WorldWideScience

Sample records for voluntary respiratory control

  1. Voluntary control of cough.

    Science.gov (United States)

    Lee, P C L; Cotterill-Jones, C; Eccles, R

    2002-01-01

    Cough is normally referred to a reflex mediated by control centres in the respiratory areas of the brainstem. However, there is much experimental information that indicates that human cough is under voluntary control and that higher centres such as the cerebral cortex have an important role in both initiating and inhibiting cough. Studies on acute cough associated with common cold, and capsaicin induced cough have demonstrated that human cough can be voluntarily inhibited and often abolished. Further evidence for some role of consciousness in the control of cough comes from studies that show that cough is inhibited or abolished during sleep and with light anaesthesia. This paper discusses the historical development of the brainstem 'cough centre' and discusses the experimental evidence on the voluntary control of cough in man. A cough model demonstrating the voluntary and reflex control of cough in man is proposed. A hypothesis is proposed that cough associated with common cold is a mixture of both reflex and voluntary cough. Copyright 2002 Published by Elsevier Science Ltd.

  2. [Likeness between respiratory responses on CO2 in conditions of natural breathing and voluntary-controlled mechanical ventilation].

    Science.gov (United States)

    Pogodin, M A; Granstrem, M P; Dimitrienko, A I

    2007-04-01

    We did Read CO2 rebreathing tests in 8 adult males. Both at natural breathing, and at self-controlled mechanical ventilation, volunteers increased ventilation proportionally to growth end-tidal PCO2. Inside individual distinctions of responses to CO2 during controlled mechanical ventilation are result of the voluntary motor control.

  3. Voluntary euthanasia under control? Further empirical evidence from The Netherlands.

    Science.gov (United States)

    Jochemsen, H; Keown, J

    1999-01-01

    Nineteen ninety-six saw the publication of a major Dutch survey into euthanasia in the Netherlands. This paper outlines the main statistical findings of this survey and considers whether it shows that voluntary euthanasia is under effective control in the Netherlands. The paper concludes that although there has been some improvement in compliance with procedural requirements, the practice of voluntary euthanasia remains beyond effective control. PMID:10070633

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

    Science.gov (United States)

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

    2012-01-01

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

  5. Expanding voluntary active-learning opportunities for pharmacy students in a Respiratory Physiology Module.

    Science.gov (United States)

    Ernst, Hardy; Colthorpe, Kay

    2008-04-15

    To expand voluntary active-learning opportunities for bachelor of pharmacy students enrolled in a third-year human physiology and pharmacology course and determine whether the additional course components improved learning outcomes. Additional voluntary active-learning opportunities including a large-class tutorial, additional formative assessment, and an online discussion were added to the Respiratory Physiology Module of the course. Examination scores were compared with those from previous years. A questionnaire was administered to assess students' perception of the active-learning components. Mean examination scores increased from 69.3% +/- 24.4% in 2003 to 88.9% +/- 13.4% in 2004 and 86.9% +/- 17.6% in 2005, after the addition of the active-learning components. Students' overall perception of the value of the active-learning activities was positive. The addition of voluntary active-learning course components to a required pharmacy course resulted in improved student examination scores, and decreased failure rate, and were accomplished at low cost and with little additional staff time.

  6. Neurons controlling voluntary vocalization in the macaque ventral premotor cortex.

    Directory of Open Access Journals (Sweden)

    Gino Coudé

    Full Text Available The voluntary control of phonation is a crucial achievement in the evolution of speech. In humans, ventral premotor cortex (PMv and Broca's area are known to be involved in voluntary phonation. In contrast, no neurophysiological data are available about the role of the oro-facial sector of nonhuman primates PMv in this function. In order to address this issue, we recorded PMv neurons from two monkeys trained to emit coo-calls. Results showed that a population of motor neurons specifically fire during vocalization. About two thirds of them discharged before sound onset, while the remaining were time-locked with it. The response of vocalization-selective neurons was present only during conditioned (voluntary but not spontaneous (emotional sound emission. These data suggest that the control of vocal production exerted by PMv neurons constitutes a newly emerging property in the monkey lineage, shedding light on the evolution of phonation-based communication from a nonhuman primate species.

  7. Respiratory function in voluntary participating Patagonia sea lions in sternal recumbency

    Directory of Open Access Journals (Sweden)

    Andreas Fahlman

    2016-11-01

    Full Text Available We measured esophageal pressures (n=4, respiratory flow rates (n=5, and expired O2 and CO2 (n=4 in five adult Patagonia sea lions (Otaria flavescens, body mass range 94.3-286.0 kg during voluntary breaths while laying down. The data were used to estimate the dynamic specific lung compliance (sCL, cmH2O-1, the O2 consumption rate (VO2 and CO2 production rates (VCO2 during rest. Our results indicate that the resting tidal volume in Patagonia sea lions is approximately 47-73% of the estimated total lung capacity. The esophageal pressures indicated that expiration is passive during voluntary breaths. The average sCL of dolphins was 0.41±0.11 cmH2O−1, which is similar to those measured in anesthetized sea lions and awake cetaceans, and significantly higher as compared with humans (0.08 cmH2O−1. The average estimated and using breath-by-breath respirometry were 1.023 ± 0.327 L O2 min-1 (range: 0.695-1.514 L O2 min−1 and 0.777 ± 0.318 L CO2 min-1, (range: 0.510-1.235 L CO2 min-1, respectively, which is similar to previously published metabolic measurements from California and Steller sea lions using conventional flow-through respirometry. Our data provide end-tidal gas composition and provide novel data for respiratory physiology in pinnpeds, which may be important for clinical medicine and conservation efforts.

  8. Alexithymic trait and voluntary control in healthy adults.

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    Xiaosi Gu

    Full Text Available BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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. CONCLUSIONS/SIGNIFICANCE: Our results suggest that alexithymic trait is associated with less efficient voluntary control.

  9. Efficiency analysis of voluntary control of human's EEG spectral characteristics.

    Science.gov (United States)

    Kiroy, Valery N; Aslanyan, Elena V; Lazurenko, Dmitry M; Minyaeva, Nadezhda R; Bakhtin, Oleg M

    2016-03-01

    Spectral power (SP) of EEG alpha and beta-2 frequencies in different cortical areas has been used for neurofeedback training to control a graphic interface in different scenarios. The results show that frequency range and brain cortical areas are associated with high or low efficiency of voluntary control. Overall, EEG phenomena observed in the course of training are largely general changes involving extensive brain areas and frequency bands. Finally, we have demonstrated EEG patterns that dynamically switch with a specific feature in different tasks within one training, after a relatively short period of training.

  10. Voluntary driven elbow orthosis with speed controlled tremor suppression

    Directory of Open Access Journals (Sweden)

    Gil eHerrnstadt

    2016-03-01

    Full Text Available Robotic technology is gradually becoming commonplace in the medical sector and in the service of patients. Medical conditions that have benefited from significant technological development include stroke, for which rehabilitation with robotic devices is administered, and surgery assisted by robots. Robotic devices have also been proposed for assistance of movement disorders. Pathological tremor, among the most common movement disorders, is such one example. In practice, the dissemination and availability of tremor suppression robotic systems has been limited. Devices in the marketplace tend to either be non-ambulatory or to target specific functions such as eating and drinking.We have developed a one degree-of-freedom (DOF elbow orthosis that could be worn by an individual with tremor. A speed controlled voluntary driven suppression approach is implemented with the orthosis. Typically tremor suppression methods estimate the tremor component of the signal and produce a canceling counterpart signal. The suggested approach, instead estimates the voluntary component of the motion. A controller then actuates the orthosis based on the voluntary signal while simultaneously rejecting the tremorous motion.In this work, we tested the suppressive orthosis using a 1 DOF robotic system that simulates the human arm. The suggested suppression approach does not require a model of the human arm. Moreover, the human input along with the orthosis forearm gravitational forces, of nonlinear nature, are considered as part of the disturbance to the suppression system. Therefore, the suppression system can be modeled linearly. Nevertheless, the orthosis forearm gravitational forces can be compensated by the suppression system.The electromechanical design of the orthosis is presented, and data from an Essential Tremor patient is used as the human input. Velocity tracking results demonstrate an RMS error of 0.31 rad/s, and a power spectral density shows a reduction of

  11. Introduction of respiratory pattern generators into models of respiratory control.

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    Longobardo, Guy; Evangelisti, Carlo J; Cherniack, Neil S

    2005-10-12

    We have adapted two models previously proposed as respiratory pattern generators (RPGs) into a neurochemical feed back control model of ventilation. The RPG models, non-dimensional as originally presented, consisted of oscillating circuits of either two or five interconnected neurons [Matsugu, M., Duffin, J., Poon, C.-S., 1998. Entrainment, instability, quasi-periodicity, and chaos in a compound neural oscillator. J. Comput. Neurosci. 5, 35-51; Botros, S.M., Bruce, E.N., 1990. Neural network implementation of a three-phase model of respiratory rhythm generation. Biol. Cybern. 63, 143-153]. The neurochemical model into which they were integrated [Longobardo, G., Evangelisti, C.J., Cherniack, N.S., 2002. Effects of neural drives on breathing in the awake state in humans. Respir. Physiol. 129, 317-333] included the effects of cerebral blood flow variation with CO2, vagal stretch receptors input and a multicompartment model of carbon dioxide stores. The methodology is described whereby these neuronal oscillator networks were quantified, a necessary step for their inclusion as RPGs in broader models of the overall control of respiration. Subsequent simulations of the ventilation response to carbon dioxide with either respiratory pattern generator model exhibited only a limited range in which tidal volume and frequency increased with increasing respiratory drive. With both models, frequency peaked and then declined, as did ventilation when P CO2 was greater than normal. The range of the models was extended if the respiratory pattern generators were considered to be composed of multiple neuronal oscillators or a single oscillator in which there was increasing phasic input that was gated or pacemaker driven.

  12. Control processes in voluntary and explicitly cued task switching.

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    Masson, Michael E J; Carruthers, Sarah

    2014-10-01

    Explicitly cued task switching slows performance relative to performing the same task on consecutive trials. This effect appears to be due partly to more efficient encoding of the task cue when the same cue is used on consecutive trials and partly to an additional task-switching process. These components were examined by comparing explicitly cued and voluntary task switching groups, with external cues presented to both groups. Cue-switch effects varied in predictable ways to dissociate explicitly cued and voluntary task switching, whereas task-switch effects had similar characteristics for both instructional groups. The data were well fitted by a mathematical model of task switching that included a cue-encoding mechanism (whereby cue repetition improves performance) and an additional process that was invoked on task-switch trials. Analyses of response-time distributions suggest that this additional process involves task-set reconfiguration that may or may not be engaged before the target stimulus is presented.

  13. Chronic respiratory patient control by multivariate charts.

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    Correia, Florbela; Nêveda, Rui; Oliveira, Pedro

    2011-01-01

    This article seeks to explain how to monitor the chronic obstructive disease patient and control any complications so that timely treatment can be applied. Control charts and statistical process control (SPC) theory were used on chronic respiratory patient follow-up and control. Controlling several variables simultaneously, using univariate charts, can be misleading, more so when there are correlated variables, so multivariate and univariate control charts were studied. One-sided control charts are preferable when the aim is to detect changes in the mean solely in one direction. Thus, one-sided, univariate and multivariate charts were built, which identified previously undetected out-of-control events. The study's main limitation is its retrospective nature. However, following-up individual patients can highlight medical therapy effects. The article concludes that control charts, in particular one-sided ones, are a valuable tool for monitoring chronic respiratory patients, thus contributing to medical decision making. The article highlights control chart application to chronic respiratory patient follow-up, permitting a global view of patient evolution over time.

  14. Prediction of tonic parasympathetic cardiac control using respiratory sinus arrhythmia: the need for respiratory control

    NARCIS (Netherlands)

    GROSSMAN, P.; Karemaker, J.; Wieling, W.

    1991-01-01

    Respiratory sinus arrhythmia (RSA) has received much attention in recent years due to the large body of evidence indicating that variations in this phenomenon represent alterations in parasympathetic cardiac control. Although it appears that respiratory sinus arrhythmia is mediated by vagal

  15. 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.

  16. Importance of Corporate Governance Quality and Voluntary Disclosures of Corporate Governance Information in Listed Malaysian Family Controlled Businesses

    OpenAIRE

    Norziana Lokman; Joseph M Mula; Julie Cotter

    2014-01-01

    This paper investigates the impact of family control on the association between corporate governance quality and voluntary disclosures of corporate governance information of publicly listed Malaysian family controlled businesses. In addition, the impact of incentive factors are also examined for both family and non-family controlled businesses in relation to voluntary disclosures. The findings suggest that the positive association between corporate governance quality and voluntary disclosures...

  17. Distinct representations of attentional control during voluntary and stimulus-driven shifts across objects and locations.

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    Stoppel, Christian Michael; Boehler, Carsten Nicolas; Strumpf, Hendrik; Krebs, Ruth Marie; Heinze, Hans-Jochen; Hopf, Jens-Max; Schoenfeld, Mircea Ariel

    2013-06-01

    Efficient interaction with the sensory environment requires the rapid reallocation of attentional resources between spatial locations, perceptual features, and objects. It is still a matter of debate whether one single domain-general network or multiple independent domain-specific networks mediate control during shifts of attention across features, locations, and objects. Here, we employed functional magnetic resonance imaging to directly compare the neural mechanisms controlling attention during voluntary and stimulus-driven shifts across objects and locations. Subjects either maintained or switched voluntarily and involuntarily their attention to objects located at the same or at a different visual location. Our data demonstrate shift-related activity in multiple frontoparietal, extrastriate visual, and default-mode network regions, several of which were commonly recruited by voluntary and stimulus-driven shifts between objects and locations. However, our results also revealed object- and location-selective activations, which, moreover, differed substantially between voluntary and stimulus-driven attention. These results suggest that voluntary and stimulus-driven shifts between objects and locations recruit partially overlapping, but also separable, cortical regions, implicating the parallel existence of domain-independent and domain-specific reconfiguration signals that initiate attention shifts in dependence of particular demands.

  18. [Cost-consequence analysis of respiratory preventive intervention among institutionalized older people: randomized controlled trial].

    Science.gov (United States)

    Cebrià I Iranzo, Maria Dels Àngels; Tortosa-Chuliá, M Ángeles; Igual-Camacho, Celedonia; Sancho, Patricia; Galiana, Laura; Tomás, José Manuel

    2014-01-01

    The institutionalized elderly with functional impairment show a greater decline in respiratory muscle (RM) function. The aims of the study are to evaluate outcomes and costs of RM training using Pranayama in institutionalized elderly people with functional impairment. A randomized controlled trial was conducted on institutionalized elderly people with walking limitation (n=54). The intervention consisted of 6 weeks of Pranayama RM training (5 times/week). The outcomes were measured at 4 time points, and were related to RM function: the maximum respiratory pressures and the maximum voluntary ventilation. Perceived satisfaction in the experimental group (EG) was assessed by means of an ad hoc questionnaire. Direct and indirect costs were estimated from the social perspective. The GE showed a significant improvement related with strength (maximum respiratory pressures) and endurance (maximum voluntary ventilation) of RM. Moreover, 92% of the EG reported a high satisfaction. The total social costs, direct and indirect, amounted to Euro 21,678. This evaluation reveals that RM function improvement is significant, that intervention is well tolerated and appreciated by patients, and the intervention costs are moderate. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

  19. Voluntary Fasting to Control Post-Ramadan Weight Gain among Overweight and Obese Women

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    Ismail, Suriani; Shamsuddin, Khadijah; Latiff, Khalib A.; Saad, Hazizi A.; Majid, Latifah A.; Othman, Fadlan M.

    2015-01-01

    Objectives: This study aimed to examine the effectiveness of an Islamic voluntary fasting intervention to control post-Ramadan weight gain. Methods: This study was conducted between July and November 2011. Two weight loss intervention programmes were developed and implemented among groups of overweight or obese Malay women living in the Malaysian cities of Putrajaya and Seremban: a standard programme promoting control of food intake according to national dietary guidelines (group B) and a faith-based programme promoting voluntary fasting in addition to the standard programme (group A). Participants’ dietary practices (i.e., voluntary fasting practices, frequency of fruit/vegetable consumption per week and quantity of carbohydrates/protein consumed per day), body mass index (BMI), blood pressure, fasting blood high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC):HDL-C ratio were assessed before Ramadan and three months post-Ramadan. Results: Voluntary fasting practices increased only in group A (P <0.01). Additionally, the quantity of protein/carbohydrates consumed per day, mean diastolic pressure and TC:HDL-C ratio decreased only in group A (P <0.01, 0.05, 0.02 and <0.01, respectively). Frequency of fruit/vegetable consumption per week, as well as HDL-C levels, increased only in group A (P = 0.03 and <0.01, respectively). Although changes in BMI between the groups was not significant (P = 0.08), BMI decrease among participants in group A was significant (P <0.01). Conclusion: Control of post-Ramadan weight gain was more evident in the faith-based intervention group. Healthcare providers should consider faith-based interventions to encourage weight loss during Ramadan and to prevent post-Ramadan weight gain among patients. PMID:25685394

  20. Supporting patients self-managing respiratory health: a qualitative study on the impact of the Breathe Easy voluntary group network.

    Science.gov (United States)

    Hashem, Ferhana; Merritt, Rowena

    2018-01-01

    Self-management strategies are designed to improve lung and respiratory health through structured self-management plans with regular practitioner reviews. Strategies have not, however, focused upon how patient support groups and advocacy networks can help with the management of these conditions; therefore, it is unknown what impact they may have on patient self-management. A qualitative study was designed to help understand what impact the British Lung Foundation's Breathe Easy (BE) groups have on patients managing their lung and respiratory conditions. A semistructured telephone interview schedule was developed to study the network. Topics covered included: perceptions about the BE groups; current referrals systems and integration pathways; benefits of attending the BE groups; and integration of the BE groups into the respiratory pathway. Key themes explored included: shared patient experience and peer support; patient self-management and self-education; attendance of healthcare professionals; and the impact of integrating BE groups into the respiratory pathway. BE networks were shown to support self-care initiatives for people attending the groups, and members expressed a social and educational benefit. BE networks were working with the local National Health Service to become an integral part of the respiratory pathway, yet there was evidence of resistance from the health service in incorporating the networks.

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

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    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 motor and cognitive resources than older nonpractitioners during a fairly complex (dynamic) postural equilibrium task while performing a verbal working memory task. They exhibited lesser cognitive-motor interference

  2. Digital anthropomorphic phantoms of non-rigid human respiratory and voluntary body motion for investigating motion correction in emission imaging

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    Könik, Arda; Connolly, Caitlin M.; Johnson, Karen L.; Dasari, Paul; Segars, Paul W.; Pretorius, P. H.; Lindsay, Clifford; Dey, Joyoni; King, Michael A.

    2014-07-01

    The development of methods for correcting patient motion in emission tomography has been receiving increased attention. Often the performance of these methods is evaluated through simulations using digital anthropomorphic phantoms, such as the commonly used extended cardiac torso (XCAT) phantom, which models both respiratory and cardiac motion based on human studies. However, non-rigid body motion, which is frequently seen in clinical studies, is not present in the standard XCAT phantom. In addition, respiratory motion in the standard phantom is limited to a single generic trend. In this work, to obtain a more realistic representation of motion, we developed a series of individual-specific XCAT phantoms, modeling non-rigid respiratory and non-rigid body motions derived from the magnetic resonance imaging (MRI) acquisitions of volunteers. Acquisitions were performed in the sagittal orientation using the Navigator methodology. Baseline (no motion) acquisitions at end-expiration were obtained at the beginning of each imaging session for each volunteer. For the body motion studies, MRI was again acquired only at end-expiration for five body motion poses (shoulder stretch, shoulder twist, lateral bend, side roll, and axial slide). For the respiratory motion studies, an MRI was acquired during free/regular breathing. The magnetic resonance slices were then retrospectively sorted into 14 amplitude-binned respiratory states, end-expiration, end-inspiration, six intermediary states during inspiration, and six during expiration using the recorded Navigator signal. XCAT phantoms were then generated based on these MRI data by interactive alignment of the organ contours of the XCAT with the MRI slices using a graphical user interface. Thus far we have created five body motion and five respiratory motion XCAT phantoms from the MRI acquisitions of six healthy volunteers (three males and three females). Non-rigid motion exhibited by the volunteers was reflected in both respiratory

  3. Digital anthropomorphic phantoms of non-rigid human respiratory and voluntary body motion for investigating motion correction in emission imaging.

    Science.gov (United States)

    Könik, Arda; Connolly, Caitlin M; Johnson, Karen L; Dasari, Paul; Segars, Paul W; Pretorius, P H; Lindsay, Clifford; Dey, Joyoni; King, Michael A

    2014-07-21

    The development of methods for correcting patient motion in emission tomography has been receiving increased attention. Often the performance of these methods is evaluated through simulations using digital anthropomorphic phantoms, such as the commonly used extended cardiac torso (XCAT) phantom, which models both respiratory and cardiac motion based on human studies. However, non-rigid body motion, which is frequently seen in clinical studies, is not present in the standard XCAT phantom. In addition, respiratory motion in the standard phantom is limited to a single generic trend. In this work, to obtain a more realistic representation of motion, we developed a series of individual-specific XCAT phantoms, modeling non-rigid respiratory and non-rigid body motions derived from the magnetic resonance imaging (MRI) acquisitions of volunteers. Acquisitions were performed in the sagittal orientation using the Navigator methodology. Baseline (no motion) acquisitions at end-expiration were obtained at the beginning of each imaging session for each volunteer. For the body motion studies, MRI was again acquired only at end-expiration for five body motion poses (shoulder stretch, shoulder twist, lateral bend, side roll, and axial slide). For the respiratory motion studies, an MRI was acquired during free/regular breathing. The magnetic resonance slices were then retrospectively sorted into 14 amplitude-binned respiratory states, end-expiration, end-inspiration, six intermediary states during inspiration, and six during expiration using the recorded Navigator signal. XCAT phantoms were then generated based on these MRI data by interactive alignment of the organ contours of the XCAT with the MRI slices using a graphical user interface. Thus far we have created five body motion and five respiratory motion XCAT phantoms from the MRI acquisitions of six healthy volunteers (three males and three females). Non-rigid motion exhibited by the volunteers was reflected in both respiratory

  4. Interactions between voluntary head control and neck proprioceptive reflexes in cervical dystonia.

    Science.gov (United States)

    Anastasopoulos, Dimitri; Maurer, Christoph; Mergner, Thomas

    2014-11-01

    To investigate deficiencies in mechanisms of sensorimotor processing and reflexive-voluntary interactions leading to the impaired head position control in primary cervical dystonia. Thirteen patients and 23 healthy controls were subjected to transient, low amplitude, low velocity head-on-trunk, trunk-under-head and whole-body rotations in the horizontal plane. With the instruction not to resist the imposed displacements, resistance to horizontal neck deflections was evaluated. Patients exhibited a torque offset (bias) in the direction of torticollis before stimulus application. While controls reduced and occasionally eliminated completely the initial resistance to head-to-trunk rotations, torque in patients increased throughout displacements. Change of resistance relative to baseline in patients was, however, symmetrical, i.e. independent of torticollis direction. Spontaneous torque fluctuations were significantly larger in patients. Strong correlations existed among these abnormal findings. Patients' ability to manipulate normal postural reactions to head-trunk rotations is impaired. The deficit is bilateral and correlates with the degree of abnormal posture. The present study extends previous work on reflexive-voluntary interactions and provides evidence that malfunctioning proprioceptive feedback may contribute to the pathophysiology of cervical dystonia. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Predictors of Nursing Staff Voluntary Termination in Nursing Homes: A Case-Control Study.

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    Zhang, Yuan; Punnett, Laura; Gore, Rebecca

    2017-08-01

    Workforce instability in the long-term care sector has raised wide attention about nursing staff turnover. Most attention has been devoted to understanding the relationship between facility's characteristics and organizational turnover. This case-control study examined the contribution of work characteristics to individual staff turnover. Surveys were collected with nursing staff in 18 for-profit nursing homes on up to five occasions between 2006 and 2012. A list of nursing staff voluntarily terminating jobs was provided by the company. Cases and controls (628 of each) were selected from survey respondents by matching on age, job category, and survey occasion. Multiple predictor conditional logistic regression models showed that evening shift work (hazards ratio [HR] = 2.00, p 8 hr (HR = 1.42, p < .05) were contributing factors to voluntary termination. This study provides different perspectives of nursing staff voluntary termination in nursing homes. Future qualitative research would be valuable to explore and understand nursing staff turnover in the health care industry.

  6. Case reports: the influence of selective voluntary motor control on gait after hamstring lengthening surgery.

    Science.gov (United States)

    Goldberg, Evan J; Fowler, Eileen G; Oppenheim, William L

    2012-05-01

    Preliminary evidence suggests selective voluntary motor control (SVMC), defined as performance of isolated voluntary joint movement on request, may be an important factor affecting functional movement tasks. Individuals with poor SVMC are unable to dissociate hip and knee synergistic movement during the swing phase of gait and have difficulty extending their knee while the hip is flexing during terminal swing regardless of hamstring length. This pattern may limit their ability to take advantage of hamstring-lengthening surgery (HLS) and may explain a lack of improved stride length postoperatively. Provide a preliminary clinical and conceptual framework for using SVMC to predict swing phase parameters of gait after HLS. We contrasted two patients with spastic diplegia of similar age, gross motor function, and spasticity but with different SVMC scores using the Selective Control Assessment of the Lower Extremity (SCALE). The patients underwent bilateral HLS. Popliteal angles, joint kinematics, step length, stride length, and walking velocity were assessed pre- and postoperatively. Popliteal angles, terminal knee extension, and knee range of motion improved for both patients. However, only the patient with higher SCALE scores improved stride length postoperatively. Although preliminary, the data suggest that SVMC, as measured by SCALE, may be a prognostic factor for improved stride length after HLS in patients with spastic diplegia. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

  7. Respiratory

    Science.gov (United States)

    The words "respiratory" and "respiration" refer to the lungs and breathing. ... Boron WF. Organization of the respiratory system. In: Boron WF, Boulpaep EL, eds. Medical Physiology . 3rd ed. Philadelphia, PA: Elsevier; 2017:chap 26.

  8. Computerized system to improve voluntary control of balance in neurological patients.

    Science.gov (United States)

    Cattaneo, D; Cardini, R

    2001-12-01

    The treatment of acquired impairments of balance is one of the most elusive problems that rehabilitative medicine faces. Computerized systems to measure how patients control their balance in static conditions were introduced long ago into clinical practice and proved to be useful; we have designed and developed a computerized system called "BioGP," which combines features of a classic stabilometric platform with those of a retraining device based on visual feedback The aim of this study was to identify homogeneous groups of patients and to provide objective proof of effectiveness for the rehabilitation of patients with balance disorders. The findings confirm that the new equipment provides clinically valid and sensitive information concerning subjects' ability to control voluntary shifts of center of pressure (COP) while standing. The information is relevant to applications using basically the same approach (1) and are encouraging for possible use of the system as a rehabilitation instrument.

  9. Impaired voluntary quadriceps force control following anterior cruciate ligament reconstruction: relationship with knee function.

    Science.gov (United States)

    Perraton, Luke; Clark, Ross; Crossley, Kay; Pua, Yong-Hao; Whitehead, Tim; Morris, Hayden; Telianidis, Stacey; Bryant, Adam

    2017-05-01

    Impairments in quadriceps force control and altered quadriceps and hamstring muscle activation strategies have been observed following anterior cruciate ligament reconstruction; however, the functional implications of these impairments are unclear. This study examined the cross-sectional associations between quadriceps force control, quadriceps activation, hamstring coactivation and clinically assessed knee function following anterior cruciate ligament reconstruction with a hamstring graft. Sixty-six patients (18 ± 3 months following surgery) and 41 uninjured individuals participated. Quadriceps force control was assessed using an isometric knee extension task. Participants cyclically increased and decreased quadriceps force at slow speeds between 5 and 30 % maximum voluntary isometric contraction matching a moving target displayed on a screen. Quadriceps activation and hamstring coactivation were assessed concurrently using surface electromyography. Knee function was assessed with the Cincinnati Knee Rating Scale and three single-leg hop tests. The reconstructed group completed the task with 48 % greater root-mean-square error (RMSE), indicating significantly worse quadriceps force control (p anterior cruciate ligament reconstruction and may contribute to irregular knee joint loading and the onset or progression of knee osteoarthritis. Impairments in quadriceps force control and altered muscle activation strategies may be modifiable through neuromuscular training, and this is an area for future research. Case-control study, Level III.

  10. Computerized assessment of voluntary control in the shift of the center of pressure: a pilot study.

    Science.gov (United States)

    Davide, C; Roldano, C; Pierpaolo, M; Giorgio, S

    2000-01-01

    The aim of the study was to test a new stabilometric platform (BioGP) designed to provide visual feedback to patients with balance disorders performing sustained voluntary shifts of their center of pressure (COP). Twenty-five outpatients with mild to moderate impairments of balance due to multiple sclerosis (MS) and 23 healthy subjects volunteered for the study. Patients' control of balance in static conditions was first rated on the Ataxia Battery and the Motricity Index; all subjects were then asked to stand on the platform in front of a large screen and try to move a visual target representing the momentary position of their COP along two vertical paths and one horizontal paths by appropriate movements of their hips and ankles along the lateral and antero-posterior planes. To assess the validity of BioGP, clinical scores of static balance were correlated with measures of speed and accuracy on the platform tasks. To assess the sensitivity of the equipment to poor balance control, patients' measures were compared with those of healthy subjects. Pearson's correlation coefficients between the Ataxia Battery scores and BioGP data ranged between -0.4 and - 0.82. As a group, patients performed statistically worse than controls on most BioGP measures. The graphic output of BioGP also contributed to define the dynamic relations between momentary COP position and balance control. These preliminary findings suggest a possible use of the system as both an evaluation and rehabilitation instrument.

  11. A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure

    OpenAIRE

    Guldager, Henrik; Nielsen, Soeren L; Carl, Peder; Soerensen, Mogens B

    1997-01-01

    Background: The aim of this study was to test the hypothesis that a new mode of ventilation (pressure-regulated volume control; PRVC) is associated with improvements in respiratory mechanics and outcome when compared with conventional volume control (VC) ventilation in patients with acute respiratory failure. We conducted a randomised, prospective, open, cross over trial on 44 patients with acute respiratory failure in the general intensive care unit of a university hospital. After a stabiliz...

  12. Comparison of activity and fatigue of the respiratory muscles and pulmonary characteristics between post-polio patients and controls: A pilot study.

    Science.gov (United States)

    Shoseyov, David; Cohen-Kaufman, Tali; Schwartz, Isabella; Portnoy, Sigal

    2017-01-01

    To compare pulmonary function measures, maximal respiratory pressure and fatigue of respiratory muscles between patients with Post-Polio Syndrome (PPS) and controls. Cross-sectional study. Patients with PPS (N = 12; age 62.1±11.6 years) able to walk for 6 minutes without human assistance; age-matched controls with no history of polio or pulmonary dysfunction (N = 12; age 62.2±6.5 years). A body plethysmograph was used to quantify Residual Volume (RV), Total Lung Capacity (TLC), and Thoracic Gas Volume (TGV) etc. A manometer was used to measure Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure. A spirometer was used to measure Maximal Voluntary Ventilation (MVV). Surface electromyography (sEMG) recorded diaphragmatic muscle activity while performing MVV. The control group had significantly higher TGV and showed improvement in MIP following the effort (difference of 5.5±4.0cmH2O) while the PPS group showed deterioration in MIP (difference of -2.5±5.0cmH2O). Subjects with scoliosis had significantly higher RV/TLC values compared with subjects without scoliosis. The 25th frequency percentile of the sEMG signal acquired during MVV was reduced in the PPS group. Maximal respiratory pressure test and sEMG measurements may identify fatigue of respiratory muscles in patients with PPS. Early diagnosis of respiratory impairment may delay respiratory decline and future need of invasive respiratory aids.

  13. Voluntary respiratory control and cerebral blood flow velocity upon ice-water immersion

    DEFF Research Database (Denmark)

    Mantoni, Teit; Rasmussen, Jakob Højlund; Belhage, Bo

    2008-01-01

    In non-habituated subjects, cold-shock response to cold-water immersion causes rapid reduction in cerebral blood flow velocity (approximately 50%) due to hyperventilation, increasing risk of syncope, aspiration, and drowning. Adaptation to the response is possible, but requires several cold immer...

  14. Voluntary respiratory control and cerebral blood flow velocity upon ice-water immersion

    DEFF Research Database (Denmark)

    Mantoni, Teit; Rasmussen, Jakob Højlund; Belhage, Bo

    2008-01-01

    INTRODUCTION: In non-habituated subjects, cold-shock response to cold-water immersion causes rapid reduction in cerebral blood flow velocity (approximately 50%) due to hyperventilation, increasing risk of syncope, aspiration, and drowning. Adaptation to the response is possible, but requires seve...

  15. Control of voluntary intake of precision-chopped silages by ruminants: a review.

    Science.gov (United States)

    Dulphy, J P; Van Os, M

    1996-01-01

    The aim of this review is to provide a better understanding of the ways in which ruminants control their voluntary intake of finely-chopped silages. Silages with an excellent conservation quality can be ingested at similar levels to the corresponding fresh or dry forages. Intake levels decrease when conservation quality decreases. The implicated physiological mechanisms for this phenomenon are discussed in this review. Poorly preserved silages may have low palatibility, decreasing the animal's motivation to ingest. At the ruminal level, the physical control of intake is generally not involved. On the other hand the fermentation products present in silage seem to induce a high and rapid level of satiation, out of proportion to their relatively low quantity. At the metabolical level some limiting factors may also exist (eg, a poor balance between amino acids and energy, and high levels of acids to be metabolized). Fermentation products induce most of the observed reactions. For well-preserved silages, high quantities of lactic and acetic acids limit intake. Their effects seem to be additive, which explains the observation that low pH often has a negative action. The negative effect of moisture is generally strengthened by that of the acids. For poorly-preserved silages, products of protein decomposition must be considered in addition to volatile fatty acids. The effect of N-compounds is less clearly explained than that of acids. For example, ammonia alone generally seems to have no direct effect. However it is clear that N-compounds taken together have a negative effect on appetite. It can be concluded that the negative effects of poor quality silages are multifactorial; each fermentation product alone has a low effect, but the sum of all the components must be considered. Moreover, it is apparent that some physiological mechanisms are used to control silage intake, which explains the complexity of the studies on this subject.

  16. Dynamic subcellular localization of a respiratory complex controls bacterial respiration.

    Science.gov (United States)

    Alberge, François; Espinosa, Leon; Seduk, Farida; Sylvi, Léa; Toci, René; Walburger, Anne; Magalon, Axel

    2015-06-16

    Respiration, an essential process for most organisms, has to optimally respond to changes in the metabolic demand or the environmental conditions. The branched character of their respiratory chains allows bacteria to do so by providing a great metabolic and regulatory flexibility. Here, we show that the native localization of the nitrate reductase, a major respiratory complex under anaerobiosis in Escherichia coli, is submitted to tight spatiotemporal regulation in response to metabolic conditions via a mechanism using the transmembrane proton gradient as a cue for polar localization. These dynamics are critical for controlling the activity of nitrate reductase, as the formation of polar assemblies potentiates the electron flux through the complex. Thus, dynamic subcellular localization emerges as a critical factor in the control of respiration in bacteria.

  17. 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 muscle mass. The aim of the present study was to investigate VA of the trapezius muscle during MVCs in subjects with and without neck/shoulder pain by use of the twitch interpolation technique. Ten cases suffering from pain and ten age and gender matched, healthy controls were included in the study....... Upper trapezius muscle thickness was measured using ultrasonography and pain intensity was measured on a 100mm visual analog scale (VAS). VA was calculated from five maximal muscle activation attempts. Superimposed stimuli were delivered to the accessory nerve at peak force and during a 2% MVC following...

  18. Vena Cava Responsiveness to Controlled Isovolumetric Respiratory Efforts.

    Science.gov (United States)

    Folino, Anna; Benzo, Marco; Pasquero, Paolo; Laguzzi, Andrea; Mesin, Luca; Messere, Alessandro; Porta, Massimo; Roatta, Silvestro

    2017-10-01

    Respirophasic variation of inferior vena cava (IVC) size is affected by large variability with spontaneous breathing. This study aims at characterizing the dependence of IVC size on controlled changes in intrathoracic pressure. Ten healthy subjects, in supine position, performed controlled isovolumetric respiratory efforts at functional residual capacity, attaining positive (5, 10, and 15 mmHg) and negative (-5, -10, and -15 mmHg) alveolar pressure levels. The isovolumetric constraint implies that equivalent changes are exhibited by alveolar and intrathoracic pressures during respiratory tasks. The IVC cross-sectional area equal to 2.88 ± 0.43 cm 2 at baseline (alveolar pressure = 0 mmHg) was progressively decreased by both expiratory and inspiratory efforts of increasing strength, with diaphragmatic efforts producing larger effects than thoracic ones: -55 ± 15% decrease, at +15 mmHg of alveolar pressure (P < .01), -80 ± 33 ± 12% at -15 mmHg diaphragmatic (P < .01), -33 ± 12% at -15 mmHg thoracic. Significant IVC changes in size (P < .01) and pulsatility (P < .05), along with non significant reduction in the response to respiratory efforts, were also observed during the first 30 minutes of supine rest, detecting an increase in vascular filling, and taking place after switching from the standing to the supine position. This study quantified the dependence of the IVC cross-sectional area on controlled intrathoracic pressure changes and evidenced the stronger influence of diaphragmatic over thoracic activity. Individual variability in thoracic/diaphragmatic respiratory pattern should be considered in the interpretation of the respirophasic modulations of IVC size. © 2017 by the American Institute of Ultrasound in Medicine.

  19. Bayesian estimation of prevalence of paratuberculosis in dairy herds enrolled in a voluntary Johne's Disease Control Programme in Ireland.

    Science.gov (United States)

    McAloon, Conor G; Doherty, Michael L; Whyte, Paul; O'Grady, Luke; More, Simon J; Messam, Locksley L McV; Good, Margaret; Mullowney, Peter; Strain, Sam; Green, Martin J

    2016-06-01

    Bovine paratuberculosis is a disease characterised by chronic granulomatous enteritis which manifests clinically as a protein-losing enteropathy causing diarrhoea, hypoproteinaemia, emaciation and, eventually death. Some evidence exists to suggest a possible zoonotic link and a national voluntary Johne's Disease Control Programme was initiated by Animal Health Ireland in 2013. The objective of this study was to estimate herd-level true prevalence (HTP) and animal-level true prevalence (ATP) of paratuberculosis in Irish herds enrolled in the national voluntary JD control programme during 2013-14. Two datasets were used in this study. The first dataset had been collected in Ireland during 2005 (5822 animals from 119 herds), and was used to construct model priors. Model priors were updated with a primary (2013-14) dataset which included test records from 99,101 animals in 1039 dairy herds and was generated as part of the national voluntary JD control programme. The posterior estimate of HTP from the final Bayesian model was 0.23-0.34 with a 95% probability. Across all herds, the median ATP was found to be 0.032 (0.009, 0.145). This study represents the first use of Bayesian methodology to estimate the prevalence of paratuberculosis in Irish dairy herds. The HTP estimate was higher than previous Irish estimates but still lower than estimates from other major dairy producing countries. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Respiratory protective device design using control system techniques

    Science.gov (United States)

    Burgess, W. A.; Yankovich, D.

    1972-01-01

    The feasibility of a control system analysis approach to provide a design base for respiratory protective devices is considered. A system design approach requires that all functions and components of the system be mathematically identified in a model of the RPD. The mathematical notations describe the operation of the components as closely as possible. The individual component mathematical descriptions are then combined to describe the complete RPD. Finally, analysis of the mathematical notation by control system theory is used to derive compensating component values that force the system to operate in a stable and predictable manner.

  1. Transmission Dynamics and Control of Severe Acute Respiratory Syndrome

    Science.gov (United States)

    Lipsitch, Marc; Cohen, Ted; Cooper, Ben; Robins, James M.; Ma, Stefan; James, Lyn; Gopalakrishna, Gowri; Chew, Suok Kai; Tan, Chorh Chuan; Samore, Matthew H.; Fisman, David; Murray, Megan

    2003-06-01

    Severe acute respiratory syndrome (SARS) is a recently described illness of humans that has spread widely over the past 6 months. With the use of detailed epidemiologic data from Singapore and epidemic curves from other settings, we estimated the reproductive number for SARS in the absence of interventions and in the presence of control efforts. We estimate that a single infectious case of SARS will infect about three secondary cases in a population that has not yet instituted control measures. Public-health efforts to reduce transmission are expected to have a substantial impact on reducing the size of the epidemic.

  2. 75 FR 64951 - Approval and Promulgation of Implementation Plans; Illinois; Voluntary Nitrogen Oxides Controls

    Science.gov (United States)

    2010-10-21

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Implementation Plans; Illinois; Voluntary Nitrogen... of a State Implementation Plan (SIP) revision for regulations governing Nitrogen Oxides (NO X... Protection Agency, Region 5, Air and Radiation Division, 77 West Jackson Boulevard, Chicago, Illinois 60604...

  3. EEG activations during intentional inhibition of voluntary action: An electrophysiological correlate of self-control?

    NARCIS (Netherlands)

    Walsh, E.; Kühn, S.; Brass, M.; Wenke, D.; Haggard, P.

    2010-01-01

    An important aspect of volition is the internal decision whether to act or to withhold an action. We used EEG frequency analysis of sensorimotor rhythms to investigate brain activity when people prepare and then cancel a voluntary action. Participants used a rotating clock-hand to report when they

  4. Reaching with the sixth sense: Vestibular contributions to voluntary motor control in the human right parietal cortex.

    Science.gov (United States)

    Reichenbach, Alexandra; Bresciani, Jean-Pierre; Bülthoff, Heinrich H; Thielscher, Axel

    2016-01-01

    The vestibular system constitutes the silent sixth sense: It automatically triggers a variety of vital reflexes to maintain postural and visual stability. Beyond their role in reflexive behavior, vestibular afferents contribute to several perceptual and cognitive functions and also support voluntary control of movements by complementing the other senses to accomplish the movement goal. Investigations into the neural correlates of vestibular contribution to voluntary action in humans are challenging and have progressed far less than research on corresponding visual and proprioceptive involvement. Here, we demonstrate for the first time with event-related TMS that the posterior part of the right medial intraparietal sulcus processes vestibular signals during a goal-directed reaching task with the dominant right hand. This finding suggests a qualitative difference between the processing of vestibular vs. visual and proprioceptive signals for controlling voluntary movements, which are pre-dominantly processed in the left posterior parietal cortex. Furthermore, this study reveals a neural pathway for vestibular input that might be distinct from the processing for reflexive or cognitive functions, and opens a window into their investigation in humans. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  5. Discrimination and recognition of facial expressions of emotion and their links with voluntary control of facial musculature in Parkinson's disease.

    Science.gov (United States)

    Marneweck, Michelle; Palermo, Romina; Hammond, Geoff

    2014-11-01

    To explore perception of facial expressions of emotion and its link with voluntary facial musculature control in Parkinson's disease (PD). We investigated in 2 sets of experiments in PD patients and healthy controls the perceptual ability to discriminate (a) graded intensities of emotional from neutral expressions, (b) graded intensities of the same emotional expressions, (c) full-blown discrepant emotional expressions from 2 similar expressions and the more complex recognition ability to label full-blown emotional expressions. We tested an embodied simulationist account of emotion perception in PD, which predicts a link between the ability to perceive emotional expressions and facial musculature control. We also explored the contribution of the ability to extract facial information (besides emotion) to emotion perception in PD. Those with PD were, as a group, impaired relative to controls (with large effect sizes) in all measures of discrimination and recognition of emotional expressions, although some patients performed as well as the best performing controls. In support of embodied simulation, discrimination and recognition of emotional expressions correlated positively with voluntary control of facial musculature (after partialing out disease severity and age). Patients were also impaired at extracting information other than emotion from faces, specifically discriminating and recognizing identity from faces (with large effect sizes); identity discrimination correlated positively with emotion discrimination and recognition but not with voluntary facial musculature control (after partialing out disease severity and age). The results indicate that impaired sensory and sensorimotor processes, which are a function of disease severity, affect emotion perception in PD. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  6. Respiratory source control versus receiver protection: impact of facemask fit.

    Science.gov (United States)

    Mansour, Mohamed Mohsen; Smaldone, Gerald C

    2013-06-01

    Placing a surgical mask on an infected patient (respiratory source control) may offer a health-care worker (HCW) more protection than donning an N95 respirator (receiver protection). This observation was made in an in vitro study that used hard, nondeformable faces, and the lack of proper N95 fit may have accounted for the observed results. In the present study, we test the effects of fit on respiratory source control protection, using a soft, deformable mannequin head. Resusci Anne CPR mannequin heads were placed in a chamber allowing 6 air exchanges/hr (14 cubic feet per minute), to simulate an infected patient (source) and an HCW (receiver). The heads were ventilated with a tidal breathing pattern. The source exhaled radioactive aerosols, and a filter was attached to the receiver to quantify inhaled exposure. N95 respirators and surgical masks were tested on both heads. The degree of protection was expressed by calculating the reduction in exposure expressed as a simulated workplace protection factor (sWPF; the ratio of exposure with mask to exposure without mask) compared statistically using confidence intervals. Use of the Resusci Anne heads resulted in improved fit, with higher sWPF than previously reported, for example, for source N95 mask combinations (7,174 vs. 317) as well as receiver (7.53 vs. 1.37). Masks placed on the receiver provided minimal exposure protection (sWPF range 0.99-7.53), except when sealed with Vaseline (sWPF 63.1). Any mask applied to the source mannequin resulted in significant reductions in exposure (sWPF range 214-17,038). Improved fit significantly enhanced the effects of source control protection. A Vaseline-sealed N95 respirator on the receiver offered less protection when compared with any mask on the source. Respiratory source control can offer more protection to HCW and potentially decrease the spread of aerosolized infections.

  7. Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial.

    NARCIS (Netherlands)

    Aardweg, M.T. van den; Boonacker, C.W.; Rovers, M.M.; Hoes, A.W.; Schilder, A.G.M.

    2011-01-01

    OBJECTIVE: To assess the effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections. DESIGN: Open randomised controlled trial. SETTING: 11 general hospitals and two academic centres. PARTICIPANTS: 111 children aged 1-6 with recurrent upper respiratory tract

  8. Plasticity in respiratory motor neurons in response to reduced synaptic inputs: A form of homeostatic plasticity in respiratory control?

    Science.gov (United States)

    Braegelmann, K M; Streeter, K A; Fields, D P; Baker, T L

    2017-01-01

    For most individuals, the respiratory control system produces a remarkably stable and coordinated motor output-recognizable as a breath-from birth until death. Very little is understood regarding the processes by which the respiratory control system maintains network stability in the presence of changing physiological demands and network properties that occur throughout life. An emerging principle of neuroscience is that neural activity is sensed and adjusted locally to assure that neurons continue to operate in an optimal range, yet to date, it is unknown whether such homeostatic plasticity is a feature of the neurons controlling breathing. Here, we review the evidence that local mechanisms sense and respond to perturbations in respiratory neural activity, with a focus on plasticity in respiratory motor neurons. We discuss whether these forms of plasticity represent homeostatic plasticity in respiratory control. We present new analyses demonstrating that reductions in synaptic inputs to phrenic motor neurons elicit a compensatory enhancement of phrenic inspiratory motor output, a form of plasticity termed inactivity-induced phrenic motor facilitation (iPMF), that is proportional to the magnitude of activity deprivation. Although the physiological role of iPMF is not understood, we hypothesize that it has an important role in protecting the drive to breathe during conditions of prolonged or intermittent reductions in respiratory neural activity, such as following spinal cord injury or during central sleep apnea. Copyright © 2016. Published by Elsevier Inc.

  9. Respiratory and Cardiovascular Response during Electronic Control Device Exposure in Law Enforcement Trainees

    Science.gov (United States)

    VanMeenen, Kirsten M.; Lavietes, Marc H.; Cherniack, Neil S.; Bergen, Michael T.; Teichman, Ronald; Servatius, Richard J.

    2013-01-01

    Objective: Law enforcement represents a large population of workers who may be exposed to electronic control devices (ECDs). Little is known about the potential effect of exposure to these devices on respiration or cardiovascular response during current discharge. Methods: Participants (N = 23) were trainees exposed to 5 s of an ECD (Taser X26®) as a component of training. Trainees were asked to volitionally inhale during exposure. Respiratory recordings involved a continuous waveform recorded throughout the session including during the exposure period. Heart rate was calculated from a continuous pulse oximetry recording. Results: The exposure period resulted in the cessation of normal breathing patterns in all participants and in particular a decrease in inspiratory activity. No significant changes in heart rate during ECD exposure were found. Conclusion: This is the first study to examine breathing patterns during ECD exposure with the resolution to detect changes over this discrete period of time. In contrast to reports suggesting respiration is unaffected by ECDs, present evidence suggests that voluntary inspiration is severely compromised. There is no evidence of cardiac disruption during ECD exposure. PMID:23616772

  10. Respiratory and cardiovascular response during electronic control device (ECD exposure in law enforcement trainees

    Directory of Open Access Journals (Sweden)

    Kirsten M. VanMeenen

    2013-04-01

    Full Text Available Objective: Law enforcement represents a large population of workers who may be exposed to electronic control devices (ECDs. Little is known about the potential effect of exposure to these devices on respiration or cardiovascular response during current discharge. Methods: Participants (N=23 were trainees exposed to 5 seconds of an ECD (Taser X26® as a component of training. Trainees were asked to volitionally inhale during exposure. Respiratory recordings involved a continuous waveform recorded throughout the session including during the exposure period. Heart rate was calculated from a continuous pulse oximetry recording. Results: The exposure period resulted in the cessation of normal breathing patterns in all participants and in particular a decrease in inspiratory activity. No significant changes in heart rate during ECD exposure were found. Conclusions: This is the first study to examine breathing patterns during ECD exposure with the resolution to detect changes over this discrete period of time. In contrast to reports suggesting respiration is unaffected by ECDs, present evidence suggests that voluntary inspiration is severely compromised. There is no evidence of cardiac disruption during ECD exposure.

  11. Stability of equilibrium in upright stance and voluntary motion control in athletes-shooters in the process of ready position and target shooting

    OpenAIRE

    A.A. Pryimakov; E. Eider; E.V. Omelchuk

    2015-01-01

    Purpose: consists in studying the relationships between the system of equilibrium regulation in upright stance and voluntary motion control in athletes-shooters during ready position and target shooting. Material: 19 highly skilled athletes specialized in pistol shooting were studied. Physiological and biomechanical characteristics of posture and voluntary motions were assessed by methods of stabilography, electromyography and tremorometry; besides, accuracy of target shooting was registered....

  12. Rethinking volitional control over task choice in multitask environments: use of a stimulus set selection strategy in voluntary task switching.

    Science.gov (United States)

    Arrington, Catherine M; Weaver, Starla M

    2015-01-01

    Under conditions of volitional control in multitask environments, subjects may engage in a variety of strategies to guide task selection. The current research examines whether subjects may sometimes use a top-down control strategy of selecting a task-irrelevant stimulus dimension, such as location, to guide task selection. We term this approach a stimulus set selection strategy. Using a voluntary task switching procedure, subjects voluntarily switched between categorizing letter and number stimuli that appeared in two, four, or eight possible target locations. Effects of stimulus availability, manipulated by varying the stimulus onset asynchrony between the two target stimuli, and location repetition were analysed to assess the use of a stimulus set selection strategy. Considered across position condition, Experiment 1 showed effects of both stimulus availability and location repetition on task choice suggesting that only in the 2-position condition, where selection based on location always results in a target at the selected location, subjects may have been using a stimulus set selection strategy on some trials. Experiment 2 replicated and extended these findings in a visually more cluttered environment. These results indicate that, contrary to current models of task selection in voluntary task switching, the top-down control of task selection may occur in the absence of the formation of an intention to perform a particular task.

  13. Visual aided pacing in respiratory maneuvers

    Energy Technology Data Exchange (ETDEWEB)

    Rambaudi, L R [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Rossi, E [Catedra de Bioingenieria II (Argentina); Mantaras, M C [Catedra de Bioingenieria II (Argentina); Perrone, M S [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Siri, L Nicola [Catedra de Bioingenieria II (Argentina)

    2007-11-15

    A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display.

  14. Neuromuscular control of scapula muscles during a voluntary task in subjects with Subacromial Impingement Syndrome

    DEFF Research Database (Denmark)

    Larsen, C M; Søgaard, Karen; Chreiteh, S S

    2013-01-01

    Imbalance of neuromuscular activity in the scapula stabilizers in subjects with Subacromial Impingement Syndrome (SIS) is described in restricted tasks and specific populations. Our aim was to compare the scapular muscle activity during a voluntary movement task in a general population with and w......Imbalance of neuromuscular activity in the scapula stabilizers in subjects with Subacromial Impingement Syndrome (SIS) is described in restricted tasks and specific populations. Our aim was to compare the scapular muscle activity during a voluntary movement task in a general population...... with and without SIS (n=16, No-SIS=15). Surface electromyography was measured from Serratus anterior (SA) and Trapezius during bilateral arm elevation (no-load, 1kg, 3kg). Mean relative muscle activity was calculated for SA and the upper (UT) and lower part of trapezius (LWT), in addition to activation ratio...... and time to activity onset. In spite of a tendency to higher activity among SIS 0.10-0.30 between-group differences were not significant neither in ratio of muscle activation 0.80-0.98 nor time to activity onset 0.53-0.98. The hypothesized between-group differences in neuromuscular activity of Trapezius...

  15. EMG and kinematic analysis of sensorimotor control for patients after stroke using cyclic voluntary movement with visual feedback

    Directory of Open Access Journals (Sweden)

    Song Rong

    2013-02-01

    Full Text Available Abstract Background Clinical scales are often used to evaluate upper-limb deficits. The objective of this study is to investigate the parameters during voluntary arm tracking at different velocities for evaluating motor control performance after stroke. Methods Eight hemiplegic chronic stroke subjects were recruited to perform voluntary movements of elbow flexion and extension by following sinusoidal trajectories from 30 deg to 90 deg at six velocities in the horizontal plane by completing 3, 6, 8, 12, 15, 18 flexion and extension cycles in 36 seconds in a single trial, and the peak velocities ranged from 15.7 to 94.2 deg/s. The actual elbow angle and the target position were displayed as real-time visual feedback. The angular displacement of the arm and electromyographic (EMG signals of biceps and triceps were captured to evaluate the sensorimotor control of the affected and unaffected side. Results The results showed significant differences in the root mean square error (RMSE, response delay (RD and cocontraction index (CI when the affected and unaffected sides were compared during the arm tracking experiment (P Conclusions The method and parameters have potential for clinical use in quantitatively evaluating the sensorimotor deficiencies for patients after stroke about the accuracy of motion, response delay and cocontraction between muscle pairs.

  16. Comparison of activity and fatigue of the respiratory muscles and pulmonary characteristics between post-polio patients and controls: A pilot study.

    Directory of Open Access Journals (Sweden)

    David Shoseyov

    Full Text Available To compare pulmonary function measures, maximal respiratory pressure and fatigue of respiratory muscles between patients with Post-Polio Syndrome (PPS and controls.Cross-sectional study.Patients with PPS (N = 12; age 62.1±11.6 years able to walk for 6 minutes without human assistance; age-matched controls with no history of polio or pulmonary dysfunction (N = 12; age 62.2±6.5 years.A body plethysmograph was used to quantify Residual Volume (RV, Total Lung Capacity (TLC, and Thoracic Gas Volume (TGV etc. A manometer was used to measure Maximal Inspiratory Pressure (MIP and Maximal Expiratory Pressure. A spirometer was used to measure Maximal Voluntary Ventilation (MVV. Surface electromyography (sEMG recorded diaphragmatic muscle activity while performing MVV.The control group had significantly higher TGV and showed improvement in MIP following the effort (difference of 5.5±4.0cmH2O while the PPS group showed deterioration in MIP (difference of -2.5±5.0cmH2O. Subjects with scoliosis had significantly higher RV/TLC values compared with subjects without scoliosis. The 25th frequency percentile of the sEMG signal acquired during MVV was reduced in the PPS group.Maximal respiratory pressure test and sEMG measurements may identify fatigue of respiratory muscles in patients with PPS. Early diagnosis of respiratory impairment may delay respiratory decline and future need of invasive respiratory aids.

  17. A 12-month follow-up of an influenza vaccination campaign based on voluntary adherence: report on upper-respiratory symptoms among volunteers and non-volunteers

    Directory of Open Access Journals (Sweden)

    Páris Ali Ramadan

    Full Text Available CONTEXT: Routine immunization of groups at high risk for influenza has been progressively implemented as a matter of Brazilian public health policy. Although the benefits of the vaccination for healthy young adults are still controversial, it has been offered yearly to hundreds of thousands of Brazilian workers, generally as part of wellness initiatives in the workplace. OBJECTIVE: To study the characteristics of subjects that accepted or refused to be vaccinated against influenza and to report on respiratory symptoms in both groups, one year after the campaign date. DESIGN: A prospective observational study. SETTING: Workers at a subsidiary of an international bank in São Paulo, Brazil. PARTICIPANTS: 124 persons that did not accept and 145 that voluntarily accepted the vaccine completed 12 months of follow-up. MAIN MEASUREMENTS: Data concerning gender, age, tobacco use, and any history of chronic respiratory illness such as asthma, bronchitis, rhinitis, and repetitive upper-respiratory infections, were recorded at the time of vaccination. After that, workers were asked monthly by questionnaire or telephone about respiratory symptoms, days of work lost and medical consultations. RESULTS: The results showed statistically significant differences regarding age (P = 0.004 with the vaccinated group (V being younger than the non-vaccinated (NV one, and with reference to previous repetitive upper-respiratory infections being higher among the V group (P < 0.0001. During the follow-up, the V group reported more occurrences of upper respiratory symptoms (P < 0.0001, due to both non-influenza (P < 0.0001 and influenza-like illness (P = 0.045. Differences were also found between V and NV groups concerning days off work and number of medical consultations due to upper-respiratory symptoms and non-influenza illness. Gender and history of repetitive upper-respiratory infections were the best predictors of influenza-like illness-related events. CONCLUSIONS

  18. 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…

  19. Respiratory modulation and baroreflex control of heart rate in space

    Science.gov (United States)

    Verheyden, Bart; Couckuyt, Kurt; Liu, Jiexin; Aubert, Andre

    During everyday life, gravity constantly stresses the human circulation by diminishing venous return in the upright position. This induces baroreflex-mediated cardiovascular adjustments that are aimed to prevent the blood pressure from falling. In weightlessness, gravitational pressure gradients do not arise in the circulation so that baroreflex function remains chronically unchallenged. This may contribute to the development of post spaceflight orthostatic intolerance. The purpose of this study was to evaluate respiratory modulation and baroreflex control of heart rate after a week of weightlessness in space. We tested the hypothesis that cardiovascular control in space will be similar to the baseline supine condition on Earth. We studied nine male cosmonauts during seven different space missions aboard the ISS (age 40 - 52 yrs, height 1.69 - 1.85 m, weight 67 - 90 kg). Data collection was performed between 30 and 45 days before launch in the standing and supine positions, and after 8 days in space. Cosmonauts were carefully trained to perform in-flight data collection by themselves. They were instructed to pace their breathing to a fixed rate of 12 breaths per minute (0.2 Hz) for a total duration of 3 minutes. The electrocardiogram and beat-by-beat finger arterial blood pressure were recorded at 1-kHz sample rate. Respiratory rate was evaluated using an abdominal pressure sensor. We used power spectral analysis to calculate respiratory sinus arrhythmia (RSA) as well as the low-frequency (0.04 - 0.15 Hz) powers of spontaneous oscillations in heart rate and systolic blood pressure. Baroreflex sensitivity (BRS) was estimated in the time domain using cross-correlation analysis. As expected, there was a rise in heart rate upon assuming the standing position before space- flight (59 ± 6 to 79 ± 11 beats per min; p ¡ 0.001). This was accompanied by an increase in mean arterial blood pressure (84 ± 6 to 93 ± 6 mmHg; p ¡ 0.001). Standing up further induced a marked

  20. Voluntary sterilization in Serbia: Unmet need?

    OpenAIRE

    Rašević Mirjana M.

    2002-01-01

    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 a...

  1. Numerical simulation of volume-controlled mechanical ventilated respiratory system with 2 different lungs.

    Science.gov (United States)

    Shi, Yan; Zhang, Bolun; Cai, Maolin; Zhang, Xiaohua Douglas

    2017-09-01

    Mechanical ventilation is a key therapy for patients who cannot breathe adequately by themselves, and dynamics of mechanical ventilation system is of great significance for life support of patients. Recently, models of mechanical ventilated respiratory system with 1 lung are used to simulate the respiratory system of patients. However, humans have 2 lungs. When the respiratory characteristics of 2 lungs are different, a single-lung model cannot reflect real respiratory system. In this paper, to illustrate dynamic characteristics of mechanical ventilated respiratory system with 2 different lungs, we propose a mathematical model of mechanical ventilated respiratory system with 2 different lungs and conduct experiments to verify the model. Furthermore, we study the dynamics of mechanical ventilated respiratory system with 2 different lungs. This research study can be used for improving the efficiency and safety of volume-controlled mechanical ventilation system. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Human Control Law and Brain Activity of Voluntary Motion by Utilizing a Balancing Task with an Inverted Pendulum

    Directory of Open Access Journals (Sweden)

    Satoshi Suzuki

    2010-01-01

    Full Text Available Human characteristics concerning voluntary motion control are investigated, because this motion is fundamental for the machine operation and human-computer system. Using a force feedback haptic device and a balancing task of a virtual inverted pendulum, participants were trained in the task, and hand motion/force was measured, and brain activity was monitored. First, through brain analysis by near-infrared spectroscopy (NIRS and motion analysis of the pendulum, we identified a participant who was the most expert. Next, control characteristics of the most expert were investigated by considering the operational force and delay factor of a human. As a result, it was found that predictive control based on velocity information was used predominantly although a perception feedback control against the pendulum posture worked. And it was shown that an on-off intermittency control, which was a strategy for the skilled balancing, can be described well by a liner model involving two types of time shifts for the position and velocity. In addition, it was confirmed that the cortex activity for observation in an ocular motor control area and visual processing area was strong to enhance above-mentioned control strategies.

  3. Should Controls With Respiratory Symptoms Be Excluded From Case-Control Studies of Pneumonia Etiology? Reflections From the PERCH Study.

    Science.gov (United States)

    Higdon, Melissa M; Hammitt, Laura L; Deloria Knoll, Maria; Baggett, Henry C; Brooks, W Abdullah; Howie, Stephen R C; Kotloff, Karen L; Levine, Orin S; Madhi, Shabir A; Murdoch, David R; Scott, J Anthony G; Thea, Donald M; Driscoll, Amanda J; Karron, Ruth A; Park, Daniel E; Prosperi, Christine; Zeger, Scott L; O'Brien, Katherine L; Feikin, Daniel R

    2017-06-15

    Many pneumonia etiology case-control studies exclude controls with respiratory illness from enrollment or analyses. Herein we argue that selecting controls regardless of respiratory symptoms provides the least biased estimates of pneumonia etiology. We review 3 reasons investigators may choose to exclude controls with respiratory symptoms in light of epidemiologic principles of control selection and present data from the Pneumonia Etiology Research for Child Health (PERCH) study where relevant to assess their validity. We conclude that exclusion of controls with respiratory symptoms will result in biased estimates of etiology. Randomly selected community controls, with or without respiratory symptoms, as long as they do not meet the criteria for case-defining pneumonia, are most representative of the general population from which cases arose and the least subject to selection bias. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  4. Relation of selective voluntary motor control of the lower extremity and extensor strength of the knee joint in children with spastic diplegia.

    Science.gov (United States)

    Kusumoto, Yasuaki; Takaki, Kenji; Matsuda, Tadamitsu; Nitta, Osamu

    2016-06-01

    [Purpose] The aim of this study was to investigate differences in selective voluntary motor control of the lower extremities by objective assessment and determine the relationship between selective voluntary motor control and knee extensor strength in children with spastic diplegia. [Subjects and Methods] Forty individuals who had spastic cerebral palsy, with Gross Motor Function Classification System levels ranging from I to III, were assessed using the Selective Control Assessment of the Lower Extremity and by testing the maximum knee extensor strength. The unaffected side was defined as the lower limb with the higher score, and the affected side was defined as the lower limb with the lower score. [Results] The Selective Control Assessment of the Lower Extremity score on the affected side had a lower average than that on the unaffected side. The scores showed a significant inverse correlation with the maximum knee extensor strength. [Conclusion] There was bilateral difference in the selective voluntary motor control of the lower extremities in children with spastic diplegia, and the selective voluntary motor control of the lower extremity was related to maximum knee extensor strength.

  5. Voluntary acceptance and consumption of two oral ciclosporin formulations in dogs: two randomised, controlled studies.

    Science.gov (United States)

    Navarro, Christelle; Crastes, Nolwenn; Benizeau, Elodie; McGahie, David

    2015-01-01

    Atopic dermatitis (AD) is the most common canine allergic skin disease and can significantly affect the quality of life of affected dogs. Treating canine AD with ciclosporin has been a subject of great interest in recent years. Many studies have provided substantial evidence of ciclosporin efficacy and safety in canine AD management, and for several years ciclosporin has been recognised as a major component of canine AD multimodal therapy. As a chronic condition, canine AD requires life-long medical management and treatment success relies in large part on product ease of administration. Two studies were conducted to assess the comparative voluntary acceptance and consumption of Cyclavance® (Virbac), a new oral liquid formulation of ciclosporin, and Atopica® (Novartis) either added to a small quantity of kibbles (study 1) or administered directly into the dog's mouth (study 2). Over the course of the two studies 70 dogs assessed each of the ciclosporin formulations and 320 individual tests were performed for each tested product. Immediate prehension (in less than 2 seconds) occurred significantly more often with Cyclavance® (90.6% of the tests) than with Atopica® (14.4% of the tests) when products were mixed with 30 grams of dry food (p Atopica® (99.3% vs 27.1% of the tests, respectively) when products were administered directly into the dogs' mouth (p Atopica® (2.2% of the tests) when mixed with a small amount of food (p < 0.001). However, both products were totally consumed once administered directly into the dogs' mouth. By facilitating cicloporin administration and consumption, Cyclavance® liquid formulation offers an interesting alternative to capsules that may improve dosing compliance and therefore the ability to benefit from the therapeutic effects in the long-term treatment of canine AD.

  6. Control of voluntary feed intake in fish: a role for dietary oxygen demand in Nile tilapia (Oreochromis niloticus) fed diets with different macronutrient profiles

    NARCIS (Netherlands)

    Subramanian, S.; Geurden, I.; Figueiredo-Silva, A.C.; Kaushik, S.J.; Haidar, M.N.; Verreth, J.A.J.; Schrama, J.W.

    2012-01-01

    It has been hypothesised that, at non-limiting water oxygen conditions, voluntary feed intake (FI) in fish is limited by the maximal physiological capacity of oxygen use (i.e. an ‘oxystatic control of FI in fish’). This implies that fish will adjust FI when fed diets differing in oxygen demand,

  7. Responses to voluntary hyperventilation in children with separation anxiety disorder: implications for the link to panic disorder.

    Science.gov (United States)

    Kossowsky, Joe; Wilhelm, Frank H; Schneider, Silvia

    2013-10-01

    Biological theories on respiratory regulation have linked separation anxiety disorder (SAD) to panic disorder (PD). We tested if SAD children show similarly increased anxious and psychophysiological responding to voluntary hyperventilation and compromised recovery thereafter as has been observed in PD patients. Participants were 49 children (5-14 years old) with SAD, 21 clinical controls with other anxiety disorders, and 39 healthy controls. We assessed cardiac sympathetic and parasympathetic, respiratory (including pCO2), electrodermal, electromyographic, and self-report variables during baseline, paced hyperventilation, and recovery. SAD children did not react with increased anxiety or panic symptoms and did not show signs of slowed recovery. However, during hyperventilation they exhibited elevated reactivity in respiratory variability, heart rate, and musculus corrugator supercilii activity indicating difficulty with respiratory regulation. Reactions to hyperventilation are much less pronounced in children with SAD than in PD patients. SAD children showed voluntary breathing regulation deficits. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Voluntary muscle activation improves with power training and is associated with changes in gait speed in mobility-limited older adults - A randomized controlled trial.

    Science.gov (United States)

    Hvid, Lars G; Strotmeyer, Elsa S; Skjødt, Mathias; Magnussen, Line V; Andersen, Marianne; Caserotti, Paolo

    2016-07-01

    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 of power training, 2 sessions per week; age: 82.3±1.3years, 56% women) and n=21 in the control group (CG: no interventions; age: 81.6±1.1years, 67% women). Knee extensor muscle thickness (ultrasonography), strength (isokinetic dynamometry), voluntary activation (interpolated twitch technique), and gait speed (2-min maximal walking test) were assessed at baseline and post-intervention. At baseline, TG and CG were comparable for all measures. Post-intervention, significant between-group changes (TG vs. CG; pmuscle activation (+6.2%), muscle strength (+13.4Nm), and gait speed (+0.12m/s), whereas the between-group change in muscle thickness was non-significant (+0.08cm). Improvements in voluntary muscle activation were associated with improvements in gait speed in TG (r=0.67, pmuscle activation 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 influencing muscle mechanical function and gait speed in older adults. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Perceived control, voluntariness and emotional reactions. A study conducted in relocated areas of Russia, Ukraine and Belarus

    Energy Technology Data Exchange (ETDEWEB)

    Figueiredo, C.J. [Norwegian Univ. of Science and Technology, Trondheim (Norway). Dept. of Psychology

    1999-12-01

    This paper use data from a pilot study to analyse relationships between type of resettlement (voluntary or involuntary) and individuals' everyday feelings, perceptions of risk, health status and control. The data were collected in 1995, within the Joint Study Project 2, i.e., a collaborative research project of the European Union and the Commonwealth of Independent States of Russia, Ukraine and Belarus, 1991/92 - 95/96. The aim of the study was to investigate reactions to change and new life conditions of people who had been resettled due to the Chernobyl accident. Participants from the respective countries included adult individuals sampled from two age groups of less than 45 years and 45 years and older, with approximately the same number of men and women. The questionnaire presented various topics to which responses were indicated on quantitative response scales, as well as in open ended response formats. The results presented here focus on emotional reactions, perceived risk and self-rated health among resettled people. The effects of type of resettlement on emotional reactions, Perceived risk and control are discussed.

