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  • Bains, KES, et al. (författare)
  • Infant lung function: criteria for selecting tidal flow-volume loops
  • 2022
  • Ingår i: ERJ open research. - : European Respiratory Society (ERS). - 2312-0541. ; 8:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Tidal flow–volume (TFV) loops are commonly recorded in infants during sleep, due to the more regular breathing patterns compared to the awake state. Standardised deselection of loops outside pre-specified ranges are based on periods of regular breathing, while criteria and available software for visual evaluation of TFV loops are lacking. We aimed to determine the reliability of standardised criteria for manual selection of infant TFV loops.MethodsUsing a pre-defined set of criteria, three independent raters manually evaluated TFV loops among 57 randomly selected awake healthy 3-month-old infants with available TFV measurements in the Scandinavian Preventing Atopic Dermatitis and ALLergies in children (PreventADALL) study. The TFV loops were sampled using the Eco Medics Exhalyzer D. Criteria for selecting TFV loops included reproducible shape and volume with only one peak in tidal expiratory flow (PTEF), excluding loops with no clear or uneven flow towards PTEF. By intraclass coefficient (ICC), the reliability of agreement between raters was determined for the time to PTEF (tPTEF) to expiratory time (tE) and other TFV loop parameters.ResultsFive infants had unsuccessful tests. Among the remaining 52 infants, the raters selected a median of 25, 26 and 15 loops per test. The ICCs (95% CI) were 0.97 (0.92–0.98) fortPTEF/tE, 0.99 (0.99–1.00) for respiratory rate, 0.98 (0.97–0.99) for tidal volume per kg and 0.98 (0.97–0.99) for expiratory volume, reflecting excellent agreement in all categories.ConclusionManual TFV loop selection using standardised criteria provides a reliable alternative for lung function measures in awake infants with interrupted breathing cycles in a real-life setting.
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  • Bains, KES, et al. (författare)
  • Infant tidal flow-volume parameters and arousal state
  • 2022
  • Ingår i: ERJ open research. - : European Respiratory Society (ERS). - 2312-0541. ; 8:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Infant lung function can be assessed with tidal flow–volume (TFV) loops. While TFV loops can be measured in both awake and sleeping infants, the influence of arousal state in early infancy is not established. The aim of the present study was to determine whether TFV loop parameters in healthy infants differed while awake compared to the sleeping state at 3 months of age.MethodsFrom the population-based Scandinavian Preventing Atopic Dermatitis and ALLergies in children (PreventADALL) birth cohort, 91 infants had reproducible TFV loops measured with Exhalyzer®D in both the awake and sleeping state at 3 months of age. The TFV loops were manually selected according to a standardised procedure. The ratio of time to peak tidal expiratory flow (tPTEF) to expiratory time (tE) and the corresponding volume ratio (VPTEF/VE), as well as tidal volume (VT) and respiratory rate were compared using nonparametric tests.ResultsThe mean (95% CI)tPTEF/tEwas significantly higher while awake compared to the sleeping state: 0.39 (0.37–0.41)versus0.28 (0.27–0.29); with the correspondingVPTEF/VEof 0.38 (0.36–0.40)versus0.29 (0.28–0.30). TheVTwas similar, while the respiratory rate was higher while awake compared to the sleeping state: 53 (51–56) breaths·min−1versus38 (36–40) breaths·min−1.ConclusionHighertPTEF/tE,VPTEF/VEand respiratory rate, but similarVTwhile awake compared to the sleeping state suggests that separate normative TFV loop values according to arousal state may be required in early infancy.
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  • Fardig, M, et al. (författare)
  • Skin Barrier Function and Infant Tidal Flow-Volume Loops-A Population-Based Observational Study
  • 2023
  • Ingår i: Children (Basel, Switzerland). - : MDPI AG. - 2227-9067. ; 10:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The relationship between the skin barrier- and lung function in infancy is largely unexplored. We aimed to explore if reduced skin barrier function by high transepidermal water loss (TEWL), or manifestations of eczema or Filaggrin (FLG) mutations, were associated with lower lung function in three-month-old infants. Methods: From the population-based PreventADALL cohort, 899 infants with lung function measurements and information on either TEWL, eczema at three months of age and/or FLG mutations were included. Lower lung function by tidal flow-volume loops was defined as a ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE) <0.25 and a tPTEF <0.17 s (<25th percentile). A high TEWL >8.83 g/m2/h (>75th percentile) denoted reduced skin barrier function, and DNA was genotyped for FLG mutations (R501X, 2282del4 and R2447X). Results: Neither a high TEWL, nor eczema or FLG mutations, were associated with a lower tPTEF/tE. While a high TEWL was associated with a lower tPTEF; adjusted OR (95% CI) 1.61 (1.08, 2.42), the presence of eczema or FLG mutations were not. Conclusions: Overall, a high TEWL, eczema or FLG mutations were not associated with lower lung function in healthy three-month-old infants. However, an inverse association between high TEWL and tPTEF was observed, indicating a possible link between the skin barrier- and lung function in early infancy.
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  • Gudmundsdottir, HK, et al. (författare)
  • Infant lung function and maternal physical activity in the first half of pregnancy
  • 2022
  • Ingår i: ERJ open research. - : European Respiratory Society (ERS). - 2312-0541. ; 8:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Physical activity (PA) in pregnancy is important for maternal and possibly offspring health. To study the early origins of lung function we aimed to determine whether PA in the first half of pregnancy is associated with lung function in healthy 3-month-old infants.MethodsFrom the general population-based Preventing Atopic Dermatitis and Allergies in Children birth cohort recruiting infants antenatally in Norway and Sweden, all 812 infants (48.8% girls) with available tidal flow–volume measures in the awake state at 3 months of age and mid-pregnancy data on PA were included. PA was self-reported by the mothers and, based on intensity, we categorised them as active or inactive during pregnancy. Furthermore, we defined active mothers as fairly or highly active. The main outcome was a ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE) <0.25. Associations were analysed by logistic regression, adjusting for maternal age, education, parity, pre-pregnancy body mass index,in uteronicotine exposure and parental atopy.ResultsThe mean±sdtPTEF/tEwas 0.391±0.08 and did not differ significantly according to maternal PA level in pregnancy. The 290 infants of inactive mothers had higher odds of havingtPTEF/tE<0.25 compared to infants of all active mothers (OR 2.07, 95% CI 1.13–3.82; p=0.019) and compared to infants (n=224) of fairly active (OR 2.83, 95% CI 1.26–7.24; p=0.018) but not highly active mothers (n=298).ConclusionBased on self-reported maternal PA in the first half of pregnancy, 3-month-old infants of inactive compared to active mothers had higher odds of a lowtPTEF/tE.
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  • Kreyberg, I, et al. (författare)
  • Snus in pregnancy and infant birth size: a mother-child birth cohort study
  • 2019
  • Ingår i: ERJ open research. - : European Respiratory Society (ERS). - 2312-0541. ; 5:4
  • Tidskriftsartikel (refereegranskat)abstract
    • While recent studies show that maternal use of snus during pregnancy is increasing, the potential effects on infant birth size is less investigated, with conflicting results.ObjectivesWe aimed to determine if maternal use of snus during pregnancy influences the infant anthropometric and proportional size measures at birth.MethodsIn 2313 mother–child pairs from the population-based, mother–child birth cohort PreventADALL (Preventing Atopic Dermatitis and ALLergies) in Norway and Sweden, we assessed nicotine exposure by electronic questionnaire(s) at 18 and 34 weeks of pregnancy, and anthropometric measurements at birth. Associations between snus exposure and birth size outcomes were analysed by general linear regression.ResultsBirthweight was not significantly different in infants exposed to snus in general, and up to 18 weeks of pregnancy in particular, when adjusting for relevant confounders including maternal age, gestational age at birth, pre-pregnancy body mass index, parity, fetal sex and maternal gestational weight gain up to 18 weeks. We found no significant effect of snus use on the other anthropometric or proportional size measures in multivariable linear regression models. Most women stopped snus use in early pregnancy.ConclusionExposure to snus use in early pregnancy, with most women stopping when knowing about their pregnancy, was not associated with birth size. We were unable to conclude on effects of continued snus use during pregnancy because of lack of exposure in our cohort.
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  • Kreyberg, I, et al. (författare)
  • Stopping when knowing: use of snus and nicotine during pregnancy in Scandinavia
  • 2019
  • Ingår i: ERJ open research. - : European Respiratory Society (ERS). - 2312-0541. ; 5:2
  • Tidskriftsartikel (refereegranskat)abstract
    • In young women, the use of snus increases in parallel with decreasing smoking rates but the  use in pregnancy is unclear. Our aims were to determine the prevalence of snus use, smoking and other nicotine-containing product use during pregnancy, and to identify predictors for snus use in pregnancy.Prevalence was determined for 2528 women in Norway and Sweden based on the Preventing Atopic Dermatitis and ALLergies (PreventADALL) study, a population-based, mother–child birth cohort. Electronic questionnaires were completed in pregnancy week 18 and/or week 34, and potential predictors of snus use were analysed using logistic regression models.Ever use of any snus, tobacco or nicotine-containing products was reported by 35.7% of women, with similar rates of snus use (22.5%) and smoking (22.6%). Overall, 11.3% of women reported any use of nicotine-containing products in pregnancy up to 34 weeks, most often snus alone (6.5%). Most women (87.2%) stopped using snus by week 6 of pregnancy.Snus use in pregnancy was inversely associated with age and positively associated with urban living and personal or maternal history of smoking. While 11.3% of women used snus or other nicotine-containing products at some time, most stopped when recognising their pregnancy. Younger, urban living, previously smoking women were more likely to use snus in pregnancy.
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  • Rehbinder, EM, et al. (författare)
  • Dry skin and skin barrier in early infancy
  • 2019
  • Ingår i: The British journal of dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 181:1, s. 218-219
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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