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1.
Front Bioeng Biotechnol ; 12: 1444598, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39148945

RESUMO

Isometric exercise is a non-pharmacologic intervention to improve muscle hemodynamic responses and blood pressure in humans. However, the effects of intensity, duration, and muscle mass factors of isometric exercise on local muscle hemodynamic responses and systemic blood pressure regulation have not been studied. The purpose of this study was to assess whether various modes of isometric exercise could induce various levels of muscle hemodynamic responses that are related to the blood pressure changes. Near-infrared spectroscopy was used to assess muscle hemodynamic responses after 4 isometric exercise protocols in 20 healthy adults. One-way analysis of variance (ANOVA) with repeated measures was used to assess the effect of factors of isometric exercise on oxyhemoglobin, deoxy-hemoglobin, blood volume, and oxygenation. For oxygenation, the lowest mean was recorded for the unilateral isometric handgrip exercise at 30% of MVC for 2 min (-0.317 ± 0.379 µM) while the highest mean was observed for the isometric wall squat (1.496 ± 0.498 µM, P < 0.05). Additionally, both the bilateral isometric handgrip exercise at 30% MVC for 1 min (1.340 ± 0.711 µM, P < 0.05) and the unilateral isometric handgrip exercise at 20% MVC for 3 min (0.798 ± 0.324 µM, P < 0.05) are significantly higher than 30% of MVC for 2 min. Blood pressure showed an inverse trend with oxygenation changes of the forearm muscle. The study indicates that the duration and muscle mass of isometric exercise are more effective on oxygenation responses and systematic blood pressure regulation, and suggests that the local muscle oxygenation factor following isometric contractions may mediate systematic blood pressure regulation.

2.
Adapt Phys Activ Q ; : 1-29, 2024 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-39122240

RESUMO

This pilot study assessed the feasibility and functional benefits of a twice-weekly, 12-week, virtual, seated, group-based Pilates program in persons with mild to severe multiple sclerosis (MS). Participants were randomized into either a Pilates-only group or a Pilates group, which also incorporated hip and shoulder-cuff activation exercises. Process, management, and scientific-feasibility metrics were analyzed descriptively. Functional outcomes, physical activity, and MS-related outcomes (impact, fatigue, and quality of life) were measured pre- and postintervention and analyzed using mixed-effects models, analysis of variance, and cluster analysis. Twenty-two participants completed baseline testing. Sixteen completed the intervention and postintervention testing. Collapsed across groups, analyses demonstrated improvements in the Timed 25-Foot Walk (36%), Timed Up-and-Go (13%), and the Berg Balance Scale (10%, statistically significant). Neither between-groups differences nor physical activity or MS outcome changes were significant. Participants reported high satisfaction. Findings suggest that virtual, seated Pilates is feasible and may confer balance benefits to individuals with MS.

3.
Sensors (Basel) ; 24(15)2024 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-39124002

RESUMO

Tai Chi is a Chinese martial art that provides an adaptive and accessible exercise for older adults with varying functional capacity. While Tai Chi is widely recommended for its physical benefits, wider adoption in at-home practice presents challenges for practitioners, as limited feedback may hamper learning. This study examined the feasibility of using a wearable sensor, combined with machine learning (ML) approaches, to automatically and objectively classify Tai Chi expertise. We hypothesized that the combination of wrist acceleration profiles with ML approaches would be able to accurately classify practitioners' Tai Chi expertise levels. Twelve older active Tai Chi practitioners were recruited for this study. The self-reported lifetime practice hours were used to identify subjects in low, medium, or highly experienced groups. Using 15 acceleration-derived features from a wearable sensor during a self-guided Tai Chi movement and 8 ML architectures, we found multiclass classification performance to range from 0.73 to 0.97 in accuracy and F1-score. Based on feature importance analysis, the top three features were found to each result in a 16-19% performance drop in accuracy. These findings suggest that wrist-wearable-based ML models may accurately classify practice-related changes in movement patterns, which may be helpful in quantifying progress in at-home exercises.


Assuntos
Aprendizado de Máquina , Tai Chi Chuan , Dispositivos Eletrônicos Vestíveis , Punho , Humanos , Tai Chi Chuan/métodos , Idoso , Punho/fisiologia , Masculino , Feminino , Pessoa de Meia-Idade
4.
Neurorehabil Neural Repair ; : 15459683241273411, 2024 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-39177188

RESUMO

BACKGROUND: Mobility and cognitive impairment are prevalent and co-occurring in older adults with multiple sclerosis (OAMS), yet there is limited research concerning the role of disability status in the cognitive control of gait among OAMS. OBJECTIVE: We investigated the levels of prefrontal cortex (PFC) activation, using oxygenated hemoglobin (HbO2), during cognitively-demanding tasks in OAMS with lower and higher disability using functional near-infrared spectroscopy (fNIRS) to: (1) identify PFC activation differences in single task walk and cognitively-demanding tasks in OAMS with different levels of disability; and (2) evaluate if disability may moderate practice-related changes in neural efficiency in OAMS. METHODS: We gathered data from OAMS with lower (n = 51, age = 65 ± 4 years) or higher disability (n = 48, age = 65 ± 5 years), using a cutoff of 3 or more, in the Patient Determined Disease Steps, for higher disability, under 3 different conditions (single-task walk, Single-Task-Alpha, and Dual-Task-Walk [DTW]) administered over 3 counterbalanced, repeated trials. RESULTS: OAMS who had a lower disability level exhibited decreased PFC activation levels during Single-Task-Walk (STW) and larger increases in PFC activation levels, when going from STW to a cognitively-demanding task, such as a DTW, than those with higher disability. OAMS with a lower disability level exhibited greater declines in PFC activation levels with additional within session practice than those with a higher disability level. CONCLUSIONS: These findings suggest that disability moderates brain adaptability to cognitively-demanding tasks and demonstrate the potential for fNIRS-derived outcome measures to complement neurorehabilitation outcomes.

5.
Polymers (Basel) ; 16(13)2024 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-39000628

RESUMO

The globalization of markets has diversified the food supply, but it has also made the distribution chain more difficult, increasing the risk of microbial contamination. One strategy to obtain safer food and extend its shelf life is to develop active packaging with antimicrobial properties that prevent the growth of pathogenic microorganisms or spoilage in food products. In this context, and in line with the growing social awareness about the environmental impact generated by plastic waste, this work evaluated the effectiveness of polylactic acid (PLA) films loaded with different concentrations of copper (II) hydroxynitrate nanoparticles (CuHS) against the microbiota of fresh foods (chicken, fish and cheese). The results showed that the developed films containing 1, 3 and 5% w/w of CuHS in the polymeric matrix caused a decrease in the microbial abundance equal to or higher than 3 logarithmic units in all foods tested. Moreover, the mechanical and thermal properties of the formulated composites showed that the added CuHS concentrations did not substantially modify these properties compared to the PLA films. Taking into account the results obtained for antimicrobial activity, Cu (II) migration levels and the cytotoxicity of the films formulated, the PLA composite loaded with 1% CuHS (w/w) was the most suitable for its potential use as food packaging material. In addition, the biodegradation of this composite film was studied under conditions simulating intensive aerobic composting, demonstrating that almost 100% disintegration after 14 days of testing was achieved. Therefore, the innovative PLA-based films developed represent a promising strategy for the fabrication of packaging and active surfaces to increase food shelf life while maintaining food safety. Moreover, their biodegradable character will contribute to efficient waste management, turning plastic residues into a valuable resource.

6.
Microorganisms ; 12(7)2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-39065096

RESUMO

Detection and enumeration of coliform bacteria using traditional methods and current molecular techniques against E. coli usually involve long processes with less sensitivity and specificity to distinguish between viable and non-viable bacteria for microbiological water analysis. This approach involves developing and validating an immunosensor comprising ring resonators functionalized with specific antibodies surrounded by a network of microchannels as an alternative method for detecting and indirectly enumerating Escherichia coli in samples of water for consumption. Different ELISA assays were conducted to characterize monoclonal and polyclonal antibodies selected as detection probes for specific B-galactosidase enzymes and membrane LPS antigens of E. coli. An immobilization control study was performed on silicon nitride surfaces used in the immunosensor, immobilized with the selected antibodies from the ELISA assays. The specificity of this method was confirmed by detecting as few as 10 CFU/mL of E. coli from viable and non-viable target bacteria after applying various disinfection methods to water samples intended for human consumption. The 100% detection rate and a 100 CFU/mL Limit of Quantification of the proposed method were validated through a comprehensive assessment of the immunosensor-coupled microfluidic system, involving at least 50 replicates with a concentration range of 10 to 106 CFU/mL of the target bacteria and 50 real samples contaminated with and without disinfection treatment. The correlation coefficient of around one calculated for each calibration curve obtained from the results demonstrated sensitive and rapid detection capabilities suitable for application in water resources intended for human consumption within the food industry. The biosensor was shown to provide results in less than 4 h, allowing for rapid identification of microbial contamination crucial for ensuring water monitoring related to food safety or environmental diagnosis and allowing for timely interventions to mitigate contamination risks. Indeed, the achieved setup facilitates the in situ execution of laboratory processes, allowing for the detection of both viable and non-viable bacteria, and it implies future developments of simultaneous detection of pathogens in the same contaminated sample.

7.
Int J Sports Med ; 2024 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-39079704

RESUMO

Bridging exercise is commonly performed in people with low back pain. However, the effect of contraction mode of bridging exercise on the hemodynamics of the low back muscle has not been investigated in people with and without LBP. The objective of this study was to assess the effect of the mode of bridging exercise on oxygenation of the low back muscle. A near-infrared spectroscopy was used to measure hemodynamic responses of the erector spinae between isometric and dynamic bridging exercise in 16 healthy participants. The results demonstrated that during exercise, isometric bridging exercise significantly decreased oxyhemoglobin and deoxyhemoglobin compared with dynamic bridging exercise (oxyhemoglobin, t = -3.109, p = 0.007, Cohen's d = 0.68) and deoxy-hemoglobin, t = -2.193, P = 0.046, Cohen's d = 0.60). The results also demonstrated that after exercise, dynamic bridging exercise induced a significantly higher oxygenation response (oxygenation, t = -2.178, P = 0.048, Cohen's d = 0.43). This study indicates that dynamic bridging exercise is more effective in improving oxygenation of low back muscles.

8.
Beilstein J Org Chem ; 20: 1580-1589, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39076287

RESUMO

The reaction mechanism for the chlorination and bromination of 2-naphthol with PIDA or PIFA and AlX3 (X = Cl, Br), previously reported by our group, was elucidated via quantum chemical calculations using density functional theory. The chlorination mechanism using PIFA and AlCl3 demonstrated a better experimental and theoretical yield compared to using PIDA. Additionally, the lowest-energy chlorinating species was characterized by an equilibrium of Cl-I(Ph)-OTFA-AlCl3 and [Cl-I(Ph)][OTFA-AlCl3], rather than PhICl2 being the active species. On the other hand, bromination using PIDA and AlBr3 was more efficient, wherein the intermediate Br-I(Ph)-OAc-AlBr3 was formed as active brominating species. Similarly, PhIBr2 was higher in energy than our proposed species. The reaction mechanisms are described in detail in this work and were found to be in excellent agreement with the experimental yield. These initial results confirmed that our proposed mechanism was energetically favored and therefore more plausible compared to halogenation via PhIX2.

