At the root of all living beings is our breath -- without it, we are not alive. Eastern practices such as yoga and meditation are conveyed through the awareness of our breath and the encouragement to be present in what our physical bodies are telling us. This awareness is a huge influence in architectural design. Building well and thinking well are in turn living well, and this architectural thesis served as a journey in discovering how human health can manifest itself in a physical building. The architectural project is an Institute for Being and is located in the Shaw neighborhood of Washington, DC. The program of this project consists of spaces to encourage people to seek their own path in spiritual grounding within the otherwise hectic urban context. / Master of Architecture

Este estudo tem como objeto de reflexão e investigação prática o processo experimental Movimento, Respiração e Canto. Esta prática fundamenta-se na Respiração Vivenciada de Ilse Middendorf. A proposta de vivência da respiração a partir dos princípios da Respiração Vivenciada viabiliza, juntamente com outras estratégias, uma determinada performance do corpo, compondo este processo experimental. O desdobramento criativo da Respiração Vivenciada ocorre inicialmente a partir das experiências didáticas, desenvolvendo-se como fruto da interseção entre pesquisa, ensino e uma proposta de criação. A forma como esta prática pode estabelecer uma ligação com a criação artística surge assim como questão central, investigando-se o que é necessário para a constituição de um processo de criação, especificamente de criação musical, que se organiza a partir da ação do corpo, da respiração e sua relação com o movimento e a voz. Partindo-se de orientações teóricas contemporâneas que consideram a performance como paradigma cultural, e constatando-se que nesta experimentação a atuação dos performers é responsável pela constituição do processo criativo, o enfoque deste estudo é sobre o processo, realizando-se uma apreciação de como se caracteriza a geração de um espaço de criação e de um corpo em estado de criação, conceitos que decorrem da própria reflexão. A vivência do processo leva o performer a adentrar um corpo em estado de criação, gerando improvisações vocais e movimentos, resultado das relações que a respiração estabelece com o movimento e a voz. Estes momentos de criação ocorrem como um evento performático, onde o corpo é o agente principal do processo artístico. A criação artística é considerada aqui como uma forma de transpor os limites entre o corpo e o espaço, levando o corpo a transfigurar-se em movimento, gestos e sons revelando uma das inúmeras possibilidades de sua metamorfose. A reflexão sobre as relações entre corpo e voz aponta para um estado de dissolução de fronteiras e a vivência deste processo experimental revela-se como possibilidade de ocupação das zonas de fronteira - entre as diversas linguagens artísticas, entre o eu e o outro - constituindo-se assim como uma experiência de comunhão. / This study has as subject of reflection and practical research the experimental process Movement, Breathing and Singing. This practice is based on the Perceptible Breath by Ilse Middendorf. The proposal of experiencing breath based on the fundamentals of Middendorfs practice enables, along with other strategies, a certain performance of the body, composing this experimental process. The creative unfolding of the Perceptible Breath derives initially from pedagogical experiences, which develops at crossing points where research, teaching as well as a proposal of artistic creation meet. How this practice can establish a connection with a process creating art emerges then as the main question. This study examines what is necessary to constitute a process of creation, specifically of musical creation, which is organized from a bodys action, that is from breathing in relation to both movement and voice. Starting with contemporary theory that considers performance as a cultural paradigm and attributing the creative process to the performers action, this study has the focus on the process, appreciating what characterizes generating space of creation and a body in a state of creation, as a concept manifesting itself as the result of reflection. Undergoing this process leads the performer to experience a body in a state of creation, generating both vocal improvisations and movements, which result from the interrelations that the breath establishes with movement and voice. These moments of creation occur like a performative event, where the body is the principal agent of the artistic process. The process of creating art is here considered like a way of transposing the limits between body and space, thus leading the body to transfigure itself in movement, gestures and sounds thereby revealing one of the many possibilities of its metamorphoses. The consideration of the relations between body and voice points to a state of dissolution of boundaries and undergoing this experimental process reveals itself as a possibility of occupying the border area - between different artistic languages, between the self and the other so as to constitute itself as a experience of communion.

Este estudo tem como objeto de reflexão e investigação prática o processo experimental Movimento, Respiração e Canto. Esta prática fundamenta-se na Respiração Vivenciada de Ilse Middendorf. A proposta de vivência da respiração a partir dos princípios da Respiração Vivenciada viabiliza, juntamente com outras estratégias, uma determinada performance do corpo, compondo este processo experimental. O desdobramento criativo da Respiração Vivenciada ocorre inicialmente a partir das experiências didáticas, desenvolvendo-se como fruto da interseção entre pesquisa, ensino e uma proposta de criação. A forma como esta prática pode estabelecer uma ligação com a criação artística surge assim como questão central, investigando-se o que é necessário para a constituição de um processo de criação, especificamente de criação musical, que se organiza a partir da ação do corpo, da respiração e sua relação com o movimento e a voz. Partindo-se de orientações teóricas contemporâneas que consideram a performance como paradigma cultural, e constatando-se que nesta experimentação a atuação dos performers é responsável pela constituição do processo criativo, o enfoque deste estudo é sobre o processo, realizando-se uma apreciação de como se caracteriza a geração de um espaço de criação e de um corpo em estado de criação, conceitos que decorrem da própria reflexão. A vivência do processo leva o performer a adentrar um corpo em estado de criação, gerando improvisações vocais e movimentos, resultado das relações que a respiração estabelece com o movimento e a voz. Estes momentos de criação ocorrem como um evento performático, onde o corpo é o agente principal do processo artístico. A criação artística é considerada aqui como uma forma de transpor os limites entre o corpo e o espaço, levando o corpo a transfigurar-se em movimento, gestos e sons revelando uma das inúmeras possibilidades de sua metamorfose. A reflexão sobre as relações entre corpo e voz aponta para um estado de dissolução de fronteiras e a vivência deste processo experimental revela-se como possibilidade de ocupação das zonas de fronteira - entre as diversas linguagens artísticas, entre o eu e o outro - constituindo-se assim como uma experiência de comunhão. / This study has as subject of reflection and practical research the experimental process Movement, Breathing and Singing. This practice is based on the Perceptible Breath by Ilse Middendorf. The proposal of experiencing breath based on the fundamentals of Middendorfs practice enables, along with other strategies, a certain performance of the body, composing this experimental process. The creative unfolding of the Perceptible Breath derives initially from pedagogical experiences, which develops at crossing points where research, teaching as well as a proposal of artistic creation meet. How this practice can establish a connection with a process creating art emerges then as the main question. This study examines what is necessary to constitute a process of creation, specifically of musical creation, which is organized from a bodys action, that is from breathing in relation to both movement and voice. Starting with contemporary theory that considers performance as a cultural paradigm and attributing the creative process to the performers action, this study has the focus on the process, appreciating what characterizes generating space of creation and a body in a state of creation, as a concept manifesting itself as the result of reflection. Undergoing this process leads the performer to experience a body in a state of creation, generating both vocal improvisations and movements, which result from the interrelations that the breath establishes with movement and voice. These moments of creation occur like a performative event, where the body is the principal agent of the artistic process. The process of creating art is here considered like a way of transposing the limits between body and space, thus leading the body to transfigure itself in movement, gestures and sounds thereby revealing one of the many possibilities of its metamorphoses. The consideration of the relations between body and voice points to a state of dissolution of boundaries and undergoing this experimental process reveals itself as a possibility of occupying the border area - between different artistic languages, between the self and the other so as to constitute itself as a experience of communion.

Exhaled breath is a rich and complex matrix containing many hundreds of compounds. Every breath offers the potential of a non-invasive measurement of the biochemical processes occurring in the human body and it is this notion that has led to the application of breath analysis for the detection of disease. With the majority of research in the field being focused on the detection of biomarkers, little has been presented on how the seemingly homeostatic matrix of breath varies during the course of normal life events. The research in this thesis describes how a subject's emotional state, physical state, and daily activities can alter the composition of exhaled breath.

No description available.

Clinical research in cystic fibrosis (CF) requires study endpoints that are sensitive to airways disease, repeatable and non-invasive. Despite significant advances in the treatment of CF, lung function assessments continue to rely on the forced expiratory volume in 1 second (FEV1). Although simple to perform, it lacks sensitivity, is difficult for younger subjects, and changes over time. An alternative method of assessing lung physiology is to derive measures of ventilation heterogeneity from inert gas washout tests. In early lung disease, measures of gas mixing appear to be more sensitive than spirometry. In addition, since only tidal breathing is required, they are more physiological and are more straightforward for younger subjects. Widespread use has been impaired by the lack of a robust and cost effective gas analyser technology. The work presented in this thesis concerns the adaptation, validation and then use of a novel gas analyser (Innocor) in a clinical system for the performance of multiple breath washouts. Lung clearance index (LCI), a simple measure of ventilation heterogeneity, has been calculated from washouts in 52 adults with CF and 50 healthy controls. LCI was more sensitive to disease than FEV1 in CF, being elevated in 11 of the 12 CF patients with normal spirometry. In healthy subjects, LCI has been shown to be repeatable and reproducible, with a narrow range of normal that is stable over a wide age range. In a separate study of 19 patients, LCI has also been shown to improve with treatment of an exacerbation in CF. Correlation with changes in other biochemical (serum CRP, peripheral blood white cell count, sputum IL-8, sputum neutrophil) clinical (symptom score) or structural (computed tomography) markers was poor. Short term change in LCI has also been demonstrated in CF patients in response to chest physiotherapy, although there was considerable heterogeneity of response in terms of both LCI and volume of lung ventilated by tidal breathing (as measured by washout functional residual capacity). In addition to LCI, multiple breath phase III slope analysis has been performed on washouts of CF patients and healthy controls, and this has been compared to other measures of lung physiology. Proposed measures of convective and diffusive gas mixing have been shown to be unreliable in CF. These studies have also been the first to demonstrate multi-centre use of washout tests as endpoints. The technology described here offers the possibility of a simple and reliable system for performing multiple breath washouts, though at present it is not available commercially. The studies have added to the understanding of the utility and reliability of washout tests, as well as some of their limitations. It is hoped that in future LCI will be an important clinical endpoint in therapeutic intervention studies in CF, and that it will also offer new ways to follow changes in lung physiology in other diseases.

Objetivo: Determinar la prevalencia de Helicobacter pylori en pacientes sintomáticos de consulta externa en la Red Rebagliati (EsSalud) en el período 2010-2013. Materiales y métodos: Estudio observacional, transversal y analítico. Se revisaron los registros de pacientes ambulatorios con la prueba en aliento con urea-13C diagnóstica de Helicobacter pylori en el período 2010-2013. Resultados: De los 1711 pacientes, la prevalencia global de Helicobacter pylori fue 45,5% (IC 95%: 43,17- 47,89), siendo mayor en mujeres que en varones (47,1% vs. 42,1%, p=0,056). Hubo diferencias significativas en la edad entre infectados y no infectados (44 vs. 39, p<0,05), con asociación entre la edad y presencia de Helicobacter pylori (p<0,001). La prevalencia estimada en la población pediátrica fue 36,3% y se encontró resultado positivo en 201 (51,1%) mujeres en edad fértil. La mayoría (43,9%) procedían del sector financiero de la ciudad. Conclusiones: La prevalencia de Helicobacter pylori en la población de estudio fue similar en ambos sexos y tuvo relación con la edad. El nivel socioeconómico medio de Lima mantiene la prevalencia de Helicobacter pylori reportada en los últimos años.

Healthcare costs are escalating in the U.S., with a projected 48 trillion dollars by 2021. More than ever medical researches are obligated to ensure that costly treatment modalities are safe and effective. Chronic obstructive pulmonary disease (COPD) is a costly and debilitating disease, ranked as the third leading cause of death in America. Currently, treatment for COPD consists of anti-inflammatory agents, bronchodilators, antibiotics and supplemental oxygen when hypoxemia or clinical manifestations ensue. Oxidative stress is central to the pathology of COPD. Supplemental oxygen has been substantiated as an instigator of oxidative stress; however, LFDO has not been evaluated as a mechanism of ongoing oxidative stress in individuals with COPD. Isofuran (IsoF), a biosynthetic relative of the validated oxidative stress biomarker 8-isoprostane, is preferentially synthesized during periods of increased tissue oxygen tension. This sort of specificity allows for refinement in the assessment of supplemental oxygen as a source of oxidative stress. To address this potential this study evaluated individuals diagnosed with COPD utilizing LFDO. The study also aimed to determine if IsoF possessed clinical application in predicting the standard pulmonary function test (PFT) parameters of FEV1, FVC, FEV1/FVC and FEF25-75. The exhaled breath condensate (EBC) of 52 individuals with COPD was evaluated for the presence of IsoF. An active control group not receiving LFDO (n=26) was compared to an active treatment group receiving LFDO for a minimum of 6 hrs/day (n=26). The groups showed no statistically significant demographic differences in age, gender, height, weight, ethnicity or smoking history or in the pulmonary function test parameters of FEV1, FVC, and FEV1/FVC, with the exception of the FEF25-75 (P=0.03). The active control group generated a mean EBC IsoF level of 35.81 ± 4.91 pg/ml (± SEM) compared to the active treatment group mean EBC IsoF level of 51.37 ± 8.27 pg/ml (P=0.057). Currently, no research has been conducted that defines baseline EBC IsoF levels in healthy or diseased lungs. No statistically significant differences in mean EBC IsoF levels were noted between the control and treatment groups; however, the results, in conjunction with the only two studies available utilizing EBC IsoF as an oxidative stress biomarker, may serve to provide benchmark information for future research regarding individuals with diseased lungs, specifically COPD.

Faculty of Health Scicence School of Medicine 0100107g johannes.geyer@wits.ac.za / The 14C and 13C labelled urea breath tests (UBT) for detecting Helico-bacter pylori infection are well established but scope for improvement exists in both to reduce some of their shortcomings. For this study, the 14C UBT investigation focussed on reducing the quantity of radioactive tracer that is administered to the subject un-dergoing this test, with the aim of lowering the radiation dose to the patient, reducing the impact to the environment and exempting the test from radioactive materials licensing. Wider acceptance, availabil-ity, affordability to lower socio-economic groups and third party medi-cal treatment payers and using readily available equipment were fac-tors considered when developing the method. The principle of the method developed is to collect larger volume breath sample, quantitatively absorbing a defined volume of extracted breath CO2 in an efficient CO2 trapping agent using a specifically de-signed apparatus and measuring the activity with a low background β-spectrometer. A reduction in the quantity of 14C labelled urea administered to the pa-tient was achieved. The method also reduced the counting error mar-gin at a lower detection limit, improving discrimination between H. py-lori positive and negative patients. iii The 13C UBT is a non-radioactive test however, it is substantially more expensive. The 13C UBT investigation aimed to determine whether commercially available un-enriched urea could be used thus reducing the cost of the 13C UBT. A simple protocol with Isotope Ratio Mass Spectrometry (IRMS) for the measurement was used as opposed to the well-established 13C UBT protocol. The principle of the 13C UBT investigation was to detect the change of the breath δ13C (13C/12C) ratio after the administration of un-enriched urea with a δ13C different to the exhaled breath. Theoretical calculations showed that an administered dose of 500mg un-enriched urea with at least a 10‰ δ13C difference may be detectable using IRMS. In vitro investigations confirmed that levels of 0.01 to 0.001‰ δ13C were detectable by IRMS. A change in the δ13C of a standard breath CO2 was confirmed for a range between 0.14 to 50% v/v mixed CO2 samples, i.e. the projected range for in-vivo investigation. Results from the in-vivo investigation however were not able to distinguish positive from negative H. pylori patients. The use of the 1000mg dose of urea appears to have caused saturation of the enzyme. It was con-cluded that some enrichment of the 13C is necessary or less urea be used.

Fissura lábio palatina é a anomalia congênita craniofacial mais comum. A síndrome da apnéia obstrutiva do sono (SAOS) é uma doença prevalente, ainda pouco diagnosticada, e frequentemente associada a malformações craniofaciais. Dessa forma este estudo busca melhor entendimento do perfil respiratório durante o sono num grupo de 23 crianças, entre 7 e 12 anos, submetidas a palatoplastia entre 12 e 15 meses de idade, sendo o principal enfoque a presença de apnéia do sono e suas correlações com os achados clínicos desta população. Foram realizadas polissonografias e um protocolo de exame físico para detectar alterações associadas à obstrução de vias aéreas superiores (VASs). Os dados obtidos foram tabulados e analisados, descritivamente, e através de gráficos Box-plot para associação entre variáveis qualitativas e quantitativas. Encontramos uma média e mediana de IAH de 1,11/h (DP=0,78) e 0,9/h, respectivamente. O IAO apresentou média de 0,27/h (DP=0,38) e mediana de 0,1/h. Cerca de 30% dos pacientes apresentaram IAH acima de 1,4/h. Não houve importantes dessaturações da oxihemoglobina no grupo estudado. Desvio septal, hipertrofia de conchas nasais e hipertrofia das tonsilas palatinas foram variáveis que elevaram a média dos índices de distúrbio respiratório do sono, enquanto a presença de disjunção da maxila reduziu a média destes índices. Neste grupo, a prevalência de SAOS foi maior do que em populações normais, quando comparado a controles históricos. Há poucos estudos, avaliando o padrão respiratório do sono em crianças com alterações nas VASs, sendo necessário melhor conhecimento deste problema. A polissonografia é fortemente recomendada na avaliação de crianças com alterações nas VASs. / Cleft lip and palate is the most common congenital craniofacial abnormality. Obstructive sleep apnea syndrome (OSAS) is prevalent disease, poorly diagnosed and frequently associated with craniofacial malformations. This study aims to better understanding about respiratory profile of a 23 infant group, between 7 and 12 years, submited to palatoplasty about 12 to 15 months of age. The principal approach is OSAS presence and its clinicals correlations. Polissonografy and physical exam protocol to detect superior airway abnormalities were performed and the data were analized. The data were tabulated and analyzed descriptively and through Box-plot graphs for association between qualitative and quantitative variables. We found a mean and median AHI of 1.11/h (SD = 0.78) and 0.9/h, respectively. The IAO had an average of 0.27/h (SD = 0.38) and a median of 0.1/h. About 30% of patients had an AHI above 1.4/h. There was no significant oxyhemoglobin dessaturation in the study group. Septal deviation, turbinate hypertrophy and hypertrophy of the tonsils were variables that increased the average indices of sleep-disordered breathing, while the presence of maxillary disjunction, reduce the average of these indices. In this group the prevalence of OSA was higher than in normal populations when compared to historical controls. There are few studies describing the sleep breath pattern in children with alterations in superior airways, being necessary better understand of this problem. Polysomnography is strongly recommended for the assessment of children with airway abnormalities.