Exercise performance and differences in physiological response to pulmonary rehabilitation in severe chronic obstructive pulmonary disease with hyperinflation

ABSTRACT Objective: Pulmonary rehabilitation (PR) improves exercise capacity in most but not all COPD patients. The factors associated with treatment success and the role of chest wall mechanics remain unclear. We investigated the impact of PR on exercise performance in COPD with severe hyperinflation. Methods: We evaluated 22 COPD patients (age, 66 ± 7 years; FEV 1 = 37.1 ± 11.8% of predicted) who underwent eight weeks of aerobic exercise and strength training. Before and after PR, each patient also performed a sixminute walk test and an incremental cycle ergometer test. During the latter, we measured chest wall volumes (total and compartmental, by optoelectronic plethysmography) and determined maximal workloads. Results: We observed significant differences between the pre-and post-PR means for six-minute walk distance (305 ± 78 vs. 330 ± 96 m, p < 0.001) and maximal workload (33 ± 21 vs. 39 ± 20 W; p = 0.02). At equivalent workload settings, PR led to lower oxygen consumption, carbon dioxide production (VCO 2 ), and minute ventilation. The inspiratory (operating) rib cage volume decreased significantly after PR. There were 6 patients in whom PR did not increase the maximal workload. After PR, those patients showed no significant decrease in VCO 2 during exercise, had higher end-expiratory chest wall volumes with a more rapid shallow breathing pattern, and continued to experience symptomatic leg fatigue. Conclusions: In severe COPD, PR appears to improve oxygen consumption and reduce VCO 2 , with a commensurate decrease in respiratory drive, changes reflected in the operating chest wall volumes. Patients with severe post-exercise hyperinflation and leg fatigue might be unable to improve their maximal performance despite completing a PR program

¿Cuánto tiempo de oclusión es necesario para evaluar la presión inspiratoria máxima por el método de la válvula espiratoria unidireccional en sujetos sin vía aérea artificial?

O objetivo desse estudo foi determinar o tempo de oclusão necessário para avaliar a pressão inspiratória máxima (PIMáx) obtida pelo método da válvula expiratória unidirecional em sujeitos sem via aérea artificial. Foram avaliados 31 sujeitos, com idade entre 18 e 60 anos. A PIMáx foi avaliada pelo método convencional (PIMáxconv) e pelo método da válvula expiratória unidirecional (PIMáxuni), sendo a ordem de avaliação definida por meio de sorteio. Para a medida da PIMáxuni, um manovacuômetro digital foi acoplado a uma válvula expiratória unidirecional e máscara orofacial por 20 segundos de oclusão. Nesse período, todos os sujeitos foram encorajados a realizar esforços inspiratórios máximos. Para definir a ótima duração da manobra, o tempo de esforço foi dividido a cada intervalo de 5 segundos (0-5s, 0-10s, 0-15s, 0-20s). Os intervalos de tempo para obtenção da PIMáxuni foram comparados por meio do teste de ANOVA One-way. Para comparação das médias dos valores de PIMáxconv e PIMáxuni, foi utilizado o teste t de Student. O nível de significância foi de 5%. A média dos valores da PIMáxconv foi de -102,5±23,9 cmH2 O, enquanto que a PIMáxuni foi de -117,3±24,8 cmH2 O (p<0,001). O valor absoluto máximo da PIMáxuni foi alcançado dentro do intervalo de 0-20 segundos, que foi significativamente superior ao valor absoluto máximo obtido nos primeiros 5 segundos (p=0,036). O tempo de oclusão necessário para avaliar a PIMáx pelo método da válvula expiratória unidirecional em sujeitos colaborativos sem via aérea artificial deve ser de pelo menos 20 segundos.The aim of this study was to determine how much occlusion time is necessary to obtain maximal inspiratory pressure (MIP) by the unidirectional expiratory valve method in subjects without artificial airway. Thirty-one subjects aged 18-60 years were evaluated. MIP was evaluated by the standard method (MIPstan) and by the unidirectional expiratory valve method MIPuni, with the order of evaluation determined randomly by lot. For MIPuni measurement, a digital vacuum manometer was attached to a unidirectional expiratory valve and an orofacial mask for 20 seconds of occlusion. During this period, all subjects were encouraged to make maximal respiratory efforts. To define the optimum duration of the maneuver, the 20 seconds of effort were partitioned at every five-second interval (0-5s, 0-10s, 0-15s, 0-20s). The time intervals for obtaining MIPuni were compared with the one-way ANOVA test. The mean values of the standard method and the unidirectional expiratory valve method were compared using the paired Student’s t-test. The significance level was established at 5%. The mean values for the MIPstan (-102.5±23.9 cmH2O) presented a statistically significant difference as compared to the mean values for MIPuni (-117.3±24.8 cmH2O; p<0.001). Maximal peak values for MIPuni were achieved within the 20-second time window, which differed significantly from the peak values obtained during the first five seconds (p=0.036). The occlusion time necessary to record MIP by the unidirectional expiratory valve method in collaborative subjects without artificial airway should be of at least 20 seconds

Época de semeadura sobre cultivares de sorgo sacarino / Planting season on sorghum cultivars of saccharine

A demanda por fontes de energia renovável tem aumentado e diversas culturas têm sido avaliadas para fornecimento de matéria-prima, entre elas o sorgo sacarino. O presente trabalho foi realizado com objetivo de avaliar o desempenho agronômico de cultivares de sorgo em diferentes épocas de semeadura, no Noroeste do Estado de São Paulo. O experimento foi instalado com cinco cultivares (BRS 506 e BRS 511, IAC-SART, BRANDES e SILOTEC 20) de sorgo sacarino em parcelas subdivididas em quatro épocas de semeadura (12/11/2013, 11/12/2013, 07/01/2014 e 17/02/2014). O delineamento utilizado foi em blocos ao acaso, com sete repetições. Cada unidade experimental foi constituída por doze linhas de seis metros de comprimento. A população inicial de plantas foi de 120 mil plantas ha-1 no espaçamento entre linhas de 0,50 m. Na maturação fisiológica dos grãos foram avaliadas as seguintes características: altura de planta (m), diâmetro do colmo (mm), acamamento de plantas (%), produtividade de biomassa fresca total (t ha-1), produtividade biomassa de colmos (t ha-1), biomassa fresca de folhas (t ha-1), produtividade biomassa de caldo (t ha-1) e o teor de sólidos solúveis totais do caldo (0Brix). A produtividade do sorgo é influenciada pela época de semeadura, com maior produção de colmos e caldo nas primeiras épocas. As cultivares BRS 511 e BRS 506 foram os mais produtivos e apresentaram grande potencial para uso na região Noroeste do Estado de São Paulo

Skeletal muscle structure and function in response to electrical stimulation in moderately impaired COPD patients

Study objective: To determine the structural and functional consequences of high-frequency neuromuscular electrical stimulation (hf-NMES) in a group of moderately impaired outpatients with chronic obstructive pulmonary disease (COPD).Design: A prospective, cross-over randomized trial.Setting: An university-based, tertiary center.Patients and materials: Seventeen patients (FEV1 = 49.6 +/- 13.4% predicted, Medical Research Council dyspnoea grades II-III) underwent 6-weeks hf-NMES (50 Hz) and sham stimulation of the quadriceps femoris in a randomized, cross-over design. Knee strength was measured by isokinetic dynamometry (peak torque) and leg muscle mass (LMM) by DEXA; in addition, median cross-sectional area (CSA) of type I and fibres and capillary-fibre ratio were evaluated in the vastus lateralis. the 6-min walking distance (6MWD) was also determined.Universidade Federal de São Paulo, UNIFESP, Pulm Funct & Clin Exercise Physiol Unit, SEFIC,Div Resp Dis,Dept Med, São Paulo, BrazilUniversidade Federal de São Paulo, UNIFESP, Neuromusc Div, São Paulo, BrazilUniv Glasgow, Inst Biomed & Life Sci, Glasgow, Lanark, ScotlandUniversidade Federal de São Paulo, UNIFESP, Pulm Funct & Clin Exercise Physiol Unit, SEFIC,Div Resp Dis,Dept Med, São Paulo, BrazilUniversidade Federal de São Paulo, UNIFESP, Neuromusc Div, São Paulo, BrazilWeb of Scienc

Mechanisms of exercise limitation in patients with chronic hypersensitivity pneumonitis

