Comparative study of the degree of patient satisfaction in intermittent catheterization with Lofric and polyvinyl chloride catheters

Actas Urol Esp. 2001 Nov-Dec;25(10):725-30. [Comparative study of the degree of patient satisfaction in intermittent catheterization with Lofric and polyvinyl chloride catheters]. [Article in Spanish] López Pereira P, Martínez Urrutia MJ, Lobato L, Rivas S, Jaureguizar Monereo E. SourceUnidad de Urología Infantil, Hospital Universitario La Paz, Madrid. Abstract PURPOSE: To assess the grade of satisfaction in children on intermittent catheterization with the use of LoFric and PVC conventional catheters. MATERIAL AND METHODS: A total of 40 p with experience in CIC were included in this study. An anonymous questionnaire was sent to all patients after 2-months using the LoFric catheter. Patients were divided in 3 groups (bladder augmentation, artificial sphincter, Mitrofanoff) because of major differences in CIC discomfort between these groups. RESULTS: The questionnaire was completed by 87.5% of the patients (35 p). In 86% (30 p) LoFric catheter training was easy or very easy but in 14% (5 p) it was difficult. Four patients had some difficulty during conventional catheter insertion, in 3 (75%) the difficulty disappeared with the use of LoFric catheter. Of the 51% (18 p) who reported some discomfort during the insertion of conventional catheter, 72% said it was eliminated when the LoFric catheter was used. Of 6 p with some discomfort when removing the conventional catheter, 5 (83%) said it disappeared with the new catheter. Th LoFric catheter was favored by 70% of patients because it reduced the discomfort caused by conventional catheters, bladder insertion was easier and smoother, and gel lubrication was not needed. The 17% of patients reported some difficulty dealing with this slippery catheter. CONCLUSIONS: The use of the LoFric catheter could be justified in patients who report with conventional catheters have some discomfort. It can also be recommended in patients with artificial sphincter, bladder augmentation and Mitrofanoff procedure, in whom any complication related to CIC would have serious consequences

On the impact of covariance functions in multi-objective Bayesian optimization for engineering design

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this recordMulti-objective Bayesian optimization (BO) is a highly useful class of methods that can effectively solve computationally expensive engineering design optimization problems with multiple objectives. However, the impact of covariance function, which is an important part of multi-objective BO, is rarely studied in the context of engineering optimization. We aim to shed light on this issue by performing numerical experiments on engineering design optimization problems, primarily low-fidelity problems so that we are able to statistically evaluate the performance of BO methods with various covariance functions. In this paper, we performed the study using a set of subsonic airfoil optimization cases as benchmark problems. Expected hypervolume improvement was used as the acquisition function to enrich the experimental design. Results show that the choice of the covariance function give a notable impact on the performance of multi-objective BO. In this regard, Kriging models with Matern-3/2 is the most robust method in terms of the diversity and convergence to the Pareto front that can handle problems with various complexities.Natural Environment Research Council (NERC

Different kidney function trajectory patterns before dialysis in elderly patients: clinical implications and outcomes

Background. Identifying trajectories of kidney disease progression in chronic kidney disease (CKD) patients may help to deliver better care. We aimed to identify and characterize trajectories of renal function decline in CKD patients and to investigate their association with mortality after dialysis.Methods. This retrospective cohort study included 378 CKD patients who initiated dialysis (aged 65 years and over) between 2009 and 2016. Were considered mixed models using linear quadratic and cubic models to define the trajectories, and we used probabilistic clustering procedures. Patient characteristics and care practices at and before dialysis were examined by multivariable multinomial logistic regression. The association of these trajectories with mortality after dialysis was examined using Cox models.Results. Four distinct groups of eGFR trajectories decline before dialysis were identified: slower decline (18.3%), gradual decline (18.3%), early rapid decline (41.2%), and rapid decline (22.2%). Patients with rapid eGFR decline were more likely to have diabetes, more cognitive impairment, to have been hospitalized before dialysis, and were less likely to have received pre-dialysis care compared to the patients with a slower decline. They had a higher risk of death within the first and fourth year after dialysis initiation, and after being more than 4 years in dialysis.Conclusions. There are different patterns of eGFR trajectories before dialysis initiation in the elderly, that may help to identify those who are more likely to experience an accelerated decline in kidney function, with impact on pre ESKD care and in the mortality risk after dialysis

