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2.
J Rehabil Med ; 52(9): jrm00100, 2020 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-32896863

RESUMO

OBJECTIVE: We present a case report that complements the conclusion of Stam et al. in their call to rehabilitation facilities to anticipate and prepare to address post intensive care syndrome in post-Covid-19 patients. METHODS: The case report presented here provides insight into treating mechanically ventilated post-Covid-19 patients. RESULTS: Early intervention with dysphagia therapy and speech therapy and ventilator-compatible speak-ing valves, provided within an interprofessional collaborative team, can mitigate the potentially negative consequences of prolonged intubation, long-term use of cuffed tracheostomy, and post intensive care syndrome resulting from Covid-19. CONCLUSION: Such a treatment approach can be used to address what is important to patients: to be able to speak with family and friends, eat what they want, and breathe spontaneously.


Assuntos
Infecções por Coronavirus/reabilitação , Transtornos de Deglutição/reabilitação , Terapia da Linguagem/métodos , Pneumonia Viral/reabilitação , Pneumologia/métodos , Fonoterapia/métodos , Betacoronavirus , Infecções por Coronavirus/virologia , Cuidados Críticos , Transtornos de Deglutição/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Equipe de Assistência ao Paciente , Pneumonia Viral/virologia , Respiração , Respiração Artificial/efeitos adversos , Fala , Síndrome , Traqueostomia/efeitos adversos , Traqueostomia/métodos
3.
Crit Care Resusc ; 22(3): 212-220, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32900327

RESUMO

OBJECTIVE: To quantify aerosol generation from respiratory interventions and the effectiveness of their removal by a personal ventilation hood. DESIGN AND SETTING: Determination of the aerosol particle generation (in a single, healthy volunteer in a clean room) associated with breathing, speaking, wet coughing, oxygen (O2) 15 L/min via face mask, O2 60 L/min via nasal prongs, bilevel non-invasive positive-pressure ventilation (BiPAP) and nebulisation with O2 10 L/min. INTERVENTIONS: Aerosol generation was measured with two particle sizer and counter devices, focusing on aerosols 0.5-5 µm (human-generated aerosols), with and without the hood. An increase from baseline of less than 0.3 particles per mL was considered a low level of generation. MAIN OUTCOME MEASURES: Comparisons of aerosol generation between different respiratory interventions. Effectiveness of aerosol reduction by a personal ventilation hood. RESULTS: Results for the 0.5-5 µm aerosol range. Quiet breathing and talking demonstrated very low increase in aerosols (< 0.1 particles/mL). Aerosol generation was low for wet coughing (0.1 particles/mL), O2 15 L/min via face mask (0.18 particles/mL), and high flow nasal O2 60 L/min (0.24 particles/mL). Non-invasive ventilation generated moderate aerosols (29.7 particles/mL) and nebulisation very high aerosols (1086 particles/mL); the personal ventilation hood reduced the aerosol counts by 98% to 0.5 particles/mL and 8.9 particles/mL respectively. CONCLUSIONS: In this human volunteer study, the administration of O2 15 L/min by face mask and 60 L/min nasal therapy did not increase aerosol generation beyond low levels. Non-invasive ventilation caused moderate aerosol generation and nebulisation therapy very high aerosol generation. The personal ventilation hood reduced the aerosol counts by at least 98%.


Assuntos
Aerossóis , Pulmão/metabolismo , Máscaras , Oxigênio , Respiração , Administração por Inalação , Humanos , Pulmão/diagnóstico por imagem , Resultado do Tratamento
4.
Sci Adv ; 6(36)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32917603

RESUMO

Mandates for mask use in public during the recent coronavirus disease 2019 (COVID-19) pandemic, worsened by global shortage of commercial supplies, have led to widespread use of homemade masks and mask alternatives. It is assumed that wearing such masks reduces the likelihood for an infected person to spread the disease, but many of these mask designs have not been tested in practice. We have demonstrated a simple optical measurement method to evaluate the efficacy of masks to reduce the transmission of respiratory droplets during regular speech. In proof-of-principle studies, we compared a variety of commonly available mask types and observed that some mask types approach the performance of standard surgical masks, while some mask alternatives, such as neck gaiters or bandanas, offer very little protection. Our measurement setup is inexpensive and can be built and operated by nonexperts, allowing for rapid evaluation of mask performance during speech, sneezing, or coughing.


