associated with the reduced incidence of PPCs compared to CV. However, PCV and VCV had similar

Impact of Fire Ventilation on General Ventilation in the Building

Science.gov (United States)

Zender-Świercz, Ewa; Telejko, Marek

2017-10-01

The fire of building is a threat to its users. The biggest threat is generation, during lifetime of fire, hot gases and smoke. The purpose of quick and efficient evacuation from the area covered by the fire, at first step the escape routes have to be secured from smokiness. The smoke ventilation systems are used for this purpose. The proper design and execution of smoke ventilation is important not only because of the safety, but also of the maintenance of comfort in the building at a time when there is no fire. The manuscript presents the effect of incorrectly realized smoke ventilation in the stairwell of the medium building. The analysis shows that the flaps of smoke ventilation located in the stairwell may have a significant impact on the proper functioning of mechanical ventilation in the period when there is no fire. The improperly installed or incorrect insulated components cause perturbation of air flow and they change pressure distribution in the building. The conclusion of the analysis is the need to include the entire technical equipment of the building during the design and realization of its individual elements. The impact of various installations at each other is very important, and the omission of any of them can cause disturbances in the proper work of another.

Trends in mechanical ventilation: are we ventilating our patients in the best possible way?

Science.gov (United States)

Dellaca', Raffaele L; Veneroni, Chiara; Farre', Ramon

2017-06-01

This review addresses how the combination of physiology, medicine and engineering principles contributed to the development and advancement of mechanical ventilation, emphasising the most urgent needs for improvement and the most promising directions of future development. Several aspects of mechanical ventilation are introduced, highlighting on one side the importance of interdisciplinary research for further development and, on the other, the importance of training physicians sufficiently on the technological aspects of modern devices to exploit properly the great complexity and potentials of this treatment. To learn how mechanical ventilation developed in recent decades and to provide a better understanding of the actual technology and practice.To learn how and why interdisciplinary research and competences are necessary for providing the best ventilation treatment to patients.To understand which are the most relevant technical limitations in modern mechanical ventilators that can affect their performance in delivery of the treatment.To better understand and classify ventilation modes.To learn the classification, benefits, drawbacks and future perspectives of automatic ventilation tailoring algorithms.

Illness, suffering and voluntary euthanasia.

Science.gov (United States)

Varelius, Jukka

2007-02-01

It is often accepted that we may legitimately speak about voluntary euthanasia only in cases of persons who are suffering because they are incurably injured or have an incurable disease. This article argues that when we consider the moral acceptability of voluntary euthanasia, we have no good reason to concentrate only on persons who are ill or injured and suffering.

46 CFR 42.15-45 - Ventilators.

Science.gov (United States)

2010-10-01

... 46 Shipping 2 2010-10-01 2010-10-01 false Ventilators. 42.15-45 Section 42.15-45 Shipping COAST... Conditions of Assignment of Freeboard § 42.15-45 Ventilators. (a) Ventilators in position 1 or 2 to spaces... any ventilator exceeds 351/2 inches in height it shall be specially supported. (b) Ventilators passing...

37 CFR 351.2 - Voluntary negotiation period; settlement.

Science.gov (United States)

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Voluntary negotiation period... CONGRESS COPYRIGHT ROYALTY JUDGES RULES AND PROCEDURES PROCEEDINGS § 351.2 Voluntary negotiation period..., the Copyright Royalty Judges will announce the beginning of a voluntary negotiation period and will...

A comparison of leak compensation in acute care ventilators during noninvasive and invasive ventilation: a lung model study.

Science.gov (United States)

Oto, Jun; Chenelle, Christopher T; Marchese, Andrew D; Kacmarek, Robert M

2013-12-01

Although leak compensation has been widely introduced to acute care ventilators to improve patient-ventilator synchronization in the presence of system leaks, there are no data on these ventilators' ability to prevent triggering and cycling asynchrony. The goal of this study was to evaluate the ability of leak compensation in acute care ventilators during invasive and noninvasive ventilation (NIV). Using a lung simulator, the impact of system leaks was compared on 7 ICU ventilators and 1 dedicated NIV ventilator during triggering and cycling at 2 respiratory mechanics (COPD and ARDS models) settings, various modes of ventilation (NIV mode [pressure support ventilation], and invasive mode [pressure support and continuous mandatory ventilation]), and 2 PEEP levels (5 and 10 cm H(2)O). Leak levels used were up to 35-36 L/min in NIV mode and 26-27 L/min in invasive mode. Although all of the ventilators were able to synchronize with the simulator at baseline, only 4 of the 8 ventilators synchronized to all leaks in NIV mode, and 2 of the 8 ventilators in invasive mode. The number of breaths to synchronization was higher during increasing than during decreasing leak. In the COPD model, miss-triggering occurred more frequently and required a longer time to stabilize tidal volume than in the ARDS model. The PB840 required fewer breaths to synchronize in both invasive and noninvasive modes, compared with the other ventilators (P ventilators. The PB840 and the V60 were the only ventilators to acclimate to all leaks, but there were differences in performance between these 2 ventilators. It is not clear if these differences have clinical importance.

Pulmonary perfusion ''without ventilation''

International Nuclear Information System (INIS)

Chapman, C.N.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

1983-01-01

An 88-yr-old man, with prior left upper lobectomy and phrenic nerve injury, had a ventilation/perfusion lung image. Both wash-in and equilibrium ventilation images showed no radioactive gas in the left lung. Nevertheless, the left lung was perfused. A similar result was obtained on a repeat study 8 days later. Delayed images, during washout, showed some radioactive gas in the left lung. Nearly absent ventilation (but continued perfusion) of that lung might have been related to altered gas dynamics brought about by the prior lobectomy, a submucosal bronchial lesion, phrenic nerve damage, and limited motion of the left part of the diaphragm. This case raises the issue of the degree of ventilation (and the phase relationship between the lungs) required for the entry of radioactive gas into a diseased lung, and the production of a ''reversed ventilation/perfusion mismatch.''

High-Frequency Percussive Ventilation Revisited

Science.gov (United States)

2010-01-01

be implemented. ‡ Follow the reverse of the ventilation sequence if respiratory alkalosis develops—however, start at ventilation goal sequence 1 not at...High-frequency percussive ventilation (HFPV) has demonstrated a potential role as a rescue option for refractory acute respiratory distress syndrome...frequency percussive ventilation (HFPV) has demon- strated a potential role as a salvage option for refrac- tory acute respiratory distress syndrome

Plane Stratified Flow in a Room Ventilated by Displacement Ventilation

DEFF Research Database (Denmark)

Nielsen, Peter Vilhelm; Nickel, J.; Baron, D. J. G.

2004-01-01

The air movement in the occupied zone of a room ventilated by displacement ventilation exists as a stratified flow along the floor. This flow can be radial or plane according to the number of wall-mounted diffusers and the room geometry. The paper addresses the situations where plane flow...

The effect of helium on ventilator performance: study of five ventilators and a bedside Pitot tube spirometer.

Science.gov (United States)

Oppenheim-Eden, A; Cohen, Y; Weissman, C; Pizov, R

2001-08-01

To assess in vitro the performance of five mechanical ventilators-Siemens 300 and 900C (Siemens-Elma; Solna, Sweden), Puritan Bennett 7200 (Nellcor Puritan Bennett; Pleasanton, CA), Evita 4 (Dragerwerk; Lubeck, Germany), and Bear 1000 (Bear Medical Systems; Riverside CA)-and a bedside sidestream spirometer (Datex CS3 Respiratory Module; Datex-Ohmeda; Helsinki, Finland) during ventilation with helium-oxygen mixtures. In vitro study. ICUs of two university-affiliated hospitals. Each ventilator was connected to 100% helium through compressed air inlets and then tested at three to six different tidal volume (VT) settings using various helium-oxygen concentrations (fraction of inspired oxygen [FIO(2)] of 0.2 to 1.0). FIO(2) and VT were measured with the Datex CS3 spirometer, and VT was validated with a water-displacement spirometer. The Puritan Bennett 7200 ventilator did not function with helium. With the other four ventilators, delivered FIO(2) was lower than the set FIO(2). For the Siemens 300 and 900C ventilators, this difference could be explained by the lack of 21% oxygen when helium was connected to the air supply port, while for the other two ventilators, a nonlinear relation was found. The VT of the Siemens 300 ventilator was independent of helium concentration, while for the other three ventilators, delivered VT was greater than the set VT and was dependent on helium concentration. During ventilation with 80% helium and 20% oxygen, VT increased to 125% of set VT for the Siemens 900C ventilator, and more than doubled for the Evita 4 and Bear 1000 ventilators. Under the same conditions, the Datex CS3 spirometer underestimated the delivered VT by about 33%. At present, no mechanical ventilator is calibrated for use with helium. This investigation offers correction factors for four ventilators for ventilation with helium.

[A comparison of leak compensation in six acute care ventilators during non-invasive ventilation].

Science.gov (United States)

Hu, X S; Wang, Y; Wang, Z T; Yan, P; Zhang, X G; Zhao, S F; Xie, F; Gu, H J; Xie, L X

2017-02-12

Objective: To compare the ability of leak compensation in 6 medical ventilators during non-invasive ventilation. Methods: Six medical ventilators were selected, including 3 non-invasive ventilators (V60, Flexo and Stellar150), and 3 invasive ventilators(Avea, Servo I and BellaVist). Using a lung simulator, the ability of leak compensation was evaluated during triggering and cycling in 2 respiratory mechanics conditions (high airway resistance condition and high elastance resistance condition), and each condition was performed under 2 PEEP levels (4, and 8 cmH(2)O, 1 mmHg=0.098 kPa) at 4 air leak level conditions (L0: 2-3 L/min, L1: 8-10 L/min, L2: 22-27 L/min, L3: 35-40 L/min). Results: In the high elastance resistance condition (L2, L3)with different leak levels, the number of auto-triggering and miss-triggering of the non-invasive ventilator Flexo was significantly less than those of the others (L2: 1, 1; L3: 1.67, 1.33, P ventilators ( P ventilators (1, 0.67, 0, P ventilators in both high airway resistance and high elastance resistance conditions with L0 and L1 leak levels and PEEP levels [ARDS, PEEP=4: (109.8±1.8) ms, (112.0±0.6) ms; ARDS, PEEP=8: (103.1±0.7) ms, (109.7±0.7) ms; COPD, PEEP=4: (207.3±1.1) ms, (220.8±1.1) ms; COPD, PEEP=8: (195.6±6.7) ms, (200.0±1.2) ms , P ventilators could be synchronized, among which V60, Stellar150 and Flexo presented a good performance features in specific conditions.

Voluntary euthanasia: a utilitarian perspective.

Science.gov (United States)

Singer, Peter

2003-10-01

Belgium legalised voluntary euthanasia in 2002, thus ending the long isolation of the Netherlands as the only country in which doctors could openly give lethal injections to patients who have requested help in dying. Meanwhile in Oregon, in the United States, doctors may prescribe drugs for terminally ill patients, who can use them to end their life--if they are able to swallow and digest them. But despite President Bush's oft-repeated statements that his philosophy is to 'trust individuals to make the right decisions' and his opposition to 'distant bureaucracies', his administration is doing its best to prevent Oregonians acting in accordance with a law that its voters have twice ratified. The situation regarding voluntary euthanasia around the world is therefore very much in flux. This essay reviews ethical arguments regarding voluntary euthanasia and physician-assisted suicide from a utilitarian perspective. I shall begin by asking why it is normally wrong to kill an innocent person, and whether these reasons apply to aiding a person who, when rational and competent, asks to be killed or given the means to commit suicide. Then I shall consider more specific utilitarian arguments for and against permitting voluntary euthanasia.

Ventilation of nuclear power plants

International Nuclear Information System (INIS)

Madoyan, A.A.; Vlasik, V.F.

1984-01-01

Foundations and calculation methods of ventilation of rooms with different degree of heat and gas release with the change of operation mode of NPP main equipment, as well as problems of NPP site and adjoining area aerodynamics, have been presented. Systems of air ventilation and conditioning, cooling equipment, are considered. The main points of designing are described and determination of economic efficiency of the ventilation systems are made. Technical characteristics of the ventilators, conditioners, filters and air heaters used, are presented. Organization of adjustment, tests, operation and maintenance of the ventilation systems of NPP with RBMK and WWER-type reactors, is described

[The investigation of control mechanisms of stepping rhythm in human in the air-stepping conditions during passive and voluntary leg movements].

Science.gov (United States)

Solopova, I A; Selionon, V A; Grishin, A A

2010-01-01

In unloading condition the degree of activation of the central stepping program was investigated during passive leg movements in healthy subjects, as well as the excitability of spinal motoneurons during passive and voluntary stepping movement. Passive stepping movements with characteristics maximally approximated to those during voluntary stepping were accomplished by experimenter. The comparison of the muscle activity bursts during voluntary and imposed movements was made. In addition to that the influence of artificially created loading onto the foot to the leg movement characteristics was analyzed. Spinal motoneuron excitability was estimated by means of evaluation of amplitude modulation of the soleus H-reflex. The changes of H-reflexes under the fixation of knee or hip joints were also studied. In majority of subjects the passive movements were accompanied by bursts of EMG activity of hip muscles (and sometimes of knee muscles), which timing during step cycle was coincided with burst timing of voluntary step cycle. In many cases the bursts of EMG activity during passive movements exceeded activity in homonymous muscles during voluntary stepping. The foot loading imitation exerted essential influence on distal parts of moving extremity during voluntary as well passive movements, that was expressed in the appearance of movements in the ankle joint and accompanied by emergence and increasing of phasic EMG activity of shank muscles. The excitability of motoneurons during passive movements was greater then during voluntary ones. The changes and modulation of H-reflex throughout the step cycle without restriction of joint mobility and during exclusion of hip joint mobility were similar. The knee joint fixation exerted the greater influence. It is supposed that imposed movements activate the same mechanisms of rhythm generation as a supraspinal commands during voluntary movements. In the conditions of passive movements the presynaptic inhibition depend on afferent

Partial liquid ventilation improves lung function in ventilation-induced lung injury

NARCIS (Netherlands)

G.F. Vazquez de Anda; R.A. Lachmann; S.J.C. Verbrugge (Serge); D.A.M.P.J. Gommers (Diederik); J.J. Haitsma (Jack); B.F. Lachmann (Burkhard)

2001-01-01

textabstractDisturbances in lung function and lung mechanics are present after ventilation with high peak inspiratory pressures (PIP) and low levels of positive end-expiratory pressure (PEEP). Therefore, the authors investigated whether partial liquid ventilation can re-establish

Phenomenology of maximal and near-maximal lepton mixing

International Nuclear Information System (INIS)

Gonzalez-Garcia, M. C.; Pena-Garay, Carlos; Nir, Yosef; Smirnov, Alexei Yu.

2001-01-01

The possible existence of maximal or near-maximal lepton mixing constitutes an intriguing challenge for fundamental theories of flavor. We study the phenomenological consequences of maximal and near-maximal mixing of the electron neutrino with other (x=tau and/or muon) neutrinos. We describe the deviations from maximal mixing in terms of a parameter ε(equivalent to)1-2sin 2 θ ex and quantify the present experimental status for |ε| e mixing comes from solar neutrino experiments. We find that the global analysis of solar neutrino data allows maximal mixing with confidence level better than 99% for 10 -8 eV 2 ∼ 2 ∼ -7 eV 2 . In the mass ranges Δm 2 ∼>1.5x10 -5 eV 2 and 4x10 -10 eV 2 ∼ 2 ∼ -7 eV 2 the full interval |ε| e mixing in atmospheric neutrinos, supernova neutrinos, and neutrinoless double beta decay

Why We Ventilate

Energy Technology Data Exchange (ETDEWEB)

Logue, Jennifer M.; Sherman, Max H.; Price, Phil N.; Singer, Brett C.

2011-09-01

It is widely accepted that ventilation is critical for providing good indoor air quality (IAQ) in homes. However, the definition of"good" IAQ, and the most effective, energy efficient methods for delivering it are still matters of research and debate. This paper presents the results of work done at the Lawrence Berkeley National Lab to identify the air pollutants that drive the need for ventilation as part of a larger effort to develop a health-based ventilation standard. First, we present results of a hazard analysis that identified the pollutants that most commonly reach concentrations in homes that exceed health-based standards or guidelines for chronic or acute exposures. Second, we present results of an impact assessment that identified the air pollutants that cause the most harm to the U.S. population from chronic inhalation in residences. Lastly, we describe the implications of our findings for developing effective ventilation standards.

Design Principles for Natural and Hybrid Ventilation

DEFF Research Database (Denmark)

Heiselberg, Per

For many years mechanical and natural ventilation systems have developed separately. Naturally, the next step in this development is the development of ventilation concepts that utilize and combine the best features from each system to create a new type of ventilation system- Hybrid Ventilation. ....... The hybrid ventilation concepts, design challenges and principles are discussed and illustrated by four building examples.......For many years mechanical and natural ventilation systems have developed separately. Naturally, the next step in this development is the development of ventilation concepts that utilize and combine the best features from each system to create a new type of ventilation system- Hybrid Ventilation...

Reliability of surface electromyography activity of gluteal and hamstring muscles during sub-maximal and maximal voluntary isometric contractions.

Science.gov (United States)

Bussey, Melanie D; Aldabe, Daniela; Adhia, Divya; Mani, Ramakrishnan

2018-04-01

Normalizing to a reference signal is essential when analysing and comparing electromyography signals across or within individuals. However, studies have shown that MVC testing may not be as reliable in persons with acute and chronic pain. The purpose of this study was to compare the test-retest reliability of the muscle activity in the biceps femoris and gluteus maximus between a novel sub-MVC and standard MVC protocols. This study utilized a single individual repeated measures design with 12 participants performing multiple trials of both the sub-MVC and MVC tasks on two separate days. The participant position in the prone leg raise task was standardised with an ultrasonic sensor to improve task precession between trials/days. Day-to-day and trial-to-trial reliability of the maximal muscle activity was examined using ICC and SEM. Day-to-day and trial-to-trial reliability of the EMG activity in the BF and GM were high (0.70-0.89) to very high (≥0.90) for both test procedures. %SEM was <5-10% for both tests on a given day but higher in the day-to-day comparisons. The lower amplitude of the sub-MVC is a likely contributor to increased %SEM (8-13%) in the day-to-day comparison. The findings show that the sub-MVC modified prone double leg raise results in GM and BF EMG measures similar in reliability and precision to the standard MVC tasks. Therefore, the modified prone double leg raise may be a useful substitute for traditional MVC testing for normalizing EMG signals of the BF and GM. Copyright © 2017 Elsevier Ltd. All rights reserved.

Voluntary Informed Consent in Paediatric Oncology Research.

Science.gov (United States)

Dekking, Sara A S; Van Der Graaf, Rieke; Van Delden, Johannes J M

2016-07-01

In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. © 2015 John Wiley & Sons Ltd.

Effects of respiratory rate and tidal volume on gas exchange in total liquid ventilation.

Science.gov (United States)

Bull, Joseph L; Tredici, Stefano; Fujioka, Hideki; Komori, Eisaku; Grotberg, James B; Hirschl, Ronald B

2009-01-01

Using a rabbit model of total liquid ventilation (TLV), and in a corresponding theoretical model, we compared nine tidal volume-respiratory rate combinations to identify a ventilator strategy to maximize gas exchange, while avoiding choked flow, during TLV. Nine different ventilation strategies were tested in each animal (n = 12): low [LR = 2.5 breath/min (bpm)], medium (MR = 5 bpm), or high (HR = 7.5 bpm) respiratory rates were combined with a low (LV = 10 ml/kg), medium (MV = 15 ml/kg), or high (HV = 20 ml/kg) tidal volumes. Blood gases and partial pressures, perfluorocarbon gas content, and airway pressures were measured for each combination. Choked flow occurred in all high respiratory rate-high volume animals, 71% of high respiratory rate-medium volume (HRMV) animals, and 50% of medium respiratory rate-high volume (MRHV) animals but in no other combinations. Medium respiratory rate-medium volume (MRMV) resulted in the highest gas exchange of the combinations that did not induce choke. The HRMV and MRHV animals that did not choke had similar or higher gas exchange than MRMV. The theory predicted this behavior, along with spatial and temporal variations in alveolar gas partial pressures. Of the combinations that did not induce choked flow, MRMV provided the highest gas exchange. Alveolar gas transport is diffusion dominated and rapid during gas ventilation but is convection dominated and slow during TLV. Consequently, the usual alveolar gas equation is not applicable for TLV.

Voluntary work, a diversity of forms

NARCIS (Netherlands)

Paul Dekker; Joep de Hart

2009-01-01

Original title: Vrijwilligerswerk in meervoud. By international standards, the level of participation in voluntary work in the Netherlands is high, and the signs are that this will continue. On the other hand, the type of voluntary work and the groups in which it is concentrated are changing.

Temperature of gas delivered from ventilators.

Science.gov (United States)

Chikata, Yusuke; Onodera, Mutsuo; Imanaka, Hideaki; Nishimura, Masaji

2013-01-01

Although heated humidifiers (HHs) are the most efficient humidifying device for mechanical ventilation, some HHs do not provide sufficient humidification when the inlet temperature to the water chamber is high. Because portable and home-care ventilators use turbines, blowers, pistons, or compressors to inhale in ambient air, they may have higher gas temperature than ventilators with piping systems. We carried out a bench study to investigate the temperature of gas delivered from portable and home-care ventilators, including the effects of distance from ventilator outlet, fraction of inspiratory oxygen (FIO2), and minute volume (MV). We evaluated five ventilators equipped with turbine, blower, piston, or compressor system. Ambient air temperature was adjusted to 24°C ± 0.5°C, and ventilation was set at FIO2 0.21, 0.6, and 1.0, at MV 5 and 10 L/min. We analyzed gas temperature at 0, 40, 80, and 120 cm from ventilator outlet and altered ventilator settings. While temperature varied according to ventilators, the outlet gas temperature of ventilators became stable after, at the most, 5 h. Gas temperature was 34.3°C ± 3.9°C at the ventilator outlet, 29.5°C ± 2.2°C after 40 cm, 25.4°C ± 1.2°C after 80 cm and 25.1°C ± 1.2°C after 120 cm (P < 0.01). FIO2 and MV did not affect gas temperature. Gas delivered from portable and home-care ventilator was not too hot to induce heated humidifier malfunctioning. Gas soon declined when passing through the limb.

Pretest Predictions for Ventilation Tests

International Nuclear Information System (INIS)

Y. Sun; H. Yang; H.N. Kalia

2007-01-01

The objective of this calculation is to predict the temperatures of the ventilating air, waste package surface, concrete pipe walls, and insulation that will be developed during the ventilation tests involving various test conditions. The results will be used as input to the following three areas: (1) Decisions regarding testing set-up and performance. (2) Assessing how best to scale the test phenomena measured. (3) Validating numerical approach for modeling continuous ventilation. The scope of the calculation is to identify the physical mechanisms and parameters related to thermal response in the ventilation tests, and develop and describe numerical methods that can be used to calculate the effects of continuous ventilation. Sensitivity studies to assess the impact of variation of linear power densities (linear heat loads) and ventilation air flow rates are included. The calculation is limited to thermal effect only

Diffuse Ceiling Ventilation

DEFF Research Database (Denmark)

Zhang, Chen; Heiselberg, Per; Nielsen, Peter V.

2014-01-01

As a novel air distribution system, diffuse ceiling ventilation combines the suspended acoustic ceiling with ventilation supply. Due to the low-impulse supply from the large ceiling area, the system does not generate draught when supplying cold air. However, heat sources play an important role...

Short-term airing by natural ventilation

DEFF Research Database (Denmark)

Perino, Marco; Heiselberg, Per

2009-01-01

The need to improve the energy efficiency of buildings requires new and more efficient ventilation systems. It has been demonstrated that innovative operating concepts that make use of natural ventilation seem to be more appreciated by occupants. This kind of system frequently integrates traditio......The need to improve the energy efficiency of buildings requires new and more efficient ventilation systems. It has been demonstrated that innovative operating concepts that make use of natural ventilation seem to be more appreciated by occupants. This kind of system frequently integrates...... traditional mechanical ventilation components with natural ventilation devices, such as motorized windows and louvers. Among the various ventilation strategies that are currently available, buoyancy driven single-sided natural ventilation has proved to be very effective and can provide high air change rates...... that was aimed at developing and validating numerical models for the analysis of buoyancy driven single-sided natural ventilation systems. Once validated, these models can be used to optimize control strategies in order to achieve satisfactory indoor comfort conditions and IAQ....

Demand controlled ventilation; Behovsstyrt ventilasjon

Energy Technology Data Exchange (ETDEWEB)

Soerensen, Henning Holm

2006-07-01

The terms CAV and VAV have been known terms for many years in the ventilation business. The terms are also included in building regulations, but the time is now right to focus on demand controlled ventilation (DCV). The new building regulations and the accompanying energy framework underline the need for a more nuanced thinking when it comes to controlling ventilation systems. Descriptions and further details of the ventilation systems are provided (ml)

Ventilator and viral induced inflammation

NARCIS (Netherlands)

Hennus, M.P.

2013-01-01

This thesis expands current knowledge on ventilator induced lung injury and provides insights on the immunological effects of mechanical ventilation during viral respiratory infections. The experimental studies in the first part of this thesis improve our understanding of how mechanical ventilation

With age a lower individual breathing reserve is associated with a higher maximal heart rate.

Science.gov (United States)

Burtscher, Martin; Gatterer, Hannes; Faulhaber, Martin; Burtscher, Johannes

2018-01-01

Maximal heart rate (HRmax) is linearly declining with increasing age. Regular exercise training is supposed to partly prevent this decline, whereas sex and habitual physical activity do not. High exercise capacity is associated with a high cardiac output (HR x stroke volume) and high ventilatory requirements. Due to the close cardiorespiratory coupling, we hypothesized that the individual ventilatory response to maximal exercise might be associated with the age-related HRmax. Retrospective analyses have been conducted on the results of 129 consecutively performed routine cardiopulmonary exercise tests. The study sample comprised healthy subjects of both sexes of a broad range of age (20-86 years). Maximal values of power output, minute ventilation, oxygen uptake and heart rate were assessed by the use of incremental cycle spiroergometry. Linear multivariate regression analysis revealed that in addition to age the individual breathing reserve at maximal exercise was independently predictive for HRmax. A lower breathing reserve due to a high ventilatory demand and/or a low ventilatory capacity, which is more pronounced at a higher age, was associated with higher HRmax. Age explained the observed variance in HRmax by 72% and was improved to 83% when the variable "breathing reserve" was entered. The presented findings indicate an independent association between the breathing reserve at maximal exercise and maximal heart rate, i.e. a low individual breathing reserve is associated with a higher age-related HRmax. A deeper understanding of this association has to be investigated in a more physiological scenario. Copyright © 2017 Elsevier B.V. All rights reserved.

Demand controlled ventilation in a bathroom

DEFF Research Database (Denmark)

Mortensen, Dorthe Kragsig; Nielsen, Toke Rammer; Topp, Claus

2008-01-01

consumption during periods where the demand for ventilation is low and poor indoor climate during periods where the demand for ventilation is high. Controlling the ventilation rate by demand can improve the energy performance of the ventilation system and the indoor climate. This paper compares the indoor...... climate and energy consumption of a Constant Air Volume (CAV) system and a Demand Controlled Ventilation (DCV) system for two different bathroom designs. The air change rate of the CAV system corresponded to 0.5h-1. The ventilation rate of the DCV system was controlled by occupancy and by the relative...

Realtime mine ventilation simulation

International Nuclear Information System (INIS)

McDaniel, K.H.

1997-01-01

This paper describes the development of a Windows based, interactive mine ventilation simulation software program at the Waste Isolation Pilot Plant (WIPP). To enhance the operation of the underground ventilation system, Westinghouse Electric Corporation developed the program called WIPPVENT. While WIPPVENT includes most of the functions of the commercially available simulation program VNETPC and uses the same subroutine to calculate airflow distributions, the user interface has been completely rewritten as a Windows application with screen graphics. WIPPVENT is designed to interact with WIPP ventilation monitoring systems through the sitewise Central monitoring System. Data can be continuously collected from the Underground Ventilation Remote Monitoring and Control System (e.g., air quantity and differential pressure) and the Mine Weather Stations (psychrometric data). Furthermore, WIPPVENT incorporates regulator characteristic curves specific to the site. The program utilizes this data to create and continuously update a REAL-TIME ventilation model. This paper discusses the design, key features, and interactive capabilities of WIPPVENT

Styret naturlig ventilation

DEFF Research Database (Denmark)

Morsing, S.; Strøm, J.S.

