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Recent Advances in the Devices for the Treatment of Chronic Obstructive Pulmonary Disease: A Review.Cureus Nov 2023Chronic obstructive pulmonary disease or COPD has been known to adversely affect people's quality of life. It influences a great number of individuals overall and is a... (Review)
Review
Chronic obstructive pulmonary disease or COPD has been known to adversely affect people's quality of life. It influences a great number of individuals overall and is a main source of horribleness and mortality. It is associated with major healthcare and socioeconomic burdens. So, it is important to cure such types of diseases. This review article deals with the proper understanding of the newly developed devices and various advances taking place in the treatment of COPD. There are many new methods and procedures being developed recently for the cure or treatment of COPD, of which some are mentioned in the following review article. The articles also deal with the beneficial effects as well as the challenges faced during the use of those newly developed methods during the treatment of the disease. Various types of management of COPD are also mentioned in the article. This article also deals with the various new advances that are currently taking place in devices used in the therapy of COPD.
PubMed: 38146553
DOI: 10.7759/cureus.49371 -
Respiratory Medicine 2023Pressurised metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs), are widely used to deliver drugs for the treatment of asthma and chronic obstructive pulmonary... (Review)
Review
Pressurised metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs), are widely used to deliver drugs for the treatment of asthma and chronic obstructive pulmonary disease (COPD). Incorrect use of inhalers is one of the main obstacles to achieving better clinical control. Indeed, with pMDIs, patients fail to synchronise actuation with inhalation due to a lack of coordination and with DPIs insufficient inspiratory effort compromises drug deposition in lungs. More than 50% of patients desire to switch their pMDIs and DPIs for a better device. This led to the development of pressurised breath-actuated inhalers (BAIs) with the aim of combining the beneficial features of pMDIs and DPIs and mitigating their problems. BAIs, e.g., Synchrobreathe™, are designed such that they are activated by a low inhalation effort and mechanically actuate the dose in synchrony to inspiration, thereby resolving the need to coordinate actuation with inspiration. BAIs have advantages, including ease of use, high lung deposition of medication, and greater patient preference. We discussed the design features, operating procedure, and clinical evidence of the Synchrobreathe™ device (Cipla Ltd, India), a BAI available with a wide range of drug combinations. Studies have shown that a higher number of patients (68.19%) used the Synchrobreathe™ without any error than the pMDI (56.21%), and that the vast majority of them (92%) found it easy to understand and use. The Synchrobreathe™ is an innovative, easy-to-use inhaler that may overcome many limitations associated with pMDIs and DPIs, thus potentially improving management of obstructive airway diseases and patients' quality of life.
Topics: Humans; Metered Dose Inhalers; Pulmonary Disease, Chronic Obstructive; Asthma; Equipment Design; Administration, Inhalation; Dry Powder Inhalers; Bronchodilator Agents
PubMed: 38652077
DOI: 10.1016/j.rmed.2023.107435 -
Developmental Science Sep 2023Music listening often entails spontaneous perception and body movement to a periodic pulse-like meter. There is increasing evidence that this cross-cultural ability...
Music listening often entails spontaneous perception and body movement to a periodic pulse-like meter. There is increasing evidence that this cross-cultural ability relates to neural processes that selectively enhance metric periodicities, even when these periodicities are not prominent in the acoustic stimulus. However, whether these neural processes emerge early in development remains largely unknown. Here, we recorded the electroencephalogram (EEG) of 20 healthy 5- to 6-month-old infants, while they were exposed to two rhythms known to induce the perception of meter consistently across Western adults. One rhythm contained prominent acoustic periodicities corresponding to the meter, whereas the other rhythm did not. Infants showed significantly enhanced representations of meter periodicities in their EEG responses to both rhythms. This effect is unlikely to reflect the tracking of salient acoustic features in the stimulus, as it was observed irrespective of the prominence of meter periodicities in the audio signals. Moreover, as previously observed in adults, the neural enhancement of meter was greater when the rhythm was delivered by low-pitched sounds. Together, these findings indicate that the endogenous enhancement of metric periodicities beyond low-level acoustic features is a neural property that is already present soon after birth. These high-level neural processes could set the stage for internal representations of musical meter that are critical for human movement coordination during rhythmic musical behavior. RESEARCH HIGHLIGHTS: 5- to 6-month-old infants were presented with auditory rhythms that induce the perception of a periodic pulse-like meter in adults. Infants showed selective enhancement of EEG activity at meter-related frequencies irrespective of the prominence of these frequencies in the stimulus. Responses at meter-related frequencies were boosted when the rhythm was conveyed by bass sounds. High-level neural processes that transform rhythmic auditory stimuli into internal meter templates emerge early after birth.
Topics: Adult; Humans; Infant; Music; Acoustic Stimulation; Electroencephalography; Sound; Periodicity; Auditory Perception
PubMed: 36415027
DOI: 10.1111/desc.13353 -
Micromachines Jan 2024This paper presents the first nickel-plated micro-Coriolis mass-flow sensor with integrated optical readout. The sensor consists of a freely suspended tube made of...
This paper presents the first nickel-plated micro-Coriolis mass-flow sensor with integrated optical readout. The sensor consists of a freely suspended tube made of electroplated nickel with a total length of 60 mm, an inner diameter of 580 µm, and a wall thickness of approximately 8 µm. The U-shaped tube is actuated by Lorentz forces. An optical readout consisting of two LEDs and two phototransistors is used to detect the tube motion. Mass-flow measurements were performed at room temperature with water and isopropyl alcohol for flows up to 200 g/h and 100 g/h, respectively. The measured resonance frequencies were 1.67 kHz and 738 Hz for water and 1.70 kHz and 752 Hz for isopropyl alcohol for the twist and swing modes, respectively. The measured phase shift between the two readout signals shows a linear response to mass flow with very similar sensitivities for water and isopropyl alcohol of 0.41mdegg/h and 0.43 mdegg/h, respectively.
PubMed: 38258233
DOI: 10.3390/mi15010114 -
Life (Basel, Switzerland) Sep 2023Blood markers of muscle microdamage and systemic inflammation do not adequately explain the reduced performance observed over a prolonged recovery after running a...
Blood markers of muscle microdamage and systemic inflammation do not adequately explain the reduced performance observed over a prolonged recovery after running a mountain ultramarathon. This case study aimed to determine whether the reduced performance after the Everesting mountain ultramarathon can be further assessed by considering cardiorespiratory and metabolic alterations determined via repeated incremental and continuous running tests. A single runner (age: 24 years, BM: 70 kg, BMI: 22, Vo: 74 mL∙min∙kg) was observed over a preparatory period of two months with a one-month recovery period. The Everesting consisted of nine ascents and descents of 9349 vertical metres completed in 18:22 (h:min). During the first phase of the recovery, enhanced peak creatine kinase (800%) and C-reactive protein (44%) levels explained the decreased performance. In contrast, decreased performance during the second, longer phase was associated with a decreased lactate threshold and Vo (21% and 17%, respectively), as well as an increased energetic cost of running (15%) and higher endogenous carbohydrate oxidation rates (87%), lactate concentrations (170%) and respiratory muscle fatigue sensations that remained elevated for up to one month. These alterations may represent characteristics that can explain the second phase of the recovery process after Everesting.
PubMed: 37895328
DOI: 10.3390/life13101946 -
Revista Espanola de Enfermedades... Feb 2024Diphyllobothrium spp., also known as fish tapeworms, is the largest human tapeworm, reaching up to 25 meters of length. Human are considered the definitive host in the...