Amiloidose renal: classificação de 102 casos consecutivos

Amyloidoses are a group of heterogeneous diseases classified according to the nature of their causative amyloid proteins. Commonly, paraffin-embedded tissue is used for the typing of amyloid by immunohistochemistry. DNA analysis should always be considered if hereditary amyloidosis is suspected. Since the kidneys are one of the organs that are most commonly involved in amyloid deposition in systemic amyloidoses, we screened 102 consecutive cases with biopsy-proven amyloid disease by immunohistochemistry. DNA analysis was performed to confirm a diagnosis of hereditary amyloidosis. Demographic characteristics, underlying disease and clinical data at the time of renal biopsy were obtained by retrospective review of medical records. The amyloidosis type according to immunohistochemical amyloid protein identification was AA in 60 (58.8%) patients, AL in 21 (20.6%), AFib in four (3.9%), ATTR in two (2.0%), AApoAI in one (1.0%), ALys in one (1.0%) and combined AL and AA in one (1.0%). The type of protein could not be classified in 12 (11.7%) patients: eight (7.8%) because of negative immunohistochemistry and four (3.9%) due to the lack of adequate tissue. DNA analysis confirmed AFib and ATTR cases by the identification of the point mutations FGA p.Glu545Val and TTR p.Met51Val, respectively. Mean age at diagnosis was 53.3 years (49.4 for AA, 63.0 for AL and 53.9 for AFib). Chronic infections were the most frequent disorder associated with AA amyloidosis, mainly tuberculosis, and only one patient had familial AA associated with Muckle-Wells syndrome. Nephrotic syndrome was the most frequent clinical manifestation, independently of the amyloid type. In our series, AA amyloidosis is still the most frequent type of systemic amyloidoses. Six patients had unequivocal hereditary amyloidosis. Immunohistochemistry did not establish the precursor protein in almost 8% of patients; however, an improvement could be obtained using a wider panel of amyloid antibodies.As amiloidoses são um grupo heterogéneo de doenças classificadas de acordo com a composição das suas proteínas amiloidogénicas. Frequentemente, os tecidos preservados em parafina são usados para identificação imunohistoquímica. A análise de ADN deve ser sempre considerada se houver suspeita de amiloidose hereditária. Dado que os rins são um dos órgãos mais frequentemente envolvidos nas amiloidoses sistémicas, procedemos à classificação imunohistoquímica de 102 casos consecutivos de doença amiloide confirmada por biópsia renal. A análise de ADN foi realizada para confirmar o diagnóstico de amiloidose hereditária. As características demográficas, doença subjacente e dados clínicos à data da biópsia foram obtidos pela revisão retrospetiva dos registos médicos. O tipo de amiloidose obtido por identificação imunohistoquímica foi AA em 60 (58,8%) doentes, AL em 21 (20,6%), AFib em quatro (3,9%), ATTR em dois (2,0%), AApoAI em um (2,0%), ALys em um (2,0%), e em um (2,0%) coexistiam os tipos AL e AA. Em 12 (11,7%) não foi identificado o tipo de amiloide: oito (7,8%) por imunohistoquímica negativa e quatro (3,9%) devido a amostra insuficiente. A análise de ADN confirmou os casos AFib e ATTR pela identificação das mutações pontuais FGA p.Glu545Val e TTR p.Met51Val, respetivamente. A média de idade à data do diagnóstico foi 53,3 anos (49,4 para AA, 63,0 para AL e 53,9 para AFib). As infeções crónicas foram a principal causa de amiloidose AA, sobretudo a tuberculose, e foi apenas identificada uma AA familiar associada a síndrome de Muckle-Wells. A síndrome nefrótica foi a manifestação clínica mais frequente, independentemente do tipo de amiloide. Na nossa série, a amiloidose AA continua a ser a amiloidose sistémica mais frequente. Seis doentes tiveram amiloidose hereditária inequívoca. A imunohistoquímica não identificou a proteína precursora em quase 8% dos doentes; contudo, a utilização de um painel de anticorpos mais alargado poderá melhorar o diagnóstico

Seasonal Shifts in Jumping Patterns: A Study of Countermovement Jump Strategies in High School Football Athletes

Modern sporting trends have begun to adopt sport science and load monitoring to identify in-season trends with the goal of improving performance and reducing injury. Although these resources have become increasingly common in professional and collegiate sports, many high school athletic programs have yet to adopt such technologies. While previous research has demonstrated season-long changes in jump performance, no research has investigated the impact of in-season demands on the changes in jump strategy in male high school football athletes. PURPOSE: The purpose of this study was to examine changes in jump strategy in high school football players over a single football season. METHODS: Sixty-nine male high school football athletes, including 25 offensive skill, 23 linemen, 12 linebackers, 7 defensive backs, and 2 special teams players were tested for maximal jump performance at the beginning and end of a high school football season. Testing was conducted using three attempts of a maximal hands-on-hips countermovement jump on portable force plates, with the average of the three jumps used for analysis. A minimum of 10-weeks between sessions accounted for the time between pre- and post-testing. A dependent-samples t-test was performed to calculate differences between the two time points. RESULTS: Significant reductions were observed across all phases of the jump movement revealed significant differences from pre- to post- testing. The largest reduction was seen during the unweighting phase (0.40 to 0.36s), followed by braking phase (0.22 to 0.19s), and finally propulsive phase (0.30 to 0.28s). Resulting in a total time to takeoff decrease of 0.92 seconds to 0.83 seconds, resulting in an increase in mean jump height (14.15 to 14.89 inches). Jump strategy differences were also significantly different between time points for modified reactive strength index (0.40 to 0.47 and stiffness metrics (-4996.86 to -5622.46N/m). No differences were seen for countermovement depth (t(68) = 0.44, p=0.663) between the two time points. CONCLUSION: At the end of a competitive season, high school football athletes increased their speed at all phases of the jumping motion. Despite the increased speed during the movement, there were no changes in the countermovement depth prior to takeoff. Our research indicates that football athletes become faster and more efficient with their CMJ strategy to achieve increased performance as measured by Jump Height. Future studies may benefit from collecting follow-up data collection to examine the detraining effect that can occur post-competition, and to incorporate differences between double and single leg jumping strategy. Doing so has the potential to identify injury risk and asymmetries throughout the season

