The perceived influence of a physical activity intervention on the intentions of parents of autistic children towards physical activities.

BACKGROUND: Autistic children can derive numerous benefits from engaging in physical activity (PA), necessitating parental support for active participation. However, parents often lack the foundational knowledge to effectively facilitate PA for their children. Despite the significance of this issue, limited research has explored the outcomes of parent-mediated PA interventions for autistic children. OBJECTIVE: The purpose of this study was to examine the attitudes and intentions of parents to include their autistic children in PA after participating in a 12-week PA intervention. METHODS: Employing the Theory of Planned Behavior as a framework, we conducted a descriptive-qualitative investigation. Fifteen parents participated in semi-structured interviews, with the data transcribed and analyzed using thematic line-by-line analysis. RESULTS: Three themes emerged, elucidating how parents fostered PA opportunities for their autistic children were constructed: (a) Awareness and reinforcement of PA benefits, (b) Keep the momentum going, and (c) From intentions to behaviors. CONCLUSIONS: The study findings indicate a positive impact on parental attitudes and intentions toward engaging in PA with their autistic children after participating in the intervention. his study highlights the significance of parent-mediated interventions in fostering PA for autistic children and suggests avenues for future research and interventions.

"I Can Do It": Perceived Competence of Parents of Autistic Children After Participating in a Physical Activity Intervention.

BACKGROUND: Autistic children can benefit from physical activity (PA) in a variety of ways. However, autistic children tend not to meet PA recommendations and, consequently, may not experience the associated benefits. Parental PA support can facilitate PA participation among autistic children, but parents of autistic children may lack the skills to help their child engage in PA. Few studies, to date, have examined the outcomes of parent-mediated PA interventions for autistic children. The purpose of this study was to explore parents' perceived behavioral control (PBC) to support their autistic children in PA after their participation in a PA intervention. METHODS: The theory of planned behavior served as the framework for this descriptive-qualitative investigation. Fifteen parents (each with 1 autistic child in the intervention) participated in semistructured interviews (3 wk after the intervention), which were transcribed and then analyzed using thematic line-by-line analysis. RESULTS: Three themes characterized the changes to parents' PBC after completing the PA intervention. Those themes were: (1) I learned by son! (2) You are my coach! and (3) I can do it! CONCLUSIONS: The results showed that by participating in a parent-mediated PA intervention, parents experienced improved confidence and awareness of their child's abilities, thus enhancing their PBC. Future research is needed to examine how these improvements in PBC may influence the actual PA behaviors of autistic children.

A randomized parent-mediated physical activity intervention for autistic children.

The purpose of this study was to examine the immediate and post effects of a parent-mediated physical activity intervention on the fundamental motor skills of autistic children. We randomly assigned parent-child dyads (n = 31) of autistic children aged 4-11 years into three groups (workshop, an online, or control group). Each dyad participated in a 12-week intervention and was given adapted physical activity equipment and over 200 activities via a mobile application. Children were tested at the start and end of the intervention. The effect size (Cohen's d ) of the control group for pre-post locomotor and ball skill scores were 0.12 and 0.06, respectively, indicating small effect size. The effect size of the online group for pre-post locomotor and ball skill scores were 49 and 0.26, respectively, indicating medium and small effect sizes. The effect size of the in-person group for pre-post locomotor and ball skill scores were 1.18 and 0.82, respectively, indicating large effect sizes. The outcomes of this physical activity intervention suggest that parents may facilitate the acquisition of fundamental motor skills of their autistic children. Although these results are positive, there is a need to further identify effective interventions for fundamental motor skill development in autistic children. Clinical Trials ID: NCT05159102.

Physical activity of children with visual impairments: intentions and behaviors of parents post intervention.