Diphyllobothrium spp., also known as fish tapeworms, is the largest human tapeworm, reaching up to 25 meters of length. Human are considered the definitive host in the Diphyllobothrium lifecycle. Adult tapeworms attach to human intestinal mucosa with to bilateral grooves. There are at least 14 different species of Diphyllobothrium spp. Capable of causing Dyphyllobothriosis, being D. latum and D. nihonkaiense the most frequent etiologic agents in humans. We present the clinical picture and endoscopic images on a patient with incidental finding of Dyphyllobothriosis in a colonoscopy.
PubMed: 38345520
DOI: 10.17235/reed.2024.10300/2024 -
Sensors (Basel, Switzerland) May 2024Dissolved Oxygen (DO) in water enables marine life. Measuring the prevalence of DO in a body of water is an important part of sustainability efforts because low oxygen...
Dissolved Oxygen (DO) in water enables marine life. Measuring the prevalence of DO in a body of water is an important part of sustainability efforts because low oxygen levels are a primary indicator of contamination and distress in bodies of water. Therefore, aquariums and aquaculture of all types are in need of near real-time dissolved oxygen monitoring and spend a lot of money on purchasing and maintaining DO meters that are either expensive, inefficient, or manually operated-in which case they also need to ensure that manual readings are taken frequently which is time consuming. Hence a cost-effective and sustainable automated Internet of Things (IoT) system for this task is necessary and long overdue. DOxy, is such an IoT system under research and development at Santa Clara University's Ethical, Pragmatic, and Intelligent Computing (EPIC) Laboratory which utilizes cost-effective, accessible, and sustainable Sensing Units (SUs) for measuring the dissolved oxygen levels present in bodies of water which send their readings to a web based cloud infrastructure for storage, analysis, and visualization. DOxy's SUs are equipped with a High-sensitivity Pulse Oximeter meant for measuring dissolved oxygen levels in human blood, not water. Hence a number of parallel readings of water samples were gathered by both the High-sensitivity Pulse Oximeter and a standard dissolved oxygen meter. Then, two approaches for relating the readings were investigated. In the first, various machine learning models were trained and tested to produce a dynamic mapping of sensor readings to actual DO values. In the second, curve-fitting models were used to produce a successful conversion formula usable in the DOxy SUs offline. Both proved successful in producing accurate results.
PubMed: 38794107
DOI: 10.3390/s24103253 -
Expert Opinion on Drug Delivery 2023The urgency to replace the propellants currently in use with the new sustainable ones has given rise to the need for investigation and reformulation of pMDIs. (Review)
Review
INTRODUCTION
The urgency to replace the propellants currently in use with the new sustainable ones has given rise to the need for investigation and reformulation of pMDIs.
AREAS COVERED
The reformulation requires in-depth knowledge of the physico-chemical characteristics of the new propellants, which impact the atomization capacity and the plume geometry. Among the investigated propellants, HFA 152a, due to its lower vapor pressure and higher surface tension compared to HFA 134a, deliver larger particles and has a higher solvent capacity toward lipophilic drugs. On the other hand, HFO 1234ze has properties more similar to HFA 134a, but showed lower reproducibility of the generated spray, indicating a possible high susceptibility to variation in the consistency of the dose delivered. In addition, the device components currently in use are compatible with the new propellants. This allowed promising preliminary results in the re-formulation of pMDIs by academia and pharma companies. However, there is little information about the clinical studies required to allow the marketing of these new products.
EXPERT OPINION
Overall, studies conducted so far show that the transition is technically possible, and the main obstacle will be represented by the investment required to put the product on the market.
Topics: Reproducibility of Results; Aerosol Propellants; Metered Dose Inhalers; Hydrocarbons, Fluorinated; Administration, Inhalation
PubMed: 37767756
DOI: 10.1080/17425247.2023.2264184 -
Schweizer Archiv Fur Tierheilkunde Jan 2024Mastitis is one of the most important factor diseases in dairy cattle worldwide. Milking technique represents one of the factors involved in the development of mastitis....
