Search

This study includes determination Montelukast sodium by using flow injection chemiluminescence technique, the optimum concentrations were (150) ppm of magnesum ion, (5×10 -4 ) M luminol, (0.001) M hydrogen peroxide, linearity of concetraction (0.1-0.001) M that give the highest luminescence intensity, and correlation cofficient was (0.9054), The relative standard deviation RSD% (2.3) and detection limit (0.0001) M and relative error (0.018) ,the percent recovery (97%). http://dx.doi.org/10.25130/tjps.23.2018.033

Background The hippocampus is a brain structure important for memory and cognitive function. Physical activity may help prevent hippocampal atrophy. However, few studies have measured sedentary behavior (SB) and intensity-specific physical activity using an accelerometer. This study aimed to examine the cross-sectional associations of objectively-determined SB, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) measured by an accelerometer with hippocampal volume among community-dwelling older adults using compositional data analysis (CoDa) approach. Methods This cross-sectional study was part of the Neuron to Environmental Impact across Generations (NEIGE) study. A randomly recruited sample of 485 Japanese older adults (47% male; aged 65-84 years) wore tri-axial accelerometers (Omron Healthcare) for seven consecutive days in 2017. Hippocampal volume was measured with magnetic resonance imaging and the left and right hippocampal volumes were automatically segmented using FreeSurfer software. Associations of sedentary and physically active behaviors with hippocampal volume were examined with compositional linear regression analysis based on isometric log-ratio transformations of time use adjusted for potential confounding factors. Results The relative proportion of time spent in MVPA, compared to the other two activities, was significantly positively associated with right hippocampal volume (β: 57.1, p-value = 0.027).However, no association existed between higher proportions of MVPA and left hippocampal volume, or between proportions of SB or LPA with either left or right hippocampal volumes. Conclusions The proportion of time spent in MVPA, relative to the other two activities, was significantly positively associated with right hippocampal volume. MVPA may be beneficial for maintaining hippocampal volume.

Although income is an important predictor of life satisfaction, the precise forces that drive this relationship remain unclear. We propose that financial resources afford individuals a path to reducing the distressing impact of everyday hassles, thereby increasing one’s life satisfaction. More specifically, we hypothesize that financial scarcity is associated with greater distress intensity in everyday life. Furthermore, we propose that lower perceived control helps explain why financial scarcity predicts higher distress intensity and lower life satisfaction. We provide evidence for these hypotheses in a 30-day daily diary study (522 participants, 13,733 observations). A second study ( N = 376) further suggests that, although everyone relies on social support to ease stress, financial scarcity shrinks the sense one can use economic resources to reduce the adverse impact of daily hassles. Although money may not necessarily buy happiness, it reduces the intensity of stressors experienced in daily life—and thereby increases life satisfaction.

Motivation is considered important in the study of emotion regulation. However, it remains unknown whether and how varied motivation may influence people's emotion regulation choice. To address this question, 51 participants first performed a global-local task that measures attentional breadth. Then, they were required to choose emotion regulation strategies, reappraisal, or distraction, to regulate their emotion in emotional contexts that varied in motivational direction and intensity. We found that distraction was chosen more often over reappraisal in high-intensity-motivated emotion, while the reverse pattern was observed in low-intensity motivated emotion. Besides, withdrawal-motivated emotion was associated with more reappraisal choices than approach-motivated emotion, an effect that, however, vanished when valence was controlled. Furthermore, participants made fewer global choices, which is indicative of narrowed attentional breadth, during high- relative to low-intensity motivated emotional contexts, and attentional breadth partially mediated the effect of motivational intensity on emotion regulation choice. These findings suggest that increased motivation promotes one's choice of distraction over reappraisal during emotion regulation, by narrowing attentional breadth. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Applying theories of emotion to understanding the regulation of aversive parenting, we used microanalytic observational methods to test whether transient changes in a mother's negative emotional reactivity predict changes over time in key parameters of her moment-to-moment aversive behavior: its intensity, variability, persistence, and connection to difficult child inputs. At multiple times over 2 years, 319 divorcing mothers and their 5- to 12-year-old children were observed as they discussed mutual disagreements. Sequences of talk-turns were recorded and coded for affect and content. Relative to days when a mother was low in negative emotional reactivity, on days when she was high she displayed more intensely aversive behavior, more variable aversiveness, more transitions from average to high or low aversiveness, tendencies to remain aversive longer following spikes in her aversiveness, and difficulty maintaining low aversiveness following drops in her aversiveness. As her negative emotional reactivity increased, she went from being relatively unaffected by children's difficult behavior to being aversively reactive; from ceasing aversive sequences increasingly quickly to ceasing aversive sequences increasingly slowly; from deviating more from her nonreactive low-aversive parenting to deviating less from her reactive high-aversive parenting. Independent of stable individual differences in mothers and children, transient variations in mothers' emotional reactivity may correspond to key moment-to-moment parameters of aversive parenting, even when interactions are relatively noncontentious. The data provide a viable account of how initially transient, context-specific reactivity could initiate moment-to-moment changes in aversive patterns that in some families influence problematic family trajectories over time. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Purpose: To examine the associations of accelerometer-derived steps volume and intensity with hospitalizations and all-cause mortality in older adults. Methods: This prospective cohort study involved 768 community-dwelling Spanish older adults (78.8 § 4.9 years, mean § SD; 53.9% females) from the Toledo Study for Healthy Aging (2012 2017). The number of steps per day and step cadence (steps/min) were derived from a hip-mounted accelerometer worn for at least 4 days at baseline. Participants were followed-up over a mean period of 3.1 years for hospitalization and 5.7 years for all-cause mortality. Cox proportional hazards regression models were used to estimate the individual and joint associations between daily steps and stepping intensity with hospitalizations and all-cause mortality. Results: Included participants walked 5835 § 3445 steps/day (mean § SD) with an intensity of 7.3 § 4.1 steps/min. After adjusting for age, sex, body mass index (BMI), education, income, marital status and comorbidities, higher step count (hazard ratio (HR) = 0.95, 95% confidence inter vals (95%CI: 0.90 1.00, and HR = 0.87, 95%CI: 0.81 0.95 per additional 1000 steps) and higher step intensity (HR = 0.95, 95%CI: 0.91 0.99, and HR = 0.89, 95%CI: 0.84 0.95 per each additional step/min) were associated with fewer hospitalizations and all-cause mortality risk, respectively. Compared to the group having low step volume and intensity, individuals in the group having high step volume and intensity had a lower risk of hospitalization (HR = 0.72, 95%CI: 0.52 0.98) and all-cause mortality (HR = 0.60, 95%CI: 0.37 0.98). Conclusion: Among older adults, both high step volume and step intensity were significantly associated with lower hospitalization and all-cause mortality risk. Increasing step volume and intensity may benefit older people.

Souza, TSP, Pfeiffer, PAS, Pereira, JN, Pereira Neto, EA, Dutra, TS, Mendonca, MGL, and Cirilo-Sousa, MS. Immune system modulation in response to strength training with blood flow restriction. J Strength Cond Res XX(X): 000-000, 2019-This study aimed to compare the strength training with blood flow restriction (ST-BFR) to the multiple-set training at different intensities (30% of 1RM and 75% of 1RM) as for their effect on immunoinflammatory responses (total leukocytes, segmented neutrophils, lymphocytes, monocytes, and lymphocyte subpopulations). It is a randomized experimental study with a repeated measures design with inter and intragroup effects of a strength training session. Eighteen physically active adults aged 20-31 years (26.17 ± 3.7 years), apparently healthy, performed a strength training session with 2 exercises. Six milliliters of blood were collected before the training, immediately after the training, and at 30 minutes and 24 hours after the session to carry out the analyses. The results showed that the strength training could promote modulation (time effect) in the leukocyte count (F = 25.86, p < 0.01, η = 0.74), regardless of the method used. Neutrophils (F = 22.71, p < 0.01, η = 0.60), specifically the TCD4+ lymphocytes (F = 6.33, p < 0.05, η = 0, 3), were the main factors responsible for this variation. Despite the similarity, there were differences between the methods in the modulations of total leukocytes (F = 4.16, p < 0.05, η = 0.36) and neutrophils (F = 4.80, p < 0.05, η = 0.39). In conclusion, compared to the multiple-set training, ST-BFR produces immunoinflammatory responses similar to the low-intensity training and different from the high-intensity training. However, the demargination process of some cells was different depending on the method and intensity used. Nevertheless, these variations are compatible with an appropriate recovery process, because the amplitude and length of the modulation curves of leukocytes, and lymphocyte subpopulations were not compatible with immunosuppression.

