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.

A smart approach to precision attitude maneuvers of spacecrafts

A nonlinear adaptive approach is presented to achieve rest-to-rest attitude maneuvers for spacecrafts in the presence of parameter uncertainties and unknown disturbances. A nonlinear controller, designed on the principle of dynamic inversion achieves the goals for the nominal model but suffers performance degradation in the presence of off-nominal parameter values and unwanted inputs. To address this issue, a model-following neuro-adaptive control design is carried out by taking the help of neural networks. Due to the structured approach followed here, the adaptation is restricted to the momentum level equations.The adaptive technique presented is computationally nonintensive and hence can be implemented in real-time. Because of these features, this new approach is named as structured model-following adaptive real-time technique (SMART). From simulation studies, this SMART approach is found to be very effective in achieving precision attitude maneuvers in the presence of parameter uncertainties and unknown disturbances.

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.

Capturability of Augmented Pure Proportional Navigation Guidance Against Time-Varying Target Maneuvers

This paper proposes a variation of the pure proportional navigation guidance law, called augmented pure proportional navigation, to account for target maneuvers, in a realistic nonlinear engagement geometry, and presents its capturability analysis. These results are in contrast to most work in the literature on augmented proportional navigation laws that consider a linearized geometry imposed upon the true proportional navigation guidance law. Because pure proportional navigation guidance law is closer to a realistic implementation of proportional navigation than true proportional navigation law, and any engagement process is predominantly nonlinear, the results obtained in this paper are more realistic than any available in the literature. Sufficient conditions on speed ratio, navigation gain, and augmentation parameter for capturability, and boundedness of lateral acceleration, against targets executing piecewise continuous maneuvers with time, are obtained. Further, based on a priori knowledge of the maximum maneuver capability of the target, a significant simplification of the guidance law is proposed in this paper. The proposed guidance law is also shown to require a shorter time of interception than standard pure proportional navigation and augmented proportional navigation. To remove chattering in the interceptor maneuver at the end phase of the engagement, a hybrid guidance law using augmented pure proportional navigation and pure proportional navigation is also proposed. Finally, the guaranteed capture zones of standard and augmented pure proportional navigation guidance laws against maneuvering targets are analyzed and compared in the normalized relative velocity space. It is shown that the guaranteed capture zone expands significantly when augmented pure proportional navigation is used instead of pure proportional navigation. Simulation results are given to support the theoretical findings.

Nonlinear control of an air-breathing engine including its validation with vehicle guidance

An implementable nonlinear control design approach is presented for a supersonic air-breathing ramjet engine. The primary objective is to ensure that the thrust generated by the engine tracks the commanded thrust without violating the operational constraints. An important constraint is to manage the shock wave location in the intake so that it neither gets detached nor gets too much inside the intake. Both the objectives are achieved by regulating the fuel flow to the combustion chamber and by varying the throat area of the nozzle simultaneously. The design approach accounts for the nonlinear cross-coupling effects and nullifies those. Also, an extended Kalman filter has been used to filter out the sensor and process noises as well as to make the states available for feedback. Furthermore, independent control design has been carried out for the actuators. To test the performance of the engine for a realistic flight trajectory, a representative trajectory is generated through a trajectory optimization process, which is augmented with a newly-developed finite-time state dependent Riccati equation technique for nullifying the perturbations online. Satisfactory overall performance has been obtained during both climb and cruise phases. (C) 2015 Elsevier Masson SAS. All rights reserved.

Cerebral hemodynamics during graded Valsalva maneuvers

The Valsalva maneuver (VM) produces large and abrupt changes in mean arterial pressure (MAP) that challenge cerebral blood flow and oxygenation. We examined the effect of VM intensity on middle cerebral artery blood velocity (MCAv) and cortical oxygenation responses during (phases I-III) and following (phase IV) a VM. Healthy participants (n = 20 mean +/- SD: 27 +/- 7 years) completed 30 and 90% of their maximal VM mouth pressure for 10 s (order randomized) whilst standing. Beat-to-beat MCAv, cerebral oxygenation (NIRS) and MAP across the different phases of the VM are reported as the difference from standing baseline. There were significant interaction (phase * intensity) effects for MCAv, total oxygenation index (TOI) and MAP (all P < 0.01). MCAv decreased during phases II and III (P < 0.01), with the greatest decrease during phase III (-5 +/- 8 and -19 +/- 15 cm.s(-1) for 30 and 90% VM, respectively). This pattern was also evident in TOI (phase III: -1 +/- 1 and -5 +/- 4%, both P < 0.05). Phase IV increased MCAv (22 +/- 15 and 34 +/- 23 cm.s(-1)), MAP (15 +/- 14 and 24 +/- 17 mm Hg) and TOI (5 +/- 6 and 7 +/- 5%) relative to baseline (all P < 0.05). Cerebral autoregulation, indexed, as the % MCAv/%MAP ratio, showed a phase effect only (P < 0.001), with the least regulation during phase IV (2.4 +/- 3.0 and 3.2 +/- 2.9). These data illustrate that an intense VM profoundly affects cerebral hemodynamics, with a reactive hyperemia occurring during phase IV following modest ischemia during phases II and III.