  10. Modification of electrical pain threshold by voluntary breathing-controlled electrical stimulation (BreEStim in healthy subjects.

    Directory of Open Access Journals (Sweden)

    Shengai Li

    Full Text Available BACKGROUND: Pain has a distinct sensory and affective (i.e., unpleasantness component. BreEStim, during which electrical stimulation is delivered during voluntary breathing, has been shown to selectively reduce the affective component of post-amputation phantom pain. The objective was to examine whether BreEStim increases pain threshold such that subjects could have improved tolerance of sensation of painful stimuli. METHODS: Eleven pain-free healthy subjects (7 males, 4 females participated in the study. All subjects received BreEStim (100 stimuli and conventional electrical stimulation (EStim, 100 stimuli to two acupuncture points (Neiguan and Weiguan of the dominant hand in a random order. The two different treatments were provided at least three days apart. Painful, but tolerable electrical stimuli were delivered randomly during EStim, but were triggered by effortful inhalation during BreEStim. Measurements of tactile sensation threshold, electrical sensation and electrical pain thresholds, thermal (cold sensation, warm sensation, cold pain and heat pain thresholds were recorded from the thenar eminence of both hands. These measurements were taken pre-intervention and 10-min post-intervention. RESULTS: There was no difference in the pre-intervention baseline measurement of all thresholds between BreEStim and EStim. The electrical pain threshold significantly increased after BreEStim (27.5±6.7% for the dominant hand and 28.5±10.8% for the non-dominant hand, respectively. The electrical pain threshold significantly decreased after EStim (9.1±2.8% for the dominant hand and 10.2±4.6% for the non-dominant hand, respectively (F[1, 10] = 30.992, p = .00024. There was no statistically significant change in other thresholds after BreEStim and EStim. The intensity of electrical stimuli was progressively increased, but no difference was found between BreEStim and EStim. CONCLUSION: Voluntary breathing controlled electrical stimulation

  11. Stability of equilibrium in upright stance and voluntary motion control in athletes-shooters in the process of ready position and target shooting

    Directory of Open Access Journals (Sweden)

    A.A. Pryimakov

    2015-02-01

    Full Text Available Purpose: consists in studying the relationships between the system of equilibrium regulation in upright stance and voluntary motion control in athletes-shooters during ready position and target shooting. Material: 19 highly skilled athletes specialized in pistol shooting were studied. Physiological and biomechanical characteristics of posture and voluntary motions were assessed by methods of stabilography, electromyography and tremorometry; besides, accuracy of target shooting was registered. Results: high degree of shooting accuracy dependence on posture somatic parameters has been revealed, of which the greatest impact upon the result is exerted by low-frequency vibrations of the body general centre of mass, subjected to voluntary control. Prognostic models of shooting accuracy dependence upon the character of posture regulation during ready position and the shot have been developed. Conclusions: obtained results reveal the mechanisms of functioning and interacting of two systems of management - posture and voluntary motion. Elaborated regression models permit to model and predict posture stability and shooting accuracy during ready position and the shot.

  12. High cable forces deteriorate pinch force control in voluntary-closing body-powered prostheses

    NARCIS (Netherlands)

    Hichert, M.; Abbink, D.A.; Kyberd, P.J.; Plettenburg, D.H.

    2017-01-01

    Background It is generally asserted that reliable and intuitive control of upper-limb prostheses requires adequate feedback of prosthetic finger positions and pinch forces applied to objects. Bodypowered prostheses (BPPs) provide the user with direct proprioceptive feedback. Currently available

  13. Cognitive Control of Intentions for Voluntary Actions in Individuals with a High Level of Autistic Traits

    Science.gov (United States)

    Poljac, Edita; Poljac, Ervin; Yeung, Nick

    2012-01-01

    Impairments in cognitive control generating deviant adaptive cognition have been proposed to account for the strong preference for repetitive behavior in autism. We examined if this preference reflects intentional deficits rather than problems in task execution in the broader autism phenotype using the Autism-Spectrum Quotient (AQ). Participants…

  14. Infection prevention and control measures for acute respiratory infections in healthcare settings: an update.

    Science.gov (United States)

    Seto, W H; Conly, J M; Pessoa-Silva, C L; Malik, M; Eremin, S

    2013-01-01

    Viruses account for the majority of the acute respiratory tract infections (ARIs) globally with a mortality exceeding 4 million deaths per year. The most commonly encountered viruses, in order of frequency, include influenza, respiratory syncytial virus, parainfluenza and adenovirus. Current evidence suggests that the major mode of transmission of ARls is through large droplets, but transmission through contact (including hand contamination with subsequent self-inoculation) and infectious respiratory aerosols of various sizes and at short range (coined as "opportunistic" airborne transmission) may also occur for some pathogens. Opportunistic airborne transmission may occur when conducting highrisk aerosol generating procedures and airborne precautions will be required in this setting. General infection control measures effective for all respiratory viral infections are reviewed and followed by discussion on some of the common viruses, including severe acute respiratory syndrome (SARS) coronavirus and the recently discovered novel coronavirus.

  15. Genetic associations with viral respiratory illnesses and asthma control in children

    DEFF Research Database (Denmark)

    Loisel, D A; Du, G; Ahluwalia, T S

    2016-01-01

    BACKGROUND: Viral respiratory infections can cause acute wheezing illnesses in children and exacerbations of asthma. OBJECTIVE: We sought to identify variation in genes with known antiviral and pro-inflammatory functions to identify specific associations with more severe viral respiratory illnesses...... and the risk of virus-induced exacerbations during the peak fall season. METHODS: The associations between genetic variation at 326 SNPs in 63 candidate genes and 10 phenotypes related to viral respiratory infection and asthma control were examined in 226 children enrolled in the RhinoGen study. Replication...... differences in childhood viral respiratory illnesses and virus-induced exacerbations of asthma. Defining mechanisms of these associations may provide insight into the pathogenesis of viral respiratory infections and virus-induced exacerbations of asthma....

  16. Factors associated with participation of Alberta dairy farmers in a voluntary, management-based Johne's disease control program.

    Science.gov (United States)

    Ritter, C; Kwong, G P S; Wolf, R; Pickel, C; Slomp, M; Flaig, J; Mason, S; Adams, C L; Kelton, D F; Jansen, J; De Buck, J; Barkema, H W

    2015-11-01

    The Alberta Johne's Disease Initiative (AJDI) is a voluntary, management-based prevention and control program for Johne's disease (JD), a wasting disease in ruminants that causes substantial economic losses to the cattle industry. Despite extensive communication about the program's benefits and low cost to participating producers, approximately 35% of Alberta dairy farmers have not enrolled in the AJDI. Therefore, the objective was to identify differences between AJDI nonparticipants and participants that may influence enrollment. Standardized questionnaires were conducted in person on 163 farms not participating and 61 farms participating in the AJDI. Data collected included demographic characteristics, internal factors (e.g., attitudes and beliefs of the farmer toward JD and the AJDI), external factors (e.g., farmers' JD knowledge and on-farm goals and constraints), as well as farmers' use and influence of various information sources. Nonparticipants and participants differed in at least some aspects of all studied categories. Based on logistic regression, participating farms had larger herds, higher self-assessed knowledge of JD, better understanding of AJDI details before participation, and used their veterinarian more often to get information about new management practices and technologies when compared with nonparticipants. In contrast, nonparticipants indicated that time was a major on-farm constraint and that participation in the AJDI would take too much time. They also indicated that they preferred to wait and see how the program worked on other farms before they participated. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  17. Effects of inspiratory muscle training and yoga breathing exercises on respiratory muscle function in institutionalized frail older adults: a randomized controlled trial.

    Science.gov (United States)

    Cebrià i Iranzo, Maria dels Àngels; Arnall, David Alan; Igual Camacho, Celedonia; Tomás, José Manuel

    2014-01-01

    In older adults, respiratory function may be seriously compromised when a marked decrease of respiratory muscle (RM) strength coexists with comorbidity and activity limitation. Respiratory muscle training has been widely studied and recommended as a treatment option for people who are unable to participate in whole-body exercise training (WBET); however, the effects of inspiratory muscle training and yoga breathing exercises on RM function remain unknown, specifically in impaired older adults. To evaluate the effects of inspiratory threshold training (ITT) and yoga respiratory training (YRT) on RM function in institutionalized frail older adults. Eighty-one residents (90% women; mean age, 85 years), who were unable to perform WBET (inability to independently walk more than 10 m), were randomly assigned to a control group or one of the 2 experimental groups (ITT or YRT). Experimental groups performed a supervised interval-based training protocol, either through threshold inspiratory muscle training device or yoga breathing exercises, which lasted 6 weeks (5 days per week). Outcome measures were collected at 4 time points (pretraining, intermediate, posttraining, and follow-up) and included the maximum respiratory pressures (maximum inspiratory pressure [MIP] and maximum expiratory pressure [MEP]) and the maximum voluntary ventilation (MVV). Seventy-one residents completed the study: control (n = 24); ITT (n = 23); YRT (n = 24). The treatment on had a significant effect on MIP YRT (F(6,204) = 6.755, P training appears to be an effective and well-tolerated exercise regimen in frail older adults and may therefore be a useful alternative to ITT or no training, to improve RM function in older population, when WBET is not possible.

  18. Isolating event-related potential components associated with voluntary control of visuo-spatial attention.

    Science.gov (United States)

    McDonald, John J; Green, Jessica J

    2008-08-28

    Attention-directing cues presented at fixation evoke several lateralized event-related potential (ERP) components prior to the onset of visual targets. These components have been associated with the control of visuo-spatial attention, but the neuro-cognitive operations and neural generators of the components are still largely unknown. Here, we isolated cue-elicited ERP activity in different ways to home in on different neuro-cognitive operations and to gain a better understanding about the possible neuroanatomical sources of the cue-elicited ERP activities. To isolate lateralized cue-ERP activity, we compared shift-left and shift-right cue ERPs to shift-up cue ERPs. To measure all of the ERP activity related to attentional control, including spatially nonspecific activity that is removed in the process of isolating lateralized cue-ERP components, we compared shift-cue ERPs to neutral-cue (i.e., no-shift) ERPs. Isolated lateralized-ERP activity was seen in the contralateral-occipital lobe in the early phase of the cue-target interval and in the ipsilateral-occipital lobe in the late phase. The later, ipsilateral activity indicates that the late directing attention positivity (LDAP) reflected processing of the to-be-ignored location. The neutral-cue isolation revealed a shift-related positivity over posterior scalp regions and a shift-related negativity over more anterior scalp regions. The spatio-temporal sequence of shift-related activity observed on the scalp, together with estimates of distributed source activity underlying the shift-related ERP components, indicated that frontal and parietal regions of cortex participated in the control of attention and led to pre-target biasing in visual cortical areas.

  19. Valence, arousal, and cognitive control: a voluntary task-switching study.

    Science.gov (United States)

    Demanet, Jelle; Liefooghe, Baptist; Verbruggen, Frederick

    2011-01-01

    The present study focused on the interplay between arousal, valence, and cognitive control. To this end, we investigated how arousal and valence associated with affective stimuli influenced cognitive flexibility when switching between tasks voluntarily. Three hypotheses were tested. First, a valence hypothesis that states that the positive valence of affective stimuli will facilitate both global and task-switching performance because of increased cognitive flexibility. Second, an arousal hypothesis that states that arousal, and not valence, will specifically impair task-switching performance by strengthening the previously executed task-set. Third, an attention hypothesis that states that both cognitive and emotional control ask for limited attentional resources, and predicts that arousal will impair both global and task-switching performance. The results showed that arousal affected task-switching but not global performance, possibly by phasic modulations of the noradrenergic system that reinforces the previously executed task. In addition, positive valence only affected global performance but not task-switching performance, possibly by phasic modulations of dopamine that stimulates the general ability to perform in a multitasking environment.

  20. Respiratory functional and motor control deficits in children with spinal cord injury.

    Science.gov (United States)

    Singh, Goutam; Behrman, Andrea L; Aslan, Sevda C; Trimble, Shelley; Ovechkin, Alexander V

    2018-01-01

    Children with spinal cord injury (SCI) are at high risk for developing complications due to respiratory motor control deficits. However, underlying mechanisms of these abnormalities with respect to age, development, and injury characteristics are unclear. To evaluate the effect of SCI and age on respiratory motor control in children with SCI, we compared pulmonary function and respiratory motor control outcome measures in healthy typically developing (TD) children to age-matched children with chronic SCI. We hypothesized that the deficits in respiratory functional performance in children with SCI are due to the abnormal and age-dependent respiratory muscle activation patterns. Fourteen TD (age 7±2 yrs., Mean±SD) and twelve children with SCI (age 6±1 yrs.) were evaluated by assessing Forced Vital Capacity (FVC); Forced Expiratory Volume in 1sec (FEV1); and respiratory electromyographic activity during maximum inspiratory and maximum expiratory airway pressure measurements (PImax and PEmax). The results indicate a significant reduction (prespiratory muscles below the neurological level of injury (rectus abdominous and external oblique muscles). In addition, children with SCI had significantly increased (prespiratory functional and motor control deficits in children are age-dependent. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. The effect of a cognitive-motor intervention on voluntary step execution under single and dual task conditions in older adults: a randomized controlled pilot study

    Directory of Open Access Journals (Sweden)

    Pichierri G

    2012-07-01

    Full Text Available Giuseppe Pichierri,1 Amos Coppe,1 Silvio Lorenzetti,2 Kurt Murer,1 Eling D de Bruin11Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Switzerland; 2Institute for Biomechanics, Department of Health Sciences and Technology, ETH Zurich, SwitzerlandBackground: This randomized controlled pilot study aimed to explore whether a cognitive-motor exercise program that combines traditional physical exercise with dance video gaming can improve the voluntary stepping responses of older adults under attention demanding dual task conditions.Methods: Elderly subjects received twice weekly cognitive-motor exercise that included progressive strength and balance training supplemented by dance video gaming for 12 weeks (intervention group. The control group received no specific intervention. Voluntary step execution under single and dual task conditions was recorded at baseline and post intervention (Week 12.Results: After intervention between-group comparison revealed significant differences for initiation time of forward steps under dual task conditions (U = 9, P = 0.034, r = 0.55 and backward steps under dual task conditions (U = 10, P = 0.045, r = 0.52 in favor of the intervention group, showing altered stepping levels in the intervention group compared to the control group.Conclusion: A cognitive-motor intervention based on strength and balance exercises with additional dance video gaming is able to improve voluntary step execution under both single and dual task conditions in older adults.Keywords: fall prevention, exercise, dance, video game

  2. Social reward improves the voluntary control over localized brain activity in fMRI-based neurofeedback training

    Directory of Open Access Journals (Sweden)

    Krystyna Anna Mathiak

    2015-06-01

    Full Text Available Neurofeedback (NF based on real-time functional magnetic resonance imaging (rt-fMRI allows voluntary regulation of the activity in a selected brain region. For the training of this regulation, a well-designed feedback system is required. Social reward may serve as an effective incentive in NF paradigms, but its efficiency has not yet been tested. Therefore, we developed a social reward NF paradigm and assessed it in comparison with a typical visual NF paradigm (moving bar.We trained 24 healthy participants, on three consecutive days, to control activation in dorsal anterior cingulate cortex (ACC with fMRI-based NF. In the social feedback group, an avatar gradually smiled when ACC activity increased, whereas in the standard feedback group, a moving bar indicated the activation level. To assess a transfer of the NF training both groups were asked to up-regulate their brain activity without receiving feedback immediately before and after the NF training (pre- and post-test. Finally, the effect of the acquired NF training on ACC function was evaluated in a cognitive interference task (Simon task during the pre- and post-test.Social reward led to stronger activity in the ACC and reward-related areas during the NF training when compared to standard feedback. After the training, both groups were able to regulate ACC without receiving feedback, with a trend for stronger responses in the social feedback group. Moreover, despite a lack of behavioral differences, significant higher ACC activations emerged in the cognitive interference task, reflecting a stronger generalization of the NF training on cognitive interference processing after social feedback.Social reward can increase self-regulation in fMRI-based NF and strengthen its effects on neural processing in related tasks, such as cognitive interference. An advantage of social feedback is that a direct external reward is provided as in natural social interactions, opening perspectives for implicit

  3. Voluntary or involuntary? Control over overtime and rewards for overtime in relation to fatigue and work satisfaction

    NARCIS (Netherlands)

    Beckers, D.G.J.; Linden, D. van der; Smulders, P.G.W.; Kompier, M.A.J.; Taris, T.W.; Geurts, S.A.E.

    2008-01-01

    This study aims to examine whether the relationship between overtime and well-being is influenced by the voluntary vs. involuntary (i.e., compulsory) nature of overtime work and by the presence or absence of rewards for overtime. We also explored the prevalence of these types of overtime and how

  4. Control of abdominal muscles by brain stem respiratory neurons in the cat

    Science.gov (United States)

    Miller, Alan D.; Ezure, Kazuhisa; Suzuki, Ichiro

    1985-01-01

    The nature of the control of abdominal muscles by the brain stem respiratory neurons was investigated in decerebrate unanesthetized cats. First, it was determined which of the brain stem respiratory neurons project to the lumbar cord (from which the abdominal muscles receive part of their innervation), by stimulating the neurons monopolarly. In a second part of the study, it was determined if lumbar-projecting respiratory neurons make monosynaptic connections with abdominal motoneurons; in these experiments, discriminate spontaneous spikes of antidromically acivated expiratory (E) neurons were used to trigger activity from both L1 and L2 nerves. A large projection was observed from E neurons in the caudal ventral respiratory group to the contralateral upper lumber cord. However, cross-correlation experiments found only two (out of 47 neuron pairs tested) strong monosynaptic connections between brain stem neurons and abdominal motoneurons.

  5. Early respiratory management of respiratory distress syndrome in very preterm infants and bronchopulmonary dysplasia: a case-control study.

    Directory of Open Access Journals (Sweden)

    Arjan B Te Pas

    Full Text Available BACKGROUND: In the period immediately after birth, preterm infants are highly susceptible to lung injury. Early nasal continuous positive airway pressure (ENCPAP is an attempt to avoid intubation and may minimize lung injury. In contrast, ENCPAP can fail, and at that time surfactant rescue can be less effective. OBJECTIVE: To compare the pulmonary clinical course and outcome of very preterm infants (gestational age 25-32 weeks with respiratory distress syndrome (RDS who started with ENCPAP and failed (ECF group, with a control group of infants matched for gestational age, who were directly intubated in the delivery room (DRI group. Primary outcome consisted of death during admission or bronchopulmonary dysplasia (BPD. RESULTS: 25 infants were included in the ECF group and 50 control infants matched for gestational age were included in the DRI group. Mean gestational age and birth weight in the ECF group were 29.7 weeks and 1,393 g and in the DRI group 29.1 weeks and 1,261 g (p = NS. The incidence of BPD was significantly lower in the ECF group than in the DRI group (4% vs. 35%; P<0.004; OR 12.6 (95% CI 1.6-101. Neonatal mortality was similar in both groups (4%. The incidence of neonatal morbidities such as severe cerebral injury, patent ductus arteriosus, necrotizing enterocolitis and retinopathy of prematurity, was not significantly different between the two groups. CONCLUSION: A trial of ENCPAP at birth may reduce the incidence of BPD and does not seem to be detrimental in very preterm infants. Randomized controlled trials are needed to test whether early respiratory management of preterm infants with RDS plays an important role in the development of BPD.

  6. Measuring Progress on the Control of Porcine Reproductive and Respiratory Syndrome (PRRS at a Regional Level: The Minnesota N212 Regional Control Project (Rcp as a Working Example.

    Directory of Open Access Journals (Sweden)

    Pablo Valdes-Donoso

    Full Text Available Due to the highly transmissible nature of porcine reproductive and respiratory syndrome (PRRS, implementation of regional programs to control the disease may be critical. Because PRRS is not reported in the US, numerous voluntary regional control projects (RCPs have been established. However, the effect of RCPs on PRRS control has not been assessed yet. This study aims to quantify the extent to which RCPs contribute to PRRS control by proposing a methodological framework to evaluate the progress of RCPs. Information collected between July 2012 and June 2015 from the Minnesota Voluntary Regional PRRS Elimination Project (RCP-N212 was used. Demography of premises (e.g. composition of farms with sows = SS and without sows = NSS was assessed by a repeated analysis of variance. By using general linear mixed-effects models, active participation of farms enrolled in the RCP-N212, defined as the decision to share (or not to share PRRS status, was evaluated and used as a predictor, along with other variables, to assess the PRRS trend over time. Additionally, spatial and temporal patterns of farmers' participation and the disease dynamics were investigated. The number of farms enrolled in RCP-N212 and its geographical coverage increased, but the proportion of SS and NSS did not vary significantly over time. A significant increasing (p<0.001 trend in farmers' decision to share PRRS status was observed, but with NSS producers less willing to report and a large variability between counties. The incidence of PRRS significantly (p<0.001 decreased, showing a negative correlation between degree of participation and occurrence of PRRS (p<0.001 and a positive correlation with farm density at the county level (p = 0.02. Despite a noted decrease in PRRS, significant spatio-temporal patterns of incidence of the disease over 3-weeks and 3-kms during the entire study period were identified. This study established a systematic approach to quantify the effect of RCPs on

  7. Monodisperse, Uniformly-Shaped Particles for Controlled Respiratory Vaccine Delivery

    Science.gov (United States)

    Fromen, Catherine Ann

    The majority of the world's most infectious diseases occur at the air-tissue interface called the mucosa, including HIV/AIDS, tuberculosis, measles, and bacterial or viral gut and respiratory infections. Despite this, vaccines have generally been developed for the systemic immune system and fail to provide protection at the mucosal site. Vaccine delivery directly to the lung mucosa could provide superior lung protection for many infectious diseases, such as TB or influenza, as well as systemic and therapeutic vaccines for diseases such as Dengue fever, asthma, or cancer. Specifically, precision engineered biomaterials are believed to offer tremendous opportunities for a new generation of vaccines. The goal of this approach is to leverage naturally occurring processes of the immune system to produce memory responses capable of rapidly destroy virulent pathogens without harmful exposure. Considerable knowledge of biomaterial properties and their interaction with the immune system of the lung is required for successful translation. The overall goal of this work was to fabricate and characterize nano- and microparticles using the Particle Replication In Non-wetting Templates (PRINT) fabrication technique and optimize them as pulmonary vaccine carriers. (Abstract shortened by ProQuest.).

  8. 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

  9. 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...

  10. Development of internal controls for the Luminex instrument as part of a multiplex seven-analyte viral respiratory antibody profile

    National Research Council Canada - National Science Library

    Martins, Thomas B

    2002-01-01

    .... During the development of a seven-analyte serologic viral respiratory antibody profile, internal controls for detecting sample addition and interfering rheumatoid factor (RF) were investigated...

  11. Effects of training programs based on ipsilateral voluntary and stimulated contractions on muscle strength and monopedal postural control of the contralateral limb.

    Science.gov (United States)

    Kadri, Mohamed Abdelhafid; Noé, Frederic; Nouar, Merbouha Boulahbel; Paillard, Thierry

    2017-07-03

    To compare the effects of unilateral strength training by stimulated and voluntary contractions on muscle strength and monopedal postural control of the contralateral limb. 36 non-active healthy male subjects were recruited and split randomly into three groups. Two groups of 12 subjects took part in a strength-training program (3 sessions a week over 8 weeks) comprising 43 contractions of the quadriceps femoris of the ipsilateral limb (at 20% of the MVC). One group carried out voluntary contractions exclusively (VOL group), while the other group benefited exclusively from electro-induced contractions (NMES group). The other 12 subjects formed the control (CON) group. Assessments of MVC and monopedal postural control in static and dynamic postural tasks were performed with the ipsilateral (ISPI) and contralateral (CONTRA) limbs before (PRE) and after (POST) completion of the training program. After the training program, the MVC of the IPSI and CONTRA limbs increased similarly for both experimental groups (VOL and NMES). There were no significant improvements of monopedal postural control for the IPSI or CONTRA limbs in either the VOL or NMES experimental group. No change was observed for the CON group over the protocol period. The purposed training program with NMES vs VOL contractions induced strength gains but did not permit any improvement of contralateral monopedal postural control in healthy young subjects. This has potential for therapeutic application and allows clinicians to focus their training programs on dynamic and poly-articular exercises to improve the postural control in young subjects.

  12. Bacteraemic urinary tract infections may mimic respiratory infections: a nested case-control study.

    Science.gov (United States)

    Denis, E; Martis, N; Guillouet-de Salvador, F; Demonchy, E; Degand, N; Carles, K; Roger, P-M

    2016-10-01

    Daily practice suggests that respiratory signs may be observed in bacteraemic urinary infections (BUI). Our objective was to search for an association between the presence of respiratory symptoms and the bacteraemic nature of urinary tract infections (UTI). A nested case-control study was carried out based on our computerised dashboard from January 2011 to June 2015. Cases were defined as patients with a BUI due to Enterobacteriaceae species, identified in blood and urine cultures. Controls had fever and a positive urinary sample but sterile blood cultures (NBUI) and a final diagnosis of urinary infection. Patients from the BUI group were 1:1 matched to the NBUI group according to four parameters: age, gender, cardiovascular and pulmonary comorbid conditions. Subjects with cognitive impairment limiting clinical accuracy and those with healthcare-associated infections were excluded. We compared systematically recorded respiratory and urinary symptoms between groups: signs on auscultation, dyspnoea, chest pain, cough and sputum, dysuria with burning, pollakiuria, flank or costovertebral angle tenderness and ischuria. One hundred BUI were compared to 100 NBUI, both groups exhibiting a similar rate for all considered comorbid conditions. In the BUI group, 58 % showed at least one respiratory sign vs. 20 % in the NBUI group, p respiratory signs, which overshadowed urinary symptoms, compared to those with non-bacteraemic UTI. Such observations impact clinical decision-making.

  13. Neonatal respiratory control : inspiration, inflammation and the prostaglandin E2 pathway

    OpenAIRE

    Siljehav, Veronica

    2014-01-01

    Immature or deficient autonomic control is a common problem in infants born at a premature age, and is of central importance in apneas. The pre- and perinatal development of the brainstem neural circuits that control autonomic functions is vital for survival after birth and for the regulation of breathing movements. Children with immature brainstem respiratory control have periods of irregular breathing with potential detrimental apneas that are increased during sleep and in...

  14. Respiratory Tract Infections and its Preventive Measures among Hajj Pilgrims, 2010: A Nested Case Control Study.

    Science.gov (United States)

    Emamian, Mohammad Hassan; Hassani, Ali Mohammad; Fateh, Mansooreh

    2013-09-01

    Respiratory tract infections are very common among the Hajj pilgrims. Some preventive measures including Influenza vaccination, using face mask and salt water gargling have been considered to control these infections and the reports show conflicting results about the effects of each one of these measures. This study is trying to assess the effects of these recommendations on respiratory tract infections. According to nested case-control design, in a cohort consisting of 338 Iranian pilgrims, the outcome examined, was all types of respiratory tract infections other than common colds. With occurrence of any patient in convoy, data collection form was completed for that person. On the same day, two people were randomly selected as control group from among pilgrims who have not affected so far. During Hajj, 32 pilgrims (9.5%) were affected by respiratory tract infections other than common colds. In univariable logistic regression analysis, salt water gargling (OR = 2.4, P = 0.08), existence of other patient in the room (OR = 2.14, P = 0.19), age over 60 years (OR = 1.84, P = 0.15) and the education more than or equal to 3 years (OR = 1.93, P = 0.16) were effective in the respiratory tract infections (P < 0.2). However, multivariable logistic regression analysis showed that none of the above mentioned factors are significantly associated with these infections. This study showed that measures such as seasonal influenza vaccination, use of face masks and personal prayer carpet have no effect on the incidence of respiratory tract infections. However, washing throat and mouth with salt water can be considered the most effective preventive measures.

  15. Intervention methods to control the transmission of noroviruses and other enteric and respiratory viruses

    NARCIS (Netherlands)

    Tuladhar, E.

    2014-01-01

    Intervention methods to control the transmission of noroviruses and other enteric and respiratory viruses Era Tuladhar Abstract Human noroviruses are the leading cause of acute and outbreak associated gastroenteritis worldwide. The outbreaks occur often in

  16. Respiratory mechanics in infants with severe bronchiolitis on controlled mechanical ventilation.

    Science.gov (United States)

    Cruces, Pablo; González-Dambrauskas, Sebastián; Quilodrán, Julio; Valenzuela, Jorge; Martínez, Javier; Rivero, Natalia; Arias, Pablo; Díaz, Franco

    2017-10-06

    Analysis of respiratory mechanics during mechanical ventilation (MV) is able to estimate resistive, elastic and inertial components of the working pressure of the respiratory system. Our aim was to discriminate the components of the working pressure of the respiratory system in infants on MV with severe bronchiolitis admitted to two PICU's. Infants younger than 1 year old with acute respiratory failure caused by severe bronchiolitis underwent neuromuscular blockade, tracheal intubation and volume controlled MV. Shortly after intubation studies of pulmonary mechanics were performed using inspiratory and expiratory breath hold. The maximum inspiratory and expiratory flow (QI and QE) as well as peak inspiratory (PIP), plateau (PPL) and total expiratory pressures (tPEEP) were measured. Inspiratory and expiratory resistances (RawI and RawE) and Time Constants (KTI and KTE) were calculated. We included 16 patients, of median age 2.5 (1-5.8) months. Bronchiolitis due to respiratory syncytial virus was the main etiology (93.8%) and 31.3% had comorbidities. Measured respiratory pressures were PIP 29 (26-31), PPL 24 (20-26), tPEEP 9 [8-11] cmH2O. Elastic component of the working pressure was significantly higher than resistive and both higher than threshold (tPEEP - PEEP) (P mechanics of infants with severe bronchiolitis receiving MV shows that the elastic component of the working pressure of the respiratory system is the most important. The elastic and resistive components in conjunction with flow profile are characteristic of restrictive diseases. A better understanding of lung mechanics in this group of patients may lead to change the traditional ventilatory approach to severe bronchiolitis.

  17. Control of Respiratory Motion by Hypnosis Intervention during Radiotherapy of Lung Cancer I

    Directory of Open Access Journals (Sweden)

    Rongmao Li

    2013-01-01

    Full Text Available The uncertain position of lung tumor during radiotherapy compromises the treatment effect. To effectively control respiratory motion during radiotherapy of lung cancer without any side effects, a novel control scheme, hypnosis, has been introduced in lung cancer treatment. In order to verify the suggested method, six volunteers were selected with a wide range of distribution of age, weight, and chest circumference. A set of experiments have been conducted for each volunteer, under the guidance of the professional hypnotist. All the experiments were repeated in the same environmental condition. The amplitude of respiration has been recorded under the normal state and hypnosis, respectively. Experimental results show that the respiration motion of volunteers in hypnosis has smaller and more stable amplitudes than in normal state. That implies that the hypnosis intervention can be an alternative way for respiratory control, which can effectively reduce the respiratory amplitude and increase the stability of respiratory cycle. The proposed method will find useful application in image-guided radiotherapy.

  18. Control of Respiratory Motion by Hypnosis Intervention during Radiotherapy of Lung Cancer I

    Science.gov (United States)

    Deng, Jie; Xie, Yaoqin

    2013-01-01

    The uncertain position of lung tumor during radiotherapy compromises the treatment effect. To effectively control respiratory motion during radiotherapy of lung cancer without any side effects, a novel control scheme, hypnosis, has been introduced in lung cancer treatment. In order to verify the suggested method, six volunteers were selected with a wide range of distribution of age, weight, and chest circumference. A set of experiments have been conducted for each volunteer, under the guidance of the professional hypnotist. All the experiments were repeated in the same environmental condition. The amplitude of respiration has been recorded under the normal state and hypnosis, respectively. Experimental results show that the respiration motion of volunteers in hypnosis has smaller and more stable amplitudes than in normal state. That implies that the hypnosis intervention can be an alternative way for respiratory control, which can effectively reduce the respiratory amplitude and increase the stability of respiratory cycle. The proposed method will find useful application in image-guided radiotherapy. PMID:24093100

  19. Greater disruption to control of voluntary saccades in autistic disorder than Asperger's disorder: evidence for greater cerebellar involvement in autism?

    Science.gov (United States)

    Stanley-Cary, Chloe; Rinehart, Nicole; Tonge, Bruce; White, Owen; Fielding, Joanne

    2011-03-01

    It remains unclear whether autism and Asperger's disorder (AD) exist on a symptom continuum or are separate disorders with discrete neurobiological underpinnings. In addition to impairments in communication and social cognition, motor deficits constitute a significant clinical feature in both disorders. It has been suggested that motor deficits and in particular the integrity of cerebellar modulation of movement may differentiate these disorders. We used a simple volitional saccade task to comprehensively profile the integrity of voluntary ocular motor behaviour in individuals with high functioning autism (HFA) or AD, and included measures sensitive to cerebellar dysfunction. We tested three groups of age-matched young males with normal intelligence (full scale, verbal, and performance IQ estimates >70) aged between 11 and 19 years; nine with AD, eight with HFA, and ten normally developing males as the comparison group. Overall, the metrics and dynamics of the voluntary saccades produced in this task were preserved in the AD group. In contrast, the HFA group demonstrated relatively preserved mean measures of ocular motricity with cerebellar-like deficits demonstrated in increased variability on measures of response time, final eye position, and movement dynamics. These deficits were considered to be consistent with reduced cerebellar online adaptation of movement. The results support the notion that the integrity of cerebellar modulation of movement may be different in AD and HFA, suggesting potentially differential neurobiological substrates may underpin these complex disorders.

  20. Effectiveness of adding voluntary pelvic floor muscle contraction to a Pilates exercise program: an assessor-masked randomized controlled trial.

    Science.gov (United States)

    Torelli, Luiza; de Jarmy Di Bella, Zsuzsanna Ilona Katalin; Rodrigues, Claudinei Alves; Stüpp, Liliana; Girão, Manoel João Batista Castello; Sartori, Marair Gracio Ferreira

    2016-11-01

    The purpose of this study was to evaluate the effectiveness of adding voluntary pelvic floor muscle contraction (PFMC) to a Pilates exercise program in sedentary nulliparous women. Fifty-seven healthy nulliparous and physically inactive women were randomized to a Pilates exercise program (PEP) with or without PFMC. Forty-eight women concluded this study (24 participants for each group). Each woman was evaluated before and after the PEP, by a physiotherapist and an urogynecologist (UG). Neither of the professionals was revealed to them. This physiotherapist measured their pelvic floor muscle strength by using both a perineometer (Peritron) and vaginal palpation (Oxford Scale). The UG, who performed 3D perineal ultrasound examinations, collected their data and evaluated the results for pubovisceral muscle thickness and the levator hiatus area (LA). Both professionals were blinded to the group allocation. The protocol for both groups consisted of 24 bi-weekly 1-h individual sessions of Pilates exercises, developed by another physiotherapist who specializes in PFM rehabilitation and the Pilates technique. The PEP+ PFMC group showed significantly greater strength improvements than the PEP group when comparing the Oxford scale, vaginal pressure and pubovisceral muscle thickness during contraction measurements at baseline and post-treatment. Our findings suggest that adding a voluntary PFMC to a Pilates exercise program is more effective than Pilates alone in improving PFM strength in sedentary nulliparous women.

  1. The efect of respiratory control in electrophisiological variables of attention

    OpenAIRE

    LOZANO, MIRNA DELPOSO

    2016-01-01

    A prática do ioga tem se tornado cada vez mais popular, não apenas pelos benefícios físicos, mas principalmente pelo bem-estar psicológico trazido pela sua prática. Um dos componentes do ioga é o Prãnãyama, ou controle da respiração. A atenção e a respiração são dois mecanismos fisiológicos e involuntários requeridos para a execução do Prãnãyama. O principal objetivo desse estudo foi verificar se variáveis contínuas do EEG (potência de diferentes faixas que o compõem) seriam moduladas pelo co...

  2. Kölliker-Fuse nuclei regulate respiratory rhythm variability via a gain-control mechanism.

    Science.gov (United States)

    Dhingra, Rishi R; Dutschmann, Mathias; Galán, Roberto F; Dick, Thomas E

    2017-02-01

    Respiration varies from breath to breath. On the millisecond timescale of spiking, neuronal circuits exhibit variability due to the stochastic properties of ion channels and synapses. Does this fast, microscopic source of variability contribute to the slower, macroscopic variability of the respiratory period? To address this question, we modeled a stochastic oscillator with forcing; then, we tested its predictions experimentally for the respiratory rhythm generated by the in situ perfused preparation during vagal nerve stimulation (VNS). Our simulations identified a relationship among the gain of the input, entrainment strength, and rhythm variability. Specifically, at high gain, the periodic input entrained the oscillator and reduced variability, whereas at low gain, the noise interacted with the input, causing events known as "phase slips", which increased variability on a slow timescale. Experimentally, the in situ preparation behaved like the low-gain model: VNS entrained respiration but exhibited phase slips that increased rhythm variability. Next, we used bilateral muscimol microinjections in discrete respiratory compartments to identify areas involved in VNS gain control. Suppression of activity in the nucleus tractus solitarii occluded both entrainment and amplification of rhythm variability by VNS, confirming that these effects were due to the activation of the Hering-Breuer reflex. Suppressing activity of the Kölliker-Fuse nuclei (KFn) enhanced entrainment and reduced rhythm variability during VNS, consistent with the predictions of the high-gain model. Together, the model and experiments suggest that the KFn regulates respiratory rhythm variability via a gain control mechanism. Copyright © 2017 the American Physiological Society.

  3. ATP and astrocytes play a prominent role in the control of the respiratory pattern generator in the lamprey.

    Science.gov (United States)

    Cinelli, Elenia; Iovino, Ludovica; Mutolo, Donatella

    2017-12-01

    The paratrigeminal respiratory group (pTRG) is responsible for the respiratory pattern generation in the lamprey. The role of ATP and astrocytes, known to control respiratory activity in mammals, was investigated in the lamprey respiratory network. ATP microinjected into the pTRG induces a biphasic response consisting of marked increases in respiratory frequency mediated by P2X receptors followed by a decrease in the respiratory motor output due to the ATP metabolite adenosine. We provide evidence that astrocytes are involved in the genesis of the normal respiratory pattern, ATP-induced responses and acidification-induced increases of the respiratory activity. The function of astrocytes in rhythmic networks appears to be phylogenetically conserved. The role of ATP and astrocytes in respiratory rhythm modulation has been recently investigated in neonatal rodents. However, no information on the role of ATP and astrocytes within the respiratory network of the lamprey is available, particularly within the paratrigeminal respiratory group (pTRG), the proposed respiratory central pattern generator. To address these issues, the present study was carried out on isolated brainstems of the adult lamprey. Bath application of ATP caused marked increases in respiratory frequency followed by decreases in the respiratory motor output, mediated by the ATP metabolite adenosine at the level of the pTRG. Bath applications and microinjections of agonists and antagonists of purinergic receptors showed that ATP increased respiratory activity through an action on pTRG P2X receptors. To disclose the respiratory role of astrocytes, we used bath application of the gliotoxin aminoadipic acid, which dramatically depressed the respiratory motor output that, however, promptly recovered following glutamine application. Furthermore, the excitatory responses to ATP-γ-S (a non-hydrolysable ATP analogue), but not to substance P, microinjected into the pTRG, were abolished. Finally, we also

  4. Control of Vocal and Respiratory Patterns in Birdsong: Dissection of Forebrain and Brainstem Mechanisms Using Temperature

    Science.gov (United States)

    Fee, Michale S.

    2011-01-01

    Learned motor behaviors require descending forebrain control to be coordinated with midbrain and brainstem motor systems. In songbirds, such as the zebra finch, regular breathing is controlled by brainstem centers, but when the adult songbird begins to sing, its breathing becomes tightly coordinated with forebrain-controlled vocalizations. The periods of silence (gaps) between song syllables are typically filled with brief breaths, allowing the bird to sing uninterrupted for many seconds. While substantial progress has been made in identifying the brain areas and pathways involved in vocal and respiratory control, it is not understood how respiratory and vocal control is coordinated by forebrain motor circuits. Here we combine a recently developed technique for localized brain cooling, together with recordings of thoracic air sac pressure, to examine the role of cortical premotor nucleus HVC (proper name) in respiratory-vocal coordination. We found that HVC cooling, in addition to slowing all song timescales as previously reported, also increased the duration of expiratory pulses (EPs) and inspiratory pulses (IPs). Expiratory pulses, like song syllables, were stretched uniformly by HVC cooling, but most inspiratory pulses exhibited non-uniform stretch of pressure waveform such that the majority of stretch occurred late in the IP. Indeed, some IPs appeared to change duration by the earlier or later truncation of an underlying inspiratory event. These findings are consistent with the idea that during singing the temporal structure of EPs is under the direct control of forebrain circuits, whereas that of IPs can be strongly influenced by circuits downstream of HVC, likely in the brainstem. An analysis of the temporal jitter of respiratory and vocal structure suggests that IPs may be initiated by HVC at the end of each syllable and terminated by HVC immediately before the onset of the next syllable. PMID:21980466

  5. Toward voluntary parenthood.

    Science.gov (United States)

    Scarr, S

    2000-06-01

    David Lykken's proposal to license married parents for child rearing, and to deny the same opportunity to single and inept parents, springs from his deep concern for millions of youngsters cruelly subjected to abusive and neglectful rearing circumstances. Children from such inadequate homes grow up to have high rates of school failure, criminality, and drug addiction. The problem is clear, but Lykken's remedies of mandated marriage and parental licensure are unacceptable in U.S. society, where our reproductive rights are fortunately protected by our Constitution. As a devoted proponent of reproductive rights, I propose a legally and morally acceptable proposal to the same end. Increasing women's effective control of reproduction and moving toward entirely voluntary parenthood will accomplish the same goals without compromising our civil liberties.

  6. Effect of mechanical pressure-controlled ventilation in patients with disturbed respiratory function during laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Šurbatović Maja

    2013-01-01

    Full Text Available Background/Aim: Laparoscopic cholecystectomy is considered to be the gold standard for laparoscopic surgical procedures. In ASA III patients with concomitant respiratory diseases, however, creation of pneumoperitoneum and the position of patients during surgery exert additional negative effect on intraoperative respiratory function, thus making a higher challenge for the anesthesiologist than for the surgeon. The aim of this study was to compare the effect of intermittent positive pressure ventilation (IPPV and pressure controlled ventilation (PCV during general anesthesia on respiratory function in ASA III patients submitted to laparoscopic cholecystectomy. Methods. The study included 60 patients randomized into two groups depending on the mode of ventilation: IPPV or PCV. Respiratory volume (VT, peak inspiratory pressure (PIP, compliance (C, end-tidal CO2 pressure (PETCO2, oxygen saturation (SpO2, partial pressures of O2, CO2 (PaO2 and PaCO2 and pH of arterial blood were recorded within four time intervals. Results. There were no statistically significant differences in VT, SpO2, PaO2, PaCO2 and pH values neither within nor between the two groups. In time interval t1 there were no statistically significant differences in PIP, C, PETCO2 values between the IPPV and the PCV group. But, in the next three time intervals there was a difference in PIP, C, and PETCO2 values between the two groups which ranged from statistically significant to highly significant; PIP was lower, C and PETCO2 were higher in the PCV group. Conclusion. Pressure controlled ventilation better maintains stability regarding intraoperative ventilatory parameters in ASA III patients with concomitant respiratory diseases during laparoscopic cholecystectomy.

  7. A case-control study of plasma antioxidant (pro-)vitamins in relation to respiratory symptoms in non-smokers

    NARCIS (Netherlands)

    Grievink, L.; Smit, H.A.; Veer, van 't P.; Brunekreef, B.; Kromhout, D.

    2000-01-01

    The aim of this study was to investigate the relations between plasma levels of antioxidants, [beta]-carotene and [alpha]-tocopherol, and chronic respiratory symptoms in Dutch adults who never smoked or were long-term former smokers. Cases (who reported one or more respiratory symptoms) and controls

  8. Weaning Off Mental Tasks to Achieve Voluntary Self-Regulatory Control of a Near-Infrared Spectroscopy Brain-Computer Interface.

    Science.gov (United States)

    Weyand, Sabine; Takehara-Nishiuchi, Kaori; Chau, Tom

    2015-07-01

    As a noninvasive and safe optical measure of hemodynamic brain activity, near-infrared spectroscopy (NIRS) has emerged as a potential brain-computer interface (BCI) access modality. Currently, to the best of our knowledge, all NIRS BCIs use mental tasks to elicit changes in regional hemodynamic activity. One of the limitations of using mental tasks is that they can be cognitively demanding, and unintuitive. The goal of this work was to explore the development of a neurofeedback-based NIRS BCI that weans users off mental tasks, to instead use voluntary self-regulation. Ten able-bodied participants were recruited for this study. After ten sessions of using two personalized mental tasks to increase and decrease the participant's hemodynamic activity, the users were asked, for the remaining sessions, to stop performing their tasks and instead use only a desire to modulate their hemodynamic activity. By the final online session, participants were able to exclusively use voluntary self-regulation with an average accuracy of 79 ±13%. Additionally, the majority of participants indicated that BCI control via self-regulation was less taxing and more intuitive than BCI operation using mental tasks.

  9. Pressure-controlled versus volume-controlled ventilation for acute respiratory failure due to acute lung injury (ALI) or acute respiratory distress syndrome (ARDS).

    Science.gov (United States)

    Chacko, Binila; Peter, John V; Tharyan, Prathap; John, George; Jeyaseelan, Lakshmanan

    2015-01-14

    Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) account for one-quarter of cases of acute respiratory failure in intensive care units (ICUs). A third to half of patients will die in the ICU, in hospital or during follow-up. Mechanical ventilation of people with ALI/ARDS allows time for the lungs to heal, but ventilation is invasive and can result in lung injury. It is uncertain whether ventilator-related injury would be reduced if pressure delivered by the ventilator with each breath is controlled, or whether the volume of air delivered by each breath is limited. To compare pressure-controlled ventilation (PCV) versus volume-controlled ventilation (VCV) in adults with ALI/ARDS to determine whether PCV reduces in-hospital mortality and morbidity in intubated and ventilated adults. In October 2014, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Isssue 9), MEDLINE (1950 to 1 October 2014), EMBASE (1980 to 1 October 2014), the Latin American Caribbean Health Sciences Literature (LILACS) (1994 to 1 October 2014) and Science Citation Index-Expanded (SCI-EXPANDED) at the Institute for Scientific Information (ISI) Web of Science (1990 to 1 October 2014), as well as regional databases, clinical trials registries, conference proceedings and reference lists. Randomized controlled trials (RCTs) and quasi-RCTs (irrespective of language or publication status) of adults with a diagnosis of acute respiratory failure or acute on chronic respiratory failure and fulfilling the criteria for ALI/ARDS as defined by the American-European Consensus Conference who were admitted to an ICU for invasive mechanical ventilation, comparing pressure-controlled or pressure-controlled inverse-ratio ventilation, or an equivalent pressure-controlled mode (PCV), versus volume-controlled ventilation, or an equivalent volume-controlled mode (VCV). Two review authors independently screened and selected trials, assessed risk of bias and extracted

  10. The Wurst protein: A novel endocytosis regulator involved in airway clearance and respiratory tube size control

    OpenAIRE

    Wingen, Christian; Aschenbrenner, Anna C; Stümpges, Birgit; Hoch, Michael; Behr, Matthias

    2009-01-01

    The mammalian lung and the Drosophila airways are composed of an intricate network of epithelial tubes that transports fluids or gases and converts during late embryogenesis from liquid- to air-filling. Conserved growth factor pathways have been characterized in model organisms such as Drosophila or the mouse that control patterning and branching of tubular networks. In contrast, knowledge of the coordination of respiratory tube size and physiology is still limited. Latest studies have shown ...

  11. Self-Reported Respiratory Health Effects Following CS Riot Control Agent Exposure in Army Officer Trainees

    Science.gov (United States)

    2016-05-20

    protective (26). In addition, conditions or habits which affect the respiratory system such as asthma, respiratory allergies, and smoking may increase an...to assess respiratory symptom severity, demographic information, and other variables of interest including respiratory allergies, asthma, smoking ...sensation on unprotected surfaces of the body and nearly instantaneous irritation of the eyes, respiratory system , and skin (36). CS is used as a

  12. Maternal pre-gravid obesity and early childhood respiratory hospitalization: a population-based case-control study.

    Science.gov (United States)

    Parsons, Elizabeth C; Patel, Kevin; Tran, Betty T; Littman, Alyson J

    2013-08-01

    Inflammation in utero is linked to childhood respiratory and infectious complications. Obesity is an increasingly common chronic inflammatory state, yet little is known about its role in childhood respiratory illness. We sought to examine the association between maternal pre-gravid BMI and early childhood respiratory hospitalization. We conducted a population-based case-control study using the Washington State Comprehensive Hospital Abstract Reporting System and linked birth certificate data. Cases were children age 0-5 years, born in Washington state, with a respiratory hospitalization between 2003 and 2008. We identified 15,318 cases, frequency matching each case to two controls by birth year (total 31,060 controls). We used logistic regression to estimate the risk (approximated by odds ratios) of early childhood respiratory hospitalization according to maternal pre-gravid body mass index (BMI) category (underweight, normal, overweight, obese), after adjustment for maternal and infant characteristics. An elevated maternal pre-gravid BMI was associated with increased risk of childhood respiratory hospitalization, with an adjusted odds ratio OR [95 % CI] = 1.08 [1.03-1.14] for overweight mothers (BMI 25-29.9 kg/m(2)), and OR = 1.29 [1.22-1.36] for obese mothers (BMI ≥ 30 kg/m(2)). An elevated maternal pre-gravid BMI was associated with higher risk of early childhood respiratory hospitalization. Childhood respiratory illness may be an important complication of excess maternal weight that should be shared with expectant mothers.

  13. Effect of singing on respiratory function, voice, and mood after quadriplegia: a randomized controlled trial.

    Science.gov (United States)

    Tamplin, Jeanette; Baker, Felicity A; Grocke, Denise; Brazzale, Danny J; Pretto, Jeffrey J; Ruehland, Warren R; Buttifant, Mary; Brown, Douglas J; Berlowitz, David J

    2013-03-01

    To explore the effects of singing training on respiratory function, voice, mood, and quality of life for people with quadriplegia. Randomized controlled trial. Large, university-affiliated public hospital, Victoria, Australia. Participants (N=24) with chronic quadriplegia (C4-8, American Spinal Injury Association grades A and B). The experimental group (n=13) received group singing training 3 times weekly for 12 weeks. The control group (n=11) received group music appreciation and relaxation for 12 weeks. Assessments were conducted pre, mid-, immediately post-, and 6-months postintervention. Standard respiratory function testing, surface electromyographic activity from accessory respiratory muscles, sound pressure levels during vocal tasks, assessments of voice quality (Perceptual Voice Profile, Multidimensional Voice Profile), and Voice Handicap Index, Profile of Mood States, and Assessment of Quality of Life instruments. The singing group increased projected speech intensity (P=.028) and maximum phonation length (P=.007) significantly more than the control group. Trends for improvements in respiratory function, muscle strength, and recruitment were also evident for the singing group. These effects were limited by small sample sizes with large intersubject variability. Both groups demonstrated an improvement in mood (P=.002), which was maintained in the music appreciation and relaxation group after 6 months (P=.017). Group music therapy can have a positive effect on not only physical outcomes, but also can improve mood, energy, social participation, and quality of life for an at-risk population, such as those with quadriplegia. Specific singing therapy can augment these general improvements by improving vocal intensity. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Vitamin E and respiratory tract infections in elderly nursing home residents: a randomized controlled trial.

    Science.gov (United States)

    Meydani, Simin Nikbin; Leka, Lynette S; Fine, Basil C; Dallal, Gerard E; Keusch, Gerald T; Singh, Maria Fiatarone; Hamer, Davidson H

    2004-08-18

    Respiratory tract infections are prevalent in elderly individuals, resulting in increased morbidity, mortality, and use of health care services. Vitamin E supplementation has been shown to improve immune response in elderly persons. However, the clinical importance of these findings has not been determined. To determine the effect of 1 year of vitamin E supplementation on respiratory tract infections in elderly nursing home residents. A randomized, double-blind, placebo-controlled trial was conducted from April 1998 to August 2001 at 33 long-term care facilities in the Boston, Mass, area. A total of 617 persons aged at least 65 years and who met the study's eligibility criteria were enrolled; 451 (73%) completed the study. Vitamin E (200 IU) or placebo capsule administered daily; all participants received a capsule containing half the recommended daily allowance of essential vitamins and minerals. Incidence of respiratory tract infections, number of persons and number of days with respiratory tract infections (upper and lower), and number of new antibiotic prescriptions for respiratory tract infections among all participants randomized and those who completed the study. Vitamin E had no significant effect on incidence or number of days with infection for all, upper, or lower respiratory tract infections. However, fewer participants receiving vitamin E acquired 1 or more respiratory tract infections (60% vs 68%; risk ratio [RR], 0.88; 95% confidence interval [CI], 0.76-1.00; P =.048 for all participants; and 65% vs 74%; RR, 0.88; 95% CI, 0.75-0.99; P =.04 for completing participants), or upper respiratory tract infections (44% vs 52%; RR, 0.84; 95% CI, 0.69-1.00; P =.05 for all participants; and 50% vs 62%; RR, 0.81; 95% CI, 0.66-0.96; P =.01 for completing participants). When common colds were analyzed in a post hoc subgroup analysis, the vitamin E group had a lower incidence of common cold (0.67 vs 0.81 per person-year; RR, 0.83; 95% CI, 0.68-1.01; P =.06 for all

  15. Infection control in cystic fibrosis: cohorting, cross-contamination, and the respiratory therapist.

    Science.gov (United States)

    O'Malley, Catherine A

    2009-05-01

    Cystic fibrosis (CF) is a complex genetic disease characterized by lung infections that lead to early morbidity and death. Pathogens that commonly infect the lungs of patients with CF include Staphylococcus aureus, Haemophilus influenzae, Pseudomonas aeruginosa, and Burkholderia cepacia. Aggressively treating pulmonary infection with antibiotics has contributed to improved survival in patients with CF but has also promoted multiple-drug-resistant bacteria. Other complexities include the ability of bacteria to form biofilms, which makes them more resistant to antibiotics, and emerging pathogens in CF, of which the clinical importance is not yet clear. Increasing evidence of patient-to-patient transmission of CF pathogens led the Cystic Fibrosis Foundation to produce evidence-based infection-control recommendations, which stress 4 principles: standard precautions, transmission-based precautions, hand hygiene, and care of respiratory equipment. Respiratory therapists need to know and follow these infection-control recommendations. Cohorting patients infected with B. cepacia complex is one of several interventions successful at keeping the spread of this pathogen low, but cohorting patients who are infected/colonized with other microbes is controversial, the main argument of which is not being certain of a patient's present respiratory culture status at any given patient visit.

  16. Effect of nitroimidazoles on the oxygen consumption rate and respiratory control ratio of beef heart mitochondria

    Energy Technology Data Exchange (ETDEWEB)

    Chao, C.F.; Ting, L.; Subjeck, J.R.; Johnson, R.J.

    1984-08-01

    The neurotoxic effect of the nitroimidazole radiosensitizers misonidazole (MISO) and desmethylmisonidazole (DMM) has seriously compromised their clinical effectiveness. The authors compare here the effect of MISO and DMM on oxygen consumption in purified beef heart mitochondria. MISO has been found to significantly increase the oxygen consumption rate and decrease the respiratory control ratio in isolated mitochondria when incubated in the presence of the NAD+ dependent substrate, ..beta..-hydroxybutyrate. DMM has a similar but less pronounced effect than MISO on these respiratory parameters. When mitochondria were incubated in the presence of these radiosensitizers for 8, 15, 30, 45, and 60 minutes, the oxygen consumption rate was decreased when succinate, a FAD dependent substrate, was added following the incubation. This decrease, which is both time and dosage dependent, is equivalent for MISO and DMM.

  17. Infection control for the otolaryngologist in the era of severe acute respiratory syndrome.

    Science.gov (United States)

    Alexander, Ashlin J; Tan, Andre K W; Evans, Gerald A; Allen, Janet

    2003-10-01

    Severe acute respiratory syndrome (SARS) has affected more than 8400 persons in 28 countries, with more than 800 deaths. The current SARS outbreak, especially in North American health care centers, has motivated a re-evaluation of infection control practices in the hospital and clinic environment. These considerations are particularly important to otolaryngology, in which examination and diagnostic procedures often bring the otolaryngologist in close--if not direct--contact with the patient's upper airway, mucosa, and secretions. The otolaryngologist is at increased risk of contracting a respiratory pathogen. A joint effort by the Department of Otolaryngology at Queen's University and the Infection Control Services of the Hotel Dieu Hospital, Kingston, Ontario, was carried out to develop specific infection control guidelines for the otolaryngologists using strategies from the Centers for Disease Control and Prevention in the United States and the Laboratory Center for Disease Control, Health Canada. A set of specific recommendations was developed for the otolaryngologists to augment current infection control, including diligent use of personal protective equipment with every patient encounter. Moreover, this equipment should be removed according to specific protocol, to avoid contamination of self, others, and surroundings. Finally, a number of practice modifications are being adopted as prudent precautionary measures. It is essential to adhere to these recommendations in order to protect the health and safety of clinicians, colleagues, and patients.

  18. Assessment of a strategy for the control of respiratory diseases in children

    Directory of Open Access Journals (Sweden)

    Pereira Julio Cesar Rodrigues

    1992-01-01

    Full Text Available A programme for the control of respiratory diseases in children was conceived for the State of S. Paulo, Brazil, in 1986. Its progress thereafter and the epidemiology of the diseases concerned are examined. Apart from an inquiry into the 64 existing State local health authorities, a sample of 18,255 cases of children assisted by the programme at different levels, including both in-patient and outpatient care, is analysed. Each case record included information about identification (child, doctor and health facility, reasons for calling, diagnoses made and outcome of treatment. Further data were also sought from hospitals and from State mortality records. The programme was found to be poorly implemented in the State but, where implemented, it showed itself capable of resolving problems (only 0.5% of the cases could not be handled as also of changing ongoing trends (more than 50% reduction in hospital admission rates. Individual assessment of each item of the programme indicated its bottlenecks. Regarding the epidemiology of respiratory diseases, it is observed that the major burden to health services comes from children aged less than five, and that the most important diseases are wheezing illnesses and pneumonia. Morevoer, they were found to be significantly associated (p = 0.000 so that a child in the community presenting wheezing diseases is 5 times more likely to develop pneumonia than a child with any other respiratory diagnosis. Similarly, among the under five deaths it was found that the risk for pneumonia is 3 times greater for children who died presenting wheezing diseases than it is for children with any other sort of diagnosis. In conclusion, the programme is deemed to be efficient and effective but its efficacy is marred by administrative flaws. The successful control of respiratory problems in childhood is related to a proper appreciation of the importance of wheezing diseases.

  19. Respiratory syncytial virus outbreak in neonatal intensive care unit: Impact of infection control measures plus palivizumab use

    Directory of Open Access Journals (Sweden)

    Silva Camila de A

    2012-05-01

    Full Text Available Abstract Background The occurrence of a respiratory syncytial virus (RSV outbreak in a Neonatal Intensive Care Unit (NICU is related to unfavorable outcomes, as this infection can lead to respiratory distress and death in premature in infants. Report the successful control of an outbreak that occurred in April 2010 in a NICU. Methods After the index case, of 18 premature infants placed in the same room 10 infants were infected. Of those 10, 6 developed mild to moderate respiratory symptoms, 4 persisted asymptomatic and no death occurred. Contact and respiratory precautions were rapidly initiated, the infants were cohorted in 3 different rooms and palivizumab was administered to all contacts. Results The outbreak was controlled and no new cases were subsequently indentified. Conclusion Standard infection control measures plus palivizumab prophylaxis were efficient in rapid control of the outbreak.

  20. Motor control exercises of the lumbar-pelvic region improve respiratory function in obese men. A pilot study.

    Science.gov (United States)

    Bezzoli, Emanuela; Andreotti, Dianne; Pianta, Lucia; Mascheroni, Martina; Piccinno, Lorena; Puricelli, Luca; Cimolin, Veronica; Salvadori, Alberto; Codecasa, Franco; Capodaglio, Paolo

    2016-11-10

    Obese subjects have decreased pulmonary function. The hypothesis of our study was that poor coordination of the lumbar-pelvic musculature secondary to obesity may hinder the synergic activation of the respiratory muscles. The aim of the paper was to evaluate whether specific motor control exercises of the lumbar-pelvic musculature were able to improve respiratory function. Twenty obese male patients underwent a rehabilitation program including adapted physical activity and respiratory physiotherapy. Patients were randomly assigned to a Specific Motor Control Exercise Group (SG) and a Control Group (CG). SG followed a protocol according to the SMARTERehab concept aimed at improving posture, intra-abdominal pressure, rib cage mobility, and perception of correct muscle activation. CG performed an exercise training protocol to improve aerobic capacity and muscle strength. After intervention, both groups showed similar changes in body weight, fat, and fat-free mass. Respiratory function indexes improved in SG due to improved proprioception and coordination of the deep lumbar-pelvic muscles. Our study provides preliminary evidence that breathing, postural control, and spinal stability are intertwined. Positive respiratory effects in obese men can be obtained by prescribing specific motor control exercises of the lumbar-pelvic muscles. Implications for rehabilitation Obese subjects present with decreased pulmonary function and postural changes. Poor coordination of the lumbar-pelvic muscles affects posture and the synergic activation of the respiratory muscles. Specific motor control exercises of the lumbar-pelvic musculature can improve respiratory function. Breathing and postural control are intertwined: positive respiratory effects can be obtained by enhancing motor control of the lumbar-pelvic muscles.

  1. Voluntary Public Unemployment Insurance

    DEFF Research Database (Denmark)

    O. Parsons, Donald; Tranæs, Torben; Bie Lilleør, Helene

    Denmark has drawn much attention for its active labor market policies, but is almost unique in offering a voluntary public unemployment insurance program requiring a significant premium payment. A safety net program – a less generous, means-tested social assistance plan – completes the system....... The voluntary system emerged as one of many European “Ghent systems,” essentially government subsidized trade union plans, but has since lost many key features of such plans. We assess system performance using a 10% sample of the Danish population drawn from administrative data. Coverage rates for the voluntary...

  2. A metagenomics and case-control study to identify viruses associated with bovine respiratory disease.

    Science.gov (United States)

    Ng, Terry Fei Fan; Kondov, Nikola O; Deng, Xutao; Van Eenennaam, Alison; Neibergs, Holly L; Delwart, Eric

    2015-05-01

    Bovine respiratory disease (BRD) is a common health problem for both dairy and beef cattle, resulting in significant economic loses. In order to identify viruses associated with BRD, we used a metagenomics approach to enrich and sequence viral nucleic acids in the nasal swabs of 50 young dairy cattle with symptoms of BRD. Following deep sequencing, de novo assembly, and translated protein sequence similarity searches, numerous known and previously uncharacterized viruses were identified. Bovine adenovirus 3, bovine adeno-associated virus, bovine influenza D virus, bovine parvovirus 2, bovine herpesvirus 6, bovine rhinitis A virus, and multiple genotypes of bovine rhinitis B virus were identified. The genomes of a previously uncharacterized astrovirus and picobirnaviruses were also partially or fully sequenced. Using real-time PCR, the rates of detection of the eight viruses that generated the most reads were compared for the nasal secretions of 50 animals with BRD versus 50 location-matched healthy control animals. Viruses were detected in 68% of BRD-affected animals versus 16% of healthy control animals. Thirty-eight percent of sick animals versus 8% of controls were infected with multiple respiratory viruses. Significantly associated with BRD were bovine adenovirus 3 (P metagenomics and real-time PCR detection approach in carefully matched cases and controls can provide a rapid means to identify viruses associated with a complex disease, paving the way for further confirmatory tests and ultimately to effective intervention strategies. Bovine respiratory disease is the most economically important disease affecting the cattle industry, whose complex root causes include environmental, genetics, and infectious factors. Using an unbiased metagenomics approach, we characterized the viruses in respiratory secretions from BRD cases and identified known and previously uncharacterized viruses belonging to seven viral families. Using a case-control format with location

  3. Social Mixing Patterns Within a South African Township Community: Implications for Respiratory Disease Transmission and Control

    Science.gov (United States)

    Johnstone-Robertson, Simon P.; Mark, Daniella; Morrow, Carl; Middelkoop, Keren; Chiswell, Melika; Aquino, Lisa D. H.; Bekker, Linda-Gail; Wood, Robin

    2011-01-01

    A prospective survey of social mixing patterns relevant to respiratory disease transmission by large droplets (e.g., influenza) or small droplet nuclei (e.g., tuberculosis) was performed in a South African township in 2010. A total of 571 randomly selected participants recorded the numbers, times, and locations of close contacts (physical/nonphysical) and indoor casual contacts met daily. The median number of physical contacts was 12 (interquartile range (IQR), 7–18), the median number of close contacts was 20 (IQR, 13–29), and the total number of indoor contacts was 30 (IQR, 12–54). Physical and close contacts were most frequent and age-associative in youths aged 5–19 years. Numbers of close contacts were 40% higher than in corresponding populations in industrialized countries (P < 0.001). This may put township communities at higher risk for epidemics of acute respiratory illnesses. Simulations of an acute influenza epidemic predominantly involved adolescents and young adults, indicating that control strategies should be directed toward these age groups. Of all contacts, 86.2% occurred indoors with potential exposure to respiratory droplet nuclei, of which 27.2%, 20.1%, 20.0%, and 8.0% were in transport, own household, crèche/school, and work locations, respectively. Indoor contact time was long in households and short during transport. High numbers of indoor contacts and intergenerational mixing in households and transport may contribute to exceptionally high rates of tuberculosis transmission reported in the community. PMID:22071585

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

    Science.gov (United States)

    Verbraecken, Johan; McNicholas, Walter T

    2013-11-20

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

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

    Science.gov (United States)

    2013-01-01

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

  6. Chronic heart failure modifies respiratory mechanics in rats: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Deise M. Pacheco

    2016-01-01

    Full Text Available ABSTRACT Objective To analyze respiratory mechanics and hemodynamic alterations in an experimental model of chronic heart failure (CHF following myocardial infarction. Method Twenty-seven male adult Wistar rats were randomized to CHF group (n=12 or Sham group (n=15. Ten weeks after coronary ligation or sham surgery, the animals were anesthetized and submitted to respiratory mechanics and hemodynamic measurements. Pulmonary edema as well as cardiac remodeling were measured. Results The CHF rats showed pulmonary edema 26% higher than the Sham group. The respiratory system compliance (Crs and the total lung capacity (TLC were lower (40% and 27%, respectively in the CHF rats when compared to the Sham group (P<0.01. There was also an increase in tissue resistance (Gti and elastance (Hti (28% and 45%, respectively in the CHF group. Moreover, left ventricular end-diastolic pressure was higher (32 mmHg vs 4 mmHg, P<0.01, while the left ventricular systolic pressure was lower (118 mmHg vs 130 mmHg, P=0.02 in the CHF group when compared to the control. Pearson’s correlation coefficient showed a negative association between pulmonary edema and Crs (r=–0.70, P=0.0001 and between pulmonary edema and TLC (r=–0.67,P=0.0034. Pulmonary edema correlated positively with Gti (r=0.68, P=0.001 and Hti (r=0.68, P=0.001. Finally, there was a strong positive relationship between pulmonary edema and heart weight (r=0.80, P=0.001. Conclusion Rats with CHF present important changes in hemodynamic and respiratory mechanics, which may be associated with alterations in cardiopulmonary interactions.

  7. The effect of feedback respiratory training on pulmonary function of children with cerebral palsy: a randomized controlled preliminary report.

    Science.gov (United States)

    Lee, Hye Young; Cha, Yong Jun; Kim, Kyoung

    2014-10-01

    To investigate the effect of feedback respiratory training on pulmonary function of children with cerebral palsy. Randomized controlled experimental study. Outpatient rehabilitation hospital. Twenty-two children with cerebral palsy were randomly assigned to two groups: the experimental group (feedback respiratory training) and the control group. Feedback respiratory training and comprehensive rehabilitation therapy were performed by children in the experimental group. Comprehensive rehabilitation therapy was performed by children in the control group. Children in both groups received training three times per week for a period of four weeks. Forced vital capacity, forced expiratory volume at one second, peak expiratory flow, vital capacity, tidal volume, inspiratory reserve volume and expiratory reserve volume were assessed before and after four weeks training period. Significant improvements in pulmonary function were observed after training in the experimental group (P 0.05). Participation in feedback respiratory training resulted in improvement of pulmonary function of children with cerebral palsy. © The Author(s) 2013.

