Lower Compliance Values Research Articles

Normal values of respiratory oscillometry in South African children and adolescents.

Noninvasive measurement of respiratory impedance by oscillometry can be used in young children aged from 3 years and those unable to perform forced respiratory manoeuvres. It can discriminate between healthy children and those with respiratory disease. However, its clinical application is limited by the lack of reference data for African paediatric populations. The aim of the present study was to develop reference equations for oscillometry outcomes in South African children and adolescents. Healthy subjects, enrolled in the Drakenstein Child Health Study, HIV-uninfected adolescents in the Cape Town Adolescent Antiretroviral Cohort and healthy children attending surgical outpatient clinics at Red Cross War Memorial Children's Hospital were measured with conventional spectral (6-32 Hz) and intra-breath (10 Hz) oscillometry. Stepwise linear regression was used to assess the relationship between respiratory variables and anthropometric predictors (height, sex, ancestry) to generate reference equations. A total of 692 subjects, 48.4% female, median age of 5.2 years (range: 3-17 years) were included. The median (interquartile range (IQR)) for weight for age z-score and height for age z-score was -0.42 (-1.11-0.35) and -0.65 (-1.43-0.35), respectively. Stepwise regression demonstrated that all the variables were significantly dependent on height only. Comparison to previous reference data indicated slightly higher resistance and lower compliance values in the smallest children. We established the first respiratory oscillometry reference equations for African children and adolescents, which will facilitate use in early identification and management of respiratory disease. Our results suggest differences in oscillometry measures by ancestry but also highlight the lack of standardisation in methodology.

Children and Adolescents’ Behavioral Patterns in Response to Escalating COVID-19 Restriction Reveal Sex and Age Differences

PurposeThe COVID-19 pandemic affects students in a myriad of different ways. Our prospective, longitudinal study in a cohort of students in Hannover, Germany explores behavioral patterns during escalating COVID-19 restrictions. MethodsIn total, 777 students between the age of 9 and 20 were assessed for their activity engagement, travel patterns, and self-assessed compliance with protective recommendations at six time points between June 2020 and June 2021 (3,564 observations) and were monitored for severe acute respiratory syndrome coronavirus 2 infection by nasal swab polymerase chain reaction and serum antibody titers. ResultsActivity engagement decreased, but self-assessed compliance with measures such as mask wearing and social distancing was stable during escalating restrictions. Although we found no sex difference during the summer break, when incidence was lowest, females engaged in a higher variety of activities than males for all other time points. Older students engaged in more activities and self-assigned themselves lower compliance values than younger ones. Greater involvement in different activities was seen in households which traveled more frequently. Infection rate in our cohort was low (0.03% acute infections, 1.94% positive seroprevalence). DiscussionOur study supports the view that, overall, students show high compliance with COVID-19 recommendations and restrictions. The identification of subsets, such as female and older students, with higher risk behavioral patterns should be considered when implementing public information campaigns. In light of the low infection rate in our cohort, we conclude that in-person learning can occur safely if extensive protective measures are in place and the incidence in the general population remains moderate.

Coffee Cherry Pulp by-Product as a Potential Fiber Source for Bread Production: A Fundamental and Empirical Rheological Approach

Effects of substituting of wheat flour with coffee cherry pulp powder (CCPP) (coffee by-product as fiber source) at 0, 1.2, 2.3, and 4.7% dry basis (0, 1.25, 2.5, and 5% wet basis) on dough and gluten rheological properties and baking quality were investigated. Rheological properties were analyzed during mixing, compression recovery, and creep-recovery. A rheological approach was adopted to study the viscoelasticity of dough enriched with fiber. The data obtained were analyzed with the Kelvin–Voigt model and the parameters were correlated to bread volume and crumb firmness to assess the effect of incorporating CCPP. A decrease in gluten’s elastic properties was attributed to the water-binding and gelling properties of CCPP. Stiffness of dough and crumb firmness increased as the level of CCPP increased and bread volume decreased. Stiffer dough corresponded with lower compliance values and higher steady state viscosity compared to the control. A follow-up study with 5% CCPP and additives is recommended to overcome the reduction in elastic recovery and bread volume.

Evaluation of permanent deformation of asphalt rubber using multiple stress creep recovery tests and flow number tests

This study used the Multiple Stress Creep Recovery Test (MSCR) and the Flow number test to analyze the characteristics of asphalt rubber and its use in hot mix asphalt (HMA) regarding to their ability to withstand permanent deformation. MSCR tests were done in three commercial asphalt rubber and in the traditional asphalt binder 50/70. Flow number tests were performed in twenty four specimens of asphalt rubber mixtures and eight specimens of conventional asphalt mixtures. The results of these tests showed that all the asphalt rubber samples had lower compliance values (Jnr) in the MSCR test, which denotes that these modified binders improved the rutting resistance of HMA. This behavior was confirmed with flow number results, since the HMA produced with asphalt rubber had always higher flow number values, when compared to the conventional asphalt mixtures. The analysis of the data showed excellent correlation between Jnr values and FN values.

