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This study investigated biomechanical assessments in trail running, comparing two wearable devices-Stryd Power Meter and GARMINRP. With the growing popularity of trail running and the complexities of varied terrains, there is a heightened interest in understanding metabolic pathways, biomechanics, and performance factors. The research aimed to assess the inter- and intra-device agreement for biomechanics under ecological conditions, focusing on power, speed, cadence, vertical oscillation, and contact time. The participants engaged in trail running sessions while wearing two Stryd and two Garmin devices. The intra-device reliability demonstrated high consistency for both GARMINRP and StrydTM, with strong correlations and minimal variability. However, distinctions emerged in inter-device agreement, particularly in power and contact time uphill, and vertical oscillation downhill, suggesting potential variations between GARMINRP and StrydTM measurements for specific running metrics. The study underscores that caution should be taken in interpreting device data, highlighting the importance of measuring with the same device, considering contextual and individual factors, and acknowledging the limited research under real-world trail conditions. While the small sample size and participant variations were limitations, the strength of this study lies in conducting this investigation under ecological conditions, significantly contributing to the field of biomechanical measurements in trail running.
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Corrida , Dispositivos Eletrônicos Vestíveis , Humanos , Corrida/fisiologia , Fenômenos Biomecânicos/fisiologia , Masculino , Adulto , Feminino , Adulto Jovem , Reprodutibilidade dos TestesRESUMO
ABSTRACT: Rabal-Pelay, J, Gutiérrez, H, Bascuas, P-J, Pareja-Blanco, F, and Marco-Contreras, LA. Load-velocity relationship in the Bulgarian split-squat exercise. J Strength Cond Res XX(X): 000-000, 2024-The objective of the current research was to analyze the load-velocity relationship in the Bulgarian split-squat (BSS) exercise and to compare these relationships between the dominant and nondominant legs. Twenty-one strength-trained men (age: 27.3 ± 7.3 years) performed a progressive loading test in the BSS exercise using a Smith machine for each leg. The protocol began with a load of 30 kg, incrementally adding 10 kg until the mean propulsive velocity (MPV) fell below 0.4 m·s-1. At that point, 5 kg increments were employed, with a final addition of 2.5 kg for the last estimated attempt one-repetition maximum (1RM). A total of 324 lifts were analyzed. Subjects exhibited a relative strength ratio of 1.23 ± 0.10, a 1RM of 91.3 ± 14.2 kg, and a mean range of motion of 44.7 ± 3.7 cm. Polynomial regression analysis showed a robust relationship with an R2 value of 0.945 (ρ ≤ 0.001) between the relative load (%1RM) and MPV. Despite the differences in 1RM between the dominant and nondominant legs, there were no significant differences in MPV at the %1RM between both legs. These findings suggest that training intensity can be prescribed via the MPV during the BSS exercise. Moreover, the load-velocity relationship is stable between limbs despite the potential differences in absolute strength levels.
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ABSTRACT: Sánchez-Sabaté, J, Gutiérrez, H, Marco-Contreras, LA, Younes-Egana, O, Gonzalo-Skok, O, and Piedrafita, E. Influence of vertical-oriented vs. horizontal-oriented combined strength training in young basketball players. J Strength Cond Res 38(7): 1280-1287, 2024-This study aimed to compare the effects of 8-week combined vertical-oriented vs. horizontal-oriented training interventions in basketball athletes. Eighteen highly trained U-16 basketball players participated in this study and were randomly assigned to either a combined vertical-oriented training group (CVG, n = 9) or a combined horizontal-oriented training group (CHG, n = 9). Bilateral and unilateral vertical jump height, unilateral horizontal jump distance, 5-m, 10-m, and 20-m sprint times, change-of-direction sprint times, and a limb symmetry index were among the measured performance variables. Combined strength training was performed twice a week for 8 weeks. CVG was compounded by the squat exercise (3 sets of 6-8 R at 30-45% 1 repetition maximum [1RM]), jump squats (2 sets of 6 R, at 5-12.5% body mass [BM]), and vertical jumps (3-4 sets × 6 R). CHG included the hip thrust exercise (3 sets of 6-8 R at 30-45% 1RM), sled towing sprints (2-3 R, at 5-12.5% BM), and sprints (3-4 R of 20-m). Within-group differences showed significant ( p < 0.05 and statistical power >80%) improvements in unilateral vertical jumping with the right leg after both training interventions. By contrast, only CHG improved 5-m, 10-m, and 20-m sprint times ( p < 0.05 and statistical power >80%). Significant effects were observed for CHG compared with CVG in 5-m, 10-m, and 20-m sprint times ( p < 0.05 and statistical power >80%). This study reinforces the importance of oriented-combined training based on force-vector specificity target, mainly in horizontal-oriented actions.