9.
Mult Scler Relat Disord ; 87: 105671, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38728961

RESUMO

BACKGROUND/OBJECTIVE: Falls research in older adults with MS (OAMS) is scarce, and no studies have reported on the association between life-space mobility and falls in this group. Herein, we hypothesized that higher baseline life-space scores would be associated with reduced odds of reporting falls during follow-up, and explored whether the association differed by MS subtype (progressive vs. relapsing-remitting). METHODS: OAMS (n = 91, mean age = 64.7 ± 4.3ys, %female = 66.9,%progressive MS = 30.7) completed the University of Alabama at Birmingham Life-Space-Assessment (UAB-LSA) scale and reported falls during a structured monthly telephone interview during follow-up (mean = 16.39 ± 11.44 months). General Estimated Equations (GEE) models were utilized to determine whether UAB-LSA scores predicted falls during follow-up. RESULTS: GEE models revealed that higher UAB-LSA scores were associated with a significant reduction in the odds of falling during follow-up (OR = 0.69, p = 0.012, 95 %CI = 0.51 to 0.92). Stratified analyses revealed that this association was significant in progressive (OR = 0.57, p = 0.004, 95 %CI = 0.39 to 0.84), but not relapsing-remitting (OR = 0.93, p = 0.779, 95 %CI = 0.57 to 1.53) MS. CONCLUSION: Higher life-space mobility was associated with lower odds of falling among OAMS with progressive subtype. The UAB-LSA may complement existing mobility measures for predicting fall risk.


Assuntos
Acidentes por Quedas , Humanos , Acidentes por Quedas/estatística & dados numéricos , Acidentes por Quedas/prevenção & controle , Feminino , Masculino , Idoso , Pessoa de Meia-Idade , Esclerose Múltipla/fisiopatologia , Esclerose Múltipla/complicações , Seguimentos , Esclerose Múltipla Recidivante-Remitente/fisiopatologia
10.
Chron Respir Dis ; 21: 14799731241255967, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38752418

RESUMO

BACKGROUND: COVID-19 demonstrated the possibility of neurological complications such as loss of sense of smell and taste, together with respiratory problems. Respiratory training and rehabilitation of neurological sequelae are essential to improve respiratory function and thus quality of life, and the aim of this study is to evaluate the efficacy of a pulmonary and neurological rehabilitation program. OBJECTIVES: To apply a treatment to reduce dyspnea, increase exertional capacity, increase vital capacity and respiratory muscle strength, together with an increase in olfactory and gustatory sensitivity in post-SARS-CoV-2 patients. METHODS: A randomised controlled experimental study was conducted in 220 patients with a medical diagnosis of COVID-19 and more than 5 months of evolution, dyspnoea or perceived fatigue, including olfactory and gustatory perception problems, of whom 200 patients completed the study. 100 patients were randomly assigned to the intervention group, consisting of an inspiratory training treatment plan (Powerbreathe Plus®) combined with aerobic exercise and olfactory gustatory treatment for 31 days, and 100 patients to the control group, for 31 days without any type of therapy. RESULTS: The study was conducted in post-Covid-19 patients for 5 months. Two hundred patients were divided into an intervention group (n = 100) and a control group (n = 100). The comparison between the groups showed significant differences in spirometric variables; forced vital capacity (p < .001; Eta2 (0.439); Mean: 0,6135), the ratio between both FEV1/FVC (p < 0.01; Eta2 (0.728); Mean:9,313), peak inspiratory pressure (p < 0.01; Eta2 (0.906); Mean:4,526); changes were observed in dyspnoea measured with the modified Borg scale (p < 0.01; Eta2 (0.811); Mean:1,481) and the modified Medical Research Council scale (p < 0.01; Eta2 (0.881); Mean: 0.777); finally, changes were found in neurological variables, in the questions of the Singapore Smell and Taste Questionnaire, How was your sense of smell after treatment? (p < 0.01; Eta2 (0.813); Mean: 1,721) and How is your sense of taste after treatment? (p < 0.01; Eta2 (0.898); Mean: 1,088). CONCLUSION: The implementation of a respiratory rehabilitation treatment plan with the Powerbreathe Plus® device, aerobic exercise and neurorehabilitation with olfactory and gustatory training, is a therapeutic option against respiratory and neurological sequelae in patients who have suffered such sequelae due to the SARS-CoV-2 virus. Clinicaltrials.gov: NCT05195099. First posted 18/01/2022; Last Update Posted 29/06/2022.