Assuntos
Infecções por Coronavirus/prevenção & controle , Filtração/estatística & dados numéricos , Máscaras/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Humanos , Imagem Óptica , Respiração , Fala
5.
AMA J Ethics ; 22(1): E739-740, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32880365

RESUMO

This painting memorializes the lives of people who died in the COVID-19 pandemic and people who have died from police brutality.


Assuntos
Infecções por Coronavirus , Homicídio , Medicina nas Artes , Pandemias , Pneumonia Viral , Polícia , Racismo , Beneficência , Betacoronavirus , Infecções por Coronavirus/mortalidade , Empatia , Esperança , Humanos , Vida , Obras Pictóricas como Assunto , Pneumonia Viral/mortalidade , Respiração , Taraxacum
8.
PLoS One ; 15(8): e0237641, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32841260

RESUMO

It is now widely accepted that the perception of emotional expression in music can be vastly different from the feelings evoked by it. However, less understood is how the locus of emotion affects the experience of music, that is how the act of perceiving the emotion in music compares with the act of assessing the emotion induced in the listener by the music. In the current study, we compared these two emotion loci based on the psychophysiological response of 40 participants listening to 32 musical excerpts taken from movie soundtracks. Facial electromyography, skin conductance, respiration and heart rate were continuously measured while participants were required to assess either the emotion expressed by, or the emotion they felt in response to the music. Using linear mixed effects models, we found a higher mean response in psychophysiological measures for the "perceived" than the "felt" task. This result suggested that the focus on one's self distracts from the music, leading to weaker bodily reactions during the "felt" task. In contrast, paying attention to the expression of the music and consequently to changes in timbre, loudness and harmonic progression enhances bodily reactions. This study has methodological implications for emotion induction research using psychophysiology and the conceptualization of emotion loci. Firstly, different tasks can elicit different psychophysiological responses to the same stimulus and secondly, both tasks elicit bodily responses to music. The latter finding questions the possibility of a listener taking on a purely cognitive mode when evaluating emotion expression.


Assuntos
Atenção , Percepção Auditiva/fisiologia , Emoções/fisiologia , Músculos Faciais/fisiologia , Resposta Galvânica da Pele , Música/psicologia , Psicofisiologia , Respiração , Adulto , Feminino , Frequência Cardíaca , Humanos , Masculino
10.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(8): 839-843, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-32800030

RESUMO

OBJECTIVE: To study the characteristics of pulmonary function in children with pertussis-like coughing caused by different pathogen infections. METHODS: The data on etiology and tidal breathing pulmonary function were collected from 95 hospitalized infants and young children with pertussis-like coughing. The tidal breathing pulmonary function was compared between these children and 67 healthy children. According to the type of pathogen, the children with pertussis-like coughing were classified to 6 groups: pertussis (n=17), viral infection (n=23), tuberculosis infection (n=6), Mycoplasma infection (n=9), other bacterial infection (n=8), and unknown pathogen (n=32). RESULTS: Among the 95 children with pertussis-like coughing, 15 (16%) had mild obstructive ventilatory dysfunction, 30 (32%) had moderate obstructive ventilatory dysfunction, and 22 (23%) had severe obstructive ventilatory dysfunction. Compared with the normal control group, the children with pertussis-like coughing had significant reductions in inspiratory-to-expiratory time ratio, ratio of time to peak tidal expiratory flow to total expiratory time (tPF%tE), and ratio of volume to peak tidal expiratory flow to total expiratory volume (vPF%vE) (P<0.05). The tuberculosis infection and Mycoplasma infection groups had a significantly lower tidal volume than the normal control group (P<0.05). All pathogen infection groups except the tuberculosis infection group had significantly lower tPF%tE and vPF%vE than the normal control group (P<0.05). The pertussis group had significantly lower tPF%tE and vPF%vE than the other infection groups (P<0.05). CONCLUSIONS: Most of children with pertussis-like coughing have abnormal pulmonary functions. The children with Bordetella pertussis infection have the most severe pulmonary function impairment. Tidal breathing pulmonary function test may provide a reference for pathogen analysis of children with pertussis-like coughing.


