Physical inactivity and sedentary behavior in individuals with stable COPD non-infected by SARS-CoV-2 during the COVID-19 pandemic / Inatividade física e comportamento sedentário em indivíduos com DPOC estável não infectados pelo SARS-CoV-2 durante a pandemia de COVID-19

Objective: to identify factors associated to sedentary behavior and physical inactivity in individuals with stable chronic obstructive pulmonary disease (COPD) non-infected by SARS-CoV-2 during the COVID-19 pandemic, and to identify possible favorable conditions during social isolation in individuals who performed pulmonary rehabilitation in the pre-pandemic period. Method: time/day in sedentary activities and moderate/vigorous physical activities (SA and MVPA, respectively), history of previous rehabilitation, laboural activity, symptoms, insecurity and quality of life (Medical Outcomes Study 36-item Short-Form Health Survey [SF-36]) were assessed during strict social isolation due to the COVID-19 pandemic. Individuals were classified as sedentary if presenting time/day in SA >8.5 h/day and physically inactive if presenting time/day in MVPA <150 min/week. Result: The sample consisted of 33 individuals (69±7 years; 20 male). Regarding the SF-36, non-sedentary individuals presented better functional capacity than sedentary individuals (65 [38-73] vs. 33 [20-63] points; p=0.01) whereas physically active individuals presented better physical and social function than physically inactive individuals (100 [100-100] vs. 50 [25-100] points, p=0.049; and 100 [100-100] vs. 75 [69-100] points, p=0.022, respectively). Having a professional activity and working outside were associated with non-sedentary behavior (X2=5.93; p=0.025 and X2=7.03; p=0.009, respectively). Having undergone rehabilitation previously to the pandemic was associated with less insecurity to walk outside (X2=4.95; p=0.034) and better perception of symptoms' worsening (X2=5.46; p=0.033). Conclusion: non-sedentarism was associated with functional capacity and laboural activity; active lifestyle was associated with physical and social function; and previous rehabilitation was associated with better symptoms' recognition and less insecurity

Objetivo: identificar fatores associados ao comportamento sedentário e inatividade física em indivíduos com doença pulmonar obstrutiva crônica (DPOC) estável não-infectados pelo SARS-CoV-2 durante o isolamento social causado pela pandemia de COVID-19, e identificar eventuais condições favoráveis durante o isolamento social em indivíduos que realizaram reabilitação pulmonar pré-pandemia. Método: tempo/dia em atividades sedentárias e em atividades físicas moderadas/vigorosas (AS e AFMV, respectivamente), reabilitação prévia, atividade laboral, sintomas, insegurança e qualidade de vida (Medical Outcomes Study 36-item Short-Form Health Survey [SF-36]) foram avaliados durante a vigência de isolamento social devido à pandemia de COVID-19. Foram considerados sedentários aqueles que apresentassem tempo/dia em AS >8,5 h/dia e fisicamente inativos os que apresentassem tempo/dia em AFMV <150 min/semana. Resultado: a amostra consistiu em 33 indivíduos (69±7 anos; 20 homens). Pelo SF-36, indivíduos não-sedentários apresentaram melhor capacidade funcional do que sedentários (65 [38-73] vs. 33 [20-63] pontos; p=0,01) enquanto indivíduos fisicamente ativos apresentaram melhor função física e social do que os fisicamente inativos (100 [100-100] vs. 50 [25-100] pontos, p=0,049; e 100 [100-100] vs. 75 [69-100] pontos, p=0,022, respectivamente). Ter atividade profissional e trabalhar fora de casa associou-se com comportamento não-sedentário (X2=5,93; p=0,025 e X2=7,03; p=0,009, respectivamente). Ter participado de reabilitação pulmonar pré-pandemia associou-se com menos insegurança para caminhar em lugares públicos (X2=4,95; p=0,034) e melhor percepção de piora dos sintomas respiratórios (X2=5,46; p=0,033). Conclusão: não-sedentarismo associou-se com capacidade funcional e atividade laboral; ser fisicamente ativo associou-se com função física e social; e ter realizado reabilitação prévia com menos insegurança e melhor percepção dos sintomas

Cultural adaptation and validation of the Brazilian Portuguese version of the PROactive Physical Activity in COPD-clinical visit instrument for individuals with COPD.

OBJECTIVE: To adapt the PROactive Physical Activity in COPD-clinical visit (C-PPAC) instrument to the cultural setting in Brazil and to determine the criterion validity, test-retest reliability agreement, and internal consistency of this version. METHODS: A protocol for cultural adaptation and validation was provided by the authors of the original instrument and, together with another guideline, was applied in a Portuguese-language version developed by a partner research group from Portugal. The adapted Brazilian Portuguese version was then cross-sectionally administered twice within a seven-day interval to 30 individuals with COPD (57% were men; mean age was 69 ± 6 years; and mean FEV1 was 53 ± 18% of predicted) to evaluate internal consistency and test-retest reliability. Participants also completed the International Physical Activity Questionnaire (IPAQ), the modified Medical Research Council scale, the COPD Assessment Test, and Saint George's Respiratory Questionnaire to evaluate criterion validity. RESULTS: The C-PPAC instrument showed good internal consistency and excellent test-retest reliability: "amount" domain = 0.87 (95% CI, 0.73-0.94) and "difficulty" domain = 0.90 (95% CI, 0.76-0.96). Bland & Altman plots, together with high Lin's concordance correlation coefficients, reinforced that agreement. Criterion validity showed moderate-to-strong correlations of the C-PPAC with all of the other instruments evaluated, especially with the IPAQ (rho = -0.63). CONCLUSIONS: The Brazilian Portuguese version of the C-PPAC is a reliable and valid instrument for evaluating the experience of Brazilian individuals with COPD with their physical activity in daily life.

Cultural adaptation and validation of the Brazilian Portuguese version of the PROactive Physical Activity in COPD-clinical visit instrument for individuals with COPD / Adaptação cultural e validação da versão brasileira do instrumento PROactive Physical Activity in COPD-clinical visit para indivíduos com DPOC

ABSTRACT Objective: To adapt the PROactive Physical Activity in COPD-clinical visit (C-PPAC) instrument to the cultural setting in Brazil and to determine the criterion validity, test-retest reliability agreement, and internal consistency of this version. Methods: A protocol for cultural adaptation and validation was provided by the authors of the original instrument and, together with another guideline, was applied in a Portuguese-language version developed by a partner research group from Portugal. The adapted Brazilian Portuguese version was then cross-sectionally administered twice within a seven-day interval to 30 individuals with COPD (57% were men; mean age was 69 ± 6 years; and mean FEV1 was 53 ± 18% of predicted) to evaluate internal consistency and test-retest reliability. Participants also completed the International Physical Activity Questionnaire (IPAQ), the modified Medical Research Council scale, the COPD Assessment Test, and Saint George's Respiratory Questionnaire to evaluate criterion validity. Results: The C-PPAC instrument showed good internal consistency and excellent test-retest reliability: "amount" domain = 0.87 (95% CI, 0.73-0.94) and "difficulty" domain = 0.90 (95% CI, 0.76-0.96). Bland & Altman plots, together with high Lin's concordance correlation coefficients, reinforced that agreement. Criterion validity showed moderate-to-strong correlations of the C-PPAC with all of the other instruments evaluated, especially with the IPAQ (rho = −0.63). Conclusions: The Brazilian Portuguese version of the C-PPAC is a reliable and valid instrument for evaluating the experience of Brazilian individuals with COPD with their physical activity in daily life.

