Does contemporary exercise-based cardiac rehabilitation improve quality of life for people with coronary artery disease? A systematic review and meta-analysis

Objectives: To determine the effect of contemporary exercise-based cardiac rehabilitation on generic and disease-specific health related quality of life for people with coronary artery disease. Design: Systematic review and meta-analysis. Study: eligibility criteria Randomised controlled trials testing exercise-based cardiac rehabilitation versus no exercise control that recruited after 31 December 1999. On 30 July 2019, we searched the Cochrane Central Register of Controlled Trials, MEDLINE (Ovid), Embase (Ovid) and CINAHL (EBSCO) databases. Study: appraisal and synthesis Studies were screened for inclusion by two independent reviewers. Risk of bias was assessed using the Cochrane risk of bias tool. Data were reported as pooled means (95% CI for between-group difference. Results: We identified 24 studies (n=4890). We performed meta-analyses for 15 short-term and 9 medium-term outcomes (36-Item Short Form Survey Instrument (SF-36), EuroQol-5D (EQ-5D) and MacNew, a cardiac-specific outcome). Six short-term and five medium-term SF-36 domains statistically favoured exercise-based cardiac rehabilitation. Only for two short-term SF-36 outcomes, ‘physical function’ (mean difference 12.0, 95% CI 4.4 to 19.6) and ‘role physical’ (mean difference 16.9, 95% CI 2.4 to 31.3), did the benefit appear to be clinically important. Meta-analyses of the short-term SF-36 physical and mental component scores, EQ-5D and MacNew and the medium-term SF-36 physical component score, did not show statistically significant benefits. Only two studies had a low risk of bias (n=463 participants). Conclusions and implications: of key findings There is some evidence of a short-term benefit of contemporary exercise-based cardiac rehabilitation on quality of life for people with coronary artery disease. However, the contemporary data presented in this review are insufficient to support its routine use

Boosted Decision Trees as an Alternative to Artificial Neural Networks for Particle Identification

The efficacy of particle identification is compared using artificial neutral networks and boosted decision trees. The comparison is performed in the context of the MiniBooNE, an experiment at Fermilab searching for neutrino oscillations. Based on studies of Monte Carlo samples of simulated data, particle identification with boosting algorithms has better performance than that with artificial neural networks for the MiniBooNE experiment. Although the tests in this paper were for one experiment, it is expected that boosting algorithms will find wide application in physics.Comment: 6 pages, 5 figures; Accepted for publication in Nucl. Inst. & Meth.

Exercise rehabilitation programmes for pulmonary hypertension – a systematic review of intervention components and reporting quality

Objectives: To identify the components, and assess the reporting quality, of exercise training interventions for people living with pulmonary hypertension. Design: Systematic review with analysis of intervention reporting quality using the Consensus on Exercise Reporting Template (CERT). Data sources: Eligible studies in the Cochrane Systematic Review of exercise-based rehabilitation for pulmonary hypertension, updated with a new search of relevant databases from 1st August 2016 to 15th January 2018. Eligibility criteria: Peer reviewed journal articles of randomised and non-randomised controlled trials, and non-controlled prospective observational studies, investigating dynamic exercise training interventions in adult humans with diagnosed pulmonary hypertension, reporting on at least one physiological and/or psychosocial outcome. Results: Interventions typically involved cycle ergometry and walking. They were delivered as three-week in-patient, or out-patient and/or home-based programmes, lasting for four to 15 weeks. Components relating specifically to exercise prescription were described satisfactorily and in more detail than motivational/behavioural change strategies, adherence and fidelity. Mean Consensus on Exercise Reporting Template (CERT) score was 13.1 (range 8 to 17) out of a possible maximum score of 19. No studies fully reported every aspect of an exercise intervention to the standard recommended by CERT. Summary/conclusion: Considerable variability was evident in the components and reporting quality of interventions for exercise rehabilitation studies in pulmonary hypertension. Interventional studies using exercise training should pay greater attention to describing motivational/ behavioural change strategies, adherence and fidelity. Detailed description of these parameters is essential for the safe and effective replication of exercise rehabilitation interventions for pulmonary hypertension in clinical practice. Trial registration number: This systematic review is registered with PROSPERO 2018 CRD4201808555

Opportunities for Public Aquariums to Increase the Sustainability of the Aquatic Animal Trade

The global aquatic pet trade encompasses a wide diversity of freshwater and marine organisms. While relying on a continual supply of healthy, vibrant aquatic animals, few sustainability initiatives exist within this sector. Public aquariums overlap this industry by acquiring many of the same species through the same sources. End users are also similar, as many aquarium visitors are home aquarists. Here we posit that this overlap with the pet trade gives aquariums significant opportunity to increase the sustainability of the trade in aquarium fishes and invertebrates. Improving the sustainability ethos and practices of the aquatic pet trade can carry a conservation benefit in terms of less waste, and protection of intact functioning ecosystems, at the same time as maintaining its economic and educational benefits and impacts. The relationship would also move forward the goal of public aquariums to advance aquatic conservation in a broad sense. For example, many public aquariums in North America have been instrumental in working with the seafood industry to enact positive change toward increased sustainability. The actions include being good consumers themselves, providing technical knowledge, and providing educational and outreach opportunities. These same opportunities exist for public aquariums to partner with the ornamental fish trade, which will serve to improve business, create new, more ethical and more dependable sources of aquatic animals for public aquariums, and perhaps most important, possibly transform the home aquarium industry from a threat, into a positive force for aquatic conservation. Zoo Biol. 32:1-12, 2013. © 2012 Wiley Periodicals, Inc

Validating the Fitbit Charge 4© wearable activity monitor for use in physical activity interventions

OBJECTIVES: Commercially available wearable activity monitors can promote physical activity behaviour. Clinical trials typically quantify physical activity with research grade activity monitors prior to testing interventions utilising commercially available wearable activity monitors aimed at increasing step count. Therefore, it is important to test the agreement of these two types of activity monitors.OBJECTIVES: Observational.METHODS: Thirty adults (20-65 years, n = 19 females) were provided a Fitbit Charge 4©. To determine reliability using an intraclass correlation coefficient, two, one-minute bouts of treadmill walking were performed at a self-selected pace. Subsequently, participants wore both an ActiGraph wGT3X-BT and the Fitbit for seven days. To determine agreement, statistical equivalence and the mean absolute percentage error were calculated and represented graphically with a Bland-Altman plot. Ordinary least products regression was performed to identify fixed or proportional bias.RESULTS: The Fitbit showed 'good' step count reliability on the treadmill (intraclass correlation coefficient = 0.75, 95 % CI = 0.53-0.87, p &lt; 0.001). In free-living however, it overestimated step count when compared to the ActiGraph wGT3X-BT (mean absolute percentage error = 26.02 % ± 14.63). Measurements did not fall within the ± 10 % equivalence region and proportional bias was apparent (slope 95 % CI = 1.09-1.35).CONCLUSIONS: The Fitbit Charge 4© is reliable when measuring step count on a treadmill. However, there is an overestimation of daily steps in free-living environments which may falsely indicate compliance with physical activity recommendations.</p

Determining position and orientation of a 3-wheel robot on a pipe using an accelerometer

Accurate positioning of robots on pipes is a challenge in automated industrial inspection. It is typically achieved using expensive and cumbersome external measurement equipment. This paper presents an Inverse Model method for determining the orientation angle (α ) and circumferential position angle (ω) of a 3 point of contact robot on a pipe where measurements are taken from a 3-axis accelerometer sensor. The advantage of this system is that it provides absolute positional measurements using only a robot mounted sensor. Two methods are presented which follow an analytical approximation to correct the estimated values. First, a correction factor found though a parametric study between the robot geometry and a given pipe radius, followed by an optimization solution which calculates the desired angles based on the system configuration, robot geometry and the output of a 3-axis accelerometer. The method is experimentally validated using photogrammetry measurements from a Vicon T160 positioning system to record the position of a three point of contact test rig in relation to a test pipe in a global reference frame. An accelerometer is attached to the 3 point of contact test rig which is placed at different orientation (α ) and circumferential position (ω) angles. This work uses a new method of processing data from an accelerometer sensor to obtain the α and ω angles. The experimental results show a maximum error of 3.40° in α and 4.17° in ω , where the ω circumferential positional error corresponds to ±18mm for the test pipe radius of 253mm

Hemodynamic Instability during Dialysis:The Potential Role of Intradialytic Exercise

Acute haemodynamic instability is a natural consequence of disordered cardiovascular physiology during haemodialysis (HD). Prevalence of intradialytic hypotension (IDH) can be as high as 20–30%, contributing to subclinical, transient myocardial ischemia. In the long term, this results in progressive, maladaptive cardiac remodeling and impairment of left ventricular function. This is thought to be a major contributor to increased cardiovascular mortality in end stage renal disease (ESRD). Medical strategies to acutely attenuate haemodynamic instability during HD are suboptimal. Whilst a programme of intradialytic exercise training appears to facilitate numerous chronic adaptations, little is known of the acute physiological response to this type of exercise. In particular, the potential for intradialytic exercise to acutely stabilise cardiovascular hemodynamics, thus preventing IDH and myocardial ischemia, has not been explored. This narrative review aims to summarise the characteristics and causes of acute haemodynamic instability during HD, with an overview of current medical therapies to treat IDH. Moreover, we discuss the acute physiological response to intradialytic exercise with a view to determining the potential for this nonmedical intervention to stabilise cardiovascular haemodynamics during HD, improve coronary perfusion, and reduce cardiovascular morbidity and mortality in ESRD