Assuntos
COVID-19 , Humanos , COVID-19/reabilitação , COVID-19/complicações , Masculino , Feminino , Adulto , Exercícios Respiratórios/métodos , Dispneia/reabilitação , Dispneia/etiologia , SARS-CoV-2 , Adulto Jovem , Reabilitação Neurológica/métodos , Estudantes , Capacidade Vital , Qualidade de Vida , Terapia por Exercício/métodos , Força Muscular/fisiologia , Universidades , Transtornos do Olfato/reabilitação , Transtornos do Olfato/etiologia
11.
PLoS One ; 19(5): e0302828, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38722930

RESUMO

Cupping therapy is a popular intervention for improving muscle recovery after exercise although clinical evidence is weak. Previous studies demonstrated that cupping therapy may improve microcirculation of the soft tissue to accelerate tissue healing. However, it is unclear whether the cupping size could affect the spatial hemodynamic response of the treated muscle. The objective of this study was to use 8-channel near-infrared spectroscopy to assess this clinical question by assessing the effect of 3 cupping sizes (35, 40, and 45 mm in inner diameter of the circular cup) under -300 mmHg for 5 min on the muscle hemodynamic response from the area inside and outside the cup, including oxyhemoglobin and deoxy-hemoglobin in 18 healthy adults. Two-way factorial design was used to assess the interaction between the cupping size (35, 40, and 45 mm) and the location (inside and outside the cup) and the main effects of the cupping size and the location. The two-way repeated measures ANOVA demonstrated an interaction between the cupping size and the location in deoxy-hemoglobin (P = 0.039) but no interaction in oxyhemoglobin (P = 0.100), and a main effect of the cup size (P = 0.001) and location (P = 0.023) factors in oxyhemoglobin. For the cupping size factor, the 45-mm cup resulted in a significant increase in oxyhemoglobin (5.738±0.760 µM) compared to the 40-mm (2.095±0.312 µM, P<0.001) and 35-mm (3.134±0.515 µM, P<0.01) cup. Our findings demonstrate that the cupping size and location factors affect the muscle hemodynamic response, and the use of multi-channel near-infrared spectroscopy may help understand benefits of cupping therapy on managing musculoskeletal impairment.


Assuntos
Hemodinâmica , Músculo Esquelético , Oxiemoglobinas , Espectroscopia de Luz Próxima ao Infravermelho , Humanos , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Masculino , Hemodinâmica/fisiologia , Feminino , Adulto , Músculo Esquelético/fisiologia , Músculo Esquelético/irrigação sanguínea , Oxiemoglobinas/metabolismo , Oxiemoglobinas/análise , Ventosaterapia/métodos , Adulto Jovem , Hemoglobinas/metabolismo
12.
Foods ; 13(6)2024 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-38540892

RESUMO

The objective of this study was to evaluate the viability and performance of nitric oxide modified-atmosphere packaging (MAP) as a novel alternative to high oxygen and carbon monoxide MAP for ground beef. Packages of ground beef under high oxygen (HI-OX), carbon monoxide (CO), and nitric oxide (NO) atmospheres were evaluated for descriptive and instrumental color every 12 h during a 120 h display period. Surface myoglobin percentages, internal cooked color, thiobarbituric acid reactive substances (TBARS), and residual nitrite and nitrate were also evaluated. There were gas × time interactions for descriptive color, discoloration, a* values, b* values, deoxymyoglobin percentages, and metmyoglobin percentages (p < 0.05). There were also gas-type main effects for cooked color and TBARS (p < 0.05). Carbon monoxide maintained the most redness and least discoloration throughout the display period, while HI-OX started with a bright red color but rapidly browned (p < 0.05). Nitric oxide started as dark red to tannish-red but transitioned to a dull red (p < 0.05). However, NO had increased redness and a* values for internal cooked color (p < 0.05). Although CO outperformed NO packages, NO exhibited a unique color cycle warranting further research to optimize its use.

13.
J Fungi (Basel) ; 10(1)2024 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-38248961

RESUMO

Among pollution remediation technologies, advanced oxidation processes (AOPs) are genuinely efficient since they are based on the production of strong, non-selective oxidants, mainly hydroxyl radicals (·OH), by a set of physicochemical methods. The biological counterparts of AOPs, which may be referred to as advanced bio-oxidation processes (ABOPs), have begun to be investigated since the mechanisms of induction of ·OH production in fungi are known. To contribute to the development of ABOPs, advanced oxidation of a wide number of dyes by the white-rot fungus Pleurotus eryngii, via a quinone redox cycling (QRC) process based on Fenton's reagent formation, has been described for the first time. The fungus was incubated with 2,6-dimethoxy-1,4-benzoquinone (DBQ) and Fe3+-oxalate, with and without Mn2+, leading to different ·OH production rates, around twice higher with Mn2+. Thanks to this process, the degradative capacity of the fungus increased, not only oxidising dyes it was not otherwise able to, but also increasing the decolorization rate of 20 dyes by more than 7 times in Mn2+ incubations. In terms of process efficacy, it is noteworthy that with Mn2+ the degradation of the dyes reached values of 90-100% in 2-4 h, which are like those described in some AOPs based on the Fenton reaction.

14.
Geroscience ; 46(3): 3169-3184, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38221528

RESUMO

The peak prevalence of multiple sclerosis has shifted into older age groups, but co-occurring and possibly synergistic motoric and cognitive declines in this patient population are poorly understood. Dual-task-walking performance, subserved by the prefrontal cortex, and compromised in multiple sclerosis and aging, predicts health outcomes. Whether acute practice can improve dual-task walking performance and prefrontal cortex hemodynamic response efficiency in multiple sclerosis has not been reported. To address this gap in the literature, the current study examined task- and practice-related effects on dual-task-walking and associated brain activation in older adults with multiple sclerosis and controls. Multiple sclerosis (n = 94, mean age = 64.76 ± 4.19 years) and control (n = 104, mean age = 68.18 ± 7.01 years) participants were tested under three experimental conditions (dual-task-walk, single-task-walk, and single-task-alpha) administered over three repeated counterbalanced trials. Functional near-infrared-spectroscopy was used to evaluate task- and practice-related changes in prefrontal cortex oxygenated hemoglobin. Gait and cognitive performances declined, and prefrontal cortex oxygenated hemoglobin was higher in dual compared to both single task conditions in both groups. Gait and cognitive performances improved over trials in both groups. There were greater declines over trials in oxygenated hemoglobin in dual-task-walk compared to single-task-walk in both groups. Among controls, but not multiple sclerosis participants, declines over trials in oxygenated hemoglobin were greater in dual-task-walk compared to single-task-alpha. Dual-task walking and associated prefrontal cortex activation efficiency improved during a single session, but improvement in neural resource utilization, although significant, was attenuated in multiple sclerosis participants. These findings suggest encouraging brain adaptability in aging and neurological disease.


Assuntos
Esclerose Múltipla , Caminhada , Humanos , Idoso , Caminhada/fisiologia , Córtex Pré-Frontal/metabolismo , Envelhecimento/fisiologia , Oxiemoglobinas/metabolismo
15.
J Vasc Surg ; 79(3): 540-546.e2, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37923020

RESUMO

OBJECTIVE/BACKGROUND: Our study analyzed the relationship between two polypharmacy scores (addition of chronic prescribed drugs [ACPDs] and Rx-Risk Comorbidity Index) and survival in patients with an intact abdominal aortic and/or common iliac aneurysm (AAA). METHODS: Consecutive retrospective, single-center cohort of patients attended for an intact AAA with indication for repair from 2008 to 2021. Demographic data, Charlson Comorbidity Index, AAA treatment, ACPD, and Rx-Risk polypharmacy scores were recorded at baseline. Main outcomes were the 5-year and long-term survival rates. The statistical analysis included Cox regression, area under the curve, and continuous net reclassification index. RESULTS: A total of 424 patients with AAA were evaluated (median age: 76 years; 92.2% male, median Charlson index 2), of whom 314 (74.1%) underwent intervention (80% endovascular and 20% open) and 110 (25.9%) did not. During follow-up (mean 4.6 years), 245 patients (57.8%) died, with 1-month, 1-year, and 5-year survival rates of 98.1%, 86.3%, and 52.7%, respectively. ACPD and Rx-Risk indices (median [interquartile range]: 6 [4-9] and 3 [0-5], respectively) were significantly and linearly associated (P < .001) with survival, with the best cutoff points at 5 and 0, respectively. An ACPD >5 (patients with >5 chronically prescribed drugs at baseline) and an Rx-Risk >0 were associated with a 45.2% (P = .038) and 102% (P = .002) increase in 5-year mortality, respectively, after adjustment for age, sex, Charlson index, and type of AAA treatment. Both polypharmacy indices improved significantly the discriminative power of the Charlson Comorbidity Index in predicting survival. CONCLUSIONS: Both ACPD and Rx-Risk polypharmacy scores are independently related to survival among patients with an intact AAA and indication for repair. Their behavior is similar, so the simple ACPD >5 appears to be sufficient to identify patients with lower survival rates.