PURPOSE To investigate the self-rated quality of vision (SQV) and optical phenomena intensity of three diffractive multifocal intraocular lenses (MIOLs). SETTING Department of Ophthalmology, Goethe University Frankfurt, Germany. DESIGN Prospective comparative case series. METHODS Patients who had bilateral implantation of a diffractive extended depth-of-focus (EDOF), trifocal or panfocal MIOL were assessed. Outcome parameters were SQV, symptom intensity of optical phenomena under three lighting conditions, quality of everyday lifestyle activities, spectacle independence (SI) and contrast sensitivity (CS). RESULTS The study comprised 108 eyes. The three lenses provide good total SQV under all lighting conditions. EDOF patients report a slightly better total SQV (EDOF: 9.8±6.67, Trifocal: 22.2±7.09, Panfocal: 19.6±16.25 VAS, p=0.041). A similar percentage of patients report the presence of optical phenomena with no difference between MIOLs (p>0.05). EDOF, trifocal and panfocal patients rate symptom intensity of optical phenomena mild to moderate under all lighting conditions, however EDOF patients reporting a lower symptom intensity of halos (p

BACKGROUND: Addressing intensity inhomogeneity is critical in magnetic resonance imaging (MRI) because associated errors can adversely affect post-processing and quantitative analysis of images (i.e., segmentation, registration, etc.), as well as the accuracy of clinical diagnosis. Although several prior methods have been proposed to eliminate or correct intensity inhomogeneity, some significant disadvantages have remained, including alteration of tissue contrast, poor reliability and robustness of algorithms, and prolonged acquisition time. OBJECTIVE: In this study, we propose an intensity inhomogeneity correction method based on volume and surface coils simultaneous reception (VSSR). METHODS: The VSSR method comprises of two major steps: 1) simultaneous image acquisition from both volume and surface coils and 2) denoising of volume coil images and polynomial surface fitting of bias field. Extensive in vivo experiments were performed considering various anatomical structures, acquisition sequences, imaging resolutions, and orientations. In terms of correction performance, the proposed VSSR method was comparatively evaluated against several popular methods, including multiplicative intrinsic component optimization and improved nonparametric nonuniform intensity normalization bias correction methods. RESULTS: Experimental results show that VSSR is more robust and reliable and does not require prolonged acquisition time with the volume coil. CONCLUSION: The VSSR may be considered suitable for general implementation.

This work analyzes the extratropical cyclone-related extreme waves in the ocean surface and their trends in the North and South Atlantic Oceans. Atmospheric and ocean wave products are obtained from ERA5, from 1979 to 2020 with 1-hourly outputs, covering 42 years with the present climate changes evaluated by the difference between the two 21-years time slices. The cyclones are tracked through the relative vorticity at 850 hPa and then associated with extreme wave events using an automated scheme that searches for an extreme wave region 1500 km from the centre of the cyclone, following criteria that exclude possible swell dominated events. The hot-spot regions of cyclone-related waves occurrence found by the method are in agreement with previous studies and are related to the cyclogenesis region and storm track orientation. Most cyclones associated with extreme wave events are generated in the western boundary of the domains. The east-poleward side of the ocean basins presents the highest density of occurrences related to the higher density of cyclone track and the dominance of more mature stage cyclones while in the west side prevail systems on developing stages, with notable propagating fronts and consequently, lower wind persistence. Changes in occurrence cannot be explained just by the storm track variation during the period due to the lack of statistical confidence. However, the wave occurrence responds to changes in the cyclone intensity, modulated by cyclone displacement speed. Regions with an increase of extreme waves are related to the effect of more intense cyclones or cyclones with slower propagation, being the last associated with a longer interaction of winds with the ocean surface.

The objective of this study was to assess the effectiveness and practicability of an activity index combining acceleration and location data for automated estrus detection in dairy cows. By using a wearable neck tag, measurements of acceleration and location were gathered from 22 multiparous cows monitored incessantly for 6 days to derive activity records of each cow. The maximum-minimum distance clustering (MMDC) method was used to divide hourly activity data into low, medium, high, and intensity level groups. The weighted sum of the proportions of the low, medium, high, and intensity activities in an hour constituted the activity level. The activity index was defined as the ratio of the variation in hourly activity level compared to the same time period during the previous three days. Furthermore, whether the cow was in estrus was judged above a set threshold. The study showed that the power consumption and communication effects of the neck tags were acceptable for indoor-housing conditions. For the two consecutive time periods, the activity-index-based detection algorithm achieved 90.91% for accuracy, 100% for precision, 100% for specificity, 83.33% for recall, 90.91% for F1 score, and 0.82 for Kappa coefficient. On the basis of these results, it can be concluded that the combination of acceleration and location in the activity index can promote estrus detection in dairy cows.

Muscle strength after detraining is still higher than the level before training, which is an important issue for middle-aged and older adults. The purpose of the present study was to examine the effects of detraining duration (DD), resistance training duration (RTD), and intensity on the maintenance of resistance training (RT) benefits after detraining in middle-aged and older adults. A systematic search yielded 15 randomized control trails (n = 383) eligible for inclusion. The results showed that RTD ≥ 24 weeks and DD ≥ RTD, the RT benefits were still significantly maintained even with medium and low intensity (standardized mean difference = 1.16, 95% confidence interval, CI [0.38, 1.94], p = .004). When RTD p = .0002; DD 8–16 weeks: standardized mean difference = 1.35, 95% CI [0.66, 2.04], p = .0001). However, when DD > RTD, the RT benefits were not maintained even with high intensity. In summary, when RTD was less than 24 weeks, RTD > DD was an important factor in maintaining muscle strength.

Dos Santos, WM, Tavares Junior, AC, Braz, TV, Lopes, CR, Brigatto, FA, and Dos Santos, JW. Resistance-trained individuals can underestimate the intensity of the resistance training session: An analysis among genders, training experience, and exercises. J Strength Cond Res 36(6): 1506-1510, 2022-Resistance training (RT) promotes improvements in healthy parameters for young to elderly adults and athletes' performance. Strength and muscle mass improvements are dependent on exercise intensity. This study verifies whether 53 healthy young adults underestimate exercise intensity in 3 different exercises, such as bench press (BP), biceps curl (BC), and leg press 45° (LP). Researchers asked the subjects "How much load do you use to perform 10 repetitions in this exercise usually in workout routines?" in each exercise. Individuals warmed up and then performed as many repetitions as possible until they reached the concentric failure. Deviations from data normality were found by using Levene's test; the number of repetitions per exercise within sex was tested by using Friedman's test and Conover's post hoc and Kruskal-Wallis tests to compare the number of repetitions between sex and RT experience. We correlated the number of repetitions and training experience using the Spearman test. The number of repetitions for both groups (male and female) is greater than 8-12 repetitions for BC and LP and BP of the female group, except for men who perform around 8-12 repetitions on BP. Frequency of maximal repetitions reached for 8-12 repetitions for women was 12% for BP, 28% for BC, and 28% for LP. The frequency men reached was 46.5% for BP, 14.3% for BC, and 14.3% for LP. Training experience did not influence the number of repetitions reached. Resistance training practitioners underestimate exercise load (56% of total sample) to be independent of experience. Women underestimate exercise load more than men. Based on the present results, it is possible to state that RT should not be prescribed considering a predefined number of repetitions and a linked percentage of loads, without the guidance for frequent adjustments of loads, according to the exercise performed.

