Long-Term Oxygen Therapy in COPD: Factors Affecting and Ways of Improving Patient Compliance

Long-term oxygen therapy (LTOT) is the cornerstone mode of treatment in patients with severe chronic obstructive pulmonary disease (COPD) associated with resting hypoxaemia. When appropriately prescribed and correctly used, LTOT has clearly been shown to improve survival in hypoxemic COPD patients. Adherence to LTOT ranges from 45% to 70% and utilization for more than 15 hours per day is widely accepted as efficacious. Although several studies have addressed the level of patients' adherence to LTOT, few have suggested or evaluated interventions that conduce to compliance enhancement. The lack of sufficient data regarding COPD patients following oxygen prescription is an enormous void that must be duly confronted to augment clinical effectiveness and cost containment for the long term use. The present review article highlights factors influencing the compliance of patients using LTOT and emphasizes novel strategies and interventions that may prove to be of significant benefit given the remarkably little current research appraising this issue. Therefore, additional research should be promptly performed to verify the efficacy of newly designed approaches in improving the outcomes of patients receiving LTOT

Sex Impacts Regression Models Predicting Upper-Body Muscular Endurance

According to Centers for Disease Control and Prevention (CDC) data and the well-established overall benefits of physical activity (PA), only one out of three adults meet the American College of Sports Medicine (ACSM) muscle strengthening guidelines in the US. PA and obesity levels, cardiovascular endurance, psychological factors, and sex disparities have been suggested as possible predictors of this statistic. Minimum levels of muscular endurance are required to perform activities of daily living (ADL), maintain functional independence during aging, and to participate in leisure and PA without undue fatigue or risk of injury. Upper-body muscular endurance is commonly measured directly using the push-up test. Males are more likely than females to meet the muscle-strengthening physical activity guidelines. Regression analysis is often used in exercise prescription in an effort to provide answers to a phenomenon and make predictions of future behavior. PURPOSE: To examine whether a prediction model for upper-body muscular endurance using predicted oxygen consumption (VO2max), physical activity (PA) level, age, body mass index (BMI) and mental toughness index (MTI) scores during a push-up endurance test is subjected to sex. METHODS: In total, 162 participants agreed to participate (Mage= 23, SD=5.7). A calibrated Monark 828E cycle ergometer, an electronic HR monitor with a chest strap were used for the VO2max test prediction based on the heart rate termination. A standardized push-up test was chosen to measure muscular endurance. BMI was calculated based on height and body weight. PA and all of the aforementioned assessments were collected and calculated according to ACSM 10th ed. guidelines. The statistical analysis involved a multiple regression of the variables described above using R and p level was set at 0.05. RESULTS: The regression model for females was: y=.7+.04*x; F5,47=5.6, p=.00, R2=.373 and for males was: y=.73+.02*x; F5,78=1.9, p=.11, R2=.108. Comparing the regression models factored for sex revealed significant difference between males and females: x2(15)= 38.67, p=.00072. CONCLUSION: Muscular endurance is associated with improvements in cardiovascular and respiratory function, reduction in cardiovascular risk factors, decreased morbidity and mortality, and other benefits, such as decreased anxiety and enhanced performance. Our prediction model for upper-body muscular endurance was significantly different based on sex. Health care professionals may need to consider sex when using models for prescribing exercise to increase North Americans’ upper-body muscular endurance. Future studies on muscular endurance should focus on creating models examining the contribution of other factors in order to investigate the unexplained variance of our modeling. However, the authors believe that sex needs to be investigated further in any future regression modeling. Limitations may include self-reported data of physical activity and mental toughness scores

The Challenging Evaluation of Patients with Severe Psoriasis for Latent Tuberculosis: An Important Indication for IGRA

It is well-established that tumour necrosis factor (TNF)-α-antagonist regimens are advisable for the control of moderate to severe psoriasis; however the application of these agents is associated with increased risk of TB reactivation. Screening for latent tuberculosis infection (LTBI) is indispensable prior to treatment inception in order to diminish the risk of active TB. Although tuberculin skin test (TST) still represents a useful tool for LTBI detection, it is difficult to be performed and read in patients with extensive psoriatic lesions. In this paper, we report the case of a 65-year-old male with severe psoriasis, who was evaluated by an interferon-gamma release assay (IGRA) for LTBI diagnosis prior to anti-TNF-α therapy. Furthermore, the physiological aspects of interferon-gamma release assays are discussed emphasizing the value of these novel immunodiagnostic tests (IGRAs) for presumable LTBI in all patients with extensive skin disorders

Production of a Laccase from Botrytis cinerea (DSMZ 877) and Application for Textile Phenolic Dye Decolorization

AbstractIn this study, the production, partial purification and characterization of a laccase from Botrytis cinerea strain (DSMZ No. 877) was studied. The production of laccase was induced using copper sulphate and Gallic acid as inducers. The maximum laccase activity observed during B. cinerea growth in the presence of 0.1% Gallic acid was 2600 UL−1. Laccase purification was performed by precipitated the enzyme with 90% ammonium sulphate followed by gel filtration chromatography. The optimum pH for the laccase activity was observed at acidic pH values (close to pH 3.5 - 4.6), while the optimum temperature was 70°C. The ability of the produced laccase as well as the laccase from T. versicolor to catalyse the decolorization of a phenolic dye (phenol red) was also investigated using natural and synthetic mediators. The higher decolorization activity was observed with 1–hydroxybenzotriazole (HBT) as mediator at pH 4.5 and temperature 30° C

Chronic eosinophilic pneumonia associated with neurofibromatosis type 1 : an unusual complication

Neurofibromatosis type 1 (formerly known as von Recklinghausen’s disease) is an autosomal dominant disorder, which results from the proliferation of the neural crest cells, thus affecting any organ system. Several pulmonary manifestations have hitherto been reported, including chest wall deformities, diffuse lung disease, thoracic neoplasms, pulmonary arterial hypertension, central hypoventilation, diaphragmatic paralysis and meningocele. However, eosinophilic lung disorders have not been described. An unusual case of chronic eosinophilic pneumonia in a patient with neurofibromatosis type 1, is reported herein. He had a propitious outcome, following corticosteroid treatment. This is the first well-documented case of chronic eosinophilic pneumonia and neurofibromatosis type 1 in the same patient. These clinical entities might share common pathogenic mechanisms, as suggested by the present study, that could explain their co-existence

A Fuzzy Criticality Assessment System of Process Equipment for Optimized Maintenance Management.

yesIn modern chemical plants, it is essential to establish an effective maintenance strategy which will deliver financially driven results at optimised conditions, that is, minimum cost and time, by means of a criticality review of equipment in maintenance. In this article, a fuzzy logic-based criticality assessment system (FCAS) for the management of a local company’s equipment maintenance is introduced. This fuzzy system is shown to improve the conventional crisp criticality assessment system (CCAS). Results from case studies show that not only can the fuzzy logic-based system do what the conventional crisp system does but also it can output more criticality classifications with an improved reliability and a greater number of different ratings that account for fuzziness and individual voice of the decision-makers

A Furcated Visual Collision Avoidance System for an Autonomous Micro Robot

This paper proposes a secondary reactive collision avoidance system for micro class of robots based on a novel approach known as the Furcated Luminance-Difference Processing (FLDP) inspired by the Lobula Giant Movement Detector, a wide-field visual neuron located in the lobula layer of a locust nervous system. This paper addresses some of the major collision avoidance challenges; obstacle proximity & direction estimation, and operation in GPS-denied environment with irregular lighting. Additionally, it has proven effective in detecting edges independent of background color, size, and contour. The FLDP executes a series of image enhancement and edge detection algorithms to estimate collision threat-level which further determines whether or not the robot’s field of view must be dissected where each section’s response is compared against the others to generate a simple collision-free maneuver. Ultimately, the computation load and the performance of the model is assessed against an eclectic set of off-line as well as real-time real-world collision scenarios validating the proposed model’s asserted capability to avoid obstacles at more than 670 mm prior to collision, moving at 1.2 ms¯¹ with a successful avoidance rate of 90% processing at 120 Hz on a simple single core microcontroller, sufficient to conclude the system’s feasibility for real-time real-world applications that possess fail-safe collision avoidance system