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Coronary computed angiography (CCTA) with non-invasive fractional flow reserve (FFR) calculates lesion-specific ischemia when compared with invasive FFR and can be considered for patients with stable chest pain and intermediate-grade stenoses according to recent guidelines. The objective of this study was to compare a new CCTA-based artificial-intelligence deep-learning model for FFR prediction (FFRAI) to computational fluid dynamics CT-derived FFR (FFRCT) in patients with intermediate-grade coronary stenoses with FFR as reference standard. The FFRAI model was trained with curved multiplanar-reconstruction CCTA images of 500 stenotic vessels in 413 patients, using FFR measurements as the ground truth. We included 37 patients with 39 intermediate-grade stenoses on CCTA and invasive coronary angiography, and with FFRCT and FFR measurements in this retrospective proof of concept study. FFRAI was compared with FFRCT regarding the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for predicting FFR ≤ 0.80. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy of FFRAI in predicting FFR ≤ 0.80 were 91% (10/11), 82% (23/28), 67% (10/15), 96% (23/24), and 85% (33/39), respectively. Corresponding values for FFRCT were 82% (9/11), 75% (21/28), 56% (9/16), 91% (21/23), and 77% (30/39), respectively. Diagnostic accuracy did not differ significantly between FFRAI and FFRCT (p = 0.12). FFRAI performed similarly to FFRCT for predicting intermediate-grade coronary stenoses with FFR ≤ 0.80. These findings suggest FFRAI as a potential non-invasive imaging tool for guiding therapeutic management in these stenoses.
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PURPOSE: Although cardiac troponin I (cTnI) increase following strenuous exercise has been observed, the development of exercise-induced myocardial edema remains unclear. Cardiac magnetic resonance (CMR) native T1/T2 mapping is sensitive to the pathological increase of myocardial water content. Therefore, we evaluated exercise-induced acute myocardial changes in recreational cyclists by incorporating biomarkers, echocardiography and CMR. METHODS: Nineteen male recreational participants (age: 48 ± 5 years) cycled the 'L'étape du tour de France" (EDT) 2021' (175 km, 3600 altimeters). One week before the race, a maximal graded cycling test was conducted to determine individual heart rate (HR) training zones. One day before and 3-6 h post-exercise 3 T CMR and echocardiography were performed to assess myocardial native T1/T2 relaxation times and cardiac function, and blood samples were collected. All participants were asked to cycle 2 h around their anaerobic gas exchange threshold (HR zone 4). RESULTS: Eighteen participants completed the EDT stage in 537 ± 58 min, including 154 ± 61 min of cycling time in HR zone 4. Post-race right ventricular (RV) dysfunction with reduced strain and increased volumes (p < 0.05) and borderline significant left ventricular global longitudinal strain reduction (p = 0.05) were observed. Post-exercise cTnI (0.75 ± 5.1 ng/l to 69.9 ± 41.6 ng/l; p < 0.001) and T1 relaxation times (1133 ± 48 ms to 1182 ± 46 ms, p < 0.001) increased significantly with no significant change in T2 (p = 0.474). cTnI release correlated with increase in T1 relaxation time (p = 0.002; r = 0.703), post-race RV dysfunction (p < 0.05; r = 0.562) and longer cycling in HR zone 4 (p < 0.05; r = 0.607). CONCLUSION: Strenuous exercise causes early post-race cTnI increase, increased T1 relaxation time and RV dysfunction in recreational cyclists, which showed interdependent correlation. The long-term clinical significance of these changes needs further investigation. TRIAL REGISTRATION NUMBERS AND DATE: NCT04940650 06/18/2021. NCT05138003 06/18/2021.
