Type Of Ventilation Research Articles

Monitoring of urinary nickel and chromium in metal industries workers in Alborz, Iran

Heavy metal contamination from occupational sources is a cause for concern due to its potential accumulation in the environment and the body of living organisms, which leads to long-term toxic effects. There is limited evidence on the concentration of heavy metals in the body fluids of welding workers. This study aimed to measure the concentration of nickel (Ni) and chromium (Cr) as two main toxic heavy metals in the urine samples of welders and determine the potential relationship of various environmental factors on their concentration levels. This study was conducted in Iran in 2022–2023. Eighty-five urine samples were collected from the studied welding workers. Inductively coupled plasma optical emission spectrometry (ICP-OES) was used to measure the concentration of Ni and Cr. Data related to socio-demographic characteristics (education level, income, work experience, age, and body mass index (BMI)), lifestyle profile (consumption of seafood and canned food, smoking, physical activity), type of ventilation and preventive devices at work, and suffering from underlying diseases (cardiovascular and high blood pressure) were collected using valid questionnaires. Ni and Cr were present in 100% of urine samples with mean concentrations of (1.09 ± 0.294) and (11.45 ± 16.751) µg/g creatinine, respectively. A significant correlation was observed between the mean concentration of Ni and Cr with the level of education, income, work experience, age, consumption of seafood and canned food, smoking, type of ventilation and preventive devices, and underlying diseases (p-value < 0.05). Also, there was no significant difference between Ni concentration and physical activity and Cr concentration with BMI. Lifestyle determinants and not using preventive devices are important predictors of urinary heavy metals in welding workers. Therefore, more research is required to determine the adverse effects of long-term exposure to these heavy metals.

High-Flow Oscillatory Ventilation: A Possible Therapeutic Option for Pediatric Patients with Cardiovascular Diseases

High-flow oscillatory ventilation (HFOV) is a common rescue treatment in infants and children with respiratory failure. This type of ventilation is an effective technique in numerous diseases that affect a child in the postnatal period, such as ARDS, meconium aspiration syndrome (MIS), postnatal pulmonary bleeding and idiopathic pulmonary hypertension (IPH). Although this ventilation technique is commonly recognized as a valuable therapeutic option in the general pediatric population, this is not the same for children with congenital cardiovascular diseases. The key mechanism of oscillatory ventilation is continuous positive pressure administered within the airways via a small tidal volume at high frequency. Tidal volumes are between 1 and 3 mL/kg delivered at 5–15 Hz, equivalent to 300–900 breaths per minute. A few older studies conducted on humans and animals highlight that HFOV may be dangerous for congenital heart patients. According to these evidences, hemodynamic parameters such as blood pressure, wedge pressure, central venous pressure, heart rate and inotrope level can be dangerously changed for patients with congenital heart disease; therefore, oscillatory ventilation should be avoided. Numerous retrospective studies have pointed out how oscillatory ventilation constitutes a valid therapeutic option in children with congenital heart disease. Recently, new evidences have highlighted how hemodynamic parameters are modified in a non-significant way by this type of ventilation, remaining beneficial as in the normal pediatric population. This narrative review aims to describe the mechanisms of oscillatory ventilation and collect all the available evidences to support its use in pediatric patients with congenital heart problems.

Association of systemic corticosteroid use with prognosis of patients with acute exacerbations of chronic obstructive pulmonary disease in the intensive care unit: a propensity score-matched cohort study

