Clinical Physiology Research Articles

Comparison of Curricula of BS Medical Imaging in UAE and Selected Countries

Background Medical imaging techniques are employed to reveal internal structures that exist beneath the skin and bones to detect anomalies and aid in the treatment of illnesses. The purpose of this work was to present and compare existing curricula of the Bachelor of Science BS Medical Imaging program in the UAE and other selected countries namely KSA India USA Australia Sudan Jordan Kuwait Qatar and Bahrain.Methods We employed the document analysis technique and mixed method qualitative and quantitative approach. The information on each of the bachelor program offered at the studied universities was obtained from the respective university websites.Results The comparison of the curricula in UAE and the selected countries showed that the range of total credit hours among the studied universities was 120 -160 credit hours while the duration of program in the all the universities was four years. The internship duration varied from 18 credit hours to one year. Among the basic medical courses Anatomy and Physiology courses were common in the curricula of the studied universities. The Queensland University did not offer any course from the basic science category. Alrazi University showed the highest similarity to the UAE universities in major courses while the Queensland University showed the highest variation in major courses. Certain universities offered unique courses that were not included in the curricula of other universities. Conclusion Among all the studied universities Alrazi University showed the highest similarity to the UAE universities in major courses while the Queensland University showed the highest variation.

Orientation and application of gamification as teaching learning method by medical physiologists in India

Background: Gamification, the integration of game elements into non-gaming contexts, has gained significant attention in education, including medical education. Researches revealed that gamification elements such as points, badges, levels, and feedback are commonly used in higher education. Gamification is seen as a tool that can help millennial and Gen Z students, who prefer social learning ecosystems, in competency development and contextual learning. A review of gamification-based learning tools in both preclinical and clinical settings highlighted heightened student engagement and superior educational outcomes, but competitive gamification yielded unexpected results, with students spending limited time and resisting competitiveness. Aims and Objectives: This paper presents a cross-sectional study conducted in India to assess the orientation and application of gamification among faculty members of Medical Physiology. The study aimed to identify the advantages, challenges, and potential of gamification in enhancing the quality of medical education in India. Materials and Methods: The authors addressed the deficiency in the orientation and application of gamification tools in medical education by conducting a questionnaire-based cross-sectional study among medical physiologists in various Indian institutions and colleges. Results: Results showed that approximately 25% of the faculty members surveyed in India were oriented toward gamification, with slightly more orientation among junior faculties and those from northern India. There were regional variations in the use of specific gamification elements, such as points and badges, letterboards, and storyline elements. Conclusion: The study highlighted a promising trend of gamification adoption among medical physiologists, while also noting that a significant portion of faculty members remained unoriented and had yet to explore the benefits of gamification in medical education. The paper emphasized the need for proactive promotion and application of gamification tools to enhance teaching and learning methods in medical education.

Neutrophil-to-Lymphocyte Ratio in Adult Patients with Anemia: A Hospital-Based Cross-Sectional Study

Background: Neutrophil-to-lymphocyte ratio, a well-defined marker of immunity, is raised in many conditions which are characterized by abnormal inflammatory and immunological responses. Anemia of chronic disease, the most prevalent type in hospitalized patients, is a dominant clinical picture in protracted stimulation of immunity. This study aimed to assess the neutrophil-to-lymphocyte ratio in adult participants with anemia and to compare of the ratio with non-anemic participants. Methods: In a cross-sectional study conducted in the Department of Clinical Physiology of Karnali Academy of Health Sciences, Teaching Hospital, Jumla, Karnali Province, Nepal, in the months of August, 2023, data on clinico-demographic variables were retrieved from the laboratory information system of hospital records of February–March, 2023. From the hematological parameters retrieved, the status of anemia and the neutrophil-to-lymphocyte ratio were calculated. Results: After scrutiny of the laboratory records of 1421 adult patients, with 69.7% (N=990) female, the prevalence of anemia was 12.4% (N=176) and the median neutrophil-to-lymphocyte ratio was 2.21 (IQR: 1.41–3.75). The median neutrophil-to-lymphocyte ratio was significantly greater in the anemic participants among the overall (p<0.001) participants and across the subgroups of gender (p<0.001) and age (p<0.05). Conclusion: The neutrophil-to-lymphocyte ratio was significantly greater in the adult anemic than in the non-anemic participants. To this end, further studies assessing the association of this ratio with the various clinical aspects of anemia, such as subtypes, severity, course, prognosis and treatment responses are needed.

