New insights in respiratory impedance in young children after repair of congenital diaphragmatic hernia: a cross-sectional study.

Lung function impairment is common in Congenital Diaphragmatic Hernia (CDH) survivors. The aim of this study was to evaluate, in children who underwent CDH surgical repair, mid and long-term consequences on respiratory impedance, investigating the impact of CDH on both resistance and reactance parameters, as well as bronchodilator response.Forced Oscillation Technique (FOT) parameters were collected from 12 patients (2-11 years).

Controlling a Lower-Leg Exoskeleton Using Voltage and Current Variation Signals of a DC Motor Mounted at the Knee Joint.

Powered exoskeleton technology helps turns dreams of recovering mobility after paralysis into reality. One of the most common problems encountered in the use of powered exoskeletons is the detection of the motion intentions of the user. Many approaches to conquering this problem have been developed using Electromyography (EMG) sensors, Electroencephalography (EEG) sensors, Center of Pressure (COP), and so forth.

Forced oscillation measurements in the first week of life and pulmonary outcome in very preterm infants on noninvasive respiratory support.

Background: We aimed at investigating whether early lung mechanics in non-intubated infants below 32 weeks of gestational age (GA) are associated with respiratory outcome.

Methods: Lung mechanics were assessed by the forced oscillation technique using a mechanical ventilator (Fabian HFOi, ACUTRONIC Medical Systems AG, Hirzel, Switzerland) that superimposed small-amplitude oscillations (10 Hz) on a continuous positive airway pressure. Measurements were performed during regular tidal breathing using a face mask on days 2, 4, and 7 of life.

Accuracy of low-dose proton CT image registration for pretreatment alignment verification in reference to planning proton CT.

Purpose: Proton CT (pCT) has the ability to reduce inherent uncertainties in proton treatment by directly measuring the relative proton stopping power with respect to water, thereby avoiding the uncertain conversion of X-ray CT Hounsfield unit to relative stopping power and the deleterious effect of X- ray CT artifacts. The purpose of this work was to further evaluate the potential of pCT for pretreatment positioning using experimental pCT data of a head phantom.

Methods: The performance of a 3D image registration algorithm was tested with pCT reconstructions of a pediatric head phantom.

Within-breath changes in respiratory system impedance in children with cystic fibrosis.

Background: The aim of this study was to assess within-breath respiratory system impedance by the forced oscillation technique (FOT) in children with cystic fibrosis (CF) and relate it to the underlying lung disease.

Methods: Thirty-three children with CF (median [range] age 12.0 [6-17] years) underwent FOT at 8 Hz during tidal breathing, multiple breath nitrogen washout (LCI), spirometry (FEV1), body plethysmography (RV/TLC), and magnetic resonance imaging (MRI).

Regional distribution of chest wall displacements in infants during high-frequency ventilation.

The distribution of ventilation during high-frequency ventilation (HFV) is asynchronous, nonhomogeneous, and frequency dependent. We hypothesized that differences in the regional distribution of ventilation at different oscillatory frequencies may affect gas exchange efficiency. We studied 15 newborn infants with a median gestational age of 28.

Pediatric and adolescent injury in skateboarding.

Skateboarding has become an international action sport attractive to young people. For this reason, skateboarding has been promoted by some researchers as important for encouraging young people to become more physically active. However, skateboarding is also considered to be inherently dangerous by the medical and broader community and as a result skateboarding is banned in many places.

Plasma proteomics reveals gestational age-specific responses to mechanical ventilation and identifies the mechanistic pathways that initiate preterm lung injury.

The preterm lung is particularly vulnerable to ventilator-induced lung injury (VILI) as a result of mechanical ventilation. However the developmental and pathological cellular mechanisms influencing the changing patterns of VILI have not been comprehensively delineated, preventing the advancement of targeted lung protective therapies. This study aimed to use SWATH-MS to comprehensively map the plasma proteome alterations associated with the initiation of VILI following 60 minutes of standardized mechanical ventilation from birth in three distinctly different developmental lung states; the extremely preterm, preterm and term lung using the ventilated lamb model.