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Disfunción Ventricular Derecha , Masculino , Humanos , Adulto , Persona de Mediana Edad , Disfunción Ventricular Derecha/diagnóstico por imagen , Disfunción Ventricular Derecha/etiología , Imagen por Resonancia Magnética , Umbral Anaerobio , Ciclismo , Relevancia ClínicaRESUMEN
PURPOSE: Persons with Multiple Sclerosis (PwMS) are physically inactive and spend more time in sedentary behaviours than healthy persons, which increases the risk of developing cardiometabolic diseases. In this randomised crossover study, the cardiometabolic health effects of replacing sitting with light-intensity physical activity (LIPA) and exercise (EX) were investigated. MATERIALS AND METHODS: Twenty-eight mildly disabled PwMS performed four 4-day activity regimens in free-living conditions; CONTROL (habitual activity), SIT, LIPA, and EX. Plasma glucose and insulin (oral glucose tolerance test), plasma lipids, inflammation, resting heart rate, blood pressure, body weight, and perceived exertion were measured (clinical-trials.gov: NCT03919058). RESULTS: CONTROL: 9.7 h sitting/day, SIT: 13.3 h sitting/day, LIPA: 8.3 h sitting, 4.7 h standing, and 2.7 h light-intensity walking/day, and EX: 11.6 h sitting/day with 1.3 h vigorous-intensity cycling. Compared to SIT, improvements (p < 0.001) after LIPA and EX were found for insulin total area under the curve (-17 019 ± 5708 and -23 303 ± 7953 pmol/L*min), insulin sensitivity (Matsuda index +1.8 ± 0.3 and +1.9 ± 0.4) and blood lipids (triglycerides: -0.4 ± 0.1 and -0.5 ± 0.1 mmol/L; non-high-density lipoprotein cholesterol: -0.3 ± 0.1 and -0.5 ± 0.1 mmol/L), with no difference between LIPA and EX. Perceived exertion was higher after EX compared to LIPA (Borg score [6-20]: +2.6 ± 3.3, p = 0.002). CONCLUSION: Replacing sitting with LIPA throughout the day exerts similar cardiometabolic health effects as a vigorous-intensity exercise in PwMS.IMPLICATIONS FOR REHABILITATIONIncreasing light-intensity physical activity (LIPA) throughout the day improves cardiometabolic health to the same extent as one vigorous-intensity exercise sessionIncreasing LIPA induces less exertion than performing a vigorous-intensity exercise.
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Enfermedades Cardiovasculares , Esclerosis Múltiple , Humanos , Estudios Cruzados , Glucemia , Ejercicio Físico/fisiología , Lípidos , InsulinaRESUMEN
BACKGROUND: Adults with obesity may display disturbed cardiac chronotropic responses during cardiopulmonary exercise testing, which relates to poor cardiometabolic health and an increased risk for adverse cardiovascular events. It is unknown whether cardiac chronotropic incompetence (CI) during maximal exercise is already present in obese adolescents and, if so, how that relates to cardiometabolic health. METHODS: Sixty-nine obese adolescents (body mass index standard deviation score = 2.23 ± 0.32, age = 14.1 ± 1.2 years; mean ± SD) and 29 lean adolescents (body mass index standard deviation score = -0.16 ± 0.84, age = 14.0 ± 1.5 years) performed a maximal cardiopulmonary exercise testing from which indicators for peak performance were determined. The resting heart rate and peak heart rate were used to calculate the maximal chronotropic response index. Biochemistry (lipid profile, glycemic control, inflammation, and leptin) was studied in fasted blood samples and during an oral glucose tolerance test within obese adolescents. Regression analyses were applied to examine associations between the presence of CI and blood or exercise capacity parameters, respectively, within obese adolescents. RESULTS: CI was prevalent in 32 out of 69 obese adolescents (46%) and 3 out of 29 lean adolescents (10%). C-reactive protein was significantly higher in obese adolescents with CI compared to obese adolescents without CI (pâ¯=â¯0.012). Furthermore, peak oxygen uptake and peak cycling power output were significantly reduced (p < 0.05) in obese adolescents with CI vs. obese adolescents without CI. The chronotropic index was independently related to blood total cholesterol (standardized coefficient ßâ¯=â¯-0.332; pâ¯=â¯0.012) and C-reactive protein concentration (standardized coefficient ßâ¯=â¯-0.269; pâ¯=â¯0.039). CONCLUSION: CI is more common in the current cohort of obese adolescents, and is related to systemic inflammation and exercise intolerance.