RESUMO Objetivo: Adaptar o instrumento PROactive Physical Activity in COPD - clinical visit (C-PPAC) ao contexto cultural brasileiro e determinar a validade de critério, concordância da confiabilidade teste-reteste e consistência interna dessa versão. Métodos: Um protocolo de adaptação cultural e validação foi fornecido pelos autores do instrumento original e, juntamente com outra diretriz, foi aplicado em uma versão em português desenvolvida por um grupo de pesquisa parceiro de Portugal. A versão brasileira adaptada foi então aplicada transversalmente duas vezes, com intervalo de sete dias, em 30 indivíduos com DPOC (57% de homens; média de idade de 69 ± 6 anos; e média do VEF1 de 53 ± 18% do previsto) para avaliação da consistência interna e da confiabilidade teste-reteste. Os participantes também responderam ao International Physical Activity Questionnaire (IPAQ), à escala modificada do Medical Research Council, ao COPD Assessment Test e ao Saint George's Respiratory Questionnaire para avaliação da validade de critério. Resultados: O instrumento C-PPAC apresentou boa consistência interna e excelente confiabilidade teste-reteste: domínio "quantidade" = 0,87 (IC95%: 0,73-0,94) e domínio "dificuldade" = 0,90 (IC95%: 0,76-0,96). As disposições gráficas de Bland-Altman, juntamente com os altos coeficientes de correlação de concordância de Lin, reforçaram essa concordância. A validade de critério mostrou correlações moderadas a fortes do instrumento C-PPAC com todos os outros instrumentos avaliados, principalmente com o IPAQ (rho = −0,63). Conclusões: A versão brasileira do instrumento C-PPAC é uma ferramenta confiável e válida para avaliar a experiência de indivíduos brasileiros com DPOC em relação à sua atividade física na vida diária.

The modeling of the reaction cross sections in the production of teranositic radionuclides / La modelación de las secciones eficaces de reacción en la producción de radionúclidos teranosíticos

Abstract We utilize various nuclear reaction codes with the aim to guide, interpret, and support the experiments in the proton-induced production measurements of radionuclides for the development of innovative radio-pharmaceuticals. The understanding of reaction cross sections at low-intermediate energies is crucial in this context and requires the knowledge of nuclear models available in different codes, such as EMPIRE, TALYS, and FLUKA. These nuclear reaction codes serve as tool to interpret the measurement of production cross-sections and to complete the measurements with estimates of production of contaminants and/or stable isotopes that are difficult to measure. We illustrate different model calculations to simulate isotope production useful in experiments devoted to the measurement of proton-induced production of the two theranostic radio-isotopes 67Cu and 47Sc.

Resumen Utilizamos varios códigos de reacción nuclear con el objetivo de guiar, interpretar y respaldar los experimentos en las mediciones de producción de radionúclidos inducidas por protones para el desarrollo de productos radio-farmacéuticos innovadores. La comprensión de las secciones eficaces de reacción en energías intermedias bajas es crucial en este contexto y requiere el conocimiento de modelos nucleares disponibles en diferentes códigos, como EMPIRE, TALYS y FLUKA. Estos códigos de reacción nuclear sirven como herramienta para interpretar la medición de secciones eficaces de producción y para completar las mediciones con estimaciones de producción de contaminantes y / o isótopos estables que son difíciles de medir. Ilustramos diferentes cálculos de modelos para simular la producción de isótopos útiles en experimentos dedicados a la medición de la producción inducida por protones de los dos isótopos teranósticos 67Cu y 47Sc.

Bariatric Surgery Associated with Practice of Moderate to Intense Physical Activity Related to Weight Loss, Activity Level in Daily Life, Dyspnea, and Quality of Life of Sedentary Individuals with Morbid Obesity: a Prospective Longitudinal Study.