Comparison of Spirometric Parameters in different Postures among Young Healthy Volunteers.

Spirometry is the most common pulmonary function tests that specifically measures volume and flow of air during respiration. It helps to identify obstructive and restrictive diseases of the lungs. The alterations of the results in spirometry can happen even in normal health due to change in body postures that alter lung volumes and muscle biomechanics. So, the objective of this study is to determine the effects of change of postures mainly supine, sitting and standing on pulmonary parameters of young healthy volunteers. A cross-sectional analytical study was conducted among young medical students of Maharajgunj Medical Campus in the department of Clinical Physiology. A total of 31 students were selected by convenient sampling technique. Pulmonary parameters: Forced Vital Capacity (FVC), Forced Expiratory Volume in 1st second (FEV1), FEV1/FVC, Peak Expiratory Flow(PEF), EF2575 were collected from spirometry. The spirometry was done in supine, sitting and standing postures and the best value of each posture was selected for the comparison and obtained data were analyzed using repeated measures ANOVA with confidence interval of 95%. The pulmonary parameters recorded in different postures showed that the mean of these variables comparatively increased in standing posture than others with mean FVC 3.98±0.66 L, mean FEV1 3.53±0.55L, mean FEV1/FVC 89.23±5.60%, mean PEF 8.60±1.62L/s and mean PEF2575 4.46±1.08 L/s. The mean comparisons of these pulmonary parameters in supine, sitting and standing postures showed statistically significant differences with P value < 0.05. The pulmonary parameters are affected by body postures. Those parameters are recorded highest during standing posture and lowest during supine posture.

Understanding the Effects of E-Learning on Subject Physiology Through Using Blackboard among Medical Students During the COVID-19 Era

Background: The COVID-19 pandemic has significantly impacted global education, including medical education, with traditional lectures and internships being disrupted and replaced by online learning platforms. This study aims to investigate the impact of e-learning through Blackboard on medical student's physiology education, as it directly relates to their curriculum and future medical practice. Methods: A structured questionnaire was developed to gather data on the impact of e-learning on physiology. The questionnaire's design ensured content validity and inter-reliability by incorporating existing literature, theoretical frameworks, and expert input. A total of 149 second and third-year medical students participated in the study. The online questionnaire, distributed via Google Forms, utilized a Likert scale for students to rate their attitudes towards online teaching. It covered demographic information, student satisfaction, and satisfaction with assignment methods. Results: Most participants were female (64%), and most students accessed online classes through their phones (93%). Results indicated that students agreed that online learning protected them from COVID-19 and facilitated better time management. However, a significant proportion for preferred face-to-face lectures and reported being distracted by the comforts of home. Overall, satisfaction rates were high, particularly for the assignment method, highlighting its benefits. Conclusion: This study shows that e-learning through Blackboard positively impacted medical students physiology education during COVID-19. Despite challenges and a preference for in-person learning, most students were satisfied with online teaching and found the assignment method beneficial. These findings highlight the potential of online platforms like Blackboard in medical education during crises, offering insights for improvement.