Análise do efeito do envelhecimento e da doença pulmonar obstrutiva crônica sobre a limitação ao fluxo expiratório por meio da técnica de pressão expiratória negativa

O termo limitação ao fluxo expiratório (LFE) refere-se a uma condição na qual o fluxo expiratório máximo obtido durante um ciclo da respiração espontânea é menor que o previsto e permanece constante apesar do aumento do gradiente pressórico. A LFE pode estar presente durante o envelhecimento pulmonar fisiológico, e em afecções pulmonares obstrutivas, como na doença pulmonar obstrutiva crônica (DPOC). A aferição direta para determinar a LFE requer a mensuração do volume pela relação entre o fluxo e a pressão transpulmonar, porém é um método invasivo. Os testes usualmente empregados estão baseados na comparação da curva fluxo-volume expiratório máximo e corrente, porém estas técnicas requerem alto grau de colaboração do indivíduo e podem gerar alteração do tônus muscular brônquico. Estudos sugerem que a Técnica de Pressão Expiratória Negativa (NEP) pode ser aplicada para detecção da LFE, sendo um método simples, não invasivo e que não requer esforço dos voluntários. Contudo, índices quantitativos para a avaliação deste fenômeno ainda não foram definidos, assim como também não foram estudadas a LFE no processo de envelhecimento e nos diversos estágios de obstrução das vias aéreas na DPOC. Neste contexto, os objetivos deste estudo foram: (1) avaliar o comportamento da LFE durante o processo de envelhecimento e (2) estudar a LFE presente nos portadores de DPOC. Trata-se de um estudo transversal controlado com avaliação de casos prevalentes, tendo como unidade de avaliação o indivíduo. Os exames realizados incluíram medidas de espirometria e NEP. Foram selecionados indivíduos saudáveis para o grupo envelhecimento separados em três grupos: grupo jovem (GJ), n=17; grupo meia idade (GMI), n=17 e grupo idoso (GI), n=17. No grupo DPOC foram selecionados indivíduos tabagistas e com doença obstrutiva, sendo classificados de acordo com o nível de obstrução sugerido pela espirometria. Essa classificação resultou em cinco categorias: indivíduos normais ao exame espirométrico (NE, n= 18); com distúrbio ventilatório obstrutivo leve (DVOL, n=15); distúrbio ventilatório obstrutivo moderado (DVOM, n= 18); distúrbio ventilatório obstrutivo acentuado (DVOA, n= 18) e distúrbio ventilatório obstrutivo muito acentuado (DVOMA, n= 18). Todos os indivíduos realizaram os exames de NEP e posteriormente foram submetidos à espirometria. No estudo sobre envelhecimento o parâmetro LFE% foi o que melhor caracterizou a LFE, apresentando uma correlação moderada com a idade. Os parâmetros ∆EF0-50% e ∆EF25-75% apresentaram uma correlação razoável com o progredir da idade, possivelmente devido a LFE no idoso apresentar componentes relacionadas às vias aéreas superiores. No grupo DPOC a NEP caracterizou adequadamente a LFE, sendo o melhor parâmetro a LFE%. Alterações significativas também foram encontradas com os parâmetros ∆EF0-50% e ∆EF25-75%. Avaliando-se a influência da idade neste grupo, pode-se observar que a idade é um fator de contribui para a LFE, no entanto, o efeito preponderante foi a gravidade da doença. Pode-se concluir que: (1) a NEP é útil no estudo da LFE em idosos saudáveis; (2) nestes indivíduos a LFE ocorre principalmente nas vias aéreas extratorácicas; (3) que a NEP é útil na avaliação de pacientes com DPOC, e: (4) que os efeitos da DPOC se sobrepõe ao efeito do envelhecimento.

Comparison of two hormone preparations on the reproductive performance of air breathing catfish Clarias batrachus (Lin.)

Two hormone preparations viz. Human Chorionic Gonadotropin (HCG) and pituitary gland (PG) suspension were compared for their comparative efficacy on the breeding performance of a air breathing catfish Clarias batrachus. It was found that HCG induced fish gave better ovulation response than PG. Both fertilization and hatching of eggs were significantly (p

Monoculture of three native air breathing fishes in homestead ditches and plastic barrels

Six on-farm trials were conducted from 1 August to 23 November 2004 in two different environments such as homestead ditches (10 to 17 square meters) and plastic barrels (240 liters) to develop techniques for nonoculture [sic] of climbing perch, Anabas testudineus, stinging catfish, Heteropneustes fossilis and walking catfish, Clarias batrachus for poor and landless people who have no access to pond. Stocking density for ditch was 10 fry/square meter while that for barrel was 20 fry/cubic meter. The fishes were fed with 3-test diets viz. low-cost formulated feed (rice bran 20%, wheat meal 10%, mustered [sic] oil cake 35%, poultry offal 35%), live foods (chopped snails and clams), and a commercial feed (Saudi-Bangla feed, starter 3: first month and grower-1: subsequent two months) and designated as T1, T2 and T3, respectively. Feeding rate was the same in all the treatments viz. 10% of body weight (first two months), 8% (third month) and 6% (fourth month). T1 and T2 had three replications while T3 had two replications. Water temperature was recorded weekly while fish growth was monitored monthly. After 4 months' rearing, H. fossilis and C. batrachus in ditches and barrels attained higher average weight in T2 followed by T3 and T1 while A. testudineus in barrels also attained higher average weight in T2. The variation in net weight gain by A. testudineus in ditch fed test diets T2 and T3 was not significantly different (P>0.05) though the net gain in both T2 and T3 was significantly (P<0.05) higher than that of T1. The yield of climbing perch as obtained from T1, T2 and T3 was 988, 1136 and 1185 kg/ha, respectively while that stinging catfish was 395, 242 and 444 kg/ha and walking catfish was 1605, 2,099 and 1,654 kg/ha respectively. All the three species showed significantly lower growth rate in barrels than in ditches.