  8. A respiratory chain controlled signal transduction cascade in the mitochondrial intermembrane space mediates hydrogen peroxide signaling.

    Science.gov (United States)

    Patterson, Heide Christine; Gerbeth, Carolin; Thiru, Prathapan; Vögtle, Nora F; Knoll, Marko; Shahsafaei, Aliakbar; Samocha, Kaitlin E; Huang, Cher X; Harden, Mark Michael; Song, Rui; Chen, Cynthia; Kao, Jennifer; Shi, Jiahai; Salmon, Wendy; Shaul, Yoav D; Stokes, Matthew P; Silva, Jeffrey C; Bell, George W; MacArthur, Daniel G; Ruland, Jürgen; Meisinger, Chris; Lodish, Harvey F

    2015-10-20

    Reactive oxygen species (ROS) such as hydrogen peroxide (H2O2) govern cellular homeostasis by inducing signaling. H2O2 modulates the activity of phosphatases and many other signaling molecules through oxidation of critical cysteine residues, which led to the notion that initiation of ROS signaling is broad and nonspecific, and thus fundamentally distinct from other signaling pathways. Here, we report that H2O2 signaling bears hallmarks of a regular signal transduction cascade. It is controlled by hierarchical signaling events resulting in a focused response as the results place the mitochondrial respiratory chain upstream of tyrosine-protein kinase Lyn, Lyn upstream of tyrosine-protein kinase SYK (Syk), and Syk upstream of numerous targets involved in signaling, transcription, translation, metabolism, and cell cycle regulation. The active mediators of H2O2 signaling colocalize as H2O2 induces mitochondria-associated Lyn and Syk phosphorylation, and a pool of Lyn and Syk reside in the mitochondrial intermembrane space. Finally, the same intermediaries control the signaling response in tissues and species responsive to H2O2 as the respiratory chain, Lyn, and Syk were similarly required for H2O2 signaling in mouse B cells, fibroblasts, and chicken DT40 B cells. Consistent with a broad role, the Syk pathway is coexpressed across tissues, is of early metazoan origin, and displays evidence of evolutionary constraint in the human. These results suggest that H2O2 signaling is under control of a signal transduction pathway that links the respiratory chain to the mitochondrial intermembrane space-localized, ubiquitous, and ancient Syk pathway in hematopoietic and nonhematopoietic cells.

  9. Prevention of postoperative pulmonary complications through respiratory rehabilitation: a controlled clinical study.

    Science.gov (United States)

    Chumillas, S; Ponce, J L; Delgado, F; Viciano, V; Mateu, M

    1998-01-01

    To investigate the efficacy of respiratory rehabilitation in preventing postoperative pulmonary complications (PPC) and to define which patients can benefit. A randomized clinical trial. A public hospital. Eighty-one patients who had upper abdominal surgery were distributed into two homogeneous groups: control (n = 41) and rehabilitation (n = 40). Breathing exercises in the rehabilitation group. Preoperative and postoperative clinical evaluation, spirometry, arterial gasometry, and simple chest X-rays. The incidence of PPC was 7.5% in the rehabilitation group and 19.5% in the control group; the control group also had more radiologic alterations (p = .01). Stratified PPC analysis did not reveal significant differences between groups. However, high- and moderate-risk patients in the rehabilitation group had fewer PPC. Multivariate analysis showed a greater PPC risk associated with pulmonary history (p = .02) and duration of surgery longer than 120 min (p = .03), while rehabilitation exerted a protective effect (p = .06). Significant postoperative decreases in pulmonary volumes and arterial gas values were recorded in both groups, without significant differences. Respiratory rehabilitation protects against PPC and is more effective in moderate- and high-risk patients, but does not affect surgery-induced functional alterations.

  10. Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety

    Directory of Open Access Journals (Sweden)

    Renata André Laurino

    2012-11-01

    Full Text Available OBJECTIVES: The objectives of this study were to verify the degree of anxiety, respiratory distress, and health-related quality of life in a group of asthmatic patients who have experienced previous panic attacks. Additionally, we evaluated if a respiratory physiotherapy program (breathing retraining improved both asthma and panic disorder symptoms, resulting in an improvement in the health-related quality of life of asthmatics. METHODS: Asthmatic individuals were assigned to a chest physiotherapy group that included a breathing retraining program held once a week for three months or a paired control group that included a Subtle Touch program. All patients were assessed using the Diagnostic and Statistical Manual of Mental Disorders IV, the Sheehan Anxiety Scale, the Quality of Life Questionnaire, and spirometry parameter measurements. RESULTS: Both groups had high marks for panic disorder and agoraphobia, which limited their quality of life. The Breathing Retraining Group program improved the clinical control of asthma, reduced panic symptoms and agoraphobia, decreased patient scores on the Sheehan Anxiety Scale, and improved their quality of life. Spirometry parameters were unchanged. CONCLUSION: Breathing retraining improves the clinical control of asthma and anxiety symptoms and the health-related quality of life in asthmatic patients.

  11. Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety.

    Science.gov (United States)

    Laurino, Renata André; Barnabé, Viviane; Saraiva-Romanholo, Beatriz M; Stelmach, Rafael; Cukier, Alberto; Nunes, Maria do Patrocínio T

    2012-11-01

    The objectives of this study were to verify the degree of anxiety, respiratory distress, and health-related quality of life in a group of asthmatic patients who have experienced previous panic attacks. Additionally, we evaluated if a respiratory physiotherapy program (breathing retraining) improved both asthma and panic disorder symptoms, resulting in an improvement in the health-related quality of life of asthmatics. Asthmatic individuals were assigned to a chest physiotherapy group that included a breathing retraining program held once a week for three months or a paired control group that included a Subtle Touch program. All patients were assessed using the Diagnostic and Statistical Manual of Mental Disorders IV, the Sheehan Anxiety Scale, the Quality of Life Questionnaire, and spirometry parameter measurements. Both groups had high marks for panic disorder and agoraphobia, which limited their quality of life. The Breathing Retraining Group program improved the clinical control of asthma, reduced panic symptoms and agoraphobia, decreased patient scores on the Sheehan Anxiety Scale, and improved their quality of life. Spirometry parameters were unchanged. Breathing retraining improves the clinical control of asthma and anxiety symptoms and the health-related quality of life in asthmatic patients.

  12. Chlamydiae in febrile children with respiratory tract symptoms and age-matched controls, Ghana

    Directory of Open Access Journals (Sweden)

    H. Bühl

    2018-03-01

    Full Text Available Members of the Chlamydiales order are obligate intracellular pathogens causing acute and chronic infectious diseases. Chlamydiaceae are established agents of community- and zoonotically acquired respiratory tract infections, and emerging pathogens among the Chlamydia-related bacteria have been implicated in airway infections. The role of both in airway infections in Africa is underexplored. We performed a case -control study on the prevalence of Chlamydiaceae and Chlamydia-related emerging pathogens in children with febrile respiratory tract infections in West Africa, Ghana. Using a pan-Chlamydiales broad-range real-time PCR, we detected chlamydial DNA in 11 (1.9% of 572 hospitalized febrile children with respiratory tract symptoms and in 24 (4.3% of 560 asymptomatic age-matched controls (p 0.03. Chlamydiaceae were found to be common among both symptomatic and healthy Ghanaian children, with Chlamydia pneumoniae being the most prevalent species. Parachlamydiaceae were detected in two children without symptoms but not in the symptomatic group. We identified neither Chlamydia psittaci nor Simkania negevensis but a member of a new chlamydial family that shared 90.2% sequence identity with the 16S rRNA gene of the zoonotic pathogen Chlamydia pecorum. In addition, we found a new Chlamydia-related species that belonged to a novel family sharing 91.3% 16S rRNA sequence identity with Candidatus Syngnamydia venezia. The prevalence and spectrum of chlamydial species differed from previous results obtained from children of other geographic regions and our study indicates that both, Chlamydiaceae and Chlamydia-related bacteria, are not clearly linked to clinical symptoms in Ghanaian children.

  13. Aerobic Exercise Training and Incentive Spirometry Can Control Age-related respiratory muscles performance Changes in Elderly

    OpenAIRE

    El-Kader, Shehab Mahmoud Abd; Ashmawy, Eman Mohamed Salah El-Den

    2013-01-01

    As aging occurs, the respiratory system undergoes a measurable decline in physiological functions. The aim of this study was to determine the effect of walking exercise and incentive spirometry in controlling age related respiratory muscles function changes in elderly. Forty elderly subjects of both sexes their age ranged from 65 to 74 years and included into two equal groups; group (A) received walking exercise and incentive spirometery three times a week for 3 months, where group (B) receiv...

  14. Peripheral-central chemoreceptor interaction and the significance of a critical period in the development of respiratory control

    Science.gov (United States)

    Wong-Riley, Margaret T.T.; Liu, Qiuli; Gao, Xiu-ping

    2012-01-01

    Respiratory control entails coordinated activities of peripheral chemoreceptors (mainly the carotid bodies) and central chemosensors within the brain stem respiratory network. Candidates for central chemoreceptors include Phox2b-containing neurons of the retrotrapezoid nucleus, serotonergic neurons of the medullary raphé, and/or multiple sites within the brain stem. Extensive interconnections among respiratory-related nuclei enable central chemosensitive relay. Both peripheral and central respiratory centers are not mature at birth, but undergo considerable development during the first two postnatal weeks in rats. A critical period of respiratory development (~P12–13 in the rat) exists when abrupt neurochemical, metabolic, ventilatory, and electrophysiological changes occur. Environmental perturbations, including hypoxia, intermittent hypoxia, hypercapnia, and hyperoxia alter the development of the respiratory system. Carotid body denervation during the first two postnatal weeks in the rat profoundly affects the development and functions of central respiratory-related nuclei. Such denervation delays and prolongs the critical period, but does not eliminate it, suggesting that the critical period may be intrinsically and genetically determined. PMID:22684042

  15. 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.

  16. Eupnea, tachypnea, and autoresuscitation in a closed-loop respiratory control model.

    Science.gov (United States)

    Diekman, Casey O; Thomas, Peter J; Wilson, Christopher G

    2017-10-01

    How sensory information influences the dynamics of rhythm generation varies across systems, and general principles for understanding this aspect of motor control are lacking. Determining the origin of respiratory rhythm generation is challenging because the mechanisms in a central circuit considered in isolation may be different from those in the intact organism. We analyze a closed-loop respiratory control model incorporating a central pattern generator (CPG), the Butera-Rinzel-Smith (BRS) model, together with lung mechanics, oxygen handling, and chemosensory components. We show that 1) embedding the BRS model neuron in a control loop creates a bistable system; 2) although closed-loop and open-loop (isolated) CPG systems both support eupnea-like bursting activity, they do so via distinct mechanisms; 3) chemosensory feedback in the closed loop improves robustness to variable metabolic demand; 4) the BRS model conductances provide an autoresuscitation mechanism for recovery from transient interruption of chemosensory feedback; and 5) the in vitro brain stem CPG slice responds to hypoxia with transient bursting that is qualitatively similar to in silico autoresuscitation. Bistability of bursting and tonic spiking in the closed-loop system corresponds to coexistence of eupnea-like breathing, with normal minute ventilation and blood oxygen level and a tachypnea-like state, with pathologically reduced minute ventilation and critically low blood oxygen. Disruption of the normal breathing rhythm, through either imposition of hypoxia or interruption of chemosensory feedback, can push the system from the eupneic state into the tachypneic state. We use geometric singular perturbation theory to analyze the system dynamics at the boundary separating eupnea-like and tachypnea-like outcomes.NEW & NOTEWORTHY A common challenge facing rhythmic biological processes is the adaptive regulation of central pattern generator (CPG) activity in response to sensory feedback. We apply

  17. Randomised placebo controlled trial of nebulised corticosteroids in acute respiratory syncytial viral bronchiolitis.

    Science.gov (United States)

    Cade, A; Brownlee, K G; Conway, S P; Haigh, D; Short, A; Brown, J; Dassu, D; Mason, S A; Phillips, A; Eglin, R; Graham, M; Chetcuti, A; Chatrath, M; Hudson, N; Thomas, A; Chetcuti, P A

    2000-02-01

    To evaluate short and long term effects of giving nebulised budesonide early in respiratory syncytial viral (RSV) bronchiolitis. A multicentre randomised double blind placebo controlled trial. Infants admitted to hospital with their first episode of RSV positive bronchiolitis. Randomisation to receive either 1 mg of nebulised budesonide (Bud) or placebo (Pla) twice daily from admission until 2 weeks after discharge. Follow up was for 12 months. Duration of hospital admission, time taken to become symptom free, re-admission rates, general practitioner consultation rates, and use of anti-wheeze medication during follow up. 161 infants were studied. Both arms were similar with respect to initial clinical severity, age, sex, socioeconomic class, and tobacco exposure. Median time from first nebulisation to discharge: Bud and Pla, 2 days. Median number of days for 50% of infants to be symptom free for 48 hours: Bud, 10 days; Pla, 12 days. Respiratory re-admission rates in the 12 month follow up: Bud, 16%; Pla, 18%; median difference (95% confidence interval (CI)), -2 (-14 to 10). Median respiratory related general practitioner attendances: Bud, 4.0; Pla, 4.5; median difference (95% CI), -1 (-2 to 0). Percentage of infants receiving at least one prescription for anti-wheeze medication during follow up, corticosteroids: Bud, 50%; Pla, 60%; difference (95% CI), -10 (-26 to 6); bronchodilators: Bud, 60%; Pla, 67%; difference (95% CI), -7 (-22 to 8). There are no short or long term clinical benefits from the administration of nebulised corticosteroids in the acute phase of RSV bronchiolitis.

  18. Automated quality control of forced oscillation measurements: respiratory artifact detection with advanced feature extraction.

    Science.gov (United States)

    Pham, Thuy T; Leong, Philip H W; Robinson, Paul D; Gutzler, Thomas; Jee, Adelle S; King, Gregory G; Thamrin, Cindy

    2017-10-01

    The forced oscillation technique (FOT) can provide unique and clinically relevant lung function information with little cooperation with subjects. However, FOT has higher variability than spirometry, possibly because strategies for quality control and reducing artifacts in FOT measurements have yet to be standardized or validated. Many quality control procedures rely on either simple statistical filters or subjective evaluation by a human operator. In this study, we propose an automated artifact removal approach based on the resistance against flow profile, applied to complete breaths. We report results obtained from data recorded from children and adults, with and without asthma. Our proposed method has 76% agreement with a human operator for the adult data set and 79% for the pediatric data set. Furthermore, we assessed the variability of respiratory resistance measured by FOT using within-session variation (wCV) and between-session variation (bCV). In the asthmatic adults test data set, our method was again similar to that of the manual operator for wCV (6.5 vs. 6.9%) and significantly improved bCV (8.2 vs. 8.9%). Our combined automated breath removal approach based on advanced feature extraction offers better or equivalent quality control of FOT measurements compared with an expert operator and computationally more intensive methods in terms of accuracy and reducing intrasubject variability.NEW & NOTEWORTHY The forced oscillation technique (FOT) is gaining wider acceptance for clinical testing; however, strategies for quality control are still highly variable and require a high level of subjectivity. We propose an automated, complete breath approach for removal of respiratory artifacts from FOT measurements, using feature extraction and an interquartile range filter. Our approach offers better or equivalent performance compared with an expert operator, in terms of accuracy and reducing intrasubject variability. Copyright © 2017 the American Physiological

  19. 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.

  20. A prospective randomized controlled blinded study of three bronchodilators in infants with respiratory syncytial virus bronchiolitis on mechanical ventilation.

    Science.gov (United States)

    Levin, Daniel L; Garg, Abhinav; Hall, Leila J; Slogic, Scott; Jarvis, J Dean; Leiter, James C

    2008-11-01

    To study patients with respiratory syncytial virus bronchiolitis in respiratory failure to make specific measurements reflecting airway resistance before and after treatment with commonly used agents. We hypothesized that racemic epinephrine would decrease airways resistance more effectively than levalbuterol, and levalbuterol would decrease airways resistance more effectively than racemic albuterol. Normal saline was used as a control. Prospective, randomized, controlled, blinded study. Tertiary Pediatric Intensive Care Unit in a University affiliated hospital in the northeastern United States. Twenty-two patients with respiratory syncytial virus bronchiolitis and in respiratory failure were enrolled. All were intubated and ventilated in a volume control mode and sedated. In a randomized, blinded fashion patients were given four agents: norepinephrine, levalbuterol, racemic albuterol, and normal saline at 6 hr intervals. As indicators of bronchodilation, peak inspiratory pressure and inspiratory respiratory system resistance were measured before and 20 mins after each agent was given. Thus, each patient acted as his/her own control. There were small but statistically significant decreases in peak inspiratory pressure after racemic epinephrine treatment, levalbuterol, and racemic albuterol. There was no change in peak inspiratory pressure after inhaled normal saline. Inspiratory respiratory system resistance fell significantly after all treatments, including saline. Heart rate rose significantly after inhaled bronchodilator treatments (p < 0.05 for all treatments). Similar statistically significant bronchodilation occurred after all three bronchodilators as indicated by a decrease in peak inspiratory pressure and respiratory system resistance, but these changes were small and probably clinically insignificant. However, side effects of bronchodilators, such as tachycardia, also occurred, and these may be clinically significant. Thus the benefit of bronchodilator

  1. Impact of Infection Prevention and Control Initiatives on Acute Respiratory Infections in a Pediatric Long-Term Care Facility.

    Science.gov (United States)

    Murray, Meghan T; Jackson, Olivia; Cohen, Bevin; Hutcheon, Gordon; Saiman, Lisa; Larson, Elaine; Neu, Natalie

    2016-07-01

    We evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly. Infect Control Hosp Epidemiol 2016;37:859-862.

  2. Respiratory sinus arrhythmia, effortful control, and parenting as predictors of children's sympathy across early childhood.

    Science.gov (United States)

    Taylor, Zoe E; Eisenberg, Nancy; Spinrad, Tracy L

    2015-01-01

    The goal of this study was to examine physiological and environmental predictors of children's sympathy (an emotional response consisting of feelings of concern or sorrow for others who are distressed or in need) and whether temperamental effortful control mediated these relations. Specifically, in a study of 192 children (23% Hispanic; 54% male), respiratory sinus arrhythmia (RSA), a measure thought to reflect physiological regulation, and observed authoritative parenting (both at 42 months) were examined as predictors of children's effortful control (at 54 months) and, in turn, children's sympathy (at 72 and 84 months). Measures of both baseline RSA and RSA suppression were examined. In a structural equation model, observed parenting was positively related to children's subsequent sympathy through its positive relation to effortful control. Furthermore, the indirect path from baseline RSA to higher sympathy through effortful control was marginally significant. Authoritative parenting and baseline RSA uniquely predicted individual differences in children's effortful control. Findings highlight the potential role of both authoritative parenting and physiological regulation in the development of children's sympathy.

  3. Respiratory sinus arrhythmia, shyness, and effortful control in preschool-age children.

    Science.gov (United States)

    Sulik, Michael J; Eisenberg, Nancy; Silva, Kassondra M; Spinrad, Tracy L; Kupfer, Anne

    2013-02-01

    Resting respiratory sinus arrhythmia (RSA) and shyness were examined as predictors of effortful control (EC) in a sample of 101 preschool-age children. Resting RSA was calculated from respiration and heart rate data collected during a neutral film; shyness was measured using parents', preschool teachers', and classroom observers' reports; and EC was measured using four laboratory tasks in addition to questionnaire measures. Principal components analysis was used to create composite measures of EC and shyness. The relation between RSA and EC was moderated by shyness, such that RSA was positively related to EC only for children high in shyness. This interaction suggests that emotional reactivity affects the degree to which RSA can be considered a correlate of EC. This study also draws attention to the need to consider the measurement context when assessing resting psychophysiology measures; shy individuals may not exhibit true baseline RSA responding in an unfamiliar laboratory setting. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. First clinical trial of tomographic neurofeedback in attention-deficit/hyperactivity disorder: evaluation of voluntary cortical control.

    Science.gov (United States)

    Liechti, Martina D; Maurizio, Stefano; Heinrich, Hartmut; Jäncke, Lutz; Meier, Lea; Steinhausen, Hans-Christoph; Walitza, Susanne; Drechsler, Renate; Brandeis, Daniel

    2012-10-01

    Tomographic neurofeedback (tNF) training was evaluated as a treatment for attention-deficit/hyperactivity disorder (ADHD). To investigate the specificity of the treatment, outcomes were related to learning during tNF. Thirteen children with ADHD trained over 36 lessons to regulate their brain activity in the anterior cingulate cortex (ACC) using both theta-beta frequency and slow cortical potential (SCP) protocols. Thirty-channel electroencephalogram (EEG) was used to calculate low-resolution electromagnetic tNF and to assess the course of the training. Pre- and post-assessments included questionnaires, tests of attention, EEG recordings, and cognitive event-related potentials. Despite behavioural improvement and EEG artefact reduction, only partial learning was found for ACC parameters. Successful regulation was observed only for a simple feedback variant of SCP training, but with ACC-specific effects. Over training, resting EEG analysis indicated individual frequency normalisation rather than unidirectional changes across subjects. These results indicate that clinical improvement after ACC-tNF training can parallel artefact reduction without substantial learning of improved cortical control. However, individual normalisation of resting EEG activity and partial SCP control proved possible in this specific brain region affected in ADHD using tNF. Further studies are needed to clarify which critical aspects mediate region-specific learning in neurofeedback. This study is the first to systematically investigate tNF in children suffering from a psychiatric disorder. Copyright © 2012 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Paralyzed Patients Regain Voluntary Movement

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Spinal Cord Stimulation Paralyzed Patients Regain Voluntary Movement Past Issues / Summer ... a lifelong sentence of permanent paralysis." Read More "Spinal Cord Stimulation" Articles Paralyzed Patients Regain Voluntary Movement / Progress in ...

  6. Factors associated with asthma control in patients with aspirin-exacerbated respiratory disease.

    Science.gov (United States)

    Bochenek, Grazyna; Szafraniec, Krystyna; Kuschill-Dziurda, Joanna; Nizankowska-Mogilnicka, Ewa

    2015-05-01

    Effective control of asthma is the primary goal of its treatment. Despite an improved understanding of asthma pathogenesis and accessibility of novel therapies, the rate of uncontrolled asthma remains high. To find potential factors associated with asthma control in patients with aspirin-exacerbated respiratory disease (AERD). Clinical data were collected from a specifically structured questionnaire. Demographics, a history of upper airway symptoms, asthma course, exacerbations expressed as emergency department (ED) visits/hospitalizations, and asthma treatment were considered. Spirometry, skin prick tests, total IgE concentration, and blood eosinophil count were evaluated. Asthma control was assessed through the Asthma Control Test (ACT). Out of 201 AERD patients, 41 (20.4%), 69 (34.3%), and 91 (45.3%) had controlled, partially controlled, and uncontrolled asthma, respectively. A multivariate ordered logistic regression analysis revealed that hospitalizations for asthma in the previous 12 months (OR 2.88; 95%CI, 1.11-7.46), ED visits for asthma throughout its duration (OR 1.05; 95%CI, 1.004-1.10), and total IgE concentration (OR 1.28; 95%CI, 1.02-1.60) were positively associated with poor asthma control, whereas FEV1 values (OR 0.98; 95%CI, 0.96-0.99) and medical care at a referential specialty clinic (OR 0.50; 95%CI, 0.27-0.95) were positively associated with good asthma control. The prevalence of uncontrolled asthma in AERD patients is high and similar to that observed in different asthmatic populations. Owing both to the specificity and complexity of the disease, AERD patients should stay under regular care of well experienced referential medical centers to ensure that this asthma phenotype is dealt with effectively. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. A generalized method for controlling end-tidal respiratory gases during nonsteady physiological conditions.

    Science.gov (United States)

    O'Connor, Shawn M; Wong, Jeremy D; Donelan, J Maxwell

    2016-12-01

    While forcing of end-tidal gases by regulating inspired gas concentrations is a common technique for studying cardiorespiratory physiology, independently controlling end-tidal gases is technically challenging. Feedforward control methods are challenging because end-tidal values vary as a dynamic function of both inspired gases and other nonregulated physiological parameters. Conventional feedback control is limited by delays within the lungs and body tissues and within the end-tidal forcing system itself. Consequently, modern end-tidal forcing studies have generally restricted their analysis to simple time courses of end-tidal gases and to resting steady-state conditions. To overcome these limitations, we have designed and validated a more generalized end-tidal forcing system that removes the need for manual tuning and rule-of-thumb based control heuristics, while allowing for accurate control of gases along spontaneous and complicated time courses and under nonsteady physiological conditions. On average during resting, steady walking, and walking with time varying speed, our system achieved step changes in PetCO2 within 3.0 ± 0.9 (mean ± SD) breaths and PetO2 within 4.4 ± 0.9 breaths, while also maintaining small steady-state errors of 0.1 ± 0.2 mmHg for PetCO2 and 0.3 ± 0.8 mmHg for PetO2 The system also accurately tracked more complicated changes in end-tidal values through a bandwidth of 1/10 the respiratory (sampling) frequency, a practical limit of feedback control systems. The primary mechanism enabling this controller performance is a generic mathematical model of the cardiopulmonary system that captures the breath-by-breath relationship between inspired and end-tidal gas concentrations, with secondary contributions from reduced delays in controlled air delivery.

  8. Infections and respiratory tract disease as risk factors for idiopathic inflammatory myopathies: a population-based case-control study.

    Science.gov (United States)

    Svensson, John; Holmqvist, Marie; Lundberg, Ingrid E; Arkema, Elizabeth V

    2017-11-01

    To investigate the association between infection or respiratory tract disease and future risk of developing idiopathic inflammatory myopathy (IIM). A case-control study was performed using Swedish nationwide registers. Adults with newly diagnosed IIM were identified (2002-2011) from the National Patient Register (NPR) and the Swedish Rheumatology Register (n=957). Controls were matched by age, sex and place of residence (n=9476). Outpatient visits and hospitalisations preceding IIM diagnosis indicating infection or respiratory disease were identified from NPR. Conditional logistic regression models were used to calculate OR and 95% CI. Sensitivity analyses were performed by varying the exposure definition, adjusting for previous healthcare consumption and excluding individuals with connective tissue disease, IIM lung phenotype or IIM-associated cancer. Preceding infections were more common in IIM cases compared with controls (13% vs 9%) and were associated with an increased risk of IIM (OR 1.5, 95% CI 1.2 to 1.9). Gastrointestinal and respiratory tract infections were associated with an increased risk of IIM while cutaneous infections were not.Preceding respiratory tract disease was present in 10% of IIM cases and 4% of controls (OR 2.3, 95% CI 1.8 to 3.0). Both upper and lower respiratory tract diseases were associated with an increased risk of IIM.Variations in exposure and outcome definitions did not greatly affect the results. Infections and respiratory tract diseases are associated with an increased risk of IIM which suggests that the triggering of the immune system may take place outside the skeletal muscle. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Differential control of respiratory frequency and tidal volume during high-intensity interval training.

    Science.gov (United States)

    Nicolò, Andrea; Marcora, Samuele M; Bazzucchi, Ilenia; Sacchetti, Massimo

    2017-08-01

    What is the central question of this study? By manipulating recovery intensity and exercise duration during high-intensity interval training (HIIT), we tested the hypothesis that fast inputs contribute more than metabolic stimuli to respiratory frequency (fR ) regulation. What is the main finding and its importance? Respiratory frequency, but not tidal volume, responded rapidly and in proportion to changes in workload during HIIT, and was dissociated from some markers of metabolic stimuli in response to both experimental manipulations, suggesting that fast inputs contribute more than metabolic stimuli to fR regulation. Differentiating between fR and tidal volume may help to unravel the mechanisms underlying exercise hyperpnoea. Given that respiratory frequency (fR ) has been proposed as a good marker of physical effort, furthering the understanding of how fR is regulated during exercise is of great importance. We manipulated recovery intensity and exercise duration during high-intensity interval training (HIIT) to test the hypothesis that fast inputs (including central command) contribute more than metabolic stimuli to fR regulation. Seven male cyclists performed an incremental test, a 10 and a 20 min continuous time trial (TT) as preliminary tests. Subsequently, recovery intensity and exercise duration were manipulated during HIIT (30 s work and 30 s active recovery) by performing four 10 min and one 20 min trial (recovery intensities of 85, 70, 55 and 30% of the 10 min TT mean workload; and 85% of the 20 min TT mean workload). The work intensity of the HIIT sessions was self-paced by participants to achieve the best performance possible. When manipulating recovery intensity, fR , but not tidal volume (VT ), showed a fast response to the alternation of the work and recovery phases, proportional to the extent of workload variations. No association between fR and gas exchange responses was observed. When manipulating exercise duration, fR and rating of

  10. Influence of deep breathing exercise on spontaneous respiratory rate and heart rate variability: a randomised controlled trial in healthy subjects.

    Science.gov (United States)

    Tharion, Elizabeth; Samuel, Prasanna; Rajalakshmi, R; Gnanasenthil, G; Subramanian, Rajam Krishna

    2012-01-01

    Studies show that yogic type of breathing exercises reduces the spontaneous respiratory rate. However, there are no conclusive studies on the effects of breathing exercise on heart rate variability. We investigated the effects of non-yogic breathing exercise on respiratory rate and heart rate variability. Healthy subjects (21-33 years, both genders) were randomized into the intervention group (n=18), which performed daily deep breathing exercise at 6 breaths/min (0.1 Hz) for one month, and a control group (n=18) which did not perform any breathing exercise. Baseline respiratory rate and short-term heart rate variability indices were assessed in both groups. Reassessment was done after one month and the change in the parameters from baseline was computed for each group. Comparison of the absolute changes [median (inter-quartile ranges)] of the parameters between the intervention and control group showed a significant difference in the spontaneous respiratory rate [intervention group -2.50 (-4.00, -1.00), control group 0.00 (-1.00, 1.00), cycles/min, Prate and cardiac autonomic modulation of the intervention group were significant, when compared to the changes in the control group. Thus practice of deep slow breathing exercise improves heart rate variability in healthy subjects, without altering their cardiac autonomic balance. These findings have implications in the use of deep breathing exercises to improve cardiac autonomic control in subjects known to have reduced heart rate variability.

  11. A Randomized Placebo Controlled Trial of Ibuprofen for Respiratory Syncytial Virus Infection in a Bovine Model.

    Directory of Open Access Journals (Sweden)

    Paul Walsh

    Full Text Available Respiratory syncytial virus (RSV is the most common cause of bronchiolitis and hospital admission in infants. An analogous disease occurs in cattle and costs US agriculture a billion dollars a year. RSV causes much of its morbidity indirectly via adverse effects of the host response to the virus. RSV is accompanied by elevated prostaglandin E2 (PGE2 which is followed by neutrophil led inflammation in the lung. Ibuprofen is a prototypical non-steroidal anti-inflammatory drug that decreases PGE2 levels by inhibiting cyclooxygenase.We hypothesized that treatment of RSV with ibuprofen would decrease PGE2 levels, modulate the immune response, decrease clinical illness, and decrease the histopathological lung changes in a bovine model of RSV. We further hypothesized that viral replication would be unaffected.We performed a randomized placebo controlled trial of ibuprofen in 16 outbred Holstein calves that we infected with RSV. We measured clinical scores, cyclooxygenase, lipoxygenase and endocannabinoid products in plasma and mediastinal lymph nodes and interleukin (Il-4, Il-13, Il-17 and interferon-γ in mediastinal lymph nodes. RSV shedding was measured daily and nasal Il-6, Il-8 and Il-17 every other day. The calves were necropsied on Day 10 post inoculation and histology performed.One calf in the ibuprofen group required euthanasia on Day 8 of infection for respiratory distress. Clinical scores (p<0.01 and weight gain (p = 0.08 seemed better in the ibuprofen group. Ibuprofen decreased cyclooxygenase, lipoxygenase, and cytochrome P450 products, and increased monoacylglycerols in lung lymph nodes. Ibuprofen modulated the immune response as measured by narrowed range of observed Il-13, Il-17 and IFN-γ gene expression in mediastinal lymph nodes. Lung histology was not different between groups, and viral shedding was increased in calves randomized to ibuprofen.Ibuprofen decreased PGE2, modulated the immune response, and improved clinical outcomes

  12. Progress in understanding and controlling respiratory syncytial virus: still crazy after all these years

    Science.gov (United States)

    Collins, Peter L.; Melero, José A.

    2011-01-01

    Human respiratory syncytial virus (RSV) is a ubiquitous pathogen that infects everyone worldwide early in life and is a leading cause of severe lower respiratory tract disease in the pediatric population as well as in the elderly and in profoundly immunosuppressed individuals. RSV is an enveloped, nonsegmented negative-sense RNA virus that is classified in Family Paramyxoviridae and is one of its more complex members. Although the replicative cycle of RSV follows the general pattern of the Paramyxoviridae, it encodes additional proteins. Two of these (NS1 and NS2) inhibit the host type I and type III interferon (IFN) responses, among other functions, and another gene encodes two novel RNA synthesis factors (M2-1 and M2-2). The attachment (G) glycoprotein also exhibits unusual features, such as high sequence variability, extensive glycosylation, cytokine mimicry, and a shed form that helps the virus evade neutralizing antibodies. RSV is notable for being able to efficiently infect early in life, with the peak of hospitalization at 2–3 months of age. It also is notable for the ability to reinfect symptomatically throughout life without need for significant antigenic change, although immunity from prior infection reduces disease. It is widely thought that re-infection is due to an ability of RSV to inhibit or subvert the host immune response. Mechanisms of viral pathogenesis remain controversial. RSV is notable for a historic, tragic pediatric vaccine failure involving a formalin-inactivated virus preparation that was evaluated in the 1960’s and that was poorly protective and paradoxically primed for enhanced RSV disease. RSV also is notable for the development of a successful strategy for passive immunoprophylaxis of high-risk infants using RSV-neutralizing antibodies. Vaccines and new antiviral drugs are in pre-clinical and clinical development, but controlling RSV remains a formidable challenge. PMID:21963675

  13. Long-term tolerability of capnography and respiratory inductance plethysmography for respiratory monitoring in pediatric patients treated with patient-controlled analgesia.

    Science.gov (United States)

    Miller, Karen M; Kim, Andrew Y; Yaster, Myron; Kudchadkar, Sapna R; White, Elizabeth; Fackler, James; Monitto, Constance L

    2015-10-01

    The Anesthesia Patient Safety Foundation has advocated the use of continuous electronic monitoring of oxygenation and ventilation to preemptively identify opioid-induced respiratory depression. In adults, capnography is the gold standard in respiratory monitoring. An alternative technique used in sleep laboratories is respiratory inductance plethysmography (RIP). However, it is not known if either monitor is well tolerated by pediatric patients for prolonged periods of time. The goal of this study was to determine whether capnography or RIP is better tolerated in nonintubated, spontaneously breathing pediatric patients being treated with intravenous patient-controlled analgesia (IVPCA). Nasal cannula capnography with oral sampling and thoracic and abdominal inductance plethysmography bands were placed along with the routine monitors on pediatric patients being treated for acute pain with IVPCA. Study monitors were left in place for as long as they were tolerated by the patient, up to a maximum of 24 consecutive hours. If the patient did not wear a particular study monitor for any reason, but tolerated the remaining monitor, participation in the study continued. If the patient would not wear either monitor, participation was terminated. Twenty-six patients (18 female, eight male, average age 10.1 ± 5.5 years) consented to participate, but only 14 patients attempted to wear one or both the devices. Among those who wore either device, median time to device removal was 8.33 h (range 0.3-23.6 h) for capnography and 23.5 h (range 0.7-24 h) for RIP bands. Children did not tolerate wearing capnography cannulae for prolonged periods of time, limiting the usefulness of this device as a continuous monitor of ventilation in children. RIP bands were better tolerated; however, they require further assessment of their utility. Until more effective, child-friendly monitors are developed and their utility is validated, guidelines recommended for adult patients cannot be extended

  14. Comparison of respiratory muscle training methods in individuals with motor and sensory complete tetraplegia: a randomized controlled trial

    NARCIS (Netherlands)

    Mueller, G.; Hopman, M.T.E.; Perret, C.

    2013-01-01

    OBJECTIVE: To compare the effects of inspiratory resistance training and isocapnic hyperpnoea vs incentive spirometry (placebo) on respiratory function, voice, thorax mobility and quality of life in individuals with tetraplegia. DESIGN: Randomized controlled trial. PATIENTS/METHODS: A total of 24

  15. Respiratory acidosis

    Science.gov (United States)

    Ventilatory failure; Respiratory failure; Acidosis - respiratory ... Causes of respiratory acidosis include: Diseases of the airways (such as asthma and COPD ) Diseases of the lung tissue (such as ...

  16. Managing a Voluntary Organisation

    OpenAIRE

    Dk. Hjh. Siti Fatimah - Pg. Hj. Petra

    2014-01-01

    This paper reveals the experience of a young member of a non-profitable organisation in managing a team of professionals in Brunei Darussalam. In a team, the experience of managing has not been as scary as expected; positions taken, however, must be firm and effective. Being a leader of the contingency approach type, actions and responses are based on circumstances. Marketing and managing changes need to be pursued as a new leader of a voluntary organization. Careful considerations and risks ...

  17. Voluntary and involuntary adaptation of gait in Parkinson's disease

    NARCIS (Netherlands)

    Zijlstra, W; Rutgers, AWF; Van Weerden, TW

    Voluntary and involuntary adaptation of gait in Parkinson's disease (PD) were studied in two separate experiments. In the first experiment, effects of changes in voluntary control were studied by asking PD patients and age-matched healthy subjects to adapt their walking pattern to visual cues

  18. Pressure controlled inverse ratio ventilation in acute respiratory distress syndrome patients.

    Directory of Open Access Journals (Sweden)

    Tripathi M

    2002-01-01

    Full Text Available Appropriate ventilatory intervention is life saving in acute respiratory distress syndrome (ARDS. Pressure controlled inverse ratio ventilation (PC-IRV is the likely mode of ventilation benefiting in extreme conditions of ARDS. However, guidelines when to start PC-IRV is not yet well defined. The ventilation-related dilemma, which we faced in two illustrative cases of ARDS are presented. The first patient presenting clinically with ARDS but with high peak airway pressure (PIP and low dynamic lung compliance, PC-IRV helped in reducing PIP, improved haemodynamics and the oxygenation of blood. In second patient with similar clinical presentation of ARDS, where although PIP was high but the dynamic compliance was better, the PC-IRV caused deterioration in PaO2. Here, patient rather did better with high PEEP (15 cm H2O and usual I: E ratio (1:2. It is probable that the dynamic lung compliance (< 20ml/cmH2O, PIP (> 50 cm H2O at conventional I: E ratio (1:2 ventilation (10 ml/kg with hypotension might form the basis to develop a scoring system for guidance to switch over to PC-IRV ventilation. Further randomised prospective controlled clinical trials will then be required to establish indication to start PC-IRV in ARDS.

  19. Successful prevention of respiratory syncytial virus nosocomial transmission following an enhanced seasonal infection control program.

    Science.gov (United States)

    Lavergne, V; Ghannoum, M; Weiss, K; Roy, J; Béliveau, C

    2011-01-01

    Respiratory syncytial virus (RSV) infections can be serious in severely immunocompromised patients. Use of a targeted infection control program (TICP) has been shown to reduce RSV nosocomial transmission. We evaluated the impact of an enhanced seasonal infection control program (ESICP) vs standard TICP in a hematology-oncology ward. TICP was applied from 1999 to 2001 and ESICP applied from 2001 to 2003. ESICP consisted of strict isolation for all patients admitted on the ward during the RSV season. We prospectively evaluated the incidence, related morbidity and mortality of nosocomial RSV in both field interventions. A total of 40 hospitalized RSV infections were documented. The cumulative incidence of nosocomial RSV during TICP and ESICP was respectively of 42.8 and 3.9 cases/1000 admissions (relative risk = 0.09). ESICP needed to be implemented on 26 admitted patients on our ward to prevent one RSV nosocomial case. Furthermore, implementation of ESICP prevented four pneumonias and two deaths per RSV season. We conclude that ESICP is significantly more efficient than TICP to reduce the occurrence of nosocomial RSV infections and its related morbidity and mortality in patients with hematological malignancy and recipients of hematopoietic SCT.

  20. Associations between respiratory sinus arrhythmia (RSA) reactivity and effortful control in preschool-age children.

    Science.gov (United States)

    Sulik, Michael J; Eisenberg, Nancy; Spinrad, Tracy L; Silva, Kassondra M

    2015-07-01

    We tested whether respiratory sinus arrhythmia (RSA) reactivity in response to each of three self-regulation tasks (bird and dragon; knock-tap; and gift wrap) would predict self-regulation performance in a sample of 101 preschool-age children (M age = 4.49, SD = .64). While controlling for baseline RSA, decreases in RSA from bird and dragon to knock-tap (but not from baseline to bird and dragon) predicted a latent variable measuring self-regulation. Furthermore, increases in RSA from the knock-tap to gift wrap-the only task involving delay of gratification-were related to concurrent task performance while controlling for the relation between RSA reactivity and the latent self-regulation variable. Results suggest that the relations between RSA reactivity and self-regulatory ability are influenced by task-specific demands and possibly by task order. Furthermore, RSA reactivity appears to relate differently to performance on motivationally salient self-regulation tasks such as delay of gratification relative to cool executive function tasks. © 2015 Wiley Periodicals, Inc.

  1. Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Henzen Christoph

    2007-07-01

    Full Text Available Abstract Background: Lower respiratory tract infections like acute bronchitis, exacerbated chronic obstructive pulmonary disease and community-acquired pneumonia are often unnecessarily treated with antibiotics, mainly because of physicians' difficulties to distinguish viral from bacterial cause and to estimate disease-severity. The goal of this trial is to compare medical outcomes, use of antibiotics and hospital resources in a strategy based on enforced evidence-based guidelines versus procalcitonin guided antibiotic therapy in patients with lower respiratory tract infections. Methods and design: We describe a prospective randomized controlled non-inferiority trial with an open intervention. We aim to randomize over a fixed recruitment period of 18 months a minimal number of 1002 patients from 6 hospitals in Switzerland. Patients must be >18 years of age with a lower respiratory tract infections Discussion: Use of and prolonged exposure to antibiotics in lower respiratory tract infections is high. The proposed trial investigates whether procalcitonin-guidance may safely reduce antibiotic consumption along with reductions in hospitalization costs and antibiotic resistance. It will additionally generate insights for improved prognostic assessment of patients with lower respiratory tract infections. Trial registration: ISRCTN95122877

  2. KIF7 Controls the Proliferation of Cells of the Respiratory Airway through Distinct Microtubule Dependent Mechanisms.

    Directory of Open Access Journals (Sweden)

    Garry L Coles

    2015-10-01

    Full Text Available The cell cycle must be tightly coordinated for proper control of embryonic development and for the long-term maintenance of organs such as the lung. There is emerging evidence that Kinesin family member 7 (Kif7 promotes Hedgehog (Hh signaling during embryonic development, and its misregulation contributes to diseases such as ciliopathies and cancer. Kif7 encodes a microtubule interacting protein that controls Hh signaling through regulation of microtubule dynamics within the primary cilium. However, whether Kif7 has a function in nonciliated cells remains largely unknown. The role Kif7 plays in basic cell biological processes like cell proliferation or cell cycle progression also remains to be elucidated. Here, we show that Kif7 is required for coordination of the cell cycle, and inactivation of this gene leads to increased cell proliferation in vivo and in vitro. Immunostaining and transmission electron microscopy experiments show that Kif7dda/dda mutant lungs are hyperproliferative and exhibit reduced alveolar epithelial cell differentiation. KIF7 depleted C3H10T1/2 fibroblasts and Kif7dda/dda mutant mouse embryonic fibroblasts have increased growth rates at high cellular densities, suggesting that Kif7 may function as a general regulator of cellular proliferation. We ascertained that in G1, Kif7 and microtubule dynamics regulate the expression and activity of several components of the cell cycle machinery known to control entry into S phase. Our data suggest that Kif7 may function to regulate the maintenance of the respiratory airway architecture by controlling cellular density, cell proliferation, and cycle exit through its role as a microtubule associated protein.

  3. Genes controlling vaccine responses and disease resistance to respiratory viral pathogens in cattle.

    Science.gov (United States)

    Glass, Elizabeth J; Baxter, Rebecca; Leach, Richard J; Jann, Oliver C

    2012-07-15

    Farm animals remain at risk of endemic, exotic and newly emerging viruses. Vaccination is often promoted as the best possible solution, and yet for many pathogens, either there are no appropriate vaccines or those that are available are far from ideal. A complementary approach to disease control may be to identify genes and chromosomal regions that underlie genetic variation in disease resistance and response to vaccination. However, identification of the causal polymorphisms is not straightforward as it generally requires large numbers of animals with linked phenotypes and genotypes. Investigation of genes underlying complex traits such as resistance or response to viral pathogens requires several genetic approaches including candidate genes deduced from knowledge about the cellular pathways leading to protection or pathology, or unbiased whole genome scans using markers spread across the genome. Evidence for host genetic variation exists for a number of viral diseases in cattle including bovine respiratory disease and anecdotally, foot and mouth disease virus (FMDV). We immunised and vaccinated a cattle cross herd with a 40-mer peptide derived from FMDV and a vaccine against bovine respiratory syncytial virus (BRSV). Genetic variation has been quantified. A candidate gene approach has grouped high and low antibody and T cell responders by common motifs in the peptide binding pockets of the bovine major histocompatibility complex (BoLA) DRB3 gene. This suggests that vaccines with a minimal number of epitopes that are recognised by most cattle could be designed. Whole genome scans using microsatellite and single nucleotide polymorphism (SNP) markers has revealed many novel quantitative trait loci (QTL) and SNP markers controlling both humoral and cell-mediated immunity, some of which are in genes of known immunological relevance including the toll-like receptors (TLRs). The sequencing, assembly and annotation of livestock genomes and is continuing apace. In

  4. High-Flow Nasal Cannula versus Nasal Continuous Positive Airway Pressure for Primary Respiratory Support in Preterm Infants with Respiratory Distress: A Randomized Controlled Trial.

    Science.gov (United States)

    Murki, Srinivas; Singh, Jayesh; Khant, Chiragkumar; Kumar Dash, Swarup; Oleti, Tejo Pratap; Joy, Percy; Kabra, Nandkishor S

    2018-01-23

    Nasal continuous positive airway pressure (nCPAP) is the standard noninvasive respiratory support for newborns with respiratory distress. Evidence for high-flow nasal cannula (HFNC) as an alternative mode of respiratory support is inconclusive. The aim of this work was to evaluate whether HFNC is not inferior to nCPAP in reducing the need for higher respiratory support in the first 72 h of life when applied as a noninvasive respiratory support mode for preterm neonates with respiratory distress. Preterm infants (gestation ≥28 weeks and birth weight ≥1,000 g) with respiratory distress were randomized to either HFNC or nCPAP in a non-inferiority trial. Failure of the support mode in the first 72 h after birth was the primary outcome. Infants failing HFNC were rescued either with nCPAP or mechanical ventilation, and those failing nCPAP received mechanical ventilation. During the study period, 139 and 133 infants were randomized to the nCPAP and HFNC groups, respectively. The study was stopped after an interim analysis showed a significant difference (p respiratory distress (SAS score >5). When comparing HFNC to nCPAP as a primary noninvasive respiratory support in preterm infants with respiratory distress, HFNC is inferior to nCPAP in avoiding the need for a higher mode of respiratory support in the first 72 h of life. © 2018 S. Karger AG, Basel.

  5. Simulation and planning of treatment of breast with respiratory control; Simulacion y planifiacion de un tratamiento de mama con control respiratorio

    Energy Technology Data Exchange (ETDEWEB)

    Pinto Monedero, M.; Martinez Ortega, J.; Castro Tejero, P.; Fuente Alonso, C. de la; Regueiro Otero, C.

    2013-07-01

    The radiotherapy with beams of photons of the breast cancer in stages I and II is an established technique. The principal risks of the treatment derived from accidental irradiation of pulmonary and cardiac tissue. Several previous studies have indicated that respiratory control techniques involve a benefit in the protection of pulmonary and cardiac volume, and therefore, it would mean a reduction in the risk of mortality and morbidity associated with pulmonary and cardiac damage. The objective of this work is to check if there is a dosimetric benefit of breast with respiratory control treatments, such as reflects the literature. (Author)

  6. Use of palivizumab with other infection control measures to control respiratory syncytial virus outbreaks in neonatal care units.

    Science.gov (United States)

    Hammoud, Majeda S; Al-Taiar, Abdullah; Raina, Aditiya; Elsori, Dalal; Al-Qabandi, Sarah; Al-Essa, Mazen

    2016-10-01

    No guidelines exist on the use of palivizumab during outbreaks of Respiratory Syncytial Virus (RSV) in Neonatal Intensive Care Units (NICUs). We aimed to describe an outbreak of RSV in NICU settings and the role of palivizumab in controlling the outbreak. The index case was a 30-day-old premature infant. During the outbreak, 13 cases of RSV were confirmed by RT-PCR. All infants in the NICU received palivizumab after RSV diagnosis. Of the 13 cases, seven were male; and the median (interquartile) of birth weight was 1585 (IQR: 1480-1705) g. All cases were premature under 34-weeks-gestation. Age at onset of disease varies between 10 and 160 days. Only four cases occurred after administering palivizumab and applying other infection control measures. During nosocomial outbreaks of RSV, administration of palivizumab to all infants in NICU appears to be rational and may help contain outbreaks. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. The study protocol for a randomized controlled trial of a family-centred tobacco control program about environmental tobacco smoke (ETS) to reduce respiratory illness in Indigenous infants.

    Science.gov (United States)

    Johnston, Vanessa; Walker, Natalie; Thomas, David P; Glover, Marewa; Chang, Anne B; Bullen, Chris; Morris, Peter; Brown, Ngiare; Vander Hoorn, Stephen; Borland, Ron; Segan, Catherine; Trenholme, Adrian; Mason, Toni; Fenton, Debra; Ellis, Kane

    2010-03-07

    Acute respiratory illness (ARI) is the most common cause of acute presentations and hospitalisations of young Indigenous children in Australia and New Zealand (NZ). Environmental tobacco smoke (ETS) from household smoking is a significant and preventable contributor to childhood ARI. This paper describes the protocol for a study which aims to test the efficacy of a family-centred tobacco control program about ETS to improve the respiratory health of Indigenous infants in Australia and New Zealand. For the purpose of this paper 'Indigenous' refers to Australia's Aboriginal and Torres Strait Islander peoples when referring to Australian Indigenous populations. In New Zealand, the term 'Indigenous' refers to Māori. This study will be a parallel, randomized, controlled trial. Participants will be Indigenous women and their infants, half of whom will be randomly allocated to an 'intervention' group, who will receive the tobacco control program over three home visits in the first three months of the infant's life and half to a control group receiving 'usual care' (i.e. they will not receive the tobacco control program). Indigenous health workers will deliver the intervention, the goal of which is to reduce or eliminate infant exposure to ETS. Data collection will occur at baseline (shortly after birth) and when the infant is four months and one year of age. The primary outcome is a doctor-diagnosed, documented case of respiratory illness in participating infants. Interventions aimed at reducing exposure of Indigenous children to ETS have the potential for significant benefits for Indigenous communities. There is currently a dearth of evidence for the effect of tobacco control interventions to reduce children's exposure to ETS among Indigenous populations. This study will provide high-quality evidence of the efficacy of a family-centred tobacco control program on ETS to reduce respiratory illness. Outcomes of our study will be important and significant for Indigenous

  8. Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety

    National Research Council Canada - National Science Library

    Laurino, Renata André; Barnabé, Viviane; Saraiva-Romanholo, Beatriz M; Stelmach, Rafael; Cukier, Alberto; Nunes, Maria do Patrocínio T

    2012-01-01

    .... Additionally, we evaluated if a respiratory physiotherapy program (breathing retraining) improved both asthma and panic disorder symptoms, resulting in an improvement in the health-related quality of life of asthmatics...

  9. Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety

    OpenAIRE

    Renata André Laurino; Viviane Barnabé; Saraiva-Romanholo, Beatriz M.; Rafael Stelmach; Alberto Cukier; Nunes,Maria do Patrocínio T.

    2012-01-01

    OBJECTIVES: The objectives of this study were to verify the degree of anxiety, respiratory distress, and health-related quality of life in a group of asthmatic patients who have experienced previous panic attacks. Additionally, we evaluated if a respiratory physiotherapy program (breathing retraining) improved both asthma and panic disorder symptoms, resulting in an improvement in the health-related quality of life of asthmatics. METHODS: Asthmatic individuals were assigned to a chest physiot...

  10. Effects of pressure-controlled and volume-controlled ventilation on respiratory mechanics and systemic stress response during prone position.

    Science.gov (United States)

    Sen, Oznur; Bakan, Mefkur; Umutoglu, Tarik; Aydın, Nurdan; Toptas, Mehmet; Akkoc, Ibrahim

    2016-01-01

    Prone position during general anesthesia for special surgical operations may be related with increased airway pressure, decreased pulmonary and thoracic compliance that may be explained by restriction of chest expansion and compression of abdomen. The optimum ventilation mode for anesthetized patients on prone position was not described and studies comparing volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) during prone position are limited. We hypothesized that PCV instead of VCV during prone position could achieve lower airway pressures and reduce the systemic stress response. In this study, we aimed to compare the effects of PCV and VCV modes during prone position on respiratory mechanics, oxygenation, and hemodynamics, as well as blood cortisol and insulin levels, which has not been investigated before. Fifty-four ASA I-II patients, 18-70 years of age, who underwent percutaneous nephrolithotomy on prone position, were randomly selected to receive either the PCV (Group PC, n = 27) or VCV (Group VC, n = 27) under general anesthesia with sevoflurane and fentanyl. Blood sampling was made for baseline arterial blood gases (ABG), cortisol, insulin, and glucose levels. After anesthesia induction and endotracheal intubation, patients in Group PC were given pressure support to form 8 mL/kg tidal volume and patients in Group VC was maintained at 8 mL/kg tidal volume calculated using predicted body weight. All patients were maintained with 5 cmH2O PEEP. Respiratory parameters were recorded during supine and prone position. Assessment of ABG and sampling for cortisol, insulin and glucose levels were repeated during surgery and 60 min after extubation. P-peak and P-plateau levels during supine and prone positions were significantly higher and P-mean and compliance levels during prone position were significantly lower in Group VC when compared with Group PC. Postoperative PaO2 level was significantly higher in Group PC compared with Group

  11. Control of porcine reproductive and respiratory syndrome (PRRS through genetic improvements in disease resistance and tolerance

    Directory of Open Access Journals (Sweden)

    Raymond eRowland

    2012-12-01

    Full Text Available Infections caused by porcine reproductive and respiratory syndrome virus (PRRSV have a severe economic impact on pig production in North America, Europe and Asia. The emergence and eventual predominance of PRRS in the 1990s are the likely result of changes in the pork industry initiated in the late 1970s, which allowed the virus to occupy a unique niche within a modern commercial production system. PRRSV infection is responsible for severe clinical disease, but can maintain a life-long subclinical infection, as well as participate in several polymicrobial syndromes. Current vaccines lessen clinical signs, but are of limited use for disease control and elimination. The relatively poor protective immunity following vaccination is a function of the virus’s capacity to generate a large degree of genetic diversity, combined with several strategies to evade innate and adaptive immune responses. In 2007, the PRRS Host Genetics consortium (PHGC was established to explore the role of host genetics as as an avenue for PRRS control. The PHGC model for PRRS incorporates the experimental infection of large numbers of growing pigs and has created the opportunity to study experimental PRRSV infection at the population level. The results show that pigs can be placed into distinct phenotypic groups, including pigs that show resistance or pigs that exhibit tolerance to infection. Tolerance is best illustrated by pigs that gain weight normally in the face of a relatively high virus load. Genome-wide association analysis has identified a region on chromosome 4 (SSC4 correlated with resistance; i.e., higher weight gain combined with lower virus load. The genomic region is near a family of genes involved in innate immunity. These results create the opportunity to develop breeding programs that will produce pigs with increased resistance to PRRS. The identification of genomic markers involved in tolerance will likely prove more difficult, primarily because tolerance

  12. Vitamin D3 supplementation and upper respiratory tract infections in a randomized, controlled trial.

    Science.gov (United States)

    Rees, Judy R; Hendricks, Kristy; Barry, Elizabeth L; Peacock, Janet L; Mott, Leila A; Sandler, Robert S; Bresalier, Robert S; Goodman, Michael; Bostick, Roberd M; Baron, John A

    2013-11-01

    Randomized controlled trials testing the association between vitamin D status and upper respiratory tract infection (URTI) have given mixed results. During a multicenter, randomized controlled trial of colorectal adenoma chemoprevention, we tested whether 1000 IU/day vitamin D(3) supplementation reduced winter episodes and duration of URTI and its composite syndromes, influenza-like illness (ILI; fever and ≥2 of sore throat, cough, muscle ache, or headache) and colds (no fever, and ≥2 of runny nose, nasal congestion, sneezing, sore throat, cough, swollen or tender neck glands). The 2259 trial participants were aged 45-75, in good health, had a history of colorectal adenoma, and had a serum 25-hydroxyvitamin D level ≥12 ng/mL. They were randomized to vitamin D(3) (1000 IU/day), calcium (1200 mg/day), both, or placebo. Of these, 759 participants completed daily symptom diaries. Secondary data included semiannual surveys of all participants. Among those who completed symptom diaries, supplementation did not significantly reduce winter episodes of URTI (rate ratio [RR], 0.93; 95% confidence interval [CI], .79-1.09) including colds (RR, 0.93; 95% CI, .78-1.10) or ILI (RR, 0.95; 95% CI, .62-1.46), nor did it reduce winter days of illness (RR, 1.13; 95% CI, .90-1.43). There was no significant benefit according to adherence, influenza vaccination, body mass index, or baseline vitamin D status. Semiannual surveys of all participants (N = 2228) identified no benefit of supplementation on ILI (odds ratio [OR], 1.14; 95% CI, .84-1.54) or colds (OR, 1.03; 95% CI, .87-1.23). Supplementation with 1000 IU/day vitamin D(3) did not significantly reduce the incidence or duration of URTI in adults with a baseline serum 25-hydroxyvitamin D level ≥12 ng/mL.

  13. μ opioid receptor activation hyperpolarizes respiratory-controlling Kölliker-Fuse neurons and suppresses post-inspiratory drive.

    Science.gov (United States)

    Levitt, Erica S; Abdala, Ana P; Paton, Julian F R; Bissonnette, John M; Williams, John T

    2015-10-01

    In addition to reductions in respiratory rate, opioids also cause aspiration and difficulty swallowing, indicating impairment of the upper airways. The Kölliker-Fuse (KF) maintains upper airway patency and a normal respiratory pattern. In this study, activation of μ opioid receptors in the KF reduced respiratory frequency and tidal volume in anaesthetized rats. Nerve recordings in an in situ preparation showed that activation of μ opioid receptors in the KF eliminated the post-inspiration phase of the respiratory cycle. In brain slices, μ opioid agonists hyperpolarized a distinct population (61%) of KF neurons by activation of an inwardly rectifying potassium conductance. These results suggest that KF neurons that are hyperpolarized by opioids could contribute to opioid-induced respiratory disturbances, particularly the impairment of upper airways. Opioid-induced respiratory effects include aspiration and difficulty swallowing, suggesting impairment of the upper airways. The pontine Kölliker-Fuse nucleus (KF) controls upper airway patency and regulates respiration, in particular the inspiratory/expiratory phase transition. Given the importance of the KF in coordinating respiratory pattern, the mechanisms of μ opioid receptor activation in this nucleus were investigated at the systems and cellular level. In anaesthetized, vagi-intact rats, injection of opioid agonists DAMGO or [Met(5) ]enkephalin (ME) into the KF reduced respiratory frequency and amplitude. The μ opioid agonist DAMGO applied directly into the KF of the in situ arterially perfused working heart-brainstem preparation of rat resulted in robust apneusis (lengthened low amplitude inspiration due to loss of post-inspiratory drive) that was rapidly reversed by the opioid antagonist naloxone. In brain slice preparations, activation of μ opioid receptors on KF neurons hyperpolarized a distinct population (61%) of neurons. As expected, the opioid-induced hyperpolarization reduced the excitability of

  14. [Voluntary euthanasia in the Netherlands].

    Science.gov (United States)

    Gordijn, B

    2001-11-16

    On 10 April last, the Dutch Senat accepted a new bill concerning voluntary active euthanasia and physician assisted suicide. This bill legally embodies a ground for exemption from punishment for physicians who conducted voluntary active euthanasia or physician assisted suicide and who complied with certain requirements. Hence, the old policy of tolerance has been transformed into a legal system of acceptance of certain forms of voluntary active euthanasia and physician assisted suicide. This contribution describes these legal changes as the final stage of a process of integration of voluntary active euthanasia and physician assisted suicide in Dutch society. In this way, it endeavours to contribute to a constructive debate.

  15. A case-control study of malignant and non-malignant respiratory disease among employees of a fiberglass manufacturing facility.

    Science.gov (United States)

    Chiazze, L; Watkins, D K; Fryar, C

    1992-05-01

    A case-control study was conducted to determine the influence of non-workplace factors on risk of respiratory disease among workers at the Owens-Corning Fiberglas plant in Newark, Ohio. Cases and controls were drawn from a historical cohort mortality study conducted on behalf of the Thermal Insulation Manufacturers Association (TIMA) of workers employed at Newark for at least one year between 1 January 1940 and 31 December 1963 and followed up to the end of 1982. The TIMA study reported a statistically significant increase in respiratory cancer (compared with national death rates). Interviews were completed for 144 lung cancer cases and 299 matching controls and 102 non-malignant respiratory disease cases and 201 matching controls. Unadjusted odds ratios (ORs) were used to assess the association between lung cancer or non-malignant respiratory disease and birthplace, education, income, marital state, smoking with a duration of six months or more, age at which smoking first started, and duration of smoking. Only the smoking variables were statistically significant. For lung cancer, of the variables entered into a conditional logistic regression model, only the smoking OR of 23.4 (95% CI 3.2-172.9) was statistically significant. For non-malignant respiratory disease no variables entered into the final model were statistically significant. Results of the interview portion of our case-control study clearly indicate that smoking is the most important non-workplace factor for risk of lung cancer in this group of workers. Smoking does not seem to play as important a part, however, for non-malignant respiratory disease. Prevalence of cigarette smoking at the Newark plant was estimated for birth cohorts by calendar year. Corresponding data for the United States were compiled from national smoking surveys. Prevalence of cigarette smoking for Newark in 1955 appears to be sufficiently greater than the corresponding United States data in 1955 to suggest that some of the

  16. Bioethics for clinicians: 4. Voluntariness.

    Science.gov (United States)

    Etchells, E; Sharpe, G; Dykeman, M J; Meslin, E M; Singer, P A

    1996-10-15

    In the context of consent, "voluntariness" refers to a patient's right to make health care choices free of any undue influence. However, a patient's freedom to make choices can be compromised by internal factors such as pain and by external factors such as force, coercion and manipulation. In exceptional circumstances--for example, involuntary admission to hospital--patients may be denied their freedom of choice; in such circumstances the least restrictive means possible of managing the patient should always be preferred. Clinicians can minimize the impact of controlling factors on patients' decisions by promoting awareness of available choices, inviting questions and ensuring that decisions are based on an adequate, unbiased disclosure of the relevant information.

  17. Bioethics for clinicians: 4. Voluntariness.

    Science.gov (United States)

    Etchells, E; Sharpe, G; Dykeman, M J; Meslin, E M; Singer, P A

    1996-01-01

    In the context of consent, "voluntariness" refers to a patient's right to make health care choices free of any undue influence. However, a patient's freedom to make choices can be compromised by internal factors such as pain and by external factors such as force, coercion and manipulation. In exceptional circumstances--for example, involuntary admission to hospital--patients may be denied their freedom of choice; in such circumstances the least restrictive means possible of managing the patient should always be preferred. Clinicians can minimize the impact of controlling factors on patients' decisions by promoting awareness of available choices, inviting questions and ensuring that decisions are based on an adequate, unbiased disclosure of the relevant information. PMID:8873637

  18. Free Voluntary Reading

    Directory of Open Access Journals (Sweden)

    Yakup Çetin

    2010-12-01

    Full Text Available Doubtless to say, the contribution of reading skill to first and second language acquisition is enormous. From one‟s speaking and writing we can more or less conclude how much s/he has read. We can list the characteristics of good readers as follows: rich vocabulary knowledge advanced reading comprehension, accurate grammar usage, broad general knowledge, correct spelling and punctuation, writing ability, and so on. If reading is so powerful, why cannot we promote reading books in our society, particularly among young people? The fact that we are imposed to read books which we think are necessary or compulsory rather than the ones which we would like to read voluntarily, is the main reason why many of us are not able to develop a life-time reading habit. Since compulsory books, such as teacher-selected books are outside one‟s interest; they are destined to be forgotten sometime, or they suffer form shallow reading, or they are mostly returned to their place on the shelf after browsing the initial pages. However, if people of all ages, especially children would read self-selected books they enjoy, they would be surprised to notice the great change inside them. Therefore, the purpose of this study is to revitalize free voluntary reading by referring to Krashen‟s well-known hypotheses. Also, it aims to revive the reader‟s belief in free voluntary reading with theoretical and practical examples

  19. Children with lower respiratory tract infections and serum 25-hydroxyvitamin D3 levels: A case-control study.

    Science.gov (United States)

    Velarde López, Angel Alfonso; Gerber, Jeffrey S; Leonard, Mary B; Xie, Dawei; Schinnar, Rita; Strom, Brian L

    2016-10-01

    Pneumonia is the leading cause of death in children under age of 5 years worldwide. The role of vitamin D in respiratory infections including pneumonia is unclear; therefore, we aimed to determine if children with lower respiratory tract infections had low serum 25-hydroxyvitamin D3 . We performed a case-control study of children ages 3-60 months from the Guatemala City metropolitan area, hospitalized with community-acquired pneumonia between September and December 2012. Controls were selected from the well-baby/care immunization clinics serving the population from which cases emerged. We analyzed serum 25-hydroxyvitamin D3 levels and conducted parental interviews to assess subject age, sex, race, feeding type, vitamin D supplementation, frequency of sun exposure, and maternal education. Height and weight were ascertained from medical records. Complete information was available for 70 (83%) of 84 eligible cases and 68 (60%) of 113 eligible controls. The median (IQR) serum 25-hydroxyvitamin D3 concentration for cases was 23.2 ng/ml (14.4-29.9) compared to 27.5 ng/ml (21.4-32.3) in controls (P = 0.006). Multiple regression analysis using an a priori cut-point for vitamin D of respiratory tract infections were more likely to have low 25-hydroxyvitamin D3 levels than controls (adjusted odds ratio 2.4, 95% confidence interval 1.1-5.2, P = 0.02). Children with lower respiratory tract infections in Guatemala had low 25-hydroxyvitamin D3 levels. Pediatr Pulmonol. 2016;51:1080-1087. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. Effects of the combination of respiratory muscle training and abdominal drawing-in maneuver on respiratory muscle activity in patients with post-stroke hemiplegia: a pilot randomized controlled trial.

    Science.gov (United States)

    Kim, Chang-Yong; Lee, Jung-Sun; Kim, Hyeong-Dong; Kim, In-Seob

    2015-08-01

    No study has examined the effects of the combination of respiratory muscle training (RMT) and abdominal drawing-in maneuver (ADIM) on respiratory muscle activity and function in stroke patients during early pulmonary rehabilitation. The purpose of this study was to investigate the effects of RMT combined with ADIM on decreased respiratory muscle activity and function in patients with post-stroke hemiplegia. Thirty-seven subjects with post-stroke hemiplegia were randomly allocated to three groups; integrated training group (ITG), respiratory muscle training group (RMTG), and control group (CG). All of the subjects received routine therapy for stroke rehabilitation for 1 hour, five times a week for 6 weeks. Especially, the ITG received RMT using an incentive respiratory spirometer and ADIM using a Stabilizer, and the RMTG only received RMT using incentive respiratory spirometer for 15  minutes a day, five times a week for 6 weeks. Pulmonary function was evaluated using spirometry for measuring the forced vital capacity (FVC) and force expiratory volume in 1  second (FEV1). Additional surface electromyography (sEMG) analysis was included by measuring the respiratory muscle activity. Our results showed that changes between the pre- and post-test values of FVC (F = 12.50, P = 0.02) and FEV1 (F = 12.81, P = 0.01) (P hemiplegia.

  1. Effect of upper extremity proprioceptive neuromuscular facilitation combined with elastic resistance bands on respiratory muscle strength: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Guilherme P. T. Areas

    2013-12-01

    Full Text Available BACKGROUND: Elastic resistance bands (ERB combined with proprioceptive neuromuscular facilitation (PNF are often used in resistance muscle training programs, which have potential effects on peripheral muscle strength. However, the effects of the combination of ERB and PNF on respiratory muscle strength warrant further investigation. OBJECTIVES: The assessment of the effects of PNF combined with ERB on respiratory muscle strength. METHOD: Twenty healthy, right-handed females were included. Subjects were randomized to either the resistance training program group (TG, n=10 or the control group (CG, n=10. Maximal expiratory pressure (MEP and inspiratory pressure (MIP were measured before and after four weeks of an upper extremity resistance training program. The training protocol consisted of upper extremity PNF combined with ERB, with resistance selected from 1 repetition maximum protocol. RESULTS: PNF combined with ERB showed significant increases in MIP and MEP (p<0.05. In addition, there were significant differences between the TG and CG regarding ∆MIP (p=0.01 and ∆MEP (p=0.04. CONCLUSIONS: PNF combined with ERB can have a positive impact on respiratory muscle strength. These results may be useful with respect to cardiopulmonary chronic diseases that are associated with reduced respiratory muscle strength.