Assuntos
Coqueluche , Criança , Pré-Escolar , Humanos , Lactente , Pulmão , Respiração , Testes de Função Respiratória , Volume de Ventilação Pulmonar
11.
PLoS One ; 15(8): e0237756, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32797072

RESUMO

Mammalian olfactory receptor neurons in the nasal cavity are stimulated by odorants carried by the inhaled air and their activation is therefore tied to and driven by the breathing or sniffing frequency. Sniffing frequency can be deliberately modulated to alter how odorants stimulate olfactory receptor neurons, giving the animal control over the frequency of odorant exposure to potentially aid odorant detection and discrimination. We monitored sniffing behaviors and odorant discrimination ability of freely-moving mice while they sampled either decreasing concentrations of target odorants or sampled a fixed target odorant concentration in the presence of a background of increasing odorant concentrations, using a Go-NoGo behavioral paradigm. This allowed us to ask how mice alter their odorant sampling duration and sampling (sniffing) frequency depending on the demands of the task and its difficulty. Mice showed an anticipatory increase in sniffing rate prior to odorant exposure and chose to sample for longer durations when exposed to odorants as compared to the solvent control odorant. Similarly, mice also took more odorant sampling sniffs when exposed to target odorants compared to the solvent control odorant. In general, odorant sampling strategies became more similar the more difficult the task was, e.g. the lower the target odorant concentration or the lower the target odorant contrast relative to the background odorant, suggesting that sniffing patterns are not preset, but are dynamically modulated by the particular task and its difficulty.


Assuntos
Camundongos/fisiologia , Odorantes , Percepção Olfatória , Olfato , Animais , Comportamento Animal , Masculino , Odorantes/análise , Bulbo Olfatório/fisiologia , Neurônios Receptores Olfatórios/fisiologia , Respiração
12.
Artigo em Inglês | MEDLINE | ID: mdl-32605056

RESUMO

Individual respiratory protective devices and face masks represent critical tools in protecting health care workers in hospitals and clinics, and play a central role in decreasing the spread of the high-risk pandemic infection of 2019, coronavirus disease (COVID-19). The aim of the present study was to compare the facial skin temperature and the heat flow when wearing medical surgical masks to the same factors when wearing N95 respirators. A total of 20 subjects were recruited and during the evaluation, each subject was invited to wear a surgical mask or respirator for 1 h. The next day in the morning at the same hour, the same subject wore a N95 mask for 1 h with the same protocol. Infrared thermal evaluation was performed to measure the facial temperature of the perioral region and the perception ratings related to the humidity, heat, breathing difficulty, and discomfort were recorded. A significant difference in heat flow and perioral region temperature was recorded between the surgical mask and the N95 respirator (p < 0.05). A statistically significant difference in humidity, heat, breathing difficulty, and discomfort was present between the groups. The study results suggest that N95 respirators are able to induce an increased facial skin temperature, greater discomfort and lower wearing adherence when compared to the medical surgical masks.


Assuntos
Infecções por Coronavirus/prevenção & controle , Mãos , Máscaras , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Dispositivos de Proteção Respiratória , Temperatura Cutânea , Betacoronavirus , Pessoal de Saúde , Temperatura Alta , Humanos , Umidade , Raios Infravermelhos , Masculino , Pessoa de Meia-Idade , Respiração , Termografia
13.
PLoS One ; 15(6): e0235308, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32603336

