Variabilidade ventilatória durante exercício dinâmico em indivíduos saudáveis e com insuficiência cardíaca

A presença de ventilação periódica durante o exercício confere pior prognóstico a pacientes com insuficiência cardíaca. Existem divergências quanto aos critérios para identificação deste fenômeno. Além disso, a interpretação dicotômica (presença ou ausência) quanto a este fenômeno dificulta a estratificação de risco mais detalhada dos pacientes com insuficiência cardíaca. Desta forma, esta tese avalia a utilização de técnicas estabelecidas para análise de variabilidade de sinais para quantificar as oscilações ventilatórias que ocorrem durante o teste cardiopulmonar de exercício, em indivíduos saudáveis, atletas e com insuficiência cardíaca. Um protocolo mais curto para realização de teste cardiopulmonar de exercício em cicloergômetro de braço foi proposto e validado. Tal protocolo foi utilizado em estudo posterior, onde se comprovou que, apesar dos tempos respiratórios não serem influenciados pelo tipo de exercício realizado, a variabilidade ventilatória é maior durante a realização de exercício dinâmico com membros superiores do que com membros inferiores. A capacidade aeróbica de indivíduos sadios também influencia a variabilidade ventilatória durante o teste cardiopulmonar de exercício. Isto foi comprovado pela menor variabilidade ventilatória no domínio do tempo em atletas do que sedentários durante exercício. A análise destes voluntários com o método da análise dos componentes principais revelou que em atletas a variabilidade do volume corrente é a principal responsável pela variabilidade da ventilação-minuto durante o exercício, ao passo que em sedentários a variabilidade da freqüência respiratória apresenta-se como principal responsável por tais variações. Em estudo randomizado e controlado comprovamos que, mesmo indivíduos sadios apresentam redução da variabilidade ventilatória ao exercício após 12 semanas de treinamento físico. Comprovamos que a reabilitação cardíaca reverteu a ocorrência de ventilação periódica em um paciente com insuficiência cardíaca e, finalmente, encontramos que a variabilidade ventilatória correlaciona-se inversamente com a fração de ejeção ventricular esquerda em pacientes com insuficiência cardíaca. Estudos futuros deverão analisar o poder prognóstico da variabilidade ventilatória nestes pacientes.

Determination of particle concentration in the breathing zone for four different types of office ventilation systems

Many factors affect the airflow patterns, thermal comfort, contaminant removal efficiency and indoor air quality at individual workstations in office buildings. In this study, four ventilation systems were used in a test chamber designed to represent an area of a typical office building floor and reproduce the real characteristics of a modern office space. Measurements of particle concentration and thermal parameters (temperature and velocity) were carried out for each of the following types of ventilation systems: a) conventional air distribution system with ceiling supply and return; b) conventional air distribution system with ceiling supply and return near the floor; c) underfloor air distribution system; and d) split system. The measurements aimed to analyse the particle removal efficiency in the breathing zone and the impact of particle concentration on an individual at the workstation. The efficiency of the ventilation system was analysed by measuring particle size and concentration, ventilation effectiveness and the Indoor/Outdoor ratio. Each ventilation system showed different airflow patterns and the efficiency of each ventilation system in the removal of the particles in the breathing zone showed no correlation with particle size and the various methods of analyses used.

Understanding nonsense : breathing life into shibboleths and killing critical thought in higher education

In this paper, I focus on the growing "nonsense industry" which is most apparent in the writing typical of business, government departments, and the financial press. This writing, like technical writing, is characterised by heavy reliance on grammatical metaphor. It endows shibboleths - for instance, "globalisation"; "efficiencies"; "competition"; "modernisation"; "consumer sentiment"; "reform"; and so on - with anthropomorphic qualities. These anthropomorphic artefacts of technocratised language are then presented as having immutable powers over people. Thus they become banal public excuses for negligent practices in both business and government.

Lung health care for Aboriginal and Torres Strait Islander Queenslanders : breathing easy is not so easy

Objectives In Aboriginal and Torres Strait Islander peoples in Queensland, to (a) determine the disease burden of common chronic lung diseases and (b) identify areas of need with respect to lung health services. Methods Literature reviews and analyses of hospitalisation and mortality data were used to describe disease epidemiology and available programs and services. Key stakeholder interviews and an online survey of health professionals were used to evaluate lung health services across the state and to identify services, needs and gaps. Results Morbidity and mortality from respiratory diseases in the Indigenous population is substantially higher than the non-Indigenous population across all age groups and regions. There are inadequate clinical services and resources to address disease prevention, detection, intervention and management in an evidence-based and culturally acceptable fashion. There is a lack of culturally appropriate educational resources and management programs, insufficient access to appropriately engaged Indigenous health professionals, a lack of multi-disciplinary specialist outreach teams, fragmented information systems and inadequate coordination of care. Conclusions Major initiatives are required at all levels of the healthcare system to adequately address service provision for Indigenous Queenslanders with lung diseases, including high quality research to investigate the causes for poor lung health, which are likely to be multifactorial.

