Post-COVID-19 respiratory sequelae two years after hospitalization: an ambidirectional study.

Background: COVID-19 lung sequelae can impact the course of patient lives. We investigated the evolution of pulmonary abnormalities in post-COVID-19 patients 18-24 months after hospital discharge. Methods: A cohort of COVID-19 patients admitted to the Hospital das Clínicas da Faculdade de Medicina da USP in São Paulo, Brazil, between March and August of 2020, were followed-up 6-12 months after hospital discharge. A subset of patients with pulmonary involvement and chest computed tomography (CT) scans were eligible to participate in this second follow-up (18-24 months). Data was analyzed in an ambidirectional manner, including retrospective data from the hospitalization, and from the first follow-up (6-12 months after discharge), and compared with the prospective data collected in this new follow-up. Findings: From 348 patients eligible, 237 (68%) participated in this follow-up. Among participants, 139 (58%) patients presented ground-glass opacities and reticulations, and 80 (33%) presented fibrotic-like lesions (traction bronchiectasis and architectural distortion). Five (2%) patients improved compared to the 6-12-month assessment, but 20 (25%) of 80 presented worsening of lung abnormalities. For those with relevant assessments on both occasions, comparing the CT findings between this follow-up with the previous assessment, there was an increase in patients with architectural distortion (43 [21%] of 204 vs 57 [28%] of 204, p = 0.0093), as well as in traction bronchiectasis (55 [27%] of 204 vs 69 [34%] of 204, p = 0.0043). Patients presented a persistent functional impairment with demonstrated restrictive pattern in both follow-ups (87 [42%] of 207 vs 91 [44%] of 207, p = 0.76), as well as for the reduced diffusion capacity (88 [42%] of 208 vs 87 [42%] of 208, p = 1.0). Length of hospitalization (OR 1.04 [1.01-1.07], p = 0.0040), invasive mechanical ventilation (OR 3.11 [1.3-7.5] p = 0.011), patient's age (OR 1.03 [1.01-1.06] p = 0.0074 were consistent predictors for development of fibrotic-like lung lesions in post-COVID-19 patients. Interpretation: Post-COVID-19 lung sequelae can persist and progress after hospital discharge, suggesting airways involvement and formation of new fibrotic-like lesions, mainly in patients who were in intensive care unit (ICU). Funding: São Paulo Research Foundation (22/01769-5) and Instituto Todos pela Saúde (C1721).

Genome-wide maps of highly-similar intrachromosomal repeats that mediate ectopic recombination in three human genome assemblies.

Repeated sequences spread throughout the genome play important roles in shaping the structure of chromosomes and facilitating the generation of new genomic variation. Through a variety of mechanisms, repeats are involved in generating structural rearrangements such as deletions, duplications, inversions, and translocations, which can have the potential to impact human health. Despite their significance, repetitive regions including tandem repeats, transposable elements, segmental duplications, and low-copy repeats remain a challenge to characterize due to technological limitations inherent to many sequencing methodologies. We performed genome-wide analyses and comparisons of direct and inverted repeated sequences in the latest available human genome reference assemblies including GRCh37 and GRCh38 and the most recent telomere-to-telomere alternate assembly (T2T-CHM13). Overall, the composition and distribution of direct and inverted repeats identified remains similar among the three assemblies but we observed an increase in the number of repeated sequences detected in the T2T-CHM13 assembly versus the reference assemblies. As expected, there is an enrichment of repetitive regions in the short arms of acrocentric chromosomes, which had been previously unresolved in the human genome reference assemblies. We cross-referenced the identified repeats with protein-coding genes across the genome to identify those at risk for being involved in genomic disorders. We observed that certain gene categories, such as olfactory receptors and immune response genes, are enriched among those impacted by repeated sequences likely contributing to human diversity and adaptation. Through this analysis, we have produced a catalogue of direct and inversely oriented repeated sequences across the currently three most widely used human genome assemblies. Bioinformatic analyses of these repeats and their contribution to genome architecture can reveal regions that are most susceptible to genomic instability. Understanding how the architectural genomic features of repeat pairs such as their homology, size and distance can lead to complex genomic rearrangement formation can provide further insights into the molecular mechanisms leading to genomic disorders and genome evolution. Author summary: This study focused on the characterization of intrachromosomal repeated sequences in the human genome that can play important roles in shaping chromosome structure and generating new genomic variation in three human genome assemblies. We observed an increase in the number of repeated sequence pairs detected in the most recent telomere-to-telomere alternate assembly (T2T-CHM13) compared to the reference assemblies (GRCh37 and GRCh38). We observed an enrichment of repeats in the T2T-CHM13 acrocentric chromosomes, which had been previously unresolved. Importantly, our study provides a catalogue of direct and inverted repeated sequences across three commonly used human genome assemblies, which can aid in the understanding of genomic architecture instability, evolution, and disorders. Our analyses provide insights into repetitive regions in the human genome that may contribute to complex genomic rearrangements.

