Search results for: thoracic breathing
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 245

Search results for: thoracic breathing

185 Mass Customization of Chemical Protective Clothing

Authors: Eugenija Strazdiene, Violeta Bytautaite, Daivute Krisciuniene

Abstract:

The object of the investigation is the suit for chemical protection, which totally covers human body together with breathing apparatus, breathing mask and helmet (JSC Ansell Protective Solutions Lithuania). The end users of such clothing are the members of rescue team – firefighters. During the presentation, the results of 3D scanning with stationary Human Solutions scanner and portable Artec Eva scanner will be compared on the basis of the efficiency of scanning procedure and scanning accuracy. Also, the possibilities to exporting scanned bodies into specialized CAD systems for suit design development and material consumption calculation will be analyzed. The necessity to understand and to implement corresponding clothing material properties during 3D visualization of garment on CAD systems will be presented. During the presentation, the outcomes of the project ‘Smart and Safe Work Wear Clothing SWW’ will be discussed. The project is carried out under the Interreg Baltic Sea Region Program as 2014-2020 European territorial cooperation objective. Thematic priority is Capacity for Innovation. The main goal of the project is to improve competitiveness and to increase business possibilities for work wear enterprises in the Baltic Sea Region. The project focuses on mass customization of products for various end users. It engages textile and clothing manufacturing technology researchers, work wear producers, end users, as well as national textile and clothing branch organizations in Finland, Lithuania, Latvia, Estonia and Poland.

Keywords: CAD systems, mass customization, 3D scanning, safe work wear

Procedia PDF Downloads 169
184 Jarcho-Levin Syndrome: A Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

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183 The Common Location and the Intensity of Surface Electrical Stimulation on the Thorax and Abdomen Areas: A Systematic Review

Authors: Vu Hoang Thu Huong

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Background: Surface electrical stimulation (SES) is a popular non-invasive approach that offers a wide range of treatments for many diseases of physical therapy. It involves applying electrical stimulation to the skin via surface electrodes to stimulate nerve fibers. SES was regularly used to treat the back and upper or lower extremities, but it was rarely used to treat the chest and abdomen. SES on the thorax and abdomen should be administered with more attention because crucial organs are under those areas (i.e., heart, lungs, liver, etc.). In these areas, safety precautions are suggested, and some SES applications might even be a contraindication. The fact that physical therapists have less experience with SES in these situations can also be attributed to these. Although a few earlier studies applied it to these settings and discovered hopeful results, none of them highlight the relationship between the intensity of SES and its depth of impact for safety considerations. Objective: To assure feasibility when using SES in these areas, the purpose of this study is to summarize the common location and intensity of those areas that have been conducted in previous studies. Method: A thorough systematic review was conducted to determine the common surface electrode position for the thorax and abdomen areas. The studies with the randomized controlled design were systematically searched using inclusion and exclusion criteria through nine electronic databases, including Pubmed, Scopus, etc., between 1975 and Dec 2021. Results: Thirty-three studies with over 1800 participants and 4 types of SES (TENS, IFC, NMES, and FES) with various categories of department hospitals were found. Following an anterior, lateral, and posterior observation, the particular SES positions found that it concentrated on 6 regions (the thoracic, abdomen, upper lateral, lower lateral, upper back, and lower back regions), and its intensity for each region was also summarized. Conclusion: This systematic review figured out the popular locations of SES in the thorax and abdominal areas as well as a summarized maximum of intensity that was found in previous studies with outstanding outcomes.

Keywords: surface electrical stimulation, electrical stimulation, thoracic, abdomen, abdominal.

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182 Traditional Medicine in Children: A Significant Cause of Morbidity and Mortality

Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Traditional medicine refers to a diverse range of therapeutic practices and knowledge systems that have been employed by different cultures over an extended period to uphold and rejuvenate health. These practices can involve herbal remedies, acupuncture, massage, and alternative healing methods that deviate from conventional medical approaches. In Tunisia, we often use unidentified utensils to scratch the oral cavity internally in infants in order to widen the oral cavity for better breathing and swallowing. However, these practices can be risky and may jeopardize the patients' prognosis or even their lives. Aim: This is the case of a nine-month-old infant, admitted to the pediatric department and subsequently to the intensive care unit due to a peritonsillar abscess following the utilization of an unidentifiable tool to scrape the interior of the oral cavity. Case Report: This is a 9-month-old infant with no particular medical history, admitted for high respiratory distress and a fever persisting for 4 days. On clinical examination, he had a respiratory rate of 70 cycles per minute with an oxygen saturation of 97% and subcostal retractions, along with a heart rate of 175 beats per minute. His white blood cell count was 40,960/mm³, and his C-reactive protein was 250 mg/L. Given the severity of the clinical presentation, the infant was transferred to the intensive care unit, intubated, and mechanically ventilated. A cervical-thoracic CT scan was performed, revealing a ruptured 18 mm left peritonsillar abscess in the oropharynx associated with cellulitis of the retropharyngeal space. The oto-rhino-laryngoscopic examination revealed an asymmetry involving the left lateral wall of the oropharynx with the presence of a fistula behind the posterior pillar. Dissection of the collection cavity was performed, allowing the drainage of 2 ml of pus. The culture was negative. The patient received cefotaxime in combination with metronidazole and gentamicin for a duration of 10 days, followed by a switch to amoxicillin-clavulanic acid for 7 days. The patient was extubated after 4 days of treatment, and the clinical and radiological progress was favorable. Conclusions: Traditional medicine remains risky due to the lack of scientific evidence and the potential for injuries and transmission of infectious diseases, especially in children, who constitute a vulnerable population. Therefore, parents should consult healthcare professionals and rely on evidence-based care.