Background Focusing on compression fractures of bone by finite elements, we evaluated bone strength based on the computed tomography-based finite element method. However, the exposure dose is an issue. We aimed to investigate the quantity of reduction of the radiation dose with respect to the reference dose by comparing the calculation results of compression fractures of the vertebral body using experimental data obtained from the spine of a pig. Methods Computed tomography images of a self-made phantom that enclosed the lower lumbar vertebra of edible wild pigs were obtained under baseline-dose conditions using various lower tube currents. Images obtained under reference-dose conditions were reconstructed using the filtered back-projection method, whereas images obtained under low-dose conditions were reconstructed using both the filtered back-projection method and the iterative reconstruction method. Computer simulations involving the creation of finite element models using all images were implemented for the compression load calculation for vertebral body parts. Based on the calculated results, images of the low-dose and reference-dose conditions were compared. Results Using pigs’ lower lumbar vertebrae, finite element model analysis of low-dose X-ray computed tomography images showed that equivalent results can be obtained with a dose of approximately 40% of the standard radiographic reference doses. As for the compression stress intensity, the same results as those under reference-dose conditions were obtained using the iterative reconstruction method in combination with computed tomography-based finite element method. Conclusions The combination of the iterative reconstruction method with the computed tomography-based finite element method is an effective image reconstruction method for achieving dose reduction.

There is controversial evidence regarding the effect of acute resistance exercise (ARE) on heart rate variability (HRV) parameters, which indicates the activities of the cardiac autonomic nervous system. The aim of this study was to perform a systematic review and meta-analysis of the literature on the effect of ARE on HRV parameters and identify its possible moderating factors.The PubMed-Medline, Web of Science, SPORTDiscus, and Cochrane Library databases were searched. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration was followed, and the methodological quality of the studies was evaluated. The level of significance was set at p ≤ 0.05. Twenty-six studies met the inclusion criteria. Main effect analyses between pre- and post-test interventions demonstrated an increase in normalized units low frequency (p0.001; standardized mean difference (SMD) = 0.78; 95% confidence interval (95%CI): 0.46‒1.11) and low frequency/high frequency ratio (p0.001; SMD = 0.82; 95%CI: 0.64‒0.99) and a decrease in standard deviation of the normal-to-normal (NN) interval (p0.001; SMD = -0.58; 95%CI: -0.85 to -0.30), root mean square of the successive differences (p0.001; SMD = -1.01; 95%CI: -1.29 to -0.74), and normalized units high frequency (p0.001; SMD: -1.08; 95%CI: -1.43 to -0.73) following ARE in healthy individuals range: 15 ± 1 to 48 ± 2 years; mean ± SD).There were differences between the subgroups in the number of sets used in an exercise (p = 0.05) for root mean square of the successive differences, as well as for exercise intensity (p = 0.01) and rest between sets (p = 0.05) for normalized units high frequency. Interestingly, there were differences between the subgroups in training volume for root mean square of the successive differences (p = 0.01), normalized units high frequency (p = 0.003) and normalized units low frequency (p = 0.02).Overall, there was a withdrawal of cardiac parasympathetic and activation of cardiac sympathetic modulations following ARE, and these changes were greater with higher training volume ∼30 min after ARE in healthy individuals. Furthermore, the number of sets, intensity, and rest between sets affected HRV parameters. However, gender, body mass index, and training status did not influence the changes in HRV parameters as a response to ARE.

This study aimed to investigate whether there is a systematic change of leg muscle activity, as quantified by surface electromyography (EMG), throughout a standard running footwear assessment protocol at a predetermined running speed.Thirty-one physically active adults (15 females and 16 males) completed 5 testing rounds consisting of overground running trials at a speed of 3.5 m/s. The level of muscle activity from 6 major leg muscles was recorded using surface EMG. The variables assessed were the EMG total intensity as a function of time and the cumulative EMG overall intensity. Systematic effects of the chronological testing round (independent variable) on the normalized EMG overall intensity (dependent variable) were examined using Friedman analysis of variates and post hoc pairwise Wilcoxon signed-rank tests (α = 0.05).There was a systematic reduction in overall EMG intensity for all 6 muscles over the time course of the running protocol (p0.001) until the fourth testing round when EMG intensities reached a steady state. The one exception was the biceps femoris muscle, which showed a significant reduction of EMG intensity during the stance phase (p0.001) but not the swing phase (p = 0.16).While running at a predetermined speed, the neuromuscular system undergoes an adaptation process characterized by a progressive reduction in the activity level of major leg muscles. This process may represent an optimization strategy of the neuromuscular system towards a more energetically efficient running style. Future running protocols should include a familiarization period of at least 7 min or 600 strides of running at the predetermined speed.

BACKGROUND: Bilateral strength asymmetry and fatigue predispose athletes to various injuries and conventional methods appear to be poor predictors of lower extremity muscular performance under NF conditions. OBJECTIVE: The purpose of the study was to compare the conventional Hcon/Qcon (HQR) ratio and the dynamic control ratio (DCR: Hecc/Qcon) under non-fatiguing (NF) and fatiguing (F) conditions and verify the effects of heavy-intensity constant running and cycling exercise on the isokinetic performance. METHODS: Twenty healthy male participants performed running and cycling VO2max at work-rate associated with the achievement of VO2max (TTE). Isokinetic muscle strength performance was tested at 60 and 180∘/s before and after these sessions with 48-hour intervals. Quadriceps (QFR) and hamstring (HFR) muscle fatigue rates were also calculated during these sessions. Blood lactate concentration was measured before and two-minutes after running and cycling TTE. RESULTS: No between-condition differences were found for the HQR while the DCR decreased significantly at 180∘/s following cycling and running sessions (p< 0.05). Cycling TTE was positively correlated with in dominant (r= 0.535, p= 0.015) and non-dominant (r= 0.446, p= 0.048) QFR. Positive correlations were also found between running TTE and dominant (r= 0.500, p= 0.25) and non-dominant (r= 0.465, p= 0.039) HFR. CONCLUSIONS: The DCR obtained at fast angular velocities following a strenuous exercise seems to be the best indicator of muscle performance while its assessment under F conditions reveals higher ratios compared to NF conditions and conventional methods.

Summary Purpose The aim of this study was to prove the hypothesis that intraoperative fluorescence-angiography using indocyanine-green (ICGFA) can be used to predict the occurrence of perfusion-associated complications following microvascular reconstruction. Materials and Methods Consecutively perioperative data of patients who received microvascular reconstruction of the head and neck region and underwent ICGFA immediately after anastomosis was established were analyzed. The flow parameters analyzed in the investigation were (1) the baseline (IntMin) and (2) peak intensity (IntMax) of fluorescence, (3) the quotient of the two aforementioned parameters (Fmax/min) as an expression of the relative total increase, (4) the absolute difference in the two parameters (DiffInt) in terms of amplitude, (5) the duration of the intensity increase (TRise) until the peak, and (6) the percent intensity increase per second (Rise/secrel). Within the first 2 weeks postoperatively, every flap complication was documented. Subsequently, statistical analysis of the flap outcome was performed based on the flow parameters obtained intraoperatively. Results Data of 67 patients (male/female: 41/26) with an average age of 64 years (range 29-84 years) were analyzed. In 10 of these patients, postoperative perfusion-associated complications were observed (arterial/venous/microcirculatory: 4/4/3; p=0.12). The analysis of the intraoperatively obtained flow parameters showed a significant difference in the ratio of maximum and minimum intensity in arterial pedicle perfusion (Fmax/min) of patients with and without complications (with vs. without complications: 2.3±1.0 vs. 5.0±4.9; p Conclusion The ratio of maximum and minimum intensity (Fmax/min) is a predictor for postoperative venous stasis, arterial hypoperfusion and impaired microcirculation of a microvascular flap. Anastomoses with Fmax/min

This paper reports the control method for the core power of the China initiative Accelerator Driven System (CiADS) facility. In the CiADS facility, an intense external neutron source provided by a proton accelerator coupled to a spallation target is used to drive a sub-critical reactor. Without any control rod inside the sub-critical reactor, the core power is controlled by adjusting the proton beam intensity. In order to continuously change the beam intensity, an adjustable aperture is considered to be used at the Low Energy Beam Transport (LEBT) line of the accelerator. The aperture size is adjusted based on the Proportional Integral Derivative (PID) controllers, by comparing either the setting beam intensity or the setting core power with the measured value. To evaluate the proposed control method, a CiADS core model is built based on the point reactor kinetics model with six delayed neutron groups. The simulations based on the CiADS core model have indicated that the core power can be controlled stably by adjusting the aperture size. The response time in the adjustment of the core power depends mainly on the adjustment time of the beam intensity.