Publikationen præsenterer et generelt dimensioneringsgrundlag for naturlig ventilation i husdyrstalde. Det er kontrolleret ved forsøg i slagtesvinestalde, hvor det ligeledes er undersøgt hvilken temperaturstabilitet, der kan opnås ved naturlig ventilation, samt produktions- og adfærdsmæssige...

[Evaluation of tidal volume delivered by ventilators during volume-controlled ventilation].

Science.gov (United States)

Zhou, Juan; Yan, Yong; Cao, Desen

2014-12-01

To study the ways which ensure the delivery of enough tidal volume to patients under various conditions close to the demand of the physician. The volume control ventilation model was chosen, and the simulation lung type was active servo lung ASL 5000 or Michigan lung 1601. The air resistance, air compliance and lung type in simulation lungs were set. The tidal volume was obtained from flow analyzer PF 300. At the same tidal volume, the displaying values of tidal volume of E5, Servo i, Evital 4, and Evital XL ventilators with different lung types of patient, compliance of gas piping, leakage, gas types, etc. were evaluated. With the same setting tidal volume of a same ventilator, the tidal volume delivered to patients was different with different lung types of patient, compliance of gas piping, leakage, gas types, etc. Reducing compliance and increasing resistance of the patient lungs caused high peak airway pressure, the tidal volume was lost in gas piping, and the tidal volume be delivered to the patient lungs was decreased. If the ventilator did not compensate to leakage, the tidal volume delivered to the patient lungs was decreased. When the setting gas type of ventilator did not coincide with that applying to the patient, the tidal volume be delivered to the patient lungs might be different with the setting tidal volume of ventilator. To ensure the delivery of enough tidal volume to patients close to the demand of the physician, containable factors such as the compliance of gas piping, leakage, and gas types should be controlled.

Ventilator associated pneumonia among patients on mechanical ventilation at tertiary care centres

International Nuclear Information System (INIS)

Rafiq, M.Y.; Ikram, A.; Ayyub, M.

2018-01-01

Objective: To determine the frequency of ventilator associated pneumonia (VAP) among patients on mechanical ventilation, and to identify the causative bacterial pathogens and antibiotic susceptibility pattern of isolated microorganisms in intensive care units of tertiary care settings. Study Design: Descriptive cross sectional. Place and Duration of Study: This study was conducted at Microbiology Department, Armed Forces Institute of Pathology (AFIP), Rawalpindi, from Dec 2014 to Aug 2015. Material and Methods: A total of 176 patients on mechanical ventilation were included in the study; patients having respiratory tract infection before putting on ventilator were excluded. Endotracheal aspirate (ETA) and Bronchoalveolar lavage (BAL) samples were collected aseptically from patients on mechanical ventilation on day zero i.e. the day on which the patient was put on ventilator to rule out any previous respiratory tract infection and then after 48 hours to observe the development of VAP. Samples were processed in the laboratory by standard culture techniques, pathogens were identified and their antibiotic susceptibility was performed as per CLSI guidelines. Results: Out of 176 patients on mechanical ventilation, 59 (33.5%) developed VAP. Acinetobacter baumanii being the predominant pathogen isolated from 32 (54.2%) patients followed by MRSA 11 (18.6%), Klebsiella pneumoniae 9 (15.2%), Pseudomonas aeruginosa 5 (8.47%) and Stenotrophomonas maltophila from 2 (3.38%) patients. Conclusion: Frequency of VAP is quite high in our setup, identification of causative bacterial pathogensand their antibiotic susceptibility pattern will not only help in providing effective treatment to the patients but will also help in the formulation of antibiogram according to local resistance patterns for empirical therapy and to reduce the morbidity and mortality. (author)

AN ECONOMETRIC APPROACH ABOUT VOLUNTARY TURNOVER

Directory of Open Access Journals (Sweden)

ADALET EREN

2013-06-01

Full Text Available This study analyzes individual and organizational variables that affect voluntary turnover are determined in the special defence and security companies. A binomial logistic regression model is used to estimate voluntary turnover.  Binomial Logistic regression, reliability test (scale alfa, variance (ANOVA, Post-hoc/Tukey, correlation (Pearson and other basic statistical techniques  with SPSS 13 statistical packet program was used in the analyzes ofresearch data. The study finds that; situation of suppose working, number of child, number of death child, number of home’s moving, support of rent, total monthly income of household, last work’s region, number of prizes, affect voluntary turnover are determined.

Effect of a ventilator-focused intervention on the rate of Acinetobacter baumannii infection among ventilated patients.

Science.gov (United States)

Cohen, Regev; Shimoni, Zvi; Ghara, Riad; Ram, Ron; Ben-Ami, Ronen

2014-09-01

Acinetobacter baumannii is a leading cause of ventilator-associated pneumonia, often as a result of ventilator equipment contamination. Evidence-based guidance on optimal care of ventilator equipment to prevent infection is lacking. Here, we report on a significant and persistent reduction in A baumannii infection rates achieved by introducing a strict policy on ventilator care. We implemented an institution-wide ventilator care policy that included routine exchange of breathing circuits and external bacterial filters (every 7-14 days) and replacement followed by routine sterilization of internal bacterial filters (every 4-8 weeks). We analyzed sputum cultures and patient outcomes among ventilated patients before and after the intervention. Between January 2012 and March 2013, 321 patients ventilated for more than 3 days comprised the study cohort. Health care-associated A baumannii acquisition was significantly reduced during the postintervention period (33% vs 16%; odds ratio, 0.39; 95% confidence interval, 0.23-0.67; P = .0008). Additionally, the median time to A baumannii acquisition was significantly longer postintervention (59 vs 21 days; P < .0001). A baumannii ventilator-associated pneumonia risk was also reduced postintervention (odds ratio, 0.39; P = .005). Implementing a stricter standard of ventilator care than that currently defined in published guidelines can significantly decrease health care-associated A baumannii acquisition and related adverse outcomes among ventilated patients. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Neonatal and adult ICU ventilators to provide ventilation in neonates, infants, and children: a bench model study.

Science.gov (United States)

Vignaux, Laurence; Piquilloud, Lise; Tourneux, Pierre; Jolliet, Philippe; Rimensberger, Peter C

2014-10-01

Using a bench test model, we investigated the hypothesis that neonatal and/or adult ventilators equipped with neonatal/pediatric modes currently do not reliably administer pressure support (PS) in neonatal or pediatric patient groups in either the absence or presence of air leaks. PS was evaluated in 4 neonatal and 6 adult ventilators using a bench model to evaluate triggering, pressurization, and cycling in both the absence and presence of leaks. Delivered tidal volumes were also assessed. Three patients were simulated: a preterm infant (resistance 100 cm H2O/L/s, compliance 2 mL/cm H2O, inspiratory time of the patient [TI] 400 ms, inspiratory effort 1 and 2 cm H2O), a full-term infant (resistance 50 cm H2O/L/s, compliance 5 mL/cm H2O, TI 500 ms, inspiratory effort 2 and 4 cm H2O), and a child (resistance 30 cm H2O/L/s, compliance 10 mL/cm H2O, TI 600 ms, inspiratory effort 5 and 10 cm H2O). Two PS levels were tested (10 and 15 cm H2O) with and without leaks and with and without the leak compensation algorithm activated. Without leaks, only 2 neonatal ventilators and one adult ventilator had trigger delays under a given predefined acceptable limit (1/8 TI). Pressurization showed high variability between ventilators. Most ventilators showed TI in excess high enough to seriously impair patient-ventilator synchronization (> 50% of the TI of the subject). In some ventilators, leaks led to autotriggering and impairment of ventilation performance, but the influence of leaks was generally lower in neonatal ventilators. When a noninvasive ventilation algorithm was available, this was partially corrected. In general, tidal volume was calculated too low by the ventilators in the presence of leaks; the noninvasive ventilation algorithm was able to correct this difference in only 2 adult ventilators. No ventilator performed equally well under all tested conditions for all explored parameters. However, neonatal ventilators tended to perform better in the presence of leaks

Summary of human responses to ventilation

Energy Technology Data Exchange (ETDEWEB)

Seppanen, Olli A.; Fisk, William J.

2004-06-01

The effects of ventilation on indoor air quality and health is a complex issue. It is known that ventilation is necessary to remove indoor generated pollutants from indoor air or dilute their concentration to acceptable levels. But, as the limit values of all pollutants are not known, the exact determination of required ventilation rates based on pollutant concentrations and associated risks is seldom possible. The selection of ventilation rates has to be based also on epidemiological research (e.g. Seppanen et al., 1999), laboratory and field experiments (e.g. CEN 1996, Wargocki et al., 2002a) and experience (e.g. ECA 2003). Ventilation may also have harmful effects on indoor air quality and climate if not properly designed, installed, maintained and operated as summarized by Seppdnen (2003). Ventilation may bring indoors harmful substances that deteriorate the indoor environment. Ventilation also affects air and moisture flow through the building envelope and may lead to moisture problems that deteriorate the structures of the building. Ventilation changes the pressure differences over the structures of building and may cause or prevent the infiltration of pollutants from structures or adjacent spaces. Ventilation is also in many cases used to control the thermal environment or humidity in buildings. Ventilation can be implemented with various methods which may also affect health (e.g. Seppdnen and Fisk, 2002, Wargocki et al., 2002a). In non residential buildings and hot climates, ventilation is often integrated with air-conditioning which makes the operation of ventilation system more complex. As ventilation is used for many purposes its health effects are also various and complex. This paper summarizes the current knowledge on positive and negative effects of ventilation on health and other human responses. The focus of the paper is on office-type working environment and residential buildings. In the industrial premises the problems of air quality are usually

Respiratory mechanics to understand ARDS and guide mechanical ventilation.

Science.gov (United States)

Mauri, Tommaso; Lazzeri, Marta; Bellani, Giacomo; Zanella, Alberto; Grasselli, Giacomo

2017-11-30

As precision medicine is becoming a standard of care in selecting tailored rather than average treatments, physiological measurements might represent the first step in applying personalized therapy in the intensive care unit (ICU). A systematic assessment of respiratory mechanics in patients with the acute respiratory distress syndrome (ARDS) could represent a step in this direction, for two main reasons. Approach and Main results: On the one hand, respiratory mechanics are a powerful physiological method to understand the severity of this syndrome in each single patient. Decreased respiratory system compliance, for example, is associated with low end expiratory lung volume and more severe lung injury. On the other hand, respiratory mechanics might guide protective mechanical ventilation settings. Improved gravitationally dependent regional lung compliance could support the selection of positive end-expiratory pressure and maximize alveolar recruitment. Moreover, the association between driving airway pressure and mortality in ARDS patients potentially underlines the importance of sizing tidal volume on respiratory system compliance rather than on predicted body weight. The present review article aims to describe the main alterations of respiratory mechanics in ARDS as a potent bedside tool to understand severity and guide mechanical ventilation settings, thus representing a readily available clinical resource for ICU physicians.

Hybrid Ventilation Air Flow Process

DEFF Research Database (Denmark)

Heiselberg, Per Kvols

The scope of this annex is therefore to obtain better knowledge of the use of hybrid ventilation technologies. The annex focus on development of control strategies for hybrid ventilation, on development of methods to predict hybrid ventilation performance in office buildings and on implementation...

Equivalence in Ventilation and Indoor Air Quality

Energy Technology Data Exchange (ETDEWEB)

Sherman, Max; Walker, Iain; Logue, Jennifer

2011-08-01

We ventilate buildings to provide acceptable indoor air quality (IAQ). Ventilation standards (such as American Society of Heating, Refrigerating, and Air-Conditioning Enginners [ASHRAE] Standard 62) specify minimum ventilation rates without taking into account the impact of those rates on IAQ. Innovative ventilation management is often a desirable element of reducing energy consumption or improving IAQ or comfort. Variable ventilation is one innovative strategy. To use variable ventilation in a way that meets standards, it is necessary to have a method for determining equivalence in terms of either ventilation or indoor air quality. This study develops methods to calculate either equivalent ventilation or equivalent IAQ. We demonstrate that equivalent ventilation can be used as the basis for dynamic ventilation control, reducing peak load and infiltration of outdoor contaminants. We also show that equivalent IAQ could allow some contaminants to exceed current standards if other contaminants are more stringently controlled.

Boundary conditions for the use of personal ventilation over mixing ventilation in open plan offices

DEFF Research Database (Denmark)

Petersen, Steffen; Hviid, Christian Anker

2013-01-01

This paper investigates the boundary conditions for choosing a combined Personal Ventilation (PV) and Mixing Ventilation (MV) over conventional mixing ventilation in an office with multiple workers. A simplified procedure for annual performance assessment of PV/MV systems in terms of air quality...

21 CFR 868.5975 - Ventilator tubing.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ventilator tubing. 868.5975 Section 868.5975 Food... DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5975 Ventilator tubing. (a) Identification. Ventilator tubing is a device intended for use as a conduit for gases between a ventilator and a patient...

Ventilating Air-Conditioner

Science.gov (United States)

Dinh, Khanh

1994-01-01

Air-conditioner provides ventilation designed to be used alone or incorporated into cooling or heating system operates efficiently only by recirculating stale air within building. Energy needed to operate overall ventilating cooling or heating system slightly greater than operating nonventilating cooling or heating system. Helps to preserve energy efficiency while satisfying need for increased forced ventilation to prevent accumulation of undesired gases like radon and formaldehyde. Provides fresh treated air to variety of confined spaces: hospital surgeries, laboratories, clean rooms, and printing shops and other places where solvents used. In mobile homes and portable classrooms, eliminates irritant chemicals exuded by carpets, panels, and other materials, ensuring healthy indoor environment for occupants.

[Effectiveness of nasal positive pressure ventilation in the management of acute refractory left ventricular insufficiency].

Science.gov (United States)

Chesi, G; Pinelli, G; Galimberti, D; Navazio, A; Montanari, P

1994-04-01

Ehen refractory to optimal medical treatment cardiogenic pulmonary edema requires mechanical ventilation as a last therapeutic resource. In recent years an increasing number of authors reported their experience in the management of acute or subacute respiratory failure with non-invasive mechanical ventilation by nasal mask. Encouraged by the first promising results reported in literature we experimented this new therapeutic tool in a first group of seven elderly patients (mean age: 76.57--range: 65-89); they all had been admitted for severe cardiogenic pulmonary edema unresponsive to maximal doses of the conventional drugs available for treating acute decompensated heart failure. The enrolled patients were treated with intermittent ventilation administered by nasal mask at selected values of inspiratory positive airway pressure (IPAP) that were comprised between 10 and 20 cm H2O. At the same time an expiratory positive airway pressure (EPAP) at values comprised between 3 and 8 cm H2O was applied. Ventilation was continued for variable periods of 3-24 hours until acceptable values of PaO2 and PaCO2 were obtained. The ventilation modality was spontaneous, spontaneous-time or timed depending on the patients' level of consciousness at starting time. A good short-term outcome was achieved in all the patients regardless of the ventilation modality applied. The main blood gas alteration was severe hypercapnia with acidosis in three patients, while the other four presented critical hypoxemia unresponsive to simple oxygen supply even if delivered by high-flow Venturi mask. Four of our seven patients were discharged from hospital in satisfactory haemodynamic conditions; the remaining three died during hospitalization from refractory heart failure. In this our preliminary experience the therapeutic approach with nasal positive pressure ventilation (NPPV) and EPAP proved to be very effective to improve the signs and symptoms of acute refractory cardiogenic pulmonary edema as

The role of ventilation. 2 v. Proceedings

International Nuclear Information System (INIS)

1994-01-01

The 78 papers which constitute the proceedings of the conference are presented in two volumes. The papers in the first volume cover sessions dealing with the following broad topics: ventilation strategies; indoor air quality; energy impact of ventilation; building design for optimum ventilation; ventilation and energy. Volume 2 also covers ventilation strategies and ventilation and energy, and in addition: calculation, measurement and design tools; measurement and modelling. Separate abstract have been prepared for 4 papers in Volume 1 which deal with the role of ventilation in mitigating the hazard of radon in buildings. (UK)

Optimization of ventilation and its effect on the microclimate of a colombian multispan greenhouse

Directory of Open Access Journals (Sweden)

Edwin Andrés Villagrán

2012-08-01

Full Text Available In Colombia, greenhouse design optimization has not been a relevant topic and, as a consequence, the ventilation systems of current structures are not optimal, generating inadequate microclimates for the development of horticultural species. At the production level, management of the greenhouse climate is deficient, and this factor is not taken into account as a function of characteristics dependent on greenhouse design that cannot be modified during its lifespan. The aim of the present work was to study the efficiency of modifications applied to the ventilation system of a commercial greenhouse available on the Colombian market. This was accomplished by using numerical simulations through the application of the computational fluid dynamics method. Based on the commercial greenhouse design, two modified models were designed by applying structural modifications and changing the orientation of the fixed open ridges. Simulations with the three greenhouse models were carried out in order to maximize the air renovation rates and improve air movement within the entire greenhouse, striving for the highest degree of climate homogenization. The best greenhouse design was the one with the highest air renovation index, high enough to ensure adequate control of temperature and humidity extremes through natural ventilation. Additionally, this design generated the most homogenous microclimate within the cultivation zone

Voluntary sterilization in Serbia: Unmet need?

Directory of Open Access Journals (Sweden)

Rašević Mirjana M.

2002-01-01

Full Text Available Is voluntary sterilization as a birth control method accepted in Serbia? This is certainly a question that is being imposed for research, regardless of the fact that voluntary sterilization is neither accessible nor promoted. Most importantly because there is no understanding in the social nor political sphere for legalization of voluntary sterilization as a form of birth control, apart from the clear necessity for this, first, step. They are: the recognition that voluntary sterilization is an efficient and safe birth control method, respectability of basic human as well as sexual and reproductive rights, spreading of sterilization as a form of birth control among population of both developed and developing countries and an epidemic diffusion of repeated induced abortions in Serbia. Thus individual recognition of the advantages of relying on voluntary sterilization, in a non-encouraging atmosphere, certainly represents one more argument to enable couples to prevent conception by sterilization. Since it was impossible to carry out a representative research among the population of men and women who are at risk for conception, an attempt was made to obtain a reply to the set question among women who decided to induce abortion. It was done out of at least two reasons. The first being that women with induced abortion in their reproductive history were the target group for voluntary sterilization. The second reason was based on the assumption that bringing a decision on induced abortion is preceded by the reconsideration of an earlier adopted strategy regarding children, giving birth and contraception and thus its rational component is revealed more and therefore more easily measurable. The research was carried out in the University Clinic of Obstetrics and Gynecology 'Narodni front' in Belgrade from January 21st o March 1st 2002, and included 296 women. By comparing the social and demographic characteristics of the female respondents, as well as

Ventilation of radioactive enclosures; Ventilation des enceintes radioactives

Energy Technology Data Exchange (ETDEWEB)

Caminade, F; Laurent, H [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1957-07-01

Mechanical, physical and chemical manipulations on radioactive products must be carried out in properly ventilated enclosed places. The air extracted can only be discharged into the atmosphere after a correct filtration. The power of the ventilation systems is a function of the dimensions and purpose of the enclosure? The choice of types of filter is determined by the physical state and chemical nature of the radioactive materials to be manipulated. This study deals with the individual equipment of small installations: glove boxes, manipulation boxes with outside control and, if necessary, production chambers (maximum useful volume: 5 m{sup 3}). The performances of three types of 'ventilators', and the modifications provided by the addition of filters, are measured and compared. (author) [French] Les manipulations oceaniques, physiques et chimiques sur des produits radioactifs doivent s'effectuer dans des enceintes convenablement ventilees. L'air extrait ne peut etre rejete dans l'atmosphere qu'apres une filtration correcte. La puissance des installations de ventilation est fonction des dimensions de l'enceinte et de son utilisation. Le choix des types de filtres est determine par l'etat physique et la nature ehimique des corps radioactifs manipules. Notre etude porte sur l'equipement individuel d'installations de petites dimensions: boites a gants, boites a pinces et, a la rigueur, enceintes de production (volume maximum utilisable 5 m{sup 3}). Nous mesurons et comparons les performances de trois types de 'ventilateurs' et les modifications apportees par l'adjonction de filtres. (auteur)

How to Plan Ventilation Systems.

Science.gov (United States)

Clarke, John H.

1963-01-01

Ventilation systems for factory safety demand careful planning. The increased heat loads and new processes of industry have introduced complex ventilation problems in--(1) ventilation supply, (2) duct work design, (3) space requirements, (4) hood face velocities, (5) discharge stacks, and (6) building eddies. This article describes and diagrams…

Thermal Plumes in Ventilated Rooms

DEFF Research Database (Denmark)

Kofoed, P.; Nielsen, Peter Vilhelm

The main objective of ventilation is to provide good air quality for the occupants. For this purpose the necessary ventilating air change rate must be determined. Within displacement ventilation the estimation is closely related to the air flow rate in the thermal plumes when an air quality based...

Hemochromatosis Patients as Voluntary Blood Donors

Directory of Open Access Journals (Sweden)

Tara E Power

2004-01-01

Full Text Available The present study was designed to investigate hemochromatosis patients' suitability as blood donors as well as their perceptions and experience with the current public donation system. Participants were gathered from a list of current hemochromatosis patients (n=120 and members of the Canadian Hemochromatosis Society (n=1000. Of the 1120 surveys mailed out to these groups, 801 surveys were returned completed. The sample respondents had a mean age of 57.44 years (SD=12.73; range 19 to 87 years, and 57% were men. It was found that 20% (160 of the respondents have donated blood since their diagnosis; however, only 12% of the respondents indicated that they use voluntary blood donation as a means of maintaining their iron levels. Forty per cent of the respondents indicated that they had been refused from voluntary donation. Despite the fact that in May 2001 the Canadian Blood Services, in collaboration with the Canadian Hemochromatosis Society, began a promotion campaign to encourage hemochromatosis patients to become voluntary blood donors, the present study found that 15% of the respondents reported having been refused from the voluntary blood donation service due to the diagnosis of hemochromatosis. With respect to quality of life, it was found that individuals who donate blood were generally healthier with respect to physical functioning and bodily pain, however, these findings may indicate that hemochromatosis patients who are healthier are better able to donate at public blood banks, rather than that voluntary blood donation has an effect on the donors' physical functioning over phlebotomy clinic users. These study findings suggest that although there may be other medical factors limiting individuals from donating, hemochromatosis patients are interested in being voluntary blood donors and this potential resource is currently under-used.

Effect of formoterol, a long-acting β2-adrenergic agonist, on muscle strength and power output, metabolism and fatigue during maximal sprinting in men

DEFF Research Database (Denmark)

Kalsen, Anders; Hostrup, Morten; Backer, Vibeke

2016-01-01

The aim was to investigate the effect of the long-acting β2-adrenergic agonist formoterol on muscle strength and power output, muscle metabolism and phosphorylation of CaMKII Thr(287) and FXYD1 during maximal sprinting. In a double-blind crossover study, thirteen males (VO2max: 45.0±0.2 (mean±SE) m......L min(-1) kg(-1)) performed a 30-s cycle ergometer sprint after inhalation of either 54 µg formoterol (FOR) or placebo (PLA). Before and after the sprint, muscle biopsies were collected from vastus lateralis and maximal voluntary contraction (MVC) and contractile properties of quadriceps were measured...

Randomized, controlled trial comparing synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in preterm infants.

Science.gov (United States)

Reyes, Zenaida C; Claure, Nelson; Tauscher, Markus K; D'Ugard, Carmen; Vanbuskirk, Silvia; Bancalari, Eduardo

2006-10-01

Prolonged mechanical ventilation is associated with lung injury in preterm infants. In these infants, weaning from synchronized intermittent mandatory ventilation may be delayed by their inability to cope with increased respiratory loads. The addition of pressure support to synchronized intermittent mandatory ventilation can offset these loads and may facilitate weaning. The purpose of this work was to compare synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in weaning from mechanical ventilation and the duration of supplemental oxygen dependency in preterm infants with respiratory failure. Preterm infants weighing 500 to 1000 g at birth who required mechanical ventilation during the first postnatal week were randomly assigned to synchronized intermittent mandatory ventilation or synchronized intermittent mandatory ventilation plus pressure support. In both groups, weaning followed a set protocol during the first 28 days. Outcomes were assessed during the first 28 days and until discharge or death. There were 107 infants enrolled (53 synchronized intermittent mandatory ventilation plus pressure support and 54 synchronized intermittent mandatory ventilation). Demographic and perinatal data, mortality, and morbidity did not differ between groups. During the first 28 days, infants in the synchronized intermittent mandatory ventilation plus pressure support group reached minimal ventilator settings and were extubated earlier than infants in the synchronized intermittent mandatory ventilation group. Total duration of mechanical ventilation, duration of oxygen dependency, and oxygen need at 36 weeks' postmenstrual age alone or combined with death did not differ between groups. However, infants in synchronized intermittent mandatory ventilation plus pressure support within the 700- to 1000-g birth weight strata had a shorter oxygen dependency. The results of this study suggest that the addition of

PREDICTING VOLUNTARY INTAKE ON MEDIUM QUALITY ...

African Journals Online (AJOL)

found a good relationship between the rate constant for fermentation and ... By dividing voluntary feed intake into the ... voluntary feed intake will be equal to the rate at which the rumen is ... per abomosum to prevent any deficiency in protein restricting .... McDougall's saliva and was not included in the calculation of the lust ...

Subsurface Ventilation System Description Document

Energy Technology Data Exchange (ETDEWEB)

Eric Loros

2001-07-25

The Subsurface Ventilation System supports the construction and operation of the subsurface repository by providing air for personnel and equipment and temperature control for the underground areas. Although the system is located underground, some equipment and features may be housed or located above ground. The system ventilates the underground by providing ambient air from the surface throughout the subsurface development and emplacement areas. The system provides fresh air for a safe work environment and supports potential retrieval operations by ventilating and cooling emplacement drifts. The system maintains compliance within the limits established for approved air quality standards. The system maintains separate ventilation between the development and waste emplacement areas. The system shall remove a portion of the heat generated by the waste packages during preclosure to support thermal goals. The system provides temperature control by reducing drift temperature to support potential retrieval operations. The ventilation system has the capability to ventilate selected drifts during emplacement and retrieval operations. The Subsurface Facility System is the main interface with the Subsurface Ventilation System. The location of the ducting, seals, filters, fans, emplacement doors, regulators, and electronic controls are within the envelope created by the Ground Control System in the Subsurface Facility System. The Subsurface Ventilation System also interfaces with the Subsurface Electrical System for power, the Monitored Geologic Repository Operations Monitoring and Control System to ensure proper and safe operation, the Safeguards and Security System for access to the emplacement drifts, the Subsurface Fire Protection System for fire safety, the Emplacement Drift System for repository performance, and the Backfill Emplacement and Subsurface Excavation Systems to support ventilation needs.

Subsurface Ventilation System Description Document

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-10-12

The Subsurface Ventilation System supports the construction and operation of the subsurface repository by providing air for personnel and equipment and temperature control for the underground areas. Although the system is located underground, some equipment and features may be housed or located above ground. The system ventilates the underground by providing ambient air from the surface throughout the subsurface development and emplacement areas. The system provides fresh air for a safe work environment and supports potential retrieval operations by ventilating and cooling emplacement drifts. The system maintains compliance within the limits established for approved air quality standards. The system maintains separate ventilation between the development and waste emplacement areas. The system shall remove a portion of the heat generated by the waste packages during preclosure to support thermal goals. The system provides temperature control by reducing drift temperature to support potential retrieval operations. The ventilation system has the capability to ventilate selected drifts during emplacement and retrieval operations. The Subsurface Facility System is the main interface with the Subsurface Ventilation System. The location of the ducting, seals, filters, fans, emplacement doors, regulators, and electronic controls are within the envelope created by the Ground Control System in the Subsurface Facility System. The Subsurface Ventilation System also interfaces with the Subsurface Electrical System for power, the Monitored Geologic Repository Operations Monitoring and Control System to ensure proper and safe operation, the Safeguards and Security System for access to the emplacement drifts, the Subsurface Fire Protection System for fire safety, the Emplacement Drift System for repository performance, and the Backfill Emplacement and Subsurface Excavation Systems to support ventilation needs.