Assuntos
Aneurisma da Aorta Abdominal , Implante de Prótese Vascular , Procedimentos Endovasculares , Humanos , Masculino , Idoso , Feminino , Procedimentos Endovasculares/efeitos adversos , Estudos Retrospectivos , Polimedicação , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Abdominal/etiologia , Resultado do Tratamento , Fatores de Tempo , Fatores de Risco , Implante de Prótese Vascular/efeitos adversos
16.
Int J Gynaecol Obstet ; 164(3): 835-842, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37493222

RESUMO

Chagas disease (CD) is caused by the parasite Trypanosoma cruzi. Although it is endemic in many Latin American (LA) countries, mother-to-child transmission has caused it to expand to other countries and continents. In places where vector transmission is controlled or absent, the epidemiological importance of T. cruzi transmission of the infected mother to her child during pregnancy or childbirth (i.e., perinatal CD) increases. In countries where CD is not endemic, CD screening should be performed in pregnant or fertile women who are native to LA countries or whose mothers are native to LA countries. Diagnosis is established by detecting anti-T. cruzi IgG antibodies in a serum or plasma sample. Antiparasitic treatment cannot be offered during pregnancy, and since the majority of infected newborns are asymptomatic at birth, a diagnosis is made by direct observation or concentration (microhematocrit) or by using molecular testing techniques. Once the infected child receives a diagnosis, it is essential to offer treatment (benznidazole/nifurtimox) as soon as possible, with good tolerance and effectiveness in the first year of life. Even if the diagnosis is negative at birth, the newborn must be followed up for at least the first 9 months of life.


Assuntos
Doença de Chagas , Trypanosoma cruzi , Gravidez , Recém-Nascido , Feminino , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Mães , Doença de Chagas/diagnóstico , Doença de Chagas/prevenção & controle , Doença de Chagas/epidemiologia
17.
Mult Scler Relat Disord ; 82: 105354, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38134603

RESUMO

BACKGROUND: Older adults with multiple sclerosis (OAMS) have declines in walking and physical performance that may erode community mobility defined as the spatial extent of mobility in one's daily life and environment. OBJECTIVE: This study provided the first application and validation of the University of Alabama Birmingham Study of Aging Life-Space Assessment (UAB LSA) as a measure of community mobility in OAMS. METHODS: The sample included 97 OAMS and 108 healthy controls (HCs) who completed baseline assessments as part of an ongoing, longitudinal study. The primary assessments included the UAB LSA and timed 25-foot walk (T25FW), short physical performance battery (SPPB), global health score (GHS), and geriatric depression scale (GDS) in both OAMS and HCs, and patient determined disease steps (PDDS) scale in only OAMS. RESULTS: OAMS had significantly lower UAB LSA scores than HCs (p < .001). UAB LSA scores had strong correlations with T25FW(rs = -.641) and SPPB(rs = 0.507) in OAMS, and moderate correlations in HCs (rs = -.300 & rs = 0.384). The correlations between UAB LSA and GHS and GDS scores were significant, but small in OAMS (rs = -.239 & rs = -.231), and not statistically significant in HCs (rs = -.009 & rs = -.166). There was a strong correlation between UAB LSA and PDDS scores in the OAMS sample (rs = -.605). CONCLUSION: We provided initial evidence for UAB LSA scores as a measure of community mobility in OAMS.