Restoring Memory Function in a Diabetic Mice Model

AbstractBackgroundDiabetes mellitus affects memory function in Alzheimer’s disease (Baglietto‐Vargas et al., 2016). Quercetin (Qt) and vitamin (Vit E) possesses anti‐inflammatory, memory enhancing and anti‐diabetic activities (Bui and Nguyen, 2017). This study explored the effects of administering both quercetin and vitamin E against cognitive deficits and neuroinflamation in high‐fat‐diet (HFD) and streptozotocin (HS)‐induced diabetic miceMethodNinety male mice (n = 15) were divided into six groups and fed with HFD except the normal group for 28 days. Diabetes was induced by STZ (50 mg/kg intraperitoneally) on day 22. Weight and blood glucose levels were taken weekly. On day 15, mice in the pretreatment groups (PQt 12.5 + Vit E 200 mg/kg and PQt 25 + Vit E) commenced treatment while on day 29, mice in the posttreatment groups (PtQt 12.5 + Vit E and PtQt 25 + Vit E) commenced treatment till day 42. Memory function (Y‐maze and NORT) was performed. The hippocampus of the animal brains were harvested for biochemical assays using ELISA (acetylcholinesterase enzyme (AChE), insulin, interleukin‐ 4 (IL‐4), interleukin‐6 (IL‐6) and tumor necrosis factor alpha (TNF‐α). Immunohistochemistry was used in detecting the expression of IBA‐1.ResultQuercetin and vitamin E significantly decreased the weight, glucose, insulin, and AChE levels in the HS‐induced mice. Memory function was restored by this combination. IL‐6 was decreased in PQt 25 + V and PtQt 25 +V; TNF‐α was decreased in PQt 25 + V and PtQt 12.5 +V while IL‐4 levels were increased in PQt 25 + V and PtQt 25 +V compared to the HS group. IBA‐1 was scarcely expressed in the PQt 12.5 mg/kg and PtQt (12.5 and 25 mg/kg) group compared to the HSgroup.ConclusionAdministering quercetin and vitamin E restored memory function through decreasing the activity of pro‐inflammatory mediators, increasing the activity of anti‐inflammatory mediators and decreasing microglial activation in HS‐induced mice.REFERENCES:Baglietto‐Vargas D, Shi J, Yaeger DM, Ager R, LaFerla FM. Diabetes and Alzheimer’s disease crosstalk. Neuroscience &amp; Biobehavioral Reviews. 2016 May 1;64:272‐87.Bui, T. T., &amp; Nguyen, T. H. (2017). Natural product for the treatment of Alzheimer’s disease. Journal of Basic and Clinical Physiology and Pharmacology, 28(5), 413‐423.

Lung functions pre- and post-endoscopic balloon dilation treatment among patients with subglottic stenosis.

Subglottic stenosis (SGS) is an unusual clinical condition of mucosal wounding, compromising the extra-thoracic part of the tracheal airway below the vocal folds. The diagnosis of SGS is established with a detailed clinical examination and a direct endoscopic examination, and the role of spirometry is also often acknowledged. This study aimed to investigate the impact of SGS on lung functions before and after the balloon dilation procedure. The respiratory functions were performed in the Department of Clinical Physiology and the Department of Otolaryngology College of Medicine, King Saud University, Riyadh, Saudi Arabia. In this study, 50 patients with SGS were referred from the Department of Otolaryngology, and lung functions before and after the balloon dilation procedure among patients with SGS were performed using an electronic spirometer. The results revealed that the mean values for lung function test parameters VC (p=0.01), FVC (p=0.01), FEV1 (p=0.004), FEV1/FVC Ratio (p=0.01), PEFR (p=0.01), FEF-25% (p=0.01), FEF-50% (p=0.01), and FEF-75%, (p=0.01) were significantly improved in both male and female patients with SGS on one month after the balloon dilation procedure. It is concluded that the lung function test parameters were increased after the balloon dilation procedure among patients with SGS. The findings showed the impact of SGS on lung function test parameters. Spirometry is a valuable test in patients with SGS and is an appropriate marker to reveal post-airway outcomes. Physicians must suggest lung function tests in patients with SGS before and after the balloon dilation procedure.

Digital flashcards and medical physiology performance: a dose-dependent effect.

Use of digital flashcards promotes active recall, spaced repetition, and self-assessment academic principles. This work explores the association and dose-dependent effect of this study method and locomotor (LP) and cardiovascular physiology (CP) grades. A single-faculty cohort study of medical LP and CP students was conducted, and 155 and 676 flashcards, respectively, were created through Moodle. An exploratory analysis examined three exam results (2019), and a confirmatory study used a fourth exam (2021) in another CP cohort. Of 685 students enrolled, 558 participated in the exploratory analysis: 319 (69%) for LP and 311 (84%) for CP, of which 203 LP and 267 CP students were flashcard users. Median grades were higher among flashcard users, and the number of cards reviewed was positively correlated with grades (r = 0.275 to 0.388 for LP and r = 0.239 to 0.432 for CP, P < 0.001). Multiple linear regression models confirmed a positive dose-dependent association between results and the number of flashcards studied: for every 100 LP cards reviewed, exam grades increased 0.44-0.75 on a 0-20 scale range (P < 0.001), and for every 1,000 CP flashcards, results raised 0.81-1.08 values (P < 0.05). These findings were confirmed in the 2021 CP cohort of 269 participants, of whom 67% were flashcard users. Digital flashcard revision has a consistent positive dose-dependent association on LP and CP grades.NEW & NOTEWORTHY Implementing flashcard-based strategies is a feasible way to promote active recall, spaced repetition, and self-assessment, and students are highly adherent to these initiatives. There is a positive dose-dependent association between the number of flashcards reviewed and physiology grades. These results are consistent across different physiology subjects, under different cohorts, over short and medium terms.

