Breathing Frequency Research Articles

Recording the peculiarities of life activities fixed on the surface of the incisors of the spotted ground squirrel (Spermophilus suslicus, Rodentia, Sciuridae)

The increments on the surface of the incisors of young spotted ground squirrels are wide, of medium definition. They probably reflect intensive nutrition and growth of the body. Starting with the third month of life, growth slows down, the width of the growths is decreased, and they become narrower and more distinct. Deformations appear in the form of swellings of the incisor wall. The frequency of occurrence of the deformations in underyearlings reaches a peak in the second half of July. The same pattern is observed in adult ground squirrels. By this time, gophers reach their maximum body weight. The majority of adult ground squirrels kept in captivity also reach the maximum body weight in the first half of July, this indirectly indicating the relationship between the appearance of deformations and the achievement of maximum fatness. Under laboratory conditions, at a temperature not exceeding 22°C, overwintered males and dry females after reaching their maximum body weight, even in the presence of food, fall into a stupor resembling a state of hibernation. Their body temperature is only 1–1.5°C higher than the room temperature, the animals are lethargic, they do not open their eyes during manipulations, and the frequency of breaths is 4–6 per minute. These observations suggest that ground squirrels living in natural conditions also fall into a similar hibernation, since the proportion of overwintered males and females among the individuals caught in the middle of summer is decreased. The appearance of deformations at this time seems to be associated with a violation of the normal growth of the incisors during physiological changes in the body, these being caused by the onset of a transition from the active nutrition of plant food to endogenous consumption of fat reserves characteristic of the state of hibernation. The record of autumn-winter hibernation is characterized by very narrow increments or deformations, a change in the enamel boundary, as well as a change in the contour of the incisor surface. After spring awakening, growths are at first narrow and distinct, 150–160 µm each, subsequently increasing in width, which is probably due to a gradual transition from endogenous nutrition of the body with fat deposits during hibernation to intensive nutrition of green vegetation. Lactation of females usually does not affect daily gains.

Respiratory sinus arrhythmia in humans: Correlation analysis with breathing-specific heart rate

In adult humans at rest, pulmonary ventilation and cardiac output share similar values, both approximately 5 L/min. Airflow is intermittent, with tidal volumes exceeding dead space, low breathing frequency (fresp), and zero air velocity at both end-inspiration and end-expiration. In contrast, the cardiac pump is in series with the vasculature, such that the small stroke volume and high heart rate (HR) (fh) allow for quasi-continuous blood flow. Based on experimental findings in dogs, it has been suggested that an elevated fh during inspiration (known as respiratory sinus arrhythmia [RSA]) decreases the disparity between air and blood flow patterns. Thus, one might hypothesize a positive correlation between the peak-trough difference of instantaneous fh (ΔHR’ = HR’peak – HR’trough) and the breathing-specific fh (fh/fresp). To test this hypothesis, we combined breath-by-breath data for ΔHR’ from several previous studies, resulting in a database of over 600 subjects. This extensive dataset allowed us to construct statistically meaningful correlations between ΔHR’ and variables associated with RSA (fh, fresp, HR’peak, and HR’trough). A strong statistically significant (r > 0.9) correlation between fh/fresp and ΔHR’ was observed. These findings support the hypothesis that RSA may be a mechanism for improving the match between the quasi-continuous blood flow and the intermittent airflow.

Clinical Validation of Respiratory Rate Estimation Using Acoustic Signals from a Wearable Device

Objectives: Respiratory rate (RR) is a clinical measure of breathing frequency, a vital metric for clinical assessment. However, the recording and documentation of RR are considered to be extremely poor due to the limitations of the current approaches to measuring RR, including capnography and manual counting. We conducted a validation of the automatic RR measurement capability of AcuPebble RE100 (Acurable, London, UK) against a gold-standard capnography system and a type-III cardiorespiratory polygraphy system in two independent prospective and retrospective studies. Methods: The experiment for the prospective study was conducted at Imperial College London. Data from AcuPebble RE100 (Acurable, London, UK) and the reference capnography system (Capnostream™35, Medtronic, Minneapolis, MN, USA) were collected simultaneously from healthy volunteers. The data from a previously published study were used in the retrospective study, where the patients were recruited consecutively from a standard Obstructive Sleep Apnea (OSA) diagnostic pathway in a UK hospital. Overnight data during sleep were collected using the AcuPebble SA100 (Acurable, London, UK) sensor and a type-III cardiorespiratory polygraphy system (Embletta MPR Sleep System, Natus Medical, Pleasanton, CA, USA) at the patients’ homes. Data from 15 healthy volunteers were used in the prospective study. For the retrospective study, 150 consecutive patients had been referred for OSA diagnosis and successfully completed the study. Results: The RR output of AcuPebble RE100 (Acurable, London, UK) was compared against the reference device in terms of the Root Mean Squared Deviation (RMSD), mean error, and standard deviation (SD) of the difference between the paired measurements. In both the prospective and retrospective studies, the AcuPebble RE100 algorithms provided accurate RR measurements, well within the clinically relevant margin of error, typically used by FDA-approved respiratory rate monitoring devices, with the RMSD under three breaths per minute (BPM) and mean errors of 1.83 BPM and 1.4 BPM, respectively. Conclusions: The evaluation results provide evidence that AcuPebble RE100 (Acurable, London, UK) algorithms produce reliable results and are hence suitable for overnight monitoring of RR.

