Search results for: nasal continuous or positive airway pressure

Authors: Ka'abu Mu'azu

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The study examines the effect of varied intensities of aerobic exercise on Systolic Blood Pressure (SBP) among HIV/AIDS positive patients. Participants of mean age of 20.4 years were randomized into four groups. High Intensity Group (HIG), Moderate Intensity Group (MIG), Low Intensity Group (LIG) and Control Group (COG). SBP was measured at baseline (pre-exercise) and post-exercise (8 weeks). Analysis of variance (ANOVA) indicates a significant training effect on resting values of SBP (F [3, 15] = 8.9, P < 0.05). Sheffe post hoc analysis indicated that both HIG and MIG significantly differ from control (P < 0.05). Dependent t- test indicates difference in HIG (t [7] = 6.5, P < 0.05) and slightly in MIG (t [7] = 5.4, P < 0.05). The study concluded that aerobic exercise is effective in reducing resting values of SBP particularly the activities that are high intensity in nature. The study recommends that high and moderate intensity aerobic exercise should be used for improving health condition of HIV/AIDS patients as regard to decrease in resting value of SBP.

Keywords: systolic blood pressure, aerobic exercise, HIV patients, health sciences

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Authors: Sabiha Sahin, Kursad Bora Carman, Coskun Yarar

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Introduction: Measuring the diameter of the optic nerve sheath is a noninvasive and easy to use imaging technique to predict intracranial pressure in children and adults. The aim was to measure the diameter of the optic nerve sheath in pediatric head trauma. Methods: The study group consisted of 40 children with healthy and 40 patients with head trauma. Transorbital sonographic measurement of the optic nerve sheath diameter was performed. Conclusion: The mean diameters of the optic nerve sheath of right and left eyes were 0.408 ± 0.064 mm and 0.417 ± 0.065 mm, respectively, in the trauma group. These results were higher in patients than in control group. There was a negative correlation between optic nerve sheath diameters and Glasgow Coma Scales in patients with head trauma (p < 0.05). There was a positive correlation between optic nerve sheath diameters and positive CT findings, systolic blood pressure in patients with head trauma. The clinical status of the patients at admission, blood pH and lactate level were related to the optic nerve sheath diameter. Conclusion: Measuring the diameter of the optic nerve sheath is not an invasive technique and can be easily used to predict increased intracranial pressure and to prevent secondary brain injury.

Keywords: head trauma, intracranial pressure, optic nerve, sonography

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Authors: Paul W. Murray

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This research explores the relationship between leadership style and continuous improvement (CI) teams. CI teams have several features that are not always found in other types of teams, including multi-functional members, short time period for performance, positive and actionable results, and exposure to senior leadership. There is not only one best style of leadership for these teams. Instead, it is important to select the best leadership style for the situation. The leader must have the flexibility to change styles and the skill to use the chosen style effectively in order to ensure the team’s success.

Keywords: leadership style, lean manufacturing, teams, cross-functional

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Authors: Musarrat Jabeen Khan, Uzma Azam, Kainat Umar, Jazba Amber Satti, Aiman Shehzadi, Nimo Omer

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This study aimed to examine the comparison between substance abusers and non-abusers on anxiety, peer pressure, and risk-taking behavior among young adults. The sample consisted of 138 individuals including 64 female and 71 males, age range from 17-35 years, drawn from non-clinical population through convenient sampling. Questionnaire technique was used for the information assortment and the scales were susceptibility to peer pressure (Dieman, Pamella, Shope & Butchart, 1987), Zung self-rating anxiety scale (Zung, 1971), and risk-taking questionnaire (Gullone, Moore, Moss & Boyd, 2000) having alpha reliability of .54, .88, and .80 respectively. Results showed that anxiety negatively correlates with the risk-taking behavior. High level of anxiety stops an individual to involve himself in risk taking activities. Peer pressure have positive correlation with risk-taking behavior. Females are more susceptible to peer pressure irrespective of being abusers or non-abusers as compared to male abusers and non-abusers. Substance abusers have less anxiety as compared to non-abusers but are more susceptible to peer pressure and risk-taking behaviors.

Keywords: substance, substance abuse, anxiety, peer pressure, risk-taking behavior

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Authors: Parul Jindal, Shubhi Singh, Priya Ramakrishnan, Shailender Raghuvanshi

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Background: Knowledge of the influence of the age of the child on laryngeal dimensions is essential for all practitioners who are dealing with paediatric airway. Choosing the correct endotracheal tube (ETT) size is a crucial step in pediatric patients because a large-sized tube may cause complications like post-extubation stridor and subglottic stenosis. On the other hand with a smaller tube, there will be increased gas flow resistance, aspiration risk, poor ventilation, inaccurate monitoring of end-tidal gases and reintubation may also be required with a different size of the tracheal tube. Recent advancement in ultrasonography (USG) techniques should now allow for accurate and descriptive evaluation of pediatric airway. Aims and objectives: This study was planned to determine the accuracy of Ultrasonography (USG) to assess the appropriate ETT size and compare it with physical indices based formulae. Methods: After obtaining approval from Institute’s Ethical and Research committee, and parental written and informed consent, the study was conducted on 100 subjects of either sex between 12-60 months of age, undergoing various elective surgeries under general anesthesia requiring endotracheal intubation. The same experienced radiologist performed ultrasonography. The transverse diameter was measured at the level of cricoids cartilage by USG. After USG, general anesthesia was administered using standard techniques followed by the institute. An experienced anesthesiologist performed the endotracheal intubations with uncuffed endotracheal tube (Portex Tracheal Tube Smiths Medical India Pvt. Ltd.) with Murphy’s eye. He was unaware of the finding of the ultrasonography. The tracheal tube was considered best fit if air leak was satisfactory at 15-20 cm H₂O of airway pressure. The obtained values were compared with the values of endotracheal tube size calculated by ultrasonography, various age, height, weight-based formulas and diameter of right and left little finger. The correlation of the size of the endotracheal tube by different modalities was done and Pearson's correlation coefficient was obtained. The comparison of the mean size of the endotracheal tube by ultrasonography and by traditional formula was done by the Friedman’s test and Wilcoxon sign-rank test. Results: The predicted tube size was equal to best fit and best determined by ultrasonography (100%) followed by comparison to left little finger (98%) and right little finger (97%) and age-based formula (95%) followed by multivariate formula (83%) and body length (81%) formula. According to Pearson`s correlation, there was a moderate correlation of best fit endotracheal tube with endotracheal tube size by age-based formula (r=0.743), body length based formula (r=0.683), right little finger based formula (r=0.587), left little finger based formula (r=0.587) and multivariate formula (r=0.741). There was a strong correlation with ultrasonography (r=0.943). Ultrasonography was the most sensitive (100%) method of prediction followed by comparison to left (98%) and right (97%) little finger and age-based formula (95%), the multivariate formula had an even lesser sensitivity (83%) whereas body length based formula was least sensitive with a sensitivity of 78%. Conclusion: USG is a reliable method of estimation of subglottic diameter and for prediction of ETT size in children.

