Normal Breathing Pattern Research Articles

Review on understanding of Astha Sthoulya Doshas and Sthoulya Lakshanas

Sthoulya is one among Santarpanotta Vikara and it is caused by Kapha Pradhana and Medodhushti. All the Santarponotta Nidanas and Medodhushti which will lead for Sthoulya. Sthoulya mainly features Chala Sphik Sthanah Udara Lambanam and Atisweda, Dhourgandy, Dourbalya as associated symptoms and these are considered as Sthoulya Doshas. Sthoulya leads to Kshudra Swasa and Alpaprana. Which implies the effect of Sthoulya on Pranavaha Srotas i.e., impairment in respiratory function which indicates Sthoulya does changes in normal breathing pattern. Life style disease and non-communicable diseases are major concern of health in present era. Obesity and Overweight are the major health care challenge that occupies the first place among non-communicable diseases creating an enormous socioeconomic and public health burden in most countries and is a worldwide epidemic. The worldwide prevalence of obesity nearly tripled between 1975 and 2020. Involvement of Meda, Agni, Kapha and Vata make the vicious curve of Samprapthi leading to chronic symptoms and complications like Ashta Sthoulya Doshas. Involved Agni and Ama in different stages which will make complicity to manage the Stholya and holistic approach is needed to treat the comorbidities like Ashta Sthoulya Doshas.

A study protocol for a randomized controlled trial on the effect of Surya Nadi Pranayama practice on cognitive abilities in school children

Abstract Background Surya Nadi Pranayama is a yogic breathing technique that involves controlled breathing through the right nostril. The study aims to evaluate the effects of the 20-min practice of Surya Nadi pranayama (4 weeks) on cognition among schoolchildren, comparing it to observing a normal breathing pattern. Methods A randomized control study design will be adopted for this study with 100 school children with 12–16 years of age, will be recruited. Subjects will be randomly divided into the study and control groups. The study group will be advised to practice Surya Nadi Pranayama (n = 50), whereas the control group (n = 50) will be asked to relax in a sitting posture between 9 am and 10 am, Monday to Friday, for 20 min daily over 30 days. Results A baseline and post-intervention assessment will be performed for all the subjects a day before and after the intervention. The primary outcome measures are visual reaction time and auditory reaction time. The secondary outcome is critical flicker fusion frequency. Conclusion The potential benefits of this yogic breathing technique and the findings of this research may contribute to the development of interventions aimed at improving cognitive functioning in school-aged children. The study is prospectively registered in the Clinical Trial Registry of India (CTRI/2024/05/067441).

Changes in Craniofacial Morphology Induced by Unilateral Nasal Obstruction in Mice of Different Ages.

Nasal obstruction in humans leads to mouth breathing and subsequent hypoxia in the entire body. Furthermore, nasal obstruction in growing children affects craniofacial growth and development. To investigate the effects of unilateral nasal obstruction (UNO) on craniofacial growth in mice of different ages, particularly on the morphology of the nasomaxillary complex and mandible. Mice aged 3, 6 and 12 weeks were selected as representatives of juvenile, adolescent and adult stages, respectively. A total of 30 male C57BL/6J mice (10 mice each at the ages of 3, 6 and 12 weeks) were used in this study for a 3-week experiment. The mice in each age stage were randomly and evenly assigned to either the control group (C3+3, C6+3 and C12+3) or the experimental group (E3+3, E6+3 and E12+3). The UNO model in experimental group was constructed by plugging the mouse's left nostril, thereby disrupting its normal nasal breathing pattern and inducing hypoxia. The control group underwent the sham procedure. After 3 weeks, the length, width and height of the cranium, nasomaxillary complex and mandible of each group were measured on two-dimensional images constructed by micro-computed tomography. Furthermore, the impact of UNO on mouse growth was evaluated through the measurement of femoral length. In juvenile mice, UNO inhibited the growth of cranial width, cranial height and mandibular length. In adolescent mice, UNO impeded the growth of the femoral length, cranial length, nasomaxillary length and mandibular length. In adult mice, no significant negative effects of UNO on craniofacial growth were found. Referring to the experimental results, in addition to actively treating nasal obstruction in patients, it is important to monitor the growth of the mandible in juveniles, as well as the nasomaxillary and mandibular growth in adolescents during orthodontic clinical practice.