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Enfermedades Cardiovasculares , Obesidad Infantil , Adulto , Humanos , Adolescente , Niño , Proteína C-Reactiva , Prueba de Esfuerzo , InflamaciónRESUMEN
Covalent organic frameworks (COFs) are porous materials with high surface areas, making them interesting for a large variety of applications including energy storage, gas separation, photocatalysis, and chemical sensing. Structural variation plays an important role in tuning COF properties. Next to the type of the building block core, bonding directionality, and linking chemistry, substitution of building blocks provides another level of synthetic control. Thorough characterization and comparison of various substitution patterns is relevant for the molecular engineering of COFs via rational design. To this end, we have systematically synthesized and characterized multiple combinations of several methylated and non-methylated building blocks to obtain a series of imine-based COFs. This includes the experimental assignment of the COF structure by solid-state NMR. By comparing the properties of all COFs, the following trends were found: (1) upon methylation of the aldehyde nodes, COFs show increased Brunauer-Emmett-Teller surface areas, reduced pore collapse, blue-shifted absorbance spectra, and â¼0.2 eV increases in their optical band gaps. (2) COFs with dimethylated amine linkers show a lower porosity. (3) In tetramethylated amine linkers, the COF porosity even further decreases, the absorbance spectra are clearly red-shifted, and smaller optical band gaps are obtained. Our study shows that methyl substitution patterns on COF building blocks are a handle to control the UV absorbance of the resulting frameworks.
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Model-free phasor image analysis, well established in fluorescence lifetime imaging and only recently applied to qMRI [Formula: see text] data processing, is here adapted and validated for myocardial qMRI [Formula: see text] mapping. Contrarily to routine mono-exponential fitting procedures, phasor enables mapping the lifetime information from all image voxels to a single plot, without resorting to any regression fitting analysis, and describing multi-exponential qMRI decays without biases due to violated modelling assumptions. In this feasibility study, we test the performance of our recently developed full-harmonics phasor method for unravelling partial-volume effects, motion or pathological tissue alteration, respectively on a numerically-simulated dataset, a healthy subject scan, and two pilot patient datasets. Our results show that phasor analysis can be used, as alternative method to fitting analysis or other model-free approaches, to identify motion artifacts or partial-volume effects at the myocardium-blood interface as characteristic deviations, or delineations of scar and remote myocardial tissue in patient data.
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Procesamiento de Imagen Asistido por Computador , Imagen Óptica , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagen Óptica/métodos , MiocardioRESUMEN
PURPOSE: Exercise training improves exercise capacity in type 2 diabetes mellitus (T2DM). It remains to be elucidated whether such improvements result from cardiac or peripheral muscular adaptations, and whether these are intensity dependent. METHODS: 27 patients with T2DM [without known cardiovascular disease (CVD)] were randomized to high-intensity interval training (HIIT, n = 15) or moderate-intensity endurance training (MIT, n = 12) for 24 weeks (3 sessions/week). Exercise echocardiography was applied to investigate cardiac output (CO) and oxygen (O2) extraction during exercise, while exercise capacity [([Formula: see text] (mL/kg/min)] was examined via cardiopulmonary exercise testing at baseline and after 12 and 24 weeks of exercise training, respectively. Changes in glycaemic control (HbA1c and glucose tolerance), lipid profile and body composition were also evaluated. RESULTS: 19 patients completed 24 weeks of HIIT (n = 10, 66 ± 11 years) or MIT (n = 9, 61 ± 5 years). HIIT and MIT similarly improved glucose tolerance (pTime = 0.001, pInteraction > 0.05), [Formula: see text] (mL/kg/min) (pTime = 0.001, pInteraction > 0.05), and exercise performance (Wpeak) (pTime < 0.001, pInteraction > 0.05). O2 extraction increased to a greater extent after 24 weeks of MIT (56.5%, p1 = 0.009, pTime = 0.001, pInteraction = 0.007). CO and left ventricular longitudinal strain (LS) during exercise remained unchanged (pTime > 0.05). A reduction in HbA1c was correlated with absolute changes in LS after 12 weeks of MIT (r = - 0.792, p = 0.019, LS at rest) or HIIT (r = - 0.782, p = 0.038, LS at peak exercise). CONCLUSION: In patients with well-controlled T2DM, MIT and HIIT improved exercise capacity, mainly resulting from increments in O2 extraction capacity, rather than changes in cardiac output. In particular, MIT seemed highly effective to generate these peripheral adaptations. TRIAL REGISTRATION: NCT03299790, initially released 09/12/2017.
