Night-to-night variation of pulse oximetry in children with sleep-disordered breathing

BACKGROUND: Sleep-disordered breathing is a common and serious feature of many paediatric conditions and is particularly a problem in children with Down syndrome. Overnight pulse oximetry is recommended as an initial screening test, but it is unclear how overnight oximetry results should be interpreted and how many nights should be recorded.

METHODS: This retrospective observational study evaluated night-to-night variation using statistical measures of repeatability for 214 children referred to a paediatric respiratory clinic, who required overnight oximetry measurements. This included 30 children with Down syndrome. We measured length of adequate trace, basal SpO2, number of desaturations (>4% SpO2 drop for >10 s) per hour ('adjusted index') and time with SpO2<90%. We classified oximetry traces into normal or abnormal based on physiology.

RESULTS: 132 out of 214 (62%) children had three technically adequate nights' oximetry, including 13 out of 30 (43%) children with Down syndrome. Intraclass correlation coefficient for adjusted index was 0.54 (95% CI 0.20 to 0.81) among children with Down syndrome and 0.88 (95% CI 0.84 to 0.91) for children with other diagnoses. Negative predictor value of a negative first night predicting two subsequent negative nights was 0.2 in children with Down syndrome and 0.55 in children with other diagnoses.

CONCLUSIONS: There is substantial night-to-night variation in overnight oximetry readings among children in all clinical groups undergoing overnight oximetry. This is a more pronounced problem in children with Down syndrome. Increasing the number of attempted nights' recording from one to three provides useful additional clinical information.

Rocking behaviour of multi-block columns subjected to pulse-type ground motion accelerations

Ancient columns, made with a variety of materials such as marble, granite, stone or masonry are an important part of the
European cultural heritage. In particular columns of ancient temples in Greece and Sicily which support only the architrave are
characterized by small axial load values. This feature together with the slenderness typical of these structural members clearly
highlights as the evaluation of the rocking behaviour is a key aspect of their safety assessment and maintenance. It has to be noted
that the rocking response of rectangular cross-sectional columns modelled as monolithic rigid elements, has been widely investigated
since the first theoretical study carried out by Housner (1963). However, the assumption of monolithic member, although being
widely used and accepted for practical engineering applications, is not valid for more complex systems such as multi-block columns
made of stacked stone blocks, with or without mortar beds. In these cases, in fact, a correct analysis of the system should consider
rocking and sliding phenomena between the individual blocks of the structure. Due to the high non-linearity of the problem, the
evaluation of the dynamic behaviour of multi-block columns has been mostly studied in the literature using a numerical approach
such as the Discrete Element Method (DEM). This paper presents an introductory study about a proposed analytical-numerical
approach for analysing the rocking behaviour of multi-block columns subjected to a sine-pulse type ground motion. Based on the
approach proposed by Spanos (2001) for a system made of two rigid blocks, the Eulero-Lagrange method to obtain the motion
equations of the system is discussed and numerical applications are performed with case studies reported in the literature and with a
real acceleration record. The rocking response of single block and multi-block columns is compared and considerations are made
about the overturning conditions and on the effect of forcing function’s frequency.
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Tissue temperature estimation with pulse-echo in blood flow presence

Aiming at time-spatial characterization of tissue temperature when ultrasound is applied for thermal therapeutic proposes two experiments were developed considering gel-based phantoms, one of them including an artificial blood vessel. The blood vessel was mimicking blood flow in a common carotid artery. For each experiment phantoms were heated by a therapeutic ultrasound (TU) device emitting different intensities (0.5, 1, 1.5, 1.8 W/cm2). Temperature was monitored by thermocouples and estimated through imaging ultrasound transducer's signals within specific special points inside the phantom. The temperature estimation procedure was based on temporal echo-shifts (TES), computed based on echo-shifts collected through image ultrasound (IU) transducer. Results show that TES is a reliable non-invasive method of temperature estimation, regardless the TU intensities applied. Presence of a pulsatile blood flow vessel in the focal point of TU transducer reduces thermal variation in more than 50%, also affecting the temperature variation in the surrounding area. In other words, vascularized tissues require longer ultrasound thermal therapeutic sessions or higher TU intensities and inclusion of IU in the therapeutic procedure enables non-invasive monitoring of temperature. © 2013 IEEE.

The role of the right parietal cortex in sound localization: a chronometric single pulse transcranial magnetic stimulation study.

Auditory spatial functions, including the ability to discriminate between the positions of nearby sound sources, are subserved by a large temporo-parieto-frontal network. With the aim of determining whether and when the parietal contribution is critical for auditory spatial discrimination, we applied single pulse transcranial magnetic stimulation on the right parietal cortex 20, 80, 90 and 150 ms post-stimulus onset while participants completed a two-alternative forced choice auditory spatial discrimination task in the left or right hemispace. Our results reveal that transient TMS disruption of right parietal activity impairs spatial discrimination when applied at 20 ms post-stimulus onset for sounds presented in the left (controlateral) hemispace and at 80 ms for sounds presented in the right hemispace. We interpret our finding in terms of a critical role for controlateral temporo-parietal cortices over initial stages of the building-up of auditory spatial representation and for a right hemispheric specialization in integrating the whole auditory space over subsequent, higher-order processing stages.

