The Multi-center Evaluation of the Accuracy of the Contrast MEdium INduced Pd/Pa RaTiO in Predicting FFR (MEMENTO-FFR) Study.

AIMS: Adenosine administration is needed for the achievement of maximal hyperaemia fractional flow reserve (FFR) assessment. The objective was to test the accuracy of Pd/Pa ratio registered during submaximal hyperaemia induced by non-ionic contrast medium (contrast FFR [cFFR]) in predicting FFR and comparing it to the performance of resting Pd/Pa in a collaborative registry of 926 patients enrolled in 10 hospitals from four European countries (Italy, Spain, France and Portugal). METHODS AND RESULTS: Resting Pd/Pa, cFFR and FFR were measured in 1,026 coronary stenoses functionally evaluated using commercially available pressure wires. cFFR was obtained after intracoronary injection of contrast medium, while FFR was measured after administration of adenosine. Resting Pd/Pa and cFFR were significantly higher than FFR (0.93±0.05 vs. 0.87±0.08 vs. 0.84±0.08, p<0.001). A strong correlation and a close agreement at Bland-Altman analysis between cFFR and FFR were observed (r=0.90, p<0.001 and 95% CI of disagreement: from -0.042 to 0.11). ROC curve analysis showed an excellent accuracy (89%) of the cFFR cut-off of ≤0.85 in predicting an FFR value ≤0.80 (AUC 0.95 [95% CI: 0.94-0.96]), significantly better than that observed using resting Pd/Pa (AUC: 0.90, 95% CI: 0.88-0.91; p<0.001). A cFFR/FFR hybrid approach showed a significantly lower number of lesions requiring adenosine than a resting Pd/Pa/FFR hybrid approach (22% vs. 44%, p<0.0001). CONCLUSIONS: cFFR is accurate in predicting the functional significance of coronary stenosis. This could allow limiting the use of adenosine to obtain FFR to a minority of stenoses with considerable savings of time and costs.info:eu-repo/semantics/publishedVersio

Peak expiratory flow mediates the relationship between handgrip strength and timed up and go performance in elderly women, but not men

OBJECTIVE: The aim of the present study was to verify if there is sex difference in the associations among handgrip strength, peak expiratory flow (PEF) and timed up and go (TUG) test results. METHODS: The sample included 288 consecutive elderly men (n=93) and women (n=195). Functional capacity was measured using the TUG test, and muscle strength was measured based on handgrip. Moreover, as a measure of current health status, PEF was evaluated. Linear regression procedures were performed to analyze the relationships between handgrip and both PEF and TUG test results, with adjustment for confounders, and to identify the possible mediating role of PEF in the association between handgrip strength and TUG test results. RESULTS: In men, handgrip strength was associated with both PEF and TUG performance (p<0.01). After adjustment for PEF, the relationship between handgrip strength and TUG performance remained significant. In women, handgrip strength was also associated with both PEF and TUG performance (p<0.01). However, after adjustment for PEF, the relationship between handgrip strength and TUG performance was no longer significant. CONCLUSION: Mobility in the elderly is sex dependent. In particular, PEF mediates the relationship between handgrip strength and TUG performance in women, but not in men

A review of the current use of commercial wearable technology and smartphone apps with application in monitoring individuals following total hip replacement surgery

The advent of commercially available wearable activity monitors and smartphone apps allows objective digital monitoring of daily activities of patients before and after THR surgery. A wide variety of wearable activity monitors and smartphone apps are being marketed to assist with enhancing physical activity following surgery. A systematic review of commercial wearable tech- nology and smartphone apps was undertaken to assess the evidence supporting their efficacy in assisting rehabilitation and patient monitoring following THR. A search was conducted using the electronic databases including Medline, CINAHL, Cochrane, PsycARTICLES and PubMed of studies from January 2000 to January 2019. Five studies met the eligibility criteria. A review of the studies found very little evidence to support long term efficacy of the technology in enhancing rehabilitation and patient monitoring post THR. Future work is required to establish which commercially available monitoring technology is most valuable to patients, which ones improve clinical outcomes post THR, and what are the best economical models for their deployment

Pharmacological Primary Cardiovascular Prevention and Subclinical Atherosclerosis in Men: Evidence from the Aragon Workers' Health Study.

