MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study

<p>Abstract</p> <p>Background</p> <p>Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF). The Medical Research Chronic (MRC) chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET) and the 6-minute walk test (6MWT) are shown to provide information on the severity and survival of disease.</p> <p>Methods</p> <p>We prospectively recruited IPF patients and examined the relationship between the MRC score and either CPET or 6MWT parameters known to reflect physiologic derangements limiting exercise capacity in IPF patients</p> <p>Results</p> <p>Twenty-five patients with IPF were included in the study. Significant correlations were found between the MRC score and the distance (r = -.781, p < 0.001), the SPO₂at the initiation and the end (r = -.542, p = 0.005 and r = -.713, p < 0.001 respectively) and the desaturation index (r = .634, p = 0.001) for the 6MWT; the MRC score and <it>V</it>O₂peak/kg (r = -.731, p < 0.001), SPO₂at peak exercise (r = -. 682, p < 0.001), VE/VCO₂slope (r = .731, p < 0.001), VE/VCO₂at AT (r = .630, p = 0.002) and the Borg scale at peak exercise (r = .50, p = 0.01) for the CPET. In multiple logistic regression analysis, the only variable independently related to the MRC is the distance walked at the 6MWT.</p> <p>Conclusion</p> <p>In this population of IPF patients a good correlation was found between the MRC chronic dyspnoea score and physiological parameters obtained during maximal and submaximal exercise testing known to reflect ventilatory impairment and exercise limitation as well as disease severity and survival. This finding is described for the first time in the literature in this group of patients as far as we know and could explain why a simple chronic dyspnea score provides reliable prognostic information on IPF.</p

Body mass index is associated with leukotriene inflammation in asthmatics

P&gt;Background Obesity and asthma are characterized by the presence of inflammation. Leptin and adiponectin are circulating hormones produced by adipose tissue that regulate several metabolic and inflammatory functions. We aimed to determine whether obesity influences asthmatic inflammation as well as the contribution of leptin or/and adiponectin to a possible linkage between asthmatic and obesity-related inflammation. Materials and methods One hundred patients with asthma and 60 healthy controls were studied. Subjects who had a comorbid illness that could interfere with the proposed tests were excluded. All subjects were divided into three groups (normal range, pre-obese, obese) according to the criteria of the current WHO international classification for body mass index (BMI). Possible associations between variables expressing airway inflammation, bronchial hyper-responsiveness, systemic inflammation and obesity, as assessed by BMI, were evaluated. Leptin and adiponectin were also measured and were associated with asthma airway and systemic inflammatory variables to elucidate possible associations. Results Obese patients had significant higher values of LTE4/creatinine in urine compared with pre-obese and normal range ones. In a linear regression model, the only significant associations were those between BMI and LTE4/creatinine in urine. Using the same model, log leptin and log adiponectin presented positive and negative associations, respectively with LTE4/creatinine in urine. No other significant associations were observed in both patients and healthy subjects. Conclusions In a selected cohort of asthmatic patients, obesity is significantly associated with increased urinary leukotriene levels. Alterations of leptin/adiponectin balance may be related to the presence of leukotriene inflammation in obese asthmatic patients

The Role of Cardiopulmonary Exercise Test in IPF Prognosis

Background. In IPF, defects in lung mechanics and gas exchange manifest with exercise limitation due to dyspnea, the most prominent and disabling symptom. Aim. To evaluate the role of exercise testing through the 6MWT (6-minute walk test) and CPET (cardiopulmonary exercise testing) in the survival of patients with IPF. Methods. This is a prospective, observational study evaluating in 25 patients the relationship between exercise variables through both the 6MWT and CPET and survival. Results. By the end of the observational period 17 patients were alive (33% mortality). Observation ranged from 9 to 64 months. VE/VCO2 slope (slope of relation between minute ventilation and CO2 production), VO2 peak/kg (peak oxygen consumption/kg), VE/VCO2 ratio at anaerobic threshold, 6MWT distance, desaturation, and DLCO% were significant predictors of survival while VE/VCO2 slope and VO2 peak/kg had the strongest correlation with outcome. The optimal model for mortality risk estimation was VO2 peak/kg + DLCO% combined. Furthermore, VE/VCO2 slope and VO2 peak/kg were correlated with distance and desaturation during the 6MWT. Conclusion. The integration of oxygen consumption and diffusing capacity proved to be a reliable predictor of survival because both variables reflect major underlying physiologic determinants of exercise limitation

