Design, Simulation, Implementation and Measurement of Respiration Rate by Strain Gauge Sensor and Induction Method

The human body has vital parameters such as respiration, heart rate, and body temperature. Respiratory rate (RR) is a parameter that expresses the rate of respiration per minute. Respiratory activities play an essential role in human life. The rate of respiration has a particular range, which is 14-18 cycles per minute for a healthy and normal person at rest. The oxygen in the blood enters the body during respiration and is expelled as carbon dioxide in return. Any problems with breathing may pose a serious health risk. An abnormal breathing pattern indicates serious illnesses such as cardiac arrest and hospitalization in the intensive care unit (ICU) and when it falls below a certain limit, it indicates a loss of consciousness. This is why it is so imperative to develop devices and methods measuring respiration rates.

Minute-Ventilation Variability During Cardiopulmonary Exercise Test Is Higher In Idiopathic Dyspnoea Subjects Compared To Subjects With Breathing Pattern Disorder.

Background: Patients with abnormal breathing responses often report presenting with debilitating symptoms that negatively impact both physical and mental quality of life.Objective: To compare time-domain variability of ventilatory components of Idiopathic dyspnoea and Breathing Pattern Disorder during a progressive maximal exercise test, evaluating their relationship to other variables usually obtained during a cardiopulmonary exercise test.Methods: Analysis of time-domain variability (RMSSD) of minute-ventilation (VE) during a maximal cardiopulmonary exercise test of 13 subjects with Idiopathic dyspnoea and 13 subjects with dysfunctional breathing pattern. Data was compared by a two-tailed Student T-test.Results: Idiopathic dyspnoea subjects exhibited a greater Minute-Ventilation Variability (31.5 ± 6.2 Vs 25.4 l/min ± 8.0, p >0.05). Inspiratory tidal volume time ratio (VTin/ti) (1.96 ± 0.7 Vs 2.58 ± 0.6, p >0.05) and Breathing Frequency (35 ± 9.3 Vs 43 breath/min ± 8.2 p >0.05) were also significantly lower in Idiopathic Dyspnoea compared to Breathing Pattern Disorder subjects.Conclusions: Time-domain variability of minute ventilation during exercise is greater in Idiopathic Dyspnoea compared to the Breathing Pattern Disorder subject’s possible highlighting a lower ventilatory threshold.

Description of call handling in emergency medical dispatch centres in Scandinavia: recognition of out-of-hospital cardiac arrests and dispatcher-assisted CPR

Background The European resuscitation council have highlighted emergency medical dispatch centres as an important key player for early recognition of Out-of-Hospital Cardiac Arrest (OHCA) and in providing dispatcher assisted cardiopulmonary resuscitation (CPR) before arrival of emergency medical services. Early recognition is associated with increased bystander CPR and improved survival rates. The aim of this study is to describe OHCA call handling in emergency medical dispatch centres in Copenhagen (Denmark), Stockholm (Sweden) and Oslo (Norway) with focus on sensitivity of recognition of OHCA, provision of dispatcher-assisted CPR and time intervals when CPR is initiated during the emergency call (NO-CPRprior), and to describe OHCA call handling when CPR is initiated prior to the emergency call (CPRprior). Methods Baseline data of consecutive OHCA eligible for inclusion starting January 1st 2016 were collected from respective cardiac arrest registries. A template based on the Cardiac Arrest Registry to Enhance Survival definition catalogue was used to extract data from respective cardiac arrest registries and from corresponding audio files from emergency medical dispatch centres. Cases were divided in two groups: NO-CPRprior and CPRprior and data collection continued until 200 cases were collected in the NO-CPRprior-group. Results NO-CPRprior OHCA was recognised in 71% of the calls in Copenhagen, 83% in Stockholm, and 96% in Oslo. Abnormal breathing was addressed in 34, 7 and 98% of cases and CPR instructions were started in 50, 60, and 80%, respectively. Median time (mm:ss) to first chest compression was 02:35 (Copenhagen), 03:50 (Stockholm) and 02:58 (Oslo). Assessment of CPR quality was performed in 80, 74, and 74% of the cases. CPRprior comprised 71 cases in Copenhagen, 9 in Stockholm, and 38 in Oslo. Dispatchers still started CPR instructions in 41, 22, and 40% of the calls, respectively and provided quality assessment in 71, 100, and 80% in these respective instances. Conclusions We observed variations in OHCA recognition in 71–96% and dispatcher assisted-CPR were provided in 50–80% in NO-CPRprior calls. In cases where CPR was initiated prior to emergency calls, dispatchers were less likely to start CPR instructions but provided quality assessments during instructions.

Risk Factors for Tracheobronchomalacia in Preterm Infants With Bronchopulmonary Dysplasia

Aim: To identify the risk factors associated with the development of tracheobronchomalacia (TBM) in preterm infants with bronchopulmonary dysplasia (BPD).Methods: This was a retrospective cohort study using chart reviews of preterm infants born at ≤ 36 week's gestation who underwent flexible fiberoptic bronchoscopy in a tertiary pediatric referral center between January 2015 and January 2020. Indications for the bronchoscopy examination included lobar atelectasis on plain chest film, persistent CO2 retention, recurrent extubation failure, or abnormal breathing sounds such as wheeze or stridor. Optimal cutoff values for each risk factor were also determined.Results: Fifty-eight preterm infants with BPD were enrolled, of whom 29 (50%) had TBM. There were no significant differences in gestational age and birth weight between those with and without TBM. Significantly more of the patients with TBM had severe BPD compared to those without TBM (68.9 vs. 20.6%, p < 0.001). Clinical parameters that were significantly different between the two groups were included in multivariate analysis. Among these factors, severe BPD was the most powerful risk factor for the development of TBM (odds ratio 5.57, 95% confidence interval 1.32–23.5, p = 0.019). The areas under the receiver operating characteristic curves for peak inspiratory pressure (PIP) and the duration of intubation were 0.788 and 0.75, respectively. The best predictive cutoff values of PIP and duration of intubation for TBM were 18.5 mmHg and 82 days, respectively.Conclusion: Preterm infants with severe BPD are at high risk for the development of TBM, and the risk is even higher in those who receive a higher PIP or are intubated for longer. Bronchoscopy examinations should be considered for the early diagnosis and management of TBM in infants with these risk factors.

RF Sensing Based Breathing Patterns Detection Leveraging USRP Devices

Non-contact detection of the breathing patterns in a remote and unobtrusive manner has significant value to healthcare applications and disease diagnosis, such as in COVID-19 infection prediction. During the epidemic prevention and control period of COVID-19, non-contact approaches have great significance because they minimize the physical burden on the patient and have the least requirement of active cooperation of the infected individual. During the pandemic, these non-contact approaches also reduce environmental constraints and remove the need for extra preparations. According to the latest medical research, the breathing pattern of a person infected with COVID-19 is unlike the breathing associated with flu and the common cold. One noteworthy symptom that occurs in COVID-19 is an abnormal breathing rate; individuals infected with COVID-19 have more rapid breathing. This requires continuous real-time detection of breathing patterns, which can be helpful in the prediction, diagnosis, and screening for people infected with COVID-19. In this research work, software-defined radio (SDR)-based radio frequency (RF) sensing techniques and machine learning (ML) algorithms are exploited to develop a platform for the detection and classification of different abnormal breathing patterns. ML algorithms are used for classification purposes, and their performance is evaluated on the basis of accuracy, prediction speed, and training time. The results show that this platform can detect and classify breathing patterns with a maximum accuracy of 99.4% through a complex tree algorithm. This research has a significant clinical impact because this platform can also be deployed for practical use in pandemic and non-pandemic situations.

Abnormal movements and diaphragmatic flutter in a case of suspected induced illness

A 6-month-old girl presented to hospital via ambulance with a decreased conscious level (initial Glasgow Coma Scale of 3) and an abnormal breathing pattern described as diaphragmatic flutter. She then developed abnormal movements and continued to have episodes of fluctuating conscious levels so was transferred to a tertiary hospital paediatric intensive care unit for further investigation. During her 16-day stay in hospital, she continued to experience discrete episodes of drowsiness, bradycardia, unusual breathing patterns and abnormal movements which were associated with agitation, tachycardia, hypertension and insomnia. The patient underwent extensive investigation for her symptoms and, after some delay in waiting for initial results before considering a urine drug screen, she was ultimately found to have lisdexamfetamine and clonidine in her urine drug screen. Her symptoms subsequently resolved after her mother’s visits were restricted.

A low-cost IoT-based auscultation training device

<span>Auscultation training devices are needed by teachers and students in health schools to practice auscultation techniques. In this paper, a low-cost IoT-based auscultation training device has been developed using NodeMCU, four proximity sensors, metal as a stethoscope, a switch, an android smartphone, an earphone, and a phantom doll. The message queuing telemetry transport (MQTT) protocol has been used for data communication between NodeMCU and smartphones, therefore an auscultation training hardware can be used by many students who have auscultation training application on their smartphones that subscribe to topics. The results showed that an auscultation training device was able to detect a stethoscope. Auscultation training application on a smartphone successfully plays normal and abnormal breathing sounds based on subscribed topics. With a production cost of less than 15 USD, we offer an inexpensive IoT-based auscultation training device. </span>

Trichotemnomania in an Adolescent Girl: A Case Report of an Asian Child and Literature Review

Trichotemnomania (TT) refers to cutting or shaving of one’s own hair as a compulsive act. This condition is reported rarely and may be indicative of an underlying obsessive-compulsive disorder. TT may be misdiagnosed with trichotillomania or other disorders such as alopecia areata, tinea capitis, and postinflammatory scars. The diagnosis of trichotemnomania is confirmed by dermoscopic assessment, histopathological changes of hair, and correlation of these findings with clinical history. A fourteen-year-old adolescent girl presented with focal hair loss over forehead for duration of two-weeks and periodic abnormal breathing and poor sleep for 2-month duration. Besides, she had also lost some of pubic hair and hair on the forearm over preceding 24 hours. This patient was assessed by a team including a paediatrician, gynecologist, dermatologist, and psychiatrist to gather focused medical history and to perform physical examination, laboratory investigations, and dermoscopic assessment. It was revealed that she used to shave or cut regularly following stressful situations across various aspects of her life and hyperventilate as a means of relieving her stress. Eventually, she was diagnosed to have trichotemnomania and was started oral sertraline 50 mg/day for one month. Clinical features and her behaviour improved with regular cognitive behavioural therapy, and hairs were demonstrated to grow up normally with change in behaviour. Currently, she does well at school and is off medications and being followed up at the child guidance clinic. Trichotemnomania is a very rare disorder which is characterised by cutting or shaving of one’s own hairs as a compulsive habit. The condition needs careful and detailed assessment by a team of specialists to identify coexisting psychiatric disorders and offer treatment.