RESUMO

BACKGROUND: Respiratory system diseases are some of the most common pathologies worldwide. Although osteopathic manual therapy (OMT) is used predominantly to treat other pathologies, certain OMT techniques have been shown to improve patients' respiratory function. OBJECTIVES: The aim of this study was to assess the influence of osteopathic techniques on breathing. METHODS: Tests were performed with the use of a spirometer and the results were expressed as Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), and Peak Expiratory Flow (PEF). Thirty healthy males and females between the age of 18 and 50 took part in the research. Fifteen individuals were randomly assigned to the experimental group and fifteen persons were assigned to the placebo group. The participants from the experimental group were treated with such osteopathic techniques aimed at the pulmonary system as the thoracic thrust (manipulations of vertebral joints and ribs), the sternal pump technique and stretching of the diaphragm. The placebo group was treated with soft tissue therapy (STT) techniques for the masseter muscle. RESULTS: The described set of osteopathic techniques exerts an influence on PEF in healthy individuals; however, it does not affect FVC and FEV1. CONCLUSION: Osteopathic techniques do not seem to improve lung health, as reflected in FEV1 and FVC, but they improve the respiratory function aspects reflected by PEF in the participants without any history of lung disease.


Assuntos
Manipulação Osteopática/métodos , Respiração , Adulto , Feminino , Volume Expiratório Forçado , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Medicina Osteopática , Pico do Fluxo Expiratório , Testes de Função Respiratória , Capacidade Vital , Adulto Jovem
14.
PLoS One ; 15(7): e0235600, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628711

RESUMO

Here we aimed for the first time to analyse whether opposite hatching patterns associated or not to high incubation temperature from day 13 to hatching interferes with the thermal preference and response of broilers to heat stress throughout the rearing period. Fertile eggs from 56-week-old broiler breeders (Cobb-500®) were used in a completely randomized trial with a 2x2 factorial arrangement (Short-Long and Long-Short hatching patterns: short time interval between internal and external pipping followed by long time interval between external pipping and hatching, and long time interval between internal and external pipping followed by short time interval between external pipping and hatching, respectively; and control and high incubation temperatures: 37.5°C and 39°C from the 13rd day, respectively). Thermal manipulation from day 13 was chosen because it is known endocrine axes are already established at this time. At hatching, male chicks were reared in climatical chamber with 16 boxes, maintained at the temperature recommended for this strain, with 4 replicates of 18 chicks per treatment. Broilers with Long-Short hatching pattern and from eggs incubation at 37.5°C preferred the lowest ambient temperature at all analyzed ages, whereas broilers with Short-Long hatching pattern and from eggs incubated at 39°C preferred the highest temperatures from 21 days of age. Heat-exposed broilers showed increased respiratory frequency in all ages analyzed, which should have to contributed to maintainance of their rectal (body) temperature. The hatching patterns did not influence the feed intake, but broilers with Short-Long hatching pattern had better feed conversion, weight gain, and body weight. High incubation temperature reduced the feed consumption, as well as the weight gain and body weight by worsening the feed conversion. The results of this study reveal that hatching patterns associated or not to high incubation temperature influence the broiler thermal preference and heat response throughout the rearing period. Chicks with Long-Short and Short-Long hatching patterns should be reared separately, although this is not practical within a hatcher.


Assuntos
Galinhas/fisiologia , Temperatura Alta , Animais , Reprodução , Respiração
15.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32680879

RESUMO

OBJECTIVES: Cardiorespiratory and pulse oximetry monitoring in children who are hospitalized should balance benefits of detecting deterioration with potential harms of alarm fatigue. We developed recommendations for monitoring outside the ICU on the basis of available evidence and expert opinion. METHODS: We conducted a comprehensive literature search for studies addressing the utility of cardiorespiratory and pulse oximetry monitoring in common pediatric conditions and drafted candidate monitoring recommendations based on our findings. We convened a panel of nominees from national professional organizations with diverse expertise: nursing, medicine, respiratory therapy, biomedical engineering, and family advocacy. Using the RAND/University of California, Los Angeles Appropriateness Method, panelists rated recommendations for appropriateness and necessity in 3 sequential rating sessions and a moderated meeting. RESULTS: The panel evaluated 56 recommendations for intermittent and continuous monitoring for children hospitalized outside the ICU with 7 common conditions (eg, asthma, croup) and/or receiving common therapies (eg, supplemental oxygen, intravenous opioids). The panel reached agreement on the appropriateness of monitoring recommendations for 55 of 56 indications and on necessity of monitoring for 52. For mild or moderate asthma, croup, pneumonia, and bronchiolitis, the panel recommended intermittent vital sign or oximetry measurement only. The panel recommended continuous monitoring for severe disease in each respiratory condition as well as for a new or increased dose of intravenous opiate or benzodiazepine. CONCLUSIONS: Expert panel members agreed that intermittent vital sign assessment, rather than continuous monitoring, is appropriate management for a set of specific conditions of mild or moderate severity that require hospitalization.