Microfluidics produced ATRA-loaded PLGA NPs reduced tuberculosis burden in alveolar epithelial cells and enabled high delivered dose under simulated human breathing pattern in 3D printed head models

Tuberculosis, caused by Mycobacterium tuberculosis (Mtb), is second only to COVID-19 as the top infectious disease killer worldwide. Multi-drug resistant TB (MDR-TB) may arise because of poor patient adherence to medications due to lengthy treatment duration and side effects. Delivering novel host directed therapies (HDT), like all trans retinoic acid (ATRA) may help to improve drug regimens and reduce the incidence of MDR-TB. Local delivery of ATRA to the site of infection leads to higher bioavailability and reduced systemic side effects. ATRA is poorly soluble in water and has a short half-life in plasma. Therefore, it requires a formulation step before it can be administered in vivo. ATRA loaded PLGA nanoparticles suitable for nebulization were manufactured and optimized using a scalable nanomanufacturing microfluidics (MF) mixing approach (MF-ATRA-PLGA NPs). MF-ATRA-PLGA NPs demonstrated a dose dependent inhibition of Mtb growth in TB-infected A549 alveolar epithelial cell model while preserving cell viability. The MF-ATRA-PLGA NPs were nebulized with the Aerogen Solo vibrating mesh nebulizer, with aerosol droplet size characterized using laser diffraction and the estimated delivered dose was determined. The volume median diameter (VMD) of the MF-ATRA-PLGA NPs was 3.00 ± 0.18 μm. The inhaled dose delivered in adult and paediatric 3D printed head models under a simulated normal adult and paediatric breathing pattern was found to be 47.05 ± 3 % and 20.15 ± 3.46 % respectively. These aerosol characteristics of MF-ATRA-PLGA NPs supports its suitability for delivery to the lungs via inhalation. The data generated on the efficacy of an inhalable, scalable and regulatory friendly ATRA-PLGA NPs formulation provides a foundation on which further pre-clinical testing can be built. Overall, the results of this project are promising for future research into ATRA loaded NPs formulations as inhaled host directed therapies for TB.

MXene-Based Fiber-Optic Humidity Sensor for Fast Human Breath Monitoring

Breath is one of the most important physiological features of human life. In particular, it is significant to monitor the physical characteristics of breath, such as breath frequency and tidal volume. Breath sensors play an important role in the field of human health monitoring. However, an electronic breath sensor is not stable or even safe when the patient is in a Magnetic Resonance Imaging (MRI) system or during any oncology treatment that requires radiation and other high electric/magnetic fields. Fiber-optic-based sensors have attracted a considerable amount of attention from researchers since they are immune to electromagnetic interference. Here, we propose and demonstrate a fiber-optic-based relative-humidity (RH)-sensing strategy by depositing Ti3C2Tx nanosheets onto an etched single-mode fiber (ESMF). The humidity sensor function is realized by modulating the transmitted light in the ESMF using the excellent hydrophilic properties of Ti3C2Tx. Experiments show that the coated Ti3C2Tx nanosheets can effectively modulate the transmitted light in the ESMF in the relative humidity range of 30~80% RH. The sensor’s fast response time of 0.176 s and recovery time of 0.521 s allow it to be suitable for real-time human breath monitoring. The effective recognition of different breath rhythms, including fast, normal, deep, and strong breathing patterns, has been realized. This work demonstrates an all-optical Ti3C2Tx-based sensing platform that combines Ti3C2Tx with an optical fiber for humidity sensing for the first time, which has great promise for breath monitoring and presents novel options for gas-monitoring applications in the biomedical and chemical fields.