Assuntos
Atividades Cotidianas , Esclerose Múltipla , Humanos , Idoso , Estudos Longitudinais , Esclerose Múltipla/diagnóstico , Avaliação Geriátrica , Envelhecimento
18.
Artigo em Inglês | MEDLINE | ID: mdl-38083240

RESUMO

Falls are one of the leading factors of injury and fatality in older adults. Given the importance of early detection of adults at higher risk of falls, we evaluated the ability of machine learning to classify fall risk in adults across the lifespan using wearable sensors embedded in a smartshirt. We evaluated the classification performance of binary and multiclass fall risk classifier models using SciKit Digital Health in adults across the lifespan. Using a k-fold and group k-fold cross-validation strategy, we demonstrate the feasibility of fall risk classification using accelerometer data from 10 second epochs of treadmill walking data from adults across the lifespan. We achieved an 88% accuracy in a binary clasifier of fallers vs. non-fallers, and an 86% accuracy in a multiclass classifier comparing non-fallers, fallers, and recurrent fallers using retrospective fall histories. Comparing group k-fold vs. k-fold cross-validation strategies, we find a 22-27% drop-off in accuracy performance. Furthering the evaluation framework presented in this study would be valuable to the development of more robust and clinically relevant models used in the prediction of fall risk. These models could one day be applied in clinical settings to help better diagnose and monitor fall risk among older adults, improving the care of at-risk individuals and reducing the injury and associated cost of falls.


Assuntos
Longevidade , Dispositivos Eletrônicos Vestíveis , Humanos , Idoso , Estudos Retrospectivos , Marcha , Caminhada
19.
Artigo em Inglês | MEDLINE | ID: mdl-38083387

RESUMO

Objective and quantitative monitoring of movement impairments is crucial for detecting progression in neurological conditions such as Parkinson's disease (PD). This study examined the ability of deep learning approaches to grade motor impairment severity in a modified version of the Movement Disorders Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) using low-cost wearable sensors. A convolutional neural network architecture, XceptionTime, was used to classify lower and higher levels of motor impairment in persons with PD, across five distinct rhythmic tasks: finger tapping, hand movements, pronation-supination movements of the hands, toe tapping, and leg agility. In addition, an aggregate model was trained on data from all tasks together for evaluating bradykinesia symptom severity in PD. The model performance was highest in the hand movement tasks with an accuracy of 82.6% in the hold-out test dataset; the accuracy for the aggregate model was 79.7%, however, it demonstrated the lowest variability. Overall, these findings suggest the feasibility of integrating low-cost wearable technology and deep learning approaches to automatically and objectively quantify motor impairment in persons with PD. This approach may provide a viable solution for a widely deployable telemedicine solution.


Assuntos
Aprendizado Profundo , Transtornos Motores , Doença de Parkinson , Humanos , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico , Movimento , Hipocinesia/diagnóstico
20.
J Biomol Struct Dyn ; : 1-12, 2023 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-37937766

RESUMO

The protein tyrosine kinase (PTK) produced by the BCR-ABL1 gene has generated significant interest in the development of inhibitors since the presence of punctual mutations causes resistance to currently approved drugs, mainly the T315I mutation has been the most difficult to address. In this work, derivatives of 1,6-dihydroazaazulenes are studied as possible inhibitors of this PTK in its wild form and the mutant T315I. The recognition of the ligands was explored through molecular docking, and the stability of the complexes and their evolution over time was studied using molecular dynamics (MD) simulations. Our results show that complexes are energetically stable and reside on the ATP binding site in all cases during the MD experiments. Interestingly, a few of our proposed ligands presented greater affinity for T315I, finding more favorable binding free energies (ΔG) than the reference drug axitinib. Furthermore, they may act as inhibitors for both isoforms. Our findings are promising because mutation of T315I does not prevent ligand recognition, as detailed in this work, which is very important to conduct further experimental research.Communicated by Ramaswamy H. Sarma.

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