Simulation models in respiratory research are increasingly used for medical product development and testing, especially because in-vivo models are coupled with a high degree of complexity and ethical concerns. This work introduces a respiratory simulation system, which is bridging the gap between the complex, real anatomical environment and the safe, cost-effective simulation methods. The presented electro-mechanical lung simulator, xPULM, combines in-silico, ex-vivo and mechanical respiratory approaches by realistically replicating an actively breathing human lung. The reproducibility of sinusoidal breathing simulations with xPULM was verified for selected breathing frequencies (10–18 bpm) and tidal volumes (400–600 ml) physiologically occurring during human breathing at rest. Human lung anatomy was modelled using latex bags and primed porcine lungs. High reproducibility of flow and pressure characteristics was shown by evaluating breathing cycles (nTotal = 3273) with highest standard deviation |3σ| for both, simplified lung equivalents ( = 23.98 ± 1.04 l/min, μP = −0.78 ± 0.63 hPa) and primed porcine lungs ( = 18.87 ± 2.49 l/min, μP = −21.13 ± 1.47 hPa). The adaptability of the breathing simulation parameters, coupled with the use of porcine lungs salvaged from a slaughterhouse process, represents an advancement towards anatomically and physiologically realistic modelling of human respiration.
The project Integrating the Energy System (IES) Austria recognises interoperability as key enabler for the deployment of smart energy systems. Interoperability is covered in the Strategic Energy Technology Plan (SET-Plan) activity A4-IA0-5 and provides an added value because it enables new business options for most stakeholders. The communication of smart energy components and systems shall be interoperable to enable smooth data exchange, and thereby, the on demand integration of heterogeneous systems, components and services. The approach developed and proposed by IES, adopts the holistic methodology from the consortium Integrating the Healthcare Enterprise (IHE), established by information technology (IT) vendors in the health sector and standardised in the draft technical report ISO DTR 28380-1, to foster interoperable smart energy systems. The paper outlines the adopted IES workflow in detail and reports on lesson learnt when trial Integration Profiles based on IEC 61850 were tested at the first Connectathon Energy instalment, organised in conjunction with the IHE Connectathon Europe 2018. The IES methodology is found perfectly applicable for smart energy systems and successfully enables peer-to-peer interoperability testing among vendors. The public specification of required Integration Profiles, to be tested at subsequent Connectathon Energy events, is encouraged.
Due to the demographic change, the need of rehabilitation is rising. Home-based rehabilitation can lower the fnancial burden, support reintegration into daily (work-)life and increase motivation as well as compliance of patients. Several device-supported approaches for rehabilitation were investigated in the research project REHABitation. An insole-based live-feedback system to support patients performing partial weight bearing was developed and tested in a clinical pilot study. Rehabilitative games using commercial gaming control systems like the Microsoft Kinect and the Nintendo Wii Balance Board were developed for range-of-motion and balance training, respectively. For these serious games, usability was tested with the System Usability Scale questionnaire. The comparability of range-of-motion measurements of shoulder movements conducted with inertial measurement units and an optical motion capture system was elaborated. Results fo the clinical study suggest that the patients' compliance with partial weight bearing load restriction was improved with the use of the live-feedback system developed. The use of Wii and Kinect solutions is possible and helps to increase compliance of patients due to high system usability scale scores and positive feedback. The use of intertial measurement units for the detection of motion and its characteristics is highly depending on the used type of system and the intended time span of use. All these approaches were interconnected with diagnosis, corresponding exercises/assessments and tools in the web-based Permission to make digital or hard copies of part or all of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for proft or commercial advantage and that copies bear this notice and the full citation on the frst page. Copyrights for third-party components of this work must be honored. For all other uses, contact the owner/author(s).
Dry powder inhalers are used by a large number of patients worldwide to treat respiratory diseases. The objective of this work is to experimentally investigate changes in aerosol particle diameter and particle number concentration of pharmaceutical aerosols generated by four dry powder inhalers under realistic inhalation and exhalation conditions. To simulate patients undergoing inhalation therapy, the active respiratory system model (xPULM™) was used. A mechanical upper airway model was developed, manufactured, and introduced as a part of the xPULM™ to represent the human upper respiratory tract with high fidelity. Integration of optical aerosol spectrometry technique into the setup allowed for evaluation of pharmaceutical aerosols. The results show that there is a significant difference (p < 0.05) in mean particle diameter between inhaled and exhaled particles with the majority of the particles depositing in the lung, while particles with the size of (> 0.5m) are least influenced by deposition mechanisms. The fraction of exhaled particles ranges from 2.13% (HandiHaler®) over 2.94% (BreezHaler®), and 6.22% (Turbohaler®) to 10.24% (Ellipta®). These values are comparable to previously published studies. Furthermore, the mechanical upper airway model increases the resistance of the overall system and acts as a filter for larger particles (> 3m). In conclusion, the xPULM™ active respiratory system model is a viable option for studying interactions of pharmaceutical aerosols and the respiratory tract regarding applicable deposition mechanisms. The model strives to support the reduction of animal experimentation in aerosol research and provides an alternative to experiments with human subjects.
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