Optimum training programme during pregnancy to prevent gestational hypertension and preeclampsia: a systematic review

Gestational hypertension and pre-eclampsia are hypertensive disorders which are the world’s leading cause of maternal and perinatal mortality. Currently, evidences support the benefit of moderate physical exercise (PE) during uncomplicated pregnancies in the prevention of HTG and pre-eclampsia. However, there is no evidence on which kind of training is more effective for its prevention. The aim of this study was to analyze which kind of exercise, duration of the intervention and session, frequency and intensity produce the greatest benefits in the prevention of gestational hypertension and pre-eclampsia in women with uncomplicated pregnancies. An exhaustive search of PubMed and Web of Science was carried out until October 21, 2020. From 705 studies found, we analyzed 14 original full-text intervention articles in English or Spanish, with a PE program in pregnant women without complications, evaluating BP and including in their methodology, at least, frequency, duration, intensity, or kind of exercise. Exercise training in healthy women with uncomplicated pregnancies reduces the incidence of HTG and preeclampsia. The program with most benefits is concurrent training combined with flexibility, with a minimum duration of 29 weeks, from the 8th-9th gestational week to 36, but can be extended until the end of pregnancy. It’s recommended to get to a training frequency equal to or greater than 3 days a week, with sessions at 50-70% of the maximum heart rate and 10-14 on the Borg Scale, and a duration of 45 and 60 minutes per session

Objective measured physical activity and metabolic syndrome score in children and adolescents: The UP&DOWN longitudinal study

Introduction: We aimed to analyze the cross-sectional and longitudinal association of physical activity (PA) levels and PA patterns with metabolic syndrome score (MetS) in children and adolescents. Methods: A total of 175 children (82 females) and 188 adolescents (95 females) were included. Objective PA levels and patterns were determined by accelerometry. MetS was computed from waist circumference, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and glucose levels. Different linear regression models were implemented to examine the associations of PA with MetS. Results: Vigorous PA, moderate-vigorous PA, number of bouts per day in 10 min (N10), and total time in bouts per day in 10 min (T10) were negatively associated with MetS in male children and adolescents at cross-sectional level (β ranging from −0.005 to −0.164, all p < 0.05). Total time in bouts per day in 20 min in male children, and vigorous PA and N10 in female children were longitudinally and negatively associated with MetS (β ranging from −0.011 to −0.247, all p < 0.05). Conclusions: Associations of PA and MetS were observed at cross-sectional level in males and longitudinally in female children. The associations in PA patterns were found when patterns were grouped into bouts of 10 min. Therefore, for future studies of PA with health markers in the pediatric population, it would be advisable to choose bouts of shorter durationEste trabajo fue financiado por el Plan Nacional de Investigación, Desarrollo e Innovación (IDi) del Ministerio de Ciencia e Innovación de España (DEP 2010-21 662-C04-00 [DEP 2010-21 662-C04-01: DEP 2010-21 662-C04-02: DEP 2010-21 662-C04-03: DEP 2010-21 662-C04-04]). Las organizaciones financiadoras no tuvieron ningún papel en la recopilación de datos, análisis, interpretación o informe final del estudio

Criterion-related validity and reliability of the 2-km walk test and the 20-m shuttle run test in adults: The role of sex, age and physical activity level

Objectives: To analyze the criterion-related validity and the reliability of fitness field tests for evaluating cardiorespiratory fitness in adults, by sex, age, and physical activity level. Design: Cross-sectional. Methods: During 3 weeks, sociodemographic, anthropometric measurements, a treadmill maximal test, the 2-km walk test, and the 20-m SRT were performed in 410 adults aged 18–64 years. Measured and estimated VO2max (by Oja's and Leger's equations) were analyzed. Results: Measured VO2max was associated with estimated VO2max by the 2-km walk test and 20-m SRT (r = 0.784 and r = 0.875, respectively; both p < 0.01). Bland–Altman analysis showed a mean difference of −0.30 ml* kg−1 * min−1 (p < 0.001, d = −0.141) in the 2-km walk test, and 0.86 ml* kg−1 * min−1 (p = 0.051) in the 20-m SRT. Significant mean differences between test and retest were found in the time to complete the 2-km walk test (−1.48 ± 0.51 s, p = 0.004, d = −0.014) and in the final stage reached in the 20-m SRT (0.04 ± 0.01, p = 0.002, d = 0.015). Non-significant differences were found between test and retest in the estimated VO2max by Oja's (−0.29 ± 0.20 ml* kg−1 * min−1 , p > 0.05) and Leger's eqs. (0.03 ± 0.04 ml* kg−1 * min−1 , p > 0.05). Moreover, both test results and estimated VO2max equations showed a high test–retest reliability. Conclusions: Both tests were valid and reliable for evaluating cardiorespiratory fitness in adults aged 18–64 years, regardless of sex, age, and physical activity level

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO

Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8 \pm 0.7 (stat) \pm 6.7 (sys) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principle calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.Comment: Replaced with published version. Added journal reference and DOI. Supplemental material in the ancillary file

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat