This study aimed to evaluate the presence of dynamic hyperinflation (DH) during the Glittre-ADL test (TGlittre) coupled to the dynamic ventilation measurements in people with central obesity (pwCO) ...and to correlate it with lung mechanics at rest. Sixty-four pwCO underwent TGlittre and the following resting lung function tests: spirometry and impulse oscillometry system (IOS). On TGlittre, 22 participants presented DH at the end of the test (DH group), while 42 did not present DH (NDH group). Body mass index (BMI), waist circumference (WC), and hip circumference (HC) were higher in the DH group than in the NDH group. IOS abnormalities were more common in the DH group compared to the NDH group. TGlittre time significantly correlated with BMI, WC, waist-to-hip ratio (WHR), and neck circumference (NC). Delta inspiratory capacity correlated significantly with WC, HC, NC, and resonance frequency measured by IOS. Thus, pwCO perform worse on TGlittre, and DH is frequent in those with higher anthropometric indices and worse lung mechanics.
•People with central obesity take 80% longer to perform the Glittre-ADL test.•Approximately one-third of them show dynamic hyperinflation on exercise.•People with central obesity and hyperinflation have higher anthropometric indices.•People with central obesity and hyperinflation have worse lung mechanics.•Worse performance on Glittre-ADL test is associated with worse lung mechanics.
To improve preoperative risk stratification in lung cancer lobectomy by identifying and comparing optimal thresholds for peak oxygen uptake (VO2peak) presented as weight-indexed and percent of ...predicted values, respectively.
This was a longitudinal cohort study including national registry data on patients scheduled for cancer lobectomy that used available data from preoperative cardiopulmonary exercise testing. The measured VO2peak was indexed by body mass (mL/kg/min) and also compared with 2 established reference equations (Wasserman-Hansen and Study of Health in Pomerania, respectively). By receiver operating characteristic analysis, a lower 90% specificity and an upper 90% sensitivity threshold were determined for each measure, in relation to the outcome of any major complication or death. For each measure and based on these thresholds, patients were categorized as low risk, intermediate risk, or high risk. The frequency of complications was compared between groups using χ2.
The frequency of complications differed significantly between the proposed low-, intermediate-, and high-risk groups when using % predicted Study of Health in Pomerania (5%, 21%, 35%, P = .007) or % predicted Wasserman-Hansen (5%, 25%, 35%, P = .002) but not when using the weight-indexed VO2peak groups (7%, 23%, 15%, P = .08). Nonsignificant differences were found using the threshold <15 mL/kg/min (P = .34).
This study showed that weight-indexed VO2peak was of less use as a marker of risk at the lower range of exercise capacity, whereas % predicted VO2peak was associated with a continuously increasing risk of major complications, also at the lower end of exercise capacity. As identifying subjects at high risk of complications is important, % predicted VO2peak is therefore preferable.
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Cardiorespiratory fitness (CRF) is a well-established biomarker that has applications to all adults across the health and disease spectrum. Despite overwhelming evidence supporting the prognostic ...utility of CRF, it remains vastly underutilized. CRF is optimally measured via cardiopulmonary exercise testing which may not be feasible to implement on a large scale. Therefore, it is prudent to develop ways to accurately estimate CRF that can be applied in clinical and community settings. As such, several prediction equations incorporating non-exercise information that is readily available from routine clinical encounters have been developed that provide an adequate reflection of CRF that could be implemented to raise awareness of the importance of CRF. Further, technological advances in smartphone apps and consumer-grade wearables have demonstrated promise to provide reasonable estimates of CRF that are widely available, which could enhance the utilization of CRF in both clinical and community settings.
Chronic low back pain (LBP) is a prevalent condition in older adults, being identified as a cause of disability in this population. Despite ir validity and reliability, the functional capacity tests ...are not often administered in patients with LBP but provide useful information related to mobility. A measurement property of the functional capacity tests that has not been investigated extensively in the LBP field is the resiveness, such as the capacity to detect changes during the intervention.
To determine the responsiveness of three functional capacity tests, the Timed Up and Go test, the 4-meter Walk test, the 5 times Sit to Stand test, and to compare with the responsiveness of the Roland Morris Disability Questionnaire (RMDQ) in older adults with chronic LBP undergoing an 8-week intervention.
This is a responsiveness study with measurement before and after an 8-week intervention. It was prospectively registered at the Brazilian Registry of Clinical Trials (RBR-9prhzng). Patients with nonspecific LBP (age ≥60) were recruited. The functional capacity tests and the RMDQ were administered at baseline and after 8 weeks. The intervention followed the recommendations from clinical practice guidelines for the management of nonspecific LBP: The responsiveness was determined by calculating the effect size (ES), correlation analysis, and the analysis of the Receiver Operating Characteristic (ROC) Curve to calculate the area under the curve (AUC).