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Diabetes Mellitus Tipo 2 , Entrenamiento de Intervalos de Alta Intensidad , Diabetes Mellitus Tipo 2/terapia , Ejercicio Físico , Entrenamiento de Intervalos de Alta Intensidad/métodos , Humanos , Oxígeno , Consumo de OxígenoRESUMEN
Prolonged periods of sedentary time appear to increase the risk for the development of several chronic conditions and all-cause mortality, even when moderate-to-vigorous physical activity (MVPA) is taken into consideration. However, whether the beneficial health effects of MVPA in highly active individuals remain present when leisure time is spent sedentary remains speculative. Therefore, we systematically evaluated off-training sedentary behaviour and physical activity levels in athletes. Studies were collected from four bibliographic databases (PubMed, Embase, Web of Science and The Cochrane Central Register of Controlled Trials). Studies were eligible for inclusion if they evaluated sedentary behaviour and physical activity levels among athletes. Data from athletes were compared with the general population and pooled using a random-effects model. After deduplication 3104 were identified of which 13 studies met inclusion criteria. Compared to the general population, athletes spent significantly more time in sedentary behaviour (+79 min/day; 95% confidence interval [CI]: [41, 65] min/day; p<0.001). In addition, athlete individuals spent less time in light intensity physical activity (-92 min/day; 95% CI: [-117, -66] min/day; p<0.001) and had increased levels of MVPA (+62 min/day; 95% CI: [38, 85] min/day; p<0.001) compared to the general population. Athletes exceed the average time spend sedentary per day and make them even more sedentary compared to the general population.
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Enfermedades Cardiovasculares , Conducta Sedentaria , Atletas , Enfermedades Cardiovasculares/epidemiología , Enfermedad Crónica , Ejercicio Físico , HumanosRESUMEN
BACKGROUND: Multiple sclerosis (MS) is a chronic autoimmune disease driven by sustained inflammation in the central nervous system. One of the pathological hallmarks of MS is extensive free radical production. However, the subsequent generation, potential pathological role, and detoxification of different lipid peroxidation-derived reactive carbonyl species during neuroinflammation are unclear, as are the therapeutic benefits of carbonyl quenchers. Here, we investigated the reactive carbonyl acrolein and (the therapeutic effect of) acrolein quenching by carnosine during neuroinflammation. METHODS: The abundance and localization of acrolein was investigated in inflammatory lesions of MS patients and experimental autoimmune encephalomyelitis (EAE) mice. In addition, we analysed carnosine levels and acrolein quenching by endogenous and exogenous carnosine in EAE. Finally, the therapeutic effect of exogenous carnosine was assessed in vivo (EAE) and in vitro (primary mouse microglia, macrophages, astrocytes). RESULTS: Acrolein was substantially increased in inflammatory lesions of MS patients and EAE mice. Levels of the dipeptide carnosine (ß-alanyl-L-histidine), an endogenous carbonyl quencher particularly reactive towards acrolein, and the carnosine-acrolein adduct (carnosine-propanal) were ~ twofold lower within EAE spinal cord tissue. Oral carnosine treatment augmented spinal cord carnosine levels (up to > tenfold), increased carnosine-acrolein quenching, reduced acrolein-protein adduct formation, suppressed inflammatory activity, and alleviated clinical disease severity in EAE. In vivo and in vitro studies indicate that pro-inflammatory microglia/macrophages generate acrolein, which can be efficiently quenched by increasing carnosine availability, resulting in suppressed inflammatory activity. Other properties of carnosine (antioxidant, nitric oxide scavenging) may also contribute to the therapeutic effects. CONCLUSIONS: Our results identify carbonyl (particularly acrolein) quenching by carnosine as a therapeutic strategy to counter inflammation and macromolecular damage in MS.
