Automobile Pollution and Risk of Impaired Lung Function and Oxygen Saturation among Vendors Near Road Traffic in Brazzaville, Congo

Context: Automobile pollution is becoming a potential threat to the cardiorespiratory health of the urban population of sub-Saharan Africa. The present study aims to evaluate the level of concentrations of fine particles (PM2.5 and PM10) near road traffic and the effects of exposure to automobile pollutants on pulmonary function and arteriolar blood oxygen saturation among sellers around road traffic. Materials and Methods: The study recruited 48 healthy people carrying out a sales activity near road traffic. PM2.5 and PM10 measurements were taken from 6 a.m. to 6 p.m. using a Temtop Airing-1000 portable particle detector. Spirometric measurements were taken in the morning and in the evening from a portable Spirobank G spirometer. Oxygen saturation measurements were also taken in the morning and evening using a Pulse oxymeter CMS50D pulse oxymeter. Results: Mean values of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and forced expiratory flow between 25% and 75% of forced vital capacity (FEF25 - 75) recorded in the evening were significantly lower than those obtained in the morning in the subjects of the total group and in the men. Only the mean values of PEF and FEF25 - 75 obtained in the evening were significantly lower than those recorded in the morning in women. Minimum PM2.5 values recorded near road traffic were negatively correlated with evening PEF in men, while maximum PM10 values were negatively correlated with evening PEF in women. The blood oxygen saturation recorded in the evening was significantly lower than that obtained in the morning. Conclusion: Short-term exposure to automobile pollutants has adverse effects on lung function and oxygen saturation in people carrying out a sales activity near road traffic.

Neuroprotection of hyperbaric oxygen therapy in sub-acute traumatic brain injury:not by immediately improving cerebral oxygen saturation and oxygen partial pressure

Although hyperbaric oxygen （HBO） therapy can promote the recovery of neural function in patients who have suffered traumatic brain injury （TBI）, the underlying mechanism is unclear. We hypothesized that hyperbaric oxygen treatment plays a neuroprotective role in TBI by increasing regional transcranial oxygen saturation （rSO2） and oxygen partial pressure （PaO2）. To test this idea, we compared two groups： a control group with 20 healthy people and a treatment group with 40 TBI patients. The 40 patients were given 100% oxygen of HBO for 90 minutes. Changes in rSO2 were measured. The controls were also examined for rSO2 and PaO2, but received no treatment, rSO2 levels in the patients did not differ significantly after treatment, but levels before and after treatment were significantly lower than those in the control group. PaO2 levels were significantly decreased after the 30-minute HBO treatment. Our findings suggest that there is a disorder of oxygen metabolism in patients with sub-acute TBI. HBO does not immediately affect cerebral oxygen metabolism, and the underlying mechanism still needs to be studied in depth.

Retinal vessel oxygen saturation in healthy subjects and early branch retinal vein occlusion

AIM： To measure the retinal oxygen saturation in healthy subjects and early branch retinal vein occlusion（BRVO） in Chinese population.METHODS： The retinal vessel oxygen saturation of the healthy subjects and BRVO patients were measured by a noninvasive retinal oximeter（Oxymap ehf.,Reykjavik,Iceland）.RESULTS： The study included 22 patients with unilateral BRVO（mean age： 55.1±8.8y） in the study group and 91 healthy participants（mean age： 37.5±14.0y） in the control group.In the healthy individuals,mean arterial and venous oxygen saturation were significantly（P〈0.001）higher in the superior nasal quadrant（98.5%±10.1%and 57.3%±8.7%,respectively） than in the inferior nasal quadrant（94.2%±9.0% and 54.1%±9.6%,respectively）,followed by the superior temporal quadrant（89.1%±10.1%and 51.9%±8.9%,respectively） and the inferior temporal quadrant（86.4%±9.4% and 46.6%±9.6%,respectively）.In patients with ischemic BRVO,arterial oxymetric values were significantly higher and venous measurements significantly lower for the affected vessel（107.5%±9.7% and46.4%±14.2%,respectively） than the unaffected vessel in the same eye（99.2%±12.2% and 55.5%±7.9%,respectively）and as compared to the vessel in the unaffected fellow eye（93.1%±6.9% and 55.7%±6.8%）（P=0.005 and P=0.02,respectively）.In the patients with non-ischemic BRVO,mean venous oxygen saturation was lower in the affected vein（39.8%±12.2%） than in the unaffected vessels of the same eye（50.8%±10.5%） and in the fellow eye（58.21%±5.7%）（P=0.03）.Mean arterial oxygen saturation did not differ significantly（P=0.42） between all three groups.CONCLUSION： In patients with BRVO,the venous oxygen saturation in the affected vessels is decreased potentially due to decreased blood velocity and flow.Interestingly,thearterial oxygen saturation in eyes with ischemic BRVO is increased in the affected arteries.

