Multiple-breath washout (MBW) is an established technique to assess functional residual capacity (FRC) and ventilation inhomogeneity in the lung. Indirect calculation of nitrogen concentration ...requires accurate measurement of gas concentrations. To investigate the accuracy of the CO
concentration and molar mass (MM) values used for the indirect calculation of nitrogen concentration in a commercial MBW device EasyOne Pro LAB (EOPL), ndd Medizintechnik AG, Switzerland and its impact on outcomes. We used high-precision gas mixtures to evaluate CO
and MM sensor output in vivo and in vitro. We developed updated algorithms to correct observed errors and assessed the impact on MBW outcomes and FRC measurement accuracy compared with body plethysmography. The respiratory exchange ratio (RER)-based adjustment of the measured CO
signal used in the EOPL led to an overestimated CO
signal (range -0.1% to 1.0%). In addition, an uncorrected dependence on humidity was identified. These combined effects resulted in an overestimation of expired nitrogen concentrations (range -0.7% to 2.6%), and consequently MBW outcomes. Corrected algorithms reduced the mean (SD) cumulative expired volume by 15.8% (9.7%), FRC by 6.6% (3.0%), and lung clearance index by 9.9% (7.6%). Differences in FRC between the EOPL and body plethysmography further increased. Inadequate signal correction causes RER- and humidity-dependent expired nitrogen concentration errors and overestimation of test outcomes. Updated algorithms reduce average signal error, however, RER values far from the population average still cause measurement errors. Despite improved signal accuracy, the updated algorithm increased the difference in FRC between the EOPL and body plethysmography.
We investigated the accuracy of the molar mass (MM) and CO
sensors of a commercial multiple-breath washout device (ndd Medizintechnik AG, Switzerland). We identified humidity and respiratory exchange ratio-dependent errors that in most measurements resulted in an overestimation of expired nitrogen concentrations, and consequently, MBW results. Functional residual capacity and lung clearance index decreased by 6.6% and 9.9%, respectively. Despite improved signal accuracy, the difference in FRC between the EOPL and body plethysmography increased.
Obesity poses a significant public health challenge. Research has examined the impact of cannabis and subproducts on health but varying results have hindered a consensus.
This study aimed to ...evaluated the effects of cannabis and subproducts on body measurements.
For searching randomized controlled trials evaluating cannabis and/or subproducts use and changes in anthropometric measures, a systematic search at MEDLINE, Embase, Cochrane Library and Web of Science was conducted until March 2023. The outcomes included changes in body weight, body mass index (BMI) and waist circumference (WC). Meta-analysis was realized using R software (version 4.2.1).
In general, cannabis use reduced weight by 1.87 kg (95% CI: -3.71 to -0.03) and WC (mean difference = -2.19, 95% CI: -4.44 to 0.06). When examining subgroups, longer follow-up periods were associated with a more pronounced BMI reduction (mean difference = -1.10, 95% CI: -2.23 to 0.03). Cannabinoid CB1 exhibited an increase in body fat (mean difference = 1.70, 95% CI: 0.66-2.74).
These findings suggest that cannabis and subproducts could be considered adjuncts in obesity treatment by helping to reduce relevant anthropometric measurements.
Combining brain imaging with dual-task paradigms provides a quantitative, direct metric of cognitive load that is agnostic to the motor task. This work aimed to quantitatively assess cognitive load ...during activities of daily living-sitting, standing, and walking-using a commercial dry encephalography headset. We recorded participants' brain activity while engaging in a stimulus paradigm that elicited event-related potentials. The stimulus paradigm consisted of an auditory oddball task in which participants had to report the number of oddball tones that were heard during each motor task. We extracted the P3 event-related potential, which is inversely proportional to cognitive load, from EEG signals in each condition. Our main findings showed that P3 was significantly lower during walking compared to sitting (p = .039), suggesting that cognitive load was higher during walking compared to the other activities. There were no significant differences in P3 between sitting and standing. Head motion did not have a significant impact on the measurement of cognitive load. This work validates the use of a commercial dry-EEG headset for measuring cognitive load across different motor tasks. The ability to accurately measure cognitive load in dynamic activities opens new avenues for exploring cognitive-motor interactions in individuals with and without motor impairments. This work highlights the potential of dry EEG for measuring cognitive load in naturalistic settings.