BackgroundPalliative sedation is sometimes needed for refractory symptoms, and the Richmond Agitation-Sedation Scale (RASS) is one of the key measures. The primary aim of this study was to explore the association between the RASS score and degree of distress quantified by other measures: Support Team Assessment Schedule, item 2 (STAS), Discomfort Scale for Dementia of Alzheimer Type (Discomfort Scale), and Non-communicative Patient’s Pain Assessment Instrument (NOPPAIN), as well as a communication capacity measured by the Communication Capacity Scale, item 4 (CCS).MethodsThis was a prospective observational study on terminally ill cancer patients who received continuous infusion of midazolam to relieve refractory symptoms in a palliative care unit of a designated cancer hospital. Primarily responsible palliative care physicians rated RASS, Discomfort Scale, NOPPAIN, and CCS just before starting infusion, and 1 hour, 4 hours, 24 hours, and 48 hours after midazolam infusion, and ward nurses rated STAS at the same time. Since the ward nurses regularly evaluated STAS to titrate midazolam during palliative sedation as routine work, we regarded STAS rated by ward nurses as a standard of distress measure.ResultsA total of 249 assessments were performed for 55 patients. The RASS score was moderately to highly associated with symptom intensity measured by STAS, discomfort measured by the Discomfort Scale, and pain measured by NOPPAIN (r = 0.63 to 0.73). On the other hand, communication capacity measured by CCS is not parallel with the RASS score, and demonstrated a valley-shape. In 82 assessments with RASS of -1 to -3, 11 patients (13%) were regarded as having physical symptoms of STAS of 2 or more.Conclusions RASS can roughly estimate physical distress in patients receiving palliative sedation, but a measure to more precisely quantify the symptom experience is needed.

Focused airborne ultrasound provides various noncontact spatiotemporal pressure patterns on the skin. However, the presentation of static force remains an untouched issue because the static radiation force by ultrasound is too weak for the human hand to perceive. Hence, creatable sensations have been limited to vibrations or some dynamically changing feelings. This study demonstrates that a non-vibratory pressure sensation is presented by low-frequency Lateral Modulation (LM) with a fine spatial step width. LM is a pressure modulation method that moves a single ultrasound focus laterally and repetitively along the skin surface. The produced sensation in this study was not perfectly static, but the vibratory perception contained in the stimulus was significantly suppressed under a condition while maintaining its intense perception. We found the condition was 5 to 15 Hz in the LM frequency with a motion step width of less than 1 mm. In a comparison test in the most vibration-suppressed case, the participants reported 0.21 N as an equivalent force to the LM stimulus, significantly higher than the 0.027 N force physically applied by the ultrasound. The statistical analysis also showed that the step width of the LM had a significant effect on its vibratory sensation but not on the intensity of the evoked pressure sensation.

Based on the ERA5 reanalysis datasets during 1980–2019, a total of eleven zonal shear lines (ZSLs) that caused heavy precipitation and lasted more than 60 hours over the Tibetan Plateau in summer are selected for composite analysis. By decomposing the kinetic energy (K) near the ZSL into divergent and rotational kinetic energies (KD and KR) and the kinetic energy of interaction between the divergent wind and the rotational wind (KRD), the influence of the rotational and divergent winds on the evolution of the ZSL intensity is investigated from the perspective of KD and KR. The main results are as follows. The ZSL is a comprehensive reflection of rotation and convergence. The intensity evolution of ZSL is essentially synchronized with those of K, KR, and KRD but lags behind KD by about three hours. The enhancement of K is mainly contributed by KR, which is governed by the conversion from KD to KR. Furthermore, the increase in the conversion from KD to KR is controlled by the geostrophic effect term Af, which is determined by the joint enhancement of the zonal rotational and meridional divergent wind components (uR and vD). Therefore, the joint enhancement of uR and vD controls the increase of the ZSL intensity, leading to increased precipitation.

AIM To determine which acoustic parameters may be associated with vocal fatigue among college professors in Bogota-Colombia. METHOD This was a cross-sectional study including 27 voice samples of college professors. RESULTS A gender analysis showed that mean fundamental frequency increased significantly among men and women who reported vocal fatigue compared with the those without fatigue (138.2Hz vs 122.3Hz for males; and 228.7Hz vs 188.9Hz for females; Mann-Whitney U test P value

Objective ranscranial direct current stimulation (tDCS) is a non-invasive neuro-modulation technique that delivers current through the scalp by a pair of patch electrodes (2-Patch). This study proposes a new multi-channel tDCS (mc-tDCS) optimization method, the distributed constrained maximum intensity (D-CMI) approach. For targeting the P20/N20 somatosensory source at Brodmann area 3b, an integrated combined magnetoencephalography (MEG) and electroencephalography (EEG) source analysis is used with individualized skull conductivity calibrated realistic head modeling. Methods Simulated electric fields (EF) for our new D-CMI method and the already known maximum intensity (MI), alternating direction method of multipliers (ADMM) and 2-Patch methods were produced and compared for the individualized P20/N20 somatosensory target for 10 subjects. Results D-CMI and MI showed highest intensities parallel to the P20/N20 target compared to ADMM and 2-Patch, with ADMM achieving highest focality. D-CMI showed a slight reduction in intensity compared to MI while reducing side effects and skin level sensations by current distribution over multiple stimulation electrodes. Conclusion Individualized D-CMI montages are preferred for our follow up somatosensory experiment to provide a good balance between high current intensities at the target and reduced side effects and skin sensations. Significance An integrated combined MEG and EEG source analysis with D-CMI montages for mc-tDCS stimulation potentially can improve control, reproducibility and reduce sensitivity differences between sham and real stimulations.

This study examined the effect of moderate intensity stair stepping exercise on the glycemic response, and antioxidant capacity (TAC) during an oral glucose tolerance test (OGTT).Thirty participants (women = 12) completed 4 OGTTs during rest or stair walking bouts of 1, 3, and 10 min in a randomized order. Blood was collected at baseline and 30 min during the OGTTs and analyzed for glucose, insulin, TAC, and lactate. Glucose concentrations were decreased following the 10 min (-22.69 (-34.66 to -10.72) mg/dL, p 0.002) and 3 min (-15.37 (-25.05 to -5.69) mg/dL, p 0.004) bouts but not the 1 min bout (-6.18 (-19.54 to 7.18) mg/dL, p = 0.352). Insulin concentrations were decreased following the 10 min (-6.11 (-8.86 to -3.36 μIU/dL), p 0.001) and 3 min (-2.589 (-4.54 to -0.63) μIU/dL, p 0.012) bouts but not the 1 min bout (-0.37 (-1.87 to 1.13) μIU/dL, p = 0.616). Insulin sensitivity index values showed a significant increase in the 10-min trial (1.81 (0.03-3.58), p 0.048), but not during the 3 min (0.65 (-0.66 to 1.96) p = 0.317) or 1 min trial (0.13 (-1.58 to 1.84) p = 0.878). There was no omnibus effect for trial in TAC (p = 0.132, ηThis study provides evidence bouts as short as 3 min decrease postprandial blood glucose and insulin levels but longer bouts are needed to affect insulin sensitivity.