Effects of Integrative Chinese and Western Medicine on Arterial Oxygen Saturation in Patients with Severe Acute Respiratory Syndrome

Objective: To evaluate the effects of treatment of integrative Chinese and Western medicine (ICWM) on arterial oxygen saturation (SaO2) in patients with severe acute respiratory syndrome (SARS). Methods:The non-randomized, controlled trial was conducted on 447 SARS patients treated synchronously with western conventional treatment (WM group, n = 171) alone and ICWM (ICWM group, n = 276). The changes of the cases with normal level (≥95% ) or abnormal level (<95% ) SaO2 were observed dynamically. Results: In the 3rd-14th day of the therapeutic course, the percentage of patients with normal SaO2 in the ICWM group was higher than that in the WM group (OR = 0.5178, P = 0.0038), and this tendency was more evident in patients of the severe type (OR = 0. 18, P = 0. 0001). However, the statistical significance of difference was only shown in patients for whom the ICWM treatment started in the early period after the onset (≤7 days after it, OR = 0.3803, P = 0.006), but not shown in those who received ICWM treatment later in the mid-late period of SARS ( P>0. 05). Conclusion: ICWM treatment, particularly when it is used for intervention in the early stage, is beneficial for maintaining normal SaO2 in SARS patients.

Effect of Hemodilution on Fluctuation of Cerebral Oxygen Saturation during Cardiopulmonary Bypass in Children with Cyanotic Congenital Heart Disease

Background:In patients with cyanotic congenital heart disease(CHD),cerebral oxygenation may be maintained by elevations in hematocrit(Hct).Hemodilution accompanying cardiopulmonary bypass(CPB),however,can disrupt cerebral oxygen balance,leading to fluctuations in cerebral oxygen saturation(ScO_(2)).The present study investigated the effects of Hct changes on the fluctuation of ScO_(2)during CPB in cyanotic CHD using performance measurement(PM).Methods:Children with CHD(51 acyanotic and 46 cyanotic)who had undergone cardiac surgery using CPB were enrolled.Median performance error(MDPE),median absolute performance error(MDAPE),and wobble parameters of ScO_(2)were calculated before(reference value),during,and after CPB.Correlations of PM parameters with Hct and reductions in Hct(ΔHct)were also evaluated.Results:Before CPB,patients with cyanotic CHD had lower MDPE and larger wobble than those with acyanotic CHD,although mean ScO_(2)did not differ significantly between the two groups.During CPB,ScO_(2)of acyanotic CHD increased asΔHct increased,but PM variables were not associated withΔHct.In cyanotic CHD,MDPE(r=−0.324,p=0.032)and MDAPE(r=0.339,p=0.024)correlated significantly withΔHct during CPB.After CPB,MDPE(r=0.574,p=0.025)and MDAPE(r=−0.543,p=0.036)were significantly correlated with Hct in children with cyanotic CHD who underwent palliative surgery.Conclusion:Therefore,ScO_(2)fluctuation during CPB in children with cyanotic CHD may be affected by the decrease in Hct,suggesting that excessive hemodilution can negatively influence the maintenance of cerebral oxygenation in these patients.

Changes and significance of retinal blood oxygen saturation and oxidative stress indexes in patients with diabetic retinopathy

BACKGROUND Diabetic retinopathy(DR)is a diabetic complication that can severely affect the patients’vision,eventually leading to blindness.DR is the most important manifestation of diabetic micro-vasculopathy and is mainly related to the course of diabetes and the degree of blood glucose control,while the age of diabetes onset,sex,and type of diabetes have little influence on it.AIM To explore the changes in blood oxygen saturation and oxidative stress indices of retinal vessels in patients with DR.METHODS In total,94 patients(94 eyes)with DR(DR group)diagnosed at Jianyang people’s Hospital between March 2019 and June 2020,and 100 volunteers(100 eyes)(control group)without eye diseases,were included in this study.Arterial and venous blood oxygen saturation,retinal arteriovenous vessel diameter,and serum oxidative stress indicators in the two groups were compared.Based on the stage of the disease,the DR group was divided into the simple DR and proliferative DR groups for stratified analysis.RESULTS The oxygen saturation of the retinal vessels in the DR group was significantly higher than that in the control group(P<0.05).The retinal vessel diameters between the DR and control groups were not significantly different.The serum malondialdehyde(MDA)and 8-hydroxydehydroguanosine(8-OHdG)levels in the DR group were significantly higher than those in the control group(P<0.05).The serum superoxide dismutase(SOD)and reduced glutathione(GSH)levels in the DR group were significantly lower than those in the control group (P < 0.05). The oxygensaturation of the retinal vessels in the patients with proliferative DR was significantly higher thanthat in the patients with simple DR (P < 0.05). The retinal vessel diameter in patients with proliferativeDR was not significantly different from that of patients with simple DR (P > 0.05). SerumMDA and 8-OHdG levels in patients with proliferative DR were significantly higher than those inpatients with simple DR (P < 0.05). Serum SOD and GSH levels in patients with proliferative DRwere significantly lower than those in patients with simple DR (P < 0.05).CONCLUSIONIncreased blood oxygen saturation of retinal arteries and veins and increased oxidative stressdamage in patients with DR may be associated with decreased retinal capillary permeability andarterial oxygen dispersion, possibly reflecting the patient’s condition.

Clinical application of vascular occlusion test based on tissue oxygen saturation monitoring

The vascular occlusion test (VOT) is an experiment that simulates the process of distal ischemia-reperfusion of tissue based on the monitoring of tissue oxygen saturation (StO2) to obtain VOT parameters related to StO2 changes to evaluate microcirculation function of the measured muscle tissue. VOT has the advantages of real-time, noninvasive and continuous, and is widely used to evaluate the functional status of peripheral microcirculation and the relationship between microcirculation changes and prognosis of patients. In clinical work, doctors mainly focus on hemodynamics of patients, while microcirculation function is often neglected due to the lack of real-time monitoring methods, which may lead to severe poor prognosis of patients, especially patients with critical illness. This paper focuses on the clinical application of vascular occlusion test based on tissue oxygen saturation monitoring.

Speed-resolved blood perfusion and oxygen saturation in human skin response to thermal stimulation

The functional status of vessels can be determined by assessing blood perfusion.By integrating diffuse reflectance spectroscopy(DRS)and Laser Doppler Flowmetry(LDF),the speed-resolved blood perfusion and blood oxygen saturation can be measured simultaneously by Enhanced Perfusion and Oxygen Saturation(EPOS).The dataset presented in this descriptor contains EPOS data recorded from a forearm point exposed to different levels of thermal stimulation,the classical LDF at control points,the R-R time series and data regarding the subjects’characteristics.All data were recorded from 60 recruited healthy subjects.Half of the subjects received different levels of thermal stimulation,and half of them were blank controls.We believe that this dataset will lead to the development of local blood perfusion methods that can be used to index vessel function assessments.This publicly available dataset will be beneficial to the microcirculation evaluation.

Trajectories of oxygen saturation within 6–72 hours after birth in neonates at moderate altitude:a prospective longitudinal cohort study