The objective of this study is to describe the profile of primary preventive treatment for cardiovascular disease in adult males and to analyze the association between treatment profile and subclinical atherosclerosis. We selected male workers who had undergone ultrasound imaging and had no previous history of cardiovascular disease (n = 2138). Data on the consumption of primary cardiovascular drugs from the previous year were obtained. We performed bivariate analyses to compare patient characteristics according to cardiovascular treatment and the presence of subclinical atherosclerosis, and logistic regression models to explore the association between these two variables. Among participants with no personal history of cardiovascular disease, subclinical atherosclerosis was present in 77.7% and 31.2% had received some form of preventive treatment. Of those who received no preventive treatment, 73.6% had subclinical atherosclerosis. Cardiovascular preventive treatment was associated only with CACS > 0 (odds ratio (OR), 1.37; 95% confidence interval (95% CI), 1.06-1.78). Statin treatment was associated with a greater risk of any type of subclinical atherosclerosis (OR, 1.73) and with CACS > 0 (OR, 1.72). Subclinical atherosclerosis existed in almost 75% of men who had no personal history of cardiovascular disease and had not received preventive treatment for cardiovascular disease

Restoration of european habitats in mainland, Portugal, using commercial seed mixtures. Considerations for its management and conservation

Permanent mountain pastures include meadows and other perennial pastures of high ecological, economic, cultural and scenic value. Increasing desertification limits the maintenance and conservation of its biodiversity and the associated landscape mosaic. A restoration experiment in permanent high altitude grasslands in Beira Alta (Centre East (CE) mainland Portugal) was made, by sowing adequate cultivars of existing grass and legume species. The main objectives addressed were: (1) comparison of floristic composition between reference communities included in the previous habitats and the improved communities; (2) evaluation of the success of sowing adequate cultivars of autochthonous species; (3) evaluation of the establishment of target species in terms of the maintenance of floristic composition of reference. The experiment was carried out in 2014 on nine farms situated in Beira Alta (Guarda District) and the phytosociological method was applied in the floristic surveys. The sown species with highest percentage of soil cover were Trifolium subterraneum, Lolium multiflorum, Ornithopus sativus and Trifolium vesiculosum. In the priority habitat 6220 it was observed a re-establishment of many species in their original composition and a high cover of several cultivars of Trifolium subterraneum. These results highlight the importance of using cultivars of autochthonous species in the improvement of altitude pasturesinfo:eu-repo/semantics/publishedVersio

Physical activity types and atrial fibrillation risk in the middle-aged and elderly: The Rotterdam Study

Background: The association between physical activity and atrial fibrillation remains controversial. Physical activity has been associated with a higher and lower atrial fibrillation risk. These inconsistent results might be related to the type of physical activity. We aimed to investigate the association of total and types of physical activity, including walking, cycling, domestic work, gardening and sports, with atrial fibrillation. Design: Prospective cohort study. Methods: Our study was performed in the Rotterdam Study, a prospective population-based cohort. We included 7018 participants aged 55 years and older with information on physical activity between 1997–2001. Cox proportional hazards models were used to examine the association of physical activity with atrial fibrillation risk. Models were adjusted for biological and behavioural risk factors and the remaining physical activity types. Physical activity was categorised in te

Predicting the onset and persistence of episodes of depression in primary health care. The predictD-Spain study: Methodology

Background: The effects of putative risk factors on the onset and/or persistence of depression remain unclear. We aim to develop comprehensive models to predict the onset and persistence of episodes of depression in primary care. Here we explain the general methodology of the predictD-Spain study and evaluate the reliability of the questionnaires used. Methods: This is a prospective cohort study. A systematic random sample of general practice attendees aged 18 to 75 has been recruited in seven Spanish provinces. Depression is being measured with the CIDI at baseline, and at 6, 12, 24 and 36 months. A set of individual, environmental, genetic, professional and organizational risk factors are to be assessed at each follow-up point. In a separate reliability study, a proportional random sample of 401 participants completed the test-retest (251 researcher-administered and 150 self-administered) between October 2005 and February 2006. We have also checked 118,398 items for data entry from a random sample of 480 patients stratified by province. Results: All items and questionnaires had good test-retest reliability for both methods of administration, except for the use of recreational drugs over the previous six months. Cronbach's alphas were good and their factorial analyses coherent for the three scales evaluated (social support from family and friends, dissatisfaction with paid work, and dissatisfaction with unpaid work). There were 191 (0.16%) data entry errors. Conclusion: The items and questionnaires were reliable and data quality control was excellent. When we eventually obtain our risk index for the onset and persistence of depression, we will be able to determine the individual risk of each patient evaluated in primary health car

IL-4-secreting CD4+ T cells are crucial to the development of CD8+ T-cell responses against malaria liver stages.