Breathing modulates network activity in frontal brain regions during anxiety.

Anxiety elicits various physiological responses, including changes in respiratory rate and neuronal activity within specific brain regions such as the medial prefrontal cortex (mPFC). Previous research suggests that the olfactory bulb (OB) modulates the mPFC through respiration-coupled neuronal oscillations (RCOs), which have been linked to fear-related freezing behavior. Nevertheless, the impact of breathing on frontal brain networks during other negative emotional responses, such as anxiety-related states characterized by higher breathing rates, remains unclear. To address this, we subjected rats to the elevated plus maze (EPM) paradigm while simultaneously recording respiration and local field potentials in the OB and mPFC. Our findings demonstrate distinct respiratory patterns during EPM exploration: slower breathing frequencies prevailed in the closed arms, whereas faster frequencies were observed in the open arms, independent of locomotor activity, indicating that anxiety-like states are associated with increased respiratory rates. Additionally, we identified RCOs at different frequencies, mirroring the bimodal distribution of respiratory frequencies. RCOs exhibited higher power during open arm exploration, when they showed greater coherence with breathing at faster frequencies. Furthermore, we confirmed that nasal respiration drives RCOs in frontal brain regions, and found a stronger effect during faster breathing. Interestingly, we observed that the frequency of prefrontal gamma oscillations modulated by respiration increased with breathing frequency. Overall, our study provides evidence for a significant influence of breathing on prefrontal cortex networks during anxious states, shedding light on the complex interplay between respiratory physiology and emotional processing.Significance Statement Understanding how breathing influences brain activity during anxious states could pave the way for novel therapeutic interventions targeting respiratory control to alleviate anxiety symptoms. Our study uncovers a crucial link between respiratory patterns and anxiety-related neural activity in the brain. By investigating the interplay between breathing, neuronal oscillations, and emotional states, we reveal that anxiety induces distinct respiratory patterns, with higher breathing rates correlating with anxious behavior. Importantly, we demonstrate that respiration drives oscillatory activity in the prefrontal cortex, and this effect is potentiated during the fast breathing associated with anxiety. Furthermore, faster breathing modulates the emergence of faster prefrontal gamma oscillations. This discovery sheds new light on the intricate relationship between respiratory physiology and emotional processing.

Changes in Negative Emotions Across Five Weeks of HRV Biofeedback Intervention were Mediated by Changes in Resting Heart Rate Variability.

Resting heart rate variability (HRV) is typically higher in those with better emotional well-being. In the current study, we examined whether changes in resting HRV mediated changes in negative emotions during a 7-week clinical trial of HRV biofeedback. Younger and older adults were randomly assigned to one of two daily biofeedback practices for 5weeks: (1) engage in slow-paced breathing to increase the amplitude of oscillations in heart rate at their breathing frequency (Osc+); or (2) engage in self-selected strategies to decrease heart rate oscillations (Osc-). We assessed negative emotion using the State Anxiety Inventory (SAI) and Profile of Mood States (POMS). Resting HRV at pre-intervention was significantly higher among those with lower negative emotion scores. Those participants showing greater increases in resting HRV showed greater decreases in negative emotion. In a mediation model with all participants, resting HRV changes significantly mediated the relationship between training performance (i.e., heart rate oscillation during practice sessions) and changes in negative emotion. However, additional analyses revealed this mediation effect was significantly moderated by condition and was only significant in the Osc+ condition. Thus, resting HRV changes mediated how biofeedback to increase amplitude of heart rate oscillations reduced negative emotion.

Respiratory Dysfunction and Abnormal Hypoxic Ventilatory Response in Mild to Moderate Parkinson's Disease.