Compliance properties of conduits used in vascular reconstruction.

Compliance mismatch between native artery and prosthetic graft used for infrainguinal bypass is implicated in the aetiology of graft failure. The aim was to quantify the elastic properties of a new compliant poly(carbonate)polyurethane (CPU) vascular graft, and to compare the compliance properties of grafts made from CPU, expanded polytetrafluoroethylene (ePTFE), Dacron and human saphenous vein with that of human muscular artery. A pulsatile flow phantom was used to perfuse vessel and prosthetic graft segments at physiological pulse pressure and flow. Intraluminal pressure was measured using a Millar Mikro-tip catheter transducer and vessel wall motion was determined with duplex ultrasonography using an echo-locked wall-tracking system. Diametrical compliance and a stiffness index were then calculated for each type of conduit over mean pressures ranging from 30 to 100 mmHg by 10-mmHg increments. The compliance values of CPU and artery (mean over the pressure range) were similar (mean(s.d.) 8.1(0.4) and 8.0(5.9) per cent per mmHg x 10(-2) respectively), although the elastic behaviour of artery was anisotropic unlike CPU, which was isotropic. Dacron and ePTFE grafts had lower compliance values (1.8(1.2) and 1.2(0.3)per cent per mmHg x 10(-2) respectively, averaged over the pressure range). In both these cases, compliance and stiffness differed significantly from that of artery over a mean pressure range of 30-90 mmHg. Human saphenous vein exhibited anisotropic behaviour and, although compliant at low pressure (30 mmHg), was markedly incompliant at higher pressures. Compliant polyurethane grafts offer a greater degree of compliance match than either ePTFE or Dacron.

Aortic elastic properties with transesophageal echocardiography with automated border detection: Validation according to regional differences between proximal and distal descending thoracic aorta

We have previously described the use of transesophageal echocardiography with automated border detection to quantify regional aortic elastic properties. The purpose of this study was to validate this technique further by measuring regional variations of aortic elastic properties and comparing them with previously published data acquired by invasive methods. In nine anesthetized, closed-chest dogs, aortic pressure and lumenal area (transesophageal echocardiography with automated border detection) signals were recorded simultaneously at two aortic sites: just distal to the branching site of the left subclavian artery (proximal) and at the level of the diaphragm (distal). Instantaneous wall thickness was estimated by combining M-mode measurement of aortic end-diastolic thickness with instantaneous lumenal area. Data were acquired over a wide range of loading conditions, generated by inferior vena caval balloon occlusion. Aortic compliance per unit length, midwall radius, midwall stress, and incremental elastic modulus were computed. Aortic midwall radius and incremental elastic modulus values for proximal and distal aortic sites were compared at a common level of midwall stress. Compliance per unit length was higher in the proximal compared with the distal descending thoracic aorta (0.013 ± 0.003 versus 0.008 ± 0.003 cm 2/mm Hg; mean ± SD; p = 0.0011). Midwall radius was larger at the proximal location (0.76 ± 0.07 cm versus 0.64 ± 0.07 cm; p = 0.0001), whereas incremental elastic modulus was greater distally (0.799 ± 0.052 dynes × 10 6/cm 2 versus 0.912 ± 0.130 dynes × 10 6/cm 2; p = 0.02). Lower compliance values at the distal site of the descending thoracic aorta resulted from greater wall stiffness and a smaller radius. Transesophageal echocardiography with automated border detection provides reliable measurements of instantaneous aortic areas necessary for quantifying regional elastic properties.

Effects of Ventilatory Techniques during Cardiopulmonary Bypass on Post-bypass and Postoperative Pulmonary Compliance and Shunt

Pulmonary compliance and shunt were evaluated preoperatively, 30 minutes after cardiopulmonary bypass, and two hours postoperatively in 132 calves undergoing open-heart surgery with halothane and oxygen anesthesia. The calves were divided into 11 groups with respect to maintenance of the lungs during bypass. In Group 1 the lungs were collapsed during bypass. In all other groups the lungs were mechanically ventilated, statically inflated, or both, with either pure oxygen or nitrous oxide, 50 per cent, in oxygen. All groups had similar compliance and shunt values before operation and sustained significant decreases in compliance and increases in shunt 30 minutes after bypass. Calves exposed to positive-pressure breathing during bypass had higher shunt and lower compliance values after bypass and postoperatively than those not exposed to mechanical ventilation, irrespective of the inflating gas or presence or absence of any amount of static airway pressure. Animals not ventilated during bypass had compliance and shunt values that were not significantly different from preoperative values, while calves that were ventilated had compliance and shunt values that were still significantly altered two hours postoperatively. These data demonstrate that positive-pressure breathing during bypass decreases pulmonary compliance after bypass and postoperatively and increases intrapulmonary shunt, but that the gas inflating the lungs during bypass does not influence either of these variables. The findings also suggest that static pulmonary inflation during bypass offers no advantage over allowing the lungs to remain collapsed.