Keywords: endotracheal intubation, pediatric airway, subglottic diameter, traditional formulas, ultrasonography

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Authors: Shi Yu, Rong Liu, Jingyun Lv

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Compression textiles with ergonomic-fit and controllable pressure performance have demonstrated positive effect on prevention and treatment of chronic venous insufficiency (CVI). Well-designed compression textile products contribute to improving user compliance in their daily application. This study explored the effects of multiple knitting variables (yarn-machinery settings) on the physical-mechanical properties and the produced pressure magnitudes of tubular compression fabrics (TCFs) through experimental testing and multiple regression modeling. The results indicated that fabric physical (stitch densities and circumference) and mechanical (tensile) properties were affected by the linear density (yarn diameters) of inlay yarns, which, to some extent, influenced pressure magnitudes of the TCFs. Knitting variables (e.g., feeding velocity of inlay yarns and loop size settings) can alter circumferences and tensile properties of tubular fabrics, respectively, and significantly varied pressure values of the TCFs. This study enhanced the understanding of the effects of knitting factors on pressure controlling of TCFs, thus facilitating dimension and pressure design of compression textiles in future development.

Keywords: laid-in knitted fabric, yarn-machinery settings, pressure magnitudes, quantitative analysis, compression textiles

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Authors: Gagandeep Singh Digra, Pawan Kumar, Mandeep Kaur Sidhu

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INTRODUCTION: Chronic Progressive External Ophthalmoplegia (CPEO), also known as Progressive External Ophthalmoplegia (PEO), is a type of eye disorder characterized by a loss of the muscle functions involved in eye and eyelid movement. CPEO can be caused by mutations in mitochondrial DNA. It typically manifests in young adults with bilateral and progressive ptosis as the most common presentation but can also present with difficulty swallowing (dysphagia) and general weakness of the skeletal muscles (myopathy), particularly in the neck, arms, or legs. CASE PRESENTATION: This is a case discussion of 3 cousins who presented to our clinic. A 23-year-old male with past surgical history (PSH) of ptosis repair 2 years ago presented with a chief complaint of nasal intonation for 1.5 years associated with difficulty swallowing. The patient also complained of nasal regurgitation of liquids. He denied any headaches, fever, seizures, weakness of arms or legs, urinary complaints or changes in bowel habits. Physical Examination was positive for facial muscle weakness, including an inability to lift eyebrows (Frontalis), inability to close eyes tightly (Orbicularis Oculi), corneal reflex absent bilaterally, difficulty clenching jaw (Masseter muscle), difficulty smiling (Zygomaticus major), inability to elevate upper lip (Zygomaticus minor). Another cousin of the first patient, a 25-year-old male with no past medical history, presented with complaints of nasal intonation for 2 years associated with difficulty swallowing. He denied a history of nasal regurgitation, headaches, fever, seizures, weakness, urinary complaints or changes in bowel habits. Physical Examination showed facial muscle weakness of the Frontalis muscle, Orbicularis Oculi muscle, Masseter Muscle, Zygomaticus Major, Zygomaticus Minor and absent corneal reflexes. A 28-year-old male, a cousin of the first two patients, presented with chief complaints of ptosis and nasal intonation for the last 8 years. He also complained of difficulty swallowing and nasal regurgitation of liquids. His physical examination showed facial muscle weakness, including frontalis muscle (inability to lift eyebrows), Orbicularis Oculi (inability to close eyes tightly), absent corneal reflexes bilaterally, Zygomaticus Major (difficulty smiling), and Zygomaticus Minor (inability to elevate upper lip). MRI brain and visual field of all the patients were normal. Differential diagnoses, including Grave’s disease, Myasthenia Gravis and Glioma, were ruled out. Due to financial reasons, muscle biopsy could not be pursued. Pedigree analysis revealed only males were affected, likely due to maternal inheritance, so the clinical diagnosis of CPEO was made. The patients underwent symptomatic management, including ptosis surgical correction for the third patient. CONCLUSION: Chronic Progressive External Ophthalmoplegia (CPEO), a rare case entity, occurs in young adults as a manifestation of mitochondrial myopathy. There are three modes of transmission- maternal transmission associated with mitochondrial point mutations, autosomal recessive, and autosomal dominant. CPEO can sometimes be difficult to diagnose, especially in asymmetric presentation. Therefore, it is crucial to keep it in differential diagnosis to avoid delay in diagnosis.