Keywords: children, peritonsillar abscess, traditional medicine, respiratory distress

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181 Accurately Measuring Stress Using Latest Breathing Technology and Its Relationship with Academic Performance

Authors: Farshid Marbouti, Jale Ulas, Julia Thompson

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The main sources of stress among college students are: changes in sleeping and eating habits, undertaking new responsibilities, and financial difficulties as the most common sources of stress, exams, meeting new people, career decisions, fear of failure, and pressure from parents, transition to university especially if it requires leaving home, working with people that they do not know, trouble with parents, and relationship with the opposite sex. The students use a variety of stress coping strategies, including talking to family and friends, leisure activities and exercising. The Yerkes–Dodson law indicates while a moderate amount of stress may be beneficial for performance, too high stress will result in weak performance. In other words, if students are too stressed, they are likely to have low academic performance. In a preliminary study conducted in 2017 with engineering students enrolled in three high failure rate classes, the majority of the students stated that they have high levels of stress mainly for academic, financial, or family-related reasons. As the second stage of the study, the main purpose of this research is to investigate the students’ level of stress, sources of stress, their relationship with student demographic background, students’ coping strategies, and academic performance. A device is being developed to gather data from students breathing patterns and measure their stress levels. In addition, all participants are asked to fill out a survey. The survey under development has the following categories: exam stressor, study-related stressors, financial pressures, transition to university, family-related stress, student response to stress, and stress management. After the data collection, Structural Equation Modeling (SEM) analysis will be conducted in order to identify the relationship among students’ level of stress, coping strategies, and academic performance.

Keywords: college student stress, coping strategies, academic performance, measuring stress

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180 Cerebral Toxoplasmosis: A Histopathological Diagnosis

Authors: Prateek Rastogi, Jenash Acharya

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Histopathology examination has been a boon to forensic experts all around the world since its implication in autopsy cases. Whenever a case of sudden death is encountered, forensic experts clandestinely focus on cardiovascular, respiratory, gastrointestinal or cranio-cerebral causes. After ruling out poisoning or trauma, they are left with the only option available, histopathology examination. Besides preserving thoracic and abdominal organs, brain tissues are very less frequently subjected for the analysis. Based on provisional diagnosis documented on hospital treatment record files, one hemisphere of grossly unremarkable cerebrum was confirmatively diagnosed by histopathology examination to be a case of cerebral toxoplasmosis.

Keywords: cerebral toxoplasmosis, sudden death, health information, histopathology

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179 Stun Practices in Swine in the Valle De Aburrá and Animal Welfare

Authors: Natalia Uribe Corrales, Carolina Cano Arroyave, Santiago Henao Villegas

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Introduction: Stunning is an important stage in the meat industry due to the repercussions on the characteristics of the carcass. It has been demonstrated that inadequate stun can lead to hematomas, fractures and promote the appearance of pale, soft and exudative meat due to the stress caused in animals. In Colombia, gas narcosis and electrical stunning are the two authorized methods in pigs. Objective: To describe the practices of stunning in the Valle de Aburrá and its relation with animal welfare. Methods: A descriptive cross - sectional study was carried out in Valle de Aburrá slaughterhouses, which were authorized by National Institute for Food and Medicine Surveillance (INVIMA). Variables such as stunning method, presence of vocalization, falls, slips, rhythmic breathing, corneal reflex and attempts to incorporate after stunning, stun time and time between stun and bleeding were analyzed. Results: 225 pigs were analyzed, finding that 50.2% had electrical stun, whose amperage and voltage were 1.23 (A) and 120 (V) respectively; 49.8% of the animals were stunned with CO2 chamber whose concentration was always above 95%, the mean desensitization time was 16.8 seconds (d.e.5.37); the mean time of stunning - bleeding was 47.9 seconds (d.e.13.9); similarly, it was found that 27.1% had vocalizations after stunning; 12% had falls; 10.7% showed rhythmic breathing; 33.3% exhibited corneal reflex; and 10.7% had reincorporation attempts. Conclusions: The methods of stunning used in the Valle de Aburrá, although performed with those permitted by law, are shortcomings in relation to the amperage and voltage used for each type of pig, as well, it is found that welfare animal is being violated to find signology of an inadequate desensitization. It is necessary to promote compliance with the principles of stunning according to Animal Welfare, and keep in mind that in electrical desensitization, the calibration of the equipment must be guaranteed (pressure according to the type of animal or current applied and the position where the electrodes are) and in the narcosis the equipment should be calibrated to ensure proper gas concentration and exposure time.

Keywords: animal welfare, pigs, quality of meat, stun methods

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178 A Theoretical Approach of Tesla Pump

Authors: Cristian Sirbu-Dragomir, Stefan-Mihai Sofian, Adrian Predescu

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This paper aims to study Tesla pumps for circulating biofluids. It is desired to make a small pump for the circulation of biofluids. This type of pump will be studied because it has the following characteristics: It doesn’t have blades which results in very small frictions; Reduced friction forces; Low production cost; Increased adaptability to different types of fluids; Low cavitation (towards 0); Low shocks due to lack of blades; Rare maintenance due to low cavity; Very small turbulences in the fluid; It has a low number of changes in the direction of the fluid (compared to rotors with blades); Increased efficiency at low powers.; Fast acceleration; The need for a low torque; Lack of shocks in blades at sudden starts and stops. All these elements are necessary to be able to make a small pump that could be inserted into the thoracic cavity. The pump will be designed to combat myocardial infarction. Because the pump must be inserted in the thoracic cavity, elements such as Low friction forces, shocks as low as possible, low cavitation and as little maintenance as possible are very important. The operation should be performed once, without having to change the rotor after a certain time. Given the very small size of the pump, the blades of a classic rotor would be very thin and sudden starts and stops could cause considerable damage or require a very expensive material. At the same time, being a medical procedure, the low cost is important in order to be easily accessible to the population. The lack of turbulence or vortices caused by a classic rotor is again a key element because when it comes to blood circulation, the flow must be laminar and not turbulent. The turbulent flow can even cause a heart attack. Due to these aspects, Tesla's model could be ideal for this work. Usually, the pump is considered to reach an efficiency of 40% being used for very high powers. However, the author of this type of pump claimed that the maximum efficiency that the pump can achieve is 98%. The key element that could help to achieve this efficiency or one as close as possible is the fact that the pump will be used for low volumes and pressures. The key elements to obtain the best efficiency for this model are the number of rotors placed in parallel and the distance between them. The distance between them must be small, which helps to obtain a pump as small as possible. The principle of operation of such a rotor is to place in several parallel discs cut inside. Thus the space between the discs creates the vacuum effect by pulling the liquid through the holes in the rotor and throwing it outwards. Also, a very important element is the viscosity of the liquid. It dictates the distance between the disks to achieve a lossless power flow.