The aim of this study was to quantify changes in physical capacities of thirty-eight basketball players selected from different teams, as well as from varying competitive levels (i.e. Division I, ...Division II and Division III) during the preparation and in-season periods.
Pre (T1) and post (T2) preparation period and during regular season (T3), the players completed a Yo-Yo Intermittent Recovery test-level 1. Following a 3 to 8 days-break, players performed a 6-min continuous running test (Mognoni's test), a counter-movement jump test and a 5-min high-intensity intermittent running test.
Blood lactate concentration measured after the Mognoni's test was significantly reduced from T1 to T2, and from T2 to T3 (P<0.001, ƞ2 = 0.424). The distance covered during the Yo-Yo Intermittent Recovery test was significantly increased only from T1 to T2 in Division II and III (P<0.001, ƞ2 = 0.789). Similarly, the physiological responses to high-intensity intermittent running test were improved only from T1 to T2 (all P<0.001, ƞ2 = 0.495 to 0.652). Despite significant changes observed in running tests from T1 to T2, at individual level 35-55% of players did not show a very likely improvement. Relative peak power produced during vertical jumps at T3 by Division I players was increased compared to T1 (ANOVA interaction, P = 0.037, ƞ2 = 0.134).
The main improvements in physical capacities occurred during the preparation period, when the aerobic fitness and the ability to sustain high-intensity intermittent efforts were moderately-to-largely improved. However, it appears that the preparation period does not consistently impact on vertical jump variables. Aerobic fitness and force/power production during vertical jumps appear to improve across the competitive season (slightly-to-moderately). Physical tests should be used to identify weaknesses in physical performance of players and to monitor their fatigue status, with the aim to develop individualized training programs.
In pregnancies of women with obesity or diabetes, neonates are often overgrown. Thus, the pregnancy period in these women offers a window of opportunity to reduce childhood obesity by preventing ...neonatal overgrowth. However, the focus has been almost exclusively on growth in late pregnancy. This perspective article addresses possible growth deviations earlier in pregnancy and their potential contribution to neonatal overgrowth. This narrative review focuses on six large-scale, longitudinal studies that included ∼14,400 pregnant women with at least three measurements of fetal growth. A biphasic pattern in growth deviation, including growth reduction in early pregnancy followed by overgrowth in late pregnancy, was found in fetuses of women with obesity, gestational diabetes mellitus (GDM), or type 1 diabetes compared with lean women and those with normal glucose tolerance. Fetuses of women with these conditions have reduced abdominal circumference (AC) and head circumference (HC) in early pregnancy (observed between 14 and 16 gestational weeks), while later in pregnancy they present the overgrown phenotype with larger AC and HC (from approximately 30 gestational weeks onwards). Fetuses with early-pregnancy growth reduction who end up overgrown presumably have undergone in utero catch-up growth. Similar to postnatal catch-up growth, this may confer a higher risk of obesity in later life. Potential long-term health consequences of early fetal growth reduction followed by in utero catch-up growth need to be explored.
Assistive devices are becoming increasingly popular for physically disabled persons suffering tetraplegia and spinal cord injuries. Intraoral tongue drive system (iTDS) is one of the most feasible ...and non-invasive assistive technology (AT), which utilises the transferring and inferring of user intentions through different tongue gestures. Wireless transferring is of prime importance and requires a suitable design of the intra-oral antenna. In this paper, a compact circularly polarized differential intra-oral antenna is designed, and its performance is analysed within heterogeneous multilayer mouth and head models. It works at 2.4 GHz in the Industrial, Scientific, and Medical (ISM) band. The footprint of the differential antenna prototype is 0.271 λ
Formula: see text 0.271 λ
Formula: see text 0.015 λ
. It is achieved using two pairs of spiral segments loaded in diagonal form near the edges of the central rotated square slot and a high dielectric constant substrate. Its spiral-slotted geometry further provides the desired swirling and miniaturization at the desired frequency band for both mouth scenarios. Additionally, corner triangular slits on the radiating patch assist in tuning the axial ratio (< 3 dB) in the desired ISM band. To validate the performance of the proposed in-mouth antenna, the measurement was carried out using the minced pork and the saline solution for closed and opened mouth cases, respectively. The measured - 10 dB impedance bandwidth and peak gain values in the minced pork are from 2.28 to 2.53 GHz (10.39%) and - 18.17 dBi, respectively, and in the saline solution, are from 2.3 to 2.54 GHz (9.92%) and - 15.47 dBi, respectively. Further, the specific absorption rate (SAR) is estimated, and the data communication link is computed with and without a balun loss. This confirms that the proposed differential intraoral antenna can establish direct interfacing at the RF front end of the intraoral tongue drive system.