Secure coprocessor-based private information retrieval without periodical preprocessing

Early works on Private Information Retrieval (PIR) focused on minimizing the necessary communication overhead. They seemed to achieve this goal but at the expense of query response time. To mitigate this weakness, protocols with secure coprocessors were introduced. They achieve optimal communication complexity and better online processing complexity. Unfortunately, all secure coprocessor-based PIR protocols require heavy periodical preprocessing. In this paper, we propose a new protocol, which is free from the periodical preprocessing while offering the optimal communication complexity and almost optimal online processing complexity. The proposed protocol is proven to be secure.

Walking and talking with living texts: Breathing life against static standardisation

Current educational reform, policy and public discourse emphasise standardisation of testing, curricula and professional practice, yet the landscape of literacy practices today is fluid, interactive, multimodal, ever-changing, adaptive and collaborative. How then can English and literacy educators negotiate these conflicting terrains? The nature of today’s literacy practices is reflected in a concept of living texts which refers to experienced events and encounters that offer meaning-making that is fluid, interactive and changing. Literacy learning possibilities with living texts are described and discussed by the authors who independently investigated the place of living texts across two distinctly different learning contexts: a young people’s community arts project and a co-taught multiliteracies project in a high school. In the community arts project, young people created living texts as guided walks of urban spaces that adapt and change to varying audiences. In the multiliteracies project, two parents and a teacher created interactive spaces through co-teaching and cogenerative dialoguing. These spaces generate living texts that yield a purposefully connected curriculum rich in community-relevant and culturally significant texts. These two studies are shared with a view of bringing living texts into literacy education to loosen rigidity in standardisation.

Nonlinear Control Design for an Air-breathing Engine with State Estimation

A nonlinear control design approach is presented in this paper for a challenging application problem of ensuring robust performance of an air-breathing engine operating at supersonic speed. The primary objective of control design is to ensure that the engine produces the required thrust that tracks the commanded thrust as closely as possible by appropriate regulation of the fuel flow rate. However, since the engine operates in the supersonic range, an important secondary objective is to ensure an optimal location of the shock in the intake for maximum pressure recovery with a sufficient margin. This is manipulated by varying the throat area of the nozzle. The nonlinear dynamic inversion technique has been successfully used to achieve both of the above objectives. In this problem, since the process is faster than the actuators, independent control designs have also been carried out for the actuators as well to assure the satisfactory performance of the system. Moreover, an extended Kalman Filter based state estimation design has been carried out both to filter out the process and sensor noises as well as to make the control design operate based on output feedback. Promising simulation results indicate that the proposed control design approach is quite successful in obtaining robust performance of the air-breathing system.

Breathing, swallowing and voice in laryngeal disorsers

The aim of this work was to examine how breathing, swallowing and voicing are affected in different laryngeal disorders. For this purpose, we examined four different patient groups: patients who had undergone total laryngectomy, anterior cervical decompression (ACD), or injection laryngoplasty with autologous fascia (ILAF), and patients with dyspnea during exercise. We studied the problems and benefits related to the automatic speech valve used for the rehabilitation of speech in laryngectomized patients. The device was given to 14 total laryngectomized patients who used the traditional valve especially well. The usefulness of voice and intelligibility of speech were assessed by speech pathologists. The results demonstrated better performance with the traditional valve in both dimensions. Most of the patients considered the automatic valve a helpful additional device but because of heavier breathing and the greater work needed for speech production, it was not suitable as a sole device in speech rehabilitation. Dysphonia and dysphagia are known complications of ACD. These symptoms are caused due to the stretching of tissue needed during the surgery, but the extent and the recovery from them was not well known before our study. We studied two patient groups, an early group with 50 patients who were examined immediately before and after the surgery and a late group with 64 patients who were examined 3 9 months postoperatively. Altogether, 60% reported dysphonia and 69% dysphagia immediately after the operation. Even though dysphagia and dysphonia often appeared after surgery, permanent problems seldom occurred. Six (12 %) cases of transient and two (3 %) permanent vocal cord paresis were detected. In our third study, the long-term results of ILAF in 43 patients with unilateral vocal cord paralysis were examined. The mean follow-up was 5.8 years (range 3 10). Perceptual evaluation demonstrated improved results for voice quality, and videostroboscopy revealed complete or partial glottal closure in 83% of the patients. Fascia showed to be a stable injection material with good vocal results. In our final study we developed a new diagnostic method for exertional laryngeal dyspnea by combining a cardiovascular exercise test with simultaneous fiberoptic observation of the larynx. With this method, it is possible to visualize paradoxal closure of the vocal cords during inspiration, which is a diagnostic criterion for vocal cord dysfunction (VCD). We examined 30 patients referred to our hospital because of suspicion of exercise-induced vocal cord dysfunction (EIVCD). Twenty seven out of thirty patients were able to perform the test. Dyspnea was induced in 15 patients, and of them five had EIVCD and four high suspicion of EIVCD. With our test it is possible to set an accurate diagnosis for exertional laryngeal dyspnea. Moreover, the often seen unnecessary use of asthma drugs among these patients can be avoided.