Pulmonary Toxicity of Boron Nitride Nanomaterials Is Aspect Ratio Dependent.

Boron nitride (BN) nanomaterials have drawn a lot of interest in the material science community. However, extensive research is still needed to thoroughly analyze their safety profiles. Herein, we investigated the pulmonary impact and clearance of two-dimensional hexagonal boron nitride (h-BN) nanosheets and boron nitride nanotubes (BNNTs) in mice. Animals were exposed by single oropharyngeal aspiration to h-BN or BNNTs. On days 1, 7, and 28, bronchoalveolar lavage (BAL) fluids and lungs were collected. On one hand, adverse effects on lungs were evaluated using various approaches (e.g., immune response, histopathology, tissue remodeling, and genotoxicity). On the other hand, material deposition and clearance from the lungs were assessed. Two-dimensional h-BN did not cause any significant immune response or lung damage, although the presence of materials was confirmed by Raman spectroscopy. In addition, the low aspect ratio h-BN nanosheets were internalized rapidly by phagocytic cells present in alveoli, resulting in efficient clearance from the lungs. In contrast, high aspect ratio BNNTs caused a strong and long-lasting inflammatory response, characterized by sustained inflammation up to 28 days after exposure and the activation of both innate and adaptive immunity. Moreover, the presence of granulomatous structures and an indication of ongoing fibrosis as well as DNA damage in the lung parenchyma were evidenced with these materials. Concurrently, BNNTs were identified in lung sections for up to 28 days, suggesting long-term biopersistence, as previously demonstrated for other high aspect ratio nanomaterials with poor lung clearance such as multiwalled carbon nanotubes (MWCNTs). Overall, we reveal the safer toxicological profile of BN-based two-dimensional nanosheets in comparison to their nanotube counterparts. We also report strong similarities between BNNTs and MWCNTs in lung response, emphasizing their high aspect ratio as a major driver of their toxicity.

Lung Persistence, Biodegradation, and Elimination of Graphene-Based Materials are Predominantly Size-Dependent and Mediated by Alveolar Phagocytes.

Graphene-based materials (GBMs) have promising applications in various sectors, including pulmonary nanomedicine. Nevertheless, the influence of GBM physicochemical characteristics on their fate and impact in lung has not been thoroughly addressed. To fill this gap, the biological response, distribution, and bio-persistence of four different GBMs in mouse lungs up to 28 days after single oropharyngeal aspiration are investigated. None of the GBMs, varying in size (large versus small) and carbon to oxygen ratio as well as thickness (few-layers graphene (FLG) versus thin graphene oxide (GO)), induce a strong pulmonary immune response. However, recruited neutrophils internalize nanosheets better and degrade GBMs faster than macrophages, revealing their crucial role in the elimination of small GBMs. In contrast, large GO sheets induce more damages due to a hindered degradation and long-term persistence in macrophages. Overall, small dimensions appear to be a leading feature in the design of safe GBM pulmonary nanovectors due to an enhanced degradation in phagocytes and a faster clearance from the lungs for small GBMs. Thickness also plays an important role, since decreased material loading in alveolar phagocytes and faster elimination are found for FLGs compared to thinner GOs. These results are important for designing safer-by-design GBMs for biomedical application.

Clasificación de los medios y métodos empleados en el entrenamiento funcional de alta intensidad: una reflexión crítica

El entrenamiento funcional de alta intensidad representa un nuevo paradigma del fitness, además es un tipo de ejercicio que crece a nivel mundial en cuanto a practicantes y centros de acondicionamiento físico que lo ofertan; no obstante, la documentación respecto a la forma de realizar este tipo de entrenamientos es escasa, por lo que se puede presentar diferentes problemáticas en este ámbito de la actividad física, el deporte y la salud por desconocimiento de cómo efectuar este tipo de ejercicio físico de alta intensidad. El objetivo estudio de este artículo es hacer una reflexión crítica sobre los medios y métodos aplicados en el entrenamiento funcional de alta intensidad. Posterior a la consulta de literatura se propone la siguiente clasificación para los medios (calisténicos/gimnásticos, cardiometabólico y levantamiento), mientras que los métodos obtuvieron dos clasificaciones, una basada en la modalidad (medios) y otra en la organización (estructura de la sesión). En conclusión, esta nueva propuesta se ajusta más a la realidad del entrenamiento funcional de alta intensidad desde las bases del entrenamiento deportivo.

