Respiratory Mechanics, Respiratory Muscle Strength, Control of Ventilation and Gas Exchange in Patients with Autoimmune Liver Disease

Objectives: To assess respiratory elastance and resistive properties in patients with autoimmune liver disorders using the passive relaxation expiration technique and compare findings to a group of patients with non-autoimmune liver disease and control subjects. These findings were then related to control of ventilation and gas exchange. A secondary objective was to assess respiratory muscle strength and gas exchange and their relation to respiratory mechanics. Methods: Measurements included respiratory elastance and resistance using the passive relaxation method. Pulmonary function, gas exchange and control of ventilation were assessed using standard methods. Results: a) Compared to control subjects, Ers in patients with liver disease was on average 50% greater than in controls;b) mean respiratory resistance, expressed as the respiratory constants, K1 and K2 in the Rohrer relationship, Pao/V’ = K1 + K2V’, was not different from control resistance;c) mean maximal inspiratory and maximal expiratory pressures averaged 36% and 55% of their respective control values;d) inspiratory occlusion pressure in 0.1 sec (P0.1) was increased and negatively associated with FVC;and e) increases in P0.1, mean inspiratory flow (Vt/Ti) and presence of respiratory alkalosis confirmed the increase in ventilatory drive. Despite inspiratory muscle weakness in patients, P0.1/Pimax averaged 5-fold higher than in control subjects. Conclusions: Despite inspiratory muscle weakness and a V’E similar to that in normal subjects, central drive is increased in patients with chronic liver disease. The increase in ventilatory drive is related to smaller lung volumes and weakly associated with increase in respiratory elastance. Findings confirm that P0.1 is a reliable measure of central drive and is an approach that can be used in the evaluation of control of ventilation in patients with chronic liver disease.

Optimized model-based control of main mine ventilation air flows with minimized energy consumption

In early 2018,the Boliden Garpenberg operation implemented an optimized control strategy as an addition to the existing ventilation on demand system.The purpose of the strategy is to further minimize energy use for main and booster fans,whilst also fulfilling airflow setpoints without violating constraints such as min/max differential pressure over fans and interaction of air between areas in mines.Using air flow measurements and a dynamical model of the ventilation system,a mine-wide coordination control of fans can be carried out.The numerical model is data driven and derived from historical operational data or step changes experiments.This makes both initial deployment and lifetime model maintenance,as the mine evolves,a comparably easy operation.The control has been proven to operate in a stable manner over long periods without having to re-calibrate the model.Results prove a 40%decrease in energy use for the fans involved and a greater controllability of air flow.Moreover,a 15%decrease of the total air flow into the mine will give additional proportional heating savings during winter periods.All in all,the multivariable controller shows a correlation between production in the mine and the ventilation system performance superior to all of its predecessors.

Resilience-Oriented Approach to the Control of Ventricular Assist Devices

Context: Advanced heart failure (AHF) poses a global challenge, where heart transplantation is a treatment option but limited by donor scarcity. Proposal: This study aims to enhance the performance of ventricular assist devices (VADs) in the face of adverse events (AEs) using a resilience-based approach. The objective is to develop a method for integrating resilience attributes into VAD control systems, employing dynamic risk analysis and control strategies. Results: The outcomes include a resilient control architecture enabling anticipatory, regenerative, and degenerative actions in response to AEs. A method of applied resilience (MAR) based on dynamic risk management and resilience attribute analysis was proposed. Conclusion: Dynamic integration between medical and technical teams allows continuous adaptation of control systems to meet patient needs over time, improving reliability, safety, and effectiveness of VADs, with potential positive impact on the health of heart failure patients.

Effect of Prone Position Ventilation in Patients with Severe Craniocerebral Injury Complicated with Pulmonary Infection

Objective:To investigate the effects of prone ventilation in patients with severe traumatic brain injury combined with pulmonary infection.Methods:A total of 100 patients with severe traumatic brain injury combined with pulmonary infection in the hospital were randomly divided into a prone ventilation group and a conventional ventilation group,with 50 patients in each group.The Glasgow Coma Scale(GCS)score,APACHE II score,sputum culture results,oxygenation indicators,and prognosis were compared between the two groups.Data were processed using SPSS 25.0 statistical software,and t-tests and chi-square tests were used to compare continuous and categorical variables,respectively.Results:The experimental group showed better oxygenation indicators,a lower positive rate of sputum cultures,and reduced intracranial pressure compared to the control group(all P<0.05).Multivariate Cox regression analysis indicated that GCS score,APACHE II score,and prone ventilation were independent risk factors affecting patient prognosis(all P<0.05).Conclusion:Prone ventilation can improve oxygenation,reduce the risk of pulmonary infection,and decrease intracranial pressure in patients with severe traumatic brain injury combined with pulmonary infection,thereby improving patient prognosis.GCS score and APACHE II score can serve as important indicators for prognostic evaluation.