Students' Satisfaction Regarding the Application of Crossword Puzzles During the Online Teaching Practice of Medical Physiology: A Promising Experience During the COVID-19 Pandemic.

The coronavirus has hit the world and has led to substantial changes in all aspects of life. One of the important affected aspects is the teaching and learning process. Most of the learning authorities including King Abdulaziz University, Rabigh branch, have shifted to distant and online learning to avoid social contact and spreading the viral infection.Creating an interesting and interactive environment via online learning became necessary to attract the students' attention and sharing in the online sessions was, therefore, crucial. Crossword puzzles were created using an online tool. A questionnaire that assesses the satisfaction of the students regarding the application of the online puzzle was built and medical education experts did the content validity. Lectures were given online via the blackboard ultra-collaborate system followed by a brief session for solving the crossword puzzle. Students were given five minutes to think and prepare their answers and then they solved the puzzle via the chat window and the teacher corrected them.The questionnaire was sent to students in a Google form. Statistical analysis was followed using SPSS software. No major gender differences in students' satisfaction levels. 75.7% strongly agreed that games are an interesting and enthusiastic method in physiology education. 78.4% strongly agreed that games are an effective tool of communication between the teacher and students. 70.3% strongly agreed: crossword puzzle is an interesting interactive online educational tool. 64.9% strongly agreed that puzzles helped them to memorize the definitions and terminologies in physiology. 78.4% strongly agreed that crossword puzzles are a good addition to the educational practice of physiology. The crossword puzzle is considered a good tool for promoting an interesting, interactive online educational practice. The presence of no major gender difference in the students' satisfaction regarding this tool casts light on the importance of interactive, enjoyable, and creative teaching practice particularly during the stigmata of epidemics.

Do Regulatory and Curriculum Requirements for Interprofessional Practice Align?

While interprofessional (IP) competency and Interprofessional Education (IPE) has received increasing attention in health, agreement on specific competencies and teaching approaches is frequently limited by profession-specific understandings. As part of a quality improvement initiative focused on improving delivery of IPE offerings, this enquiry maps current regulatory and curricula requirements for IP practice to health professional students from 12 professions trained across Aotearoa New Zealand's national vocational education provider. Requirements for IP competency in national accreditation documents and in an operative teaching curricula were mapped for 12 professions, namely, clinical exercise physiology, counselling, massage, medical radiology, midwifery, nursing, occupational therapy, osteopathy, paramedicine, physiotherapy, social work, and sport and exercise science. A desk audit was conducted to identify the presence of core IP competencies for each profession. This involved a four-step process 1) Examination of regulatory standards for each profession to confirm IP requirements for each profession; 2) Examination of an operative curricula from each profession to identify the presence and translation of IP regulatory requirements to each of the profession-specific programs of study; 3) Mapping to identify within domains the core (common) IP competencies across the professions, and 4) Consideration of the similarities and differences between accreditation documents and curricula. Of 12 professions, 10 clearly identified IP competency as an expectation. Clinical Exercise Physiology and Counselling were exceptions with explicit requirement for IP competency not evident. Coordination and collaboration were the most identified competency domains in accreditation documents and curricula. In descending order of prevalence, communication, shared values, reflexivity, role-understanding, and teamwork were also identified requirements amongst the 10 professions with IP competency requirements. The IP competencies identified as common across professions can be used to inform development of teaching and assessment. Greater alignment between teaching curricula and required competency standards in this area is recommended.

Interactive audio human organ model combined with team-based learning improves the motivation and performance of nursing students in learning anatomy and physiology.

Among the basic medical sciences, anatomy and physiology (anatomy & physiology) is a fundamental subject for students majoring in nursing. Due to its diversity and difficulty, nursing students experience stress when studying it. Previous graduates generally presented lower achievements in anatomy & physiology than in other nursing-related subjects in the National Council Licensure Examination-Registered Nurse, indicating that anatomy & physiology education requires improvement. Accordingly, we examined the impact of innovative teaching on students' motivation and performance when learning anatomy & physiology through a quasi-experimental pre-/post-test design. For innovative teaching, we used the novel interactive audio human organ model, followed by team-based learning. The participants were 200 lower-grade students in the nursing department of a junior college in Taiwan, divided into two groups receiving innovative teaching (experimental group) or traditional teaching (control group). Questionnaire surveys were administered, and the collected data were statistically analyzed. The innovative teaching in anatomy & physiology improved learning motivation, especially in terms of affect, executive volition, and learning performance. The essential components of learning motivation, such as value, expectation, affect, and executive volition, were positively correlated with the reaction levels of learning performance. Regarding the improvement in academic performance, the experimental group performed significantly better than the control group. The use of innovative teaching in class enhances students' learning motivation and learning performance when studying anatomy & physiology. Interactive teaching aids enhance the enjoyment of learning anatomy & physiology while facilitating in-depth exploration of the human organs and systems.

Extracellular DNA enhances biofilm integrity and mechanical properties of mucoid Pseudomonas aeruginosa.

Pseudomonas aeruginosa is one of the most common biofilm-forming pathogens responsible for lung infections of individuals with cystic fibrosis (CF). P. aeruginosa becomes tolerant to antimicrobials in the biofilm state and is difficult to treat. Production of extracellular polymeric substances (EPS), such as alginate and extracellular DNA (eDNA), can allow adherence to abiotic and biotic surfaces, antimicrobial evasion, and resilience to environmental pressures. Alginate-producing mucoid variants of P. aeruginosa are frequently isolated from CF airway samples and are associated with worsening patient outcomes. While eDNA is a major structural component of nonmucoid P. aeruginosa biofilms, the potential role of eDNA in mucoid biofilms is unclear. Here, we investigate how eDNA contributes to clinical mucoid biofilm physiology and integrity. We predicted that eDNA plays a structural and mechanical role in mucoid biofilms. To test this, we quantified biofilm eDNA in mucoid biofilms and used microscopy and rheology to visualize eDNA and detect changes in biofilm structure and mechanics upon DNaseI treatment. We showed that biofilm eDNA abundance is diverse across clinical mucoid strains and observed a temporal increase in foci of eDNA within intact mucoid biofilms. Increased cell dispersal and reduced biomass were also observed following DNaseI treatment of mucoid biofilms. Degradation of eDNA also impacted the mechanical integrity of mucoid biofilms by increasing the stiffness and decreasing the cohesion of the biofilm. These findings advance our understanding of clinical mucoid P. aeruginosa biofilms and facilitate the development of new approaches to target biofilms by exploiting the functions of EPS components. IMPORTANCE Understanding the role of eDNA in mucoid Pseudomonas aeruginosa biofilms will lead to therapeutic strategies that combat the biophysical and structural function of EPS for the eradication of bacteria in mucoid biofilms during chronic infections. This knowledge can be used to further identify unknown matrix component interactions within pathogenic biofilm-forming clinical isolates.

Alteration of the maximal renal water excretion capacity with kidney function and age in human.

The kidney's capability to concentrate and dilute urine is crucial to maintaining body fluid compartments and plasma osmolality. Advanced age and chronic kidney disease (CKD) result in decreased maximal urine concentration. Less is known regarding urine dilution ability. The primary purpose of this study was to determine the relationship between maximal renal water excretion and renal function, age, and gender in humans. This monocentric retrospective study includes patients referred to the Department of Clinical Physiology in Toulouse University Hospital to measure the glomerular filtration rate (mGFR) between April 2013 and February 2018. mGFR was assessed using inulin renal clearance and required ample hydration. We quantified the effects of age, gender and mGFR have on water excretion ability, which was assessed by minimal urinary osmolality (minUosm) and maximal free water clearance (maxCH2O). 666 patients were included (mean age 51 ± 14years, 53% female). Mean mGFR was 82 ± 25mL/min/1.73m2. MinUosm after hydration was higher in patients with renal insufficiency while maxCH2O was markedly lower. Age was also, with a weaker effect, associated with decreased in water excretion, independently of mGFR. MaxCH2O clearance was similar in both genders, whereas minUosm was lower in women, possibly resulting from a lower osmotic load. This study shows a decrease in maximal urinary dilution capacity and free water clearance with CKD and age, without gender difference. These alterations are mild but must be considered when a significant water intake is required or in the case of hyponatremia.

Evaluating ChatGPT-3.5 and Claude-2 in Answering and Explaining Conceptual Medical Physiology Multiple-Choice Questions.

Background Generative artificial intelligence (AI) systems such as ChatGPT-3.5 and Claude-2 may assist in explaining complex medical science topics. A few studies have shown that AI can solve complicated physiology problems that require critical thinking and analysis. However, further studies are required to validate the effectiveness of AI in answering conceptual multiple-choice questions (MCQs) in human physiology. Objective This study aimed to evaluate and compare the proficiency of ChatGPT-3.5 and Claude-2 in answering and explaining a curated set of MCQs in medical physiology. Methods In this cross-sectional study, a set of 55 MCQs from 10 competencies of medical physiology was purposefully constructed that required comprehension, problem-solving, and analytical skills to solve them. The MCQs and a structured prompt for response generation were presented to ChatGPT-3.5 and Claude-2. The explanations provided by both AI systems were documented in an Excel spreadsheet. All three authors subjected these explanations to a rating process using a scale of 0 to 3. A rating of 0 was assigned to an incorrect, 1 to a partially correct, 2 to a correct explanation with some aspects missing, and 3 to a perfectly correct explanation. Both AI models were evaluated for their ability to choose the correct answer (option) and provide clear and comprehensive explanations of the MCQs. The Mann-Whitney U test was used to compare AI responses. The Fleiss multi-rater kappa (κ) was used to determine the score agreement among the three raters. The statistical significance level was decided at P ≤ 0.05. Results Claude-2 answered 40 MCQs correctly, which was significantly higher than the 26 correct responses from ChatGPT-3.5. The rating distribution for the explanations generated by Claude-2 was significantly higher than that of ChatGPT-3.5. The κ values were 0.804 and 0.818 for Claude-2 and ChatGPT-3.5, respectively. Conclusion In terms of answering and elucidating conceptual MCQs in medical physiology, Claude-2 surpassed ChatGPT-3.5. However, accessing Claude-2 from India requires the use of a virtual private network, which may raise security concerns.

Buzz Session as an Active Learning Method in Medical Undergraduate Physiology Teaching-An Institutional-Based Study.

In the current era of medical teaching, multiple active teaching-learning strategies are being explored due to drawbacks of conventional didactic learning methodology which are applicable to a typical classroom setting. Our attempt was to introduce short interactive buzz sessions in the midst of a lecture and assess the perception of students and faculty towards the use of these buzz sessions as an active learning method in physiology. To introduce buzz sessions as a teaching-learning tool in undergraduate medical teaching and to assess the student and faculty perception of this teaching method. This prospective, non-randomized, interventional study was carried out in the Department of Physiology, GMC Srinagar. The participants were 180 students of MBBS 1st Phase and 08 faculty members of the Physiology Department. Both the students and faculty were sensitized about the buzz sessions. Ten lectures of 1 h each were chosen from the Endocrine System, and taught by incorporating the buzz session in the lecture. The study was approved by the Institutional Ethical Committee. Both the students and the faculty favoured incorporating buzz sessions during the lectures as this teaching method makes the class interesting and interactive and helps to enhance communication, reasoning skills, and collaborative learning among the students. The study concludes that learning physiology using buzz sessions is liked and preferred by both students and faculty, and hence the need for buzz sessions in current medical teaching.

Clinical Exercise Physiology Accreditation: An Audit of Existing Standards

Abstract Background Health professions such as clinical exercise physiology are founded on a set of standards that outline base level knowledge, skills, and competencies to define the roles and scope of practice of the profession. Despite the practice of clinical exercise physiology having many common features regardless of the country in which it is conveyed, a harmonized set of international standards does not exist. The aim of this study was to systematically audit the professional standards for the 5 countries recognized as having existing national certification systems for clinical exercise physiology. Method: The audit process was conducted using a modified scoping review protocol based on the documentation provided by the American College of Sports Medicine, Exercise and Sports Science Australia, British Association of Sport and Exercise Sciences, Canadian Society for Exercise Physiology, and Sport and Exercise Science New Zealand. Two reviewers independently extracted data from the standards documents, and results were cross-checked by relevant experts from each jurisdiction. Results: Commonality of themes was found for 60% of all content extracted. The overall coverage of themes was 60%, 67%, 76%, 88%, and 98% from New Zealand, Canada, the United States, the United Kingdom, and Australia, respectively. Conclusion: A common core of themes is covered by all current national standards for clinical exercise physiology across the 5 nations audited but only variable coverage in the remaining 40%. These findings are important for understanding the differences in current training and certification of clinical exercise physiology professionals and how this might influence the internationalization of the profession.

Referral Sources To A Clinical Exercise Physiology Consultation For Special Populations In A Preventive Cardiology Practice

Referral Sources To A Clinical Exercise Physiology Consultation For Special Populations In A Preventive Cardiology Practice

Extracorporeal life support use in limited lung function: a narrative review.

In thoracic surgery, different modalities of extracorporeal life support (ECLS) can be used for cardiorespiratory support in complex scenarios. Decades of learning in clinical practice and physiology associated with technological development led to a great variety of ECLS technologies available. Thoracic surgery procedures with difficult or impossible single lung ventilation may still be performed using different ECLS modalities. The aim of this review is to describe the use of ECLS, with its different modalities, as a solution to perform complex surgeries in a patient with difficult or impossible single lung ventilation. A literature review was conducted using the terms "extracorporeal life support pulmonary resection" and "extracorporeal life support thoracic surgery", and articles were selected according to defined criteria. To support lung function during thoracic surgery, the most efficient and popular variety of ECLS is venovenous extracorporeal membrane oxygenation. Lung resection on a single lung after pneumonectomy, surgery in a patient with severe hypercapnia and/or low respiratory reserve, carinal and airway surgery, and severe thoracic trauma are the main examples of situations where ECLS may be the solution to provide a safe surgical environment in patients who cannot tolerate single lung ventilation. Multidisciplinarity, selection of patients and careful surgical planning are cornerstones in defining the situations that may benefit from ECLS support. Knowledge on techniques of ECLS are essential for every thoracic surgeon. Although rarely used, these techniques of cardiorespiratory support should be considered when planning complex cases with difficulties in ventilation and emergent situations.

Clinical Exercise Physiology Accreditation: An Audit Of Existing Standards

Clinical Exercise Physiology Accreditation: An Audit Of Existing Standards

Seasonal Patterns of Peak Expiratory Flow Rate in Young Healthy Individuals

Background: The seasonal changes are associated with changes in pulmonary functions including Peak Expiratory Flow Rate (PEFR). These changes are different among different population and location. This study thus aimed to evaluate the seasonal variations in PEFR among healthy young individuals in Kathmandu. Methods: A comaparative study was carried out among 60 undergraduate medical students of Maharajgunj Medical Campus in the department of Clinical Physiology. The students were selected by convenient sampling technique and after obtaining the informed consent, the PEFR was recorded with the help of Wright’s peak flow meter with proper training. The PEFR was recorded two times i.e. morning and daytime hours in winter season (January-February) 2023 and also in same daily hours of summer season (May-June) 2023 in the same participants. The data were analyzed using SPSS-16 version and the paired T test was used to compare the mean changes in PEFR in winter and in summer seasons. Results: The PEFR in summer morning (499.50±89.50 L/min) was recorded higher than in winter morning (487.50±86.09 L/min) among total participants and also in male participants (567.33±69.34; 550.83±69.58) which was statistically significant with P value &lt;0.05. Similarly, the PEFR in summer daytime (505.08±88.85 L/min) was comparatively more than in winter daytime (491.27±92.07 L/min) which was statistically significant among all participants with P value &lt;0.05. The PEFR in the winter and summer seasons of male participants and in the summer of total participants showed the existence of diurnal variation which was statistically significant. Conclusions: There is seasonal variation as well as diurnal variations of PEFR. So, the clinicians should be aware that the PEFR recorded in winter season and in the morning time might be less than that recorded in the summer and at the daytime respectively.