High-intensity functional training represents a new fitness paradigm, it is also a type of exercise that is growing worldwide in terms of practitioners and fitness centers that offer it, despite the documentation regarding how to perform this type of exercise is scarce, so different problems can arise in this area of physical activity, sports and health due to a lack of knowledge of how to carry out this type of high-intensity physical exercise. The study objective of this article is to make a critical reflection on the means and methods applied in high intensity functional training. After consulting the literature, the following classification is proposed for the means (calisthenics/gymnastics, cardiometabolic and lifting), while the methods obtained two classifications, one based on the modality (means) and the other on the organizational (structure of the session). In conclusion, this new proposal is more in line with the reality of high-intensity functional training from the bases of sports training.

Relación del ritmo de repetición del CrossFit WOD Karen con la frecuencia cardíaca y el esfuerzo percibido / Relationship of Crossfit wod Karen repetition rate to heart rate and perceived exertion

Introducción: El CrossFit representa un paradigma interesante del fitness para los profesionales del ejercicio y la medicina deportiva. No obstante, aún se desconoce si el ritmo de repetición influye en las respuestas cardiovasculares y la percepción del esfuerzo en este tipo de entrenamiento físico. Objetivo: Relacionar el ritmo de repetición del CrossFit WOD Karen con la frecuencia cardíaca y el esfuerzo percibido en sujetos físicamente activos. Métodos: Se realizó un estudio descriptivo-correlacional de enfoque cuantitativo a una muestra no probabilística de 20 sujetos. Durante la aplicación de la prueba WOD Karen y el test Course-Navette, la frecuencia cardíaca se monitoreó a través de pulsómetros Polar H7; el esfuerzo percibido se valoró con la escala de Borg CR-10 y el ritmo de repetición se calculó mediante una ecuación matemática. Los datos se analizaron con el paquete estadístico PSPP y se empleó el coeficiente de correlación de Spearman. Resultados: La intensidad relativa del entrenamiento (r = -0,67) y la percepción subjetiva del esfuerzo (r = -0,68) se relacionan negativamente en las mujeres. En ambos sexos no existió significación (p < 0,05). Conclusión: Las mujeres con un ritmo de repetición más rápido presentaron una frecuencia cardíaca y un esfuerzo percibido más bajo(AU)

Introduction: CrossFit represents an interesting fitness paradigm for exercise and sports medicine professionals. However, it is still unknown whether the repetition rate of this type of physical training influences cardiovascular responses and perceived exertion. Objective: To find the relation between the repetition rate of the CrossFit WOD Karen to heart rate and the perceived exertion in physically active subjects. Methods: A descriptive-correlational study with a quantitative approach was performed with a non-probabilistic sample of 20 subjects. During the application of the WOD Karen test and the Course-Navette test, heart rate was monitored with pulsometers; perceived exertion was assessed through the Borg CR-10 scale and repetition rate was calculated using a mathematical equation. Data were analyzed with the PSPP statistical package and the Spearman's correlation coefficient was used. Results: Relative training intensity (r = -0.67) and subjective perception of effort (r = -0.68) were negatively related in women. In both genders there was no significance (p < 0.05). Conclusion: Women with a faster repetition rate had a lower heart rate and lower perceived exertion(AU)

Outpatient management of acute uncomplicated appendicitis after laparoscopic appendectomy: a randomized controlled trial.

OBJECTIVE: To confirm the safety and efficacy of outpatient management of laparoscopic appendectomy, with an enhanced recovery after surgery (ERAS) protocol, in adult patients with uncomplicated acute appendicitis. Outpatient laparoscopic appendectomy is feasible and secure in selected patients in observational studies. The benefits include reduced length of stay (LOS) and postoperative complications. This is the first randomized controlled trial of outpatient management following ERAS protocol. METHODS: Patients admitted from the emergency department with acute appendicitis were randomized into one of two groups: standard care within the hospital (HG) or the outpatient group (OG). An ERAS protocol was followed for both groups. Patients in the HG were admitted to the surgical ward. Patients in the OG were referred to the day-surgery unit. The primary endpoint was the length of stay. RESULTS: Ninety-seven patients were included: 49 in the OG and 48 in the HG. LOS was significantly shorter in the OG (mean 8.82 h) than in the HG (mean 43.53 h), p < 0.001. There was no difference in readmission rates (p = 0.320); we observed only one readmission in the OG. No further emergency consultations or complications were observed. The cost saving was $516.52/patient as a result of the intervention. CONCLUSION: Outpatient management of appendectomy is safe and feasible procedure in selected patients. This approach could become the standard of care for patients with uncomplicated appendicitis, showing fewer complications, lower LOS and cost. TRIAL REGISTRATION: Registration: www. CLINICALTRIALS: gov (NCT05401188) Clinical Trial ID: NCT05401188.

Lung recovery from DNA damage induced by graphene oxide is dependent on size, dose and inflammation profile.

BACKGROUND: A key aspect of any new material safety assessment is the evaluation of their in vivo genotoxicity. Graphene oxide (GO) has been studied for many promising applications, but there are remaining concerns about its safety profile, especially after inhalation. Herein we tested whether GO lateral dimension, comparing micrometric (LGO) and nanometric (USGO) GO sheets, has a role in the formation of DNA double strand breaks in mouse lungs. We used spatial resolution and differential cell type analysis to measure DNA damages in both epithelial and immune cells, after either single or repeated exposure. RESULTS: GO induced DNA damages were size and dose dependent, in both exposure scenario. After single exposure to a high dose, both USGO and LGO induced significant DNA damage in the lung parenchyma, but only during the acute phase response (p < 0.05 for USGO; p < 0.01 for LGO). This was followed by a fast lung recovery at day 7 and 28 for both GOs. When evaluating the chronic impact of GO after repeated exposure, only a high dose of LGO induced long-term DNA damages in lung alveolar epithelia (at 84 days, p < 0.05). Regardless of size, low dose GO did not induce any significant DNA damage after repeated exposure. A multiparametric correlation analysis of our repeated exposure data revealed that transient or persistent inflammation and oxidative stress were associated to either recovery or persistent DNA damages. For USGO, recovery from DNA damage was correlated to efficient recovery from acute inflammation (i.e., significant secretion of SAA3, p < 0.001; infiltration of neutrophils, p < 0.01). In contrast, the persistence of LGO in lungs was associated to a long-lasting presence of multinucleated macrophages (up to 84 days, p < 0.05), an underlying inflammation (IL-1α secretion up to 28 days, p < 0.05) and the presence of persistent DNA damages at 84 days. CONCLUSIONS: Overall these results highlight the importance of the exposure scenario used. We showed that LGO was more genotoxic after repeated exposure than single exposure due to persistent lung inflammation. These findings are important in the context of human health risk assessment and toward establishing recommendations for a safe use of graphene based materials in the workplace.

Hazard assessment of abraded thermoplastic composites reinforced with reduced graphene oxide.

Graphene-related materials (GRMs) are subject to intensive investigations and considerable progress has been made in recent years in terms of safety assessment. However, limited information is available concerning the hazard potential of GRM-containing products such as graphene-reinforced composites. In the present study, we conducted a comprehensive investigation of the potential biological effects of particles released through an abrasion process from reduced graphene oxide (rGO)-reinforced composites of polyamide 6 (PA6), a widely used engineered thermoplastic polymer, in comparison to as-produced rGO. First, a panel of well-established in vitro models, representative of the immune system and possible target organs such as the lungs, the gut, and the skin, was applied. Limited responses to PA6-rGO exposure were found in the different in vitro models. Only as-produced rGO induced substantial adverse effects, in particular in macrophages. Since inhalation of airborne materials is a key occupational concern, we then sought to test whether the in vitro responses noted for these materials would translate into adverse effects in vivo. To this end, the response at 1, 7 and 28 days after a single pulmonary exposure was evaluated in mice. In agreement with the in vitro data, PA6-rGO induced a modest and transient pulmonary inflammation, resolved by day 28. In contrast, rGO induced a longer-lasting, albeit moderate inflammation that did not lead to tissue remodeling within 28 days. Taken together, the present study suggests a negligible impact on human health under acute exposure conditions of GRM fillers such as rGO when released from composites at doses expected at the workplace.

Midazolam reduction with pre-operative melatonin in abdominal hysterectomy: double-blind randomized clinical trial.

INTRODUCTION: Midazolam is a benzodiazepine used for sedation, however, can cause respiratory depression and increases morbidity in patients. Melatonin is an effective alternative to manage anxiety in the perioperative period and could help to reduce the use of benzodiazepines during surgery. The aim of this clinical trial was to determine the efficacy of pre-operative sedation with a single-dose melatonin to reduce intraoperative use of midazolam in women under total abdominal hysterectomy (TAH). MATERIALS AND METHODS: This is a double-blind randomized clinical trial conducted in women over 25 years, scheduled for TAH, with American Society of Anesthesiologists Grade I or II. Each patient was randomly assigned to receive 5 mg of melatonin prolonged-release oral capsules or placebo. Midazolam use for anesthetic management was the decision of the treating anesthesiologist and sedation status was determined using the observer's assessment of alertness/sedation scale. RESULTS: In patients receiving melatonin, the use of midazolam during surgery was less than in patients receiving placebo. In addition, melatonin produces sedation 30 min after administration, the sedative effect was maintained at 60- and 90-min. Furthermore, hospital stay was shorter in patients who received melatonin (p = 0.006). CONCLUSION: Melatonin is effective for reduces intraoperative midazolam consumption and hospital stay in women undergoing TAH.

INTRODUCCIÓN: El midazolam es una benzodiazepina utilizada para la sedación, sin embargo, puede causar depresión respiratoria y aumentar la morbilidad en los pacientes. La melatonina es una alternativa eficaz para controlar la ansiedad en el período perioperatorio y podría ayudar a reducir el uso de benzodiazepinas durante la cirugía. El objetivo de este ensayo clínico fue determinar la eficacia de la sedación preoperatoria con una dosis única de melatonina para reducir el uso intraoperatorio de midazolam en mujeres sometidas a histerectomía abdominal total (HTA). MATERIAL Y MÉTODOS: Se trata de un ensayo clínico aleatorizado doble ciego realizado en mujeres mayores de 25 años, programadas para TAH, con American Society of Anesthesiologists Grado I o II. Cada paciente fue asignado al azar para recibir 5 mg de cápsulas orales de liberación prolongada de melatonina o placebo. El uso de midazolam para el manejo anestésico fue decisión del anestesiólogo tratante y el estado de sedación se determinó mediante la escala OAA/S. RESULTADOS: En las pacientes que recibieron melatonina, el uso de midazolam durante la cirugía fue menor que en las pacientes que recibieron placebo. Además, la melatonina produce sedación 30 min después de la administración, el efecto sedante se mantuvo a los 60 y 90 min. Además, la estancia hospitalaria fue más corta en los pacientes que recibieron melatonina (p = 0.006). CONCLUSIÓN: La melatonina es eficaz para reducir el consumo de midazolam intraoperatorio y la estancia hospitalaria en mujeres sometidas a HTA.

Clinical characteristics and outcomes in a cohort of oncologic patients with COVID-19 during the first year of the pandemic in Mexico.

BACKGROUND: Literature on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in cancer patients is scarce in Latin America. This population seems to have a higher risk for adverse outcomes. This study aims to correlate clinical characteristics with outcomes in patients with cancer. METHODS: We included all patients with cancer and confirmed SARS-CoV-2 infection from April 19 to December 31, 2020, at the Instituto Nacional de Cancerologia, Mexico. Clinical information was obtained from medical and epidemiological records. For the association between variables and hospitalization, invasive mechanical ventilation (IMV), and mortality, univariate and multivariate logistic regression were performed; odds ratios and 95% confidence intervals were calculated. RESULTS: Four hundred thirty-three patients were included; 268 (62%) were female, the median age was 55 years. One hundred thirty-five (31%), 131 (30%), and 93 (21%) patients had obesity, hypertension, and diabetes mellitus (DM), respectively. Three hundred forty-one (79%) had solid cancer. One hundred seventy (39%) had advanced cancer. Two hundred (46%) patients were hospitalized. Age (p < 0.01), male gender (p = 0.03), hematological malignancies (HM) (p = 0.04) and advanced cancer (p = 0.03) increased the risk for hospital admission. Forty-five (10%) patients required IMV. Age (p = 0.02); DM (p = 0.04); high C-reactive protein (p < 0.01), and lactate dehydrogenase (p = 0.03) were associated with IMV. Mortality within 30 days after diagnosis was 18% (76 cases). Associated characteristics were age (p = 0.04) and low albumin (p < 0.01). CONCLUSIONS: In this study, patients with cancer showed higher mortality, need for hospitalization, and IMV compared with other non-cancer cohorts. We did not find an increased risk in mortality for HM. Although our cohort was younger than others previously reported, age was a strong predictor of adverse outcomes. Variables associated with IMV and death were similar to those previously described in cancer patients with COVID-19.

Innate but Not Adaptive Immunity Regulates Lung Recovery from Chronic Exposure to Graphene Oxide Nanosheets.

Graphene has drawn a lot of interest in the material community due to unique physicochemical properties. Owing to a high surface area to volume ratio and free oxygen groups, the oxidized derivative, graphene oxide (GO) has promising potential as a drug delivery system. Here, the lung tolerability of two distinct GO varying in lateral dimensions is investigated, to reveal the most suitable candidate platform for pulmonary drug delivery. Following repeated chronic pulmonary exposure of mice to GO sheet suspensions, the innate and adaptive immune responses are studied. An acute and transient influx of neutrophils and eosinophils in the alveolar space, together with the replacement of alveolar macrophages by interstitial ones and a significant activation toward anti-inflammatory subsets, are found for both GO materials. Micrometric GO give rise to persistent multinucleated macrophages and granulomas. However, neither adaptive immune response nor lung tissue remodeling are induced after exposure to micrometric GO. Concurrently, milder effects and faster tissue recovery, both associated to a faster clearance from the respiratory tract, are found for nanometric GO, suggesting a greater lung tolerability. Taken together, these results highlight the importance of dimensions in the design of biocompatible 2D materials for pulmonary drug delivery system.