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Desempenho Atlético , Basquetebol , Força Muscular , Treinamento Resistido , Humanos , Basquetebol/fisiologia , Treinamento Resistido/métodos , Desempenho Atlético/fisiologia , Adolescente , Masculino , Força Muscular/fisiologia , AtletasRESUMO
BACKGROUND: Although there are currently alternative treatments to the long-term use of oral corticosteroids (OCS) in severe asthma, recent studies show excessive use depending on geography and differences in medical practice. The objective of the study was to describe the differences in OCS use for severe asthma across the Spanish geography. METHODS: This is a real-world study using existing databases (year 2019): longitudinal patient database (EMR), based on electronic medical records, and database of pharmacological consumption (Sell-in) in basic healthcare areas. With EMR, the percentage of OCS prescriptions corresponding to patients with severe asthma (ICD-9 "asthma" and prescription of biological treatment and/or high dose of inhaled corticosteroids/long-acting inhaled ß2 agonists) was calculated. This percentage was transferred to the OCS consumption of each basic healthcare area as reported in the Sell-in database and a national heat map was created. The estimation of OCS use in patients with severe asthma per 100,000 inhabitants for each region was calculated by grouping basic healthcare areas and the mean OCS use per patient for different regions in Spain was also estimated. RESULTS: Patients with severe asthma in Spain were mostly female (69.6%), with a mean age (SD) of 57.6 years (18.01). Median time (Pc25-Pc75) since asthma diagnosis was 83.1 months (34.65-131.56). Of all patients with OCS prescriptions in 2019 identified in EMR, 4.4% corresponded to patients with severe asthma. Regions with the highest OCS use were Asturias, Andalucía, and Galicia, whereas those with the lowest use were Navarra, Baleares, Madrid and País Vasco. The mean OCS use per patient with severe asthma in 2019 throughout Spain was 1099.85 mg per patient, ranging from 782.99 mg in Navarra to 1432.64 in Asturias. CONCLUSIONS: There are geographical differences between Spanish regions with respect to the use of OCS in patients with severe asthma. The national mean consumption of OCS per patient with severe asthma and year is above the limits that indicate good asthma control.
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Antiasmáticos , Asma , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Espanha/epidemiologia , Temperatura Alta , Asma/tratamento farmacológico , Asma/epidemiologia , Asma/diagnóstico , Corticosteroides/uso terapêutico , Prescrições , Antiasmáticos/uso terapêuticoRESUMO
This paper describes the deployment, integration, and demonstration of a Smartphone Video Guidance Sensor (SVGS) as a novel technology for autonomous 6-DOF proximity maneuvers and precision landing of a quadcopter drone. The proposed approach uses a vision-based photogrammetric position and attitude sensor (SVGS) to estimate the position of a landing target after video capture. A visual inertial odometry sensor (VIO) is used to provide position estimates of the UAV in a ground coordinate system during flight on a GPS-denied environment. The integration of both SVGS and VIO sensors enables the accurate updating of position setpoints during landing, providing improved performance compared with VIO-only landing, as shown in landing experiments. The proposed technique also shows significant operational advantages compared with state-of-the-art sensors for indoor landing, such as those based on augmented reality (AR) markers.
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Real-time flight controllers are becoming dependent on general-purpose operating systems, as the modularity and complexity of guidance, navigation, and control systems and algorithms increases. The non-deterministic nature of operating systems creates a critical weakness in the development of motion control systems for robotic platforms due to the random delays introduced by operating systems and communication networks. The high-speed operation and sensitive dynamics of UAVs demand fast and near-deterministic communication between the sensors, companion computer, and flight control unit (FCU) in order to achieve the required performance. In this paper, we present a method to assess communications latency between a companion computer and an RTOS open-source flight controller, which is based on an XRCE-DDS bridge between clients hosted in the low-resource environment and the DDS network used by ROS2. A comparison based on the measured statistics of latency illustrates the advantages of XRCE-DDS compared to the standard communication method based on MAVROS-MAVLink. More importantly, an algorithm to estimate latency offset and clock skew based on an exponential moving average filter is presented, providing a tool for latency estimation and correction that can be used by developers to improve synchronization of processes that rely on timely communication between the FCU and companion computer, such as synchronization of lower-level sensor data at the higher-level layer. This addresses the challenges introduced in GNC applications by the non-deterministic nature of general-purpose operating systems and the inherent limitations of standard flight controller hardware.