BackgroundSystemic corticosteroid has been recommended for the treatment of severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Little is known about the use of systemic corticosteroid in patients admitted to intensive care units (ICU) since most of previous trials excluded these critically ill patients.MethodsWe conducted a matched cohort study based on the Medical Information Mart in Intensive Care-IV database. Patients with AECOPD in ICUs were included. Patients in the exposure group should be intravenously administrated with methylprednisolone or treated with oral prednisone within 24 h after ICU admission. The propensity score matching and multivariable analyses were used to adjust for covariates. The primary outcome was 28-day mortality, and secondary outcomes included ICU mortality, in-hospital mortality, the duration of ICU stay, and mechanical ventilation. Subgroup analyses for the primary outcome were performed according to age, sex, type of corticosteroid, type of ICU admission, type of mechanical ventilation, and co-morbidities/complications.ResultsThe entire cohort and the matched cohort included 763 and 412 patients, respectively. In the matched cohort, the use of systemic corticosteroid had no impact on 28-day mortality (OR: 1.00, 95% CI: 0.61–1.64, P = 1.000). The results kept consistent in all subgroups. Additionally, systemic corticosteroid showed no benefits on ICU mortality, in-hospital mortality, the length of ICU stay, and the duration of mechanical ventilation.ConclusionsThe results of this study do not support routine use of systemic corticosteroid in patients with AECOPD admitted to ICUs.

Effects of mechanical ventilation on neurodevelopment at 12 months in preterm low birth weight pediatric patients: a systematic review

IntroductionThe objective of this review is to know the existing scientific evidence about the effects of mechanical ventilation (MV) on neurological development in low-birth-weight premature pediatric patients after 12 months of life, taking as background the direct impact that ventilation has on the central nervous system in the newborn during the first days of life.MethodsA systematic search was carried out between 2003 and 2024 in the data bases of: PUBMED, Cochrane Library Plus, PEDro, CINAHL, and SciELO, and two investigators scored the articles according to the Newcastle-Ottawa Assessment scale.ResultsWere found 129 non-replicated articles, and 10 cohort and cross-sectional studies were selected that performed an assessment of neurodevelopment in the three spheres after 12 months of life in corrected age of premature infants exposed to ventilator support and related the two variables independently.ConclusionsMechanical ventilation is an independent neurodevelopmental risk factor in low-birth-weight preterm infants. The time of exposure and the type of ventilation were the variables with the most scientific evidence.Systematic Review Registrationhttps://www.crd.york.ac.uk/, Identifier CRD42023446797.

Prognostic nutritional index as a predictor of mortality among patients admitted to ICU with acute exacerbation of chronic obstructive pulmonary disease

BackgroundThe PNI is a metric that may assess the combined impact of the inflammatory process and nutritional condition. It may be beneficial in evaluating the nutritional state of patients with AECOPD.In recent years, it has also been utilized for prognostic assessment of cases admitted to the critical care unit.Aim of the workThe objective of the research was to assess the relationship between PNI and the prognosis for ICU patients with AECOPD.Patients and methodsThis was a prospective cross-sectional observational research carried out in the RICU of Ain Shams University Hospitals from April 2023 to March 2024. The study included 161 AECOPD patients who were admitted to RICU. All patients underwent demographic data collection, special habits and comorbid conditions evaluations, and hematological indices with laboratory markers and ABG. ICU and hospital stay duration, SOFA score, and SAPS II were also documented. The PNI value was computed using the following equation: the formula to calculate the value is 10 times the serum albumin concentration in grams per deciliter plus 0.005 times the total lymphocyte count in cubic millimeters. The main measure of interest was the death rate within 30 days for all causes. Additional measures were the duration of stay in the ICU, the duration of hospitalization, and the rate of MV.ResultsThere was a significant relationship between PNI and type of respiratory failure, mechanical ventilation, fate, hypertension, and diabetes. One hundred five (65.2%) of the patients were extubated and discharged, while 56 (34.8%) of them died. The study also noted a significant positive relationship among PNI and HCT, lymphocytic %, HB, and albumin. However, there was a significant negative relationship between PNI and age, RDW, WBC, neutrophil count, neutrophil %, NLR, CRP, SAPSII, and SOFA. The SAPS II score (with SAPS II mortality) had greater AUROC in predicting mortality than PNI, NLR, and SOFA. The optimal cut-off value for PNI in this study was ≤ 29 with sensitivity 82.14% and specificity 56.19%.ConclusionThe study showed that PNI can be a useful biomarker for AECOPD. PNI with SAPS II scores on admission to ICU were closely correlated to adverse outcomes.