PURPOSE: Physical activity (PA) can provide multiple benefits for children with visual impairments (VI). To date, little research has explored the retention effects of PA interventions for children with VI. Thus, the purpose of this study was to explore the PA experiences of parents of children with VI three months after completing a PA intervention. METHOD: This descriptive-qualitative study was situated in the Theory of Planned Behavior. Five parents completed semi-structured interviews that were transcribed and analyzed using a thematic line-by-line analysis. RESULTS: Four themes characterizing how parents created PA opportunities for their children with VI were constructed: (a) Teaching from Awareness (b) Advocating for Needs, (c) Engaging Family through Community, and (d) Seeking More PA Opportunities. CONCLUSION: Parent's awareness of their child's abilities, parents' advocacy, and parents' teaching skills all helped to expose their children to new types of PA in the community. Parents reflected about a lack of consistently offered community-based PA for their children. Researchers must consider the importance of educating parents on how to teach skills, increase awareness, and advocate for more community-based PA programs.IMPLICATIONS FOR REHABILITATIONThree months after a physical activity intervention for children with visual impairments, parents' awareness of their child's abilities, advocacy, and competence teaching motor skills helped to expose their children to new types of physical activities in the community and at home.The lack of consistently offered community-based physical activities for children with visual impairments calls for rehabilitation professionals to create or promote existing physical activity programs for children with visual impairments.Rehabilitation professionals should explore how physical activity programs can address barriers faced by participants (e.g., lack of knowledge, lack of physical activity equipment), and offer a continuum of activities and programming for these families in the home and community setting.Rehabilitation professionals should educate parents on the importance of physical activity, how to teach motor skills, and advocate for more community-based physical activity programs for their children with visual impairments.

Youth Sport Participation Experiences From the Perspective of Hispanic/Latinx Parents and Their Children.

Hispanic/Latinx communities remain an underserved population in terms of health and physical activity opportunities. The rise of sport specialization can jeopardize these opportunities. Understanding the appeal and welcomeness that minoritized populations feel toward sport and sport specialization culture can play an important role in health promotion and breaking down barriers that widen the gap on physical activity levels in Hispanic/Latinx communities. To date, these studies have not qualitatively investigated Hispanic/Latinx youth sport dyads (parent and child) and how sport specialization perceptions have affected their sport participation experiences. We used a qualitative interpretative phenomenological analysis to explore experiences of Hispanic/Latinx high school athletes. We engaged in semistructured interviews with 12 parent-child dyads. The following 3 interrelated themes emerged: (a) expectations of youth sport participation, (b) meeting expectations of youth sport participation, (c) and (mis)alignment of cultures. Dyads describe a negative youth sport experience when both cultures do not align because of the rise in sport specialization and pay-to-play culture. Findings indicate that dyads understand what is necessary to participate in organized sport and do this by methods that are rooted in their Hispanic/Latinx culture.

Nine decades of data on environmental chemical pollutant exposure in dogs: a bibliometric analysis.

In recent decades, a global concern associated with environmental chemical contamination has emerged as an important risk factor for the development of human diseases. Risk assessment methods based on animal approaches have shown to be very useful as early warning systems. However, questions, knowledge gaps, and limitations still need to be addressed in animals close to humans, such as dogs. The objective of this study was to analyze citation patterns, impact of publications, and most relevant authors, countries, institutional affiliations, and lines of research on environmental chemical contaminants and their relationship with dogs, in terms of exposure and biological effects. For this, a bibliometric analysis was carried out. Results revealed an increase in scientific production on this subject during the last 90 years in journals such as Health Physics, Science of the Total Environment, and Plos One, highlighting authors such as Muggenburg, Sonne, Boecker, and Dietz. The USA, Brazil, Germany, and the UK and universities such as California, Colorado State, and Purdue were the most relevant countries and institutional affiliations in scientific production and collaboration in relation to this topic. There is a growing interest in the development of lines of research related to heavy metals (mercury and lead mainly) and persistent organic compounds (PCBs, PBDEs, pesticides) using dogs as sentinels, as well as new sources of interest related to zoonosis and One Health. Finally, issues related to pollutants, sentinel lymph nodes, and epidemiology appear as new areas of research. These results highlight interesting current challenges and future research perspectives on dogs as sentinels for environmental chemical contamination.

A novel endocast technique providing a 3D quantitative analysis of the gastrovascular system in Rhizostoma pulmo: An unexpected through-gut in cnidaria.