Regulation proposal for voluntary energy efficiency labelling of commercial buildings

International Nuclear Information System (INIS)

Lamberts, Roberto; Goulart, Solange; Carlo, Joyce; Westphal, Fernando

2006-01-01

Despite of Brazil not being between the major world energy consumers, the consumption of electricity has significantly increased in the late years. The National Energy Balance of 2005, published by the Brazilian Ministry of Energy, showed an increasing of the participation of electricity in the final energy consumption of 15.7% in 2002 to 16.2% in 2004. Initially, a brief review of the initiatives taken by Brazilian Government aiming to limit and control the energy consumption in buildings is presented. Then, the regulation proposal containing the technical requirements to classify the energy efficiency level of buildings is shown. The purpose of this voluntary regulation is to provide conditions to certify the energy efficiency level of Brazilian buildings (commercial and public). It specifies the methods for energy efficiency rating of buildings and includes requirements to attend energy conservation measures in three main issues: lighting system; air conditioning system and envelope. The regulation applies to large buildings (minimum total area of 500 m 2 or when the energy demand is greater than or equal to 2,3 kV, including: Conditioned buildings; Partially conditioned buildings and Naturally ventilated buildings. (author)

Intelligent ventilation in the intensive care unit

Directory of Open Access Journals (Sweden)

Sigal Sviri

2012-08-01

Full Text Available Objectives. Automated, microprocessor-controlled, closed-loop mechanical ventilation has been used in our Medical Intensive Care Unit (MICU at the Hadassah Hebrew-University Medical Center for the past 15 years; for 10 years it has been the primary (preferred ventilator modality. Design and setting. We describe our clinical experience with adaptive support ventilation (ASV over a 6-year period, during which time ASV-enabled ventilators became more readily available and were used as the primary (preferred ventilators for all patients admitted to the MICU. Results. During the study period, 1 220 patients were ventilated in the MICU. Most patients (84% were ventilated with ASV on admission. The median duration of ventilation with ASV was 6 days. The weaning success rate was 81%, and tracheostomy was required in 13%. Sixty-eight patients (6% with severe hypoxia and high inspiratory pressures were placed on pressure-controlled ventilation, in most cases to satisfy a technical requirement for precise and conservative administration of inhaled nitric oxide. The overall pneumothorax rate was less than 3%, and less than 1% of patients who were ventilated only using ASV developed pneumothorax. Conclusions. ASV is a safe and acceptable mode of ventilation for complicated medical patients, with a lower than usual ventilation complication rate.

Protective garment ventilation system

Science.gov (United States)

Lang, R. (Inventor)

1970-01-01

A method and apparatus for ventilating a protective garment, space suit system, and/or pressure suits to maintain a comfortable and nontoxic atmosphere within is described. The direction of flow of a ventilating and purging gas in portions of the garment may be reversed in order to compensate for changes in environment and activity of the wearer. The entire flow of the ventilating gas can also be directed first to the helmet associated with the garment.

Voluntary inhibitory motor control over involuntary tic movements.

Science.gov (United States)

Ganos, Christos; Rothwell, John; Haggard, Patrick

2018-03-06

Inhibitory control is crucial for normal adaptive motor behavior. In hyperkinesias, such as tics, disinhibition within the cortico-striato-thalamo-cortical loops is thought to underlie the presence of involuntary movements. Paradoxically, tics are also subject to voluntary inhibitory control. This puzzling clinical observation questions the traditional definition of tics as purely involuntary motor behaviors. Importantly, it suggests novel insights into tic pathophysiology. In this review, we first define voluntary inhibitory tic control and compare it with other notions of tic control from the literature. We then examine the association between voluntary inhibitory tic control with premonitory urges and review evidence linking voluntary tic inhibition to other forms of executive control of action. We discuss the somatotopic selectivity and the neural correlates of voluntary inhibitory tic control. Finally, we provide a scientific framework with regard to the clinical relevance of the study of voluntary inhibitory tic control within the context of the neurodevelopmental disorder of Tourette syndrome. We identify current knowledge gaps that deserve attention in future research. © 2018 International Parkinson and Movement Disorder Society. © 2018 International Parkinson and Movement Disorder Society.

46 CFR 153.312 - Ventilation system standards.

Science.gov (United States)

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Ventilation system standards. 153.312 Section 153.312... Handling Space Ventilation § 153.312 Ventilation system standards. A cargo handling space ventilation system must meet the following: (a) A ventilation system exhaust duct must discharge no less than 10 m...

The effects of a single intercuspal interference on electromyographic characteristics of human masticatory muscles during maximal voluntary teeth clenching.

Science.gov (United States)

Ferrario, V F; Sforza, C; Serrao, G; Colombo, A; Schmitz, J H

1999-07-01

In 13 healthy subjects (eight men and five women, mean age, 22 years), an aluminum intercuspal interference (height, 0.25 mm) was placed on the maxillary right first premolar to study its effect on the contractile symmetry of the right and left masseter and anterior temporalis muscles when measured through a Percentage Overlapping Coefficient (POC), derived from surface electromyographic recordings of maximum voluntary teeth clenching. Additionally, and to estimate the potential of the experimental intercuspal interference to induce lateral displacement of the mandible, a Torque Coefficient (TC) was derived from surface electromyographic recordings. The conclusion was that the experimental occlusal interference gave rise to asymmetric contractile activity in the studied mandibular elevator muscles as well as a potential to displace the mandible in a lateral direction.

Design of Energy Efficient Hybrid Ventilation

DEFF Research Database (Denmark)

Heiselberg, Per

The focus in the development has for both systems been to minimise energy consumption while maintaining a comfortable and healthy indoor environment. The natural next step in this development is to develop ventilation concepts that utilises and combines the best features from each system......[Mechanical and natural ventilation] into a new type of ventilation system- Hybrid Ventilation....

Ventilation system design for educational facilities

Energy Technology Data Exchange (ETDEWEB)

Elsafty, A.F.; Abo Elazm, M.M. [Arab Academy for Science, Alexandria (Egypt). Technology and Maritime Transport; Safwan, M. [Arab Academy for Science, Cairo (Egypt). Technology and Maritime Transport

2010-07-01

In order to maintain acceptable indoor air quality levels in classrooms, high ventilation rates are needed to dilute the concentration of indoor contaminants, resulting in higher energy consumption for the operation of mechanical ventilation systems. Three factors are usually considered when determining the adequate ventilation rate for classrooms in educational facilities. These include the maximum population served in the classroom; carbon dioxide (CO{sub 2}) production rate by occupants; and outdoor air conditions. CO{sub 2} concentrations usually indicate the rate of ventilation required. This paper presented a newly developed computer software program for determining the ventilation rates needed to enhance indoor air quality and to maintain CO{sub 2} concentration within the recommended levels by ANSI/ASHRAE standards for best student performance. This paper also presented design curves for determining the ventilation rates and air changes per hour required for the ventilated educational zone. 15 refs., 2 tabs., 5 figs.

Understanding mechanical ventilators.

Science.gov (United States)

Chatburn, Robert L

2010-12-01

The respiratory care academic community has not yet adopted a standardized system for classifying and describing modes of ventilation. As a result, there is enough confusion that patient care, clinician education and even ventilator sales are all put at risk. This article summarizes a ventilator mode taxonomy that has been extensively published over the last 15 years. Specifically, the classification system has three components: a description of the control variables within breath; a description of the sequence of mandatory and spontaneous breaths; and a specification for the targeting scheme. This three-level specification provides scalability of detail to make the mode description appropriate for the particular need. At the bedside, we need only refer to a mode briefly using the first or perhaps first and second components. To distinguish between similar modes and brand names, we would need to include all components. This taxonomy uses the equation of motion for the respiratory system as the underlying theoretical framework. All terms relevant to describing modes of mechanical ventilation are defined in an extensive appendix.

SU-F-J-219: Predicting Ventilation Change Due to Radiation Therapy: Dependency On Pre-RT Ventilation and Effort Correction

Energy Technology Data Exchange (ETDEWEB)

Patton, T; Du, K; Bayouth, J [University of Wisconsin, Madison, WI (United States); Christensen, G; Reinhardt, J [University of Iowa, Iowa City, IA (United States)

2016-06-15

Purpose: Ventilation change caused by radiation therapy (RT) can be predicted using four-dimensional computed tomography (4DCT) and image registration. This study tested the dependency of predicted post-RT ventilation on effort correction and pre-RT lung function. Methods: Pre-RT and 3 month post-RT 4DCT images were obtained for 13 patients. The 4DCT images were used to create ventilation maps using a deformable image registration based Jacobian expansion calculation. The post-RT ventilation maps were predicted in four different ways using the dose delivered, pre-RT ventilation, and effort correction. The pre-RT ventilation and effort correction were toggled to determine dependency. The four different predicted ventilation maps were compared to the post-RT ventilation map calculated from image registration to establish the best prediction method. Gamma pass rates were used to compare the different maps with the criteria of 2mm distance-to-agreement and 6% ventilation difference. Paired t-tests of gamma pass rates were used to determine significant differences between the maps. Additional gamma pass rates were calculated using only voxels receiving over 20 Gy. Results: The predicted post-RT ventilation maps were in agreement with the actual post-RT maps in the following percentage of voxels averaged over all subjects: 71% with pre-RT ventilation and effort correction, 69% with no pre-RT ventilation and effort correction, 60% with pre-RT ventilation and no effort correction, and 58% with no pre-RT ventilation and no effort correction. When analyzing only voxels receiving over 20 Gy, the gamma pass rates were respectively 74%, 69%, 65%, and 55%. The prediction including both pre- RT ventilation and effort correction was the only prediction with significant improvement over using no prediction (p<0.02). Conclusion: Post-RT ventilation is best predicted using both pre-RT ventilation and effort correction. This is the only prediction that provided a significant

The impact of a ventilator bundle on preventing ventilator-associated pneumonia: a multicenter study.

Science.gov (United States)

Eom, Joong Sik; Lee, Mi-Suk; Chun, Hee-Kyung; Choi, Hee Jung; Jung, Sun-Young; Kim, Yeon-Sook; Yoon, Seon Jin; Kwak, Yee Gyung; Oh, Gang-Bok; Jeon, Min-Hyok; Park, Sun-Young; Koo, Hyun-Sook; Ju, Young-Su; Lee, Jin Seo

2014-01-01

For prevention of ventilator-associated pneumonia (VAP), a bundle approach was applied to patients receiving mechanical ventilation in intensive care units. The incidence of VAP and the preventive efficacy of the VAP bundle were investigated. A quasi-experimental study was conducted in adult intensive care units of 6 university hospitals with similar VAP rates. We implemented the VAP bundle between March 2011 and June 2011, then compared the rate of VAP after implementation of the VAP bundle with the rate in the previous 8 months. Our ventilator bundle included head of bed elevation, peptic ulcer disease prophylaxis, deep venous thrombosis prophylaxis, and oral decontamination with chlorhexidine 0.12%. Continuous aspiration of subglottic secretions was an option. Implementation of the VAP bundle reduced the VAP rate from a mean of 4.08 cases per 1,000 ventilator-days to 1.16 cases per 1,000 ventilator-days. The incidence density ratio (rate) was 0.28 (95% confidence interval, 0.275-0.292). Implementing the appropriate VAP bundle significantly decreased the incidence of VAP in patients with mechanical ventilation. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Fungal volatiles associated with moldy grain in ventilated and non-ventilated bin-stored wheat.

Science.gov (United States)

Sinha, R N; Tuma, D; Abramson, D; Muir, W E

1988-01-01

The fungal odor compounds 3-methyl-1-butanol, 1-octen-3-ol and 3-octanone were monitored in nine experimental bins in Winnipeg, Manitoba containing a hard red spring wheat during the autumn, winter and summer seasons of 1984-85. Quality changes were associated with seed-borne microflora and moisture content in both ventilated and non-ventilated bins containing wheat of 15.6 and 18.2% initial moisture content. All three odor compounds occurred in considerably greater amounts in bulk wheat in non-ventilated than in ventilated bins, particularly in those with wheat having 18.2% moisture content. The presence of these compounds usually coincided with infection of the seeds by the fungi Alternaria alternata (Fr.) Keissler, Aspergillus repens DeBarry, A. versicolor (Vuill.) Tiraboschi, Penicillium crustosum Thom, P. oxalicum Currie and Thom, P. aurantiogriesum Dierckx, and P. citrinum Thom. High production of all three odor compounds in damp wheat stored in non-ventilated bins was associated with heavy fungal infection of the seeds and reduction in seed germinability. High initial moisture content of the harvested grain accelerated the production of all three fungal volatiles in non-ventilated bins.

Ventilation rates and health

DEFF Research Database (Denmark)

Sundell, Jan; Levin, H; Nazaroff, W W

2011-01-01

and health effects to inform the relationship. Consistency was found across multiple investigations and different epidemiologic designs for different populations. Multiple health endpoints show similar relationships with ventilation rate. There is biological plausibility for an association of health outcomes...... studies of the relationship between ventilation rates and health, especially in diverse climates, in locations with polluted outdoor air and in buildings other than offices. PRACTICAL IMPLICATIONS: Ventilation with outdoor air plays an important role influencing human exposures to indoor pollutants...

Methodology for ventilation/perfusion SPECT

DEFF Research Database (Denmark)

Bajc, Marika; Neilly, Brian; Miniati, Massimo

2010-01-01

radiolabeled liquid aerosols are not restricted to the presence of obstructive lung disease. Radiolabeled macroaggregated human albumin is the imaging agent of choice for perfusion scintigraphy. An optimal combination of nuclide activities and acquisition times for ventilation and perfusion, collimators......Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas over......, and imaging matrix yields an adequate V/Q SPECT study in approximately 20 minutes of imaging time. The recommended protocol based on the patient remaining in an unchanged position during the initial ventilation study and the perfusion study allows presentation of matching ventilation and perfusion slices...

Assisted Ventilation in Patients with Acute Respiratory Distress Syndrome: Lung-distending Pressure and Patient-Ventilator Interaction

NARCIS (Netherlands)

Doorduin, J.; Sinderby, C.A.; Beck, J.; Hoeven, J.G. van der; Heunks, L.M.

2015-01-01

BACKGROUND: In patients with acute respiratory distress syndrome (ARDS), the use of assisted mechanical ventilation is a subject of debate. Assisted ventilation has benefits over controlled ventilation, such as preserved diaphragm function and improved oxygenation. Therefore, higher level of

TS LOOP ALCOVE VENTILATION ANALYSIS

International Nuclear Information System (INIS)

T.M. Lahnalampi

2000-01-01

The scope of this analysis is to examine the existing, constructor installed, physical ventilation installations located in each of the Exploratory Studies Facility (ESF) Topopah Springs (TS) Loop Alcoves No.1, No.2, No.3, No.4, No.6, and No.7. Alcove No.5 is excluded from the scope of this analysis since it is an A/E design system. Each ventilation installation will be analyzed for the purpose of determining if requirements for acceptance into the A/E design technical baseline have been met. The ventilation installations will be evaluated using Occupational Safety and Health Administration (OSHA) standards and Exploratory Studies Facility Design Requirements (ESFDR) (YMP 1997) requirements. The end product will be a technical analysis that will define ventilation installation compliance issues, any outstanding field changes, and use-as-is design deviations that are required to bring the ventilation installations into compliance with requirements for acceptance into the A/E design technical baseline. The analysis will provide guidance for alcove ventilation component design modifications to be developed to correct any deficient components that do not meet minimum requirements and standards

Mechanical ventilation for severe asthma.

Science.gov (United States)

Leatherman, James

2015-06-01

Acute exacerbations of asthma can lead to respiratory failure requiring ventilatory assistance. Noninvasive ventilation may prevent the need for endotracheal intubation in selected patients. For patients who are intubated and undergo mechanical ventilation, a strategy that prioritizes avoidance of ventilator-related complications over correction of hypercapnia was first proposed 30 years ago and has become the preferred approach. Excessive pulmonary hyperinflation is a major cause of hypotension and barotrauma. An appreciation of the key determinants of hyperinflation is essential to rational ventilator management. Standard therapy for patients with asthma undergoing mechanical ventilation consists of inhaled bronchodilators, corticosteroids, and drugs used to facilitate controlled hypoventilation. Nonconventional interventions such as heliox, general anesthesia, bronchoscopy, and extracorporeal life support have also been advocated for patients with fulminant asthma but are rarely necessary. Immediate mortality for patients who are mechanically ventilated for acute severe asthma is very low and is often associated with out-of-hospital cardiorespiratory arrest before intubation. However, patients who have been intubated for severe asthma are at increased risk for death from subsequent exacerbations and must be managed accordingly in the outpatient setting.

Wind Extraction for Natural Ventilation

Science.gov (United States)

Fagundes, Tadeu; Yaghoobian, Neda; Kumar, Rajan; Ordonez, Juan

2017-11-01

Due to the depletion of energy resources and the environmental impact of pollution and unsustainable energy resources, energy consumption has become one of the main concerns in our rapidly growing world. Natural ventilation, a traditional method to remove anthropogenic and solar heat gains, proved to be a cost-effective, alternative method to mechanical ventilation. However, while natural ventilation is simple in theory, its detailed design can be a challenge, particularly for wind-driven ventilation, which its performance highly involves the buildings' form, surrounding topography, turbulent flow characteristics, and climate. One of the main challenges with wind-driven natural ventilation schemes is due to the turbulent and unpredictable nature of the wind around the building that impose complex pressure loads on the structure. In practice, these challenges have resulted in founding the natural ventilation mainly on buoyancy (rather than the wind), as the primary force. This study is the initial step for investigating the physical principals of wind extraction over building walls and investigating strategies to reduce the dependence of the wind extraction on the incoming flow characteristics and the target building form.

Thermal comfort of seated occupants in rooms with personalized ventilation combined with mixing or displacement ventilation

DEFF Research Database (Denmark)

Forejt, L.; Melikov, Arsen Krikor; Cermak, Radim

2004-01-01

The performance of two personalized ventilation systems combined with mixing or displacement ventilation was studied under different conditions in regard to thermal comfort of seated occupants. The cooling performance of personalized ventilation was found to be independent of room air distribution...

Low tidal volume ventilation ameliorates left ventricular dysfunction in mechanically ventilated rats following LPS-induced lung injury.

Science.gov (United States)

Cherpanath, Thomas G V; Smeding, Lonneke; Hirsch, Alexander; Lagrand, Wim K; Schultz, Marcus J; Groeneveld, A B Johan

2015-10-07

High tidal volume ventilation has shown to cause ventilator-induced lung injury (VILI), possibly contributing to concomitant extrapulmonary organ dysfunction. The present study examined whether left ventricular (LV) function is dependent on tidal volume size and whether this effect is augmented during lipopolysaccharide(LPS)-induced lung injury. Twenty male Wistar rats were sedated, paralyzed and then randomized in four groups receiving mechanical ventilation with tidal volumes of 6 ml/kg or 19 ml/kg with or without intrapulmonary administration of LPS. A conductance catheter was placed in the left ventricle to generate pressure-volume loops, which were also obtained within a few seconds of vena cava occlusion to obtain relatively load-independent LV systolic and diastolic function parameters. The end-systolic elastance / effective arterial elastance (Ees/Ea) ratio was used as the primary parameter of LV systolic function with the end-diastolic elastance (Eed) as primary LV diastolic function. Ees/Ea decreased over time in rats receiving LPS (p = 0.045) and high tidal volume ventilation (p = 0.007), with a lower Ees/Ea in the rats with high tidal volume ventilation plus LPS compared to the other groups (p tidal volume ventilation without LPS (p = 0.223). A significant interaction (p tidal ventilation and LPS for Ees/Ea and Eed, and all rats receiving high tidal volume ventilation plus LPS died before the end of the experiment. Low tidal volume ventilation ameliorated LV systolic and diastolic dysfunction while preventing death following LPS-induced lung injury in mechanically ventilated rats. Our data advocates the use of low tidal volumes, not only to avoid VILI, but to avert ventilator-induced myocardial dysfunction as well.

Lung-protective ventilation in abdominal surgery.

Science.gov (United States)

Futier, Emmanuel; Jaber, Samir

2014-08-01

To provide the most recent and relevant clinical evidence regarding the use of prophylactic lung-protective mechanical ventilation in abdominal surgery. Evidence is accumulating, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary complications in patients undergoing abdominal surgery. Nonprotective ventilator settings, especially high tidal volume (>10-12 ml/kg), very low level of positive end-expiratory pressure (PEEP, ventilator-associated lung injury in patients with healthy lungs. Stimulated by the previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung-protective mechanical ventilation. Recent data provide compelling evidence that prophylactic lung-protective mechanical ventilation using lower tidal volume (6-8 ml/kg of predicted body weight), moderate PEEP (6-8 cm H2O), and recruitment maneuvers is associated with improved functional or physiological and clinical postoperative outcome in patients undergoing abdominal surgery. The use of prophylactic lung-protective ventilation can help in improving the postoperative outcome.

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.

Maximal Bell's inequality violation for non-maximal entanglement

International Nuclear Information System (INIS)

Kobayashi, M.; Khanna, F.; Mann, A.; Revzen, M.; Santana, A.

2004-01-01

Bell's inequality violation (BIQV) for correlations of polarization is studied for a product state of two two-mode squeezed vacuum (TMSV) states. The violation allowed is shown to attain its maximal limit for all values of the squeezing parameter, ζ. We show via an explicit example that a state whose entanglement is not maximal allow maximal BIQV. The Wigner function of the state is non-negative and the average value of either polarization is nil

Design Principles for Natural and Hybrid Ventilation

OpenAIRE

Heiselberg, Per

2000-01-01

For many years mechanical and natural ventilation systems have developed separately. Naturally, the next step in this development is the development of ventilation concepts that utilize and combine the best features from each system to create a new type of ventilation system- Hybrid Ventilation. The hybrid ventilation concepts, design challenges and principles are discussed and illustrated by four building examples.

Ventilation effectiveness : health benefits of heat recovery ventilators

Energy Technology Data Exchange (ETDEWEB)

Anon.

2010-08-15

Studies have shown that the installation of a heat recovery ventilator (HRV) in homes in northern Canada could improve indoor air quality and the respiratory health of inhabitants. Low ventilation rates are common in many homes in the North because the climate is severe, homes are smaller and lack basements, and occupancies are higher, leading to unhealthy indoor air quality. Northern communities also have a high rate of respiratory infections. HRVs recover much of the energy used to ventilate, which is desirable in cold regions with high heating costs. For the study, the test sample was divided into two types of houses, notably houses with active HRVs and those with control HRVs that were installed and operated but that did not function. The study results showed that HRVs provided increased ventilation. Complaints by residents about HRV noise, discomfort, or low humidity were common but equally spread between those with active and placebo HRVs. The study showed that the system design needs to be improved to better suit the needs of Inuit families. The nature of northern housing presents installation and maintenance challenges. It is hard to retrofit HRV ducting inside small, existing houses, and building supplies arrive infrequently, so detailed planning and careful take-offs of all supplies and materials must be done well in advance of construction. In addition, contractors are hard to locate and have variable expertise, and there is little technical follow-up. Robust technical support by local contractors and housing authorities is therefore important. 2 refs.

Voluntary reporting of greenhouse gases, 1995

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-07-01

The Voluntary Reporting Program for greenhouse gases is part of an attempt by the U.S. Government to develop innovative, low-cost, and nonregulatory approaches to limit emissions of greenhouse gases. It is one element in an array of such programs introduced in recent years as part of the effort being made by the United States to comply with its national commitment to stabilize emissions of greenhouse gases under the Framework Convention on Climate Change. The Voluntary Reporting Program, developed pursuant to Section 1605(b) of the Energy Policy Act of 1992, permits corporations, government agencies, households, and voluntary organizations to report to the Energy Information Administration (EIA) on actions taken that have reduced or avoided emissions of greenhouse gases.

Effect of vibration during fatiguing resistance exercise on subsequent muscle activity during maximal voluntary isometric contractions.

Science.gov (United States)

McBride, Jeffrey M; Porcari, John P; Scheunke, Mark D

2004-11-01

This investigation was designed to determine if vibration during fatiguing resistance exercise would alter associated patterns of muscle activity. A cross-over design was employed with 8 subjects completing a resistance exercise bout once with a vibrating dumbbell (V) (44 Hz, 3 mm displacement) and once without vibration (NV). For both exercise bouts, 10 sets were performed with a load that induced concentric muscle failure during the 10th repetition. The appropriate load for each set was determined during a pretest. Each testing session was separated by 1 week. Electromyography (EMG) was obtained from the biceps brachii muscle at 12 different time points during a maximum voluntary contraction (MVC) at a 170 degrees elbow angle after each set of the dumbbell exercise. The time points were as follows: pre (5 minutes before the resistance exercise bout), T1-T10 (immediately following each set of resistance exercise), and post (15 minutes after the resistance exercise bout). EMG was analyzed for median power frequency (MPF) and maximum (mEMG). NV resulted in a significant decrease in MPF at T1-T4 (p recruitment of high threshold motor units during fatiguing contractions. This may indicate the usage of vibration with resistance exercise as an effective tool for strength training athletes.

Voluntary Wheel Running in Mice.

Science.gov (United States)

Goh, Jorming; Ladiges, Warren

2015-12-02

Voluntary wheel running in the mouse is used to assess physical performance and endurance and to model exercise training as a way to enhance health. Wheel running is a voluntary activity in contrast to other experimental exercise models in mice, which rely on aversive stimuli to force active movement. This protocol consists of allowing mice to run freely on the open surface of a slanted, plastic saucer-shaped wheel placed inside a standard mouse cage. Rotations are electronically transmitted to a USB hub so that frequency and rate of running can be captured via a software program for data storage and analysis for variable time periods. Mice are individually housed so that accurate recordings can be made for each animal. Factors such as mouse strain, gender, age, and individual motivation, which affect running activity, must be considered in the design of experiments using voluntary wheel running. Copyright © 2015 John Wiley & Sons, Inc.

Weaning newborn infants from mechanical ventilation

Directory of Open Access Journals (Sweden)

Paolo Biban

2013-06-01

Full Text Available Invasive mechanical ventilation is a life-saving procedure which is largely used in neonatal intensive care units, particularly in very premature newborn infants. However, this essential treatment may increase mortality and cause substantial morbidity, including lung or airway injuries, unplanned extubations, adverse hemodynamic effects, analgosedative dependency and severe infectious complications, such as ventilator-associated pneumonia. Therefore, limiting the duration of airway intubation and mechanical ventilator support is crucial for the neonatologist, who should aim to a shorter process of discontinuing mechanical ventilation as well as an earlier appreciation of readiness for spontaneous breathing trials. Unfortunately, there is scarce information about the best ways to perform an effective weaning process in infants undergoing mechanical ventilation, thus in most cases the weaning course is still based upon the individual judgment of the attending clinician. Nonetheless, some evidence indicate that volume targeted ventilation modes are more effective in reducing the duration of mechanical ventilation than traditional pressure limited ventilation modes, particularly in very preterm babies. Weaning and extubation directly from high frequency ventilation could be another option, even though its effectiveness, when compared to switching and subsequent weaning and extubating from conventional ventilation, is yet to be adequately investigated. Some data suggest the use of weaning protocols could reduce the weaning time and duration of mechanical ventilation, but better designed prospective studies are still needed to confirm these preliminary observations. Finally, the implementation of short spontaneous breathing tests in preterm infants has been shown to be beneficial in some centres, favoring an earlier extubation at higher ventilatory settings compared with historical controls, without worsening the extubation failure rate. Further

A Porcine Model for Initial Surge Mechanical Ventilator Assessment and Evaluation of Two Limited Function Ventilators

Science.gov (United States)

Dickson, Robert P; Hotchkin, David L; Lamm, Wayne JE; Hinkson, Carl; Pierson, David J; Glenny, Robb W; Rubinson, Lewis

2013-01-01

Objective To adapt an animal model of acute lung injury for use as a standard protocol for a screening, initial evaluation of limited function, or “surge,” ventilators for use in mass casualty scenarios. Design Prospective, experimental animal study. Setting University research laboratory. Subjects 12 adult pigs. Interventions 12 spontaneously breathing pigs (6 in each group) were subjected to acute lung injury/acute respiratory distress syndrome (ALI/ARDS) via pulmonary artery infusion of oleic acid. Following development of respiratory failure, animals were mechanically ventilated with a limited function ventilator (Simplified Automatic Ventilator [SAVe] I or II; Automedx) for one hour or until the ventilator could not support the animal. The limited function ventilator was then exchanged for a full function ventilator (Servo 900C; Siemens). Measurements and Main Results Reliable and reproducible levels of ALI/ARDS were induced. The SAVe I was unable to adequately oxygenate 5 animals, with PaO2 (52.0 ± 11.1 torr) compared to the Servo (106.0 ± 25.6 torr; p=0.002). The SAVe II was able to oxygenate and ventilate all 6 animals for one hour with no difference in PaO2 (141.8 ± 169.3 torr) compared to the Servo (158.3 ± 167.7 torr). Conclusions We describe a novel in vivo model of ALI/ARDS that can be used to initially screen limited function ventilators considered for mass respiratory failure stockpiles, and is intended to be combined with additional studies to defintively assess appropriateness for mass respiratory failure. Specifically, during this study we demonstrate that the SAVe I ventilator is unable to provide sufficient gas exchange, while the SAVe II, with several more functions, was able to support the same level of hypoxemic respiratory failure secondary to ALI/ARDS for one hour. PMID:21187747

Comparison between conventional protective mechanical ventilation and high-frequency oscillatory ventilation associated with the prone position.