Respiratory dysfunction is an important contributor to morbidity and mortality in advanced Parkinson's disease (PD), but it is unclear what parameters are sensitive to diagnose and monitor respiratory dysfunction across disease phases. We aimed to characterize respiratory dysfunction in mild to moderate PD. In 20 individuals without cardiopulmonary comorbidity, pulmonary and inspiratory muscle function testing were performed ON-medication. Subsequently, the acute ventilatory response to hypoxia (HVR) was assessed by gradually decreasing FIO2 from 0.209 (room air) to 0.127, which was compared to eight age- and sex-matched healthy controls under arterial blood gas monitoring. Lastly, on different days, the same 20 individuals with PD underwent six blinded exposures to 45-min normobaric hypoxia at FiO2 0.163 and 0.127 or placebo OFF-medication to assess breathing responses. At rest, individuals with greatest PD severity had a lower tidal volume (pairwise comparisons: 0.59 vs. 0.74, P = 0.038-0.050) and tended to have a higher breathing frequency (17.7 vs. 14.4, P = 0.076), despite normal pulmonary function. A 45-min exposure to hypoxia induced a significantly lower acute HVR in individuals with PD compared to controls (-0.0489 vs. 0.133 L.min/%, P = 0.0038). Acute HVR was reduced regardless of disease severity. Subacute HVR in individuals with milder disease tended to be higher compared to those with more advanced disease (P = 0.079). Respiratory dysfunction is present in individuals with PD, including those with relatively mild disease severity, and is characterized by altered breathing patterns at rest, as well as a lower HVR, despite normal pulmonary and inspiratory muscle function testing.

Relationships between capnogram parameters by mainstream and sidestream techniques at different breathing frequencies

Capnography, routinely used in operating rooms and intensive care units, reveals essential information on lung ventilation and ventilation–perfusion matching. Mainstream capnography directly measures CO2 in the breathing circuit for accurate analysis and is considered a reference technique. Sidestream capnography, however, analyzes gas away from the patient leading to potentially less accurate measures. While these methodological differences impact the capnogram indices in mechanically ventilated patients, such assessments during spontaneous breathing are essentially lacking. Accordingly, we aimed to compare mainstream and sidestream capnography in spontaneously breathing subjects, focusing on differences in capnogram shape and dead space indices at various respiratory rates. Simultaneous mainstream and sidestream time and volumetric capnography were performed on spontaneously breathing adults (n = 35). Measurements were performed during controlled low (10/min), medium (12/min), and high (20/min) breathing rates as a challenge. Correlation and Bland–Altman analyses were used to assess trends and agreements between time and volumetric capnography indices obtained by the mainstream and sidestream techniques, including end-tidal CO2 (ETCO2), shape factors reflecting the slopes of phases 2 and 3, and anatomical and physiological dead space fractions. ETCO2 and physiological dead space measured by mainstream and sidestream techniques showed excellent correlations (r > 0.90, p < 0.001 for all breathing rates) and agreements. While strong correlations and moderate agreements were evidenced in the parameters reflecting the late phase of expiration (phase 3 slope and exhaled CO2 volume), these relationships were weaker for indices related to the early phase of expiration (phase 2 slope, anatomical dead space). Changing breathing frequency caused significant alterations in all capnography parameters, which were detectable by both mainstream and sidestream techniques. Sidestream capnography cannot substitute the more accurate mainstream technique for measuring the absolute values of shape factors and ventilation dead space fractions. However, sidestream capnography is also able to detect and track changes in uneven alveolar emptying, ventilation–perfusion matching and ventilation dead space fraction in spontaneously breathing subjects.

High-Flow Nasal Aerosol Therapy; Regional Aerosol Deposition and Airway Responsiveness.