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New and promising variables are being developed to analyze performance and fatigue in trail running, such as mechanical power, metabolic power, metabolic cost of transport and mechanical efficiency. The aim of this study was to analyze the behavior of these variables during a real vertical kilometer field test. Fifteen trained trail runners, eleven men (from 22 to 38 years old) and four women (from 19 to 35 years old) performed a vertical kilometer with a length of 4.64 km and 835 m positive slope. During the entire race, the runners were equipped with portable gas analyzers (Cosmed K5) to assess their cardiorespiratory and metabolic responses breath by breath. Significant differences were found between top-level runners versus low-level runners in the mean values of the variables of mechanical power, metabolic power and velocity. A repeated-measures ANOVA showed significant differences between the sections, the incline and the interactions between all the analyzed variables, in addition to differences depending on the level of the runner. The variable of mechanical power can be statistically significantly predicted from metabolic power and vertical net metabolic COT. An algebraic expression was obtained to calculate the value of metabolic power. Integrating the variables of mechanical power, vertical velocity and metabolic power into phone apps and smartwatches is a new opportunity to improve performance monitoring in trail running.
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Consumo de Oxigênio , Corrida , Masculino , Humanos , Feminino , Adulto Jovem , Adulto , Consumo de Oxigênio/fisiologia , Corrida/fisiologia , Metabolismo Energético , Fadiga , Fenômenos BiomecânicosRESUMO
Chronic obstructive pulmonary disease (COPD) patients due to biomass exposure (BE-COPD) could be more affected than COPD due to tobacco smoke (TE-COPD) by the coronavirus disease 2019 (COVID-19) pandemic. The aim of this work was to determine the prevalence of COVID-19 in BE-COPD and TE-COPD and if housing conditions, poor attitude, knowledge, and risk perception towards COVID-19, particularly in BE-COPD women, could represent a risk factor for contagion.An 11% prevalence of COVID-19 was found with no significant difference between COPD groups. The BE-COPD group showed poorer socioeconomic status. No significant differences were found to be associated with SARS-CoV-2 infection regarding housing conditions, poor knowledge, attitude, and risk perception towards COVID-19. Living in urban areas and perceiving risk in COVID-19 were significantly associated with increased adherence to sanitary measures and concern of contagion. Around 40% of all patients showed poor risk perception and adherence to sanitary measures towards COVID-19.
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COVID-19 , Doença Pulmonar Obstrutiva Crônica , Humanos , Feminino , Fumar/epidemiologia , Biomassa , Prevalência , COVID-19/epidemiologia , SARS-CoV-2 , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/etiologia , Fatores de Risco , PercepçãoRESUMO
Several aflatoxin inhibitors can modulate the antioxidant system in fungi. In this work, the effect of the ethanolic extract of Capsicum chinense and Piper nigrum fruits, capsaicin, and piperine on the expression of the aflE, aflG, aflH, aflI, aflK, aflL, aflO, aflP, and aflQ genes involved in the aflatoxin biosynthetic pathway in Aspergillus parasiticus were studied by qRT-PCR analysis. As well as, the effect on the expression of fungal antioxidant genes (sod1, catA, and cat2) and enzymatic activity of catalase (CAT) and superoxide dismutase (SOD). Results reveal that the highest (p < 0.05) radial growth inhibition (68 and 86%) and aflatoxins production inhibition (73 and 80%) was observed with capsaicin and piperine respectively, at 300 µg/mL, instead of the ethanolic extract at the same concentration. The qRT-PCR analysis showed that compounds and extracts at 300 µg/mL induced a down-regulation of aflatoxin genes and an up-regulation on the fungal antioxidant genes. CAT activity increased by 23.15, 36.65, 51.40, and 65.50%, in the presence of C. chinense and P. nigrum extract, capsaicin, and piperine exposure, respectively. While SOD activity was not significantly impacted (p > 0.05). In conclusion, the capsaicin and piperine, two antifungal and anti-aflatoxigenic compounds produce an up-regulation of antioxidant defense genes accompanied by an enhancement of catalase enzymatic activity in A. parasiticus.
