59 research outputs found
The Impact of Endonasal Endoscopic Sinus Surgery on Patients with Chronic Pulmonary Diseases
Introduction: The impact of endoscopic sinus surgery on bronchial asthma has been studied by several groups. According to the latest studies, patients with chronic obstructive pulmonary disease (COPD) seem to have frequent symptoms of chronic rhinosinusitis. Our study compares the impact of endoscopic sinus surgery on both the upper and lower airways of patients with bronchial asthma as well as those with COPD. Methods: This study includes 43 patients (bronchial asthma, n = 32, COPD, n = 11) undergoing surgical treatment for chronic rhinosinusitis at the ENT-Department, University of Homburg (Homburg, Germany). To assess the effect of sinus surgery, the Sino-Nasal Outcome Test 20 German Adapted Version (SNOT-20 GAV) and St. Georgeâs Respiratory Questionnaire (SGRQ) were used both pre- and postoperatively. Results: Both SNOT-20 (p < 0.001) and SGRQ (p = 0.021) scores improved significantly after sinus surgery. The postoperative improvement in bronchial asthma and COPD was similar in both groups, indicating no difference of the diseases in regards to postoperative symptom improvement. There was no difference indicated in SNOT-20 GAV or SGRQ when grouping patients by polyps, aspirin (ASS) intolerance, allergies, eosinophilia or previous surgery. Conclusions: The treatment of chronic rhinosinusitis by sinus surgery may help to improve the therapy outcome of patients with bronchial asthma as well as patients with COPD
Analysis and evaluation of environmental tobacco smoke exposure as a risk factor for chronic cough
Exposure to environmental tobacco smoke (ETS) and active tobacco smoking has been shown to increase symptoms of bronchial asthma such as bronchoconstriction but effects on other respiratory symptoms remain poorly assessed. Current levels of exposure to tobacco smoke may also be responsible for the development of chronic cough in both children and adults. The present study analyses the effects of tobacco smoke exposure as potential causes of chronic cough. A panel of PubMed-based searches was performed relating the symptom of cough to various forms of tobacco smoke exposure. It was found that especially prenatal and postnatal exposures to ETS have an important influence on children's respiratory health including the symptom of cough. These effects may be prevented if children and pregnant women are protected from exposure to ETS. Whereas the total number of studies adressing the relationship between cough and ETS exposure is relatively small, the present study demonstrated that there is a critical amout of data pointing to a causative role of environmental ETS exposure for the respiratory symptom of cough. Since research efforts have only targeted this effect to a minor extent, future epidemiological and experimental studies are needed to further unravel the relation between ETS and cough
Allergic airway inflammation induces upregulation of the expression of IL-23R by macrophages and not in CD3â+âT cells and CD11c+F4/80- dendritic cells of the lung
Interleukin 23 and the interleukin 23 receptor (IL-23-IL23R) are described as the major enhancing factors for Interleukin
17 (IL-17) in allergic airway infammation. IL-17 is considered to induce neutrophilic infammation in the lung, which is
often observed in severe, steroid-resistant asthma-phenotypes. For that reason, understanding of IL-23 and IL-17 axis is
very important for future therapy strategies, targeting neutrophil pathway of bronchial asthma.
This study aimed to investigate the distribution and expression of IL-23R under physiological and infammatory conditions.
Therefore, a house dust mite (HDM) model of allergic airway infammation was performed by treating mice with HDM
intranasally. Immunofuorescence staining with panel of antibodies was performed in lung tissues to examine the macrophage,
dendritic cell, and T cell subpopulations. The allergic airway infammation was quantifed by histopathological analysis,
ELISA measurements, and airway function.
HDM-treated mice exhibited a signifcant allergic airway infammation including higher amounts of NE+ cells in lung
parenchyma. We found only a small amount of IL-23R positives, out of total CD3+T cells, and no upregulation in HDMtreated animals. In contrast, the populations of F4/80+ macrophages and CD11c+F4/80â dendritic cells (DCs) with IL-23R
expression were found to be higher. But HDM treatment leads to a signifcant increase of IL-23R+ macrophages, only. IL23R was expressed by every examined macrophage subpopulation, whereas only MÏ1 and hybrids between MÏ1 and MÏ2
phenotype and not MÏ2 were found to upregulate IL-23R. Co-localization of IL-23R and IL-17 was only observed in F4/80+
macrophages, suggesting F4/80+ macrophages express IL-23R along with IL-17 in lung tissue.
The study revealed that macrophages involving the IL-23 and IL-17 pathway may provide a potential interesting therapeutic
target in neutrophilic bronchial asthma
Label driven Knowledge Distillation for Federated Learning with non-IID Data
In real-world applications, Federated Learning (FL) meets two challenges: (1)
scalability, especially when applied to massive IoT networks; and (2) how to be
robust against an environment with heterogeneous data. Realizing the first
problem, we aim to design a novel FL framework named Full-stack FL (F2L). More
specifically, F2L utilizes a hierarchical network architecture, making
extending the FL network accessible without reconstructing the whole network
system. Moreover, leveraging the advantages of hierarchical network design, we
propose a new label-driven knowledge distillation (LKD) technique at the global
server to address the second problem. As opposed to current knowledge
distillation techniques, LKD is capable of training a student model, which
consists of good knowledge from all teachers' models. Therefore, our proposed
algorithm can effectively extract the knowledge of the regions' data
distribution (i.e., the regional aggregated models) to reduce the divergence
between clients' models when operating under the FL system with non-independent
identically distributed data. Extensive experiment results reveal that: (i) our
F2L method can significantly improve the overall FL efficiency in all global
distillations, and (ii) F2L rapidly achieves convergence as global distillation
stages occur instead of increasing on each communication cycle.Comment: 28 pages, 5 figures, 10 table
A Survey on Intelligent Internet of Things: Applications, Security, Privacy, and Future Directions
peer reviewedThe rapid advances in the Internet of Things (IoT) have promoted a revolution
in communication technology and offered various customer services. Artificial
intelligence (AI) techniques have been exploited to facilitate IoT operations
and maximize their potential in modern application scenarios. In particular,
the convergence of IoT and AI has led to a new networking paradigm called
Intelligent IoT (IIoT), which has the potential to significantly transform
businesses and industrial domains. This paper presents a comprehensive survey
of IIoT by investigating its significant applications in mobile networks, as
well as its associated security and privacy issues. Specifically, we explore
and discuss the roles of IIoT in a wide range of key application domains, from
smart healthcare and smart cities to smart transportation and smart industries.
Through such extensive discussions, we investigate important security issues in
IIoT networks, where network attacks, confidentiality, integrity, and intrusion
are analyzed, along with a discussion of potential countermeasures. Privacy
issues in IIoT networks were also surveyed and discussed, including data,
location, and model privacy leakage. Finally, we outline several key challenges
and highlight potential research directions in this important area
A mock circulation loop to test extracorporeal CO2 elimination setups
Background: Extracorporeal carbon dioxide removal (ECCO2R) is a promising yet
limited researched therapy for hypercapnic respiratory failure in acute respiratory
distress syndrome and exacerbated chronic obstructive pulmonary disease. Herein,
we describe a new mock circuit that enables experimental ECCO2R research without
animal models. In a second step, we use this model to investigate three experimental
scenarios of ECCO2R: (I) the influence of hemoglobin concentration on CO2 removal. (II)
a potentially portable ECCO2R that uses air instead of oxygen, (III) a low-flow ECCO2R
that achieves effective CO2 clearance by recirculation and acidification of the limited
blood volume of a small dual lumen cannula (such as a dialysis catheter).
Results: With the presented ECCO2R mock, CO2 removal rates comparable to previous
studies were obtained. The mock works with either fresh porcine blood or diluted
expired human packed red blood cells. However, fresh porcine blood was preferred
because of better handling and availability. In the second step of this work, hemoglobin
concentration was identified as an important factor for CO2 removal. In the second
scenario, an air-driven ECCO2R setup showed only a slightly lower CO2 wash-out than the
same setup with pure oxygen as sweep gas. In the last scenario, the low-flow ECCO2R,
the blood flow at the test membrane lung was successfully raised with a recirculation
channel without the need to increase cannula flow. Low recirculation ratios resulted in
increased efficiency, while high recirculation ratios caused slightly reduced CO2 removal
rates. Acidification of the CO2 depleted blood in the recirculation channel caused an
increase in CO2 removal rate.
Conclusions: We demonstrate a simple and cost effective, yet powerful, âin-vitroâ
ECCO2R model that can be used as an alternative to animal experiments for many
research scenarios. Moreover, in our approach parameters such as hemoglobin level can
be modified more easily than in animal models
A Novel Mock Circuit to Test Full-Flow Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation (ECMO) has become an important therapeutic
approach in the COVID-19 pandemic. The development and research in this field strongly relies on
animal models; however, efforts are being made to find alternatives. In this work, we present a new
mock circuit for ECMO that allows measurements of the oxygen transfer rate of a membrane lung at
full ECMO blood flow. The mock utilizes a large reservoir of heparinized porcine blood to measure the
oxygen transfer rate of the membrane lung in a single passage. The oxygen transfer rate is calculated
from blood flow, hemoglobin value, venous saturation, and post-membrane arterial oxygen pressure.
Before the next measuring sequence, the blood is regenerated to a venous condition with a sweep
gas of nitrogen and carbon dioxide. The presented mock was applied to investigate the effect of a
recirculation loop on the oxygen transfer rate of an ECMO setup. The recirculation loop caused a
significant increase in post-membrane arterial oxygen pressure (paO2
). The effect was strongest for
the highest recirculation flow. This was attributed to a smaller boundary layer on gas fibers due to
the increased blood velocity. However, the increase in paO2 did not translate to significant increases
in the oxygen transfer rate because of the minor significance of physically dissolved oxygen for gas
transfer. In conclusion, our results regarding a new ECMO mock setup demonstrate that recirculation
loops can improve ECMO performance, but not enough to be clinically relevant
- âŠ