Nonlinear Sliding Mode Control Design for an Air-breathing Engine with State Estimation

A modern system theory based nonlinear control design is discussed in this paper for successful operation of an air-breathing engine operating at supersonic speed. The primary objective of the control design of such an air-breathing engine is to ensure that the engine dynamically produces the thrust that tracks a commanded value of thrust as closely as possible by regulating the fuel flow to the combustion system. However, since the engine operates in the supersonic range, an important secondary objective is to manage the shock wave configuration in the intake section of the engine which is manipulated by varying the throat area of the nozzle. A nonlinear sliding mode control technique has been successfully used to achieve both of the above objectives. In this problem, since the process is faster than the actuators, independent control designs are also carried out for the actuators as well to assure the satisfactory performance of the system. Moreover, to filter out the sensor and process noises and to estimate the states for making the control design operate based on output feedback, an Extended Kalman Filter based state estimation design is also carried out. The promising simulation results suggest that the proposed control design approach is quite successful in obtaining robust performance of the air-breathing engine.

Nonlinear measures of heart rate time series: influence of posture and controlled breathing

In this study, we investigated measures of nonlinear dynamics and chaos theory in regards to heart rate variability in 27 normal control subjects in supine and standing postures, and 14 subjects in spontaneous and controlled breathing conditions. We examined minimum embedding dimension (MED), largest Lyapunov exponent (LLE) and measures of nonlinearity (NL) of heart rate time series. MED quantifies the system's complexity, LLE predictability and NL, a measure of deviation from linear processes. There was a significant decrease in complexity (P<0.00001), a decrease in predictability (P<0.00001) and an increase in nonlinearity (P=0.00001) during the change from supine to standing posture. Decrease in MED, and increases in NL score and LLE in standing posture appear to be partly due to an increase in sympathetic activity of the autonomous nervous system in standing posture. An improvement in predictability during controlled breathing appears to be due to the introduction of a periodic component. (C) 2000 published by Elsevier Science B.V.

Modulation of redox regulatory molecules and electron transport chain activity in muscle of air breathing fish Heteropneustes fossilis under air exposure stress

Responses of redox regulatory system to long-term survival (> 18 h) of the catfish Heteropneustes fossilis in air are not yet understood. Lipid and protein oxidation level, oxidant (H2O2) generation, antioxidative status (levels of superoxide dismutase, catalase, glutathione peroxidase and reductase, ascorbic acid and non-protein sulfhydryl) and activities of respiratory complexes (I, II, III and IV) in mitochondria were investigated in muscle of H. fossilis under air exposure condition (0, 3, 6, 12 and 18 h at 25 A degrees C). The increased levels of both H2O2 and tissue oxidation were observed due to the decreased activities of antioxidant enzymes in muscle under water deprivation condition. However, ascorbic acid and non-protein thiol groups were the highest at 18 h air exposure time. A linear increase in complex II activity with air exposure time and an increase up to 12 h followed by a decrease in activity of complex I at 18 h were observed. Negative correlation was observed for complex III and V activity with exposure time. Critical time to modulate the above parameters was found to be 3 h air exposure. Dehydration induced oxidative stress due to modulation of electron transport chain and redox metabolizing enzymes in muscle of H. fossilis was clearly observed. Possible contribution of redox regulatory system in muscle tissue of the fish for long-term survival in air is elucidated. Results of the present study may be useful to understand the redox metabolism in muscle of fishes those are exposed to air in general and air breathing fishes in particular.