  2. Molecular point-of-care testing for respiratory viruses versus routine clinical care in adults with acute respiratory illness presenting to secondary care: a pragmatic randomised controlled trial protocol (ResPOC).

    Science.gov (United States)

    Brendish, Nathan J; Malachira, Ahalya K; Clark, Tristan W

    2017-02-06

    Respiratory viruses are associated with a huge socio-economic burden and are responsible for a large proportion of acute respiratory illness in hospitalised adults. Laboratory PCR is accurate but takes at least 24 h to generate a result to clinicians and antigen-based point-of-care tests (POCT) lack sensitivity. Rapid molecular platforms, such as the FilmArray Respiratory Panel, have equivalent diagnostic accuracy to laboratory PCR and can generate a result in 1 h making them deployable as POCT. Molecular point-of-care testing for respiratory viruses in hospital has the potential to improve the detection rate of respiratory viruses, improve the use of influenza antivirals and reduce unnecessary antibiotic use, but high quality randomised trials with clinically relevant endpoints are needed. The ResPOC study is a pragmatic randomised controlled trial of molecular point-of-care testing for respiratory viruses in adults with acute respiratory illness presenting to a large teaching hospital in the United Kingdom. Eligible participants are adults presenting with acute respiratory illness to the emergency department or the acute medicine unit. Participants are allocated 1:1 by internet-based randomisation service to either the intervention of a nose and throat swab analysed immediately on the FilmArray Respiratory Panel as a POCT or receive routine clinical care. The primary outcome is the proportion of patients treated with antibiotics. Secondary outcomes include turnaround time, virus detection, neuraminidase inhibitor use, length of hospital stay and side room use. Analysis of the primary outcome will be by intention-to-treat and all enrolled participants will be included in safety analysis. Multiple novel molecular POCT platforms for infections including respiratory viruses have been developed and licensed in the last few years and many more are in development but the evidence base for clinical benefit above standard practice is minimal. This randomised controlled

  3. Probiotics and vitamin C for the prevention of respiratory tract infections in children attending preschool: a randomised controlled pilot study

    OpenAIRE

    Garaiova, I.; Muchová, J; Nagyová, Z; Wang, Duolao; Li, J. V.; Országhová, Z; Michael, D. R.; Plummer, S.F.; Ďuračková, Z

    2014-01-01

    Background:\\ud This pilot study investigates the efficacy of a probiotic consortium (Lab4) in combination with vitamin C on the prevention of respiratory tract infections in children attending preschool facilities.\\ud \\ud Subjects/methods:\\ud In a double-blind, randomised, placebo-controlled pilot study with children aged 3–6 years, 57 received 1.25 × 1010 colony-forming units of Lactobacillus acidophilus CUL21 (NCIMB 30156), Lactobacillus acidophilus CUL60 (NCIMB 30157), Bifidobacterium bifi...

  4. Vitamin D3 and gargling for the prevention of upper respiratory tract infections: a randomized controlled trial

    OpenAIRE

    Goodall, Emma C; Granados, Andrea C; Luinstra, Kathy; Pullenayegum, Eleanor; Coleman, Brenda L; Loeb, Mark; Smieja, Marek

    2014-01-01

    Background We undertook a 2X2 factorial, randomized controlled trial (RCT) to assess whether vitamin D3 supplementation (10,000 international units per week) versus placebo and gargling versus no gargling could prevent viral, clinical upper respiratory tract infection (URTI) in university students. Methods We randomized 600 students into 4 treatment arms: 1) vitamin D3 and gargling, 2) placebo and gargling, 3) vitamin D3 and no gargling, and 4) placebo and no gargling. Students completed week...

  5. Effects of Swiss ball exercise and resistance exercise on respiratory function and trunk control ability in patients with scoliosis

    OpenAIRE

    Kim, Jwa Jun; Song, Gui Bin; Park, Eun Cho

    2015-01-01

    [Purpose] This study compared the effects of Swiss ball exercise and resistance exercise on the respiratory function and trunk control ability of patients with scoliosis. [Subjects] Forty scoliosis patients were randomly divided into the Swiss ball exercise group (n= 20) and resistance exercise group (n = 20). [Methods] The Swiss ball and resistance exercise groups performed chest expansion and breathing exercises with a Swiss ball and a therapist?s resistance, respectively. Both groups recei...

  6. 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

  7. Chronic heart failure modifies respiratory mechanics in rats: a randomized controlled trial.

    Science.gov (United States)

    Pacheco, Deise M; Silveira, Viviane D; Thomaz, Alex; Nunes, Ramiro B; Elsner, Viviane R; Dal Lago, Pedro

    2016-01-01

    To analyze respiratory mechanics and hemodynamic alterations in an experimental model of chronic heart failure (CHF) following myocardial infarction. Twenty-seven male adult Wistar rats were randomized to CHF group (n=12) or Sham group (n=15). Ten weeks after coronary ligation or sham surgery, the animals were anesthetized and submitted to respiratory mechanics and hemodynamic measurements. Pulmonary edema as well as cardiac remodeling were measured. The CHF rats showed pulmonary edema 26% higher than the Sham group. The respiratory system compliance (Crs) and the total lung capacity (TLC) were lower (40% and 27%, respectively) in the CHF rats when compared to the Sham group (Prespiratory mechanics, which may be associated with alterations in cardiopulmonary interactions.

  8. Voluntary Environmental Regulation in Developing Countries: A Mexican Case Study

    National Research Council Canada - National Science Library

    ALLEN BLACKMAN; NICHOLAS SISTO

    2006-01-01

    .... This article presents a case study of four high-profile voluntary environmental agreements used during the 1980s and 1990s in an attempt to control pollution from leather tanneries in León, Guanajuato...

  9. 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.

  10. Voluntary Sleep Loss in Rats

    Science.gov (United States)

    Oonk, Marcella; Krueger, James M.; Davis, Christopher J.

    2016-01-01

    Study Objectives: Animal sleep deprivation (SDEP), in contrast to human SDEP, is involuntary and involves repeated exposure to aversive stimuli including the inability of the animal to control the waking stimulus. Therefore, we explored intracranial self-stimulation (ICSS), an operant behavior, as a method for voluntary SDEP in rodents. Methods: Male Sprague-Dawley rats were implanted with electroencephalography/electromyography (EEG/EMG) recording electrodes and a unilateral bipolar electrode into the lateral hypothalamus. Rats were allowed to self-stimulate, or underwent gentle handling-induced SDEP (GH-SDEP), during the first 6 h of the light phase, after which they were allowed to sleep. Other rats performed the 6 h ICSS and 1 w later were subjected to 6 h of noncontingent stimulation (NCS). During NCS the individual stimulation patterns recorded during ICSS were replayed. Results: After GH-SDEP, ICSS, or NCS, time in nonrapid eye movement (NREM) sleep and rapid eye movement (REM) sleep increased. Further, in the 24 h after SDEP, rats recovered all of the REM sleep lost during SDEP, but only 75% to 80% of the NREM sleep lost, regardless of the SDEP method. The magnitude of EEG slow wave responses occurring during NREM sleep also increased after SDEP treatments. However, NREM sleep EEG slow wave activity (SWA) responses were attenuated following ICSS, compared to GH-SDEP and NCS. Conclusions: We conclude that ICSS and NCS can be used to sleep deprive rats. Changes in rebound NREM sleep EEG SWA occurring after ICSS, NCS, and GH-SDEP suggest that nonspecific effects of the SDEP procedure differentially affect recovery sleep phenotypes. Citation: Oonk M, Krueger JM, Davis CJ. Voluntary sleep loss in rats. SLEEP 2016;39(7):1467–1479. PMID:27166236

  11. A cardiorespiratory classifier of voluntary and involuntary electrodermal activity

    Directory of Open Access Journals (Sweden)

    Sejdic Ervin

    2010-02-01

    Full Text Available Abstract Background Electrodermal reactions (EDRs can be attributed to many origins, including spontaneous fluctuations of electrodermal activity (EDA and stimuli such as deep inspirations, voluntary mental activity and startling events. In fields that use EDA as a measure of psychophysiological state, the fact that EDRs may be elicited from many different stimuli is often ignored. This study attempts to classify observed EDRs as voluntary (i.e., generated from intentional respiratory or mental activity or involuntary (i.e., generated from startling events or spontaneous electrodermal fluctuations. Methods Eight able-bodied participants were subjected to conditions that would cause a change in EDA: music imagery, startling noises, and deep inspirations. A user-centered cardiorespiratory classifier consisting of 1 an EDR detector, 2 a respiratory filter and 3 a cardiorespiratory filter was developed to automatically detect a participant's EDRs and to classify the origin of their stimulation as voluntary or involuntary. Results Detected EDRs were classified with a positive predictive value of 78%, a negative predictive value of 81% and an overall accuracy of 78%. Without the classifier, EDRs could only be correctly attributed as voluntary or involuntary with an accuracy of 50%. Conclusions The proposed classifier may enable investigators to form more accurate interpretations of electrodermal activity as a measure of an individual's psychophysiological state.

  12. A randomized placebo controlled trial of ibuprofen for respiratory syncytial infection in a bovine model study

    Science.gov (United States)

    Background: Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and hospital admission in infants. An analogous disease occurs in cattle and costs US agriculture a billion dollars a year. RSV causes much of its morbidity indirectly via adverse effects of the host response to ...

  13. Vitamin D3 Supplementation and Upper Respiratory Tract Infections in a Randomized, Controlled Trial

    OpenAIRE

    Rees, Judy R.; Hendricks, Kristy; Barry, Elizabeth L.; Peacock, Janet L.; Mott, Leila A.; Sandler, Robert S.; Bresalier, Robert S.; Goodman, Michael; Bostick, Roberd M.; Baron, John A.

    2013-01-01

    In a trial substudy of 1000 IU vitamin D3 supplementation, 759 participants completed daily health diaries for up to 17 months. Supplementation provided no significant reduction in upper respiratory tract infections, colds, or influenza-like illness during winter or overall.

  14. Genetic control of host resistance to porcine reproductive and respiratory syndrome virus (PRRSV) infection

    Science.gov (United States)

    This manuscript focuses on the advances made using genomic approaches to identify biomarkers that define genes and pathways that are correlated with swine resistance to infection with porcine reproductive and respiratory syndrome virus (PRRSV), the most economically important swine viral pathogen wo...

  15. Bubble CPAP versus ventilator CPAP in preterm neonates with early onset respiratory distress--a randomized controlled trial.

    Science.gov (United States)

    Tagare, Amit; Kadam, Sandeep; Vaidya, Umesh; Pandit, Anand; Patole, Sanjay

    2013-04-01

    Bubble continuous positive airway pressure (BCPAP) is a low cost nasal CPAP delivery system with potential benefits to developing nations. To compare the efficacy and safety of BCPAP with ventilator-derived CPAP (VCPAP) in preterm neonates with respiratory distress. In a randomized controlled trial, preterm neonates with Silverman-Anderson score ≥ 4 and oxygen requirement >30% within first 6 h of life were randomly allocated to BCPAP or VCPAP. Proportion of neonates with success or failure was compared. In all, 47 of 57 (82.5%) neonates from BCPAP group and 36 of 57 (63.2%) neonates from the VCPAP group completed CPAP successfully (p = 0.03). Neonates who failed CPAP had higher Silverman-Anderson score (p < 0.01), lower arterial to alveolar oxygenation ratio (p < 0.05) and needed surfactant more frequently (p < 0.01). BCPAP has higher success rate than VCPAP for managing preterm neonates with early onset respiratory distress, with comparable safety.

  16. Respiratory alkalosis

    Science.gov (United States)

    Alkalosis - respiratory ... leads to shortness of breath can also cause respiratory alkalosis (such as pulmonary embolism and asthma). ... Treatment is aimed at the condition that causes respiratory alkalosis. Breathing into a paper bag -- or using ...

  17. On the role of emerging voluntary control of vocalization in language evolution. Comment on "Towards a Computational Comparative Neuroprimatology: Framing the language-ready brain" by Michael A. Arbib

    Science.gov (United States)

    Coudé, Gino

    2016-03-01

    This comment will be focused on the role of monkey vocal control in the evolution of language. I will essentially reiterate the observations expressed in a commentary [1] about the book ;How the brain got language: the mirror system hypothesis;, written by Arbib [2]. I will hopefully clarify our suggestion that non-human primates vocal communication, in conjunction with gestures, could have had an active role in the emergence of the first voluntary forms of utterances that will later shape protospeech. This suggestion is mainly rooted in neurophysiological data about vocal control in monkey. I will very briefly summarize how neurophysiological data allowed us to suggest a possible role for monkey vocalization in language evolution. We conducted a study [3] in which we recorded from ventral premotor cortex (PMv) of macaques trained to emit vocalizations (i.e. coo-calls). The results showed that the rostro-lateral part of PMv contains neurons that fire during conditioned vocalization. The involvement of PMv in vocalization production was further supported by electrical microstimulation of the cortical sector where some of the vocalization neurons were found. Microstimulation elicited in some cases a combination of jaw, tongue and larynx movements. To us, the evolutionary implications of those results were obvious: a partial voluntary vocal control was already taking place in the primate PMv cortex some 25 million years ago.

  18. Absence of association between angiotensin converting enzyme polymorphism and development of adult respiratory distress syndrome in patients with severe acute respiratory syndrome: a case control study

    Directory of Open Access Journals (Sweden)

    Chiu Rossa WK

    2005-04-01

    Full Text Available Abstract Background It has been postulated that genetic predisposition may influence the susceptibility to SARS-coronavirus infection and disease outcomes. A recent study has suggested that the deletion allele (D allele of the angiotensin converting enzyme (ACE gene is associated with hypoxemia in SARS patients. Moreover, the ACE D allele has been shown to be more prevalent in patients suffering from adult respiratory distress syndrome (ARDS in a previous study. Thus, we have investigated the association between ACE insertion/deletion (I/D polymorphism and the progression to ARDS or requirement of intensive care in SARS patients. Method One hundred and forty genetically unrelated Chinese SARS patients and 326 healthy volunteers were recruited. The ACE I/D genotypes were determined by polymerase chain reaction and agarose gel electrophoresis. Results There is no significant difference in the genotypic distributions and the allelic frequencies of the ACE I/D polymorphism between the SARS patients and the healthy control subjects. Moreover, there is also no evidence that ACE I/D polymorphism is associated with the progression to ARDS or the requirement of intensive care in the SARS patients. In multivariate logistic analysis, age is the only factor associated with the development of ARDS while age and male sex are independent factors associated with the requirement of intensive care. Conclusion The ACE I/D polymorphism is not directly related to increased susceptibility to SARS-coronavirus infection and is not associated with poor outcomes after SARS-coronavirus infection.

  19. [Respiratory physicians' knowledge, attitude and practice of tobacco control and their smoking status in the city of Chongqing].

    Science.gov (United States)

    Peng, Dan-yi; Zhou, Jun-hao; Chen, Hong; Li, Rui; Li, Cen; Zhou, Hong-yu; Wang, Dao-xin; Wang, Chang-zheng

    2013-04-01

    To investigate the smoking status, knowledge of smoking hazards, attitude of tobacco control and skill of assisting smoking cessation in respiratory physicians in the city of Chongqing and therefore to provide references for their further participation in social tobacco control. With a self-designed questionnaire, a cross-sectional study was conducted on respiratory physicians of 8 hospitals in Chongqing, which were selected with stratified random sampling method. All the data were inputted with software Epidata 3.1 and were analyzed with SPSS 13.0. A total of 428 valid questionnaires were retrieved, with a valid rate of 95.1% (428/450). The total smoking rate was 12.4% (95%CI: 9.3% - 15.5%), with 7.4% in physicians of teaching hospitals, 8.13% in those of hospitals located in urban areas, and 19.0% in those of hospitals located in suburban district counties. The differences in smoking rates in the respiratory physicians among different hospitals showed statistical significance (χ(2) = 11.734, P = 0.014). The smoking rate of the male was higher than that of the female. Of the surveyed doctors, 80.14% had awareness that tobacco dependence was a neuropsychiatric disease characterized as nicotine addiction, while 34.8% claimed that they had no idea about quitting smoking drugs. Although all participants claimed that they knew the harm of secondhand smoke, 16.36% of them still had never come forward to prevent smoking behavior in hospitals. There was only 27.4% of the surveyed discouraging smoking behavior with the reason of unwillingness to breath in secondhand smoke, while 53.9% of the surveyed discouraged smoking behavior because of regulations of hospitals. Most of the surveyed did relatively well in routinely inquiring and recording the smoking status of patients, but only 27.1% of them had recommended specific quitting smoking methods to patients, and there were few successful cases in practice. The situations of smoking cessation assistance in hospitals located

  20. A cluster-randomised controlled trial to test the efficacy of facemasks in preventing respiratory viral infection among Hajj pilgrims.

    Science.gov (United States)

    Wang, Mandy; Barasheed, Osamah; Rashid, Harunor; Booy, Robert; El Bashir, Haitham; Haworth, Elizabeth; Ridda, Iman; Holmes, Edward C; Dwyer, Dominic E; Nguyen-Van-Tam, Jonathan; Memish, Ziad A; Heron, Leon

    2015-06-01

    Cost-effective interventions are needed to control the transmission of viral respiratory tract infections (RTIs) in mass gatherings. Facemasks are a promising preventive measure, however, previous studies on the efficacy of facemasks have been inconclusive. This study proposes a large-scale facemask trial during the Hajj pilgrimage in Saudi Arabia and presents this protocol to illustrate its feasibility and to promote both collaboration with other research groups and additional relevant studies. A cluster-randomised controlled trial is being conducted to test the efficacy of standard facemasks in preventing symptomatic and proven viral RTIs among pilgrims during the Hajj season in Mina, Mecca, Saudi Arabia. The trial will compare the 'supervised use of facemasks' versus 'standard measures' among pilgrims over several Hajj seasons. Cluster-randomisation will be done by accommodation tents with a 1:1 ratio. For the intervention tents, free facemasks will be provided to be worn consistently for 7days. Data on flu-like symptoms and mask use will be recorded in diaries. Nasal samples will be collected from symptomatic recruits and tested for nucleic acid of respiratory viruses. Data obtained from questionnaires, diaries and laboratory tests will be analysed to examine whether mask use significantly reduces the frequency of laboratory-confirmed respiratory viral infection and syndromic RTI as primary outcomes. This trial will provide valuable evidence on the efficacy of standard facemask use in preventing viral respiratory tract infections at mass gatherings. This study is registered at the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN: ACTRN12613001018707 (http://www.anzctr.org.au). Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  1. Effects of pressure-controlled and volume-controlled ventilation on respiratory mechanics and systemic stress response during laparoscopic cholecystectomy.

    Science.gov (United States)

    Sen, Oznur; Umutoglu, Tarik; Aydın, Nurdan; Toptas, Mehmet; Tutuncu, Ayse Cigdem; Bakan, Mefkur

    2016-01-01

    Pressure-controlled ventilation (PCV) is less frequently employed in general anesthesia. With its high and decelerating inspiratory flow, PCV has faster tidal volume delivery and different gas distribution. The same tidal volume setting, delivered by PCV versus volume-controlled ventilation (VCV), will result in a lower peak airway pressure and reduced risk of barotrauma. We hypothesized that PCV instead of VCV during laparoscopic surgery could achieve lower airway pressures and reduce the systemic stress response. Forty ASA I-II patients were randomly selected to receive either the PCV (Group PC, n = 20) or VCV (Group VC, n = 20) during laparoscopic cholecystectomy. Blood sampling was made for baseline arterial blood gases (ABG), cortisol, insulin, and glucose levels. General anesthesia with sevoflurane and fentanyl was employed to all patients. After anesthesia induction and endotracheal intubation, patients in Group PC were given pressure support to form 8 mL/kg tidal volume and patients in Group VC was maintained at 8 mL/kg tidal volume calculated using predicted body weight. All patients were maintained with 5 cmH2O positive-end expiratory pressure (PEEP). Respiratory parameters were recorded before and 30 min after pneumoperitonium. Assessment of ABG and sampling for cortisol, insulin and glucose levels were repeated 30 min after pneumoperitonium and 60 min after extubation. The P-peak levels observed before (18.9 ± 3.8 versus 15 ± 2.2 cmH2O) and during (23.3 ± 3.8 versus 20.1 ± 2.9 cmH2O) pneumoperitoneum in Group VC were significantly higher. Postoperative partial arterial oxygen pressure (PaO2) values are higher (98 ± 12 versus 86 ± 11 mmHg) in Group PC. Arterial carbon dioxide pressure (PaCO2) values (41.8 ± 5.4 versus 36.7 ± 3.5 mmHg) during pneumoperitonium and post-operative mean cortisol and insulin levels were higher in Group VC. When compared to VCV mode, PCV mode may improve compliance during pneumoperitoneum

  2. Detection and control of a nosocomial respiratory syncytial virus outbreak in a stem cell transplantation unit: the role of palivizumab.

    Science.gov (United States)

    Kassis, Christelle; Champlin, Richard E; Hachem, Ray Y; Hosing, Chitra; Tarrand, Jeffrey J; Perego, Cheryl A; Neumann, Joyce L; Raad, Issam I; Chemaly, Roy F

    2010-09-01

    Respiratory syncytial virus (RSV) is a common community-acquired virus that causes upper and lower respiratory tract infections in children, hematologic malignancy patients, and hematopoietic stem cell transplant (HSCT) recipients. Nosocomial transmission of RSV in immunocompromised patients can significantly affect morbidity, mortality, and duration of hospitalization. Stringent infection control measurements are needed to control further hospital transmission. Prophylactic palivizumab was found to result in a significant reduction in hospitalization rates in high-risk children. In this article, we report a nosocomial outbreak of RSV in an adult HSCT unit (4 pods) from January 16 to February 4, 2004, including the infection control interventions used and the prophylactic administration of palivizumab in high-risk patients. Active surveillance identified 5 cases, a substantial increase from previous seasons (2 or 3 cases per season). All infected patients were isolated to 1 nursing pod and placed on contact isolation. All patients on the HSCT unit underwent rapid RSV antigen screening using nasal washes; this was repeated 1 week later, and 1 additional RSV case was identified. Patients identified to be at increased risk for RSV infection received prophylactic palivizumab. Routine screenings of the staff and visitors were undertaken. All patient and visitor areas were thoroughly cleaned with bleach. We educated health care workers about RSV transmission, highlighting proper hand hygiene and contact precautions. Four of 6 patients with RSV infection developed RSV pneumonia, and 2 of these patients died. Staff and visitors with upper respiratory symptoms were screened, and all were negative for RSV. Prophylactic palivizumab was administered in 16 patients who tested negative for RSV, but were considered to be at increased risk for RSV infection. None of these patients developed RSV infections. An RSV outbreak was controlled using prompt preventive measures, including

  3. Statistical analysis plan for the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART). A randomized controlled trial.

    Science.gov (United States)

    Damiani, Lucas Petri; Berwanger, Otavio; Paisani, Denise; Laranjeira, Ligia Nasi; Suzumura, Erica Aranha; Amato, Marcelo Britto Passos; Carvalho, Carlos Roberto Ribeiro; Cavalcanti, Alexandre Biasi

    2017-01-01

    The Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART) is an international multicenter randomized pragmatic controlled trial with allocation concealment involving 120 intensive care units in Brazil, Argentina, Colombia, Italy, Poland, Portugal, Malaysia, Spain, and Uruguay. The primary objective of ART is to determine whether maximum stepwise alveolar recruitment associated with PEEP titration, adjusted according to the static compliance of the respiratory system (ART strategy), is able to increase 28-day survival in patients with acute respiratory distress syndrome compared to conventional treatment (ARDSNet strategy). To describe the data management process and statistical analysis plan. The statistical analysis plan was designed by the trial executive committee and reviewed and approved by the trial steering committee. We provide an overview of the trial design with a special focus on describing the primary (28-day survival) and secondary outcomes. We describe our data management process, data monitoring committee, interim analyses, and sample size calculation. We describe our planned statistical analyses for primary and secondary outcomes as well as pre-specified subgroup analyses. We also provide details for presenting results, including mock tables for baseline characteristics, adherence to the protocol and effect on clinical outcomes. According to best trial practice, we report our statistical analysis plan and data management plan prior to locking the database and beginning analyses. We anticipate that this document will prevent analysis bias and enhance the utility of the reported results. ClinicalTrials.gov number, NCT01374022.

  4. Respiratory muscle training on pulmonary and swallowing function in patients with Huntington's disease: a pilot randomised controlled trial.

    Science.gov (United States)

    Reyes, Alvaro; Cruickshank, Travis; Nosaka, Kazunori; Ziman, Mel

    2015-10-01

    To examine the effects of 4-month of respiratory muscle training on pulmonary and swallowing function, exercise capacity and dyspnoea in manifest patients with Huntington's disease. A pilot randomised controlled trial. Home based training program. Eighteen manifest Huntington's disease patients with a positive genetic test and clinically verified disease expression, were randomly assigned to control group (n=9) and training group (n=9). Both groups received home-based inspiratory (5 sets of 5 repetitions) and expiratory (5 sets of 5 repetitions) muscle training 6 times a week for 4 months. The control group used a fixed resistance of 9 centimeters of water, and the training group used a progressively increased resistance from 30% to 75% of each patient's maximum respiratory pressure. Spirometric indices, maximum inspiratory pressure, maximum expiratory pressure, six minutes walk test, dyspnoea, water-swallowing test and swallow quality of life questionnaire were assessed before, at 2 and 4 months after training. The magnitude of increases in maximum inspiratory (d=2.9) and expiratory pressures (d=1.5), forced vital capacity (d=0.8), forced expiratory volume in 1 second (d=0.9) and peak expiratory flow (d=0.8) was substantially greater for the training group in comparison to the control group. Changes in swallowing function, dyspnoea and exercise capacity were small (d ≤ 0.5) for both groups without substantial differences between groups. A home-based respiratory muscle training program appeared to be beneficial to improve pulmonary function in manifest Huntington's disease patients but provided small effects on swallowing function, dyspnoea and exercise capacity. © The Author(s) 2015.

  5. The study protocol for a randomized controlled trial of a family-centred tobacco control program about environmental tobacco smoke (ETS to reduce respiratory illness in Indigenous infants

    Directory of Open Access Journals (Sweden)

    Segan Catherine

    2010-03-01

    Full Text Available Abstract Background Acute respiratory illness (ARI is the most common cause of acute presentations and hospitalisations of young Indigenous children in Australia and New Zealand (NZ. Environmental tobacco smoke (ETS from household smoking is a significant and preventable contributor to childhood ARI. This paper describes the protocol for a study which aims to test the efficacy of a family-centred tobacco control program about ETS to improve the respiratory health of Indigenous infants in Australia and New Zealand. For the purpose of this paper 'Indigenous' refers to Australia's Aboriginal and Torres Strait Islander peoples when referring to Australian Indigenous populations. In New Zealand, the term 'Indigenous' refers to Māori. Methods/Design This study will be a parallel, randomized, controlled trial. Participants will be Indigenous women and their infants, half of whom will be randomly allocated to an 'intervention' group, who will receive the tobacco control program over three home visits in the first three months of the infant's life and half to a control group receiving 'usual care' (i.e. they will not receive the tobacco control program. Indigenous health workers will deliver the intervention, the goal of which is to reduce or eliminate infant exposure to ETS. Data collection will occur at baseline (shortly after birth and when the infant is four months and one year of age. The primary outcome is a doctor-diagnosed, documented case of respiratory illness in participating infants. Discussion Interventions aimed at reducing exposure of Indigenous children to ETS have the potential for significant benefits for Indigenous communities. There is currently a dearth of evidence for the effect of tobacco control interventions to reduce children's exposure to ETS among Indigenous populations. This study will provide high-quality evidence of the efficacy of a family-centred tobacco control program on ETS to reduce respiratory illness. Outcomes of

  6. Beyond regulations: industry voluntary ban in arsenic use.

    Science.gov (United States)

    Hsueh, Lily

    2013-12-15

    Firms play a key role in pollution abatement and control by engaging in beyond-compliance actions without the force of law in voluntary programs. This study examines the effectiveness of a bilateral voluntary agreement, one type of voluntary programs, negotiated between the U.S. Environmental Protection Agency (EPA) and the pressure-treated wood industry to phase-out the use of chromated copper arsenate (CCA), a poisonous arsenic compound. Arsenic is ranked number one on the EPA's priority list of hazardous substances. Unlike a majority of earlier studies on voluntary programs, dynamic panel estimation and structural break analysis show that while a technological innovation in semiconductors is associated with arsenic use increases, the CCA voluntary agreement is associated with a reduction in arsenic use to levels not seen since the 1920s. A voluntary ban in arsenic acid by pesticide manufacturers in the agriculture sector has also contributed to arsenic reductions. Furthermore, the results suggest that environmental activism has played a role in curbing arsenic use. Increasing stakeholder pressures, as measured by membership in the Sierra Club, improves voluntary agreement effectiveness. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Activation of respiratory muscles during respiratory muscle training.

    Science.gov (United States)

    Walterspacher, Stephan; Pietsch, Fabian; Walker, David Johannes; Röcker, Kai; Kabitz, Hans-Joachim

    2018-01-01

    It is unknown which respiratory muscles are mainly activated by respiratory muscle training. This study evaluated Inspiratory Pressure Threshold Loading (IPTL), Inspiratory Flow Resistive Loading (IFRL) and Voluntary Isocapnic Hyperpnea (VIH) with regard to electromyographic (EMG) activation of the sternocleidomastoid muscle (SCM), parasternal muscles (PARA) and the diaphragm (DIA) in randomized order. Surface EMG were analyzed at the end of each training session and normalized using the peak EMG recorded during maximum inspiratory maneuvers (Sniff nasal pressure: SnPna, maximal inspiratory mouth occlusion pressure: PImax). 41 healthy participants were included. Maximal activation was achieved for SCM by SnPna; the PImax activated predominantly PARA and DIA. Activations of SCM and PARA were higher in IPTL and VIH than for IFRL (pVIH (pVIH differ in activation of inspiratory respiratory muscles. Whereas all methods mainly stimulate accessory respiratory muscles, diaphragm activation was predominant in IPTL. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Buoyancy under control: underwater locomotor performance in a deep diving seabird suggests respiratory strategies for reducing foraging effort.

    Directory of Open Access Journals (Sweden)

    Timothée R Cook

    Full Text Available BACKGROUND: Because they have air stored in many body compartments, diving seabirds are expected to exhibit efficient behavioural strategies for reducing costs related to buoyancy control. We study the underwater locomotor activity of a deep-diving species from the Cormorant family (Kerguelen shag and report locomotor adjustments to the change of buoyancy with depth. METHODOLOGY/PRINCIPAL FINDINGS: Using accelerometers, we show that during both the descent and ascent phases of dives, shags modelled their acceleration and stroking activity on the natural variation of buoyancy with depth. For example, during the descent phase, birds increased swim speed with depth. But in parallel, and with a decay constant similar to the one in the equation explaining the decrease of buoyancy with depth, they decreased foot-stroke frequency exponentially, a behaviour that enables birds to reduce oxygen consumption. During ascent, birds also reduced locomotor cost by ascending passively. We considered the depth at which they started gliding as a proxy to their depth of neutral buoyancy. This depth increased with maximum dive depth. As an explanation for this, we propose that shags adjust their buoyancy to depth by varying the amount of respiratory air they dive with. CONCLUSIONS/SIGNIFICANCE: Calculations based on known values of stored body oxygen volumes and on deep-diving metabolic rates in avian divers suggest that the variations of volume of respiratory oxygen associated with a respiration mediated buoyancy control only influence aerobic dive duration moderately. Therefore, we propose that an advantage in cormorants--as in other families of diving seabirds--of respiratory air volume adjustment upon diving could be related less to increasing time of submergence, through an increased volume of body oxygen stores, than to reducing the locomotor costs of buoyancy control.

  9. Middle East respiratory syndrome coronavirus (MERS-CoV): challenges in identifying its source and controlling its spread.

    Science.gov (United States)

    Lu, Lu; Liu, Qi; Du, Lanying; Jiang, Shibo

    2013-01-01

    Middle East respiratory syndrome coronavirus (MERS-CoV), a novel human coronavirus that caused outbreaks of a SARS-like illness in the Middle East, is now considered a threat to global public health. This review discusses the challenges in identifying the source of this fatal virus and developing effective and safe anti-MERS-CoV vaccines and therapeutics in order to control its spread and to combat any future pandemic. Copyright © 2013 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

  10. [Clinical and epidemiological differences between Bordetella pertussis and respiratory syncytial virus infections in infants: a matched case control study].

    Science.gov (United States)

    Giménez-Sánchez, Francisco; Cobos-Carrascosa, Elena; Sánchez-Forte, Miguel; López-Sánchez, María Ángeles; González-Jiménez, Yolanda; Azor-Martínez, Ernestina

    2014-01-01

    An increase in cases of pertussis, mainly in young infants, has been reported in the last few years. The clinical presentation of this disease is very similar to that produced by respiratory syncytial virus (RSV), which makes the diagnosis difficult. To compare the clinical and epidemiological characteristics between Bordetella pertussis and RSV infections in infants admitted to hospital. An analytical matched case-control study was conducted during the period 2008-2011. Cases were defined as infants admitted with pertussis confirmed by PCR in nasopharyngeal aspirate. Each case was matched by age, sex and date of admission to two controls defined as patients with RSV infection detected by immunochromatography in nasal aspirate. Demographic, clinical, laboratory data were compared. Seventy eight patients (26 cases of pertussis and 52 controls RSV+) were included. Sociodemographic characteristics were similar in both groups. Cases had more days of symptoms prior to admission, longer hospital stays, and increased frequency of epidemic family environment. Apnoea and cyanosis were more frequent. Cases of pertussis were more likely to have apnoea, cyanosis, and lymphocytosis while RSV infections had more frequent fever, vomiting and respiratory distress. The clinical presentations of pertussis and RSV infection are similar, but there are some characteristics that can help to distinguish between them. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  11. Effects of Swiss ball exercise and resistance exercise on respiratory function and trunk control ability in patients with scoliosis.

    Science.gov (United States)

    Kim, Jwa Jun; Song, Gui Bin; Park, Eun Cho

    2015-06-01

    [Purpose] This study compared the effects of Swiss ball exercise and resistance exercise on the respiratory function and trunk control ability of patients with scoliosis. [Subjects] Forty scoliosis patients were randomly divided into the Swiss ball exercise group (n= 20) and resistance exercise group (n = 20). [Methods] The Swiss ball and resistance exercise groups performed chest expansion and breathing exercises with a Swiss ball and a therapist's resistance, respectively. Both groups received training 30 min per day, 5 times per week for 8 weeks. [Results] Both groups exhibited significant changes in forced vital capacity, forced expiratory volume in one second, and trunk impairment scale after the intervention. However, there was no significant change in the forced expiratory volume in one second/forced vital capacity ratio after the intervention in either group. Meanwhile, forced expiratory volume in one second and trunk impairment scale were significantly greater in the resistance exercise group after the intervention. [Conclusion] Both Swiss ball exercise and resistance exercise are effective for improving the respiratory function and trunk control ability of patients with scoliosis. However, resistance exercise is more effective for increasing the forced expiratory volume in one second and trunk control ability.

  12. Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Kany-Kany Angelique Luabeya

    2007-06-01

    Full Text Available Prophylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its efficacy in children in Africa is uncertain.To determine if zinc, or zinc plus multiple micronutrients, reduces diarrhea and respiratory disease prevalence.Randomized, double-blind, controlled trial.Rural community in South Africa.THREE COHORTS: 32 HIV-infected children; 154 HIV-uninfected children born to HIV-infected mothers; and 187 HIV-uninfected children born to HIV-uninfected mothers.Children received either 1250 IU of vitamin A; vitamin A and 10 mg of zinc; or vitamin A, zinc, vitamins B1, B2, B6, B12, C, D, E, and K and copper, iodine, iron, and niacin starting at 6 months and continuing to 24 months of age. Homes were visited weekly.Primary outcome was percentage of days of diarrhea per child by study arm within each of the three cohorts. Secondary outcomes were prevalence of upper respiratory symptoms and percentage of children who ever had pneumonia by maternal report, or confirmed by the field worker.Among HIV-uninfected children born to HIV-infected mothers, median percentage of days with diarrhea was 2.3% for 49 children allocated to vitamin A; 2.5% in 47 children allocated to receive vitamin A and zinc; and 2.2% for 46 children allocated to multiple micronutrients (P = 0.852. Among HIV-uninfected children born to HIV-uninfected mothers, median percentage of days of diarrhea was 2.4% in 56 children in the vitamin A group; 1.8% in 57 children in the vitamin A and zinc group; and 2.7% in 52 children in the multiple micronutrient group (P = 0.857. Only 32 HIV-infected children were enrolled, and there were no differences between treatment arms in the prevalence of diarrhea. The prevalence of upper respiratory symptoms or incidence of pneumonia did not differ by treatment arms in any of the cohorts.When compared with vitamin A alone, supplementation with zinc, or with zinc and multiple

  13. Progesterone after previous preterm birth for prevention of neonatal respiratory distress syndrome (PROGRESS: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Flenady Vicki

    2009-02-01

    Full Text Available Abstract Background Neonatal respiratory distress syndrome, as a consequence of preterm birth, is a major cause of early mortality and morbidity during infancy and childhood. Survivors of preterm birth continue to remain at considerable risk of both chronic lung disease and long-term neurological handicap. Progesterone is involved in the maintenance of uterine quiescence through modulation of the calcium-calmodulin-myosin-light-chain-kinase system in smooth muscle cells. The withdrawal of progesterone, either actual or functional is thought to be an antecedent to the onset of labour. While there have been recent reports of progesterone supplementation for women at risk of preterm birth which show promise in this intervention, there is currently insufficient data on clinically important outcomes for both women and infants to enable informed clinical decision-making. The aims of this randomised, double blind, placebo controlled trial are to assess whether the use of vaginal progesterone pessaries in women with a history of previous spontaneous preterm birth will reduce the risk and severity of respiratory distress syndrome, so improving their infant's health, without increasing maternal risks. Methods Design: Multicentred randomised, double blind, placebo-controlled trial. Inclusion Criteria: pregnant women with a live fetus, and a history of prior preterm birth at less than 37 weeks gestation and greater than 20 weeks gestation in the immediately preceding pregnancy, where onset of labour occurred spontaneously, or in association with cervical incompetence, or following preterm prelabour ruptured membranes. Trial Entry & Randomisation: After obtaining written informed consent, eligible women will be randomised between 18 and 23+6 weeks gestation using a central telephone randomisation service. The randomisation schedule prepared by non clinical research staff will use balanced variable blocks, with stratification according to plurality of the

  14. Alterations in minute ventilation, maximum voluntary ventilation and dyspneic index in different trimesters of pregnancy.

    Science.gov (United States)

    Tell, Anita; Bagali, Shrilaxmi; Aithala, Manjunatha; Khodnapur, Jyoti; Dhanakshirur, Gopal B

    2014-01-01

    Respiratory function in pregnancy is of special importance since the life of fetus depends primarily upon its oxygen supply. Thus this study was designed to evaluate the Minute ventilation (MV), Maximum Voluntary Ventilation (MVV) & Dyspneic Index (DI) in different trimesters of pregnancy & compare the results with non- pregnant control group. A cross-sectional study was carried out in 200 healthy women in the age range of 19-35 years with 50 subjects each in 1st, 2nd, 3rd trimesters of pregnancy and non-pregnant control group. We recorded respiratory parameters in study and control groups. Statistical analysis was done by ANOVA and Tukey Krammer post Hoc tests. It was observed that there was a significant decrease in MVV and dyspneic index in all trimesters of pregnancy and an insignificant variation in MV when compared to the control group. The changes in pulmonary function are influenced by the mechanical pressure of enlarging gravid uterus, elevating the diaphragm and restricting the movements of lungs thus hampering forceful expiration. The decrease seen in MVV in 1st trimester might be due to bronchoconstriction effect of decreased alveolar Pco2 on the bronchial smooth muscles.

  15. Middle East Respiratory Syndrome (MERS)

    Science.gov (United States)

    Middle East Respiratory Syndrome Coronavirus; MERS-CoV; Novel coronavirus; nCoV ... Centers for Disease Control and Prevention. Middle East Respiratory Syndrome (MERS): Frequently Asked Questions and Answers. Updated ...

  16. The spinal reflex cannot be perceptually separated from voluntary movements

    Science.gov (United States)

    Ghosh, Arko; Haggard, Patrick

    2014-01-01

    Abstract Both voluntary and involuntary movements activate sensors in the muscles, skin, tendon and joints. As limb movement can result from a mixture of spinal reflexes and voluntary motor commands, the cortical centres underlying conscious proprioception might either aggregate or separate the sensory inputs generated by voluntary movements from those generated by involuntary movements such as spinal reflexes. We addressed whether healthy volunteers could perceive the contribution of a spinal reflex during movements that combined both reflexive and voluntary contributions. Volunteers reported the reflexive contribution in leg movements that were partly driven by the knee-jerk reflex induced by a patellar tendon tap and partly by voluntary motor control. In one condition, participants were instructed to kick back in response to a tendon tap. The results were compared to reflexes in a resting baseline condition without voluntary movement. In a further condition, participants were instructed to kick forwards after a tap. Volunteers reported the perceived reflex contribution by repositioning the leg to the perceived maximum displacement to which the reflex moved the leg after each tendon tap. In the resting baseline condition, the reflex was accurately perceived. We found a near-unity slope of linear regressions of perceived on actual reflexive displacement. Both the slope value and the quality of regression fit in individual volunteers were significantly reduced when volunteers were instructed to generate voluntary backward kicks as soon as they detected the tap. In the kick forward condition, kinematic analysis showed continuity of reflex and voluntary movements, but the reflex contribution could be estimated from electromyography (EMG) recording on each trial. Again, participants’ judgements of reflexes showed a poor relation to reflex EMG, in contrast to the baseline condition. In sum, we show that reflexes can be accurately perceived from afferent information

  17. Belief in Life After Death and Attitudes Toward Voluntary Euthanasia.

    Science.gov (United States)

    Sharp, Shane

    2017-01-01

    Research has documented associations among religious affiliation, religious practice, and attitudes toward voluntary euthanasia, yet very few studies have investigated how particular religious beliefs influence these attitudes. I use data from the General Social Survey (GSS; N = 19,967) to evaluate the association between the belief in life after death and attitudes toward voluntary euthanasia. I find that those who believe in life after death are significantly less likely than those who do not believe in life after death or those who doubt the existence of life after death to have positive 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' views about voluntary euthanasia, one must pay attention to individuals' particular religious beliefs.

  18. Safety, bioavailability and mechanism of action of nitric oxide to control Bovine Respiratory Disease Complex in calves entering a feedlot.

    Science.gov (United States)

    Regev-Shoshani, G; Vimalanathan, S; Prema, D; Church, J S; Reudink, M W; Nation, N; Miller, C C

    2014-04-01

    Bovine Respiratory Disease Complex (BRDc), a multi-factorial disease, negatively impacts the cattle industry. Nitric oxide (NO), a naturally occurring molecule, may have utility controlling incidence of BRDc. Safety, bioavailability, toxicology and tolerance/stress of administering NO to cattle is evaluated herein. Thirteen, crossbred, multiple-sourced, commingled commercial weaned beef calves were treated multiple times intranasally over a 4 week period with either a nitric oxide releasing solution (treatment) or saline (control). Exhaled NO, methemoglobin percent (MetHg) and serum nitrites demonstrated biological availability as a result of treatment. Cortisol levels, tissue nitrites, behavior and gross and macroscopic pathology of organs were all normal. Moreover, preliminary in vitro studies using Mannheimia haemolytica, Infectious Bovine Rhinotracheitis, Bovine Parainfluenza-3 and Bovine Respiratory Syncytial Virus, suggest a potential explanation for the previously demonstrated efficacy for BRDc. These data confirm the bioavailability, safety and lack of residual of NO treatment to cattle, along with the bactericidal and virucidal effects. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2014-02-01

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

  20. Progesterone after previous preterm birth for prevention of neonatal respiratory distress syndrome (PROGRESS): a randomised controlled trial.

    Science.gov (United States)

    Dodd, Jodie M; Crowther, Caroline A; McPhee, Andrew J; Flenady, Vicki; Robinson, Jeffrey S

    2009-02-24

    Neonatal respiratory distress syndrome, as a consequence of preterm birth, is a major cause of early mortality and morbidity during infancy and childhood. Survivors of preterm birth continue to remain at considerable risk of both chronic lung disease and long-term neurological handicap. Progesterone is involved in the maintenance of uterine quiescence through modulation of the calcium-calmodulin-myosin-light-chain-kinase system in smooth muscle cells. The withdrawal of progesterone, either actual or functional is thought to be an antecedent to the onset of labour. While there have been recent reports of progesterone supplementation for women at risk of preterm birth which show promise in this intervention, there is currently insufficient data on clinically important outcomes for both women and infants to enable informed clinical decision-making. The aims of this randomised, double blind, placebo controlled trial are to assess whether the use of vaginal progesterone pessaries in women with a history of previous spontaneous preterm birth will reduce the risk and severity of respiratory distress syndrome, so improving their infant's health, without increasing maternal risks. Multicentered randomised, double blind, placebo-controlled trial. pregnant women with a live fetus, and a history of prior preterm birth at less than 37 weeks gestation and greater than 20 weeks gestation in the immediately preceding pregnancy, where onset of labour occurred spontaneously, or in association with cervical incompetence, or following preterm prelabour ruptured membranes. Trial Entry & Randomisation: After obtaining written informed consent, eligible women will be randomised between 18 and 23+6 weeks gestation using a central telephone randomisation service. The randomisation schedule prepared by non clinical research staff will use balanced variable blocks, with stratification according to plurality of the pregnancy and centre where planned to give birth. Eligible women will be

  1. Milk containing probiotic Lactobacillus rhamnosus GG and respiratory illness in children: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Kumpu, M; Kekkonen, R A; Kautiainen, H; Järvenpää, S; Kristo, A; Huovinen, P; Pitkäranta, A; Korpela, R; Hatakka, K

    2012-09-01

    To determine whether long-term daily consumption of milk containing probiotic Lactobacillus rhamnosus GG (GG) decreases respiratory illness in children. A randomized, double-blind, placebo-controlled trial was conducted with 523 children aged 2-6 years attending day care centers in Finland. Subjects received either normal milk or the same milk with GG on three daily meals for 28 weeks. Daily recording of children' symptoms was done by parents. Primary outcome data from 501 subjects were available for analysis, and data from 128 subjects were analyzed as completed cases in terms of recovery of GG in fecal samples. Number of days with at least one respiratory symptom in all subjects was 5.03/month (95% confidence interval (CI): 4.92-5.15) in the GG group and 5.17/month (95% CI: 5.05-5.29) in the placebo group incidence rate ratio (IRR) 0.97; 95% CI: 0.94-1.00; P=0.098). In the completed cases, the figures were 4.71 days/month (95% CI: 4.52-4.90) in the GG group and 5.67 days/month (95% CI: 5.40-5.94) in the placebo group (IRR 0.83; 95% CI: 0.78-0.88; PGG reduced the occurrence of respiratory illness in children attending day care centers in the completed cases subgroup, but not in the total population. Thus, future clinical trials are warranted to clarify the association between fecal recovery of a probiotic and the symptom prevalence.

  2. Effects of respiratory muscle training on pulmonary functions in patients with slowly progressive neuromuscular disease: a randomized controlled trial.

    Science.gov (United States)

    Aslan, Goksen Kuran; Gurses, H Nilgun; Issever, Halim; Kiyan, Esen

    2014-06-01

    To investigate the effects of inspiratory and expiratory muscle training on pulmonary functions in patients with slowly progressive neuromuscular disease. Prospective randomized controlled double-blinded study. Chest diseases clinic of university hospital. Twenty-six patients with slowly progressive neuromuscular disease followed for respiratory problems were included in the study. Patients were randomly divided into two groups; experimental (n = 14; age 31.6 ±12.3 years) and sham (n = 12; age 26.5 ±8.6 years) groups. Spirometry, peak cough flow, maximal inspiratory pressure, maximal expiratory pressure, and sniff nasal inspiratory pressure were measured before the eighth week of study, and subsequently at end of it. Respiratory muscle training was performed by inspiratory (Threshold Inspiratory Muscle Trainer) and expiratory (Threshold Positive Expiratory Pressure) threshold loading methods. Training intensities were increased according to maximal inspiratory and expiratory pressures in the experimental group, while the lowest loads were used for training in the sham group. Patients performed 15 minutes inspiratory muscle training and 15 minutes expiratory muscle training, twice a day, five days/week, for a total of eight weeks at home. Training intensity was adjusted in the training group once a week. Maximal inspiratory and expiratory pressures (cmH2O, % predicted) (respectively p = 0.002, p = 0.003, p = 0.04, p = 0.03) and sniff nasal inspiratory pressure (p = 0.04) were improved in the experimental group when compared with the sham group. However, there was no improvement in spirometric measurements when groups were compared (p > 0.05). As a conclusion of our study, we found that respiratory muscle strength improved by inspiratory and expiratory muscle training in patients with slowly progressive neuromuscular disease. © The Author(s) 2013.

  3. Probiotics and vitamin C for the prevention of respiratory tract infections in children attending preschool: a randomised controlled pilot study.

    Science.gov (United States)

    Garaiova, I; Muchová, J; Nagyová, Z; Wang, D; Li, J V; Országhová, Z; Michael, D R; Plummer, S F; Ďuračková, Z

    2015-03-01

    This pilot study investigates the efficacy of a probiotic consortium (Lab4) in combination with vitamin C on the prevention of respiratory tract infections in children attending preschool facilities. In a double-blind, randomised, placebo-controlled pilot study with children aged 3-6 years, 57 received 1.25 × 10(10) colony-forming units of Lactobacillus acidophilus CUL21 (NCIMB 30156), Lactobacillus acidophilus CUL60 (NCIMB 30157), Bifidobacterium bifidum CUL20 (NCIMB 30153) and Bifidobacterium animalis subsp. lactis CUL34 (NCIMB 30172) plus 50 mg vitamin C or a placebo daily for 6 months. Significant reductions in the incidence rate of upper respiratory tract infection (URTI; 33%, P=0.002), the number of days with URTI symptoms (mean difference: -21.0, 95% confidence interval (CI):-35.9, -6.0, P=0.006) and the incidence rate of absence from preschool (30%, P=0.007) were observed in the active group compared with the placebo. The number of days of use of antibiotics, painkillers, cough medicine or nasal sprays was lower in the active group and reached significance for use of cough medicine (mean difference: -6.6, 95% CI: -12.9, -0.3, P=0.040). No significant differences were observed in the incidence rate ratio or duration of lower respiratory tract infection or in the levels of plasma cytokines, salivary immunoglobulin A or urinary metabolites. Supplementation with a probiotic/vitamin C combination may be beneficial in the prevention and management of URTIs.

  4. Comparing Voluntary and Mandatory Gameplay

    Directory of Open Access Journals (Sweden)

    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.

  5. Respiratory Failure

    Science.gov (United States)

    Respiratory failure happens when not enough oxygen passes from your lungs into your blood. Your body's organs, ... brain, need oxygen-rich blood to work well. Respiratory failure also can happen if your lungs can' ...

  6. 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.

  7. Randomized Controlled Study to Evaluate the Efficacy of a Preoperative Respiratory Rehabilitation Program to Prevent Postoperative Pulmonary Complications after Esophagectomy.

    Science.gov (United States)

    Yamana, Ippei; Takeno, Shinsuke; Hashimoto, Tatsuya; Maki, Kenji; Shibata, Ryosuke; Shiwaku, Hironari; Shimaoka, Hideki; Shiota, Etsuji; Yamashita, Yuichi

    2015-01-01

    Patients with postoperative pulmonary complications after esophagectomy often have increased mortality. The purpose of the study was to examine the efficacy of preventing postoperative pulmonary complications by an intensive preoperative respiratory rehabilitation (PR) program for esophageal cancer patients. This study was a prospective randomized controlled study. Thirty patients in the PR group and 30 patients in the no preoperative respiratory rehabilitation (NPR) group were included. The PR group received preoperative rehabilitation for more than 7 days, while the NPR group did not receive any preoperative rehabilitation. All patients underwent postoperative rehabilitation from the first postoperative day. The postoperative pulmonary complications were evaluated using the Clavien-Dindo classification (CDC) and the Utrecht Pneumonia Scoring System (UPSS). The CDC grade in the PR group was significantly lower than that in the NPR group (p = 0.014). The UPSS score in the PR group was significantly lower than that in the NPR group at postoperative day 1 (p = 0.031). In the multivariate analysis, NPR was an independent risk factor for postoperative pulmonary complications greater than CDC grade II (OR: 3.99, 95% CI: 1.28-12.4, p = 0.017). This study showed that the intensive PR program was capable of reducing the postoperative pulmonary complications in esophageal cancer patients. © 2015 S. Karger AG, Basel.

  8. An early rehabilitation intervention to enhance recovery during hospital admission for an exacerbation of chronic respiratory disease: randomised controlled trial.

    Science.gov (United States)

    Greening, Neil J; Williams, Johanna E A; Hussain, Syed F; Harvey-Dunstan, Theresa C; Bankart, M John; Chaplin, Emma J; Vincent, Emma E; Chimera, Rudo; Morgan, Mike D; Singh, Sally J; Steiner, Michael C

    2014-07-08

    To investigate whether an early rehabilitation intervention initiated during acute admission for exacerbations of chronic respiratory disease reduces the risk of readmission over 12 months and ameliorates the negative effects of the episode on physical performance and health status. Prospective, randomised controlled trial. An acute cardiorespiratory unit in a teaching hospital and an acute medical unit in an affiliated teaching district general hospital, United Kingdom. 389 patients aged between 45 and 93 who within 48 hours of admission to hospital with an exacerbation of chronic respiratory disease were randomised to an early rehabilitation intervention (n=196) or to usual care (n=193). The primary outcome was readmission rate at 12 months. Secondary outcomes included number of hospital days, mortality, physical performance, and health status. The primary analysis was by intention to treat, with prespecified per protocol analysis as a secondary outcome. Participants in the early rehabilitation group received a six week intervention, started within 48 hours of admission. The intervention comprised prescribed, progressive aerobic, resistance, and neuromuscular electrical stimulation training. Patients also received a self management and education package. Of the 389 participants, 320 (82%) had a primary diagnosis of chronic obstructive pulmonary disease. 233 (60%) were readmitted at least once in the following year (62% in the intervention group and 58% in the control group). No significant difference between groups was found (hazard ratio 1.1, 95% confidence interval 0.86 to 1.43, P=0.4). An increase in mortality was seen in the intervention group at one year (odds ratio 1.74, 95% confidence interval 1.05 to 2.88, P=0.03). Significant recovery in physical performance and health status was seen after discharge in both groups, with no significant difference between groups at one year. Early rehabilitation during hospital admission for chronic respiratory disease

  9. Epizootiological and diagnostic significance of porcine reproductive and respiratory syndrome control

    Directory of Open Access Journals (Sweden)

    Radojičić Biljana

    2002-01-01

    Full Text Available The porcine reproductive and respiratory syndrome (PRRS is a new viral disease in swine, designated exclusively under the acronym PRRS by the European Commission in 1991. The cause of this disease was isolated and determined in 1991 at the Lelystad Institute in The Netherlands as Lelystad aretrivirus. The PRRSV is an RNA virus of the order Nidovirales, the family Arteriviridae, the genus Arterivirus (Cavanaugh, 1997. Different genomic and pheriotypic varieties of the virus are significant. It is replicated in macrophages, it induces permanent viraemia, causes the creation of antibodies, and leads to persistent and latent infections. It is isolated from tonsil tissue, alveolar macrophages, the uterus, and fetal homogenate composed of different tissues (Wills et al., 1997. All production categories of swine can contract PRRS, but pregnant sows, suckling piglets and fattening swine are considered endangered categories. Morbidity and mortapty is between 8-80%, which also depends on the animal category. Economic damages are substantial when one considers the high percentage of still-born piglets, mummified fetuses and suckling piglets. Irregular successive cycles in sows are also expressed. In fattening swine, in addition to a respiratory form of the clinical picture, the time period until animals reach abattoir weight is extended even up to 30 days, which is also a considerable economic loss. Costs of treating possible secondary bacterial infections, diagnostics and immunoprophylaxis are not negligible. The OIE placed PRRS on the B list in 1992 as a contagious disease of swine which incurs economic losses in almost all countries of the world. Diagnosis is made by isolating and determining the virus and/or by serodiagnostics (ELISA and PCR. Certain countries have already made up protocols for the implementation of constant diagnostics and suggested eradication measures (Dee S.A. et al., 2000. In our country, the first clinical cases of PRRS were

  10. Voluntary Sleep Loss in Rats.

    Science.gov (United States)

    Oonk, Marcella; Krueger, James M; Davis, Christopher J

    2016-07-01

    Animal sleep deprivation (SDEP), in contrast to human SDEP, is involuntary and involves repeated exposure to aversive stimuli including the inability of the animal to control the waking stimulus. Therefore, we explored intracranial self-stimulation (ICSS), an operant behavior, as a method for voluntary SDEP in rodents. Male Sprague-Dawley rats were implanted with electroencephalography/electromyography (EEG/EMG) recording electrodes and a unilateral bipolar electrode into the lateral hypothalamus. Rats were allowed to self-stimulate, or underwent gentle handling-induced SDEP (GH-SDEP), during the first 6 h of the light phase, after which they were allowed to sleep. Other rats performed the 6 h ICSS and 1 w later were subjected to 6 h of noncontingent stimulation (NCS). During NCS the individual stimulation patterns recorded during ICSS were replayed. After GH-SDEP, ICSS, or NCS, time in nonrapid eye movement (NREM) sleep and rapid eye movement (REM) sleep increased. Further, in the 24 h after SDEP, rats recovered all of the REM sleep lost during SDEP, but only 75% to 80% of the NREM sleep lost, regardless of the SDEP method. The magnitude of EEG slow wave responses occurring during NREM sleep also increased after SDEP treatments. However, NREM sleep EEG slow wave activity (SWA) responses were attenuated following ICSS, compared to GH-SDEP and NCS. We conclude that ICSS and NCS can be used to sleep deprive rats. Changes in rebound NREM sleep EEG SWA occurring after ICSS, NCS, and GH-SDEP suggest that nonspecific effects of the SDEP procedure differentially affect recovery sleep phenotypes. © 2016 Associated Professional Sleep Societies, LLC.

  11. Iron status of regular voluntary blood donors

    Directory of Open Access Journals (Sweden)

    Mahida Vilsu

    2008-01-01

    Full Text Available Background: Our blood bank is a regional blood transfusion centre, which accepts blood only from voluntary donors. Aim: The aim is to study iron status of regular voluntary donors who donated their blood at least twice in a year. Materials and Methods: Prior to blood donation, blood samples of 220 male and 30 female voluntary donors were collected. Control included 100 each male and female healthy individuals in the 18- to 60-year age group, who never donated blood and did not have any chronic infection. In the study and control groups, about 10% subjects consumed non-vegetarian diet. After investigation, 85 males and 56 females having haemoglobin (Hb levels above 12.5 g/dl were selected as controls. Donors were divided into ≤10, 11-20, 21-50 and> 50 blood donation categories. Majority of the donors in> 50 donation category donated blood four times in a year, whereas the remaining donors donated two to three times per year. Haematological parameters were measured on fully automatic haematology analyzer, serum iron and total iron-binding capacity (TIBC by biochemical methods, ferritin using ELISA kits and transferrin using immunoturbidometry kits. Iron/TIBC ratio x 100 gave percentage of transferrin saturation value. Statistical Analysis: Statistical evaluation was done by mean, standard deviation, pair t -test, χ2 and anova ( F -test. Results: Preliminary analysis revealed that there was no significant difference in the iron profile of vegetarian and non-vegetarian subjects or controls and the donors donating < 20 times. Significant increase or decrease was observed in mean values of various haematological and iron parameters in donors who donated blood for> 20 times ( P < 0.001, compared to controls. Anaemia, iron deficiency and depletion of iron stores were more prevalent in female donors ( P < 0.05 compared to males and especially in those male donors who donated their blood for more than 20 times. Conclusion: Regular voluntary blood

  12. Mucosal adjuvants for vaccines to control upper respiratory infections in the elderly.

    Science.gov (United States)

    Fujihashi, Kohtaro; Sato, Shintaro; Kiyono, Hiroshi

    2014-06-01

    Influenza virus and Streptococcus pneumoniae are two major pathogens that lead to significant morbidity and mortality in the elderly. Since both pathogens enter the host via the mucosa, especially the upper respiratory tract (URT), it is essential to elicit pathogen-specific secretory IgA (SIgA) antibody (Ab) responses at mucosal surfaces for defense of the elderly. However, as aging occurs, alterations in the mucosal immune system of older individuals result in a failure to induce SIgA Abs for protection from these infections. To overcome mucosal immunosenescence, we have developed a mucosal dendritic cell targeting, novel double adjuvant system which we show to be an attractive and effective immunological modulator. This system induces a more balanced Th1- and Th2-type cytokine response which supports both mucosal SIgA and systemic IgG1 and IgG2a Ab responses. Thus, adaptation of this adjuvant system to nasal vaccines for influenza virus and S. pneumoniae could successfully provide protection by supporting pathogen-specific SIgA Ab responses in the URT in the mouse model of aging. In summary, a double adjuvant system is considered to be an attractive and potentially important strategy for the future development of mucosal vaccines for the elderly. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Respiratory control during hypoxia in newborn rabbits: implied action of endorphins.

    Science.gov (United States)

    Grunstein, M M; Hazinski, T A; Schlueter, M A

    1981-07-01

    The mechanism of ventilatory depression during hypoxia in the neonate is unknown. Since endorphins depress ventilation and their actions are antagonized by naloxone, we tested the effect of naloxone on respiration during acute hypoxia in newborn rabbits. In 27 tracheotomized unanesthetized pups, ranging in age from 1 to 15 days, ventilation (VE) was measured in a body plethysmograph. At all ages, inhalation of 5% O2 initially increased VE; thereafter VE became depressed in association with a decrease in CO2 elimination (VCO2). The time constant of VE depression increased with age. During ventilatory and VCO2 depression, saline infusion had no effect. Infusion of naloxone (4 micrograms/g body wt), however, abruptly stimulated both VE and VCO2. Since naloxone acts by competitive blockade of opiate (endorphin) receptors, these data provide evidence that 1) depression in respiration and metabolism during hypoxia is related to the action of endorphins, 2) the degree of endorphin influence decreases with age, and 3) naloxone is effective in reversing hypoxic respiratory depression provided apnea is not established.

  14. Control of abdominal and expiratory intercostal muscle activity during vomiting - Role of ventral respiratory group expiratory neurons

    Science.gov (United States)

    Miller, Alan D.; Tan, L. K.; Suzuki, Ichiro

    1987-01-01

    The role of ventral respiratory group (VRG) expiratory (E) neurons in the control of abdominal and internal intercostal muscle activity during vomiting was investigated in cats. Two series of experiments were performed: in one, the activity of VRG E neurons was recorded during fictive vomiting in cats that were decerebrated, paralyzed, and artificially ventilated; in the second, the abdominal muscle activity during vomiting was compared before and after sectioning the axons of descending VRG E neurons in decerebrate spontaneously breathing cats. The results show that about two-thirds of VRG E neurons that project at least as far caudally as the lower thoracic cord contribute to internal intercostal muscle activity during vomiting. The remaining VRG E neurons contribute to abdominal muscle activation. As shown by severing the axons of the VRG E neurons, other, as yet unidenified, inputs (either descending from the brain stem or arising from spinal reflexes) can also produce abdominal muscle activation.

  15. Multimodal nutritional rehabilitation improves clinical outcomes of malnourished patients with chronic respiratory failure: a randomised controlled trial.

    Science.gov (United States)

    Pison, Christophe M; Cano, Noël J; Chérion, Cécile; Caron, Fabrice; Court-Fortune, Isabelle; Antonini, Marie-Thérèse; Gonzalez-Bermejo, Jésus; Meziane, Lahouari; Molano, Luis Carlos; Janssens, Jean-Paul; Costes, Frédéric; Wuyam, Bernard; Similowski, Thomas; Melloni, Boris; Hayot, Maurice; Augustin, Julie; Tardif, Catherine; Lejeune, Hervé; Roth, Hubert; Pichard, Claude

    2011-11-01

    In chronic respiratory failure (CRF), body composition strongly predicts survival. A prospective randomised controlled trial was undertaken in malnourished patients with CRF to evaluate the effects of 3 months of home rehabilitation on body functioning and composition. 122 patients with CRF on long-term oxygen therapy and/or non-invasive ventilation (mean (SD) age 66 (10) years, 91 men) were included from eight respiratory units; 62 were assigned to home health education (controls) and 60 to multimodal nutritional rehabilitation combining health education, oral nutritional supplements, exercise and oral testosterone for 90 days. The primary endpoint was exercise tolerance assessed by the 6-min walking test (6MWT). Secondary endpoints were body composition, quality of life after 3 months and 15-month survival. Mean (SD) baseline arterial oxygen tension was 7.7 (1.2) kPa, forced expiratory volume in 1 s 31 (13)% predicted, body mass index (BMI) 21.5 (3.9) kg/m2 and fat-free mass index (FFMI) 15.5 (2.4) kg/m2. The intervention had no significant effect on 6MWT. Improvements (treatment effect) were seen in BMI (+0.56 kg/m2, 95% CI 0.18 to 0.95, p=0.004), FFMI (+0.60 kg/m2, 95% CI 0.15 to 1.05, p=0.01), haemoglobin (+9.1 g/l, 95% CI 2.5 to 15.7, p=0.008), peak workload (+7.2 W, 95% CI 3.7 to 10.6, pRespiratory Questionnaire (+16.5 units, 95% CI 5.3 to 27.7, p=0.006). In a multivariate Cox analysis, only rehabilitation in a per-protocol analysis predicted survival (HR 0.27, 95% CI 0.07 to 0.95, p=0.042). Multimodal nutritional rehabilitation aimed at improving body composition increased exercise tolerance, quality of life in women and survival in compliant patients, supporting its incorporation in the treatment of malnourished patients with CRF. Clinical Trial number NCT00230984.

  16. 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.

  17. Chronic pain and voluntary euthanasia.

    Science.gov (United States)

    Rismanchi, Mojtaba

    2008-01-01

    Emotional status and its brain bases change in a chronic pain patient and this change affects his/her decision making ability. Moreover, it is accepted that a mentally disturbed individual is not competent to make critical decisions. According to these bases, this article demonstrates that such patients are not entitled to request voluntary euthanasia.

  18. Social Cohesion and Voluntary Associations

    Science.gov (United States)

    Heuser, Brian L.

    2005-01-01

    Voluntary organizations exert great influence over how social norms and ethical codes are guided into action. As such, they have a significant impact on societal levels of social cohesion. Although social capital involves generalized trust becoming manifest as spontaneous sociability, social cohesion is determined by how that sociability is…

  19. Between voluntary agreement and legislation

    DEFF Research Database (Denmark)

    Gwozdz, Wencke; Hedegaard, Liselotte; Reisch, Lucia

    2009-01-01

    Voluntary agreements and self-imposed standards are broadly applied to restrict the influence food advertising exerts on children’s food choices – yet their effects are unknown. The current project will therefore investigate whether and, if yes, how the Danish Code for Responsible Food Marketing...

  20. Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review.

