Early indication of decompensated heart failure in patients on home-telemonitoring: a comparison of prediction algorithms based on daily weight and noninvasive transthoracic bio-impedance

Background: Heart Failure (HF) is a common reason for hospitalization. Admissions might be prevented by early detection of and intervention for decompensation. Conventionally, changes in weight, a possible measure of fluid accumulation, have been used to detect deterioration. Transthoracic impedance may be a more sensitive and accurate measure of fluid accumulation. Objective: In this study, we review previously proposed predictive algorithms using body weight and noninvasive transthoracic bio-impedance (NITTI) to predict HF decompensations. Methods: We monitored 91 patients with chronic HF for an average of 10 months using a weight scale and a wearable bio-impedance vest. Three algorithms were tested using either simple rule-of-thumb differences (RoT), moving averages (MACD), or cumulative sums (CUSUM). Results: Algorithms using NITTI in the 2 weeks preceding decompensation predicted events (P<.001); however, using weight alone did not. Cross-validation showed that NITTI improved sensitivity of all algorithms tested and that trend algorithms provided the best performance for either measurement (Weight-MACD: 33%, NITTI-CUSUM: 60%) in contrast to the simpler rules-of-thumb (Weight-RoT: 20%, NITTI-RoT: 33%) as proposed in HF guidelines. Conclusions: NITTI measurements decrease before decompensations, and combined with trend algorithms, improve the detection of HF decompensation over current guideline rules; however, many alerts are not associated with clinically overt decompensation

Quarter-mile walk test sensitive to training-induced fitness changes

BACKGROUND: Cardiorespiratory fitness (CRF) is an important aspect of the overall health of an individual and its monitoring must be promoted in the general population. Thus, the aim of the study was to cross-validate and improve CRF estimation based on quarter-mile Rockport Fitness Walking Test. METHODS: Thirty participants (31.4±7.99 years) were randomized in either a four-week aerobic training group (10 men and 10 women) or a control group (eight men and two women). CRF was assessed via VO2max test and estimated via quarter-mile Rockport Fitness and Ebbeling treadmill tests, before and after the training intervention. The original quarter-mile Rockport VO2max estimation was found to greatly overestimate CRF by 22 mL/kg/min. When its coefficient was updated according to our data, it largely improved (by 6.8 mL/kg/min). Furthermore, a new algorithm for predicting VO2max was designed using multi-linear regression analysis. RESULTS: The original quarter-mile Rockport Fitness Walking Test was not sensitive to CRF changes. It showed changes in VO2max, which were significantly different from the actual observed changes (-1.1±4.08 vs. 1.61±2.84, P=0.02, respectively). The Ebbeling treadmill test appeared to systematically overestimate CRF changes. Our new algorithm showed improved sensitivity for detecting CRF changes and stability. CONCLUSIONS: The original quarter-mile Rockport Fitness Walking Test equation for predicting VO2max was neither accurate nor sensitive to changes in CRF, most likely due to cardiovascular drift. Our new algorithm, based on the same brisk walking test, can provide a more accurate estimate of CRF, which is also sensitive to VO2max changes, in a broad age range (18 to 50 years)

A 45-Second Self-Test for Cardiorespiratory Fitness:Heart Rate-Based Estimation in Healthy Individuals

Cardio-respiratory fitness (CRF) is a widespread essential indicator in Sports Science as well as in Sports Medicine. This study aimed to develop and validate a prediction model for CRF based on a 45 second self-test, which can be conducted anywhere. Criterion validity, test re-test study was set up to accomplish our objectives. Data from 81 healthy volunteers (age: 29 ± 8 years, BMI: 24.0 ± 2.9), 18 of whom females, were used to validate this test against gold standard. Nineteen volunteers repeated this test twice in order to evaluate its repeatability. CRF estimation models were developed using heart rate (HR) features extracted from the resting, exercise, and the recovery phase. The most predictive HR feature was the intercept of the linear equation fitting the HR values during the recovery phase normalized for the height2 (r2 = 0.30). The Ruffier-Dickson Index (RDI), which was originally developed for this squat test, showed a negative significant correlation with CRF (r = -0.40), but explained only 15% of the variability in CRF. A multivariate model based on RDI and sex, age and height increased the explained variability up to 53% with a cross validation (CV) error of 0.532 L ∙ min-1 and substantial repeatability (ICC = 0.91). The best predictive multivariate model made use of the linear intercept of HR at the beginning of the recovery normalized for height2 and age2; this had an adjusted r2 = 0. 59, a CV error of 0.495 L·min-1 and substantial repeatability (ICC = 0.93). It also had a higher agreement in classifying CRF levels (κ = 0.42) than RDI-based model (κ = 0.29). In conclusion, this simple 45 s self-test can be used to estimate and classify CRF in healthy individuals with moderate accuracy and large repeatability when HR recovery features are included