Trajectories of pulse oxygen saturation(SpO_(2))within the first few days after birth are important to inform the strategy for identifying asymptomatic hypoxemic disease but remain poorly substantiated at higher altitudes.Methods We performed a longitudinal cohort study with consecutive neonates at a local hospital in Luchun County,China,at an altitude of 1650 m between January and July 2020.We repeatedly measured the pre-and post-ductal SpO_(2)values at 6,12,18,24,36,48,and 72 hours after birth for neonates without oxygen supplements.All neonates underwent echocardiography and were followed up to 42 days after discharge.We included neonates without hypoxemic diseases to characterize the trajectories of SpO_(2)over time using a linear mixed model.We considered the 2.5th percentile as the reference value to define hypoxemic conditions.Results A total of 1061 neonates were enrolled.Twenty-five had non-cardiac hypoxemic diseases,with 84%(21/25)presenting with abnormal SpO_(2)within 24 hours.One had tetralogy of Fallot identified by echocardiography.Among the 1035 asymptomatic neonates,SpO_(2)values declined from 6 hours after birth,reached a nadir at 48 hours,and tended to level off thereafter,with identical patterns for both pre-and post-ductal SpO_(2).The reference percentile was 92%for both pre-and post-ductal SpO_(2)and was time independent.Conclusions A decline within 48 hours features SpO_(2)trajectories within the first 72 hours at moderate altitude.Our findings suggest that earlier screening may favorably achieve a benefit–risk balance in identifying asymptomatic hypoxemic diseases in this population.

High Arterial Oxygen Saturation in the Acclimatized Lowlanders Living at High Altitude

Blood oxygen saturation(SpO_(2))is a key indicator of oxygen availability in the body.It is known that a low SpO_(2)at high altitude is associated with morbidity and mortality risks due to physiological hypoxemia.Previously,it was proposed that the lowlander immigrants living at high altitude should have a lower SpO_(2)level compared to the highlander natives,but this proposal has not been rigorously tested due to the lack of data from the lowlander immigrants living at high altitude.In this study,we compared arterial oxygen saturation of 5929 Tibetan natives and 1034 Han Chinese immigrants living at altitudes ranging from 1120 m to 5020 m.Unexpectedly,the Han immigrants had a higher SpO_(2)than the Tibetan natives at the same high altitudes.At the same time,there is a higher prevalence of chronic mountain sickness in Han than in Tibetans at the same altitude.This result suggests that the relatively higher SpO_(2)level of the acclimatized Han is associated with a physiological cost,and the SpO_(2)level of Tibetans tends to be sub-optimal.Consequently,SpO_(2)alone is not a robust indicator of physiological performance at high altitude.

Highly sensitive,sub-microsecond polymer photodetectors for blood oxygen saturation testing

Bottom surface of active layers and interface of indium tin oxide(ITO)electrodes and active layers play a crucial role in determining the performance of polymer photodetectors with photomultiplication(PM-PPDs).The interfacial trapped electron distribution closing to ITO electrodes will determine spectral response range and external quantum efficiency(EQE)of PMPPDs.The bottom interface is more sensitive than top interface when light is coming from the ITO side,and the larger density of generated charge on the bottom interfaces will induce interfacial band more bending for efficient charge tunneling injection.Highly sensitive and sub-microsecond PM-PPDs are achieved with PMBBDT:Y6(100:7,w/w)as active layers under forward bias,yielding EQE of 18,700%at 320 nm,21,700%at 600 nm and 16,400%at 810 nm under a bias of 7 V,respectively,as well as fast response time of 79μs.The high EQE of the PM-PPDs is attributed to efficient hole tunneling injection from ITO electrode under forward bias.The electron traps closing to ITO electrode will be quickly filled up when light is coming from ITO side,leading to interfacial band more bending for hole tunneling injection.Importantly,the PM-PPDs is performed to measure heart rate(HR)and blood oxygen saturation(SpO_(2)),and the measured data by the PM-PPDs are very similar with those obtained by commercial photodetectors.

Effects of oxygen concentration and flow rate on cognitive ability and physiological responses in the elderly

The supply of highly concentrated oxygen positively affects cognitive processing in normal young adults. However, there have been few reports on changes in cognitive ability in elderly subjects following highly concentrated oxygen administration. This study investigated changes in cognitive ability, blood oxygen saturation （%）, and heart rate （beats/min） in normal elderly subjects at three different levels of oxygen [21% （1 L/min）, 93% （1 L/min）, and 93% （5 L/min）] administered during a 1-back task. Eight elderly male （75.3 ＋ 4.3 years old） and 10 female （71.1 ＋ 3.9 years old） subjects, who were normal in cognitive ability as shown by a score of more than 24 points in the Mini-Mental State Examination-Korea, participated in the experiment. The experiment consisted of an adaptation phase after the start of oxygen administration （3 minutes）, a control phase to obtain stable baseline measurements of heart rate and blood oxygen saturation before the task （2 minutes） and a task phase during which the 1-back task was performed （2 minutes）. Three levels of oxygen were administered throughout the three phases （7 minutes）. Blood oxygen saturation and heart rate were measured during each phase. Our results show that blood oxygen saturation increased, heart rate decreased, and response time in the 1-back task decreased as the concentration and amount of administered oxygen increased. This shows that administration of sufficient oxygen for optimal cognitive functioning increases blood oxygen saturation and decreases heart rate.