    Science.gov (United States)

    French, Clare E; McKenzie, Bruce C; Coope, Caroline; Rajanaidu, Subhadra; Paranthaman, Karthik; Pebody, Richard; Nguyen-Van-Tam, Jonathan S; Higgins, Julian P T; Beck, Charles R

    2016-07-01

    Respiratory syncytial virus (RSV) causes a significant public health burden, and outbreaks among vulnerable patients in hospital settings are of particular concern. We reviewed published and unpublished literature from hospital settings to assess: (i) nosocomial RSV transmission risk (attack rate) during outbreaks, (ii) effectiveness of infection control measures. We searched the following databases: MEDLINE, EMBASE, CINAHL, Cochrane Library, together with key websites, journals and grey literature, to end of 2012. Risk of bias was assessed using the Cochrane risk of bias tool or Newcastle-Ottawa scale. A narrative synthesis was conducted. Forty studies were included (19 addressing research question one, 21 addressing question two). RSV transmission risk varied by hospital setting; 6-56% (median: 28·5%) in neonatal/paediatric settings (n = 14), 6-12% (median: 7%) in adult haematology and transplant units (n = 3), and 30-32% in other adult settings (n = 2). For question two, most studies (n = 13) employed multi-component interventions (e.g. cohort nursing, personal protective equipment (PPE), isolation), and these were largely reported to be effective in reducing nosocomial transmission. Four studies examined staff PPE; eye protection appeared more effective than gowns and masks. One study reported on RSV prophylaxis for patients (RSV-Ig/palivizumab); there was no statistical evidence of effectiveness although the sample size was small. Overall, risk of bias for included studies tended to be high. We conclude that RSV transmission risk varies widely during hospital outbreaks. Although multi-component control strategies appear broadly successful, further research is required to disaggregate the effectiveness of individual components including the potential role of palivizumab prophylaxis. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  1. Yogurt supplemented with probiotics can protect the healthy elderly from respiratory infections: A randomized controlled open-label trial

    Directory of Open Access Journals (Sweden)

    Pu F

    2017-08-01

    Full Text Available Fangfang Pu,1,* Yue Guo,1,2,* Ming Li,1 Hong Zhu,3 Shijie Wang,3 Xi Shen,1 Miao He,1 Chengyu Huang,1 Fang He1 1Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Microbiology laboratory, Chengdu Center for Disease Control & Prevention, Chengdu, Sichuan, People’s Republic of China; 3R&D center, Shijiazhuang Junlebao Dairy Co. Ltd., Shijiazhuang, Hebei, People’s Republic of China *These authors contributed equally to this work Purpose: To evaluate whether yogurt supplemented with a probiotic strain could protect middle-aged and elderly people from acute upper respiratory tract infections (URTI using a randomized, blank-controlled, parallel-group design.Patients and methods: Two hundred and five volunteers aged ≥45 years were randomly divided into two groups. The subjects in the intervention group were orally administered 300 mL/d of yogurt supplemented with a probiotic strain, Lactobacillus paracasei N1115 (N1115, 3.6×107 CFU/mL for 12 weeks, while those in the control group retained their normal diet without any probiotic supplementation. The primary outcome was the incidence of URTI, and changes in serum protein, immunoglobulins, and the profiles of the T-lymphocyte subsets (total T-cells [CD3+], T-helper cells [CD4+], and T-cytotoxic-suppressor cells [CD8+] during the intervention were the secondary outcomes.Results: Compared to the control group, the number of persons diagnosed with an acute URTI and the number of URTI events significantly decreased in the intervention group (P=0.038, P=0.030, respectively. The risk of URTI in the intervention group was evaluated as 55% of that in the control group (relative risk =0.55, 95% CI: 0.307–0.969. The change in the percentage of CD3+ cells in the intervention group was significantly higher than in the control group (P=0.038. However, no significant differences were observed in the

  2. The associations of humorous coping styles, affective states, job demands and job control with the frequency of upper respiratory tract infection

    Directory of Open Access Journals (Sweden)

    Sibe Doosje

    2011-05-01

    Full Text Available Orientation: There is some evidence that job demands and job resources such as job control and humorous coping may contribute to the risk of upper respiratory tract infections (URTI.Research purpose: The purpose of this study was to test a model including these variables as well as job-related affect, in order to explore their role in the explanation of the frequency of upper respiratory tract infection.Motivation of the study: This study has been conducted in order to extend our understanding of the role of traditional variables like job demands and job control with humorous coping styles and affective variables with regard to the explanation of the frequency of URTI.Research design, approach and method: A sample of 2094 employees filled out questionnaires assessing job demands, job control, generic (MSHS-C, antecedent-focused and responsefocused humorous coping (QOHC and job-related affect (JAWS.Main findings: Job demands were indirectly related to the frequency of upper respiratory tract infections, mediated by their relationships with job control and negative job-related affect. Generic and response-focused humorous coping were less relevant for the explanation of the frequency of upper respiratory tract infections than the presumably ‘healthy’ antecedentfocused humorous coping style. The latter showed a negative association with negative jobrelated affect. The frequency of upper respiratory tract infections was better predicted by job control and negative job-related affect than by humorous coping, in the expected directions.Practical/managerial implication: These findings may have practical relevance for the improvement of stress management interventions in organisations.Contribution/value-add: Although it was shown that healthy humorous coping does contribute to decreases in upper respiratory tract infection, job demands, job resources and negative affective state seem the most important predictors.

  3. 75 FR 14245 - Voluntary Intermodal Sealift Agreement

    Science.gov (United States)

    2010-03-24

    ... Maritime Administration Voluntary Intermodal Sealift Agreement AGENCY: Maritime Administration, DOT. ACTION: Notice of Voluntary Intermodal Sealift Agreement (VISA). SUMMARY: The Maritime Administration (MARAD... sustainment of U.S. military forces. This is to be accomplished through cooperation among the maritime...

  4. Lactobacillus fermentum (PCC® supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes

    Directory of Open Access Journals (Sweden)

    Hopkins William G

    2011-04-01

    Full Text Available Abstract Background Probiotics purportedly reduce symptoms of gastrointestinal and upper respiratory-tract illness by modulating commensal microflora. Preventing and reducing symptoms of respiratory and gastrointestinal illness are the primary reason that dietary supplementation with probiotics are becoming increasingly popular with healthy active individuals. There is a paucity of data regarding the effectiveness of probiotics in this cohort. The aim of this study was to evaluate the effectiveness of a probiotic on faecal microbiology, self-reported illness symptoms and immunity in healthy well trained individuals. Methods Competitive cyclists (64 males and 35 females; age 35 ± 9 and 36 ± 9 y, VO2max 56 ± 6 and 52 ± 6 ml.kg-1.min-1, mean ± SD were randomised to either probiotic (minimum 1 × 109 Lactobacillus fermentum (PCC® per day or placebo treatment for 11 weeks in a double-blind, randomised, controlled trial. The outcome measures were faecal L. fermentum counts, self-reported symptoms of illness and serum cytokines. Results Lactobacillus numbers increased 7.7-fold (90% confidence limits 2.1- to 28-fold more in males on the probiotic, while there was an unclear 2.2-fold (0.2- to 18-fold increase in females taking the probiotic. The number and duration of mild gastrointestinal symptoms were ~2-fold greater in the probiotic group. However, there was a substantial 0.7 (0.2 to 1.2 of a scale step reduction in the severity of gastrointestinal illness at the mean training load in males, which became more pronounced as training load increased. The load (duration×severity of lower respiratory illness symptoms was less by a factor of 0.31 (99%CI; 0.07 to 0.96 in males taking the probiotic compared with placebo but increased by a factor of 2.2 (0.41 to 27 in females. Differences in use of cold and flu medication mirrored these symptoms. The observed effects on URTI had too much uncertainty for a decisive outcome. There were clear reductions in

  5. Microtopographic and Hydrological Controls over Respiratory Efflux and Late-Season Arctic Methane Emissions

    Science.gov (United States)

    Wilkman, E.; Zona, D.; Oechel, W. C.

    2014-12-01

    In recent years, Arctic peatlands have released approximately 35 Tg (3.5 x 1012g) of CH4 annually, corresponding to around 1/3 of the aggregate wetland CH4 fluxes and 16% of all natural emissions. As climate models increasingly suggest that current warming trends in the Arctic (4-8 °C higher annual surface air temperatures) will continue by century's end, carbon (C) cycling in these northern climes may be further amplified. Although much has been learned in recent decades, uncertainty remains in regard to the spatial and temporal extent of CO2 and CH4 emissions from these systems. Chamber based carbon flux measurements were gathered for three growing seasons from June 2007 to September 2013 in Barrow, Alaska to investigate the diurnal, weekly, and monthly patterns of CO2 and CH4 flux in the North American Arctic. For the 2007 and 2008 growing seasons, high temporal frequency auto-chambers (LI-8100A Automated Soil Flux System, LI-COR Biosciences) were used to gather over 18,000 individual flux measurements. From July to September 2013 an Ultraportable Greenhouse Gas Analyzer (Los Gatos Research Inc.) was deployed in concert with this soil flux system to gather high temporal frequency soil CO2 and CH4 fluxes. Nearby eddy covariance towers provided auxiliary meteorological and environmental data, while weekly transects amassed further surficial hydrological measures (pH, thaw depth, water table). For earlier periods of data, respiratory fluxes were partitioned into five microtopographic classes (polygon rims and troughs, low centered basins, high ridges, and flat mesic terrain). Conversely, for the later periods of data covered chamber fluxes were partitioned into three 'habitat' types (High, Medium, Wet) based on corresponding aboveground average water table extent. Marked dissimilarities were noted across habitat types and microtopographic classes. In general more mesic, waterlogged regions released greater quantities of CO2 across the growing season, while

  6. Sex-dependent effects of developmental exposure to bisphenol A and ethinyl estradiol on metabolic parameters and voluntary physical activity

    Science.gov (United States)

    Johnson, S. A.; Painter, M. S.; Javurek, A. B.; Ellersieck, M. R.; Wiedmeyer, C. E.; Thyfault, J. P.; Rosenfeld, C. S.

    2016-01-01

    Endocrine disrupting chemicals (EDC) have received considerable attention as potential obesogens. Past studies examining obesogenic potential of one widespread EDC, bisphenol A (BPA), have generally focused on metabolic and adipose tissue effects. However, physical inactivity has been proposed to be a leading cause of obesity. A paucity of studies has considered whether EDC, including BPA, affects this behavior. To test whether early exposure to BPA and ethinyl estradiol (EE, estrogen present in birth control pills) results in metabolic and such behavioral disruptions, California mice developmentally exposed to BPA and EE were tested as adults for energy expenditure (indirect calorimetry), body composition (echoMRI) and physical activity (measured by beam breaks and voluntary wheel running). Serum glucose and metabolic hormones were measured. No differences in body weight or food consumption were detected. BPA-exposed females exhibited greater variation in weight than females in control and EE groups. During the dark and light cycles, BPA females exhibited a higher average respiratory quotient than control females, indicative of metabolizing carbohydrates rather than fats. Various assessments of voluntary physical activity in the home cage confirmed that during the dark cycle, BPA and EE-exposed females were significantly less active in this setting than control females. Similar effects were not observed in BPA or EE-exposed males. No significant differences were detected in serum glucose, insulin, adiponectin and leptin concentrations. Results suggest that females developmentally exposed to BPA exhibit decreased motivation to engage in voluntary physical activity and altered metabolism of carbohydrates v. fats, which could have important health implications. PMID:26378919

  7. Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Bergman, Peter; Lindh, Asa U; Björkhem-Bergman, Linda; Lindh, Jonatan D

    2013-01-01

    Low levels of 25-OH vitamin D are associated with respiratory tract infection (RTI). However, results from randomized controlled trials are inconclusive. Therefore, we performed a systematic review and meta-analysis to assess the preventive effect of vitamin D supplementation on RTI. Randomized, controlled trials of vitamin D for prevention of RTI were used for the analysis. The risks of within-trial and publication bias were assessed. Odds ratios of RTI were pooled using a random-effects model. Heterogeneity was assessed using Cochran's Q and I(2). Meta-regressions and subgroup analyses were used to assess the influence of various factors on trial outcome. The pre-defined review protocol was registered at the PROSPERO international prospective register of systematic reviews, registration number CRD42013003530. Of 1137 citations retrieved, 11 placebo-controlled studies of 5660 patients were included in the meta-analysis. Overall, vitamin D showed a protective effect against RTI (OR, 0.64; 95% CI, 0.49 to 0.84). There was significant heterogeneity among studies (Cohran's Q pvitamin D has a protective effect against RTI, and dosing once-daily seems most effective. Due to heterogeneity of included studies and possible publication bias in the field, these results should be interpreted with caution.

  8. High frequency oscillatory ventilation versus conventional mechanical ventilation in pediatric acute respiratory distress syndrome: A randomized controlled study.

    Science.gov (United States)

    El-Nawawy, Ahmed; Moustafa, Azza; Heshmat, Hassan; Abouahmed, Ahmed

    2017-01-01

    El-Nawawy A, Moustafa A, Heshmat H, Abouahmed A. High frequency oscillatory ventilation versus conventional mechanical ventilation in pediatric acute respiratory distress syndrome: A randomized controlled study. Turk J Pediatr 2017; 59: 130-143. The aim of this prospective randomized study is to compare the outcomes of the early use of either high frequency oscillation (HFO) or conventional mechanical ventilation (CMV) in patients with pediatric acute respiratory distress syndrome (PARDS). We allocated two hundred PARDS patients over 5 years in 1:1 ratio to either mode. The HFO group showed a significantly higher median partial arterial oxygen pressure to fraction of inspired oxygen (PaO2/FiO2) values after 24 hours of enrollment (p=0.011), higher oxygenation index (OI) decrease percent (p=0.004) and lower cross-over rates (p ventilation days (p=0.77, p=0.28, p=0.65 respectively). The second day values (after 24 hours) of both OI and PaO 2 /FiO 2 were found to be more significant discriminators for mortality when compared to the baseline values (cutoff values > 8.5, ≤139 respectively). PARDS patients with baseline OI > 16 had a better chance of survival if initially ventilated with the HFO (p=0.004). Although the HFO mode appeared to be a safe mode with a significant better oxygenation improvement (after the first 24 hours) and fewer cross-over rates, it failed to show differences as regards mortality or LOS when compared to the CMV adopting protective lung strategy. In PARDS, HFO had a superior advantage in improving oxygenation, yet with no significant mortality improvement, as multi-organ dysfunction syndrome (MODS) was the most common cause of death in our study and not refractory hypoxemia which is the main problem in PARDS; highlighting that mortality in PARDS is multi-factorial and may not depend only on how fast oxygenation improves.

  9. Sildenafil to improve respiratory rehabilitation outcomes in COPD: a controlled trial

    National Research Council Canada - National Science Library

    Blanco, Isabel; Santos, Salud; Gea, Joaqím; Güell, Rosa; Torres, Ferran; Gimeno-Santos, Elena; Rodriguez, Diego A; Vilaró, Jordi; Gómez, Begona; Roca, Josep; Barberà, Joan Albert

    2013-01-01

    ... rehabilitation in patients with COPD and increased pulmonary arterial pressure (PAP). In this double-blind, randomised controlled trial patients received 20 mg sildenafil or placebo three times daily and underwent pulmonary rehabilitation for 3 months...

  10. Serum pneumolysin antibody and urinary pneumococcal antigens (Binax level in children with upper respiratory tract infection versus normal controls

    Directory of Open Access Journals (Sweden)

    Noorbakhsh S

    2010-11-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Streptococcus pneumoniae is a common cause of respiratory infection. Pneumococcal upper respiratory tract infection (URTI in children is seldom bacteremic. Determination the prevalence of S.pneumoniae infections in children with URTI using rapid urinary antigen test (BINAX now and titration of serum pneumolysin antibody (added to conventional culture was the object of this study."n"n Methods: A cross sectional, case-control study done in ENT & pediatric departments of Rasoul Hospital in Tehran, Iran, (2008 -2010 upon 133 cases with upper respiratory tract infection (otitis media, sinusitis and tracheitis. The nosocomial infection omitted in first step. 60 remaining cases followed for S.pneumoniae infection by culture and rapid urinary antigen test (Binax Now. Serum pneumolysin antibody titers compared between 45 cases and 66 controls. "n"n Results: Positive culture (S.pneumoniae, H.influenza obtained in 4/60 URTI cases. Positive urinary S.pneumoniae antigen detected in 50% (30/60 of cases and 6% (4/66 of controls (p=0.01. The pneumolysin antibody level with cut-off level 525pg/ml was higher in URTI cases than controls (982±441 Vs. 525±42, p<0.0001. Area under the ROC curve for pneumolysin antibody was 0

  11. Electrical stimulation superimposed onto voluntary muscular contraction.

    Science.gov (United States)

    Paillard, Thierry; Noé, Frédéric; Passelergue, Philippe; Dupui, Philippe

    2005-01-01

    Electrical stimulation (ES) reverses the order of recruitment of motor units (MU) observed with voluntary muscular contraction (VOL) since under ES, large MU are recruited before small MU. The superimposition of ES onto VOL (superimposed technique: application of an electrical stimulus during a voluntary muscle action) can theoretically activate more motor units than VOL performed alone, which can engender an increase of the contraction force. Two superimposed techniques can be used: (i) the twitch interpolation technique (ITT), which consists of interjecting an electrical stimulus onto the muscle nerve; and (ii) the percutaneous superimposed electrical stimulation technique (PST), where the stimulation is applied to the muscle belly. These two superimposed techniques can be used to evaluate the ability to fully activate a muscle. They can thus be employed to distinguish the central or peripheral nature of fatigue after exhausting exercise. In general, whatever the technique employed, the superimposition of ES onto volitional exercise does not recruit more MU than VOL, except with eccentric actions. Nevertheless, the neuromuscular response associated with the use of the superimposed technique (ITT and PST) depends on the parameter of the superimposed current. The sex and the training level of the subjects can also modify the physiological impact of the superimposed technique. Although the motor control differs drastically between training with ES and VOL, the integration of the superimposed technique in training programmes with healthy subjects does not reveal significant benefits compared with programmes performed only with voluntary exercises. Nevertheless, in a therapeutic context, training programmes using ES superimposition compensate volume and muscle strength deficit with more efficiency than programmes using VOL or ES separately.

  12. Lateral hypothalamus as a sensor-regulator in respiratory and metabolic control

    Science.gov (United States)

    Burdakov, Denis; Karnani, Mahesh M.; Gonzalez, Antonio

    2018-01-01

    Physiological fluctuations in the levels of hormones, nutrients, and gasses are sensed in parallel by interacting control systems distributed throughout the brain and body. We discuss the logic of this arrangement and the definitions of “sensing”; and then focus on lateral hypothalamic (LH) control of energy balance and respiration. LH neurons control diverse behavioral and autonomic processes by projecting throughout the neuraxis. Three recently characterized types of LH cells are discussed here. LH orexin/hypocretin (ORX) neurons fire predominantly during wakefulness and are thought to promote reward-seeking, arousal, obesity resistance, and adaptive thermogenesis. Bidirectional control of ORX cells by extracellular macronutrients may add a new regulatory loop to these processes. ORX neurons also stimulate breathing and are activated by acid/CO2 in vivo and in vitro. LH melanin-concentrating hormone (MCH) neurons fire mostly during sleep, promote physical inactivity, weight gain, and may impair glucose tolerance. Reported stimulation of MCH neurons by glucose may thus modulate energy homeostasis. Leptin receptor (LepR) neurons of the LH are distinct from ORX and MCH neurons, and may suppress feeding and locomotion by signaling to the mesolimbic dopamine system and local ORX neurons. Integration within the ORX–MCH–LepR microcircuit is suggested by anatomical and behavioral data, but requires clarification with direct assays of functional connectivity. Further studies of how LH circuits counteract evolutionarily-relevant environmental fluctuations will provide key information about the logic and fragilities of brain controllers of healthy homeostasis. PMID:23562864

  13. Effects of influenza plus pneumococcal conjugate vaccination versus influenza vaccination alone in preventing respiratory tract infections in children : a randomized, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    Jansen, Angelique G S C; Sanders, Elisabeth A M; Hoes, Arno W; van Loon, Anton M; Hak, Eelko

    2008-01-01

    OBJECTIVE: To evaluate the effects of influenza vaccination with or without heptavalent pneumococcal conjugate vaccination on respiratory tract infections (RTIs) in children. STUDY DESIGN: This was a randomized, double-blind, placebo-controlled trial comprising 579 children age 18 to 72 months with

  14. The anti-malarial drug Mefloquine disrupts central autonomic and respiratory control in the working heart brainstem preparation of the rat

    Directory of Open Access Journals (Sweden)

    Lall Varinder K

    2012-12-01

    Full Text Available Abstract Background Mefloquine is an anti-malarial drug that can have neurological side effects. This study examines how mefloquine (MF influences central nervous control of autonomic and respiratory systems using the arterially perfused working heart brainstem preparation (WHBP of the rat. Recordings of nerve activity were made from the thoracic sympathetic chain and phrenic nerve, while heart rate (HR and perfusion pressure were also monitored in the arterially perfused, decerebrate, rat WHBP. MF was added to the perfusate at 1 μM to examine its effects on baseline parameters as well as baroreceptor and chemoreceptor reflexes. Results MF caused a significant, atropine resistant, bradycardia and increased phrenic nerve discharge frequency. Chemoreceptor mediated sympathoexcitation (elicited by addition of 0.1 ml of 0.03% sodium cyanide to the aortic cannula was significantly attenuated by the application of MF to the perfusate. Furthermore MF significantly decreased rate of return to resting HR following chemoreceptor induced bradycardia. An increase in respiratory frequency and attenuated respiratory-related sympathetic nerve discharge during chemoreceptor stimulation was also elicited with MF compared to control. However, MF did not significantly alter baroreceptor reflex sensitivity. Conclusions These studies indicate that in the WHBP, MF causes profound alterations in autonomic and respiratory control. The possibility that these effects may be mediated through actions on connexin 36 containing gap junctions in central neurones controlling sympathetic nervous outflow is discussed.

  15. The associations of humorous coping styles, affective states, job demands and job control with the frequency of upper respiratory tract infection

    NARCIS (Netherlands)

    Doosje, S.; De Goede, M.P.M.; Van Doornen, L.J.P.; Van de Schoot, R.

    2011-01-01

    Orientation: There is some evidence that job demands and job resources such as job control and humorous coping may contribute to the risk of upper respiratory tract infections (URTI). Research purpose: The purpose of this study was to test a model including these variables as well as job-related

  16. Impact of amoxicillin therapy on resistance selection in patients with community-acquired lower respiratory tract infections : A randomized, placebo-controlled study

    NARCIS (Netherlands)

    Malhotra-Kumar, Surbhi; Van Heirstraeten, Liesbet; Coenen, Samuel; Lammens, Christine; Adriaenssens, Niels; Kowalczyk, Anna; Godycki-Cwirko, Maciek; Bielicka, Zuzana; Hupkova, Helena; Lannering, Christina; Mölstad, Sigvard; Fernandez-Vandellos, Patricia; Torres, Antoni; Parizel, Maxim; Ieven, Margareta; Butler, Chris C.; Verheij, Theo; Little, Paul; Goossens, Hermanon; Frimodt-Møller, Niels; Bruno, Pascale; Hering, Iris; Lemiengre, Marieke; Loens, Katherine; Malmvall, Bo Eric; Muras, Magdalena; Romano, Nuria Sanchez; Prat, Matteu Serra; Svab, Igor; Swain, Jackie; Tarsia, Paolo; Leus, Frank; Veen, Robert; Worby, Tricia

    2016-01-01

    Objectives: To determine the effect of amoxicillin treatment on resistance selection in patients with community-acquired lower respiratory tract infections in a randomized, placebo-controlled trial. Methods: Patients were prescribed amoxicillin 1 g, three times daily (n = 52) or placebo (n = 50) for

  17. A case-control questionnaire survey of risk factors for Porcine Reproductive and Respiratory Syndrome (PRRS) seropositi¬vity in Danish swine herds

    DEFF Research Database (Denmark)

    Mousing, J.; Permin, A.; Mortensen, S.

    1997-01-01

    Sixty-eight case herds seropositive to porcine reproductive and respiratory syndrome (PRRS) were compared to 128 seronegative controls in a double-blinded questionnaire survey. The study indicated no increased risk of PRRS seropositivity for herds using artificial insemination with semen from PRRS...

  18. 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.

  19. 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.

  20. Effects of aerobic training combined with respiratory muscle stretching on the functional exercise capacity and thoracoabdominal kinematics in patients with COPD: a randomized and controlled trial

    Directory of Open Access Journals (Sweden)

    Wada JT

    2016-10-01

    Full Text Available Juliano T Wada,1 Erickson Borges-Santos,1 Desiderio Cano Porras,1 Denise M Paisani,1 Alberto Cukier,2 Adriana C Lunardi,1 Celso RF Carvalho1 1Department of Physical Therapy, 2Department of Cardiopneumology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil Background: Patients with COPD present a major recruitment of the inspiratory muscles, predisposing to chest incoordination, increasing the degree of dyspnea and impairing their exercise capacity. Stretching techniques could decrease the respiratory muscle activity and improve their contractile capacity; however, the systemic effects of stretching remain unknown.Objective: The aim of this study was to evaluate the effects of aerobic training combined with respiratory muscle stretching on functional exercise capacity and thoracoabdominal kinematics in patients with COPD.Design: This study was a randomized and controlled trial.Participants: A total of 30 patients were allocated to a treatment group (TG or a control group (CG; n=15, each group.Intervention: The TG was engaged in respiratory muscle stretching and the CG in upper and lower limb muscle stretching. Both groups performed 24 sessions (twice a week, 12 weeks of aerobic training.Evaluations: Functional exercise capacity (6-minute walk test, thoracoabdominal kinematics (optoelectronic plethysmography, and respiratory muscle activity (surface electromyography were evaluated during exercise. Analysis of covariance was used to compare the groups at a significance level of 5%.Results: After the intervention, the TG showed improved abdominal (ABD contribution, compartmental volume, mobility, and functional exercise capacity with decreased dyspnea when compared with the CG (P<0.01. The TG also showed a decreased respiratory muscle effort required to obtain the same pulmonary volume compared to the CG (P<0.001.Conclusion: Our results suggest that aerobic training combined with respiratory muscle stretching increases the functional

  1. A comparison of synchronized intermittent mandatory ventilation and pressure-regulated volume control ventilation in elderly patients with acute exacerbations of COPD and respiratory failure

    Directory of Open Access Journals (Sweden)

    Chang SC

    2016-05-01

    Full Text Available Suchi Chang,1 Jindong Shi,2 Cuiping Fu,1 Xu Wu,1 Shanqun Li1 1Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, 2Department of Respiratory Medicine, The Fifth People’s Hospital of Shanghai, Fudan University, Shanghai, People’s Republic of China Background: COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Intensive care unit patients with acute exacerbations of COPD requiring mechanical ventilation have higher mortality rates than other hospitalized patients. Although mechanical ventilation is the most effective intervention for these conditions, invasive ventilation techniques have yielded variable effects. Objective: We evaluated pressure-regulated volume control (PRVC ventilation treatment efficacy and preventive effects on pulmonary barotrauma in elderly COPD patients with respiratory failure. Patients and methods: Thirty-nine intubated patients were divided into experimental and control groups and treated with the PRVC and synchronized intermittent mandatory ventilation – volume control methods, respectively. Vital signs, respiratory mechanics, and arterial blood gas analyses were monitored for 2–4 hours and 48 hours. Results: Both groups showed rapidly improved pH, partial pressure of oxygen (PaO2, and PaO2 per fraction of inspired O2 levels and lower partial pressure of carbon dioxide (PaCO2 levels. The pH and PaCO2 levels at 2–4 hours were lower and higher, respectively, in the test group than those in the control group (P<0.05 for both; after 48 hours, blood gas analyses showed no statistical difference in any marker (P>0.05. Vital signs during 2–4 hours and 48 hours of treatment showed no statistical difference in either group (P>0.05. The level of peak inspiratory pressure in the experimental group after mechanical ventilation for 2–4 hours and 48

  2. Autonomic nervous system control of the cardiovascular and respiratory systems in asthma.

    Science.gov (United States)

    Lewis, M J; Short, A L; Lewis, K E

    2006-10-01

    Patients with asthma have exaggerated bronchoconstriction of their airways in response to certain indirect (e.g. cold air, allergens, dust, exercise) or direct (e.g. inhaled methacholine) stimuli. This 'hyper-reactivity' usually co-exists with airway inflammation, although the pathophysiological mechanisms underlying these changes are not fully understood. It is likely that this hyper-reactivity is associated with abnormal autonomic nervous system (ANS) control. In particular, the parasympathetic (vagal) component of the ANS appears to be implicated in the pathogenesis of asthma. In addition, several studies have suggested the existence of differential alteration in ANS function following exercise in asthmatics compared with non-asthmatic individuals. Several early studies suggested that the altered autonomic control of airway calibre in asthma might be reflected by a parallel change in heart rate. Cardiac vagal reactivity does indeed appear to be increased in asthma, as demonstrated by the cardiac response to various autonomic functions tests. However, other studies have reported a lack of association between bronchial and cardiac vagal tone, and this is in accord with the concept of system-independent ANS control. This review provides a discussion of cardiovascular-autonomic changes associated with either the pathophysiology of asthma per se or with asthma pharmacotherapy treatment. Previous investigations are summarised suggesting an apparent association between altered autonomic-cardiovascular control and bronchial asthma. The full extent of autonomic dysfunction, and its clinical implications, has yet to be fully determined and should be the subject of future investigation.

  3. Bioethics for clinicians: 4. Voluntariness.

    OpenAIRE

    Etchells, E; Sharpe, G.; Dykeman, M J; Meslin, E M; Singer, P A

    1996-01-01

    In the context of consent, "voluntariness" refers to a patient's right to make health care choices free of any undue influence. However, a patient's freedom to make choices can be compromised by internal factors such as pain and by external factors such as force, coercion and manipulation. In exceptional circumstances--for example, involuntary admission to hospital--patients may be denied their freedom of choice; in such circumstances the least restrictive means possible of managing the patie...

  4. Targeting the Mitochondrial Respiratory Chain of Cryptococcus through Antifungal Chemosensitization: A Model for Control of Non-Fermentative Pathogens

    Directory of Open Access Journals (Sweden)

    Kathleen L. Chan

    2013-07-01

    Full Text Available Enhanced control of species of Cryptococcus, non-fermentative yeast pathogens, was achieved by chemosensitization through co-application of certain compounds with a conventional antimicrobial drug. The species of Cryptococcus tested showed higher sensitivity to mitochondrial respiratory chain (MRC inhibition compared to species of Candida. This higher sensitivity results from the inability of Cryptococcus to generate cellular energy through fermentation. To heighten disruption of cellular MRC, octyl gallate (OG or 2,3-dihydroxybenzaldehyde (2,3-DHBA, phenolic compounds inhibiting mitochondrial functions, were selected as chemosensitizers to pyraclostrobin (PCS; an inhibitor of complex III of MRC. The cryptococci were more susceptible to the chemosensitization (i.e., PCS + OG or 2,3-DHBA than the Candida with all Cryptococcus strains tested being sensitive to this chemosensitization. Alternatively, only few of the Candida strains showed sensitivity. OG possessed higher chemosensitizing potency than 2,3-DHBA, where the concentration of OG required with the drug to achieve chemosensitizing synergism was much lower than that required of 2,3-DHBA. Bioassays with gene deletion mutants of the model yeast Saccharomyces cerevisiae showed that OG or 2,3-DHBA affect different cellular targets. These assays revealed mitochondrial superoxide dismutase or glutathione homeostasis plays a relatively greater role in fungal tolerance to 2,3-DHBA or OG, respectively. These findings show that application of chemosensitizing compounds that augment MRC debilitation is a promising strategy to antifungal control against yeast pathogens.

  5. Is acute idiopathic pericarditis associated with recent upper respiratory tract infection or gastroenteritis? A case–control study

    Science.gov (United States)

    Rey, Florian; Delhumeau-Cartier, Cecile; Meyer, Philippe; Genne, Daniel

    2015-01-01

    Objectives The aim of this study was to assess the association of a clinical diagnosis of acute idiopathic pericarditis (AIP), and a reported upper respiratory tract infection (URTI) or gastroenteritis (GE) in the preceding month. Design Patients who were hospitalised with a first diagnosis of AIP were retrospectively compared with a control group of patients admitted with deep vein thrombosis (DVT), matched by gender and age. Setting Primary and secondary care level; one hospital serving a population of about 170 000. Participants A total of 51 patients with AIP were included, of whom 46 could be matched with 46 patients with control DVT. Only patients with a complete review of systems on the admission note were included in the study. Main outcome measure Conditional logistic regression was used to assess the association of a clinical diagnosis of AIP and an infectious episode (URTI or GE) in the month preceding AIP diagnosis. Results Patients with AIP had more often experienced a recent episode of URTI or GE than patients with DVT (39.1% vs 10.9%, p=0.002). The multivariate conditional regression showed that AIP was independently associated with URTI or GE in the last month preceding diagnosis (OR=37.18, 95% CI=1.91 to 724.98, p=0.017). Conclusions This is, to the best of our knowledge, the first study demonstrating an association between a recent episode of URTI or GE and a clinical diagnosis of AIP. PMID:26603247

  6. Respiratory Muscle Training in Patients Recovering Recent Open Cardiothoracic Surgery: A Randomized-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Ernesto Crisafulli

    2013-01-01

    Full Text Available Objectives. To evaluate the clinical efficacy and feasibility of an expiratory muscle training (EMT device (Respilift applied to patients recovering from recent open cardiothoracic surgery (CTS. Design. Prospective, double-blind, 14-day randomised-controlled trial. Participants and Setting. A total of 60 inpatients recovering from recent CTS and early admitted to a pulmonary rehabilitation program. Interventions. Chest physiotherapy plus EMT with a resistive load of 30 cm H2O for active group and chest physiotherapy plus EMT with a sham load for control group. Measures. Changes in maximal expiratory pressure (MEP were considered as primary outcome, while maximal inspiratory pressures (MIP, dynamic and static lung volumes, oxygenation, perceived symptoms of dyspnoea, thoracic pain, and well being (evaluated by visual analogic scale—VAS and general health status were considered secondary outcomes. Results. All outcomes recorded showed significant improvements in both groups; however, the change of MEP (+34.2 mmHg, and +26.1%, for absolute and % of predicted, resp. was significantly higher in active group. Also VAS dyspnoea improved faster and more significantly ( at day 12, and 14 in active group when compared with control. The drop-out rate was 6%, without differences between groups. Conclusions. In patients recovering from recent CTS, specific EMT by Respilift is feasible and effective. This trial is registered with ClinicalTrials.gov NCT01510275.

  7. The Prevention of Respiratory Insufficiency after Surgical Management (PRISM) Trial. Report of the protocol for a pragmatic randomized controlled trial of CPAP to prevent respiratory complications and improve survival following major abdominal surgery.

    Science.gov (United States)

    Pearse, Rupert M; Abbott, Tom E; Haslop, Richard; Ahmad, Tahania; Kahan, Brennan C; Filipini, Claudia; Rhodes, Andrew; Ranieri, Marco

    2017-02-01

    Over 300 million patients undergo surgery worldwide each year. Postoperative morbidity - particularly respiratory complications - are most frequent and severe among high-risk patients undergoing major abdominal surgery. However, standard treatments, like physiotherapy or supplemental oxygen, often fail to prevent these. Preliminary research suggests that prophylactic continuous positive airways pressure (CPAP) can reduce the risk of postoperative respiratory complications. However, without evidence from a large clinical effectiveness trial, CPAP has not become routine care. This trial aims to determine whether early postoperative CPAP reduces the incidence of respiratory complications and improves one-year survival following major intra-peritoneal surgery. This is an international multicenter randomized controlled trial with open study group allocation. The participants are aged 50 years and over undergoing major elective intra-peritoneal surgery. The intervention is CPAP for at least four hours, started within four hours of the end of surgery. The primary outcome is a composite of pneumonia, re-intubation, or death within 30 days of randomization. All participants with a recorded outcome will be analyzed on an intention-to-treat basis. The primary analysis will use a mixed-effects logistic regression model, which includes center as a random-intercept, and will be adjusted for the minimization factors and other pre-specified covariates. Trial Registration: ISRCTN 56012545. This is the first proposed clinical effectiveness trial of postoperative CPAP to prevent respiratory complications of which we are aware. The large sample size and multicenter international design will make the result generalizable to a variety of healthcare settings.

  8. Respiratory mechanics

    CERN Document Server

    Wilson, Theodore A

    2016-01-01

    This book thoroughly covers each subfield of respiratory mechanics: pulmonary mechanics, the respiratory pump, and flow. It presents the current understanding of the field and serves as a guide to the scientific literature from the golden age of respiratory mechanics, 1960 - 2010. Specific topics covered include the contributions of surface tension and tissue forces to lung recoil, the gravitational deformation of the lung, and the interdependence forces that act on pulmonary airways and blood vessels. The geometry and kinematics of the ribs is also covered in detail, as well as the respiratory action of the external and internal intercostal muscles, the mechanics of the diaphragm, and the quantitative compartmental models of the chest wall is also described. Additionally, flow in the airways is covered thoroughly, including the wave-speed and viscous expiratory flow-limiting mechanisms; convection, diffusion and the stationary front; and the distribution of ventilation. This is an ideal book for respiratory ...

  9. Interaction between the long-latency stretch reflex and voluntary electromyographic activity prior to a rapid voluntary motor reaction.

    Science.gov (United States)

    Day, B L; Rothwell, J C; Marsden, C D

    1983-06-27

    The size of the long-latency component of the stretch reflex has been examined in the time interval between a signal to move and the required rapid voluntary contraction of triceps and flexor pollicis longus in 8 normal subjects. Bilateral movements of the elbow and thumb were made following an auditory signal. In 50% of the trials a torque pulse was applied unilaterally in order to elicit a stretch reflex response in one arm. The voluntary response in the contralateral arm was uncorrupted by a stretch reflex response, so was used as an indicator of voluntary reaction time. Control experiments, using an electrical stimulus to the fingers rather than muscle stretch, verified that both arms reacted almost simultaneously to the auditory cue, even when the reaction time was shortened by the presence of a unilateral electrical stimulus. Similarly, an interposed muscle stretch stimulus considerably reduced the reaction time to the audio signal. Because of this, the start of the voluntary EMG response frequently 'over-lapped' the end of the long-latency stretch reflex. Failure to take this shortening of voluntary reaction time into consideration can lead to the erroneous conclusion that reflex gain is increased prior to a rapid movement. If the 'overlap' of EMG responses is accounted for, very little change in the size of the long-latency stretch reflex is evident prior to activation of the muscles responsible for the movement of either the elbow or the thumb.

  10. 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. ... Conclusion: In order to promote VCT service, more emphasis should be given to the knowledge and attitudes of students towards VCT, and to help the students to internalize the risk ...

  11. Determinants of acceptance of voluntary HIV testing among ...

    African Journals Online (AJOL)

    2006-09-10

    Objective: The objective of this study was to identify factors that determine the acceptance of voluntary HIV testing among pregnant women attending antenatal care at Dil Chora Hospital in Dire Dawa. Method: The study employed unmatched case control study which was conducted from August 20 to September 10, 2006.

  12. Force-directed design of a voluntary closing hand prosthesis

    NARCIS (Netherlands)

    De Visser, H.; Herder, J.L.

    2000-01-01

    This paper presents the design of a body-powered voluntary closing prosthetic hand. It is argued that the movement of the fingers before establishing a grip is much less relevant for good control of the object held than the distribution of forces once the object has been contacted. Based on this

  13. Cortical and cerebellar activation induced by reflexive and voluntary saccades

    NARCIS (Netherlands)

    C.K. Schraa-Tam (Caroline); P.C.A. van Broekhoven (Flip); J.N. van der Geest (Jos); M.A. Frens (Maarten); M. Smits (Marion); A. van der Lugt (Aad)

    2009-01-01

    textabstractReflexive saccades are driven by visual stimulation whereas voluntary saccades require volitional control. Behavioral and lesional studies suggest that there are two separate mechanisms involved in the generation of these two types of saccades. This study investigated differences in

  14. Comparison of functional exercise capacity, pulmonary function and respiratory muscle strength in patients with multiple sclerosis with different disability levels and healthy controls.

    Science.gov (United States)

    Bosnak-Guclu, Meral; Gunduz, Arzu Guclu; Nazliel, Bijen; Irkec, Ceyla

    2012-01-01

    To compare functional exercise capacity, pulmonary function and respiratory muscle strength in fully ambulatory patients with multiple sclerosis with different disability levels and healthy controls, and to elucidate the determinant factors of functional exercise capacity. Forty-three fully ambulatory patients with multiple sclerosis and 30 healthy controls were included in the study. Patients were grouped according to Expanded Disability Status Scale (EDSS); Group I (EDSS 0-2), Group II (EDSS 2.5-4.5). Functional exercise capacity was evaluated using a six-minute walk test, and measurement of pulmonary function, and maximal inspiratory and expiratory pressures (MIP, MEP). The Pulmonary Index was used as a clinical predictor of respiratory dysfunction. Respiratory muscle strength was lower in multiple sclerosis groups compared with controls, but the difference in MIP and %MIP did not reach statistical significance in Group I. The six-minute walk test distance was significantly shorter and peak expiratory flow was lower in multiple sclerosis groups (p difference in heart rate (R2 = 0.06, p = 0.007), age (R2 = 0.05, p = 0.009) and gender (R2 = 0.09, p = 0.003). Respiratory muscles are weakened, functional exercise capacity is reduced and pulmonary function is affected even in the early phase of multiple sclerosis. Ambulatory patients with multiple sclerosis who have a higher level of disability have lower pulmonary function, respiratory muscle strength and functional capacity than less disabled ones and controls. Neurological disability level, age, gender and heart rate difference on exertion are the determinants of functional exercise capacity.

  15. Health care worker protection in mass casualty respiratory failure: infection control, decontamination, and personal protective equipment.

    Science.gov (United States)

    Daugherty, Elizabeth L

    2008-02-01

    Maintenance of a safe and stable health care infrastructure is critical to an effective mass casualty disaster response. Both secondary contamination during chemical disasters and hospital-associated infections during epidemic illness can pose substantial threats to achieving this goal. Understanding basic principles of decontamination and infection control during responses to chemical and biologic disasters can help minimize the risks to patients and health care workers. Effective decontamination following toxic chemical exposure should include both removal of contaminated clothing and decontamination of the victim's skin. Wet decontamination is the most feasible strategy in a mass casualty situation and should be performed promptly by trained personnel. In the event of an epidemic, infection prevention and control measures are based on essential principles of hand hygiene and standard precautions. Expanded precautions should be instituted as needed to target contact, droplet, and airborne routes of infectious disease transmission. Specific equipment and measures for critical care delivery may serve to decrease risk to health care workers in the event of an epidemic. Their use should be considered in developing comprehensive disaster response plans.

  16. Early severe acute respiratory distress syndrome: What's going on? Part II: controlled vs. spontaneous ventilation?

    Science.gov (United States)

    Petitjeans, Fabrice; Pichot, Cyrille; Ghignone, Marco; Quintin, Luc

    2016-01-01

    The second part of this overview on early severe ARDS delineates the pros and cons of the following: a) controlled mechanical ventilation (CMV: lowered oxygen consumption and perfect patient-to-ventilator synchrony), to be used during acute cardio-ventilatory distress in order to "buy time" and correct circulatory insufficiency and metabolic defects (acidosis, etc.); b) spontaneous ventilation (SV: improved venous return, lowered intrathoracic pressure, absence of muscle atrophy). Given a stabilized early severe ARDS, as soon as the overall clinical situation improves, spontaneous ventilation will be used with the following stringent conditionalities: upfront circulatory optimization, upright positioning, lowered VO2, lowered acidotic and hypercapnic drives, sedation without ventilatory depression and without lowered muscular tone, as well as high PEEP (titrated on transpulmonary pressure, or as a second best: "trial"-PEEP) with spontaneous ventilation + pressure support (or newer modes of ventilation). As these propositions require evidence-based demonstration, the reader is reminded that the accepted practice remains, in 2016, controlled mechanical ventilation, muscle relaxation and prone position.

  17. [The effects of endotracheal suction on gas exchange and respiratory mechanics in mechanically ventilated patients under pressure-controlled or volume-controlled ventilation].

    Science.gov (United States)

    Liu, Xiao-wei; Liu, Zhi

    2007-10-01

    To compare the effects of endotracheal suction on gas exchange and respiratory mechanics in mechanically ventilated patients receiving pressure-controlled ventilation (PCV) or volume-controlled ventilation (VCV). A randomized cross-over study was conducted. Twenty-three mechanically ventilated patients were randomly assigned to ventilation with either PCV or VCV at first, and then the other. Endotracheal suction was performed with an open suction system. Changes in gas exchange and respiratory mechanics after suctions under the two modes were compared. With PCV, the tidal volume (VT) and the compliance were (6.60+/-1.95) ml/kg and (18+/-7) ml/cm H2O (1 cm H2O=0.098 kPa) respectively at 30 minutes after suction, as compared to (9.05+/-0.22) ml/kg and (24+/-6) ml/cm H2O respectively at baseline; the difference being significant (F=8.47, 8.01, all P0.05). With PCV, the heart rate (HR) and the mean systemic arterial pressure (MAP) were (109+/-20) beats/min and (89+/-10) mm Hg respectively at 5 minutes after suction, as compared to (97+/-17) beats/min and (83+/-12) mm Hg respectively at baseline; the difference being significant (F=5.86, 9.49, all P<0.05). With VCV, HR and MAP were (110+/-17) beats/min and (87+/-11) mm Hg respectively at 5 minutes after suction, as compared to (96+/-17) beats/min and (79+/-11) mm Hg respectively at baseline; the difference being significant (F=7.33, 7.96, all P<0.05). Endotracheal suction causes lung collapse leading to impairment of gas exchange and decreased compliance both under PCV and VCV, but the effect on gas exchange was more severe and persistent under PCV than under VCV.

  18. Sleeping and resting respiratory rates in dogs and cats with medically-controlled left-sided congestive heart failure.

    Science.gov (United States)

    Porciello, F; Rishniw, M; Ljungvall, I; Ferasin, L; Haggstrom, J; Ohad, D G

    2016-01-01

    Sleeping and resting respiratory rates (SRR and RRR, respectively) are commonly used to monitor dogs and cats with left-sided cardiac disease and to identify animals with left-sided congestive heart failure (L-CHF). Dogs and cats with subclinical heart disease have SRRmean values dogs and cats with CHF that is well controlled with medical therapy. In this study, SRR and RRR were measured by the owners of 51 dogs and 22 cats with stable, well-controlled CHF. Median canine SRRmean was 20 breaths/min (7-39 breaths/min); eight dogs were ≥25 breaths/min and one dog only was ≥30 breaths/min. Canine SRRmean was unrelated to pulmonary hypertension or diuretic dose. Median feline SRRmean was 20 breaths/min (13-31 breaths/min); four cats were ≥25 breaths/min and only one cat was ≥30 breaths/min. Feline SRRmean was unrelated to diuretic dose. SRR remained stable during collection in both species with little day-to-day variability. The median canine RRRmean was 24 breaths/min (12-44 breaths/min), 17 were ≥25 breaths/min, seven were ≥30 breaths/min, two were >40 breaths/min. Median feline RRRmean was 24 breaths/min (15-45 breaths/min); five cats had RRRmean ≥25 breaths/min; one had ≥30 breaths/min, and two had ≥40 breaths/min. These data suggest that most dogs and cats with CHF that is medically well-controlled and stable have SRRmean and RRRmean dogs and cats. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Peter Bergman

    Full Text Available Low levels of 25-OH vitamin D are associated with respiratory tract infection (RTI. However, results from randomized controlled trials are inconclusive. Therefore, we performed a systematic review and meta-analysis to assess the preventive effect of vitamin D supplementation on RTI.Randomized, controlled trials of vitamin D for prevention of RTI were used for the analysis. The risks of within-trial and publication bias were assessed. Odds ratios of RTI were pooled using a random-effects model. Heterogeneity was assessed using Cochran's Q and I(2. Meta-regressions and subgroup analyses were used to assess the influence of various factors on trial outcome. The pre-defined review protocol was registered at the PROSPERO international prospective register of systematic reviews, registration number CRD42013003530.Of 1137 citations retrieved, 11 placebo-controlled studies of 5660 patients were included in the meta-analysis. Overall, vitamin D showed a protective effect against RTI (OR, 0.64; 95% CI, 0.49 to 0.84. There was significant heterogeneity among studies (Cohran's Q p<0.0001, I(2 = 72%. The protective effect was larger in studies using once-daily dosing compared to bolus doses (OR = 0.51 vs OR = 0.86, p = 0.01. There was some evidence that results may have been influenced by publication bias.Results indicate that vitamin D has a protective effect against RTI, and dosing once-daily seems most effective. Due to heterogeneity of included studies and possible publication bias in the field, these results should be interpreted with caution.

  20. Prevention of respiratory distress syndrome in preterm infants by antenatal ambroxol: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Zhang, Zhi-Qun; Wu, Qian-Qian; Huang, Xian-Mei; Lu, Hui

    2013-08-01

    To evaluate the efficacy and safety of antenatal ambroxol as a preventive therapeutic of respiratory distress syndrome (RDS) in preterm infants. Randomized controlled trials of antenatal ambroxol treatment for RDS in preterm infants published up to March 2012 were downloaded from the Cochrane Library, PubMed, EMBASE, Science Citation Index, and Google Scholar databases. Data were evaluated for homogeneity and analyzed by the Cochrane Collaboration's RevMan software. Twelve trials involving a total of 1335 premature infants were selected for meta-analysis. Neonatal RDS was lower in the ambroxol-treated group than in the groups treated with placebo (risk ratio [RR] = 0.38, 95% confidence interval [CI]: 0.24 to 0.59) or corticosteroids (RR = 0.49, 95% CI: 0.31 to 0.78). The ambroxol-treated group had lower risk of neonatal infection than the corticosteroid-treated group (RR = 0.36, 95% CI: 0.18 to 0.73). In cases of inevitable preterm birth, antenatal ambroxol is recommended over corticosteroids to prevent neonatal RDS. However, further research is necessary to determine the optimal treatment dosages and regimens of antenatal ambroxol to achieve consistent superior results over corticosteroids. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  1. High-dose Oral Ambroxol for Early Treatment of Pulmonary Acute Respiratory Distress Syndrome: an Exploratory, Randomized, Controlled Pilot Trial.

    Science.gov (United States)

    Baranwal, Arun K; Murthy, Aparna S; Singhi, Sunit C

    2015-10-01

    To evaluate efficacy of high-dose oral ambroxol in acute respiratory distress syndrome (ARDS) with respect to ventilator-free days (VFD). Prospective, randomized, placebo-controlled, blinded pilot trial. Sixty-six mechanically ventilated patients (1 month to 12 years) with ARDS who were hand-ventilated for ambroxol (40 mg/kg/day, in four divided doses) (n = 32) or placebo (n = 34) until 10 days, extubation or death whichever is earlier. Majority (91%) had pneumonia and bronchiolitis. Two study groups were similar in baseline characteristics. Mean partial pressure of arterial oxygen/fraction of inspired oxygen and oxygenation index were >175 and ambroxol. Among ventilated pulmonary ARDS patients with oxygenation index of Ambroxol did not improve VFD. Study with higher and more frequently administered doses of ambroxol in larger sample is suggested after having generated relevant pharmacokinetic data among critically ill children. © The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Zinc and vitamin A supplementation in Indigenous Australian children hospitalised with lower respiratory tract infection: a randomised controlled trial.

    Science.gov (United States)

    Chang, Anne B; Torzillo, Paul J; Boyce, Naomi C; White, Andrew V; Stewart, Peter M; Wheaton, Gavin R; Purdie, David M; Wakerman, John; Valery, Patricia C

    2006-02-06

    To evaluate the efficacy of supplementation with zinc and vitamin A in Indigenous children hospitalised with acute lower respiratory infection (ALRI). Randomised controlled, 2-by-2 factorial trial of supplementation with zinc and vitamin A. 187 Indigenous children aged Vitamin A was administered on Days 1 and 5 of admission at a dose of 50 000 IU (infants under 12 months), or 100 000 IU; and zinc sulfate was administered daily for 5 days at a daily dose of 20 mg (infants under 12 months) or 40 mg. Time to clinical recovery from fever and tachypnoea, duration of hospitalisation, and readmission for ALRI within 120 days. There was no clinical benefit of supplementation with vitamin A, zinc or the two combined, with no significant difference between zinc and no-zinc, vitamin A and no-vitamin A or zinc + vitamin A and placebo groups in time to resolution of fever or tachypnoea, or duration of hospitalisation. Instead, we found increased morbidity; children given zinc had increased risk of readmission for ALRI within 120 days (relative risk, 2.4; 95% CI, 1.003-6.1). This study does not support the use of vitamin A or zinc supplementation in the management of ALRI requiring hospitalisation in Indigenous children living in remote areas. Even in populations with high rates of ALRI and poor living conditions, vitamin A and zinc therapy may not be useful. The effect of supplementation may depend on the prevalence of deficiency of these micronutrients in the population.

  3. Effect of Experimental Technology of Control in Physical Education of Students of Special Medical Groups with Respiratory Diseases on their Morphofunctional State

    Directory of Open Access Journals (Sweden)

    В. М. Корягін

    2016-12-01

    Full Text Available The research objective is to analyze the dynamics of the parameters of the morphfunctional state of students of special medical groups with respiratory diseases under the influence of the experimental technology of control in physical education of students of these groups. Materials and Methods: pedagogical experiment, pedagogical testing: methods of recording of morphfunctional state parameters, functional tests and medical-biological tests, mathematical methods of digital data processing. Results. The paper presents the results of the experimental technology control tried and tested in physical education of the students of special medical groups with respiratory diseases. The foundation for the special analysis of the effectiveness of the effect the designed technology had on the morphfunctional state of the students of special medical groups with respiratory diseases is assessment of the monitoring results for its parameters during the period of implementation of the designed technology. The analysis of the data obtained confirms the statistic-significant changes (p < 0.05 by all the indicators under study in the students of experimental groups. Conclusions. The comparative characteristics of the functional indicators of the respiratory system of the students from the selection under study showed that the experimental groups had significantly better results than the reference groups (p < 0.05. This confirms the effective influence of the designed technology on the morphfunctional state of the students of the experimental groups.

  4. Induced hypothermia in patients with septic shock and respiratory failure (CASS): a randomised, controlled, open-label trial.

    Science.gov (United States)

    Itenov, Theis Skovsgaard; Johansen, Maria Egede; Bestle, Morten; Thormar, Katrin; Hein, Lars; Gyldensted, Louise; Lindhardt, Anne; Christensen, Henrik; Estrup, Stine; Pedersen, Henrik Planck; Harmon, Matthew; Soni, Uday Kant; Perez-Protto, Silvia; Wesche, Nicolai; Skram, Ulrik; Petersen, John Asger; Mohr, Thomas; Waldau, Tina; Poulsen, Lone Musaeus; Strange, Ditte; Juffermans, Nicole P; Sessler, Daniel I; Tønnesen, Else; Møller, Kirsten; Kristensen, Dennis Karsten; Cozzi-Lepri, Alessandro; Lundgren, Jens D; Jensen, Jens-Ulrik

    2018-01-08

    Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock. In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America. Inclusion criteria for patients with severe sepsis or septic shock were a mean arterial pressure of less than 70 mm Hg, mechanical ventilation in an ICU, age at least 50 years, predicted length of stay in the ICU at least 24 h, and recruitment into the study within 6 h of fulfilling inclusion criteria. Exclusion criteria were uncontrolled bleeding, clinically important bleeding disorder, recent open surgery, pregnancy or breastfeeding, or involuntary psychiatric admission. We randomly allocated patients 1:1 (with variable block sizes ranging from four to eight; stratified by predictors of mortality, age, Acute Physiology and Chronic Health Evaluation II score, and study site) to routine thermal management or 24 h of induced hypothermia (target 32-34°C) followed by 48 h of normothermia (36-38°C). The primary endpoint was 30 day all-cause mortality in the modified intention-to-treat population (all randomly allocated patients except those for whom consent was withdrawn or who were discovered to meet an exclusion criterion after randomisation but before receiving the trial intervention). Patients and health-care professionals giving the intervention were not masked to treatment allocation, but assessors of the primary outcome were. This trial is registered with ClinicalTrials.gov, number NCT01455116. Between Nov 1, 2011, and Nov 4, 2016, we screened 5695 patients. After recruitment of 436 of the planned 560 participants, the trial was terminated for futility (220 [50%] randomly allocated to

  5. Influenza vaccine effectiveness for hospital and community patients using control groups with and without non-influenza respiratory viruses detected, Auckland, New Zealand 2014.

    Science.gov (United States)

    Pierse, Nevil; Kelly, Heath; Thompson, Mark G; Bissielo, Ange; Radke, Sarah; Huang, Q Sue; Baker, Michael G; Turner, Nikki

    2016-01-20

    We aimed to estimate the protection afforded by inactivated influenza vaccine, in both community and hospital settings, in a well characterised urban population in Auckland during 2014. We used two different comparison groups, all patients who tested negative for influenza and only those patients who tested negative for influenza and had a non-influenza respiratory virus detected, to calculate the vaccine effectiveness in a test negative study design. Estimates were made separately for general practice outpatient consultations and hospitalised patients, stratified by age group and by influenza type and subtype. Vaccine status was confirmed by electronic record for general practice patients and all respiratory viruses were detected by real time polymerase chain reaction. 1039 hospitalised and 1154 general practice outpatient consultations met all the study inclusion criteria and had a respiratory sample tested for influenza and other respiratory viruses. Compared to general practice patients, hospitalised patients were more likely to be very young or very old, to be Māori or Pacific Islander, to have a low income and to suffer from chronic disease. Vaccine effectiveness (VE) adjusted for age and other participant characteristics using all influenza negative controls was 42% (95% CI: 16 to 60%) for hospitalised and 56% (95% CI: 35 to 70%) for general practice patients. The vaccine appeared to be most effective against the influenza A(H1N1)pdm09 strain with an adjusted VE of 62% (95% CI:38 to 77%) for hospitalised and 59% (95% CI:36 to 74%) for general practice patients, using influenza virus negative controls. Similar results found when patients testing positive for a non-influenza respiratory virus were used as the control group. This study contributes to validation of the test negative design and confirms that inactivated influenza vaccines continue to provide modest but significant protection against laboratory-confirmed influenza. Copyright © 2015 Elsevier Ltd

  6. Respiratory protection.

    Science.gov (United States)

    Cohen, Howard J; Birkner, Jeffrey S

    2012-12-01

    Respiratory protection is used as a method of protecting individuals from inhaling harmful airborne contaminants and in some cases to supply them with breathable air in oxygen-deficient environments. This article focuses on the use and types of personal respiratory protection (respirators) worn by individuals at workplaces where airborne hazardous contaminants may exist. Respirators are increasingly also being used in nonindustrial settings such as health care facilities, as concerns regarding infectious epidemics and terrorist threats grow. Pulmonologists and other clinicians should understand fundamental issues regarding respiratory protection against airborne contaminants and the use of respirators. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Randomised double blind placebo controlled trial of prednisolone in children admitted to hospital with respiratory syncytial virus bronchiolitis

    NARCIS (Netherlands)

    van Woensel, JBM; Wolfs, TFW; vanAalderen, WMC; Brand, PLP; Kimpen, JLL

    Background - Experimental and clinical evidence suggests that respiratory syncytial virus (RSV) bronchiolitis is an immune mediated disease. Corticosteroids might therefore be effective in the treatment of RSV bronchiolitis. Methods - A randomised double blind trial was conducted in children up to

  8. Smart Care? versus respiratory physiotherapy?driven manual weaning for critically ill adult patients: a randomized controlled trial

    OpenAIRE

    Taniguchi,Corinne; Victor, Elivane S.; Pieri, Talita; Henn, Renata; Santana, Carolina; Giovanetti, Erica; Saghabi, Cilene; Timenetsky, Karina; Caserta Eid, Raquel; Silva,Eliezer; Matos, Gustavo F. J.; Schettino, Guilherme P. P.; Barbas, Carmen S. V.

    2015-01-01

    Introduction A recent meta-analysis showed that weaning with SmartCare? (Dr?ger, L?beck, Germany) significantly decreased weaning time in critically ill patients. However, its utility compared with respiratory physiotherapist?protocolized weaning is still a matter of debate. We hypothesized that weaning with SmartCare? would be as effective as respiratory physiotherapy?driven weaning in critically ill patients. Methods Adult critically ill patients mechanically ventilated for more than 24 hou...

  9. A comparison of synchronized intermittent mandatory ventilation and pressure-regulated volume control ventilation in elderly patients with acute exacerbations of COPD and respiratory failure.

    Science.gov (United States)

    Chang, Suchi; Shi, Jindong; Fu, Cuiping; Wu, Xu; Li, Shanqun

    2016-01-01

    COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Intensive care unit patients with acute exacerbations of COPD requiring mechanical ventilation have higher mortality rates than other hospitalized patients. Although mechanical ventilation is the most effective intervention for these conditions, invasive ventilation techniques have yielded variable effects. We evaluated pressure-regulated volume control (PRVC) ventilation treatment efficacy and preventive effects on pulmonary barotrauma in elderly COPD patients with respiratory failure. Thirty-nine intubated patients were divided into experimental and control groups and treated with the PRVC and synchronized intermittent mandatory ventilation - volume control methods, respectively. Vital signs, respiratory mechanics, and arterial blood gas analyses were monitored for 2-4 hours and 48 hours. Both groups showed rapidly improved pH, partial pressure of oxygen (PaO2), and PaO2 per fraction of inspired O2 levels and lower partial pressure of carbon dioxide (PaCO2) levels. The pH and PaCO2 levels at 2-4 hours were lower and higher, respectively, in the test group than those in the control group (P0.05). Vital signs during 2-4 hours and 48 hours of treatment showed no statistical difference in either group (P>0.05). The level of peak inspiratory pressure in the experimental group after mechanical ventilation for 2-4 hours and 48 hours was significantly lower than that in the control group (P0.05). Among elderly COPD patients with respiratory failure, application of PRVC resulted in rapid improvement in arterial blood gas analyses while maintaining a low peak inspiratory pressure. PRVC can reduce pulmonary barotrauma risk, making it a safer protective ventilation mode than synchronized intermittent mandatory ventilation - volume control.

  10. Bordetella PlrSR regulatory system controls BvgAS activity and virulence in the lower respiratory tract.

    Science.gov (United States)

    Bone, M Ashley; Wilk, Aaron J; Perault, Andrew I; Marlatt, Sara A; Scheller, Erich V; Anthouard, Rebecca; Chen, Qing; Stibitz, Scott; Cotter, Peggy A; Julio, Steven M

    2017-02-21

    Bacterial pathogens coordinate virulence using two-component regulatory systems (TCS). The Bordetella virulence gene (BvgAS) phosphorelay-type TCS controls expression of all known protein virulence factor-encoding genes and is considered the "master virulence regulator" in Bordetella pertussis, the causal agent of pertussis, and related organisms, including the broad host range pathogen Bordetella bronchiseptica We recently discovered an additional sensor kinase, PlrS [for persistence in the lower respiratory tract (LRT) sensor], which is required for B. bronchiseptica persistence in the LRT. Here, we show that PlrS is required for BvgAS to become and remain fully active in mouse lungs but not the nasal cavity, demonstrating that PlrS coordinates virulence specifically in the LRT. PlrS is required for LRT persistence even when BvgAS is rendered constitutively active, suggesting the presence of BvgAS-independent, PlrS-dependent virulence factors that are critical for bacterial survival in the LRT. We show that PlrS is also required for persistence of the human pathogen B. pertussis in the murine LRT and we provide evidence that PlrS most likely functions via the putative cognate response regulator PlrR. These data support a model in which PlrS senses conditions present in the LRT and activates PlrR, which controls expression of genes required for the maintenance of BvgAS activity and for essential BvgAS-independent functions. In addition to providing a major advance in our understanding of virulence regulation in Bordetella, which has served as a paradigm for several decades, these results indicate the existence of previously unknown virulence factors that may serve as new vaccine components and therapeutic or diagnostic targets.

  11. Prevalence of tuberculosis, HIV and respiratory symptoms in two Zambian communities: implications for tuberculosis control in the era of HIV.

    Directory of Open Access Journals (Sweden)

    Helen Ayles

    Full Text Available The Stop TB Partnership target for tuberculosis is to have reduced the prevalence of tuberculosis by 50% comparing 2015 to 1990. This target is challenging as few prevalence surveys have been conducted, especially in high burden tuberculosis and HIV countries. Current tuberculosis control strategies in high HIV prevalent settings are therefore based on limited epidemiological evidence and more evidence is needed from community-based surveys to inform improved policy formulation.8044 adults were sampled from 2 sub-districts (wards in Lusaka province, Zambia. Questionnaires were used to screen for symptoms, respiratory samples were obtained for culture and oral secretions collected for HIV testing. 79 individuals were found to have Mycobacterium tuberculosis in their sputum, giving an adjusted overall prevalence of tuberculosis of 870/100,000 (95% CI 570-1160/100,000. The adjusted overall prevalence of HIV was 28.61% (95% CI 26.04-31.19. HIV- infection was significantly associated with prevalent tuberculosis (Adj OR 2.3, 95% CI 1.42-3.74 and the population attributable fraction of HIV for prevalent tuberculosis was 36%. Symptoms such as prolonged cough (adj OR 12.72, 95% CI 7.05-22.94 and fever (Adj OR 2.04, 95%CI 1.23-3.39, were associated with prevalent tuberculosis, but 8 (10% individuals with prevalent tuberculosis denied having any symptoms at all and only 34 (43% would have been classified as a TB suspect by current guidelines.Undiagnosed tuberculosis is a challenge for tuberculosis control and new approaches are needed if we are to reach international targets. Epidemiological studies can inform screening algorithms for both detection and prevention of active tuberculosis.

  12. Vitamin D supplementation and risk of respiratory tract infections: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Mao, Song; Huang, Songming

    2013-09-01

    It is well-documented that serum levels of 25-hydroxyvitamin D (25-OHD) are inversely associated with the risk of respiratory tract infections (RTIs). However, whether or not vitamin D supplementation prevents RTIs remains inconclusive. The aim of this study was to evaluate the role of vitamin D supplementation in preventing RTIs in healthy populations by performing a meta-analysis of randomized controlled trials (RCTs). RCTs regarding the association between vitamin D supplementation and the risk of RTIs were identified by searching PubMed, Embase, and Cochrane databases through January 2013. Reference lists of retrieved articles were also reviewed. Either a fixed-effects or, in the presence of heterogeneity, a random-effects model was used to calculate the pooled preventive effects. Seven RCTs involving 4827 participants were included in this meta-analysis. The pooled relative risk (RR) for subjects administered with vitamin D compared with control groups was 0.98 (95% confidence interval 0.93-1.03, p = 0.45). Meta-regression analyses showed almost no impact on the RR of age, vitamin D dosing regimen, and length of follow-up. Omission of any single trial had little impact on the pooled risk estimates. No evidence of publication bias was observed. Our findings do not support the routine use of vitamin D supplementation for RTI prevention in healthy populations. Larger studies are needed to investigate the effects of vitamin D supplementation on RTI prevention in various populations and to further clarify the influences of age, vitamin D dosing regimen, baseline levels of vitamin D, and study length.

  13. Oxygen-dependent control of respiratory nitrate reduction in mycelium of Streptomyces coelicolor A3(2).

    Science.gov (United States)

    Fischer, Marco; Falke, Dörte; Pawlik, Tony; Sawers, R Gary

    2014-12-01

    Several members of the obligately aerobic genus Streptomyces are able to reduce nitrate, catalyzed by Nar-type respiratory nitrate reductases. A unique feature of Streptomyces coelicolor A3(2) compared with other streptomycetes is that it synthesizes three nonredundant Nar enzymes. In this study, we show that Nar2 is the main Nar enzyme active in mycelium and could characterize the conditions governing its synthesis. Nar2 was present at low levels in aerobically cultivated mycelium, but synthesis was induced when cultures were grown under oxygen limitation. Growth in the presence of high oxygen concentrations prevented the induction of Nar2 synthesis. Equally, an abrupt shift from aerobiosis to anaerobiosis did not result in the immediate induction of Nar2 synthesis. This suggests that the synthesis of Nar2 is induced during a hypoxic downshift, probably to allow maintenance of a proton gradient during the transition to anaerobiosis. Although no Nar2 could be detected in freshly harvested mature spores, synthesis of the enzyme could be induced after long-term (several days) incubation of these resting spores under anaerobic conditions. Induction of Nar2 synthesis in spores was linked to transcriptional control. Nar2 activity in whole mycelium was strictly dependent on the presence of a putative nitrate transporter, NarK2. The oxygen-dependent inhibition of nitrate reduction by Nar2 was mediated by NarK2-dependent nitrate:nitrite antiport. This antiport mechanism likely prevents the accumulation of toxic nitrite in the cytoplasm. A deletion of the narK2 gene had no effect on Nar1-dependent nitrate reduction in resting spores. Together, our results indicate redox-dependent transcriptional and posttranslational control of nitrate reduction by Nar2. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  14. Respiratory Therapists

    Science.gov (United States)

    ... saturated with workers, and other areas (more often, rural areas) will be in need of respiratory therapists’ ... workers in the occupation, including what tools and equipment they use and how closely they are supervised. ...

  15. Effect of educational outreach to nurses on tuberculosis case detection and primary care of respiratory illness: pragmatic cluster randomised controlled trial.

    Science.gov (United States)

    Fairall, Lara R; Zwarenstein, Merrick; Bateman, Eric D; Bachmann, Max; Lombard, Carl; Majara, Bosielo P; Joubert, Gina; English, Rene G; Bheekie, Angeni; van Rensburg, Dingie; Mayers, Pat; Myers, Pat; Peters, Annatjie C; Chapman, Ronald D

    2005-10-01

    To develop and implement an educational outreach programme for the integrated case management of priority respiratory diseases (practical approach to lung health in South Africa; PALSA) and to evaluate its effects on respiratory care and detection of tuberculosis among adults attending primary care clinics. Pragmatic cluster randomised controlled trial, with clinics as the unit of randomisation. 40 primary care clinics, staffed by nurse practitioners, in the Free State province, South Africa. 1999 patients aged 15 or over with cough or difficult breathing (1000 in intervention clinics, 999 in control clinics). Between two and six educational outreach sessions delivered to nurse practitioners by usual trainers from the health department. The emphasis was on key messages drawn from the customised clinical practice guideline for the outreach programme, with illustrative support materials. Sputum screening for tuberculosis, tuberculosis case detection, inhaled corticosteroid prescriptions for obstructive lung disease, and antibiotic prescriptions for respiratory tract infections. All clinics and almost all patients (92.8%, 1856/1999) completed the trial. Although sputum testing for tuberculosis was similar between the groups (22.6% in outreach group v 19.3% in control group; odds ratio 1.22, 95% confidence interval 0.83 to 1.80), the case detection of tuberculosis was higher in the outreach group (6.4% v 3.8%; 1.72, 1.04 to 2.85). Prescriptions for inhaled corticosteroids were also higher (13.7% v 7.7%; 1.90, 1.14 to 3.18) but the number of antibiotic prescriptions was similar (39.7% v 39.4%; 1.01, 0.74 to 1.38). Combining educational outreach with integrated case management provides a promising model for improving quality of care and control of priority respiratory diseases, without extra staff, in resource poor settings. Current controlled trials ISRCTN13438073.