Asociación de la resistencia muscular en flexiones de brazo y el test de repetición máxima en press banca / Association of muscle resistance in arm push-ups and maximum repetition test in bench press

RESUMEN Introducción: Estimar la fuerza muscular en miembros superiores con diferentes pruebas es primordial para la cuantificación de las cargas de entrenamiento, sin embargo, son escasos los estudios científicos que correlacionan las flexiones de brazos con la repetición máxima en press banca plano, un ejercicio de peso libre comúnmente utilizado para activar la musculatura del tren superior. Objetivo: Determinar la asociación entre la resistencia muscular en flexiones de brazos y la repetición máxima en press banca plano en sujetos físicamente activos. Métodos: Estudio descriptivo de tipo correlacional con una muestra a conveniencia de 15 hombres y 7 mujeres estudiantes de educación física, recreación y deportes de la Universidad de Pamplona. Se aplicó el protocolo de la National Strength and Conditioning Association para la evaluación de la resistencia muscular en flexiones de brazo y para el press banca plano se aplicó el test de la repetición máxima que consiste en ejecutar una repetición con la mayor cantidad de peso posible. Se utilizó el paquete estadístico PSPP (p-valor de 0,05) para aplicar las pruebas de normalidad (Shapiro-Wilk) y el coeficiente de correlación de Spearman. Resultados: El principal hallazgo fue la asociación positiva y no significativa (p > 0,05) de la resistencia muscular en flexiones de brazos con la repetición máxima en press banca plano en hombres (r = 0,26) y mujeres (r = 0,49). Conclusión: En sujetos físicamente activos no existe una asociación significativa entre la resistencia muscular en flexiones de brazo y la repetición máxima en press banca plano.

ABSTRACT Introduction: Estimating muscle strength in upper limbs with different tests is paramount for quantifying training loads, however, there are few scientific studies that correlate the push-ups of the arms with the maximum repetition in flat bench press, a free weight exercise commonly used to activate the upper train musculature. Objective: To determine the association between muscle resistance in arm flexions and maximum repetition in flat bench press in physically active subjects. Methods: Descriptive study of correlational type with a sample of 15 men and 7 women students of physical education, recreation and sports of the University of Pamplona. The National Strength and Conditioning Association protocol was applied for the evaluation of muscle endurance in arm push-ups and for the flat bench press the maximum repetition test was applied which consists of executing a repetition with as much weight as possible. In addition, the statistical package PSPP (p-value of 0,05) was used to apply the normality tests (Shapiro-Wilk) and the Spearman correlation coefficient. Results: The main finding was the positive and non-significant association (p>0,05) of muscle endurance in push-ups with maximum repetition in bench press in men (r = 0,26) and women (r = 0,49). Conclusion: In physically active subjects there is no significant association between muscle resistance in arm push-ups and maximum repetition in flat bench press.

Experimental and computational data on two-photon absorption and spectral deconvolution of the upper excited states of dye IR780.

Evaluating candidates for novel materials with high nonlinear absorption properties for applications as biomarkers is a very important field of research. In this context, experimental and computational information on the two-photon absorption (TPA) properties of the dye IR780 is shown. The two-photon absorption data from 850 to 1000 nm for IR780 and other two well-known dyes, taken as reference, are presented. The experimental data were collected via an implementation of the two-photon induced fluorescence technique, while the quantum chemical data were produced by implementing DFT (Density-functional theory) methods. The data presented here supplement the paper "Two-photon absorption spectrum and characterization of the upper electronic states of dye IR780" by Guarin et al. (2021).

Two-photon absorption spectrum and characterization of the upper electronic states of the dye IR780.

In this work, the full two-photon absorption (2PA) spectrum of cyanine dye IR780 in methanol was measured and some important properties of the upper excited electronic states were investigated. Specifically, two IR780 2PA bands of intensities nearing 140 and 2800 Goeppert-Mayer (GM) were found. In order to determine the optical properties of the upper electronic singlet states, a deconvolution of the absorption peaks in the UV region of the spectrum was made. Based on this, properties such as transition dipole moments, oscillator strengths, absorption maxima in the UV-vis spectra, S2-S1 vibrational couplings and predictions of the lifetime of the second excited state were calculated. Moreover, by combining experimental and computational results, the 2PA transitions were assigned to the upper excited states S2 and S4. Cross-section magnitudes, positions and shapes of the 2PA bands have been satisfactorily explained with a four-state model that comprises the singlet states S1, S2 and S4. From these results, the cyanine investigated in the present work could be used as a novel and interesting moiety for more complex systems that respond to two-photon excitation.

Disnea e impacto en la calidad de vida de los pacientes COVID-19 después del alta hospitalaria / Dyspnea and impact on the quality of life of COVID-19 patients after hospital discharge / Dispneia e impacto na qualidade de vida de pacientes com COVID-19 após alta hospitalar

INTRODUCCIÓN: el COVID-19 es una enfermedad infecciosa que puede causar disfunciones respiratorias y físicas a corto y largo plazo. La disnea como consecuencia de la fibrosis pulmonar progresa a medida que la enfermedad avanza y afecta la calidad de vida. OBEJTIVO: determinar el nivel de disnea y su impacto en la calidad de vida de los pacientes post COVID-19 después del alta hospitalaria. METODOLOGÍA: enfoque cuantitativo, alcance descriptivo relacional, diseño no experimental con una muestra de 82 pacientes de 20 a 65 años de edad, pertenecientes al Hospital Monte Sinaí de la ciudad de Guayaquil. RESULTADOS: el mayor porcentaje de la población evaluada pertenecía al sexo masculino y las edades entre 50 a 59 años, donde la hipertensión sobresale entre las patologías pre-existentes; el 71% de los pacientes evaluados tiene disminución de la capacidad física, 1 a 4 en la escala de Borg; el 30% de los pacientes posee disnea moderada, el 35% indicó que su calidad de vida relacionada con la salud, ha tenido un impacto alto previo alta hospitalaria y se comprobó su dependencia entre el CAT y la mMRC, ya que aquellos pacientes con disnea grado 3 y 4 presentaban un impacto alto y muy alto en su calidad de vida y en el 70% de los pacientes evaluados la fatiga interfiere en sus actividades generales. CONCLUSIÓN: los pacientes Post COVID-19 presentan disnea moderada que interfiere en su calidad de vida, las mismas que están relacionadas a la edad, antecedentes patológicos y el tiempo de evolución.

INTRODUCTION: COVID-19 is an infectious disease that can cause respiratory and physical dysfunctions in the short and long term. Dyspnea as a consequence of pulmonary fibrosis progresses as the disease progresses and affects quality of life. OBJECTIVE: to determine the level of dyspnea and its impact on the quality of life of post-COVID-19 patients after hospital discharge. METHODOLOGY: quantitative approach, relational descriptive scope, non-experimental design with a sample of 82 patients from 20 to 65 years of age, belonging to the Monte Sinaí Hospital in the city of Guayaquil. RESULTS: the highest percentage of the evaluated population belonged to the male sex and the ages between 50 to 59 years, where hypertension stands out among the pre-existing pathologies; 71% of the patients evaluated have decreased physical capacity, 1 to 4 on the Borg scale; 30% of the patients have moderate dyspnea, 35% indicated that their health-related quality of life has had a high impact prior to discharge from hospital and their dependence between CAT and mMRC was confirmed, since those patients with dyspnea Grade 3 and 4 had a high and very high impact on their quality of life and in 70% of the patients evaluated, fatigue interferes with their general activities. CONCLUSION: post COVID-19 patients present moderate dyspnea that interferes with their quality of life, which are related to age, pathological history and time of evolution.

INTRODUÇÃO: COVID-19 é uma doença infecciosa que pode causar disfunções respiratórias e físicas em curto e longo prazo. A dispneia como consequência da fibrose pulmonar progride com a progressão da doença e afeta a qualidade de vida. OBJETIVO: determinar o grau de dispneia e seu impacto na qualidade de vida de pacientes pós-COVID-19 após a alta hospitalar. METODOLOGIA: abordagem quantitativa, âmbito descritivo relacional, delineamento não experimental com amostra de 82 pacientes de 20 a 65 anos, pertencentes ao Hospital Monte Sinaí na cidade de Guayaquil. RESULTADOS: o maior percentual da população avaliada pertencia ao sexo masculino e na faixa etária de 50 a 59 anos, onde a hipertensão se destaca entre as patologias pré-existentes; 71% dos pacientes avaliados têm capacidade física diminuída, 1 a 4 na escala de Borg; 30% dos pacientes apresentam dispneia moderada, 35% indicaram que sua qualidade de vida relacionada à saúde teve um alto impacto antes da alta hospitalar e sua dependência entre CAT e mMRC foi confirmada, uma vez que aqueles pacientes com dispneia Os graus 3 e 4 tiveram um impacto alto e muito alto em sua qualidade de vida e em 70% dos pacientes avaliados, a fadiga interfere em suas atividades gerais. CONCLUSÃO: pacientes pós COVID-19 apresentam dispneia moderada que interfere em sua qualidade de vida, que estão relacionados à idade, história patológica e tempo de evolução.

Immersive Virtual Reality for Pain Relief in Upper Limb Complex Regional Pain Syndrome: A Pilot Study.

Objective: This pilot study explored the effects of therapeutic immersive virtual reality (VR) on pain in upper limb complex regional pain syndrome (CRPS). While acute pain relief with VR has been studied in multiple populations, there is little data on the use of this modality in treating chronic pain, especially CRPS. Participants: Volunteer participants were recruited from outpatient rehabilitation services. Inclusion criteria required the diagnosis of CRPS in at least one upper limb and the ability to communicate in English to receive instructions from study personnel. A total of eight participants were recruited, with six fully completing the study. Interventions: An immersive virtual three-dimensional interactive kitchen environment was designed that allowed visualization of and object manipulation with virtual hands. Participants performed tasks representative of daily activities, as well as guided visualization exercises for a total of 10 sessions. Main Outcome Measure: Preand post-session pain scale measurements (Short Form McGill Pain Questionnaire, Visual Analog Scale, and Wong-Baker FACES) and subjective feedback were collected with each session. Results: Four of the six participants that completed the study reported subjective improvement of their pain and daily function. However, objective pain scales had limited correlation to reported subjective relief. Conclusions: Immersive virtual reality might provide subjective analgesia and functional improvement in select patients with upper limb complex regional pain syndrome, but objective data is lacking.

Aptitud médica ocupacional y perfil clínico en conductores profesionales de un centro de salud ocupacional en Lima Metropolitana, 2014 - 2018 / Occupational medical and clinical profile in professional drivers of an occupational health center in Lima Metropolitana, 2014 - 2018

Objetivos: Describir las características médicas ocupacionales de los conductores profesionales y los resultados toxicológicos presentes en accidentes de tránsito en un centro de salud ocupacional de Lima Metropolitana. 2014-2018. Material y métodos: Estudio descriptivo retrospectivo de análisis de datos de fuente secundaria. El tamaño de muestra analizado fue 11520 conductores profesionales de la ciudad de Lima metropolitana durante 2014 al 2018, seleccionado de base de datos innominada mediante un muestreo probabilístico de aleatorización simple. Se utilizó estadística descriptiva univariadas usando valores de frecuencias absolutas y relativas, cálculo de intervalos de confianza al 95% y diagramas de error para cada una de las variables, identificando las diferencias existentes en cada una de las categorías o niveles de la variable. El procesamiento de la información fue realizado en el programa estadístico R versión 3.6. Resultados: El 64% de conductores sufren de sobrepeso u obesidad, el 58% de los conductores sufren alguna enfermedad de visión, el 67% siempre estuvieron en vigilia en cada conducción, el 73% de los conductores estuvieron actos para la conducción automovilística y un 13.3% de los conductores que sufrieron un accidente de tránsito estuvieron bajo efecto de las drogas. Conclusiones: Los conductores profesionales atendidos en salud ocupacional presentan con frecuencia obesidad y presbicia como defecto visual; mientras que el 27% fueron calificados como aptos para sus funciones, pero con restricciones. Las drogas detectadas con mayor frecuencia en conductores con accidentes de tránsito fue el alcohol y la marihuana.

Objetives:To describe the occupational medical characteristics of professional drivers and the toxicological results present in traffic accidents in an occupational health center in Metropolitan Lima. 2014-2018. Material and methods: Retrospective descriptive study of secondary source data analysis. The sample size analyzed was 11520 professional drivers from the city of metropolitan Lima during 2014 to 2018, selected from an unnamed database using a probabilistic simple randomization sample. Univariate descriptive statistics were used using absolute and relative frequency values, calculation of 95% confidence intervals and error diagrams for each of the variables, identifying the differences in each of the categories or levels of the variable. The information processing was performed in the statistical program R version 3.6. Results: 64% of drivers suffer from overweight or obesity, 58% of drivers suffer from some vision illness, 67% were always on the lookout in each driving, 73% of drivers were acts for car driving and a 13.3% of drivers who suffered a traffic accident were under the influence of drugs. Conclusions: Professional drivers treated in occupational health frequently have obesity and presbyopia as a visual defect; while 27% were qualified as fit for their functions, but with restrictions. The drugs most frequently detected in drivers with traffic accidents were alcohol and marijuana.