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Acroleína/metabolismo , Enfermedades Autoinmunes del Sistema Nervioso/metabolismo , Enfermedades Autoinmunes del Sistema Nervioso/patología , Carnosina/farmacología , Enfermedades Neuroinflamatorias/metabolismo , Animales , Encefalomielitis Autoinmune Experimental/metabolismo , Encefalomielitis Autoinmune Experimental/patología , Femenino , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Esclerosis Múltiple/metabolismo , Esclerosis Múltiple/patologíaRESUMEN
BACKGROUND: Mechanical efficiency (ME) might be an important parameter evaluating cardiometabolic health and the effectiveness of physical activity interventions in individuals with obesity. However, whether these cardiometabolic risk factors may relate to ME in adolescents with obesity is not known yet. Therefore, this study aims to compare the mechanical efficiency during maximal exercise testing between adolescents with obesity and lean adolescents, and to examine associations with exercise tolerance and metabolic health. METHODS: Twenty-nine adolescents with obesity (BMI SDS: 2.11 ± 0.32, age: 13.4 ± 1.1 years, male/female: 15/14) and 29 lean (BMI SDS: -0.16 ± 0.84, age: 14.0 ± 1.5 years, male/female: 16/13) adolescents performed a maximal cardiopulmonary exercise test from which the net mechanical efficiency (MEnet) and substrate oxidation (carbohydrates and lipids) were calculated. Indicators for peak performance were collected. Biochemistry (lipid profile, glycaemic control, inflammation, leptin) was studied in fasted blood samples. Regression analyses were applied to examine relations between MEnet and exercise tolerance or blood variables in the total group. RESULTS: Peak work rate (WRpeak), oxygen uptake (VËO2peak)/WRpeak, ME, and MEnet were significantly lower (p < 0.05) in adolescents with obesity compared to their lean counterparts (p < 0.05). Furthermore, a reduced MEnet was independently related to a lower WRpeak (SC ß = 2.447; p < 0.001) and elevated carbohydrate oxidation during exercise (SC ß = -0.497; p < 0.001), as well as to elevated blood low-density lipoprotein cholesterol (SC ß = -0.275; p = 0.034) and fasting glucose (SC ß = -0.256; p = 0.049) concentration. CONCLUSION: In adolescents with obesity, the mechanical efficiency is lowered during exercise and this relates to exercise intolerance and a worse metabolic health.
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Obesidad Infantil , Adolescente , Niño , Ejercicio Físico , Prueba de Esfuerzo , Tolerancia al Ejercicio , Femenino , Humanos , Masculino , Consumo de OxígenoRESUMEN
Cardiometabolic comorbidities are highly prevalent in clinical populations, and have been associated (partly) with their sedentary lifestyle. Although lifestyle interventions targeting sedentary behaviour (SB) have been studied extensively in the general population, the effect of such strategies in clinical populations is not yet clear. Therefore, this systematic review and meta-analysis evaluated the effect of different lifestyle interventions on SB and cardiometabolic health in clinical populations. Randomised controlled trials were collected from five bibliographic databases (PubMed, Embase, Web of Science, The Cochrane Central Register of Controlled Trials, and Scopus). Studies were eligible for inclusion if they evaluated a lifestyle intervention to reduce objectively measured SB, in comparison with a control intervention among persons with a clinical condition. Data were pooled using a random-effects meta-analysis. In total, 7094 studies were identified. Eighteen studies met the inclusion criteria and were categorised in five population groups: overweight/obesity, type 2 diabetes mellitus, cardiovascular, neurological/cognitive and musculoskeletal diseases. Participants reduced their SB by 64 min/day (95%CI: [-91, -38] min/day; p < 0.001), with larger within-group differences of multicomponent behavioural interventions including motivational counselling, self-monitoring, social facilitation and technologies (-89 min/day; 95%CI: [-132, -46] min/day; p < 0.001). Blood glycated haemoglobin concentration (-0.17%; 95% CI: [-0.30, -0.04]%; p = 0.01), fat percentage (-0.66%; 95% CI: [-1.26, -0.06]%, p = 0.03) and waist circumference (-1.52 cm; 95%CI: [-2.84, -0.21] cm; p = 0.02) were significantly reduced in the intervention groups compared to control groups. Behavioural lifestyle interventions reduce SB among clinical populations and improve cardiometabolic risk markers such as waist circumference, fat percentage, and glycaemic control. Sedentary behaviour, Cardiometabolic health, Clinical populations.
