Inspiratory muscle training and its effect on indices of physiological and perceived stress during incremental walking exercise in normobaric hypoxia

This study evaluated the effects of inspiratory muscle training (IMT) on inspiratory muscle fatigue (IMF) and physiological and perceptual responses during trekking-specific exercise. An 8-week IMT program was completed by 21 males (age 32.4 ± 9.61 years, VO2peak 58.8 ± 6.75 mL/kg/min) randomised within matched pairs to either the IMT group (n = 11) or the placebo group [(P), n = 9]. Twice daily, participants completed 30 (IMT) or 60 (P) inspiratory efforts using a Powerbreathe initially set at a resistance of 50% (IMT) or used at 15% (P) of maximal inspiratory pressure (MIP) throughout. A loaded (12.5 kg) 39-minute incremental walking protocol (3–5 km/hour and 1–15% gradient) was completed in normobaric hypoxia (PIO2 = 110 mmHg, 3000 m) before and after training. MIP increased from 164 to 188 cmH2O (18%) and from 161 to 171 cmH2O (6%) in the IMT and P groups (P = 0.02). The 95% CI for IMT showed a significant improvement in MIP (5.21±43.33 cmH2O), but not for P. IMF during exercise (MIP) was*5%, showing no training effect for either IMT or P (P = 0.23). Rating of perceived exertion (RPE) was consistently reduced (*1) throughout exercise following training for IMT, but not for P (P = 0.03). The mean blood lactate concentration during exercise was significantly reduced by 0.26 and 0.15 mmol/L in IMT and P (P = 0.00), with no differences between groups (P = 0.34). Rating of dyspnoea during exercise decreased (*0.4) following IMT but increased (*0.3) following P (P = 0.01). IMT may attenuate the increased physiological and perceived exercise stress experienced during normobaric hypoxia, which may benefit moderate altitude expedition

ADVANCED 3D TECHNOLOGY IN SUPPORT OF THE BIM PROCESSES IN THE CULTURAL HERITAGE: IN-DEPTH ANALYSIS OF THE CASE STUDY OF THE ROMAN FLUVIAL PORT OF AQUILEIA (ITALY)

Abstract. Advanced 3D technology, in line with the directives of the European Commission's Reflective 7 - Horizon 2020 project, allows to represent in an organized and accurate way (geometrically and chromatically speaking) any type of artefact belonging to the Cultural Heritage. This article will deal with the specific case-study of the research carried out in the archaeological site of the Roman fluvial port of Aquileia, in collaboration with the University of Trieste. Thirtysix MA Architecture students attending the experimental course in "Technologies for the conservation and enhancement of architectural heritage" were involved. The Advanced 3D model of the fluvial port was conveniently divided into 15 sectors, in order to allow the assignment of each sector to a different group of students. The students, using the tools provided by the proprietary EasyCUBE PRO software, were able to create a digital database with an accurate 3D representation of all types of degradation affecting the archaeological structures existing in situ. Starting from the digital database, the students created a report containing the surfaces, volumes, count of the specific elements and all the other textual and graphical data related to the degradation processes. The collected data allowed to produce a metric estimate of the restoration intervention and to realize visual simulations of the post-intervention result. This experience gave the chance to evaluate the advantages of creating a digital database of 3D representations of the various forms of degradation, also in terms of possible future developments.</p

Daedalus: A hardware signal analyser for Icarus

Icarus detector [1] is a large-volume (400 cm) liquid Argon TPC that requires continuous high rate sampling signal recording on each channel (about 50 000) to produce event images quite similar to the ones from bubble chambers. In order to optimize the memory usage, a signal feature extractor, that commands memory writing only upon signal detection, has been designed in VLSI CMOS. ( 1998 Elsevier Science B.V. All rights reserved

Surgical Treatment of Annuloaortic Ectasia - Replace or Repair?