The investigation of jellyfish gastrovascular systems mainly focused on stain injections and dissections, negatively affected by thickness and opacity of the mesoglea. Therefore, descriptions are incomplete and data about tridimensional structures are scarce. In this work, morphological and functional anatomy of the gastrovascular system of Rhizostoma pulmo (Macri 1778) was investigated in detail with innovative techniques: resin endocasts and 3D X-ray computed microtomography. The gastrovascular system consists of a series of branching canals ending with numerous openings within the frilled margins of the oral arms. Canals presented a peculiar double hemi-canal structure with a medial adhesion area which separates centrifugal and centripetal flows. The inward flow involves only the "mouth" openings on the internal wing of the oral arm and relative hemi-canals, while the outward flow involves only the two outermost wings' hemi-canals and relative "anal" openings on the external oral arm. The openings differentiation recalls the functional characteristics of a through-gut apparatus. We cannot define the gastrovascular system in Rhizostoma pulmo as a traditional through-gut, rather an example of adaptive convergence, that partially invalidates the paradigm of a single oral opening with both the uptake and excrete function.

Impact of Xpert MTB/RIF in the Diagnosis of Childhood Tuberculosis in Rural Ethiopia.

BACKGROUND: This study assesses the impact of the Xpert MTB/RIF in the diagnosis of childhood tuberculosis (TB) in a rural hospital in a resource-constrained setting. METHODS: Retrospective cross-sectional study in children evaluated for presumptive TB from 1 June 2016 to 31 May 2017 at the Gambo General Hospital in rural Southern Ethiopia. Children were evaluated according to a defined protocol based on national guidelines. Samples were submitted for Xpert MTB/RIF assay to the nearest reference laboratory. RESULTS: Of the 201 children assessed for presumptive TB, 46.3% (93/201) were diagnosed with TB. Of these, 49.5% (46/93) were microbiologically confirmed, mostly by Xpert MTB/RIF (only one patient was diagnosed by smear alone). The rest were clinically diagnosed. Microbiologically confirmed patients had a higher mean age, longer duration of fever and cough and lymphadenopathy more frequently than those clinically diagnosed. Gastric aspirates were Xpert MTB/RIF-positive in 18.2% of the samples (26/143); none were smear-positive (0/140). Sputum samples were Xpert MTB/RIF-positive in 27.1% (13/35) of the samples and smear-positive in 8.6% (3/35). There were no HIV-positive patients and just one case of rifampicin-resistant TB. A long delay (median 15 days) was detected in returning the results. CONCLUSION: Xpert MTB/RIF serves as an important adjunctive test for diagnosing childhood TB in rural settings, with microbiological confirmation in up to half the TB cases. Processes need to be optimized to achieve an early diagnosis. The diagnosis of childhood TB in high-burden countries such as Ethiopia still relies largely upon diagnostic algorithms and the clinician's skills.Lay summaryWorld Health Organization recommends the use of Xpert MTB/RIF to improve the microbiological diagnosis of childhood tuberculosis (TB) since 2014, but the impact of this test under real conditions in rural areas of low-income countries is not clear. We conducted a cross-sectional study in children evaluated for presumptive TB from 1 June 2016 to 31 May 2017 at the Gambo General Hospital in rural Southern Ethiopia. Children were evaluated according to a clinical protocol based on national guidelines and samples were submitted for Xpert MTB/RIF assay to the nearest reference laboratory.Of the 201 children assessed, 46.3% (93/201) were diagnosed with tuberculosis. Of these, 48.4% (45/93) were microbiologically confirmed by Xpert MTB/RIF [smear microscopy only diagnosed the 5.4% (5/93)]. Patients with microbiologically confirmed tuberculosis had a higher mean age, longer duration of fever and cough and had lymphadenopathy more frequently than those clinically diagnosed. A long delay in returning the results (median 15 days) was detected. Xpert MTB/RIF serves as an important test for diagnosing childhood TB in rural settings, with microbiological confirmation in up to half the cases. Processes need to be optimized to achieve an early diagnosis. The diagnosis of childhood TB in high-burden countries still relies largely upon diagnostic algorithms and the clinician's skills.

The Brainstem-Vermis and Brainstem-Tentorium Angles in the Fetus: A Study of Their Reproducibility by Fetal Magnetic Resonance Imaging and Their Evolution Along the Gestation.