Dimensionless Study on Secretion Clearance of a Pressure Controlled Mechanical Ventilation System with Double Lungs

A pressure controlled mechanical ventilator with an automatic secretion clearance function can improve secretion clearance safely and efficiently.Studies on secretion clearance by pressure controlled systems show that these are suited for clinical applications.However,these studies are based on a single lung electric model and neglect the coupling between the two lungs.The research methods applied are too complex for the analysis of a multi-parameter system.In order to understand the functioning of the human respiratory system,this paper develops a dimensionless mathematical model of doublelung mechanical ventilation system with a secretion clearance function.An experiment is designed to verify the mathematical model through comparison of dimensionless experimental data and dimensionless simulation data.Finally,the coupling between the two lungs is studied,and an orthogonal experiment designed to identify the impact of each parameter on the system.

Modelling and Simulation of Pressure Controlled Mechanical Ventilation System

A mathematical model of mechanical ventilator describes its behavior during artificial ventilation. This paper purposes to create and simulate Mathematical Model (MM) of Pressure Controlled Ventilator (PCV) signal. This MM represents the respiratory activities and an important controlled parameter during mechanical ventilation—Positive End Expiration Pressure (PEEP). The MM is expressed and modelled using periodic functions with inequalities to control the beginning of inspiration and expiration durations. The created MM of PCV signal is combined with an existing multi compartmental model of respiratory system that is modified and developed in the internal parameters—compliances (C) to test created MM. The created MM and model of respiratory system are constructed and simulated using Simulink package in MATLAB platform. The obtained simulator of mechnical ventilation system could potentially represent the pressure signal of PVC as a complete respiratory cycle and continuance waveform. This simulator is also able to reflect a respiratory mechanic by changing some input variables such as inspiration pressure (IP), PEEP and C, which are monitored in volume, flow, pressure and PV loop waveforms. The obtained simulator has provided a simple environment for testing and monitoring PCV signal and other parameters (volume, flow and dynamic compliance) during artificial ventilation. Furthermore, the simulator may be used for studying in the laboratory and training ventilator’s operators.

Harmonic excitation of linear respiratory mechanics for physiological dual controlled ventilation

The theoretical approach along with the rationale of harmonic excitation modality (HEM) applied as optimal dual controlled ventilation (DCV) to anaesthetized or severe brain injured patients, whose respiretory mechanics can be properly assumed steady and linear, are presented and discussed. The design criteria of an improved version of the Advanced Lung Ventilation System (ALVS), including HEM in its functional features, are described in details. In particular, the elimination of any undesiderable artificial distortion affecting the respiratory and ventilation pattern waveforms is achieved by maintaining continuous forever the airflow inside the ventilation circuit, ensuring also the highest level of safety for patient in any condition. In such a way, the full-time compatibility of controlled breathings with spontaneous breathing activity of patient during continuous positive airways pressure (CPAP) or bilevel positive airways pressure (BiPAP) ventilation modalities and during assisted/controlled ventilation(A/CV), includeing also synchronized or triggered ventilation modalities, is an intrinsic innovative feature of the system available for clinical application. As expected and according to the clinical requirements, HEM provides for physiological respiratory and ventilation pattern waveforms together with optimal “breath to breath” feedback control of lung volume driven by an improved diagnostic measurement procedure, whose outputs are also vital for adapting all the preset ventilation parameters to the current value of the respiratory parameters of patient. The results produced by software simulations concerning both adult and neonatal patients in different clinical conditions are completely consistent with those obtained by the theoretical treatment, showing that HEM reaches the best performances from both clinical and engineering points of view.

