Automatic electrical stimulation of abdominal wall muscles increases tidal volume and cough peak flow in tetraplegia

<p>Paralysis of the respiratory muscles in people with tetraplegia affects their ability to breathe and contributes to respiratory complications. Surface functional electrical stimulation (FES) of abdominal wall muscles can be used to increase tidal volume (V_{T}) and improve cough peak flow (CPF) in tetraplegic subjects who are able to breathe spontaneously.</p> <p>This study aims to evaluate the feasibility and effectiveness of a novel abdominal FES system which generates stimulation automatically, synchronised with the subjects' voluntary breathing activity. Four subjects with complete tetraplegia (C4-C6), breathing spontaneously, were recruited.</p> <p>The automatic stimulation system ensured that consistent stimulation was achieved. We compared spirometry during unassisted and FES-assisted quiet breathing and coughing, and measured the effect of stimulation on end-tidal CO_2 (EtCO_2) during quiet breathing.</p> <p>The system dependably recognised spontaneous respiratory effort, stimulating appropriately, and was well tolerated by patients. Significant increases in V_T during quiet breathing (range 0.05–0.23 L) and in CPF (range 0.04–0.49 L/s) were observed. Respiratory rate during quiet breathing decreased in all subjects when stimulated, whereas minute ventilation increased by 1.05–2.07 L/min. The changes in EtCO_2 were inconclusive.</p> <p>The automatic stimulation system augmented spontaneous breathing and coughing in tetraplegic patients and may provide a potential means of respiratory support for tetraplegic patients with reduced respiratory capacity.</p&gt

Validity of telemetric-derived measures of heart rate variability: a systematic review

Heart rate variability (HRV) is a widely accepted indirect measure of autonomic function with widespread application across many settings. Although traditionally measured from the 'gold standard' criterion electrocardiography (ECG), the development of wireless telemetric heart rate monitors (HRMs) extends the scope of the HRV measurement. However, the validity of telemetric-derived data against the criterion ECG data is unclear. Thus, the purpose of this study was twofold: (a) to systematically review the validity of telemetric HRM devices to detect inter-beat intervals and aberrant beats; and (b) to determine the accuracy of HRV parameters computed from HRM-derived inter-beat interval time series data against criterion ECG-derived data in healthy adults aged 19 to 62 yrs. A systematic review of research evidence was conducted. Four electronic databases were accessed to obtain relevant articles (PubMed, EMBASE, MEDLINE and SPORTDiscus. Articles published in English between 1996 and 2016 were eligible for inclusion. Outcome measures included temporal and power spectral indices (Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996). The review confirmed that modern HRMs (Polar® V800™ and Polar® RS800CX™) accurately detected inter-beat interval time-series data. The HRV parameters computed from the HRM-derived time series data were interchangeable with the ECG-derived data. The accuracy of the automatic in-built manufacturer error detection and the HRV algorithms were not established. Notwithstanding acknowledged limitations (a single reviewer, language bias, and the restricted selection of HRV parameters), we conclude that the modern Polar® HRMs offer a valid useful alternative to the ECG for the acquisition of inter-beat interval time series data, and the HRV parameters computed from Polar® HRM-derived inter-beat interval time series data accurately reflect ECG-derived HRV metrics, when inter-beat interval data are processed and analyzed using identical protocols, validated algorithms and software, particularly under controlled and stable conditions

Design optimisation of air-fed full pressurised suits

This article is a post-print version of the published article which may be accessed at the link below.The JET machine and associated facilities require significant maintenance and enhancement installation activities in support of the experimental exploitation programme. A proportion of these activities are within radiological and respiratory hazardous environments. As such, breathing air-fed one-piece pressurised suits provide workers with protection from the inhalation of both airborne tritium and beryllium dust. The design of these suits has essentially developed empirically. There is a practical necessity to improve the design to optimise worker performance, protection and thermal comfort. This paper details the complexity of modeling the three-dimensional thermofluid domain between the inner surface of the suit and under garments that includes mass as well as heat transfer, suiting geometry, human metabolism and respiration and effects of limb movements. The methods used include computational fluid dynamics (CFD), theoretical adaptations of mixed-phase turbulent flow, profile scanning of a suit and actuating life size mannequin and data processing of the images and experimental validation trials. The achievements of the current programme and collaborations are presented in the paper and future endeavors are discussed.The author gratefully acknowledges the loan of the articulated mannequin from the Defence Science and Technology Laboratories. This work was funded jointly by EPSRC and by the European Communities under the contract of Association between EURATOM and UKAEA. The views and opinions expressed herein do not necessarily reflect those of the European Commission. This work was carried out within the framework of EFDA