Here, we report on the Fano resonance characteristics tunability in a coupled system of magnonic stripes and resonators by variation the geometric parameters, the magnitude of the coupling between them, and the intensity of spin waves. Using numerical integration of the coupled wave equation system, we calculated the transfer characteristics of the considered system and the parameters of Fano resonance taking into account the cubic nonlinearity of magnetic media. We demonstrate the features of constructive and destructive interference of spin waves at Fano resonance. Our results reveals the mechanism of the spin-wave spectra control of the nonlinear Fano resonance (asymmetry coefficient, resonance frequency shifts) via the intensity of spin wave.

Purpose: To analyze the training structure following a heart rate variability (HRV) -guided training or traditional training protocol, determining their effects on the cardiovascular performance of professional endurance runners, and describing the vagal modulation interaction. Methods: This was an 8-week cluster-randomized controlled trial. Twelve professional endurance runners were randomly assigned to an HRV-guided training group (HRV-G; n = 6) or a traditional training group (TRAD-G; n = 6). The training methodology followed by the HRV-G was determined by their daily HRV scores. Training intensities were recorded daily. HRV4Training was used to register the rMSSD every morning and during a 60-second period. Cardiovascular outcomes were obtained through an incremental treadmill test. The primary outcome was the maximal oxygen uptake (VO2max). Results: Total training volume was significantly higher in TRAD-G, but moderate intensity training was significantly higher in HRV-G (X ± SDDif=1.98 ± 0.1%; P = 0.006; d = 1.22) and low intensity training in TRAD-G (X ± SDDif=2.03 ± 0.74%; P = 0.004; d = 1.36). The maximal velocity increased significantly in HRV-G (P = 0.027, d = 0.66), while the respiratory exchange ratio increased in TRAD-G (P = 0.017, d = 1). There was a small effect on the LnRMSSD increment (P = 0.365, d = 0.4) in HRV-G. There were statistical inter-group differences in the ∆maximal heart rate when ∆LnrMSSD was considered as a covariable (F = 7.58; P = 0.025; d = 0.487). There were significant and indirect correlations of LnRMSSDTEST with VO2max (r =-0.656, P = 0.02), ∆LnrMSSD with ∆VO2max (r = -0.606, P = 0.037), and ∆LnrMSSDCV with ∆VENT (r = -0.790, P = 0.002). Conclusions: higher HRV scores suggest better cardiovascular adaptations due to higher training intensities, favoring HRV as a measure to optimize individualized training in professional runners.

Purpose: In modern conformal radiation therapy of distal esophageal cancer, target coverage can be affected by variations in the diaphragm position. We investigated if daily position verification (PV) extended by a diaphragm position correction would optimize target dose coverage for esophageal cancer treatment.Methods and Materials: For 15 esophageal cancer patients, intensity modulated proton therapy (IMPT) and volumetric modulated arc therapy (VMAT) plans were computed. Displacements of the target volume were correlated with diaphragm displacements using repeated 4-dimensional computed tomography images to determine the correction needed to account for diaphragm variations. Afterwards, target coverage was evaluated for 3 PV approaches based on: (1) bony anatomy (PV_B), (2) bony anatomy corrected for the diaphragm position (PV_BD) and (3) target volume (PV_T).Results: The cranial-caudal mean target displacement was congruent with almost half of the diaphragm displacement (y = 0.459x), which was used for the diaphragm correction in PV_BD. Target dose coverage using PV_B was adequate for most patients with diaphragm displacements up till 10 mm (>= 94% of the dose in 98% of the volume [D-98%]). For larger displacements, the target coverage was better maintained by PV_T and PV_BD. Overall, PV_BD accounted best for target displacements, especially in combination with tissue density variations (D-98%: IMPT 94% +/- 5%, VMAT 96% +/- 5%). Diaphragm displacements of more than 10 mm were observed in 22% of the cases.Conclusions: PV_B was sufficient to achieve adequate target dose coverage in case of small deviations in diaphragm position. However, large deviations of the diaphragm were best mitigated by PV_BD. To detect the cases where target dose coverage could be compromised due to diaphragm position variations, we recommend monitoring of the diaphragm position before treatment through online imaging. (C) 2021 Elsevier Inc. All rights reserved.

To mitigate artifactual choriocapillaris flow deficits in optical coherence tomography angiography, which are a side effect of inverse structural optical coherence tomography compensation.In a modified algorithm, we set pixels in the original structural optical coherence tomography that were greater than one SD above the mean intensity (hyperreflective regions) to the mean pixel intensity of the image to remove hyporeflective regions in the inverse slab. We compared this algorithm to the original using flow deficit density and multiscale structural similarity index obtained from three distinct thresholding methods (local Phansalkar, global MinError (I), and global Li).We included 16 eyes of 16 healthy subjects (31.1 ± 6.9 years, 10 females). Using the modified optical coherence tomography correction, flow deficit density was lower compared with the original algorithm using Phansalkar (P0.001) but higher using Li thresholding (P = 0.049). Multiscale structural similarity index was increased after applying the modified algorithm with all three thresholding methods (P0.001), indicating a closer relationship to the original optical coherence tomography angiography scan.We demonstrate a new method that significantly reduced the introduction of artifactual flow deficits in the choriocapillaris during postprocessing. Given the improved multiscale structural similarity index, we believe our algorithm more accurately represents the choriocapillaris.

BackgroundChronic pain diseases are characterised by an ongoing and fluctuating endogenous pain, yet it remains to be elucidated how this is reflected by the dynamics of ongoing functional cortical connections. The present study addresses this disparity by taking the individual perspective of pain patients into account, which is the varying intensity of endogenous pain.MethodsTo this end, we investigated the cortical encoding of 20 chronic back pain patients and 20 chronic migraineurs in four repeated fMRI sessions. During the recording, the patients were asked to continuously rate their pain intensity. A brain parcellation approach subdivided the whole brain into 408 regions. A 10 s sliding-window connectivity analysis computed the pair-wise and time-varying connectivity between all brain regions across the entire recording period. Linear mixed effects models were fitted for each pair of brain regions to explore the relationship between cortical connectivity and the observed trajectory of the patients’ fluctuating endogenous pain.ResultsTwo pain processing entities were taken into account: pain intensity (high, middle, low pain) and the direction of pain intensity changes (rising vs. falling pain). Overall, we found that periods of high and increasing pain were predominantly related to low cortical connectivity. For chronic back pain this applies to the pain intensity-related connectivity for limbic and cingulate areas, and for the precuneus. The change of pain intensity was subserved by connections in left parietal opercular regions, right insular regions, as well as large parts of the parietal, cingular and motor cortices. The change of pain intensity direction in chronic migraine was reflected by decreasing connectivity between the anterior insular cortex and orbitofrontal areas, as well as between the PCC and frontal and ACC regions.ConclusionsInterestingly, the group results were not mirrored by the individual patterns of pain-related connectivity, which is suggested to deny the idea of a common neuronal core problem for chronic pain diseases. In a similar vein, our findings are supported by the experience of clinicians, who encounter patients with a unique composition of characteristics: personality traits, various combinations of symptoms, and a wide range of individual responses to treatment. The diversity of the individual cortical signatures of chronic pain encoding results adds to the understanding of chronic pain as a complex and multifaceted disease. The present findings support recent developments for more personalised medicine.

Although we know sensation is continuous, research on long-lasting and continuously changing stimuli is scarce and the dynamic nature of ongoing cortical processing is largely neglected. In a longitudinal study, 38 participants across four sessions were asked to continuously rate the intensity of an applied tonic heat pain for 20 min. Using group-independent component analysis and dual regression, we extracted the subjects’ time courses of intrinsic network activity. The relationship between the dynamic fluctuation of network activity with the varying time courses of three pain processing entities was computed: pain intensity, the direction of pain intensity changes, and temperature. We were able to dissociate the spatio-temporal patterns of objective (temperature) and subjective (pain intensity/changes of pain intensity) aspects of pain processing in the human brain. We found two somatosensory networks with distinct functions: one network that encodes the small fluctuations in temperature and consists mainly of bilateral primary somatosensory cortex (SI), and a second right-lateralized network that encodes the intensity of the subjective experience of pain consisting of SI, secondary somatosensory cortex, the posterior cingulate cortex, and the thalamus. We revealed the somatosensory dynamics that build up toward a current subjective percept of pain. The timing suggests a cascade of subsequent processing steps toward the current pain percept.

BACKGROUND: Recent clinical studies have revealed the advantages of using suspension devices. Although the supine, lateral, and forward leaning bridge exercises are low-intensity exercises with suspension devices, there is a lack of studies directly comparing exercise progression by measuring muscular activity and subjective difficulty. OBJECTIVE: To identify how the variations in the bridge exercise affects trunk muscle activity, the present study investigated changes in neuromuscular activation during low-intensity bridge exercises. We furthermore explored whether the height of the suspension point affects muscle activation and subjective difficulty. METHODS: Nineteen asymptomatic male participants were included. Three bridge exercise positions, supine bridge (SB), lateral bridge (LB), forward leaning (FL), and two exercise angles (15 and 30 degrees) were administered, thereby comparing six bridge exercise conditions with suspension devices. Surface electromyography and subjective difficulty data were collected. RESULTS: The rectus abdominis activity was significantly higher with the LB and FL exercises compared with the SB exercise (p< 0.05). The erector spinae muscle activity was significantly higher with the SB and LB exercises, compared with the FL exercise (p< 0.05). The LB exercise significantly increased the internal oblique muscle activity, compared with other exercise variations (p< 0.05). The inclination angle of the exercise only affected the internal oblique muscle and subjective difficulty, which were significantly higher at 30 degrees compared with 15 degrees (p< 0.05). CONCLUSIONS: Relatively higher inclination angle was not effective in overall activation of the trunk muscles; however, different bridge-type exercises could selectively activate the trunk muscles. The LB and SB exercises could be good options for stimulating the internal oblique abdominis, and the erector spinae muscle, while the FL exercise could minimize the erector spinae activity and activate the abdominal muscles.

Purpose: The goal of this study was to examine the effects of increases in vocal effort, without changing speech intensity, on respiratory and articulatory kinematics in young adults with typical voices. Method: A total of 10 participants completed a reading task under three speaking conditions: baseline, mild vocal effort, and maximum vocal effort. Respiratory inductance plethysmography bands around the chest and abdomen were used to estimate lung volumes during speech, and sensor coils for electromagnetic articulography were used to transduce articulatory movements, resulting in the following outcome measures: lung volume at speech initiation (LVSI) and at speech termination (LVST), articulatory kinematic vowel space (AKVS) of two points on the tongue dorsum (body and blade), and lip aperture. Results: With increases in vocal effort, and no statistical changes in speech intensity, speakers showed: (a) no statistically significant differences in LVST, (b) statistically significant increases in LVSI, (c) no statistically significant differences in AKVS measures, and (d) statistically significant reductions in lip aperture. Conclusions: Speakers with typical voices exhibited larger lung volumes at speech initiation during increases in vocal effort, paired with reduced lip displacements. To our knowledge, this is the first study to demonstrate evidence that articulatory kinematics are impacted by modulations in vocal effort. However, the mechanisms underlying vocal effort may differ between speakers with and without voice disorders. Thus, future work should examine the relationship between articulatory kinematics, respiratory kinematics, and laryngeal-level changes during vocal effort in speakers with and without voice disorders. Supplemental Material: https://doi.org/10.23641/asha.17065457

Background. Uterine fibroid is one of the most common diseases in gynaecological practice accounting from 32 to 70 % according to various authors. In 80 % of cases, fibroids are observed in women of reproductive age. Laparoscopic myomectomy is one of the main methods of surgical treatment for uterine fibroids in wo­men of reproductive age. A large number of advantages of this method of surgical treatment in many cases lead to underestimation of the existing risks such as the risk of thrombosis in women with elevated body mass index (BMI). The purpose of this study is to detect the risk of thrombosis in adequate comprehensive thromboprophylaxis of patients with elevated BMI in the perioperative period of laparoscopic myomectomy using an instrumental method of diagnosis such as low-frequency piezoelectric blood viscometer. Materials and methods. Patients aged 30–45 years undergoing laparoscopic myomectomy (n = 60) were exa­mined. They were divided into 3 groups depending on the BMI and thromboprophylaxis method. Group 1 (n = 16) included women with the BMI 30 kg/m2, who were treated with enoxaparin thromboprophylaxis at a dose of 2,000 anti-Xa IU/0.2 ml subcutaneously (at the BMI of 30–40 kg/m2) and 4,000 anti-Xa IU/0.4 ml subcutaneously (at the BMI > 40 kg/m2). Third group (n = 26) included individuals with the BMI > 30 kg/m2 who received enoxaparin and pentoxifylline for thromboprophylaxis. Results. The low-frequency piezoelectric blood viscometry revealed statistically significant (p < 0.05) deviations from the reference values of the coagulogram towards structural (increased maximum clot density) and chronometric hypercoagulation (acceleration of the time of formation of fibrin-platelet structure T5, shift of the blood clotting time T3 to the left, an increase in the intensity of coagulation drive), elevated thrombin activity (an increase in the constant of thrombin activity, a decrease in T2 time), activation of vascular-platelet hemostasis (reduced period of T1 reaction onset, increased intensity of contact coagulation), inhibition of the lytic activity (a decrease in the intensity of retraction and lysis of the clot) in groups 2 and 3. On the first day after surgery in groups 2 and 3, there was a significant increase (compared to preoperative indicators) in the chronometric indicators such as T1, T2 and T5; a decrease in the structural indicator of maximum clot density, as well as a significant decrease in the constant of thrombin activity, intensity of contact coagulation, which confirms the effectiveness of antithrombotic therapy. However, group 2 reported an increase in the activity of vascular-platelet hemostasis, higher intensity of contact coagulation compared to group 3, shorter T1 and T2 time, and the constant of thrombin activity was higher. On the 5th day after surgery, a normocoagulation trend of hemostatic potential was observed in all groups of patients. Conclusions. The use of low-frequency piezoelectric blood viscometry allows reliably and quickly assessing the kinetics of thrombosis formation., Актуальність. Міома матки — одне з найпоширеніших захворювань у гінекологічний практиці та становить, за даними різних авторів, від 32 до 70 %. У 80 % випадків міома спостерігається у жінок репродуктивного віку. Одним з основних методів хірургічного лікування міоми матки у жінок репродуктивного віку є лапароскопічна міомектомія. Велика кількість переваг даного методу хірургічного лікування призводить в багатьох випадках до недооцінки наявного ризику, такого як тромбонебезпека у жінок із підвищеним індексом маси тіла (ІМТ). Мета даного дослідження — виявлення стану тромбонебезпеки для проведення адекватної комплексної тромбопрофілактики пацієнток із підвищеним індексом маси тіла в періопераційному періоді при лапароскопічній міомектомії, використовуючи інструментальний метод діагностики — низькочастотний п’єзоелектричний гемовіскозиметр. Матеріали та методи. Пацієнтки 30–45 років, які підлягають лапароскопічній міомектомії (n = 60). Пацієнтки були розподілені на 3 групи залежно від величини індексу маси тіла та вибору методу тромбопрофілактики. До 1-ї групи (16 пацієнток) увійшли хворі з ІМТ < 30 кг/м2, яким медикаментозна тромбопрофілактика не проводилась. До 2-ї групи (18 пацієнток) увійшли хворі з ІМТ > 30 кг/м2, які з метою тромбопрофілактики отримували еноксапарин в дозі 2000 анти-Ха МО/0,2 мл підшкірно (при ІМТ 30–40 кг/м2) та 4000 анти-Ха МО/0,4 мл підшкірно (при ІМТ > 40 кг/м2). До 3-ї групи (26 пацієнток) увійшли хворі з ІМТ > 30 кг/м2, які з метою тромбопрофілактики отримували еноксапарин та пентоксифілін. Результати. За даними низькочастотного вібраційного п’єзоелектричного гемовіскозиметра були виявлені статистично вірогідні (р