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Aflatoxinas , Capsicum , Piper nigrum , Aflatoxinas/análise , Alcaloides , Antioxidantes/farmacologia , Aspergillus , Benzodioxóis , Capsaicina/farmacologia , Catalase/genética , Frutas/química , Piperidinas , Extratos Vegetais/farmacologia , Alcamidas Poli-Insaturadas , Superóxido Dismutase/genéticaRESUMO
Affinin present in Heliopsis longipes roots has been identified as an anti-aflatoxin molecule. However, its mechanism of action has yet to be clarified. Aflatoxins biosynthesis involves not less than 27 enzymatic reactions. In this work, the genes aflG, aflH, aflI, aflK, aflL, aflM, aflO, aflP, and aflQ of the aflatoxins cluster and the aflS gene encoding an internal regulatory factor involved in aflatoxins biosynthesis in Aspergillus parasiticus, were studied by qRT-PCR. Results demonstrated that ethanolic extract of H. longipes roots and affinin inhibit aflatoxin biosynthesis and fungal growth in a dose-dependent manner. At 300 µg/mL, ethanolic extract and affinin presented the highest inhibition of radial growth (86% and 94%) and aflatoxin production (68% and 80%). The qRT-PCR analysis demonstrated that nine tested genes were down-regulated by affinin and ethanolic extract. The most down-regulated was the aflK, a gene that encodes an enzyme cyclase with double function during the aflatoxin biosynthesis. While no significant down-regulation was obtaining for aflH gene. Exposure to affinin also resulted in decreased transcript levels of the internal regulator factor aflS. Based on our results, a model showing the regulatory mechanism in aflatoxin biosynthesis and its role in gene expression was proposed. In conclusion, affinin modulates the expression of several aflatoxin biosynthetic genes, leading to mycotoxin biosynthesis inhibition. Therefore, H. longipes roots is a suitable candidate to developed control strategies via lowering gene expressions as a future perspective in reducing aflatoxin contamination.
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Aflatoxinas , Aspergillus/genética , Asteraceae/química , Alcamidas Poli-Insaturadas , Regulação para Baixo , Raízes de PlantasRESUMO
The Smartphone Video Guidance Sensor (SVGS) is a vision-based sensor that computes the six-state position and orientation vector of a target relative to a coordinate system attached to a smartphone. This paper presents accuracy-characterization measurements of the Smartphone Video Guidance Sensor (SVGS) to assess its performance as a position and attitude estimator, evaluating its accuracy in linear and angular motion for different velocities and various types of targets based on the mean and standard deviation errors between SVGS estimates and known motion profiles, in both linear and angular motions. The study also examines the effects of target velocity and sampling rate on the overall performance of SVGS and provides an overall assessment of SVGS' performance as a position/attitude estimator. While the error metrics are dependent on range and camera resolution, the results of this paper can be scaled to other operational conditions by scaling the blob size in pixels (the light markers identified in the images) relative to the total resolution (number of pixels) of the image. The error statistics of SVGS enable its incorporation (by synthesis of a Kalman estimator) in advanced motion-control systems for navigation and guidance.
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Colombia is the country with the highest bird diversity in the world. Despite active research in ornithology, compelling morphological information of most bird species is still sparse. However, morphological information is the baseline to understand how species respond to environmental variation and how ecosystems respond to species loss. As part of a national initiative, the Instituto Alexander von Humboldt in collaboration with 12 Colombian institutions and seven biological collections, measured up to 15 morphological traits of 9,892 individuals corresponding to 606 species: 3,492 from individuals captured in field and 6,400 from museum specimens. Species measured are mainly distributed in high Andean forest, páramo, and wetland ecosystems. Seven ornithological collections in Colombia and 18 páramo complexes throughout Colombia were visited from 2013 to 2015. The morphological traits involved measurements from bill (total and exposed culmen, bill width and depth), wing (length, area, wingspan, and the distance between longest primary and longest secondary), tail (length and shape), tarsus (length), hallux (length and claw hallux), and mass. The number of measured specimens per species was variable, ranging from 1 to 321 individuals with a median of four individuals per species. Overall, this database gathered morphological information for >30% of Colombian bird diversity. No copyright, proprietary, or cost restrictions apply; the data should be cited appropriately when used.
