Impact of ActiGraph® cutoffs on time spent in moderate to vigorous physical activities in COPD

ActiGraphs® are often used to assess time in moderate to vigorous physical activities (MVPA) in people with COPD. Different cutoffs can be used to quantify MVPA. If they yield similar or different MVPA results is yet unknown. There are no cutoffs specifically developed, nor validated, for COPD, but Troiano and Freedson cutoffs are the most used. Recently, Santos-Lozano proposed a cutoff specific for older people, that has been used in COPD. This study aimed to explore MVPA results quantified with different cutoffs in COPD. Participants wore the ActiGraph wGT3X for 7 days and data were included if they had used it for at least 8h (7am to 10pm) for 4 days (Choi algorithm for non-wear time). MVPA was estimated using the cutoffs from Troiano, Freedson and Santos-Lozano. Differences between cutoffs were explored with Friedman Test, followed by post-hoc comparisons. 107 people with COPD (79%♂; 68±8y; FEV1pp 49±17) were included. MVPA was affected by cutoffs (χ2(2)=194.56, p<0.001). Santos-Lozano cutoff yielded the highest MVPA estimates, followed by Freedson and Troiano cutoffs (median [Interquatile Range] = 57[30-90] vs 16[4-38] vs 8[2-22] (Fig.1). All cutoffs differed significantly from each other (p<0.001). The cutoff selection affects MVPA estimates in people with COPD and may mislead the classification of these patients as physically (in)active. Future studies should develop MVPA cutoffs adapted to people with COPD.CENTR(AR): pulmões em andamento by Programa de Parcerias para o Impacto, Portugal Inovação Social through Programa Operacional Inclusão Social e Emprego (POISE-03-4639-FSE-000597). Fundação para a Ciência e a Tecnologia (SFRH/BD/148738/2019), by Fundo Social Europeu through Programa Operacional Regional Centro, and by Programa Operacional Competitividade e Internacionalização (COMPETE 2020 - POCI-01-0145-FEDER-007628; UIDB/04501/2020).publishe

Atypical Non-H2S-Producing Monophasic Salmonella Typhimurium ST3478 Strains from Chicken Meat at Processing Stage Are Adapted to Diverse Stresses

Poultry products are still an important cause of Salmonella infections worldwide, with an increasingly reported expansion of less-frequent serotypes or atypical strains that are frequently multidrug-resistant. Nevertheless, the ability of Salmonella to survive antimicrobials promoted in the context of antibiotic reducing/replacing and farming rethinking (e.g., organic acids and copper in feed/biocides) has been scarcely explored. We investigated Salmonella occurrence (conventional and molecular assays) among chicken meat at the processing stage (n = 53 batches/29 farms) and characterized their tolerance to diverse stress factors (antibiotics, copper, acid pH, and peracetic acid). Whole-genome sequencing was used to assess adaptive features and to perform comparative analysis. We found a low Salmonella occurrence (4%) and identified S. Enteritidis/ST11 plus atypical non-H2S-producing S. 1,4,[5],12:i:-/ST3478. The ST3478 presented the ability to grow under diverse stresses (antibiotics, copper, and acid-pH). Comparative genomics among ST3478 isolates showed similar antibiotic/metal resistance gene repertoires and identical nonsense phsA thiosulfate reductase mutations (related to H2S-negative phenotype), besides their close phylogenetic relationship by cgMLST and SNPs. This study alerts for the ongoing national and international spread of an emerging monophasic Salmonella Typhimurium clonal lineage with an enlarged ability to survive to antimicrobials/biocides commonly used in poultry production, being unnoticed by conventional Salmonella detection approaches due to an atypical non-H2S-producing phenotype

Impact of atrial fibrillation in acute coronary syndrome

INTRODUCTION: Atrial fibrillation (AF) is a relatively common arrhythmia in the context of acute coronary syndromes (ACS). However, the impact of AF on these patients' survival is not well established. The present study aimed to estimate the prevalence of AF in ACS patients and to evaluate its impact on in-hospital and six-month post-event mortality, from any cause. METHODS: This was a retrospective cohort study that included 1183 patients admitted consecutively to a Coronary Care Unit with ACS. Demographic and clinical data and information from various complementary exams were collected and occurrence of AF during the first 48 hours of hospitalization was analyzed. Six-month follow-up was achieved in 95.9% of the patients. Logistic regression statistical analysis was used to identify independent predictors of in-hospital and six-month post-event mortality. RESULTS: AF was diagnosed in 140 patients (11.8%); these patients were older (73.89 +/- 8.69 vs. 63.20 +/- 12.73 years; p75 years, severe left ventricular dysfunction and heart failure. The performance of coronary angiography correlated with improved prognosis. CONCLUSIONS: AF in the context of ACS is an independent predictor of increased in-hospital and six-month mortality. These findings should be taken into consideration in the management and treatment of such patients