Science.gov (United States)

Fioretto, José Roberto; Klefens, Susiane Oliveira; Pires, Rafaelle Fernandes; Kurokawa, Cilmery Suemi; Carpi, Mario Ferreira; Bonatto, Rossano César; Moraes, Marcos Aurélio; Ronchi, Carlos Fernando

2017-01-01

To compare the effects of high-frequency oscillatory ventilation and conventional protective mechanical ventilation associated with the prone position on oxygenation, histology and pulmonary oxidative damage in an experimental model of acute lung injury. Forty-five rabbits with tracheostomy and vascular access were underwent mechanical ventilation. Acute lung injury was induced by tracheal infusion of warm saline. Three experimental groups were formed: healthy animals + conventional protective mechanical ventilation, supine position (Control Group; n = 15); animals with acute lung injury + conventional protective mechanical ventilation, prone position (CMVG; n = 15); and animals with acute lung injury + high-frequency oscillatory ventilation, prone position (HFOG; n = 15). Ten minutes after the beginning of the specific ventilation of each group, arterial gasometry was collected, with this timepoint being called time zero, after which the animal was placed in prone position and remained in this position for 4 hours. Oxidative stress was evaluated by the total antioxidant performance assay. Pulmonary tissue injury was determined by histopathological score. The level of significance was 5%. Both groups with acute lung injury showed worsening of oxygenation after induction of injury compared with the Control Group. After 4 hours, there was a significant improvement in oxygenation in the HFOG group compared with CMVG. Analysis of total antioxidant performance in plasma showed greater protection in HFOG. HFOG had a lower histopathological lesion score in lung tissue than CMVG. High-frequency oscillatory ventilation, associated with prone position, improves oxygenation and attenuates oxidative damage and histopathological lung injury compared with conventional protective mechanical ventilation.

Protective ventilation of preterm lambs exposed to acute chorioamnionitis does not reduce ventilation-induced lung or brain injury.

Science.gov (United States)

Barton, Samantha K; Moss, Timothy J M; Hooper, Stuart B; Crossley, Kelly J; Gill, Andrew W; Kluckow, Martin; Zahra, Valerie; Wong, Flora Y; Pichler, Gerhard; Galinsky, Robert; Miller, Suzanne L; Tolcos, Mary; Polglase, Graeme R

2014-01-01

The onset of mechanical ventilation is a critical time for the initiation of cerebral white matter (WM) injury in preterm neonates, particularly if they are inadvertently exposed to high tidal volumes (VT) in the delivery room. Protective ventilation strategies at birth reduce ventilation-induced lung and brain inflammation and injury, however its efficacy in a compromised newborn is not known. Chorioamnionitis is a common antecedent of preterm birth, and increases the risk and severity of WM injury. We investigated the effects of high VT ventilation, after chorioamnionitis, on preterm lung and WM inflammation and injury, and whether a protective ventilation strategy could mitigate the response. Pregnant ewes (n = 18) received intra-amniotic lipopolysaccharide (LPS) 2 days before delivery, instrumentation and ventilation at 127±1 days gestation. Lambs were either immediately euthanased and used as unventilated controls (LPSUVC; n = 6), or were ventilated using an injurious high VT strategy (LPSINJ; n = 5) or a protective ventilation strategy (LPSPROT; n = 7) for a total of 90 min. Mean arterial pressure, heart rate and cerebral haemodynamics and oxygenation were measured continuously. Lungs and brains underwent molecular and histological assessment of inflammation and injury. LPSINJ lambs had poorer oxygenation than LPSPROT lambs. Ventilation requirements and cardiopulmonary and systemic haemodynamics were not different between ventilation strategies. Compared to unventilated lambs, LPSINJ and LPSPROT lambs had increases in pro-inflammatory cytokine expression within the lungs and brain, and increased astrogliosis (pVentilation after acute chorioamnionitis, irrespective of strategy used, increases haemodynamic instability and lung and cerebral inflammation and injury. Mechanical ventilation is a potential contributor to WM injury in infants exposed to chorioamnionitis.

Changing Dynamics in the Voluntary Market (Presentation)

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.

2014-12-01

Voluntary green power markets are those in which consumers and institutions voluntarily purchase renewable energy to match their electricity needs. This presentation, presented at the Renewable Energy Markets Conference in December 2014, outlines the voluntary market in 2013, including community choice aggregation and community solar.

Use of Ventilator Bundle and Staff Education to Decrease Ventilator-Associated Pneumonia in Intensive Care Patients.

Science.gov (United States)

Parisi, Maria; Gerovasili, Vasiliki; Dimopoulos, Stavros; Kampisiouli, Efstathia; Goga, Christina; Perivolioti, Efstathia; Argyropoulou, Athina; Routsi, Christina; Tsiodras, Sotirios; Nanas, Serafeim

2016-10-01

Ventilator-associated pneumonia (VAP), one of the most common hospital-acquired infections, has a high mortality rate. To evaluate the incidence of VAP in a multidisciplinary intensive care unit and to examine the effects of the implementation of ventilator bundles and staff education on its incidence. A 24-month-long before/after study was conducted, divided into baseline, intervention, and postintervention periods. VAP incidence and rate, the microbiological profile, duration of mechanical ventilation, and length of stay in the intensive care unit were recorded and compared between the periods. Of 1097 patients evaluated, 362 met the inclusion criteria. The baseline VAP rate was 21.6 per 1000 ventilator days. During the postintervention period, it decreased to 11.6 per 1000 ventilator days (P = .01). Length of stay in the intensive care unit decreased from 36 to 27 days (P = .04), and duration of mechanical ventilation decreased from 26 to 21 days (P = .06). VAP incidence was high in a general intensive care unit in a Greek hospital. However, implementation of a ventilator bundle and staff education has decreased both VAP incidence and length of stay in the unit. ©2016 American Association of Critical-Care Nurses.

Numerical Study on Different Series Modes of Jet Fan in a Longitudinal Tunnel Ventilation System

Directory of Open Access Journals (Sweden)

Guihong Pei

2014-01-01

Full Text Available Efficient ventilation systems will contribute to maintaining air quality in the tunnel. In order to improve ventilation performance in normal traffic condition, the 3D tunnel models were established according to the original design for the tunnel located in central plains of China. Based on the commercial CFD software Fluent 6.3 and k-ε turbulence model, numerical simulations were carried out to study the patterns of jet flow and the optimization of fan combinations. It is found that the axial velocity profile obtained from numerical simulation agrees quite well with turbulent free jet theory although there is a little difference on the magnitude. The comparison of four combination modes under the condition of operating four fans indicates that the ventilation effectiveness is affected mainly by both the interval of adjacent groups of fans and the combination modes of operational fans. According to the simulation results, a novel combination mode which consists of a group double paralleled fans and two groups single fan is designed. The novel combination mode is regarded as the optimum combination mode with respect to maximizing air velocity in the tunnel. Compared to the traditional combination modes, it will increase the air velocity by 5.7%.

Implementation of voluntary agreements for energy efficiency in China

International Nuclear Information System (INIS)

Hu Yuan

2007-01-01

Low-energy efficiency and environmental pollution have long been taken as key problems of Chinese industry, although a number of command-and-control and economic instruments have been adopted in the last few decades. In this paper, policy and legislation development for voluntary agreements were summarized. The voluntary agreements pilot project in two iron and steel companies in Shandong Province as well as other cases were analyzed. In order to identify the existing problems in Chinese cases, comparison was made between China and industrialized countries in the practices of energy efficiency voluntary agreements. Based on the analysis, detained recommendations, including the use of supporting policies for voluntary agreements, were raised. It is expected that voluntary agreements could play a more important role in energy efficiency improvement of Chinese industry

46 CFR 153.310 - Ventilation system type.

Science.gov (United States)

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Ventilation system type. 153.310 Section 153.310... Handling Space Ventilation § 153.310 Ventilation system type. A cargo handling space must have a permanent forced ventilation system of the exhaust type. ...

Personalized ventilation

DEFF Research Database (Denmark)

Melikov, Arsen Krikor

2004-01-01

microenvironment. Furthermore, HVAC systems should be designed to protect occupants from airborne transmission of infectious agents that may be present in exhaled air. Personalized ventilation is a new development in the field of HVAC and has the potential to fulfill the above requirements. This paper reviews...... existing knowledge on performance of personalized ventilation (PV) and on human response to it. The airflow interaction in the vicinity of the human body is analyzed and its impact on thermal comfort and inhaled air quality is discussed together with control strategies and the application of PV in practice...

Mechanical ventilation during extracorporeal membrane oxygenation.

Science.gov (United States)

Schmidt, Matthieu; Pellegrino, Vincent; Combes, Alain; Scheinkestel, Carlos; Cooper, D Jamie; Hodgson, Carol

2014-01-21

The timing of extracorporeal membrane oxygenation (ECMO) initiation and its outcome in the management of respiratory and cardiac failure have received considerable attention, but very little attention has been given to mechanical ventilation during ECMO. Mechanical ventilation settings in non-ECMO studies have been shown to have an effect on survival and may also have contributed to a treatment effect in ECMO trials. Protective lung ventilation strategies established for non-ECMO-supported respiratory failure patients may not be optimal for more severe forms of respiratory failure requiring ECMO support. The influence of positive end-expiratory pressure on the reduction of the left ventricular compliance may be a matter of concern for patients receiving ECMO support for cardiac failure. The objectives of this review were to describe potential mechanisms for lung injury during ECMO for respiratory or cardiac failure, to assess the possible benefits from the use of ultra-protective lung ventilation strategies and to review published guidelines and expert opinions available on mechanical ventilation-specific management of patients requiring ECMO, including mode and ventilator settings. Articles were identified through a detailed search of PubMed, Ovid, Cochrane databases and Google Scholar. Additional references were retrieved from the selected studies. Growing evidence suggests that mechanical ventilation settings are important in ECMO patients to minimize further lung damage and improve outcomes. An ultra-protective ventilation strategy may be optimal for mechanical ventilation during ECMO for respiratory failure. The effects of airway pressure on right and left ventricular afterload should be considered during venoarterial ECMO support of cardiac failure. Future studies are needed to better understand the potential impact of invasive mechanical ventilation modes and settings on outcomes.

[Mechanical ventilation in acute asthma crisis].

Science.gov (United States)

Barbas, Carmen Sílvia Valente; Pinheiro, Bruno do Valle; Vianna, Arthur; Magaldi, Ricardo; Casati, Ana; José, Anderson; Okamoto, Valdelis Novis

2007-06-01

The II Brazilian Consensus Conference on Mechanical Ventilation was published in 2000. Knowledge on the field of mechanical ventilation evolved rapidly since then, with the publication of numerous clinical studies with potential impact on the ventilatory management of critically ill patients. Moreover, the evolving concept of evidence - based medicine determined the grading of clinical recommendations according to the methodological value of the studies on which they are based. This explicit approach has broadened the understanding and adoption of clinical recommendations. For these reasons, AMIB - Associação de Medicina Intensiva Brasileira and SBPT - Sociedade Brasileira de Pneumologia e Tisiologia - decided to update the recommendations of the II Brazilian Consensus. Mechanical ventilation in the asthma attack has been one of the updated topics. Describe the most important topics on the mechanical ventilation during the asthma attack and suggest the main therapeutic approaches. Systematic review of the published literature and gradation of the studies in levels of evidence, using the key words "mechanical ventilation" and "asthma". We present recommendations on the ventilatory modes and settings to be adopted when ventilating a patient during an asthma attack, as well as the recommended monitoring. Alternative ventilation techniques are also presented. Protective ventilatory strategies are recommended when ventilating a patient during a severe asthma attack.

Sensor-based demand controlled ventilation

Energy Technology Data Exchange (ETDEWEB)

De Almeida, A.T. [Universidade de Coimbra (Portugal). Dep. Eng. Electrotecnica; Fisk, W.J. [Lawrence Berkeley National Lab., CA (United States)

1997-07-01

In most buildings, occupancy and indoor pollutant emission rates vary with time. With sensor-based demand-controlled ventilation (SBDCV), the rate of ventilation (i.e., rate of outside air supply) also varies with time to compensate for the changes in pollutant generation. In other words, SBDCV involves the application of sensing, feedback and control to modulate ventilation. Compared to ventilation without feedback, SBDCV offers two potential advantages: (1) better control of indoor pollutant concentrations; and (2) lower energy use and peak energy demand. SBDCV has the potential to improve indoor air quality by increasing the rate of ventilation when indoor pollutant generation rates are high and occupants are present. SBDCV can also save energy by decreasing the rate of ventilation when indoor pollutant generation rates are low or occupants are absent. After providing background information on indoor air quality and ventilation, this report provides a relatively comprehensive discussion of SBDCV. Topics covered in the report include basic principles of SBDCV, sensor technologies, technologies for controlling air flow rates, case studies of SBDCV, application of SBDCV to laboratory buildings, and research needs. SBDCV appears to be an increasingly attractive technology option. Based on the review of literature and theoretical considerations, the application of SBDCV has the potential to be cost-effective in applications with the following characteristics: (a) a single or small number of dominant pollutants, so that ventilation sufficient to control the concentration of the dominant pollutants provides effective control of all other pollutants; (b) large buildings or rooms with unpredictable temporally variable occupancy or pollutant emission; and (c) climates with high heating or cooling loads or locations with expensive energy.

Comparison of airway pressure release ventilation to conventional mechanical ventilation in the early management of smoke inhalation injury in swine.

Science.gov (United States)

Batchinsky, Andriy I; Burkett, Samuel E; Zanders, Thomas B; Chung, Kevin K; Regn, Dara D; Jordan, Bryan S; Necsoiu, Corina; Nguyen, Ruth; Hanson, Margaret A; Morris, Michael J; Cancio, Leopoldo C

2011-10-01

The role of airway pressure release ventilation in the management of early smoke inhalation injury has not been studied. We compared the effects of airway pressure release ventilation and conventional mechanical ventilation on oxygenation in a porcine model of acute respiratory distress syndrome induced by wood smoke inhalation. Prospective animal study. Government laboratory animal intensive care unit. Thirty-three Yorkshire pigs. Smoke inhalation injury. Anesthetized female Yorkshire pigs (n = 33) inhaled room-temperature pine-bark smoke. Before injury, the pigs were randomized to receive conventional mechanical ventilation (n = 15) or airway pressure release ventilation (n = 12) for 48 hrs after smoke inhalation. As acute respiratory distress syndrome developed (PaO2/Fio2 ratio conventional mechanical ventilation for 48 hrs and served as time controls. Changes in PaO2/Fio2 ratio, tidal volume, respiratory rate, mean airway pressure, plateau pressure, and hemodynamic variables were recorded. Survival was assessed using Kaplan-Meier analysis. PaO2/Fio2 ratio was lower in airway pressure release ventilation vs. conventional mechanical ventilation pigs at 12, 18, and 24 hrs (p conventional mechanical ventilation animals between 30 and 48 hrs post injury (p animals between 6 and 48 hrs (p conventional mechanical ventilation and airway pressure release ventilation pigs. In this model of acute respiratory distress syndrome caused by severe smoke inhalation in swine, airway pressure release ventilation-treated animals developed acute respiratory distress syndrome faster than conventional mechanical ventilation-treated animals, showing a lower PaO2/Fio2 ratio at 12, 18, and 24 hrs after injury. At other time points, PaO2/Fio2 ratio was not different between conventional mechanical ventilation and airway pressure release ventilation.

The fluid mechanics of natural ventilation

Science.gov (United States)

Linden, Paul

1999-11-01

Natural ventilation of buildings is the flow generated by temperature differences and by the wind. Modern buildings have extreme designs with large, tall open plan spaces and large cooling requirements. Natural ventilation offers a means of cooling these buildings and providing good indoor air quality. The essential feature of ventilation is an exchange between an interior space and the external ambient. Recent work shows that in many circumstances temperature variations play a controlling feature on the ventilation since the directional buoyancy force has a large influence on the flow patterns within the space and on the nature of the exchange with the outside. Two forms of buoyancy-driven ventilation are discussed: mixing ventilation in which the interior is at approximately uniform temperature and displacement ventilation where there is strong internal stratification. The dynamics of these flows are considered and the effects of wind on them are examined both experimentally and theoretically. The aim behind this work is to give designers rules and intuition on how air moves within a building and the research shows a fascinating branch of fluid mechanics.

Turkish nursing students' attitudes towards voluntary induced abortion.

Science.gov (United States)

Yanikkerem, Emre; Üstgörül, Sema; Karakus, Asli; Baydar, Ozge; Esmeray, Nicole; Ertem, Gül

2018-03-01

To evaluate Turkish nursing students' attitudes towards voluntary induced abortion.. This cross-sectional study was conducted between January and June 2015, comprising students of Ege University Nursing Faculty and Celal Bayar University School of Health, located in two different cities of Turkey. Data was collected with a three-part questionnaire, focussing on students' characteristics, the knowledge of abortion law in Turkey and attitudes towards voluntary induced abortion. SPSS 15 was used for data analysis.. The mean score of students' attitude towards voluntary induced abortion was 39.8±7.9 which shows that nursing students moderately support abortion. Female students, students coming from upper class in society, and students who had higher family income and sexual experiences had more supportiveness attitudes towards voluntary induced abortion (pabortion.

Ventilation of an hydrofoil wake

Science.gov (United States)

Arndt, Roger; Lee, Seung Jae; Monson, Garrett

2013-11-01

Ventilation physics plays a role in a variety of important engineering applications. For example, hydroturbine ventilation is used for control of vibration and cavitation erosion and more recently for improving the dissolved oxygen content of the flow through the turbine. The latter technology has been the focus of an ongoing study involving the ventilation of an hydrofoil wake to determine the velocity and size distribution of bubbles in a bubbly wake. This was carried out by utilizing particle shadow velocimetry (PSV). This technique is a non-scattering approach that relies on direct in-line volume illumination by a pulsed source such as a light-emitting diode (LED). The data are compared with previous studies of ventilated flow. The theoretical results of Hinze suggest that a scaling relationship is possible that can lead to developing appropriate design parameters for a ventilation system. Sponsored by ONR and DOE.

Maximizing and customer loyalty: Are maximizers less loyal?

Directory of Open Access Journals (Sweden)

Linda Lai

2011-06-01

Full Text Available Despite their efforts to choose the best of all available solutions, maximizers seem to be more inclined than satisficers to regret their choices and to experience post-decisional dissonance. Maximizers may therefore be expected to change their decisions more frequently and hence exhibit lower customer loyalty to providers of products and services compared to satisficers. Findings from the study reported here (N = 1978 support this prediction. Maximizers reported significantly higher intentions to switch to another service provider (television provider than satisficers. Maximizers' intentions to switch appear to be intensified and mediated by higher proneness to regret, increased desire to discuss relevant choices with others, higher levels of perceived knowledge of alternatives, and higher ego involvement in the end product, compared to satisficers. Opportunities for future research are suggested.

Ways of sampling voluntary and involuntary autobiographical memories in daily life.

Science.gov (United States)

Rasmussen, Anne S; Johannessen, Kim B; Berntsen, Dorthe

2014-11-01

Cognitive psychologists have often equaled retrieval of personal events with voluntary recall from autobiographical memory, but more recent research shows that autobiographical memories often come to mind involuntarily-that is, with no retrieval effort. Voluntary memories have been studied in numerous laboratory experiments in response to word-prompts, whereas involuntary memories primarily have been examined in an everyday living context, using a structured diary procedure. However, it remains unclear how voluntary memories sampled in the laboratory map onto self-prompted voluntary memories in daily life. Here, we used a structured diary procedure to compare different types of voluntary autobiographical memories to their involuntary counterparts. The results replicated previous findings with regard to differences between word-prompted voluntary and involuntary memories, whereas there were fewer differences between self-prompted voluntary and involuntary memories. The findings raise the question as to what is the best way of sampling voluntary memories and the best comparison for involuntary memories. Copyright © 2014 Elsevier Inc. All rights reserved.

Mechanical ventilators in US acute care hospitals.

Science.gov (United States)

Rubinson, Lewis; Vaughn, Frances; Nelson, Steve; Giordano, Sam; Kallstrom, Tom; Buckley, Tim; Burney, Tabinda; Hupert, Nathaniel; Mutter, Ryan; Handrigan, Michael; Yeskey, Kevin; Lurie, Nicole; Branson, Richard

2010-10-01

The supply and distribution of mechanical ventilation capacity is of profound importance for planning for severe public health emergencies. However, the capability of US health systems to provide mechanical ventilation for children and adults remains poorly quantified. The objective of this study was to determine the quantity of adult and pediatric mechanical ventilators at US acute care hospitals. A total of 5,752 US acute care hospitals included in the 2007 American Hospital Association database were surveyed. We measured the quantities of mechanical ventilators and their features. Responding to the survey were 4305 (74.8%) hospitals, which accounted for 83.8% of US intensive care unit beds. Of the 52,118 full-feature mechanical ventilators owned by respondent hospitals, 24,204 (46.4%) are pediatric/neonatal capable. Accounting for nonrespondents, we estimate that there are 62,188 full-feature mechanical ventilators owned by US acute care hospitals. The median number of full-feature mechanical ventilators per 100,000 population for individual states is 19.7 (interquartile ratio 17.2-23.1), ranging from 11.9 to 77.6. The median number of pediatric-capable device full-feature mechanical ventilators per 100,000 population younger than 14 years old is 52.3 (interquartile ratio 43.1-63.9) and the range across states is 22.1 to 206.2. In addition, respondent hospitals reported owning 82,755 ventilators other than full-feature mechanical ventilators; we estimate that there are 98,738 devices other than full-feature ventilators at all of the US acute care hospitals. The number of mechanical ventilators per US population exceeds those reported by other developed countries, but there is wide variation across states in the population-adjusted supply. There are considerably more pediatric-capable ventilators than there are for adults only on a population-adjusted basis.

Low-energy mechanical ventilation

DEFF Research Database (Denmark)

Andersen, Claus Wessel; Hviid, Christian Anker

2014-01-01

and with as little energy consumption as 41.1 kWh/m2/year including heating and all building services with no use of renewable energy such as PVcells or solar heating. One of the key means of reaching the objectives was to implement mechanical ventilation with low pressure loss and therefore low energy consumption....... The project consists of two buildings, building one is 6 stories high, and building two is 4 stories high. The buildings have a gross area of 50,500 m2 including underground parking. The ventilation and indoor climate concept was to use mechanical ventilation together with mechanical cooling and fanassisted......, with an average of 1.1 kJ/m3. The yearly mean SFP based on estimated runtime is approx. 0.8 kJ/m3. The case shows the unlocked potential that lies within mechanical ventilation for nearzero energy consuming buildings....

Intraoperative mechanical ventilation for the pediatric patient.

Science.gov (United States)

Kneyber, Martin C J

2015-09-01

Invasive mechanical ventilation is required when children undergo general anesthesia for any procedure. It is remarkable that one of the most practiced interventions such as pediatric mechanical ventilation is hardly supported by any scientific evidence but rather based on personal experience and data from adults, especially as ventilation itself is increasingly recognized as a harmful intervention that causes ventilator-induced lung injury. The use of low tidal volume and higher levels of positive end-expiratory pressure became an integral part of lung-protective ventilation following the outcomes of clinical trials in critically ill adults. This approach has been readily adopted in pediatric ventilation. However, a clear association between tidal volume and mortality has not been ascertained in pediatrics. In fact, experimental studies have suggested that young children might be less susceptible to ventilator-induced lung injury. As such, no recommendations on optimal lung-protective ventilation strategy in children with or without lung injury can be made. Copyright © 2015 Elsevier Ltd. All rights reserved.

Changes in lung volume and ventilation during surfactant treatment in ventilated preterm infants

NARCIS (Netherlands)

Miedema, Martijn; de Jongh, Frans H.; Frerichs, Inez; van Veenendaal, Mariëtte B.; van Kaam, Anton H.

2011-01-01

The immediate and regional effects of exogenous surfactant in open lung high-frequency oscillatory ventilated (HFOV) preterm infants are unknown. To assess regional changes in lung volume, mechanics, and ventilation during and after surfactant administration in HFOV preterm infants with respiratory

Monitoring of noninvasive ventilation by built-in software of home bilevel ventilators: a bench study.

Science.gov (United States)

Contal, Olivier; Vignaux, Laurence; Combescure, Christophe; Pepin, Jean-Louis; Jolliet, Philippe; Janssens, Jean-Paul

2012-02-01

Current bilevel positive-pressure ventilators for home noninvasive ventilation (NIV) provide physicians with software that records items important for patient monitoring, such as compliance, tidal volume (Vt), and leaks. However, to our knowledge, the validity of this information has not yet been independently assessed. Testing was done for seven home ventilators on a bench model adapted to simulate NIV and generate unintentional leaks (ie, other than of the mask exhalation valve). Five levels of leaks were simulated using a computer-driven solenoid valve (0-60 L/min) at different levels of inspiratory pressure (15 and 25 cm H(2)O) and at a fixed expiratory pressure (5 cm H(2)O), for a total of 10 conditions. Bench data were compared with results retrieved from ventilator software for leaks and Vt. For assessing leaks, three of the devices tested were highly reliable, with a small bias (0.3-0.9 L/min), narrow limits of agreement (LA), and high correlations (R(2), 0.993-0.997) when comparing ventilator software and bench results; conversely, for four ventilators, bias ranged from -6.0 L/min to -25.9 L/min, exceeding -10 L/min for two devices, with wide LA and lower correlations (R(2), 0.70-0.98). Bias for leaks increased markedly with the importance of leaks in three devices. Vt was underestimated by all devices, and bias (range, 66-236 mL) increased with higher insufflation pressures. Only two devices had a bias ventilation must be aware of differences in the estimation of leaks and Vt by ventilator software. Also, leaks are reported in different ways according to the device used.

A bench study of intensive-care-unit ventilators: new versus old and turbine-based versus compressed gas-based ventilators

Science.gov (United States)

Thille, Arnaud W.; Lyazidi, Aissam; Richard, Jean-Christophe M.; Galia, Fabrice; Brochard, Laurent

2009-01-01

Objective To compare 13 commercially available, new-generation, intensive-care-unit (ICU) ventilators regarding trigger function, pressurization capacity during pressure-support ventilation (PSV), accuracy of pressure measurements and expiratory resistance. Design and Setting Bench study at a research laboratory in a university hospital. Material Four turbine-based ventilators and nine conventional servo-valve compressed-gas ventilators were tested using a two-compartment lung model. Results Three levels of effort were simulated. Each ventilator was evaluated at four PSV levels (5, 10, 15, and 20 cm H2O), with and without positive end-expiratory pressure (5 cm H2O, Trigger function was assessed as the time from effort onset to detectable pressurization. Pressurization capacity was evaluated using the airway pressure-time product computed as the net area under the pressure-time curve over the first 0.3 s after inspiratory effort onset. Expiratory resistance was evaluated by measuring trapped volume in controlled ventilation. Significant differences were found across the ventilators, with a range of triggering-delay from 42 ms to 88 ms for all conditions averaged (Pventilators at PSV5 and three at PSV10, suggesting an inability to unload patient’s effort. On average, turbine-based ventilators performed better than conventional ventilators, which showed no improvement compared to a 2000 bench comparison. Conclusion Technical performances of trigger function, pressurization capacity and expiratory resistance vary considerably across new-generation ICU ventilators. ICU ventilators seem to have reached a technical ceiling in recent years, and some ventilators still perform inadequately. PMID:19352622

Minute Ventilation Limitations of Two Field Transport Ventilators.