Study of indications, associated comorbid condi-tions and outcome of patients requiring Bilevel type of Non Inva-sive Positive Pressure Ventilation in a tertiary care hospital

BiLevel non-invasive positive pressure ventilation (BiPAP) is the most utilised supportive treatment in the world of medicine for respiratory failure. COPD is the most common indication for its use. We in-vestigated the indications and effects of comorbidities on BiPAP outcomes because there have been few studies on it. It is a descriptive, observational, cross-sectional study conducted over period of 12 months, wherein 60 patients fulfilling the inclusion criteria for the requirement of BiPAP were includ-ed in the study and evaluated. The indications, associated comorbid conditions and the outcomes of NIV therapy were studied. COPD exacerbation with Type II Respiratory failure was the most common indication (71.4%), followed by asthma [near fatal/severe] (21.4%). Success with BiPAP in COPD was 67.6% . In COPD patients with co-morbidities, success came down to 47.4%. Pneumonia, ILD &amp; Cardiogenic Pulmonary Edema (CPE) had success rates of 0%, 16.7% and 66.7% respectively with BiPAP therapy,with higher mortality rates for pneumonia and ILD. Comorbidities were present in 51.7% of patients and Hypertension (35%) and Diabetes Mellitus (21.7%) were the most common. In patients who had co-morbidities, the mean hospital stay was 12 days, which was higher than the mean hospital stay of 9.3 days in patient with no co-morbidities. The presence of co-morbidities was associated with higher failures with BiPAP (51.6%) comapred to ones with no co-morbidities (13.8%) (p value &lt;0.05). Higher respiratory rate (&gt;28/min), lower ABG pO2, pCO2 and bicarbonate levels and higher blood glucose and total leucocyte counts were associated with higher BiPAP failures and mortality. The conclusion was that the most common indication of BiPAP was a COPD exacerbation with type II respiratory failure and presence of comorbidities led to a poorer outcome with prolonged hospital stay. ABG parameters, blood glucose levels and total leucocyte counts has an effect on NIV outcome and mortality.

Performance and PV benefits analysis of multi-source renewable energy systems for different types of buildings on university campus

Due to the large campus area and high personnel density, universities experience significant building energy consumption. The comprehensive utilization of renewable energy can greatly alleviate energy consumption in higher education institutions. To explore the application prospects of renewable energy systems in universities, this study takes a university in Wuhan as a case example, investigating the performance and potential of various types of Photovoltaic-assisted Heating, Ventilation, and Air Conditioning (PV-HVAC) systems. First, the building load was calculated using DeST software. Subsequently, the potential for solar energy application on campus was assessed using a combination of QGIS, Labelme, and Python. Moreover, three types of PV-HVAC systems were designed for five categories of buildings based on their distinct characteristics, and TRNSYS software was utilized for performance simulation and analysis. The results indicate that the annual performance coefficients of the three systems are 3.8, 3.2, and 4.5, with corresponding annual energy self-sufficiency rates of 114 %, 72 %, and 32 %, respectively. Finally, the overall energy self-sufficiency rate of the PV-HVAC system across the campus is 65 %. This research provides valuable insights for achieving nearly zero-energy HVAC systems in university campuses.

