The interest in the development of nanoscale plasmonic technologies has dramatically increased in recent years. The photonic properties of plasmonic nanopatterns can be controlled and tuned via their ...size, shape, or the arrangement of their constituents. In this work, we propose a 2D hybrid metallic polymeric nanostructure based on the octupolar framework with enhanced sensing property. We analyze its plasmonic features both numerically and experimentally, demonstrating the higher values of their relevant figures of merit: we estimated a surface-enhanced Raman spectroscopy (SERS) enhancement factor of 9 × 107 and a SPR bulk sensitivity of 430 nm/RIU. In addition, our nanostructure exhibits a dual resonance in the visible and near-infrared region, enabling our system toward multispectral plasmonic analysis. Finally, we illustrate our design engineering strategy as enabled by electron beam lithography by the outstanding performance of a SERS-based biosensor that targets the Shiga toxin 2a, a clinically relevant bacterial toxin. To the best of our knowledge, this is the first time that a SERS fingerprint of this toxin has been evidenced.
In multidimensional Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, the choice of the symptom assessment instrument (modified Medical Research Council dyspnea scale mMRC ...or COPD assessment test CAT) can lead to a different distribution of patients in each quadrant. Considering that physical activities of daily living (PADL) is an important functional outcome in COPD, the objective of this study was to determine which symptom assessment instrument is more strongly associated with and differentiates better the PADL of patients with COPD.
The study included 115 subjects with COPD (GOLD 2-4), who were submitted to spirometry, the mMRC, the CAT, and monitoring of PADL (triaxial accelerometer). Subjects were divided into 2 groups using the cutoffs proposed by the multidimensional GOLD classification: mMRC < 2 and ≥ 2 and CAT < 10 and ≥ 10.
Both mMRC and CAT reflected the PADL of COPD subjects. Subjects with mMRC < 2 and CAT < 10 spent less time in physical activities < 1.5 metabolic equivalents of task (METs) (mean of the difference 95% CI = -62.9 -94.4 to -31.4,
< .001 vs -71.0 -116 to -25.9,
= .002) and had a higher number of steps (3,076 1,999-4,153,
< .001 vs 2,688 1,042-4,333,
= .002) than subjects with mMRC > 2 and CAT > 10, respectively. Physical activities ≥ 3 METs differed only between mMRC < 2 and mMRC ≥ 2 (39.2 18.8-59.6,
< .001). Furthermore, only the mMRC was able to predict the PADL alone (time active, r
= 0.16; time sedentary, r
= 0.12; time ≥ 3 METs, r
= 0.12) and associated with lung function (number of steps, r
= 0.35; walking time, r
= 0.37; time < 1.5 METs, r
= 0.25).
The mMRC should be adopted as the classification criterion for symptom assessment in the GOLD ABCD system when focusing on PADL.
Nanogold has been investigated in a wide variety of biomedical applications because of the anti-inflammatory properties. The purpose of this study was to evaluate the effects of TPU (Therapeutic ...Pulsed Ultrasound) with gold nanoparticles (GNP) on oxidative stress parameters and the expression of pro-inflammatory molecules after traumatic muscle injury.
Animals were divided in nine groups: sham (uninjured muscle); muscle injury without treatment; muscle injury + DMSO; muscle injury + GNP; muscle injury + DMSO + GNP; muscle injury + TPU; muscle injury + TPU + DMSO; muscle injury + TPU + GNP; muscle injury + TPU + DMSO + GNP. The ROS production was determined by concentration of superoxide anion, modulation of antioxidant defenses was determined by the activity of superoxide dismutase, catalase and glutathione peroxidase enzymes, oxidative damage determined by formation of thiobarbituric acid-reactive substance and protein carbonyls. The levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were measured as inflammatory parameters.
Compared to muscle injury without treatment group, the muscle injury + TPU + DMSO + GNP gel group promoted a significant decrease in superoxide anion production and lipid peroxidation levels (p < 0.050). It also showed a significant decrease in TNF-α and IL-1β levels (p < 0.050) when compared to muscle injury without treatment group.
Our results suggest that TPU + DMSO + GNP gel presents beneficial effects on the muscular healing process, inducing a reduction in the production of ROS and also the expression of pro-inflammatory molecules.
BACKGROUND: The 20-m 6-min-walk test (6MWT20) is a valid, reliable alternative for functional capacity assessment; however, its responsiveness and minimally important difference (MID) have yet to be ...investigated. The aim of this study was to assess the responsiveness and MID of the 6MWT20 in individuals with COPD. METHODS: Fifty-three subjects completed the study from August 2011-March 2020. The following were assessed: lung function, activities of daily living (ADLs), functional capacity 6MWT20, dyspnea, health status, quality of life, and limitations in ADLs. The primary outcome was the 6MWT20 distance. RESULTS: The study demonstrated that the 6MWT20 is responsive to pulmonary rehabilitation (PR), with an average improvement of 39 + or - 36.3 m (P < .001) and an effect size of 1.07. The learning effect declined to 1.45% after PR, with an intraclass correlation coefficient of 0.99 (95% CI 0.98-0.99). The receiver operating characteristic curve indicated a cutoff point of 20 m for the MID of the 6MWT20 based on the MIDs for the modified St George Respiratory Questionnaire (sensitivity 87%, specificity 69%, area under the curve 0.80 95% CI 0.66-0.90, P < .001, Youden index 0.56) and the number of steps (sensitivity 92%, specificity 73%, area under the curve 0.83 95% CI 0.70-0.92, P < .01, Youden index 0.56). CONCLUSIONS: The 6MWT20 is responsive to PR, and the MID for the test is 20 m (17-47 m). Key words: COPD; activities of daily living; walking; result assessment (health care); exercise. Respir Care 2023;68(11):1546-1552. c 2023 Daedalus Enterprises
This study aims to translate, culturally adapt, and test the reliability and construct validity of the Brazilian Portuguese version of the Basic Psychological Needs in Exercise Scale (BPNES) for ...patients with Chronic Obstructive Pulmonary Disease (COPD) and Interstitial Lung Disease (ILD). Pulmonary function, dyspnea, quality of life, anxiety and depression symptoms, and functional status were assessed, and two raters independently applied the BPNES. BPNES scores were compared between raters' applications to assess reliability, internal consistency, and agreement. Confirmatory Factor Analysis was used to assess the factor structure of the BPNES model.
Results
59 patients were included (61% with COPD and 39% with ILD). BPNES factor scores were not significantly different between raters’ assessments (p > 0.05). The internal consistency was 0.70 for autonomy, 0.76 for competence, and 0.80 for relatedness. Inter-rater and test-retest reliability were good to very good for autonomy (ICC = 0.78, 95%CI 0.62–0.87; ICC = 0.75, 95%CI 0.57–0.86, respectively), competence (ICC = 0.81, 95%CI 0.68–0.89; ICC = 0.65, 95%CI 0.43–0.80, respectively), and relatedness (ICC = 0.79, 95%CI 0.65–0.88; ICC = 0.70, 95%CI 0.50–0.83, respectively). Significant correlations were observed between BPNES factors and quality of life, anxiety, depression, and functional status. In conclusion, this study confirmed the reliability and construct validity of the Brazilian Portuguese version of the BPNES in patients with COPD and ILD.
PURPOSE:To describe physiological responses during the 6-min step test (6MST) in patients with chronic obstructive pulmonary disease (COPD), to investigate whether COPD severity and test ...interruptions could determine different physiological responses, and to test the reproducibility of 6MST performance.
METHODS:Cross-sectional study. Patients with moderate to very severe COPD underwent lung function assessment and 2 6MSTs, with physiological responses measurement by a gas analyzer and a near-infrared spectroscopy device.
RESULTS:Thirty-six patients (29 men; forced expiratory volume in the first second of expiration FEV1 = 51.1 ± 13.6%pred) participated in the study. Most of the physiological variables stabilized between the second and fourth minutes of the 6MST, except the respiratory rate and heart rate (HR), which stabilized after the fifth minute. The patients who interrupted the 6MST showed higher minute ventilation to maximal voluntary ventilation ratio ((Equation is included in full-text article.)E/MVV; all test minutes) and HR (first and second minutes) (P < .05) and worse pulmonary function (FEV1 = 1.37 ± 0.37 L vs 1.82 ± 0.41 L, P = .002, and 47.2 ± 13.2%pred vs 56.6 ± 12.4%pred, P = .04, respectively) than those who did not interrupt the 6MST. However, their performance was similar (P = .11). 6MST performance and physiological variables were reproducible, and there was a learning effect of 6.28%.
CONCLUSIONS:The 6MST showed a stabilization of the most physiological variables. In addition, interruptions were usually made by patients with a greater impairment of lung function and they presented greater increased ventilatory demand during the 6MST. However, these interruptions do not interfere with 6MST physiological responses. Moreover, the 6MST is a reliable test to evaluate the functional capacity of patients with COPD.
Promotoras have worked in various areas of public health; however, there is a lack of understanding about their work in mental health. This article reviews the literature in 3 different ...cultures/languages (English, Spanish, and Portuguese) and aims to describe promotoras' roles, training, and interventions and their outcomes related to mental health activities. Results demonstrate that in different cultures/languages, promotoras empower community members to promote mental health and prevent exacerbation of individuals' mental illness. Promotoras, when trained carefully, have the ability to increase awareness and to promote mental health in populations that would otherwise have limited or no access to care.
