Puritan-Bennett, the Renaissance Spirometry System listening to the voice of the customer

John R. Hauser

Hot-thermistor spirometry for the artificial ventilation of infants

Bibliography: leaves 230-245.This thesis describes equipment and techniques which were developed for use in monitoring mechanical aspects of artificial ventilation and optimising ventilation procedures. A strong emphasis is placed on the clinical applicability of the techniques and clinical applications are discussed. A new temperature-compensated hot-thermistor anemometer/spirometer was developed because the wide variety of spirometers described previously for-measuring respiratory volumes •and volume flow rates were unsatisfactory for routine use in monitoring infant ventilation. The principles of hot-thermistor spirometry were investigated both theoretically and experimental.ly to develop new temperature-compensation techniques and to predict the effect of gas composition changes on spirometer celebration. New electronic circuits were developed which greatly simplify the construction of temperature-compensated hot- thermistor anemometers and extend the dynamic range off low rates that can be measured

Sistema para Avaliação e Feedback de Manobras Respiratórias Forçadas em Crianças

A asma é a doença crónica mais comum em crianças, não curável mas tratável, e é uma causa frequente de admissões hospitalares evitáveis. Devido ao custo associado a equipamentos clínicos para uso pessoal e à crescente universalidade de smartphones, tem-se vindo a desenvolver trabalho na extração de parâmetros clínicos de manobras respiratórias forçadas com o auxílio destes últimos, particularmente através do microfone. Contudo, não têm sido explorados métodos para avaliação de qualidade destes registos áudio, limitando a utilidade destas soluções sem a presença física de profissionais de saúde. Como tal, no âmbito desta tese pretendemos desenvolver um sistema para avaliar três critérios de qualidade em espirometria móvel com recurso ao microfone. Adicionalmente, o sistema foi também utilizado para fornecer feedback ao utilizador sobre como melhorar execução da manobra respiratória. Planeamos duas fases de colheita de dados num ambiente controlado, a primeira para permitir o desenvolvimento dos algoritmos de avaliação automática dos critérios de qualidade, e a segunda para validação do feedback associado a cada um. Na primeira fase foram efetuadas 400 gravações de espirometria com o microfone de um smartphone em 55 crianças (dos 8 aos 10 anos), usando um jogo móvel desenvolvido para esse propósito. Um profissional de saúde seguidamente procedeu ao registo da qualidade dessas gravações e a dar feedback às crianças. Para dois dos três algoritmos desenvolvidos obtiveram-se correlações relevantes com a classificação do profissional de saúde. Na segunda fase realizaram-se 93 gravações em 20 crianças, de forma idêntica à primeira fase, mas com o próprio jogo a fornecer o feedback em vez do profissional de saúde, para efeitos de validação desse feedback automático baseado nos algoritmos desenvolvidos. Verificou-se que todas essas crianças foram capazes de perceber como melhorar a sua execução sem intervenção do profissional de saúde, satisfazendo os critérios antes de atingir o número máximo de tentativas recomendados na literatura existente. Os resultados obtidos reforçam a ideia de que a Espirometria Móvel, utilizando um microfone, é um campo de estudo viável e promissor. Contudo, estudos com uma maior amostra de crianças representativa de toda a demográfica alvo serão necessários para melhorar o sistema, bem como para garantir a aplicabilidade destes resultados na população geral.Asthma is the most common chronic disease in children, uncurable but treatable, and is na important cause for preventable hospitalizations. Due to the cost of spirometers for personal use and the smartphone ubiquity, work has been developed for extracting clinical parameters from spirometry manoeuvres using smartphones, particularly through the embedded microphone. However, quality evaluation of those audio captures has not been explored, limiting the usefulness of these solutions in the absence of healthcare professionals. Therefore, we developed a system to evaluate three quality criteria in smartphone spirometry, and to provide feedback on how to improve users’ performance. We recorded 400 microphone spirometries in 55 children (8-10 years), using a mobile game engineered for the purpose, and a healthcare professional registered its quality. For two of the developed algorithms we were able to attain relevant correlations with the healthcare professional’s classification. In a second assessment for the validation of the automatic feedback, we observed that all participants understood how to improve without intervention by the healthcare professional, and were able to satisfy the criteria before reaching the maximum attempt count defined in existing literature. These results suggest that child microphone spirometry in the absence of a healthcare professional is feasible

Evidence for models of diagnostic service provision in the community: literature mapping exercise and focused rapid reviews

Background Current NHS policy favours the expansion of diagnostic testing services in community and primary care settings. Objectives Our objectives were to identify current models of community diagnostic services in the UK and internationally and to assess the evidence for quality, safety and clinical effectiveness of such services. We were also interested in whether or not there is any evidence to support a broader range of diagnostic tests being provided in the community. Review methods We performed an initial broad literature mapping exercise to assess the quantity and nature of the published research evidence. The results were used to inform selection of three areas for investigation in more detail. We chose to perform focused reviews on logistics of diagnostic modalities in primary care (because the relevant issues differ widely between different types of test); diagnostic ultrasound (a key diagnostic technology affected by developments in equipment); and a diagnostic pathway (assessment of breathlessness) typically delivered wholly or partly in primary care/community settings. Databases and other sources searched, and search dates, were decided individually for each review. Quantitative and qualitative systematic reviews and primary studies of any design were eligible for inclusion. Results We identified seven main models of service that are delivered in primary care/community settings and in most cases with the possible involvement of community/primary care staff. Not all of these models are relevant to all types of diagnostic test. Overall, the evidence base for community- and primary care-based diagnostic services was limited, with very few controlled studies comparing different models of service. We found evidence from different settings that these services can reduce referrals to secondary care and allow more patients to be managed in primary care, but the quality of the research was generally poor. Evidence on the quality (including diagnostic accuracy and appropriateness of test ordering) and safety of such services was mixed. Conclusions In the absence of clear evidence of superior clinical effectiveness and cost-effectiveness, the expansion of community-based services appears to be driven by other factors. These include policies to encourage moving services out of hospitals; the promise of reduced waiting times for diagnosis; the availability of a wider range of suitable tests and/or cheaper, more user-friendly equipment; and the ability of commercial providers to bid for NHS contracts. However, service development also faces a number of barriers, including issues related to staffing, training, governance and quality control. Limitations We have not attempted to cover all types of diagnostic technology in equal depth. Time and staff resources constrained our ability to carry out review processes in duplicate. Research in this field is limited by the difficulty of obtaining, from publicly available sources, up-to-date information about what models of service are commissioned, where and from which providers. Future work There is a need for research to compare the outcomes of different service models using robust study designs. Comparisons of ‘true’ community-based services with secondary care-based open-access services and rapid access clinics would be particularly valuable. There are specific needs for economic evaluations and for studies that incorporate effects on the wider health system. There appears to be no easy way of identifying what services are being commissioned from whom and keeping up with local evaluations of new services, suggesting a need to improve the availability of information in this area. Funding The National Institute for Health Research Health Services and Delivery Research programme

The application of aerospace technology to biomedical problems Quarterly report, 15 Jun. - 31 Aug. 1969

Applications of aerospace technology to biomedical problem

Some NASA contributions to human factors engineering: A survey

This survey presents the NASA contributions to the state of the art of human factors engineering, and indicates that these contributions have a variety of applications to nonaerospace activities. Emphasis is placed on contributions relative to man's sensory, motor, decisionmaking, and cognitive behavior and on applications that advance human factors technology

Medical semiconductor sensors: a market perspective on state-of-the-art solutions and trends