Inter-rater and intra-rater reliability of manual assessment of respiratory motion in patients with unilateral cervical radiculopathy: A cross-sectional study

BackgroundAltered breathing pattern is a consequence of dysfunctional breathing. The respiratory pattern might be impaired in patients with cervical radiculopathy due to the involvement of common nerve roots with the phrenic nerve (C3– C5). ObjectiveThe aim of this study was to investigate the inter-rater and intra-rater reliability of a technique for evaluating the breathing pattern known as manual assessment of respiratory motion (MARM) in patients with unilateral cervical radiculopathy. DesignCross-sectional study. SettingRehabilitation Sciences Research Center ParticipantsTwenty-five patients with unilateral cervical radiculopathy aged 30–55 years participated in this study. MethodsTwo experienced physical therapists investigated the respiratory pattern of the patients during normal and deep breathing using MARM, separately. Assessments were repeated again a week apart by each examiner. The inter- and intra-rater reliability of the MARM were calculated. Results“Very good” inter-rater and intra-rater reliability were found with the MARM values during both normal and deep breathing patterns. (Inter-rater: ICC range = 0.71 to 0.82; intra-rater: ICC range = 0.72 to 0.80). ConclusionsMARM is a reliable clinical and research tool for assessing breathing patterns with very good inter- and intra-rater reliability in patients with unilateral cervical radiculopathy.

Exploring the role of the Kölliker-Fuse nucleus in breathing variability by mathematical modelling.

The Kölliker-Fuse nucleus (KF), which is part of the parabrachial complex, participates in the generation of eupnoea under resting conditions and the control of active abdominal expiration when increased ventilation is required. Moreover, dysfunctions in KF neuronal activity are believed to play a role in the emergence of respiratory abnormalities seen in Rett syndrome (RTT), a progressive neurodevelopmental disorder associated with an irregular breathing pattern and frequent apnoeas. Relatively little is known, however, about the intrinsic dynamics of neurons within the KF and how their synaptic connections affect breathing pattern control and contribute to breathing irregularities. In this study, we use a reduced computational model to consider several dynamical regimes of KF activity paired with different input sources to determine which combinations are compatible with known experimental observations. We further build on these findings to identify possible interactions between the KF and other components of the respiratory neural circuitry. Specifically, we present two models that both simulate eupnoeic as well as RTT-like breathing phenotypes. Using nullcline analysis, we identify the types of inhibitory inputs to the KF leading to RTT-like respiratory patterns and suggest possible KF local circuit organizations. When the identified properties are present, the two models also exhibit quantal acceleration of late-expiratory activity, a hallmark of active expiration featuring forced exhalation, with increasing inhibition to KF, as reported experimentally. Hence, these models instantiate plausible hypotheses about possible KF dynamics and forms of local network interactions, thus providing a general framework as well as specific predictions for future experimental testing. KEY POINTS: The Kölliker-Fuse nucleus (KF), a part of the parabrachial complex, is involved in regulating normal breathing and controlling active abdominal expiration during increased ventilation. Dysfunction in KF neuronal activity is thought to contribute to respiratory abnormalities seen in Rett syndrome (RTT). This study utilizes computational modelling to explore different dynamical regimes of KF activity and their compatibility with experimental observations. By analysing different model configurations, the study identifies inhibitory inputs to the KF that lead to RTT-like respiratory patterns and proposes potential KF local circuit organizations. Two models are presented that simulate both normal breathing and RTT-like breathing patterns. These models provide testable hypotheses and specific predictions for future experimental investigations, offering a general framework for understanding KF dynamics and potential network interactions.