Occupant’s behavior investigation related to the building openings in a rural pavilion: A case study of a bioclimatic designed building in a hot semi-arid climate

This study targets the building openings management as a sustainable, passive, cost-effective technique in a rural context with limited budget. Ensuring health and well-being and promoting energy-saving in building operation phase based on natural ventilation and sun management in interaction with the building design. The study utilizes thermo-aeraulic simulation through TRNSYS software, exploring the effects of altered seasonal day and night ventilation and vertical shading management. The findings highlight the significant impact of night natural cross ventilation on energy saving during June and September. Conversely, for July and August, early morning cross ventilation proves to be a more effective option for refreshing the indoor environment. During the cold season, minimizing or avoiding natural ventilation, especially cross ventilation, is advised; in addition, the mandatory overhangs on the south side and the vertical adjustable blinds enhance the energy saving inside the building. With a humidity interval ratio of 30 % to 70 % and two different set-point temperature ranges of 18 °C-28 °C and 20 °C-26 °C respectively, the annual thermal loads per square meter for two of the simulated scenarios are optimal, measuring 22.28 kWh/m2 and 22.85 kWh/m2 compared to 56 kWh/m2, respectively. These results can be further optimized by altering both types of ventilation mentioned earlier.

Evaluating building-level parameters for lower-temperature heating readiness: A sampling-based approach to addressing the heterogeneity of Dutch housing stock

The Dutch government aims to eliminate natural gas for residential heating in 1.5 million homes by 2030. One strategy is connecting existing dwellings to lower-temperature district heating (DH) systems, although these dwellings might require energy renovations. The heterogeneous dwelling stock causes varying renovation needs that complicate the energy transition. The present study addresses this issue by assessing the building-level parameters affecting the readiness of the Dutch terraced-intermediate and apartment types for lower-temperature heating (LTH) supplied by DH systems. A sampling-based approach was employed to capture variability within these dwelling types, addressing the limitations of archetype-based methods. The findings suggest a sample size of 1300 to represent the variations in these dwelling types. Parametric simulations and machine learning methods were used to identify significant building-level parameters for medium-temperature (MT: 70/50 °C) and low-temperature (LT: 55/35 °C) supply levels. These include heating setpoints (desired indoor temperature) and ventilation-related parameters (ventilation system type and air infiltration rate), followed by fabric-related parameters (roof, glazing, wall, ground, and door insulation) and geometric properties (orientation, compactness ratio, and window-to-wall ratio). Additionally, radiator oversizing also impacts LTH readiness. These results broadly apply to the studied dwelling types, although feature importance varies by supply temperature and dwelling type. The findings can guide stakeholders in assessing current conditions and prioritising renovation measures, aiding the development of targeted renovation solutions. Encompassing the representative variations within studied dwelling types enhances the robustness of the results. However, incorporating more refined data could improve the accuracy of the findings, better supporting the energy transition of these dwellings.

Analysis of condensation phenomena according to the type of energy recovery ventilator—Simulation and experiments

Ventilation plays a crucial role in maintaining indoor air quality. Energy recovery ventilators (ERVs) have emerged as a solution to balance ventilation needs and energy consumption in buildings. However, ERVs can encounter condensation issues in extreme outdoor conditions, impacting their performance and indoor air quality. In this study, we investigate occurrence conditions and ratios of condensation in ERVs through dynamic simulations and experimental tests using different heat exchanger types: plastic-based plate, membrane-based plate, and rotary. The simulation results show that condensation ratios vary depending on the heat exchanger type and seasonal conditions, with higher latent effectiveness playing a significant role in reducing condensation. Notably, we demonstrate that rotary ERVs rarely exhibit the generation of condensation. The simulation results are validated through experimental tests, ensuring reliable condensation predictions in ERVs. Our findings underline the importance of selecting appropriate type of ERV to mitigate condensation and enhance indoor comfort while promoting energy efficiency. The proposed simulation methodology will provide valuable insights into estimating condensation ratios in ERVs under diverse climatic conditions.

Risk factors for COVID-19 and their association with mortality in Ecuadorian patients admitted to the ICU: A retrospective cohort multicentric study.

Several risk factors were associated with mortality in patients with coronavirus disease 2019 (COVID-19) infection in intensive care units (ICU). We assessed the effect of risk factors related to the characteristics and clinical history of the population, laboratory test results, drug management, and type of ventilation on the probability of survival/discharge from the ICU. A retrospective cohort multicentric study of adults with COVID-19 admitted to the ICU between March 2020 and December 2021. Data were collected from 6 hospitals in 5 cities in Ecuador. The primary outcome was ICU survival/discharge. Survival analysis was conducted using semi-parametric Cox proportional hazards models. Of those admitted to the ICU with COVID-19, (n = 991), mean age was 56.76 ± 13.14, and 65.9% were male. Regarding the primary outcome, 51.1% (n = 506) died and 48.9% (n = 485) survived. Of the group that died, their mean age was higher than the survivors (60.7 vs 52.60 years, respectively), and they had a higher prevalence of comorbidities such as arterial hypertension (37.2% vs 20.4%, respectively) and diabetes mellitus (26.9% vs 15.7%, respectively), with P < .001. In ventilatory management, 32.7% of patients used noninvasive ventilation and high-flow nasal cannula, and 67.3% required invasive ventilatory support. After adjusting for confounders, Cox regression analysis showed that patients were less likely to be discharged alive from the ICU if they met the following conditions: arterial hypertension (hazard ratio [HR] = 0.83 95% CI 0.723-0.964), diabetes mellitus (HR = 0.80 95% CI 0.696-0.938), older than 62 years (HR = 0.86 95% CI 0.790-0.956), obese (body mass index ≥ 30) (HR = 0.78 95% CI 0.697-0.887), 1 unit increase in SOFA score (HR = 0.94 95% CI 0.937-0.961), PaO2/FiO2 ratio <100 mm Hg (HR = 0.84 95% CI 0.786-0.914), and the use of invasive mechanical ventilation (HR = 0.68 95% CI 0.614-0.769). Risk factors associated with increased mortality were older age, obesity, arterial hypertension, and diabetes. Factors such as male gender, chronic obstructive pulmonary disease, acute kidney injury, and cancer reported in other investigations did not have the same effect on mortality in our study.

The Impact of Ventilation System Type on the Microclimate of Boar's Pen and Their Clinical Triad Parameters

The purpose of the study was the impact of different types of ventilation systems in boar`s pen on the microclimate and their physiological parameters. The control group of boars was kept in a house with a transverse ventilation system, and the animals of the experimental group were kept in a geothermal air supply. It was found that, regardless of the season, transverse ventilation provides a significantly higher air velocity and relative humidity: in Winter - 0.15 m s–1 and 5.4%; in Spring - 0.35 m s–1 and 5.3%; in Summer - 0.41 m s–1 and 0.7%; in Autumn - 0.28 m s–1 and 8.1%. Maintaining a stable temperature by the normative values in the boar housing was due to geothermal ventilation, regardless of the season, especially the "basement effect" was observed in the summer months, where the air temperature was cooled to 4.5°C (P &amp;lt; 0.001), compared to the transverse ventilation system. Compared with the boars in the experimental group, under the influence of the temperature increase in Summer, the boars in the control group increased significantly the respiratory rate to 50.9 ppm (P &amp;lt; 0.001) and heartbeat rate of 45.7 ppm (P &amp;lt; 0.001). An increase in rectal temperature in boars at elevated ambient temperature under both air ventilation systems was not found. The obtained results make it possible to introduce the use of cost-effective geothermal air supply technology in pig farms to harmonize the physiological parameters of boars to meet their biological needs, even in closed housing to improve their welfare.

Efficacy of home healthcare on the management of tracheostomy patients.

To evaluated the home healthcare efficacy in managing tracheostomy patients at King Abdulaziz Medical City under the Ministry of National Guard Health Affairs. Home healthcare is care provided to patients in the convenience of their homes to ensure high-quality care based on healthcare providers' supervision. This retrospective cohort study utilizing a non-probability consecutive sampling technique, including all available tracheal patients with no exclusion criteria, was carried out in Riyadh, Saudi Arabia, between January 2019 and June 2022. The collected data included patient demographic variables and respiratory settings (ventilation type, daily ventilation need, tracheostomy duration, and ventilator settings). The outcomes included mortality rate and therapeutic outcomes of tracheal management. Of the 183 patients in the study, the most common type of respiratory-related infection was pneumonia (53%). Unlike respiratory-related causes, The mortality rate of patients admitted to the intensive care unit that was unrelated to respiratory causes was statistically significant (57%) (p=0.003). The mortality rate of patients who used aerosol tracheal collars (34%) was markedly higher than mechanically ventilated patients (57%) (p=0.004). The mortality rate following discharge from HHC was 40%, and was higher among patients aged >70 years (47%) (p=0.04). Pneumonia was associated with the majority of ventilator-related infections and resulted in hospital readmissions. Ensuring proper practices and caregiver education is crucial to decrease the incidence of ventilator-related infections.

Serial paired arterial and jugular venous point-of-care values in dogs undergoing manual basic life support.

To evaluate differences in point-of-care (POC) variables obtained from arterial and jugular venous blood in dogs undergoing manual basic life support (BLS) and report changes over time. Experimental study. Small animal research facility. Twenty-four purpose-bred research dogs. Dogs were anesthetized, and arterial catheters were placed before euthanasia. One minute after cardiopulmonary arrest, BLS consisting of manual chest compressions and ventilation delivered via endotracheal intubation, face mask, mouth-to-nose, or no ventilation was initiated. Paired arterial and jugular venous blood samples were obtained for POC testing before euthanasia (T0), at 3minutes (T3), and at 6minutes (T6) into BLS. The association of POC variables with arterial or venous sample type while controlling for type of ventilation and sampling timepoint was determined using a generalized linear mixed model. Variables obtained from arterial and venous blood samples were compared over time using repeated measures ANOVA or Friedman test. Pao2, anion gap, potassium, chloride, glucose concentration, and PCV were significantly higher in arterial blood samples compared with venous samples (P<0.03). By T6, arterial glucose concentration, arterial and venous base excess, venous pH, and plasma lactate, potassium, creatinine, bicarbonate, and sodium concentrations were significantly increased, and arterial and venous Po2, ionized calcium concentration, PCV, and total plasma protein concentration were significantly decreased from T0 (P<0.05). Although statistically significant, arteriovenous differences and changes in POC blood variables during BLS were small and not clinically relevant over time. Given the challenges of arterial blood sampling, it may be reasonable to pursue venous blood sampling during CPR. Further studies in dogs undergoing BLS and advanced life support are needed to better understand the potential clinical role of POC testing during CPR.

Characterising indoor air quality in private vehicle cabins under unprecedented traffic conditions during COVID-19 lockdown

Air pollution negatively impacts human health, yet it is rarely studied inside vehicles. This study aimed to characterise indoor air quality (IAQ) in vehicle cabins, focusing on the concentrations of key pollutants and the influence of various factors on IAQ including vehicle-specific characteristics (self-pollution), traffic intensity, ventilation type, and enclosed spaces like parking garages. It addressed a significant literature gap by using real-world driving data, a multipollutant approach, real-time monitoring, and a detailed log of influencing factors. Additionally, part of the study was conducted during the COVID-19 lockdown, providing an unprecedented opportunity to gather real-world data with reduced traffic emissions. Forty trips were conducted with four diesel vehicles of different ages and emission standards. Concentrations of VOCs, CO, CO₂, NO₂, SO₂, O₃, and PM₁, PM₂.₅, PM₁₀, and TSP were monitored, alongside detailed logbook entries. This study evidenced the formation of O₃ inside vehicle cabins under conditions of high NO₂ and/or VOC concentrations and direct sunlight, a phenomenon not previously reported. Results also showed that IAQ inside vehicle cabins depended largely on vehicle-specific factors, the surrounding environment, and indoor-outdoor air exchange. CO, NO₂, SO₂, and PM levels varied mainly with the external environment and air exchange, while CO₂ levels were influenced primarily by ventilation settings. The concentrations of certain pollutants exceeded reference levels for indoor environments, potentially posing health risks to occupants. Further research is needed to study the pioneer evidence of O3 formation and to develop a comprehensive health risk assessment, thereby contributing to developing specific IAQ guidelines for vehicles.

Effectiveness and Safety of Superimposed High-Frequency Jet Ventilation in Rigid Bronchoscopy: A Single-Center, Retrospective Study.

Introduction: Superimposed high-frequency jet ventilation (SHFJV) is a new type of jet ventilation, but its safety and effectiveness in rigid bronchoscopy have not been fully verified, especially in patients with airway stenosis and preoperative cardiovascular disease. This study is intended to retrospectively analyze the effectiveness and safety of SHFJV in the endobronchial treatment under rigid bronchoscopy. Methods: A total of 363 patients were included in this study. They were divided into 2 groups: Group A (n = 176)-presence of airway stenosis; Group B (n = 187)-absence of airway stenosis. Mean arterial pressure, heart rate, and pulse oxygen saturation were recorded before anesthesia and during the procedure. Arterial blood gases was recorded before anesthesia, at the end of the procedure and second-day postoperation respectively. The duration of procedure, extubation time, length of stay in the postanesthesia care unit (PACU), length of postoperative hospitalization, incidence of intraoperative and postoperative complications as well as 30 day mortality were also recorded. Results: All the patients had stable circulation during the procedure, including that with preoperative cardiovascular and pulmonary diseases. There were no substantial differences observed in terms of extubation time, PACU stay, and postoperative hospital days. Patients with severe preoperative airway stenosis exhibited longer procedure duration compared to those with mild to moderate stenosis, but there was no difference noted in terms of the extubation and PACU time. Conclusion: SHFJV is effective and safe in the endobronchial treatment for patients with airway stenosis and preoperative cardiovascular disease. It can serve as an ideal airway management strategy for rigid bronchoscopy.

CFD Simulation to Assess the Effects of Asphalt Pavement Combustion on User Safety in the Event of a Fire in Road Tunnels

This paper presents a specific 3D computational fluid dynamics model to quantify the effects of the combustion of asphalt road pavement on user safety in the event of a fire in a bi-directional road tunnel. Since the consequences on tunnel users and/or rescue teams might be affected not only by the tunnel geometry but also by the type of ventilation and traffic flow, the environmental conditions caused by the fire in the tunnel under natural or longitudinal mechanical ventilation, as well as congested traffic conditions, were more especially investigated. The simulation results showed that the combustion of the asphalt pavement in the event of a 100 MW fire, compared to the case of a non-combustible road pavement, caused (i) an increase in smoke concentrations; (ii) a greater number of users exposed to the risk of incapacity to escape from the tunnel; (iii) a more difficult situation for the firefighters entering the tunnel upstream of the fire source in the case of natural ventilation; (iv) a higher probability of the domino effect for vehicles queued downstream of the fire when the tunnel is mechanically ventilated.

Evaluation of eustachian tube and mastoid parameters in chronic otitis media: A computed tomography-based study

Objectives: The study aimed to understand the causes of chronic otitis media (COM) with unilateral or bilateral cholesteatoma by examining the eustachian tube (ET) and mastoid ventilation from preoperative high-resolution temporal computed tomography (HRTCT) scans. Patients and Methods: In this retrospective case-control study, COM patients with cholesteatoma who underwent preoperative HRTCT scanning between January 2021 and December 2023 were analyzed. The study included 102 ears of 51 participants (31 males, 20 females; mean age: 35.7±14.0 years; range, 18 to 65 years). The participants were divided into three groups, each with 17 individuals: unilateral COM with cholesteatoma, bilateral COM with cholesteatoma, and a healthy control group. Variables, including Reid plane-ET angle, tubotympanic angle (TTA), ET length, ET tympanic orifice and isthmus widths, and mastoid ventilation type and volume, were examined in CT images. Results: The mean left TTA (p=0.045) was higher in the unilateral cholesteatoma group compared to the control group (148.88±5.30 and 144.24±6.51, respectively; p=0.045). The bilateral cholesteatoma group exhibited higher values for right and left ET isthmus widths (p=0.015 and p=0.014, respectively). The control group had significantly higher mastoid volumes compared to groups with cholesteatoma (p&lt;0.001). Type 3 mastoid distribution was notably higher in groups with cholesteatoma (p&lt;0.001). In the control group, the mean right and left ET angles were 25.13±3.35° and 24.67±3.38°, respectively. Conclusion: Tubotympanic angle and ET isthmus width may be a potential marker for cholesteatoma. Large-scale studies targeting the anatomy and function of the isthmus in combination with mastoid and ET radiomorphological data and clinical scores using standardized protocols may improve treatment strategies.

An IoT based Low-cost Artificial Mechanical Ventilator for Patients

This paper presents the construction of a low-cost, open-source mechanical ventilator. The motto behind making this type of ventilator comes from the global shortage of ventilators to treat patients suffering with Covid-19. This paper presents a digital method to monitor the lung status of patients. This is achieved by determining pressure measurements from the inspiratory arm and alerts clinicians if the patient is in a healthy or unhealthy condition. The common symptoms of Covid-19 that can be easily identified are body temperature, blood oxygen level and heart rate that we must check to identify the virus. Hence this system can help in case a patient is unable to meet the doctor or requires frequent monitoring. These are going to develop a system which can monitor, and all the monitored data is stored in the cloud. When people suffer from breathing problems, this can be used for emergencies. The ventilator will be able to monitor the patient's blood oxygen levels and exhaled lung pressure while avoiding high pressure. Designed using Arduino, the ventilator meets all these requirements, creating an affordable ventilator to help during a pandemic. A motor mechanism is used to push the air bag. When the oxygen level counts are low, this mechanism is utilized. LCD screens are used to display oxygen levels. Whenever a patient faces a dangerous position, a buzzer sounds to notify a nearby caretaker. The entire system is driven by an Arduino microcontroller and a buzzer is fitted to detect any low levels of oxygen count. Index Terms: Oxygen, Covid-19, Ventilator, Lung pressure, Air bag.

Prediction models for COVID-19 disease outcomes

ABSTRACT SARS-CoV-2 has caused over 6.9 million deaths and continues to produce lasting health consequences. COVID-19 manifests broadly from no symptoms to death. In a retrospective cross-sectional study, we developed personalized risk assessment models that predict clinical outcomes for individuals with COVID-19 and inform targeted interventions. We sequenced viruses from SARS-CoV-2-positive nasopharyngeal swab samples between July 2020 and July 2022 from 4450 individuals in Missouri and retrieved associated disease courses, clinical history, and urban-rural classification. We integrated this data to develop machine learning-based predictive models to predict hospitalization, ICU admission, and long COVID. The mean age was 38.3 years (standard deviation = 21.4) with 55.2% (N = 2453) females and 44.8% (N = 1994) males (not reported, N = 4). Our analyses revealed a comprehensive set of predictors for each outcome, encompassing human, environment, and virus genome-wide genetic markers. Immunosuppression, cardiovascular disease, older age, cardiac, gastrointestinal, and constitutional symptoms, rural residence, and specific amino acid substitutions were associated with hospitalization. ICU admission was associated with acute respiratory distress syndrome, ventilation, bacterial co-infection, rural residence, and non-wild type SARS-CoV-2 variants. Finally, long COVID was associated with hospital admission, ventilation, and female sex. Overall, we developed risk assessment models that offer the capability to identify patients with COVID-19 necessitating enhanced monitoring or early interventions. Of importance, we demonstrate the value of including key elements of virus, host, and environmental factors to predict patient outcomes, serving as a valuable platform in the field of personalized medicine with the potential for adaptation to other infectious diseases.