  16. Effects of low back pain and of Stabilization or Movement-System-Impairment treatments on voluntary postural adjustments: randomized, controlled trial

    Science.gov (United States)

    Lomond, Karen V.; Jacobs, Jesse V.; Hitt, Juvena R.; DeSarno, Michael J.; Bunn, Janice Y.; Henry, Sharon M.

    2014-01-01

    Background People with low back pain (LBP) exhibit impaired anticipatory postural adjustment (APAs). Objective To evaluate whether current motor retraining treatments address LBP-associated changes in movement coordination during tasks that do and do not require APAs. Design Prospectively registered, randomized controlled trial with a blinded assessor. Setting Outcome evaluations occurred in a university laboratory; treatments, in outpatient physical therapy clinics. Patients Fifteen subjects without LBP and 33 subjects with chronic, recurrent, non-specific LBP. Intervention Twelve subjects with LBP received stabilization treatment, 21 received Movement System Impairment (MSI)-based treatment, over 6 weekly 1-hour sessions plus home exercises. Measurements Pre- and post- treatment, surface electromyography (EMG) was recorded bilaterally from trunk and leg muscles during unsupported and supported leg-lifting tasks, which did and did not require an APA, respectively. Vertical reaction forces under the contralateral leg were recorded to characterize the APA. Oswestry disability scores and numeric pain ratings were also recorded. Results Persons with LBP demonstrated an impaired APA compared to persons without LBP, characterized by increased pre-movement contralateral force application and increased post-movement trunk EMG amplitude, regardless of the task. Following treatments, both groups similarly improved in disability and function; however, APA characteristics did not change (i.e. force application or EMG amplitude) in either task. Limitations Treating clinicians were not blinded to treatment allocation, only short-term outcomes were assessed, and main effects of treatment do not rule out non-specific effects of time or repeated exposure. Conclusions Movement impairments in persons with LBP are not limited to tasks requiring an APA. Stabilization and MSI-based treatments for LBP do not ameliorate, and may exacerbate, APA impairments (i.e., excessive force

  17. The effect of using an interactive booklet on childhood respiratory tract infections in consultations: Study protocol for a cluster randomised controlled trial in primary care

    Directory of Open Access Journals (Sweden)

    Nuttall Jacqueline

    2008-04-01

    Full Text Available Abstract Background Respiratory tract infections in children result in more primary care consultations than any other acute condition, and are the most common reason for prescribing antibiotics (which are largely unnecessary. About a fifth of children consult again for the same illness episode. Providing parents with written information on respiratory tract infections may result in a reduction in re-consultation rates and antibiotic prescribing for these illnesses. Asking clinicians to provide and discuss the information during the consultation may enhance effectiveness. This paper outlines the protocol for a study designed to evaluate the use of a booklet on respiratory tract infections in children within primary care consultations. Methods/Design This will be a cluster randomised controlled trial. General practices will be randomised to provide parents consulting because their child has an acute respiratory tract infection with either an interactive booklet, or usual care. The booklet provides information on the expected duration of their child's illness, the likely benefits of various treatment options, signs and symptoms that should prompt re-consultation, and symptomatic treatment advice. It has been designed for use within the consultation and aims to enhance communication through the use of specific prompts. Clinicians randomised to using the interactive booklet will receive online training in its use. Outcomes will be assessed via a telephone interview with the parent two weeks after first consulting. The primary outcome will be the proportion of children who re-consult for the same illness episode. Secondary outcomes include: antibiotic use, parental satisfaction and enablement, and illness costs. Consultation rates for respiratory tract infections for the subsequent year will be assessed by a review of practice notes. Discussion Previous studies in adults and children have shown that educational interventions can result in reductions

  18. Reporting effectiveness of an extract of three traditional Cretan herbs on upper respiratory tract infection: results from a double-blind randomized controlled trial.

    Science.gov (United States)

    Duijker, G; Bertsias, A; Symvoulakis, E K; Moschandreas, J; Malliaraki, N; Derdas, S P; Tsikalas, G K; Katerinopoulos, H E; Pirintsos, S A; Sourvinos, G; Castanas, E; Lionis, C

    2015-04-02

    Observations from the island of Crete, Greece suggest that infusions of traditional Cretan aromatic plants, well known for their ethnopharmacological use in Eastern Mediterranean region and Near East, could be effective in the prevention and treatment of upper respiratory tract infections, including viral-induced infections. The aim of this study was to report the effectiveness of an essential-oil extract of three Cretan aromatic plants in the treatment of cases with an upper respiratory tract infection. A double blind randomized controlled trial was implemented between October 2013 and February 2014. An essential-oil extract of Cretan aromatic plants in olive oil (total volume of 15ml of essential oil per litre of olive oil) was administered as 0.5ml soft gel capsules, twice a day, for 7 days. Placebo treatment was 0.5ml olive oil in soft gel capsules. Eligible patients were those presenting for clinical examination in the selected setting with signs and symptoms of upper respiratory tract infection that had begun within the previous 24 hours. Real-Time Polymerase Chain Reaction (PCR) was used for the detection of respiratory viruses. The primary outcome was the severity and duration of symptoms of upper respiratory tract infection, assessed using the Wisconsin Upper Respiratory System Survey (WURSS-21) questionnaire. A secondary outcome of interest was the change in C-reactive protein (CRP) status. One hundred and five patients completed the study: 51 in the placebo group, and 54 in the intervention (treated) group. Baseline characteristics were similar in the two groups. No statistically significant differences were found in symptom duration or severity between the two groups, although small and clinically favorable effects were observed. When the analysis was restricted to subjects with a laboratory-documented viral infection, the percentage of patients with cessation of symptoms after 6 days of treatment was 91% in the intervention group and 70% in the control

  19. BioFire FilmArray Decreases Infection Control Isolation Times by 4 days in ICU, BMT and Respiratory Wards

    Science.gov (United States)

    Wong, Titus; Stefanovic, Aleksandra; Locher, Kerstin; Bryce, Elizabeth; Grant, Jennifer M; Connolly, Eithne; Woznow, Tracey; Charles, Marthe; Hoang, Linda Mn; Jassem, Agatha; Roscoe, Diane

    2017-01-01

    Abstract Background Novel, rapid, syndromic testing of patients presenting with respiratory infections has the potential to improve patient access and care by decreasing time to diagnosis. BioFire FilmArray (BioFire Diagnostics, bioMerieux) is a cartridge-based, multiplex PCR platform capable of detecting 17 viral and 3 bacterial targets in one hour. This study assessed the impact of implementing this technology on the duration of infection control isolation. Methods A randomized control trial in a 900-bed tertiary-care academic hospital was conducted between December 2016 and January 2017. Fifty consecutive samples of patients with respiratory infections on our ICU, BMT and Respiratory wards to received either BioFire FilmArray Respiratory Panel (BF) diagnostic testing or our routine diagnostic testing (RO) consisting of an influenza A/B/RSV PCR (in-house) followed by Luminex NxTag Respiratory Pathogen Panel that was batched at a reference lab. Five patient charts with missing data were excluded from analysis. Statistical analysis was completed using RStudio Version 1.0.136 – © 2009–2016 RStudio, Inc. Results Patients randomized to the BF arm remained on respiratory isolation precautions on average (42.3 ± 72.9 hours) over 100 hours less than patients randomized to the routine arm (151.3 ± 151.8 hours) (95% CI: 35.6–184.4 hours, P = 0.0052). Conclusion Implementing the BioFire FilmArray Respiratory Panel decreased infection control isolation time by approximately 4 days compared with routine testing; further study is warranted to determine the impact of this technology on patient outcomes and cost benefit. Table 1: Mean Hours in Respiratory Isolation is Statistically Significantly Decreased with BioFire FilmArray Respiratory Panel Arm N Mean (hours) SD 
(hours) Median (hours) 95% CI* P value* BioFire 24 42.3 72.9 8.2 35.6–184.4 0.005253 Routine 21 152.3 151.8 67.0 *Welch two-sample t-test (assumed unequal variance), significance set at p≤0

  20. Comparison of respiratory muscle training methods in individuals with motor and sensory complete tetraplegia: a randomized controlled trial.

    Science.gov (United States)

    Mueller, Gabi; Hopman, Maria T E; Perret, Claudio

    2013-03-01

    To compare the effects of inspiratory resistance training and isocapnic hyperpnoea vs incentive spirometry (placebo) on respiratory function, voice, thorax mobility and quality of life in individuals with tetraplegia. Randomized controlled trial. A total of 24 individuals with traumatic, complete tetraplegia (C5-C8, American Spinal Injury Association (ASIA) Impairment Scale; AIS A) were randomly assigned to 1 of 3 groups. They completed 32 supervised training sessions over a period of 8 weeks. Before and after the training period, the following tests were performed: body plethysmography, inspiratory and expiratory muscle strength, subjective breathing parameters using a visual analogue scale, voice measurements, thorax mobility and quality of life. Cohen's effect sizes and Kruskal-Wallis tests for differences between pre- and post-training values were calculated. Compared with placebo training, inspiratory resistance training showed high effect sizes for inspiratory muscle strength (d = 1.13), the subjective ability "to blow one's nose" (d = 0.97) and the physical component of quality of life (d = 0.82). Isocapnic hyperpnoea compared with placebo showed a high effect size for breathlessness during exercise (d = 0.81). We found a significant effect of inspiratory resistance training vs placebo (p = 0.016) and vs isocapnic hyperpnoea (p = 0.012) for inspiratory muscle strength. In individuals with motor and sensory complete tetraplegia during the first year post-injury, inspiratory resistance training is more advantageous than isocapnic hyperpnoea, performed 4 times a week for 10 min.

  1. Reduced primary care respiratory infection visits following pregnancy and infancy vitamin D supplementation: a randomised controlled trial.

    Science.gov (United States)

    Grant, Cameron C; Kaur, Suhina; Waymouth, Ellen; Mitchell, Edwin A; Scragg, Robert; Ekeroma, Alec; Stewart, Alistair; Crane, Julian; Trenholme, Adrian; Camargo, Carlos A

    2015-04-01

    To determine whether vitamin D supplementation reduces primary care visits for acute respiratory infection (ARI). A randomised, double-blind, placebo-controlled trial was conducted in New Zealand and powered to determine the vitamin D dose needed to achieve normal vitamin D status during infancy. Healthy pregnant women, from 27 weeks' gestation to birth, and their infants, from birth to age 6 months, were assigned to placebo or one of the two dosages of daily oral vitamin D3 . Woman/infant pairs were randomised to placebo/placebo, 1000 IU/400 IU or 2000 IU/800 IU. For this ad hoc analysis, the primary care records of enrolled children were audited to age 18 months. Two hundred and sixty pregnant women were randomised to placebo (n = 87), lower-dose (n = 87) or higher-dose (n = 86) vitamin D3 . In comparison with the placebo group (99%), the proportion of children making any ARI visits was smaller in the higher-dose (87%, p = 0.004), but not the lower-dose vitamin D3 group (95%, p = 0.17). The median number of ARI visits/child was less in the higher-dose vitamin D3 group from age 6-18 months (placebo 4, lower dose 3, higher dose 2.5; p = 0.048 for higher-dose vitamin D3 vs. placebo). Vitamin D3 supplementation during pregnancy and infancy reduces primary care visits for ARI during early childhood. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  2. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial.

    Science.gov (United States)

    Liao, Lin-Yu; Chen, Kuei-Min; Chung, Wei-Sheng; Chien, Jung-Yien

    2015-01-01

    NCT02329873. Acute exacerbation (AE) of COPD is characterized by a sudden worsening of COPD symptoms. Previous studies have explored the effectiveness of respiratory rehabilitation for patients with COPD; however, no training program specific to acute exacerbation in elderly patients or unstable periods during hospitalization has been developed. To evaluate the effects of a respiratory rehabilitation exercise training package on dyspnea, cough, exercise tolerance, and sputum expectoration among hospitalized elderly patients with AECOPD. A randomized control trial was conducted. Pretest and posttest evaluations of 61 elderly inpatients with AECOPD (experimental group n=30; control group n=31) were performed. The experimental group received respiratory rehabilitation exercise training twice a day, 10-30 minutes per session for 4 days. The clinical parameters (dyspnea, cough, exercise tolerance, and sputum expectoration) were assessed at the baseline and at the end of the fourth day. All participants (median age =70 years, male =60.70%, and peak expiratory flow 140 L) completed the study. In the patients of the experimental group, dyspnea and cough decreased and exercise tolerance and sputum expectoration increased significantly compared with those of the patients in the control group (all Prespiratory rehabilitation exercise training package reduced symptoms and enhanced the effectiveness of the care of elderly inpatients with AECOPD.

  3. Protocol for diaphragm pacing in patients with respiratory muscle weakness due to motor neurone disease (DiPALS: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    McDermott Christopher J

    2012-08-01

    Full Text Available Abstract Background Motor neurone disease (MND is a devastating illness which leads to muscle weakness and death, usually within 2-3 years of symptom onset. Respiratory insufficiency is a common cause of morbidity, particularly in later stages of MND and respiratory complications are the leading cause of mortality in MND patients. Non Invasive Ventilation (NIV is the current standard therapy to manage respiratory insufficiency. Some MND patients however do not tolerate NIV due to a number of issues including mask interface problems and claustrophobia. In those that do tolerate NIV, eventually respiratory muscle weakness will progress to a point at which intermittent/overnight NIV is ineffective. The NeuRx RA/4 Diaphragm Pacing System was originally developed for patients with respiratory insufficiency and diaphragm paralysis secondary to stable high spinal cord injuries. The DiPALS study will assess the effect of diaphragm pacing (DP when used to treat patients with MND and respiratory insufficiency. Method/Design 108 patients will be recruited to the study at 5 sites in the UK. Patients will be randomised to either receive NIV (current standard care or receive DP in addition to NIV. Study participants will be required to complete outcome measures at 5 follow up time points (2, 3, 6, 9 and 12 months plus an additional surgery and 1 week post operative visit for those in the DP group. 12 patients (and their carers from the DP group will also be asked to complete 2 qualitative interviews. Discussion The primary objective of this trial will be to evaluate the effect of Diaphragm Pacing (DP on survival over the study duration in patients with MND with respiratory muscle weakness. The project is funded by the National Institute for Health Research, Health Technology Assessment (HTA Programme (project number 09/55/33 and the Motor Neurone Disease Association and the Henry Smith Charity. Trial Registration: Current controlled trials ISRCTN53817913. The

  4. Protocol for diaphragm pacing in patients with respiratory muscle weakness due to motor neurone disease (DiPALS): a randomised controlled trial

    Science.gov (United States)

    2012-01-01

    Background Motor neurone disease (MND) is a devastating illness which leads to muscle weakness and death, usually within 2-3 years of symptom onset. Respiratory insufficiency is a common cause of morbidity, particularly in later stages of MND and respiratory complications are the leading cause of mortality in MND patients. Non Invasive Ventilation (NIV) is the current standard therapy to manage respiratory insufficiency. Some MND patients however do not tolerate NIV due to a number of issues including mask interface problems and claustrophobia. In those that do tolerate NIV, eventually respiratory muscle weakness will progress to a point at which intermittent/overnight NIV is ineffective. The NeuRx RA/4 Diaphragm Pacing System was originally developed for patients with respiratory insufficiency and diaphragm paralysis secondary to stable high spinal cord injuries. The DiPALS study will assess the effect of diaphragm pacing (DP) when used to treat patients with MND and respiratory insufficiency. Method/Design 108 patients will be recruited to the study at 5 sites in the UK. Patients will be randomised to either receive NIV (current standard care) or receive DP in addition to NIV. Study participants will be required to complete outcome measures at 5 follow up time points (2, 3, 6, 9 and 12 months) plus an additional surgery and 1 week post operative visit for those in the DP group. 12 patients (and their carers) from the DP group will also be asked to complete 2 qualitative interviews. Discussion The primary objective of this trial will be to evaluate the effect of Diaphragm Pacing (DP) on survival over the study duration in patients with MND with respiratory muscle weakness. The project is funded by the National Institute for Health Research, Health Technology Assessment (HTA) Programme (project number 09/55/33) and the Motor Neurone Disease Association and the Henry Smith Charity. Trial Registration: Current controlled trials ISRCTN53817913. The views and opinions

  5. 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.

  6. 12 CFR 546.4 - Voluntary dissolution.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Voluntary dissolution. 546.4 Section 546.4... ASSOCIATIONS-MERGER, DISSOLUTION, REORGANIZATION, AND CONVERSION § 546.4 Voluntary dissolution. A Federal savings association's board of directors may propose a plan for dissolution of the association. The plan...

  7. PREDICTING VOLUNTARY INTAKE ON MEDIUM QUALITY ...

    African Journals Online (AJOL)

    hediction, voluntary intake, roughages, model). (Sleutelwoorde: ... fibre kinetics. By dividing voluntary feed intake into the fraction that is fermented in the rumen and the fraction which flows from the rumen, the basic model provides a logical way in ... Casein was infused per rumen to supply ammonia and amino acids to ...

  8. 78 FR 6208 - Voluntary Education Programs

    Science.gov (United States)

    2013-01-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF DEFENSE Office of the Secretary 32 CFR Part 68 RIN 0790-AI50 Voluntary Education Programs AGENCY: Office of the... the Federal Register titled Voluntary Education Programs. Subsequent to the publication of that rule...

  9. Respiratory Mechanics

    OpenAIRE

    Martin R. Miller

    2016-01-01

    Respiratory Mechanics by Theodore Wilson is a slim paperback volume (64 pages) describing three aspects of the way the lungs work: 1) pressure?volume relationships with regard to the lungs, 2) chest wall and muscles with regard to how the respiratory pump works, and 3) gas flow and transport. Relevant details about the author are missing, which I think is a loss. He is Emeritus Professor of Aerospace Engineering and Mechanics and this background and his expertise was a perfect fit for the inv...

  10. Bronchiectasis exacerbation study on azithromycin and amoxycillin-clavulanate for respiratory exacerbations in children (BEST-2: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Chang Anne B

    2013-02-01

    Full Text Available Abstract Background Bronchiectasis unrelated to cystic fibrosis (CF is being increasingly recognized in children and adults globally, both in resource-poor and in affluent countries. However, high-quality evidence to inform management is scarce. Oral amoxycillin-clavulanate is often the first antibiotic chosen for non-severe respiratory exacerbations, because of the antibiotic-susceptibility patterns detected in the respiratory pathogens commonly associated with bronchiectasis. Azithromycin has a prolonged half-life, and with its unique anti-bacterial, immunomodulatory, and anti-inflammatory properties, presents an attractive alternative. Our proposed study will test the hypothesis that oral azithromycin is non-inferior (within a 20% margin to amoxycillin-clavulanate at achieving resolution of non-severe respiratory exacerbations by day 21 of treatment in children with non-CF bronchiectasis. Methods This will be a multicenter, randomized, double-blind, double-dummy, placebo-controlled, parallel group trial involving six Australian and New Zealand centers. In total, 170 eligible children will be stratified by site and bronchiectasis etiology, and randomized (allocation concealed to receive: 1 azithromycin (5 mg/kg daily with placebo amoxycillin-clavulanate or 2 amoxycillin-clavulanate (22.5 mg/kg twice daily with placebo azithromycin for 21 days as treatment for non-severe respiratory exacerbations. Clinical data and a parent-proxy cough-specific quality of life (PC-QOL score will be obtained at baseline, at the start and resolution of exacerbations, and on day 21. In most children, blood and deep-nasal swabs will also be collected at the same time points. The primary outcome is the proportion of children whose exacerbations have resolved at day 21. The main secondary outcome is the PC-QOL score. Other outcomes are: time to next exacerbation; requirement for hospitalization; duration of exacerbation, and spirometry data. Descriptive viral and

  11. Effect of thoracic mobilization on respiratory parameters in chronic non-specific low back pain: A randomized controlled trial.

    Science.gov (United States)

    Babina, R; Mohanty, P P; Pattnaik, M

    2016-02-19

    Altered respiratory function has been found to be associated with back pain. Limited chest excursion in subjects with chronic low back pain (CLBP) may be due to co-contraction or bracing of erector spinae and abdominal muscles; their flexed spinal posture; and/or their compromised spinal stability resulting from dysfunctional transversus abdominis. To check for the effects of thoracic mobilization on respiratory parameters in subjects with chronic non-specific low back pain. Sixty-two subjects (excluding 11 dropouts) with CLBP of age group 30-60 were randomly allocated to two groups. Both groups received individualized treatment for low back pain (LBP) and HEP (home exercise program) regime of breathing exercises. In addition, group 1 received Maitland's Central postero-anterior vertebral pressure for thoracic spine (T1-T8). Total treatment duration was 10 sessions in 2 weeks (5 sessions/week). Results showed significant improvement in respiratory parameters viz. Forced Vital Capacity (FVC), Sustained Maximal Inspiratory Pressure (SMIP) and Chest Wall Expansion (CWE) and Oswestry Disability Index (ODI) in both groups (plow back pain with or without radiation to lower limbs when treated with thoracic central PA mobilization, in addition to LBP specific treatment and breathing exercises, show an improvement in respiratory parameters and reduction in disability.

  12. An integrated palliative and respiratory care for patients with advanced disease and refractory breathlessness: a randomised controlled trial

    NARCIS (Netherlands)

    Higginson, I.J.; Bausewein, C.; Reilly, C.C.; Gao, W.; Gysels, M.; Dzingina, M.; McCrone, P.; Booth, S.; Jolley, C.J.; Moxham, J.

    2014-01-01

    Background Breathlessness is a common and distressing symptom, which increases in many diseases as they progress and is difficult to manage. We assessed the effectiveness of early palliative care integrated with respiratory services for patients with advanced disease and refractory breathlessness.

  13. Respiratory virus-induced TLR7 activation controls IL-17-associated increased mucus via IL-23 regulation

    NARCIS (Netherlands)

    Lukacs, Nicholas W; Smit, Joost J; Mukherjee, Sumanta; Morris, Susan B; Nunez, Gabriel; Lindell, Dennis M

    2010-01-01

    The response to respiratory syncytial virus (RSV), negative strand ssRNA virus, depends upon the ability to recognize specific pathogen-associated targets. In the current study, the role of TLR7 that recognizes ssRNA was examined. Using TLR7(-/-) mice, we found that the response to RSV infection in

  14. Induced hypothermia in patients with septic shock and respiratory failure (CASS): a randomised, controlled, open-label trial

    NARCIS (Netherlands)

    Itenov, Theis Skovsgaard; Johansen, Maria Egede; Bestle, Morten; Thormar, Katrin; Hein, Lars; Gyldensted, Louise; Lindhardt, Anne; Christensen, Henrik; Estrup, Stine; Pedersen, Henrik Planck; Harmon, Matthew; Soni, Uday Kant; Perez-Protto, Silvia; Wesche, Nicolai; Skram, Ulrik; Petersen, John Asger; Mohr, Thomas; Waldau, Tina; Poulsen, Lone Musaeus; Strange, Ditte; Juffermans, Nicole P.; Sessler, Daniel I.; Tønnesen, Else; Møller, Kirsten; Kristensen, Dennis Karsten; Cozzi-Lepri, Alessandro; Lundgren, Jens D.; Jensen, Jens-Ulrik; Jensen, Jens-Ulrik Stæhr; Lundgren, Jens; Planck Pedersen, Henrik; Illkjær, Susanne; Masur, Henry; Torp-Pedersen, Christian; Copas, Andrew; Nielsen, Birgit Riis; Grarup, Jesper; Hansen, Jette; Nielsen, Kim; Valbjørn, Lone; Lauritzen, Sanne; Kold, Tina; Grundahl, Kathrine; Rasmussen, Rikke Hein; Wesche, Nikolaj; Blom, Hasse; Jensen, Peer Eske; Galle, Tina; Thaarslund, Bente; Skandov, Camilla; Langholz, Iben; Berthelsen, Rasmus Ehrenfried; Kjær, Dorthe; Uldbjerg, Merete; Lipsius, Lily; Engsig, Magaly; Helsted, Rikke; Andersen, Birgitte; Nygaard, Eigil; Strande, Søren; Bangash, Aimal Khan; Søe-Jensen, Peter; Tousi, Hamid; Tangager, Malene; Hagi-Pedersen, Daniel; Gatz, Rainer Karl-Heinz; Engen, Marte Kaasen; Wamberg, Christian Åge; Westergaard, Bo; Stoktoft, Stine; Scherwin, Rebecca; Bærentzen, Finn; Lauritzen, Marlene; Pott, Frank; Bruun, Christina; Meyhoff, Christian; Strange, Ditte Gry; Palmqvist, Dorthe Fris; Hemmingsen, Claus; Gärtner, Rune; Jung, Kai Dieter; La Porte, Louise; Viuf, Mette; Troglauer, Johannes; Borovnjak, Silva; Strandkjær, Nina; Bretlau, Claus; Hansen, Marianna; Zaulich, Lea Kielsgaard; Overgaard, Christian; Bergenholtz, Katja; Jansen, Tejs; Bæk-Jensen, Mette Astrup; Detlefsen, Monika; Albrechtsen, Tannie Lund; Sode, Birgitte Margareta; Boesen, Hans Christian; Thostrup, Maria; Andersen, Torben Mogens; Kjelsteen, Katrine; Winther Kjær, Cilia Klara; Haunstrup, Elsebeth; Christensen, Ole; Spliid, Lone; Rasmussen, Birgitte; Jejlskov, Henriette; Borchorst, Søren; Abdel-Wahab, Akil Walli Raad; Brysting, Marianne; Victor, Jette; Stensbirk, Anette; Bjerregaard, Karen; Poulsen, Anne; Roed, Annette Brix; Bech, Bianca; Yilmaz, Oguz; Ahuja, Sanchit; Suleiman, Iman; Iglesias, Rodrigo; Breum, Olena

    2018-01-01

    Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent

  15. Randomised controlled trial of CRP rapid test as a guide to treatment of respiratory infections in general practice

    DEFF Research Database (Denmark)

    Diederichsen, H Z; Skamling, M; Diederichsen, Axel Cosmus Pyndt

    2000-01-01

    To assess whether the frequency of antibiotic prescriptions to patients with respiratory infections is reduced when general practitioners (GPs) use a C-reactive protein (CRP) rapid test in support of their clinical assessment, and to study whether using the test will have any effect on the course...

  16. The impact of laboratory characteristics on molecular detection of respiratory syncytial virus in a European multicentre quality control study

    NARCIS (Netherlands)

    Meerhoff, T. J.; MacKay, W. G.; Meijer, A.; Paget, W. J.; Niesters, H. G. M.; Kimpen, J. L. L.; Schellevis, F.

    2008-01-01

    The performance of nucleic acid amplification techniques for detecting respiratory syncytial virus (RSV) was evaluated in 25 laboratories across Europe by an external quality assessment study. In addition, factors related to the diagnostic performance of laboratories were explored. The results of

  17. The impact of laboratory characteristics on molecular detection of respiratory syncytial virus in a European multicentre quality control study.

    NARCIS (Netherlands)

    Meerhoff, T.J.; MacKay, W.G.; Meijer, A.; Paget, W.J.; Niesters, H.G.M.; Kimpen, J.L.L.; Schellevis, F.

    2008-01-01

    The performance of nucleic acid amplification techniques for detecting respiratory syncytial virus (RSV) was evaluated in 25 laboratories across Europe by an external quality assessment study. In addition, factors related to the diagnostic performance of laboratories were explored. The results of

  18. Smart Care™ versus respiratory physiotherapy-driven manual weaning for critically ill adult patients: a randomized controlled trial.

    Science.gov (United States)

    Taniguchi, Corinne; Victor, Elivane S; Pieri, Talita; Henn, Renata; Santana, Carolina; Giovanetti, Erica; Saghabi, Cilene; Timenetsky, Karina; Caserta Eid, Raquel; Silva, Eliezer; Matos, Gustavo F J; Schettino, Guilherme P P; Barbas, Carmen S V

    2015-06-11

    A recent meta-analysis showed that weaning with SmartCare™ (Dräger, Lübeck, Germany) significantly decreased weaning time in critically ill patients. However, its utility compared with respiratory physiotherapist-protocolized weaning is still a matter of debate. We hypothesized that weaning with SmartCare™ would be as effective as respiratory physiotherapy-driven weaning in critically ill patients. Adult critically ill patients mechanically ventilated for more than 24 hours in the adult intensive care unit of the Albert Einstein Hospital, São Paulo, Brazil, were randomly assigned to be weaned either by progressive discontinuation of pressure support ventilation (PSV) with SmartCare™. Demographic data, respiratory function parameters, level of PSV, tidal volume (VT), positive end-expiratory pressure (PEEP), inspired oxygen fraction (FIO2), peripheral oxygen saturation (SpO2), end-tidal carbon dioxide concentration (EtCO2) and airway occlusion pressure at 0.1 second (P0.1) were recorded at the beginning of the weaning process and before extubation. Mechanical ventilation time, weaning duration and rate of extubation failure were compared. Seventy patients were enrolled 35 in each group. There was no difference between the two groups concerning age, sex or diagnosis at study entry. There was no difference in maximal inspiratory pressure, maximal expiratory pressure, forced vital capacity or rapid shallow breathing index at the beginning of the weaning trial. PEEP, VT, FIO2, SpO2, respiratory rate, EtCO2 and P0.1 were similar between the two groups, but PSV was not (median: 8 vs. 10 cmH2O; p =0.007). When the patients were ready for extubation, PSV (8 vs. 5 cmH2O; p =0.015) and PEEP (8 vs. 5 cmH2O; p respiratory physiotherapy-driven weaning group. Total duration of mechanical ventilation (3.5 [2.0-7.3] days vs. 4.1 [2.7-7.1] days; p =0.467) and extubation failure (2 vs. 2; p =1.00) were similar between the two groups. Weaning duration was shorter in the

  19. Pneumococcal lower respiratory tract infections in adults: an observational case-control study in primary care in Belgium.

    Science.gov (United States)

    Flamaing, Johan; De Backer, Wilfried; Van Laethem, Yves; Heijmans, Stéphane; Mignon, Annick

    2015-05-27

    Serious lower respiratory tract infections (SLRTIs), especially Streptococcus pneumoniae (SP)-related pneumonia cause considerable morbidity and mortality. Chest imaging, sputum and blood culture are not routinely obtained by general practitioners (GPs). Antibiotic therapy is usually started empirically. The BinaxNOW® and Urine Antigen Detection (UAD) assays have been developed respectively to detect a common antigen from all pneumococcal strains and the 13 pneumococcal serotypes present in the vaccine Prevenar 13® (PCV13). OPUS-B was a multicentre, prospective, case-control, observational study of patients with SLRTI in primary care in Belgium, conducted during two winter seasons (2011-2013). A urine sample was collected at baseline for the urine assays. GPs were blinded to the results. All patients with a positive BinaxNOW® test and twice as much randomly selected BinaxNOW® negative patients were followed up. Recorded data included: socio-demographics, medical history, vaccination history, clinical symptoms, CRB-65 score, treatments, hospitalization, blood cultures, healthcare use, EQ-5D score. The objectives were to evaluate the percentage of SP SLRTI within the total number of SLRTIs, to assess the percentage of SP serotypes and to compare the burden of disease between pneumococcal and non-pneumococcal SLRTIs. There were 26 patients with a BinaxNOW® positive test and 518 patients with a BinaxNOW® negative test. The proportion of pneumococcal SLRTI was 4.8 % (95 % CI: 3.1 %-7.2 %). Sixty-eight percent of positive cases showed serotypes represented in PCV13. In the BinaxNOW-positive patients, women were more numerous, there was less exposure to young children, seasonal influenza vaccination was less frequent, COPD was more frequent, the body temperature and the number of breaths per minute were higher, the systolic blood pressure was lower, the frequency of sputum, infiltrate, chest pain, muscle ache, confusion/disorientation, diarrhoea, pneumonia and

  20. Effect of vitamin D3 supplementation on upper respiratory tract infections in healthy adults: the VIDARIS randomized controlled trial.

    Science.gov (United States)

    Murdoch, David R; Slow, Sandy; Chambers, Stephen T; Jennings, Lance C; Stewart, Alistair W; Priest, Patricia C; Florkowski, Christopher M; Livesey, John H; Camargo, Carlos A; Scragg, Robert

    2012-10-03

    Observational studies have reported an inverse association between serum 25-hydroxyvitamin D (25-OHD) levels and incidence of upper respiratory tract infections (URTIs). However, results of clinical trials of vitamin D supplementation have been inconclusive. To determine the effect of vitamin D supplementation on incidence and severity of URTIs in healthy adults. Randomized, double-blind, placebo-controlled trial conducted among 322 healthy adults between February 2010 and November 2011 in Christchurch, New Zealand. Participants were randomly assigned to receive an initial dose of 200,000 IU oral vitamin D3, then 200,000 IU 1 month later, then 100,000 IU monthly (n = 161), or placebo administered in an identical dosing regimen (n = 161), for a total of 18 months. The primary end point was number of URTI episodes. Secondary end points were duration of URTI episodes, severity of URTI episodes, and number of days of missed work due to URTI episodes. The mean baseline 25-OHD level of participants was 29 (SD, 9) ng/mL. Vitamin D supplementation resulted in an increase in serum 25-OHD levels that was maintained at greater than 48 ng/mL throughout the study. There were 593 URTI episodes in the vitamin D group and 611 in the placebo group, with no statistically significant differences in the number of URTIs per participant (mean, 3.7 per person in the vitamin D group and 3.8 per person in the placebo group; risk ratio, 0.97; 95% CI, 0.85-1.11), number of days of missed work as a result of URTIs (mean, 0.76 days in each group; risk ratio, 1.03; 95% CI, 0.81-1.30), duration of symptoms per episode (mean, 12 days in each group; risk ratio, 0.96; 95% CI, 0.73-1.25), or severity of URTI episodes. These findings remained unchanged when the analysis was repeated by season and by baseline 25-OHD levels. In this trial, monthly administration of 100,000 IU of vitamin D did not reduce the incidence or severity of URTIs in healthy adults. anzctr.org.au Identifier: ACTRN12609000486224.

  1. Vitamin D3 and gargling for the prevention of upper respiratory tract infections: a randomized controlled trial.

    Science.gov (United States)

    Goodall, Emma C; Granados, Andrea C; Luinstra, Kathy; Pullenayegum, Eleanor; Coleman, Brenda L; Loeb, Mark; Smieja, Marek

    2014-05-19

    We undertook a 2X2 factorial, randomized controlled trial (RCT) to assess whether vitamin D3 supplementation (10,000 international units per week) versus placebo and gargling versus no gargling could prevent viral, clinical upper respiratory tract infection (URTI) in university students. We randomized 600 students into 4 treatment arms: 1) vitamin D3 and gargling, 2) placebo and gargling, 3) vitamin D3 and no gargling, and 4) placebo and no gargling. Students completed weekly electronic surveys and submitted self-collected mid-turbinate nasal flocked swabs during September and October in 2010 or 2011. Symptomatic students also completed an electronic symptom diary. The primary and secondary outcomes were the occurrence of symptomatic clinical URTI and laboratory confirmed URTI respectively. Of 600 participants, 471 (78.5%) completed all surveys while 43 (7.2%) completed none; 150 (25.0%) reported clinical URTI. Seventy participants (23.3%) randomized to vitamin D3 reported clinical URTI compared to 80 (26.7%) randomized to placebo (RR:0.79, CI95:0.61-1.03, p = 0.09). Eighty-five participants (28.3%) randomized to gargling reported clinical URTI compared to 65 participants (21.7%) randomized to the no gargling arm (RR:1.3, CI95:0.92-1.57, p = 0.19). Laboratory testing identified 70 infections (46.7 per 100 URTIs). Vitamin D3 treatment was associated with a significantly lower risk for laboratory confirmed URTI (RR: 0.54, CI95:0.34-0.84, p = 0.007) and with a significantly lower mean viral load measured as log10 viral copies/mL (mean difference: -0.89, CI95: -1.7, -0.06, p = 0.04). Fewer students assigned to gargling experienced laboratory confirmed URTI, however this was not statistically significant (RR:0.82, CI95:0.53-1.26, p = 0.36). These results suggest that vitamin D3 is a promising intervention for the prevention of URTI. Vitamin D3 significantly reduced the risk of laboratory confirmed URTI and may reduce the risk of clinical infections

  2. The Improved Sensitivity to Crossmodal Asynchrony Caused by Voluntary Action: Comparing Combinations of Sensory Modalities

    Directory of Open Access Journals (Sweden)

    Norimichi Kitagawa

    2011-10-01

    Full Text Available The brain has to assess the fine temporal relationship between voluntary actions and their sensory effects to achieve precise spatiotemporal control of body movement. Recently we found that voluntary action improved the subsequent perceptual temporal discrimination between somatosensory and auditory events. In voluntary condition, participants actively pressed a button and a noise burst was presented at various onset asynchronies relative to the button press. The participants made either ‘sound-first’ or ‘touch-first’ responses. We found that the temporal order judgment performance in the voluntary condition (as indexed by just noticeable difference was significantly better than that when their finger was passively stimulated (passive condition. Temporal attention and comparable involuntary movement did not explain the improvement caused by the voluntary action. The results suggest that predicting sensory consequences via a ‘forward’ model enhances perceptual temporal resolution for precise control of the body. The present study examined whether this improved temporal sensitivity caused by the voluntary action is also observed for the other combinations of sensory modalities. We compared the effects of voluntary action on the temporal sensitivity between auditory-somatosensory, visual-somatosensory, and somatosensory-somatosensory stimulus pairs.

  3. Respiratory Home Health Care

    Science.gov (United States)

    ... Control Preventing infections can help the respiratory home care patient stay as healthy as possible. Hand-washing is the single most important thing for patients and caregivers to perform on a routine basis. Use a liquid soap and lots of warm running water. Work up a good lather and scrub for at ...

  4. Respiratory Support

    African Journals Online (AJOL)

    can be caused by inappropriate mechanical ventilation. This soft-cover review of the current practice of appropriate respiratory support is not controversia(it describes in an easily readable and concise fashio-n the development, physiological implications, mechanical and technological basis, safety aspects and careful ...

  5. Clinical evaluation of a novel adaptive algorithm for automated control of oxygen therapy in preterm infants on non-invasive respiratory support.

    Science.gov (United States)

    Plottier, Gemma K; Wheeler, Kevin I; Ali, Sanoj K M; Fathabadi, Omid Sadeghi; Jayakar, Rohan; Gale, Timothy J; Dargaville, Peter A

    2017-01-01

    To evaluate the performance of a novel rapidly responsive proportional-integral-derivative (PID) algorithm for automated oxygen control in preterm infants with respiratory insufficiency. Interventional study of a 4-hour period of automated oxygen control compared with combined data from two flanking periods of manual control (4 hours each). Neonatal intensive care unit. Preterm infants (n=20) on non-invasive respiratory support and supplemental oxygen, with oxygen saturation (SpO2) target range 90%-94% (manual control) and 91%-95% (automated control). Median gestation at birth 27.5 weeks (IQR 26-30 weeks), postnatal age 8.0 (1.8-34) days. Automated oxygen control using a standalone device, receiving SpO2 input from a standard oximeter and computing alterations to oxygen concentration that were actuated with a modified blender. The PID algorithm was enhanced to avoid iatrogenic hyperoxaemia and adapt to the severity of lung dysfunction. Proportion of time in the SpO2 target range, or above target range when in air. Automated oxygen control resulted in more time in the target range or above in air (manual 56 (48-63)% vs automated 81 (76-90)%, pManual changes to oxygen therapy were infrequent during automated control (0.24/hour vs 2.3/hour during manual control), and oxygen requirements were unchanged (automated control period 27%, manual 27% and 26%, p>0.05). The novel PID algorithm was very effective for automated oxygen control in preterm infants, and deserves further investigation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Effects of sodium hyaluronate in children with recurrent upper respiratory tract infections: results of a randomised controlled study.

    Science.gov (United States)

    Macchi, A; Castelnuovo, P; Terranova, P; Digilio, E

    2013-01-01

    Hyaluronic acid is a major component of many extracellular matrices that plays a role in the regulation of vasomotor tone and mucous gland secretion, and in the modulation of the inflammatory process in upper and lower airways. This pilot study was aimed at evaluating the effects of nasal washes with 9 mg nebulised sodium hyaluronate given for 15 days per month over 3 months in 75 paediatric patients with recurrent upper respiratory tract infections (URTI). Eligible patients were randomized to treatment with nasal washes containing 9 mg sodium hyaluronate plus saline solution or saline alone, according to an open-label, parallel group design, with blind observer assessment. Ciliary motility, which was assessed based on a 0-3 point rating scale (0 = absent, 1 = less than 5 minutes, 2 = greater than or equal to 5 and ≤ 10 minutes, 3 = greater than 10 minutes) was the primary study endpoint. The secondary efficacy variables included cytological (presence of neutrophils, eosinophils and mast cells), microbiological (presence of bacteria and mycetes), endoscopical (presence of adenoid hypertrophy and biofilm) and clinical (presence of rhinitis, post-nasal drip, nasal dyspnoea) parameters. The two treatment groups (mean age 7.5 years, 53percent of males) were comparable for baseline data, except a higher mean age in the control group than in the treated group. Treatment with 9 mg sodium hyaluronate was associated with significantly greater improvements (p less than 0.001 between groups) in primary outcome ciliary motility [odds ratio (OR) 13.61; 95 percent CI 4.51-41.00 in the univariate regression analysis that examined the probability of improvement]. Treatment with 9 mg sodium hyaluronate was also significantly superior to saline alone in adenoid hypertrophy (p less than 0.001; OR 14.72; 95 percent CI 4.74-45.68), presence of bacteria (p = 0.026; OR 2.95; 95 percent CI 1.15-7.55), neutrophils (p = 0.002; OR 4.51; 95 percent CI 1.75-11.62), rhinitis (p = 0.040; OR 10

  7. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial

    Directory of Open Access Journals (Sweden)

    Liao LY

    2015-08-01

    Full Text Available Lin-Yu Liao,1,2 Kuei-Min Chen,2 Wei-Sheng Chung,3 Jung-Yien Chien4 1Department of Nursing, Chest Hospital, Ministry of Health and Welfare, Rende District, Tainan, 2College of Nursing, Kaohsiung Medical University, Sanmin District, Kaohsiung, 3Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, 4Department of Medicine, Chest Hospital, Ministry of Health and Welfare, Rende District, Tainan, Taiwan Clinical trials identifier: NCT02329873 Background: Acute exacerbation (AE of COPD is characterized by a sudden worsening of COPD symptoms. Previous studies have explored the effectiveness of respiratory rehabilitation for patients with COPD; however, no training program specific to acute exacerbation in elderly patients or unstable periods during hospitalization has been developed.Objective: To evaluate the effects of a respiratory rehabilitation exercise training package on dyspnea, cough, exercise tolerance, and sputum expectoration among hospitalized elderly patients with AECOPD.Methods: A randomized control trial was conducted. Pretest and posttest evaluations of 61 elderly inpatients with AECOPD (experimental group n=30; control group n=31 were performed. The experimental group received respiratory rehabilitation exercise training twice a day, 10–30 minutes per session for 4 days. The clinical parameters (dyspnea, cough, exercise tolerance, and sputum expectoration were assessed at the baseline and at the end of the fourth day.Results: All participants (median age =70 years, male =60.70%, and peak expiratory flow 140 L completed the study. In the patients of the experimental group, dyspnea and cough decreased and exercise tolerance and sputum expectoration increased significantly compared with those of the patients in the control group (all P<0.05. Within-group comparisons revealed that the dyspnea, cough, and exercise tolerance significantly improved in the experimental group by the end of the fourth

  8. Saccadic suppression during voluntary versus reactive saccades.

    Science.gov (United States)

    Gremmler, Svenja; Lappe, Markus

    2017-07-01

    Saccades are fast eye movements that reorient gaze. They can be performed voluntarily-for example, when viewing a scene-but they can also be triggered in reaction to suddenly appearing targets. The generation of these voluntary and reactive saccades have been shown to involve partially different cortical pathways. However, saccades of either type confront the visual system with a major challenge from massive image motion on the retina. Despite the fact that the whole scene is swept across the retina, a saccade usually does not elicit a percept of motion. This saccadic omission has been linked to a transient decrease of visual sensitivity during the eye movement, a phenomenon called saccadic suppression. A passive origin of saccadic suppression based on temporal masking has been proposed as well as an active central process that inhibits visual processing during the saccade. The latter one would need to include an extraretinal signal, which is generated already during saccade preparation. Since saccade generation differs for voluntary and reactive saccades, timing and nature of this extraretinal signal as well as its impact on visual sensitivity might also differ. We measured detection thresholds for luminance stimuli that were flashed during voluntary and reactive saccades and during fixation. Detection thresholds were higher during voluntary than during reactive saccades such that suppression appeared stronger during voluntary saccades. Stronger suppression in voluntary saccades could arise from a stronger extraretinal signal that activates suppression or could indicate that a suppression underlying process itself partially differs between voluntary and reactive saccades.

  9. Obesity and respiratory diseases

    Directory of Open Access Journals (Sweden)

    Christopher Zammit

    2010-10-01

    Full Text Available Christopher Zammit, Helen Liddicoat, Ian Moonsie, Himender MakkerSleep and Ventilation Unit, Department of Respiratory Medicine, North Middlesex University Hospital, London, UKAbstract: The obesity epidemic is a global problem, which is set to increase over time. However, the effects of obesity on the respiratory system are often underappreciated. In this review, we will discuss the mechanical effects of obesity on lung physiology and the function of adipose tissue as an endocrine organ producing systemic inflammation and effecting central respiratory control. Obesity plays a key role in the development of obstructive sleep apnea and obesity hypoventilation syndrome. Asthma is more common and often harder to treat in the obese population, and in this study, we review the effects of obesity on airway inflammation and respiratory mechanics. We also discuss the compounding effects of obesity on chronic obstructive pulmonary disease (COPD and the paradoxical interaction of body mass index and COPD severity. Many practical challenges exist in caring for obese patients, and we highlight the complications faced by patients undergoing surgical procedures, especially given the increased use of bariatric surgery. Ultimately, a greater understanding of the effects of obesity on the respiratory disease and the provision of adequate health care resources is vital in order to care for this increasingly important patient population.Keywords: obesity, lung function, obstructive sleep apnea, obesity hypoventilation syndrome, anesthesia

  10. Imaging the effects of oxygen saturation changes in voluntary apnea and hyperventilation on susceptibility-weighted imaging.

    Science.gov (United States)

    Chang, K; Barnes, S; Haacke, E M; Grossman, R I; Ge, Y

    2014-06-01

    Cerebrovascular oxygenation changes during respiratory challenges have clinically important implications for brain function, including cerebral autoregulation and the rate of brain metabolism. SWI is sensitive to venous oxygenation level by exploitation of the magnetic susceptibility of deoxygenated blood. We assessed cerebral venous blood oxygenation changes during simple voluntary breath-holding (apnea) and hyperventilation by use of SWI at 3T. We performed SWI scans (3T; acquisition time of 1 minute, 28 seconds; centered on the anterior commissure and the posterior commissure) on 10 healthy male volunteers during baseline breathing as well as during simple voluntary hyperventilation and apnea challenges. The hyperventilation and apnea tasks were separated by a 5-minute resting period. SWI venograms were generated, and the signal changes on SWI before and after the respiratory stress tasks were compared by means of a paired Student t test. Changes in venous vasculature visibility caused by the respiratory challenges were directly visualized on the SWI venograms. The venogram segmentation results showed that voluntary apnea decreased the mean venous blood voxel number by 1.6% (P hyperventilation increased the mean venous blood voxel number by 2.7% (P < .0001). These results can be explained by blood CO2 changes secondary to the respiratory challenges, which can alter cerebrovascular tone and cerebral blood flow and ultimately affect venous oxygen levels. These results highlight the sensitivity of SWI to simple and noninvasive respiratory challenges and its potential utility in assessing cerebral hemodynamics and vasomotor responses. © 2014 by American Journal of Neuroradiology.

  11. Impact of early diagnosis and control of chronic respiratory diseases on active and healthy ageing. A debate at the European Union Parliament.

    Science.gov (United States)

    Bousquet, J; Tanasescu, C C; Camuzat, T; Anto, J M; Blasi, F; Neou, A; Palkonen, S; Papadopoulos, N G; Antunes, J P; Samolinski, B; Yiallouros, P; Zuberbier, T

    2013-01-01

    A debate at the European Union Parliament was held on 13 November 2012 on the Impact of early diagnosis and control of chronic respiratory diseases on Active and Healthy Ageing (AHA). The debate was held under the auspices of the Cyprus Presidency of the European Union (2012) and represents a follow-up of the priorities of the Polish Presidency of the European Union (2011). It highlighted the importance of early life events on the occurrence of chronic respiratory diseases later in life and their impact on active and healthy ageing. Epidemiologic evidence was followed by actions that should be taken to prevent and manage chronic respiratory diseases in children. The debate ended by practical, feasible and achievable projects, demonstrating the strength of the political action in the field. Three projects will be initiated from this debate: The first will be a meeting sponsored by the Région Languedoc-Roussillon on the developmental origins of chronic diseases and ageing: from research to policies and value creation. The second project is being led by the WHO Collaborating Centre for Asthma and Rhinitis: Prevention of Asthma, Prevention of Allergy (PAPA). The third project is the GA(2)LEN sentinel network. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  12. First non-contingent respiratory biofeedback placebo versus contingent biofeedback in patients with chronic low back pain: a randomized, controlled, double-blind trial.

    Science.gov (United States)

    Kapitza, Karl Peter; Passie, Torsten; Bernateck, Michael; Karst, Matthias

    2010-09-01

    Previous studies reported that respiratory feedback (RFB) aids in alleviating chronic pain. However, to date, this adjunct treatment has not been rigorously tested against non-contingent (placebo) feedback. Forty-two patients with chronic low back pain were randomized to either RFB or non-contingent RFB. Both groups performed a daily 30-min home training for 15 consecutive days. A respiratory associated relaxation index (RI) was measured. Pain levels and a somatosensory profile were assessed before and after intervention. Additionally, pain levels were assessed 3 months after the end of intervention. Secondary outcome parameters included daily functioning, psychopathology, and suggestibility. T-tests showed higher and significant pain reductions for RFB, compared to non-contingent RFB. Between-group comparisons reached no significance. However, changes were more pronounced in the RFB condition, which was also true for the course of the RI and the psychopathological scores. This is the first study using a non-contingent respiratory placebo feedback in a randomized, controlled design. Within this design previous positive findings of symptom reductions in patients treated with RFB could partially replicated. Nonetheless, tendencies suggest that contingent feedback patients compared to placebo patients profit more from RFB in the long run regarding reduction of chronic pain and psychological distress.

  13. Vibrating Platform Training Improves Respiratory Muscle Strength, Quality of Life, and Inspiratory Capacity in the Elderly Adults: A Randomized Controlled Trial.

    Science.gov (United States)

    Pessoa, Maíra Florentino; Brandão, Daniela Cunha; Sá, Rafaela Barros de; Barcelar, Jacqueline de Melo; Rocha, Taciano Dias de Souza; Souza, Helga Cecília Muniz de; Dornelas de Andrade, Armele

    2017-05-01

    Aging affects respiratory strength that could cause reduction in functional capacity and quality of life, playing a fundamental role in healthy aging and survival. To prevent these declines, the whole body vibration (WBV) has been proposed to increase strength and functional capacity. The aim of the study was to evaluate the effects of WBV on respiratory muscle strength, thoracoabdominal ventilation, and quality of life in the elderly adults. This study was a controlled, randomized double-blind clinical trial. The study included 28 elderly adults randomized into three groups: Resistance (n = 9), WBV (n = 9), or WBV + resistance exercises (n = 10), performing training, sham, or double training for 3 months, twice per week. The variables of the study were as follows: maximal inspiratory and expiratory pressures (MIP and MEP), distribution of thoracoabdominal volumes variation in optoelectronic plethysmography (pulmonary rib cage-VRCp, abdominal rib cage-VRCa, and abdomen-VAB), and quality of life. After training, WBV and WBV + resistance groups increased MIP and MEP (p training that could improve respiratory muscle strength and quality of life and promote different ventilatory strategies in chest wall and thoracoabdominal compartments in healthy elderly adults.

  14. Molecular point-of-care testing for respiratory viruses versus routine clinical care in adults with acute respiratory illness presenting to secondary care: a pragmatic randomised controlled trial protocol (ResPOC)

    OpenAIRE

    Brendish, Nathan; Malachira, Ahalya; Clark, Tristan

    2016-01-01

    Background: Respiratory viruses are associated with a huge socio-economic burden and are responsible for a large proportion of acute respiratory illness in hospitalised adults. Laboratory PCR is accurate but takes at least 24 hours to generate a result to clinicians and antigen-based point-of-care tests (POCT) lack sensitivity. Rapid molecular platforms, such as the FilmArray Respiratory Panel, have equivalent diagnostic accuracy to laboratory PCR and can generate a result in 1 hour making th...

  15. Living with Respiratory Failure

    Science.gov (United States)

    ... Research Home / Respiratory Failure Respiratory Failure What Is Respiratory (RES-pih-rah-tor- ... injure your lungs. Normal Lungs and Conditions Causing Respiratory Failure Figure A shows the location of the ...

  16. What Causes Respiratory Failure?

    Science.gov (United States)

    ... Research Home / Respiratory Failure Respiratory Failure What Is Respiratory (RES-pih-rah-tor- ... injure your lungs. Normal Lungs and Conditions Causing Respiratory Failure Figure A shows the location of the ...

  17. 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.

  18. Cardiopulmonary function of Young bronchitics (mostly mineworkers) before and after respiratory physiotherapy and physical training. Comparison with a control group

    Energy Technology Data Exchange (ETDEWEB)

    Marcq, M.; Minette, A.

    1981-01-01

    This article covers the effects of 4 weeks' treatment consisting of respiratory physiotherapy associated with physical training on cardiopulmonary function. It involved 12 patients (updated group) suffering from chronic bronchitis, still at an early stage in clinical terms. All patients showed signs of early broncho-destructive problems. This research was carried out with financial aid from the EEC (Agreement No. 7246-30-2-001). (32 refs.)

  19. High fatty acid oxidation capacity and phosphorylation control despite elevated leak and reduced respiratory capacity in northern elephant seal muscle mitochondria.

    Science.gov (United States)

    Chicco, Adam J; Le, Catherine H; Schlater, Amber; Nguyen, Alex; Kaye, Spencer; Beals, Joseph W; Scalzo, Rebecca L; Bell, Christopher; Gnaiger, Erich; Costa, Daniel P; Crocker, Daniel E; Kanatous, Shane B

    2014-08-15

    Northern elephant seals (Mirounga angustirostris) are extreme, hypoxia-adapted endotherms that rely largely on aerobic metabolism during extended breath-hold dives in near-freezing water temperatures. While many aspects of their physiology have been characterized to account for these remarkable feats, the contribution of adaptations in the aerobic powerhouses of muscle cells, the mitochondria, are unknown. In the present study, the ontogeny and comparative physiology of elephant seal muscle mitochondrial respiratory function was investigated under a variety of substrate conditions and respiratory states. Intact mitochondrial networks were studied by high-resolution respirometry in saponin-permeabilized fiber bundles obtained from primary swimming muscles of pup, juvenile and adult seals, and compared with fibers from adult human vastus lateralis. Results indicate that seal muscle maintains a high capacity for fatty acid oxidation despite a progressive decrease in total respiratory capacity as animals mature from pups to adults. This is explained by a progressive increase in phosphorylation control and fatty acid utilization over pyruvate in adult seals compared with humans and seal pups. Interestingly, despite higher indices of oxidative phosphorylation efficiency, juvenile and adult seals also exhibit a ~50% greater capacity for respiratory 'leak' compared with humans and seal pups. The ontogeny of this phenotype suggests it is an adaptation of muscle to the prolonged breath-hold exercise and highly variable ambient temperatures experienced by mature elephant seals. These studies highlight the remarkable plasticity of mammalian mitochondria to meet the demands for both efficient ATP production and endothermy in a cold, oxygen-limited environment. © 2014. Published by The Company of Biologists Ltd.

  20. Quality assurance program of a respiratory gating irradiation system based on external and internal fiducial markers; Programa de garantia de calidad de un sistema de irradiacion con control respiratorio basado en marcadores fiduciales externos e internos

    Energy Technology Data Exchange (ETDEWEB)

    Zucca Aparicio, D.; Perez Moreno, J. M.; Fernandez Leton, P.; Garcia Ruiz-Zorrilla, J.; Minambres Moro, A.

    2011-07-01

    Respiratory Gating involves the administration of radiation during treatment delivery within a particular portion of the patients breathing cycle, so the absorbed dose administration with respiratory control techniques requires specific quality control to ensure the correctness of the delivered dose. The establishment of a Quality Control Program (QC) is proposed for the Respiratory Gating based techniques in order to have a better understanding of how this system works and to know its associated dosimetric impact. The influence of the CT acquisition under respiratory motion conditions has been analyzed for the treatment isocenter localization, using internal and external fiducial markers with IGRT techniques that allow the correlation of the isocenter positioning with the phase of the respiratory cycle. Radiation delivery in the presence of intra fraction organ motion causes an averaging or blurring of the static dose distribution over the path of motion increasing the beam penumbra of the radiation field and reducing the therapeutic region when the irradiation is not breath controlled. The feasibility of intensity modulated treatments (IMRT) for both static and dynamic techniques, managed by respiratory control has been tested, demonstrating the possibility of synchronizing the movement of the leaves in the microfluorimeter collimator (mMLC) with the gated beam irradiation. (Author) 45 refs.

  1. The Use of Benzodiazepine Receptor Agonists and Risk of Respiratory Failure in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Population-Based Case-Control Study.

    Science.gov (United States)

    Chen, Su-Jung; Yeh, Chiu-Mei; Chao, Tze-Fan; Liu, Chia-Jen; Wang, Kang-Ling; Chen, Tzeng-Ji; Chou, Pesus; Wang, Fu-Der

    2015-07-01

    Insomnia is prevalent in patients with chronic obstructive pulmonary disease (COPD), and benzodiazepine receptor agonists (BZRAs) are the most commonly used drugs despite their adverse effects on respiratory function. The aim of this study was to investigate whether the use of BZRAs was associated with an increased risk of respiratory failure (RF) in COPD patients. Matched case-control study. National Health Insurance Research Database (NHIRD) in Taiwan. The case group consisted of 2,434 COPD patients with RF, and the control group consisted of 2,434 COPD patients without RF, matched for age, sex, and date of enrollment. Exposure to BZRAs during the 180-day period preceding the index date was analyzed and compared in the case and control groups. Conditional logistic regression was performed, and the use of BZRAs was associated with an increased risk of RF (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI] 1.14-2.13). In subgroup analysis, we found that the benzodiazepine (BZD) users had a higher risk of RF (aOR 1.58, 95% CI 1.14-2.20), whereas the risk in non-benzodiazepine (non-BZD) users was insignificant (aOR 0.85, 95% CI 0.51-1.44). A greater than 2-fold increase in risk was found in those who received two or more kinds of BZRAs and those using a combination of BZD and non-BZD medications. The use of benzodiazepine receptor agonists was a significant risk factor for respiratory failure in patients with chronic obstructive pulmonary disease (COPD). Compared to benzodiazepine, the prescription of non-benzodiazepine may be safer for the management of insomnia in COPD patients. © 2015 Associated Professional Sleep Societies, LLC.

  2. Effectiveness of prophylactic non-invasive ventilation on respiratory function in the postoperative phase of pediatric cardiac surgery: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Camilla R. S. Silva

    Full Text Available ABSTRACT Objective To evaluate the effectiveness of prophylactic, non-invasive ventilation (NIV on respiratory function in seven- to 16-year-old children in the post-operative phase of cardiac surgery. Method A randomized, controlled trial with 50 children who had undergone cardiac surgery with median sternotomy. After extubation, patients were randomly assigned to one of two groups: control group (n=26, which received instructions regarding posture, early ambulation, and cough stimulation, and CPAP group (continuous positive airway pressure; n=24, which received the same instructions as the control group and CPAP=10 cmH20 twice daily for 30 minutes from the 1st to the 5th post-operative day (POD. As a primary outcome, lung function was evaluated before and on the 1st, 3rd, and 5th PODs with measures of respiratory rate (RR, tidal volume (TV, slow vital capacity (SVC, inspiratory capacity (IC, minute volume (MV, peak expiratory flow (PEF, and maximal inspiratory pressure (MIP. As secondary outcomes, the time of hospitalization and intensive care were recorded. A mixed, linear regression model and z-test were used to analyze respiratory function, considering p<0.05. Results All variables, except RR and MV, showed a significant drop on the 1st POD, with gradual recovery; however, only MIP had returned to pre-operative values on the 5th POD in both groups. The RR showed a significant increase on the 1st POD, with a gradual reduction but without returning to baseline. In the intergroup analysis, significant improvement (p=0.04 was observed only in PEF in the CPAP group on the 1st DPO. The length of hospitalization and intensive care showed no significant differences. Conclusion NIV was safe and well accepted in this group of patients, and the protocol used was effective in improving PEF on the 1st DPO in the CPAP group.

  3. Managing voluntary turnover through challenging assignments

    NARCIS (Netherlands)

    Preenen, P.T.Y.; de Pater, I.E.; van Vianen, A.E.M.; Keijzer, L.

    2011-01-01

    This study examines employees’ challenging assignments as manageable means to reduce turnover intentions, job search behaviors, and voluntary turnover. Results indicate that challenging assignments are negatively related to turnover intentions and job search behaviors and that these relationships

  4. Managing voluntary turnover through challenging assignments

    NARCIS (Netherlands)

    Preenen, P.T.Y.; Pater, I.E. de; Vianen, A.E.M. van; Keijzer, L.

    2011-01-01

    This study examines employees' challenging assignments as manageable means to reduce turnover intentions, job search behaviors, and voluntary turnover. Results indicate that challenging assignments are negatively related to turnover intentions and job search behaviors and that these relationships

  5. Contemplated Suicide Among Voluntary and Involuntary Retirees

    Science.gov (United States)

    Peretti, Peter O.; Wilson, Cedric

    1978-01-01

    This study explored anomic and egoistic dimensions of contemplated suicide among voluntary and involuntary retired males. Results indicated a direct relationship between anomie and egoism on the one hand, and contemplation of suicide on the other. (Author)

  6. Pedagogical Aspects of Voluntary School Work

    Directory of Open Access Journals (Sweden)

    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.

  7. 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......This paper draws attention to the importance of the understanding of voluntary actions in the free market construct. Failing to understand the role of voluntary actions in the free market construct will often result in discussions of capitalism versus socialism focusing on asset ownership...... 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....

  8. Voluntary Community Organisations in Metropolitan Development

    DEFF Research Database (Denmark)

    Larsen, Jacob Norvig

    as well as the resilience of targeted urban neighbourhoods. The aim in the paper is to explore the different ways voluntary community organisations interact with public sector urban regeneration activities. The paper includes data from a survey and case studies of urban regeneration programmes in three......While short-term enrolling of citizens in urban regeneration projects often has proven quite successful, permanent embedding of projects in voluntary community-based settings seems to be much more difficult to obtain. This has implications for long term sustainability of urban regeneration projects...... Danish municipalities. In the paper is proposed a conceptual framework for understanding the logic and types of voluntary organisations and the nature of the collaboration between voluntary organisations and public sector counterparts within the domain of urban regeneration. The study showed...

  9. Effects of Aerobic Exercise Applied Early After Coronary Artery Bypass Grafting on Pulmonary Function, Respiratory Muscle Strength, and Functional Capacity: A Randomized Controlled Trial.

    Science.gov (United States)

    Borges, Daniel L; Silva, Mayara Gabrielle; Silva, Luan Nascimento; Fortes, João Vyctor; Costa, Erika Thalita; Assunção, Rebeca Pessoa; Lima, Carlos Magno; da Silva Nina, Vinícius José; Bernardo-Filho, Mário; Caputo, Danúbia Sá

    2016-09-01

    Physical activity is beneficial in several clinical situations and recommended for patients with ischemic heart disease, as well as for those undergoing cardiac surgery. In a randomized controlled trial, 34 patients underwent coronary artery bypass grafting. A randomized control group (n = 15) submitted to conventional physiotherapy. The intervention group (n = 19) received the same protocol plus additional aerobic exercise with cycle ergometer. Pulmonary function by spirometry, respiratory muscle strength by manovacuometry, and functional capacity through 6-minute walking test was assessed before surgery and at hospital discharge. There was significant reduction in pulmonary function in both groups. In both groups, inspiratory muscle strength was maintained while expiratory muscle strength significantly decreased. Functional capacity was maintained in the intervention group (364.5 [324.5 to 428] vs. 348 [300.7 to 413.7] meters, P = .06), but it decreased significantly in control group patients (320 [288.5 to 393.0] vs. 292 [237.0 to 336.0] meters, P = .01). A significant difference in functional capacity was also found in intergroup analyses at hospital discharge (P = .03). Aerobic exercise applied early on coronary artery bypass grafting patients may promote maintenance of functional capacity, with no impact on pulmonary function and respiratory muscle strength when compared with conventional physiotherapy.

  10. 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 hyperventilation during prolonged exercise, and this suppression mitigates changes in PaCO2 and CBF. Copyright © 2015 the American Physiological Society.

  11. Effect of daily vitamin E and multivitamin-mineral supplementation on acute respiratory tract infections in elderly persons: a randomized controlled trial.

    Science.gov (United States)

    Graat, Judith M; Schouten, Evert G; Kok, Frans J

    2002-08-14

    Immune response in elderly individuals has been reported to improve after micronutrient supplementation. However, efficacy trials evaluating infectious diseases as outcomes are scarce and inconclusive. To investigate the effect of daily multivitamin-mineral and vitamin E supplementation on incidence and severity of acute respiratory tract infections in elderly individuals. A randomized, double blind, placebo-controlled, 2 x 2 factorial trial. A total of 652 noninstitutionalized individuals aged 60 years or older enrolled from 2 community-based sampling strategies in the Wageningen area of the Netherlands, conducted from 1998 to 2000. At baseline, 6% of participants had suboptimal ascorbic acid and 1.3% had suboptimal alpha-tocopherol plasma concentration. Physiological doses of multivitamin-minerals, 200 mg of vitamin E, both, or placebo. Incidence and severity of self-reported acute respiratory tract infections at 15 months, as assessed by a nurse (telephone contact), home visits, and microbiological and serological testing in subsets of patients. During a median observation period of 441 days, 443 (68%) of 652 participants recorded 1024 respiratory tract infection episodes. The incidence rate ratio of acute respiratory tract infection for multivitamin-mineral supplementation was 0.95 (95% confidence interval, 0.75-1.15; P =.58) and for vitamin E supplementation, 1.12 (95% confidence interval, 0.88-1.25; P =.21). Severity of infections was not influenced by multivitamin-mineral supplementation. For vitamin E vs no vitamin E, severity was worse: median (interquartile range) for illness-duration was 19 (9-37) vs 14 (6-29) days, P =.02; number of symptoms, 6 (3-8) vs 4 (3-8), P =.03; presence of fever, 36.7% vs 25.2%, P =.009; and restriction of activity, 52.3% vs 41.1%, P =.02. Neither daily multivitamin-mineral supplementation at physiological dose nor 200 mg of vitamin E showed a favorable effect on incidence and severity of acute respiratory tract infections in

  12. Initial treatment of respiratory distress syndrome with nasal intermittent mandatory ventilation versus nasal continuous positive airway pressure: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Amir-Mohammad Armanian

    2014-01-01

    Full Text Available Background: Neonatal respiratory distress syndrome (RDS in premature infants who survived and its complications are a common problem. Due to high morbidity and mechanical ventilation (MV nowadays researchers in interested minimizing MV. To determine, in very low birth weight (BW preterm neonates with RDS, if initial treatment with nasal intermittent mandatory ventilation (early NIMV compared with early nasal continuous positive airway pressure (early NCPAP obtains more favorable outcomes in terms of the duration of treatment, and the need for endotracheal tube ventilation. Methods: In this single-center randomized control trial study, infants (BW ≤ 1500 g and/or gestational age ≤ 34 weeks with respiratory distress were considered eligible. Forty-four infants were randomly assigned to receive early-NIMV and 54 comparable infants to early-NCPAP. Surfactants were given, when FIO 2 requirement was of >30%. Primary outcomes were failure of noninvasive respiratory support, that is, the need for MV in the first 48 h of life and for the duration of noninvasive respiratory support in each group. Results: 98 infants were enrolled (44 in the NIMV and 54 in the NCPAP group. The Preventive power of MV of NIMV usage (95.5% was not lower than the NCPAP (98.1% strength (hazard ratio: 0.21 (95% confidence interval: 0.02-2.66; P: 0.23. The duration of noninvasive respiratory support in the NIMV group was significantly shorter than NCPAP (the median (range was 24 (18.00-48.00 h versus 48.00 (22.00-120.00 h in NIMV versus NCPAP groups; P < 0.001. Similarly, the duration of dependency on oxygen was less, for NIMV (the median (range was 96.00 (41.00-504.00 h versus144.00 (70.00-1130.00 h in NIMV versus NCPAP groups; P: 0.009. Interestingly, time to full enteral feeds and length of hospital stay were more favorable in the NIMV versus the NCPAP group. Conclusions: Initial treatment of RDS with NIMV was safe, and well tolerated. Furthermore, NIMV had excellent

  13. Respiratory effort from the photoplethysmogram.

    Science.gov (United States)

    Addison, Paul S

    2017-03-01

    The potential for a simple, non-invasive measure of respiratory effort based on the pulse oximeter signal - the photoplethysmogram or 'pleth' - was investigated in a pilot study. Several parameters were developed based on a variety of manifestations of respiratory effort in the signal, including modulation changes in amplitude, baseline, frequency and pulse transit times, as well as distinct baseline signal shifts. Thirteen candidate parameters were investigated using data from healthy volunteers. Each volunteer underwent a series of controlled respiratory effort maneuvers at various set flow resistances and respiratory rates. Six oximeter probes were tested at various body sites. In all, over three thousand pleth-based effort-airway pressure (EP) curves were generated across the various airway constrictions, respiratory efforts, respiratory rates, subjects, probe sites, and the candidate parameters considered. Regression analysis was performed to determine the existence of positive monotonic relationships between the respiratory effort parameters and resulting airway pressures. Six of the candidate parameters investigated exhibited a distinct positive relationship (p<0.001 across all probes tested) with increasing upper airway pressure repeatable across the range of respiratory rates and flow constrictions studied. These were: the three fundamental modulations in amplitude (AM-Effort), baseline (BM-Effort) and respiratory sinus arrhythmia (RSA-Effort); two pulse transit time modulations - one using a pulse oximeter probe and an ECG (P2E-Effort) and the other using two pulse oximeter probes placed at different peripheral body sites (P2-Effort); and baseline shifts in heart rate, (BL-HR-Effort). In conclusion, a clear monotonic relationship was found between several pleth-based parameters and imposed respiratory loadings at the mouth across a range of respiratory rates and flow constrictions. The results suggest that the pleth may provide a measure of changing upper

  14. VOLUNTARY NOISE MAPPING FOR SMART CITY

    Directory of Open Access Journals (Sweden)

    V. Poslončec-Petrić

    2016-09-01

    Full Text Available One of the main concept objectives of smart cities is to create a quality living environment that is long-term sustainable and economically justified. In that context, modern cities are aware of the exposure to various forms of physical and non-physical pollution that needs to be remediated, eliminated or reduced. To achieve that it is necessary to quality determine the sources and reasons of each pollution. The most prominent examples of physical pollution that affects the quality of life of citizens in cities are light and noise pollution. Noise pollution or noise, is mostly the consequence of road and rail traffic in cities and it directly affects the health of citizens. Traffic control, reduction of peak congestion, dispersion and traffic redirection or building protective barriers, are ways that cities use to reduce the amount of noise or its effects. To make these measures efficient it is necessary to obtain the information related to the level of noise in certain areas, streets, cities. To achieve this, smart cities use noise mapping. The city of Zagreb since 2012, participates in the i-SCOPE project (interoperable Smart City services trough Open Platform for urban Ecosystems. i-SCOPE delivers an open platform on top of which it develops, three "smart city" services: optimization of energy consumption through a service for accurate assessment of solar energy potential and energy loss at building level, environmental monitoring through a real-time environmental noise mapping service leveraging citizen's involvement will who act as distributed sensors city-wide measuring noise levels through an application on their mobile phones and improved inclusion and personal mobility of aging and diversely able citizens through an accurate personal routing service. The students of Faculty of Geodesy University of Zagreb, who enrolled in the course Thematic Cartography, were actively involved in the voluntary data acquisition in order to monitor the

  15. Voluntary Noise Mapping for Smart City

    Science.gov (United States)

    Poslončec-Petrić, V.; Vuković, V.; Frangeš, S.; Bačić, Ž.