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Aves , Ecossistema , Animais , Colômbia , Fenótipo , Áreas AlagadasRESUMO
BACKGROUND: There was a need for a solid asthma guideline in Mexico to update and unify asthma management. Because high-quality asthma guidelines exist worldwide, in which the latest evidence on asthma management is summarized, the ADAPTE approach allows for the development of a national asthma guideline based on evidence from already existing guidelines, adapted to national needs. OBJECTIVE: To fuse evidence from the best asthma guidelines and adapt it to local needs with the ADAPTE approach. METHODS: The Appraisal of Guidelines for Research and Evaluation (AGREE) II asthma guidelines were evaluated by a core group to select 3 primary guidelines. For each step of asthma management, clinical questions were formulated and replied according to (1) evidence in the primary guidelines, (2) safety, (3) Cost, and (4) patient preference. The Guidelines Development Group, composed of a broad range of experts from medical specialties, primary care physicians, and methodologists, adjusted the draft questions and replies in several rounds of a Delphi process and 3 face-to-face meetings, taking into account the reality of the situation in Mexico. We present the results of the pediatric asthma treatment part. RESULTS: Selected primary guidelines are from the British Thoracic Society and Scottish Intercollegiate Guidelines Network (BTS/SIGN), Global Initiative for Asthma (GINA), and Spanish Guidelines on the Management of Asthma (GEMA) 2015, with 2016 updates. Recommendations or suggestions were made for asthma treatment in Mexico. In this article, the detailed analysis of the evidence present in the BTS/SIGN, GINA, and GEMA sections on the (non) pharmacologic treatment of pediatric asthma, education, and devices are presented for 2 age groups: children 5 years or younger and children 6 to 11 years old with asthma. CONCLUSION: For the pediatric treatment and patient education sections, applying the AGREE II and Delphi methods is useful to develop a scientifically sustained document, adjusted to the Mexican situation, as is the Mexican Guideline on Asthma.
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Antiasmáticos/uso terapêutico , Asma/terapia , Gerenciamento Clínico , Asma/fisiopatologia , Criança , Pré-Escolar , Esquema de Medicação , Cálculos da Dosagem de Medicamento , Feminino , Humanos , Lactente , Masculino , México , Monitorização Fisiológica , Guias de Prática Clínica como AssuntoRESUMO
Aggression is an adaptive behavioral trait that is important for the establishment of social hierarchies and competition for mating partners, food, and territories. While a certain level of aggression can be beneficial for the survival of an individual or species, abnormal aggression levels can be detrimental. Abnormal aggression is commonly found in human patients with psychiatric disorders. The predisposition to aggression is influenced by a combination of environmental and genetic factors and a large number of genes have been associated with aggression in both human and animal studies. In this review, we compare and contrast aggression studies in zebrafish and mouse. We present gene ontology and pathway analyses of genes linked to aggression and discuss the molecular pathways that underpin agonistic behavior in these species. © 2015 Wiley Periodicals, Inc.
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Agressão/fisiologia , Agressão/psicologia , Animais , Comportamento Animal , Genótipo , Humanos , Camundongos/genética , Comportamento Social , Vertebrados , Peixe-Zebra/genéticaRESUMO
The house wren shows complex song, and the rufous-tailed hummingbird has a simple song. The location of vocal brain areas supports the song's complexity; however, these still need to be studied. The astrocytic population in songbirds appears to be associated with change in vocal control nuclei; however, astrocytic distribution and morphology have not been described in these species. Consequently, we compared the distribution and volume of the vocal brain areas: HVC, RA, Area X, and LMAN, cell density, and the morphology of astrocytes in the house wren and the rufous-tailed hummingbird. Individuals of the two species were collected, and their brains were analyzed using serial Nissl- NeuN- and MAP2-stained tissue scanner imaging, followed by 3D reconstructions of the vocal areas; and GFAP and S100ß astrocytes were analyzed in both species. We found that vocal areas were located close to the cerebral midline in the house wren and a more lateralized position in the rufous-tailed hummingbird. The LMAN occupied a larger volume in the rufous-tailed hummingbird, while the RA and HVC were larger in the house wren. While Area X showed higher cell density in the house wren than the rufous-tailed hummingbird, the LMAN showed a higher density in the rufous-tailed hummingbird. In the house wren, GFAP astrocytes in the same bregma where the vocal areas were located were observed at the laminar edge of the pallium (LEP) and in the vascular region, as well as in vocal motor relay regions in the pallidum and mesencephalon. In contrast, GFAP astrocytes were found in LEP, but not in the pallidum and mesencephalon in hummingbirds. Finally, when comparing GFAP astrocytes in the LEP region of both species, house wren astrocytes exhibited significantly more complex morphology than those of the rufous-tailed hummingbird. These findings suggest a difference in the location and cellular density of vocal circuits, as well as morphology of GFAP astrocytes between the house wren and the rufous-tailed hummingbird.
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BACKGROUND: Factors associated with severe COVID-19 infection have been identified; however, the impact of infection on longer-term outcomes is unclear. The objective of this study was to examine the impact of COVID-19 infection on the trajectory of lung function and nutritional status in people with cystic fibrosis (pwCF). METHODS: This is a retrospective global cohort study of pwCF who had confirmed COVID-19 infection diagnosed between January 1, 2020 and December 31, 2021. Forced expiratory volume in one second percent predicted (ppFEV1) and body mass index (BMI) twelve months prior to and following a diagnosis of COVID-19 were recorded. Change in mean ppFEV1 and BMI were compared using a t-test. A linear mixed-effects model was used to estimate change over time and to compare the rate of change before and after infection. RESULTS: A total of 6,500 cases of COVID-19 in pwCF from 33 countries were included for analysis. The mean difference in ppFEV1 pre- and post-infection was 1.4 %, (95 % CI 1.1, 1.7). In those not on modulators, the difference in rate of change pre- and post-infection was 1.34 %, (95 % CI -0.88, 3.56) per year (p = 0.24) and -0.74 % (-1.89, 0.41) per year (p = 0.21) for those on elexacaftor/tezacaftor/ivacaftor. No clinically significant change was noted in BMI or BMI percentile before and after COVID-19 infection. CONCLUSIONS: No clinically meaningful impact on lung function and BMI trajectory in the year following infection with COVID-19 was identified. This work highlights the ability of the global CF community to unify and address critical issues facing pwCF.
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Scanning acoustic microscopy (SAM) technique has been applied to defect inspection in electronic devices. With the increase of packaging density, detection of the micro-defects in high density devices becomes more and more challenging. The SAM test is suffering from sacrificing the spatial resolution to reach a certain penetration depth of the ultrasonic waves. So it is necessary to enhance the resolution level of the SAM image. In this paper, a wavelet based resolution enhancement technique was investigated to reconstruct a high quality image for SAM test of the flip chip packages. The stationary wavelet transform was adopted to decompose the captured SAM image into four frequency subbands, and the high frequency subbands were enhanced by adding the difference matrix in the intermediate stage, and a super resolution SAM image was derived from combining all the subbands by using the Inverse Discrete Wavelet Transform. Then the solder joints segmented from the SR-SAM image were classified by using the SVM algorithm. The results validated that the proposed technique is effective to improve the detection accuracy of SAM test.
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Background: Some infants undergoing newborn screening (NBS) tests have inconclusive sweat chloride test (SCT) results that lead to the designation of Cystic Fibrosis Screen Positive, Inconclusive Diagnosis/CFTR-related metabolic syndrome (CFSPID/CRMS). Some proportion of them transition to a CF diagnosis, but no predictive markers can stratify which are at risk for this transition. We report single-center outcomes of children with CRMS. Methods: We retrospectively identified all infants born in Alabama from 2008 through 2020 referred to our CF Center with an elevated immunoreactive trypsinogen level (IRT) associated with a cystic fibrosis transmembrane conductance regulator (CFTR) mutation (IRT+/DNA+) who had at least one SCT result documented. Infants were classified per established guidelines as Carrier, CRMS, or CF based on the IRT+/DNA+ and SCT results. The electronic health record was reviewed for follow-up visits until the children received a definitive diagnosis (to carrier or CF) according to current diagnostic guidelines for CF, or through the end of the 2020 year. Results: Of the 1,346 infants with IRT+ and at least 1 CFTR mutation identified (IRT+/DNA+), 63 (4.7%) were designated as CRMS. Of these infants, 12 (19.1%) transitioned to Carrier status (CRMS-Carrier), 40 (63.5%) of them remained CRMS status (CRMS-Persistent) and 11 (17.5%) of them transitioned to a diagnosis of CF (CRMS-CF). Of the 11 children in the CRMS-CF group, 4 (36%) had an initial SCT 30-39â mmol/L, 4 (36%) had an initial SCT 40-49â mmol/L and 3 (27%) had an initial SCT 50-59â mmol/L. These children also had higher initial sweat tests and greater yearly increases in sweat chloride values than others with CRMS. We found that in comparison to children in the CRMS-P group, a greater proportion of children in the CRMS-CF group cultured bacteria like methicillin-resistant Staphylococcus aureus, Stenotrophomonas maltophilia, and Pseudomonas aeruginosa, had smaller weight-for-height percentiles and remained smaller over time despite slightly greater growth. Conclusion: Infants with an inconclusive diagnosis of CF should continue to receive annual care and management given their potential risk of transition to CF. Further research is needed to assess whether certain phenotypic patterns, clinical symptoms, diagnostic tests or biomarkers could better stratify these children.
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BACKGROUND: Previously, we adapted a mobile health platform (Genia) to the needs of patients and families in a pediatric CF center in the United States. In this feasibility study, we tested the impact of Genia on measures of patient-centered care. METHODS: In a one-group pre-post study with adolescents with CF and caregivers of children with CF, we tested Genia's effect over 6 months on patient satisfaction with chronic illness care (PACIC) and shared decision-making (CollaboRate). Feasibility and acceptability were assessed with exit interviews and app analytics. RESULTS: The intervention included 40 participants: 30 caregivers of children with CF age ≤14 years and 10 patients with CF age ≥15 years. The use of Genia was associated with increased satisfaction with care (p = 0.024), including delivery system and decision support (p = 0.017), goal setting (p = 0.006), and shared decision-making (p<0.001). The use of Genia was associated with nominal improvements in all QOL domains and symptom scales. The platform was feasible, with participants recording more than 4,400 observations (mean 84.2) and submitting 496 weekly reports (mean 13.8) and 70 quarterly reports (mean 1.8), and acceptable (95% retention rate). For participants, the most useful app feature was pre-visit reports (66.7%), and the top symptom trackers were those for cough (23.7%), appetite (21.1%), energy (18.4%), and medicines (18.4%). CONCLUSION: The use of Genia over 6 months was feasible, acceptable, and associated with improved measures of patient-centered care. Study results support wider use of Genia in clinical settings. Efficacy for clinical outcomes should be assessed in a randomized clinical trial.
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Fibrose Cística , Autogestão , Telemedicina , Adolescente , Criança , Humanos , Fibrose Cística/terapia , Assistência Centrada no Paciente , Qualidade de VidaRESUMO
This study investigates electrospun fibers of metal-organic frameworks (MOFs), particularly CuBTC and ZIF-8, in polyacrylonitrile (PAN) for the solid-phase extraction (SPE) of Tamoxifen (TAM) and its metabolites (NDTAM, ENDO, and 4OHT) from human blood plasma. The focus is on the isolation, pre-concentration, and extraction of the analytes, aiming to provide a more accessible and affordable breast cancer patient-monitoring technology. The unique physicochemical properties of MOFs, such as high porosity and surface area, combined with PAN's stability and low density, are leveraged to improve SPE efficiency. The study meticulously examines the interactions of these MOFs with the analytes under various conditions, including elution solvents and protein precipitators. Results reveal that ZIF-8/PAN composites outperform CuBTC/PAN and PAN alone, especially when methanol is used as the protein precipitator. This superior performance is attributed to the physicochemical compatibility between the analytes' properties, like solubility and polarity, and the MOFs' structural features, including pore flexibility, active site availability, surface polarity, and surface area. The findings underscore MOFs' potential in SPE applications and provide valuable insights into the selectivity and sensitivity of different MOFs towards specific analytes, advancing more efficient targeted extraction methods in biomedical analysis.