Pendelluft in Chronic Obstructive Lung Disease Measured with Lung Sounds

Objective. The phenomenon of pendelluft was described over five decades ago. In patients with regional variations in resistance and elastance, gas moves at the beginning of inspiration out of some alveoli into others. Gas moves in the opposite direction at the end of inspiration. The objective of this study was to apply the method of lung sounds mapping, which is known to provide regional information about gas flow, to study pendelluft in COPD patients. Methods. A 16-channel lung sound analyzer was used to collect sounds from patients with COPD (n = 90) and age-matched normals (n = 90). Pendelluft at the beginning of inspiration is expected to result in vesicular sounds leading the tracheal sound by a few milliseconds. Pendelluft at the end of inspiration is expected to result in vesicular sounds lagging the tracheal sound. These lead and lag times were calculated for the 14 chest wall sites. Results. The lead time was significantly longer in COPD patients: 123 ± 107 ms versus 48 ± 59 ms in controls (P < 0.0001). The lag time was also significantly longer in COPD patients: 269 ± 249 ms in COPD patients versus 147 ± 124 ms in controls (P < 0.0001). When normalized by the duration of the inspiration at the trachea, the lead was 14 ± 13% for COPD versus 4 ± 5% for controls (P < 0.0001). The lag was 28 ± 25% for COPD versus 13 ± 12% for controls (P < 0.0001). Both lead and lag correlated moderately with the GOLD stage (correlation coefficient 0.43). Conclusion. Increased lead and lag times in COPD patients are consistent with the phenomenon of pendelluft as has been observed by other methods

Crackle Pitch Rises Progressively during Inspiration in Pneumonia, CHF, and IPF Patients

Objective. It is generally accepted that crackles are due to sudden opening of airways and that larger airways produce crackles of lower pitch than smaller airways do. As larger airways are likely to open earlier in inspiration than smaller airways and the reverse is likely to be true in expiration, we studied crackle pitch as a function of crackle timing in inspiration and expiration. Our goal was to see if the measurement of crackle pitch was consistent with this theory. Methods. Patients with a significant number of crackles were examined using a multichannel lung sound analyzer. These patients included 34 with pneumonia, 38 with heart failure, and 28 with interstitial fibrosis. Results. Crackle pitch progressively increased during inspirations in 79% of all patients. In these patients crackle pitch increased by approximately 40 Hz from the early to midinspiration and by another 40 Hz from mid to late-inspiration. In 10% of patients, crackle pitch did not change and in 11% of patients crackle pitch decreased. During expiration crackle pitch progressively decreased in 72% of patients and did not change in 28% of patients. Conclusion. In the majority of patients, we observed progressive crackle pitch increase during inspiration and decrease during expiration. Increased crackle pitch at larger lung volumes is likely a result of recruitment of smaller diameter airways. An alternate explanation is that crackle pitch may be influenced by airway tension that increases at greater lung volume. In any case improved understanding of the mechanism of production of these common lung sounds may help improve our understanding of pathophysiology of these disorders

Dietary Factors Impact Developmental Trajectories in Young Autistic Children

Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Purpose The purpose of this research was to investigate the impact of dietary factors on developmental trajectories in young autistic children. Methods A gluten-free and casein-free diets, as well as six types of food (meat and eggs, vegetables, uncooked vegetables, sweets, bread, and “white soft bread that never molds”) were investigated observationally for up to three years in 5,553 children 2 to 5 years of age via parent-report measures completed within a mobile application. Children had a parent-reported diagnosis of Autism Spectrum Disorder (ASD); 78% were males; the majority of participants resided in the USA. Outcome was monitored on five orthogonal subscales: Language Comprehension, Expressive Language, Sociability, Sensory Awareness, and Health, assessed by the Autism Treatment Evaluation Checklist (ATEC) (Rimland & Edelson, 1999) and Mental Synthesis Evaluation Checklist (MSEC) (Arnold & Vyshedskiy, 2022; Braverman et al., 2018). Results Consumption of fast-acting carbohydrates – sweets, bread, and “white soft bread that never molds” – was associated with a significant and a consistent Health subscale score decline. On the contrary, a gluten-free diet, as well as consumption of meat, eggs, and vegetables were associated with a significant and consistent improvement in the Language Comprehension score. Consumption of meat and eggs was also associated with a significant and consistent improvement in the Sensory Awareness score. Conclusion The results of this study demonstrate a strong correlation between a diet and developmental trajectories and suggest possible dietary interventions for young autistic children.info:eu-repo/semantics/publishedVersio

Neuroscience of imagination and implications for human evolution

Vivid dreaming often conjures-up imaginary novel images during the sleep. Humans can also imagine novel mental images consciously and purposefully in the process of Prefrontal Synthesis (PFS). Despite both processes commonly referred to as ‘constructive imagination,’ their mechanisms of mental image creation are very different. PFS is completely dependent on the lateral prefrontal cortex (LPFC) and patients with damage to the LPFC often lose their PFS ability. Conversely, dreaming is not controlled by the LPFC: the LPFC is inactive during the sleep and patients whose LPFC is damaged do not notice any change in their dreams. Other neurobiologically distinct components of imagination discussed in this manuscript include amodal completion, categorically-primed spontaneous imagination, integration of modifiers and mental rotation, and Prefrontal Analysis. Clearer neurobiological definitions of separate imagination mechanisms can lead to better understanding of hominin evolution and better educational strategies in children with neurodevelopmental delays. J. Curr. Neurobiol. 10, 89–109 (2019)