    2016-09-01

    One of the main concept objectives of smart cities is to create a quality living environment that is long-term sustainable and economically justified. In that context, modern cities are aware of the exposure to various forms of physical and non-physical pollution that needs to be remediated, eliminated or reduced. To achieve that it is necessary to quality determine the sources and reasons of each pollution. The most prominent examples of physical pollution that affects the quality of life of citizens in cities are light and noise pollution. Noise pollution or noise, is mostly the consequence of road and rail traffic in cities and it directly affects the health of citizens. Traffic control, reduction of peak congestion, dispersion and traffic redirection or building protective barriers, are ways that cities use to reduce the amount of noise or its effects. To make these measures efficient it is necessary to obtain the information related to the level of noise in certain areas, streets, cities. To achieve this, smart cities use noise mapping. The city of Zagreb since 2012, participates in the i-SCOPE project (interoperable Smart City services trough Open Platform for urban Ecosystems). i-SCOPE delivers an open platform on top of which it develops, three "smart city" services: optimization of energy consumption through a service for accurate assessment of solar energy potential and energy loss at building level, environmental monitoring through a real-time environmental noise mapping service leveraging citizen's involvement will who act as distributed sensors city-wide measuring noise levels through an application on their mobile phones and improved inclusion and personal mobility of aging and diversely able citizens through an accurate personal routing service. The students of Faculty of Geodesy University of Zagreb, who enrolled in the course Thematic Cartography, were actively involved in the voluntary data acquisition in order to monitor the noise in real time

  16. A case-control study of malignant and non-malignant respiratory disease among employees of a fiberglass manufacturing facility. II. Exposure assessment.

    Science.gov (United States)

    Chiazze, L; Watkins, D K; Fryar, C; Kozono, J

    1993-08-01

    A case-control study of malignant and non-malignant respiratory disease among employees of the Owens-Corning Fiberglas Corporation's Newark, Ohio plant was undertaken. The aim was to determine the extent to which exposures to substances in the Newark plant environment, to non-workplace factors, or to a combination may play a part in the risk of mortality from respiratory disease among workers in this plant. A historical environmental reconstruction of the plant was undertaken to characterise the exposure profile for workers in this plant from its beginnings in 1934 to the end of 1987. The exposure profile provided estimates of cumulative exposure to respirable fibres, fine fibres, asbestos, talc, formaldehyde, silica, and asphalt fumes. Employment histories from Owens-Corning Fiberglas provided information on employment characteristics (duration of employment, year of hire, age at first hire) and an interview survey obtained information on demographic characteristics (birthdate, race, education, marital state, parent's ethnic background, and place of birth), lifetime residence, occupational and smoking histories, hobbies, and personal and family medical history. Matched, unadjusted odds ratios (ORs) were used to assess the association between lung cancer or non-malignant respiratory disease and the cumulative exposure history, demographic characteristics, and employment variables. Only the smoking variables and employment characteristics (year of hire and age at first hire) were statistically significant for lung cancer. For non-malignant respiratory disease, only the smoking variables were statistically significant in the univariate analysis. Of the variables entered into a conditional logistic regression model for lung cancer, only smoking (smoked for six months or more v never smoked: OR = 26.17, 95% confidence interval (95% CI) 3.316-206.5) and age at first hire (35 and over v less than 35: OR = 0.244, 95% CI 0.083-0.717) were statistically significant. There

  17. Maternal voluntary physical activity attenuates delayed neurodevelopment in malnourished rats.

    Science.gov (United States)

    Fragoso, Jéssica; Lira, Allan de Oliveira; Chagas, Guilherme Souza; Lucena Cavalcanti, Carolina Cadete; Beserra, Renata; de Santana-Muniz, Gisélia; Bento-Santos, Adriano; Martins, Gerffeson; Pirola, Luciano; da Silva Aragão, Raquel; Leandro, Carol Góis

    2017-11-01

    What is the central question of this study? In the present study, a reproducible model of maternal voluntary physical activity was developed to evaluate the adaptive response of physical activity by attenuating the effects of maternal undernutrition on physical features, reflex ontogeny and growth trajectory of offspring during development. What is the main finding and its importance? Maternal physical activity may induce neuronal maturation of sensorimotor connections impacting on the patterns of locomotor activity in malnourished offspring. Thus, physical activity should be considered as a therapeutic means of countering the effects of maternal undernutrition, by providing a useful strategy for enhancing the neuronal activity of children born to mothers who experience a restricted diet during pregnancy. This study evaluated the effects of maternal voluntary physical activity during pregnancy and lactation on somatic growth (SG), reflex ontogeny (RO) and locomotor activity (LA) of rats whose mothers were protein restricted. Virgin female Wistar rats were divided into the following six groups: control, normal protein (C-NP, n = 4); control, low protein (C-LP, n = 4); inactive, normal protein (I-NP, n = 8); inactive, low protein (I-LP, n = 7); very active, normal protein (VA-NP, n = 8); and very active, low protein (VA-LP, n = 6). Voluntary physical activity was recorded daily in dams. The LP groups were fed an 8% casein diet, whereas control groups were fed a 17% casein diet during pregnancy and lactation. Offspring were evaluated in terms of SG (body weight and length, latero-lateral skull axis and anteroposterior head axis) and RO (palmar grasp, righting, free-fall righting, negative geotaxis, cliff avoidance, auditory startle response and vibrissa placing). The LA was evaluated at 23, 45 and 60 days old in the open field. Voluntary physical activity was reduced during pregnancy and lactation independent of the maternal diet. Pups from LP dams showed

  18. Rewiring AMPK and Mitochondrial Retrograde Signaling for Metabolic Control of Aging and Histone Acetylation in Respiratory-Defective Cells

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    R. Magnus N. Friis

    2014-04-01

    Full Text Available Abnormal respiratory metabolism plays a role in numerous human disorders. We find that regulation of overall histone acetylation is perturbed in respiratory-incompetent (ρ0 yeast. Because histone acetylation is highly sensitive to acetyl-coenzyme A (acetyl-CoA availability, we sought interventions that suppress this ρ0 phenotype through reprogramming metabolism. Nutritional intervention studies led to the discovery that genetic coactivation of the mitochondrion-to-nucleus retrograde (RTG response and the AMPK (Snf1 pathway prevents abnormal histone deacetylation in ρ0 cells. Metabolic profiling of signaling mutants uncovered links between chromatin-dependent phenotypes of ρ0 cells and metabolism of ATP, acetyl-CoA, glutathione, branched-chain amino acids, and the storage carbohydrate trehalose. Importantly, RTG/AMPK activation reprograms energy metabolism to increase the supply of acetyl-CoA to lysine acetyltransferases and extend the chronological lifespan of ρ0 cells. Our results strengthen the framework for rational design of nutrient supplementation schemes and drug-discovery initiatives aimed at mimicking the therapeutic benefits of dietary interventions.

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

    Science.gov (United States)

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

    1997-01-01

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

  20. Neural correlates (ERP/fMRI) of voluntary selection in adult ADHD patients.

    Science.gov (United States)

    Karch, Susanne; Thalmeier, Tobias; Lutz, Jürgen; Cerovecki, Anja; Opgen-Rhein, Markus; Hock, Bettina; Leicht, Gregor; Hennig-Fast, Kristina; Meindl, Thomas; Riedel, Michael; Mulert, Christoph; Pogarell, Oliver

    2010-08-01

    Deficits in executive functions, e.g. voluntary selection, are considered central to the attention-deficit/hyperactivity disorder (ADHD). The aim of this simultaneous EEG/fMRI study was to examine associated neural correlates in ADHD patients. Patients with ADHD and healthy subjects performed an adapted go/nogo task including a voluntary selection condition allowing participants to freely decide, whether to press the response button. Electrophysiologically, response inhibition and voluntary selection led to fronto-central responses. The fMRI data revealed increased medial/lateral frontal and parietal activity during the voluntary selection task. Frontal brain responses were reduced in ADHD patients compared to controls during free responses, whereas parietal brain functions seemed to be unaffected. These results may indicate that selection processes are related to dysfunctions, predominantly in frontal brain regions in ADHD patients.

  1. Effects of electromyostimulation versus voluntary isometric training on elbow flexor muscle strength.

    Science.gov (United States)

    Colson, Serge S; Martin, Alain; Van Hoecke, Jacques

    2009-10-01

    The purpose of this study was to determine whether 7 weeks of standardized (same number and duration of repetitions, sets and rest strictly identical) electromyostimulation training of the elbow flexor muscles would induce strength gains equivalent to those of voluntary isometric training in isometric, eccentric and concentric contractions. Twenty-five males were randomly assigned to an electromyostimulated group (EMS, n=9), a voluntary isometric group (VOL, n=8), or a control group (CON, n=8). Maximal voluntary isometric, eccentric and concentric strength, electromyographic (EMG) activity of the biceps and triceps brachii muscles, elbow flexor muscle activation (twitch interpolation technique) and contractile properties were assessed before and after the training period. The main findings were that the isometric torque gains of EMS were greater than those of VOL after the training period (Pelectromyostimulation training would be more efficient than voluntary isometric training to improve both isometric and dynamic strength.

  2. Effect of bovine lactoferrin from iron-fortified formulas on diarrhea and respiratory tract infections of weaned infants in a randomized controlled trial.

    Science.gov (United States)

    Chen, Ke; Chai, Lingying; Li, Hua; Zhang, Ying; Xie, Hu-Mina; Shang, Jia; Tian, Weizheng; Yang, Ping; Jiang, Alice C

    2016-02-01

    The aim of this study was to evaluate the effect of supplementation with bovine lactoferrin (bLf) from iron-fortified formulas on diarrhea and respiratory tract infections (RTIs) in weaned infants. In this prospective, multicenter, controlled intervention study, 260 infants ages 4 to 6 mo who previously were exclusively breastfed but weaned were randomized into two groups: a lactoferrin-fortified formula milk group (fortified group, FG, containing lactoferrin 38 mg/100 g milk) and a no lactoferrin-fortified milk (control group, CG); breastfed infants were enrolled and served as a reference group (breastfed group, BG). The intervention duration was 3 mo. The morbidity of diarrhea and RTIs were collected during supplementation. The results of the study demonstrated evidence of a lower incidence rate of respiratory-related illnesses and fewer symptoms of running nose, cough, and wheezing for infants in the FG and BG groups compared with those in the CG (P < 0.05). Despite the undistinguished incidence rate of vomiting, nausea, and colic, the occurrences of diarrhea-related illnesses were significantly lower for children in the FG and BG than for those in CG (P < 0.05). The beneficial effects on infectious morbidity over 3 mo highlighted the potential of bLF supplementation for previously weaned infants; these findings may be applicable to other infants living in similar socioeconomic districts. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Preliminary study: voluntary food intake in dogs during tryptophan supplementation.

    Science.gov (United States)

    Fragua, Víctor; González-Ortiz, Gemma; Villaverde, Cecilia; Hervera, Marta; Mariotti, Valentina Maria; Manteca, Xavier; Baucells, María Dolores

    2011-10-01

    Tryptophan, a precursor of important molecules such as serotonin, melatonin and niacin, is an essential amino acid for dogs. In pigs, tryptophan supplementation has been shown to induce a significant increase in food intake. The aim of the present study was to assess whether long-term tryptophan supplementation increases voluntary food intake in dogs and to observe whether this was accompanied by a change in serum ghrelin. In the present study, sixteen adult Beagle dogs were used, with four male and four female dogs fed diets supplemented with tryptophan (1 g/dog per d) during 81 d (Trp) and four male and four female dogs that were not supplemented (control). A voluntary food intake test was performed during 5 d following the supplementation period. The Trp group tended to show a higher food intake during the voluntary food intake test (58.0 (SE 5.37) v. 77.5 (SE 3.65) g/kg metabolic weight per d; P = 0.074). No significant differences were found for serum ghrelin concentrations.

  4. Social contact networks and disease eradicability under voluntary vaccination.

    Directory of Open Access Journals (Sweden)

    Ana Perisic

    2009-02-01

    eradicability in populations where voluntary vaccination is the primary control mechanism may depend partly on whether the disease is transmissible only to a few close social contacts or to a larger subset of the population.

  5. Social contact networks and disease eradicability under voluntary vaccination.

    Science.gov (United States)

    Perisic, Ana; Bauch, Chris T

    2009-02-01

    populations where voluntary vaccination is the primary control mechanism may depend partly on whether the disease is transmissible only to a few close social contacts or to a larger subset of the population.

  6. Sleep study, respiratory mechanics, chemosensitive response and quality of life in morbidly obese patients undergoing bariatric surgery: a prospective, randomized, controlled trial

    Directory of Open Access Journals (Sweden)

    Leitao Filho Fernando SS

    2011-10-01

    Full Text Available Abstract Background Obesity is a major public health problem in both developed and developing countries alike and leads to a series of changes in respiratory physiology. There is a strong correlation between obesity and cardiopulmonary sleep disorders. Weight loss among such patients leads to a reduction in these alterations in respiratory physiology, but clinical treatment is not effective for a long period of time. Thus, bariatric surgery is a viable option. Methods/Design The present study involves patients with morbid obesity (BMI of 40 kg/m2 or 35 kg/m2 to 39.9 kg/m2 with comorbidities, candidates for bariatric surgery, screened at the Santa Casa de Misericórdia Hospital in the city of Sao Paulo (Brazil. The inclusion criteria are grade III morbid obesity, an indication for bariatric surgery, agreement to participate in the study and a signed term of informed consent. The exclusion criteria are BMI above 55 kg/m2, clinically significant or unstable mental health concerns, an unrealistic postoperative target weight and/or unrealistic expectations of surgical treatment. Bariatric surgery candidates who meet the inclusion criteria will be referred to Santa Casa de Misericórdia Hospital and will be reviewed again 30, 90 and 360 days following surgery. Data collection will involve patient records, personal data collection, objective assessment of HR, BP, neck circumference, chest and abdomen, collection and analysis of clinical preoperative findings, polysomnography, pulmonary function test and a questionnaire on sleepiness. Discussion This paper describes a randomised controlled trial of morbidly obese patients. Polysomnography, respiratory mechanics, chemosensitive response and quality of life will be assessed in patients undergoing or not undergoing bariatric surgery. Trial Registration The protocol for this study is registered with the Brazilian Registry of Clinical Trials - ReBEC (RBR-9k9hhv.

  7. Assessing Dutch farmers' incentives to join a voluntary Johne's Disease programme

    NARCIS (Netherlands)

    Hop, G.E.; Velthuis, A.G.J.; Frankena, K.

    2011-01-01

    The incentives of Dutch dairy farmers to participate in a voluntary Johne's Disease (JD) control programme were investigated using a case–control design. Furthermore, farm and farmers’ characteristics of case and control farmers were compared. Dairy farmers in the northern part of the Netherlands

  8. Differential Effects of Endotracheal Suctioning on Gas Exchanges in Patients with Acute Respiratory Failure under Pressure-Controlled and Volume-Controlled Ventilation

    Directory of Open Access Journals (Sweden)

    Xiao-Wei Liu

    2015-01-01

    Full Text Available This study was conducted to evaluate the effects of open endotracheal suctioning on gas exchange and respiratory mechanics in ARF patients under the modes of PCV or VCV. Ninety-six ARF patients were treated with open endotracheal suctioning and their variations in respiratory mechanics and gas exchange after the suctions were compared. Under PCV mode, compared with the initial level of tidal volume (VT, ARF patients showed 30.0% and 27.8% decrease at 1 min and 10 min, respectively. Furthermore, the initial respiratory system compliance (Crs decreased by 29.6% and 28.5% at 1 min and 10 min, respectively. Under VCV mode, compared with the initial level, 38.6% and 37.5% increase in peak airway pressure (PAP were found at 1 min and 10 min, respectively. Under PCV mode, the initial PaO2 increased by 6.4% and 10.2 % at 3 min and 10 min, respectively, while 18.9% and 30.6% increase of the initial PaO2 were observed under VCV mode. Summarily, endotracheal suctioning may impair gas exchange and decrease lung compliance in ARF patients receiving mechanical ventilation under both PCV and VCV modes, but endotracheal suctioning effects on gas exchange were more severe and longer-lasting under PCV mode than VCV.

  9. Amoxicillin for acute lower-respiratory-tract infection in primary care when pneumonia is not suspected: a 12-country, randomised, placebo-controlled trial.

    Science.gov (United States)

    Little, Paul; Stuart, Beth; Moore, Michael; Coenen, Samuel; Butler, Christopher C; Godycki-Cwirko, Maciek; Mierzecki, Artur; Chlabicz, Slawomir; Torres, Antoni; Almirall, Jordi; Davies, Mel; Schaberg, Tom; Mölstad, Sigvard; Blasi, Francesco; De Sutter, An; Kersnik, Janko; Hupkova, Helena; Touboul, Pia; Hood, Kerenza; Mullee, Mark; O'Reilly, Gilly; Brugman, Curt; Goossens, Herman; Verheij, Theo

    2013-02-01

    Lower-respiratory-tract infection is one of the most common acute illnesses managed in primary care. Few placebo-controlled studies of antibiotics have been done, and overall effectiveness (particularly in subgroups such as older people) is debated. We aimed to compare the benefits and harms of amoxicillin for acute lower-respiratory-tract infection with those of placebo both overall and in patients aged 60 years or older. Patients older than 18 years with acute lower-respiratory-tract infections (cough of ≤28 days' duration) in whom pneumonia was not suspected were randomly assigned (1:1) to either amoxicillin (1 g three times daily for 7 days) or placebo by computer-generated random numbers. Our primary outcome was duration of symptoms rated "moderately bad" or worse. Secondary outcomes were symptom severity in days 2-4 and new or worsening symptoms. Investigators and patients were masked to treatment allocation. This trial is registered with EudraCT (2007-001586-15), UKCRN Portfolio (ID 4175), ISRCTN (52261229), and FWO (G.0274.08N). 1038 patients were assigned to the amoxicillin group and 1023 to the placebo group. Neither duration of symptoms rated "moderately bad" or worse (hazard ratio 1.06, 95% CI 0.96-1.18; p=0.229) nor mean symptom severity (1.69 with placebo vs 1.62 with amoxicillin; difference -0.07 [95% CI -0.15 to 0.007]; p=0.074) differed significantly between groups. New or worsening symptoms were significantly less common in the amoxicillin group than in the placebo group (162 [15.9%] of 1021 patients vs 194 [19.3%] of 1006; p=0.043; number needed to treat 30). Cases of nausea, rash, or diarrhoea were significantly more common in the amoxicillin group than in the placebo group (number needed to harm 21, 95% CI 11-174; p=0.025), and one case of anaphylaxis was noted with amoxicillin. Two patients in the placebo group and one in the amoxicillin group needed to be admitted to hospital; no study-related deaths were noted. We noted no evidence of

  10. Safety and efficacy of diaphragm pacing in patients with respiratory insufficiency due to amyotrophic lateral sclerosis (DiPALS): a multicentre, open-label, randomised controlled trial.

    Science.gov (United States)

    McDermott, Christopher J; Bradburn, Mike J; Maguire, Chin; Cooper, Cindy L; Baird, Wendy O; Baxter, Susan K; Bourke, Stephen C; Imam, Ibrahim; Bentley, Andrew; Ealing, John; Elliott, Mark; Hanemann, C Oliver; Hughes, Philip; Orrell, Richard W; Shaw, Pamela J; Talbot, Kevin; Williams, Tim; Ackroyd, Roger; Berrisford, Richard; Galloway, Simon; Karat, Dayalan; Maynard, Nick; Sarela, Abeezar; Simonds, Anita K; Taylor, Lyn; Leek, Roger; Darlison, Roy; Leigh, Nigel; Dewey, Michael; Radunovic, Aleksandar

    2015-09-01

    Non-invasive ventilation is part of the standard of care for treatment of respiratory failure in patients with amyotrophic lateral sclerosis (ALS). The NeuRx RA/4 Diaphragm Pacing System has received Humanitarian Device Exemption approval from the US Food and Drug Administration for treatment of respiratory failure in patients with ALS. We aimed to establish the safety and efficacy of diaphragm pacing with this system in patients with respiratory muscle weakness due to ALS. We undertook a multicentre, open-label, randomised controlled trial at seven specialist ALS and respiratory centres in the UK. Eligible participants were aged 18 years or older with laboratory supported probable, clinically probable, or clinically definite ALS; stable riluzole treatment for at least 30 days; and respiratory insufficiency. We randomly assigned participants (1:1), via a centralised web-based randomisation system with minimisation that balanced patients for age, sex, forced vital capacity, and bulbar function, to receive either non-invasive ventilation plus pacing with the NeuRx RA/4 Diaphragm Pacing System or non-invasive ventilation alone. Patients, carers, and outcome assessors were not masked to treatment allocation. The primary outcome was overall survival, defined as the time from randomisation to death from any cause. Analysis was by intention to treat. This trial is registered, ISRCTN number 53817913. Between Dec 5, 2011, and Dec 18, 2013, we randomly assigned 74 participants to receive either non-invasive ventilation alone (n=37) or non-invasive ventilation plus diaphragm pacing (n=37). On Dec 18, 2013, the Data Monitoring and Ethics Committee (DMEC) recommended suspension of recruitment on the basis of overall survival figures. Randomly assigned participants continued as per the study protocol until June 23, 2014, when the DMEC advised discontinuation of pacing in all patients. Follow-up assessments continued until the planned end of the study in December, 2014. Survival

  11. 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.

  12. SEA Screening of voluntary Climate Change Plans

    DEFF Research Database (Denmark)

    Kørnøv, Lone; Wejs, Anja

    2013-01-01

    that discretionary judgement takes place and will impact on the screening decision. This article examines the results of discretion involved in screening of climate change plans (CCPs) in a Danish context. These years voluntary CCPs are developed as a response to the global and local emergence of both mitigation...... and adap- tation, and the voluntary commitment by the local authorities is an indication of an emerging norm of climate change as an important issue. This article takes its point of departure in the observation that SEA is not undertaken for these voluntary CCPs. The critical analysis of this phenomenon...... rests upon a docu- mentary study of Danish CCPs, interviews with a lawyer and ministerial key person and informal discussions between researchers, practitioners and lawyers on whether climate change plans are covered by SEA legislation and underlying reasons for the present practice. Based on a critical...

  13. Cross-education of muscle strength is greater with stimulated than voluntary contractions.

    Science.gov (United States)

    Hortobágyi, T; Scott, K; Lambert, J; Hamilton, G; Tracy, J

    1999-04-01

    Cross-education enhances the performance of muscles not directly involved in the chronic conditioning of the muscles in a remote limb. Substantial cross-education occurs after training with eccentric contractions or with contractions evoked by electromyostimulation (EMS). Since during EMS and eccentric contractions, skin and muscle afferents are activated that have excitatory effects on contralateral homologous muscles, it was hypothesized that exercise training with stimulated vs. voluntary eccentric contractions would lead to greater cross-education. Thirty-two women were randomly assigned to a voluntary (Vol), an EMS, or remote EMS (rEMS) exercise group and performed 840 voluntary or stimulated eccentric contractions over 6 weeks. All subjects, including nonexercising controls (Con), were tested pre- and posttraining for maximal voluntary and stimulated isometric and eccentric quadriceps strength. Ipsilateral voluntary and stimulated forces increased in all groups. Changes in EMG activity paralleled those in voluntary force in each limb. No changes occurred in grip strength. The great contra- and ipsilateral strength gains after EMS training were most likely related to an additive effect of EMS and muscle lengthening.

  14. Lungs and Respiratory System

    Science.gov (United States)

    ... Transplant Vision Facts and Myths Lungs and Respiratory System KidsHealth > For Parents > Lungs and Respiratory System Print ... have taken at least 600 million breaths. Respiratory System Basics All of this breathing couldn't happen ...

  15. Neonatal respiratory distress syndrome

    Science.gov (United States)

    Hyaline membrane disease (HMD); Infant respiratory distress syndrome; Respiratory distress syndrome in infants; RDS - infants ... after that. Some infants with severe respiratory distress syndrome will die. This most often occurs between days ...

  16. 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.

  17. Effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation: a randomized controlled trial.

    Science.gov (United States)

    Zeren, Melih; Demir, Rengin; Yigit, Zerrin; Gurses, Hulya N

    2016-12-01

    To investigate the effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation. Prospective randomized controlled single-blind study. Cardiology department of a university hospital. A total of 38 patients with permanent atrial fibrillation were randomly allocated to either a treatment group (n = 19; age 66.2 years (8.8)) or a control group (n = 19; age 67.1 years (6.4)). The training group received inspiratory muscle training at 30% of maximal inspiratory pressure for 15 minutes twice a day, 7 days a week, for 12 weeks alongside the standard medical treatment. The control group received standard medical treatment only. Spirometry, maximal inspiratory and expiratory pressures and 6-minute walking distance was measured at the beginning and end of the study. There was a significant increase in maximal inspiratory pressure (27.94 cmH2O (8.90)), maximal expiratory pressure (24.53 cmH2O (10.34)), forced vital capacity (10.29% (8.18) predicted), forced expiratory volume in one second (13.88% (13.42) predicted), forced expiratory flow 25%-75% (14.82% (12.44) predicted), peak expiratory flow (19.82% (15.62) predicted) and 6-minute walking distance (55.53 m (14.13)) in the training group (p  0.05). Inspiratory muscle training can improve pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation. © The Author(s) 2016.

  18. Impairment of voluntary saccades and facilitation of reflexive saccades do not co-occur in Parkinson's disease.

    Science.gov (United States)

    van Stockum, Saskia; MacAskill, Michael R; Anderson, Tim J

    2012-08-01

    Reflexive saccades (fast eye movements) and voluntary saccades activate overlapping parts of the oculomotor system. It is assumed that striatal dopamine depletion in Parkinson's disease (PD) only affects the voluntary saccadic system and that the often-reported facilitation of the reflexive saccadic system in PD is secondary to impairment of the voluntary saccadic system. If this assumption is correct, facilitation of reflexive saccades should co-occur with impaired performance of voluntary saccades in patients with PD. We measured reflexive and voluntary saccades in a group of patients with PD (both "on" and "off" medication) and a matching group of control subjects. Interestingly, performance measures showed strong positive correlations across reflexive and voluntary saccades in the PD group. Our results suggest that facilitation of reflexive saccades does not co-occur with impairment of voluntary saccades and that PD may affect the parts of the oculomotor system which are common to reflexive and voluntary saccade generation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. From Voluntary Collective Action to Organized Collaboration?

    DEFF Research Database (Denmark)

    Hattke, Fabian; Blaschke, Steffen; Frost, Jetta

    2016-01-01

    Our study examines the relationship between voluntary collective action, organized collaboration, and the provision of public goods in pluralistic organizations. Using German higher education as a context, we investigate whether specialized central support structures contribute to performance...... institutional environments. It also informs higher education research and policy on the effectiveness of new organizational designs based on centralized and specialized support structures at universities....... in three fields of action: the training of young scientists, internationalization, and gender diversity. The findings indicate that organized collaboration may lead to improved performance in the training of young scientists and gender diversity. Conversely, voluntary collective action enhances...

  20. Normative and microeconomic models of voluntary childlessness.

    Science.gov (United States)

    Dietz, T

    1984-01-01

    This paper employs microeconomic and normative variables rather than the more commonly used social psychological modesl to examine voluntary childlessness. The author uses religion, race, ruban versus sural residence, education, and region of residence as normative determinants of fertility; he hypothesizes that fewer Catholics will be childless and that urban dwellers, the well-educated, and those from the West, Midwest, and Northeast will be most likely to remain childless. Microeconomic theory, emphasizing the costs of children, assumes that income and fertility are directly related and that income and childlessness are inversely related. Because loss of wife's income is a greater factor than the direct costs of a child, childlessness should be more common when the wife's earning potential, or opportunity costs, is highest. In the microeconomic model, education is the most important determinant in the wife's opportunity costs. The findings indicate that husband's income is directly related to the first birth, and that wife's education (and opportunity costs) reduces the chances of a first birth. Microeconomic theory suggests that differences in child costs or in tastes could produce urban-rural, regional, or racial differences in childlessness. Demographic variables such as age, age at marriage, and marital duration also influence the likelihood of a first birth. The author uses data for 2182 intentionally childless black and white women, aged 20-34, from the 1965 National Fertility Survey to test his models. Study findings indicate that 1) marital duration greater than 15 years is the only significant demographic control variable, 2) normative variables generally meet expectations; only the coefficient for Catholicism is significant, and 3) financial satisfaction is positively associated with childlessness; husband's income is the only significant variable. Future research should 1) examine how Catholicism acts to discourage childlessness, 2) employ normative

  1. Respiratory sinus arrhythmia as a predictor of eating disorder symptoms in college students: Moderation by responses to stress and parent psychological control.

    Science.gov (United States)

    Abaied, Jamie L; Wagner, Caitlin; Breslend, Nicole Lafko; Flynn, Megan

    2016-04-01

    This longitudinal study examined the prospective contribution of respiratory sinus arrhythmia (RSA), a key physiological indicator of self-regulation, to eating disorder symptoms in college students, and whether this link was moderated by maladaptive responses to stress and parent psychological control. At Wave 1, college students' RSA was measured at rest. At Waves 1 and 2 (six-month follow-up), students reported on their eating disorder symptoms, coping and involuntary responses to stress, and perceptions of their parents' use of psychological control. Significant three-way interactions indicated that the link between RSA and subsequent eating disorder symptoms was contingent on responses to stress and parent psychological control. In the context of maladaptive responses to stress and high psychological control, RSA predicted increased eating disorder symptoms over time. In the absence of parent psychological control, high RSA was beneficial in most cases, even when individuals reported maladaptive responses to stress. This study presents novel evidence that high RSA contributes to risk for or resilience to eating disorder symptoms over time. RSA can be protective against eating disorder symptoms, but in some contexts, the self-regulation resources that high RSA provides may be inappropriately applied to eating cognitions and behaviors. This research highlights the importance of examining physiological functioning conjointly with other risk factors as precursors to eating disorder symptoms over time. Copyright © 2016. Published by Elsevier Ltd.

  2. Experience with the use of palivizumab together with infection control measures to prevent respiratory syncytial virus outbreaks in neonatal intensive care units.

    Science.gov (United States)

    Kurz, H; Herbich, K; Janata, O; Sterniste, W; Bauer, K

    2008-11-01

    Respiratory syncytial virus (RSV) frequently causes nosocomial outbreaks in general paediatric wards and occasionally in neonatal intensive care units (NICUs). Conventional infection control measures often fail to prevent the spread of RSV, and it can cause significant morbidity especially in preterm and young infants. We report our experience in preventing an outbreak on a NICU after RSV had been detected in a premature infant. The index case was a 34-day-old premature infant who presented with clinical infection and RSV was detected in a clinical specimen. There were 11 patients in the ward at the time including the index case. The RSV-positive patient was isolated, the ward closed to admissions and infection control measures were implemented. Two patients were transferred to another hospital. Palivizumab 15 mg/kg i.m. was given to all patients and no further cases occurred. All subsequent RSV tests on nasal secretions were negative. Palivizumab combined with conventional infection control measures appeared to prevent the spread of RSV in this NICU. Strategies for the prevention of RSV outbreaks on NICUs all recommend the reinforcement of routine infection control measures. Recommendations concerning the use of palivizumab range from monthly prophylaxis to all infants at risk, to prophylaxis of selected cases only. Currently there are no guidelines for the use of palivizumab in NICUs or for the control of RSV outbreaks.

  3. 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.

  4. Feasibility to apply eucapnic voluntary hyperventilation in young elite athletes.

    Science.gov (United States)

    Van der Eycken, S; Schelpe, A; Marijsse, G; Dilissen, E; Troosters, T; Vanbelle, V; Aertgeerts, S; Dupont, L J; Peers, K; Bullens, D M; Seys, S F

    2016-02-01

    Exercise-induced bronchoconstriction (EIB) is more common in athletes compared to the general population. The eucapnic voluntary hyperventilation test is used to detect EIB in adult athletes. It is however unclear whether this technique is also applicable to young athletes. Young athletes (basketball (n = 13), football (n = 19), swimming (n = 12)) were recruited at the start of their elite sports career (12-14 years). Eight age-matched controls were also recruited. Eucapnic voluntary hyperventilation test was performed according to ATS guidelines in all subjects. A second (after 1 year, n = 32) and third (after 2 years, n = 39) measurement was performed in a subgroup of athletes and controls. At time of first evaluation, 3/13 basketball players, 4/19 football players, 5/11 swimmers and 1/8 controls met criteria for EIB (fall in FEV1≥10% after EVH). A ventilation rate of >85% of the maximal voluntary ventilation (MVV) is recommended by current guidelines (for adults) but was only achieved by a low number of individuals (first occasion: 27%, third occasion: 45%) However, MVV in young athletes corresponds to 30 times FEV1, which is equivalent to 85% of MVV in adults. A threshold of 70% of MVV (21 times FEV1) is feasible in the majority of young athletes. EIB is present in a substantial number of individuals at the age of 12-14 years, especially in swimmers. This underscores the importance of screening for EIB at this age. EVH is feasible in young elite athletes, however target ventilation needs to be adjusted accordingly. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Belief in miracles and attitudes towards voluntary euthanasia.

    Science.gov (United States)

    Sharp, Shane

    2017-04-01

    Results of logistic regression analysis of data from the General Social Survey (N = 1,799) find that those who have a strong belief in miracles are more likely to say that a person with an incurable illness should not be allowed to accept medical treatments that painlessly hasten death than those who have a less strong belief in miracles or do not believe in miracles, net of respondents' religious affiliations, frequency of religious attendance, views of the Bible, and other sociodemographic controls. Results highlight the need to consider specific religious beliefs when predicting individuals' attitudes towards voluntary euthanasia.

  6. A perceptual discrimination task results in greater facilitation of voluntary saccades in Parkinson's disease patients.

    Science.gov (United States)

    van Stockum, Saskia; MacAskill, Michael R; Myall, Daniel; Anderson, Tim J

    2013-01-01

    Many studies have shown that Parkinson's disease (PD) affects not only the ability to generate voluntary saccades but also the ability to suppress reflexive saccades (hyper-reflexivity). To further investigate these apparently contradictory effects of PD on the saccade system we adapted a well-known dual-task paradigm (Deubel, 2008) to measure saccades with and without a peripheral discrimination task. Previously we reported that the concurrent performance of a perceptual discrimination task abnormally reduced the latencies of reflexive saccades in PD. Here we report the effects of the concurrent discrimination task on the generation of voluntary saccades in a PD and a control group. As expected, when saccades were performed without the discrimination task the PD group made voluntary saccades with longer latencies and smaller gain than the control group. The concurrent performance of the perceptual discrimination task facilitated the initiation of voluntary saccades in both groups, but, surprisingly, this facilitatory effect was stronger in the PD group than in the control group. In addition, in the PD group voluntary saccades were abnormally facilitated by the peripheral symbol-changes that occur during saccade planning in this paradigm. The results of this study may help to clarify apparently contradictory oculomotor abnormalities observed in PD. © 2012 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.

  7. Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans.

    Science.gov (United States)

    Kox, Matthijs; van Eijk, Lucas T; Zwaag, Jelle; van den Wildenberg, Joanne; Sweep, Fred C G J; van der Hoeven, Johannes G; Pickkers, Peter

    2014-05-20

    Excessive or persistent proinflammatory cytokine production plays a central role in autoimmune diseases. Acute activation of the sympathetic nervous system attenuates the innate immune response. However, both the autonomic nervous system and innate immune system are regarded as systems that cannot be voluntarily influenced. Herein, we evaluated the effects of a training program on the autonomic nervous system and innate immune response. Healthy volunteers were randomized to either the intervention (n = 12) or control group (n = 12). Subjects in the intervention group were trained for 10 d in meditation (third eye meditation), breathing techniques (i.a., cyclic hyperventilation followed by breath retention), and exposure to cold (i.a., immersions in ice cold water). The control group was not trained. Subsequently, all subjects underwent experimental endotoxemia (i.v. administration of 2 ng/kg Escherichia coli endotoxin). In the intervention group, practicing the learned techniques resulted in intermittent respiratory alkalosis and hypoxia resulting in profoundly increased plasma epinephrine levels. In the intervention group, plasma levels of the anti-inflammatory cytokine IL-10 increased more rapidly after endotoxin administration, correlated strongly with preceding epinephrine levels, and were higher. Levels of proinflammatory mediators TNF-α, IL-6, and IL-8 were lower in the intervention group and correlated negatively with IL-10 levels. Finally, flu-like symptoms were lower in the intervention group. In conclusion, we demonstrate that voluntary activation of the sympathetic nervous system results in epinephrine release and subsequent suppression of the innate immune response in humans in vivo. These results could have important implications for the treatment of conditions associated with excessive or persistent inflammation, such as autoimmune diseases.

  8. Reversal of functional disorders by aspiration, expiration and cough reflexes and their voluntary counterparts

    Directory of Open Access Journals (Sweden)

    Zoltan eTomori

    2012-12-01

    Full Text Available Agonal gasping provoked by asphyxia can save ~15% of mammals even from untreated ventricular fibrillation, but it fails to revive infants with sudden infant death syndrome. Our systematic study of airway reflexes in cats and other animals indicated that in addition to cough, there are 2 distinct airway reflexes that may contribute to auto-resuscitation. Gasp- and sniff-like spasmodic inspirations can be elicited by nasopharyngeal stimulation, strongly activating the brainstem generator for inspiration, which is also involved in the control of gasping. This aspiration reflex (AspR is characterized by spasmodic inspiration without subsequent active expiration and can be elicited during agonal gasping, caused by brainstem trans-sections in cats. Stimulation of the larynx can activate the generator for expiration to evoke the expiration reflex, manifesting with prompt expiration without preceding inspiration. Stimulation of the oro-pharynx and lower airways provokes the cough reflex which results from activating of both generators. The powerful potential of the AspR resembling auto-resuscitation by gasping can influence the control mechanisms of vital functions, mediating reversal of various functional disorders.The AspR in cats interrupted hypoxic apnea, laryngo- and bronchospasm, apneusis and even transient asphyxic coma, and can normalize various hypo- and hyper-functional disorders. Introduction of a nasogastric catheter evoked similar spasmodic inspirations in premature infants and interrupted hiccough attacks in adults. Coughing on demand can prevent anaphylactic shock and resuscitate the pertinent subject. Sniff representing nasal inspiratory pressure and maximal inspiratory and expiratory pressures are voluntary counterparts of airway reflexes, and are useful for diagnosis and therapy of various cardio-respiratory and neuromuscular disorders.

  9. Automated respiratory cycles selection is highly specific and improves respiratory mechanics analysis.

    Science.gov (United States)

    Rigo, Vincent; Graas, Estelle; Rigo, Jacques

    2012-07-01

    Selected optimal respiratory cycles should allow calculation of respiratory mechanic parameters focusing on patient-ventilator interaction. New computer software automatically selecting optimal breaths and respiratory mechanics derived from those cycles are evaluated. Retrospective study. University level III neonatal intensive care unit. Ten mins synchronized intermittent mandatory ventilation and assist/control ventilation recordings from ten newborns. The ventilator provided respiratory mechanic data (ventilator respiratory cycles) every 10 secs. Pressure, flow, and volume waves and pressure-volume, pressure-flow, and volume-flow loops were reconstructed from continuous pressure-volume recordings. Visual assessment determined assisted leak-free optimal respiratory cycles (selected respiratory cycles). New software graded the quality of cycles (automated respiratory cycles). Respiratory mechanic values were derived from both sets of optimal cycles. We evaluated quality selection and compared mean values and their variability according to ventilatory mode and respiratory mechanic provenance. To assess discriminating power, all 45 "t" values obtained from interpatient comparisons were compared for each respiratory mechanic parameter. A total of 11,724 breaths are evaluated. Automated respiratory cycle/selected respiratory cycle selections agreement is high: 88% of maximal κ with linear weighting. Specificity and positive predictive values are 0.98 and 0.96, respectively. Averaged values are similar between automated respiratory cycle and ventilator respiratory cycle. C20/C alone is markedly decreased in automated respiratory cycle (1.27 ± 0.37 vs. 1.81 ± 0.67). Tidal volume apparent similarity disappears in assist/control: automated respiratory cycle tidal volume (4.8 ± 1.0 mL/kg) is significantly lower than for ventilator respiratory cycle (5.6 ± 1.8 mL/kg). Coefficients of variation decrease for all automated respiratory cycle parameters in all infants. "t

  10. Transfusion Transmissible Infections among Voluntary Blood ...

    African Journals Online (AJOL)

    Background: HIV1&2, HBsAg, anti-HCV and syphilis antibody are mandatory disease marker tests of Transfusion Transmissible Infections (TTIs) conducted on every donated unit of blood in Zambia. Blood is donated by first time voluntary donors and repeat/regular donors of ages between 16 and 65 years. Both first time ...

  11. 1. Transfusion Transmissible Infections among Voluntary Blood ...

    African Journals Online (AJOL)

    Esem

    ABSTRACT. Background: HIV1&2, HBsAg, anti-HCV and syphilis antibody are mandatory disease marker tests of Transfusion Transmissible Infections (TTIs) conducted on every donated unit of blood in Zambia. Blood is donated by first time voluntary donors and repeat/regular donors ofages between 16 and 65 years.

  12. The Voluntary Euthanasia (Legalization) Bill (1936) revisited.

    Science.gov (United States)

    Helme, T

    1991-01-01

    In view of the continuing debate on euthanasia, the restrictions and safeguards which were introduced into the Voluntary Euthanasia (Legislation) Bill 1936 are discussed. Proposals for a new Terminal Care and Euthanasia Bill are suggested, based on some of the principles of the Mental Health Act 1983. PMID:2033626

  13. Voluntary Oral Administration of Losartan in Rats.

    Science.gov (United States)

    Diogo, Lucília N; Faustino, Inês V; Afonso, Ricardo A; Pereira, Sofia A; Monteiro, Emília C; Santos, Ana I

    2015-09-01

    Gavage is a widely performed technique for daily dosing in laboratory rodents. Although effective, gavage comprises a sequence of potentially stressful procedures for laboratory animals that may introduce bias into experimental results, especially when the drugs to be tested interfere with stress-dependent parameters. We aimed to test vehicles suitable for drug delivery by voluntary ingestion in rats. Specifically, Male Wistar rats (age, 2 to 3 mo) were used to test nut paste (NUT), peanut butter (PB), and sugar paste (SUG) as vehicles for long-term voluntary oral administration of losartan, an angiotensin II receptor blocker. Vehicles were administered for 28 d without drug to assess effects on the glucose level and serum lipid profile. Losartan was mixed with vehicles and either offered to the rats or administered by gavage (14 d) for subsequent quantification of losartan plasma levels by HPLC. After a 2-d acclimation period, all rats voluntarily ate the vehicles, either alone or mixed with losartan. NUT administration reduced blood glucose levels. The SUG group had higher concentrations of losartan than did the gavage group, without changes in lipid and glucose profiles. Our results showed that NUT, PB, and SUG all are viable for daily single-dose voluntary ingestion of losartan and that SUG was the best alternative overall. Drug bioavailability was not reduced after voluntary ingestion, suggesting that this method is highly effective for chronic oral administration of losartan to laboratory rodents.

  14. School Ethical Climate and Teachers' Voluntary Absence

    Science.gov (United States)

    Shapira-Lishchinsky, Orly; Rosenblatt, Zehava

    2010-01-01

    Purpose: This paper aims to offer a theoretical framework for linking school ethical climate with teachers' voluntary absence. The paper attempts to explain this relationship using the concept of affective organizational commitment. Design/methodology/approach: Participants were 1,016 school teachers from 35 high schools in Israel. Data were…

  15. Decentralized trade with bargaining and voluntary matching

    DEFF Research Database (Denmark)

    Tranæs, Torben; Sloth, Birgitte; Hendon, Ebbe

    1994-01-01

    Rubinstein and Wolinsky (1990) study a market with one seller, two buyers, and voluntary matching. Both the competitive outcomepc and the bilateral bargaining outcomepb are possible in subgame perfect equilibrium. We consider two variations. First, if there is a cost larger thanpc−pc to the seller...

  16. Patterns of Voluntary Counselling and Testing among ...

    African Journals Online (AJOL)

    It is critically important for individuals to learn about their HIV status and make informed decisions about their future. The study aimed at determining the patterns of voluntary counselling and testing among undergraduate university students in Lagos, Nigeria. The study was conducted in May 2010 among students recruited ...

  17. Attitudes of patients towards voluntary human immunodeficiency ...

    African Journals Online (AJOL)

    Attitudes of patients towards voluntary human immunodeficiency virus counselling and testing in two Nigerian tertiary hospitals. ... Asked Questions about PDFs. Alternatively, you can download the PDF file directly to your computer, from where it can be opened using a PDF reader. To download the PDF, click the Download ...

  18. 22 CFR 127.12 - Voluntary disclosures.

    Science.gov (United States)

    2010-04-01

    ... Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS VIOLATIONS AND PENALTIES... sole discretion to consider whether “voluntary disclosure,” in context with other relevant information... shipment, doing business with a party denied U.S. export privileges, etc.); (ii) The exact circumstances...

  19. Voluntary Flammability Regulations for Residential Upholstered Furniture

    Science.gov (United States)

    Waxman, Lisa K.; Moore, Mary Ann; Fox, Amy

    2008-01-01

    This article provides merchandising, housing, and design professionals, as well as educators, with a clear understanding of the program objectives and development of the Upholstered Furniture Action Council (UFAC), an industry-driven voluntary product safety association. The central mission of UFAC is to conduct research on cigarette-ignition…

  20. Equality, self‐respect and voluntary separation

    NARCIS (Netherlands)

    Merry, M.S.

    2012-01-01

    This paper argues that self‐respect constitutes an important value, and further, an important basis for equality. It also argues that under conditions of inequality‐producing segregation, voluntary separation in schooling may be more likely to provide the resources necessary for self‐respect. A

  1. 78 FR 51678 - Voluntary Education Programs; Correction

    Science.gov (United States)

    2013-08-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF DEFENSE 32 CFR Part 68 RIN 0790-AJ06 Voluntary Education Programs; Correction AGENCY: Office of the Under Secretary of... Education Programs. Subsequent to the publication of the proposed rule in the Federal Register, DoD...

  2. Voluntary Organizations: Commitment, Leadership, and Organizational Effectiveness

    Science.gov (United States)

    Ekeland, Terry P.

    2004-01-01

    Voluntary organizations offer a unique opportunity to interpret participant relationships, leadership influences, and organizational effectiveness unencumbered by employment relationships. Regardless of organizational structure or purpose, all organizations are affected to some degree by their leadership and their membership. Based on the…

  3. Randomised double blind placebo controlled trial of prednisolone in children admitted to hospital with respiratory syncytial virus bronchiolitis.

    Science.gov (United States)

    van Woensel, J B; Wolfs, T F; van Aalderen, W M; Brand, P L; Kimpen, J L

    1997-07-01

    Experimental and clinical evidence suggests that respiratory syncytial virus (RSV) bronchiolitis is an immune mediated disease. Corticosteroids might therefore be effective in the treatment of RSV bronchiolitis. A randomised double blind trial was conducted in children up to two years of age admitted to hospital with RSV bronchiolitis to compare prednisolone (1 mg/ kg/day orally for seven days) with placebo. Variables used for the efficacy analysis were a daily symptom score and the length of time in hospital in the non-ventilated patients, and the duration of mechanical ventilation and the length of time in hospital in the ventilated patients. Fifty four patients were included in the trial, 40 of whom were non-ventilated (20 in each group) and 14 were ventilated (seven in each group). During the first three days of treatment the symptom score decreased significantly faster in the prednisolone group than in the placebo group (mean (SE) decrease -1.2 (0.2) points/day versus -0.6 (0.2) points/day; mean (95% confidence interval (CI)) for difference = -0.6 (-0.1 to -1.2); p = 0.02). The mean duration of hospital stay of all 40 non-ventilated patients was not significantly different between the two groups. In the ventilated patients the duration of mechanical ventilation was not significantly different, but the length of time in hospital was six days shorter in the prednisolone group than in the placebo group (mean (SE) 11.0 (0.7) versus 17.0 (2.0) days; mean (95% CI) difference = 7.0 (1.8 to 10.2) days; p < 0.01). These results suggest that prednisolone may be effective in accelerating the clinical recovery of children admitted to hospital with RSV bronchiolitis.

  4. A randomized controlled trial of vitamin D3 supplementation for the prevention of symptomatic upper respiratory tract infections.

    Science.gov (United States)

    Li-Ng, M; Aloia, J F; Pollack, S; Cunha, B A; Mikhail, M; Yeh, J; Berbari, N

    2009-10-01

    Vitamin D has been shown to be an important immune system regulator. Vitamin D insufficiency during winter may cause increased susceptibility to upper respiratory tract infections (URIs). To determine whether vitamin D supplementation during the winter season prevents or decreases URI symptoms, 162 adults were randomized to receive 50 microg vitamin D3 (2000 IU) daily or matching placebo for 12 weeks. A bi-weekly questionnaire was used to record the incidence and severity of URI symptoms. There was no difference in the incidence of URIs between the vitamin D and placebo groups (48 URIs vs. 50 URIs, respectively, P=0.57). There was no difference in the duration or severity of URI symptoms between the vitamin D and placebo groups [5.4+/-4.8 days vs. 5.3+/-3.1 days, respectively, P=0.86 (95% CI for the difference in duration -1.8 to 2.1)]. The mean 25-hydroxyvitamin D level at baseline was similar in both groups (64.3+/-25.4 nmol/l in the vitamin D group; 63.0+/-25.8 nmol/l in the placebo group; n.s.). After 12 weeks, 25-hydroxyvitamin D levels increased significantly to 88.5+/-23.2 nmol/l in the vitamin D group, whereas there was no change in vitamin D levels in the placebo group. There was no benefit of vitamin D3 supplementation in decreasing the incidence or severity of symptomatic URIs during winter. Further studies are needed to determine the role of vitamin D in infection.

  5. Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study

    Directory of Open Access Journals (Sweden)

    Joohae Kim

    2017-05-01

    Full Text Available Background Acute respiratory distress syndrome (ARDS remains a life-threatening disease. Many patients with ARDS do not recover fully, and progress to terminal lung fibrosis. Angiotensin-converting enzyme (ACE inhibitor is known to modulate the neurohormonal system to reduce inflammation and to prevent tissue fibrosis. However, the role of ACE inhibitor in the lungs is not well understood. We therefore conducted this study to elucidate the effect of renin-angiotensin system (RAS blockage on the prognosis of patients with ARDS. Methods We analyzed medical records of patients who were admitted to the medical intensive care unit (ICU at a tertiary care hospital from January 2005 to December 2010. ARDS was determined using the Berlin definition. The primary outcome was the mortality rate of ICU. Survival analysis was performed after adjustment using propensity score matching. Results A total of 182 patients were included in the study. Thirty-seven patients (20.3% took ACE inhibitor or angiotensin receptor blocker (ARB during ICU admission, and 145 (79.7% did not; both groups showed similar severity scores. In the ICU, mortality was 45.9% in the RAS inhibitor group and 58.6% in the non-RAS inhibitor group (P = 0.166. The RAS inhibitor group required a longer duration of mechanical ventilation (29.5 vs. 19.5, P = 0.013 and longer ICU stay (32.1 vs. 20.2 days, P < 0.001. In survival analysis, the RAS inhibitor group showed better survival rates than the non-RAS group (P < 0.001. Conclusions ACE inhibitor or ARB may have beneficial effect on ARDS patients.

  6. Effect of stimulation intensity on assessment of voluntary activation

    NARCIS (Netherlands)

    van Leeuwen, D.M.; de Ruiter, C.J.; de Haan, A.

    2012-01-01

    Introduction: The interpolated twitch technique is often used to assess voluntary activation (VA) of skeletal muscles. We investigated VA and the voluntary torque-superimposed torque relationship using either supramaximal nerve stimulation or better tolerated submaximal muscle stimulation, which is

  7. Effect of stimulation intensity on assessment of voluntary activation.

    NARCIS (Netherlands)

    Dr. D.M. van Leeuwen; C.J. de Ruiter; A.J. de Haan

    2012-01-01

    INTRODUCTION: The interpolated twitch technique is often used to assess voluntary activation (VA) of skeletal muscles. We investigated VA and the voluntary torque-superimposed torque relationship using either supramaximal nerve stimulation or better tolerated submaximal muscle stimulation, which is

  8. Aspects of respiratory muscle fatigue in a mountain ultramarathon race.

    Science.gov (United States)

    Wüthrich, Thomas U; Marty, Julia; Kerherve, Hugo; Millet, Guillaume Y; Verges, Samuel; Spengler, Christina M

    2015-03-01

    Ultramarathon running offers a unique possibility to investigate the mechanisms contributing to the limitation of endurance performance. Investigations of locomotor muscle fatigue show that central fatigue is a major contributor to the loss of strength in the lower limbs after an ultramarathon. In addition, respiratory muscle fatigue is known to limit exercise performance, but only limited data are available on changes in respiratory muscle function after ultramarathon running and it is not known whether the observed impairment is caused by peripheral and/or central fatigue. In 22 experienced ultra-trail runners, we assessed respiratory muscle strength, i.e., maximal voluntary inspiratory and expiratory pressures, mouth twitch pressure (n = 16), and voluntary activation (n = 16) using cervical magnetic stimulation, lung function, and maximal voluntary ventilation before and after a 110-km mountain ultramarathon with 5862 m of positive elevation gain. Both maximal voluntary inspiratory (-16% ± 13%) and expiratory pressures (-21% ± 14%) were significantly reduced after the race. Fatigue of inspiratory muscles likely resulted from substantial peripheral fatigue (reduction in mouth twitch pressure, -19% ± 15%; P fatigue. Forced vital capacity remained unchanged, whereas forced expiratory volume in 1 s, peak inspiratory and expiratory flow rates, and maximal voluntary ventilation were significantly reduced (P muscle strength for inspiratory muscles shown to result from significant peripheral muscle fatigue with only little contribution of central fatigue. This is in contrast to findings in locomotor muscles. Whether this difference between muscle groups results from inherent neuromuscular differences, their specific pattern of loading or other reasons remain to be clarified.

  9. Plantarflexor stretch training increases reciprocal inhibition measured during voluntary dorsiflexion.

    Science.gov (United States)

    Blazevich, A J; Kay, A D; Waugh, C; Fath, F; Miller, S; Cannavan, D

    2012-01-01

    Agonist-mediated reciprocal inhibition (RI) in distal skeletal muscles is an important neurophysiological phenomenon leading to improved movement coordination and efficiency. It has been shown to be reduced in aged and clinical populations, so the development of interventions augmenting RI is an important research goal. We examined the efficacy of using chronic passive muscle stretching to augment RI. The influence of 3 wk of plantarflexor stretching (4 × 30 s, two times/day) on RI of soleus and gastrocnemius initiated by tonic, voluntary dorsiflexion contractions [20% of maximum voluntary contraction (MVC)] was examined in 11 healthy men who performed stretch training and in nine nontraining controls. Hoffmann's reflexes (H-reflexes) were elicited by tibial nerve stimulation during both weak isometric (2% MVC) plantarflexions and dorsiflexion contractions at 20% MVC. Changes were examined at three joint angles, normalized to each subject's range of motion (ROM; plantarflexed = 10 ± 0°, neutral = -3.3 ± 2.9°, dorsiflexed = -16.5 ± 5.6°). No changes were detected in controls. A 20% increase in ROM in the stretch subjects was associated with a significant decrease in maximum H-reflex (H(max)): maximum evoked potential (M(max)), measured during 2% plantarflexion at the plantarflexed and neutral angles in soleus and at the plantarflexed angle in gastrocnemius (P dorsiflexion contract were also seen at each angle in soleus and at the dorsiflexed angle in gastrocnemius. However, a greater decrease in H(max):M(max) measured during voluntary dorsiflexion rather than during plantarflexion, which indicates a specific change in RI, was detected only at the dorsiflexed angle (-30.7 ± 9.4% and -35.8 ± 6.8% for soleus and gastrocnemius, respectively). These results demonstrate the efficacy of soleus-gastrocnemius stretch training in increasing agonist-mediated RI from tibialis anterior onto soleus-gastrocnemius in young, healthy individuals at dorsiflexed, but not

  10. A comparison of synchronized intermittent mandatory ventilation and pressure-regulated volume control ventilation in elderly patients with acute exacerbations of COPD and respiratory failure

    OpenAIRE

    Chang SC; Shi JD; Fu CP; Wu X; Li SQ

    2016-01-01

    Suchi Chang,1 Jindong Shi,2 Cuiping Fu,1 Xu Wu,1 Shanqun Li1 1Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, 2Department of Respiratory Medicine, The Fifth People’s Hospital of Shanghai, Fudan University, Shanghai, People’s Republic of China Background: COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Inten...

  11. Middle East Respiratory Syndrome

    Centers for Disease Control (CDC) Podcasts

    2014-07-07

    This podcast discusses Middle East Respiratory Syndrome, or MERS, a viral respiratory illness caused by Middle East Respiratory Syndrome Coronavirus—MERS-CoV.  Created: 7/7/2014 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 7/7/2014.

  12. Pidotimod for the prevention of acute respiratory infections in healthy children entering into daycare: A double blind randomized placebo-controlled study.

    Science.gov (United States)

    Mameli, Chiara; Pasinato, Angela; Picca, Marina; Bedogni, Giorgio; Pisanelli, Stefania; Zuccotti, Gian Vincenzo

    2015-07-01

    Acute respiratory tract infections (ARTIs) are very common in pediatric age and reach a peak in the first 4 years of life, especially in children attending daycare. Pidotimod, a synthetic immunostimulant, may reduce the incidence of ARTIs in children with predisposing risk factors. Nevertheless studies on healthy children are presently lacking. We performed a double-blinded randomized placebo-controlled trial study to assess the efficacy of Pidotimod in a population of 3-year-old healthy children who just entered kindergarten. The main outcome was the incidence of respiratory infections in this population and the secondary outcome was the prescription of antibiotics. The study group consisted of healthy 3-year-old children who had not yet attended day-care centers. Patients were enrolled by a convenience sample of 17 family pediatricians (FP). Children were randomized to receive either Pidotimod 400 mg per os or placebo twice daily for the last 10 days of each month from October 2013 to April 2014. Any time a child presented to his/her FP with fever and ARTI was diagnosed, clinical and therapeutic data were collected. A total of 800 children were pre-screened, 733 did not meet the inclusion criteria and 10 refused to participate. Of the 67 eligible subjects, 57 were successfully enrolled within the study recruitment period and randomized to receive Pidotimod (n = 29) or placebo (n = 28). Eight children were lost to follow-up. In the final analysis were thus included 24 children who received Pidotimod and 25 who received placebo. The incidence rate ratio for respiratory infections was 0.78 (95%CI 0.53 to 1.15, p = 0.211) for Pidotimod vs. placebo. The corresponding risk ratio for antibiotic usage was 0.56 (95%CI 0.27 to 1.16, p = 0.120). In our trial, Pidotimod did not prove to be statistically superior to placebo for the prevention of ARTI in a population of healthy children who entered kindergarten. However, Pidotimod showed some potential as a means for reducing

  13. Use of palivizumab and infection control measures to control an outbreak of respiratory syncytial virus in a neonatal intensive care unit confirmed by real-time polymerase chain reaction.

    LENUS (Irish Health Repository)

    O'Connell, K

    2011-04-01

    Respiratory syncytial virus (RSV) is a potentially life-threatening infection in premature infants. We report an outbreak involving four infants in the neonatal intensive care unit (NICU) of our hospital that occurred in February 2010. RSV A infection was confirmed by real-time polymerase chain reaction. Palivizumab was administered to all infants in the NICU. There were no additional symptomatic cases and repeat RSV surveillance confirmed that there was no further cross-transmission within the unit. The outbreak highlighted the infection control challenge of very high bed occupancy in the unit and the usefulness of molecular methods in facilitating detection and management.

  14. 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.

  15. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial

    National Research Council Canada - National Science Library

    Liao, Lin-Yu; Chen, Kuei-Min; Chung, Wei-Sheng; Chien, Jung-Yien

    2015-01-01

    .... To evaluate the effects of a respiratory rehabilitation exercise training package on dyspnea, cough, exercise tolerance, and sputum expectoration among hospitalized elderly patients with AECOPD...

  16. Development of patient-controlled respiratory gating system based on visual guidance for magnetic-resonance image-guided radiation therapy.

    Science.gov (United States)

    Kim, Jung-In; Lee, Hanyoung; Wu, Hong-Gyun; Chie, Eui Kyu; Kang, Hyun-Cheol; Park, Jong Min

    2017-09-01

    The aim of this study is to develop a visual guidance patient-controlled (VG-PC) respiratory gating system for respiratory-gated magnetic-resonance image-guided radiation therapy (MR-IGRT) and to evaluate the performance of the developed system. The near-real-time cine planar MR image of a patient acquired during treatment was transmitted to a beam projector in the treatment room through an optical fiber cable. The beam projector projected the cine MR images inside the bore of the ViewRay system in order to be visible to a patient during treatment. With this visual information, patients voluntarily controlled their respiration to put the target volume into the gating boundary (gating window). The effect of the presence of the beam projector in the treatment room on the image quality of the MRI was investigated by evaluating the signal-to-noise ratio (SNR), uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity with the VG-PC gating system. To evaluate the performance of the developed system, we applied the VG-PC gating system to a total of seven patients; six patients received stereotactic ablative radiotherapy (SABR) and one patient received conventional fractionated radiation therapy. The projected cine MR images were visible even when the room light was on. No image data loss or additional time delay during delivery of image data were observed. Every indicator representing MRI quality, including SNR, uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity exhibited values higher than the tolerance levels of the manufacturer with the VG-PC gating system; therefore, the presence of the VG-PC gating system in the treatment room did not degrade the MR image quality. The average beam-off times due to respiratory gating with and without the VG-PC gating system were 830.3 ± 278.2 s and 1264.2 ± 302.1 s respectively (P = 0.005). Consequently, the total treatment times excluding

  17. 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...

  18. 77 FR 55487 - Agency Information Collection Activities; Voluntary Customer Survey

    Science.gov (United States)

    2012-09-10

    ... SECURITY U.S. Customs and Border Protection Agency Information Collection Activities; Voluntary Customer... approval in accordance with the Paperwork Reduction Act: Voluntary Customer Survey. This is a proposed...: Voluntary Customer Survey. OMB Number: 1651-0135. Abstract: Customs and Border Protection (CBP) plans to...

  19. 75 FR 27563 - Agency Information Collection Activities: Voluntary Customer Survey

    Science.gov (United States)

    2010-05-17

    ... SECURITY U.S. Customs and Border Protection Agency Information Collection Activities: Voluntary Customer... Voluntary Customer Survey. This request for comment is being made pursuant to the Paperwork Reduction Act of... following information collection: Title: Voluntary Customer Survey. OMB Number: Will be assigned upon...

  20. 77 FR 36566 - Agency Information Collection Activities: Voluntary Customer Survey

    Science.gov (United States)

    2012-06-19

    ... SECURITY U.S. Customs and Border Protection Agency Information Collection Activities: Voluntary Customer... Voluntary Customer Survey. This request for comment is being made pursuant to the Paperwork Reduction Act of...: Voluntary Customer Survey. OMB Number: 1651-0135. Abstract: Customs and Border Protection (CBP) plans to...

  1. 75 FR 47607 - Agency Information Collection Activities: Voluntary Customer Survey

    Science.gov (United States)

    2010-08-06

    ... SECURITY U.S. Customs and Border Protection Agency Information Collection Activities: Voluntary Customer... accordance with the Paperwork Reduction Act: Voluntary Customer Survey. This is a new collection of... other technological techniques or other forms of information. Title: Voluntary Customer Survey. OMB...

  2. 75 FR 72751 - Voluntary Mergers of Federal Home Loan Banks

    Science.gov (United States)

    2010-11-26

    ... AGENCY 12 CFR Part 1278 RIN 2590-AA37 Voluntary Mergers of Federal Home Loan Banks AGENCY: Federal... approval of voluntary Bank mergers. DATES: Written comments must be received on or before January 25, 2011....C. 1427. \\4\\ See 12 U.S.C. 1424; 12 CFR part 1263. B. HERA Provisions Addressing Voluntary Mergers...

  3. 76 FR 72823 - Voluntary Mergers of Federal Home Loan Banks

    Science.gov (United States)

    2011-11-28

    ... RIN 2590-AA37 Voluntary Mergers of Federal Home Loan Banks AGENCY: Federal Housing Finance Agency... for the consideration and approval of voluntary Bank mergers. DATES: The final rule is effective on... Voluntary Mergers Section 1209 of HERA added new paragraphs (b)(1) and (b)(2) to section 26 of the Bank Act...

  4. Low Serum Levels of Vitamins A, D, and E Are Associated with Recurrent Respiratory Tract Infections in Children Living in Northern China: A Case Control Study.

    Directory of Open Access Journals (Sweden)

    Xuguang Zhang

    Full Text Available This study aimed to investigate the association of serum concentrations of vitamin A, D, and E with recurrent respiratory tract infections (RRTIs.A total of 1200 children aged at 0.5-14 years were selected via a face-to-face survey in Harbin, China. Among the participants, 600 children with RRTIs comprised the symptomatic group (RRTI group, whereas 600 healthy children were used as controls (control group. Blood samples were collected to measure serum levels of vitamins A and E by HPLC; the serum level of 25-hydroxycholecalciferol (25(OHD, was measured by HPLC-MS/MS.Serum levels of vitamins A and E, as well as 25(OHD, were significantly lower in the RRTI group than the control group. The conditional logistic regression model and the receiver-operating characteristic curve showed that the insufficiency or deficiency of vitamins A, D, and E was positively correlated with RRTI occurrence (p < 0.05.Low serum concentrations of vitamins A, D, and E were associated with RRTIs in children from northern China.

  5. Low Serum Levels of Vitamins A, D, and E Are Associated with Recurrent Respiratory Tract Infections in Children Living in Northern China: A Case Control Study.

    Science.gov (United States)

    Zhang, Xuguang; Ding, Fengshu; Li, Huaining; Zhao, Wenfeng; Jing, Hong; Yan, Yageng; Chen, Yanping

    2016-01-01

    This study aimed to investigate the association of serum concentrations of vitamin A, D, and E with recurrent respiratory tract infections (RRTIs). A total of 1200 children aged at 0.5-14 years were selected via a face-to-face survey in Harbin, China. Among the participants, 600 children with RRTIs comprised the symptomatic group (RRTI group), whereas 600 healthy children were used as controls (control group). Blood samples were collected to measure serum levels of vitamins A and E by HPLC; the serum level of 25-hydroxycholecalciferol (25(OH)D), was measured by HPLC-MS/MS. Serum levels of vitamins A and E, as well as 25(OH)D, were significantly lower in the RRTI group than the control group. The conditional logistic regression model and the receiver-operating characteristic curve showed that the insufficiency or deficiency of vitamins A, D, and E was positively correlated with RRTI occurrence (p vitamins A, D, and E were associated with RRTIs in children from northern China.