Introduction: In normal subjects, during tidal breathing, aerosols deposit by settling in small airways. With obstructive lung disease (OLD), collapse of airways during expiration causes turbulence and increased deposition in central airways. High-flow nasal cannula (HFNC) therapy, washing out dead space, may affect deposition mechanisms and drug delivery. This study compared aerosol deposition and airway responsiveness in OLD after traditional and HFNC nebulization therapy. Methods: Twelve subjects with moderate to severe OLD participated in a two-day study. Spirometry was measured pre- and post-aerosol inhalation. On Day 1 (D1) subjects tidally inhaled radiolabeled albuterol (99mTc DTPA) by mouth via AeroTech II, (Biodex. Shirley, NY). Day 2 (D2) inhalation was via HFNC using i-AIRE (InspiRx, Inc. Somerset, NJ). The HFNC system (60 L/m) was infused by syringe pump at 50 mL/h. D2 lung deposition was monitored in real time by gamma camera to match D1. Pre and post heart rate, O2 sat, and nasopharyngeal deposition (NP) were measured. Mechanistic contributions were modeled using multiple linear regression (MLR) of deposition rate (DR µg/m) as a function of breathing frequency, airway geometry (FEV1), and parenchymal integrity (DLCO). Results: Albuterol lung depositions were matched (p = 0.13) with D1 central/peripheral (sC/P) ratios 1.99 ± 0.98. Following HFNC, peripheral deposition increased (31% ± 33%, sC/P = 1.51 ± 0.43, p = 0.01). D2/D1% change FVC increased by 16.1 ± 16.7% (p = 0.003). NP deposition averaged 333% of lung. Heart rate and O2 sat were unaffected (p = 0.31, p = 0.63 respectively). DR analysis was markedly different between D1 (R2 = 0.82) and D2 (R2 = 0.12). Conclusion: In subjects with OLD, HFNC nebulization at 60 L/min was well tolerated and increased peripheral drug delivery. Spirometry significantly improved. Systemic effects were undetected indicating limited nasal absorption. MLR demonstrated that different mechanisms of deposition govern traditional vs HFNC aerosol delivery. Breath-enhanced nebulization via HFNC may provide controllable and effective aerosol therapy in OLD.

Validity and Reliability of a New Wearable Chest Strap to Estimate Respiratory Frequency in Elite Soccer Athletes.

Assessing respiratory frequency (fR) is practical in monitoring training progress in competitive athletes, especially during exercise. This study aimed to validate a new wearable chest strap (wCS) to estimate fR against ergospirometry as a criterion device in soccer players. A total of 26 elite professional soccer players (mean [standard deviation]: 23.6 [4.8] years; 180.6 [5.7] cm; 77.2 [5.4] kg) from three Italian Serie A League teams participated in this cross-sectional study. The sample included attackers, midfielders, and defenders. fR was assessed during a maximal cardiopulmonary exercise test (CPET) on a treadmill using (i) a breath-by-breath gas exchange analyzer (Vyntus® CPX, Vyaire Medical) and (ii) a novel wCS with sensors designed to assess breath frequency following chest expansions. Pearson's correlation coefficient (r), adjusted coefficient of determination (aR2), Bland-Altman plot analysis, and Lin's concordance correlation coefficient (ρc) were used for comparative analysis (correlation and concordance) among the methods. The repeated measures correlation coefficient (rrm) was used to assess the strength of the linear association between the methods. The intraclass correlation coefficient (ICC) and the Finn coefficient (rF) were used for inter-rater reliability. All statistical analyses were performed within the R statistical computing environment, with 95% confidence intervals (95% CIs) reported and statistical significance set at p < 0.05. A total of 16529 comparisons were performed after collecting the CPET data. The robust time series analysis with Hodges-Lehmann estimation showed no significant differences between both methods (p > 0.05). Correlation among devices was statistically significant and very large (r [95% CI]: 0.970 [0.970, 0.971], p < 0.01; aR2 [95% CI]: 0.942 [0.942, 0.943], p < 0.01) with strong evidence supporting consistency of the new wCS (BF10 > 100). In addition, a high concordance was found (ρc [95% CI]: 0.970 [0.969, 0.971], bias correction factor: 0.999). VyntusTM CPX, as a standard criterion, showed moderate agreement with wCS after Bland-Altman analysis (bias [95% lower to the upper limit of agreement]; % agree: 0.170 [-4.582 to 4.923] breaths·min-1; 69.9%). A strong association between measurements (rrm [95% CI]: 0.960 [0.959, 0.961]), a high absolute agreement between methods (ICC [95% CI]: 0.970 [0.970, 0.971]), and high inter-rater reliability (rF: 0.947) were found. With an RMSE = 2.42 breaths·min-1, the new wCS seems to be an valid and reliable in-field method to evaluate fR compared to a breath-by-breath gas exchange analyzer. Notwithstanding, caution is advised if methods are used interchangeably while further external validation occurs.

Deep brain stimulation of the motor thalamus relieves experimentally induced air hunger.