Keywords: lubrication, temperature, tesla-pump, viscosity

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177 Effects of Umbilical Cord Clamping on Puppies Neonatal Vitality

Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

In veterinary medicine, the standard procedure during a caesarian section is clamping the umbilical cord immediately after birth. In human neonates, when the umbilical cord is kept intact after birth, blood continues to flow from the cord to the newborn, but this procedure may prove to be difficult in dogs due to the shorter umbilical cord and the number of newborns in the litter. However, a possible detachment of the placenta while keeping the umbilical cord intact may make the residual blood to flow to the neonate. This study compared the effects on neonatal vitality between clamping and no clamping the umbilical cord of dogs born through cesarean section, assessing them through Apgar and reflex scores. Fifty puppies delivered from 16 bitches were randomly allocated to receive clamping of the umbilical cord immediately (n=25) or to not receive the clamping until breathing (n=25). The neonates were assessed during the first five min of life and once again 10 min after the first assessment. The differences observed between the two moments were significant (p < 0.01) for both the Apgar and reflex scores. The differences observed between the groups (clamped vs. not clamped) were not significant for the Apgar score in the 1st moment (p=0.1), but the 2nd moment was significantly (p < 0.01) in the group not clamped, as well as significant (p < 0.05) for the reflex score in the 1st moment and 2nd moment (p < 0.05), revealing higher neonatal vitality in the not clamped group. The differences observed between the moments (1st vs. 2nd) of each group as significant (p < 0.01), revealing higher neonatal vitality in the 2nd moments. In the no clamping group, after removing the neonates together with the umbilical cord and the placenta, we observed that the umbilical cords were full of blood at the time of birth and later became whitish and collapsed, demonstrating the blood transfer. The results suggest that keeping the umbilical cord intact for at least three minutes after the onset breathing is not detrimental and may contribute to increase neonate vitality in puppies delivered by cesarean section.

Keywords: puppy vitality, newborn dog, cesarean section, Apgar score

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176 Optical Properties of Tetrahydrofuran Clathrate Hydrates at Terahertz Frequencies

Authors: Hyery Kang, Dong-Yeun Koh, Yun-Ho Ahn, Huen Lee

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Terahertz time-domain spectroscopy (THz-TDS) was used to observe the THF clathrate hydrate system with dosage of polyvinylpyrrolidone (PVP) with three different average molecular weights (10,000 g/mol, 40,000 g/mol, 360,000 g/mol). Distinct footprints of phase transition in the THz region (0.4 - 2.2 THz) were analyzed and absorption coefficients and complex refractive indices are obtained and compared in the temperature range of 253 K to 288 K. Along with the optical properties, ring breathing and stretching modes for different molecular weights of PVP in THF hydrate are analyzed by Raman spectroscopy.

Keywords: clathrate hydrate, terahertz, polyvinylpyrrolidone (PVP), THz-TDS, inhibitor

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175 A Preliminary Study on the Effects of Lung Impact on Ballistic Thoracic Trauma

Authors: Amy Pullen, Samantha Rodrigues, David Kieser, Brian Shaw

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The aim of the study was to determine if a projectile interacting with the lungs increases the severity of injury in comparison to a projectile interacting with the ribs or intercostal muscle. This comparative study employed a 10% gelatine based model with either porcine ribs or balloons embedded to represent a lung. Four sample groups containing five samples were evaluated; these were control (plain gel), intercostal impact, rib impact, and lung impact. Two ammunition natures were evaluated at a range of 10m; these were 5.56x45mm and 7.62x51mm. Aspects of projectile behavior were quantified including exiting projectile weight, location of yawing, projectile fragmentation and distribution, location and area of the temporary cavity, permanent cavity formation, and overall energy deposition. Major findings included the cavity showing a higher percentage of the projectile weight exit the block than the intercostal and ribs, but similar to the control for the 5.56mm ammunition. However, for the 7.62mm ammunition, the lung was shown to have a higher percentage of the projectile weight exit the block than the control, intercostal and ribs. The total weight of projectile fragments as a function of penetration depth revealed large fluctuations and significant intra-group variation for both ammunition natures. Despite the lack of a clear trend, both plots show that the lung leads to greater projectile fragments exiting the model. The lung was shown to have a later center of the temporary cavity than the control, intercostal and ribs for both ammunition types. It was also shown to have a similar temporary cavity volume to the control, intercostal and ribs for the 5.56mm ammunition and a similar temporary cavity to the intercostal for the 7.62mm ammunition The lung was shown to leave a similar projectile tract than the control, intercostal and ribs for both ammunition types. It was also shown to have larger shear planes than the control and the intercostal, but similar to the ribs for the 5.56mm ammunition, whereas it was shown to have smaller shear planes than the control but similar shear planes to the intercostal and ribs for the 7.62mm ammunition. The lung was shown to have less energy deposited than the control, intercostal and ribs for both ammunition types. This comparative study provides insights into the influence of the lungs on thoracic gunshot trauma. It indicates that the lungs limits projectile deformation and causes a later onset of yawing and subsequently limits the energy deposited along the wound tract creating a deeper and smaller cavity. This suggests that lung impact creates an altered pattern of local energy deposition within the target which will affect the severity of trauma.

Keywords: ballistics, lung, trauma, wounding

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174 Uncommon Case of Falx Subdural Hematoma

Authors: Thu Nguyen, Jane Daugherty-Luck

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Falx subdural hematoma is a life-threatening condition associated with high mortality. We present a patient case who had fallen with no head injury or loss of conspicuousness. She had tenderness along cervical and thoracic lumbar spine. CT head revealed falx subdural hematoma. The patient was managed medically. The pathophysiology of falx subdural hematoma is linked to laceration of bridging veins provoked by frontal or occipital impact. Posttraumatic subdural hematoma is commonly caused by inertia instead of facture or cerebral contusion resulting from direct impact. The theory is consistent with the lack of fracture in most cases in the literature. Our patient had neither contusion nor fracture.