To determine the effect of low-intensity, long-wavelength red light therapy (LLRT) on the inhibition of myopia progression in children.A retrospective study was conducted. One hundred and five myopic children (spherical equivalent refractive error [SER] -3.09 ± 1.74 dioptres [D]; mean age, 9.19 ± 2.40 years) who underwent LLRT treatment (power 0.4 mW, wavelength 635 nm) twice per day for 3 min each session, with at least a 4-h interval between sessions, and a control group of 56 myopic children (SER -3.04 ± 1.66 D; mean age, 8.62 ± 2.45 years) were evaluated. Both groups wore single-vision distance spectacles. Each child returned for a follow-up examination every 3 months after the initial measurements for a total of 9 months.At 9 months, the mean SER in the LLRT group was -2.87 ± 1.89 D, significantly greater than that of the control group (-3.57 ± 1.49 D, p 0.001). Axial length (AL) changes were -0.06 ± 0.19 mm and 0.26 ± 0.15 mm in the LLRT group and control group (p 0.001), respectively. The subfoveal choroidal thickness changed by 45.32 ± 30.88 μm for children treated with LLRT at the 9-month examination (p 0.001). Specifically, a substantial hyperopic shift (0.31 ± 0.24 D and 0.20 ± 0.14 D, respectively, p = 0.02) was found in the 8-14 year olds compared with 4-7 year old children. The decrease in AL in subjects with baseline AL24 mm was -0.08 ± 0.19 mm, significantly greater than those with a baseline AL ≤24 mm (-0.04 ± 0.18 mm, p = 0.03).Repetitive exposure to LLRT therapy was associated with slower myopia progression and reduced axial growth after short durations of treatment. These results require further validation in randomised controlled trials.

This study investigated the effect of high-intensity interval training (HIIT) cycling elevation training mask (ETM) in moderately trained participants on both aerobic (VO2max) and anaerobic power performance. Sixteen participants, five females (25.8 ± 7.6 years) and eleven males (22.2 ± 3.5 years) took part in this randomized controlled trial. Participants were assigned to the experimental group (ETM, n = 8 participants) wearing an ETM or the control group (CON, n = 8 participants) without the ETM. VO2max was determined during a standardized protocol using Cortex Metalyzer-3B on a cycle ergometer. Peak and average power were calculated a 30-second Wingate test. Participants completed 4-weeks (two sessions a week) of high-intensity cycle training. Each training session consisting of 4 separate bouts of 4-minutes of high-intensity cycling exercise. After the training period, ETM reported an increment in VO2max (effect size (d) = 1.19), peak power (d = 0.77), and average power (d = 0.76). CON reported an increment only in VO2max (d = 1.00). No-between group differences were found in any parameter (ANCOVA), therefore the two protocols should be considered equally effective. In conclusion, this study reported that both HIIT protocols significantly enhance VO2max in a very short training period (4 weeks).

It is unclear whether neuromuscular electrical stimulation (NMES) has meaningful metabolic effects when users have the opportunity to self-select the intensity to one that can be comfortably tolerated. Nine healthy men aged 28 ± 9 y (mean ± SD) with a body mass index 22.3 ± 2.3 kg/m2 completed 3 trials involving a 2-h oral glucose tolerance test whilst, in a randomised counterbalanced order, (1) sitting motionless (SIT), (2) standing motionless (STAND); and (3) sitting motionless with NMES of quadriceps and calves at a self-selected tolerable intensity. The mean (95% confidence interval [CI]) total energy expenditure was greater in the NMES trial (221 [180–262] kcal/2 h) and STAND trial (178 [164–191] kcal/2 h) than during SIT (159 [150–167] kcal/2 h) (both, p < 0.05). This was primarily driven by an increase in carbohydrate oxidation in the NMES and STAND trials compared with the SIT trial (p < 0.05). Postprandial insulin iAUC was lower in both NMES and STAND compared with SIT (16.4 [7.7–25.1], 17 [7–27] and 22.6 [10.8–34.4] nmol·120 min/L, respectively; both, p < 0.05). Compared with sitting, both NMES and STAND increased energy expenditure and whole-body carbohydrate oxidation and reduced postprandial insulin concentrations in healthy men, with more pronounced effects seen with NMES. Self-selected NMES is a potential strategy for improving metabolic health. This trial is registered at ClinicalTrials.gov (ID: NCT04389736). Novelty: NMES at a comfortable intensity enhances energy expenditure and carbohydrate oxidation, and reduces postprandial insulinemia. Thus, self-selected NMES represents a potential strategy to improve metabolic health.

Background Persons with Parkinson’s disease (PD) participate in low levels of physical activity. This has prompted interest in developing interventions targeting physical activity behavior in PD. However, the current cut-points to quantify moderate-to-vigorous physical activity (MVPA) developed for PD have been derived from a single, vertical axis using hip-worn accelerometers, and this cut-point may not be applicable for wrist-worn devices. Wrist-worn devices might improve accessibility and compliance with physical activity monitoring in PD. Research Question What is the relationship between wrist-based activity counts and energy expenditure during treadmill walking in persons with PD? Do cut-points for quantifying time spent in MVPA differ between persons with PD and controls matched by age and sex? Methods The sample included 26 persons with mild-to-moderate PD (Hoehn and Yahr stages 2–3) and 27 age- and sex-matched controls. Participants completed three, 6-minute bouts of walking on a treadmill at three increasing speeds. Vector magnitude was measured using ActiGraph GT3X+ accelerometer worn on the more affected side for persons with PD and the non-dominant side for controls. The rate of oxygen consumption, or energy expenditure, was measured using a portable, open-circuit spirometry system. Results Our results indicated a strong association between activity counts and energy expenditure for persons with PD and controls with R2 values of 0.94(0.07) and 0.95(0.06), respectively. Persons with PD had a cut-point of 2883(871) counts·min−1; this was significantly lower than the cut-point of 4389(1844) counts·min−1 for controls. Conclusion We generated a PD-specific cut-point for wrist-worn ActiGraph accelerometers among persons with PD, and this was lower than controls. This disease-specific cut-point may provide more accurate measurements of time spent in MVPA in PD.

