Effect of Trendelenburg position during prone ventilation in fifteen COVID-19 patients. Observational study

Background Prone position ventilation has shown to improve oxygenation and mortality in severe ARDS. The data of prone position ventilation during severe ARDS secondary to COVID-19 have shown similar benefit in oxygenation and mortality. Usually, patient placed in prone position are placed flat or in reverse Trendelenburg positioning to decrease risk of aspiration and abdominal girth compressing the chest. To date, no studies are available to compare the effects of positioning the bed in different angles during the prone position ventilation. Methods An observational study in fifteen patients with severe ARDS secondary to COVID-19 who were placed in the prone position for the first time. All the patients were sedated and chemically paralyzed with no spontaneous effort. All patients were ventilated with the pressure-controlled mode with set PEEP according to the pressure-volume curves. Five patients had esophageal balloon manometry to estimate pleural pressures and trans-pulmonary pressures. Patients were initially placed in reverse Trendelenburg position and later in Trendelenburg position. Tidal volume and respiratory compliance were observed for 30 minutes after bed positioning has been achieved. Tidal volume and total respiratory compliance in both Trendelenburg and reverse Trendelenburg position were compared. Ventilator settings were not changed during the observation. No patients were suspected of increased intra-cranial or intra-ocular pressures. T-test was done to compare the values. Results Tidal volume significantly increased by 80.26 ± 23.4 ml/breath (95% CI 37.7 - 122.9) from 391.3 ± 52.7 to 471.6 ± 60.9 (20.5%) P 0.001. The respiratory system compliance significantly increased by 4.9 ml/cmH2O (95% CI 1.4 - 8.4) from 34.6 ± 4.7 to 39.5 ± 4.6 (14%) P 0.001. Of the five patients with esophageal balloon, the lung compliance significantly increased by 16.7 ml/cmH2O (95% CI 12.8 – 20.6) from 66.6 ± 1.7 to 83.3 ± 3.3 (25%) P 0.001. The chest wall compliance had small but non-significant increase by 1.5 ml/cmH2O (95% CI -1.3 – 4.3) from 65 ± 1.4 to 66.5 ± 2.3 (2%) P 0.085. Conclusion In this study, statistically significant increase in tidal volume, lung and respiratory system compliance were observed in patients placed in the Trendelenburg position during prone position ventilation. The results reflect the effect of body positioning during prone position ventilation. These effects may be the reflection of altered ventilation distribution throughout the lungs and change in pleural pressure as well as trans-pulmonary pressure during body positioning. More studies need to be done to confirm and examine this phenomenon. Precautions should be taken as this maneuver can increase the intra-cranial and intra-ocular pressures. Keywords: COVID-19, Trendelenburg, Reverse Trendelenburg, ARDS

Exploring The Power Clean

The power clean and its variations are prescribed by strength and conditioning coaches as part of the ‘big three’ to develop “total body strength”. This article explores the application of the power clean and its variations to athletic performance and introduces strength and conditioning coaches to teaching progressions, with specific emphasis on developing the correct body positioning required for the power clean. Teaching components are addressed with special reference to taller athletes. It is recommended that strength and conditioning coaches teach the hang clean follow a progression model to decrease movement complexity when advancing athletes to the power clean.

I’ll show you what I witnessed. Children’s abilities to use non-anatomical dolls in forensic interviewing

<p>Two studies examined the effectiveness of using non-anatomical (non-AD) dolls as an interview tool, to aid children's communication about body positioning. In the first study, 49 6-8-year-old children took part in a game. Thirty minutes to an hour later, they were interviewed using the Specialist Child Witness Interview model. This was done verbally or with the opportunity to use non-AD dolls to clarify their own and others' body positioning. There was no difference in the amount of information reported nor the accuracy of children's reports when comparing both conditions. To complement the first study, the second study examined jurors' perceptions of children's abilities to use non-AD dolls. Non-AD dolls were generally thought to be helpful, but jurors identified some risks. However, jurors did not have strong beliefs about how non-AD dolls would influence the evidence that children provided. When jurors viewed a video of a child recounting a past event, their beliefs about non-AD dolls were more influential when evaluating a child's credibility than whether or not a non-AD doll was used during the interview. Overall, even when used in conjunction with evidence-based techniques, these findings do not support the use of non-AD dolls to help communicate body positioning in child forensic interviewing.</p>

I’ll show you what I witnessed. Children’s abilities to use non-anatomical dolls in forensic interviewing

<p>Two studies examined the effectiveness of using non-anatomical (non-AD) dolls as an interview tool, to aid children's communication about body positioning. In the first study, 49 6-8-year-old children took part in a game. Thirty minutes to an hour later, they were interviewed using the Specialist Child Witness Interview model. This was done verbally or with the opportunity to use non-AD dolls to clarify their own and others' body positioning. There was no difference in the amount of information reported nor the accuracy of children's reports when comparing both conditions. To complement the first study, the second study examined jurors' perceptions of children's abilities to use non-AD dolls. Non-AD dolls were generally thought to be helpful, but jurors identified some risks. However, jurors did not have strong beliefs about how non-AD dolls would influence the evidence that children provided. When jurors viewed a video of a child recounting a past event, their beliefs about non-AD dolls were more influential when evaluating a child's credibility than whether or not a non-AD doll was used during the interview. Overall, even when used in conjunction with evidence-based techniques, these findings do not support the use of non-AD dolls to help communicate body positioning in child forensic interviewing.</p>

Research on Body Positioning Measurement Method of Bolting Robot based on Vision Theory

In view of the intelligent demand of underground roadway support and the precise positioning of underground unmanned fully mechanized face, a method of body positioning measurement of bolting robot based on the principle of monocular vision is proposed. In this paper, a vehicle body positioning model based on image data is established. The data is obtained by camera, and the transformation between image coordinates and world coordinates is completed by coordinate system transformation. The monocular vision positioning system of bolting robot is designed, and the simulation experimental model is built to measure the effective positioning distance of monocular vision positioning system in the simulation experimental conditions. The experimental platform of bolting robot is designed, and the vehicle is measured Real time data of body positioning, analysis of experimental error and demonstration of reliability of the method. In this method, the real-time localization of underground mine is realized by the robot of bolting, and the accuracy and efficiency of localization are improved, which lays the foundation for the localization control of mining face and the automation and unmanned of the robot of bolting.

A Comparison of Effect of Semi Fowler’s and Side Lying Position on Pulmonary Functions and Oxygen Saturation in Bedridden Patients

Background: Body positioning is prescribed to optimize cardiopulmonary functions. Positioning helps to improve lung function and oxygen saturation in patients who are bedridden for longer duration. The aim of the present study is comparing semi fowler’s position to side lying position (right and left side lying). Method: Thirty bedridden subjects who were haemodynamically stable were included in the study. Out of them three groups were made in which first group was given semi fowler’s position, second group was given left side lying and third group was given right side lying position. Patients have to maintain this position for 30 minutes. Outcome measure: FVC, FEV1, RR and SPO2 were taken before and after positioning which are objective measure of lung function and oxygen saturation respectively. Parameters were compared before and after positioning and between groups by non-parametric tests. Result: shows significant difference between before and after within groups. When each of these sides lying position were compared to semi fowler’s positions, semi fowler’s position was found to be more effective in improving pulmonary functions and oxygen saturation. Key words: Semi Fowler’s, Side Lying, Positioning, Pulmonary Functions, Oxygen Saturation.

Taking an Extended Embodied Perspective of Touch: Connection-Disconnection in iVR

Bringing touch into VR experiences through haptics is considered increasingly important for user engagement and fostering feelings of presence and immersion, yet few qualitative studies have explored users' iVR touch experiences. This paper takes an embodied approach–bringing attention to the tactile-kinaesthetic body–to explore users' wholistic experiences of touch in iVR, moving beyond the cutaneous and tactile elements of “feeling” to elaborate upon themes of movement and kinetics. Our findings show how both touch connections and disconnections emerged though material forms of tactility (the controller, body positioning, tactile expectations) and through “felt proximities” and the tactile-kinaesthetic experience thus shaping the sense of presence. The analysis shows three key factors that influence connection and disconnection, and how connection is re-navigated or sought at moments of experienced disconnection: a sense of control or agency; identity; and bridging between the material and virtual. This extended notion of touch deepens our understanding of its role in feelings of presence by providing insight into a range of factors related to notions of touch – both physical and virtual–that come into play in creating a sense of connection or presence (e.g., histories, expectations), and highlights the potential for iVR interaction to attend to the body beyond the hands in terms of touch.

Agreement between ECG values obtained in the sternal recumbent position and right lateral recumbency in goats

The aim of the study was to analyze if body positioning during electrocardiogram recording has an influence on the results in goats. Forty-seven Polish White Improved and Polish Fawn Improved goats from a large dairy herd selected for sanitary culling due to caprine arthritis-encephalitis virus (CAEV) infection, ranging from 2-12 years (median 5.5 years) were included in the study. ECG records were obtained from each goat in the sternal recumbent position and in right lateral recumbency using ASPEL AsCARD Mr. Silver machine with a frequency range of 0.05-150 Hz. The signals from leads I, II, III, aVR, aVL and aVF were recorded for 30 seconds. The mean values of P, QRS, T, PQ, QT, P-R duration (in sec) and P, Q, R, S, T waves amplitude (mV) were measured and analyzed. Values obtained in both positions did not differ significantly.

INFLUENCE OF DIFFERENT SITTING POSITIONS ON THE MAXIMAL RESPIRATORY PRESSURES IN HEALTHY INDIVIDUALS OF VARIOUS AGE GROUPS: AN EXPERIMENTAL STUDY

Background: Variation in the position of the body influences the orientation and length of the muscle. The ability of the respiratory muscles to generate force depends upon its length. There is a dearth of literature about the effect of pressures generated by the respiratory muscles due to the different sitting positions. Purpose of the study: Due to the importance of body positioning in the optimization of breathing exercises, a need was felt to compare maximal respiratory pressures of the respiratory muscles in different sitting positions and identify a suitable position in which respiratory muscles work the best. Participants: Total 144 participants were included in the study according to the inclusion and exclusion criteria. Participants were divided into age groups of 18-40years, 41-60years and 60years and above. Equal representation was given to sample number and gender in each group. Method: MIP and MEP were measured in three different sitting positions i.e. upright sitting position, forward leaning position and semi fowlers position by using the Micro RPM (Micro Medical/Care Fusion, Kent, United Kingdom). The best of the three measurements was taken. Results: There is a significant difference in the values of MIP and MEP in different sitting positions in all the age groups with p-value < 0.05. In each age group it was found that the values of MIP was better in upright sitting position as compared to forward leaning position (p-value <0.01) with no difference found in the values of MIP between the upright sitting position and semi-fowlers position (p-value > 0.05). The values for MEP was found to be increased in forward leaning position as compared to upright sitting position and semi-fowlers position p-value <0.05 Conclusion: The present study concluded that, there is a significant influence of different sitting positions on the maximal respiratory pressures in healthy individuals of various age groups. Implication: The results of this study can be used to make a good clinical decision about which sitting position should be adapted while giving the various types of breathing exercises to the patient. KEY WORDS: Maximal respiratory pressures, MIP, MEP, body positioning, sitting positions, breathing exercises.