Oscillatory respiratory mechanics on the first day of life improves prediction of respiratory outcomes in extremely preterm newborns.

Background: We aimed to evaluate if lung mechanics measured by forced oscillatory technique (FOT) during the first day of life help identify extremely low gestational age newborns (ELGANs) at risk of prolonged mechanical ventilation (MV) and oxygen dependency.

Methods: Positive end-expiratory pressure (PEEP) was increased 2 cmHO above the clinically set PEEP, then decreased by four 5-min steps of 1 cmHO, and restored at the clinical value. At each PEEP, FOT measurements were performed bedside during MV.

Stacked sparse autoencoder networks and statistical shape models for automatic staging of distal femur trochlear dysplasia.

Background: The quantitative morphological analysis of the trochlear region in the distal femur and the precise staging of the potential dysplastic condition constitute a key point for the use of personalized treatment options for the patella-femoral joint. In this paper, we integrated statistical shape models (SSM), able to represent the individual morphology of the trochlea by means of a set of parameters and stacked sparse autoencoder (SSPA) networks, which exploit the parameters to discriminate among different levels of abnormalities.

Methods: Two datasets of distal femur reconstructions were obtained from CT scans, including pathologic and physiologic shapes.

Accuracy of oscillatory pressure measured by mechanical ventilators during high frequency oscillatory ventilation in newborns.

Background: Oscillatory pressure (ΔP) measurement during high frequency oscillatory ventilation (HFOV) is technically challenging and influenced by all the components of the measurement system.

Objectives: To evaluate the differences between the ΔP delivered at the inlet of the endotracheal tube and those displayed by commercial neonatal mechanical ventilators and monitoring devices and to characterize how the ventilator circuit and the flowmeter proximal to the patient affect these differences.

Methods: Six devices were evaluated while ventilating three mechanical analogues representing the newborn respiratory system in different disease states.

Effect of continuous positive airway pressure on breathing variability in early preterm lung disease.

Objectives: In preterm infants, the application of nasal Continuous Positive Airway Pressure (nCPAP) improves lung function through several mechanisms and may interact with the control of breathing. Our aim was to evaluate the effect of increasing/decreasing nCPAP on gas exchange, breathing pattern, and its variability in preterm infants.

Methods: Fifeteen infants with mild to moderate respiratory distress syndrome (RDS) were studied on the first day of life.

Telemonitoring in Chronic Obstructive Pulmonary Disease (CHROMED). A Randomized Clinical Trial.

Rationale: Early detection of chronic obstructive pulmonary disease (COPD) exacerbations using telemonitoring of physiological variables might reduce the frequency of hospitalization.

Objectives: To evaluate the efficacy of home monitoring of lung mechanics by the forced oscillation technique and cardiac parameters in older patients with COPD and comorbidities.

Methods: This multicenter, randomized clinical trial recruited 312 patients with Global Initiative for Chronic Obstructive Lung Disease grades II to IV COPD (median age, 71 yr [interquartile range, 66-76 yr]; 49.

Three dimensional motion capture applied to violin playing: A study on feasibility and characterization of the motor strategy.

Background And Objective: Playing string instruments requires advanced motor skills and a long training that is often spent in uncomfortable postures that may lead to injuries or musculoskeletal disorders. Thus, it is interesting to objectively characterize the motor strategy adopted by the players. In this work, we implemented a method for the quantitative analysis of the motor performance of a violin player.

The association of tidal EFL with exercise performance, exacerbations, and death in COPD.

Background: Tidal expiratory flow limitation (EFL) is frequently found in patients with COPD and can be detected by forced oscillations when within-breath reactance of a single-breath is ≥0.28 kPa·s·L. The present study explored the association of within-breath reactance measured over multiple breaths and EFL with 6-minute walk distance (6MWD), exacerbations, and mortality.