The aim of this Master Thesis is to analyse the worldwide state-of-the art market solutions and trends in semiconductor sensors within medical applications; specially magnetic and pressure sensors, with the intention of developing a potential entry plan of Infineon Technologies AG into this market. For that purpose, a fit between a top-down and bottom-up qualitative and quantitative estimation of the medical semiconductor sensor’s market size has been made; with application units, sensor volumes and sensor revenues, with a horizontal scope of five years. Once understood the existing market, some insight into the competitive landscape is provided, where the key suppliers are analysed in terms of product portfolio and revenue share estimates, on an application basis. And also, a spotlight on innovation and trends at three levels – healthcare, medical devices and medical semiconductor sensors – is presented, to forecast a possible evolution of the fore-mentioned market. The research that has been conducted is based on three main sources of information; internal contacts (i.e. within Infineon), external contacts (most of them through internal references) and internet research. Access to market research company’s reports and interviews has been particularly helpful, to complement extensive internet research. Outcomes of this study indicate that the global medical semiconductor magnetic sensor market reveals low revenue potential; as most of the applications are yet innovation fields. Reed switch replacement in battery-powered medical devices can be an opportunity for magnetic switches. However, this project suggests that there is a key investment opportunity: magnetic beads for viral detection with spintronics sensors. The global medical semiconductor pressure sensor market seems a fairly mature market; the gross part of the revenue comes from blood pressure measurement. Blood pressure measurement might be an opportunity for existing automotive semiconductor pressure sensor products. Furthermore, this report suggests that the future of blood pressure measurement might tend towards implantable pressure sensors, with a non-significantly different technological basis. To conclude, this report unveils certain business opportunities for Infineon’s semiconductor magnetic and pressure sensor products; and puts special focus on the development of derivative products to pioneer the commercialization of innovative medical applications, with a forecasted huge revenue potential

Health and nutrition examination survey

The equipment, procedures, and data reduction methods employed in the National Health and Nutrition Examination Survey for the collection and analysis of spirometric data are described. Data variability and testing methodology are discussed, as well as the influence of milieu and technician training. The computer programs that drive the data reduction and calibration are detailed, as are the algorithms used in the calculation of various spirometric parameters. The algorithms chosen for the determination of certain critical parameters are documented and validated.Authors: David P. Discher and others."October 1980."DHHS publication ; no. (PHS) 80-1360

Welding, brazing, and thermal cutting.

"This document examines the occupational health risks associated with welding, brazing, and thermal cutting, and it provides criteria for eliminating or minimizing the risks encountered by workers in these occupations. The main health concerns are increased risks of lung cancer and acute or chronic respiratory disease. The data in this document indicate that welders have a 40% increase in relative risk of developing lung cancer as a result of their work experience. The basis for this excess risk is difficult to determine because of uncertainties about smoking habits, possible interactions among the various components of welding emissions, and possible exposures to other occupational carcinogens. However, the risk of lung cancer for workers who weld on stainless steel appears to be associated with exposure to fumes that contain nickel and chromium. The severity and prevalence of noncarcinogenic respiratory conditions are not well characterized among welders, but they have been observed in both smoking and nonsmoking workers in occupations associated with welding. Excesses in morbidity and mortality among welders exist even when reported exposures are below current Occupational Safety and Health Administration (OSHA) permissible exposure limits (PELs) for the many individual components of welding emissions. An exposure limit for total welding emissions cannot be established because the composition of welding fumes and gases varies for different welding processes and because the various components of a welding emission may interact to produce adverse health effects. Some of these include alkali metals, alkaline earths, aluminum, beryllium, cadmium, chromium, fluorides, iron, lead, manganese, nickel, silica, titanium, zinc, carbon monoxide, nitrogen oxides, and ozone. NIOSH therefore recommends that exposures to all welding emissions be reduced to the lowest feasible concentrations using state-of-the-art engineering controls and work practices. Exposure limits for individual chemical or physical agents are to be considered upper boundaries of exposure." - NIOSHTIC-2CurrentPrevention and ControlEnvironmental Healt