Assuntos
Eletrocardiografia , Monitorização Fisiológica/métodos , Oximetria , Guias de Prática Clínica como Assunto , Transtornos Respiratórios/fisiopatologia , Testes de Função Respiratória , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/farmacologia , Benzodiazepinas/efeitos adversos , Benzodiazepinas/farmacologia , Criança , Criança Hospitalizada , Técnica Delfos , Relação Dose-Resposta a Droga , Humanos , Oxigenoterapia , Respiração/efeitos dos fármacos , Transtornos Respiratórios/etiologia , Sepse/fisiopatologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-32645890

RESUMO

Background: Due to the importance of energy efficiency and economy in endurance performance, it is important to know the influence of different paddling cadences on these variables in the stand-up paddleboarding (SUP). The purpose of this study was to determine the effect of paddling at different cadences on the energy efficiency, economy, and physiological variables of international SUP race competitors. Methods: Ten male paddlers (age 28.8 ± 11.0 years; height 175.4 ± 5.1 m; body mass 74.2 ± 9.4 kg) participating in international tests carried out two test sessions. In the first one, an incremental exercise test was conducted to assess maximal oxygen uptake and peak power output (PPO). On the second day, they underwent 3 trials of 8 min each at 75% of PPO reached in the first test session. Three cadences were carried out in different trials randomly assigned between 45-55 and 65 strokes-min-1 (spm). Heart rate (HR), blood lactate, perceived sense of exertion (RPE), gross efficiency, economy, and oxygen uptake (VO2) were measured in the middle (4-min) and the end (8-min) of each trial. Results: Economy (45.3 ± 5.7 KJ·l-1 at 45 spm vs. 38.1 ± 5.3 KJ·l-1 at 65 spm; p = 0.010) and gross efficiency (13.4 ± 2.3% at 45 spm vs. 11.0 ± 1.6% at 65 spm; p = 0.012) was higher during de 45 spm condition than 65 spm in the 8-min. Respiratory exchange ratio (RER) presented a lower value at 4-min than at 8-min in 55 spm (4-min, 0.950 ± 0.065 vs. 8-min, 0.964 ± 0.053) and 65 spm cadences (4-min, 0.951 ± 0.030 vs. 8-min, 0.992 ± 0.047; p < 0.05). VO2, HR, lactate, and RPE were lower (p < 0.05) at 45 spm (VO2, 34.4 ± 6.0 mL·kg-1·min-1; HR, 161.2 ± 16.4 beats·min-1; lactate, 3.5 ± 1.0 mmol·l-1; RPE, 6.0 ± 2.1) than at 55 spm (VO2, 38.6 ± 5.2 mL·kg-1·min-1; HR, 168.1 ± 15.1 beats·min-1; lactate, 4.2 ± 1.2 mmol·l-1; RPE, 6.9 ± 1.4) and 65 spm (VO2, 38.7 ± 5.9 mL·kg-1·min-1; HR, 170.7 ± 13.0 beats·min-1; 5.3 ± 1.8 mmol·l-1; RPE, 7.6 ± 1.4) at 8-min. Moreover, lactate and RPE at 65 spm was greater than 55 spm (p < 0.05) at 8-min. Conclusion: International male SUP paddlers were most efficient and economical when paddling at 45 spm vs. 55 or 65 spm, confirmed by lower RPE values, which may likely translate to faster paddling speed and greater endurance.