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Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus Tipo 2/prevención & control , Humanos , Estilo de Vida , Sobrepeso , Conducta SedentariaRESUMEN
OBJECTIVES: Cardiovascular diseases and exercise intolerance elevate mortality in type 1 diabetes (T1D). Left ventricular systolic and diastolic function are already affected in adolescents with T1D, displaying poor glycemic control (glycated hemoglobin [A1C]>7.5%) and exercise intolerance. We investigated the extent to which left ventricular function is affected by disease severity/duration and whether this is related to exercise capacity. METHODS: Transthoracic echocardiography was performed in 19 adolescents with T1D (14.8±1.9 years old, A1C 7.4±0.9%) and 19 controls (14.4±1.3 years old, A1C 5.3±0.2%), matched for age and Tanner stage. Diastolic and systolic (ejection fraction [EF]) function were assessed. Cardiopulmonary exercise testing was used to evaluate exercise capacity, as measured by peak oxygen uptake (VO2peak). RESULTS: VO2peak and left ventricular systolic and diastolic function were similar in both groups. Within the T1D group, EF was negatively associated with disease duration (r=-0.79 corrected for age, standardized body mass index, glucose variability and VO2peak; p=0.011). Regression analyses revealed that 37.6% of the variance in EF could be attributed to disease duration. CONCLUSIONS: Although left ventricular systolic and diastolic function are preserved in T1D with adequate exercise capacity, disease duration negatively affects EF. The detrimental effects of T1D seem to be driven by disease duration, rather than by disease severity, at least during adolescence. Young patients with T1D may, therefore, benefit from cardiovascular evaluation in order to detect cardiovascular abnormalities early in the disease course, and, therefore, improve long-term cardiovascular health.
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Diabetes Mellitus Tipo 1 , Adolescente , Niño , Estudios Transversales , Prueba de Esfuerzo , Humanos , Aptitud Física , Volumen Sistólico , Función Ventricular IzquierdaRESUMEN
Phasor analysis is a robust, nonfitting, method for the study of multiexponential decays in lifetime imaging data, routinely used in Fluorescence Lifetime Imaging Microscopy (FLIM) and only recently validated for Magnetic Resonance Imaging (MRI). In the established phasor approach, typically only the first Fourier harmonic is used to unravel time-domain exponential trends and their intercorrelations across image voxels. Here, we demonstrate the potential of full-harmonics (FH) phasor analysis by using all frequency-domain data points in simulations and quantitative MRI (qMRI) T2 measurements of phantoms with bulk liquids or liquid-filled porous particles and of a human brain. We show that FH analysis, while of limited advantage in FLIM due to the correlated nature of shot noise, in MRI outperforms single-harmonic phasor in unravelling multiple physical environments and partial-volume effects otherwise undiscernible. We foresee application of FH phasor to, e.g., big-data analysis in qMRI of biological or other multiphase systems, where multiparameter fitting is unfeasible.