Keywords: falx subdural hematoma, traumatic head injury, CT head scan, bridging veins, inertia

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173 Amifostine Analogue, Drde-30, Attenuates Radiation-Induced Lung Injury in Mice

Authors: Aastha Arora, Vikas Bhuria, Saurabh Singh, Uma Pathak, Shweta Mathur, Puja P. Hazari, Rajat Sandhir, Ravi Soni, Anant N. Bhatt, Bilikere S. Dwarakanath

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Radiotherapy is an effective curative and palliative option for patients with thoracic malignancies. However, lung injury, comprising of pneumonitis and fibrosis, remains a significant clin¬ical complication of thoracic radiation, thus making it a dose-limiting factor. Also, injury to the lung is often reported as part of multi-organ failure in victims of accidental radiation exposures. Radiation induced inflammatory response in the lung, characterized by leukocyte infiltration and vascular changes, is an important contributing factor for the injury. Therefore, countermeasure agents to attenuate radiation induced inflammatory response are considered as an important approach to prevent chronic lung damage. Although Amifostine, the widely used, FDA approved radio-protector, has been found to reduce the radiation induced pneumonitis during radiation therapy of non-small cell lung carcinoma, its application during mass and field exposure is limited due to associated toxicity and ineffectiveness with the oral administration. The amifostine analogue (DRDE-30) overcomes this limitation as it is orally effective in reducing the mortality of whole body irradiated mice. The current study was undertaken to investigate the potential of DRDE-30 to ameliorate radiation induced lung damage. DRDE-30 was administered intra-peritoneally, 30 minutes prior to 13.5 Gy thoracic (60Co-gamma) radiation in C57BL/6 mice. Broncheo- alveolar lavage fluid (BALF) and lung tissues were harvested at 12 and 24 weeks post irradiation for studying inflammatory and fibrotic markers. Lactate dehydrogenase (LDH) leakage, leukocyte count and protein content in BALF were used as parameters to evaluate lung vascular permeability. Inflammatory cell signaling (p38 phosphorylation) and anti-oxidant status (MnSOD and Catalase level) was assessed by Western blot, while X-ray CT scan, H & E staining and trichrome staining were done to study the lung architecture and collagen deposition. Irradiation of the lung increased the total protein content, LDH leakage and total leukocyte count in the BALF, reflecting endothelial barrier dysfunction. These disruptive effects were significantly abolished by DRDE-30, which appear to be linked to the DRDE-30 mediated abrogation of activation of the redox-sensitive pro- inflammatory signaling cascade, the MAPK pathway. Concurrent administration of DRDE-30 with radiation inhibited radiation-induced oxidative stress by strengthening the anti-oxidant defense system and abrogated p38 mitogen-activated protein kinase activation, which was associated with reduced vascular leak and macrophage recruitment to the lungs. Histopathological examination (by H & E staining) of the lung showed radiation-induced inflammation of the lungs, characterized by cellular infiltration, interstitial oedema, alveolar wall thickening, perivascular fibrosis and obstruction of alveolar spaces, which were all reduced by pre-administration of DRDE-30. Structural analysis with X-ray CT indicated lung architecture (linked to the degree of opacity) comparable to un-irradiated mice that correlated well with the lung morphology and reduced collagen deposition. Reduction in the radiation-induced inflammation and fibrosis brought about by DRDE-30 resulted in a profound increase in animal survival (72 % in the combination vs 24% with radiation) observed at the end of 24 weeks following irradiation. These findings establish the potential of the Amifostine analogue, DRDE-30, in reducing radiation induced pulmonary injury by attenuating the inflammatory and fibrotic responses.

Keywords: amifostine, fibrosis, inflammation, lung injury radiation

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172 Airway Resistance Evaluation by Respiratory İnductive Plethysmography in Subjects with Airway Obstructions

Authors: Aicha Laouani, Sonia Rouatbi, Saad Saguem, Gila Benchetrit, Pascale calabrese

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A new approach based on respiratory inductive plethysmography (RIP) signal analysis has been used for bronchoconstriction changes evaluation in 50 healthy controls and in 44 adults with moderate bronchial obstruction treated with a bronchodilatation protocol. Thoracic and abdominal motions were recorded ( 5 min) by RIP. For each recording the thoracoabdominal signals were analysed and a mean distance (D) was calculated. Airway resistance (Raw) and spirometric data were measured with a body plethysmograph. The results showed that both D and Raw were higher in subjects compared to the healthy group. Significant decreases of D and Raw were also observed after bronchodilatation in the obstructive group. There was also a positive and a significant correlation between D and Raw in subjects before and after bronchodilatation. This D calculated from RIP Signals could be used as a non invasive tool for continuous monitoring of bronchoconstriction changes.

Keywords: airway resistance, bronchoconstriction, thorax, respiratory inductive plethysmography

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171 Numerical Simulation on Airflow Structure in the Human Upper Respiratory Tract Model