Protonium production in ATHENA

Abstract The ATHENA experiment at CERN, after producing cold antihydrogen atoms for the first time in 2002, has synthesised protonium atoms in vacuum at very low energies. Protonium, i.e. the antiproton–proton bound system, is of interest for testing fundamental physical theories. In the nested penning trap of the ATHENA apparatus protonium has been produced as result of a chemical reaction between an antiproton and the simplest matter molecule, H 2 + . The formed protonium atoms have kinetic energies in the range 40–700 meV and are metastable with mean lifetimes of the order of 1 μs. Our result shows that it will be possible to start measurements on protonium at low energy antiproton facilities, such as the AD at CERN or FLAIR at GSI

A Proton Recoil Telescope for Neutron Spectroscopy

The N2P research program funded by the INFN committee for Experimental Nuclear Physics (CSNIII) has among his goals the construction of a Proton Recoil Telescope (PRT), a detector to measure neutron energy spectra. The interest in such a detector is primarily related to the SPES project for rare beams production at the Laboratori Nazionali di Legnaro. For the SPES project it is, in fact, of fundamental importance to have reliable information about energy spectra and yield for neutrons produced by d or p projectiles on thick light targets to model the ''conversion target'' in which the p or d are converted in neutrons. These neutrons, in a second stage, will induce the Uranium fission in the ''production target''. The fission products are subsequently extracted, selected and re-accelerated to produce the exotic beam. The neutron spectra and angular distribution are important parameters to define the final production of fission fragments. In addition, this detector can be used to measure neutron spectra in the field of cancer therapy (this topic is nowadays of particular interest to INFN, for the National Centre for Hadron therapy (CNAO) in Pavia) and space applications

Dynamics of antiproton cooling in a positron plasma during antihydrogen formation

Abstract We demonstrate cooling of 10 4 antiprotons in a dense, cold plasma of ∼10 8 positrons, confined in a nested cylindrical Penning trap at about 15 K. The time evolution of the cooling process has been studied in detail, and several distinct types of behavior identified. We propose explanations for these observations and discuss the consequences for antihydrogen production. We contrast these results with observations of interactions between antiprotons and "hot" positrons at about 3000 K, where antihydrogen production is strongly suppressed

Measuring the free fall of antihydrogen

After the first production of cold antihydrogen by the ATHENA and ATRAP experiments ten years ago, new second-generation experiments are aimed at measuring the fundamental properties of this anti-atom. The goal of AEGIS (Antimatter Experiment: Gravity, Interferometry, Spectroscopy) is to test the weak equivalence principle by studying the gravitational interaction between matter and antimatter with a pulsed, cold antihydrogen beam. The experiment is currently being assembled at CERN's Antiproton Decelerator. In AEGIS, antihydrogen will be produced by charge exchange of cold antiprotons with positronium excited to a high Rydberg state (n > 20). An antihydrogen beam will be produced by controlled acceleration in an electric-field gradient (Stark acceleration). The deflection of the horizontal beam due to its free fall in the gravitational field of the earth will be measured with a moire deflectometer. Initially, the gravitational acceleration will be determined to a precision of 1%, requiring the detection of about 105 antihydrogen atoms. In this paper, after a general description, the present status of the experiment will be reviewed

Greater male variability in daily energy expenditure develops through puberty

The authors also gratefully acknowledge funding from the Chinese Academy of Sciences (grant no. CAS153E11KYSB20190045) to J.R.S. and the US National Science Foundation (grant no. BCS-1824466) awarded to H.P. Acknowledgements Yvonne Schönbeck provided important information about morphometric measurements for Dutch children. A chat over dinner with Karsten Koehler, Eimear Dolan and Danny Longman brought up a number of thoughts that influenced this manuscript. The DLW database, which can be found at https://doublylabelled-waterdatabase.iaea.org/home, is hosted by the IAEA and generously supported by Taiyo Nippon Sanso and SERCON. We are grateful to the IAEA and these companies for their support and especially to Takashi Oono for his tremendous efforts at fundraising on our behalf.Peer reviewedPublisher PD

Total energy expenditure is repeatable in adults but not associated with short-term changes in body composition

Low total energy expenditure (TEE, MJ/d) has been a hypothesized risk factor for weight gain, but repeatability of TEE, a critical variable in longitudinal studies of energy balance, is understudied. We examine repeated doubly labeled water (DLW) measurements of TEE in 348 adults and 47 children from the IAEA DLW Database (mean ± SD time interval: 1.9 ± 2.9 y) to assess repeatability of TEE, and to examine if TEE adjusted for age, sex, fat-free mass, and fat mass is associated with changes in weight or body composition. Here, we report that repeatability of TEE is high for adults, but not children. Bivariate Bayesian mixed models show no among or within-individual correlation between body composition (fat mass or percentage) and unadjusted TEE in adults. For adults aged 20-60 y (N = 267; time interval: 7.4 ± 12.2 weeks), increases in adjusted TEE are associated with weight gain but not with changes in body composition; results are similar for subjects with intervals >4 weeks (N = 53; 29.1 ± 12.8 weeks). This suggests low TEE is not a risk factor for, and high TEE is not protective against, weight or body fat gain over the time intervals tested