118 older adults with chronic LBP were recruited. The RMDQ was the most responsiveness measure, followed by the Sit to Stand test. The ES for the RMDQ was large (ES= -0,74; 95%IC: -0,56; -0,92), whereas the 5 Times Sit to Stand test presented a small effect (EF= -0,45, 95%CI: - 0,26; -0,64). The Timed UP and Go test and the 4-meter Walk test small ESs (ES< 0,25). The 5 Times Sit to Stand test was the only one to show a fair correlation (0,25 < r <0,50) with RMDQ. The ROC analysis, only the RMDQ showed AUC values above the cut-off point of 0,70.
The RMDQ was responsive to an 8-week lumbar stabilization program in older adults with chronic LBP. The 5 Times Sit to Stand test was the most responsive but presented limitations with regard to the capacity to discriminate patients who recovered from those who did not recover. A possible explanation for the lack of responsiveness foto the tests may be due to the nature of the intervention, which was not focused on increasing ability and balance, components that are necessarily assessed by functional capacity tests.
Functional capacity tests are widely used to assess mobility and balance in older adults. Only the 5 Times Sit to Stand test was considered to able to detect changes in older adults who underwent an 8-week intervention program. The RMDQ was more responsive than any of the functional capacity tests.
Background and Objective:Adolescent idiopathic scoliosis is one of the complex and common deformities of the spine. It is a condition that can cause a lot of pain and discomfort for individuals and ...has consequences and complications. There are different exercises and approaches for correction of this deformity, such as Schroth exercise. In this regard, the purpose of this study was to investigate the effect of corrective exercises on Cobb angle, flexibility, functional capacity, and quality of life of adolescents with idiopathic scoliosis. Materials and Methods:This controlled clinical trial with pre-test and post-test design was performed on 24 adolescents with idiopathic scoliosiswho were randomly divided into control and experimental groups. Cobb angle, flexibility, and functional capacity were measured by X-ray imaging, flexibility box, and six-minute walk test, respectively. The collected data were statistically analyzed in SPSS software (version 23) using a mixed-design analysis of variance with repeated measures. It must be noted that a p-value of 0.05 was considered statistically significant. Results:Based on the results, after 10 weeks of Schroth exercises, there was a significant difference in the exercise group regarding the reduction of Cobb angle as well as the increase of flexibility and functional capacity. However, no significant difference was observed in the control group from pre-test to post-test (P≤0.05). Conclusion:According to the results, it can be concluded that the Schroth exercise program that involves the whole motor chain can effectively decrease the lateral curvature angle of patients with idiopathicscoliosis. Therefore, this type of exercise can be useful to use to treat people with Idiopathic scoliosisdeformity.
Abstract
Background and hypothesis
Recovery from psychosis is a complex phenomenon determined by an array of variables mutually impacting each other in a manner that is not fully understood. The aim ...of this study is to perform an approximated replication of a previous network analysis study investigating how different clinical aspects—covering psychopathology, cognition, personal resources, functional capacity, and real-life functioning—are interrelated in the context of schizophrenia-spectrum disorders.
Study design
A sample of 843 subjects from a multisite cohort study, with the diagnosis of a schizophrenia-spectrum disorder, was used to estimate a network comprising 27 variables. The connectivity and relative importance of the variables was examined through network analysis. We used a quantitative and qualitative approach to infer replication quality.
Study results
Functional capacity and real-life functioning were central and bridged different domains of the network, in line with the replicated study. Neurocognition, interpersonal relationships, and avolition were also key elements of the network, in close relation to aspects of functioning. Despite significant methodological differences, the current study could substantially replicate previous findings.
Conclusions
Results solidify the network analysis approach in the context of mental disorders and further inform future studies about key variables in the context of recovery from psychotic disorders.
Emerging evidence has supported the idea that goal-directed prehabilitation is a promising approach to boost functional capacity in preoperative patients. However, its usefulness has not been tested ...in the hepatobiliary and pancreatic (HBP) field. The objective of this trial was to investigate the efficacy of goal-directed prehabilitation for improving functional capacity in patients who were planned to undergo major HBP operations.
This assessor-blinded, parallel-arm, randomized clinical trial recruited patients who were scheduled for major HBP surgeries for malignancy. Patients were randomly allocated into the step goal-directed prehabilitation (GOLD) group as the test group and into the conventional prehabilitation (CONV) group as the control group. Patients in the GOLD group participated in a walking prehabilitation program with an intergrading goal of the step count. Patients in the CONV group received standard physical and nutritional prehabilitation. The primary outcome was change in the 6-minute walking distance (6MWD), which ranged from the time before starting prehabilitation (baseline) to the time after completing prehabilitation (immediately before surgery).
