Lung volume, breathing pattern and ventilation inhomogeneity in preterm and term infants

BACKGROUND: Morphological changes in preterm infants with bronchopulmonary dysplasia (BPD) have functional consequences on lung volume, ventilation inhomogeneity and respiratory mechanics. Although some studies have shown lower lung volumes and increased ventilation inhomogeneity in BPD infants, conflicting results exist possibly due to differences in sedation and measurement techniques. METHODOLOGY/PRINCIPAL FINDINGS: We studied 127 infants with BPD, 58 preterm infants without BPD and 239 healthy term-born infants, at a matched post-conceptional age of 44 weeks during quiet natural sleep according to ATS/ERS standards. Lung function parameters measured were functional residual capacity (FRC) and ventilation inhomogeneity by multiple breath washout as well as tidal breathing parameters. Preterm infants with BPD had only marginally lower FRC (21.4 mL/kg) than preterm infants without BPD (23.4 mL/kg) and term-born infants (22.6 mL/kg), though there was no trend with disease severity. They also showed higher respiratory rates and lower ratios of time to peak expiratory flow and expiratory time (t(PTEF)/t(E)) than healthy preterm and term controls. These changes were related to disease severity. No differences were found for ventilation inhomogeneity. CONCLUSIONS: Our results suggest that preterm infants with BPD have a high capacity to maintain functional lung volume during natural sleep. The alterations in breathing pattern with disease severity may reflect presence of adaptive mechanisms to cope with the disease process.

End-tidal CO2 pressure: an important parameter for a correct interpretation of changes in cerebral hemodynamics and oxygenation measured with functional near infrared spectrophotometry (fNIRS)

The aim of the present study was to investigate the effects of different speech tasks (recitation of prose (PR), alliteration (AR) and hexameter (HR) verses) and a control task (mental arithmetic (MA) with voicing of the result) on endtidal CO2 (ET-CO2), cerebral hemodynamics; i.e. total hemoglobin (tHb) and tissue oxygen saturation (StO2). tHb and StO2 were measured with a frequency domain near infrared spectrophotometer (ISS Inc., USA) and ET-CO2 with a gas analyzer (Nellcor N1000). Measurements were performed in 24 adult volunteers (11 female, 13 male; age range 22 to 64 years) during task performance in a randomized order on 4 different days to avoid potential carry over effects. Statistical analysis was applied to test differences between baseline, 2 recitation and 5 recovery periods. The two brain hemispheres and 4 tasks were tested separately. Data analysis revealed that during the recitation tasks (PR, AR and HR) StO2 decreased statistically significant (p < 0.05) during PR and AR in the right prefrontal cortex (PFC) and during AR and HR in the left PFC. tHb showed a significant decrease during HR in the right PFC and during PR, AR and HR in the left PFC. During the MA task, StO2 increased significantly. A significant decrease in ET-CO2 was found during all 4 tasks with the smallest decrease during the MA task. In conclusion, we hypothesize that the observed changes in tHb and StO2 are mainly caused by an altered breathing during the tasks that led a lowering of the CO2 content in the blood provoked a cerebral CO2 reaction, i.e. a vasoconstriction of blood vessels due to decreased CO2 pressure and thereby decrease in cerebral blood volume. Therefore, breathing changes should be monitored during brain studies involving speech when using functional near infrared spectroscopy (fNIRS) to ensure a correct interpretation of changes in hemodynamics and oxygenation.

Tidal-induced mixing and diapycnal nutrient fluxes in the Mauritanian upwelling region

The Mauritanian coastal area is one of the most biologically productive upwelling regions in the world ocean. Shipboard observations carried out during maximum upwelling season and short-term moored observations are used to investigate diapycnal mixing processes and to quantify diapycnal fluxes of nutrients. The observations indicate strong tide-topography interactions that are favored by near-critical angles occurring on large parts of the continental slope. Moored velocity observations reveal the existence of highly nonlinear internal waves and bores and levels of internal wave spectra are strongly elevated near the buoyancy frequency. Dissipation rates of turbulent kinetic energy at the slope and shelf determined from microstructure measurements in the upper 200 m averages to ? = 5 × 10-8 W kg-1. Particularly elevated dissipation rates were found at the continental slope close to the shelf break, being enhanced by a factor of 100 to 1000 compared to dissipation rates farther offshore. Vertically integrated dissipation rates per unit volume are strongest at the upper continental slope reaching values of up to 30 mW m-2. A comparison of fine-scale parameterizations of turbulent dissipation rates for shelf regions and the open ocean to the measured dissipation rates indicates deficiencies in reproducing the observations. Diapycnal nitrate fluxes above the continental slope at the base of the mixed layer yielding a mean value of 12 × 10-2 µmol m-2 s-1 are amongst the largest published to date. However, they seem to only represent a minor contribution (10% to 25%) to the net community production in the upwelling region.

Airborne laser quantification of Florida shoreline and beach volume change caused by hurricanes

This dissertation combines three separate studies that measure coastal change using airborne laser data. The initial study develops a method for measuring subaerial and subaqueous volume change incrementally alongshore, and compares those measurements to shoreline change in order to quantify their relationship in Palm Beach County, Florida. A poor correlation (R2 = 0.39) was found between shoreline and volume change before the hurricane season in the northern section of Palm Beach County because of beach nourishment and inlet dynamics. However, a relatively high R2 value of 0.78 in the southern section of Palm Beach County was found due to little disturbance from tidal inlets and coastal engineering projects. The shoreline and volume change caused by the 2004 hurricane season was poorly correlated with R 2 values of 0.02 and 0.42 for the north and south sections, respectively. The second study uses airborne laser data to investigate if there is a significant relationship between shoreline migration before and after Hurricane Ivan near Panama City, Florida. In addition, the relationship between shoreline change and subaerial volume was quantified and a new method for quantifying subaqueous sediment change was developed. No significant spatial relationship was found between shoreline migration before and after the hurricane. Utilization of a single coefficient to represent all relationships between shoreline and subaerial volume change was found to be problematic due to the spatial variability in the linear relationship. Differences in bathymetric data show only a small portion of sediment was transported beyond the active zone and most sediment remained within the active zone despite the occurrence of a hurricane. The third study uses airborne laser bathymetry to measure the offshore limit of change, and compares that location with calculated depth of closures and subaqueous geomorphology. There appears to be strong geologic control of the depth of closure in Broward and Miami-Dade Counties. North of Hillsboro Inlet, hydrodynamics control the geomorphology which in turn indicates the location of the depth of closure.

Airborne Laser Quantification of Florida Shoreline and Beach Volume Change Caused by Hurricanes

This dissertation combines three separate studies that measure coastal change using airborne laser data. The initial study develops a method for measuring subaerial and subaqueous volume change incrementally alongshore, and compares those measurements to shoreline change in order to quantify their relationship in Palm Beach County, Florida. A poor correlation (R2 = 0.39) was found between shoreline and volume change before the hurricane season in the northern section of Palm Beach County because of beach nourishment and inlet dynamics. However, a relatively high R2 value of 0.78 in the southern section of Palm Beach County was found due to little disturbance from tidal inlets and coastal engineering projects. The shoreline and volume change caused by the 2004 hurricane season was poorly correlated with R2 values of 0.02 and 0.42 for the north and south sections, respectively. The second study uses airborne laser data to investigate if there is a significant relationship between shoreline migration before and after Hurricane Ivan near Panama City, Florida. In addition, the relationship between shoreline change and subaerial volume was quantified and a new method for quantifying subaqueous sediment change was developed. No significant spatial relationship was found between shoreline migration before and after the hurricane. Utilization of a single coefficient to represent all relationships between shoreline and subaerial volume change was found to be problematic due to the spatial variability in the linear relationship. Differences in bathymetric data show only a small portion of sediment was transported beyond the active zone and most sediment remained within the active zone despite the occurrence of a hurricane. The third study uses airborne laser bathymetry to measure the offshore limit of change, and compares that location with calculated depth of closures and subaqueous geomorphology. There appears to be strong geologic control of the depth of closure in Broward and Miami-Dade Counties. North of Hillsboro Inlet, hydrodynamics control the geomorphology which in turn indicates the location of the depth of closure.

Predictable hydrodynamic conditions explain temporal variations in the density of benthic foraging seabirds in a tidal stream environment

Tidal stream turbines could have several direct impacts upon pursuit-diving seabirds foraging within tidal stream environments (mean horizontal current speeds > 2 ms−1), including collisions and displacement. Understanding how foraging seabirds respond to temporally variable but predictable hydrodynamic conditions immediately around devices could identify when interactions between seabirds and devices are most likely to occur; information which would quantify the magnitude of potential impacts, and also facilitate the development of suitable mitigation measures. This study uses shore-based observational surveys and Finite Volume Community Ocean Model outputs to test whether temporally predictable hydrodynamic conditions (horizontal current speeds, water elevation, turbulence) influenced the density of foraging black guillemots Cepphus grylle and European shags Phalacrocorax aristotelis in a tidal stream environment in Orkney, United Kingdom, during the breeding season. These species are particularly vulnerable to interactions with devices due to their tendency to exploit benthic and epi-benthic prey on or near the seabed. The density of both species decreased as a function of horizontal current speeds, whereas the density of black guillemots also decreased as a function of water elevation. These relationships could be linked to higher energetic costs of dives in particularly fast horizontal current speeds (>3 ms−1) and deeper water. Therefore, interactions between these species and moving components seem unlikely at particularly high horizontal current speeds. Combining this information, with that on the rotation rates of moving components at lower horizontal current speeds, could be used to assess collision risk in this site during breeding seasons. It is also likely that moderating any device operation during both lowest water elevation and lowest horizontal current speeds could reduce the risk of collisions for these species in this site during this season. The approaches used in this study could have useful applications within Environmental Impact Assessments, and should be considered when assessing and mitigating negative impacts from specific devices within development sites.

The study of the sedimentation mechanism in channels under the impact of tidal currents

The purpose of this research is to study sedimentation mechanism by mathematical modeling in access channels which are affected by tidal currents. The most important factor for recognizing sedimentation process in every water environment is the flow pattern of that environment. It is noteworthy that the flow pattern is affected by the geometry and the shape of the environment as well as the type of existing affects in area. The area under the study in this thesis is located in Bushehr Gulf and the access channels (inner and outer). The study utilizes the hydrodynamic modeling with unstructured triangular and non-overlapping grids, using the finite volume, From method analysis in two scale sizes: large scale (200 m to 7.5km) and small scale (50m to 7.5km) in two different time durations of 15 days and 3.5 days to obtain the flow patterns. The 2D governing equations used in the model are the Depth-Averaged Shallow Water Equations. Turbulence Modeling is required to calculate the Eddy Viscosity Coefficient using the Smagorinsky Model with coefficient of 0.3. In addition to the flow modeling in two different scales and the use of the data of 3.5 day tidal current modeling have been considered to study the effects of the sediments equilibrium in the area and the channels. This model is capable of covering the area which is being settled and eroded and to identify the effects of tidal current of these processes. The required data of the above mentioned models such as current and sediments data have been obtained by the measurements in Bushehr Gulf and the access channels which was one of the PSO's (Port and Shipping Organization) project-titled, "The Sedimentation Modeling in Bushehr Port" in 1379. Hydrographic data have been obtained from Admiralty maps (2003) and Cartography Organization (1378, 1379). The results of the modeling includes: cross shore currents in northern and north western coasts of Bushehr Gulf during the neap tide and also the same current in northern and north eastern coasts of the Gulf during the spring tide. These currents wash and carry fine particles (silt, clay, and mud) from the coastal bed of which are generally made of mud and clay with some silts. In this regard, the role of sediments in the islands of this area and the islands made of depot of dredged sediments should not be ignored. The result of using 3.5 day modeling is that the cross channels currents leads to settlement places in inner and outer channels in tidal period. In neap tide the current enters the channel from upside bend of the two channels and outer channel. Then it crosses the channel oblique in some places of the outer channel. Also the oblique currents or even almost perpendicular current from up slope of inner channel between No. 15 and No. 18 buoys interact between the parallel currents in the channel and made secondary oblique currents which exit as a down-slope current in the channel and causes deposit of sediments as well as settling the suspended sediments carried by these currents. In addition in outer channel the speed of parallel currents in the bend of the channel which is naturally deeper increases. Therefore, it leads to erosion and suspension of sediments in this area. The speed of suspended sediments carried by this current which is parallel to the channel axis decreases when they pass through the shallower part of the channel where it is in the buoys No.7 and 8 to 5 and 6 are located. Therefore, the suspended sediment settles and because of this process these places will be even shallower. Furthermore, the passing of oblique upstream leads to settlement of the sediments in the up-slope and has an additional effect on the process of decreasing the depth of these locations. On the contrary, in the down-slope channel, as the results of sediments and current modeling indicates the speed of current increases and the currents make the particles of down-slope channel suspended and be carried away. Thus, in a vast area of downstream of both channels, the sediments have settled. At the end of the neap tide, the process along with circulations in this area produces eddies which causes sedimentation in the area. During spring some parts of this active location for sedimentation will enter both channels in a reverse process. The above mentioned processes and the places of sedimentation and erosion in inner and outer channels are validated by the sediments equilibrium modeling. This model will be able to estimate the suspended, bed load and the boundary layer thickness in each point of both channels and in the modeled area.

Volumetric Capnography For The Evaluation Of Chronic Airways Diseases.

Obstructive lung diseases of different etiologies present with progressive peripheral airway involvement. The peripheral airways, known as the silent lung zone, are not adequately evaluated with conventional function tests. The principle of gas washout has been used to detect pulmonary ventilation inhomogeneity and to estimate the location of the underlying disease process. Volumetric capnography (VC) analyzes the pattern of CO2 elimination as a function of expired volume. To measure normalized phase 3 slopes with VC in patients with non-cystic fibrosis bronchiectasis (NCB) and in bronchitic patients with chronic obstructive pulmonary disease (COPD) in order to compare the slopes obtained for the groups. NCB and severe COPD were enrolled sequentially from an outpatient clinic (Hospital of the State University of Campinas). A control group was established for the NCB group, paired by sex and age. All subjects performed spirometry, VC, and the 6-Minute Walk Test (6MWT). Two comparisons were made: NCB group versus its control group, and NCB group versus COPD group. The project was approved by the ethical committee of the institution. Statistical tests used were Wilcoxon or Student's t-test; P<0.05 was considered to be a statistically significant difference. Concerning the NCB group (N=20) versus the control group (N=20), significant differences were found in body mass index and in several functional variables (spirometric, VC, 6MWT) with worse results observed in the NCB group. In the comparison between the COPD group (N=20) versus the NCB group, although patients with COPD had worse spirometric and 6MWT values, the capnographic variables mean phase 2 slope (Slp2), mean phase 3 slope normalized by the mean expiratory volume, or mean phase 3 slope normalized by the end-tidal CO2 concentration were similar. These findings may indicate that the gas elimination curves are not sensitive enough to monitor the severity of structural abnormalities. The role of normalized phase 3 slope may be worth exploring as a more sensitive index of small airway disease, even though it may not be equally sensitive in discriminating the severity of the alterations.

Myocardial Extracellular Volume Expansion And The Risk Of Recurrent Atrial Fibrillation After Pulmonary Vein Isolation.

This study tested whether myocardial extracellular volume (ECV) is increased in patients with hypertension and atrial fibrillation (AF) undergoing pulmonary vein isolation and whether there is an association between ECV and post-procedural recurrence of AF. Hypertension is associated with myocardial fibrosis, an increase in ECV, and AF. Data linking these findings are limited. T1 measurements pre-contrast and post-contrast in a cardiac magnetic resonance (CMR) study provide a method for quantification of ECV. Consecutive patients with hypertension and recurrent AF referred for pulmonary vein isolation underwent a contrast CMR study with measurement of ECV and were followed up prospectively for a median of 18 months. The endpoint of interest was late recurrence of AF. Patients had elevated left ventricular (LV) volumes, LV mass, left atrial volumes, and increased ECV (patients with AF, 0.34 ± 0.03; healthy control patients, 0.29 ± 0.03; p < 0.001). There were positive associations between ECV and left atrial volume (r = 0.46, p < 0.01) and LV mass and a negative association between ECV and diastolic function (early mitral annular relaxation [E'], r = -0.55, p < 0.001). In the best overall multivariable model, ECV was the strongest predictor of the primary outcome of recurrent AF (hazard ratio: 1.29; 95% confidence interval: 1.15 to 1.44; p < 0.0001) and the secondary composite outcome of recurrent AF, heart failure admission, and death (hazard ratio: 1.35; 95% confidence interval: 1.21 to 1.51; p < 0.0001). Each 10% increase in ECV was associated with a 29% increased risk of recurrent AF. In patients with AF and hypertension, expansion of ECV is associated with diastolic function and left atrial remodeling and is a strong independent predictor of recurrent AF post-pulmonary vein isolation.

Reference Values For High-density Lipoprotein Particle Size And Volume By Dynamic Light Scattering In A Brazilian Population Sample And Their Relationships With Metabolic Parameters.

Current data indicate that the size of high-density lipoprotein (HDL) may be considered an important marker for cardiovascular disease risk. We established reference values of mean HDL size and volume in an asymptomatic representative Brazilian population sample (n=590) and their associations with metabolic parameters by gender. Size and volume were determined in HDL isolated from plasma by polyethyleneglycol precipitation of apoB-containing lipoproteins and measured using the dynamic light scattering (DLS) technique. Although the gender and age distributions agreed with other studies, the mean HDL size reference value was slightly lower than in some other populations. Both HDL size and volume were influenced by gender and varied according to age. HDL size was associated with age and HDL-C (total population); non- white ethnicity and CETP inversely (females); HDL-C and PLTP mass (males). On the other hand, HDL volume was determined only by HDL-C (total population and in both genders) and by PLTP mass (males). The reference values for mean HDL size and volume using the DLS technique were established in an asymptomatic and representative Brazilian population sample, as well as their related metabolic factors. HDL-C was a major determinant of HDL size and volume, which were differently modulated in females and in males.

Lateral Pterygoid Muscle Volume And Migraine In Patients With Temporomandibular Disorders.

Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

Correlation Between The Friedman Staging System And The Upper Airway Volume In Patients With Obstructive Sleep Apnea.

This study was designed to evaluate the correlation between computed tomography findings and data from the physical examination and the Friedman Staging System (FSS) in patients with obstructive sleep apnea (OSA). We performed a retrospective evaluation by reviewing the medical records of 33 patients (19 male and 14 female patients) with a mean body mass index of 30.38 kg/m(2) and mean age of 49.35 years. Among these patients, 14 presented with severe OSA, 7 had moderate OSA, 7 had mild OSA, and 5 were healthy. The patients were divided into 2 groups according to the FSS: Group A comprised patients with FSS stage I or II, and group B comprised patients with FSS stage III. By use of the Fisher exact test, a positive relationship between the FSS stage and apnea-hypopnea index (P = .011) and between the FSS stage and body mass index (P = .012) was found. There was no correlation between age (P = .55) and gender (P = .53) with the FSS stage. The analysis of variance test comparing the upper airway volume between the 2 groups showed P = .018. In this sample the FSS and upper airway volume showed an inverse correlation and were useful in analyzing the mechanisms of airway collapse in patients with OSA.

Teste de banco com carga continua para analise do volume de oxigenio (VO2) predito e analisado por tempo de esforço em pessoas treinadas (TRD), ativas (ATV) e destreinadas (DTR) a partir dos 13 anos : proposta de validação

Universidade Estadual de Campinas . Faculdade de Educação Física

Circulation and suspended particulate matter transport in a tidally dominated estuary: caravelas estuary, Bahia, Brazil

The circulation and transport of suspended particulate matter in the Caravelas Estuary are assessed. Nearly-synoptic hourly hydrographic, current (ADCP velocity and volume transport) and suspended particulate matter data were collected during a full semidiurnal spring tide, on the two transects Boca do Tomba and Barra Velha and on longitudinal sections at low and high tide. On the first transect the peak ebb currents (-1.5 ms-1) were almost twice as strong as those of the wider and shallow Barra Velha inlet (-0.80 ms-1) and the peak flood currents were 0.75 and 0.60 ms-1, respectively. Due to the strong tidal currents both inlets had weak vertical salinity stratification and were classified with the Stratification-circulation Diagram as Type 2a (partially mixed-weakly stratified) and Type 1a (well mixed). Volume transports were very close, ranging from -3,500 to 3,100 m³s-1 at the ebb and flood, respectively, with a residual -630 m³s-1. The concentration of the suspended particulate matter was closely related to the tidal variation and decreased landwards from 50 mg.L-1 at the estuary mouth, to 10 mg.L-1 at distances of 9 and 16 km for the low and high tide experiments, respectively. The total residual SPM transport was out of the estuary at rates of -18 tons per tidal cycle.

Striatal volume abnormalities in treatment-naive patients diagnosed with pediatric major depressive disorder

Objective: The striatum, including the putamen and caudate, plays an important role in executive and emotional processing and may be involved in the pathophysiology of mood disorders. Few studies have examined structural abnormalities of the striatum in pediatric major depressive disorder (MDD) patients. We report striatal volume abnormalities in medication-naive pediatric MDD compared to healthy comparison subjects. Method: Twenty seven medication-naive pediatric Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition (DSM-IV) MDD and 26 healthy comparison subjects underwent volumetric magnetic resonance imaging (MRI). The putamen and caudate volumes were traced manually by a blinded rater, and the patient and control groups were compared using analysis of covariance adjusting for age, sex, intelligence quotient, and total brain volumes. Results: MDD patients had significantly smaller right striatum (6.0% smaller) and right caudate volumes (7.4% smaller) compared to the healthy subjects. Left caudate volumes were inversely correlated with severity of depression in MDD subjects. Age was inversely correlated with left and right putamen volumes in MDD patients but not in the healthy subjects. Conclusions: These findings provide fresh evidence for abnormalities in the striatum of medication-naive pediatric MDD patients and suggest the possible involvement of the striatum in the pathophysiology of MDD.