330 research outputs found
Hering-Breuer reflex, lung volume and position in prematurely born infants
No full textOBJECTIVES: To investigate the effect of position on the strength of the Hering-Breuer reflex in prematurely born infants and determine whether any differences seen were related to differences in lung or tidal volume between positions. WORKING HYPOTHESIS: Position related differences in the strength of the Hering-Breuer reflex relate to differences in lung or tidal volume. STUDY DESIGN: Prospective observational study. PATIENT/SUBJECT SELECTION: Eighteen infants, median gestational age 30 (range 25-32) weeks were studied. METHODOLOGY: Infants were examined in the supine and prone position, each position was maintained for 2 hr. At the end of each 2-hr period, the strength of the Hering-Breuer reflex was assessed by determining the prolongation of expiration following an end inspiratory occlusion. In addition, tidal volume and functional residual capacity (FRC) were assessed in each position. RESULTS: The strength of the Hering-Breuer reflex was greater (P = 0.01) and the mean FRC was higher (P < 0.0001) in the prone compared to the supine position. The position related differences in the strength of the reflex correlated significantly with position related differences in FRC (P = 0.05). CONCLUSIONS: The Hering-Breuer reflex is stronger in the prone compared to the supine position. Our results suggest this is explained by position related differences in lung volume
End-tidal carbon monoxide levels in prematurely born infants developing bronchopulmonary dysplasia
No full textBronchopulmonary dysplasia (BPD) is associated with an early inflammatory response that persists after the first week of life. Inflammatory mediators can induce hemoxygenase-1 with a consequent increase in carbon monoxide (CO) production. End-tidal CO (ETCO) levels would be elevated in infants developing BPD. Serial measurements of ETCO levels were attempted on d 3, 5, 7, 14, 21, and 28 in 50 prematurely born infants (median gestational age 29 wk). Fourteen infants developed BPD [oxygen dependent beyond 36 wk post-menstrual age (PMA)] and had higher ETCO levels compared with the rest of the cohort on d 7, 14, 21, and 28. On d 14, the mean (SD) ETCO levels of the BPD group were 3.19 (1.11) ppm and 1.43 (0.61) ppm in the non-BPD group (p 2.15 ppm had a sensitivity of 80% and specificity of 92% in predicting oxygen dependency at 36 wk PMA. Measurement of ETCO levels in prematurely born infants may be useful in the prediction of BP
MAYER: Designing a modular upgradeable subscription speaker for Gerrard Street
No full textGerrard Street is a company that designs and produces a modular set of headphones called BIRD. The BIRD is not for sell, but is part of a subscription to consumers. If something breaks the user can request a new part for repair as part of the service. In the near future Gerrard Street is going to launch a new Bluetooth, Wired and Noise Cancelling variant of the headphone, but what can they do after?This project is about MAYER a Bluetooth speaker designed using the Gerrard Street philosophy and attending to the needs of consumers. This project uses the agile bussiness canvas a main methodology.Integrated Product Desig
Effect of prone and supine position on sleep, apneas, and arousal in preterm infants
No full textOBJECTIVE. Prematurely born compared with term born infants are at increased risk of sudden infant death syndrome, particularly if slept prone. The purpose of this work was to test the hypothesis that preterm infants with or without bronchopulmonary dysplasia being prepared for neonatal unit discharge would sleep longer and have less arousals and more central apneas in the prone position.METHODS. This was a prospective observational study in a tertiary NICU. Twenty-four infants (14 with bronchopulmonary dysplasia) with a median gestational age of 27 weeks were studied at a median postconceptional age of 37 weeks. Video polysomnographic recordings of 2-channel electroencephalogram, 2-channel electro-oculogram, nasal airflow, chest and abdominal wall movements, limb movements, electrocardiogram, and oxygen saturation were made in the supine and prone positions, each position maintained for 3 hours. The duration of sleep, sleep efficiency (total sleep time/total recording time), and number and type of apneas, arousals, and awakenings were recorded.RESULTS. Overall, in the prone position, infants slept longer, had greater sleep efficiency (89.5% vs 72.5%), and had more central apneas (median: 5.6 vs 2.2), but fewer obstructive apneas (0.5 vs 0.9). The infants had more awakenings (9.7 vs 3.5) and arousals per hour (13.6 vs 9.0) when supine. There were similar findings in the bronchopulmonary dysplasia infants.CONCLUSIONS. Very prematurely born infants studied before neonatal unit discharge sleep more efficiently with fewer arousals and more central apneas in the prone position, emphasizing the importance of recommending supine sleeping after neonatal unit discharge for prematurely born infants
Very prematurely born infants wheezing at follow-up: lung function and risk factors
No full textOBJECTIVES: To determine whether abnormalities of lung volume and/or airway function were associated with wheeze at follow-up in infants born very prematurely and to identify risk factors for wheeze. DESIGN: Lung function data obtained at 1 year of age were collated from two cohorts of infants recruited into the UKOS and an RSV study, respectively. SETTING: Infant pulmonary function laboratory. PATIENTS: 111 infants (mean gestational age 26.3 (SD 1.6) weeks). INTERVENTIONS: Lung function measurements at 1 year of age corrected for gestational age at birth. Diary cards and respiratory questionnaires were completed to document wheeze. MAIN OUTCOME MEASURES: Functional residual capacity (FRC(pleth) and FRC(He)), airways resistance (R(aw)), FRC(He):FRC(pleth) and tidal breathing parameters (T(PTEF):T(E)). RESULTS: The 60 infants who wheezed at follow-up had significantly lower mean FRC(He), FRC(He):FRC(pleth) and T(PTEF):T(E), but higher mean R(aw) than the 51 without wheeze. Regression analysis demonstrated that gestational age, length at assessment, family history of atopy and a low FRC(He):FRC(pleth) were significantly associated with wheeze. CONCLUSIONS: Wheeze at follow-up in very prematurely born infants is associated with gas trapping, suggesting abnormalities of the small airway
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Effect of the Paris Climate Agreement on U.S. Businesses
No full textIn December, 195 countries convened in Paris for the 21st Conference of the Parties to the United Nations Framework Convention on Climate Change. To the surprise and delight of most of the participants, the conference ended in consensus among all the participants on a document, the Paris Agreement, that will be opened for signature on April 22, 2016. President Barack Obama has indicated that the United States will sign it. (Co-author Michael Gerrard participated in the conference.
Effect of the Paris Climate Agreement on U.S. Businesses
No full textIn December, 195 countries convened in Paris for the 21st Conference of the Parties to the United Nations Framework Convention on Climate Change. To the surprise and delight of most of the participants, the conference ended in consensus among all the participants on a document, the Paris Agreement, that will be opened for signature on April 22, 2016. President Barack Obama has indicated that the United States will sign it. (Co-author Michael Gerrard participated in the conference.
Gerrard Winstanley y los diggers: análisis de su aparición en la Revolución Inglesa
No full textEl presente trabajo trata sobre Gerrard Winstanley y el movimiento radical llamado diggers, quienes llevaron a cabo un proyecto de colectivización agraria basados en la idea milenarista de Winstanley durante la Revolución Inglesa. De este modo, por un lado, se analizarán los aspectos sociales, económicos y religiosos que precedieron a su aparición; por otro lado, se estudiarán la vida y obra de Winstanley poniendo sus ideas en contexto con otros movimientos radicales importantes de su época. El objetivo es tratar de mostrar la particularidad del mensaje de Winstanley y de dar visibilidad a un autor poco conocido, pero con una gran profundidad en su obra.This paper deals with Gerrard Winstanley and the radical movement called diggers, who carried out an agrarian collectivization project based on Winstanley's millenarian idea during the English Revolution. In this way, on the one hand, the social, economic and religious aspects that preceded its appearance will be analyzed; on the other hand, the life and work of Winstanley will be studied, putting his ideas in context with other important radical movements of his time. The objective is to try to show the particularity of Winstanley's message and to give visibility to a little-known author but with great depth in his work.<br /
Assessing cardiopulmonary function: a model-based approach to interpreting gas exchange data
No full textNormal cardiopulmonary function is vital to life. The techniques currently used in the assessment of respiratory health and cardiac function have significant limitations. Conventional lung function measures are insensitive to early disease, whilst measures of cardiac function have limited applications due to being highly invasive or expensive to carry out. This thesis outlines the further development and clinical application of an emerging assessment of cardiac and respiratory function, Computed Cardiopulmonography (CCP).
CCP employs two novel technologies; the Molecular Flow Sensor (MFS), capable of measuring respiratory gas profiles with high precision, and a computational model of the cardiopulmonary
system. By optimising the model to accurately simulate the experimental data measured by the MFS, CCP develops a participant-specific model of an individual’s cardiopulmonary system. The
clinical potential of the parameters that define this model, specifically those pertaining to lung inhomogeneity, has previously been demonstrated and is expanded in this work.
Significant development of the cardiopulmonary model has been undertaken, with the improvements to model performance demonstrated in this thesis. Following this, CCP has been deployed in four different patient cohorts; it has been used to quantify gas exchange inefficiency in post-COVID patients, assess the lung inhomogeneity present in adult and paediatric patients with cystic fibrosis via simulation of another clinical test, and finally it has been used for the first time to assess cardiac function in patients with pulmonary hypertension
Poems, [electronic resource] : By John Gerrard, curate of Withycombe in the Moor, Devon.
No full textWith a half-title.Electronic reproduction.English Short Title Catalog,Reproduction of original from British Library
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