The effects of an acute bout of whole-body vibration on pulse wave velocity in individuals with SCI

Cardiovascular disease is a leading cause of mortality in the spinal cord injured (SCI) population. Reduced arterial compliance is a cardiovascular risk factor and whole body vibration (WBV) has be en shown to improve arterial compliance in able-bodied individuals. The study investigated the effect of an acute session ofWBV on arterial compliance as measured by pulse wave velocity (PWV). On separate days, arm, leg and aortic PWV were measured pre- and post- a 45 minute session of passive stance (PS) and WBV. The WBV was intermittent with a set frequency of 45Hz and amplitude of O.6mm. There was no condition by time effect when comparing PWV after WBV and PS. Following WBV, aortic (928.6±127.7 vs. 901.1±96.6cm/sec), leg (1035.2±113.8 vs.l099.8±114.2cm/sec) and arm PWV (1118.9±119.8 vs. 1181.1±124.4cm/s) did not change. As such, WBV did not reduce arterial compliance, however future research with protocol modifications is recommended.

Étude de l’impact de la pression pulsée sur la réactivité cérébrovasculaire

In vivo, la pression artérielle au niveau des artères cérébrales est pulsée, alors que ex vivo, l’étude de la fonction cérébrovasculaire est majoritairement mesurée en pression statique. L’impact de la pression pulsée sur la régulation du tonus myogénique et sur la fonction endothéliale cérébrale est inconnu. Nous avons posé l’hypothèse selon laquelle en présence d'une pression pulsée physiologique, la dilatation dépendante de l’endothélium induite par le flux et le tonus myogénique seraient optimisés. L’objectif de notre étude est d’étudier ex vivo l’impact de la pression pulsée sur le tonus myogénique et la dilatation induite par le flux dans les artères cérébrales de souris. Nous avons utilisé un artériographe pressurisé couplé à un système générant une onde pulsée de fréquence et d’amplitude réglables. Les artères cérébrales moyennes (≈160 μm de diamètre) ont été isolées de souris C57BL6 âgées de 3 mois et pressurisées à 60 mm Hg, en pression statique ou en pression pulsée. En pression statique, le tonus myogénique est faible mais est potentialisé par le L-NNA (un inhibiteur de la eNOS) et la PEG-catalase (qui dégrade le H2O2), suggérant une influence des produits dilatateurs dérivés de la eNOS sur le tonus myogénique. En présence de pression pulsée (pulse de 30 mm Hg, pression moyenne de 60 mm Hg, 550 bpm), le tonus myogénique est significativement augmenté, indépendamment du L-NNA et de la PEG-catalase, suggérant que la pression pulsée lève l’impact de la eNOS. En pression statique ou pulsée, les artères pré-contractées se dilatent de façon similaire jusqu’à une force de cisaillement de 15 dyn/cm2. Cette dilatation, dépendante de l’endothélium et de la eNOS, est augmentée en condition pulsée à une force de cisaillement de 20 dyn/cm2. En présence de PEG-catalase, la dilatation induite par le flux est diminuée en pression statique mais pas en pression pulsée, suggérant que la pression statique, mais pas la pression pulsée, favorise la production de O2 -/H2O2. En effet, la dilatation induite par le flux est associée à une production de O2 -/H2O2 par la eNOS, mesurable en pression statique, alors que la dilatation induite par le flux en pression pulsée est associée à la production de NO. Les différences de sensibilité à la dilatation induite par le flux ont été abolies après inhibition de Nox2, en condition statique ou pulsée. La pression pulsée physiologique régule donc l’activité de la eNOS cérébrale, en augmentant le tonus myogénique et, en présence de flux, permet la relâche de NO via la eNOS.

L'étude in vivo de l'impact de la pression pulsée sur les capillaires cérébraux de souris