CD4+ T cells are crucial to the development of CD8+ T cell responses against hepatocytes infected with malaria parasites. In the absence of CD4+ T cells, CD8+ T cells initiate a seemingly normal differentiation and proliferation during the first few days after immunization. However, this response fails to develop further and is reduced by more than 90%, compared to that observed in the presence of CD4+ T cells. We report here that interleukin-4 (IL-4) secreted by CD4+ T cells is essential to the full development of this CD8+ T cell response. This is the first demonstration that IL-4 is a mediator of CD4/CD8 cross-talk leading to the development of immunity against an infectious pathogen

Analytical model for predicting the buckling load of continuous welded rail tracks

The use of continuous welded rail (CWR) track has solved many of the problems associated with tread surface discontinuities that occur in jointed tracks. However, due to the longitudinal expansion of the rails in CWR tracks being highly constrained, the generated compressive stresses in the rails can cause track buckling in the horizontal plane. Track buckling is a complex phenomenon, in which many factors are involved and around which there is much uncertainty. The objective of this paper is to present an analytical model that can be used to calculate the buckling load of a CWR track. This model accounts for the contributions of base, crib and shoulder ballast and includes the effect of vertical loading on each of these components. Moreover, a parametric study based on this model is developed, in order to understand how and the extent to which the considered factors affect track stability. The results of the study indicate that the characteristics of the existing misalignments in the track are the critical parameters involved in the phenomenon. In addition, maintenance operations that affect the ballast, such as tamping or surfacing, and the dimensions and material of the track sleepers are also important factors.Navarro Martinez, JI.; Villalba Sanchis, I.; Martínez Fernández, P.; Insa Franco, R. (2015). Analytical model for predicting the buckling load of continuous welded rail tracks. Proceedings of the Institution of Mechanical Engineers, Part F: Journal of Rail and Rapid Transit. 229(5):542-552. doi:10.1177/0954409713518039S5425522295Kerr, A. D. (1978). Analysis of thermal track buckling in the lateral plane. Acta Mechanica, 30(1-2), 17-50. doi:10.1007/bf01177436Grissom, G. T., & Kerr, A. D. (2006). Analysis of lateral track buckling using new frame-type equations. International Journal of Mechanical Sciences, 48(1), 21-32. doi:10.1016/j.ijmecsci.2005.09.006Le Pen, L. M., & Powrie, W. (2011). Contribution of Base, Crib, and Shoulder Ballast to the Lateral Sliding Resistance of Railway Track: A Geotechnical Perspective. Proceedings of the Institution of Mechanical Engineers, Part F: Journal of Rail and Rapid Transit, 225(2), 113-128. doi:10.1177/095440971039709

Glyph reader app: multisensory stimulation through ICT to intervene literacy disorders in the classroom

This article shows the experience in the implementation of a tool called Glyph Reader, which is an application that has two interfaces, Web and Mobile and that responds to the need for an educational and interactive resource whose main objective is the Multisensory stimulation for literacy training in a population with cognitive disabilities and/specific learning disorder. The design of the activities that this application has is based on the theoretical model of multisensory stimulation Orton Gillingham, which seeks the development of basic skills for decoding isolated words based on a phonetic - graphic analysis of them. The techniques within this model use the basic concepts of intersensory integration of simultaneous visual-auditory-kinesthetic- tactile differentiation (VAKT), to which the Glyph Reader application takes full advantage, by including graphic phonetic recognition and training activities of syllables/words (exercises with symphons and exercises with combinations of consonants or working syllables), which pass from basic levels to complex levels of decoding, necessary for the development of literacy skills. The study sample for software validation is 250 students from the Eustorgio Salgar educational institution, in the municipality of Puerto Colombia, in the department of Atlántico – Colombi