Science.gov (United States)

Szpisjak, Dale F; Horn, Gregory; Shalov, Samuel; Abes, Alvin Angelo; Van Decar, Lauren

2017-01-01

Knowledge of transport ventilator performance impacts patient safety. This study compared minute ventilation (V E ) of the MOVES and Uni-Vent 731 when ventilating the VentAid Training Test Lung with compliance (C) ranging from 0.02 to 0.10 L/cm H 2 O and three different airway resistances (R) (none, Rp5, or Rp20). Tidal volume (V T ) was 800 ± 25 mL. Respiratory rate was increased to ventilator's maximum or until auto-PEEP > 5 cm H 2 O. Respiratory parameters were recorded with the RSS 100HR Research Pneumotach. Data were reported as median (interquartile range). Peak inspiratory pressure (PIP) of the Uni-Vent and MOVES ranged from 22.3 (22.2-22.5) to 82.6 (82.2-83.2) and 20.8 (20.6-20.9) to 50.6 (50.2-50.9) cm H 2 O, respectively. V E of the Uni-Vent and MOVES ranged from 17.7 (17.7-17.7) to 31.5 (31.5-31.5) and 11.3 (10.5-11.3) to 20.2 (19.7-20.5) L/min, respectively. Linear regression demonstrated strong, negative correlation of V E with PIP for the MOVES (V E [L/min] = 26 - 0.31 × PIP [cm H 2 O], r = -0.97) but weak, positive correlation for the Uni-Vent (r = 0.05). Uni-Vent V E exceeded MOVES V E under each test condition (p = 0.0002). If patient V E requirements exceed those predicted by the MOVES regression equation, then using the Uni-Vent should be considered. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Final voluntary release assessment/corrective action report

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-11-12

The US Department of Energy, Carlsbad Area Office (DOE-CAO) has completed a voluntary release assessment sampling program at selected Solid Waste Management Units (SWMUs) at the Waste Isolation Pilot Plant (WIPP). This Voluntary Release Assessment/Corrective Action (RA/CA) report has been prepared for final submittal to the Environmental protection Agency (EPA) Region 6, Hazardous Waste Management Division and the New Mexico Environment Department (NMED) Hazardous and Radioactive Materials Bureau to describe the results of voluntary release assessment sampling and proposed corrective actions at the SWMU sites. The Voluntary RA/CA Program is intended to be the first phase in implementing the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) and corrective action process at the WIPP. Data generated as part of this sampling program are intended to update the RCRA Facility Assessment (RFA) for the WIPP (Assessment of Solid Waste Management Units at the Waste Isolation Pilot Plant), NMED/DOE/AIP 94/1. This Final Voluntary RA/CA Report documents the results of release assessment sampling at 11 SWMUs identified in the RFA. With this submittal, DOE formally requests a No Further Action determination for these SWMUs. Additionally, this report provides information to support DOE`s request for No Further Action at the Brinderson and Construction landfill SWMUs, and to support DOE`s request for approval of proposed corrective actions at three other SWMUs (the Badger Unit Drill Pad, the Cotton Baby Drill Pad, and the DOE-1 Drill Pad). This information is provided to document the results of the Voluntary RA/CA activities submitted to the EPA and NMED in August 1995.

Mechanical ventilation in abdominal surgery.

Science.gov (United States)

Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

2014-01-01

One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEPventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC).

Science.gov (United States)

Kneyber, Martin C J; de Luca, Daniele; Calderini, Edoardo; Jarreau, Pierre-Henri; Javouhey, Etienne; Lopez-Herce, Jesus; Hammer, Jürg; Macrae, Duncan; Markhorst, Dick G; Medina, Alberto; Pons-Odena, Marti; Racca, Fabrizio; Wolf, Gerhard; Biban, Paolo; Brierley, Joe; Rimensberger, Peter C

2017-12-01

Much of the common practice in paediatric mechanical ventilation is based on personal experiences and what paediatric critical care practitioners have adopted from adult and neonatal experience. This presents a barrier to planning and interpretation of clinical trials on the use of specific and targeted interventions. We aim to establish a European consensus guideline on mechanical ventilation of critically children. The European Society for Paediatric and Neonatal Intensive Care initiated a consensus conference of international European experts in paediatric mechanical ventilation to provide recommendations using the Research and Development/University of California, Los Angeles, appropriateness method. An electronic literature search in PubMed and EMBASE was performed using a combination of medical subject heading terms and text words related to mechanical ventilation and disease-specific terms. The Paediatric Mechanical Ventilation Consensus Conference (PEMVECC) consisted of a panel of 15 experts who developed and voted on 152 recommendations related to the following topics: (1) general recommendations, (2) monitoring, (3) targets of oxygenation and ventilation, (4) supportive measures, (5) weaning and extubation readiness, (6) normal lungs, (7) obstructive diseases, (8) restrictive diseases, (9) mixed diseases, (10) chronically ventilated patients, (11) cardiac patients and (12) lung hypoplasia syndromes. There were 142 (93.4%) recommendations with "strong agreement". The final iteration of the recommendations had none with equipoise or disagreement. These recommendations should help to harmonise the approach to paediatric mechanical ventilation and can be proposed as a standard-of-care applicable in daily clinical practice and clinical research.

Ventilation of carbon monoxide from a biomass pellet storage tank--a study of the effects of variation of temperature and cross-ventilation on the efficiency of natural ventilation.

Science.gov (United States)

Emhofer, Waltraud; Lichtenegger, Klaus; Haslinger, Walter; Hofbauer, Hermann; Schmutzer-Roseneder, Irene; Aigenbauer, Stefan; Lienhard, Martin

2015-01-01

Wood pellets have been reported to emit toxic gaseous emissions during transport and storage. Carbon monoxide (CO) emission, due to the high toxicity of the gas and the possibility of it being present at high levels, is the most imminent threat to be considered before entering a pellet storage facility. For small-scale (ventilation, preferably natural ventilation utilizing already existing openings, has become the most favored solution to overcome the problem of high CO concentrations. However, there is little knowledge on the ventilation rates that can be reached and thus on the effectiveness of such measures. The aim of the study was to investigate ventilation rates for a specific small-scale pellet storage system depending on characteristic temperature differences. Furthermore, the influence of the implementation of a chimney and the influence of cross-ventilation on the ventilation rates were investigated. The air exchange rates observed in the experiments ranged between close to zero and up to 8 m(3) h(-1), depending largely on the existing temperature differences and the existence of cross-ventilation. The results demonstrate that implementing natural ventilation is a possible measure to enhance safety from CO emissions, but not one without limitations. © The Author 2014. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Why this crisis in residential ventilation

NARCIS (Netherlands)

Hasselaar, E.

2008-01-01

Ventilation is the cornerstone of good indoor air quality. Ventilation requirements have major attention in building regulations, but ventilation in practice is often poor, resulting in increased concentration of pollutants and hence exposure to health risk. Inspection of 500 houses with interviews

Heliox allows for lower minute volume ventilation in an animal model of ventilator-induced lung injury.

Directory of Open Access Journals (Sweden)

Charlotte J Beurskens

Full Text Available BACKGROUND: Helium is a noble gas with a low density, allowing for lower driving pressures and increased carbon dioxide (CO2 diffusion. Since application of protective ventilation can be limited by the development of hypoxemia or acidosis, we hypothesized that therefore heliox facilitates ventilation in an animal model of ventilator-induced lung injury. METHODS: Sprague-Dawley rats (N=8 per group were mechanically ventilated with heliox (50% oxygen; 50% helium. Controls received a standard gas mixture (50% oxygen; 50% air. VILI was induced by application of tidal volumes of 15 mL kg(-1; lung protective ventilated animals were ventilated with 6 mL kg(-1. Respiratory parameters were monitored with a pneumotach system. Respiratory rate was adjusted to maintain arterial pCO2 within 4.5-5.5 kPa, according to hourly drawn arterial blood gases. After 4 hours, bronchoalveolar lavage fluid (BALF was obtained. Data are mean (SD. RESULTS: VILI resulted in an increase in BALF protein compared to low tidal ventilation (629 (324 vs. 290 (181 μg mL(-1; p<0.05 and IL-6 levels (640 (8.7 vs. 206 (8.7 pg mL(-1; p<0.05, whereas cell counts did not differ between groups after this short course of mechanical ventilation. Ventilation with heliox resulted in a decrease in mean respiratory minute volume ventilation compared to control (123 ± 0.6 vs. 146 ± 8.9 mL min(-1, P<0.001, due to a decrease in respiratory rate (22 (0.4 vs. 25 (2.1 breaths per minute; p<0.05, while pCO2 levels and tidal volumes remained unchanged, according to protocol. There was no effect of heliox on inspiratory pressure, while compliance was reduced. In this mild lung injury model, heliox did not exert anti-inflammatory effects. CONCLUSIONS: Heliox allowed for a reduction in respiratory rate and respiratory minute volume during VILI, while maintaining normal acid-base balance. Use of heliox may be a useful approach when protective tidal volume ventilation is limited by the development of

[Ventilator associated pneumonia].

Science.gov (United States)

Bellani, S; Nesci, M; Celotto, S; Lampati, L; Lucchini, A

2003-04-01

Ventilator associated pneumonia (VAP) is a nosocomial lower respiratory tract infection that ensues in critically ill patients undergoing mechanical ventilation. The reported incidence of VAP varies between 9% and 68% with a mortality ranging between 33% and 71%. Two key factors are implicated in the pathogenesis of VAP: bacterial colonization of the upper digestive-respiratory tract and aspiration of oral secretions into the trachea. Preventive measurements are advocated to reduce the incidence of VAP, such as selective decontamination of the digestive tract (SDD), supraglottic aspiration and positioning. Prompt recognition and treatment of established VAP has also been demostrated to affect outcome. Therefore, the knowledge of risk factors associated with the development of VAP and the implementation of strategies to prevent, diagnose and treat VAP are mainstems in the nursing of mechanically ventilated patients.

75 FR 27563 - Agency Information Collection Activities: Voluntary Customer Survey

Science.gov (United States)

2010-05-17

... Activities: Voluntary Customer Survey AGENCY: U.S. Customs and Border Protection (CBP), Department of... collection requirement concerning a Voluntary Customer Survey. This request for comment is being made... soliciting comments concerning the following information collection: Title: Voluntary Customer Survey. OMB...

Assessment of factors associated with voluntary counseling and ...

African Journals Online (AJOL)

Assessment of factors associated with voluntary counseling and testing uptake among students in Bahir Dar University: A case control study. ... Background: Voluntary counseling and testing (VCT) is one of the ... AJOL African Journals Online.

Assessment of Effective Coverage of Voluntary Counseling and ...

African Journals Online (AJOL)

Assessment of Effective Coverage of Voluntary Counseling and Testing ... The objective of this study was to assess effective coverage level for Voluntary Counseling and testing services in major health facilities ... AJOL African Journals Online.

Ventilation-perfused studies using SPECT

International Nuclear Information System (INIS)

Zwijnenburg, A.

1989-01-01

A method for the quantitative analysis of ventilation-perfusion SPECT studies is decribed and an effort is made to evaluate its usefullness. The technical details of the emthod are described. In the the transaxial reconstructions of the tomographic studies the contour of the lungs is detected and regional values of lung volume, ventilation, perfusion and ventilation-perfusion ratios are calculated. The method is operator independent. The lung volume calculations from the SPECT studies are validated by comparing them with lung volume measurements using the helium dilution technique. A good correlation (r=0.91) was found between the two volumes. SPECT volume was greater than the volume measured with helium dilution, which was attributed to non-gas-containing structures in the. lungs. The use of ventilation-perfusion ratio SPECT is described to evaluate the effect of ionizing radiation on the lungs in patients treated with mantle field irradiation for Hodgkin's disease. Perfusion changes appear as early as 2 months after the start of irradiation. Ventilation changes appear later and relatively minor. No changes are seen outside the radiation portals. The ventilation-perfusion inequality in pulmonary sarcoidosis is treated. It is suggested that the decrease D LCO in these patients may be partly due to an even distribution of ventilation perfusion ratios. An effort is made to establish the properties of a new tracer used for the assessment of the metabolic function of the pulmonary endothelium. The lung uptake of I-123 IMP mimics the distribution of a perfusion tracer and it is suggested that this tracer may be useful for the early detection of pulmonary vascular damage, even when blood flow is still intact. Some aspects of the use of Kr-81m as a ventilation tracer are discussed as well as the effect of noise on Kr-81m SPECT reconstructions. (author). 146 refs.; 39 figs.; 8 tabs

Can mechanical ventilation strategies reduce chronic lung disease?

Science.gov (United States)

Donn, Steven M; Sinha, Sunil K

2003-12-01

Chronic lung disease (CLD) continues to be a significant complication in newborn infants undergoing mechanical ventilation for respiratory failure. Although the aetiology of CLD is multifactorial, specific factors related to mechanical ventilation, including barotrauma, volutrauma and atelectrauma, have been implicated as important aetiologic mechanisms. This article discusses the ways in which these factors might be manipulated by various mechanical ventilatory strategies to reduce ventilator-induced lung injury. These include continuous positive airway pressure, permissive hypercapnia, patient-triggered ventilation, volume-targeted ventilation, proportional assist ventilation, high-frequency ventilation and real-time monitoring.

33 CFR 183.610 - Powered ventilation system.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Powered ventilation system. 183... (CONTINUED) BOATING SAFETY BOATS AND ASSOCIATED EQUIPMENT Ventilation § 183.610 Powered ventilation system... must: (1) Be open to the atmosphere, or (2) Be ventilated by an exhaust blower system. (b) Each exhaust...

21 CFR 868.5895 - Continuous ventilator.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Continuous ventilator. 868.5895 Section 868.5895...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5895 Continuous ventilator. (a) Identification. A continuous ventilator (respirator) is a device intended to mechanically control or assist...

Experimental study of airflow characteristics of stratum ventilation in a multi-occupant room with comparison to mixing ventilation and displacement ventilation.

Science.gov (United States)

Cheng, Y; Lin, Z

2015-12-01

The motivation of this study is stimulated by a lack of knowledge about the difference of airflow characteristics between a novel air distribution method [i.e., stratum ventilation (SV)] and conventional air distribution methods [i.e., mixing ventilation (MV) and displacement ventilation (DV)]. Detailed air velocity and temperature measurements were conducted in the occupied zone of a classroom with dimensions of 8.8 m (L) × 6.1 m (W) × 2.4 m (H). Turbulence intensity and power spectrum of velocity fluctuation were calculated using the measured data. Thermal comfort and cooling efficiency were also compared. The results show that in the occupied zone, the airflow characteristics among MV, DV, and SV are different. The turbulent airflow fluctuation is enhanced in this classroom with multiple thermal manikins due to thermal buoyancy and airflow mixing effect. Thermal comfort evaluations indicate that in comparison with MV and DV, a higher supply air temperature should be adopted for SV to achieve general thermal comfort with low draft risk. Comparison of the mean air temperatures in the occupied zone reveals that SV is of highest cooling efficiency, followed by DV and then MV. This study reports the unique profiles of flow, temperature, turbulence intensity, and power spectrum of stratum ventilation, which can have a number of implications for both knowledge and understanding of the flow characteristics in a stratum-ventilated room. With respect to the former, it expounds the fundamental characteristics of this air distribution method; and with respect to the latter, it reveals the mechanism of thermal comfort and energy saving under stratum ventilation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Voluntary emission trading potential of Turkey

International Nuclear Information System (INIS)

Ari, İzzet

2013-01-01

Climate change is likely to cause serious market failures, and carbon trading as a market instrument can help correct its negative impacts. The global carbon markets established to combat climate change include regulatory and voluntary markets. Turkey cannot utilise regulatory carbon markets under the Kyoto Protocol. As a result of her unique position in the UNFCCC, some offsetting projects in Turkey have benefitted only voluntary emission trading for the reduction of GHG emissions. Due to on-going climate change negotiation under the UNFCCC, it seems that Turkey will not use the current regulatory carbon markets. Thus, Turkey should promote the use of and participation in voluntary carbon markets. In this article, emission reduction potential via energy efficiency, renewable energy and solid waste management, and corresponding offsetting of credits with their estimated prices is investigated for the period between 2013 and 2020. The emission reduction potential for energy efficiency, renewable energy and solid waste management projects are estimated at 403, 312 and 356 million tons of CO 2 equivalent emissions respectively, totalling 1,071 million tons of CO 2 equivalent. The total revenue of the carbon certificates are estimated in the range of 19,775–33,386 million US Dollars for the same period. -- Highlights: •Turkey has 1,071 million tons GHG emission reduction in three sectors for 2013–2020. •Turkey can only use voluntary emission trading for reduction of GHGs. •Total revenue estimation could be between 19,775 and 33,386 million US Dollars. •Turkey's economy and emissions have been rapidly growing. •Turkey can more easily reduce its emission by using voluntary emission trading

77 FR 36566 - Agency Information Collection Activities: Voluntary Customer Survey

Science.gov (United States)

2012-06-19

... Activities: Voluntary Customer Survey AGENCY: U.S. Customs and Border Protection (CBP), Department of... requirement concerning a Voluntary Customer Survey. This request for comment is being made pursuant to the... following information collection: Title: Voluntary Customer Survey. OMB Number: 1651-0135. Abstract: Customs...

77 FR 55487 - Agency Information Collection Activities; Voluntary Customer Survey

Science.gov (United States)

2012-09-10

... Activities; Voluntary Customer Survey AGENCY: U.S. Customs and Border Protection, Department of Homeland... (OMB) for review and approval in accordance with the Paperwork Reduction Act: Voluntary Customer Survey... forms of information. Title: Voluntary Customer Survey. OMB Number: 1651-0135. Abstract: Customs and...

Performance of ICU ventilators during noninvasive ventilation with large leaks in a total face mask: a bench study.

Science.gov (United States)

Nakamura, Maria Aparecida Miyuki; Costa, Eduardo Leite Vieira; Carvalho, Carlos Roberto Ribeiro; Tucci, Mauro Roberto

2014-01-01

Discomfort and noncompliance with noninvasive ventilation (NIV) interfaces are obstacles to NIV success. Total face masks (TFMs) are considered to be a very comfortable NIV interface. However, due to their large internal volume and consequent increased CO2 rebreathing, their orifices allow proximal leaks to enhance CO2 elimination. The ventilators used in the ICU might not adequately compensate for such leakage. In this study, we attempted to determine whether ICU ventilators in NIV mode are suitable for use with a leaky TFM. This was a bench study carried out in a university research laboratory. Eight ICU ventilators equipped with NIV mode and one NIV ventilator were connected to a TFM with major leaks. All were tested at two positive end-expiratory pressure (PEEP) levels and three pressure support levels. The variables analyzed were ventilation trigger, cycling off, total leak, and pressurization. Of the eight ICU ventilators tested, four did not work (autotriggering or inappropriate turning off due to misdetection of disconnection); three worked with some problems (low PEEP or high cycling delay); and one worked properly. The majority of the ICU ventilators tested were not suitable for NIV with a leaky TFM.

Performance of ICU ventilators during noninvasive ventilation with large leaks in a total face mask: a bench study* **

Science.gov (United States)

Nakamura, Maria Aparecida Miyuki; Costa, Eduardo Leite Vieira; Carvalho, Carlos Roberto Ribeiro; Tucci, Mauro Roberto

2014-01-01

Objective: Discomfort and noncompliance with noninvasive ventilation (NIV) interfaces are obstacles to NIV success. Total face masks (TFMs) are considered to be a very comfortable NIV interface. However, due to their large internal volume and consequent increased CO2 rebreathing, their orifices allow proximal leaks to enhance CO2 elimination. The ventilators used in the ICU might not adequately compensate for such leakage. In this study, we attempted to determine whether ICU ventilators in NIV mode are suitable for use with a leaky TFM. Methods: This was a bench study carried out in a university research laboratory. Eight ICU ventilators equipped with NIV mode and one NIV ventilator were connected to a TFM with major leaks. All were tested at two positive end-expiratory pressure (PEEP) levels and three pressure support levels. The variables analyzed were ventilation trigger, cycling off, total leak, and pressurization. Results: Of the eight ICU ventilators tested, four did not work (autotriggering or inappropriate turning off due to misdetection of disconnection); three worked with some problems (low PEEP or high cycling delay); and one worked properly. Conclusions: The majority of the ICU ventilators tested were not suitable for NIV with a leaky TFM. PMID:25029653

Ventilation Model and Analysis Report

International Nuclear Information System (INIS)

Chipman, V.

2003-01-01

This model and analysis report develops, validates, and implements a conceptual model for heat transfer in and around a ventilated emplacement drift. This conceptual model includes thermal radiation between the waste package and the drift wall, convection from the waste package and drift wall surfaces into the flowing air, and conduction in the surrounding host rock. These heat transfer processes are coupled and vary both temporally and spatially, so numerical and analytical methods are used to implement the mathematical equations which describe the conceptual model. These numerical and analytical methods predict the transient response of the system, at the drift scale, in terms of spatially varying temperatures and ventilation efficiencies. The ventilation efficiency describes the effectiveness of the ventilation process in removing radionuclide decay heat from the drift environment. An alternative conceptual model is also developed which evaluates the influence of water and water vapor mass transport on the ventilation efficiency. These effects are described using analytical methods which bound the contribution of latent heat to the system, quantify the effects of varying degrees of host rock saturation (and hence host rock thermal conductivity) on the ventilation efficiency, and evaluate the effects of vapor and enhanced vapor diffusion on the host rock thermal conductivity

Design ventilátoru

OpenAIRE

Macháčková, Petra

2013-01-01

Předmětem této bakalářské práce je návrh designu stolního ventilátoru. Hlavní myšlenkou je inovativní přístup a dodržení technických, estetických a ergonomických požadavků a současně splnění psychologických a ekonomických funkcí. Navržený ventilátor by měl využívat inovativní technologie bezlopatkových ventilátorů. Ventilátor by měl působit jako vhodný doplněk do moderního interiéru. Cílem je propojit originální design s modernizací přístroje při splnění obecných předpokladů průmyslového desi...

Comparative performances analysis of neonatal ventilators.

Science.gov (United States)

Baldoli, Ilaria; Tognarelli, Selene; Scaramuzzo, Rosa T; Ciantelli, Massimiliano; Cecchi, Francesca; Gentile, Marzia; Sigali, Emilio; Ghirri, Paolo; Boldrini, Antonio; Menciassi, Arianna; Laschi, Cecilia; Cuttano, Armando

2015-02-08

Mechanical ventilation is a therapeutic action for newborns with respiratory diseases but may have side effects. Correct equipment knowledge and training may limit human errors. We aimed to test different neonatal mechanical ventilators' performances by an acquisition module (a commercial pressure sensor plus an isolated chamber and a dedicated software). The differences (ΔP) between peak pressure values and end-expiration pressure were investigated for each ventilator. We focused on discrepancies among measured and imposed pressure data. A statistical analysis was performed. We investigated the measured/imposed ΔP relation. The ΔP do not reveal univocal trends related to ventilation setting parameters and the data distributions were non-Gaussian. Measured ΔP represent a significant parameter in newborns' ventilation, due to the typical small volumes. The investigated ventilators showed different tendencies. Therefore, a deep specific knowledge of the intensive care devices is mandatory for caregivers to correctly exploit their operating principles.

The value relevance of voluntary disclosure in the annual report

DEFF Research Database (Denmark)

Banghøj, Jesper; Plenborg, Thomas

2006-01-01

This paper examines if the level of voluntary disclosure affects the association between current returns and future earnings. Economic theory suggests that firms might find it advantageous to provide additional pieces of information (i.e., voluntary disclosure) to investors and analysts (Verrecchia...... 1983). Our results indicate that more voluntary disclosure does not improve the association between current returns and future earnings; i.e. current returns do not reflect more future earnings news. This finding raises the question whether voluntary information in the annual report contains value...... relevant information about future earnings or if investors are simply not capable of incorporating voluntary information in the firm value estimates. Key words: Disclosure, future earnings, informativeness...

75 FR 47607 - Agency Information Collection Activities: Voluntary Customer Survey

Science.gov (United States)

2010-08-06

... Activities: Voluntary Customer Survey AGENCY: U.S. Customs and Border Protection, Department of Homeland... review and approval in accordance with the Paperwork Reduction Act: Voluntary Customer Survey. This is a.... Title: Voluntary Customer Survey. OMB Number: Will be assigned upon approval. Form Number: None...

Mechanical Ventilation and Bronchopulmonary Dysplasia.

Science.gov (United States)

Keszler, Martin; Sant'Anna, Guilherme

2015-12-01

Mechanical ventilation is an important potentially modifiable risk factor for the development of bronchopulmonary dysplasia. Effective use of noninvasive respiratory support reduces the risk of lung injury. Lung volume recruitment and avoidance of excessive tidal volume are key elements of lung-protective ventilation strategies. Avoidance of oxidative stress, less invasive methods of surfactant administration, and high-frequency ventilation are also important factors in lung injury prevention. Copyright © 2015 Elsevier Inc. All rights reserved.

Prevention of ventilator-associated pneumonia

OpenAIRE

J. Oliveira; C. Zagalo; P. Cavaco-Silva

2014-01-01

Invasive mechanical ventilation (IMV) represents a risk factor for the development of ventilator-associated pneumonia (VAP), which develops at least 48 h after admission in patients ventilated through tracheostomy or endotracheal intubation. VAP is the most frequent intensive-care-unit (ICU)-acquired infection among patients receiving IMV. It contributes to an increase in hospital mortality, duration of MV and ICU and length of hospital stay. Therefore, it worsens the condition of the critica...

Contaminants in ventilated filling boxes

Science.gov (United States)

Bolster, D. T.; Linden, P. F.

While energy efficiency is important, the adoption of energy-efficient ventilation systems still requires the provision of acceptable indoor air quality. Many low-energy systems, such as displacement or natural ventilation, rely on temperature stratification within the interior environment, always extracting the warmest air from the top of the room. Understanding buoyancy-driven convection in a confined ventilated space is key to understanding the flow that develops with many of these modern low-energy ventilation schemes. In this work we study the transport of an initially uniformly distributed passive contaminant in a displacement-ventilated space. Representing a heat source as an ideal sourced of buoyancy, analytical and numerical models are developed that allow us to compare the average efficiency of contaminant removal between traditional mixing and modern low-energy systems. A set of small-scale analogue laboratory experiments was also conducted to further validate our analytical and numerical solutions.We find that on average traditional and low-energy ventilation methods are similar with regard to pollutant flushing efficiency. This is because the concentration being extracted from the system at any given time is approximately the same for both systems. However, very different vertical concentration gradients exist. For the low-energy system, a peak in contaminant concentration occurs at the temperature interface that is established within the space. This interface is typically designed to sit at some intermediate height in the space. Since this peak does not coincide with the extraction point, displacement ventilation does not offer the same benefits for pollutant flushing as it does for buoyancy removal.

14 CFR 252.9 - Ventilation systems.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Ventilation systems. 252.9 Section 252.9... REGULATIONS SMOKING ABOARD AIRCRAFT § 252.9 Ventilation systems. Air carriers shall prohibit smoking whenever the ventilation system is not fully functioning. Fully functioning for this purpose means operating so...

Ventilation in Commercial and Residential Buildings

DEFF Research Database (Denmark)

Nielsen, Peter V.

A number of areas have to be considered in connection with indoor air quality and ventilation. The selection of ventilation principle and components in the ventilation system will have influence on the indoor air quality and this subject will be discussed on the following pages. The main object o...

46 CFR 98.25-75 - Ventilation.

Science.gov (United States)

2010-10-01

... shall be fitted with efficient natural or mechanical ventilation. (b) Enclosed compartments in which... 46 Shipping 4 2010-10-01 2010-10-01 false Ventilation. 98.25-75 Section 98.25-75 Shipping COAST... Ventilation. (a) All enclosed spaces containing cargo tanks fitted with bottom outlet connections shall be...

46 CFR 194.10-25 - Ventilation.

Science.gov (United States)

2010-10-01

... magazines. (1) All integral magazines shall be provided with natural or mechanical ventilation. Design... vans shall be provided with natural ventilation sufficient to maintain the inside air temperature below... 46 Shipping 7 2010-10-01 2010-10-01 false Ventilation. 194.10-25 Section 194.10-25 Shipping COAST...

Contaminant Distribution Around Persons in Rooms Ventilated by Displacement Ventilation

DEFF Research Database (Denmark)

Brohus, Henrik; Nielsen, Peter V.

An optimal design of the ventilation system needs a proper prediction of the velocity, temperature and contaminant distribution in the room. Traditionally this is done either by the use of simplified models or by a somewhat more comprehensive CFD-simulation. Common to both methods is usually...... the lack of consideration for the persons present in the room. This paper deals with some of the effects of persons present in a displacement ventilated room, especially the effect on the contaminant distribution....

Current State of the Voluntary Renewable Energy Market (Presentation)

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.

2013-09-01

This presentation highlights the status of the voluntary green power market in 2012. The voluntary green power market totaled more than 48 million MWh in 2012, with about 1.9 million customers participating. The supply continues to be dominated by wind, though solar is increasing its share of utility green pricing programs. Prices for voluntary renewable energy certificates (RECs) increased to above $1/MWh.

Burrowing as a novel voluntary strength training method for mice: A comparison of various voluntary strength or resistance exercise methods.

Science.gov (United States)

Roemers, P; Mazzola, P N; De Deyn, P P; Bossers, W J; van Heuvelen, M J G; van der Zee, E A

2018-04-15

Voluntary strength training methods for rodents are necessary to investigate the effects of strength training on cognition and the brain. However, few voluntary methods are available. The current study tested functional and muscular effects of two novel voluntary strength training methods, burrowing (digging a substrate out of a tube) and unloaded tower climbing, in male C57Bl6 mice. To compare these two novel methods with existing exercise methods, resistance running and (non-resistance) running were included. Motor coordination, grip strength and muscle fatigue were measured at baseline, halfway through and near the end of a fourteen week exercise intervention. Endurance was measured by an incremental treadmill test after twelve weeks. Both burrowing and resistance running improved forelimb grip strength as compared to controls. Running and resistance running increased endurance in the treadmill test and improved motor skills as measured by the balance beam test. Post-mortem tissue analyses revealed that running and resistance running induced Soleus muscle hypertrophy and reduced epididymal fat mass. Tower climbing elicited no functional or muscular changes. As a voluntary strength exercise method, burrowing avoids the confounding effects of stress and positive reinforcers elicited in forced strength exercise methods. Compared to voluntary resistance running, burrowing likely reduces the contribution of aerobic exercise components. Burrowing qualifies as a suitable voluntary strength training method in mice. Furthermore, resistance running shares features of strength training and endurance (aerobic) exercise and should be considered a multi-modal aerobic-strength exercise method in mice. Copyright © 2017 Elsevier B.V. All rights reserved.

Mechanical ventilation strategies.

Science.gov (United States)

Keszler, Martin

2017-08-01

Although only a small proportion of full term and late preterm infants require invasive respiratory support, they are not immune from ventilator-associated lung injury. The process of lung damage from mechanical ventilation is multifactorial and cannot be linked to any single variable. Atelectrauma and volutrauma have been identified as the most important and potentially preventable elements of lung injury. Respiratory support strategies for full term and late preterm infants have not been as thoroughly studied as those for preterm infants; consequently, a strong evidence base on which to make recommendations is lacking. The choice of modalities of support and ventilation strategies should be guided by the specific underlying pathophysiologic considerations and the ventilatory approach must be individualized for each patient based on the predominant pathophysiology at the time. Copyright © 2017 Elsevier Ltd. All rights reserved.

Why we ventilate our houses - An historical look

Energy Technology Data Exchange (ETDEWEB)

Matson, Nance E.; Sherman, Max H.

2004-05-14

The knowledge of how to ventilate buildings, and how much ventilation is necessary for human health and comfort, has evolved over centuries of trial and error. Humans and animals have developed successful solutions to the problems of regulating temperature and removing air pollutants through the use of ventilation. These solutions include ingenious construction methods, such as engineered passive ventilation (termite mounds and passive stacks), mechanical means (wing-powered, fans), and an evolving effort to identify problems and develop solutions. Ventilation can do more than help prevent building occupants from getting sick; it can provide an improved indoor environment. Codes and standards provide minimum legal requirements for ventilation, but the need for ventilation goes beyond code minima. In this paper we will look at indoor air pollutant sources over time, the evolution of ventilation strategies, current residential ventilation codes and standards (e.g., recently approved ASHRAE Standard 62.2), and briefly discuss ways in which we can go beyond the standards to optimize residential ventilation, reduce indoor air quality problems, and provide corresponding social and economic benefit.

5 CFR 630.1014 - Movement between voluntary leave bank programs.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Movement between voluntary leave bank programs. 630.1014 Section 630.1014 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ABSENCE AND LEAVE Voluntary Leave Bank Program § 630.1014 Movement between voluntary leave bank...

Development of a Residential Integrated Ventilation Controller

Energy Technology Data Exchange (ETDEWEB)

Staff Scientist; Walker, Iain; Sherman, Max; Dickerhoff, Darryl

2011-12-01

The goal of this study was to develop a Residential Integrated Ventilation Controller (RIVEC) to reduce the energy impact of required mechanical ventilation by 20percent, maintain or improve indoor air quality and provide demand response benefits. This represents potential energy savings of about 140 GWh of electricity and 83 million therms of natural gas as well as proportional peak savings in California. The RIVEC controller is intended to meet the 2008 Title 24 requirements for residential ventilation as well as taking into account the issues of outdoor conditions, other ventilation devices (including economizers), peak demand concerns and occupant preferences. The controller is designed to manage all the residential ventilation systems that are currently available. A key innovation in this controller is the ability to implement the concept of efficacy and intermittent ventilation which allows time shifting of ventilation. Using this approach ventilation can be shifted away from times of high cost or high outdoor pollution towards times when it is cheaper and more effective. Simulations, based on the ones used to develop the new residential ventilation requirements for the California Buildings Energy code, were used to further define the specific criteria and strategies needed for the controller. These simulations provide estimates of the energy, peak power and contaminant improvement possible for different California climates for the various ventilation systems. Results from a field test of the prototype controller corroborate the predicted performance.

Market Brief. Status of the Voluntary Renewable Energy Certificate Market (2011 Data)

Energy Technology Data Exchange (ETDEWEB)

Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States); Armstrong, Philip [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2012-09-01

This report documents the status and trends of U.S. 'voluntary' markets -- those in which consumers and institutions purchase renewable energy to match their electricity needs on a voluntary basis. Voluntary REC markets continue to exhibit growth and spur renewable energy development. Voluntary green power markets provide an additional revenue stream for renewable energy projects and raise consumer awareness of the benefits of renewable energy. Although a full estimate of the size of the voluntary market is not available for 2011, this review uses indicative metrics to capture 2011 voluntary market trends.

Market Brief: Status of the Voluntary Renewable Energy Certificate Market (2011 Data)

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.; Armstrong, P.; Bird, L.

2012-09-01

This report documents the status and trends of U.S. 'voluntary' markets -- those in which consumers and institutions purchase renewable energy to match their electricity needs on a voluntary basis. Voluntary REC markets continue to exhibit growth and spur renewable energy development. Voluntary green power markets provide an additional revenue stream for renewable energy projects and raise consumer awareness of the benefits of renewable energy. Although a full estimate of the size of the voluntary market is not available for 2011, this review uses indicative metrics to capture 2011 voluntary market trends.

Mechanical ventilation in neurosurgical patients

Directory of Open Access Journals (Sweden)

Keshav Goyal

2013-01-01

Full Text Available Mechanical ventilation significantly affects cerebral oxygenation and cerebral blood flow through changes in arterial carbon dioxide levels. Neurosurgical patients might require mechanical ventilation for correction and maintenance of changes in the pulmonary system that occur either due to neurosurgical pathology or following surgery during the acute phase. This review discusses the basics of mechanical ventilation relevant to the neurosurgeon in the day-to-day management of neurosurgical patient requiring artificial support of the respiration.

Rules regarding voluntary contributions to the Agency

International Nuclear Information System (INIS)

1989-11-01

The texts of the following Rules Regarding Voluntary Contributions to the Agency are reproduced: 1. Rules to Govern the Acceptance of Gifts of Services, Equipment and Facilities (adopted by the Board of Governors on 13 June 1989); 2. Rules Regarding the Acceptance of Voluntary Contributions of Money to the Agency (approved by the General Conference on 29 September 1989)

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

Directory of Open Access Journals (Sweden)

Jed Lipes

2012-01-01

Full Text Available Protective ventilation with low tidal volume has been shown to reduce morbidity and mortality in patients suffering from acute lung injury (ALI and acute respiratory distress syndrome (ARDS. Low tidal volume ventilation is associated with particular clinical challenges and is therefore often underutilized as a therapeutic option in clinical practice. Despite some potential difficulties, data have been published examining the application of protective ventilation in patients without lung injury. We will briefly review the physiologic rationale for low tidal volume ventilation and explore the current evidence for protective ventilation in patients without lung injury. In addition, we will explore some of the potential reasons for its underuse and provide strategies to overcome some of the associated clinical challenges.

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

Science.gov (United States)

Lipes, Jed; Bojmehrani, Azadeh; Lellouche, Francois

2012-01-01

Protective ventilation with low tidal volume has been shown to reduce morbidity and mortality in patients suffering from acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Low tidal volume ventilation is associated with particular clinical challenges and is therefore often underutilized as a therapeutic option in clinical practice. Despite some potential difficulties, data have been published examining the application of protective ventilation in patients without lung injury. We will briefly review the physiologic rationale for low tidal volume ventilation and explore the current evidence for protective ventilation in patients without lung injury. In addition, we will explore some of the potential reasons for its underuse and provide strategies to overcome some of the associated clinical challenges. PMID:22536499

15 CFR 764.8 - Voluntary self-disclosures for boycott violations.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Voluntary self-disclosures for boycott... ENFORCEMENT AND PROTECTIVE MEASURES § 764.8 Voluntary self-disclosures for boycott violations. This section... provisions. Voluntary self-disclosures are a mitigating factor with respect to any enforcement action that...

Bench test evaluation of volume delivered by modern ICU ventilators during volume-controlled ventilation.

Science.gov (United States)

Lyazidi, Aissam; Thille, Arnaud W; Carteaux, Guillaume; Galia, Fabrice; Brochard, Laurent; Richard, Jean-Christophe M

2010-12-01

During volume-controlled ventilation, part of the volume delivered is compressed into the circuit. To correct for this phenomenon, modern ventilators use compensation algorithms. Humidity and temperature also influence the delivered volume. In a bench study at a research laboratory in a university hospital, we compared nine ICU ventilators equipped with compensation algorithms, one with a proximal pneumotachograph and one without compensation. Each ventilator was evaluated under normal, obstructive, and restrictive conditions of respiratory mechanics. For each condition, three tidal volumes (V (T)) were set (300, 500, and 800 ml), with and without an inspiratory pause. The insufflated volume and the volume delivered at the Y-piece were measured independently, without a humidification device, under ambient temperature and pressure and dry gas conditions. We computed the actually delivered V (T) to the lung under body temperature and pressure and saturated water vapour conditions (BTPS). For target V (T) values of 300, 500, and 800 ml, actually delivered V (T) under BTPS conditions ranged from 261 to 396 ml (-13 to +32%), from 437 to 622 ml (-13 to +24%), and from 681 to 953 ml (-15 to +19%), respectively (p ventilators.

Computer program for sizing residential energy recovery ventilator

International Nuclear Information System (INIS)

Koontz, M.D.; Lee, S.M.; Spears, J.W.; Kesselring, J.P.

1991-01-01

Energy recovery ventilators offer the prospect of tighter control over residential ventilation rates than manual methods, such as opening windows, with a lesser energy penalty. However, the appropriate size of such a ventilator is not readily apparent in most situations. Sizing of energy recovery ventilation software was developed to calculate the size of ventilator necessary to satisfy ASHRAE Standard 62-1989, Ventilation for Acceptable Air Quality, or a user-specified air exchange rate. Inputs to the software include house location, structural characteristics, house operations and energy costs, ventilation characteristics, and HVAC system COP/efficiency. Based on these inputs, the program estimates the existing air exchange rate for the house, the ventilation rate required to meet the ASHRAE standard or user-specified air exchange rate, the size of the ventilator needed to meet the requirement, and the expected changes in indoor air quality and energy consumption. In this paper an illustrative application of the software is provided

Preoperational test report, vent building ventilation system

International Nuclear Information System (INIS)

Clifton, F.T.

1997-01-01

This represents a preoperational test report for Vent Building Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides Heating, Ventilation, and Air Conditioning (HVAC) for the W-030 Ventilation Building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System

Air Distribution in a Furnished Room Ventilated by Mixing Ventilation

DEFF Research Database (Denmark)

Nielsen, June Richter; Nielsen, Peter V.; Svidt, Kjeld

Using isothermal full-scale experiments and two-dimensional isothermal CFD simulations it is investigated how normal office furniture influences the air movements in a room with mixing ventilation. Three different set-ups are made in the experiments and different sizes and locations of the furnit......Using isothermal full-scale experiments and two-dimensional isothermal CFD simulations it is investigated how normal office furniture influences the air movements in a room with mixing ventilation. Three different set-ups are made in the experiments and different sizes and locations...

Short Term Airing by Natural Ventilation

DEFF Research Database (Denmark)

Heiselberg, Per; Perino, M.

2010-01-01

The need to improve the energy efficiency of buildings requires new and more efficient ventilation systems. It has been demonstrated that innovative operating concepts that make use of natural ventilation seem to be more appreciated by occupants. Among the available ventilation strategies...... that are currently available, buoyancy driven, single-sided natural ventilation has proved to be very effective and can provide high air change rates for temperature and Indoor Air Quality (IAQ) control. However, to promote a wider distribution of these systems an improvement in the knowledge of their working...... airflow rate, ventilation efficiency, thermal comfort and dynamic temperature conditions. A suitable laboratory test rig was developed to perform extensive experimental analyses of the phenomenon under controlled and repeatable conditions. The results showed that short-term window airing is very effective...

Fatigue reduces the complexity of knee extensor torque fluctuations during maximal and submaximal intermittent isometric contractions in man

Science.gov (United States)

Pethick, Jamie; Winter, Samantha L; Burnley, Mark

2015-01-01

Neuromuscular fatigue increases the amplitude of fluctuations in torque output during isometric contractions, but the effect of fatigue on the temporal structure, or complexity, of these fluctuations is not known. We hypothesised that fatigue would result in a loss of temporal complexity and a change in fractal scaling of the torque signal during isometric knee extensor exercise. Eleven healthy participants performed a maximal test (5 min of intermittent maximal voluntary contractions, MVCs), and a submaximal test (contractions at a target of 40% MVC performed until task failure), each with a 60% duty factor (6 s contraction, 4 s rest). Torque and surface EMG signals were sampled continuously. Complexity and fractal scaling of torque were quantified by calculating approximate entropy (ApEn), sample entropy (SampEn) and the detrended fluctuation analysis (DFA) scaling exponent α. Fresh submaximal contractions were more complex than maximal contractions (mean ± SEM, submaximal vs. maximal: ApEn 0.65 ± 0.09 vs. 0.15 ± 0.02; SampEn 0.62 ± 0.09 vs. 0.14 ± 0.02; DFA α 1.35 ± 0.04 vs. 1.55 ± 0.03; all P torque, fatigue reduces the neuromuscular system's adaptability to external perturbations. PMID:25664928

Principles of maximally classical and maximally realistic quantum ...

Indian Academy of Sciences (India)

Principles of maximally classical and maximally realistic quantum mechanics. S M ROY. Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400 005, India. Abstract. Recently Auberson, Mahoux, Roy and Singh have proved a long standing conjecture of Roy and Singh: In 2N-dimensional phase space, ...

Guidelines for the prevention of ventilator-associated pneumonia and their implementation. The Spanish "Zero-VAP" bundle.

Science.gov (United States)

Álvarez Lerma, F; Sánchez García, M; Lorente, L; Gordo, F; Añón, J M; Álvarez, J; Palomar, M; García, R; Arias, S; Vázquez-Calatayud, M; Jam, R

2014-05-01

"Zero-VAP" is a proposal for the implementation of a simultaneous multimodal intervention in Spanish intensive care units (ICU) consisting of a bundle of ventilator-associated pneumonia (VAP) prevention measures. An initiative of the Spanish Societies of Intensive Care Medicine and of Intensive Care Nurses, the project is supported by the Spanish Ministry of Health, and participation is voluntary. In addition to guidelines for VAP prevention, the "Zero-VAP" Project incorporates an integral patient safety program and continuous online validation of the application of the bundle. For the latter, VAP episodes and participation indices are entered into the web-based Spanish ICU Infection Surveillance Program "ENVIN-HELICS" database, which provides continuous information about local, regional and national VAP incidence rates. Implementation of the guidelines aims at the reduction of VAP to less than 9 episodes per 1000 days of mechanical ventilation. A total of 35 preventive measures were initially selected. A task force of experts used the Grading of Recommendations, Assessment, Development and Evaluation Working Group methodology to generate a list of 7 basic "mandatory" recommendations (education and training in airway management, strict hand hygiene for airway management, cuff pressure control, oral hygiene with chlorhexidine, semi-recumbent positioning, promoting measures that safely avoid or reduce time on ventilator, and discouraging scheduled changes of ventilator circuits, humidifiers and endotracheal tubes) and 3 additional "highly recommended" measures (selective decontamination of the digestive tract, aspiration of subglottic secretions, and a short course of iv antibiotic). We present the Spanish VAP prevention guidelines and describe the methodology used for the selection and implementation of the recommendations and the organizational structure of the project. Compared to conventional guideline documents, the associated safety assurance program, the

Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

Directory of Open Access Journals (Sweden)

Susan R. Wilcox

2016-05-01

Full Text Available Introduction: Although emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM education or clinical practice. The objective of this study was to quantify EM attendings’ education, experience, and knowledge regarding mechanical ventilation in the emergency department. Methods: We developed a survey of academic EM attendings’ educational experiences with ventilators and a knowledge assessment tool with nine clinical questions. EM attendings at key teaching hospitals for seven EM residency training programs in the northeastern United States were invited to participate in this survey study. We performed correlation and regression analyses to evaluate the relationship between attendings’ scores on the assessment instrument and their training, education, and comfort with ventilation. Results: Of 394 EM attendings surveyed, 211 responded (53.6%. Of respondents, 74.5% reported receiving three or fewer hours of ventilation-related education from EM sources over the past year and 98 (46% reported receiving between 0-1 hour of education. The overall correct response rate for the assessment tool was 73.4%, with a standard deviation of 19.9. The factors associated with a higher score were completion of an EM residency, prior emphasis on mechanical ventilation during one’s own residency, working in a setting where an emergency physician bears primary responsibility for ventilator management, and level of comfort with managing ventilated patients. Physicians’ comfort was associated with the frequency of ventilator changes and EM management of ventilation, as well as hours of education. Conclusion: EM attendings report caring for mechanically ventilated patients frequently, but most receive fewer than three educational hours a year on mechanical ventilation, and nearly half receive 0-1 hour. Physicians’ performance on an assessment tool for mechanical ventilation is

Uranium mine ventilation

International Nuclear Information System (INIS)

Katam, K.; Sudarsono

1982-01-01

Uranium mine ventilation system aimed basically to control and decreasing the air radioactivity in mine caused by the radon emanating from uranium ore. The control and decreasing the air ''age'' in mine, with adding the air consumption volume, increasing the air rate consumption, closing the mine-out area; using closed drainage system. Air consumption should be 60m 3 /minute for each 9m 2 uranium ore surfaces with ventilation rate of 15m/minute. (author)

Natural ventilation for reducing airborne infection in hospitals

Energy Technology Data Exchange (ETDEWEB)

Qian, Hua [School of Energy and Environment, Southeast University, Nanjing (China); Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, Hong Kong (China); Li, Yuguo; Ching, W.H.; Sun, H.Q. [Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, Hong Kong (China); Seto, W.H.; Ching, Patricia [Department of Microbiology, Queen Mary Hospital, Hong Kong (China)

2010-03-15

High ventilation rate is shown to be effective for reducing cross-infection risk of airborne diseases in hospitals and isolation rooms. Natural ventilation can deliver much higher ventilation rate than mechanical ventilation in an energy-efficient manner. This paper reports a field measurement of naturally ventilated hospital wards in Hong Kong and presents a possibility of using natural ventilation for infection control in hospital wards. Our measurements showed that natural ventilation could achieve high ventilation rates especially when both the windows and the doors were open in a ward. The highest ventilation rate recorded in our study was 69.0 ACH. The airflow pattern and the airflow direction were found to be unstable in some measurements with large openings. Mechanical fans were installed in a ward window to create a negative pressure difference. Measurements showed that the negative pressure difference was negligible with large openings but the overall airflow was controlled in the expected direction. When all the openings were closed and the exhaust fans were turned on, a reasonable negative pressure was created although the air temperature was uncontrolled. The high ventilation rate provided by natural ventilation can reduce cross-infection of airborne diseases, and thus it is recommended for consideration of use in appropriate hospital wards for infection control. Our results also demonstrated a possibility of converting an existing ward using natural ventilation to a temporary isolation room through installing mechanical exhaust fans. (author)

Lecture Notes on Mixing Ventilation

DEFF Research Database (Denmark)

Nielsen, Peter Vilhelm

The main task of the ventilation system or the air-conditioning system is to supply· and remove air and airborne materials and to supply or remove heat from a room. The necessary level of fresh air will be supplied to· a room by a ventilation system, and heat from equipment or solar radiation can...... be removed by an air-conditioning system. An industrial ventilation system may both take care of the occupants' comfort and the industrial processes in the area....

Efficiency of voluntary closing hand and hook prostheses

NARCIS (Netherlands)

Smit, G.; Plettenburg, D.H.

2010-01-01

The Delft Institute of Prosthetics and Orthotics has started a research program to develop an improved voluntary closing, body-powered hand prosthesis. Five commercially available voluntary closing terminal devices were mechanically tested: three hands [Hosmer APRL VC hand, Hosmer Soft VC Male hand,

Current concerns in involuntary and voluntary autobiographical memories

DEFF Research Database (Denmark)

Johannessen, Kim Berg; Berntsen, Dorthe

2010-01-01

Involuntary autobiographical memories are conscious memories of personal events that come to mind with no preceding attempts at retrieval. It is often assumed that such memories are closely related to current concerns - i.e., uncompleted personal goals. Here we examined involuntary versus volunta...... concern related involuntary and voluntary memories. The findings support the view that involuntary and voluntary remembering is subject to similar motivational constraints.......Involuntary autobiographical memories are conscious memories of personal events that come to mind with no preceding attempts at retrieval. It is often assumed that such memories are closely related to current concerns - i.e., uncompleted personal goals. Here we examined involuntary versus voluntary...... (deliberately retrieved) autobiographical memories in relation to earlier registered current concerns measured by the Personal Concern Inventory (PCI; Cox & Klinger, 2000). We found no differences between involuntary and voluntary memories with regard to frequency or characteristics of current concern related...

Control of Airborne Infectious Diseases in Ventilated Spaces

DEFF Research Database (Denmark)

Nielsen, Peter V.

2009-01-01

We protect ourselves from airborne cross-infection in the indoor environment by supplying fresh air to a room by natural or mechanical ventilation. The air is distributed in the room according to different principles: mixing ventilation, displacement ventilation, etc. A large amount of air...... to have high ventilation effectiveness. Furthermore, personalized ventilation may reduce the risk of cross-infection, and in some cases, it can also reduce the source of infection. Personalized ventilation can especially be used in hospital wards, aircraft cabins and, in general, where people are in fixed...

Profit maximization mitigates competition

DEFF Research Database (Denmark)

Dierker, Egbert; Grodal, Birgit

1996-01-01

We consider oligopolistic markets in which the notion of shareholders' utility is well-defined and compare the Bertrand-Nash equilibria in case of utility maximization with those under the usual profit maximization hypothesis. Our main result states that profit maximization leads to less price...... competition than utility maximization. Since profit maximization tends to raise prices, it may be regarded as beneficial for the owners as a whole. Moreover, if profit maximization is a good proxy for utility maximization, then there is no need for a general equilibrium analysis that takes the distribution...... of profits among consumers fully into account and partial equilibrium analysis suffices...

Implications of maximal Jarlskog invariant and maximal CP violation

International Nuclear Information System (INIS)

Rodriguez-Jauregui, E.; Universidad Nacional Autonoma de Mexico

2001-04-01

We argue here why CP violating phase Φ in the quark mixing matrix is maximal, that is, Φ=90 . In the Standard Model CP violation is related to the Jarlskog invariant J, which can be obtained from non commuting Hermitian mass matrices. In this article we derive the conditions to have Hermitian mass matrices which give maximal Jarlskog invariant J and maximal CP violating phase Φ. We find that all squared moduli of the quark mixing elements have a singular point when the CP violation phase Φ takes the value Φ=90 . This special feature of the Jarlskog invariant J and the quark mixing matrix is a clear and precise indication that CP violating Phase Φ is maximal in order to let nature treat democratically all of the quark mixing matrix moduli. (orig.)

Iatrogenic pneumothorax related to mechanical ventilation

Science.gov (United States)

Hsu, Chien-Wei; Sun, Shu-Fen

2014-01-01

Pneumothorax is a potentially lethal complication associated with mechanical ventilation. Most of the patients with pneumothorax from mechanical ventilation have underlying lung diseases; pneumothorax is rare in intubated patients with normal lungs. Tension pneumothorax is more common in ventilated patients with prompt recognition and treatment of pneumothorax being important to minimize morbidity and mortality. Underlying lung diseases are associated with ventilator-related pneumothorax with pneumothoraces occurring most commonly during the early phase of mechanical ventilation. The diagnosis of pneumothorax in critical illness is established from the patients’ history, physical examination and radiological investigation, although the appearances of a pneumothorax on a supine radiograph may be different from the classic appearance on an erect radiograph. For this reason, ultrasonography is beneficial for excluding the diagnosis of pneumothorax. Respiration-dependent movement of the visceral pleura and lung surface with respect to the parietal pleura and chest wall can be easily visualized with transthoracic sonography given that the presence of air in the pleural space prevents sonographic visualization of visceral pleura movements. Mechanically ventilated patients with a pneumothorax require tube thoracostomy placement because of the high risk of tension pneumothorax. Small-bore catheters are now preferred in the majority of ventilated patients. Furthermore, if there are clinical signs of a tension pneumothorax, emergency needle decompression followed by tube thoracostomy is widely advocated. Patients with pneumothorax related to mechanical ventilation who have tension pneumothorax, a higher acute physiology and chronic health evaluation II score or PaO2/FiO2 < 200 mmHg were found to have higher mortality. PMID:24834397

Auxiliary mine ventilation manual

International Nuclear Information System (INIS)

Workplace Safety North

2010-01-01

An adequate ventilation system is needed for air quality and handling in a mine and is comprised of many different pieces of equipment for removing contaminated air and supplying fresh air and thereby provide a satisfactory working environment. This manual highlights auxiliary ventilation systems made up of small fans, ducts, tubes, air movers, deflectors and additional air flow controls which distribute fresh air delivered by the primary system to all areas. A review of auxiliary ventilation is provided. Design, operation and management issues are discussed and guidelines are furnished. This manual is limited to underground hard rock operations and does not address directly other, specific auxiliary systems, either in underground coal mines or uranium mines.

Auxiliary mine ventilation manual

Energy Technology Data Exchange (ETDEWEB)

Workplace Safety North

2010-07-01

An adequate ventilation system is needed for air quality and handling in a mine and is comprised of many different pieces of equipment for removing contaminated air and supplying fresh air and thereby provide a satisfactory working environment. This manual highlights auxiliary ventilation systems made up of small fans, ducts, tubes, air movers, deflectors and additional air flow controls which distribute fresh air delivered by the primary system to all areas. A review of auxiliary ventilation is provided. Design, operation and management issues are discussed and guidelines are furnished. This manual is limited to underground hard rock operations and does not address directly other, specific auxiliary systems, either in underground coal mines or uranium mines.

Modelling and Simulation of Volume Controlled Mechanical Ventilation System

Directory of Open Access Journals (Sweden)

Yan Shi

2014-01-01

Full Text Available Volume controlled mechanical ventilation system is a typical time-delay system, which is applied to ventilate patients who cannot breathe adequately on their own. To illustrate the influences of key parameters of the ventilator on the dynamics of the ventilated respiratory system, this paper firstly derived a new mathematical model of the ventilation system; secondly, simulation and experimental results are compared to verify the mathematical model; lastly, the influences of key parameters of ventilator on the dynamics of the ventilated respiratory system are carried out. This study can be helpful in the VCV ventilation treatment and respiratory diagnostics.

Mechanical Ventilation: State of the Art.

Science.gov (United States)

Pham, Tài; Brochard, Laurent J; Slutsky, Arthur S

2017-09-01

Mechanical ventilation is the most used short-term life support technique worldwide and is applied daily for a diverse spectrum of indications, from scheduled surgical procedures to acute organ failure. This state-of-the-art review provides an update on the basic physiology of respiratory mechanics, the working principles, and the main ventilatory settings, as well as the potential complications of mechanical ventilation. Specific ventilatory approaches in particular situations such as acute respiratory distress syndrome and chronic obstructive pulmonary disease are detailed along with protective ventilation in patients with normal lungs. We also highlight recent data on patient-ventilator dyssynchrony, humidified high-flow oxygen through nasal cannula, extracorporeal life support, and the weaning phase. Finally, we discuss the future of mechanical ventilation, addressing avenues for improvement. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Pandemic ventilator rationing and appeals processes.

Science.gov (United States)

Patrone, Daniel; Resnik, David

2011-06-01

In a severe influenza pandemic, hospitals will likely experience serious and widespread shortages of patient pulmonary ventilators and of staff qualified to operate them. Deciding who will receive access to mechanical ventilation will often determine who lives and who dies. This prospect raises an important question whether pandemic preparedness plans should include some process by which individuals affected by ventilator rationing would have the opportunity to appeal adverse decisions. However, the issue of appeals processes to ventilator rationing decisions has been largely neglected in state pandemic planning efforts. If we are to devise just and effective plans for coping with a severe influenza pandemic, more attention to the issue of appeals processes for pandemic ventilator rationing decisions is needed. Arguments for and against appeals processes are considered, and some suggestions are offered to help efforts at devising more rational pandemic preparedness plans.

Outcome-based ventilation: A framework for assessing performance, health, and energy impacts to inform office building ventilation decisions.

Science.gov (United States)

Rackes, A; Ben-David, T; Waring, M S

2018-04-23

This article presents an outcome-based ventilation (OBV) framework, which combines competing ventilation impacts into a monetized loss function ($/occ/h) used to inform ventilation rate decisions. The OBV framework, developed for U.S. offices, considers six outcomes of increasing ventilation: profitable outcomes realized from improvements in occupant work performance and sick leave absenteeism; health outcomes from occupant exposure to outdoor fine particles and ozone; and energy outcomes from electricity and natural gas usage. We used the literature to set low, medium, and high reference values for OBV loss function parameters, and evaluated the framework and outcome-based ventilation rates using a simulated U.S. office stock dataset and a case study in New York City. With parameters for all outcomes set at medium values derived from literature-based central estimates, higher ventilation rates' profitable benefits dominated negative health and energy impacts, and the OBV framework suggested ventilation should be ≥45 L/s/occ, much higher than the baseline ~8.5 L/s/occ rate prescribed by ASHRAE 62.1. Only when combining very low parameter estimates for profitable impacts with very high ones for health and energy impacts were all outcomes on the same order. Even then, however, outcome-based ventilation rates were often twice the baseline rate or more. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Reverse ventilation--perfusion mismatch

International Nuclear Information System (INIS)

Palmaz, J.C.; Barnett, C.A.; Reich, S.B.; Krumpe, P.E.; Farrer, P.A.

1984-01-01

Patients having lobar airway obstruction or consolidation usually have decreases of both ventilation and perfusion on lung scans. We report three patients in whom hypoxic vasoconstriction was apparently incomplete, resulting in a ''reversed'' ventilation-perfusion mismatch. Perfusion of the hypoxic lobe on the radionuclide scan was associated with metabolic alkalosis, pulmonary venous and pulmonary arterial hypertension in these patients

Multifamily Ventilation Retrofit Strategies

Energy Technology Data Exchange (ETDEWEB)

Ueno, K. [Building Science Corporation (BSC), Somerville, MA (United States); Lstiburek, J. [Building Science Corporation (BSC), Somerville, MA (United States); Bergey, D. [Building Science Corporation (BSC), Somerville, MA (United States)

2012-12-01

In multifamily buildings, central ventilation systems often have poor performance, overventilating some portions of the building (causing excess energy use), while simultaneously underventilating other portions (causing diminished indoor air quality). BSC and Innova Services Corporation performed a series of field tests at a mid-rise test building undergoing a major energy audit and retrofit, which included ventilation system upgrades.

Efficacy of an expanded ventilator bundle for the reduction of ventilator-associated pneumonia in the medical intensive care unit.

Science.gov (United States)

Blamoun, John; Alfakir, Maria; Rella, Marie E; Wojcik, Janice M; Solis, Roberto A; Anees Khan, M; DeBari, Vincent A

2009-03-01

The ventilator bundle (VB) includes a group of clinical maneuvers (head-of-bed elevation, "sedation vacation," deep vein thrombosis prophylaxis, and peptic ulcer disease prophylaxis) to improve outcomes in patients undergoing mechanical ventilation. We modified the standard VB in our medical intensive care unit to include a group of respiratory therapist-driven protocols and, postimplementation, observed a statistically significant (P = .0006) reduction in ventilator-associated pneumonia (VAP), from a median of 14.1 cases/10(3) ventilator-days (interquartile range [IQR] = 12.1 to 20.6) to 0 cases/10(3) ventilator-days (IQR = 0 to 1.1).

Performance of current intensive care unit ventilators during pressure and volume ventilation.

Science.gov (United States)

Marchese, Andrew D; Sulemanji, Demet; Chipman, Daniel; Villar, Jesús; Kacmarek, Robert M

2011-07-01

Intensive-care mechanical ventilators regularly enter the market, but the gas-delivery capabilities of many have never been assessed. We evaluated 6 intensive-care ventilators in the pressure support (PS), pressure assist/control (PA/C), and volume assist/control (VA/C) modes, with lung-model mechanics combinations of compliance and resistance of 60 mL/cm H(2)O and 10 cm H(2)O/L/s, 60 mL/cm H(2)O and 5 cm H(2)O/L/s, and 30 mL/cm H(2)O and 10 cm H(2)O/L/s, and inspiratory muscle effort of 5 and 10 cm H(2)O. PS and PA/C were set to 15 cm H(2)O, and PEEP to 5 and 15 cm H(2)O in all modes. During VA/C, tidal volume was set at 500 mL and inspiratory time was set at 0.8 second. Rise time and termination criteria were set at the manufacturers' defaults, and to an optimal level during PS and PA/C. There were marked differences in ventilator performance in all 3 modes. VA/C had the greatest difficulty meeting lung model demand and the greatest variability across all tested scenarios and ventilators. From high to low inspiratory muscle effort, pressure-to-trigger, time for pressure to return to baseline, and triggering pressure-time product decreased in all modes. With increasing resistance and decreasing compliance, tidal volume, pressure-to-trigger, time-to-trigger, time for pressure to return to baseline, time to 90% of peak pressure, and pressure-time product decreased. There were large differences between the default and optimal settings for all the variables in PS and PA/C. Performance was not affected by PEEP. Most of the tested ventilators performed at an acceptable level during the majority of evaluations, but some ventilators performed inadequately during specific settings. Bedside clinical evaluation is needed.

Pulmonary function and dysfunction in multiple sclerosis.

Science.gov (United States)

Smeltzer, S C; Utell, M J; Rudick, R A; Herndon, R M

1988-11-01

Pulmonary function was studied in 25 patients with clinically definite multiple sclerosis with a range of motor impairment. Forced vital capacity (FVC), maximal voluntary ventilation (MVV), and maximal expiratory pressure (MEP) were normal in the ambulatory patients (mean greater than or equal to 80% predicted) but reduced in bedridden patients (mean, 38.5%, 31.6%, and 36.3% predicted; FCV, MVV, and MEP, respectively) and wheelchair-bound patients with upper extremity involvement (mean, 69.4%, 50.4%, and 62.6% predicted; FVC, MVV, and MEP, respectively). Forced vital capacity, MVV, and MEP correlated with Kurtzke Expanded Disability Status scores (tau = -0.72, -0.70, and -0.65) and expiratory muscle weakness occurred most frequently. These findings demonstrate that marked expiratory weakness develops in severely paraparetic patients with multiple sclerosis and the weakness increases as the upper extremities become increasingly involved.

75 FR 34148 - Voluntary Private Sector Accreditation and Certification Preparedness Program

Science.gov (United States)

2010-06-16

...] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency...) announces its adoption of three standards for the Voluntary Private Sector Accreditation and Certification... DHS to develop and implement a Voluntary Private Sector Preparedness Accreditation and Certification...

A NEW EXHAUST VENTILATION SYSTEM DESIGN SOFTWARE

Directory of Open Access Journals (Sweden)

H. Asilian Mahabady

2007-09-01

Full Text Available A Microsoft Windows based ventilation software package is developed to reduce time-consuming and boring procedure of exhaust ventilation system design. This program Assure accurate and reliable air pollution control related calculations. Herein, package is tentatively named Exhaust Ventilation Design Software which is developed in VB6 programming environment. Most important features of Exhaust Ventilation Design Software that are ignored in formerly developed packages are Collector design and fan dimension data calculations. Automatic system balance is another feature of this package. Exhaust Ventilation Design Software algorithm for design is based on two methods: Balance by design (Static pressure balance and design by Blast gate. The most important section of software is a spreadsheet that is designed based on American Conference of Governmental Industrial Hygienists calculation sheets. Exhaust Ventilation Design Software is developed so that engineers familiar with American Conference of Governmental Industrial Hygienists datasheet can easily employ it for ventilation systems design. Other sections include Collector design section (settling chamber, cyclone, and packed tower, fan geometry and dimension data section, a unit converter section (that helps engineers to deal with units, a hood design section and a Persian HTML help. Psychometric correction is also considered in Exhaust Ventilation Design Software. In Exhaust Ventilation Design Software design process, efforts are focused on improving GUI (graphical user interface and use of programming standards in software design. Reliability of software has been evaluated and results show acceptable accuracy.

Advanced Controls for Residential Whole-House Ventilation Systems

Energy Technology Data Exchange (ETDEWEB)

Turner, William [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2014-08-01

Whole-house ventilation systems are becoming commonplace in new construction, remodeling/renovation, and weatherization projects, driven by combinations of specific requirements for indoor air quality (IAQ), health and compliance with standards, such as ASHRAE 62.2. Ventilation systems incur an energy penalty on the home via fan power used to drive the airflow, and the additional space-conditioning load associated with heating or cooling the ventilation air. Finding a balance between IAQ and energy use is important if homes are to be adequately ventilated while not increasing the energy burden. This study used computer simulations to examine RIVEC the Residential Integrated Ventilation Controller - a prototype ventilation controller that aims to deliver whole-house ventilation rates that comply with ventilation standards, for the minimum use of energy. Four different whole-house ventilation systems were simulated, both with and without RIVEC, so that the energy and IAQ results could be compared. Simulations were conducted for 13 US climate zones, three house designs, and three envelope leakage values. The results showed that the RIVEC controller could typically return ventilation energy savings greater than 40percent without compromising long-term chronic or short-term acute exposures to relevant indoor contaminants. Critical and average peak power loads were also reduced as a consequence of using RIVEC.

Comparison of two modes of ventilation after fast-track cardiac surgery: Adaptive support ventilation versus synchronized intermittent mandatory ventilation

International Nuclear Information System (INIS)

Aghadavoudi, O.

2012-01-01

Objective: There is substantial debate regarding the appropriate protocol for ventilatory management in fast-track cardiac anesthesia (FTCA). This study was carried out to assess and compare the risks and benefits of respiratory weaning based on adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) after uncomplicated cardiac surgery. Methodology: In a randomized clinical trial, after receiving approval of the Department Research Committee and informed consent from study subjects, 100 patients undergoing elective coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) were enrolled during a 4-month period at a university-based hospital. After surgery and admission to the intensive care unit (ICU), patients were randomized to ASV and SIMV groups. Arterial blood gas (ABG) and hemodynamic variables, respiratory and ventilator characteristics including lung compliance, rapid shallow breathing index (RSBI), tidal volume (TV), respiratory rate (RR), peak inspiratory pressure (P peak), mean airway pressure (p mean), Pao2/FIo2, duration of mechanical ventilation and tracheal intubation, and length of ICU stay were recorded and compared between the two groups. The data were analyzed in 82 patients after considering the exclusion criteria. Results: There were no differences between ASV and SIMV groups in demographics and preoperative characteristics. The duration of tracheal intubation and the length of ICU stay were similar in both groups. There were no statistically and clinically relevant differences between the two groups in ABG, hemodynamic changes, and respiratory and ventilator characteristics during ICU stay. Conclusion: Although ASV may facilitate postoperative respiratory management in FTCA, both ASV and SIMV provide similarly safe and practicable respiratory weaning in the cardiac ICU. The evaluation of potential advantages in patient outcomes and resource utilization of respiratory weaning based on ASV

Influences of Duration of Inspiratory Effort, Respiratory Mechanics, and Ventilator Type on Asynchrony With Pressure Support and Proportional Assist Ventilation.

Science.gov (United States)

Vasconcelos, Renata S; Sales, Raquel P; Melo, Luíz H de P; Marinho, Liégina S; Bastos, Vasco Pd; Nogueira, Andréa da Nc; Ferreira, Juliana C; Holanda, Marcelo A

2017-05-01

Pressure support ventilation (PSV) is often associated with patient-ventilator asynchrony. Proportional assist ventilation (PAV) offers inspiratory assistance proportional to patient effort, minimizing patient-ventilator asynchrony. The objective of this study was to evaluate the influence of respiratory mechanics and patient effort on patient-ventilator asynchrony during PSV and PAV plus (PAV+). We used a mechanical lung simulator and studied 3 respiratory mechanics profiles (normal, obstructive, and restrictive), with variations in the duration of inspiratory effort: 0.5, 1.0, 1.5, and 2.0 s. The Auto-Trak system was studied in ventilators when available. Outcome measures included inspiratory trigger delay, expiratory trigger asynchrony, and tidal volume (V T ). Inspiratory trigger delay was greater in the obstructive respiratory mechanics profile and greatest with a effort of 2.0 s (160 ms); cycling asynchrony, particularly delayed cycling, was common in the obstructive profile, whereas the restrictive profile was associated with premature cycling. In comparison with PSV, PAV+ improved patient-ventilator synchrony, with a shorter triggering delay (28 ms vs 116 ms) and no cycling asynchrony in the restrictive profile. V T was lower with PAV+ than with PSV (630 mL vs 837 mL), as it was with the single-limb circuit ventilator (570 mL vs 837 mL). PAV+ mode was associated with longer cycling delays than were the other ventilation modes, especially for the obstructive profile and higher effort values. Auto-Trak eliminated automatic triggering. Mechanical ventilation asynchrony was influenced by effort, respiratory mechanics, ventilator type, and ventilation mode. In PSV mode, delayed cycling was associated with shorter effort in obstructive respiratory mechanics profiles, whereas premature cycling was more common with longer effort and a restrictive profile. PAV+ prevented premature cycling but not delayed cycling, especially in obstructive respiratory mechanics

Duration of Mechanical Ventilation in the Emergency Department

Directory of Open Access Journals (Sweden)

Lauren B. Angotti

2017-07-01

Full Text Available Introduction: Due to hospital crowding, mechanically ventilated patients are increasingly spending hours boarding in emergency departments (ED before intensive care unit (ICU admission. This study aims to evaluate the association between time ventilated in the ED and in-hospital mortality, duration of mechanical ventilation, ICU and hospital length of stay (LOS. Methods: This was a multi-center, prospective, observational study of patients ventilated in the ED, conducted at three academic Level I Trauma Centers from July 2011 to March 2013. All consecutive adult patients on invasive mechanical ventilation were eligible for enrollment. We performed a Cox regression to assess for a mortality effect for mechanically ventilated patients with each hour of increasing LOS in the ED and multivariable regression analyses to assess for independently significant contributors to in-hospital mortality. Our primary outcome was in-hospital mortality, with secondary outcomes of ventilator days, ICU LOS and hospital LOS. We further commented on use of lung protective ventilation and frequency of ventilator changes made in this cohort. Results: We enrolled 535 patients, of whom 525 met all inclusion criteria. Altered mental status without respiratory pathology was the most common reason for intubation, followed by trauma and respiratory failure. Using iterated Cox regression, a mortality effect occurred at ED time of mechanical ventilation > 7 hours, and the longer ED stay was also associated with a longer total duration of intubation. However, adjusted multivariable regression analysis demonstrated only older age and admission to the neurosciences ICU as independently associated with increased mortality. Of interest, only 23.8% of patients ventilated in the ED for over seven hours had changes made to their ventilator. Conclusion: In a prospective observational study of patients mechanically ventilated in the ED, there was a significant mortality benefit to

Duration of Mechanical Ventilation in the Emergency Department.

Science.gov (United States)

Angotti, Lauren B; Richards, Jeremy B; Fisher, Daniel F; Sankoff, Jeffrey D; Seigel, Todd A; Al Ashry, Haitham S; Wilcox, Susan R

2017-08-01

Due to hospital crowding, mechanically ventilated patients are increasingly spending hours boarding in emergency departments (ED) before intensive care unit (ICU) admission. This study aims to evaluate the association between time ventilated in the ED and in-hospital mortality, duration of mechanical ventilation, ICU and hospital length of stay (LOS). This was a multi-center, prospective, observational study of patients ventilated in the ED, conducted at three academic Level I Trauma Centers from July 2011 to March 2013. All consecutive adult patients on invasive mechanical ventilation were eligible for enrollment. We performed a Cox regression to assess for a mortality effect for mechanically ventilated patients with each hour of increasing LOS in the ED and multivariable regression analyses to assess for independently significant contributors to in-hospital mortality. Our primary outcome was in-hospital mortality, with secondary outcomes of ventilator days, ICU LOS and hospital LOS. We further commented on use of lung protective ventilation and frequency of ventilator changes made in this cohort. We enrolled 535 patients, of whom 525 met all inclusion criteria. Altered mental status without respiratory pathology was the most common reason for intubation, followed by trauma and respiratory failure. Using iterated Cox regression, a mortality effect occurred at ED time of mechanical ventilation > 7 hours, and the longer ED stay was also associated with a longer total duration of intubation. However, adjusted multivariable regression analysis demonstrated only older age and admission to the neurosciences ICU as independently associated with increased mortality. Of interest, only 23.8% of patients ventilated in the ED for over seven hours had changes made to their ventilator. In a prospective observational study of patients mechanically ventilated in the ED, there was a significant mortality benefit to expedited transfer of patients into an appropriate ICU setting.

Alexithymic trait and voluntary control in healthy adults.

Directory of Open Access Journals (Sweden)

Xiaosi Gu

Full Text Available Alexithymia is a personality trait characterized by deficiency in understanding, processing, or describing emotions. Recent studies have revealed that alexithymia is associated with less activation of the anterior cingulate cortex, a brain region shown to play a role in cognitive and emotional processing. However, few studies have directly investigated the cognitive domain in relation to alexithymia to examine whether alexithymic trait is related to less efficient voluntary control.We examined the relationship between alexithymic trait and voluntary control in a group of healthy volunteers. We used the 20-item Toronto Alexithymia Scale (TAS-20 to measure alexithymic trait. Additionally, we examined state and trait voluntary control using the revised Attention Network Test (ANT-R and the Adult Temperament Questionnaire (ATQ, respectively. Alexithymic trait was positively correlated with the overall reaction time of the ANT-R, and negatively correlated with the Effortful Control factor of the ATQ.Our results suggest that alexithymic trait is associated with less efficient voluntary control.

Initial ventilator settings for critically ill patients

OpenAIRE

Kilickaya, Oguz; Gajic, Ognjen

2013-01-01

The lung-protective mechanical ventilation strategy has been standard practice for management of acute respiratory distress syndrome (ARDS) for more than a decade. Observational data, small randomized studies and two recent systematic reviews suggest that lung protective ventilation is both safe and potentially beneficial in patients who do not have ARDS at the onset of mechanical ventilation. Principles of lung-protective ventilation include: a) prevention of volutrauma (tidal volume 4 to 8 ...

Artificial humidification for the mechanically ventilated patient

OpenAIRE

Selvaraj, Nelson

2010-01-01

Caring for patients who are mechanically ventilated poses many\\ud challenges for critical care nurses. It is important to humidify the\\ud patient’s airways artificially to prevent complications such as\\ud ventilator-associated pneumonia. There is no gold standard to\\ud determine which type of humidification is best for patients who\\ud are artificially ventilated. This article provides an overview of\\ud commonly used artificial humidification for mechanically ventilated\\ud patients and discuss...

Artificial humidification for the mechanically ventilated patient.

Science.gov (United States)

Selvaraj, N

Caring for patients who are mechanically ventilated poses many challenges for critical care nurses. It is important to humidify the patient's airways artificially to prevent complications such as ventilator-associated pneumonia. There is no gold standard to determine which type of humidification is best for patients who are artificially ventilated. This article provides an overview of commonly used artificial humidification for mechanically ventilated patients and discusses nurses' responsibilities in caring for patients receiving artificial humidification.

75 FR 60773 - Voluntary Private Sector Accreditation and Certification Preparedness Program

Science.gov (United States)

2010-10-01

...] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency... concerns in the Voluntary Private Sector Accreditation and Certification Preparedness Program (PS-Prep...-53 (the 9/11 Act) mandated DHS to establish a voluntary private sector preparedness accreditation and...

Beliefs in and About God and Attitudes Toward Voluntary Euthanasia.

Science.gov (United States)

Sharp, Shane

2018-06-01

I use data from the General Social Survey to evaluate several hypotheses regarding how beliefs in and about God predict attitudes toward voluntary euthanasia. I find that certainty in the belief in God significantly predicts negative attitudes toward voluntary euthanasia. I also find that belief in a caring God and in a God that is the primary source of moral rules significantly predicts negative attitudes toward voluntary euthanasia. I also find that respondents' beliefs about the how close they are to God and how close they want to be with God predict negative attitudes toward voluntary euthanasia. These associations hold even after controlling for religious affiliation, religious attendance, views of the Bible, and sociodemographic factors. The findings indicate that to understand individuals' attitudes about voluntary euthanasia, one must pay attention to their beliefs in and about God.

Natural ventilation of buildings: opposing wind and buoyancy

Science.gov (United States)

Linden, Paul; Hunt, Gary

1998-11-01

The use of natural ventilation in buildings is an attractive way to reduce energy usage thereby reducing costs and CO2 emissions. Generally, it is necessary to remove excess heat from a building and the designer can use the buoyancy forces associated with the above ambient temperatures within the building to drive a flow - 'stack' ventilation. The most efficient mode is displacement ventilation where warm air accumulates near the top of the building and flows out through upper level vents and cooler air flows in at lower levels. Ventilation will also be driven between these lower and upper openings by the wind. We report on laboratory modeling and theory which investigates the effects of an opposing wind on stack ventilation driven by a constant source of heat within a space under displacement ventilation. We show that there is a critical wind speed, expressed in dimensionless terms as a critical Froude number, above which displacement ventilation is replaced by (less efficient) mixing ventilation with reversed flow. Below this critical speed, displacement ventilation, in which the interior has a two-layer stratification, is maintained. The criterion for the change in ventilation mode is derived from general considerations of mixing efficiencies in stratified flows. We conclude that even when wind effects might appear to be dominant, the inhibition of mixing by the stable stratification within the space ensures that stack ventilation can operate over a wide range of apparently adverse conditions.

Lung-protective ventilation in neonatology

NARCIS (Netherlands)

van Kaam, Anton

2011-01-01

Ventilator-induced lung injury (VILI) is considered an important risk factor in the development of bronchopulmonary dysplasia (BPD) and is primarily caused by overdistension (volutrauma) and repetitive opening and collapse (atelectrauma) of terminal lung units. Lung-protective ventilation should

Maximizers versus satisficers

Directory of Open Access Journals (Sweden)

Andrew M. Parker

2007-12-01

Full Text Available Our previous research suggests that people reporting a stronger desire to maximize obtain worse life outcomes (Bruine de Bruin et al., 2007. Here, we examine whether this finding may be explained by the decision-making styles of self-reported maximizers. Expanding on Schwartz et al. (2002, we find that self-reported maximizers are more likely to show problematic decision-making styles, as evidenced by self-reports of less behavioral coping, greater dependence on others when making decisions, more avoidance of decision making, and greater tendency to experience regret. Contrary to predictions, self-reported maximizers were more likely to report spontaneous decision making. However, the relationship between self-reported maximizing and worse life outcomes is largely unaffected by controls for measures of other decision-making styles, decision-making competence, and demographic variables.

Noninvasive ventilation reduces energy expenditure in amyotrophic lateral sclerosis.

Science.gov (United States)

Georges, Marjolaine; Morélot-Panzini, Capucine; Similowski, Thomas; Gonzalez-Bermejo, Jesus

2014-02-07

Amyotrophic lateral sclerosis (ALS) leads to chronic respiratory failure. Diaphragmatic dysfunction, a major driver of dyspnea and mortality, is associated with a shift of the burden of ventilation to extradiaphragmatic inspiratory muscles, including neck muscles. Besides, energy expenditure is often abnormally high in ALS, and this is associated with a negative prognostic value. We hypothesized that noninvasive ventilation (NIV) would relieve inspiratory neck muscles and reduce resting energy expenditure (REE). Using indirect calorimetry, we measured REE during spontaneous breathing (REESB) and NIV (REENIV) in 16 ALS patients with diaphragmatic dysfunction, during the first 3 months of NIV. Measured values were compared with predicted REE (REEpred)(Harris-Benedict equation). NIV abolished inspiratory neck muscle activity. Even though our patients were not hypermetabolic, on the contrary, with a REESB that was lower than REEpred (average 11%), NIV did reduce energy expenditure. Indeed, median REENIV, in this population with a mean body mass index of 21.4 kg.m-2, was 1149 kcal/24 h [interquartile 970-1309], lower than REESB (1197 kcal/24 h, 1054-1402; mean difference 7%; p = 0.03, Wilcoxon). REESB and REENIV were correlated with forced vital capacity and maximal inspiratory pressure. NIV can reduce energy expenditure in ALS patients probably by alleviating the ventilatory burden imposed on inspiratory neck muscles to compensate diaphragm weakness. It remains to be elucidated whether or not, in which population, and to what extent, NIV can be beneficial in ALS through the corresponding reduction in energy expenditure.

[Lung protective ventilation - pathophysiology and diagnostics].

Science.gov (United States)

Uhlig, Stefan; Frerichs, Inéz

2008-06-01

Mechanical ventilation may lead to lung injury depending on the ventilatory settings (e.g. pressure amplitudes, endexpiratory pressures, frequency) and the length of mechanical ventilation. Particularly in the inhomogeneously injured lungs of ARDS patients, alveolar overextension results in volutrauma, cyclic opening and closure of alveolar units in atelectrauma. Particularly important appears to be the fact that these processes may also cause biotrauma, i.e. the ventilator-induced hyperactivation of inflammatory responses in the lung. These side effects are reduced, but not eliminated with the currently recommended ventilation strategy with a tidal volume of 6 ml/kg idealized body weight. It is our hope that in the future optimization of ventilator settings will be facilated by bedside monitoring of novel indices of respiratory mechanics such as the stress index or the Slice technique, and by innovative real-time imaging technologies such as electrical impedance tomography.

Lung-protective mechanical ventilation does not protect against acute kidney injury in patients without lung injury at onset of mechanical ventilation.

Science.gov (United States)

Cortjens, Bart; Royakkers, Annick A N M; Determann, Rogier M; van Suijlen, Jeroen D E; Kamphuis, Stephan S; Foppen, Jannetje; de Boer, Anita; Wieland, Cathrien W; Spronk, Peter E; Schultz, Marcus J; Bouman, Catherine S C

2012-06-01

Preclinical and clinical studies suggest that mechanical ventilation contributes to the development of acute kidney injury (AKI), particularly in the setting of lung-injurious ventilator strategies. To determine whether ventilator settings in critically ill patients without acute lung injury (ALI) at onset of mechanical ventilation affect the development of AKI. Secondary analysis of a randomized controlled trial (N = 150), comparing conventional tidal volume (V(T), 10 mL/kg) with low tidal volume (V(T), 6 mL/kg) mechanical ventilation in critically ill patients without ALI at randomization. During the first 5 days of mechanical ventilation, the RIFLE class was determined daily, whereas neutrophil gelatinase-associated lipocalin and cystatin C levels were measured in plasma collected on days 0, 2, and 4. Eighty-six patients had no AKI at inclusion, and 18 patients (21%) subsequently developed AKI, but without significant difference between ventilation strategies. (Cumulative hazard, 0.26 vs 0.23; P = .88.) The courses of neutrophil gelatinase-associated lipocalin and cystatin C plasma levels did not differ significantly between randomization groups. In the present study in critically patients without ALI at onset of mechanical ventilation, lower tidal volume ventilation did not reduce the development or worsening of AKI compared with conventional tidal volume ventilation. Copyright © 2012 Elsevier Inc. All rights reserved.

Cost effectiveness of facility and home based HIV voluntary ...

African Journals Online (AJOL)

Cost effectiveness of facility and home based HIV voluntary counseling and ... Background: In Uganda, the main stay for provision of human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) ... AJOL African Journals Online.