Assuntos
Frequência Cardíaca/fisiologia , Consumo de Oxigênio/fisiologia , Oxigênio , Esforço Físico , Esportes Aquáticos , Adulto , Eficiência , Exercício Físico/fisiologia , Teste de Esforço , Humanos , Lactatos/sangue , Masculino , Pessoa de Meia-Idade , Respiração , Esportes Aquáticos/fisiologia
17.
Rev Mal Respir ; 37(7): 608-612, 2020 09.
Artigo em Francês | MEDLINE | ID: mdl-32600900
18.
Nat Commun ; 11(1): 3350, 2020 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-32620767

RESUMO

Odor landscapes contain complex blends of molecules that each activate unique, overlapping populations of olfactory sensory neurons (OSNs). Despite the presence of hundreds of OSN subtypes in many animals, the overlapping nature of odor inputs may lead to saturation of neural responses at the early stages of stimulus encoding. Information loss due to saturation could be mitigated by normalizing mechanisms such as antagonism at the level of receptor-ligand interactions, whose existence and prevalence remains uncertain. By imaging OSN axon terminals in olfactory bulb glomeruli as well as OSN cell bodies within the olfactory epithelium in freely breathing mice, we find widespread antagonistic interactions in binary odor mixtures. In complex mixtures of up to 12 odorants, antagonistic interactions are stronger and more prevalent with increasing mixture complexity. Therefore, antagonism is a common feature of odor mixture encoding in OSNs and helps in normalizing activity to reduce saturation and increase information transfer.


Assuntos
Misturas Complexas/farmacologia , Odorantes , Percepção Olfatória/fisiologia , Neurônios Receptores Olfatórios/fisiologia , Olfato/fisiologia , Animais , Antagonismo de Drogas , Feminino , Ligantes , Masculino , Camundongos , Microscopia de Fluorescência por Excitação Multifotônica , Bulbo Olfatório/citologia , Bulbo Olfatório/diagnóstico por imagem , Bulbo Olfatório/fisiologia , Mucosa Olfatória/citologia , Mucosa Olfatória/efeitos dos fármacos , Mucosa Olfatória/metabolismo , Percepção Olfatória/efeitos dos fármacos , Neurônios Receptores Olfatórios/efeitos dos fármacos , Terminações Pré-Sinápticas/fisiologia , Receptores Odorantes/metabolismo , Respiração , Olfato/efeitos dos fármacos
19.
Trials ; 21(1): 648, 2020 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-32665041

