Search Results (28)

Congenital Central Hypoventilation Syndrome (CCHS) is a rare disorder that impairs autonomic breathing control, leading to alveolar hypoventilation and sometimes to central apnoea, predominantly during sleep. Patients typically require nocturnal ventilatory support and alarms to prevent life-threatening desaturation events. However, current alarm systems integrated into pulse oximeters do not provide adequate assistance at home. To address these limitations, we developed an assistive device with customizable multisensory stimulation that activates based on the severity and duration of desaturation episodes. In a multicenter clinical trial involving 4 children and 11 young adults with CCHS, we assessed the device’s effectiveness and the role of arousals over three nights: one baseline and two test nights. The results showed that the device significantly improved awakening rates and enabled faster recovery from desaturations in young adults. However, no such improvements were observed in children compared to the baseline. Arousal events and sleep efficiency were unaffected by the device in both groups. These findings suggest that the device can enhance the safety and autonomy of young adults with CCHS but may be more effective in alerting caregivers in pediatric cases than directly waking children. Further studies are needed to refine its application across different age groups, given the limited sample size. Full article

Spontaneous/timed (ST) mode is widely used for long-term noninvasive ventilation (NIV) in adults and children. It combines controlled, assisted, and spontaneous breaths. Cycling refers to the switch from inspiration to exhalation. In ST mode, different cycling mechanisms coexist. In spontaneous breathing, cycling is set by the expiratory trigger sensitivity (TgE) based on the inspiratory flow signal, which results in variable inspiratory times (Ti) and appears to be more physiological. In the case of controlled breathing or unintentional leaks, the cycling is time-dependent according to the set backup Ti or Ti max, respectively. Cycling is an important parameter to set adequately to avoid patient–ventilator asynchronies. This article gathers all the information about cycling in long-term NIV, presenting the cycling settings for different devices, addressing cycling issues, and detailing how to set the cycling criteria. Advanced monitoring with statistics and waveforms is discussed to detect early and delayed cycling. Full article

Background: Respiratory complications in patients with amyotrophic lateral sclerosis (ALS), due to the involvement of respiratory muscles, are the leading cause of death, and respiratory physiotherapy (RP) focuses on addressing these complications. Objectives: The objective was to evaluate the effectiveness of an RP intervention that combines the four specific techniques (inspiratory muscle training, lung volume recruitment, manually assisted coughing, and diaphragmatic breathing training) in patients with ALS. Methods: A quasi-experimental study was carried out, and a specific RP programme was implemented in 15 patients with ALS (12 sessions, 30 min/session, one session/week, duration of three months), based on directed ventilation techniques, lung volume recruitment, manually assisted coughing, and the use of incentive spirometry and a cough assist device, along with a daily home exercise programme. Respiratory functions were assessed (pre- and post-intervention, with follow-up at three months) using Forced Vital Capacity (FVC) and Peak Expiratory Cough Flow (PECF); functionality was assessed using the Revised ALS Functional Rating Scale (ALSFRS-R) and the Modified Barthel Index by Granger. Results: FVC experienced an increase after three months of the intervention initiation (p = 0.30), which was not sustained at the three-month follow-up after the intervention ended. All other variables remained practically constant after treatment, with their values decreasing at follow-up. Conclusion: A specific RP intervention could have beneficial effects on respiratory functions, potentially preventing pulmonary infections and hospitalisations in patients with ALS. It may improve FVC and help stabilize the patient's functional decline. Considering the progressive and degenerative nature of the disease, this finding could support the usefulness of these techniques in maintaining respiratory function. Full article

Haptics for stress regulation is well developed these years. Using vibrotactile to present biofeedback, guiding breathing or heartbeat regulation is a dominant technical approach. However, designing computer-mediated affective touch for stress regulation is also a promising way and has not been fully explored. In this paper, a haptic device was developed to test whether the computer-mediated affective stroking on the forearm could help to assist people in reducing stress. In our method, we used mid-air technology to generate subtle pressure force by blowing air and generating thermal feedback by using Peltier elements simultaneously. Firstly, we found intensity and velocity parameters to present comfort and pleasant stroking sensations. Afterward, an experiment was conducted to find out whether this approach could help people mediate their perceived and physiological stress. A total of 49 participants were randomly assigned to either a Stroking Group (SG) or a Control Group (CG). Results showed that participants from SG felt more relaxed than those from CG. The physiological stress index, RMSSD, increased and LF/HF decreased in SG although these changes were not statistically significant. Our exploration created subtle, non-invasive, noiseless haptic sensations. It could be a promising alternative for assisting people in stress regulation. Design implications and future applicable scenarios were discussed. Full article

The C-MAC video stylet (Karl Storz KG, Tuttlingen, Germany) is proposed as a successor to the familiar retromolar intubation endoscope. With its flexible tip, it may be especially useful for patients with a limited mouth opening. An awake or sedated airway management technique is often preferred when a difficult airway is anticipated. Due to the challenges in preparation, sedation, topical airway anesthesia and the execution of such an airway management technique itself, these techniques are often clinically underused. The C-MAC video stylet seems to be well suited for an awake or sedated airway approach, as its handling is easier and faster than a flexible fiberscope. It does not exert pressure on the tongue as direct laryngoscopy or video laryngoscopy do. We report two cases of a difficult airway in which intubation was performed by using the C-MAC video stylet in sedated, spontaneously breathing patients. After a low dose of 3 mg midazolam IV, remimazolam was administered continuously (0.46–0.92 mg/kg/h). This was supplemented with a low dose of remifentanil (0.04–0.05 µg/kg/min). The Trachospray device (MedSpray Anesthesia BV, Enschede, The Netherlands) was used for topicalization of the upper airway by means of 4 mL of lidocaine 5%. In addition, a further 5 mL of lidocaine 5% was sprayed via an epidural catheter advanced through the oxygenation port of the C-MAC video stylet for further topicalization of the vocal cords and proximal part of the trachea. The well-coordinated steps described in these two cases may represent a blueprint and a good starting point for future studies with a larger number of patients. Full article

This article details the existing wearable assistive devices that could mimic a human’s active range of motion and aid individuals in recovering from stroke. The survey has identified several risk factors associated with musculoskeletal pain, including physical factors such as engaging in high-intensity exercises, experiencing trauma, aging, dizziness, accidents, and damage from the regular wear and tear of daily activities. These physical risk factors impact vital body parts such as the cervical spine, spinal cord, ankle, elbow, and others, leading to dysfunction, a decrease in the range of motion, and diminished coordination ability, and also influencing the ability to perform the activities of daily living (ADL), such as speaking, breathing and other neurological responses. An individual with these musculoskeletal disorders requires therapies to regain and restore the natural movement. These therapies require an experienced physician to treat the patient, which makes the process expensive and unreliable because the physician might not repeat the same procedure accurately due to fatigue. These reasons motivated researchers to develop and control robotics-based wearable assistive devices for various musculoskeletal disorders, with economical and accessible solutions to aid, mimic, and reinstate the natural active range of motion. Recently, advancements in wearable sensor technologies have been explored in healthcare by integrating machine-learning (ML) and artificial intelligence (AI) techniques to analyze the data and predict the required setting for the user. This review provides a comprehensive discussion on the importance of personalized wearable devices in pre- and post-clinical settings and aids in the recovery process. Full article

Breathing is one of the most vital functions for being mentally and emotionally healthy. A growing number of studies confirm that breathing, although unconscious, can be under voluntary control. However, it requires systematic practice to acquire relevant experience and skillfulness to consciously utilize breathing as a tool for self-regulation. After the COVID-19 pandemic, a global discussion has begun about the potential role of emerging technologies in breath-control interventions. Emerging technologies refer to a wide range of advanced technologies that have already entered the race for mental health training. Artificial intelligence, immersive technologies, biofeedback, non-invasive neurofeedback, and other wearable devices provide new, but yet underexplored, opportunities in breathing training. Thus, the current systematic review examines the synergy between emerging technologies and breathing techniques for improving mental and emotional health through the lens of skills development. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology is utilized to respond to the objectives and research questions. The potential benefits, possible risks, ethical concerns, future directions, and implications are also discussed. The results indicated that digitally assisted breathing can improve various aspects of mental health (i.e., attentional control, emotional regulation, mental flexibility, stress management, and self-regulation). A significant finding of this review indicated that the blending of different technologies may maximize training outcomes. Thus, future research should focus on the proper design and evaluation of different digital designs in breathing training to improve health in different populations. This study aspires to provide positive feedback in the discussion about the role of digital technologies in assisting mental and emotional health-promoting interventions among populations with different needs (i.e., employees, students, and people with disabilities). Full article

Background and objectives: Mechanical ventilation is often used in intensive care units to assist patients’ breathing. This often leads to respiratory muscle weakness and diaphragmatic dysfunction, causing weaning difficulties. Inspiratory muscle training (IMT) has been found to be beneficial in increasing inspiratory muscle strength and facilitating weaning. Over the years, different protocols and devices have been used. Materials and Methods: The aim of this systematic review and meta-analysis was to investigate the effectiveness of low-medium (LM-IMT) and high-intensity (H-IMT) threshold inspiratory muscle training in critically ill patients. A systematic literature search was performed for randomized controlled trials (RCTs) in the electronic databases Google Scholar, PubMed, Scopus, and Science Direct. The search involved screening for studies examining the effectiveness of two different intensities of threshold IMT in critically ill patients published the last 10 years. The Physiotherapy Evidence Database (PEDro) scale was chosen as the tool to assess the quality of studies. A meta-analysis was performed where possible. Results: Fourteen studies were included in the systematic review, with five of them having high methodological quality. Conclusions: When examining LM-IMT and H-IMT though, neither was able to reach statistically significant improvement in their maximal inspiratory pressure (MIP), while LM-IMT reached it in terms of weaning duration. Additionally, no statistical difference was noticed in the duration of mechanical ventilation. The application of IMT is recommended to ICU patients in order to prevent diaphragmatic dysfunction and facilitate weaning from mechanical ventilation. Therefore, further research as well as additional RCTs regarding different protocols are needed to enhance its effectiveness. Full article

Air-breathing proton exchange membrane fuel cells (PEMFCs) show enormous potential in small and portable applications because of their brief construction time without the need for gas supply, humidification and cooling devices. In the current work, a 3D multiphase model of single air-breathing PEMFCs is developed by considering the contact resistance between the gas diffusion layer and bipolar plate and the anisotropic thermal conduction and electric conductive in the through-plane and in-plane directions. The 3D model presents good grid independence and agreement with the experimental polarization curve. The single PEMFC with the best open area ratio of 55% achieves the maximum peak power density of 179.3 mW cm⁻². For the fuel cell stack with 10 single fuel cells, the application of the anode window flow field is beneficial to improve the stack peak power density compared to the anode serpentine flow field. The developed model is capable of providing assistance in designing high-performance air-breathing PEMFC stacks. Full article

The Wearable Robotic Limb (WRL) is a type of robotic arm worn on the human body, aiming to enhance the wearer’s operational capabilities. However, proposing additional methods to control and perceive the WRL when human limbs are heavily occupied with primary tasks presents a challenge. Existing interactive methods, such as voice, gaze, and electromyography (EMG), have limitations in control precision and convenience. To address this, we have developed an interactive device that utilizes the mouth and tongue. This device is lightweight and compact, allowing wearers to achieve continuous motion and contact force control of the WRL. By using a tongue controller and mouth gas pressure sensor, wearers can control the WRL while also receiving sensitive contact feedback through changes in mouth pressure. To facilitate bidirectional interaction between the wearer and the WRL, we have devised an algorithm that divides WRL control into motion and force-position hybrid modes. In order to evaluate the performance of the device, we conducted an experiment with ten participants tasked with completing a pin-hole assembly task with the assistance of the WRL system. The results show that the device enables continuous control of the position and contact force of the WRL, with users perceiving feedback through mouth airflow resistance. However, the experiment also revealed some shortcomings of the device, including user fatigue and its impact on breathing. After experimental investigation, it was observed that fatigue levels can decrease with training. Experimental studies have revealed that fatigue levels can decrease with training. Furthermore, the limitations of the device have shown potential for improvement through structural enhancements. Overall, our mouth and tongue interactive device shows promising potential in controlling the WRL during tasks where human limbs are occupied. Full article

Accurate and fast breath monitoring is of great importance for various healthcare applications, for example, medical diagnoses, studying sleep apnea, and early detection of physiological disorders. Devices meant for such applications tend to be uncomfortable for the subject (patient) and pricey. Therefore, there is a need for a cost-effective, lightweight, small-dimensional, and non-invasive device whose presence does not interfere with the observed signals. This paper reports on the fabrication of a highly sensitive human respiratory sensor based on silicon nanowires (SiNWs) fabricated by a top-down method of metal-assisted chemical-etching (MACE). Besides other important factors, reducing the final cost of the sensor is of paramount importance. One of the factors that increases the final price of the sensors is using gold (Au) electrodes. Herein, we investigate the sensor’s response using aluminum (Al) electrodes as a cost-effective alternative, considering the fact that the electrode’s work function is crucial in electronic device design, impacting device electronic properties and electron transport efficiency at the electrode–semiconductor interface. Therefore a comparison is made between SiNWs breath sensors made from both p-type and n-type silicon to investigate the effect of the dopant and electrode type on the SiNWs respiratory sensing functionality. A distinct directional variation was observed in the sample’s response with Au and Al electrodes. Finally, performing a qualitative study revealed that the electrical resistance across the SiNWs renders greater sensitivity to breath than to dry air pressure. No definitive research demonstrating the mechanism behind these effects exists, thus prompting our study to investigate the underlying process. Full article

Exhaled breath volatile organic compounds (VOCs) are elevated in heart failure (HF). The ability of VOCs to predict long term cardiovascular mortality and morbidity has not been independently verified. In 55 patients admitted with acute decompensated heart failure (ADHF), we measured exhaled breath acetone and pentane levels upon admission and after 48 h of diuresis. In a separate cohort of 51 cardiac patients undergoing cardiopulmonary exercise testing (CPET), we measured exhaled breath acetone and pentane levels before and at peak exercise. In the ADHF cohort, admission acetone levels correlated with lower left ventricular ejection fraction (LVEF, r = −0.297, p = 0.035). Greater weight loss with diuretic therapy correlated with a greater reduction in both acetone levels (r = −0.398, p = 0.003) and pentane levels (r = −0.309, p = 0.021). In patients with above-median weight loss (≥4.5 kg), patients demonstrated significantly greater percentage reduction in acetone (59% reduction vs. 7% increase, p < 0.001) and pentane (23% reduction vs. 2% reduction, p = 0.008). In the CPET cohort, admission acetone and pentane levels correlated with higher VE/VCO2 (r = 0.39, p = 0.005), (r = 0.035, p = 0.014). However, there were no significant correlations between baseline or peak exercise acetone and pentane levels and peak VO2. In longitudinal follow-up with a median duration of 33 months, patients with elevated exhaled acetone and pentane levels experienced higher composite adverse events of death, ventricular assist device implantation, or orthotopic heart transplantation. In patients admitted with ADHF, higher exhaled breath acetone levels are associated with lower LVEF and poorer outcomes, and greater reductions in exhaled breath acetone and pentane tracked with greater weight loss. Exhaled acetone and pentane may be novel biomarkers in heart failure worthy of future investigation. Full article

Since the outbreak of COVID-19, as of January 2023, there have been over 670 million cases and more than 6.8 million deaths worldwide. Infections can cause inflammation in the lungs and decrease blood oxygen levels, which can lead to breathing difficulties and endanger life. As the situation continues to escalate, non-contact machines are used to assist patients at home to monitor their blood oxygen levels without encountering others. This paper uses a general network camera to capture the forehead area of a person’s face, using the RPPG (remote photoplethysmography) principle. Then, image signal processing of red and blue light waves is carried out. By utilizing the principle of light reflection, the standard deviation and mean are calculated, and the blood oxygen saturation is computed. Finally, the effect of illuminance on the experimental values is discussed. The experimental results of this paper were compared with a blood oxygen meter certified by the Ministry of Health and Welfare in Taiwan, and the experimental results had only a maximum error of 2%, which is better than the 3% to 5% error rates in other studies The measurement time was only 30 s, which is better than the one minute reported using similar equipment in other studies. Therefore, this paper not only saves equipment expenses but also provides convenience and safety for those who need to monitor their blood oxygen levels at home. Future applications can combine the SpO2 detection software with camera-equipped devices such as smartphones and laptops. The public can detect SpO2 on their own mobile devices, providing a convenient and effective tool for personal health management. Full article

Cancer patients receiving palliative care may face significant challenges in attending outpatient appointments. Patients on controlled substances such as opioids require frequent visits and often rely on assistive devices and/or a caregiver to accompany them to these visits. In addition, pain, fatigue, and shortness of breath may magnify the challenges associated with in-person visits. The rapid adoption of telemedicine in response to the COVID-19 pandemic has proven to be highly beneficial for advanced cancer patients and caregivers. The hurried COVID-19-related implementation of telemedicine is now evolving into a permanent platform for providing palliative care. This review will focus on the best practices and recommendations to deliver high-quality, interdisciplinary tele-palliative care. Full article

A quantitative evaluation of kinetic parameters, the joint’s range of motion, heart rate, and breathing rate, can be employed in sports performance tracking and rehabilitation monitoring following injuries or surgical operations. However, many of the current detection systems are expensive and designed for clinical use, requiring the presence of a physician and medical staff to assist users in the device’s positioning and measurements. The goal of wearable sensors is to overcome the limitations of current devices, enabling the acquisition of a user’s vital signs directly from the body in an accurate and non–invasive way. In sports activities, wearable sensors allow athletes to monitor performance and body movements objectively, going beyond the coach’s subjective evaluation limits. The main goal of this review paper is to provide a comprehensive overview of wearable technologies and sensing systems to detect and monitor the physiological parameters of patients during post–operative rehabilitation and athletes’ training, and to present evidence that supports the efficacy of this technology for healthcare applications. First, a classification of the human physiological parameters acquired from the human body by sensors attached to sensitive skin locations or worn as a part of garments is introduced, carrying important feedback on the user’s health status. Then, a detailed description of the electromechanical transduction mechanisms allows a comparison of the technologies used in wearable applications to monitor sports and rehabilitation activities. This paves the way for an analysis of wearable technologies, providing a comprehensive comparison of the current state of the art of available sensors and systems. Comparative and statistical analyses are provided to point out useful insights for defining the best technologies and solutions for monitoring body movements. Lastly, the presented review is compared with similar ones reported in the literature to highlight its strengths and novelties. Full article