Small airway and interstitial pulmonary involvements are prominent in chronic hypersensitivity pneumonitis (cHP). However, their roles on exercise limitation and the relationship with functional lung tests have not been studied in detail. Our aim was to evaluate exercise performance and its determinants in cHP. We evaluated maximal cardiopulmonary exercise testing performance in 28 cHP patients (forced vital capacity 57±17% pred) and 18 healthy controls during cycling. Patients had reduced exercise performance with lower peak oxygen production (16.6 (12.3-19.98) mL·kg-1·min-1versus 25.1 (16.9-32.0), p=0.003), diminished breathing reserve (% maximal voluntary ventilation) (12 (6.4-34.8)% versus 41 (32.7-50.8)%, p<0.001) and hyperventilation (minute ventilation/carbon dioxide production slope 37±5 versus 31±4, p<0.001). All patients presented oxygen desaturation and augmented Borg dyspnoea scores (8 (5-10) versus 4 (1-7), p=0.004). The prevalence of dynamic hyperinflation was found in only 18% of patients. When comparing cHP patients with normal and low peak oxygen production (<84% pred, lower limit of normal), the latter exhibited a higher minute ventilation/carbon dioxide production slope (39±5.0 versus 34±3.6, p=0.004), lower tidal volume (0.84 (0.78-0.90) L versus 1.15 (0.97-1.67) L, p=0.002), and poorer physical functioning score on the Short form-36 health survey. Receiver operating characteristic curve analysis showed that reduced lung volumes (forced vital capacity %, total lung capacity % and diffusing capacity of the lung for carbon dioxide %) were high predictors of poor exercise capacity. Reduced exercise capacity was prevalent in patients because of ventilatory limitation and not due to dynamic hyperinflation. Reduced lung volumes were reliable predictors of lower performance during exercise

Enteric methane mitigation strategies for ruminant livestock systems in the Latin America and Caribbean region: A meta-analysis

