Reliability of nasal auscultation and their relation to middle ear condition – a clinical interest to pediatrics respiratory physiotherapy

Background: Acute respiratory infections are usual in children under three years old occurring in upper respiratory tract, having an impact on child and caregiver’s quality of life predisposing to otitis media or bronchiolitis. There are few valid and reliable measures to determine the child’s respiratory condition and to guide the physiotherapy intervention. Aim: To assess the intra and inter rater reliability of nasal auscultation, to analyze the relation between sounds’ classification and middle ear’s pressure and compliance as well as with the Clinical Severity Score. Methods: A cross-sectional observational study was composed by 125 nursery children aged up to three years old. Tympanometry, pulmonary and nasal auscultation and application of Clinical Severity Score were performed to each child. Nasal auscultation sounds’ were recorded and sent to 3 blinded experts, that classified, as “obstructed” and “unobstructed”, with a 48 hours interval, in order to analyze inter and intra rater reliability. Results: Nasal auscultation revealed a substantial inter and intra rater reliability (=0,749 and evaluator A - K= 0,691; evaluator B - K= 0,605 and evaluator C - K= 0,724, respectively). Both ears’ pressure was significantly lower in children with an "unobstructed" nasal sound when compared with an “obstructed” nasal sound (t=-3,599, p<0,001 in left ear; t=-2,258, p=0,026 in right ear). Compliance in both ears was significantly lower in children with an "obstructed" nasal sound when compared with “unobstructed” nasal sound (t=-2,728, p=0,007 in left ear; t=-3,830, p<0,001 in right ear). There was a statistically significant association between sounds’ classification and tympanograms types in both ear’s (=11,437, p=0,003 in left ear; =13,535, p=0,001 in right ear). There was a trend to children with an "unobstructed" nasal sound that had a lower clinical severity score when compared with “obstructed” children. Conclusion: It was observed a good intra and substantial inter reliability for nasal auscultation. Nasal auscultation sounds’ classification was related to middle ears’ pressure and compliance.

Foraging at the Edge of Chaos: Internal Clock versus External Forcing

Activity rhythms in animal groups arise both from external changes in the environment, as well as from internal group dynamics. These cycles are reminiscent of physical and chemical systems with quasiperiodic and even chaotic behavior resulting from “autocatalytic” mechanisms. We use nonlinear differential equations to model how the coupling between the self-excitatory interactions of individuals and external forcing can produce four different types of activity rhythms: quasiperiodic, chaotic, phase locked, and displaying over or under shooting. At the transition between quasiperiodic and chaotic regimes, activity cycles are asymmetrical, with rapid activity increases and slower decreases and a phase shift between external forcing and activity. We find similar activity patterns in ant colonies in response to varying temperature during the day. Thus foraging ants operate in a region of quasiperiodicity close to a cascade of transitions leading to chaos. The model suggests that a wide range of temporal structures and irregularities seen in the activity of animal and human groups might be accounted for by the coupling between collectively generated internal clocks and external forcings.

Characterization of middle-ear condition of Oporto daycare children up-to 3 years-old: A cross sectional study

Objective The aim of this study was to determine tympanometric values of children who attend Oporto daycare centers and further analyze any relations with host and environmental factors. Methods Cross sectional study in a randomly selected sample of 117 daycare children up-to 3-years old from Oporto. Tympanometric measures were collected. Results Children presented in left ear (LE) a mean peak pressure (PP) of −156.53 daPa and a mean compliance of 0.16 cm3. Right ear (RE) revealed a PP of −145.61 daPa and a compliance of 0.19 cm3. Normal tympanograms (type A) had a lower frequency than abnormal tympanograms (type B and type C). There was a positive association between age and compliance (LE: p = 0.016; RE: p = 0.013) and between the presence of rhinorrhea and PP (LE: p = 0.002; RE: p < 0.05). Abnormal tympanograms were more frequent in Spring (RE: p = 0.009), in younger children (LE: p = 0.03) and in children that had rhinorrhea (LE: p = 0.002; RE: p = 0.044). Healthy children had a mean PP of −125.19 daPa and a mean compliance of 0.21 cm3 in LE and a mean PP of −144.27 daPa and a mean compliance of 0.22 cm3 in RE. Conclusion Tympanometric measures presented in this paper may be applicable to Oporto daycare children up-to 3 years-old. Most of daycare children revealed abnormal tympanograms. Age, rhinorrhea and season influenced children's middle-ear condition.

Resource Scheduling in Residential Microgrids Considering Energy Selling to External Players

The operation of distribution networks has been facing changes with the implementation of smart grids and microgrids, and the increasing use of distributed generation. The specific case of distribution networks that accommodate residential buildings, small commerce, and distributed generation as the case of storage and PV generation lead to the concept of microgrids, in the cases that the network is able to operate in islanding mode. The microgrid operator in this context is able to manage the consumption and generation resources, also including demand response programs, obtaining profits from selling electricity to the main network. The present paper proposes a methodology for the energy resource scheduling considering power flow issues and the energy buying and selling from/to the main network in each bus of the microgrid. The case study uses a real distribution network with 25 bus, residential and commercial consumers, PV generation, and storage.

Shoulder Kinematics Is Not Influenced by External Load During Elevation in the Scapular Plane

The current study aimed to compare the shoulder kinematics (3D scapular orientation, scapular angular displacement and scapulohumeral rhythm) of asymptomatic participants under unloaded and loaded conditions during unilateral shoulder elevation in the scapular plane. We used a repeated-measures design with a convenience sample. Eleven male participants with an age range of 21–28 years with no recent history of shoulder injury participated in the study. The participants performed isometric shoulder elevation from a neutral position to approximately 150 degrees of elevation in the scapular plane in intervals of approximately 30 degrees during unloaded and loaded conditions. Shoulder kinematic data were obtained with videogrammetry. During shoulder elevation, the scapula rotated upwardly and externally, and tilted posteriorly. The addition of an external load did not affect 3D scapular orientation, scapular angular displacement, or scapulohumeral rhythm throughout shoulder elevation (P > .05). In clinical practice, clinicians should expect to observe upward and external rotation and posterior tilt of the scapula during their assessments of shoulder elevation. Such behavior was not influenced by an external load normalized to 5% of body weight when performed in an asymptomatic population.

RoutesMobilityModel: easy realistic mobility simulation using external information services

Workshop on ns-3 (WNS '15). 13, May, 2015. Castelldefels, Spain.

Strength improvement of adhesively-bonded scarf repairs in aluminium structures with external reinforcements

Adhesively bonded techniques are an attractive option to repair aluminium structures, compared to more traditional methods. Actually, as a result of the improvement in the mechanical characteristics of adhesives, adhesive bonding has progressively replaced the traditional joining methods. There are several bonded repair configurations, as single-strap, double-strap and scarf. Compared with strap repairs, scarf repairs have the advantages of a higher efficiency and the absence of aerodynamic disturbance. The higher efficiency is caused by the elimination of the significant joint eccentricities of strap repairs. Moreover, stress distributions along the bond length are more uniform, due to tapering of the scarf edges. The main disadvantages of this technique are the difficult machining of the surfaces, associated costs and requirement of specialised labour. This work reports on an experimental and numerical study of the tensile behaviour of two-dimensional (2D) scarf repairs of aluminium structures bonded with the ductile epoxy adhesive Araldite® 2015. The numerical analysis, by Finite Elements (FE), was performed in Abaqus® and used cohesive zone models (CZM) for the simulation of damage onset and growth in the adhesive layer, thus enabling the strength prediction of the repairs. A parametric study was performed on the scarf angle (α) and different configurations of external reinforcement (applied on one or two sides of the repair, and also different reinforcement lengths). The obtained results allowed the establishment of design guidelines for repairing, showing that the use of external reinforcements enables increasing α for equal strength recovery, which makes the repair procedure easier. The numerical technique was accurate in predicting the repairs’ strength, enabling its use for design and optimisation purposes.