AIM: To evaluate the association of moderate-to-intense physical activity with the effects of bariatric surgery on weight loss, level of activities of daily living, dyspnea, and quality of life in sedentary individuals with grade II and III obesity. METHOD: Seventy-eight candidates for bariatric surgery were evaluated for anthropometry, dyspnea, quality of life, level of activities of daily living, and physical activity. After surgery, all patients were instructed to perform moderate-to-intense physical activity. All 78 patients were reassessed 6 months after bariatric surgery, and 52 patients were reassessed 3 years after bariatric surgery. RESULTS: Adherence to physical activity during the postoperative period was 36% at 6 months and 38% at 3 years. Compared with the patients who did not adhere to physical activity, weight loss was higher in the adherent patients at 6 months (29 ± 4% vs. 26 ± 5%; p = 0.01) and 3 years (32 ± 8% vs. 26 ± 6%, p = 0.005). The level of activities of daily living and quality of life also improved in the patients that adhered to physical activity at both 6 months and 3 years after bariatric surgery. However, no difference in dyspnea was observed between the adherent and non-adherent patients. Adherence to physical activity was an independent factor for postoperative weight loss. CONCLUSION: Moderate-to-intense physical activity after bariatric surgery increases weight loss, quality of life, and level of activities of daily living, but does not directly influence dyspnea in individuals with morbid obesity.

Cyclotron production of 67Cu: A new measurement of the 68Zn(p,2p)67Cu, 68Zn(p,2n)67Ga and 68Zn(p,3n)66Ga nuclear cross sections

The cross sections of the 68Zn(p,2p)67Cu,68Zn(p,2n)67Ga and 68Zn(p,3n)66Ga reactions were measured at the ARRONAX facility by using the 70 MeV cyclotron, with particular attention to the production of the theranostic radionuclide 67Cu. Enriched 68Zn material was electroplated on silver backing and exposed to alow-intensity proton beam by using the stacked-foils target method. Since 67Cu and 67Ga radionuclides have similar half-lives and same γ-lines (they both decay to 67Zn), a radiochemical process aimed at Cu/Ga separation was mandatory to avoid interferences in γ-spectrometry measurements. A simple chemical procedure having a high separation efficiency (>99%)was developed and monitored during each foil processing, thanks to the tracer isotopes 61Cu and 66Ga.Nuclear cross sections were measured in the energy range 35-70 MeV by using reference reactions recommended by the International Atomic Energy Agency (IAEA) to monitor beam flux. In comparison with literature data a general good agreement on the trend of the nuclear reactions was noted, especially with latest measurements, but slightly lower values were obtained in case of 67Cu. Experimental results of the 68Zn(p,2p)67Cu,68Zn(p,2n)67Ga and 68Zn(p,3n)66Ga reactions were also compared with the theoretical values estimated by using the nuclear reaction code TALYS. The production yield of the theranostic radionuclide 67Cu was estimated considering the results obtained in this work.

Las secciones eficaces de las reacciones 68Zn (p, 2p) 67Cu, 68Zn (p, 2n) 67Ga y 68Zn (p, 3n) 66Ga se midieron en la instalación ARRONAX utilizando el ciclotrón 70 MeV, con especial atención a la producción del radionucleidos teranóstico 67Cu. El material enriquecido 68Zn se galvanizó sobre soporte de plata y se expuso a un haz de protones de baja intensidad utilizando un blanco de láminas apiladas. Como los radionucleidos 67Cu y 67Ga tienen periodos de semidesintegración y líneas γ similares (ambos se desintegran a 67Zn), un proceso radioquímico dirigido a la separación Cu / Ga fue obligatorio para evitar interferencias en las mediciones de espectrometría γ. Se desarrolló un procedimiento químico simple con una alta eficiencia de separación (> 99%) durante cada procesamiento de la lámina, gracias a los isótopos trazadores 61Cu y 66Ga. Las secciones eficaces nucleares se midieron en el rango de energía de 35-70 MeV utilizando reacciones de referencia recomendadas por el Organismo Internacional de Energía Atómica (OIEA) para monitorear el flujo del haz. Al comparar con los datos de la literatura, se observó una buena concordancia en general con la tendencia de las reacciones nucleares, particularmente con las últimas mediciones, pero se obtuvieron valores ligeramente inferiores en el caso de 67Cu. Los resultados experimentales de las reacciones 68Zn (p, 2p) 67Cu, 68Zn (p, 2n) 67Ga y 68Zn (p, 3n) 66Ga también se compararon con los valores teóricos estimados usando el código de reacción nuclear TALYS. El rendimiento de producción del radionucleido teranóstico 67Cu se estimó considerando los resultados obtenidos en este trabajo.

Cyclotron production of 67Cu: A new measurement of the 68Zn(p,2p)67Cu, 68Zn(p,2n)67Ga and 68Zn(p,3n)66Ga nuclear cross sections / Producción de 67Cu en ciclotrón: una nueva medición de secciones eficaces nucleares de 68Zn(p,2p)67Cu, 68Zn(p,2n)67Ga and 68Zn(p,3n)66Ga

Abstract The cross sections of the 68Zn(p,2p)67Cu,68Zn(p,2n)67Ga and 68Zn(p,3n)66Ga reactions were measured at the ARRONAX facility by using the 70 MeV cyclotron, with particular attention to the production of the theranostic radionuclide 67Cu. Enriched 68Zn material was electroplated on silver backing and exposed to alow-intensity proton beam by using the stacked-foils target method. Since 67Cu and 67Ga radionuclides have similar half-lives and same γ-lines (they both decay to 67Zn), a radiochemical process aimed at Cu/Ga separation was mandatory to avoid interferences in γ-spectrometry measurements. A simple chemical procedure having a high separation efficiency (>99%)was developed and monitored during each foil processing, thanks to the tracer isotopes 61Cu and 66Ga.Nuclear cross sections were measured in the energy range 35-70 MeV by using reference reactions recommended by the International Atomic Energy Agency (IAEA) to monitor beam flux. In comparison with literature data a general good agreement on the trend of the nuclear reactions was noted, especially with latest measurements, but slightly lower values were obtained in case of 67Cu. Experimental results of the 68Zn(p,2p)67Cu,68Zn(p,2n)67Ga and 68Zn(p,3n)66Ga reactions were also compared with the theoretical values estimated by using the nuclear reaction code TALYS. The production yield of the theranostic radionuclide 67Cu was estimated considering the results obtained in this work.

Resumen Las secciones eficaces de las reacciones 68Zn (p, 2p) 67Cu, 68Zn (p, 2n) 67Ga y 68Zn (p, 3n) 66Ga se midieron en la instalación ARRONAX utilizando el ciclotrón 70 MeV, con especial atención a la producción del radionucleidos teranóstico 67Cu. El material enriquecido 68Zn se galvanizó sobre soporte de plata y se expuso a un haz de protones de baja intensidad utilizando un blanco de láminas apiladas. Como los radionucleidos 67Cu y 67Ga tienen periodos de semidesintegración y líneas γ similares (ambos se desintegran a 67Zn), un proceso radioquímico dirigido a la separación Cu / Ga fue obligatorio para evitar interferencias en las mediciones de espectrometría γ. Se desarrolló un procedimiento químico simple con una alta eficiencia de separación (> 99%) durante cada procesamiento de la lámina, gracias a los isótopos trazadores 61Cu y 66Ga. Las secciones eficaces nucleares se midieron en el rango de energía de 35-70 MeV utilizando reacciones de referencia recomendadas por el Organismo Internacional de Energía Atómica (OIEA) para monitorear el flujo del haz. Al comparar con los datos de la literatura, se observó una buena concordancia en general con la tendencia de las reacciones nucleares, particularmente con las últimas mediciones, pero se obtuvieron valores ligeramente inferiores en el caso de 67Cu. Los resultados experimentales de las reacciones 68Zn (p, 2p) 67Cu, 68Zn (p, 2n) 67Ga y 68Zn (p, 3n) 66Ga también se compararon con los valores teóricos estimados usando el código de reacción nuclear TALYS. El rendimiento de producción del radionucleido teranóstico 67Cu se estimó considerando los resultados obtenidos en este trabajo.

Evaluation of a new motion sensor in patients with chronic obstructive pulmonary disease.

OBJECTIVE: To assess the criterion validity and reproducibility of a new pedometer in patients with chronic obstructive pulmonary disease (COPD). DESIGN: Cross-sectional study. SETTING: Outpatient physiotherapy clinic from a university hospital. PARTICIPANTS: Patients with COPD (N=30; 17 men; forced expiratory volume in the first second, 44±17% predicted) were videotaped while performing 2 protocols: one including 2 slow and 2 fast 5-minute walks, and another including a circuit of activities of daily living (ADLs). Concomitantly, patients wore 2 motion sensors: the new pedometer and a multisensor accelerometer. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Step counting (SC), energy expenditure (EE), walking distance (WD), activity time (AT), and walking intensity (WI) registered by the pedometer were compared with video and the multisensor as criterion methods. RESULTS: Correlations between the pedometer and the criterion method were high for SC during slow and fast walking (r=.79 and r=.95) and for EE during fast walking (r=.83). Correlation was more modest for EE during slow walking (r=.65) and for WD and WI during both speeds (.47.79 for all). During the ADLs circuit, the pedometer underestimated AT by an average of 55% but provided an acceptable EE estimation in a group basis (average difference of 6% with the multisensor). CONCLUSIONS: In patients with COPD, the new pedometer analyzed in the present study is reproducible for most outcomes and highly valid for SC during slow and fast walking and EE during fast walking. The device's validity is more limited for EE during slow walking, and WD and WI at both speeds. Furthermore, during the performance of ADLs, it significantly underestimates activity time but provides an acceptable estimation of EE in a group basis.

Comparison of daily physical activity between COPD patients from Central Europe and South America.

BACKGROUND: In healthy elderly and adults, lower physical activity level in daily life has been associated with lower socio-economic level and non-Caucasian race. The objective of this study was to determine if this is also applicable in chronic obstructive pulmonary disease (COPD) by comparing physical activity levels in daily life in stable patients from two countries (Austria and Brazil) with different socio-economic and ethnic characteristics. METHODS: Physical activity in daily life was objectively assessed in 40 Austrian and 40 Brazilian COPD patients. Groups were matched for age, gender, body mass index, disease severity, smoking history, presence of concomitant heart disease, lung function, dyspnea and functional exercise capacity. In addition, climatic conditions were similar during the period of data collection in the two groups. RESULTS: In comparison to Brazilian patients, Austrian patients had a significantly lower walking time (p=0.04), higher sitting time (p=0.02) and lower movement intensity (p=0.0001). The proportion of patients who did not reach an average of 30min of walking per day was 48% in the Austrian group and 23% in the Brazilian group. CONCLUSIONS: Austrian patients with COPD showed a significantly lower daily physical activity level in comparison to matched Brazilian patients. Socio-economic and ethnic factors appear to influence stable COPD patients differently than described in previous studies including healthy subjects.

Relationship between pulmonary function and physical activity in daily life in patients with COPD.

BACKGROUND: It remains unclear how closely the physical inactivity observed in patients with Chronic Obstructive Pulmonary Disease (COPD) relates to the severity of their airflow limitation. Furthermore, it is unknown whether spirometric variables such as maximal voluntary ventilation (MVV) and inspiratory capacity (IC) reflect the level of physical activity in daily life better than the forced expiratory volume in the first second (FEV(1)), the main spirometric variable used to determine the severity of COPD. The objective of the present study was to investigate the relationship between physical activity in daily life and the severity of COPD assessed by different spirometric variables: MVV, IC and FEV(1). METHODS: Forty patients with COPD (21 men; 68+/-7 years; FEV(1) 41+/-14% predicted) were performed spirometry and assessment of the physical activity level in daily life using an accelerometer (SenseWear Armband). RESULTS: MVV was significantly correlated to total energy expenditure per day, energy expenditure per day in activities demanding more than 3 metabolic equivalents (METs), number of steps per day and time spent per day in moderate and vigorous activities (0.42