Background: Patients with annuloaortic ectasia may be surgically treated with modified Bentall or David I valve-sparing procedures. Here, we compared the long-term results of these procedures. Methods: A total of 181 patients with annuloaortic ectasia underwent modified Bentall (102 patients, Group 1) or David I (79 patients, Group 2) procedures from 1994 to 2015. Mean age was 62 ± 11 years in Group? 1? and 64? ± 16 years in Group 2. Group 1 patients were in poorer health, with a lower ejection fraction and higher functional class. Results: Early mortality was 3% in Group 1 and 2.5% in Group 2. Patients undergoing a modified Bentall procedure had a higher incidence of thromboembolism and hemorrhage, whereas those undergoing a David I procedure had a higher incidence of endocarditis. Actuarial survival was 70 ± 6% at 15 years in Group 1 and 84 ± 7% at 10 years in Group 2. Actuarial freedom from reoperation was 97 ± 2% at 15 years in Group 1 and 84 ± 7% at 10 years in Group 2. In Group 2, freedom from procedure-related reoperations was 98 ± 2% at 10 years. At last follow-up, no cases of moderate or severe aortic regurgitation were observed. Conclusions: The modified Bentall and David I procedures showed excellent early and late results. The modified Bentall procedure with a mechanical conduit was associated with thromboembolic and hemorrhagic complications, whereas the David I procedure was associated with unexplained occurrences of endocarditis. Thus, the David I procedure appears to be safe, reproducible, and capable of achieving stable aortic valve repair and is therefore our currently preferred solution for patients with annuloaortic ectasia. However, the much shorter follow-up for David I patients limits the strength of our comparison between the two techniques

THE REAL IN THE VIRTUAL. THE 3D MODEL IN THE CULTURAL HERITAGE SECTOR: THE TIP OF THE ICEBERG

The twenty-year and interdisciplinary research activity carried out by Virtualgeo has focused on the development of new methods and tools for 3D modeling that go beyond the simple digital-virtual reconstruction of solid modelling, in order to realize three-dimensional informative and photogrammetric representations that faithfully reproduce reality. These so called Advanced 3D models are the basis for carrying out metrological investigations to support the design and the BIM database population. In particular, in this paper we will deal with the segmentation tool, which allows the classification of the photogrammetric 3D model (material, degradation and chronological features). In detail, we will illustrate the collaboration experience between Virtualgeo and the University of Trieste, course in Technologies for the conservation and enhancement of architectural heritage of the Master's Degree in Architecture. The experience focused on the study of the archaeological site of the Roman river port of Aquileia, which Advanced 3D model was supplied by Virtualgeo. Firstly, the work focused on the informative contents necessary for the subsequent elaborations (different types of materials, alteration/degradation forms), starting from the use of coded lexicons (UNI 11182/2006). Subsequently, the quantitative data were associated to each category of homogeneous elements, obtainable from the segmentation (“mapping”) of the 3D model. This experience gave the chance to test the EasyCUBE PRO software: it was gradually adapted to the specific needs emerged both during the analysis of the site and the definition of conservation interventions, so as the outputs that can be generated after the elaboration of the Advanced 3D model

A Brazilian Portuguese cross-cultural adaptation of the modified JOA scale for myelopathy

OBJECTIVES: To develop a version of the modified Japanese Orthopaedic Association (mJOA) scale that had been translated into Portuguese and cross-culturally adapted for the Brazilian population. METHODS: The well-established process of forward-backward translation was employed along with cross-cultural adaptation. RESULTS: Three bilingual translators (English and native Portuguese) performed the forward translation of the mJOA scale from English to Portuguese based on iterative discussions used to reach a consensus translation. The translated version of the mJOA scale was then back-translated into English by a native English-speaking translator unaware of the concepts involved with the mJOA scale. The original mJOA scale and the back-translated version were compared by a native North American neurosurgeon, and as they were considered equivalent, the final version of the mJOA scale that had been translated into Portuguese and cross-culturally adapted was defined. CONCLUSION: To facilitate global and cross-cultural comparisons of the severity of cervical myelopathy, this study presents a version of the mJOA scale that was translated into Portuguese and cross-culturally adapted for the Brazilian population

Feasibility of real-time three-dimensional stress echocardiography: pharmacological and semi-supine exercise

<p>Abstract</p> <p>Background</p> <p>Real time three dimensional (RT3D) echocardiography is an accurate and reproducible method for assessing left ventricular shape and function.</p> <p>Aim</p> <p>assess the feasibility and reproducibility of RT3D stress echocardiography (SE) (exercise and pharmacological) in the evaluation of left ventricular function compared to 2D.</p> <p>Methods and results</p> <p>One hundred eleven patients with known or suspected coronary artery disease underwent 2D and RT3DSE. The agreement in WMSI, EDV, ESV measurements was made off-line.</p> <p>The feasibility of RT-3DSE was 67%. The inter-observer variability for WMSI by RT3D echo was higher during exercise and with suboptimal quality images (good: k = 0.88; bad: k = 0.69); and with high heart rate both for pharmacological (HR < 100 bpm, k = 0.83; HR ≥ 100 bpm, k = 0.49) and exercise SE (HR < 120 bpm, k = 0.88; HR ≥ 120 bpm, k = 0.78). The RT3D reproducibility was high for ESV volumes (0.3 ± 14 ml; CI 95%: -27 to 27 ml; p = n.s.).</p> <p>Conclusions</p> <p>RT3DSE is more vulnerable than 2D due to tachycardia, signal quality, patient decubitus and suboptimal resting image quality, making exercise RT3DSE less attractive than pharmacological stress.</p

Arthroscopic removal of an osteoid osteoma of the acetabulum

In this case report, we describe the arthroscopic removal of an osteoid osteoma from the acetabulum in a young adolescent. After identifying the osteoid osteoma close to the cartilage with MRI and CT investigations, we decided that in this case, arthroscopic removal was the best treatment. In the case of an osteoid osteoma in the acetabulum close to the cartilage, arthroscopic removal should be considered as one can treat the associated osteochondritic lesion during this procedure

Head to head comparison of 2D vs real time 3D dipyridamole stress echocardiography

Real-time three-dimensional (RT-3D) echocardiography has entered the clinical practice but true incremental value over standard two-dimensional echocardiography (2D) remains uncertain when applied to stress echo. The aim of the present study is to establish the additional value of RT-3D stress echo over standard 2D stress echocardiography. We evaluated 23 consecutive patients (age = 65 ± 10 years, 16 men) referred for dipyridamole stress echocardiography with Sonos 7500 (Philips Medical Systems, Palo, Alto, CA) equipped with a phased – array 1.6–2.5 MHz probe with second harmonic capability for 2D imaging and a 2–4 MHz matrix-phased array transducer producing 60 × 70 volumetric pyramidal data containing the entire left ventricle for RT-3D imaging. In all patients, images were digitally stored in 2D and 3D for baseline and peak stress with a delay between acquisitions of less than 60 seconds. Wall motion analysis was interpreted on-line for 2D and off-line for RT-3D by joint reading of two expert stress ecocardiographist. Segmental image quality was scored from 1 = excellent to 5 = uninterpretable. Interpretable images were obtained in all patients. Acquisition time for 2D images was 67 ± 21 sec vs 40 ± 22 sec for RT-3D (p = 0.5). Wall motion analysis time was 2.8 ± 0.5 min for 2D and 13 ± 7 min for 3D (p = 0.0001). Segmental image quality score was 1.4 ± 0.5 for 2D and 2.6 ± 0.7 for 3D (p = 0.0001). Positive test results was found in 5/23 patients. 2D and RT-3D were in agreement in 3 out of these 5 positive exams. Overall stress result (positive vs negative) concordance was 91% (Kappa = 0.80) between 2D and RT-3D. During dipyridamole stress echocardiography RT-3D imaging is highly feasible and shows a high concordance rate with standard 2D stress echo. 2D images take longer time to acquire and RT-3D is more time-consuming to analyze. At present, there is no clear clinical advantage justifying routine RT-3D stress echocardiography use

Randomized trial on the effects of a combined physical/cognitive training in aged MCI subjects: the Train the Brain study

Age-related cognitive impairment and dementia are an increasing societal burden. Epidemiological studies indicate that lifestyle factors, e.g. physical, cognitive and social activities, correlate with reduced dementia risk; moreover, positive effects on cognition of physical/cognitive training have been found in cognitively unimpaired elders. Less is known about effectiveness and action mechanisms of physical/cognitive training in elders already suffering from Mild Cognitive Impairment (MCI), a population at high risk for dementia. We assessed in 113 MCI subjects aged 65-89 years, the efficacy of combined physical-cognitive training on cognitive decline, Gray Matter (GM) volume loss and Cerebral Blood Flow (CBF) in hippocampus and parahippocampal areas, and on brain-blood-oxygenation-level-dependent (BOLD) activity elicited by a cognitive task, measured by ADAS-Cog scale, Magnetic Resonance Imaging (MRI), Arterial Spin Labeling (ASL) and fMRI, respectively, before and after 7 months of training vs. usual life. Cognitive status significantly decreased in MCI-no training and significantly increased in MCI-training subjects; training increased parahippocampal CBF, but no effect on GM volume loss was evident; BOLD activity increase, indicative of neural efficiency decline, was found only in MCI-no training subjects. These results show that a non pharmacological, multicomponent intervention improves cognitive status and indicators of brain health in MCI subjects