Mastitis is one of the most important factor diseases in dairy cattle worldwide. Milking technique represents one of the factors involved in the development of mastitis. The purpose of this study was to investigate the influence of vibrations during milking on the rate of clinical and subclinical mastitis. For this purpose, milking measurements, tank milk analyses and survey forms (general farm data, assessment of milking work and milking hygiene, teat condition, feeding, farm problems, animal behavior) were assessed in 8 Swiss dairy farms. The results show a correlation between present vibrations at the output of the milk meter and increasing bulk milk somatic cell count. Further, a tendency was shown for vibrations at the input of the milk meter to influence bulk milk somatic cell count. Also, a tendency regarding vibrations at the outlet of the milk meter and acute phase protein milk amyloid A was evident. In conclusion, the results suggest that vibration during milking might have a negative effect on udder health. However, further research with a larger number of dairies is needed to make a more generally valid statement.
Topics: Animals; Cattle; Female; Vibration; Dairying; Mastitis, Bovine; Milk; Mammary Glands, Animal; Cell Count; Cattle Diseases
PubMed: 38174764
DOI: 10.17236/sat00416 -
Journal of Neuromuscular Diseases 2024The objective of this study was to describe predictors of loss of ambulation in Duchenne muscular dystrophy (DMD). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The objective of this study was to describe predictors of loss of ambulation in Duchenne muscular dystrophy (DMD).
METHODS
This systematic review and meta-analysis included searches of MEDLINE ALL, Embase, and the Cochrane Database of Systematic Reviews from January 1, 2000, to December 31, 2022, for predictors of loss of ambulation in DMD. Search terms included "Duchenne muscular dystrophy" as a Medical Subject Heading or free text term, in combination with variations of the term "predictor". Risk of bias was assessed using the Newcastle-Ottawa Scale. We performed meta-analysis pooling of hazard ratios of the effects of glucocorticoids (vs. no glucocorticoid therapy) by fitting a common-effect inverse-variance model.
RESULTS
The bibliographic searches resulted in the inclusion of 45 studies of children and adults with DMD from 17 countries across Europe, Asia, and North America. Glucocorticoid therapy was associated with delayed loss of ambulation (overall meta-analysis HR deflazacort/prednisone/prednisolone: 0.44 [95% CI: 0.40-0.48]) (n = 25 studies). Earlier onset of first signs or symptoms, earlier loss of developmental milestones, lower baseline 6MWT (i.e.,<350 vs. ≥350 metres and <330 vs. ≥330 metres), and lower baseline NSAA were associated with earlier loss of ambulation (n = 5 studies). Deletion of exons 3-7, proximal mutations (upstream intron 44), single exon 45 deletions, and mutations amenable of skipping exon 8, exon 44, and exon 53, were associated with prolonged ambulation; distal mutations (intron 44 and downstream), deletion of exons 49-50, and mutations amenable of skipping exon 45, and exon 51 were associated with earlier loss of ambulation (n = 13 studies). Specific single-nucleotide polymorphisms in CD40 gene rs1883832, LTBP4 gene rs10880, SPP1 gene rs2835709 and rs11730582, and TCTEX1D1 gene rs1060575 (n = 7 studies), as well as race/ethnicity and level of family/patient deprivation (n = 3 studies), were associated with loss of ambulation. Treatment with ataluren (n = 2 studies) and eteplirsen (n = 3 studies) were associated with prolonged ambulation. Magnetic resonance biomarkers (MRI and MRS) were identified as significant predictors of loss of ambulation (n = 6 studies). In total, 33% of studies exhibited some risk of bias.
CONCLUSION
Our synthesis of predictors of loss of ambulation in DMD contributes to the understanding the natural history of disease and informs the design of new trials of novel therapies targeting this heavily burdened patient population.
Topics: Muscular Dystrophy, Duchenne; Humans; Glucocorticoids; Walking; Pregnenediones; Latent TGF-beta Binding Proteins
PubMed: 38669554
DOI: 10.3233/JND-230220