Aim: To assess the reproducibility of brainstem-vermis (BV) and brainstem-tentorium (BT) angles measured by fetal Magnetic Resonance Imaging (MRI) during second half of pregnancy in normal and abnormal fetuses. Secondly, to assess reproducibility of two alternative methodologies to measure the brainstem-tentorium angle (BT1 and BT2) proposed by our group that could be more reliable in fetuses with posterior fossa fluid collection (PFFC) anomalies. Finally, to describe the evolution of BV and BT angles along gestation in normal fetuses. Methods: We conducted a cross-sectional study of BV and BT angles obtained by MRI performed at our center, in 22 fetuses with PFFC and 8 fetuses without PFFC to calculate both angles' reproducibility and the correlation between them and the gestational age. Results: We found good interobserver reproducibility for the BV, BT1 and BT2 angles (Intraclass correlation coefficient: 0.98; 0.89 and 0.88 for each of these angles, with p < 0.001). In patients with PFFC the BT angle could not always be measured. BT angle presented a positive relationship with gestational age (p = 0.002) but BV angle stayed stable. The measurements of BV, BT1, and BT2 angles can be reliably performed by MRI with good interobserver reproducibility. Conclusion: BV angle stays stable during pregnancy, whereas BT angle tends to augment with gestational age.

A Comparative Study of Cell Culture Conditions during Conversion from Primed to Naive Human Pluripotent Stem Cells.

The successful reprogramming of human somatic cells into induced pluripotent stem cells (hiPSCs) represented a turning point in the stem cell research field, owing to their ability to differentiate into any cell type with fewer ethical issues than human embryonic stem cells (hESCs). In mice, PSCs are thought to exist in a naive state, the cell culture equivalent of the immature pre-implantation embryo, whereas in humans, PSCs are in a primed state, which is a more committed pluripotent state than a naive state. Recent studies have focused on capturing a similar cell stage in human cells. Given their earlier developmental stage and therefore lack of cell-of-origin epigenetic memory, these cells would be better candidates for further re-differentiation, use in disease modeling, regenerative medicine and drug discovery. In this study, we used primed hiPSCs and hESCs to evaluate the successful establishment and maintenance of a naive cell stage using three different naive-conversion media, both in the feeder and feeder-free cells conditions. In addition, we compared the directed differentiation capacity of primed and naive cells into the three germ layers and characterized these different cell stages with commonly used pluripotent and lineage-specific markers. Our results show that, in general, naive culture NHSM medium (in both feeder and feeder-free systems) confers greater hiPSCs and hESCs viability and the highest naive pluripotency markers expression. This medium also allows better cell differentiation cells toward endoderm and mesoderm.

Injury prevention for older adults: A dataset of safety concern narratives from online reviews of mobility-related products.

Older adults are among the fastest-growing demographic groups in the United States, increasing by over a third this past decade. Consequently, the older adult consumer product market has quickly become a multi-billion-dollar industry in which millions of products are sold every year. However, the rapidly growing market raises the potential for an increasing number of product safety concerns and consumer product-related injuries among older adults. Recent manufacturer and consumer injury prevention efforts have begun to turn towards online reviews, as these provide valuable information from which actionable, timely intelligence can be derived and used to detect safety concerns and prevent injury. The presented dataset contains 1966 curated online product reviews from consumers, equally distributed between safety concerns and non-concerns, pertaining to product categories typically intended for older adults. Identified safety concerns were manually sub-coded across thirteen dimensions designed to capture relevant aspects of the consumer's experience with the purchased product, facilitate the safety concern identification and sub-classification process, and serve as a gold-standard, balanced dataset for text classifier learning.

HIV-reservoir size is not affected either by HCV coinfection or by direct acting antivirals (DAAs) therapy.

The role of HCV on the HIV reservoir is controversial since the reduction on HIV-DNA levels after HCV eradication with IFNα/RBV treatment seems to be the result of drugs instead of HCV clearance. We assessed whether HCV eradication can decrease HIV-DNA content in HIV/HCV-coinfected patients treated with direct-acting antivirals, DAAs (IFNα/RBV-free regimens). Cell-associated HIV-DNA was measured by ddPCR in 25 HIV-monoinfected and 25 HIV/HCV-coinfected patients. There were no differences in HIV-DNA levels between groups neither at baseline nor at 12 weeks after DAAs treatment completion. Our results indicate that HCV does not appear to influence the HIV reservoir size and suggest the lack of an anti-HIV action for DAAs.

A Feasibility Trial for Virtual Administration of the Test of Gross Motor Development-3 for Children With Autism Spectrum Disorders During the COVID-19 Pandemic.

The Test of Gross Motor Development-3 is one of the most popular assessment tools in physical education and physical activity settings. It is a valid assessment originally designed to administer in-person, but the virtual administration of the assessment has yet to be deemed feasible. Thus, the purpose of this study was to explore the trial feasibility of virtual data collection using the Test of Gross Motor Development-3 to assess the fundamental motor skills of children with autism spectrum disorder. Most specifically, we report on the design and feasibility of the online assessment process. A total of 22 families of children with autism spectrum disorder participated in the online data collection.

S-allylCysteine Ester/Caffeic Acid Amide Hybrids as Promising Antiprotozoal Candidates: Synthesis, Biological Evaluation and Molecular Modeling Studies

Abstract In order to overcome the challenges of discovering new antiprotozoal drugs, we synthesized a new class of hybrids based on S-allylCysteine Ester/Caffeic Acid Amide and evaluated four of them against Trypanosoma cruzi and Plasmodium falciparum. Hybrid 6 exhibited good activity on T. cruzi with an EC50 value of 5.45 µM, whereas hybrid 3 was active over P. falciparum with an EC50 of 18.08 µM. All hybrids displayed a good selectivity index on P. falciparum. Molecular docking computations indicated that several hybrids have good binding affinities towards the protozoa related enzymes (Cruzipain or Falcipain-2) when compared against current inhibitors. In silico studies showed that conjugates 1-3 and 6 fulfilled optimal ADME characteristics, suggesting them as safe alternatives for oral treatment of protozoal infections.

A Randomized Feasibility Trial of a Fundamental Motor Skill Parent-Mediated Intervention for Children with Autism Spectrum Disorders.

The purpose of this pilot study was to examine the feasibility of a fundamental motor skills (FMS) intervention with two groups on the acquisition of FMS of children with autism spectrum disorders (ASD). We randomly assigned families (n = 15) of children with ASD aged 4-11 years into two groups (a workshop or a home-based group) focused on FMS development. Both groups participated in a 10-week intervention and were given the same instructional manual and adapted physical activity equipment. The workshop group also attended four in-person workshops targeting the needs of children with ASD and their parents. Children were tested on their FMS using the third edition of the Test of Gross Motor Development at the start and end of the intervention and then three months following the intervention. The recruitment rate was 50%, and the retention rate was 80% for all participants. The intervention for groups was safe and accepted by the participants as evaluated by post-program interviews. The outcomes of this pilot study suggest that parents can facilitate the acquisition of FMS of their children with ASD. Although these results are positive, there is a need to further identify effective interventions for FMS development in children with ASD.

Analysis of the experience of the geriatric fracture program in two institutions in Colombia: a reproducible model? / Análisis de la experiencia del programa de fracturas geriátricas en dos instituciones en Colombia: ¿un modelo reproducible?

Abstract Background: hip fracture is the major cause of morbidity and mortality. Geriatric fracture programs promise to improve the quality of care, health outcomes and reduce costs. Objective: To describe the results related to the Geriatric fracture programs implementation in two Colombian institutions to assess reproducibility. Methods: We performed A retrospective descriptive study of the patients treated under the Geriatric fracture programs in two institutions in Colombia. The information was collected from the initial year of implementation until 2018. Demographic characteristics, length of stay, hospitalization complications, readmissions and mortality were described. Consumption of healthcare resources was defined using base cases determined with local experts and costs were estimated using standard methods. Results: 475 patients were included in the Geriatric fracture programs. We observed an increase in the number of patients. The length of stay decreased between 8.5% and 26.1% as did the proportion of total complications, with delirium having the greatest reduction. A similar situation was seen for first year mortality (from 10.9% to 4.7%), in-hospital deaths and readmissions. Estimates of costs of stay and complications showed reductions in all scenarios, varying between 22% and 68.3%. Conclusions: The present study presents the experience of two institutions that implemented the Geriatric fracture programs with increase in the number of patients treated and reductions in the time of hospital stay, the proportion of complications, readmissions, mortality and estimated costs. These are similar between both institutions and with other published implementations. This could hint that geriatric fracture program may be implemented with reproducible results.

Resumen Antecedentes: las fracturas de cadera son una causa importante de morbilidad y mortalidad. Los programas de fracturas geriátricas prometen mejorar la calidad de la atención, los desenlaces clínicos y reducir costos, Objetivos: Describir los resultados relacionados con la implementación de un programa de fracturas geriátricas en dos instituciones en Colombia para evaluar la reproducibilidad Métodos: Realizamos un estudio retrospectivo descriptivo de los pacientes atendidos en el programa de fracturas geriátricas en dos instituciones en Colombia. Se obtuvo información desde el año de implementación hasta 2018. Se describió información demográfica, de estancia hospitalaria, de complicaciones, de rehospitalizaciones y de mortalidad. Se determinó un caso base de consumo de recursos con expertos y se costeó usando métodos estandarizados. Resultados: Se incluyeron 475 pacientes. Se observó un aumento en la cantidad de pacientes. La duración de estancia disminuyó entre 8.5% y 26.1%, así como la frecuencia de complicaciones. Se encontraron reducciones en mortalidad en el primer año (entre 10.9% y 4.7%), muertes hospitalarias y rehospitalizaciones. Los costos estimados mostraron reducciones entre 22% y 68.3%. Conclusiones: El presente estudio muestra la experiencia de implementación de programa de fracturas geriátricas en dos instituciones en Colombia, mostrando aumento en cantidades de pacientes y reducciones en estancia hospitalaria, frecuencia de complicaciones, rehospitalizaciones, mortalidad y costos estimados. Los resultados fueron similares en las dos instituciones y comparables con otros descritos en literatura. Esto sugiero que los programas de fracturas geriátricas se pueden implementar con resultados reproducibles.

Impact of ocean warming and ocean acidification on asexual reproduction and statolith formation of the symbiotic jellyfish Cotylorhiza tuberculata.

Ocean acidification and warming are challenging marine organisms and ecosystems around the world. The synergetic effects of these two climate change stressors on jellyfish remain still understudied. Here, we examine the independent and combined effects of these two environmental variables on polyp population dynamics of the Mediterranean jellyfish Cotylorhiza tuberculata. An experiment was conducted to examine asexual reproduction by budding and strobilation considering current and ca. 2100 winter (Trial 1, 36 days) and summer (Trial 2, 36 days) conditions under the RCP8.5 (IPCC 2013). In Trial 1, a temperature of 18°C and two pH levels (current: 7.9 and, reduced: 7.7) were tested. Trial 2 considered two temperature levels 24°C and 30°C, under current and reduced acidification conditions (8.0 and 7.7, respectively). Ephyrae size and statolith formation of released ephyrae from polyps exposed to summer temperatures under both acidification treatment was also analyzed. Zooxanthellae density inside the polyps throughout the experiment was measured. C. tuberculata polyps could cope with the conditions mimicked in all experimental treatments and no significant effect of pH, temperature, or the combination of both variables on the abundance of polyps was observed. At 18°C, strobilation was reduced under high PCO2 conditions. Under summer treatments (24°C and 30°C), percentage strobilation was very low and several released ephyrae suffered malformations and reduced size, as a consequence of reduced pH and elevated temperatures, separately. The number of statoliths was not affected by pH or temperature, however, bigger statoliths were formed at elevated temperatures (30°C). Finally, zooxanthellae density was not affected by experimental conditions, even if, the duration of the experiment significantly affected symbiont concentration. Our results show that even though polyps of C. tuberculata would thrive the future worst scenario predicted for the Mediterranean Sea, their capacity to undergo a proper strobilation and to produce healthy ephyrae will be more vulnerable to climate induced environmental conditions, thereby affecting medusae recruitment and, therefore, population dynamics of the species.

Exercise Ventilatory Inefficiency in Post-COVID-19 Syndrome: Insights from a Prospective Evaluation.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a systemic disease characterized by a disproportionate inflammatory response in the acute phase. This study sought to identify clinical sequelae and their potential mechanism. METHODS: We conducted a prospective single-center study (NCT04689490) of previously hospitalized COVID-19 patients with and without dyspnea during mid-term follow-up. An outpatient group was also evaluated. They underwent serial testing with a cardiopulmonary exercise test (CPET), transthoracic echocardiogram, pulmonary lung test, six-minute walking test, serum biomarker analysis, and quality of life questionaries. RESULTS: Patients with dyspnea (n = 41, 58.6%), compared with asymptomatic patients (n = 29, 41.4%), had a higher proportion of females (73.2 vs. 51.7%; p = 0.065) with comparable age and prevalence of cardiovascular risk factors. There were no significant differences in the transthoracic echocardiogram and pulmonary function test. Patients who complained of persistent dyspnea had a significant decline in predicted peak VO2 consumption (77.8 (64-92.5) vs. 99 (88-105); p < 0.00; p < 0.001), total distance in the six-minute walking test (535 (467-600) vs. 611 (550-650) meters; p = 0.001), and quality of life (KCCQ-23 60.1 ± 18.6 vs. 82.8 ± 11.3; p < 0.001). Additionally, abnormalities in CPET were suggestive of an impaired ventilatory efficiency (VE/VCO2 slope 32 (28.1-37.4) vs. 29.4 (26.9-31.4); p = 0.022) and high PETCO2 (34.5 (32-39) vs. 38 (36-40); p = 0.025). INTERPRETATION: In this study, >50% of COVID-19 survivors present a symptomatic functional impairment irrespective of age or prior hospitalization. Our findings suggest a potential ventilation/perfusion mismatch or hyperventilation syndrome.

Factors Associated with Failure of Bakri Balloon Tamponade for the Management of Postpartum Haemorrhage. Case Series Study and Systematic Review.

BACKGROUND: Postpartum haemorrhage (PPH) is an unpredictable obstetric emergency that requires a multidisciplinary approach. Bakri balloon tamponade (BBT) is recommended when PPH does not respond to medical treatment. Nowadays few published studies have performed a multivariate analysis to determine the variables independently associated with BBT failure. METHODS: Our study purpose was to determine the variables independently associated with BBT failure: first, in a large single-centre cohort study between 2010 and 2020, and second, in a systematic literature review using Medline and the Cochrane Library. Maternal and perinatal variables, PPH characteristics, technique-related variables and complications were recorded in the case series study, comparing between successful and failed BBT patients. Study characteristic and variables significantly associated with BBT failure were recorded in the systematic review. All studies used a logistic regression test. RESULTS: The case series included 123 patients. The profile of these patients were primiparous, with vaginal delivery and a full-term new-born. BBT was successful in 81.3% of cases. Five studies were included in the systematic review, providing data from 551 patients. BBT was successful in 79.5% of cases. CONCLUSIONS: Maternal age, caesarean delivery, ≥7 red blood cells units (RBCU) transfused and curettage before BBT insertion, history of caesarean section, pre-pregnancy obesity, anteriorly placed placenta, placenta accreta, caesarean delivery, estimated blood loss before insertion of BBT, long operation duration, and coagulopathy were independent factors for BBT failure.

Allogeneic Stem Cell Transplantation in Mature T Cell and Natural Killer/T Neoplasias: A Registry Study from Spanish GETH/GELTAMO Centers.

Despite advances in understanding the biology of mature T and natural killer (NK)/T cell neoplasia, current therapies, even the most innovative ones, are still far from ensuring its cure. The only treatment to date that has been shown to control aggressive T cell neoplasms in the long term is allogeneic stem cell transplantation (alloSCT). We aim to report the results of alloSCT for advanced mature T and NK/T neoplasias performed in centers from our national GELTAMO/GETH (Grupo Español de Linfoma y Trasplante de Médula Ósea/Grupo Español de Trasplante Hematopoyético y Terapia Celular) over the past 25 years. As a secondary objective, we analyzed the results of alloSCT from haploidentical donors. We performed a retrospective analysis of all patients who received an alloSCT in Spanish centers (n = 201) from September 1995 to August 2018. The 2-year overall survival (OS) and disease-free survival (DFS) were 65.5% and 58.2%, respectively. The univariate for OS and DFS showed statistically different hazard ratios for conditioning intensity, response pre-alloSCT, comorbidity index, donor/receptor cytomegalovirus status and Eastern Cooperative Oncology Group (ECOG) pre-alloSCT, but only a better ECOG pre-alloSCT remained significant in the multivariate analysis. There was an increased incidence of relapse in those patients who did not develop chronic graft-versus-host disease (GVHD) and an increased risk of death in those developing moderate to severe acute GVHD. The 1-year nonrelapse mortality was 21.9% and was mainly due to GVHD (30%) and bacterial infections (17%). When comparing unrelated donors with haploidentical donors, we found similar results in terms of OS and DFS. There was, however, a reduction of acute GVHD in the haploidentical group (P = .04) and trend to a reduction of chronic GVHD. In conclusion, alloSCT is the only curative option for most aggressive T cell neoplasias. Haploidentical donors offer similar results to related donors in terms of survival with a reduction of acute GVHD.