Multispectral imaging of acute wound tissue oxygenation

This paper investigates the appropriate range of values for the transcutaneous blood oxygen saturation(StO2)of granulating tissues and the surrounding tissue that can ensure timely wound recovery.This work has used a multispectral imaging system to collect wound images at wave-lengths ranging between 520 nm and 600 nm with a resolution of 10 nm.As part of this research,a pilot study was conducted on three injured individuals with superfcial wounds of different wound ages at different skin locations.The S_(t)O_(2)value predicted for the examined wounds using the Extended Modified Lambert-Beer model revealed a mean S_(t)O_(2)of 61±10.3%compared to 41.6±6.2%at the surrounding tissues,and 50.1±1.53%for control sites.These preliminary results contribute to the existing knowledge on the possible range and variation of wound bed S_(t)O_(2)that are to be used as indicators of the functioning of the vasomotion system and wound health.This study has concluded that a high S_(t)O_(2)of approximately 60%and a large fuctuation in this value should precede a good progression in wound healing.

The Feasibility of Flat, Portable and Wireless Device for Non-Invasive Peripheral Oxygenation Measurement over the Entire Body

Peripheral oxygenation level (SpO2) can provide vital information on body functions. Continuous monitoring facilitates effective diagnosis and treatment and can even be lifesaving. Clinical device monitor SpO2 using a clip, and measure light transmission through the tissue. This method limits the body locations of the clip’s placement and is sensitive to body movement, which hampers continuous SpO2 monitoring during wakefulness or sleep, thus decreasing its usability in clinics and its accessibility in homecare usage. We developed a portable, wireless, flat and low cost prototype for continuous monitoring of SpO2 that overcomes those limitations. The prototype enables convenient measurement in larger variety of body locations by spectrophotometric measurements of changes in the optical reflectance unlike other device that measure absorption through the tissue. The original design and signal processing enable reliable signal acquisition, synchronization and control. An Android’s application was developed to provide a user friendly interface for results display on smartphones. The prototype’s measurements were compared to commercial device that simultaneously measured heart rate frequency, transcutaneous oxygen tension (tcPO2) and SpO2. The prototype’s measurements accurately reflected changes caused by blood pulses, were correlated to the heart rate, and were sensitive to changes in oxygen saturation. Excellent real time behavior and synchronization were demonstrated between the hardware and smartphone software. Our prototype thus enables convenient SpO2 measurement over the entire body, while maintaining accuracy comparable to commercial device. Its smartphone application enables accessible and understandable results display to patients, care-givers and healthcare professionals. The application’s display and alert calibration flexibility facilitates the prototype’s usage in changing medical requirements and for various disease and conditions. A device based on this prototype can monitor continuously and accurately patients’ SpO2 without limiting their everyday activities or disturbing their sleep and can thus significantly im-prove their medical care in both clinics and home.