Duration, intensity, and type of exercise can affect serum cytokine levels and change inflammatory indices. The present study aimed to examine the acute effect of two different exercise intensity programs on levels of circulating interleukin (IL)-6, IL-1β and tumour necrosis factor-α (TNF-α) in athletes. Eleven female futsal players aged 20.6±1.2 years completed this cross-over study. Participants performed, either a MI (moderate intensity: 60-65%) or a HI (high intensity: 75-80% heart rate reserve) exercise program. The study was performed on different days separated by a 1-week washout period. Each session consisted of 30 min running, either MI or HI. Blood samples were taken before (Pre) and immediately after (Post) each exercise session from an antecubital vein by venous puncture in a seated position. A Student’s t-test (P

Introduction The observed variability in the effects of transcranial direct current stimulation (tDCS) is influenced by the amount of current reaching the targeted region-of-interest (ROI). Age and sex might affect current density at target ROI due to their impact on cortical anatomy. The present tDCS simulation study investigates the effects of cortical anatomical parameters (volumes, dimension, and torque) on simulated tDCS current density in healthy young, middle-aged, and older males and females. Methodology Individualized head models from 240 subjects (120 males, 18–87 years of age) were used to identify the estimated current density (2 mA current intensity, 25 cm2 electrode) from two simulated tDCS montages (CP5_CZ and F3_FP2) targeting the inferior parietal lobule (IPL) and middle frontal gyrus (MFG), respectively. Cortical parameters including segmented brain volumes (cerebrospinal fluid [CSF], grey and white matter), cerebral-dimensions ( length / width & length / height ) and brain-torque (front and back shift, petalia, and bending) were measured using the magnetic resonance images (MRIs) from each subject. The present study estimated sex differences in current density at these target ROIs mediated by these cortical parameters within each age group. Results For both tDCS montages, females in the older age group received higher current density than their male counterparts at the target ROIs. No sex differences were observed in the middle-aged group. Males in the younger age group had a higher current density than females, only for the parietal montage. Across all age groups, CSF, and grey matter volumes significantly predicted the current intensity estimated at the target sites. In the older age group only, brain-torque was a significant mediator of the sex difference. Conclusions Our findings demonstrate the presence of sex differences in the simulated tDCS current density, however this pattern differed across age groups and stimulation locations. Future studies should consider influence of age and sex on individual cortical anatomy and tailor tDCS stimulation parameters accordingly.

Rationale: Early mobilization of ECMO-supported patients is increasingly common, but it remains unknown whether there are factors predictive of achieving higher intensity mobilization among those a...

To compare the dosimetric performance of Intensity Modulated Proton Therapy (IMPT) and Intensity Modulated Radiotherapy (IMRT) in terms of target volume coverage and sparing of neurological organs-at-risk (OARs) in salvaging recurrent nasopharyngeal carcinoma (rNPC). The maximum dose to the internal carotid artery (ICA) and nasopharyngeal (NP) mucosa, which are associated with potential carotid blowout and massive epistaxis, were also evaluated.IMRT and IMPT treatment plans were created for twenty patients with locally advanced rNPC. Planning Target Volume (PTV) was used to account for the setup and spatial error/uncertainty in the IMRT planning. Robust optimization on Clinical Target Volume (CTV) coverage with consideration of range and setup uncertainty was employed to produce two IMPT plans with 3-field and 4-field arrangements. The planning objective was to deliver 60 Gy to the PTV (IMRT) and CTV (IMPT) without exceeding the maximum lifetime cumulative Biologically Effective Dose (BED) of the neurological OARs (applied to the Planning organs-at-risk volume). The target dose coverage as well as the maximum dose to the neurological OARs, ICA, and NP mucosa were compared.Compared with IMRT, 3-field IMPT achieved better coverage to GTV V100% (83.3% vs. 73.2%, P0.01) and CTV V100% (80.5% vs. 72.4%, P0.01), and lower maximum dose to the critical OARs including the spinal cord (19.2 Gy vs. 22.3 Gy, P0.01), brainstem (30.0 Gy vs. 32.3 Gy, P0.01) and optic chiasm (6.6 Gy vs. 9.8 Gy, P0.01). The additional beam with the 4-fields IMPT plans further improved the target coverage from the 3-field IMPT (CTV V98%: 85.3% vs. 82.4%, P0.01) with similar OAR sparing. However, the target dose was highly non-uniform with both IMPT plans, leading to a significantly higher maximum dose to the ICA (∼68 Gy vs. 62.6 Gy, P0.01) and NP mucosa (∼72 Gy vs. 62.8 Gy, P0.01) than IMRT.IMPT demonstrated some dosimetric advantage over IMRT in treating rNPC. However, IMPT could also result in very high dose hot spots in the target volume. Careful consideration of the ICA and NP mucosal complications is recommended when applying IMPT on rNPC patients.

We present a numerical analysis of noise performance improvement of the erbium-doped fiber amplifier by flatting the mode field intensity distribution within the interaction region of erbium ions. Three different refractive index types of erbium-doped fiber were used to study the effect of the pump mode intensity distribution on noise performance. The results show that taking advantage of the depressed refractive index erbium-doped fiber which has a flat mode distribution in the fiber core, the maximum reduction of nearly 0.53 dB for noise figure was achieved across the full C-band. Based on the center depressed refractive index profile, the noise figure was further decreased by about 0.1 dB by reducing the doping radius to 0.71 μm. Finally, maintaining the same gain level of ∼38.3 dB, a NF reduction of ∼0.63 dB was realized by introducing the center depressed refractive index profile and narrowing the erbium doping region. It is suggested that our investigation shows great potential for improving the noise performance of the erbium-doped fiber amplifier.

Objectives This study investigated whether pulmonary artery (PA) 18F-FDG uptake is associated with hypertension, and if it correlates to elevated pulmonary pressures. Background 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with computed tomography or cardiac magnetic resonance (CMR) has been used to assess inflammation mostly in large arteries of the systemic circulation. Much less is known about inflammation of the vasculature of the pulmonary system and its relationship to pulmonary hypertension (PH). Methods In a single-center cohort of 175 patients with suspected cardiac sarcoidosis, who underwent hybrid thoracic PET/CMR, 18F-FDG uptake in the PA was quantified according to maximum standardized uptake value (SUVmax) and target-to-background ratio (TBR) and compared with available results from right heart catheterization (RHC) or transthoracic echocardiography (TTE). Results Thirty-three subjects demonstrated clear 18F-FDG uptake in the PA wall. In the subgroup of patients who underwent RHC (n = 10), the mean PA pressure was significantly higher in the group with PA 18F-FDG uptake compared with the group without uptake (34.4 ± 7.2 mm Hg vs 25.6 ± 9.3 mm Hg; P = 0.003), and 9 (90%) patients with PA 18F-FDG uptake had PH when a mean PA pressure cutoff of 25 mm Hg was used compared with 18 (45%) in the nonuptake group (P Conclusions We demonstrate that 18F-FDG uptake by PET/CMR in the PA is associated with PH and that its intensity correlates with PA pressure.

The present study compared intensity of training between technology-supported and conventional exercises during a regular therapy session in three brain injured patients with arm/hand limitations. Results showed that intensity was higher during technology-supported exercises. Further research with a larger sample is needed to confirm these outcomes and assess its potential relation to treatment effect.

Background: Due to its specific physical characteristics, proton irradiation is especially suited for irradiation of chordomas and chondrosarcoma in the axial skeleton. Robust plan optimization renders the proton beam therapy more predictable upon individual setup errors. Reported experience with the planning and delivery of robustly optimized plans in chordoma and chondrosarcoma of the mobile spine and sacrum, is limited. In this study, we report on the clinical use of robustly optimized, intensity modulated proton beam therapy in these patients.Methods: We retrospectively reviewed patient, treatment and acute toxicity data of all patients with chordoma and chondrosarcoma of the mobile spine and sacrum, treated between 1 April 2019 and 1 April 2020 at our institute. Anatomy changes during treatment were evaluated by weekly cone-beam CTs (CBCT), supplemented by scheduled control-CTs or ad-hoc control-CTs. Acute toxicity was scored weekly during treatment and at 3 months after therapy according to CTCAE 4.0.Results: 17 chordoma and 3 chondrosarcoma patients were included. Coverage of the high dose clinical target volume was 99.8% (range 56.1-100%) in the nominal and 80.9% (range 14.3-99.6%) in the voxel-wise minimum dose distribution. Treatment plan adaptation was needed in 5 out of 22 (22.7%) plans. Reasons for plan adaptation were either reduced tumor coverage or increased dose to the OAR.Conclusions: Robustly optimized intensity modulated proton beam therapy for chordoma and chondrosarcoma of the mobile spine is feasible. Plan adaptations due to anatomical changes were required in approximately 23 percent of treatment courses. (C) 2021 The Authors. Published by Elsevier B.V.