Supraglottic Atomization of Surfactant in Spontaneously Breathing Lambs Receiving Continuous Positive Airway Pressure.

Objectives: To determine the short-term tolerance, efficacy, and lung deposition of supraglottic atomized surfactant in spontaneously breathing lambs receiving continuous positive airway pressure.

Design: Prospective, randomized animal study.

Setting: Animal research laboratory.

Role of interim F-FDG-PET/CT for the early prediction of clinical outcomes of Non-Small Cell Lung Cancer (NSCLC) during radiotherapy or chemo-radiotherapy. A systematic review.

Background: Non-Small Cell Lung Cancer (NSCLC) is characterized by aggressiveness and includes the majority of thorax malignancies. The possibility of early stratification of patients as responsive and non-responsive to radiotherapy with a non-invasive method is extremely appealing. The distribution of the Fluorodeoxyglucose (F-FDG) in tumours, provided by Positron-Emission-Tomography (PET) images, has been proved to be useful to assess the initial staging of the disease, recurrence, and response to chemotherapy and chemo-radiotherapy (CRT).

Managing Information More Effectively in Health Informatics Applications.

Conceptual clarity and predicative/impredicative competence are the fundamental components for managing information more effectively in Health Informatics, Healthcare and Medicine applications, while promoting innovation and creativity. Medicine was always the art and science of healing. The science became more and more a mechanistic technology in Healthcare; the art was dropped altogether.

Health Informatics and Wellbeing by Enhanced Knowledge Formalisation.

Only once we agree upon our understanding of what words really mean can we debate whether a concept, represented by those words, is or not well represented significantly in specific application. In a previous paper we presented an innovative point of view on deeper wellbeing understanding towards its increased, effective Health Informatics and clinical usage and applications. Medicine was always the art and science of healing.

Trends in mechanical ventilation: are we ventilating our patients in the best possible way?

Unlabelled: This review addresses how the combination of physiology, medicine and engineering principles contributed to the development and advancement of mechanical ventilation, emphasising the most urgent needs for improvement and the most promising directions of future development. Several aspects of mechanical ventilation are introduced, highlighting on one side the importance of interdisciplinary research for further development and, on the other, the importance of training physicians sufficiently on the technological aspects of modern devices to exploit properly the great complexity and potentials of this treatment.

Educational Aims: To learn how mechanical ventilation developed in recent decades and to provide a better understanding of the actual technology and practice.

Understanding Action and Adventure Sports Participation-An Ecological Dynamics Perspective.

Previous research has considered action and adventure sports using a variety of associated terms and definitions which has led to confusing discourse and contradictory research findings. Traditional narratives have typically considered participation exclusively as the pastime of young people with abnormal characteristics or personalities having unhealthy and pathological tendencies to take risks because of the need for thrill, excitement or an adrenaline 'rush'. Conversely, recent research has linked even the most extreme forms of action and adventure sports to positive physical and psychological health and well-being outcomes.

2D/3D reconstruction of the distal femur using statistical shape models addressing personalized surgical instruments in knee arthroplasty: A feasibility analysis.

Background: Personalized surgical instruments (PSI) have gained success in the domain of total knee replacement, demonstrating clinical outcomes similar or even superior to both traditional and navigated surgeries. The key requirement for prototyping PSI is the availability of the digital bony surface. In this paper, we aim at verifying whether the 2D/3D reconstruction of the distal femur, based on statistical shape models (SSM), grants sufficient accuracy, especially in the condylar regions, to support a PSI technique.

Comparison between model-predicted tumor oxygenation dynamics and vascular-/flow-related Doppler indices.

Purpose: Mathematical modeling is a powerful and flexible method to investigate complex phenomena. It discloses the possibility of reproducing expensive as well as invasive experiments in a safe environment with limited costs. This makes it suitable to mimic tumor evolution and response to radiotherapy although the reliability of the results remains an issue.