Convolutional neural network for breathing phase detection in lung sounds

We applied deep learning to create an algorithm for breathing phase detection in lung sound recordings, and we compared the breathing phases detected by the algorithm and manually annotated by two experienced lung sound researchers. Our algorithm uses a convolutional neural network with spectrograms as the features, removing the need to specify features explicitly. We trained and evaluated the algorithm using three subsets that are larger than previously seen in the literature. We evaluated the performance of the method using two methods. First, discrete count of agreed breathing phases (using 50% overlap between a pair of boxes), shows a mean agreement with lung sound experts of 97% for inspiration and 87% for expiration. Second, the fraction of time of agreement (in seconds) gives higher pseudo-kappa values for inspiration (0.73-0.88) than expiration (0.63-0.84), showing an average sensitivity of 97% and an average specificity of 84%. With both evaluation methods, the agreement between the annotators and the algorithm shows human level performance for the algorithm. The developed algorithm is valid for detecting breathing phases in lung sound recordings

TOBE: Tangible Out-of-Body Experience

We propose a toolkit for creating Tangible Out-of-Body Experiences: exposing the inner states of users using physiological signals such as heart rate or brain activity. Tobe can take the form of a tangible avatar displaying live physiological readings to reflect on ourselves and others. Such a toolkit could be used by researchers and designers to create a multitude of potential tangible applications, including (but not limited to) educational tools about Science Technologies Engineering and Mathematics (STEM) and cognitive science, medical applications or entertainment and social experiences with one or several users or Tobes involved. Through a co-design approach, we investigated how everyday people picture their physiology and we validated the acceptability of Tobe in a scientific museum. We also give a practical example where two users relax together, with insights on how Tobe helped them to synchronize their signals and share a moment

Standard Testing Procedure for Quantifying Breathing Gas Carbon Dioxide Partial Pressure for Extravehicular Activity and Launch, Entry, Survival Pressure Suits

This standard test and analysis protocol establishes the procedure for determining the partial pressure of inspired carbon dioxide (PICO2) exposure level experienced by persons operating a pressurized suit. The purpose of this Standard Testing Procedure (STP) is to describe the test conditions and procedures necessary to acquire data in support of certification that manufacturer submitted Extravehicular Activity (EVA) and/or Launch, Entry, Survival (LES) suit designs maintain safe levels of carbon dioxide (CO2) in the helmet during suited operations. The STP shall be used to measure the in-suit inhaled and exhaled dry-gas partial pressure of CO2 (PCO2), followed by calculation of the water vapor saturated PICO2 during the inhalation portion of the breathing cycle, while a human test subject is performing work at levels anticipated during suited operations in ground and flight environments. The procedure is designed to test the evaluated suit on a human test subject as a dynamic system, generate repeatable results under defined laboratory conditions, and perform consistent analysis on acquired samples.This STP is used to evaluate space suits in a hyperbaric environment (above atmospheric pressure). Changes would need to be made to the test equipment/setup to accommodate a hypobaric environment. There is no specific EVA or LES suit performance requirement to meet or pass/fail criteria associated with this STP

Studies of the effects of gravitational and inertial forces on cardiovascular and respiratory dynamics

The current status and application are described of the biplane video roentgen densitometry, videometry and video digitization systems. These techniques were developed, and continue to be developed for studies of the effects of gravitational and inertial forces on cardiovascular and respiratory dynamics in intact animals and man. Progress is reported in the field of lung dynamics and three-dimensional reconstruction of the dynamic thoracic contents from roentgen video images. It is anticipated that these data will provide added insight into the role of shape and internal spatial relationships (which is altered particularly by acceleration and position of the body) of these organs as an indication of their functional status

Exploratory study to evaluate respiratory rate using a thermal imaging camera

Background: Respiratory rate is a vital physiological measurement used in the immediate assessment of unwell children and adults. Convenient electronic devices exist for measurement of pulse, blood pressure, oxygen saturation and temperature. Although devices which measure respiratory rate exist, none has entered everyday clinical practice for acute assessment of children and adults. An accurate and practical device which has no physical contact with the patient is important to ensure readings are not affected by distress caused by the assessment method. Objective: To evaluate the use of a thermal imaging method to monitor respiratory rate in children and adults. Methods: Facial thermal images of adult volunteers and children undergoing elective polysomnography were included. Respiration was recorded for at least two minutes with the camera positioned one metre from the subject's face. Values obtained using the thermal imaging camera were compared with those obtained from contact methods such as nasal thermistor, respiratory inductance plethysmography, nasal airflow and End Tidal Carbon Dioxide (CO2). Results: A total of 61 subjects, including 41 adults (age range 27 to 46 years) and 20 children (age range 0.5 to 18 years) were enrolled. The correlation between respiratory rate measured using thermal imaging and the contact method was r=0.94. Sequential refinements to the thermal imaging algorithms resulted in the ability to perform real-time measurements and an improvement of the correlation to r=0.995. Conclusion: This exploratory study shows that thermal imaging derived respiratory rates in children and adults correlate closely with the best performing standard method. With further refinements, this method could be implemented in both acute and chronic care in children and adults