Among 180 randomized patients, 144 patients were included in the primary analysis (73 patients in the CONV group and 71 patients in the GOLD group). The mean change in the 6MWD was 27 m in the CONV group and 31 m in the GOLD group (P = 0.633).
In patients undergoing major HBP surgeries for malignancies, a goal-directed prehabilitation program did not result in a significantly greater increase in functional capacity than did conventional prehabilitation. Registration number: UMIN000038791 (https://www.umin.ac.jp/).
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•Mung bean protein (MBP) was hydrolyzed by five proteases.•Alcalase had a stronger hydrolytic ability to MBP than other proteases.•Five proteases hydrolysis significantly destroyed the α-helix and ...β-sheet of MBP.•Protamex, papain hydrolysates had stronger functional properties than others.•Alcalase hydrolysate exhibited stronger antioxidant activity than other hydrolysates.
This study aimed to investigate physicochemical, functional and antioxidant properties of mung bean protein (MBP) enzymatic hydrolysates (MBPEHs) by alcalase, neutrase, protamex, flavourzyme and papain. Physicochemical properties were evaluated by SDS-PAGE, particle size distribution, FTIR, ultraviolet visible and fluorescence spectrophotometries. ABTS, hydroxyl scavenging, Fe2+ chelating activity were used to evaluate antioxidant activity. Enzymolysis with five proteases decreased average particle size, α-helix, β-sheet, surface hydrophobicity of hydrolysates. Alcalase hydrolysate had the highest degree of hydrolysis (23.55%), absolute zeta potential (33.73 mV) and the lowest molecular weight (<10 kDa). Protamex and papain hydrolysates had higher foaming capacities, emulsification activity indexes, emulsion stability indexes (235.00%, 123.07 m2/g, 132.54 min; 200.10%, 105.39 m2/g, 190.67 min) than MBP (135.03%, 20.03 m2/g, 30.88 min). Alcalase hydrolysate demonstrated the lowest IC50 (mg/mL) in ABTS (0.12), hydroxyl (2.98), Fe2+ chelating (0.22). These results provide support for application of MBPEHs as foaming agent, emulsifier and antioxidant in food industry.
Aging research has been very successful at identifying signaling pathways and evolutionarily conserved genes that extend lifespan with the assumption that an increase in lifespan will also increase ...healthspan. However, it is largely unknown whether we are extending the healthy time of life or simply prolonging a period of frailty with increased incidence of age-associated diseases. Here we use Caenorhabditis elegans, one of the premiere systems for lifespan studies, to determine whether lifespan and healthspan are intrinsically correlated. We conducted multiple cellular and organismal assays on wild type as well as four long-lived mutants (insulin/insulin-like growth factor-1, dietary restriction, protein translation, mitochondrial signaling) in a longitudinal manner to determine the health of the animals as they age. We find that some long-lived mutants performed better than wild type when measured chronologically (number of days). However, all long-lived mutants increased the proportion of time spent in a frail state. Together, these data suggest that lifespan can no longer be the sole parameter of interest and reveal the importance of evaluating multiple healthspan parameters for future studies on antiaging interventions.
Improving real-life functioning is the main goal of the most advanced integrated treatment programs in people with schizophrenia. The Italian Network for Research on Psychoses used network analysis ...in a four-year follow-up study to test whether the pattern of relationships among illness-related variables, personal resources and context-related factors differed between patients who were classified as recovered at follow-up versus those who did not recover. In a large sample (N=618) of clinically-stable, community-dwelling subjects with schizophrenia, the study demonstrated a considerable stability of the network structure. Functional capacity and everyday life skills had a high betweenness and closeness in the network at both baseline and follow-up, while psychopathological variables remained more peripheral. The network structure and connectivity of non-recovered patients were similar to those observed in the whole sample, but very different from those in recovered subjects, in which we found few connections only. These data strongly suggest that tightly coupled symptoms/dysfunctions tend to maintain each other’s activation, contributing to poor outcome in subjects with schizophrenia. The data suggest that early and integrated treatment plans, targeting variables with high centrality, might prevent the emergence of self-reinforcing networks of symptoms and dysfunctions in people with schizophrenia. Disclosure Honoraria, advisory board, or consulting fees from Angelini, Astra Zeneca, Bristol-Myers Squibb, Gedeon Richter Bulgaria, Innova-Pharma, Janssen Pharmaceuticals, Lundbeck, Otsuka, Pfizer, and Pierre Fabre, for services not related to this abstract
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