Signals Analysis and Clinical Validation of Blood and Oxygen Data in Human Brain

With a self-made near-infrared analytical instrument to blood and oxygen parameters in human brain, 80 cases in which 20 are healthy persons and 30 are anaesthetised cases and others are patients with heart function lack is taken to examine, and the data of blood and oxygen in brain tissue were collected and analyzed by the method of power spectrum and correlation function. The results indicate that: (1) The average brain oxygen saturation of healthy persons and anaesthetised cases is about 80%, in accord with normal parameter of physiology. Contrastively, the average brain oxygen saturation of patients with heart function lack is 72.8%, which is obviously less than that of healthy persons and anaesthetised cases. The probability of medical statistics is less than 0.01. (2) The shapes of wave of brain blood and oxygen for the healthy person and the anaesthetised case reveal small periodical fluctuations with stable shape and base line, and the trend of increase or decrease of blood and oxygen parameters in brain tissue is synchronous and a phase reversal, but for the patient with heart function lack in a brain oxygen lack state, the shapes of wave are irregular. This is a hint that near infrared light passing through tissue can reflect the intuitionistic change of brain blood and oxygen parameters.(3) The power spectra of brain blood and oxygen for the healthy person and the anaesthetised case has a clear main peak, narrow bandwidth and perfect superposition each other, but the power spectra for the patient with heart function lack in a brain oxygen lack state is on the contrary.(4) The average cross correlation coefficient of brain blood and oxygen for healthy persons and anaesthetised cases is -0.9825±0.1027 close to -1. But the average cross correlation coefficient for patients with heart function lack in a brain oxygen lack state is merely -0.8923±0.1035 which is obviously greater than -1 and the probability of medical statistics is less than 0.01. The clinic experiments have proved that the shapes of waves, the power spectrum and cross correlation coefficient of brain blood and oxygen are useful to analyze the physiological status and changes of blood and oxygen in human brain.

Oxygenation target in acute respiratory distress syndrome

Determining oxygenation targets in acute respiratory distress syndrome(ARDS)remains a challenge.Althoughoxygenation targets have been used since ARDS was first described,they have not been investigated in detail.However,recent retrospective and prospective trials have evaluated the optimal oxygenation threshold in patientsadmitted to the general intensive care unit.In view of the lack of prospective data,clinicians continue to relyon data from the few available trials to identify the optimal oxygenation strategy.Assessment of the cost-benefitratio of the fraction of inspired oxygen(FiO_(2))to the partial pressure of oxygen in the arterial blood(PaO_(2))is an additional challenge.A high FiO_(2) has been found to be responsible for respiratory failure and deaths innumerous animal models.Low and high PaO_(2) values have also been demonstrated to be potential risk factors inexperimental and clinical situations.The findings from this literature review suggest that PaO_(2) values rangingbetween 80 mmHg and 90 mmHg are acceptable in patients with ARDS.The costs of rescue maneuvers needed toreach these targets have been discussed.Several recent papers have highlighted the risk of disagreement betweenarterial oxygen saturation(SaO_(2))and peripheral oxygen saturation(SpO_(2))values.In order to avoid discrepanciesand hidden hypoxemia,SpO_(2) readings need to be compared with those of SaO_(2).Higher SpO_(2) values may beneeded to achieve the recommended PaO_(2) and SaO_(2) values.

Functional Imaging of Breast Tissue and Clinical Application

A novel approach to image hemoglobin concentration（△Dhb） and oxygen saturation （△Doxy） of breast tissue is presented. The scenograph of dual-wavelength （760 and 850 nm） near infrared lights through breast tissue is acquired by high sensitive charge coupled device （CCD） camera. The evaluation criterion of the difference of △Dhh and △Doxy between detected and referenced breast tissue can be obtained by a calculation formula without complicate caculation. This approach is applied to clinic detection in breast tissue. The ongoing clinical experiments indicate that malignant tumor usually exhibits characterize of ＂higher △Dhb and lower △Doxy＂, while benign lesion often shows ＂lower △Dhb and higher △Doxy＂ or other characters. So it is useful to assist the diagnosis of breast disease.

A specific objective supplemental factor in evaluating acute mountain sickness: ΔHR in combination with SaO_2

Background: So far, there have been no measurements confirmed useful in diagnosing acute mountain sickness(AMS). The aim of this study was to determine the role of heart rate(HR) difference(ΔHR) and oxygen saturation(Sa O2) as objective risk factors in aiding the diagnosis of AMS.Methods: A total of 1,019 participants were assigned to either the acute exposure group(AEG): from 500 m to 3,700 m by flight within 2.5 hours(n=752); or the pre-acclimatization group(PAG): ascended to 4,400 m from 3,650 m within three hours by car after adapting 33 days at 3,650m(n=267). The questionnaires or measurements of resting Sa O2 and HR were completed between 18 and 24 hours before departure and after arrival.Results: Incidence of AMS was 61.3%(461) in AEG, with 46.1%(347) mild cases and 15.2%(114) severe cases. In PAG, the incidence was 38.9%(104), with 30.7%(82) mild cases and 8.2%(22) severe cases. The AMS subjects showed a significant increase in HR and a decrease in Sa O2 levels compared with the non-AMS subjects in both groups. ΔHR and post-exposure Sa O2 were significantly correlated with the Lake Louise Score(LLS) in both groups. Stepwise logistic regression analysis revealed the ΔHR >25 and Sa O2 <88% in AEG as well as ΔHR >15 and Sa O2 <86% in PAG to be independent risk factors of AMS. Combining these two measurements could specifically indicate participants with AMS, which showed a positive predictive value of 89% and specificity of 97% in AEG as well as 85% and 98% in PAG.Conclusion:ΔHR or Sa O2, as objective measurements, correlate with AMS. Combination of these two measurements may be useful as an additional specific and objective factor to further confirm the diagnosis of AMS.