We previously reported that Deep Brain Stimulation (DBS) of motor thalamus (MT), in a patient with post-stroke tremor, relieved breathlessness associated with chronic obstructive pulmonary disease. This raised the question of whether MT DBS mitigates the ascending dyspnoea signal. We therefore sought to conduct a fully powered cohort study of experimentally induced air hunger (AH), an uncomfortable urge to breathe in patients with MT DBS ON and OFF. 16 patients (3 females) with DBS of the ventral intermediate nucleus (VIM) as treatment for tremor, underwent hypercapnic AH tests, with DBS "ON" and "OFF". Patients rated AH on a visual analogue scale (VAS) every 15 s. Hypercapnia and ventilation were matched for ON and OFF states (mean±sd 43±4 and 43±4 mmHg for end-tidal PCO2, 13.7 and 13.4 L·min-1 for ventilation). Participants ventilation was constrained to baseline levels by breathing from a 3-litre inspiratory reservoir with fixed flow of fresh gas while targeting their resting breathing frequency to a metronome. Overall steady state AH was 52±28%VAS for "ON" and 67±20%VAS for "OFF" (p=0.002; two-tailed paired t-test). The mean reduction in AH during VIM DBS was -14.4%VAS. MT DBS relieved AH in thirteen patients, heightened AH in two and caused no change in one. MT DBS for tremor relief also mitigates the AH component of dyspnoea. We posit that DBS of the MT heightens the gating control of the thalamus modulating the ascending air hunger signal. Extent of relief suggests that thalamic DBS may prove to be a viable therapy for intractable dyspnoea.

Frequency of Screening and Spontaneous Breathing Trial Techniques

The optimal screening frequency and spontaneous breathing trial (SBT) technique to liberate adults from ventilators are unknown. To compare the effects of screening frequency (once-daily screening vs more frequent screening) and SBT technique (pressure-supported SBT with a pressure support level that was >0-≤8 cm H2O and a positive end-expiratory pressure [PEEP] level that was >0-≤5 cm H2O vs T-piece SBT) on the time to successful extubation. Randomized clinical trial with a 2 × 2 factorial design including critically ill adults who were receiving invasive mechanical ventilation for at least 24 hours, who were capable of initiating spontaneous breaths or triggering ventilators, and who were receiving a fractional concentration of inspired oxygen that was 70% or less and a PEEP level of 12 cm H2O or less. Recruitment was between January 2018 and February 2022 at 23 intensive care units in North America; last follow-up occurred October 18, 2022. Participants were enrolled early to enable protocolized screening (more frequent vs once daily) to identify the earliest that patients met criteria to undergo pressure-supported or T-piece SBT lasting 30 to 120 minutes. Time to successful extubation (time when unsupported, spontaneous breathing began and was sustained for ≥48 hours after extubation). Of 797 patients (198 in the once-daily screening and pressure-supported SBT group, 204 in once-daily screening and T-piece SBT, 195 in more frequent screening and pressure-supported SBT, and 200 in more frequent screening and T-piece SBT), the mean age was 62.4 (SD, 18.4) years and 472 (59.2%) were men. There were no statistically significant differences by screening frequency (hazard ratio [HR], 0.88 [95% CI, 0.76-1.03]; P = .12) or by SBT technique (HR, 1.06 [95% CI, 0.91-1.23]; P = .45). The median time to successful extubation was 2.0 days (95% CI, 1.7-2.7) for once-daily screening and pressure-supported SBT, 3.1 days (95% CI, 2.7-4.8) for once-daily screening and T-piece SBT, 3.9 days (95% CI, 2.9-4.7) for more frequent screening and pressure-supported SBT, and 2.9 days (95% CI, 2.0-3.1) for more frequent screening and T-piece SBT. An unexpected interaction between screening frequency and SBT technique required pairwise contrasts that revealed more frequent screening (vs once-daily screening) and pressure-supported SBT increased the time to successful extubation (HR, 0.70 [95% CI, 0.50-0.96]; P = .02). Once-daily screening and pressure-supported SBT (vs T-piece SBT) did not reduce the time to successful extubation (HR, 1.30 [95% CI, 0.98-1.70]; P = .08). Among critically ill adults who received invasive mechanical ventilation for more than 24 hours, screening frequency (once-daily vs more frequent screening) and SBT technique (pressure-supported vs T-piece SBT) did not change the time to successful extubation. However, an unexpected and statistically significant interaction was identified; protocolized more frequent screening combined with pressure-supported SBTs increased the time to first successful extubation. ClinicalTrials.gov Identifiers: NCT02399267 and NCT02969226.

Altered control of breathing in a rat model of allergic lower airway inflammation.

Obstructive sleep apnea (OSA) is highly prevalent in patients with asthma. Asthma, dose-dependently to its duration, promotes incident OSA, suggesting that asthma plays a role in OSA pathogenesis. We hypothesized that asthma-related inflammation alters breathing control mechanisms, specifically the carotid chemoreflex. Accordingly, we measured hypoxic ventilatory responses (HVR) in awake, unrestrained, ovalbumin (OVA)-sensitized Brown Norway rats and compared them with responses in sham-sensitized (SALINE) controls. To differentiate the role of allergic inflammation from bronchoconstriction, we repeated hypoxic ventilatory response (HVR) after administration of formoterol, a long-acting bronchodilator. Blood and bronchoalveolar lavage (BAL) fluid were collected for quantification of inflammatory cytokines. The rise in ventilatory equivalent for O2 evoked by acute exposure to hypoxia was augmented following sensitization by OVA, whereas it remained stable after SALINE. This augmentation was driven by increased breathing frequency with no change in tidal volume. Tachypneic hyperventilation in normoxia was also observed with OVA. Neither the increased HVR nor excessive normoxic ventilation was affected by formoterol, suggesting that they were not secondary to lung mechanical constraints. Higher levels of inflammatory cytokines were observed in BAL fluid and serum of OVA versus SALINE. In OVA, serum interleukin-5 levels significantly correlated with change from baseline in ventilatory responses to severe hypoxia ([Formula: see text], 0.09). These observations are consistent with inflammation-induced enhancement of carotid chemoreflex function, i.e., increased controller gain, and they suggest a possible role for asthma-related allergic inflammation in the ventilatory instability known to promote upper airway collapse and sleep apnea in humans.NEW & NOTEWORTHY Asthma is a risk factor for obstructive sleep apnea (OSA); however, the mechanisms are incompletely understood. In a rat model of allergic inflammation associated with asthma, we found that ventilation in normoxia and ventilatory responses to hypoxia were markedly enhanced and related with systemic inflammation. These alterations indicating carotid chemoreflex sensitization, known to promote ventilatory instability during sleep in humans, may contribute to the increased OSA risk in asthma.

A selective frequency damping and Janus adhesive hydrogel as bioelectronic interfaces for clinical trials

Maintaining stillness is essential for accurate bioelectrical signal acquisition, but dynamic noise from breathing remains unavoidable. Isotropic adhesives are often used as bioelectronic interfaces to ensure signal fidelity, but they can leave irreversible residues, compromising device accuracy. We propose a hydrogel with selective frequency damping and asymmetric adhesion as a bioelectronic interface. This hydrogel mitigates dynamic noise from breathing, with a damping effect in the breathing frequency range 60 times greater than at other frequencies. It also exhibits an asymmetric adhesion difference of up to 537 times, preventing residues. By homogenizing ion distribution, extending Debye length, and densifying the electric field, the hydrogel ensures stable signal transmission over 10,000 cycles. Additionally, it can non-invasively diagnose otitis media with higher sensitivity than invasive probes and has been effective in clinical polysomnography monitoring, aiding in the diagnosis of obstructive sleep apnea.

Oscillatory airflow through the hypopharyngeal and supraglottic airway

Exercise-induced laryngeal obstruction (EILO) is a known cause of exertional dyspnoea, characterised by paradoxical inward collapse of laryngeal tissues. The pathophysiological mechanisms of EILO remain to be fully established, but insufficient mechanical resistance of laryngeal tissues to air-induced loads is hypothesised. It is understood that airflow and anatomic configurations of the airway play a key role in the wall pressure distribution of the larynx. While breathing is a cyclic process with directional changes of airflow, the literature is confined to steady, unidirectional airflow. It is necessary to assess the role of oscillatory airflow on the loads on the laryngeal airway. This study investigates the effect of oscillatory airflow on the laryngeal flow fields and air-induced loads. A computational fluid dynamics model of the upper respiratory tract (URT) is developed using the Reynolds-averaged Navier-Stokes equations. Five oscillatory airflow cases through a single geometry are considered, utilising sinusoidal breathing cycles with different breathing frequencies (24, 32 and 40 breaths per minute) and peak inspiratory flow rates (96, 168 and 240 L/min). Results include the airflow velocity distribution in the URT, and the air-induced pressure and forces. It is demonstrated that inspiratory velocity distribution varies with breathing frequency and intensity. The force acting on the URT walls are in-phase with the airflow rate and therefore exhibit quasi-steady behaviour. These findings are also reflected in the force vectors acting on the aryepiglottic folds and indicate that air-induced closure of the supraglottis in EILO is influenced by the breathing intensity rather than the breathing frequency.

Custom Smartphone Application to Guide Locomotor-Respiratory Coupling in the Field Using Step-Adaptive Breathing Sounds.

While running is amongst the most popular activities for competition and leisure, an estimated 20-40% of runners may suffer from respiratory limitations. Some of these runners may benefit from breathing techniques to improve performance or alleviate respiratory discomfort. One such technique is locomotor-respiratory coupling (LRC), a frequency and phase synchronization of breath to step. Studies have demonstrated that LRC may benefit ventilatory efficiency via "step-driven flows," and some experts have argued it could be used for pacing exercise or increasing positive emotional states. Nevertheless, it may be difficult to perform without coaching or guidance. Here we propose RunRhythm, a custom smartphone application to deliver step-synchronized sound guidance for LRC. This concept builds on previous evidence that sound guidance can be effective and integrates features to maximize adherence and individualization. Preliminary results show that this application is a promising and efficacious method suitable for research on LRC in field exercise. Recommendations for use and further development are discussed to further develop this concept for the benefit of a wider population.

Validation of a Textile-Based Wearable Measuring Electrocardiogram and Breathing Frequency for Sleep Apnea Monitoring

Sleep apnea (SA) is a prevalent disorder characterized by recurrent events of nocturnal apnea. Polysomnography (PSG) represents the gold standard for SA diagnosis. This laboratory-based procedure is complex and costly, and less cumbersome wearable devices have been proposed for SA detection and monitoring. A novel textile multi-sensor monitoring belt recording electrocardiogram (ECG) and breathing frequency (BF) measured by thorax excursion was developed and tested in a sleep laboratory for validation purposes. The aim of the current study was to evaluate the diagnostic performance of ECG-derived heart rate variability and BF-derived breathing rate variability and their combination for the detection of sleep apnea in a population of patients with a suspicion of SA. Fifty-one patients with a suspicion of SA were recruited in the sleep laboratory of the Cantonal Hospital St. Gallen. Patients were equipped with the monitoring belt and underwent a single overnight laboratory-based PSG. In addition, some patients further tested the monitoring belt at home. The ECG and BF signals from the belt were compared to PSG signals using the Bland-Altman methodology. Heart rate and breathing rate variability analyses were performed. Features derived from these analyses were used to build a support vector machine (SVM) classifier for the prediction of SA severity. Model performance was assessed using receiver operating characteristics (ROC) curves. Patients included 35 males and 16 females with a median age of 49 years (range: 21 to 65) and a median apnea-hypopnea index (AHI) of 33 (IQR: 16 to 58). Belt-derived data provided ECG and BF signals with a low bias and in good agreement with PSG-derived signals. The combined ECG and BF signals improved the classification accuracy for SA (area under the ROC curve: 0.98; sensitivity and specificity greater than 90%) compared to single parameter classification based on either ECG or BF alone. This novel wearable device combining ECG and BF provided accurate signals in good agreement with the gold standard PSG. Due to its unobtrusive nature, it is potentially interesting for multi-night assessments and home-based patient follow-up.

High-performance flexible humidity sensor based on B-TiO2/ SnS2 nanoflowers for non-contact sensing and respiration detection

The development of flexible humidity sensors is essential for the advancement of wearable devices and electronic skin. However, the process of preparing these sensors is typically complex, and they often suffer from poor stability and a limited sensing range, which fails to meet the requirements for practical applications. Here, we prepared SnS2 with nanoflower morphology by hydrothermal method, and successfully prepared a high-performance flexible humidity sensor with a high response range (20-95 %) by compositing it with B-TiO2 nanoparticles with oxygen defects after sodium borohydride reduction and coating it on a PET flexible substrate. This sensor demonstrates an exceptional response (753.2 at 90 % RH) in high humidity environments and exhibits rapid response (13 s) and recovery times (19 s). Moreover, the sensor accurately detects human breathing patterns and frequencies, making it suitable for non-contact sensing applications. This research offers valuable insights into the simplified preparation and advancement of flexible humidity sensors.

An IoT-based contactless neonatal respiratory monitoring system for neonatal care assistance in postpartum center

According to previous studies, one of the major causes of 20 % to 25 % of neonatal deaths is respiratory distress syndrome (RDS). Early identification, progressive monitoring, and treatment and/or management of neonatal RDS can substantially increase the rate of survival in neonates. However, global research indicates frequent shortages and burnout among nursing staff, especially in postpartum units, contributing to the difficulty in early identification of RDS in neonates. Clinicians currently use breathing sounds and frequency as key criteria in the Neonatal Resuscitation Program (NRP) for identifying and treating RDS. In practice, the monitoring of respiratory signal abnormalities relies on sensor patches, which frequently detach from the neonates’ slippery skin, leading to potential skin injuries and unstable signal reception. This paper presents an Internet of Things (IoT)-based contactless neonatal respiratory monitoring system that integrates computer vision (CV), beamforming microphone array (BFMA), and millimeter Wave (mmWave) radar, all connected to a cloud platform. Clinical trials revealed that CV-based neonatal feature identification achieved over 96 % accuracy within 40 cm to 120 cm. The neonatal breathing sound strengthening, utilized CV and BFMA, achieved an average sound-to-noise ratio (SNR) of 5.07 dB, and CV with mmWave radar reduced chest displacement signal error from 0.66 to 0.26 BPM. Additionally, survey results showed that doctors and clinical personnel were satisfied with the system's functionality and usability. This demonstrates the system's ability to assist in monitoring respiratory signals of swaddled neonates and in the early identification of neonatal RDS, with further applications in neonatal care at postpartum centers.

Comparative Study of Different Respiratory Muscle Training Methods: Effects on Cardiopulmonary Indices and Athletic Performance in Elite Short-Track Speedskaters.

Respiratory muscle training (RMT) improves endurance performance, balance, and ability to repeat high-intensity exercise bouts, providing a rationale to be applied in short-track speedskating. To establish a preferable RMT method for short-track speedskating, the influence of inspiratory pressure threshold loading (IPTL) and voluntary isocapnic hyperpnoea (VIH) on cardiopulmonary indices and athletic performance was investigated. Sixteen elite short-track speedskaters completed 6 weeks of RMT based on IPTL or VIH. Wingate Anaerobic Tests (WAnTs), cardiopulmonary exercise tests (CPETs), spirometry assessments, and on-ice time trials were performed before and after RMT intervention. Repeated measures ANOVA was used to assess the differences between each method's influence. No statistically significant (p > 0.05) differences between RMT methods were found in performance during the WAnT, CPET, or specific on-ice time trials. Spirometry measures were similar between both methods. Significant effects were found for the interaction between maximum breathing frequency during CPET (BFmax) and method (p = 0.009), as well as for the interaction between BFMax, method, and sex (p = 0.040). BFmax decreased for IPTL and increased for VIH. The interaction between method and sex revealed that BFmax increased only in males performing VIH. Our findings suggest that IPTL and VIH lead to analogous effects in the study participants, highlighting a negligible practical disparity in the impact of different RMT methods in elite short-track speedskaters.

The impact of controlled breathing on autonomic nervous system modulation: analysis using phase-rectified signal averaging, entropy and heart rate variability

Objective.The present study investigated how breathing stimuli affect both non-linear and linear metrics of the autonomic nervous system (ANS).Approach.The analysed dataset consisted of 70 young, healthy volunteers, in whom arterial blood pressure (ABP) was measured noninvasively during 5 min sessions of controlled breathing at three different frequencies: 6, 10 and 15 breaths min-1. CO2concentration and respiratory rate were continuously monitored throughout the controlled breathing sessions. The ANS was characterized using non-linear methods, including phase-rectified signal averaging (PRSA) for estimating heart acceleration and deceleration capacity (AC, DC), multiscale entropy, approximate entropy, sample entropy, and fuzzy entropy, as well as time and frequency-domain measures (low frequency, LF; high-frequency, HF; total power, TP) of heart rate variability (HRV).Main results.Higher breathing rates resulted in a significant decrease in end-tidal CO2concentration (p< 0.001), accompanied by increases in both ABP (p <0.001) and heart rate (HR,p <0.001). A strong, linear decline in AC and DC (p <0.001 for both) was observed with increasing breathing rate. All entropy metrics increased with breathing frequency (p <0.001). In the time-domain, HRV metrics significantly decreased with breathing frequency (p <0.01 for all). In the frequency-domain, HRV LF and HRV HF decreased (p= 0.038 andp= 0.040, respectively), although these changes were modest. There was no significant change in HRV TP with breathing frequencies.Significance.Alterations in CO2levels, a potent chemoreceptor trigger, and changes in HR most likely modulate ANS metrics. Non-linear PRSA and entropy appear to be more sensitive to breathing stimuli compared to frequency-dependent HRV metrics. Further research involving a larger cohort of healthy subjects is needed to validate our observations.