Clinical Study The Role of Cardiopulmonary Exercise Test in IPF Prognosis

Background. In IPF, defects in lung mechanics and gas exchange manifest with exercise limitation due to dyspnea, the most prominent and disabling symptom. Aim. To evaluate the role of exercise testing through the 6MWT (6-minute walk test) and CPET (cardiopulmonary exercise testing) in the survival of patients with IPF. Methods. This is a prospective, observational study evaluating in 25 patients the relationship between exercise variables through both the 6MWT and CPET and survival. Results. By the end of the observational period 17 patients were alive (33% mortality). Observation ranged from 9 to 64 months. VE/VCO 2 slope (slope of relation between minute ventilation and CO 2 production), VO 2 peak/kg (peak oxygen consumption/kg), VE/VCO 2 ratio at anaerobic threshold, 6MWT distance, desaturation, and DLCO% were significant predictors of survival while VE/VCO 2 slope and VO 2 peak/kg had the strongest correlation with outcome. The optimal model for mortality risk estimation was VO 2 peak/kg + DLCO% combined. Furthermore, VE/VCO 2 slope and VO 2 peak/kg were correlated with distance and desaturation during the 6MWT. Conclusion. The integration of oxygen consumption and diffusing capacity proved to be a reliable predictor of survival because both variables reflect major underlying physiologic determinants of exercise limitation

Demonstration of a Hybrid Analog–Digital Transport System Architecture for 5G and Beyond Networks

In future mobile networks, the evolution of optical transport architectures enabling the flexible, scalable interconnection of Baseband Units (BBUs) and Radio Units (RUs) with heterogeneous interfaces is a significant issue. In this paper, we propose a multi-technology hybrid transport architecture that comprises both analog and digital-Radio over Fiber (RoF) mobile network segments relying on a dynamically reconfigurable optical switching node. As a step forward, the integration of the discussed network layout into an existing mobile infrastructure is demonstrated, enabling the support of real-world services through both standard digital and Analog–Intermediate- Frequency over Fiber (A-IFoF)-based converged fiber–wireless paths. Emphasis has been placed on the implementation of a real-time A-IFoF transceiver that is employed through a single embedded fully programmable gateway array (FPGA)-based platform that serves as an Ethernet to Intermediate Frequency (IF) bridge for the transmission of legacy traffic over the analog network segment. The experimental evaluation of the proposed concept was based on the dynamic optical routing of the legacy Common Public Radio Interface (CPRI), 1.5 GBaud analog-intermediate frequency-over-fiber (A-IFoF)/mmWave and 10 Gbps binary optical waveforms, showing acceptable error vector magnitude (EVM) values for the complex radio waveforms and error-free operation for binary optical streams, with Bit Error Rate (BER) values less than 10−9. Finally, the end-to-end proof-of-concept demonstration of the proposed solution was achieved through the delivery of 4K video streaming and Internet Protocol (IP) calls over a mobile core network

5G-VICTORI: Future Railway Communications Requirements Driving 5G Deployments in Railways

Part 1: 6th Workshop on “5G – Putting Intelligence to the Network Edge” (5G-PINE 2021)International audienceThe complete transformation of the ICT domain driven by 5G network principles and capabilities, will impact significantly the path towards digitalization of many vertical industries, with modern railway transportations being one of them. In this context, Future Railway Mobile Communication System (FRMCS) service requirements and system principles are very well mapped to 5G service and network concepts associated with network performance, technology neutrality at various levels as well as network planning and deployment options. However, the flexibility of 5G networks implies that concepts are pinned down to deployment paradigms so that afore assertions are proved. The 5G-PPP project 5G-VICTORI aims at delivering a complete 5G solution suitable for railway environments and FRMCS services, along with experimentation deployments for testing and evaluation in operational railway environments. This paper discusses the service Key Performance Indicators (KPIs) and technical requirements and provides an overview of the proposed experimental deployment in an operational railway environment in the area of Patras, Greece

Active and healthy ageing for Parkinson's disease patient's support: a user's perspective within the i-PROGNOSIS framework

In this paper, the user requirements, along with the methodology adopted towards their identification within the i-PROGNOSIS framework (www.i-prognosis.eu), are presented. The latter are placed within the concept of active and healthy ageing (AHA), focusing on the case of Parkinson’s Disease (PD) patients’ support. The bases for the user requirements identification were face-to-face sessions, focus groups and a large scale Web-survey. Towards the efficient user requirements identification and i-PROGNOSIS components development, exemplified usage scenarios and related business processes the stakeholders of i-PROGNOSIS can perform, are discussed. Overall, 122 functional and non-functional requirements were identified, serving as a basis for the spiral development model of i-PROGNOSIS, revealing the beneficial role of the users in designing solutions within the AHA concept