Keywords: neurology, chronic, progressive, ophthalmoplegia

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Authors: Subhamita Chakraborty, Shubhabrata Datta, Sujay Kumar Mukherjea, Partha Protim Chattopadhyay

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Manufacturing of multiphase high strength steel in hot strip mill have drawn significant attention due to the possibility of forming low temperature transformation product of austenite under continuous cooling condition. In such endeavor, reliable prediction of temperature profile of hot strip coil is essential in order to accesses the evolution of microstructure at different location of hot strip coil, on the basis of corresponding Continuous Cooling Transformation (CCT) diagram. Temperature distribution profile of the hot strip coil has been determined by using finite volume method (FVM) vis-à-vis finite difference method (FDM). It has been demonstrated that FVM offer greater computational reliability in estimation of contact pressure distribution and hence the temperature distribution for curved and irregular profiles, owing to the flexibility in selection of grid geometry and discrete point position, Moreover, use of finite volume concept allows enforcing the conservation of mass, momentum and energy, leading to enhanced accuracy of prediction.

Keywords: simulation, modeling, thermal analysis, coil cooling, contact pressure, finite volume method

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Authors: In Kyong Yi, Yun Jeong Chae, Jihoon Hwang, Sook-Young Lee, Jong-Yeop Kim

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Background: Pentax airway scope (AWS) is a recently developed video laryngoscope for use in both normal and difficult airways, providing a good laryngeal view. The purpose of this randomized noninferior study was to evaluate the efficacy of the Pentax-AWS regarding intubation time, laryngeal view and ease of intubation in pediatric patients with normal airway, compared to Macintosh laryngoscope. Method: A total of 136 pediatric patients aged 1 to 10 with American Society of Anesthesiologists physical status I or II undergoing general anesthesia required orotracheal intubation were randomly allocated into two groups: Macintosh laryngoscope (n =68) and Pentax AWS (n=68). Anesthesia was induced with propofol, rocuronium, and sevoflurane. The primary outcome was intubation time. Cormack-Lehane laryngeal view grade, application of optimal laryngeal external manipulation (OELM), intubation difficulty scale (IDS), intubation failure rate and adverse events were also measured. Result: No significant difference was observed between the two groups regarding intubation time (Macintosh; 23[22-26] sec vs. Pentax; 23.5[22-27.75] sec, p=0.713). As for the laryngeal view grade, the Pentax group showed less number of grade 2a or higher grade cases compared to the Macintosh group (1/2a/2b/3; 52.9%/41.2%/4.4%/1.5% vs. 98.5%/1.5%/0%/0%, p=0.000). No optimal laryngeal external manipulation application was required in the Pentax group (38.2% vs. 0%, p=0.000). Intubation difficulty scale resulted in lower values for Pentax group (0 [0-2] vs. 0 [0-0.55], p=0.001). Failure rate was not different between the two groups (1.5% vs. 4.4%, p=0.619). Adverse event-wise, slightly higher incidence of bleeding (1.5% vs. 5.9%, p=0.172) and teeth injury (0% vs. 5.9%, p=0.042) occurred in the Pentax group. Conclusion: In conclusion, Pentax-AWS provided better laryngeal view, similar intubation time and similar success rate compared with Macintosh laryngoscope in children with normal airway. However, the risk of teeth injury might increase and warrant special attention.

Keywords: Pentax-AWS, pediatric, video laryngoscope, intubation

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Authors: Nathalie Bolding, Marta Montero, Joaquim Cevallos, Juan F. Martin-Lazaro

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Background: Inhaled epoprostenol (iEPO) have been shown to improve PaO2:FiO2 (PF) in combination with bronchodilators (BD). However, there is not an available device to deliver these two therapies concomitantly. We describe a new method to provide this therapy successfully. Objective: To evaluate the response to continuous nebulization of iEPO and intermittent nebulization of Salbutamol/Ipratropium bromide in adults with severe respiratory failure through a double mesh nebulisation in tandem. Methods: This observational study included two mechanical ventilated adults under hourly ventilatory, gasometrical and clinical measurements during 48h. Both had severe respiratory failure treated with continuous iEPO (50 – 200 micrograms/h) and BD (Salbutamol 2.5 mg and Ipratropium bromide 500 mcg every 6 hours) through double mesh nebulisation (Aerogen solo®) placed in tandem in the dry side of the humidificator. The primary endpoints were the variables associated with a positive response to this tandem nebulised therapy (PaFiO2 index, ROX index). Secondary endpoints were laboratory (ABG) clinical and ventilatory variables. Statistical analysis (SPSS v29) included linear regression and ANOVA. Results: The patients included (n=2) survived, both extubated, one after ECMO therapy. Severe acute respiratory failure had a positive response rate to continuous iEPO and intermittent BD: PaFiO2 increased (7.40 to 30.91; P75: 27%) as well as ROX index (2.91 to 11.43; P75: 33%). There was a linear correlation of improvement between iEPO with PaFiO2 (ANOVA, r=0.393, p<0.002) and ROX (r=0.419, p<0.001). iEPO+BD therapy did not show any complications. Conclusion: Continuous and intermittent mesh tandem nebulisation can be effectively delivered with this method with a positive effect in ventilatory parameters without observed complications. Randomised studies will be able to provide reassurance in this new therapy.

Keywords: tandem, mesh, nebulisers, pulmonary, vasoldilators, bronchodilators, respiratory, failure

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Authors: L. Parisi

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A blood pressure monitor or sphygmomanometer can be either manual or automatic, employing respectively either the auscultatory method or the oscillometric method. The manual version of the sphygmomanometer involves an inflatable cuff with a stethoscope adopted to detect the sounds generated by the arterial walls to measure blood pressure in an artery. An automatic sphygmomanometer can be effectively used to monitor blood pressure through a pressure sensor, which detects vibrations provoked by oscillations of the arterial walls. The pressure sensor implemented in this device improves the accuracy of the measurements taken.

Keywords: blood pressure, blood saturation, sensors, actuators, design improvement

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Authors: Babar Rasheed

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The organizations are in continuous effort to increase their yield and to retain their associates, employees. Technology is considered an integral part of attaining apposite work practices, work environment, and employee engagement. Unconsciously, these advanced practices like work from home, personalized intra-network are disturbing employee work-life balance which ultimately increases psychological pressure on employees. The smart work practice is to develop business models and organizational practices with enhanced employee engagement, minimum trouncing of organization resources with persistent revenue and positive addition in global societies. Need of smart work practices comes from increasing employee turnover rate, global economic recession, unnecessary job pressure, increasing contingent workforce and advancement in technologies. Current practices are not enough elastic to tackle global changing work environment and organizational competitions. Current practices are causing many reciprocal problems among employee and organization mechanically. There is conscious understanding among business sectors smart work practices that will deal with new century challenges with addressing the concerns of relevant issues. It is aimed in this paper to endorse customized and smart work practice tools along knowledge framework to manage the growing concerns of employee engagement, use of technology, orgaization concerns and challenges for the business. This includes a Smart Management Information System to address necessary concerns of employees and combine with a framework to extract the best possible ways to allocate companies resources and re-align only required efforts to adopt the best possible strategy for controlling potential risks.

Keywords: employees engagement, management information system, psychological pressure, current and future HR practices

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Authors: Tina Naser Torabi

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Prevalence of allergy is affected by different factors according to its base and seasonal weather changes, and it also needs various treatments.Although reasons of allergy existence are not clear but generally, allergens cause reaction between antigen and antibody because of their antigenic traits. In this state, allergens cause immune system to make mistake and identify safe material as threat, therefore function of immune system impaired because of histamine secretion. There are different reasons for allergy, but herbal reasons are on top of the list, although animal causes cannot be ignored. Important point is that allergenic compounds, cause making dedicated antibody, so in general every kind of allergy is different from the other one. Therefore, most of the plants in herbal allergenic category can cause various allergies for human beings, such as respiratory allergies, nutritional allergies, injection allergies, infection allergies, touch allergies, that each of them show different symptoms based on the reason of allergy and also each of them requires different prevention and treatment. Geographical condition is another effective factor in allergy. Seasonal changes, weather condition, herbal coverage variety play important roles in different allergies. It goes without saying that humid climate and herbal coverage variety in different seasons especially spring cause most allergies in human beings in Iran and India that are discussed in this article. These two countries are good choices for allergy prevalence because of their condition, various herbal coverage, human and animal factors. Hay fever is one of the allergies, although the reasons of its prevalence are unknown yet. It is one of the most popular allergies in Iran and India because of geographical, human, animal and herbal factors. Hay fever is on top of the list in these two countries. Significant point about these two countries is that herbal factor is the most important factor in prevalence of hay fever. Variety of herbal coverage especially in spring during herbal pollination is the main reason of hay fever prevalence in these two countries. Based on the research result of Pharmacognosy and Phytochemistry, pollination of some plants in spring is major reason of hay fever prevalence in these countries. If airborne pollens in pollination season enter the human body through air, they will cause allergic reactions in eyes, nasal mucosa, lungs, and respiratory system, and if these particles enter the body of potential person through food, they will cause allergic reactions in mouth, stomach, and other digestive systems. Occasionally, chemical materials produced by human body such as Histamine cause problems like: developing of nasal polyps, nasal blockage, sleep disturbance, risk of asthma developing, blood vasodilation, sneezing, eye tears, itching and swelling of eyes and nasal mucosa, Urticaria, decrease in blood pressure, and rarely trauma, anesthesia, anaphylaxis and finally death. This article is going to study the reasons of hay fever prevalence in Iran and India and presents prevention and treatment Method from Phytochemistry and Pharmocognocy point of view by using local natural products in these two countries.

Keywords: hay fever, India, Iran, natural treatment, phytochemistry

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Authors: Adam M. Pitz, Gillian L. Phillipson, Jayant E. Khanolkar, Andrew M. Middleton

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New emerging evidence suggests that the nose is the predominant route for entry of the SARS-CoV-2 virus into the host. A virucidal suspension test (conforming in principle to the European Standard EN14476) was conducted to determine whether a commercial liquid gel intranasal spray containing 1% of the mucoadhesive hydroxypropyl methylcellulose (HPMC) could inhibit the cellular infectivity of the SARS-CoV-2 coronavirus. Virus was added to the test product samples and to controls in a 1:8 ratio and mixed with one part bovine serum albumin as an interfering substance. The test samples were pre-equilibrated to 34 ± 2°C (representing the temperature of the nasopharynx) with the temperature maintained at 34 ± 2°C for virus contact times of 1, 5 and 10 minutes. Neutralized aliquots were inoculated onto host cells (Vero E6 cells, ATCC CRL-1586). The host cells were then incubated at 36 ± 2°C for a period of 7 days. The residual infectious virus in both test and controls was detected by viral-induced cytopathic effect. The 50% tissue culture infective dose per mL (TCID50/mL) was determined using the Spearman-Karber method with results reported as the reduction of the virus titer due to treatment with test product, expressed as log10. The controls confirmed the validity of the results with no cytotoxicity or viral interference observed in the neutralized test product samples. The HPMC formulation reduced SARS-CoV-2 titer, expressed as log10TCID50, by 2.30 ( ± 0.17), 2.60 ( ± 0.19), and 3.88 ( ± 0.19) with the respective contact times of 1, 5 and 10 minutes. The results demonstrate that this 1% HPMC gel formulation can reduce the cellular infectivity of the SARS-CoV-2 virus with an increasing viral inhibition observed with increasing exposure time. This 1% HMPC gel is well tolerated and can reside, when delivered via nasal spray, for up to one hour in the nasal cavity. We conclude that this intranasal gel spray with 1% HPMC repeat-dosed every few hours may offer an effective preventive or early intervention solution to limit the transmission and impact of the SARS-CoV-2 coronavirus.

Keywords: hydroxypropyl methylcellulose, mucoadhesive nasal spray, respiratory viruses, SARS-CoV-2

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Authors: Hadj Abd El Kader Benghenia, Fethi Bereksi Reguig

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In clinical medicine, blood pressure, raised blood hemodynamic monitoring is rich pathophysiological information of cardiovascular system, of course described through factors such as: blood volume, arterial compliance and peripheral resistance. In this work, we are interested in analyzing these signals to propose a detection algorithm to delineate the different sequences and especially systolic blood pressure (SBP), diastolic blood pressure (DBP), and the wave and dicrotic to do their analysis in order to extract the cardiovascular parameters.

Keywords: blood pressure, SBP, DBP, detection algorithm

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Authors: Martina Šutovská, Marta Jošková, Ivana Kazimierová, Lenka Pappová, Maroš Adamkov, Soňa Fraňová

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Bronchial asthma is characterized by increased bronchoconstrictor responses to provoking agonists, airway inflammation and remodeling. All these processes involve Ca2+ influx through Ca2+-release-activated Ca2+ channels (CRAC) that are widely expressed in immune, respiratory epithelium and airway smooth muscle (ASM) cells. Our previous study pointed on possible therapeutic potency of CRAC blockers using experimental guinea pigs asthma model. Presented work analyzed complex anti-asthmatic effect of long-term administered CRAC blocker, including impact on allergic inflammation, airways hyperreactivity, and remodeling and mucociliary clearance. Ovalbumin-induced allergic inflammation of the airways according to Franova et al. was followed by 14 days lasted administration of CRAC blocker (3-fluoropyridine-4-carboxylic acid, FPCA) in the dose 1.5 mg/kg bw. For comparative purposes salbutamol, budesonide and saline were applied to control groups. The anti-inflammatory effect of FPCA was estimated by serum and bronchoalveolar lavage fluid (BALF) changes in IL-4, IL-5, IL-13 and TNF-α analyzed by Bio-Plex® assay as well as immunohistochemical staining focused on assessment of tryptase and c-Fos positivity in pulmonary samples. The in vivo airway hyperreactivity was evaluated by Pennock et al. and by organ tissue bath methods in vitro. The immunohistochemical changes in ASM actin and collagen III layer as well as mucin secretion evaluated anti-remodeling effect of FPCA. The measurement of ciliary beat frequency (CBF) in vitro using LabVIEW™ Software determined impact on mucociliary clearance. Long-term administration of FPCA to sensitized animals resulted in: i. Significant decrease in cytokine levels, tryptase and c-Fos positivity similar to budesonide effect; ii.Meaningful decrease in basal and bronchoconstrictors-induced in vivo and in vitro airway hyperreactivity comparable to salbutamol; iii. Significant inhibition of airway remodeling parameters; iv. Insignificant changes in CBF. All these findings confirmed complex anti-asthmatic effect of CRAC channels blocker and evidenced these structures as the rational target in the treatment of allergic bronchial asthma.

Keywords: allergic asthma, CRAC channels, cytokines, respiratory epithelium

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Authors: Beverly Wang

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Background: Rosai-Dorfman disease (RDD), aka sinus histiocytosis with massive lymphadenopathy, is a rare, idiopathic histiocytic proliferative disorder. Although RDD can be seen involving the head and neck lymph nodes, rarely it can affect other extranodal sites. It present 3 unique cases of RDD affecting the nasal cavity, paranasal sinuses, and ear canal. The initial clinical presentation on two cases mimicked a malignant neoplasm. The 3rd case of RDD co-existed with a cholesteatoma of the ear canal. The clinical presentation, histology and immunohistochemical stains, and radiographic findings are discussed. Design: An overview of 3 cases of RDD affected sinonasal cavity and ear canal from UCI Medical Center was conducted. Case 1: A 61 year old male complaining of breathing difficulty presented with bilateral polypoid sinonasal masses and severe nasal obstruction. The masses elevated the nasal floor, and involved the anterior nasal septum to lateral wall. It was endoscopically excised. At intraoperative consultation, frozen section reported a pleomorphic spindle cell neoplasm with scattered large atypical spindle cells, resembling a high grade sarcoma. Case 2: A 46 year old male presented with recurrent bilateral maxillary chronic sinusitis with mass formation, clinically suspicious for malignant lymphoma. Excisional tissue sample showed large irregular spindled histiocytes with abundant granular and vacuolated cytoplasm. Case 3: A 36 year old female with a history of asthma initially presented with left-sided chronic otalgia, occasional nausea, vertigo, and fluctuating pain exacerbated by head movement and temperature changes. CT scan revealed an external auditory canal mass extending to the middle ear, coexisting with a small cholesteatoma. Results: The morphology of all cases revealed large atypical spindled histiocytes resembling fibrohistiocytic or myofibroblastic proliferative neoplasms. Scattered emperipolesis was seen. All 3 cases were confirmed as extranodal sinus RDD, confirmed by immunohistochemistry. The large atypical cells were positive for S100, CD68, and CD163. No evidence for malignancy was identified. Case 3 showed concurrent RDD co-existing with a cholesteatoma. Conclusion: Due to its rarity and variable clinical presentations, the diagnosis of RDD is seldom clinically considered. Extranodal sinus RDD morphologically can be pitfall as mimicker of spindly neoplasm, especially at intraoperative consultation. It can create diagnostic and therapeutic challenges. Correlation of radiological findings with histologic features will help to reach the diagnosis.

Keywords: head and neck, extranodal, rosai-dorfman disease, mimicker, immunohistochemistry

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Authors: Klara Smith-Etxeberria

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main goal of this study was to analyze the predictive ability of some variables associated with the parental divorce process alongside attachment history with parents on both, mother-child and father-child relationship quality. Our sample consisted of 173 undergraduate and vocational school students from the Autonomous Community of the Basque Country. All of them belonged to a divorced family. Results showed that adequate maternal strategies during the divorce process (e.g.: stable, continuous and positive role as a mother) was the variable with greater predictive ability on mother-child relationships quality. In addition, secure attachment history with mother also predicted positive mother-child relationships. On the other hand, father-child relationship quality was predicted by adequate paternal strategies during the divorce process, such as his stable, continuous and positive role as a father, along with not badmouthing the mother and promoting good mother-child relationships. Furthermore, paternal negative emotional state due to divorce was positively associated with father-child relationships quality, and both, history of attachment with mother and with father predicted father-child relationships quality. In conclusion, our data indicate that both, paternal and maternal strategies for children´s adequate adjustment during the divorce process influence on mother-child and father-child relationships quality. However, these results suggest that paternal strategies during the divorce process have a greater predictive ability on father-child relationships quality, whereas maternal positive strategies during divorce determine positive mother-child relationships among young adults.

Keywords: father-child relationships quality, mother-child relationships quality, parental divorce process, young adulthood

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Authors: Sinem O. Aktan, Musa Y. Akkurt

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Experimental pressure calibration methods can be classified into three areas: (1) measurements in liquid or gas systems, (2) measurements in static-solid media systems, and (3) measurements in dynamic shock systems. Fluid (liquid and gas) systems high accuracies can be obtainable and commonly used for the calibration method of a pressure sensor. Pressure calibrations can be performed for metrological traceability in two ways, which are on-site (field) and in the laboratory. Laboratory and on-site calibration procedures and the requirements of the DKD-R-6-1 and Euramet cg-17 guidelines will also be addressed. In this study, calibration methods of direct and indirect reading pressure sensor and measurement uncertainty contributions will be explained.

Keywords: pressure metrology, pressure calibration, dead-weight tester, pressure uncertainty

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Authors: Navid P Roodaki, Rochelle Abila, Daisy Evangeline Garcia

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Background and Objective: Respiratory Distress Syndrome (RDS) among premature infants is a major causes of neonatal death. The use of Continuous Positive Airway Pressure (CPAP) has become a standard of care for preterm newborns with RDS hence cost-effective innovations are needed. This study compared a novel low-cost Bubble CPAP (bCPAP) device to ventilator driven CPAP in the treatment of RDS. Methods: This is a single-blind, randomized controlled trial done on May 2022 to October 2022 in a Level III Neonatal Intensive Care Unit in the Philippines. Preterm newborns (<36 weeks) with RDS were randomized to receive Vayu bCPAP device or Ventilator-derived CPAP. Arterial Blood Gases, Oxygen Saturation, administration of surfactant, and CPAP failure rates were measured. Results: Seventy preterm newborns were included. No differences were observed between the Ventilator driven CPAP and Vayu bCPAP on the PaO2 (97.51mmHg vs 97.37mmHg), So2 (97.08% vs 95.60%) levels, amount of surfactant administered between groups. There were no observed differences in CPAP failure rates between Vayu bPCAP (x̄ 3.23 days) and ventilator-driven CPAP (x̄ 2.98 days). However, a significant difference was noted on the CO2 level (40.32mmHg vs 50.70mmHg), which was higher among those hooked to Ventilator-driven CPAP (p 0.004). Conclusion: This study has shown that the novel low-cost bubble CPAP (Vayu bCPAP) can be used as an efficacious alternate non invasive oxygen therapy among preterm neonates with RDS, although the CO2 levels were higher among those hooked to ventilator driven CPAP, other outcome parameters measured showed that both devices are comparable. Recommendation: A multi-center or national study to account for geographic region, which may alter the outcomes of patients connected to different ventilatory support. Cost comparison between devices is also suggested. A mixed-method research assessing the experiences of health care professionals in assembling and utilizing the gadget is a second consideration.

Keywords: bubble CPAP, ventilator-derived CPAP; infant, premature, respiratory distress syndrome

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Authors: Joon-Ho Lee, Jeong-Hwan Yoon, Jung-Hwan Yoon, Sangmo Kang, Su-Yeon Hong, Hyun-Woo Jeong, Jaeick Chae

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There are several dedicated individual chambers for sports that are supplied and used, but none of them are multi-pressured all-in-one chambers that can provide a sports multi-environment simultaneously. In this study, we design a multi-pressure (positive/atmospheric/negative pressure) integrated vessel that can be used for the sport-multi-artificial environment system. We presented additional vessel designs with enlarged space for the tall users; with reinforcement pads added to reduce the maximum stress in the joints of its shells, and then carried out numerical analysis for the structural analysis with maximum stress and structural safety. Under the targeted allowable pressure conditions, maximum stresses occurred at the joint of the shell, and the entrance, the safety of the structure was checked with the allowable stress of its material.

Keywords: structural analysis, multi-pressure, integrated vessel, sport-multi-artificial environment

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Authors: S. C. Gupta

Abstract:

The wind flow over several buildings lying in close vicinity in urban areas generates flow interference effects causing problems related to pedestrian comfort and ventilation within the buildings. This promoted a lot of research interest in the recent years. Airflow over a building creates a positive pressure zone on the upstream side and negative pressure zones (cavities or eddy zones) on the roof and all other sides. Large eddy simulation model is used along with sub-grid-scale model to numerically simulate turbulence for this purpose. The basis of flow outside the building is the pressure difference (between the wind and building interior). Wind Tunnel models are fabricated and tested in the subsonic wind tunnel. Theoretical results are compared with the experimental data. Newer configuration is tried for favorable effects in recovering static pressure values. Results obtained are seen very encouraging. The proposed exhaustive research investigation through numerical simulations and the experimental work are described and some interesting findings are brought out.

Keywords: wind flow, buildings, static pressure wind tunnel testing, CFD

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Authors: Nouri, K., Ghassem Alaskari, M., K., Amiri Hazaveh, A., Nabi Bidhendi, M.

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Pore pressure is one on the key Petrophysical parameter in exploration discussion and survey on hydrocarbon reservoir. Determination of pore pressure in various levels of drilling and integrity of drilling mud and high pressure zones in order to restrict blow-out and following damages are significant. The pore pressure is obtained by seismic and well logging data. In this study the pore pressure and over burden pressure through the matrix stress and Tarzaqi equation and other related formulas are calculated. By making a comparison on variation of density log in over normal pressure zones with change of sonic impedance under influence of compressional, shear, and Stonely waves, the correlation level of sonic impedance with density log is studied. The level of correlation and variation trend is recorded in sonic impedance under influence Stonely wave with density log that key factor in recording of over burden pressure and pore pressure in Tarzaqi equation is high. The transition time is in divert relation with porosity and fluid type in the formation and as a consequence to the pore pressure. The density log is a key factor in determination of pore pressure therefore sonic impedance under Stonley wave is denotes well the identification of high pressure besides other used factors.

Keywords: pore pressure, stonely wave, density log, sonic impedance, high pressure zone

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Authors: Luis A. Paipa-Galeano, Yavar Jarrah-Nezhad, César A. Bernal-Torres

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This paper presents a case study of four companies in an emerging economy to identify the key success factors and barriers to sustaining continuous improvement practices. The study analyzes the empirical evidence and compares it to the literature review to provide insights for companies looking to increase their maturity level in this area. The five success factors identified are the availability of resources, commitment and support from management, participation of employees in identifying tasks to improve, clear and realistic objectives for continuous improvement, and the existence of a leader or responsible for continuous improvement. The major barriers to success are a lack of alignment between the organization’s strategic objectives and continuous improvement objectives, a lack of motivation in the team, and resistance to change. The paper concludes with recommendations for companies to reduce the risk of improvement failure and increase their maturity level in continuous improvement.

Keywords: emerging economies, Kaizen, continuous improvement sustainability, maturity model

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Authors: Mohammad Afzal Khan, Fatimah Alanazi, Hala Abdalrahman Ahmed, Talal Shamma, Kilian Kelly, Mohammed A. Hammad, Abdullah O. Alawad, Abdullah Mohammed Assiri, Dieter Clemens Broering

Abstract:

Lung transplantation is a life-saving surgical replacement of diseased lungs in patients with end-stage respiratory malfunctions. Despite the remarkable short-term recovery, long-term lung survival continues to face several significant challenges, including chronic rejection and severe toxic side-effects due to global immunosuppression. Stem cell-based immunotherapy has been recognized as a crucial immunoregulatory regimen in various preclinical and clinical studies. Despite initial therapeutic outcomes, conventional stem cells face key limitations. The Cymerus™ manufacturing facilitates the production of a virtually limitless supply of consistent human induced pluripotent stem cell (iPSC)-derived mesenchymal stem cells, which could play a key role in selective immunosuppression and graft repair during rejection. Here, we demonstrated the impact of iPSC-derived human MSCs on the development of immune-tolerance and long-term graft survival in mouse orthotopic airway allografts. BALB/c→C57BL/6 allografts were reconstituted with iPSC-derived MSCs (2 million/transplant/ at d0), and allografts were examined for regulatory T cells (Tregs), oxygenation, microvascular blood flow, airway epithelium and collagen deposition during rejection. We demonstrated that iPSC-derived MSC treatment leads to significant increase in tissue expression of hTSG-6 protein, followed by an upregulation of mouse Tregs and IL-5, IL-10, IL-15 cytokines, which augments graft microvascular blood flow and oxygenation, and thereby maintained a healthy airway epithelium and prevented the subepithelial deposition of collagen at d90 post-transplantation. Collectively, these data confirmed that iPSC-derived MSC-mediated immunosuppression has potential to establish immune-tolerance and rescue allograft from sustained hypoxic/ischemic phase and subsequently limits long-term airway epithelial injury and collagen progression, which therapeutically warrant a study of Cymerus iPSC-derived MSCs as a potential management option for immunosuppression in transplant recipients.

Keywords: stem cell therapy, immunotolerance, regulatory T cells, hypoxia and ischemia, microvasculature

Procedia PDF Downloads 132

Authors: Anoop T. R., Otman Basir, Robert F. Hess, Eileen E. Birch, Brooke A. Koritala, Reed M. Jost, Becky Luu, David Stager, Ben Thompson

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Strabismus refers to a misalignment of the eyes. Early detection and treatment of strabismus in childhood can prevent the development of permanent vision loss due to abnormal development of visual brain areas. We developed a two-stage method for strabismus detection and classification based on photographs of the face. The first stage detects the presence or absence of strabismus, and the second stage classifies the type of strabismus. The first stage comprises face detection using Haar cascade, facial landmark estimation, face alignment, aligned face landmark detection, segmentation of the eye region, and detection of strabismus using VGG 16 convolution neural networks. Face alignment transforms the face to a canonical pose to ensure consistency in subsequent analysis. Using facial landmarks, the eye region is segmented from the aligned face and fed into a VGG 16 CNN model, which has been trained to classify strabismus. The CNN determines whether strabismus is present and classifies the type of strabismus (exotropia, esotropia, and vertical deviation). If stage 1 detects strabismus, the eye region image is fed into stage 2, which starts with the estimation of pupil center coordinates using mask R-CNN deep neural networks. Then, the distance between the pupil coordinates and eye landmarks is calculated along with the angle that the pupil coordinates make with the horizontal and vertical axis. The distance and angle information is used to characterize the degree and direction of the strabismic eye misalignment. This model was tested on 100 clinically labeled images of children with (n = 50) and without (n = 50) strabismus. The True Positive Rate (TPR) and False Positive Rate (FPR) of the first stage were 94% and 6% respectively. The classification stage has produced a TPR of 94.73%, 94.44%, and 100% for esotropia, exotropia, and vertical deviations, respectively. This method also had an FPR of 5.26%, 5.55%, and 0% for esotropia, exotropia, and vertical deviation, respectively. The addition of one more feature related to the location of corneal light reflections may reduce the FPR, which was primarily due to children with pseudo-strabismus (the appearance of strabismus due to a wide nasal bridge or skin folds on the nasal side of the eyes).

Keywords: strabismus, deep neural networks, face detection, facial landmarks, face alignment, segmentation, VGG 16, mask R-CNN, pupil coordinates, angle deviation, horizontal and vertical deviation

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Authors: Sonia Nemakallu, Pota Kalima

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Introduction: Vancomycin is a glycopeptide antibiotic, commonly used to treat gram-positive bacteraemia. It has been increasingly used in the critical care setting due to an increased awareness of resistant gram positive organisms. In Edinburgh both tertiary hospitals, The Western General Hospital and The Royal Infirmary Of Edinburgh, commonly use Vancomycin for a variety of infections. Administration of Vancomyicn in these hospitals is by continuous infusion as it is thought to maintain serum concentrations easier and is a simpler monitoring system. Purpose: The aim of the study was to evaluate the efficacy and reliability in which Vancomycin is used. Material and Methods: A retrospective study, over a 6-month period from January 2014 to June 2014. 91 admissions were included, all received Vancomycin by continuous infusion during their critical care stay. Results: The number one use for Vancomycin in critical care settings was in the treatment of ventilator or hospital-acquired pneumonia. Only 3% of population had MRSA. 49% of admissions were not therapeutic on day 1 post loading dose. Of those that were therapeutic on day 1 post loading dose, 39% of admissions showed no organisms in any cultures taken, 42% had organisms sensitive to Vancomycin and 19% had only organisms resistant to Vancomycin. Those that were not therapeutic on day 1 showed similar organism sensitivities. 15% of admissions had Vancomycin levels above 25 (levels should be maintained between 15-25). An increase in creatinine was proportionally seen with an increase in Vancomycin levels. Conclusion: Within Edinburgh Vancomycin is being overused in the critical care setting with only 3% of the population having highly resistant organisms. Continuous infusion have not ruled out the complexity of maintaining therapeutic levels, with a large proportion of patients not being therapeutic on day 1. Further research is also required into the nephrotoxic effects of using higher doses of Vancomycin.

Keywords: Vancomycin, continuous infusion, multi resistant organisms, sepsis, renal toxicity

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Authors: Aicha Rima Cheniti, Hatem Besbes, Joseph Haggege, Christophe Sintes

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In this paper, we are interested to determine the carbon dioxide pressure in the arterial blood through radial velocity difference. The blood was modeled as a two phase mixture (an aqueous carbon dioxide solution with carbon dioxide gas) by Drift flux model and the Young-Laplace equation. The distributions of mixture velocities determined from the considered model permitted the calculation of the radial velocity distributions with different values of mean mixture pressure and the calculation of the mean carbon dioxide pressure knowing the mean mixture pressure. The radial velocity distributions are used to deduce a calculation method of the mean mixture pressure through the radial velocity difference between two positions which is measured by ultrasound. The mean carbon dioxide pressure is then deduced from the mean mixture pressure.

Keywords: mean carbon dioxide pressure, mean mixture pressure, mixture velocity, radial velocity difference

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Authors: Fauzi Jarushi, Paul Cosentino, Edward Kalajian, Hadeel Dekhn

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At certain depths during large diameter displacement pile driving, rebound well over 0.25 inches was experienced, followed by a small permanent set during each hammer blow. High pile rebound (HPR) soils may stop the pile driving and results in a limited pile capacity. In some cases, rebound leads to pile damage, delaying the construction project, and the requiring foundations redesign. HPR was evaluated at seven Florida sites, during driving of square precast, prestressed concrete piles driven into saturated, fine silty to clayey sands and sandy clays. Pile Driving Analyzer (PDA) deflection versus time data recorded during installation, was used to develop correlations between cone penetrometer (CPT) pore-water pressures, pile displacements and rebound. At five sites where piles experienced excessive HPR with minimal set, the pore pressure yielded very high positive values of greater than 20 tsf. However, at the site where the pile rebounded, followed by an acceptable permanent set, the measured pore pressure ranged between 5 and 20 tsf. The pore pressure exhibited values of less than 5 tsf at the site where no rebound was noticed. In summary, direct correlations between CPTu pore pressure and rebound were produced, allowing identification of soils that produce HPR.

Keywords: CPTU, pore water pressure, pile rebound

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Authors: Vinod Kumar, Navin Kumar, Surjit Angra, Prince Sharma

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This paper presents the design analysis of saddle support of a horizontal pressure vessel. Since saddle have the vital role to support the pressure vessel and to maintain its stability, it should be designed in such a way that it can afford the vessel load and internal pressure of the vessel due to liquid contained in the vessel. A model of horizontal pressure vessel and saddle support is created in Ansys. Stresses are calculated using mathematical approach and Ansys software. The analysis reveals the zone of high localized stress at the junction part of the pressure vessel and saddle support due to operating conditions. The results obtained by both the methods are compared with allowable stress value for safe designing.

Keywords: ANSYS, pressure vessel, saddle, support

Procedia PDF Downloads 706