Authors: Xiuguo Zhao, Xudong Ren, Chen Su, Xinxi Xu, Fu Niu, Lingshuai Meng

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The respiratory diseases such as asthma, emphysema and bronchitis are connected with the air pollution and the number of these diseases tends to increase, which may attribute to the toxic aerosol deposition in human upper respiratory tract or in the bifurcation of human lung. The therapy of these diseases mostly uses pharmaceuticals in the form of aerosol delivered into the human upper respiratory tract or the lung. Understanding of airflow structures in human upper respiratory tract plays a very important role in the analysis of the “filtering” effect in the pharynx/larynx and for obtaining correct air-particle inlet conditions to the lung. However, numerical simulation based CFD (Computational Fluid Dynamics) technology has its own advantage on studying airflow structure in human upper respiratory tract. In this paper, a representative human upper respiratory tract is built and the CFD technology was used to investigate the air movement characteristic in the human upper respiratory tract. The airflow movement characteristic, the effect of the airflow movement on the shear stress distribution and the probability of the wall injury caused by the shear stress are discussed. Experimentally validated computational fluid-aerosol dynamics results showed the following: the phenomenon of airflow separation appears near the outer wall of the pharynx and the trachea. The high velocity zone is created near the inner wall of the trachea. The airflow splits at the divider and a new boundary layer is generated at the inner wall of the downstream from the bifurcation with the high velocity near the inner wall of the trachea. The maximum velocity appears at the exterior of the boundary layer. The secondary swirls and axial velocity distribution result in the high shear stress acting on the inner wall of the trachea and bifurcation, finally lead to the inner wall injury. The enhancement of breathing intensity enhances the intensity of the shear stress acting on the inner wall of the trachea and the bifurcation. If human keep the high breathing intensity for long time, not only the ability for the transportation and regulation of the gas through the trachea and the bifurcation fall, but also result in the increase of the probability of the wall strain and tissue injury.

Keywords: airflow structure, computational fluid dynamics, human upper respiratory tract, wall shear stress, numerical simulation

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170 Overview and Pathophysiology of Radiation-Induced Breast Changes as a Consequence of Radiotherapy Toxicity

Authors: Monika Rezacova

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Radiation-induced breast changes are a consequence of radiotherapy toxicity over the breast tissues either related to targeted breast cancer treatment or other thoracic malignancies (eg. lung cancer). This study has created an overview of different changes and their pathophysiology. The main conditions included were skin thickening, interstitial oedema, fat necrosis, dystrophic calcifications, skin retractions, glandular atrophy, breast fibrosis and radiation induced breast cancer. This study has performed focused literature search through multiple databases including pubmed, medline and embase. The study has reviewed English as well as non English publications. As a result of the literature the study provides comprehensive overview of radiation-induced breast changes and their pathophysiology with small focus on new development and prevention.

Keywords: radiotherapy toxicity, breast tissue changes, breast cancer treatment, radiation-induced breast changes

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169 Trauma Scores and Outcome Prediction After Chest Trauma

Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

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Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

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168 Recurrent Fevers with Weight Gain - Possible Rapid onset Obesity with Hypoventilation, Hypothalamic Dysfunction and Autonomic Dysregulation Syndrome

Authors: Lee Rui, Rajeev Ramachandran

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The approach to recurrent fevers in the paediatric or adolescent age group is not a straightforward one. Causes range from infectious diseases to rheumatological conditions to endocrinopathies, and are usually accompanied by weight loss rather than weight gain. We present an interesting case of a 16-year-old girl brought by her mother to the General Pediatrics Clinic for concerns of recurrent fever paired with significant weight gain over 1.5 years, with no identifiable cause found despite extensive work-up by specialists ranging from Rheumatologists to Oncologists. This case provides a learning opportunity on the approach to weight gain paired with persistent fevers in a paediatric population, one which is not commonly encountered and prompts further evaluation and consideration of less common diagnoses. In a span of 2 years, the girl’s weight had increased from 55 kg at 13 years old (75th centile) to 73.9 kg at 16 years old (>97th centile). About 1 year into her rapid weight gain, she started developing recurrent fevers of documented temperatures > 37.5 – 38.6 every 2-3 days, resulting in school absenteeism when she was sent home after temperature-taking in school found her to be febrile. The rapid onset of weight gain paired with unexplained fevers prompted the treating physician to consider the diagnosis of ROHHAD syndrome. Rapid onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation (ROHHAD) syndrome is a rare disorder first described in 2007. It is characterized by dysfunction of the autonomic and endocrine system, characterized by hyperphagia and rapid-onset weight gain. This rapid weight gain is classically followed by hypothalamic manifestations with neuroendocrine deficiencies, hypo-ventilatory breathing abnormalities, and autonomic dysregulation. ROHHAD is challenging to diagnose with and diagnosis is made based mostly on clinical judgement. However if truly diagnosed, the condition is characterized by high morbidity and mortality rates. Early recognition of sleep disorders breathing and targeted therapeutic interventions helps limit morbidity and mortality associated with ROHHAD syndrome. This case poses an interesting diagnostic challenge and a diagnosis of ROHHAD has to be considered, given the serious complications that can come with disease progression while conditions such as Munchausen’s or drug fever remain as diagnoses of exclusion until we have exhausted all other possible conditions.

Keywords: pediatrics, endocrine, weight gain, recurrent fever, adolescent

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167 Ayurvastra: A Study on the Ancient Indian Textile for Healing

Authors: Reena Aggarwal

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The use of textile chemicals in the various pre and post-textile manufacturing processes has made the textile industry conscious of its negative contribution to environmental pollution. Popular environmentally friendly fibers such as recycled polyester and organic cotton have been now increasingly used by fabrics and apparel manufacturers. However, after these textiles or the finished apparel are manufactured, they have to be dyed in the same chemical dyes that are harmful and toxic to the environment. Dyeing is a major area of concern for the environment as well as for people who have chemical sensitivities as it may cause nausea, breathing difficulties, seizures, etc. Ayurvastra or herbal medical textiles are one step ahead of the organic lifestyle, which supports the core concept of holistic well-being and also eliminates the impact of harmful chemicals and pesticides. There is a wide range of herbs that can be used not only for dyeing but also for providing medicinal properties to the textiles like antibacterial, antifungal, antiseptic, antidepressant and for treating insomnia, skin diseases, etc. The concept of herbal dyeing of fabric is to manifest herbal essence in every aspect of clothing, i.e., from production to end-use, additionally to eliminate the impact of harmful chemical dyes and chemicals which are known to result in problems like skin rashes, headache, trouble concentrating, nausea, diarrhea, fatigue, muscle and joint pain, dizziness, difficulty breathing, irregular heartbeat and seizures. Herbal dyeing or finishing on textiles will give an extra edge to the textiles as it adds an extra function to the fabric. The herbal extracts can be applied to the textiles by a simple process like the pad dry cure method and mainly acts on the human body through the skin for aiding in the treatment of disease or managing the medical condition through its herbal properties. This paper, therefore, delves into producing Ayurvastra, which is a perfect amalgamation of cloth and wellness. The aim of the paper is to design and create herbal disposable and non-disposable medical textile products acting mainly topically (through the skin) for providing medicinal properties/managing medical conditions. Keeping that in mind, a range of antifungal socks and antibacterial napkins treated with turmeric and aloe vera were developed, which are recommended for the treatment of fungal and bacterial infections, respectively. Both Herbal Antifungal socks and Antibacterial napkins have proved to be efficient enough in managing and treating fungal and bacterial infections of the skin, respectively.

