1,721,002 research outputs found
Respiration Measurement in a Simulated Setting Incorporating the Internet of Things
Full text linkThe Internet of Things (IoT) in healthcare has gained significant attention in recent years. This study demonstrates an adaptation of IoT in healthcare by illustrating a method of respiration rate measurement from a platform that simulates breathing. Respiration rate is a crucial physiological measure in monitoring critically ill patients. The devised approach, with further development, may be suitable for integration into neonatal intensive care units (NICUs) to measure infants’ respiration rate. A potential advantage of this method is that it monitors respiration using a wireless non-contact method and could add benefits such as preservation of skin integrity. The paper aimed to assess the accuracy of an IoT-integrated ultrasound (US)-based method for measuring respiration rate. Chest movement due to respiration was simulated by a platform with a controllable moving surface. The magnitude and frequency of the movements were accurately controlled by a signal generator. The surface movements were tracked using US as a reliable and cost-effective technology. ESP8266 NodeMCU was used to wirelessly record the US signal and ThingSpeak and Matlab© were used to analyze and visualize the data in the cloud. A close relationship between the measured rate of the simulated respiration and the actual frequency was observed. The study demonstrated a possible adaption of IoT for respiration rate measurement, however further work will be needed to ensure security and reliability of data handling before use of the system in medical environments
Home oximetry to screen for obstructive sleep apnoea in Down syndrome
No full textObjective Children with Down
syndrome are at high risk of obstructive sleep apnoea (OSA) and screening is
recommended. Diagnosis of OSA should be confirmed with multichannel sleep
studies. We aimed to determine whether home pulse oximetry (HPO) discriminates
children at high risk of OSA, who need further diagnostic multichannel sleep
studies.Design Cross-sectional prospective study
in a training sample recruited through three UK centres. Validation sample used
single-centre retrospective analysis of clinical data.Patients Children with Down
syndrome aged 0.5–6 years.Intervention Diagnostic multichannel
sleep study and HPO.Main outcome measures Sensitivity and
specificity of HPO to predict moderate-to-severe OSA.Results 161/202 children with Down syndrome
met quality criteria for inclusion and 25 had OSA. In this training sample, the
best HPO parameter predictors of OSA were the delta 12 s index >0.555
(sensitivity 92%, specificity 65%) and 3% oxyhaemoglobin (SpO2) desaturation index (3% ODI)>6.15 dips/hour
(sensitivity 92%, specificity 63%). Combining variables (delta 12 s index, 3%
ODI, mean and minimum SpO2) achieved
sensitivity of 96% but reduced specificity to 52%. All predictors retained or
improved sensitivity in a clinical validation sample of 50 children with
variable loss of specificity, best overall was the delta 12 s index, a measure
of baseline SpO2 variability (sensitivity 92%;
specificity 63%).
Conclusions HPO screening could
halve the number of children with Down syndrome needing multichannel sleep
studies and reduce the burden on children, families and health services alike.
This approach offers a practical universal screening approach for OSA in Down
syndrome that is accessible to the non-specialist paediatrician.</p
Development of Doppler ultrasound for measuring the neonatal heart rate at birth.
Full text linkThe heart rate of a newborn baby is a very important measure of its health and is routinely required to be documented at every birth. The imprecise measurement and lack of real-time
documentation of the neonatal heart rate at birth has been recognised for many years but auscultation still remains the recommended method in routine births. The heart rate of the
fetus is measured and documented during pregnancy and labour by Doppler ultrasound but immediately after birth the heart rate is measured by auscultation. Auscultation is well
recognised to be inaccurate and undocumented in real-time.to obtain the beats per minute heart rate. The contrast with determining and documenting the fetal heart rate with the
neonatal heart rate is remarkable. Recently a new ECG device has been developed in an attempt to provide more continuous monitoring and documentation of the neonatal heart rate
has been developed. There has also been investigation of the use of a hand-held foetal Doppler recently to determine the neonatal heart rate immediately after birth. It was found to
be very effective but has not been seriously considered by the International Liaison Committee On Resuscitation. One reason may be the fact that, unlike the ECG, but similar to
a stethoscope, the Doppler is not hands-free, as it requires one member of the resuscitation team to keep the transducer on the neonatal chest. Experience of over 50 years shows that even the slowest and weakest fetal hearts can be detected by Doppler ultrasound.
This research was to develop and test a hands-free version of a hand-held fetal Doppler device and to test this device for accuracy and functionality on adults and neonates. The
initial study was carried out on healthy adult volunteers using a standard hand-held fetal Doppler device. The Doppler heart rate was compared with the ECG heart rate and found to
have good correlation. The Bland Altman Plot of Doppler vs ECG showed all but two measurements were within the 95% confidence intervals.
A problem with documentation and the need for a hands-free transducer was highlighted.