Weighted aggregation through probability based ranking: An optimized federated learning architecture to classify respiratory diseases

Background and ObjectiveRespiratory Diseases are one of the leading chronic illnesses in the world according to the reports by World Health Organization. Diagnosing these respiratory diseases is done through auscultation where a medical professional listens to sounds of air in the lungs for anomalies through a stethoscope. This method necessitates extensive experience and can also be misinterpreted by the medical professional. To address this issue, we introduce an AI-based solution that listens to the lung sounds and classifies the respiratory disease detected. Since the research work deals with medical data that is tightly under wraps due to privacy concerns in the medical field, we introduce a Deep learning solution to classify the diseases and a custom Federated learning (FL) approach to further improve the accuracy of the deep learning model and simultaneously maintain data privacy. Federated Learning architecture maintains data privacy and facilitates a distributed learning system for medical infrastructures.MethodsThe approach utilizes Generative Adversarial Networks (GAN) based Federated learning approach to ensure data privacy. Generative Adversarial Networks generate new data by synthesizing new lung sounds. This new synthesized data is then converted to spectrograms and trained on a neural network to classify four lung diseases, Heart Attack and Normal breathing patterns. Furthermore, to address performance loss during FL, we also propose a new “Weighted Aggregation through Probability-based Ranking (FedWAPR)” algorithm for optimizing the FL aggregation process. The FedWAPR aggregation takes inspiration from exponential distribution function and ranks better performing clients according to it.Results and ConclusionA test accuracy of about 92% was achieved by the trained model while classifying various respiratory diseases and heart failure. Additionally, we developed a novel FedWAPR approach that significantly outperformed the FedAVG approach for the FL aggregate function. A patient can be checked for respiratory diseases using this improved learning approach without the need for extensive sensitive data recording or for making sure the data sample obtained is secure. In a decentralized training runtime, the trained model successfully classifies various respiratory diseases and heart failure using lung sounds with a test accuracy on par with a centralized model.

Influence of Aerosol Mask Design on Fugitive Aerosol Concentrations During Nebulization.

Secondhand exposure to fugitive aerosols may cause airway diseases in health providers. We hypothesized that redesigning aerosol masks to be closed-featured would reduce the fugitive aerosol concentrations during nebulization. This study aimed to evaluate the influence of a mask designed for a jet nebulizer on the concentration of fugitive aerosols and delivered doses. An adult intubation manikin was attached to a lung simulator to mimic normal and distressed adult breathing patterns. The jet nebulizer delivered salbutamol as an aerosol tracer. The nebulizer was attached to 3 aerosol face masks: an aerosol mask, a modified non-rebreathing mask (NRM, with no vent holes), and an AerosoLess mask. An aerosol particle sizer measured aerosol concentrations at parallel distances of 0.8 m and 2.2 m and a frontal distance of 1.8 m from the manikin. The drug dose delivered distal to the manikin's airway was collected, eluted, and analyzed using a spectrophotometer at a 276 nm wavelength. With a normal breathing pattern, the trends of aerosol concentrations were higher with an NRM followed by an aerosol mask and AerosoLess mask (P < .001) at 0.8 m; however, the concentrations were higher with an aerosol mask followed by NRM and AerosoLess mask at 1.8 m (P < .001) and 2.2 m (P < .001). With a distressed breathing pattern, the aerosol concentrations were higher with an aerosol mask followed by an NRM and AerosoLess mask at 0.8 m, 1.8 m (P < .001), and 2.2 m (P = .005). The delivered drug dose was significantly higher with AerosoLess mask with a normal breathing pattern and with an aerosol mask with a distressed breathing pattern. Mask design influences fugitive aerosol concentrations in the environment, and a filtered mask reduces the concentration of aerosols at 3 different distances and with 2 breathing patterns.

Respiratory Feature Extraction for Contactless Breathing Pattern Recognition Using a Single Digital Camera

Non-contact respiratory monitoring is gaining attention due to its unobtrusive form of measurement. Among all other non-contact sensing modalities, optical sensors integrated with commercial video cameras have received more attention due to their ease of use and low cost, allowing non-experts to employ these methods without any prior knowledge. Prior research mostly focused on extracting breathing rate and heart rate-related information for sedentary breathing patterns using camera to determine health status. However, for abnormal breathing patterns, a range of respiratory-pattern-related signatures need to be monitored to investigate the associated primary cause of pattern change. In this paper, we propose a novel feature extraction technique to recognize respiratory patterns such as eupnea, tachypnea, bradypnea, and apnea retrieved from videos captured using a single digital camera working in the visible range. At this aim, a hyper-feature algorithm has been implemented to extract distinguishable air-flow-related from videos collected on twenty-four participants having four different respiratory patterns. After the training of the algorithm using the reference respiratory signal obtained from a medical-grade chest strap, the performance of the system has been evaluated on additional five participants whose measurement was not used for algorithm development and on seven patients. Results demonstrated an accuracy of 96.07% in the recognition of all the respiratory patterns, with minimum performances (81.81%) in detecting bradypnea and 100% in detecting apnea events. Additionally, including the patient’s dataset with the apnea and the normal breathing pattern, the accuracy of the proposed algorithm becomes 97.39%, demonstrating its robustness on the patient’s dataset.