Intensity and safety of community-based physical activities for people with COPD

Background: long-term maintenance of the benefits obtained with pulmonary rehabilitation (PR) in people with COPD is of upmost importance, yet highly challenging. Integrating these people in community-based physical activities (PAs), after PR, can be a promising strategy to maintain achieved benefits. Nevertheless, to confidently advise people with COPD to enrol these community-based PAs, clinicians must ensure those are safe and ideally are of at least moderate intensity (following PAs guidelines). This study aimed to explore safety and intensity level of community-based PAs (cardiofitness room, senior gymnastics, and aquatic gymnastics) in people with COPD, after PR. Methods: an observational cross-sectional study, part of a larger trial (NCT04223362) was conducted. People with COPD that had finished a community-based PR programme, conducted in the Respiratory Research and Rehabilitation Laboratory (Lab3R) or in four primary health care centres (Aveiro, Estarreja, Oliveira do Bairro and Montemor-o-Velho), and that had a positive risk-benefit analysis regarding their inclusion on community-based PAs were included. Participants were given the opportunity to choose among the available community-based PAs (previously identified as adequate), the one(s), they wanted to try, and were then accompanied by a physiotherapist. During the community-based PAs, dyspnoea and fatigue perception were assessed every 20 minutes using the modified Borg 0-10 scale; and heart rate (HR) and percentage of peripheral oxygen saturation (SpO2) were constantly monitored. Participants wore the SenseWear Armband on the left triceps to estimate the Metabolic Equivalent Task (METs) of each community-based PA. The final community-based PAs intensity level was obtained by summing the intensity levels yielded by: dyspnoea and fatigue Borg scores, maximal HR percentage predicted (HRmax%predicted) (where HRmaxpredicted=220-age), and METs; with 3-6 Borg scores, 64-76% of HRmax%predicted, and 3-6 METs identifying moderate intensities. For security standards, SpO2 below 88% and HRmax%predicted above 85% were considered. The occurrence of any adverse event during the PAs was registered. Results: three community-based PAs were included, cardiofitness room (9 people with COPD, 68±9 years, 100% men, 58±21 FEV1 %predicted), senior gymnastics (8 people with COPD, 70±9 years, 75% men, 53±11 FEV1 %predicted), and aquatic gymnastics (6 people with COPD, 68±10 years, 100% men, 49±16 FEV1 %predicted). Overall, the explored community-based PAs were classified as of moderate intensity (Figure 1 – a, b, c). Only one participant presented a SpO2 below 88% on the cardiofitness room (lowest SpO2 registered was 86%) and the HRmax%predicted was below 85% in all participants. Mean values of SpO2 and HRmax%predicted are presented in Figure 1 (d, e, f). No adverse event was registered. Conclusion: Cardiofitness room, senior gymnastics, and aquatic gymnastics seem safe and of moderate intensity for people with COPD. Enrolment of people with COPD on these community-based PAs, following PR, should be advised, as these may facilitate the long-term maintenance of PR benefits, while promoting a more physically active lifestyle in this population. Nevertheless, caution is needed when interpreting these results, since intensity of PA is highly influenced by individual factors and patients’ enrolment must be preceded by a careful patient selection to ensure their safety.publishe

Linking solar and long baseline terrestrial neutrino experiments

We show that in the framework of three light neutrino species with hierarchical masses and assuming no fine tuning between the entries of the neutrino mass matrix, one can use the solar neutrino data to obtain information on the element $U_{e3}$ of the lepton mixing matrix. Conversely, a measurement of $U_{e3}$ in atmospheric or long baseline accelerator or reactor neutrino experiments would help discriminate between possible oscillation solutions of the solar neutrino problem.Comment: revtex, 4 pages, no figures. Discussion of the LOW solution modified; results unchanged. References adde

Leptogenesis

I present the theoretical basis for Leptogenesis and its implications for the structure of the universe. It is suggested that density fluctuations grow during the transition period and remnants of this effect should be sought in the universe. The relation between theories with Majorana neutrinos and low energy phenomena, including oscillations, advanced considerably during the past two years with a consistent picture developed in several models.Comment: 9 pages, 3 figures.To appear in the proceedings of The IXth International Symposium on Particles, Strings and Cosmology at the Tata Institute of Fundamental Research, Mumbai (Bombay), India, during 3-8 January 200