Plusieurs décennies de recherche ont permis de mieux comprendre les effets de l’athérosclérose sur le système cardiovasculaire, d’améliorer la prévention et de développer des traitements efficaces. Les effets de l’athéroslérose sur le cerveau demeurent toutefois mal compris même si le lien entre le fonctionnement cognitif et la santé du système vasculaire est maintenant bien établi. La venue de nouvelles méthodes d’imagerie telle la microscopie laser à 2-photons (TPLM) permet d’étudier l’impact de certaines maladies sur la microvasculature cérébrale en mesurant le flux sanguin dans des vaisseaux uniques situés dans des régions cérébrales millimétriques sous la surface. Les résultats des études in vitro peuvent dorénavant être corrélés à ceux obtenus in vivo. En premier lieu, ce mémoire revoit la théorie ayant permis le développement de la TPLM qui permet de prendre des mesures hémodynamiques in vivo dans des vaisseaux de très petits calibres tels des capillaires cérébraux de souris. Par la suite, son utilisation est décrite chez des souris anesthésiées afin de comparer les mesures d’hémodynamie cérébrale tels la vitesse des globules rouges, le flux de globules rouges, le flux sanguin cérébral, l’hématocrite sanguin et le diamètre des vaisseaux. Finalement, nous avons comparé les données hémodynamiques entre des souris de 3 mois normales (WT ; n=6) et des souris atteintes d’athérosclérose précoce (ATX ; n=6). Les résultats obtenus sur un nombre total de 209 capillaires (103 pour les souris WT et 106 pour les souris ATX) démontrent que les souris ATX possèdent une vitesse des globules rouges (+40%) plus grande, un flux de globule rouge plus grand (+12%) et un flux capillaire plus élevé (+14%) sans démontrer pour aucun de ces paramètres, une différence statistiquement significative. L’hématocrite moyen (35±4% vs 33±2% ; p=0.71) et le diamètre moyen des vaisseaux (4.88±0.22μm vs 4.86±0.20μm ; p=0.23) étaient également comparables. La vitesse des globules rouges a démontré une faible corrélation avec le diamètre des vaisseaux (r=0.39) et avec le flux de globules rouges/seconde (r=0.59). En conclusion, les travaux menés dans le cadre de ce mémoire de maîtrise permettent d'envisager, grâce aux nouvelles méthodes d’imagerie cérébrale telle la TPLM, une meilleure compréhension des mécanismes hémodynamiques sous-jacents à la microcirculation cérébrale. L’effet d’une pression pulsée augmentée, tel que proposée dans l’athérosclérose reste cependant à démontrer avec cette méthode d’imagerie.

Pulse Wave Propagating in Coplanar Waveguides (cPWS) on LTCC Substrates

The propagation of pulse waves in coplanar waveguides (CPWs) is investigated, and these CPWs are assumed to be fabricated on a single -layer low- temperature co-fired ceramic (LTCC) substrate. The input pulse wave can be a Gaussian pulse or a sinusoldally modulated Gaussian pulse. Based on the standard Galerkin 's method in the spectral domain, combined with fast Fourier transform (FFT), the pulse waveform and delay in CPWs are demonstrated and compared for a second plate, oriented orthogonally to the primary planar element, thus producing a crossed planar monopole (CPM), which is simpler to produce and has lower cost than a conical monopole. In this paper, further measurements have been made on this element

Non-invasive Studies on Age Related Parameters Using a Blood Volume Pulse Sensor

A non-invasive technique is implemented to measure a parameter which is closely related to the distensibility of large arteries, using the second derivative of the infrared photoplethysmographic waveform. Thirty subjects within the age group of 20-61 years were involved in this pilot study. Two new parameters, namely the area of the photoplethysmographic waveform under the systolic peak, and the ratio of the time delay between the systolic and the diastolic peaks and the time period of the waveform ( T/T) were studied as a function of age. It was found that while the parameter which is supposed to be a marker of distensibility of large arteries and T /T values correlate negatively with age, the area under the systolic peak correlates positively with age. The results suggest that the derived parameters could provide a simple, non-invasive means for studying the changes in the elastic properties of the vascular system as a function of age.

Studies on some nonlinear schrodinger type equations describing pulse propagation through optical fibers

The discovery of the soliton is considered to be one of the most significant events of the twentieth century. The term soliton refers to special kinds of waves that can propagate undistorted over long distances and remain unaffected even after collision with each other. Solitons have been studied extensively in many fields of physics. In the context of optical fibers, solitons are not only of fundamental interest but also have potential applications in the field of optical fiber communications. This thesis is devoted to the theoretical study of soliton pulse propagation through single mode optical fibers.

The use of pulse amplitude modulated fluorescence techniques for metal toxicity assessment in fluvial biofilms

Metal pollution in rivers is in great concern with human activities in the fluvial watershed. This thesis aims to investigate the potential use of chl-a fluorescence parameters as biomarkers of metal toxicity, and to find cause-effect relationships between metal exposures, other environmental factor (i.e. light), and functional and structural biofilm responses. This thesis demonstrates that the use of chl-a fluorescence parameters allows detect early effects on biofilms caused by zinc toxicity, both in the laboratory as in polluted rivers. In microcosm experiments, the use of chl-a fluorescence parameters allows evaluates structural changes on photosynthetic apparatus and in algal groups’ composition of biofilms long-term exposed to zinc. In order to evaluate the effects of chronic metal pollution in rivers, it is recommended the use of biofilm translocation experiments and the use of a multi-biomarker approach.

Differentiating bone osteonal turnover rates by density fractionation; validation using the bomb C-14 atmospheric pulse

The density (BSG) of bone increases, at the osteon scale, during lifetime aging within the bone. In addition, post-mortem diagenetic change due to microbial attack produces denser bioapatite. Thus, fractionation of finely powdered bone on the basis of density should not only enable younger and older populations of osteons to be separated but also make it possible to separate out a less diagenetically altered component. We show that the density fractionation method can be used as a tool to investigate the isotopic history within an individual's lifetime, both in recent and archaeological contexts, and we use the bomb C-14 atmospheric pulse for validating the method.