Background
Tuberculosis (TB) prevalence remains persistently high in many settings, with new or expanded interventions required to achieve substantial reductions. The HIV Prevention Trials Network ...(HPTN) 071 (PopART) community-randomised trial randomised 14 communities to receive the “PopART” intervention during 2014 to 2017 (7 arm A and 7 arm B communities) and 7 communities to receive standard-of-care (arm C). The intervention was delivered door-to-door by community HIV care providers (CHiPs) and included universal HIV testing, facilitated linkage to HIV care at government health clinics, and systematic TB symptom screening. The Tuberculosis Reduction through Expanded Anti-retroviral Treatment and Screening (TREATS) study aimed to measure the impact of delivering the PopART intervention on TB outcomes, in communities with high HIV and TB prevalence.
Methods and findings
The study population of the HPTN 071 (PopART) trial included individuals aged ≥15 years living in 21 urban and peri-urban communities in Zambia and South Africa, with a total population of approximately 1 million and an adult HIV prevalence of around 15% at the time of the trial. Two sputum samples for TB testing were provided to CHiPs by individuals who reported ≥1 TB suggestive symptom (a cough for ≥2 weeks, unintentional weight loss ≥1.5 kg in the last month, or current night sweats) or that a household member was currently on TB treatment. Antiretroviral therapy (ART) was offered universally at clinics in arm A and according to local guidelines in arms B and C. The TREATS study was conducted in the same 21 communities as the HPTN 071 (PopART) trial between 2017 and 2022, and TB prevalence was a co-primary endpoint of the TREATS study. The primary comparison was between the PopART intervention (arms A and B combined) and the standard-of-care (arm C). During 2019 to 2021, a TB prevalence survey was conducted among randomly selected individuals aged ≥15 years (approximately 1,750 per community in arms A and B, approximately 3,500 in arm C). Participants were screened on TB symptoms and chest X-ray, with diagnostic testing using Xpert-Ultra followed by culture for individuals who screened positive. Sputum eligibility was determined by the presence of a cough for ≥2 weeks, or ≥2 of 5 “TB suggestive” symptoms (cough, weight loss for ≥4 weeks, night sweats, chest pain, and fever for ≥2 weeks), or chest X-ray CAD4TBv5 score ≥50, or no available X-ray results. TB prevalence was compared between trial arms using standard methods for cluster-randomised trials, with adjustment for age, sex, and HIV status, and multiple imputation was used for missing data on prevalent TB. Among 83,092 individuals who were eligible for the survey, 49,556 (59.6%) participated, 8,083 (16.3%) screened positive, 90.8% (7,336/8,083) provided 2 sputum samples for Xpert-Ultra testing, and 308 (4.2%) required culture confirmation. Overall, estimated TB prevalence was 0.92% (457/49,556). The geometric means of 7 community-level prevalence estimates were 0.91%, 0.70%, and 0.69% in arms A, B, and C, respectively, with no evidence of a difference comparing arms A and B combined with arm C (adjusted prevalence ratio 1.14, 95% confidence interval, CI 0.67, 1.95,
p
= 0.60). TB prevalence was higher among people living with HIV than HIV–negative individuals, with an age-sex-community adjusted odds ratio of 2.29 95% CI 1.54, 3.41 in Zambian communities and 1.61 95% CI 1.13, 2.30 in South African communities. The primary limitations are that the study was powered to detect only large reductions in TB prevalence in the intervention arm compared with standard-of-care, and the between-community variation in TB prevalence was larger than anticipated.
Conclusions
There was no evidence that the PopART intervention reduced TB prevalence. Systematic screening for TB that is based on symptom screening alone may not be sufficient to achieve a large reduction in TB prevalence over a period of several years. Including chest X-ray screening alongside TB symptom screening could substantially increase the sensitivity of systematic screening for TB.
Trial registration
The TREATS study was registered with
ClinicalTrials.gov
Identifier:
NCT03739736
on November 14, 2018. The HPTN 071 (PopART) trial was registered at
ClinicalTrials.gov
under number
NCT01900977
on July 17, 2013.