Cephalometric evaluation of adenoids and upper airway.

Abstract Cephalometric analysis performed on lateral X-ray allow orthodontists to evaluate soft tissues as well. Enlargement of adenoids, changes of the position of the tongue can be diagnosed parallel with skeletal assessment. Our purpose was to investigate the skeletal growth direction and the posterior airway depth in mouth breather patients and to underline the importance of a complex cephalometric analysis prior orthodontic treatment. 30 mouth breather patients were selected from our database (17 boys and 13 girls, age 10.8±1.2), in every case ENT examination confirmed the hypertrophy of adenoids. From the same database 30 patients with normal breathing pattern (17 boys and 13 girls, age 11.1±0.9) for the control group. For every patient, the size of the adenoids, the depth of the palate and the position of the tongue. After filtering out the outliers in GraphPad-InStat system, standard deviation (±SD) was calculated, descriptive analytical statistics were performed. Statistically significant differences were recorded regarding: 1.) the distance between adenoid vegetation and the palate (p=0.014, mouth breathers mean 9.76 ± SD 3.04; control group mean 14.38 ± SD 4.41), 2.) the distance between Sella and the adenoids (p=0.186, study group mean 33.39 ± SD 4.39; control group mean 28.38 ± SD 8.91), 3.) adenoidal-nasopharyngeal ratio (p = 0.05). Cephalometric evaluation of adenoids revealed considerable enlargement of this in mouth-breather children, meanwhile upper airway constriction will appear in the same group. Depth of the palatum will increase when breathing pattern is modified.

OSA and Subsequent Risk of Hospitalization With Pneumonia, Respiratory Infection, and Total Infection: The Atherosclerosis Risk in Communities Study

OSA has been linked to microaspiration, systemic inflammation, and suboptimal immune function. Is OSA prospectively associated with risk of hospitalization for pneumonia, respiratory, and total infections? Prospective cohort. Participants in the Atherosclerosis Risk in Communities (ARIC) study (N= 1,586) underwent polysomnography in 1996-1998 and were followed up through 2018 for infection-related hospitalizations. The apnea-hypopnea index (AHI; events/h) was used to categorize participants as having severe OSA (≥ 30), moderate OSA (15-29), mild OSA (5-14), or a normal breathing pattern (< 5). Cox regression was used to calculate hazard ratios (HRs) and 95%CIs. ARIC participants were on average 62.7 (SD= 5.5) years of age, and 52.8%were female. Severe OSA was present in 6.0%, moderate OSA in 12.7%, mild OSA in 30.0%, and normal breathing in 51.3%. A total of 253 hospitalizations with pneumonia occurred over a median 20.4 (max, 22.9) years' follow-up. Participants with severe OSA were at 1.87 times (95%CI, 1.19-2.95) higher risk of hospitalization with pneumonia compared with those with a normal breathing pattern after adjustment for demographics and lifestyle behaviors. Results were attenuated modestly after adjustment for BMI (1.62 [0.99-2.63]), and prevalent asthma and COPD (1.62 [0.99-2.63]). A similar pattern existed for hospitalization with respiratory infection and composite infection (demographic and behavior-adjusted HRs: 1.47 [0.96-2.25] and 1.48 [1.07-2.04], respectively). Severe OSA was associated with increased risk of hospitalizations with pneumonia in this community-based cohort. OSA patients may benefit from more aggressive efforts to prevent pneumonia and other infectious conditions.

Assessment of Respiratory Morbidity and Epidemiological Survey of Tobacco Smokers and Non-Smokers Among Educated Young Adults in Visva-Bharati, Santiniketan: A Case Study

Tobacco smoking among adults have become a serious health concern worldwide due to its increasing addicting nature. Tobacco smoke contains highly harmful gaseous and volatile chemical substances that impair the respiratory system and reduce lung function capacity. The study's primary objectives were to investigate the cause of smoking, behaviour of smokers, social responsibility, family history of the smoker, and significant respiratory health problems among young educated adults. The survey was conducted with some pre-framed questionnaires and screening relevant to the subjects for our study. The respiratory health assessment was carried out by questionnaire-based personal interviews for different respiratory and non-respiratory health symptoms. Subsequently, the lung function or pulmonary function test (LFT or PFT) for selected individuals was performed, revealing the lung performances of smokers and non-smokers. The LFT or PFT test predicts the normal and abnormal breathing patterns of exposed and non-exposed studied groups. The significant findings indicated that curiosity (72%) and displaying of smartness were the leading cause of smoking in early adulthood (16 to 20 years). Family history of smoking also influenced young adults to initiate regular smoking. Smoking within thirty minutes after waking up in the morning was - a habit in 52% of smokers. Findings revealed that 50% of the heavy smokers smoke 11-15 units daily. The average weekly expenditure for the smoking materials was INR 100 to 150 (26.32%) rupees for smokers. Spirometric indices such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), percentage forced expiratory volume in one second (FEV1%), and peak expiratory flow rate (PEFR), showed a reduced performance of lungs in smokers as compared to their fellow non-smokers. This study has focused on the smoking behaviour of educated young adults and revealed the presence of different respiratory symptoms in smokers than non-smokers, which is an immerging health issue. The study revealed that smokers grouped are more susceptible to lung diseases than non-smokers in the future due to their reduced lung function capacity compared to non-smokers.

Design of the remedē System Therapy (rēST) study: A prospective non-randomized post-market study collecting clinical data on safety and effectiveness of the remedē system for the treatment of central sleep apnea

BackgroundCentral sleep apnea (CSA) is a disorder defined by lack of respiratory drive from the brain stem on breathing efforts. There is a lack of established therapies for CSA and most available therapies are limited by poor patient adherence, limited randomized controlled studies, and potentially adverse cardiovascular effects. The remedē System (ZOLL Respicardia, Inc., Minnetonka, Minnesota) uses transvenous phrenic nerve stimulation to stimulate the diaphragm, thereby restoring a more normal breathing pattern throughout the sleep period. MethodsThe remedē System Therapy (rēST) Study is a prospective non-randomized multicenter international study evaluating long-term safety and effectiveness of the remedē System in the post-market setting. Up to 500 adult patients with moderate to severe CSA will be enrolled and followed up to 5 years at approximately 50 sites in the United States and Europe. Safety objectives include evaluation of adverse events related to the implant procedure, device or delivered therapy, death, and hospitalizations. Effectiveness endpoints include assessment of changes in sleep-disordered breathing metrics from polysomnograms and home sleep tests, changes in daytime sleepiness using the Epworth Sleepiness Scale, and changes in QoL using the PROMIS-29 and Patient Global Assessment questionnaires. The subgroup of patients with heart failure will undergo additional assessments including echocardiography to assess cardiac reverse remodeling, 6-min walk distance, QoL assessment by Kansas City Cardiomyopathy Questionnaire and measurement of biomarkers. ConclusionThis will be the largest prospective study evaluating long-term safety and effectiveness of transvenous phrenic nerve stimulation for the treatment of moderate to severe CSA in adult patients.

Rapid Maxillary Expansion in Pediatric Patients with Sleep-Disordered Breathing: Cephalometric Variations in Upper Airway’s Dimension

Rapid maxillary expansion (RME) is considered an effective treatment in the management of sleep-disordered breathing (SDB) and malocclusions in pediatric patients, not only because it is able to correct the transverse maxillary deficiency, but it also widens the floor of the nasal cavities, leading to a drastic and immediate reduction in air resistance and facilitating a normal nasal breathing pattern. The aim of this study was to evaluate cephalometric changes in the upper airway’s dimensions and facial morphology in pediatric SDB patients treated with RME, comparing data with a no-SDB group treated with RME for malocclusion. In this retrospective study, pre-treatment and post-treatment cephalometric variables were measured on lateral skull radiographs from 20 SDB pediatric patients (nine males and 11 females) aged 6 to 9 years (mean age 7.61 ± 0.6), treated with a rapid maxillary expander, and 20 control patients without SDB (nine males and 11 females) aged 6 to 11 years (mean age 8.4 ± 0.5). In both groups, there were statistically significant changes in the variables indicating the airway’s dimensions and mandibular sagittal position in relation to the cranial base, with a skeletal class II correction in SDB children. Rapid maxillary expansion is associated with an increase in upper-airway dimensions in SDB children, as well as in control healthy subjects, with a possible correction of class II relationship.

Impact of the Mouth Breathing Occurred During Childhood with Lordotic Changes; An Analytic Study

Introduction: Nasopharyngeal passages are the primary passageway for respiratory exchange in humans. But chronic obstruction of the nasal passage encountered in youth causes a physiological shift in normal breathing pattern from nasal to oral breathing. Oral breathing results in craniofacial modification and postural adjustments. This study will be helpful for orthodontists to observe the cervical vertebral column area in growing children to prevent changes in cervical lordosis and associated sequelae from developing by early intervention, when required. Material &amp; Methods: In this case control study conducted at the ’Montmorency College of Dentistry over 6 month period from 10th July, 2017 till 10th January, 2018, 60 patients fulfilling inclusion and exclusion criteria, were recruited from OPD and divided into two groups. Group “A” patients showing alteration in their cervical lordosis as observed on lateral cephalograms and group “B” patients with normal cervical lordosis on lateral cephalograms. Their breathing pattern, BMI and other demographic information were recorded. All the collected data were analyzed with SPSS version 23.0. Results: Mean age of the patients in group A (altered cervical lordosis) was 9.13 (+/- 1.68) years and in group B (normal cervical lordosis) was 8.77 (+/-1.91) years). Chi square test was applied for comparison of groups, p-value ≤ 0.05 considered as statistically significant. The alteration in cervical lordosis had a statistically significant association with oral breathing when compared with nasal breathers, chi square value 27.149 (p value 0.000). Conclusion: Significant association between alteration in cervical lordosis and oral breathing.

Classification and occurrence of an abnormal breathing pattern during cardiopulmonary exercise testing in subjects with persistent symptoms following COVID-19 disease.

Reduced exercise capacity and several limiting symptoms during exercise have been reported following severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) infection. From clinical observations, we hypothesized that an abnormal breathing pattern (BrP) during exercise may be common in these patients and related to reduced exercise capacity. We aimed to (a) evaluate a method to classify the BrP as normal/abnormal or borderline in terms of inter‐rater agreement; (b) determine the occurrence of an abnormal BrP in patients with post‐COVID; and (c) compare characteristics of post‐COVID patients with normal and abnormal BrP. In a retrospective, cross‐sectional study of patients referred for CPET due to post‐COVID April 2020–April 2021, we selected subjects without a history of intensive care and with available medical records. Three raters independently categorized patients’ BrP as normal, abnormal, or borderline, using four traditional CPET plots (respiratory exchange ratio, tidal volume over ventilation, ventilatory equivalent for oxygen, and ventilation over time). Out of 20 patients (11 male), 10 were categorized as having a normal, 7 an abnormal, and three a borderline BrP. Inter‐rater agreement was good (Fleiss’ kappa: 0.66 [0.66–0.67]). Subjects with an abnormal BrP had lower peak ventilation, lower exercise capacity, similar ventilatory efficiency and a similar level of dyspnea at peak exercise, as did subjects with a normal BrP. Patients’ BrP was possible to classify with good agreement between observers. A third of patients had an abnormal BrP, associated with lower exercise capacity, which could possibly explain exercise related symptoms in some patients with post‐COVID syndrome.

Mining Knowledge of Respiratory Rate Quantification and Abnormal Pattern Prediction

The described application of granular computing is motivated because cardiovascular disease (CVD) remains a major killer globally. There is increasing evidence that abnormal respiratory patterns might contribute to the development and progression of CVD. Consequently, a method that would support a physician in respiratory pattern evaluation should be developed. Group decision-making, tri-way reasoning, and rough set–based analysis were applied to granular computing. Signal attributes and anthropomorphic parameters were explored to develop prediction models to determine the percentage contribution of periodic-like, intermediate, and normal breathing patterns in the analyzed signals. The proposed methodology was validated employing k-nearest neighbor (k-NN) and UMAP (uniform manifold approximation and projection). The presented approach applied to respiratory pattern evaluation shows that median accuracies in a considerable number of cases exceeded 0.75. Overall, parameters related to signal analysis are indicated as more important than anthropomorphic features. It was also found that obesity characterized by a high WHR (waist-to-hip ratio) and male sex were predisposing factors for the occurrence of periodic-like or intermediate patterns of respiration. It may be among the essential findings derived from this study. Based on classification measures, it may be observed that a physician may use such a methodology as a respiratory pattern evaluation-aided method.

Obstructive and Central Sleep Apnea in First Ever Ischemic Stroke are Associated with Different Time Course and Autonomic Activation.

IntroductionSleep-related breathing disorders are highly prevalent in patients with ischemic stroke. Among sleep-disordered breathing disorders, obstructive sleep apnea is the most represented one, but central sleep apnea, isolated or in the context of a periodic breathing/Cheyne–Stokes respiration, is frequently reported in these patients. Altered baroreflex responses have been reported in the acute phases of a cerebral event.MethodsWe conducted, in a group of patients with ischemic stroke (n=60), a prospective 3-month follow-up physiological study to describe the breathing pattern during sleep and baroreflex sensitivity in the acute phase and in the recovery phase.ResultsIn the acute phase, within 10 days from the onset of symptoms, 22.4% of patients had a normal breathing pattern, 40.3% had an obstructive pattern, 16.4% had a central pattern, and 29.9% showed a mixed pattern. Smaller variations in the Apnea–Hypopnea Index were found in normal breathing and obstructive groups (ΔAHI 2.1±4.1 and −2.8±11.6, respectively) in comparison with central and mixed patterns (ΔAHI −6.9±15.1 and −12.5±13.1, respectively; ANOVA p=0.01). The obstructive pattern became the most frequent pattern, in 38.3% of patients at baseline and 61.7% of patients at follow-up. Modification of baroreflex sensitivity over time was influenced by the site of the lesion and by the sleep disorder pattern in the acute phase (MANOVA p=0.005).ConclusionWe suggest that a down-regulation of autonomic activity, possibly related to reduced vagal modulation, may help the recovery after stroke, or a transitory disconnection from the cortical node that participates in the regulation of sympathetic outflow.

Study on the shouting breathing pattern while jogging wearing a mask

Because of the COVID-19 epidemic, many countries have made the obligation to wear masks normal. Wearing masks in public places has become a must. At present, wearing a mask to participate in sports makes it very common. People seek to gain health through exercise but ignore the potential respirato-ry health threat. That is, wearing a mask will cause a decrease in oxygen content in the body. This neg-ative impact becomes more prominent as the wear-ing time and oxygen consumption increase. To pro-tect people from viruses and enjoy a healthy life. This paper proposes a breathing pattern that im-proves blood oxygen saturation while wearing a jogging mask and walking. Namely, shouting breathing pattern. Use a pulse oximeter to measure the blood oxygen saturation of running at different speeds and compare the normal breathing pattern and the shouting breathing pattern. The results show that the shouting breathing pattern has a sig-nificant improvement in the blood oxygen satura-tion of low-speed walking and medium-speed jog-ging.