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BACKGROUND: To date, it is unclear if consumer wearable activity trackers (CWATs), with or without behaviour multi-component strategies, effectively improve adherence to physical activity and health outcomes under free living conditions in populations with chronic diseases. Therefore, we systematically evaluated the efficacy of CWAT-based interventions to promote physical activity levels and cardiometabolic health in populations with chronic diseases. METHODS: Randomised controlled trials were collected from five bibliographic databases (PubMed, Embase, Web of Science, The Cochrane Central Register of Controlled Trials and CINAHL). Studies were eligible for inclusion if they evaluated a CWAT-based counselling intervention versus control intervention among patients with chronic respiratory diseases, type 2 diabetes mellitus, cardiovascular diseases, overweight/obesity, cognitive disorders, or sedentary older adults. Data were pooled using a random-effects model. RESULTS: After deduplication 8147 were identified of which 35 studies met inclusion criteria (chronic respiratory diseases: 7, type 2 diabetes mellitus: 12, cardiovascular diseases: 6, overweight/obesity: 3, cognitive disorders: 1, sedentary older adults: 6). Compared to control groups, CWAT-based interventions significantly increased physical activity by 2123 steps per day (95% confidence interval [CI], [1605-2641]; p < 0.001). In addition, CWAT-based interventions in these populations significantly decreased systolic blood pressure (- 3.79 mm Hg; 95% CI: [- 4.53, - 3.04] mm Hg; p < 0.001), waist circumference (- 0.99 cm; 95% CI: [- 1.48, - 0.50] cm; p < 0.001) and low-density lipoprotein cholesterol concentration (- 5.70 mg/dl; 95% CI: [- 9.24, - 2.15] mg/dl; p = 0.002). CONCLUSION: CWAT-based interventions increase physical activity and have beneficial effects on important health-related outcomes such as systolic blood pressure, waist circumference and LDL cholesterol concentration in patients with chronic diseases.
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Enfermedad Crónica/prevención & control , Ejercicio Físico , Monitores de Ejercicio , Promoción de la Salud/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Anciano , Presión Sanguínea , LDL-Colesterol , Femenino , Humanos , Masculino , Persona de Mediana Edad , Circunferencia de la CinturaRESUMEN
Recently, a number of variations to the hybrid perovskite structure have been suggested in order to improve on the properties of methylammonium lead iodide, the archetypical hybrid halide perovskite material. In particular, with respect to the chemical stability of the material, steps should be taken. We performed an in-depth analysis of the structure of MAPbI3 upon incorporation of dimethylammonium (DMA) in order to probe the integrity of the perovskite lattice in relation to changes in the organic cation. This material, with formula MA1-xDMAxPbI3, adopts a 3D perovskite structure for 0 < x < 0.2, while a nonperovskite yellow phase is formed for 0.72 < x < 1. In the perovskite phase, the methylammonium and dimethylammonium ions are distributed randomly throughout the lattice. For 0.05 < x < 0.2, the phase-transition temperature of the material is lowered when compared to that of pure MAPbI3 (x = 0). The material, although disordered, has apparent cubic symmetry at room temperature. This leads to a small increase in the band gap of the material of about 20 meV. Using 14N NMR relaxation experiments, the reorientation times of the MA and DMA cations in MA0.8DMA0.2PbI3 were established to be 1.6 and 2.6 ps, respectively, indicating that both ions are very mobile in this material, on par with the MA ions in MAPbI3. All of the produced MA1-xDMAxPbI3 materials were richer in DMA than the precursor solution from which they were crystallized, indicating that DMA incorporation is energetically favorable and suggesting a higher thermodynamic stability of these materials when compared to that of pure MAPbI3.
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Enfermedades Cardiovasculares , Obesidad , Aptitud Física , Adolescente , Humanos , Factores de RiesgoRESUMEN
Recent advances in the development of perovskite based solar cells have increased the demand for in-depth characterisation of the perovskite structures and the dynamics of their various constituents in relation to the potential impact on the photovoltaic performance. NMR can play an important role in this respect; NMR has been used to study the incorporation of different ionic species, characterize their internal dynamics and diffusion, and monitor the chemical stability of these technologically relevant materials, including upcoming lower dimensional perovskite materials. Furthermore, the flexibility of NMR allows the study of the materials under relevant conditions e.g. under illumination. Here we present an overview of the recent literature on NMR of (hybrid) halide perovskites, focusing on the insights that NMR can provide.