Countermovement Jump Performance Trends in High School Football Players Throughout a Competitive Season

Football is the largest participation sport amongst male high school athletes in the country with over one million participants. Previous research has demonstrated that countermovement jump (CMJ) performance is negatively affected by in-season fatigue in contact sports such as rugby and hockey. However, little data are available to describe how CMJ performance and force metrics change in high school athletes throughout a competitive football season. PURPOSE: The purpose of this study was to examine the changes in strength and power metrics in high school football players over a single football season. METHODS: Sixty-nine male high school football athletes comprised of 25 offensive skill players, 23 linemen, 12 linebackers 7 defensive backs, and 2 special teams players were tested for maximal lower body force output at the beginning and end of a high school football season. Testing was conducted using three attempts of a maximal hands-on-hips countermovement jump on portable force plates, with the average of the three jumps used for analysis. Pre-testing occurred prior to the first game of the season, and post-test was conducted after the final game of the season with a minimum of 10-weeks between sessions accounted for the time between pre- and post-testing. A dependent-samples t-test was performed to calculate differences between the two time points. RESULTS: Significant improvements in jump height (14.15 to 14.89 inches), relative force at minimum displacement (220.36 to 235.77% body weight), peak relative braking force (220.72 to 236.39% body weight), peak relative propulsive force (238.07 to 248.02% body weight), peak braking velocity (-1.17 to -1.30m/s), and takeoff velocity (2.64 to 2.71m/s). No significant differences were seen in relative peak landing force (t(68) = 0.53, p=0.600). CONCLUSION: At the end of a competitive season, high school football athletes produced more force and increased their movement velocity, resulting in improvements in jump height compared to the beginning of the season. However, there were no significant differences in landing metrics indicating no changes in force absorption capacity. These increases in jump performance do not reflect results previously reported in contact sports such as rugby and hockey where jump performance typically decreased over the course of a season. Future studies may benefit from collecting additional performance data to assess the impact seasonal fatigue has on other body systems separate to lower body power production, and the effect to which practice and strength and conditioning programming impact force metrics. Without appropriate monitoring strategies, coaches are leaving the assessment of load management to chance, which can potentially lead to decreased performance and an increased chance of injury

Oxidative stability of functional phytosterol-enriched dark chocolate

A dark chocolate containing phytosterols (PS) esters was developed to reduce cholesterol in individuals. However, oxidative instability during chocolate processing and storage could reduce the PS bioactivity. Chocolate bars were prepared containing palm oil (CONT) or 2.2 g of PS (PHYT). All samples were stored at 20°C and 30°C during 5 months. A peak of hydroperoxides formation was observed after 60 days at 20°C and after 30 days at 30°C. PS-enriched samples presented higher values of hydroperoxides than control samples, which could be attributed to the higher level of alpha-linolenic acid present in the PHYT samples. All chocolate bars became lighter and softer after 90 days of storage. However, these physical changes did not reduce their sensory acceptability. In addition, PS bioactivity was kept during the storage, since no significant alterations in the PS esters were observed up to 5 months. However, some PS oxidation occurred in the PHYT bars, being sitostanetriol, 6-ketositosterol, 6beta-hydroxycampesterol and 7-ketocampesterol the major phytosterol oxidation products (POPs). The POPs/PS ratio was low (0.001). Therefore, the dark chocolate bars developed in this study kept their potential functionality after 5 months of storage at room temperature, representing an option as a functional food

Selecting a Control Strategy for Plug and Process Loads

Plug and Process Loads (PPLs) are building loads that are not related to general lighting, heating, ventilation, cooling, and water heating, and typically do not provide comfort to the building occupants. PPLs in commercial buildings account for almost 5% of U.S. primary energy consumption. On an individual building level, they account for approximately 25% of the total electrical load in a minimally code-compliant commercial building, and can exceed 50% in an ultra-high efficiency building such as the National Renewable Energy Laboratory's (NREL) Research Support Facility (RSF) (Lobato et al. 2010). Minimizing these loads is a primary challenge in the design and operation of an energy-efficient building. A complex array of technologies that measure and manage PPLs has emerged in the marketplace. Some fall short of manufacturer performance claims, however. NREL has been actively engaged in developing an evaluation and selection process for PPLs control, and is using this process to evaluate a range of technologies for active PPLs management that will cap RSF plug loads. Using a control strategy to match plug load use to users' required job functions is a huge untapped potential for energy savings