RESUMO

OBJECTIVES: Objective 1: To determine if it is feasible to conduct an RCT of online Sudarshan Kriya Yoga (SKY) for frontline hospital and long-term care home staff under the constraints imposed by the COVID-19 pandemic and need for remote trial monitoring. Objective 2: To assess whether online versions of SKY and/or Health Enhancement Program (HEP) result in improvement in self-rated measures of insomnia, anxiety, depression, and resilience. TRIAL DESIGN: This is an open-label feasibility randomized controlled trial (RCT), comparing an online breath based yogic intervention SKY versus an online control mind-body intervention HEP in frontline hospital and long-term care home staff managing the COVID-19 pandemic. PARTICIPANTS: Participants will include frontline hospital and long-term care home staff that are involved in the management of COVID-19 patients in London, Ontario, Canada. Participants will be willing and able to attend via online video conferencing software to participate in the study interventions. Participants must have an adequate understanding of English and be able to sit without physical discomfort for 60 minutes. INTERVENTION AND COMPARATOR: Sudarshan Kriya Yoga (SKY): The online version of SKY will be delivered by at least one certified Canadian SKY teacher, with at least one back up teacher at all times, under the supervision of Ms. Ronnie Newman, Director of Research and Health Promotion, Art of Living Foundation, USA. The online version of SKY for healthcare workers has a total duration of 3 hours. Phase I will consist of 5 self-paced online modules of 4-10 minutes each to learn the breath control techniques. Participants will be sent an online survey in REDCap requesting that they self-confirm completion of the Phase I modules. In Phase II, 2 interactive online sessions of 1 hour each will be held on consecutive days with a certified SKY teacher, during which participants will learn the fast, medium and slow breaths. For ease of scheduling, multiple time windows will be offered for Phase II. There will be at least one back up teacher at all times. Both Phase I and II will be completed in the first week. Health Enhancement Program (HEP): The active control arm, HEP, will consist of time-matched online self-paced modules for Phase I. Phase II will consist of mindfulness-based meditation sessions delivered by mental health staff. HEP will be an active treatment program that incorporates mind-body interventions. HEP will consist of time-matched online self-paced modules with psychoeducation on healthy active living as well as interactive modules comprising of guided de-stressing exercises including music therapy, mindfulness and progressive muscle relaxation. Weekly follow up sessions will be offered to all recruited participants for 30 minutes each for the subsequent 4 weeks in both study arms. MAIN OUTCOMES: The following feasibility outcomes will be measured at the end of the study: (1) rate of participant recruitment, (2) rate of retention, (3) completeness of data entry, (4) cost of interventions, and (5) unexpected costs. Such measures will be collected on a daily basis through-out the study and tabulated 5 weeks later at the end of the study. RANDOMISATION: Participants will be randomized after they have electronically signed the consent form and the research staff have confirmed eligibility. We will use REDCap to perform randomization in a 1:1 ratio as well as allocation concealment. REDCap is widely used by health researchers worldwide to significantly reduce data entry and study management errors to improve data fidelity. BLINDING (MASKING): All study participants will be blinded to the study hypotheses so as to prevent any expectation bias. Group allocation will be masked during analysis. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): This study will randomize a total of 60 participants in a 1:1 ratio to either SKY or HEP interventions. TRIAL STATUS: Protocol version number 2.0 (June 5, 2020). Recruitment is currently ongoing (starting June 25, 2020). We anticipate to complete recruitment by June 30, 2021 and complete the study by September 30, 2021. TRIAL REGISTRATION: ClinicalTrials.gov protocol ID NCT04368676 (posted April 30, 2020). FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Educação a Distância , Assistência de Longa Duração , Pneumonia Viral/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Respiração , Ioga , Estudos de Viabilidade , Humanos , Terapias Mente-Corpo , Avaliação de Resultados em Cuidados de Saúde , Pandemias
20.
PLoS One ; 15(6): e0230222, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32603332

RESUMO

Conservation efforts are increasingly being challenged by a rapidly changing environment, and for some aquatic species the use of captive rearing or selective breeding is an attractive option. However, captivity itself can impose unintended artificial selection known as domestication selection (adaptation to culture conditions) and is relatively understudied for most marine species. To test for domestication selection in marine bivalves, we focused on a fitness-related trait (larval starvation resistance) that could be altered under artificial selection. Using larvae produced from a wild population of Crassostrea virginica and a selectively bred, disease-resistant line we measured growth and survival during starvation versus standard algal diet conditions. Larvae from both lineages showed a remarkable resilience to food limitation, possibly mediated by an ability to utilize dissolved organic matter for somatic maintenance. Water chemistry analysis showed dissolved organic carbon in filtered tank water to be at concentrations similar to natural river water. We observed that survival in larvae produced from the aquaculture line was significantly lower compared to larvae produced from wild broodstock (8 ± 3% and 21 ± 2%, respectively) near the end of a 10-day period with no food (phytoplankton). All larval cohorts had arrested growth and depressed respiration during the starvation period and took at least two days to recover once food was reintroduced before resuming growth. Respiration rate recovered rapidly and final shell length was similar between the two treatments Phenotypic differences between the wild and aquaculture lines suggest potential differences in the capacity to sustain extended food limitation, but this work requires replication with multiple selection lines and wild populations to make more general inferences about domestication selection. With this contribution we explore the potential for domestication selection in bivalves, discuss the physiological and fitness implications of reduced starvation tolerance, and aim to inspire further research on the topic.


Assuntos
Crassostrea/fisiologia , Domesticação , Larva/fisiologia , Inanição/fisiopatologia , Animais , Carbono/metabolismo , Crassostrea/metabolismo , Larva/metabolismo , Nitrogênio/metabolismo , Respiração , Inanição/metabolismo
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