Modelo do estudo: Estudo transversal. Objetivo: Investigar se existe associação entre qualidade de vida relacionada à saúde e força muscular periférica e respiratória em pacientes com DPOC, bem como ...investigar se há diferença no comprometimento da qualidade de vida de pacientes com e sem fraqueza muscular. Metodologia: Vinte pacientes foram submetidos à avaliação antropométrica, função pulmonar, aplicação do Questionário do Hospital Saint George na Doença Respiratória (SGRQ) e avaliação de força de músculos respiratórios, de preensão palmar e quadríceps. Utilizou-se o teste de Shapiro-Wilk para verificar a normalidade dos dados e coeficiente de correlação de Pearson para testar a correlação dos domínios e do escore total do SGRQ (SGRQtotal) com a força muscular periférica e respiratória e seus percentuais do previsto (%prev). Para comparar o domínio “impacto” entre os subgrupos de força de quadríceps, utilizou-se o teste U de Mann-Whitney. O teste t para amostras independentes foi utilizado para comparar os demais escores de qualidade de vida entre os subgrupos. Resultados: Verificou-se moderada correlação do SGRQtotal e dos domínios “atividades” e “impacto” com o %prev da força de quadríceps (r=-0,51; r=-0,52 e r=-0,46, respectivamente). O domínio “atividades” também correlacionouse com o valor absoluto da força de quadríceps (r=-0,44) enquanto o %prev da pressão expiratória máxima apresentou correlação com o SGRQtotal (r=-0,45) e com o domínio “impacto” (r=-0,49). Conclusões: A força de quadríceps e de músculos expiratórios é capaz de refletir o impacto que a limitação das atividades de vida diária exerce sobre a qualidade de vida de pacientes com DPOC.
Airflow limitation frequently leads to the interruption of activities of daily living (ADL) in patients with Chronic Obstructive Pulmonary Disease (COPD). These patients commonly show absence of ...ventilatory reserve, reduced inspiratory reserve volume, and dynamic hyperinflation (DH).
To investigate ventilatory response and DH induced by three ADL-based protocols in COPD patients and compare them to healthy subjects.
Cross-sectional study. COPD group: 23 patients (65±6 years, FEV1 37.2±15.4%pred); control group: 14 healthy subjects (64±4 years) matched for age, sex, and body mass index. Both groups performed all three tests: Glittre-ADL test; an activity test that involved moving objects on a shelf (TSHELF); and a modified shelf protocol isolating activity with upper limbs (TSHELF-M). Ventilatory response and inspiratory capacity were evaluated.
Baseline ventilatory variables were similar between groups (p>0.05). The ventilatory demand increased and the inspiratory capacity decreased significantly at the end of the tests in the COPD group. Ventilatory demand and DH were higher (p<0.05) in the TSHELF than in the TSHELF-M in the COPD group (p<0.05). There were no differences in DH between the three tests in the control group (p>0.05) and ventilatory demand increased at the end of the tests (p<0.05) but to a lower extent than the COPD group.
The TSHELF induces similar ventilatory responses to the Glittre-ADL test in COPD patients with higher ventilatory demand and DH. In contrast, the ventilatory response was attenuated in the TSHELF-M, suggesting that squatting and bending down during the Glittre-ADL test could trigger significant ventilatory overload.
The 20-m 6-min-walk test (6MWT20) is a valid, reliable alternative for functional capacity assessment; however, its responsiveness and minimally important difference (MID) have yet to be ...investigated.
The aim of this study was to assess the responsiveness and MID of the 6MWT20 in individuals with COPD.
Fifty-three subjects completed the study from August 2011-March 2020. The following were assessed: lung function, activities of daily living (ADLs), functional capacity 6MWT20, dyspnea, health status, quality of life, and limitations in ADLs. The primary outcome was the 6MWT20 distance.
The study demonstrated that the 6MWT20 is responsive to pulmonary rehabilitation (PR), with an average improvement of 39 ± 36.3 m (
< .001) and an effect size of 1.07. The learning effect declined to 1.45% after PR, with an intraclass correlation coefficient of 0.99 (95% CI 0.98-0.99). The receiver operating characteristic curve indicated a cutoff point of 20 m for the MID of the 6MWT20 based on the MIDs for the modified St George Respiratory Questionnaire (sensitivity 87%, specificity 69%, area under the curve 0.80 95% CI 0.66-0.90,
< .001, Youden index 0.56) and the number of steps (sensitivity 92%, specificity 73%, area under the curve 0.83 95% CI 0.70-0.92,
< .01, Youden index 0.56).
The 6MWT20 is responsive to PR, and the MID for the test is 20 m (17-47 m).
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