This initial study fuelled the drive to construct a modified Doppler device to be hands-free and document electronically the heart rate results in real time. The problem of precise
documentation of both the Doppler heart rate and the ECG heart rate was explored. A further modification was required and the final device tested in a second adult study. This showed much improved ease of use during the investigation, excellent correlation and that the Doppler usually determined the heart rate consistently before the ECG.
The final part of the study involved using the modified hands free Doppler device on neonates at the Children’s Hospital Sleep Unit and comparing the Doppler heart rate with that of the hospital ECG. This demonstrated that the modified Doppler device was truly hands-free and, in the opinion of the parents, highly acceptable for use on their neonate
Sleep in infants and toddlers with Down syndrome compared to typically developing peers: looking beyond snoring
Full text linkAims: to compare sleep in infants and toddlers with Down syndrome (DS) to typically developing controls, including differences in snoring and sleep ecology (sleep setting and parent behaviors).Methods: parents of 104 children with DS and 489 controls aged 6-36 months completed the Brief Infant Sleep Questionnaire. We explored group differences, controlling for demographic variables.Results: parents of children with DS reported more sleep problems (45% v 19%), snoring (19% vs 2%), room-sharing (37% vs 17%), and less night-time sleep (55 mins) and total sleep over 24 hours (38 mins). They were more likely to be present when their child fell asleep (OR 4.40). Snoring increased night waking but did not limit night-time/24-hour sleep. However, parental presence was associated with 55 minutes less night-time and 64 minutes less 24-hour sleep. After controlling for snoring and parental presence, children with DS slept less at night (38 mins) but more in the day (21 mins) with no significant difference in 24-hour sleep. Conclusions: overall, significant differences in sleep patterns, problems, and ecology were found between children with DS and controls. Parental presence at settling, not snoring, explained most differences, including over an hour’s less 24-hour sleep. Early intervention programmes that promote self-soothing skills could prevent the burden of sleep loss in young children with DS. <br/
Sleep-related rhythmic movement disorder in young children with down syndrome: prevalence and clinical features
No full textSleep-related Rhythmic Movement Disorder (RMD) affects around 1% of UK pre-school children. Little is known about RMD in Down syndrome (DS). We aimed to determine: (a) the prevalence of RMD in children with DS aged 1.5-8 years; (b) phenotypic and sleep quality differences between children with DS and RMD and sex- and age-matched DS controls; and (c) night-to-night variability in rhythmic movements (RMs). Parents who previously reported RMs from a DS research registry of 202 children were contacted. If clinical history suggested RMD, home videosomnography (3 nights) was used to confirm RMs and actigraphy (5 nights) was used to assess sleep quality. Phenotype was explored by demographic, strengths and difficulties, Q-CHAT-10/social communication and life events questionnaires. Eight children had confirmed RMD. Minimal and estimated maximal prevalence were 4.10% and 15.38%, respectively. Sleep efficiency was significantly lower in RMD-cases (69.1%) versus controls (85.2%), but there were no other phenotypic differences. There was considerable intra-individual night-to-night variability in RMs. In conclusion, RMD has a high prevalence in children with DS, varies from night to night and is associated with poor sleep quality but, in this small sample, no daytime phenotypic differences were found compared to controls. Children with DS should be screened for RMD, which is amenable to treatment.</p
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Obstructive sleep apnoea contributes to executive function impairment in young children with Down syndrome
Full text linkObjective/Background: children with Down syndrome (DS) commonly experience difficulties with executive function (EF). They are also vulnerable to obstructive sleep apnoea (OSA). OSA is associated with EF deficits in typically developing children. A recent study reported an association between OSA and cognitive deficits in 38 school-aged children with DS. We experimentally investigated EF behaviours in young children with DS, and their association with OSA. Participants and Methods: children with DS were recruited to take part in a larger study of OSA (N=202). Parents of 80 children (50 male) aged 36 to 71 months (M = 56.90, SD = 10.19 months) completed the Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P). Of these 80 children, 69 were also successfully studied overnight with domiciliary cardiorespiratory polygraphy to diagnose OSA. Results: obstructive apnoea/hypopnoea index was in the normal range (0-1.49/h) for 28 children but indicated OSA (≥1.5/h) in 41 children. Consistent with previous research, we found a large effect for children experiencing particular weaknesses in working memory, planning and organising, whilst emotional control was a relative strength. OSA was associated with poorer working memory (β=.23, R2=.05, p=.025), emotional control (β=.20, R2=.04, p=.047) and shifting (β=.24, R2=.06, p=.023). Conclusions: findings suggest that known EF difficulties in DS are already evident at this young age. Children with DS already have limited cognitive reserve and can ill afford additional EF deficit associated with OSA. OSA is amendable to treatment and should be actively treated in these children to promote optimal cognitive development
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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