Language evolution to revolution: the leap from rich-vocabulary non-recursive communication system to recursive language 70,000 years ago was associated with acquisition of a novel component of imagination, called Prefrontal Synthesis, enabled by a mutation that slowed down the prefrontal cortex maturation simultaneously in two or more children – the Romulus and Remus hypothesis

There is an overwhelming archeological and genetic evidence that modern speech apparatus was acquired by hominins by 600,000 years ago. On the other hand, artifacts signifying modern imagination, such as (1) composite figurative arts, (2) bone needles with an eye, (3) construction of dwellings, and (4) elaborate burials arose not earlier than 70,000 years ago. It remains unclear (1) why there was a long gap between acquisition of modern speech apparatus and modern imagination, (2) what triggered the acquisition of modern imagination 70,000 years ago, and (3) what role language might have played in this process. Our research into evolutionary origin of modern imagination has been driven by the observation of a temporal limit for the development of a particular component of imagination. Modern children not exposed to recursive language in early childhood never acquire the type of active constructive imagination called Prefrontal Synthesis (PFS). Unlike vocabulary and grammar acquisition, which can be learned throughout one’s lifetime, there is a strong critical period for the development of PFS and individuals not exposed to recursive language in early childhood can never acquire PFS as adults. Their language will always lack understanding of spatial prepositions and recursion that depend on the PFS ability. In a similar manner, early hominins would not have been able to learn recursive language as adults and, therefore, would not be able to teach recursive language to their children. Thus, the existence of a strong critical period for PFS acquisition creates an evolutionary barrier for behavioral modernity. An evolutionary mathematical model suggests that a synergistic confluence of three events (1) a genetic mutation that extended the critical period by slowing down the prefrontal cortex development simultaneously in two or more children, (2) invention of recursive elements of language, such as spatial prepositions, by these children and (3) their dialogic communications using these recursive elements, resulted in concurrent conversion of a non-recursive communication system of their parents to recursive language and acquisition of PFS around 70,000 years ago

Language evolution is not limited to speech acquisition: a large study of language development in children with language deficits highlights the importance of the voluntary imagination component of language

Did the boy bite the cat or was it the other way around? When processing a sentence with several objects, one has to establish ‘who did what to whom’. When a sentence cannot be interpreted by recalling an image from memory, we rely on the special type of voluntary constructive imagination called Prefrontal synthesis (PFS). PFS is defined as the ability to juxtapose mental visuospatial objects at will. We hypothesised that PFS has fundamental importance for language acquisition. To test this hypothesis, we designed a PFS-targeting intervention and administered it to 6,454 children with language deficiencies (age 2 to 12 years). The results from the three-year-long study demonstrated that children who engaged with the PFS intervention showed 2.2-fold improvement in combinatorial language comprehension compared to children with similar initial evaluations. These findings suggest that language can be improved by training the PFS and exposes the importance of the visuospatial component of language. This manuscript reflects on the experimental findings from the point of view of human language evolution. When used as a proxy for evolutionary language acquisition, the study results suggest a dichotomy of language evolution, with its speech component and its visuospatial component developing in parallel. The study highlights the radical idea that evolutionary acquisition of language was driven primarily by improvements of voluntary imagination rather than by improvements in the speech apparatus

Imagination in Autism: A Chance to Improve Early Language Therapy

Children with autism often have difficulties in imaginative play, Theory of Mind, and playing out different scenarios in their minds. Research shows that the root of these problems may be the voluntary imagination network that involves the lateral prefrontal cortex and its long frontoposterior connections to the temporal-parietal-occipital area. Previously disconnected visuospatial issues (stimulus overselectivity and tunnel vision) and language issues (lack of comprehension of spatial prepositions and complex recursive sentences) may be explained by the same voluntary imagination deficit. This review highlights the new insights into the mechanism of voluntary imagination, its difference from involuntary imagination, and its unusually strong critical period. Clearer developmental terminology and a better understanding of voluntary imagination have the potential to facilitate communication between therapists and parents, and improve therapy outcomes in children

Figure 1 from: Vyshedskiy A, Murphy R (2016) Acoustic biomarkers of Chronic Obstructive Lung Disease. Research Ideas and Outcomes 2: e9173. https://doi.org/10.3897/rio.2.e9173

Figure 1 - Poster as it was presented at the conference. Please see text for details

Figure 1. from: Acoustic biomarkers of Chronic Obstructive Lung Disease - Research Ideas and Outcomes 2: e9173 (11 May 2016) https://doi.org/10.3897/rio.2.e9173

Figure 1. - Poster as it was presented at the conference. Please see text for details

Mental synthesis involves the synchronization of independent neuronal ensembles

Mental synthesis involves the synchronization of independent neuronal ensemble