Latin America and Caribbean (LAC) is a developing region characterized for its importance for global food security, producing 23 and 11% of the global beef and milk production, respectively. The region's ruminant livestock sector however, is under scrutiny on environmental grounds due to its large contribution to enteric methane (CH4) emissions and influence on global climate change. Thus, the identification of effective CH4 mitigation strategies which do not compromise animal performance is urgently needed, especially in context of the Sustainable Development Goals (SDG) defined in the Paris Agreement of the United Nations. Therefore, the objectives of the current study were to: 1) collate a database of individual sheep, beef and dairy cattle records from enteric CH4 emission studies conducted in the LAC region, and 2) perform a meta-analysis to identify feasible enteric CH4 mitigation strategies, which do not compromise animal performance. After outlier's removal, 2745 animal records (65% of the original data) from 103 studies were retained (from 2011 to 2021) in the LAC database. Potential mitigation strategies were classified into three main categories (i.e., animal breeding, dietary, and rumen manipulation) and up to three subcategories, totaling 34 evaluated strategies. A random effects model weighted by inverse variance was used (Comprehensive Meta-Analysis V3.3.070). Six strategies decreased at least one enteric CH4 metric and simultaneously increased milk yield (MY; dairy cattle) or average daily gain (ADG; beef cattle and sheep). The breed composition F1 Holstein × Gyr decreased CH4 emission per MY (CH4IMilk) while increasing MY by 99%. Adequate strategies of grazing management under continuous and rotational stocking decreased CH4 emission per ADG (CH4IGain) by 22 and 35%, while increasing ADG by 22 and 71%, respectively. Increased dietary protein concentration, and increased concentrate level through cottonseed meal inclusion, decreased CH4IMilk and CH4IGain by 10 and 20% and increased MY and ADG by 12 and 31%, respectively. Lastly, increased feeding level decreased CH4IGain by 37%, while increasing ADG by 171%. The identified effective mitigation strategies can be adopted by livestock producers according to their specific needs and aid LAC countries in achieving SDG as defined in the Paris Agreement.Fil: Congio, Guilhermo Francklin de Souza. Universidade do Sao Paulo. Escola Superior de Agricultura Luiz de Queiroz; Brasil. Corporación Colombiana de Investigación Agropecuaria; ColombiaFil: Bannink, André. University of Agriculture Wageningen; Países BajosFil: Mayorga Mogollón, Olga Lucía. Corporación Colombiana de Investigación Agropecuaria; ColombiaFil: Jaurena, Gustavo. Universidad de Buenos Aires. Facultad de Agronomia. Departamento de Producción Animal. Cátedra de Nutrición Animal; ArgentinaFil: Gonda, Horacio Leandro. Uppsala Universitet; SueciaFil: Gere, José Ignacio. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Patobiología Veterinaria - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Patobiología Veterinaria; ArgentinaFil: Cerón Cucchi, María Esperanza. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Patobiología; ArgentinaFil: Ortiz Chura, Abimael. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Patobiología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Tieri, María Paz. Universidad Tecnológica Nacional. Facultad Regional Rafaela; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Investigación de la Cadena Láctea. - Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela. Instituto de Investigación de la Cadena Láctea; ArgentinaFil: Hernandez, Olegario. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Tucuman-Santiago del Estero; ArgentinaFil: Ricci, Patricia. Instituto Nacional de Tecnologia Agropecuaria. Centro Regional Buenos Aires Sur. Estacion Experimental Agropecuaria Balcarce. Instituto de Innovación Para la Producción Agropecuaria y El Desarrollo Sostenible. Grupo Vinculado Estacion Experimental Agropecuaria Cuenca del Salado Al Ipads | Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Mar del Plata. Instituto de Innovación Para la Producción Agropecuaria y El Desarrollo Sostenible. Grupo Vinculado Estacion Experimental Agropecuaria Cuenca del Salado Al Ipads.; ArgentinaFil: Juliarena, María Paula. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigaciones en Física e Ingeniería del Centro de la Provincia de Buenos Aires. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigaciones en Física e Ingeniería del Centro de la Provincia de Buenos Aires. - Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigaciones en Física e Ingeniería del Centro de la Provincia de Buenos Aires; ArgentinaFil: Lombardi, Banira. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigaciones en Física e Ingeniería del Centro de la Provincia de Buenos Aires. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigaciones en Física e Ingeniería del Centro de la Provincia de Buenos Aires. - Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigaciones en Física e Ingeniería del Centro de la Provincia de Buenos Aires; ArgentinaFil: Abdalla, Adibe Luiz. Universidade de Sao Paulo; BrasilFil: Abdalla Filho, Adibe Luiz. Universidade de Sao Paulo; BrasilFil: Berndt, Alexandre. Ministerio da Agricultura Pecuaria e Abastecimento de Brasil. Empresa Brasileira de Pesquisa Agropecuaria; BrasilFil: Oliveira, Patrícia Perondi Anchão. Ministerio da Agricultura Pecuaria e Abastecimento de Brasil. Empresa Brasileira de Pesquisa Agropecuaria; BrasilFil: Henrique, Fábio Luis. Colegios Asociados de Uberaba; BrasilFil: Monteiro, Alda Lúcia Gomes. Universidade Federal do Paraná; BrasilFil: Borges, Luiza Ilha. Universidade Federal do Paraná; BrasilFil: Ribeiro Filho, Henrique Mendonça Nunes. Universidade Federal de Santa Catarina; BrasilFil: Ribeiro Pereira, Luiz Gustavo. Ministerio da Agricultura Pecuaria e Abastecimento de Brasil. Empresa Brasileira de Pesquisa Agropecuaria; BrasilFil: Tomich, Thierry Ribeiro. Ministerio da Agricultura Pecuaria e Abastecimento de Brasil. Empresa Brasileira de Pesquisa Agropecuaria; BrasilFil: Campos, Mariana Magalhães. Ministerio da Agricultura Pecuaria e Abastecimento de Brasil. Empresa Brasileira de Pesquisa Agropecuaria; BrasilFil: Machado, Fernanda Samarini. Ministerio da Agricultura Pecuaria e Abastecimento de Brasil. Empresa Brasileira de Pesquisa Agropecuaria; BrasilFil: Marcondes, Marcos Inácio. Universidade Federal de Viçosa.; BrasilFil: Mercadante, Maria Eugênia Zerlotti. Agencia de Tecnología Agroindustrial de Sao Paulo; ArgentinaFil: Sakamoto, Leandro Sannomiya. Agencia de Tecnología Agroindustrial de Sao Paulo; ArgentinaFil: Albuquerque, Lucia Galvão. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Carvalho, Paulo César de Faccio. Universidade Federal do Rio Grande do Sul; BrasilFil: Hristov, Alexander Nikolov. State University of Pennsylvania; Estados Unidos. University of Agriculture Wageningen; Países Bajos. Universidade de Sao Paulo; Brasil. Corporación Colombiana de Investigación Agropecuaria; Colombi

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio