Pulse Transit Time as a Tool in the Diagnosis of Paediatric Sleep Related Breathing Disorders

Sleep related breathing disorders in childhood are increasingly recognised as contributors to morbidity as well as suboptimal physical, mental and social development. The associated cost in social and economic terms is clearly significant. Detection and diagnosis of such disorders can be costly and technically difficult. Multi-parameter monitoring like polysomnography is expensive and inappropriate for mass screening or investigations remote from tertiary centres. A simple and non-invasive cardiovascular approach termed pulse transit time (PTT) is useful in determining the status of upper airways during sleep. This approach employs the measurement of the time delay in the arterial pulse pressure wave from the aortic valve of the heart to a peripheral site. PTT has shown promise to provide quantify inspiratory effort in adults with sleep disordered breathing (SDB) and can then be an effective monitoring tool in children. Initial investigations explore the parameters that can confound the PTT measurements of a child. This work provides an estimate of the expected PTT ranges from infancy to childhood. Thereafter, overnight PTT recordings were performed in conjunction with PSG studies to corroborate evidence for its capability in paediatric respiratory studies. The results show that PTT has the ability to identify abnormal respiratory events during sleep. Furthermore, the use of PTT can differentiate the nature of respiratory events as obstructive or central. Technological considerations to improve the robustness of PTT measure to be used not only in cardiorespiratory but also cardiovascular studies on children were also illustrated. Preliminary findings obtained here suggest that the properties of PTT show promise as a predictor for obstructive sleep apnoea. There is a need to bridge the gap of providing quality SDB diagnosis and yet accommodating requirements for a robust screening measure. PTT has demonstrated its suitability and utility as a measure to play a role in the investigation and monitoring of treatment in this area

Respiration rhythmic and quality of sleep to the total wellness and development of a child

There is an increasing interest to improve the wellbeing of life especially amongst the middle to upper social class in the well-developed nations. Particularly, the study on quality sleep each night has refueled much attention to the overall wellness of these individuals. Studies have shown that disturbances during sleep not only can lead to mild irritations but also adverse events and life satisfaction as a whole. At the heart of the issue, the rhythmical functions of the body can be distorted when the occurrences of sleep disturbances become frequent. Sleep is now no longer viewed simply as a state of rest but it has specific and affirmative effects. Essentially, the brain is the prime beneficiary of sleep in order to maintain its cerebral capacities. Hormonal changes under the control of the sympathetic nervous system can increase blood flow to the muscles. This promotes the breakdown of stored nutrients into glucose in muscle tissue, thus providing energy available for the body to use. Monitoring the quality of sleep has stretched beyond just for individuals with susceptible sleep disorders but for many who want to maximize their daily lives. Compound with the fact that in many well-developed countries, birth rate has been low; caregivers are becoming more concerned in bestowing prime care for the long-term development and wellness of their children. However, limited research has been initiated to assess the quality of sleep in children until the recent decades. This can be due to the misconception or poor understanding of caregivers in pediatric sleep disorders. With much recent public knowledge in this domain, there is a paradigm shift in the mindset of caregivers. Thus, the once much-neglected yet specialized field of study has evolved since, from complex studies only conducted in fully equipped sleep laboratories to possibly simplified, miniature and portable ambulatory based studies. In this chapter, the comprehensive coverage of this topic will be presented together with a general perspective from a child, caregiver and healthcare provider

Ethics and biomedical engineering practice and research: origins of principles and consent

Modern biomedical engineering practice relies heavily on the evidence base developed from trials, evaluations and audit studies of biomedical diagnostics and therapies. It is rare for a modern-day professional not to be exposed to such research and most accept the conduct of such an activity core to the profession. The basis of how we conduct studies both with and without human subject involvement is a well-developed and developing area. Principally, how we structure and conduct any study in this field is subject to ethical review. The subject of ethics arises from the philosophical basis of how we treat each other or, more generally, how we determine right from wrong behaviour

Ethics for biomedical engineers

Over the last few decades, there are increasing public awareness of adverse events involving engineering failures that not only led to monetary losses but also more importantly, human injuries and deaths. Whilst it is vital for an engineering professional or student to acquire the necessary technical knowledge and skills in their respective field, they must also understand the ethical essences that are relevant to their profession. Engineering professionals like biomedical engineers, need to appreciate the fundamentals of best practices and recognise how any derivation from such practices can have undesirable impacts on human lives. Through this book, it is hoped that readers would draw the relevance between the study of ethics and biomedical engineering. The book would be a useful source and reference for college-level and university-level students. Moreover, the contents are written so as to also provide valuable insights even for existing biomedical engineers and those enrolled in continual engineering education programs.</p

A Retrospective Analysis of the Trend of Retracted Publications in the Field of Biomedical and Life Sciences

Among the many forms of research misconduct, publishing fraudulent data is considered to be serious where the confidence and validity of the research is detrimentally undermined. In this study, the trend of 303 retracted publications from 44 authors (with more than three retracted publications each) was analysed. The results showed that only 6.60% of the retracted publications were single-authored and the discovery of fraudulent publications had reduced from 52.24 months (those published before the year 2000) to 33.23 months (those published on the year 2000 and onwards). It appears that with the widely accessible public databases like PubMed, fraudulent publications can be detected more easily. The different approaches adopted by authors who had previous publications retracted are also discussed herein

An Analysis on the Research Ethics Cases Managed by the Committee on Publication Ethics (COPE) Between 1997 and 2010

The growing emphasis on the importance of publishing scientific findings in the academic world has led to increasing prevalence of potentially significant publications in which scientific and ethical rigour may be questioned. This has not only hindered research progress, but also eroded public trust in all scientific advances. In view of the increasing concern and the complexity of research misconduct, the Committee on Publication Ethics (COPE) was established in 1997 to manage cases with ethical implications. In order to review the outcomes of cases investigated by COPE, a total of 408 cases that had been managed by COPE were successfully extracted and analysed with respect to 7 distinct criteria. The results obtained indicate that the number of ethical implications per case has not changed significantly (p > 0.01) since the year COPE was instigated. Interestingly, the number of ethical cases, and to some extent, research misconduct, is not diminishing. Therefore, journal editors and publishers need to work closely together with COPE to inculcate adoption of appropriate research ethics and values in younger researchers while discouraging others from lowering standards. It is hoped that with a more concerted effort from the academic community and better public awareness, there will be fewer incidences of ethically and scientifically challenged publications. The ultimate aim being to enhance the quality of published works with concomittant public trust in the results