Keywords: ayurvastra, ayurveda, herbal, pandemic, sustainable

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166 Phase Transition of Aqueous Ternary (THF + Polyvinylpyrrolidone + H2O) System as Revealed by Terahertz Time-Domain Spectroscopy

Authors: Hyery Kang, Dong-Yeun Koh, Yun-Ho Ahn, Huen Lee

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Determination of the behavior of clathrate hydrate with inhibitor in the THz region will provide useful information about hydrate plug control in the upstream of the oil and gas industry. In this study, terahertz time-domain spectroscopy (THz-TDS) revealed the inhibition of the THF clathrate hydrate system with dosage of polyvinylpyrrolidone (PVP) with three different molecular weights. Distinct footprints of phase transition in the THz region (0.4–2.2 THz) were analyzed and absorption coefficients and real part of refractive indices are obtained in the temperature range of 253 K to 288 K. Along with the optical properties, ring breathing and stretching modes for different molecular weights of PVP in THF hydrate are analyzed by Raman spectroscopy.

Keywords: clathrate hydrate, terahertz spectroscopy, tetrahydrofuran, inhibitor

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165 Gross and Histological Studies on the Thymus of the Grasscutter (Thyronomys swinderianus)

Authors: R. M. Korzerzer, J. O. Hambolu, S. O. Salami, S. B. Oladele

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Twelve apparently healthy grasscutters between the ages of three and seven months were used for this study. The animals were purchased from local breeders in Oturkpo, Benue state, Nigeria and transported to the research laboratory in the Department of Veterinary Anatomy, Ahmadu Bello University, Zaria by means of constructed cages. The animals were divided into three groups according to their ages and acclimatised. Sacrifice was done using chloroform gaseous inhalation anaesthesia. An incision was made at the neck region and the thymus located and identified by its prominent bilateral nature. Extirpated thymuses from each animal were immediately weighed and fixed in Bouin’s fluid for 48 hours. The tissues were then prepared using standard methods. Haematoxilin and eosin was used for routine histology and Rhodamine B aniline methylene blue was for studying the architecture of the elastic and reticular fibres of the thymus. Grossly, the thymus appeared as a bilateral organ on either side of the thoracic midline. The organ size decreased consistently as the animals advanced in age. Mean ± SEM values for thymic weights were 1.23 ± 0.048 g, 0.53 ± 0.019 g and 0.30 ± 0.042 g at three, five and seven months of age respectively.

Keywords: gross, histological, thymus, grasscutter

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164 The Effects of Qigong Exercise Intervention on the Cognitive Function in Aging Adults

Authors: D. Y. Fong, C. Y. Kuo, Y. T. Chiang, W. C. Lin

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Objectives: Qigong is an ancient Chinese practice in pursuit of a healthier body and a more peaceful mindset. It emphasizes on the restoration of vital energy (Qi) in body, mind, and spirit. The practice is the combination of gentle movements and mild breathing which help the doers reach the condition of tranquility. On account of the features of Qigong, first, we use cross-sectional methodology to compare the differences among the varied levels of Qigong practitioners on cognitive function with event-related potential (ERP) and electroencephalography (EEG). Second, we use the longitudinal methodology to explore the effects on the Qigong trainees for pretest and posttest on ERP and EEG. Current study adopts Attentional Network Test (ANT) task to examine the participants’ cognitive function, and aging-related researches demonstrated a declined tread on the cognition in older adults and exercise might ameliorate the deterioration. Qigong exercise integrates physical posture (muscle strength), breathing technique (aerobic ability) and focused intention (attention) that researchers hypothesize it might improve the cognitive function in aging adults. Method: Sixty participants were involved in this study, including 20 young adults (21.65±2.41 y) with normal physical activity (YA), 20 Qigong experts (60.69 ± 12.42 y) with over 7 years Qigong practice experience (QE), and 20 normal and healthy adults (52.90±12.37 y) with no Qigong practice experience as experimental group (EG). The EG participants took Qigong classes 2 times a week and 2 hours per time for 24 weeks with the purpose of examining the effect of Qigong intervention on cognitive function. ANT tasks (alert network, orient network, and executive control) were adopted to evaluate participants’ cognitive function via ERP’s P300 components and P300 amplitude topography. Results: Behavioral data: 1.The reaction time (RT) of YA is faster than the other two groups, and EG was faster than QE in the cue and flanker conditions of ANT task. 2. The RT of posttest was faster than pretest in EG in the cue and flanker conditions. 3. No difference among the three groups on orient, alert, and execute control networks. ERP data: 1. P300 amplitude detection in QE was larger than EG at Fz electrode in orient, alert, and execute control networks. 2. P300 amplitude in EG was larger at pretest than posttest on the orient network. 3. P300 Latency revealed no difference among the three groups in the three networks. Conclusion: Taken together these findings, they provide neuro-electrical evidence that older adults involved in Qigong practice may develop a more overall compensatory mechanism and also benefit the performance of behavior.

