Physical activity promotion interventions in chronic airways disease: a systematic review and meta-analysis.

Physical inactivity is common in people with chronic airways disease (pwCAD) and associated with worse clinical outcomes and impaired quality of life. We conducted a systematic review and meta-analysis to characterise and evaluate the effectiveness of interventions promoting step-based physical activity (PA) in pwCAD. We searched for studies that included a form of PA promotion and step-count outcome measure. A random-effects model was used to determine the overall effect size using post-intervention values. 38 studies (n=32 COPD; n=5 asthma; n=1 bronchiectasis; study population: n=3777) were included. Overall, implementing a form of PA promotion resulted in a significant increase in step-count: median (IQR) 705 (183-1210) when compared with usual standard care: -64 (-597-229), standardised mean difference (SMD) 0.24 (95% CI: 0.12-0.36), p<0.01. To explore the impact of specific interventions, studies were stratified into subgroups: PA promotion+wearable activity monitor-based interventions (n=17) (SMD 0.37, p<0.01); PA promotion+step-count as an outcome measure (n=9) (SMD 0.18, p=0.09); technology-based interventions (n=12) (SMD 0.16, p=0.01). Interventions promoting PA, particularly those that incorporate wearable activity monitors, result in a significant and clinically meaningful improvement in daily step-count in pwCAD.

Smartphone pedometers in adults with asthma: a practical approach to physical activity assessment? A pilot validation study.

OBJECTIVE: The aim of this pilot validation study was to determine the accuracy of a smartphone (iPhone®) pedometer in adults with and without asthma. METHODS: Ten adults with asthma and ten healthy controls underwent clinical assessment prior to completing two separate trials. Phase 1. standardized treadmill and self-paced walking tests. Total steps were recorded via: (i) Yamax Digiwalker™ SW800 pedometer positioned on the waistband, (ii) iPhone® pedometer positioned on the upper body, (iii) iPhone® pedometer positioned on the lower body and evaluated against a video-verified manual step-count. Phase 2. step-count was evaluated over seven-days during habitual free-living conditions via Yamax Digiwalker™ SW800 and iPhone® pedometers. RESULTS: During treadmill walking, the iPhone® positioned on the lower body correlated strongly (r = 0.96) and produced the highest level of agreement (mean bias: -11 steps, LOA: -43 to 21 steps) in comparison to video-verified manual step-count. During self-paced walking, all devices provided an excellent step-count estimate. During free-living conditions, no difference was observed between the Yamax Digiwalker™ SW800 pedometer and iPhone® (P = 0.10) and a strong correlation (r = 0.94) and acceptable agreement (mean bias: -343, LOA: -1963 to 1276 steps) was observed. CONCLUSION: Our findings indicate that an in-built iPhone® pedometer offers a practical approach to physical activity assessment in adults with and without asthma. Future research is now required to further validate the precision of this approach and evaluate the efficacy and effectiveness of smartphone pedometers to monitor and promote physical activity when employed during medical consultation and/or clinical research trials.

Metalorganic chemical vapor deposition of InN quantum dots and nanostructures.

Using one material system from the near infrared into the ultraviolet is an attractive goal, and may be achieved with (In,Al,Ga)N. This III-N material system, famous for enabling blue and white solid-state lighting, has been pushing towards longer wavelengths in more recent years. With a bandgap of about 0.7 eV, InN can emit light in the near infrared, potentially overlapping with the part of the electromagnetic spectrum currently dominated by III-As and III-P technology. As has been the case in these other III-V material systems, nanostructures such as quantum dots and quantum dashes provide additional benefits towards optoelectronic devices. In the case of InN, these nanostructures have been in the development stage for some time, with more recent developments allowing for InN quantum dots and dashes to be incorporated into larger device structures. This review will detail the current state of metalorganic chemical vapor deposition of InN nanostructures, focusing on how precursor choices, crystallographic orientation, and other growth parameters affect the deposition. The optical properties of InN nanostructures will also be assessed, with an eye towards the fabrication of optoelectronic devices such as light-emitting diodes, laser diodes, and photodetectors.

Dye-Sensitized Nonstoichiometric Strontium Titanate Core-Shell Photocathodes for Photoelectrosynthesis Applications.

A core-shell approach that utilizes a high-surface-area conducting core and an outer semiconductor shell is exploited here to prepare p-type dye-sensitized solar energy cells that operate with a minimal applied bias. Photocathodes were prepared by coating thin films of nanocrystalline indium tin oxide with a 0.8 nm Al2O3 seeding layer, followed by the chemical growth of nonstoichiometric strontium titanate. Films were annealed and sensitized with either a porphyrin chromophore or a chromophore-catalyst molecular assembly consisting of the porphyrin covalently tethered to the ruthenium complex. The sensitized photoelectrodes produced cathodic photocurrents of up to -315 µA/cm2 under simulated sunlight (AM1.5G, 100 mW/cm2) in aqueous media, pH 5. The photocurrent was increased by the addition of regenerative hole donors to the system, consistent with slow interfacial recombination kinetics, an important property of p-type dye-sensitized electrodes.

Hemodynamic effects of portable non-invasive ventilation in healthy men.

VitaBreath is a portable, non-invasive ventilation device (pNIV) that relieves shortness of breath in COPD by delivering fixed inspiratory and expiratory positive airway pressures (IPAP/EPAP: 18/8 cmH2O). Fixed pressures may cause circulatory compromise. We investigated the circulatory effects of pNIV during normal breathing (NB) and after Eucapnic Voluntary Hyperpnoea trials (EVH) sustained at 80% MVV. In a balanced order sequence, 10 healthy men performed four trials on one visit: 1-min of pNIV (intervention) or 1-min quiet breathing (QB) during NB; and 1-min pNIV (intervention) or 1-min QB during recovery from 3-min EVH. Compared to QB, pNIV application was associated with greater cardiac output (CO: 1.6 ± 1.9 L.min-1; P = 0.03). One minute into recovery from EVH, pNIV caused greater CO (2.2 ± 1.6 L.min-1; P = 0.01) compared to QB. Mean blood pressure was not different with pNIV compared to control. pNIV increased thoracoabdominal volumes and breathing frequency during NB and recovery from EVH. pNIV application does not induce adverse hemodynamic effects in healthy men.

Emergency Department Care of Young Children at Risk for Traumatic Brain Injury: What Are We Doing and Do Parents Understand?

OBJECTIVES: The aims of the study were to describe emergency department (ED) management of young children with head injury and to assess parental comfort level and perceptions of ED care. METHODS: This was a prospective observational study of children younger than 5 years who presented to a pediatric ED after head injury. Children were eligible if clinical observation was an appropriate ED management option per the Pediatric Emergency Care Academic Research Network's neuroimaging clinical decision rule. Demographics, injury variables, and ED clinician surveys explaining the care provided were collected at time of study enrollment. Parents were subsequently contacted to assess understanding of ED management and comfort with care. RESULTS: One hundred four children were enrolled with a mean (standard deviation) age of 1.19 (1.34) years. Thirty (29%) had emergent neuroimaging and 59 (57%) were placed into a period of observation per clinician report. A total of 37 children received a head computed tomography, of which 21 (57%) were normal. Eighty-four parents (81%) completed the phone follow-up. Of these children, there was a significant difference between whether parents and clinicians reported that the child had been clinically observed in the ED (P < 0.0001). Parents of children who did not receive a head CT were more likely to be uncomfortable with the decision to obtain neuroimaging compared with those who did receive a head CT (P = 0.003). CONCLUSIONS: Parents are not always comfortable with the medical care practices provided and are often unaware of clinical observation when it does occur. Better parent-clinician communication could improve parental understanding and reduce overall discomfort.

Chromophore-Catalyst Assembly for Water Oxidation Prepared by Atomic Layer Deposition.

Visible-light-driven water splitting was investigated in a dye sensitized photoelectrosynthesis cell (DSPEC) based on a photoanode with a phosphonic acid-derivatized donor-π-acceptor (D-π-A) organic chromophore, 1, and the water oxidation catalyst [Ru(bda)(4-O(CH2)3P(O3H2)2-pyr)2], 2, (pyr = pyridine; bda = 2,2'-bipyridine-6,6'-dicarboxylate). The photoanode was prepared by using a layering strategy beginning with the organic dye anchored to an FTO|core/shell electrode, atomic layer deposition (ALD) of a thin layer (<1 nm) of TiO2, and catalyst binding through phosphonate linkage to the TiO2 layer. Device performance was evaluated by photocurrent measurements for core/shell photoanodes, with either SnO2 or nanoITO core materials, in acetate-buffered, aqueous solutions at pH 4.6 or 5.7. The absolute magnitudes of photocurrent changes with the core material, TiO2 spacer layer thickness, or pH, observed photocurrents were 2.5-fold higher in the presence of catalyst. The results of transient absorption measurements and DFT calculations show that electron injection by the photoexcited organic dye is ultrafast promoted by electronic interactions enabled by orientation of the dye's molecular orbitals on the electrode surface. Rapid injection is followed by recombination with the oxidized dye which is 95% complete by 1.5 ns. Although chromophore decomposition limits the efficiency of the DSPEC devices toward O2 production, the flexibility of the strategy presented here offers a new approach to photoanode design.

The relationship between cervical flexor endurance, cervical extensor endurance, VAS, and disability in subjects with neck pain.

BACKGROUND: Several tests have been suggested to assess the isometric endurance of the cervical flexor (NFME) and extensors (NEE) muscles. This study proposes to determine whether neck flexors endurance is related to extensor endurance, and whether cervical muscle endurance is related to disability, pain amount and pain stage in subjects with neck pain. METHODS: Thirty subjects (18 women, 12 men, mean ± SD age: 43 ± 12 years) complaining of neck pain filled out the Visual Analogue Scale (VAS) and the Neck Pain and Disability Scale-Italian version (NPDS-I). They also completed the timed endurance tests for the cervical muscles. RESULTS: The mean endurance was 246.7 ± 150 seconds for the NEE test, and 44.9 ± 25.3 seconds for the NMFE test. A significant correlation was found between the results of these two tests (r = 0.52, p = 0.003). A positive relationship was also found between VAS and NPDS-I (r = 0.549, p = 0.002). The endurance rates were similar for acute/subacute and chronic subjects, whereas males demonstrated significantly higher values compared to females in NFME test. CONCLUSIONS: These findings suggest that neck flexors and extensors endurance are correlated and that the cervical endurance is not significantly altered by the duration of symptoms in subjects with neck pain.

Clinical presentation and physiotherapy treatment of 4 patients with low back pain and isthmic spondylolisthesis.

OBJECTIVE: Spondylolisthesis is a pathological condition characterized by the slipping of a vertebral body, compared with the underlying one, following structural and/or degenerative changes of the spine. The purpose of this case series is to describe clinical presentations and the conservative physiotherapy management of 4 patients with low back pain and lumbar isthmic spondylolisthesis. CLINICAL FEATURES: Four patients aged 25, 43, 36, and 50 years presented with low back pain of various duration. Radiographs confirmed the presence of lumbar isthmic spondylolisthesis. Outcome measures included numerical rating scale, disability outcome measure (Oswestry Disability Index), spinal instability tests (Prone Instability Test, Passive Lumbar Extension test), and muscle function tests (Aberrant Movement Patterns, Active Straight Leg Raising, Prone and Supine Bridge Tests). INTERVENTION AND OUTCOMES: Treatment consisted of postural reeducation, stretching, and strengthening exercises. Over the course of individualized treatment, ranging from 8 to 10 treatment visits, outcomes improved for all 4 patients. CONCLUSION: This report describes varying clinical presentations and treatment of 4 patients with isthmic spondylolisthesis, suggesting that different pain generators could be managed by different conservative approaches.

Validity of the straight-leg raise test for patients with sciatic pain with or without lumbar pain using magnetic resonance imaging results as a reference standard.

OBJECTIVE: The aim of this retrospective study was to assess validity of the straight-leg raise (SLR) test using magnetic resonance imaging (MRI) results as a reference standard in a group of patients with L4-L5 and L5-S1 lumbar-herniated disks and sciatic pain. The relationship between diagnostic accuracy of this test, age classes, and grade of lumbar disk displacement was investigated. METHODS: The charts of 2352 patients with sciatic pain with/without lumbar pain were examined. Results of the SLR were then compared with previous spinal MRI. A 2 × 2 contingency table was created, and analysis of sensitivity, specificity, positive and negative predictive values, diagnostic odds ratio, likelihood ratio (LR), and receiver operating characteristic (ROC) curve was carried out. Homogeneous age classes were created to compare them statistically. RESULTS: Magnetic resonance imaging findings showed lumbar disk herniation (LDH) in 1305 patients. Of these subjects, 741 were positive on SLR testing. Sensitivity was 0.36, whereas specificity was 0.74. Positive and negative predictive values were 0.69 and 0.52, respectively. Positive LR was 1.38, and negative LR was 0.87. Diagnostic odds ratio was 1.59, and ROC analysis showed an area under the curve (AUC) of 0.596. The AUC decreased from 0.730 in the 16- to 25-year subgroup to 0.515 in the 76- to 85-year subgroup. Similar results were obtained in subjects with LDH and nerve root compression. CONCLUSIONS: Our results indicate low accuracy of the SLR in diagnosis of LDH if compared with MRI results. The discriminative power of the SLR seemed to decrease as age increased; thus, positive and negative results may be less conclusive in older patients.

Effect of influent COD/SO4(2-) ratios on mesophilic anaerobic reactor biomass populations: physico-chemical and microbiological properties.

The competitive and syntrophic interactions between different anaerobic bacterial trophic groups in sulphate limited expanded granular sludge bed (EGSB) reactors was investigated. The outcome of competition between the sulphate-reducing, methanogenic and syntrophic populations after development in reactors at varying influent COD/SO4 (2-) ratios was examined in batch activity tests with the inclusion of specific sulphate reducing bacteria (SRB) and methane producing archaea (MPA) inhibitors. SRB species could not out-compete MPA species for acetate at influent COD/SO4 (2-) ratios as low as 2. The SRB were seen to play a more significant role in the conversion of hydrogen but did not become completely dominant. HMPA were responsible for hydrogen utilization at an influent COD/SO4 (2-) ratio of 16, and were still dominant when the ratio was reduced to 4. It was only when the COD/SO4 (2-) ratio was reduced to 2 that the HSRB assumed a more influential role. SRB species were significant in the degradation of propionate at all COD/SO4 (2-) ratios applied. Sludge samples were analysed by scanning electron microscopy (SEM), granule size distribution and fluorescent in situ hybridization (FISH), combined with confocal laser scanning microscopy (CLSM), to monitor any changes in granule morphology under the various COD/SO4 (2-) ratios imposed during the reactor trial. In situ hybridization with domain- and species-specific oligonucleotide probes demonstrated a layered architecture with an outer layer harboring mainly Eubacterial cells and an inner layer dominated by Archaeal species.

Toxicity of nitrite toward mesophilic and thermophilic sulphate-reducing, methanogenic and syntrophic populations in anaerobic sludge.

The various problems associated with treating sulphate-containing wastewaters stem inherently from successful competitive interactions between sulphate reducing bacteria (SRB) and other bacteria involved in the process, resulting in the formation of H(2)S. Prevention of in-reactor sulphide generation by use of specific SRB inhibitors presents a potential solution. Nitrite has been reported to be a specific inhibitor of SRB but its possible toxicity to syntrophic and methanogenic members of the anaerobic consortium has not been investigated. In batch activity and toxicity tests, under both mesophilic and thermophilic conditions, nitrite, at concentrations of up to 150 mg L(-1), was found to be ineffective as a specific inhibitor of SRB, and was also shown to have an inhibitory effect on the activity of syntrophic and methane-producing bacteria in mesophilic and thermophilic digester sludge samples.