Potential benefits of Qi Gong meditation in quantifiable physiology: A five-year longitudinal observation

Objective: Qi Gong is a mind-and-body intervention to improve health and relieve disease conditions,which has been practiced for thousands of years. Lack of quantitative measures to monitor the quality and progress of Qi Gong practice has hindered the high-quality study to evaluate its health benefits.Methods: To develop such quantitative measures, vital sign changes in Qi Gong meditation practice of a single individual were monitored for 5 years by wearable devices.Results: This retrospective and exploratory analysis revealed significant changes in blood oxygen saturation, pulse rate, respiration rate, and perfusion index in response to Qi Gong practice and physiological adaptation to its long-term training. Among the physiological changes in vital signs, a physiological state with a significant 2-fold increase in pulse-respiration rate ratio was detected during Qi Gong meditation while the ratios were maintained at 4 under resting, sleeping, and mild cycling conditions.Conclusion: This is an inaugural report of a five-year longitudinal observation of this kind. Once validated in a well-designed cohort study, these non-invasive and easily obtained vital signs may be used as biomarkers to assess the adherence to breathing control during Qi Gong practice and can be applied to quantify the quality of Qi Gong practice in clinical trials with Qi Gong intervention.

Systematic Review and Meta-Analysis of the Palatal Surgeries in the Treatment of Obstructive Sleep Apnea

Background: This paper aims to examine published articles between January 2008 and January 2019 on the different palatal surgeries performed on OSA patients and the treatment outcomes, which in turn will be used to determine the effectiveness of various palatal surgical techniques in treating OSAS and the most effective of the palatal surgical techniques in treating OSAS. Patients and Methods: The current review followed the guidelines of preferred reporting items for systematic reviews and meta-analysis statement 2009 (PRISMA). The quality of relevant studies was assessed using NIH quality assessment tool for observational cohort and cross-sectional studies as well as NIH tool for quality assessment for case series studies. Results: Meta-analyses of relevant studies showed that the surgical technique that achieved the best reduction on AHI (Apnea/Hypopnea Index) was the lateral pharyngoplasty followed by the Anterior Palatoplasty, with a significant mean reduction of [(SMD = −0.848, 95% CI (−1.209 - −0.487), p-value < 0.001) and (SMD = −0.864, 95% CI (−1.234 - −0.494), p-value < 0.001), respectively]. The technique responsible for the best improvement in Epworth Sleepiness Score (ESS) was the Relocation Pharyngoplasty, with a significant mean reduction of [SMD = −0.998, 95% CI (−1.253 - −0.743), p-value < 0.001]. Minimal O2 saturation level improved most with the Expansion Sphincter Pharyngoplasty, with a significant mean reduction of [SMD = 1.011, 95% CI (0.581 - 1.440), p-value < 0.001]. The surgical procedure that results in the best post-operative Visual Analogue Scale (VAS) was Z-Palatoplasty, with a significant mean reduction of [SMD = −1.551, 95% CI (−2.049 - −1.052), p-value < 0.001]. Soft palate length changes with a significant mean reduction of [SMD = −2.219, 95% CI (−2.730 - −1.708), p-value < 0.001]. Finally, meta-analyses of relevant studies showed that expansion sphincter pharyngoplasty achieved the overall highest success rate [event rate = 77%, 95% CI (65.4% - 85.5%), p-value < 0.001]. Conclusion: The best procedure for treating OSA varies from patient to patient and there is no universal cure-all. Careful patient selection and pre-operative evaluation are mandatory.