Theoretical modeling of airways pressure waveform for dual-controlled ventilation with physiological pattern and linear respiratory mechanics

The present paper describes the theoretical treatment performed for the geometrical optimization of advanced and improved-shape waveforms as airways pressure excitation for controlled breathings in dual-controlled ventilation applied to anaesthetized or severe brain injured patients, the respiratory mechanics of which can be assumed linear. Advanced means insensitive to patient breathing activity as well as to ventilator settings while improved-shape intends in comparison to conventional square waveform for a progressive approaching towards physiological transpulmonary pressure and respiratory airflow waveforms. Such functional features along with the best ventilation control for the specific therapeutic requirements of each patient can be achieved through the implementation of both diagnostic and compensation procedures effectively carried out by the Advance Lung Ventilation System (ALVS) already successfully tested for square waveform as airways pressure excitation. Triangular and trapezoidal waveforms have been considered as airways pressure excitation. The results shows that the latter fits completely the requirements for a physiological pattern of endoalveolar pressure and respiratory airflow waveforms, while the former exhibits a lower physiological behaviour but it is anyhow periodically recommended for performing adequately the powerful diagnostic procedure.

The effect of different inflation volumes of laryngeal mask airway on efficacy of closed circuit controlled ventilation in pediatric cancer patients

Objective： The laryngeal mask airway （LMA） is an established way for airway control during spontaneous ventila- tion. Its ability to deliver positive pressure ventilation without leakage especially in low flow states is still controversy. The aim of this study is to test the possibility of using LMA in pediatric closed circuit controlled ventilation, and to find out the optimum cuff volume to perform closed system ventilation. Methods： Twenty children scheduled for elective surgeries were enrolled in a crossover study. Laryngeal mask airway was used. In stage I, the cuff was inflated with the maximum volume of air as rec- ommended by the manufacturers. Adjustment of volume of air inflated into the LMA cuff to the minimum volume to obtain the effective seal was done at stage II. The leak pressure, intracuff pressure and the leak volume were measured in both stages. Results： The cuff filling volume was significantly lower compared to the maximum cuff inflation volume in stage I. Leakage values showed significantly less values in stage II of the study with smaller cuff inflation volumes. The airway leakage pressure was significantly lower in stage fl in comparison to stage I. Cuff inflation pressure in stage I showed marked elevation which dropped significantly after adjustment of cuff volume in stage I1. Conclusion： Laryngeal mask airway is an effective tool to provide closed circuit controlled ventilation in pediatrics. Inflation of the cuff by the minimum volume of air needed to reach the just sealing pressure is suggested to minimize the leakage volume.

Experimental Investigation of Demand Controlled Ventilation Systems： A Suitable Alternative for Controlling Ventilation in Dwellings

Indoor CO2 concentration depends on the number of persons, their metabolic rates, other sources of indoor pollution, ventilation rate and ventilation efficiency. These factors are not considered by the Spanish technical building code since ventilation is set only by a fixed air change rate. This paper aims to explore the possibilities of DCVS （demand controlled ventilation systems） to ensure adequate and sustainable ventilation. It is based on a research project carried out by the University of the Basque Country （EHU-UPV） and Euskadi Public Housing and Soil Join-Stock Company （VISESA）： the living rooms of 90 dwellings were provided with DCVS, where CO2 sensors were used to dynamically control the ventilation rate. Tests were carried out using tracer gas techniques, with results showing the air age to be adequate at every point of the occupied zones and free of stagnant areas, therefore proving the system＇s effectiveness and rapid response, and its energy savings.

Application of fiberoptic bronchscopy in patients with acute exacerbations of chronic obstructive pulmonary disease during sequential weaning of invasive-noninvasive mechanical ventilation

BACKGROUND:Early withdrawal of invasive mechanical ventilation(IMV) followed by noninvasive MV(NIMV) is a new strategy for changing modes of treatment in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD) with acute respiratory failure(ARF).Using pulmonary infection control window(PIC window) as the switch point for transferring from invasive to noninvasive MV,the time for early extubation can be more accurately judged,and therapy efficacy can be improved.This study aimed to prospectively investigate the clinical effectiveness of fiberoptic bronchscopy(FOB) in patients with AECOPD during sequential weaning of invasive-noninvasive MV.METHODS:Since July 2006 to January 2011,106 AECOPD patients with ARF were treated with comprehensive medication and IMV after hospitalization.Patients were randomly divided into two groups according to whether fiberoptic bronchoscope is used(group A,n=54) or not(group B,n=52) during sequential weaning from invasive to noninvasive MV.In group A,for sputum suction and bronchoalveolar lavage(BAL),a fiberoptic bronchoscope was put into the airway from the outside of an endotracheal tube,which was accompanied with uninterrupted use of a ventilator.After achieving PIC window,patients of both groups changed to NIMV mode,and weaned from ventilation.The following listed indices were used to compare between the groups after treatment:1) the occurrence time of PIC,the duration of MV,the length of ICU stay,the success rate of weaning from MV for the first time,the rate of reventilatJon and the occurrence rate of ventilator-associated pneumonia(VAP);2) the convenience and safety of FOB manipulation.The results were compared using Student's f test and the Chi-square test.RESULTS:The occurrence time of PIC was(5.01 ±1.49) d,(5.87±1.87) d in groups A and B,respectively(P<0.05);the duration of MV was(6.98±1.84) d,(8.69±2.41) d in groups A and B,respectively(P<0.01);the length of ICU stay was(9.25±1.84) d,(11.10±2.63) d in groups A and B,respectively(P<0.01);the success rate of weaning for the first time was 96.30%,76.92%in groups A and B,respectively(P<0.01);the rate of reventilation was 5.56%,19.23%in groups A and B,respectively(P<0.05);and the occurrence rate of VAP was 3.70%,23.07%in groups A and B,respectively(P<0.01).Moreover,it was easy and safe to manipulate FOB,and no side effect was observed.CONCLUSIONS:The application of FOB in patients with AECOPD during sequential weaning of invasive-noninvasive MV is effective in ICU.It can decrease the duration of MV and the length of ICU stay,increase the success rate from weaning MV for the first time,reduce the rate of reventilation and the occurrence rate of VAP.In addition,such a method is convenient and safe in patients of this kind.

Alternate solutions for mine ventilation network to keep a preassigned fixed quantity in a working place

In underground constructions, a good ventilation design not only delivers fresh air to establish good working environment, but also provides a scientific and reliable basis to prevent disasters. In emergency cases, unexpected closure of the main airways may occur, providing the workers with alternative airways is substantial. This is important not only to sustain personnel lives, but also to prevent the mine ventilation system from damage. In this research, alternate solutions were introduced in case of failure in the underground construction to keep a pre-assigned fixed quantity in a working place for mine ventilation network. Eight different collapse scenarios were proposed to study their effect on the air quantity distribution among the branches in the ventilation circuit. From these scenarios, it is found that providing a sufficient air quantity in the working places could be achieved through modification of the network topology and adjusting the values of the regulators pressure. It is also indicated that the distance between the collapse and working places has a great effect on the amount of air delivered to it. A reduction in the power consumption could be done by re-arrange the installed regulators and decreasing the number of nodes and branches inside the network. A relationship representing the effect of changing the network topology on the total network power consumption was deduced through regression analysis. It is found that the total network power is quadratic dependent on the number of regulators and number of branches while it is directly dependent on the regulator power.

Adaptive Gain Tuning Rule for Nonlinear Sliding-mode Speed Control of Encoderless Three-phase Permanent Magnet Assisted Synchronous Motor

In this paper, an adaptive gain tuning rule is designed for the nonlinear sliding mode speed control(NSMSC) in order to enhance the dynamic performance and the robustness of the permanent magnet assisted synchronous reluctance motor(PMa-Syn RM) with considering the parameter uncertainties. A nonlinear sliding surface whose parameters are altering with time is designed at first. The proposed NSMSC can minimize the settling time without any overshoot via utilizing a low damping ratio at starting along with a high damping ratio as the output approaches the target set-point. In addition, it eliminates the problem of the singularity with the upper bound of an uncertain term that is hard to be measured practically as well as ensures a rapid convergence in finite time, through employing a simple adaptation law. Moreover, for enhancing the system efficiency throughout the constant torque region, the control system utilizes the maximum torque per ampere technique. The nonlinear sliding surface stability is assured via employing Lyapunov stability theory. Furthermore, a simple sliding mode estimator is employed for estimating the system uncertainties. The stability analysis and the experimental results indicate the effectiveness along with feasibility of the proposed speed estimation and the NSMSC approach for a 1.1-k W PMa-Syn RM under different speed references, electrical and mechanical parameters disparities, and load disturbance conditions.

Water-Assisted Injection Molding System Based on Water Hydraulic Proportional Control Technique

Water-assisted injection molding（WAIM）, an innovative process to mold plastic parts with hollow sections, is characterized with intermittent, periodic process and large pressure and flow rate variation. Energy savings and injection pressure control can not be .attained based on conventional valve control system. Moreover, the injection water can not be supplied directly by water hydraulic proportional control system. Poor efficiency and control performance are presented by current trial systems, which pressurize injection water by compressed air. In this paper, a novel water hydraulic system is developed applying an accumulator for energy saving. And a new differential pressure control method is proposed by using pressure cylinder and water hydraulic proportional pressure relief valve for back pressure control. Aiming at design of linear controller for injection water pressure regulation, a linear load model is approximately built through computational fluid dynamics（CFD） simulation on two-phase flow cavity filling process with variable temperature and viscosity, and a linear model of pressure control system is built with the load model and linearization of water hydraulic components. According to the simulation, model based feedback is brought forward to compensate the pressure decrease during accumulator discharge and eliminate the derivative element of the system. Meanwhile, the steady-state error can be reduced and the capacity of resisting disturbance can be enhanced, by closed-loop control of load pressure with integral compensation. Through the developed experimental system in the State Key Lab of Fluid Power Transmission and Control, Zhejiang University, China, the static characteristic of the water hydraulic proportional relief valve was tested and output pressure control of the system in Acrylonitrile Butadiene Styrene（ABS） parts molding experiments was also studied. The experiment results show that the dead band and hysteresis of the water hydraulic proportional pressure relief valve are large, but the control precision and linearity can be improved with feed-forward compensation. With the experimental results of injection water pressure control, the applicability of this WAIM system and the effect of its linear controller are verified. The novel proposed process of WAIM pressure control and study on characteristics of control system contribute to the application of water hydraulic proportional control and WAIM technology.

Alternative ventilation strategies in U.S.offices:Comprehensive assessment and sensitivity analysis of energy saving potential

Mature technologies exist to reduce the heating,ventilation,and air-conditioning(HVAC) energy associated with ventilation and use ventilation proactively to save energy.This study investigated the energy use impacts in U.S.office buildings of multiple alternative ventilation strategies that combined:economizing,demand controlled ventilation(DCV),supply air temperature reset(SR),and/or a doubled ventilation rate.We used energy simulations in a Monte Carlo analysis,sampling 17 building inputs and varying locations to match the climate zone distribution of the U.S.office stock.Results indicated the possibility for significant savings compared to a baseline that ventilated constantly at a minimum rate in both a small office type with a constant air volume(CAV) HVAC system and a medium office type with a variable air volume(VAV) system.In 95%of instances,HVAC source energy savings were 5-25%in the small-CAV office(median:11%) and 6-42%in the medium-VAV office(median:27%).In the small-CAV office,DCV typically saved the most energy,usually from heating,and heating degree days and occupant density were decisive influences.In the medium-VAV office,economizing and SR were most important,DCV usually only had minor impacts,and zone temperature setpoints,along with climate indicators,were the critical influences.Other than infiltration,envelope characteristics did not strongly influence energy impacts.The untapped primary energy savings of alternative ventilation strategies over the 74%of U.S.office floorspace reasonably represented by our modeling was estimated at 36 TWh per year,with an annual value of U.S.$ 1.25 billion.

Simulation and Experiment Research on the Proportional Pressure Control of Water-assisted Injection Molding

Water-assisted injection molding（WAIM）,a newly developed fluid-assisted injection molding technology has drawn more and more attentions for the energy saving,short cooling circle time and high quality of products.Existing research for the process of WAIM has shown that the pressure control of the injecting water is mostly important for the WAIM.However,the proportional pressure control for the WAIM system is quite complex due to the existence of nonlinearities in the water hydraulic system.In order to achieve better pressure control performance of the injecting water to meet the requirements of the WAIM,the proportional pressure control of the WAIM system is investigated both numerically and experimentally.A newly designed water hydraulic system for WAIM is first modeled in AMEsim environment,the load characteristics and the nonlinearities of water hydraulic system are both considered,then the main factors affecting the injecting pressure and load flow rate are extensively studied.Meanwhile,an open-loop model-based compensation control strategy is employed to regulate the water injection pressure and a feedback proportional integrator controller is further adopted to achieve better control performance.In order to verify the AMEsim simulation results WAIM experiment for particular Acrylonitrile Butadiene Styrene（ABS） parts is implemented and the measured experimental data including injecting pressure and flow rate results are compared with the simulation.The good coincidence between experiment and simulation shows that the AMEsim model is accurate,and the tracking performance of the load pressure indicates that the proposed control strategy is effective for the proportional pressure control of the nonlinear WAIM system.The proposed proportional pressure control strategy and the conclusions drawn from simulation and experiment contribute to the application of water hydraulic proportional control and WAIM technology.

Research on Noise Control for Ventilators with Resonance

A study was carried out to control the noise produced by the ventilators at the Luling coalmine, which had caused serious noise pollution to the residents living around the mine for a long time. The main noise source was found to be the dynamic noise at the outlet of the diffuser. The frequency of its peak value was 250 Hz. A special brick with a resonant frequency of 250 Hz was designed to eliminate this noise. The diffusion of a lower frequency noise has been successfully controlled by the installation of a noise-eliminating tower above the diffuser outlet. The detection results show that the noise in the nearby residential area has been lowered to an average 55.3dB(A) in the daytime from 69.8dB(A) and to 48.4dB(A) at night from 65.8dB(A).

An Improved Torque Sensorless Speed Control Method for Electric Assisted Bicycle With Consideration of Coordinate Conversion

In this paper,we propose an improved torque sensorless speed control method for electric assisted bicycle,this method considers the coordinate conversion.A low-pass filter is designed in disturbance observer to estimate and compensate the variable disturbance during cycling.A DC motor provides assisted power driving,the assistance method is based on the realtime wheel angular velocity and coordinate system transformation.The effect of observer is proved,and the proposed method guarantees stability under disturbances.It is also compared to the existing methods and their performances are illustrated through simulations.The proposed method improves the performance both in rapidity and stability.

Advances in magnetic-assisted triboelectric nanogenerators:structures,materials and self-sensing systems

Triboelectric nanogenerators(TENG),renowned for their remarkable capability to harness weak mechanical energy from the environment,have gained considerable attention owing to their cost-effectiveness,high output,and adaptability.This review provides a unique perspective by conducting a comprehensive and in-depth analysis of magnetically assisted TENGs that encompass structures,materials,and self-powered sensing systems.We systematically summarize the diverse functions of the magnetic assistance for TENGs,including system stiffness,components of the hybrid electromagnetic-triboelectric generator,transmission,and interaction forces.In the material domain,we review the incorporation of magnetic nano-composites materials,along with ferrofluid-based TENG and microstructure verification,which have also been summarized based on existing research.Furthermore,we delve into the research progress on physical quantity sensing and human-machine interface in magnetic-assisted TENGs.Our analysis highlights that magnetic assistance extends beyond the repulsive and suction forces under a magnetic field,thereby playing multifaceted roles in improving the output performance and environmental adaptability of the TENGs.Finally,we present the prevailing challenges and offer insights into the future trajectory of the magnetic-assisted TENGs development.

ACOUSTICAL IMPROVEMENTS WITH NATURAL AIR VENTILATION IN THE LIU INSTITUTE FOR GLOBAL ISSUES AT THE UNIVERSITY OF BRITISH COLUMBIA

Low speech privacy in shared and private offices in one of the early generation of a“green”building resulted in occupants’dissatisfaction.This problem is experienced in Liu institute with a natural-ventilation system.Such a system requires low air-flow resistance which is achieved by large openings which will result in noise transmission between various spaces within the building.The poor acoustical quality in this building resulted in occupants’noise complaints which were further investigated by way of relevant acoustical measurements.CATT-Acoustic software was utilized to modify the acoustical quality of the building without any disturbance to the occupants.The optimized design of the transfer box above the office door was selected based on CATT-Acoustic predictions.The acoustical measurements were conducted after installation of the transfer box above the office door.The measurements’results agreed with the predictions which led to improved speech privacy to an acceptable level between the office and the corridor in Liu Institute.More work should be done to improve the acoustical quality of natural-ventilated building to conform to ANSI standards.1 The results of this study strongly support including acoustics in“green”building designs with natural ventilation to avoid users’complaints.