  6. High spatial validity is not sufficient to elicit voluntary shifts of attention.

    Science.gov (United States)

    Pauszek, Joseph R; Gibson, Bradley S

    2016-10-01

    Previous research suggests that the use of valid symbolic cues is sufficient to elicit voluntary shifts of attention. The present study interpreted this previous research within a broader theoretical context which contends that observers will voluntarily use symbolic cues to orient their attention in space when the temporal costs of using the cues are perceived to be less than the temporal costs of searching without the aid of the cues. In this view, previous research has not addressed the sufficiency of valid symbolic cues, because the temporal cost of using the cues is usually incurred before the target display appears. To address this concern, 70%-valid spatial word cues were presented simultaneously with a search display. In addition, other research suggests that opposing cue-dependent and cue-independent spatial biases may operate in these studies and alter standard measures of orienting. After identifying and controlling these opposing spatial biases, the results of two experiments showed that the word cues did not elicit voluntary shifts of attention when the search task was relatively easy but did when the search task was relatively difficult. Moreover, the findings also showed that voluntary use of the word cues changed over the course of the experiment when the task was difficult, presumably because the temporal cost of searching without the cue lessened as the task got easier with practice. Altogether, the present findings suggested that the factors underlying voluntary control are multifaceted and contextual, and that spatial validity alone is not sufficient to elicit voluntary shifts of attention.

  7. Impact of amoxicillin therapy on resistance selection in patients with community-acquired lower respiratory tract infections: a randomized, placebo-controlled study.

    Science.gov (United States)

    Malhotra-Kumar, Surbhi; Van Heirstraeten, Liesbet; Coenen, Samuel; Lammens, Christine; Adriaenssens, Niels; Kowalczyk, Anna; Godycki-Cwirko, Maciek; Bielicka, Zuzana; Hupkova, Helena; Lannering, Christina; Mölstad, Sigvard; Fernandez-Vandellos, Patricia; Torres, Antoni; Parizel, Maxim; Ieven, Margareta; Butler, Chris C; Verheij, Theo; Little, Paul; Goossens, Herman

    2016-11-01

    To determine the effect of amoxicillin treatment on resistance selection in patients with community-acquired lower respiratory tract infections in a randomized, placebo-controlled trial. Patients were prescribed amoxicillin 1 g, three times daily (n = 52) or placebo (n = 50) for 7 days. Oropharyngeal swabs obtained before, within 48 h post-treatment and at 28-35 days were assessed for proportions of amoxicillin-resistant (ARS; amoxicillin MIC ≥2 mg/L) and -non-susceptible (ANS; MIC ≥0.5 mg/L) streptococci. Alterations in amoxicillin MICs and in penicillin-binding-proteins were also investigated. ITT and PP analyses were conducted. ARS and ANS proportions increased 11- and 2.5-fold, respectively, within 48 h post-amoxicillin treatment compared with placebo [ARS mean increase (MI) 9.46, 95% CI 5.57-13.35; ANS MI 39.87, 95% CI 30.96-48.78; P  0.1588). ARS/ANS were grouped by pbp mutations. Group 1 strains exhibited significantly lower amoxicillin resistance (mean MIC 2.8 mg/L, 95% CI 2.6-3.1) than group 2 (mean MIC 9.3 mg/L, 95% CI 8.1-10.5; P amoxicillin is modest and short-lived, probably due to 'fitness costs' engendered by high-level resistance-conferring mutations. This evidence further supports European guidelines that recommend amoxicillin when an antibiotic is indicated for community-acquired lower respiratory tract infections. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  8. [Dietary efficacy of a micronutrient combination in patients with recurrent upper respiratory tract infections. Results of a placebo-controlled double-blind study].

    Science.gov (United States)

    Schmidt, K; Zirkler, S

    2011-10-06

    An optimal vitamin and mineral supply may contribute to the enhancement of immune defenses and thus favorably influence the course and intensity of recurrent upper respiratory tract infections (URIs). ln the present study the dietary efficacy and benefits of a micronutrient combination in patients with recurrent URls was evaluated. 192 patients with recurrent URIs were enrolled in this randomized, placebo-controlled, double-blind multicenter trial for a study duration of 16 weeks. Efficacy variables were number, intensity and course of URIs (as assessed using a total common cold score [CCS]) and the alterations in micronutrient supply (vitamins C and D3, folic acid and selenium) during the study. In subjects who initially had at least two common cold symptoms (N = 107) the symptoms improved in the active group (AG) significantly more than in the placebo group (PG; ACCS: AG -6.9 +/- 4.8; PG -5.4 +/- 4.5; p = 0.034). In patients with initially severe common cold (CC) episodes the symptoms improved in the AG to a statistically significant extent (ACCS: AG -93.8%, PG -91.2%, p = 0.043). In the age group below 45 years significantly fewer AG than PG patients were absent from their job during the second or third CC episode (AG: 14.3%, PG: 47.8%, p = 0.038). Patients with vitamin-D deficiency and/or insufficient vitamin-C supply reported significantly fewer CC episodes in AG than in PG. In the course of the trial, in AG vs. PG the serum vitamin C, folic acid and selenium levels increased (p infections and suffering from recurrent respiratory tract infections.

  9. Questionnaire-based analysis of infection prevention and control in healthcare facilities in Saudi Arabia in regards to Middle East Respiratory Syndrome.

    Science.gov (United States)

    Rabaan, Ali A; Alhani, Hatem M; Bazzi, Ali M; Al-Ahmed, Shamsah H

    Effective implementation of infection prevention and control in healthcare facilities depends on training, awareness and compliance of healthcare workers. In Saudi Arabia recent significant hospital outbreaks, including Middle East Respiratory Syndrome Coronavirus (MERS-CoV), have resulted from lack of, or breakdown in, infection prevention and control procedures. This study was designed to assess attitudes to, and awareness of, infection prevention and control policies and guidelines among healthcare workers of different professions and institution types in Saudi Arabia. A questionnaire was administered to 607 healthcare workers including physicians (n=133), nurses (n=162), laboratory staff (n=233) and other staff (n=79) in government hospitals, private hospitals and poly clinics. Results were compared using Chi square analysis according to profession type, institution type, age group and nationality (Saudi or non-Saudi) to assess variability. Responses suggested that there are relatively high levels of uncertainty among healthcare workers across a range of infection prevention and control issues, including institution-specific issues, surveillance and reporting standards, and readiness and competence to implement policies and respond to outbreaks. There was evidence to suggest that staff in private hospitals and nurses were more confident than other staff types. Carelessness of healthcare workers was the top-cited factor contributing to causes of outbreaks (65.07% of total group), and hospital infrastructure and design was the top-cited factor contributing to spread of infection in the hospital (54.20%), followed closely by lack and shortage of staff (53.71%) and no infection control training program (51.73%). An electronic surveillance system was considered the most effective by staff (81.22%). We have identified areas of concern among healthcare workers in Saudi Arabia on infection prevention and control which vary between institutions and among different

  10. Efficacy of continuous positive airway pressure and incentive spirometry on respiratory functions during the postoperative period following supratentorial craniotomy: A prospective randomized controlled study.

    Science.gov (United States)

    Sah, Hulya Kahraman; Akcil, Eren Fatma; Tunali, Yusuf; Vehid, Hayriye; Dilmen, Ozlem Korkmaz

    2017-11-01

    Volume controlled ventilation with low PEEP is used in neuro-anesthesia to provide constant PaCO2 levels and prevent raised intracranial pressure. Therefore, neurosurgery patients prone to atelectasis formation, however, we could not find any study that evaluates prevention of postoperative pulmonary complications in neurosurgery. A prospective, randomized controlled study. Intensive care unit in a university hospital in Istanbul. Seventy-nine ASAI-II patients aged between 18 and 70years scheduled for elective supratentorial craniotomy were included in the study. Patients randomized into 3 groups after surgery. The Group IS (n=20) was treated with incentive spirometry 5 times in 1min and 5min per hour, the Group CPAP (n=20) with continuous positive airway pressure 10 cmH2O pressure and 0.4 FiO2 via an oronasal mask 5min per hour, and the Group Control (n=20) 4L·min-1O2 via mask; all during the first 6h postoperatively. Respiratory functions tests and arterial blood gases analysis were performed before the induction of anesthesia (Baseline), 30min, 6h, 24h postoperatively. The IS and CPAP applications have similar effects with respect to FVC values. The postoperative 30min FEV1 values were statistically significantly reduced compared to the Baseline in all groups (ppostoperative 24h compared to the postoperative 30min in the Groups IS and CPAP (ppostoperative 24h FEV1 values were statistically significantly lower in the Group Control compared to the Group IS (p=0.015). Although this study is underpowered to detect differences in FEV1 values, the postoperative 24h FEV1 values were significantly higher in the IS group than the Control group and this difference was not observed between the CPAP and Control groups. It might be evaluate a favorable effect of IS in neurosurgery patients. But larger studies are needed to make a certain conclusion. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. The respiratory pump: past and present understanding.

    Science.gov (United States)

    Devlieger, H

    2003-11-01

    The history of our understanding of the respiratory system has been long and progressive, probably starting with Galenus who did experimental spinal cord sections, and progressed through the poorly known work of Leonardo da Vinci on the structure-function relation of chest wall components. Despite numerous experiments in the past, the respiratory control system remains complex and poorly integrated because of the diversity of the afferent pathways and of the interacting respiratory centres.

  12. 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

    2017-01-01

    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

  13. Infection control and prevention practices implemented to reduce transmission risk of Middle East respiratory syndrome-coronavirus in a tertiary care institution in Saudi Arabia.

    Science.gov (United States)

    Butt, Taimur S; Koutlakis-Barron, Irene; AlJumaah, Suliman; AlThawadi, Sahar; AlMofada, Saleh

    2016-05-01

    Transmission of Middle East respiratory syndrome-coronavirus (MERS-CoV) among health care workers (HCWs) and patients has been documented with mortality rate approximating 36%. We propose advanced infection control measures (A-IC) used in conjunction with basic infection control measures (B-IC) help reduce pathogen transmission. B-IC include standard and transmission-based precautions. A-IC are initiatives implemented within our center to enhance effectiveness of B-IC. Study effectiveness of combining B-IC and A-IC to prevent transmission of MERS-CoV to HCWs. A retrospective observational study was undertaken. A-IC measures include administrative support with daily rounds; infection control risk assessment; timely screening, isolation, and specimen analysis; collaboration; epidemic planning; stockpiling; implementation of contingency plans; full personal protective equipment use for advanced airway management; use of a real-time electronic isolation flagging system; infection prevention and control team on-call protocols; pretransfer MERS-CoV testing; and education. A total of 874 real-time polymerase chain reaction MERS-CoV tests were performed during the period beginning July 1, 2013, and ending January 31, 2015. Six hundred ninety-four non-HCWs were tested, of these 16 tested positive for MERS-CoV and their infection was community acquired. Sixty-nine percent of the confirmed MERS-CoV-positive cases were men, with an average age of 56 years (range, 19-84 years). Of the total tested for MERS-CoV, 180 individuals were HCWs with zero positivity. Adhering to a combination of B-IC and A-IC reduces the risk of MERS-CoV transmission to HCWs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Evaluation of Control Strategies for Porcine Reproductive and Respiratory Syndrome (PRRS) in Swine Breeding Herds Using a Discrete Event Agent-Based Model.

    Science.gov (United States)

    Arruda, Andréia Gonçalves; Friendship, Robert; Carpenter, Jane; Greer, Amy; Poljak, Zvonimir

    2016-01-01

    The objective of this study was to develop a discrete event agent-based stochastic model to explore the likelihood of the occurrence of porcine reproductive and respiratory syndrome (PRRS) outbreaks in swine herds with different PRRS control measures in place. The control measures evaluated included vaccination with a modified-live attenuated vaccine and live-virus inoculation of gilts, and both were compared to a baseline scenario where no control measures were in place. A typical North American 1,000-sow farrow-to-wean swine herd was used as a model, with production and disease parameters estimated from the literature and expert opinion. The model constructed herein was not only able to capture individual animal heterogeneity in immunity to and shedding of the PRRS virus, but also the dynamic animal flow and contact structure typical in such herds under field conditions. The model outcomes included maximum number of females infected per simulation, and time at which that happened and the incidence of infected weaned piglets during the first year of challenge-virus introduction. Results showed that the baseline scenario produced a larger percentage of simulations resulting in outbreaks compared to the control scenarios, and interestingly some of the outbreaks occurred over long periods after virus introduction. The live-virus inoculation scenario showed promising results, with fewer simulations resulting in outbreaks than the other scenarios, but the negative impacts of maintaining a PRRS-positive population should be considered. Finally, under the assumptions of the current model, neither of the control strategies prevented the infection from spreading to the piglet population, which highlights the importance of maintaining internal biosecurity practices at the farrowing room level.

  15. Evaluation of Control Strategies for Porcine Reproductive and Respiratory Syndrome (PRRS) in Swine Breeding Herds Using a Discrete Event Agent-Based Model

    Science.gov (United States)

    Arruda, Andréia Gonçalves; Friendship, Robert; Carpenter, Jane; Greer, Amy; Poljak, Zvonimir

    2016-01-01

    The objective of this study was to develop a discrete event agent-based stochastic model to explore the likelihood of the occurrence of porcine reproductive and respiratory syndrome (PRRS) outbreaks in swine herds with different PRRS control measures in place. The control measures evaluated included vaccination with a modified-live attenuated vaccine and live-virus inoculation of gilts, and both were compared to a baseline scenario where no control measures were in place. A typical North American 1,000-sow farrow-to-wean swine herd was used as a model, with production and disease parameters estimated from the literature and expert opinion. The model constructed herein was not only able to capture individual animal heterogeneity in immunity to and shedding of the PRRS virus, but also the dynamic animal flow and contact structure typical in such herds under field conditions. The model outcomes included maximum number of females infected per simulation, and time at which that happened and the incidence of infected weaned piglets during the first year of challenge-virus introduction. Results showed that the baseline scenario produced a larger percentage of simulations resulting in outbreaks compared to the control scenarios, and interestingly some of the outbreaks occurred over long periods after virus introduction. The live-virus inoculation scenario showed promising results, with fewer simulations resulting in outbreaks than the other scenarios, but the negative impacts of maintaining a PRRS-positive population should be considered. Finally, under the assumptions of the current model, neither of the control strategies prevented the infection from spreading to the piglet population, which highlights the importance of maintaining internal biosecurity practices at the farrowing room level. PMID:27875546

  16. Laryngopharyngeal reflux and herpes simplex virus type 2 are possible risk factors for adult-onset recurrent respiratory papillomatosis (prospective case-control study).

    Science.gov (United States)

    Formánek, M; Jančatová, D; Komínek, P; Matoušek, P; Zeleník, K

    2017-06-01

    The human papillomavirus (HPV) causes recurrent respiratory papillomatosis (RRP). Although HPV prevalence is high, the incidence of papillomatosis is low. Thus, factors other than HPV infection probably contribute to RRP. This study investigated whether patients with papillomatosis are more often infected with herpes simplex virus type 2 and chlamydia trachomatis (ChT) and whether laryngopharyngeal reflux (LPR) occurs in this group of patients more often. Prospective case-control study. Department of Otorhinolaryngology of University Hospital. The study included 20 patients with adult-onset RRP and 20 adult patients with vocal cord cyst and no pathology of laryngeal mucosa (control group). Immunohistochemical analysis of pepsin, HPV, herpes simplex virus type 2 and ChT was performed in biopsy specimens of laryngeal papillomas and of healthy laryngeal mucosa (control group) obtained from medial part of removed vocal cord cyst during microlaryngoscopy procedures. Pathologic LPR (pepsin in tissue) was diagnosed in 8/20 (40.0%) patients with papillomatosis and in 0/20 control patients (P = .003). Herpes simplex virus type 2 was present in 9/20 (45.0%) patients with papillomatosis and in 0/20 control patients (P = .001). Five specimens were positive for both pepsin and herpes simplex virus type 2. No samples were positive for ChT. There were no significant differences between groups for age, body mass index, diabetes mellitus and gastrooesophageal reflux disease. Tobacco exposure was not more frequent in RRP group either (P = .01). Results show that LPR and herpes simplex virus type 2 are significantly more often present in patients with RRP. LPR and herpes simplex virus type 2 might activate latent HPV infection and thereby be possible risk factors for RRP. © 2016 John Wiley & Sons Ltd.

  17. Investigation of occupational and environmental causes of respiratory cancers (ICARE: a multicenter, population-based case-control study in France

    Directory of Open Access Journals (Sweden)

    Luce Danièle

    2011-12-01

    Full Text Available Abstract Background Occupational causes of respiratory cancers need to be further investigated: the role of occupational exposures in the aetiology of head and neck cancers remains largely unknown, and there are still substantial uncertainties for a number of suspected lung carcinogens. The main objective of the study is to examine occupational risk factors for lung and head and neck cancers. Methods/design ICARE is a multi-center, population-based case-control study, which included a group of 2926 lung cancer cases, a group of 2415 head and neck cancer cases, and a common control group of 3555 subjects. Incident cases were identified in collaboration with cancer registries, in 10 geographical areas. The control group was a random sample of the population of these areas, with a distribution by sex and age comparable to that of the cases, and a distribution by socioeconomic status comparable to that of the population. Subjects were interviewed face to face, using a standardized questionnaire collecting particularly information on tobacco and alcohol consumption, residential history and a detailed description of occupational history. Biological samples were also collected from study subjects. The main occupational exposures of interest are asbestos, man-made mineral fibers, formaldehyde, polycyclic aromatic hydrocarbons, chromium and nickel compounds, arsenic, wood dust, textile dust, solvents, strong acids, cutting fluids, silica, diesel fumes, welding fumes. The complete list of exposures of interest includes more than 60 substances. Occupational exposure assessment will use several complementary methods: case-by-case evaluation of exposure by experts; development and use of algorithms to assess exposure from the questionnaires; application of job-exposure matrices. Discussion The large number of subjects should allow to uncover exposures associated with moderate increase in risks, and to evaluate risks associated with infrequent or widely

  18. Decline of ambient air pollution levels due to measures to control automobile emissions and effects on the prevalence of respiratory and allergic disorders among children in Japan.

    Science.gov (United States)

    Hasunuma, Hideki; Ishimaru, Yasushi; Yoda, Yoshiko; Shima, Masayuki

    2014-05-01

    In Japan, air pollution due to nitrogen oxides (NOx) and particulate matter (PM) has been gradually reduced since control measures based on the Automobile NOx/PM law were enforced beginning in 2001. The effects of decrease in air pollutants due to the control measures during the past decade on the prevalence of respiratory and allergic disorders such as asthma in children were evaluated. Using data of 618,973 children collected in 28 regions of Japan from 1997 to 2009, we evaluated whether reductions in the concentrations of nitrogen dioxide (NO2) and suspended particulate matter (SPM) contribute to the decrease in the prevalence of asthma, wheezing, bronchitis, allergic rhinitis, and atopic dermatitis by multiple linear regression analysis, including adjustments for related factors. The annual rates of decrease in air pollution in the PM-law-enforced areas were 2.0 and 2.5 times higher for NO2 and SPM, respectively, compared with those in the non-enforced areas. The prevalence of asthma decreased significantly at -0.073% per year in the areas in which measures based on the Automobile NOx/PM law were taken but not in area where such measures were not applied. Multiple linear regression analysis showed a reduction in the ambient air pollution was significantly associated with a reduction in the prevalence of asthma, with a rate of 0.118% [95% confidence interval (CI): 0.012-0.225] per 1 ppb for NO2, and 0.050% [95% CI: 0.020-0.080] per 1 μg/m(3) for SPM. An increase in the ambient air pollution was associated with an increase in the prevalence of atopic dermatitis of 0.390% [95% CI: 0.107-0.673] per 1 ppb for NO2, 0.141% [95% CI: 0.058-0.224] per 1 μg/m(3) for SPM. The changes in the prevalence of wheezing and allergic rhinitis were not significantly correlated with changes in air pollutant concentrations. The enforcement of measures to control automobile emissions based on the Automobile NOx/PM law was shown to have reduced air pollution and contributed to

  19. Eucapnic voluntary hyperventilation in diagnosing exercise-induced laryngeal obstructions.

    Science.gov (United States)

    Christensen, Pernille M; Rasmussen, Niels

    2013-11-01

    Exercise-induced laryngeal obstructions (EILOs) cause exercise-related respiratory symptoms (ERRS) and are important differential diagnoses to exercise-induced asthma. The diagnostic method for EILOs includes provocation to induce the obstruction followed by a verification of the obstruction and the degree thereof. The objective of the present study was to examine if a eucapnic voluntary hyperventilation (EVH) test could induce laryngeal obstructions laryngoscopically identical in subtypes and development as seen during an exercise test. EVH and exercise testing with continuous laryngoscopy were performed during a screening of two national athletic teams (n = 67). The laryngoscopic recordings were examined for usability, abnormalities and maximal supraglottic and glottic obstruction using two currently available methods (Eilomea and CLE-score). The participants were asked questions on ERRS, and whether the symptoms experienced during each provocation matched those experienced during regular training. A total of 39 completed both tests. There were no significant differences in subtypes and development thereof, the experience of symptoms, and specificity and sensitivity between the methods. Significantly more recordings obtained during the exercise test were usable for evaluation primarily due to resilient mucus on the tip of the fiber-laryngoscope in the EVH test. Only recordings of six athletes from both provocation methods were usable for evaluation using the Eilomea method (high-quality demand). Amongst these, a linear correlation was found for the glottic obstruction. EVH tests can induce EILOs. However, the present test protocol needs adjustments to secure better visualisation of the larynx during provocation.

  20. Vietnam seeks help expanding voluntary surgical contraception.

    Science.gov (United States)

    Piet-pelon, N J; Sukop, S

    1992-07-01

    Recent surveys by the Vietnamese Ministry of Health suggest that 60% of married women desire no more children. Yet only 2% of currently married women and less than 1/2 of 1% of their partners use sterilization. Underscoring the high unmet need for effective family planning, over 1 million abortions (legal in Vietnam for the past 20 years) are performed annually. This rate corresponds to 1 abortion for every live birth. The Ministry of Health has recently welcomed a variety of organizations, including AVSC, whose assistance can help expand the country's family planning programs. Sorely lacking in supplies, equipment, and trained personnel, Vietnam has merited priority status--2nd only to China and India--from the UNFPA, which has committed $36 million over the next 4 years. Other organizations currently working in Vietnam include the Population Council, the Population Crisis Committee, and the International Planned Parenthood Federation. Despite enormous casualties during the war years, and a decrease since the 1970s in average family size from 6 to 4 children, the population of Vietnam has continued to grow rapidly, far outpacing economic growth. Currently 67 million, the population is expected to reach 80 million by the year 2000. The average Vietnamese annual income is only $195, among the lowest in the world. Doi moi, the process of economic reform begun in 1986, coupled with new government incentives for families who have no more than 2 children, is changing the face of family planning in Vietnam. Newly opened pharmacies sell imported birth control pills and condoms (to those who can afford them), while government hospitals and health clinics provide mainly IUDs, in addition to limited supplies of pills and condoms. Throughout the country, some 8000 community-level health centers are staffed by nurse-midwives trained in family planning. Voluntary sterilization is available at the district, provincial, and national hospitals. All married women may obtain family

  1. Outcomes of a Telehealth Intervention for Homebound Older Adults with Heart or Chronic Respiratory Failure: A Randomized Controlled Trial

    Science.gov (United States)

    Gellis, Zvi D.; Kenaley, Bonnie; McGinty, Jean; Bardelli, Ellen; Davitt, Joan; Ten Have, Thomas

    2012-01-01

    Purpose: Telehealth care is emerging as a viable intervention model to treat complex chronic conditions, such as heart failure (HF) and chronic obstructive pulmonary disease (COPD), and to engage older adults in self-care disease management. Design and Methods: We report on a randomized controlled trial examining the impact of a multifaceted…

  2. Respiratory Sinus Arrhythmia, Effortful Control, and Parenting as Predictors of Children's Sympathy across Early Childhood

    Science.gov (United States)

    Taylor, Zoe E.; Eisenberg, Nancy; Spinrad, Tracy L.

    2015-01-01

    The goal of this study was to examine physiological and environmental predictors of children's sympathy (an emotional response consisting of feelings of concern or sorrow for others who are distressed or in need) and whether temperamental effortful control mediated these relations. Specifically, in a study of 192 children (23% Hispanic; 54%…

  3. Evaluation of two different respiratory physiotherapy methods after ...

    African Journals Online (AJOL)

    Evaluation of two different respiratory physiotherapy methods after thoracoscopy with regard to arterial blood gas, respiratory function test, number of days until discharge, cost analysis, comfort and pain control.

  4. Voluntary reporting of greenhouse gases 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    The Voluntary Reporting of Greenhouse Gases Program, required by Section 1605(b) of the Energy Policy Act of 1992, records the results of voluntary measures to reduce, avoid, or sequester greenhouse gas emissions. In 1998, 156 US companies and other organizations reported to the Energy information Administration that, during 1997, they had achieved greenhouse gas emission reductions and carbon sequestration equivalent to 166 million tons of carbon dioxide, or about 2.5% of total US emissions for the year. For the 1,229 emission reduction projects reported, reductions usually were measured by comparing an estimate of actual emissions with an estimate of what emissions would have been had the project not been implemented.

  5. Voluntary Management Earnings Forecasts and Discretionary Accruals

    DEFF Research Database (Denmark)

    Gramlich, Jeffrey; Sørensen, Ole Vagn

    2004-01-01

    as a natural laboratory for learning how business would occur without strict rules, enforcement and sanctions. Danish managers often volunteer pro forma financial statements for results that are expected to occur subsequent to the IPO. We examine a sample of 58 Danish firms that issue voluntary management......This paper seeks to determine whether Danish managers exercise discretionary accruals to reach earnings forecast targets they voluntarily specify in conjunction with initial public offerings (IPOs). Because the Danish accounting and legal environment is more permissive than the US, we use Denmark...... earnings forecasts in connection with IPOs that occur between 1984 and 1996. The evidence we uncover strongly suggests that pre-managed earnings are adjusted toward these targets. In contrast with Kasznik's (1999 Kasznik, R. (1999). On the association between voluntary disclosure and earnings management...

  6. The Political Importance of Voluntary Work.

    Science.gov (United States)

    Kunneman, Harry

    This paper aims to develop a complex articulation of the civic meaningfulness of voluntary work that clarifies its political importance as a countervailing narrative pointing beyond dominant neoliberal and consumptive articulations of a good life. To start with, it sketches a hermeneutic perspective on civic meaningfulness based on the work of Paul Ricoeur. Subsequently, it introduces the ideas of 'ethical complexity', 'epistemological complexity' and 'diapoiesis', building on insights from critical complexity thinking and relational biology. It argues that these notions can provide a bridge between hermeneutic perspectives on meaning and values, on the one hand, and questions of meaning and values on the level of scientific and technological developments and within professional organizations, on the other. Thus a broader, more complex picture emerges of the civic meaningfulness of voluntary work in our times.

  7. Voluntary simulation workshops in nursing education

    DEFF Research Database (Denmark)

    Selberg, Hanne; Nielsen, Mette Elisabeth

    2012-01-01

    the students’ decision to drop out (Jensen et al. 2008). Within the past year our faculty has conducted several projects with the aim of integrating simulation into the curriculum. Furthermore, voluntary simulation workshop has been carried out as an additional offer in the nursing education. The purpose has...... were conducted with participation of 118 students in total from different levels of the nursing education. The workshops focused on both hands-on skills, communicative and teamwork skills and attention was continuously put on combining theory and practice. A questionnaire using a 10 point scale (1......Voluntary simulation workshops in nursing education Hanne Selberg1, Mette Elisabeth Nielsen1, Mette Wenzel Horsted2, Karen Bertelsen2, Marianne Linnet Rasmussen2,Rikke Lohmann Panton3, Copenhagen, Mette Kjeldal Jensen4 Background Changes in nursing education in Denmark towards an academic approach...

  8. Energy expenditure at rest and during walking in patients with chronic respiratory failure: a prospective two-phase case-control study.

    Directory of Open Access Journals (Sweden)

    Ernesto Crisafulli

    Full Text Available BACKGROUND: Measurements of Energy Expenditure (EE at rest (REE and during physical activities are increasing in interest in chronic patients. In this study we aimed at evaluating the validity/reliability of the SenseWear®Armband (SWA device in terms of REE and EE during assisted walking in Chronic Respiratory Failure (CRF patients receiving long-term oxygen therapy (LTOT. METHODOLOGY/PRINCIPAL FINDINGS: In a two-phase prospective protocol we studied 40 severe patients and 35 age-matched healthy controls. In phase-1 we determined the validity and repeatability of REE measured by SWA (REEa in comparison with standard calorimetry (REEc. In phase-2 we then assessed EE and Metabolic Equivalents-METs by SWA during the 6-minute walking test while breathing oxygen in both assisted (Aid or unassisted (No-Aid modalities. When compared with REEc, REEa was slightly lower in patients (1351±169 vs 1413±194 kcal/day respectively, p<0.05, and less repeatable than in healthy controls (0.14 and 0.43 coefficient respectively. COPD patients with CRF patients reported a significant gain with Aid as compared with No-Aid modality in terms of meters walked, perceived symptoms and EE. CONCLUSIONS/SIGNIFICANCE: SWA provides a feasible and valid method to assess the energy expenditure in CRF patients on LTOT, and it shows that aided walking results in a substantial energy saving in this population.

  9. A concept analysis of voluntary active euthanasia.

    Science.gov (United States)

    Guo, Fenglin

    2006-01-01

    Euthanasia has a wide range of classifications. Confusion exists in the application of specific concepts to various studies. To analyze the concept of voluntary active euthanasia using Walker and Avant's concept analysis method. A comprehensive literature review from various published literature and bibliographies. Clinical, ethical, and policy differences and similarities of euthanasia need to be debated openly, both within the medical profession and publicly. Awareness of the classifications about euthanasia may help nurses dealing with "end of life issues" properly.

  10. Certification as a Rationale for Voluntary Agreements

    OpenAIRE

    Patrick Gonzalez

    2011-01-01

    I model the participation of firms in a voluntary agreement as a costly certification process whereby a firm informs the Regulator of its pollution intensity. Without this knowledge, the Regulator imposes the same tax on all firms in a heterogeneous industry, unduly hurting the clean ones with the lowest intensity. Certification allows clean firms to get a tax rebate. It also entails an informational externality as the dispersion of types decreases within the pool of non-participating firms, ...

  11. Pre-acculturation among voluntary migrants

    OpenAIRE

    Yijälä, Anu

    2012-01-01

    This dissertation research focused on the pre-migration stage of the migration process and, specifically, the action period, which starts from making a decision to move abroad and lasts until the actual move. The research further developed the concept of pre-acculturation, that is, the active process that voluntary migrants in particular go through during the preparatory stage of migration process. As studies on pre-acculturation are still rather scarce, the theoretical background of the rese...

  12. 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 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.

  13. 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 (Verrecch...... 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......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...

  14. Voluntary Green Power Market Forecast through 2015

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Holt, E.; Sumner, J.; Kreycik, C.

    2010-05-01

    Various factors influence the development of the voluntary 'green' power market--the market in which consumers purchase or produce power from non-polluting, renewable energy sources. These factors include climate policies, renewable portfolio standards (RPS), renewable energy prices, consumers' interest in purchasing green power, and utilities' interest in promoting existing programs and in offering new green options. This report presents estimates of voluntary market demand for green power through 2015 that were made using historical data and three scenarios: low-growth, high-growth, and negative-policy impacts. The resulting forecast projects the total voluntary demand for renewable energy in 2015 to range from 63 million MWh annually in the low case scenario to 157 million MWh annually in the high case scenario, representing an approximately 2.5-fold difference. The negative-policy impacts scenario reflects a market size of 24 million MWh. Several key uncertainties affect the results of this forecast, including uncertainties related to growth assumptions, the impacts that policy may have on the market, the price and competitiveness of renewable generation, and the level of interest that utilities have in offering and promoting green power products.

  15. Mitigating greenhouse gas emissions: Voluntary reporting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-01

    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 on their emissions of greenhouse gases, and on actions taken that have reduced or avoided emissions or sequestered carbon, to the Energy Information Administration (EIA). This, the second annual report of the Voluntary Reporting Program, describes information provided by the participating organizations on their aggregate emissions and emissions reductions, as well as their emissions reduction or avoidance projects, through 1995. This information has been compiled into a database that includes reports from 142 organizations and descriptions of 967 projects that either reduced greenhouse gas emissions or sequestered carbon. Fifty-one reporters also provided estimates of emissions, and emissions reductions achieved, for their entire organizations. The projects described actions taken to reduce emissions of carbon dioxide from energy production and use; to reduce methane and nitrous oxide emissions from energy use, waste management, and agricultural processes; to reduce emissions of halocarbons, such as CFCs and their replacements; and to increase carbon sequestration.

  16. Early maternal deprivation enhances voluntary alcohol intake induced by exposure to stressful events later in life.

    Science.gov (United States)

    Peñasco, Sara; Mela, Virginia; López-Moreno, Jose Antonio; Viveros, María-Paz; Marco, Eva M

    2015-01-01

    In the present study, we aimed to assess the impact of early life stress, in the form of early maternal deprivation (MD, 24 h on postnatal day, pnd, 9), on voluntary alcohol intake in adolescent male and female Wistar rats. During adolescence, from pnd 28 to pnd 50, voluntary ethanol intake (20%, v/v) was investigated using the two-bottle free choice paradigm. To better understand the relationship between stress and alcohol consumption, voluntary alcohol intake was also evaluated following additional stressful events later in life, that is, a week of alcohol cessation and a week of alcohol cessation combined with exposure to restraint stress. Female animals consumed more alcohol than males only after a second episode of alcohol cessation combined with restraint stress. MD did not affect baseline voluntary alcohol intake but increased voluntary alcohol intake after stress exposure, indicating that MD may render animals more vulnerable to the effects of stress on alcohol intake. During adolescence, when animals had free access to alcohol, MD animals showed lower body weight gain but a higher growth rate than control animals. Moreover, the higher growth rate was accompanied by a decrease in food intake, suggesting an altered metabolic regulation in MD animals that may interact with alcohol intake.

  17. Addiction, Voluntary Choice, and Informed Consent: A Reply to Uusitalo and Broers.

    Science.gov (United States)

    Henden, Edmund

    2016-05-01

    In an earlier article in this journal I argued that the question of whether heroin addicts can give voluntary consent to take part in research which involves giving them a choice of free heroin does not - in contrast with a common assumption in the bioethics literature - depend exclusively on whether or not they possess the capacity to resist their desire for heroin. In some cases, circumstances and beliefs might undermine the voluntariness of the choices a person makes even if they do possess a capacity for self-control. Based on what I took to be a plausible definition of voluntariness, I argued that the circumstances and beliefs typical of many vulnerable heroin addicts are such that we have good reasons to suspect they cannot give voluntary consent to take part in such research, even assuming their desire for heroin is not irresistible. In a recent article in this journal, Uusitalo and Broers object to this on the grounds that I misdescribe heroin addicts' options set, that the definition of voluntariness on which I rely is unrealistic and too demanding, and, more generally, that my view of heroin addiction is flawed. I think their arguments derive from a misunderstanding of the view I expressed in my article. In what follows I hope therefore to clarify my position. © 2015 John Wiley & Sons Ltd.

  18. Voluntary stand-up physical activity enhances endurance exercise capacity in rats.

    Science.gov (United States)

    Seo, Dae Yun; Lee, Sung Ryul; Kwak, Hyo-Bum; Seo, Kyo Won; McGregor, Robin A; Yeo, Ji Young; Ko, Tae Hee; Bolorerdene, Saranhuu; Kim, Nari; Ko, Kyung Soo; Rhee, Byoung Doo; Han, Jin

    2016-05-01

    Involuntary physical activity induced by the avoidance of electrical shock leads to improved endurance exercise capacity in animals. However, it remains unknown whether voluntary stand-up physical activity (SPA) without forced simulating factors improves endurance exercise capacity in animals. We examined the eff ects of SPA on body weight, cardiac function, and endurance exercise capacity for 12 weeks. Twelve male Sprague-Dawley rats (aged 8 weeks, n=6 per group) were randomly assigned to a control group (CON) or a voluntary SPA group. The rats were induced to perform voluntary SPA (lifting a load equal to their body weight), while the food height (18.0 cm) in cages was increased progressively by 3.5 every 4 weeks until it reached 28.5 cm for 12 weeks. The SPA group showed a lower body weight compared to the CON group, but voluntary SPA did not affect the skeletal muscle and heart weights, food intake, and echocardiography results. Although the SPA group showed higher grip strength, running time, and distance compared to the CON group, the level of irisin, corticosterone, genetic expression of mitochondrial biogenesis, and nuclei numbers were not affected. These findings show that voluntary SPA without any forced stimuli in rats can eff ectively reduce body weight and enhance endurance exercise capacity, suggesting that it may be an important alternative strategy to enhance endurance exercise capacity.

  19. Early Maternal Deprivation Enhances Voluntary Alcohol Intake Induced by Exposure to Stressful Events Later in Life

    Directory of Open Access Journals (Sweden)

    Sara Peñasco

    2015-01-01

    Full Text Available In the present study, we aimed to assess the impact of early life stress, in the form of early maternal deprivation (MD, 24 h on postnatal day, pnd, 9, on voluntary alcohol intake in adolescent male and female Wistar rats. During adolescence, from pnd 28 to pnd 50, voluntary ethanol intake (20%, v/v was investigated using the two-bottle free choice paradigm. To better understand the relationship between stress and alcohol consumption, voluntary alcohol intake was also evaluated following additional stressful events later in life, that is, a week of alcohol cessation and a week of alcohol cessation combined with exposure to restraint stress. Female animals consumed more alcohol than males only after a second episode of alcohol cessation combined with restraint stress. MD did not affect baseline voluntary alcohol intake but increased voluntary alcohol intake after stress exposure, indicating that MD may render animals more vulnerable to the effects of stress on alcohol intake. During adolescence, when animals had free access to alcohol, MD animals showed lower body weight gain but a higher growth rate than control animals. Moreover, the higher growth rate was accompanied by a decrease in food intake, suggesting an altered metabolic regulation in MD animals that may interact with alcohol intake.

  20. Extracorporeal membrane oxygenation (ECMO) in adults with acute respiratory distress syndrome (ARDS): A 6-year experience and case-control study.

    Science.gov (United States)

    Muñoz, Javier; Santa-Teresa, Patricia; Tomey, María Jesus; Visedo, Lourdes Carmen; Keough, Elena; Barrios, Juan Camilo; Sabell, Santiago; Morales, Antonio

    To evaluate the development of an extracorporeal membrane oxygenation (ECMO) program for the treatment of acute respiratory distress syndrome (ARDS) in adults. a) Descriptive study of 15 cases treated since the program approval from 2010 to 2016. b) Case-control study matching the 15 ECMO cases with the 52 severe ARDS treated between 2005 and 2011 in which alternative rescue treatments (prone ventilation, tracheal gas insufflation (TGI) and/or the administration of inhaled nitric oxide (iNO)) were used. ECMO experience: Mortality 47% (7/15). Four patients died due to complications directly related to ECMO therapy. ICU stay 46.6 ± 45 days (range 4-138). Hospital stay 72.4 ± 98 days (range 4-320). Case-control: The mortality in the control group was 77% (44/52). The ECMO group practically doubled the mean days of ICU and hospital stay (p ECMO treatment. The following were also independent predictors of mortality: age (OR 1.05, 95% CI 1-11), SOFA score (OR 1.34, 95% CI 1.04-1.7), and the need for renal replacement therapy (OR 1.3, 95% CI 1.04-1.7). Economic analysis: The hospital cost per patient in the ECMO group doubled compared to that of the control group (USD 77,099 vs USD 37,660). However, the cost per survivor was reduced by 4% (USD 144,560 vs USD 150,640, respectively). Our results endorse the use of ECMO as a rescue therapy in adults with ARDS, although there are some risks associated with a learning curve as well as an important increase in the days of patient stay. The justification for the maintenance of an ECMO program in adults should be based on future studies of efficacy and cost effectiveness. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Benzyl alcohol increases voluntary ethanol drinking in rats.

    Science.gov (United States)

    Etelälahti, T J; Eriksson, C J P

    2014-09-01

    The anabolic steroid nandrolone decanoate has been reported to increase voluntary ethanol intake in Wistar rats. In recent experiments we received opposite results, with decreased voluntary ethanol intake in both high drinking AA and low drinking Wistar rats after nandrolone treatment. The difference between the two studies was that we used pure nandrolone decanoate in oil, whereas in the previous study the nandrolone product Deca-Durabolin containing benzyl alcohol (BA) was used. The aims of the present study were to clarify whether the BA treatment could promote ethanol drinking and to assess the role of the hypothalamic-pituitary-adrenal-gonadal axes (HPAGA) in the potential BA effect. Male AA and Wistar rats received subcutaneously BA or vehicle oil for 14 days. Hereafter followed a 1-week washout and consecutively a 3-week voluntary alcohol consumption period. The median (± median absolute deviation) voluntary ethanol consumption during the drinking period was higher in BA-treated than in control rats (4.94 ± 1.31 g/kg/day vs. 4.17 ± 0.31 g/kg/day, p = 0.07 and 1.01 ± 0.26 g/kg/day vs. 0.38 ± 0.27 g/kg/day, p = 0.05, for AA and Wistar rats, respectively; combined effect p < 0.01). The present results can explain the previous discrepancy between the two nandrolone studies. No significant BA effects on basal and ethanol-mediated serum testosterone and corticosterone levels were observed in blood samples taken at days 1, 8 and 22. However, 2h after ethanol administration significantly (p = 0.02) higher frequency of testosterone elevations was detected in high drinking AA rats compared to low drinking Wistars, which supports our previous hypotheses of a role of testosterone elevation in promoting ethanol drinking. Skin irritation and dermatitis were shown exclusively in the BA-treated animals. Altogether, the present results indicate that earlier findings obtained with Deca-Durabolin containing BA need to be re-evaluated. Copyright © 2014 Elsevier Inc. All

  2. Dexamethasone for treatment of patients mechanically ventilated for lower respiratory tract infection caused by respiratory syncytial virus

    NARCIS (Netherlands)

    van Woensel, JBM; van Aalderen, WMC; de Weerd, W; Jansen, NJG; van Gestel, JPJ; Markhorst, DG; van Vught, AJ; Bos, AP; Kimpen, JLL

    Background: A study was undertaken to evaluate the efficacy of dexamethasone in patients mechanically ventilated for lower respiratory infection caused by respiratory syncytial virus (RSV-LRTI). Methods: In a multicentre randomised controlled trial patients were randomised to receive either

  3. Pulmonary Function Tests and Work-Related Respiratory and Allergic

    OpenAIRE

    Boskabady Mohammad Hosein; Taheri Ehsan; Ahmadi Sina; Ebrahimi Kolsoumeh; Soudaneh Malihe; Mohammadi Fatemeh; Sabourhasanzadeh Alireza

    2009-01-01

    Bakers are frequently exposed to various irritant chemicals during work which can induce respiratory problems. In this study, pulmonary function tests and self-reported respiratory and allergic symptoms in bakers were compared with matched control subjects. The frequency of respiratory and allergic symptoms was evaluated in a sample of 58 Iranian bakers and 58 control subjects using a questionnaire. Pulmonary function tests (PFT) were also measured in all participants. All respiratory symptom...

  4. Reported occupational respiratory diseases in Catalonia

    Science.gov (United States)

    Orriols, R; Costa, R; Albanell, M; Alberti, C; Castejon, J; Monso, E; Panades, R; Rubira, N; Zock, J‐P

    2006-01-01

    Objectives A voluntary surveillance system was implemented in Catalonia (Spain) to ascertain the feasibility, incidence, and characteristics of occupational respiratory diseases and compare them with those of the compulsory official system. Methods In 2002, in collaboration with the Occupational and Thoracic Societies of Catalonia, occupational and chest physicians and other specialists were invited to report, on a bimonthly basis, newly diagnosed cases of occupational respiratory diseases. Information requested on each case included diagnosis, age, sex, place of residence, occupation, suspected agent, and physician's opinion on the likelihood that the condition was work related. Compulsory official system data derived from statistics on work related diseases for possible disability benefits declared by insurance companies, which are responsible for declaring these diseases to the Autonomous Government of Catalonia. Results Of 142 physicians seeing patients with occupational respiratory diseases approached, 102 (74%) participated. Three hundred and fifty nine cases were reported, of which asthma (48.5%), asbestos related diseases (14.5%), and acute inhalations (12.8%) were the most common. Physicians rated 63% of suspected cases as highly likely, 28% as likely, and 8% as low likelihood. The most frequent suspected agents reported for asthma were isocyanates (15.5%), persulphates (12.1%), and cleaning products (8.6%). Mesothelioma (5.9%) was the most frequent diagnosis among asbestos related diseases. The number of acute inhalations reported was high, with metal industries (26%), cleaning services (22%), and chemical industries (13%) being the most frequently involved. The frequency of occupational respiratory diseases recorded by this voluntary surveillance system was four times higher than that reported by the compulsory official system. Conclusions The compulsory scheme for reporting occupational lung diseases is seriously underreporting in Catalonia. A

  5. Using farmers' attitude and social pressures to design voluntary Bluetongue vaccination strategies.

    Science.gov (United States)

    Sok, J; Hogeveen, H; Elbers, A R W; Oude Lansink, A G J M

    2016-10-01

    Understanding the context and drivers of farmers' decision-making is critical to designing successful voluntary disease control interventions. This study uses a questionnaire based on the Reasoned Action Approach framework to assess the determinants of farmers' intention to participate in a hypothetical reactive vaccination scheme against Bluetongue. Results suggest that farmers' attitude and social pressures best explained intention. A mix of policy instruments can be used in a complementary way to motivate voluntary vaccination based on the finding that participation is influenced by both internal and external motivation. Next to informational and incentive-based instruments, social pressures, which stem from different type of perceived norms, can spur farmers' vaccination behaviour and serve as catalysts in voluntary vaccination schemes. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Comparing outcomes of 'voluntary' and 'quasi-compulsory' treatment of substance dependence in Europe.

    Science.gov (United States)

    Schaub, Michael; Stevens, Alex; Berto, Daniele; Hunt, Neil; Kerschl, Viktoria; McSweeney, Tim; Oeuvray, Kerrie; Puppo, Irene; Santa Maria, Alberto; Trinkl, Barbara; Werdenich, Wolfgang; Uchtenhagen, Ambros

    2010-01-01

    This study evaluates quasi-compulsory drug treatment (QCT) arrangements for substance-dependent offenders receiving treatment instead of imprisonment in comparison to voluntary treatment within five European countries. Participants were interviewed with the European Addiction Severity Index, the ASI-crime module, questions on perception of pressure and self-efficacy, and the Readiness-to-Change Questionnaire at treatment entry and after 6, 12, and 18 months. Reductions in substance use and crime as well as improvements in health and social integration were observed in QCT and voluntary treatment groups. After controlling for various factors, subjects in the QCT and the comparison group showed similar reductions in substance use and crime over time. Study retention was comparable in both groups. QCT is as effective as voluntary treatment provided in the same services in reducing substance use and crime. Copyright 2009 S. Karger AG, Basel.

  7. Respiratory syncytial virus: co-infection and paediatric lower respiratory tract infections.

    Science.gov (United States)

    Yoshida, Lay-Myint; Suzuki, Motoi; Nguyen, Hien Anh; Le, Minh Nhat; Dinh Vu, Thiem; Yoshino, Hiroshi; Schmidt, Wolf-Peter; Nguyen, Thi Thuy Ai; Le, Huu Tho; Morimoto, Konosuke; Moriuchi, Hiroyuki; Dang, Duc Anh; Ariyoshi, Koya

    2013-08-01

    Comprehensive population-based data on the role of respiratory viruses in the development of lower respiratory tract infections (LRTIs) remain unclear. We investigated the incidence and effect of single and multiple infections with respiratory viruses on the risk of LRTIs in Vietnam. Population-based prospective surveillance and a case-control study of hospitalised paediatric patients with acute respiratory infection (ARI) were conducted from April 2007 through to March 2010. Healthy controls were randomly recruited from the same community. Nasopharyngeal samples were collected and tested for 13 respiratory viruses using multiplex PCRs. 1992 hospitalised ARI episodes, including 397 (19.9%) with LRTIs, were enrolled. Incidence of hospitalised LRTIs among children aged respiratory syncytial virus (20.1%) and influenza A virus (12.0%) were the most common and 9.5% had multiple-viral infections. Respiratory syncytial virus and human metapneumovirus infections independently increased the risk of LRTIs. Respiratory syncytial virus further increased the risk, when co-infected with human rhinovirus, human metapneumovirus and parainfluenza virus-3 but not with influenza A virus. The case-control analysis revealed that respiratory syncytial virus and influenza A virus increased the risk of ARI hospitalisation but not human rhinovirus. Respiratory syncytial virus is the leading pathogen associated with risk of ARI hospitalisation and LRTIs in Vietnam.

  8. Downregulation of cough by exercise and voluntary hyperpnea.

    Science.gov (United States)

    Fontana, Giovanni A

    2010-01-01

    No information exists on the effects of hyperpnea on the sensory and cognitive aspects of coughing evoked by inhalation of tussigenic agents. The threshold for the cough reflex induced by inhalation of increasing concentrations of ultrasonically nebulized distilled water (fog), and the index of cough reflex sensitivity, was assessed in 12 healthy humans in control conditions, during exercise, and during voluntary isocapnic hyperventilation (VIH) to the same level as the exercise. The intensity of the urge-to-cough (UTC), a cognitive component of coughing, was also recorded throughout the trials. The log-log relationship between inhaled fog concentrations and the correspondingly evoked UTC values, an index of the perceptual magnitude of the UTC sensitivity, was also calculated. Cough appearance was always assessed audiovisually. At an exercise level of 80% of anaerobic threshold, the mean cough threshold was increased from a control value of 1.03 +/- 0.65 to 2.25 +/- 1.14 ml/min (p VIH, the mean (+/-SD) threshold increased from 1.03 +/- 0.65 to 2.42 +/- 1.16 ml/min (p VIH compared with control, mean UTC values at cough threshold were not significantly changed: control, 3.83 +/- 1.11 cm; exercise, 3.12 +/- 0.82 cm; VIH, 4.08 +/- 1.67 cm. Since the slopes of the log fog concentration/log UTC value were approximately halved during exercise and VIH compared with control, the UTC sensitivity to fog was depressed (p < 0.01). The results indicate that the adjustments brought into action by exercise-induced or voluntary hyperventilation exert inhibitory influences on the sensory and cognitive components of fog-induced cough.

  9. [Efficacy of integrative respiratory rehabilitation training in exercise ability and quality of life of patients with chronic obstructive pulmonary disease in stable phase: a randomized controlled trial].

    Science.gov (United States)

    Xu, Yuan-hong; Wang, Jun-hua; Li, Hai-feng; Zhu, Xiao-hu; Wang, Gang

    2010-05-01

    Chronic obstructive pulmonary disease (COPD) is an important clinical disease, and its global prevalence and mortality rates are high. It is meaningful to investigate the efficacy of integrative respiratory rehabilitation training in quality of life and respiratory physiology of COPD patients in stable phase. To observe the efficacy of integrative respiratory rehabilitation training in exercise ability and quality of life of COPD patients in stable phase. Eighty outpatients and inpatients with COPD from Department of Respiratory Medicine, Taihe Hospital, Yunyang Medical College were randomly divided into 4 groups, with 20 patients in each group. The patients in group A only received drug therapy, the patients in group B received traditional qigong training, the patients in group C received modern rehabilitation training, and the patients in group D received integrative respiratory rehabilitation training. Chronic respiratory questionnaire (CRQ), 6-minute walking distance and Borg score in each group were examined before and after one-, three-, and six-month and one-year treatment. The 6-minute walking distance, Borg score and CRQ score in group A had no significant changes after treatment (P>0.05). After one-month treatment, there were no significant differences in 6-minute walking distance and Borg score in groups B, C and D as compared with those before treatment (Prehabilitation training, traditional qigong training and integrative respiratory rehabilitation training programs all can improve the quality of life and exercise ability of COPD patients, and integrative respiratory rehabilitation training program is better than modern rehabilitation training and traditional qigong training programs. The efficacy of respiratory rehabilitation training is time-dependent, and need long-time adherence to the therapy.

  10. Voluntary or Mandatory Enrollment in Training and the Motivation to Transfer Training

    Science.gov (United States)

    Curado, Carla; Henriques, Paulo Lopes; Ribeiro, Sofia

    2015-01-01

    The purpose of this study is to examine the motivation to transfer training in a multidimensional way. It investigates autonomous and controlled motivation and explores the difference in motivation to transfer according to whether the employee is enrolled in training on a voluntary or mandatory basis. This is a cross-sectional hypotheses-testing…

  11. Leading Voluntary-Aided Faith Schools in England: Perspectives from Catholic, Anglican and Jewish Headteachers

    Science.gov (United States)

    Shaw, Alan

    2017-01-01

    Voluntary-aided faith schools exhibit a unique combination of characteristics that is not shared by other state-funded schools in England including responsibility for admissions, employment of staff (including the right to prioritise on the basis of faith), control of the RE curriculum, ownership of the premises, and funding from and being part of…

  12. Voluntary binocular gaze-shifts in the plane of regard: Dynamics of version and vergence

    NARCIS (Netherlands)

    H. Collewijn (Han); D.W. Erkelens (Dirk Willem); R.M. Steinman (Robert)

    1995-01-01

    textabstractWe studied the dynamics of voluntary, horizontal, binocular gaze-shifts between pairs of continuously visible, real three-dimensional targets. Subjects were stabilized on a biteboard to allow full control of target angles, which were made to differ only in distance (pure vergence), only

  13. The respiratory microbiome and respiratory infections

    NARCIS (Netherlands)

    Unger, Stefan A.; Bogaert, Debby|info:eu-repo/dai/nl/264105834

    2017-01-01

    Despite advances over the past ten years lower respiratory tract infections still comprise around a fifth of all deaths worldwide in children under five years of age with the majority in low- and middle-income countries. Known risk factors for severe respiratory infections and poor chronic

  14. Does training family physicians in shared decision making promote optimal use of antibiotics for acute respiratory infections? Study protocol of a pilot clustered randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Côté Luc

    2007-11-01

    Full Text Available Abstract Background In North America, although it varies according to the specific type of acute respiratory infections (ARI, use of antibiotics is estimated to be well above the expected prevalence of bacterial infections. The objective of this pilot clustered randomized controlled trial (RCT is to assess the feasibility of a larger clustered RCT aiming at evaluating the impact of DECISION+, a continuing professional development (CPD program in shared decision making, on the optimal use of antibiotics in the context of ARI. Methods/design This pilot study is a cluster RCT conducted with family physicians from Family Medicine Groups (FMG in the Quebec City area, Canada. Participating FMG are randomised to an immediate DECISION+ group, a CPD program in shared decision making, (experimental group, or a delayed DECISION+ group (control group. Data collection involves recruiting five patients consulting for ARI per physician from both study groups before (Phase 1 and after (Phase 2 exposure of the experimental group to the DECISION+ program, and after exposure of the control group to the DECISION+ program (Phase 3. The primary outcome measures to assess the feasibility of a larger RCT include: 1 proportion of contacted FMG that agree to participate; 2 proportion of recruited physicians who participate in the DECISION+ program; 3 level of satisfaction of physicians regarding DECISION+; and 4 proportion of missing data in each data collection phase. Levels of agreement of the patient-physician dyad on the Decisional Conflict Scale and physicians' prescription profile for ARI are performed as secondary outcome measures. Discussion This study protocol is informative for researchers and clinicians interested in designing and/or conducting clustered RCT with FMG regarding training of physicians in shared decision making. Trial Registration ClinicalTrials.gov Identifier: NCT00354315

  15. Effects of acute voluntary loaded wheel running on BDNF expression in the rat hippocampus.

    Science.gov (United States)

    Lee, Minchul; Soya, Hideaki

    2017-12-31

    Voluntary loaded wheel running involves the use of a load during a voluntary running activity. A muscle-strength or power-type activity performed at a relatively high intensity and a short duration may cause fewer apparent metabolic adaptations but may still elicit muscle fiber hypertrophy. This study aimed to determine the effects of acute voluntary wheel running with an additional load on brain-derived neurotrophic factor (BDNF) expression in the rat hippocampus. Ten-week old male Wistar rats were assigned randomly to a (1) sedentary (Control) group; (2) voluntary exercise with no load (No-load) group; or (3) voluntary exercise with an additional load (Load) group for 1-week (acute period). The expression of BDNF genes was quantified by real-time PCR. The average distance levels were not significantly different in the No-load and Load groups. However, the average work levels significantly increased in the Load group. The relative soleus weights were greater in the No-load group. Furthermore, loaded wheel running up-regulated the BDNF mRNA level compared with that in the Control group. The BDNF mRNA levels showed a positive correlation with workload levels (r=0.75), suggesting that the availability of multiple workload levels contributes to the BDNF-related benefits of loaded wheel running noted in this study. This novel approach yielded the first set of findings showing that acute voluntary loaded wheel running, which causes muscular adaptation, enhanced BDNF expression, suggesting a possible role of high-intensity short-term exercise in hippocampal BDNF activity.

  16. The Ins and Outs of Breath Holding: Simple Demonstrations of Complex Respiratory Physiology

    Science.gov (United States)

    Skow, Rachel J.; Day, Trevor A.; Fuller, Jonathan E.; Bruce, Christina D.; Steinback, Craig D.

    2015-01-01

    The physiology of breath holding is complex, and voluntary breath-hold duration is affected by many factors, including practice, psychology, respiratory chemoreflexes, and lung stretch. In this activity, we outline a number of simple laboratory activities or classroom demonstrations that illustrate the complexity of the integrative physiology…

  17. Probiotics in respiratory virus infections.

    Science.gov (United States)

    Lehtoranta, L; Pitkäranta, A; Korpela, R

    2014-08-01

    Viral respiratory infections are the most common diseases in humans. A large range of etiologic agents challenge the development of efficient therapies. Research suggests that probiotics are able to decrease the risk or duration of respiratory infection symptoms. However, the antiviral mechanisms of probiotics are unclear. The purpose of this paper is to review the current knowledge on the effects of probiotics on respiratory virus infections and to provide insights on the possible antiviral mechanisms of probiotics. A PubMed and Scopus database search was performed up to January 2014 using appropriate search terms on probiotic and respiratory virus infections in cell models, in animal models, and in humans, and reviewed for their relevance. Altogether, thirty-three clinical trials were reviewed. The studies varied highly in study design, outcome measures, probiotics, dose, and matrices used. Twenty-eight trials reported that probiotics had beneficial effects in the outcome of respiratory tract infections (RTIs) and five showed no clear benefit. Only eight studies reported investigating viral etiology from the respiratory tract, and one of these reported a significant decrease in viral load. Based on experimental studies, probiotics may exert antiviral effects directly in probiotic-virus interaction or via stimulation of the immune system. Although probiotics seem to be beneficial in respiratory illnesses, the role of probiotics on specific viruses has not been investigated sufficiently. Due to the lack of confirmatory studies and varied data available, more randomized, double-blind, and placebo-controlled trials in different age populations investigating probiotic dose response, comparing probiotic strains/genera, and elucidating the antiviral effect mechanisms are necessary.

  18. Respiratory effects of fine and ultrafine particles from indoor sources--a randomized sham-controlled exposure study of healthy volunteers.

    Science.gov (United States)

    Soppa, Vanessa J; Schins, Roel P F; Hennig, Frauke; Hellack, Bryan; Quass, Ulrich; Kaminski, Heinz; Kuhlbusch, Thomas A J; Hoffmann, Barbara; Weinmayr, Gudrun

    2014-07-04

    Particulate air pollution is linked to impaired respiratory health. We analyzed particle emissions from common indoor sources (candles burning (CB), toasting bread (TB), frying sausages (FS)) and lung function in 55 healthy volunteers (mean age 33.0 years) in a randomized cross-over controlled exposure study. Lung-deposited particle surface area concentration (PSC), size-specific particle number concentration (PNC) up to 10 µm, and particle mass concentration (PMC) of PM1, PM2.5 and PM10 were determined during exposure (2 h). FEV1, FVC and MEF25%-75% was measured before, 4 h and 24 h after exposure. Wilcoxon-rank sum tests (comparing exposure scenarios) and mixed linear regression using particle concentrations and adjusting for personal characteristics, travel time and transportation means before exposure sessions were performed. While no effect was seen comparing the exposure scenarios and in the unadjusted model, inverse associations were found for PMC from CB and FS in relation to FEV1 and MEF25%-75%. with a change in 10 µg/m3 in PM2.5 from CB being associated with a change in FEV1 of -19 mL (95%-confidence interval:-43; 5) after 4 h. PMC from TB and PNC of UFP were not associated with lung function changes, but PSC from CB was. Elevated indoor fine particles from certain sources may be associated with small decreases in lung function in healthy adults.

  19. Homeopathic medicine for acute cough in upper respiratory tract infections and acute bronchitis: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Zanasi, Alessandro; Mazzolini, Massimiliano; Tursi, Francesco; Morselli-Labate, Antonio Maria; Paccapelo, Alexandro; Lecchi, Marzia

    2014-02-01

    Cough is a frequent symptom associated to upper respiratory tract infections (URTIs) and, although being self-limiting, it might deeply affect the quality of life. Homeopathic products are often employed by patients to treat cough, but the evidence on their efficacy is scarce. Thus, we tested the efficacy of a homeopathic syrup in treating cough arising from URTIs with a randomized, double blind, placebo controlled clinical trial. Patients were treated with either the homeopathic syrup or a placebo for a week, and recorded cough severity in a diary by means of a verbal category-descriptive score for two weeks. Sputum viscosity was assessed with a viscosimeter before and after 4 days of treatment; patients were also asked to provide a subjective evaluation of viscosity. Eighty patients were randomized to receive placebo (n = 40) or the homeopathic syrup (n = 40). All patients completed the study. In each group cough scores decreased over time, however, after 4 and 7 days of treatment, cough severity was significantly lower in the homeopathic group than in the placebo one (p acute cough induced by URTIs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Vitamin D supplementation improves well-being in patients with frequent respiratory tract infections: a post hoc analysis of a randomized, placebo-controlled trial.

    Science.gov (United States)

    Bergman, Peter; Norlin, Anna-Carin; Hansen, Susanne; Björkhem-Bergman, Linda

    2015-09-29

    The aim of this study was to test the hypothesis that vitamin D supplementation improves well-being in patients with frequent respiratory tract infections (RTIs). We performed a post hoc analysis of a randomized, placebo-controlled and double-blind study in which patients with frequent RTIs were randomized to placebo or vitamin D (4000 IE/day for 1 year, n = 124). At the last visit of the study, patients were asked to perform a general assessment of their well-being during the study. The majority of patients, both placebo- and vitamin D treated, stated that they had felt 'better' during the study; 52% in the placebo group and 70% in the vitamin D group, relative risk 1.3 (95% CI 1.0-1.8; p = 0.06, Fisher's exact test). Statement of better well-being was associated with an increase in 25-hydroxyvitamin D (25-OHD) levels (p Vitamin D supplementation to patients with frequent RTIs might be beneficial, not only for infections, but also for their general well-being. However, given the post hoc design of this study, these findings need to be confirmed in additional clinical trials before firm conclusions can be drawn. http://www.clinicaltrials.gov (NCT01131858), registered March 22, 2010.

  1. Identification of a previously undetected metabolic defect in the Complex II Caenorhabditis elegans mev-1 mutant strain using respiratory control analysis.

    Science.gov (United States)

    Fong, Sheng; Ng, Li Fang; Ng, Li Theng; Moore, Philip K; Halliwell, Barry; Gruber, Jan

    2017-04-01

    Hypometabolism may play an important role in the pathogenesis of ageing and ageing-related diseases. The nematode Caenorhabditis elegans offers the opportunity to study "living mitochondria" in a small (~1 mm) animal replete with a highly stereotypical, yet complex, anatomy and physiology. Basal oxygen consumption rate is often employed as a proxy for energy metabolism in this context. This parameter is traditionally measured using single-chamber Clark electrodes without the addition of metabolic modulators. Recently, multi-well oxygen electrodes, facilitating addition of metabolic modulators and hence study of respiratory control during different mitochondrial respiration states, have been developed. However, only limited official protocols exist for C. elegans, and key limitations of these techniques are therefore unclear. Following modification and testing of some of the existing protocols, we used these methods to explore mitochondrial bioenergetics in live nematodes of an electron transfer chain Complex II mutant strain, mev-1, and identified a previously undetected metabolic defect. We find that mev-1 mutants cannot respond adequately to increased energy demands, suggesting that oxidative phosphorylation is more severely impaired in these animals than has previously been appreciated.

  2. Respiratory Effects of Fine and Ultrafine Particles from Indoor Sources—A Randomized Sham-Controlled Exposure Study of Healthy Volunteers

    Science.gov (United States)

    Soppa, Vanessa J.; Schins, Roel P. F.; Hennig, Frauke; Hellack, Bryan; Quass, Ulrich; Kaminski, Heinz; Kuhlbusch, Thomas A. J.; Hoffmann, Barbara; Weinmayr, Gudrun

    2014-01-01

    Particulate air pollution is linked to impaired respiratory health. We analyzed particle emissions from common indoor sources (candles burning (CB), toasting bread (TB), frying sausages (FS)) and lung function in 55 healthy volunteers (mean age 33.0 years) in a randomized cross-over controlled exposure study. Lung-deposited particle surface area concentration (PSC), size-specific particle number concentration (PNC) up to 10 µm, and particle mass concentration (PMC) of PM1, PM2.5 and PM10 were determined during exposure (2 h). FEV1, FVC and MEF25%–75% was measured before, 4 h and 24 h after exposure. Wilcoxon-rank sum tests (comparing exposure scenarios) and mixed linear regression using particle concentrations and adjusting for personal characteristics, travel time and transportation means before exposure sessions were performed. While no effect was seen comparing the exposure scenarios and in the unadjusted model, inverse associations were found for PMC from CB and FS in relation to FEV1 and MEF25%–75%. with a change in 10 µg/m3 in PM2.5 from CB being associated with a change in FEV1 of −19 mL (95%-confidence interval:−43; 5) after 4 h. PMC from TB and PNC of UFP were not associated with lung function changes, but PSC from CB was. Elevated indoor fine particles from certain sources may be associated with small decreases in lung function in healthy adults. PMID:25000149

  3. Mechanism for Controlling the Dimer-Monomer Switch and Coupling Dimerization to Catalysis of the Severe Acute Respiratory Syndrome Coronavirus 3C-Like Protease

    Energy Technology Data Exchange (ETDEWEB)

    Shi,J.; Sivaraman, J.; Song, J.

    2008-01-01

    Unlike 3C protease, the severe acute respiratory syndrome coronavirus (SARS-CoV) 3C-like protease (3CLpro) is only enzymatically active as a homodimer and its catalysis is under extensive regulation by the unique extra domain. Despite intense studies, two puzzles still remain: (i) how the dimer-monomer switch is controlled and (ii) why dimerization is absolutely required for catalysis. Here we report the monomeric crystal structure of the SARS-CoV 3CLpro mutant R298A at a resolution of 1.75 Angstroms . Detailed analysis reveals that Arg298 serves as a key component for maintaining dimerization, and consequently, its mutation will trigger a cooperative switch from a dimer to a monomer. The monomeric enzyme is irreversibly inactivated because its catalytic machinery is frozen in the collapsed state, characteristic of the formation of a short 310-helix from an active-site loop. Remarkably, dimerization appears to be coupled to catalysis in 3CLpro through the use of overlapped residues for two networks, one for dimerization and another for the catalysis.

  4. Instantaneous responses to high-frequency chest wall oscillation in patients with acute pneumonic respiratory failure receiving mechanical ventilation: A randomized controlled study.

    Science.gov (United States)

    Chuang, Ming-Lung; Chou, Yi-Ling; Lee, Chai-Yuan; Huang, Shih-Feng

    2017-03-01

    Endotracheal intubation and prolonged immobilization of patients receiving mechanical ventilation may reduce expectoration function. High-frequency chest wall oscillation (HFCWO) may ameliorate airway secretion movement; however, the instantaneous changes in patients' cardiopulmonary responses are unknown. Moreover, HFCWO may influence ventilator settings by the vigorous oscillation. The aim of this study was to investigate these issues. Seventy-three patients (52 men) aged 71.5 ± 13.4 years who were intubated with mechanical ventilation for pneumonic respiratory failure were recruited and randomly classified into 2 groups (HFCWO group, n = 36; and control group who received conventional chest physical therapy (CCPT, n = 37). HFCWO was applied with a fixed protocol, whereas CCPT was conducted using standard protocols. Both groups received sputum suction after the procedure. Changes in ventilator settings and the subjects' responses were measured at preset intervals and compared within groups and between groups. Oscillation did not affect the ventilator settings (all P > 0.05). The mean airway pressure, breathing frequency, and rapid shallow breathing index increased, and the tidal volume and SpO2 decreased (all P ventilation decreased (all P ventilator settings, whereas CCPT maintains a steadier condition. After sputum suction, HFCWO slightly improved Ppeak compared to CCPT, suggesting that the study extends the indications of HFCWO for these patients in intensive care unit. (ClinicalTrials.gov number NCT02758106, retrospectively registered.).