Objective Identifying metabolic disorders at the earliest phase of their development allows for an early intervention and the prevention of serious consequences of diseases. However, it is difficult ...to determine which of the anthropometric indices of obesity is the best tool for diagnosing metabolic disorders. The aims of this study were to evaluate the usefulness of selected anthropometric indices and to determine optimal cut-off points for the identification of single metabolic disorders that are components of metabolic syndrome (MetS). Design Cross-sectional study. Participants We analyzed the data of 12,328 participants aged 55.7#177;5.4 years. All participants were of European descent. Primary outcome measure Four MetS components were included: high glucose concentration, high blood triglyceride concentration, low high-density lipoprotein cholesterol concentration, and elevated blood pressure. The following obesity indices were considered: waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), body fat percentage (%BF), Cl#237;nica Universidad de Navarra-body adiposity estimator (CUN-BAE), body roundness index (BRI), and a body shape index (ABSI). Results The following indices had the highest discriminatory power for the identification of at least one MetS component: CUN-BAE, BMI, and WC in men (AUC = 0.734, 0.728, and 0.728, respectively) and WHtR, CUN-BAE, and WC in women (AUC = 0.715, 0.714, and 0.712, respectively) (p0.001 for all). The other indices were similarly useful, except for the ABSI. Conclusions For the BMI, the optimal cut-off point for the identification of metabolic abnormalities was 27.2 kg/m.sup.2 for both sexes. For the WC, the optimal cut-off point was of 94 cm for men and 87 cm for women. Prospective studies are needed to identify those indices in which changes in value predict the occurrence of metabolic disorders best.
This study aimed to identify physique characteristics (anthropometry, somatotype, body proportionality) of Brazilian female artistic gymnasts, and to compare them across competitive levels (sub-elite ...versus non-elite) within competitive age-categories. Two hundred forty-nine female gymnasts (68 sub-elite; 181 non-elite) from 26 Brazilian gymnastics clubs, aged 9-20 years and split into four age-categories, were sampled. Gymnasts were assessed for 16 anthropometric traits (height, weight, lengths, widths, girths, and skinfolds); somatotype was determined according to Heath-Carter method, body fat was estimated by bioimpedance, and proportionality was computed based on the z-phantom strategy. Non-elite and sub-elite gymnasts had similar values in anthropometric characteristics, however non-elite had higher fat folds in all age-categories (P < 0.01). In general, mesomorphy was the salient somatotype component in all age-categories, and an increase in endomorphy, followed by a decrease in ectomorphy across age was observed. Regarding proportionality, profile similarity was found between sub-elite and non-elite within age-categories. In conclusion results suggest the presence of a typical gymnast's physical prototype across age and competitive level, which can be useful to coaches during their selection processes in clubs and regional/national teams.
Objective
To assess the effects of weight loss and weight gain on hip and knee radiographic changes, pain, and joint replacement over 4 years.
Methods
Participants (n = 2,752) from the Osteoarthritis ...Initiative were classified as those with weight gain (more than 5% gain), weight loss (more than –5% loss), or as controls (–3% to 3% change) over 4 years. Generalized estimating equations (adjusted for age, sex, and body mass index) were used to assess the relationship between the weight‐change group and 4‐year changes in knee radiographic osteoarthritis (OA) (Kellgren/Lawrence K/L grade), hip OA (Croft summary grade), joint space narrowing (JSN), and joint pain.
Results
For radiographic knee OA, weight loss was associated with significantly lower odds of K/L grade worsening over 4 years (odds ratio OR 0.69 95% confidence interval (95% CI) 0.53–0.91, P = 0.009), and weight gain was significantly associated with higher odds of medial knee JSN (OR 1.29 95% CI 1.01–1.64, P = 0.038) compared to controls. For knee pain, weight loss was significantly associated with knee pain resolution over 4 years (OR 1.40 95% CI 1.06–1.86, P = 0.019) while weight gain was associated with knee pain development (OR 1.34 95% CI 1.08–1.67, P = 0.009) compared to controls. For all hip outcomes, no significant associations (P > 0.05) were found with weight‐change groups. The associations between the weight‐change group and total hip or total knee replacement were not significant (P > 0.05).
Conclusion
This large, longitudinal study (n = 2,752 with 4‐year follow‐up) suggests that weight loss may protect against, and weight gain may exacerbate, radiographic and symptomatic knee OA, while weight change (at a 5% threshold) does not have significant effects on hip OA.
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