Keywords: Qigong, cognitive function, aging, event-related potential (ERP)

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163 Harmful Algal Poisoning Symptoms in Coastal Areas of Nigeria

Authors: Medina Kadiri

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Nigeria has an extensive coastline of 853 km long between latitude 4°10′ to 6°20′ N and longitude 2°45′ to 8°35′ E and situated in the Gulf of Guinea within the Guinea Current Large Marine Ecosystem. There is a substantial coastal community relying on this region for their livelihood of fishing, aquaculture, mariculture for various sea foods either for consumption or economic sustenance or both. Socio-economic study was conducted, using questionnaires and interview, to investigate the health symptoms of harmful algae experienced by these communities on consumption of sea foods. Eighteen symptoms were recorded. Of the respondents who experienced symptoms after consumption of sea foods, overall, more people (33.5%) experienced vomiting as a symptom, followed by nausea (14.03%) and then diarrhea (13.57%). Others were headache (9.95%), mouth tingling (8.6%) and tiredness (7.24%).The least were muscle pain, rashes, confusion, chills, burning sensation, breathing difficulty and balance difficulty which represented 0.45% each and the rest (dizziness, digestive tract tumors, itching, memory loss, & stomach pain) were less than 3% each. In terms of frequency, the most frequent symptom was diarrhea with 87.5% occurrence, closely followed by vomiting with 81.3%. Tiredness was 75% while nausea was 62.5% and headache 50%. Others such as dizziness, itching, memory loss, mouth tingling and stomach pain had about 40% occurrence or less. The least occurring symptoms were muscle pain, rashes, confusion, chills and balance difficulty and burning sensation occurring only once i.e 6.3%. Breathing difficulty was last but one with 12.5%. Visible symptom from seafood and the particular seafood consumed that prompted the visible symptoms, shows that 3.5% of the entire respondents who ate crab experienced various symptoms ranging from vomiting (2.4%), itching (0.5%) and headache (0.4%). For periwinkle, vomiting had 1.7%, while 1.2% represented diarrhea and nausea symptom comprised 0.8% of all the respondents who ate periwinkle. Some respondents who consumed fish shows that 0.4% of the respondents had Itching. From the respondents who preferred to consume shrimps/crayfish and crab, shrimps/crayfish, crab and periwinkle, the most common illness was tiredness (1.2%), while 0.5% had experienced diarrhea and many others. However, for most respondents who claimed to have no preference for any seafood, with 55.7% affirming this with vomiting being the highest (6.1%), followed closely by mouth tingling/ burning sensation (5.8%). Examining the seasonal influence on visible symptoms revealed that vomiting occurred more in the month of January with 5.5%, while headache and itching were predominant in October with (2.8%). Nausea has 3.1% in January than any season of the year, 2.6% of the entire respondents opined to have experience diarrhea in October than in any other season of the year. Regular evaluation of harmful algal poisoning symptoms is recommended for coastal communities.

Keywords: coastal, harmful algae, human poisoning symptoms, Nigeria, phycotoxins

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162 HelpMeBreathe: A Web-Based System for Asthma Management

Authors: Alia Al Rayssi, Mahra Al Marar, Alyazia Alkhaili, Reem Al Dhaheri, Shayma Alkobaisi, Hoda Amer

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We present in this paper a web-based system called “HelpMeBreathe” for managing asthma. The proposed system provides analytical tools, which allow better understanding of environmental triggers of asthma, hence better support of data-driven decision making. The developed system provides warning messages to a specific asthma patient if the weather in his/her area might cause any difficulty in breathing or could trigger an asthma attack. HelpMeBreathe collects, stores, and analyzes individuals’ moving trajectories and health conditions as well as environmental data. It then processes and displays the patients’ data through an analytical tool that leads to an effective decision making by physicians and other decision makers.

Keywords: asthma, environmental triggers, map interface, web-based systems

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161 An Effective Noise Resistant Frequency Modulation Continuous-Wave Radar Vital Sign Signal Detection Method

Authors: Lu Yang, Meiyang Song, Xiang Yu, Wenhao Zhou, Chuntao Feng

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To address the problem that the FM continuous-wave radar (FMCW) extracts human vital sign signals which are susceptible to noise interference and low reconstruction accuracy, a new detection scheme for the sign signals is proposed. Firstly, an improved complete ensemble empirical modal decomposition with adaptive noise (ICEEMDAN) algorithm is applied to decompose the radar-extracted thoracic signals to obtain several intrinsic modal functions (IMF) with different spatial scales, and then the IMF components are optimized by a BP neural network improved by immune genetic algorithm (IGA). The simulation results show that this scheme can effectively separate the noise and accurately extract the respiratory and heartbeat signals and improve the reconstruction accuracy and signal-to-noise ratio of the sign signals.

Keywords: frequency modulated continuous wave radar, ICEEMDAN, BP neural network, vital signs signal

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160 Determination of Air Quality Index Using Respirable Dust Sampler

Authors: Sapan Bhatnagar, Danish Akhtar, Salman Ahmed, Asif Ekbal, Gufran Beig

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Particulates are the solid and liquid droplets present in the atmosphere, they have serious negative effects on human health and environment. PM10 and PM2.5 are so small that they can penetrate deep into our lungs through the respiratory system. Determination of the amount of particulates present in the atmosphere per cubic meter is necessary to monitor, regulate and model atmospheric particulate levels. Air Quality Index is an index tells us how clean or polluted our air is, and what associated health effects might be a concern for us. The AQI focuses on health affects you may experience within a few hours or days after breathing polluted air. The quality rating for each pollutant was calculated. The geometric mean of these quality ratings gives the Air Quality Index. The existing concentrations of pollutants were compared with ambient air quality standards.

Keywords: air quality index, particulate, respirable dust sampler, dust sampler

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159 Characterizing the Rectification Process for Designing Scoliosis Braces: Towards Digital Brace Design

Authors: Inigo Sanz-Pena, Shanika Arachchi, Dilani Dhammika, Sanjaya Mallikarachchi, Jeewantha S. Bandula, Alison H. McGregor, Nicolas Newell

Abstract:

The use of orthotic braces for adolescent idiopathic scoliosis (AIS) patients is the most common non-surgical treatment to prevent deformity progression. The traditional method to create an orthotic brace involves casting the patient’s torso to obtain a representative geometry, which is then rectified by an orthotist to the desired geometry of the brace. Recent improvements in 3D scanning technologies, rectification software, CNC, and additive manufacturing processes have given the possibility to compliment, or in some cases, replace manual methods with digital approaches. However, the rectification process remains dependent on the orthotist’s skills. Therefore, the rectification process needs to be carefully characterized to ensure that braces designed through a digital workflow are as efficient as those created using a manual process. The aim of this study is to compare 3D scans of patients with AIS against 3D scans of both pre- and post-rectified casts that have been manually shaped by an orthotist. Six AIS patients were recruited from the Ragama Rehabilitation Clinic, Colombo, Sri Lanka. All patients were between 10 and 15 years old, were skeletally immature (Risser grade 0-3), and had Cobb angles between 20-45°. Seven spherical markers were placed at key anatomical locations on each patient’s torso and on the pre- and post-rectified molds so that distances could be reliably measured. 3D scans were obtained of 1) the patient’s torso and pelvis, 2) the patient’s pre-rectification plaster mold, and 3) the patient’s post-rectification plaster mold using a Structure Sensor Mark II 3D scanner (Occipital Inc., USA). 3D stick body models were created for each scan to represent the distances between anatomical landmarks. The 3D stick models were used to analyze the changes in position and orientation of the anatomical landmarks between scans using Blender open-source software. 3D Surface deviation maps represented volume differences between the scans using CloudCompare open-source software. The 3D stick body models showed changes in the position and orientation of thorax anatomical landmarks between the patient and the post-rectification scans for all patients. Anatomical landmark position and volume differences were seen between 3D scans of the patient’s torsos and the pre-rectified molds. Between the pre- and post-rectified molds, material removal was consistently seen on the anterior side of the thorax and the lateral areas below the ribcage. Volume differences were seen in areas where the orthotist planned to place pressure pads (usually at the trochanter on the side to which the lumbar curve was tilted (trochanter pad), at the lumbar apical vertebra (lumbar pad), on the rib connected to the apical vertebrae at the mid-axillary line (thoracic pad), and on the ribs corresponding to the upper thoracic vertebra (axillary extension pad)). The rectification process requires the skill and experience of an orthotist; however, this study demonstrates that the brace shape, location, and volume of material removed from the pre-rectification mold can be characterized and quantified. Results from this study can be fed into software that can accelerate the brace design process and make steps towards the automated digital rectification process.

Keywords: additive manufacturing, orthotics, scoliosis brace design, sculpting software, spinal deformity

Procedia PDF Downloads 119
158 Hypoglossal Nerve Stimulation (Baseline vs. 12 months) for Obstructive Sleep Apnea: A Meta-Analysis

Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

Abstract:

Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

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157 Anaesthetic Management of a Huge Oropharyngeal Mass

Authors: Vasudha Govil, Suresh Singhal

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Introduction: Patients with oropharyngeal masses pose a challenge for an anaesthetist in terms of ventilation and tracheal intubation. Thus, preoperative assessment and preparation become an integral part of managing such anticipated difficult airway cases. Case report: A 45- year old female presented with growth in the oropharynx causing dysphagia and hoarseness of voice. Clinical examination and investigations predicted a difficult airway. It was managed with fibreoptic nasotracheal intubation with a successful perioperative outcome. Tracheostomy was kept as plan B in case of the CVCI situation. Conclusion: Careful preoperative examination and assessment is required to prepare oneself for difficult airway. Fibreoptic bronchoscope-guided nasotracheal intubation in a spontaneously breathing patient is a safe and successful airway management technique in difficult airway cases.

Keywords: airway, difficult, mass, oropharyngeal

Procedia PDF Downloads 162
156 Therapy Finding and Perspectives on Limbic Resonance in Gifted Adults

Authors: Andreas Aceranti, Riccardo Dossena, Marco Colorato, Simonetta Vernocchi

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By the term “limbic resonance,” we usually refer to a state of deep connection, both emotional and physiological, between people who, when in resonance, find their limbic systems in tune with one another. Limbic resonance is not only about sharing emotions but also physiological states. In fact, people in such resonance can influence each other’s heart rate, blood pressure, and breathing. Limbic resonance is fundamental for human beings to connect and create deep bonds among a certain group. It is fundamental for our social skills. A relationship between gifted and resonant subjects is perceived as feeling safe, living the relation like an isle of serenity where it is possible to recharge, to communicate without words, to understand each others without giving explanations, to strengthen the balance of each member of the group. Within the circle, self-esteem is consolidated and makes it stronger to face what is outside, others, and reality. The idea that gifted people who are together may be unfit for the world does not correspond to the truth. The circle made up of people with high cognitive potential characterized by a limbic resonance is, in general, experienced as a solid platform from which you can safely move away and where you can return to recover strength. We studied 8 adults (between 21 and 47 years old). All of them with IQ higher than 130. We monitored their brain waves frequency (alpha, beta, theta, gamma, delta) by means of biosensing tracker along with their physiological states (heart beat frequency, blood pressure, breathing frequency, pO2, pCO2) and some blood works only (5-HT, dopamine, catecholamines, cortisol). The subjects of the study were asked to adhere to a protocol involving bonding activities (such as team building activities), role plays, meditation sessions, and group therapy. All these activities were carried out together. We observed that after about 4 months of activities, their brain waves frequencies tended to tune quicker and quicker. After 9 months, the bond among them was so important that they could “sense” each other inner states and sometimes also guess each others’ thoughts. According to our findings, it may be hypothesized that large synchronized outbursts of cortex neurons produces not only brain waves but also electromagnetic fields that may be able to influence the cortical neurons’ activity of other people’s brain by inducing action potentials in large groups of neurons and this is reasonably conceivable to be able to transmit information such as different emotions and cognition cues to the other’s brain. We also believe that upcoming research should focus on clarifying the role of brain magnetic particles in brain-to-brain communication. We also believe that further investigations should be carried out on the presence and role of cryptochromes to evaluate their potential roles in direct brain-to-brain communication.

Keywords: limbic resonance, psychotherapy, brain waves, emotion regulation, giftedness

Procedia PDF Downloads 62