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OBJECTIVE: To gain greater insights in the etiology and clinical consequences of altered cardiac function in obese adolescents. Therefore, we aimed to examine cardiac structure and function in obese adolescents, and to examine associations between altered cardiac function/structure and cardiometabolic disease risk factors or cardiopulmonary exercise capacity. METHODS: In 29 obese (BMI 31.6 ± 4.2 kg/m², age 13.4 ± 1.1 years) and 29 lean (BMI 19.5 ± 2.4 kg/m², age 14.0 ± 1.5 years) adolescents, fasted blood samples were collected to study hematology, biochemistry, liver function, glycemic control, lipid profile, and hormones, followed by a transthoracic echocardiography to assess cardiac structure/function, and a cardiopulmonary exercise test (CPET) to assess cardiopulmonary exercise parameters. Regression analyses were applied to examine relations between altered echocardiographic parameters and blood parameters or CPET parameters in the entire group. RESULTS: In obese adolescents, left ventricular septum thickness, left atrial diameter, mitral A-wave velocity, E/e' ratio were significantly elevated (p < 0.05), as opposed to lean controls, while mitral e'-wave velocity was significantly lowered (p < 0.01). Elevated homeostatic model assessment of insulin resistance and blood insulin, c-reactive protein, and uric acid concentrations (all significantly elevated in obese adolescents) were independent risk factors for an altered cardiac diastolic function (p < 0.01). An altered cardiac diastolic function was not related to exercise tolerance but to a delayed heart rate recovery (HRR; p < 0.01). CONCLUSIONS: In obese adolescents, an altered cardiac diastolic function was independently related to hyperinsulinemia and whole-body insulin resistance, and only revealed by a delayed HRR during CPET. This indicates that both hyperinsulinemia, whole-body insulin resistance, and delayed HRR could be regarded as clinically relevant outcome parameters.
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Gasto Cardíaco/fisiología , Tolerancia al Ejercicio/fisiología , Ejercicio Físico/fisiología , Obesidad/fisiopatología , Aptitud Física/fisiología , Adolescente , Estudios Transversales , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Obesidad/complicaciones , Obesidad/epidemiología , Factores de RiesgoRESUMEN
Over the last years, several different pathways have been suggested for producing perovskite thin films for solar cell applications. While the merit of these methods with respect to the solar cell efficiency have been shown, the actual composition of the resulting thin films is often not investigated. Here, we show that methylammonium lead iodide films produced using lead acetate as a lead source can have up to 15 % dimethylammonium incorporated into their crystal structure, even though this ion is often consider to be too large for incorporation. The origin of this ion lies in the precursor solution, where it is formed in a reaction that is facilitated by the basic character of the acetate ions. We further show that these dimethylammonium ions are incorporated in a random fashion throughout the crystal structure, owing to the lack of observable ordered domains.
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In this contribution we used solid state 35Cl (I=3/2) quadrupolar NMR to study a MgCl2/2,2-dimethyl-1,3-dimethoxypropane (DMDOMe) adduct that serves as a model system for Ziegler-Natta catalysis. Employing large Radio-Frequency (RF) field strengths we observe three spectral features with strongly varying line widths. The assignment of the spectra is complicated because of the large difference in quadrupolar interactions experienced by the different sites in the system. The satellite transitions (ST) of relatively well-defined bulk Cl sites are partially excited and may overlap with the central transition (CT) resonances of more distorted surface sites. We show that nutation NMR of the ST of I=3/2 spins yields a unique pattern that makes a clear distinction between an extensively broadened central transition and the satellite transitions of a component with a smaller quadrupolar interaction. This allows us to unambiguously unravel the spectra of the MgCl2 adduct showing that we observe CT and ST of the bulk phase of MgCl2-nanoparticles with a CQ of 4.6MHz together with the CT of surface sites displaying an average CQ of â¼10MHz.