Recommended Ventilation Strategies for Energy-Efficient Production Homes

Energy Technology Data Exchange (ETDEWEB)

Roberson, J.; Brown, R.; Koomey, J.; Warner, J.; Greenberg, S.

1998-12-01

This report evaluates residential ventilation systems for the U.S. Environmental Protection Agency's (EPA's) ENERGY STAR{reg_sign} Homes program and recommends mechanical ventilation strategies for new, low-infiltration, energy-efficient, single-family, ENERGY STAR production (site-built tract) homes in four climates: cold, mixed (cold and hot), hot humid, and hot arid. Our group in the Energy Analysis Department at Lawrence Berkeley National Lab compared residential ventilation strategies in four climates according to three criteria: total annualized costs (the sum of annualized capital cost and annual operating cost), predominant indoor pressure induced by the ventilation system, and distribution of ventilation air within the home. The mechanical ventilation systems modeled deliver 0.35 air changes per hour continuously, regardless of actual infiltration or occupant window-opening behavior. Based on the assumptions and analysis described in this report, we recommend independently ducted multi-port supply ventilation in all climates except cold because this strategy provides the safety and health benefits of positive indoor pressure as well as the ability to dehumidify and filter ventilation air. In cold climates, we recommend that multi-port supply ventilation be balanced by a single-port exhaust ventilation fan, and that builders offer balanced heat-recovery ventilation to buyers as an optional upgrade. For builders who continue to install forced-air integrated supply ventilation, we recommend ensuring ducts are airtight or in conditioned space, installing a control that automatically operates the forced-air fan 15-20 minutes during each hour that the fan does not operate for heating or cooling, and offering ICM forced-air fans to home buyers as an upgrade.

Cellular phone interference with the operation of mechanical ventilators.

Science.gov (United States)

Shaw, Cheryl I; Kacmarek, Robert M; Hampton, Rickey L; Riggi, Vincent; El Masry, Ashraf; Cooper, Jeffrey B; Hurford, William E

2004-04-01

To determine whether a cellular phone would interfere with the operation of mechanical ventilators. Laboratory study. University medical center. Fourteen mechanical ventilators. We evaluated change in operation and malfunction of the mechanical ventilators. The cellular phone (Nokia 6120i) was computer controlled, operating at 828.750 MHz analog modulation. It was operated at 16, 40, 100, 250, and 600 mW, 30 cm from the floor and 30, 15, and ventilator. Six of the 14 ventilators tested malfunctioned when a cellular phone at maximum power output was placed ventilating when the cellular phone at maximum power output was placed ventilator. One ventilator doubled the ventilatory rate and another increased the displayed tidal volume from 350 to 1033 mL. In one of the infant ventilators, displayed tidal volume increased from 21 to 100 mL. In another ventilator, the high respiratory rate alarm sounded but the rate had not changed. In a controlled laboratory setting, cellular phones placed in close proximity to some commercially available intensive care ventilators can cause malfunctions, including irrecoverable cessation of ventilation. This is most likely to occur if the cellular phone is or =3 feet from all medical devices. The current electromagnetic compatibility standards for mechanical ventilators are inadequate to prevent malfunction. Manufacturers should ensure that their products are not affected by wireless technology even when placed immediately next to the device.

ASPECTS REGARDING CORPORATE MANDATORY AND VOLUNTARY DISCLOSURE

Directory of Open Access Journals (Sweden)

Popa Adina

2008-05-01

Full Text Available The paper highlights theoretical aspects regarding corporate mandatory and voluntary disclosure. Since financial and business reporting are important information sources for different stakeholders, especially for publicly traded companies, the business reporting is increasingly oriented to the need of different users. In order to make rational investment decisions, users of corporate annual and interim reports require an extensive range of information. The increasing needs of the users persuade different international bodies and researchers to investigate the improvements that can be done in business reporting. The results of those studies usually were different reporting models. Because voluntary dimension of corporate disclosure involve the manifestation of free choice of the firm and its managers, we have considered as necessary to achieve a theoretical analysis of the main costs and profits of the voluntary disclosure policy.

Ventilation of radioactive enclosures

International Nuclear Information System (INIS)

Caminade, F.; Laurent, H.

1957-01-01

Mechanical, physical and chemical manipulations on radioactive products must be carried out in properly ventilated enclosed places. The air extracted can only be discharged into the atmosphere after a correct filtration. The power of the ventilation systems is a function of the dimensions and purpose of the enclosure? The choice of types of filter is determined by the physical state and chemical nature of the radioactive materials to be manipulated. This study deals with the individual equipment of small installations: glove boxes, manipulation boxes with outside control and, if necessary, production chambers (maximum useful volume: 5 m 3 ). The performances of three types of 'ventilators', and the modifications provided by the addition of filters, are measured and compared. (author) [fr

Secretion management in the mechanically ventilated patient.

Science.gov (United States)

Branson, Richard D

2007-10-01

Secretion management in the mechanically ventilated patient includes routine methods for maintaining mucociliary function, as well as techniques for secretion removal. Humidification, mobilization of the patient, and airway suctioning are all routine procedures for managing secretions in the ventilated patient. Early ambulation of the post-surgical patient and routine turning of the ventilated patient are common secretion-management techniques that have little supporting evidence of efficacy. Humidification is a standard of care and a requisite for secretion management. Both active and passive humidification can be used. The humidifier selected and the level of humidification required depend on the patient's condition and the expected duration of intubation. In patients with thick, copious secretions, heated humidification is superior to a heat and moisture exchanger. Airway suctioning is the most important secretion removal technique. Open-circuit and closed-circuit suctioning have similar efficacy. Instilling saline prior to suctioning, to thin the secretions or stimulate a cough, is not supported by the literature. Adequate humidification and as-needed suctioning are the foundation of secretion management in the mechanically ventilated patient. Intermittent therapy for secretion removal includes techniques either to simulate a cough, to mechanically loosen secretions, or both. Patient positioning for secretion drainage is also widely used. Percussion and postural drainage have been widely employed for mechanically ventilated patients but have not been shown to reduce ventilator-associated pneumonia or atelectasis. Manual hyperinflation and insufflation-exsufflation, which attempt to improve secretion removal by simulating a cough, have been described in mechanically ventilated patients, but neither has been studied sufficiently to support routine use. Continuous lateral rotation with a specialized bed reduces atelectasis in some patients, but has not been shown

Natural ventilation for the prevention of airborne contagion.

Science.gov (United States)

Escombe, A Roderick; Oeser, Clarissa C; Gilman, Robert H; Navincopa, Marcos; Ticona, Eduardo; Pan, William; Martínez, Carlos; Chacaltana, Jesus; Rodríguez, Richard; Moore, David A J; Friedland, Jon S; Evans, Carlton A

2007-02-01

Institutional transmission of airborne infections such as tuberculosis (TB) is an important public health problem, especially in resource-limited settings where protective measures such as negative-pressure isolation rooms are difficult to implement. Natural ventilation may offer a low-cost alternative. Our objective was to investigate the rates, determinants, and effects of natural ventilation in health care settings. The study was carried out in eight hospitals in Lima, Peru; five were hospitals of "old-fashioned" design built pre-1950, and three of "modern" design, built 1970-1990. In these hospitals 70 naturally ventilated clinical rooms where infectious patients are likely to be encountered were studied. These included respiratory isolation rooms, TB wards, respiratory wards, general medical wards, outpatient consulting rooms, waiting rooms, and emergency departments. These rooms were compared with 12 mechanically ventilated negative-pressure respiratory isolation rooms built post-2000. Ventilation was measured using a carbon dioxide tracer gas technique in 368 experiments. Architectural and environmental variables were measured. For each experiment, infection risk was estimated for TB exposure using the Wells-Riley model of airborne infection. We found that opening windows and doors provided median ventilation of 28 air changes/hour (ACH), more than double that of mechanically ventilated negative-pressure rooms ventilated at the 12 ACH recommended for high-risk areas, and 18 times that with windows and doors closed (p ventilation than modern naturally ventilated rooms (40 versus 17 ACH; p natural ventilation exceeded mechanical (p ventilated rooms 39% of susceptible individuals would become infected following 24 h of exposure to untreated TB patients of infectiousness characterised in a well-documented outbreak. This infection rate compared with 33% in modern and 11% in pre-1950 naturally ventilated facilities with windows and doors open. Opening windows and

REVERSIBLE VENTILATION SYSTEM FOR ADMINISTRATIVE BUILDINGS

Directory of Open Access Journals (Sweden)

Valery Yu. Kravchuk

2017-01-01

Full Text Available Abstract. Objectives To consider the possibility of applying the principle of reversing air flows for a centralised ventilation system; to develop a specific scheme for air exchange reversible ventilation, which will take into account the peculiarities of the microclimate of administrative buildings; to select the type of filling of the air-permeable element and justify this choice; to determine the conditions for changing the direction of air movement in the ventilation system and the area of its application; to form a list of equipment necessary for the operation of such a system; to consider the influence of supply and exhaust devices on the heat and humidity regime of claddings. Methods  To achieve this goal, the published thematic material was reviewed and a patent search carried out using Russian and European databases. Data on mathematical modelling of filtration in porous media and experimental results were used. A method for ventilating rooms in administrative building using the reversal of movement of supply and exhaust air streams along the same channels was applied. Results  Schemas for reversible ventilation systems are presented and their modes of operation considered. It is established that the idea of reversing ventilation flows has not yet been applied in the development of centralised ventilation systems. Based on these published materials, it was concluded that the proposed design of supply and exhaust devices can be used in practice. An original air exchange scheme for the ventilation of administrative buildings and design of supply and exhaust devices for this system are proposed. The conditions for changing the operating modes of the system and the scope of its application are determined. Conclusion The use of the proposed ventilation system allows normative air exchange to be provided without using a supply unit during the cold season. This application of airflow reversal allows the potential of natural forces to be used

Building ventilation, state of the art, prospective

International Nuclear Information System (INIS)

1995-10-01

This conference is composed of 21 communications and 21 posters in the domain of building ventilation and indoor air quality; the main themes are: indoor air quality assessment and optimization; performance enhancement and optimization of ventilation systems and equipment; ventilation systems for renovated and rehabilitated buildings; French and European regulations, standardizations and certifications; experimental and numerical simulation studies concerning ventilation systems, air flow, temperature distribution, air quality, radon decontamination, thermal comfort and acoustic levels in buildings

Implementation of a Goal-Directed Mechanical Ventilation Order Set Driven by Respiratory Therapists Improves Compliance With Best Practices for Mechanical Ventilation.

Science.gov (United States)

Radosevich, Misty A; Wanta, Brendan T; Meyer, Todd J; Weber, Verlin W; Brown, Daniel R; Smischney, Nathan J; Diedrich, Daniel A

2017-01-01

Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice. We evaluated 1302 patients undergoing invasive mechanical ventilation (1693 separate episodes of invasive mechanical ventilation) prior to and after institution of a standardized, goal-directed mechanical ventilation order set using a controlled before-and-after study design. Patient-specific goals for oxygenation partial pressure of oxygen in arterial blood (Pao 2 ), ARDS Network [Net] positive end-expiratory pressure [PEEP]/fraction of inspired oxygen [Fio 2 ] table use) and ventilation (pH, partial pressure of carbon dioxide) were selected by prescribers and implemented by RTs. Compliance with the new mechanical ventilation order set was high: 88.2% compliance versus 3.8% before implementation of the order set ( P mechanical ventilation, intensive care unit (ICU) length of stay, and in-hospital or ICU mortality. A standardized best practice mechanical ventilation order set can be implemented by a multidisciplinary team and is associated with improved compliance to written orders and adherence to the ARDSNet PEEP/Fio 2 table.

Interaction of Compliance and Voluntary Renewable Energy Markets

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Lokey, E.

2007-10-01

In recent years, both compliance and voluntary markets have emerged to help support the development of renewable energy resources. Both of these markets are growing rapidly and today about half of U.S. states have RPS policies in place, with a number of these policies adopted in the last several years. In addition, many states have recently increased the stringency of their RPS policies. This paper examines key market interaction issues between compliance and voluntary renewable energy markets. It provides an overview of both the compliance and voluntary markets, addressing each market's history, purpose, size, scope, and benefits while addressing issues, including double counting.

Influence of ventilation and hypocapnia on sympathetic nerve responses to hypoxia in normal humans.

Science.gov (United States)

Somers, V K; Mark, A L; Zavala, D C; Abboud, F M

1989-11-01

The sympathetic response to hypoxia depends on the interaction between chemoreceptor stimulation (CRS) and the associated hyperventilation. We studied this interaction by measuring sympathetic nerve activity (SNA) to muscle in 13 normal subjects, while breathing room air, 14% O2, 10% O2, and 10% O2 with added CO2 to maintain isocapnia. Minute ventilation (VE) and blood pressure (BP) increased significantly more during isocapnic hypoxia (IHO) than hypocapnic hypoxia (HHO). In contrast, SNA increased more during HHO [40 +/- 10% (SE)] than during IHO (25 +/- 19%, P less than 0.05). To determine the reason for the lesser increase in SNA with IHO, 11 subjects underwent voluntary apnea during HHO and IHO. Apnea potentiated the SNA responses to IHO more than to HHO. SNA responses to IHO were 17 +/- 7% during breathing and 173 +/- 47% during apnea whereas SNA responses to HHO were 35 +/- 8% during breathing and 126 +/- 28% during apnea. During ventilation, the sympathoexcitation of IHO (compared with HHO) is suppressed, possibly for two reasons: 1) because of the inhibitory influence of activation of pulmonary afferents as a result of a greater increase in VE, and 2) because of the inhibitory influence of baroreceptor activation due to a greater rise in BP. Thus in humans, the ventilatory response to chemoreceptor stimulation predominates and restrains the sympathetic response. The SNA response to chemoreceptor stimulation represents the net effect of the excitatory influence of the chemoreflex and the inhibitory influence of pulmonary afferents and baroreceptor afferents.

Numerical simulation and comparison of two ventilation methods for a restaurant - displacement vs mixed flow ventilation

Science.gov (United States)

Chitaru, George; Berville, Charles; Dogeanu, Angel

2018-02-01

This paper presents a comparison between a displacement ventilation method and a mixed flow ventilation method using computational fluid dynamics (CFD) approach. The paper analyses different aspects of the two systems, like the draft effect in certain areas, the air temperatureand velocity distribution in the occupied zone. The results highlighted that the displacement ventilation system presents an advantage for the current scenario, due to the increased buoyancy driven flows caused by the interior heat sources. For the displacement ventilation case the draft effect was less prone to appear in the occupied zone but the high heat emissions from the interior sources have increased the temperature gradient in the occupied zone. Both systems have been studied in similar conditions, concentrating only on the flow patterns for each case.

Functionality of Ventilated Facades: Protection of Insulation

Directory of Open Access Journals (Sweden)

Petrichenko Mikhail

2016-01-01

Full Text Available This article discusses about methods of construction of the ventilated facades. The ventilated facade is not only the element of facing, it is the supporting structure. Their main objective - creation of air ventilating space between a facade and an external wall of the building. Moving of air in this gap protects a heater from destruction, interfering with a moisture congestion. In addition, the ventilated facade protect the building from aggressive influence of external environment, have a sound and thermal insulation properties. There are several problems of systems of the ventilated facades connected with an application of a heater. For more effective using it is necessary to minimize contact of a heater with environment.

Methodology for ventilation/perfusion SPECT

DEFF Research Database (Denmark)

Bajc, Marika; Neilly, Brian; Miniati, Massimo

2010-01-01

Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas ov...

Implementation of natural ventilation in pig houses

NARCIS (Netherlands)

Klooster, van 't C.E.

1994-01-01

A description of experimental work and discussion on implementation of natural ventilation in pig houses is given. A literature review describes the state of the art, animal growth data are given. It includes characterization of ventilation openings, a technique to estimate the ventilation

Echocardiographic evaluation during weaning from mechanical ventilation

Directory of Open Access Journals (Sweden)

Luciele Medianeira Schifelbain

2011-01-01

Full Text Available INTRODUCTION: Echocardiographic, electrocardiographic and other cardiorespiratory variables can change during weaning from mechanical ventilation. OBJECTIVES: To analyze changes in cardiac function, using Doppler echocardiogram, in critical patients during weaning from mechanical ventilation, using two different weaning methods: pressure support ventilation and T-tube; and comparing patient subgroups: success vs. failure in weaning. METHODS: Randomized crossover clinical trial including patients under mechanical ventilation for more than 48 h and considered ready for weaning. Cardiorespiratory variables, oxygenation, electrocardiogram and Doppler echocardiogram findings were analyzed at baseline and after 30 min in pressure support ventilation and T-tube. Pressure support ventilation vs. T-tube and weaning success vs. failure were compared using ANOVA and Student's t-test. The level of significance was p<0.05. RESULTS: Twenty-four adult patients were evaluated. Seven patients failed at the first weaning attempt. No echocardiographic or electrocardiographic differences were observed between pressure support ventilation and T-tube. Weaning failure patients presented increases in left atrium, intraventricular septum thickness, posterior wall thickness and diameter of left ventricle and shorter isovolumetric relaxation time. Successfully weaned patients had higher levels of oxygenation. CONCLUSION: No differences were observed between Doppler echocardiographic variables and electrocardiographic and other cardiorespiratory variables during pressure support ventilation and T-tube. However cardiac structures were smaller, isovolumetric relaxation time was larger, and oxygenation level was greater in successfully weaned patients

Performance of Leak Compensation in All-Age ICU Ventilators During Volume-Targeted Neonatal Ventilation: A Lung Model Study.

Science.gov (United States)

Itagaki, Taiga; Bennett, Desmond J; Chenelle, Christopher T; Fisher, Daniel F; Kacmarek, Robert M

2017-01-01

Volume-targeted ventilation is increasingly used in low birthweight infants because of the potential for reducing volutrauma and avoiding hypocapnea. However, it is not known what level of air leak is acceptable during neonatal volume-targeted ventilation when leak compensation is activated concurrently. Four ICU ventilators (Servo-i, PB980, V500, and Avea) were compared in available invasive volume-targeted ventilation modes (pressure control continuous spontaneous ventilation [PC-CSV] and pressure control continuous mandatory ventilation [PC-CMV]). The Servo-i and PB980 were tested with (+) and without (-) their proximal flow sensor. The V500 and Avea were tested with their proximal flow sensor as indicated by their manufacturers. An ASL 5000 lung model was used to simulate 4 neonatal scenarios (body weight 0.5, 1, 2, and 4 kg). The ASL 5000 was ventilated via an endotracheal tube with 3 different leaks. Two minutes of data were collected after each change in leak level, and the asynchrony index was calculated. Tidal volume (V T ) before and after the change in leak was assessed. The differences in delivered V T between before and after the change in leak were within ±5% in all scenarios with the PB980 (-/+) and V500. With the Servo-i (-/+), baseline V T was ≥10% greater than set V T during PC-CSV, and delivered V T markedly changed with leak. The Avea demonstrated persistent high V T in all leak scenarios. Across all ventilators, the median asynchrony index was 1% (interquartile range 0-27%) in PC-CSV and 1.8% (0-45%) in PC-CMV. The median asynchrony index was significantly higher in the Servo-i (-/+) than in the PB980 (-/+) and V500 in 1 and 2 kg scenarios during PC-CSV and PC-CMV. The PB980 and V500 were the only ventilators to acclimate to all leak scenarios and achieve targeted V T . Further clinical investigation is needed to validate the use of leak compensation during neonatal volume-targeted ventilation. Copyright © 2017 by Daedalus Enterprises.

Biofeedback, voluntary control, and human potential.

Science.gov (United States)

Norris, P

1986-03-01

This paper examines some of the philosophical and scientific relationships involving self-control, voluntary control, and psychophysiologic self-regulation. The role of biofeedback in mediating conscious and unconscious processes is explored. Demonstrations of superior voluntary control and its relationship to belief, confidence, and expectation are examined. Biofeedback demonstrates the potential of control to oneself, creating confidence in one's ability to establish enhanced and peak performance in athletics, education, and psychophysiologic therapy. Emphasis is placed on the power of images in all human functioning, and in enhancing human potential.

A Free Market Requires Voluntary Actions

DEFF Research Database (Denmark)

Sløk-Madsen, Stefan Kirkegaard

and not consumer sovereignty. I argue that asset ownership is less important than true consumer sovereignty, which again is the essential argument for why capitalism is the superior mode of resource allocation and social organization. The paper analyzes how our understanding of markets and voluntary actions...... are essential to the construct of consumer sovereignty. Understanding the degree of voluntary actions in a given commercial setting has implications for both business strategy and policy making. This paper thus aims to contribute to explain why restricted markets become crony capitalism....

Voluntary non-monetary approaches for implementing conservation

OpenAIRE

Santangeli, Andrea; Arroyo, Beatriz; Dicks, Lynn V.; Herzon, Irina; Kukkala, Aija S.; Sutherland, William J.; Moilanen, Atte

2016-01-01

The voluntary non-monetary approach to conservation refers to actions that citizens or organizations could voluntarily implement in their area of influence without the incentive of monetary compensations. To be effectively implemented by untrained actors, actions should be clearly defined, straightforward to implement and not require specific scientific knowledge. The costs of actions should also be sufficiently affordable to be widely applied without monetary incentives. A voluntary non-mone...

Rules regarding voluntary contributions to the Agency

International Nuclear Information System (INIS)

2004-01-01

The texts of the following Rules Regarding Voluntary Contributions to the Agency are reproduced for the information of all Members of the Agency. Rules to Govern the Acceptance of Gifts of Services, Equipment and Facilities - adopted by the Board of Governors on 10 March 2004; Rules Regarding the Acceptance of Voluntary Contributions of Money to the Agency - approved by the General Conference on 21 September 2001 (GC (45)/RES/9)

Voluntary "involuntary" commitment--the briar-patch syndrome.

Science.gov (United States)

Miller, R D

1980-01-01

Szasz and others have pointed out that many so-called voluntary admissions to mental hospitals have various elements of coercion involved, and are thus not truly voluntary. The author contends that the converse situation is also true, that many patients admitted under involuntary commitment papers arrange for their own commitments. Reasons for such choices are discussed in the context of a review of the literature and several case histories.

Rules regarding voluntary contributions to the Agency

International Nuclear Information System (INIS)

2001-01-01

The texts of the following Rules Regarding Voluntary Contributions to the Agency are reproduced for the information of all Members of the Agency. Rules to Govern the Acceptance of Gifts of Services, Equipment and Facilities - adopted by the Board of Governors on 13 June 2001; Rules Regarding the Acceptance of Voluntary Contributions of Money to the Agency - approved by the General Conference on 21 September 2001 (GC(45)/RES/9)

Discussion for management of ventilation system in uranium mines

International Nuclear Information System (INIS)

Li Xianjie; Ren Jianjun; Hu Penghua

2014-01-01

Radon exhaustion and ventilation are surely regarded as key links for safety production and radiation protection in underground uranium mines, and the crucial point to achieve safety production goals lies in timely and accurately adjusting and controlling of ventilation technical measures and ventilation system management with the changing operation conditions of mines. This paper proposes corresponding countermeasures based on the respectively systematical analysis of daily ventilation management, ventilation facilities and structures management, and ventilation system information management in uranium mines. Furthermore, standardized management approaches and suggestions are put forward to realize standardization of uranium mines' ventilation management and radon exhaustion technique. (authors)

Voluntary Running Aids to Maintain High Body Temperature in Rats Bred for High Aerobic Capacity

Science.gov (United States)

Karvinen, Sira M.; Silvennoinen, Mika; Ma, Hongqiang; Törmäkangas, Timo; Rantalainen, Timo; Rinnankoski-Tuikka, Rita; Lensu, Sanna; Koch, Lauren G.; Britton, Steven L.; Kainulainen, Heikki

2016-01-01

The production of heat, i.e., thermogenesis, is a significant component of the metabolic rate, which in turn affects weight gain and health. Thermogenesis is linked to physical activity (PA) level. However, it is not known whether intrinsic exercise capacity, aging, and long-term voluntary running affect core body temperature. Here we use rat models selectively bred to differ in maximal treadmill endurance running capacity (Low capacity runners, LCR and High capacity Runners, HCR), that as adults are divergent for aerobic exercise capacity, aging, and metabolic disease risk to study the connection between PA and body temperature. Ten high capacity runner (HCR) and ten low capacity runner (LCR) female rats were studied between 9 and 21 months of age. Rectal body temperature of HCR and LCR rats was measured before and after 1-year voluntary running/control intervention to explore the effects of aging and PA. Also, we determined whether injected glucose and spontaneous activity affect the body temperature differently between LCR and HCR rats at 9 vs. 21 months of age. HCRs had on average 1.3°C higher body temperature than LCRs (p temperature level of HCRs to similar levels with LCRs. The opportunity to run voluntarily had a significant impact on the body temperature of HCRs (p temperature at a similar level as when at younger age. Compared to LCRs, HCRs were spontaneously more active, had higher relative gastrocnemius muscle mass and higher UCP2, PGC-1α, cyt c, and OXPHOS levels in the skeletal muscle (p temperature of LCRs. However, glucose injection resulted in a lowering of the body temperature of LCRs (p temperature compared to rats born with low exercise capacity and disease risk. Voluntary running allowed HCRs to maintain high body temperature during aging, which suggests that high PA level was crucial in maintaining the high body temperature of HCRs. PMID:27504097

KEBERADAAN CORPORATE GOVERNANCE DAN KONDISI FINANCIAL DISTRESSED TERHADAP VOLUNTARY DISCLOSURE

Directory of Open Access Journals (Sweden)

Riesanti Edie Wijaya

2017-03-01

Full Text Available Voluntary disclosure meant giving information to public either about fi nancial or non-fi -nancial regarding the fi rm’s operations without any legal requirement (Fishman and Hagerty, 1997.Giving information about voluntary disclosure enables all the concerned parties obtaining more relevantinformation about the strategies and critical elements of the fi rms. In this study, we examinedthe impact of corporate governance and fi nancial distress condition on the level of voluntary informationdisclosure. This research used a sample of manufacture fi rms listed in Indonesian stockexchange. Based on data processing using sample above, we found that corporate governance andfi nancial distress could be associated with the voluntary disclosure level.

Nasal mask ventilation is better than face mask ventilation in edentulous patients

OpenAIRE

Kapoor, Mukul Chandra; Rana, Sandeep; Singh, Arvind Kumar; Vishal, Vindhya; Sikdar, Indranil

2016-01-01

Background and Aims: Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated. Material and Methods: Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively ev...

Computational modeling of particle transport and distribution emitted from a Laserjet printer in a ventilated room with different ventilation configurations

International Nuclear Information System (INIS)

Ansaripour, Mehrzad; Abdolzadeh, Morteza; Sargazizadeh, Saleh

2016-01-01

Highlights: • The distribution of emitted particles form a laserjet printer was studied in the breathing zone. • Effects of different ventilation configurations on the breathing zone concentration were investigated. • Mixing ventilation system has a low mean particle concentration in the breathing zone. - Abstract: In the present research, computational modeling of particle transport and distribution emitted from a Laserjet printer was carried out in a ventilated room. A seated manikin was integrated into the study room and the manikin was evaluated in two cases: heated and unheated. Effects of different ventilation configurations of the room on the particle distribution were studied, including three displacement ventilation systems and a mixing ventilation system. The printer was located on different sides of the manikin and the particle concentrations in the breathing zone of the manikin due to the printer’s particles were evaluated in all the ventilation configurations. The averaged particle concentration in the breathing zone of the manikin was calculated and validated with the experimental and numerical data available in the literature. The results of the present study showed that in case of the heated manikin, the particle concentration due to the printer pollutants is significant in the breathing zone of the manikin. The results also showed that when the printer is located on the front side of the manikin, the particle concentration in the breathing zone is quite high in most of the used ventilation configurations. Furthermore, it was found that the mixing ventilation system has a lower mean particle concentration in the breathing zone compared to the most displacement ventilation systems.

21 CFR 868.5925 - Powered emergency ventilator.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Powered emergency ventilator. 868.5925 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5925 Powered emergency ventilator. (a) Identification. A powered emergency ventilator is a demand valve or inhalator intended to provide emergency...

Ventilation strategies and indoor environment in classrooms

DEFF Research Database (Denmark)

Zhang, Chen; Liu, Li

2017-01-01

Compared with the other building types, the school building has much higher occupancy density and ventilation demand. In Demark, most of the school buildings are ventilated by natural manner. There is a risk of poor indoor environment associated with the lack of ventilation system or insufficient...

Fire, safety and ventilation