Urban grey spaces are associated with increased allergy in the general population.

BACKGROUND: the built environment in urban areas may have side effects on children's respiratory health, whilst less is known for adulthood. AIM: to assess the association between increasing exposure to grey spaces and allergic status in an adult general population sample. METHODS: 2070 subjects (age range 15-84 yrs), living in Pisa/Cascina, Italy, were investigated in 1991-93 through a questionnaire on health status and risk factors, skin prick test (SPT), serum Immunoglobulins E (IgE), and serum antibodies to benzo(a)pyrene diol epoxide (BPDE)-DNA adducts. Land-cover exposure within a 1000 m buffer from each subject's home address was assessed through the CORINE Land Cover program (CLC 1990) within the FP7/HEALS project (2013-2018). Participants' residential addresses were geocoded and the proportion of surrounding grey spaces was calculated. Through logistic regression models, adjusting for potential confounding factors, the effect of a 10% increase in grey spaces exposure on allergic biomarkers/conditions was assessed; the relationship with serum antibodies to BPDE-DNA adducts positivity was also analyzed. RESULTS: A 10% increase in grey spaces coverage was associated with a higher probability of having SPT positivity (OR 1.07, 95% CI 1.02-1.13), seasonal SPT positivity (OR 1.12, 1.05-1.19), polysensitization (OR 1.11, 1.04-1.19), allergic rhinitis (OR 1.10, 1.04-1.17), co-presence of SPT positivity and asthma/allergic rhinitis (OR 1.16, 1.08-1.25), asthma/allergic rhinitis (OR 1.06, 1.00-1.12), presence of serum antibodies to BPDE-DNA adducts positivity (OR 1.07, 1.01-1.14). CONCLUSIONS: grey spaces have adverse effects on allergic status and are related to a biomarker of polycyclic aromatic hydrocarbons exposure in adulthood. Thus, they may be used as a proxy of urban environmental exposure.

Elevated Glucose Oxidation, Reduced Insulin Secretion, and a Fatty Heart May Be Protective Adaptions in Ischemic CAD.

BACKGROUND: Insulin resistance, ß-cell dysfunction, and ectopic fat deposition have been implicated in the pathogenesis of coronary artery disease (CAD) and type 2 diabetes, which is common in CAD patients. We investigated whether CAD is an independent predictor of these metabolic abnormalities and whether this interaction is influenced by superimposed myocardial ischemia. METHODS AND RESULTS: We studied CAD patients with (n = 8) and without (n = 14) myocardial ischemia and eight non-CAD controls. Insulin sensitivity and secretion and substrate oxidation were measured during fasting and oral glucose tolerance testing. We used magnetic resonance imaging/spectroscopy, positron emission and computerized tomography to characterize CAD, cardiac function, pericardial and abdominal adipose tissue, and myocardial, liver, and pancreatic triglyceride contents. Ischemic CAD was characterized by elevated oxidative glucose metabolism and a proportional decline in ß-cell insulin secretion and reduction in lipid oxidation. Cardiac function was preserved in CAD groups, whereas cardiac fat depots were elevated in ischemic CAD compared to non-CAD subjects. Liver and pancreatic fat contents were similar in all groups and related with surrounding adipose masses or systemic insulin sensitivity. CONCLUSIONS: In ischemic CAD patients, glucose oxidation is enhanced and correlates inversely with insulin secretion. This can be seen as a mechanism to prevent glucose lowering because glucose is required in oxygen-deprived tissues. On the other hand, the accumulation of cardiac triglycerides may be a physiological adaptation to the limited fatty acid oxidative capacity. Our results underscore the urgent need of clinical trials that define the optimal/safest glycemic range in situations of myocardial ischemia.

Monitoring nocturnal heart rate with bed sensor.

INTRODUCTION: This article is part of the Focus Theme of Methods of Information in Medicine on "Biosignal Interpretation: Advanced Methods for Studying Cardiovascular and Respiratory Systems". OBJECTIVES: The aim of this study is to assess the reliability of the estimated Nocturnal Heart Rate (HR), recorded through a bed sensor, compared with the one obtained from standard electrocardiography (ECG). METHODS: Twenty-eight sleep deprived patients were recorded for one night each through matrix of piezoelectric sensors, integrated into the mattress, through polysomnography (PSG) simultaneously. The two recording methods have been compared in terms of signal quality and differences in heart beat detection. RESULTS: On average, coverage of 92.7% of the total sleep time was obtained for the bed sensor, testifying the good quality of the recordings. The average beat-to-beat error of the inter-beat intervals was 1.06%. These results suggest a good overall signal quality, however, considering fast heart rates (HR > 100 bpm), performances were worse: in fact, the sensitivity in the heart beat detection was 28.4% while the false positive rate was 3.8% which means that a large amount of fast beats were not detected. CONCLUSIONS: The accuracy of the measurements made using the bed sensor has less than 10% of failure rate especially in periods with HR lower than 70 bpm. For fast heart beats the uncertainty increases. This can be explained by the change in morphology of the bed sensor signal in correspondence of a higher HR.

Cardiomyocyte apoptosis after cardioplegic ischemia: comparison to unprotected regional ischemia-reperfusion.

BACKGROUND: Cardiomyocyte apoptosis might contribute to left ventricular (LV) dysfunction following cardiac surgery. Magnetic resonance imaging is considered the most accurate method of determining LV function. We compared apoptosis (by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling, TUNEL, staining and detection of caspase 3 activation) and LV function after regional ischemia-reperfusion (I-R) and global cardioplegic ischemia. METHODS: Pigs were randomized to undergo regional myocardial I-R for 20 + 20 min, global myocardial ischemia with cardiopulmonary bypass (CPB) for 40 min or CPB without ischemia (control), followed by 274 min of reperfusion. RESULTS: Compared with the control group, the number of TUNEL-positive cardiomyocytes was higher in the global ischemia group with CPB (0.024 ± 0.014%; p = 0.02) and further increased in areas of unprotected regional I-R (0.444 ± 0.562%; p = 0.003, vs. control). Myocytes with active caspase 3 were detected after global and regional ischemia. The global ejection fraction did not differ between CPB and regional I-R groups. CONCLUSIONS: The use of cardioplegia and CPB efficiently protects the heart from global I-R-induced cardiomyocyte apoptosis during open heart surgery.

Detection of daily activities and sports with wearable sensors in controlled and uncontrolled conditions.

Physical activity has a positive impact on people's well-being, and it may also decrease the occurrence of chronic diseases. Activity recognition with wearable sensors can provide feedback to the user about his/her lifestyle regarding physical activity and sports, and thus, promote a more active lifestyle. So far, activity recognition has mostly been studied in supervised laboratory settings. The aim of this study was to examine how well the daily activities and sports performed by the subjects in unsupervised settings can be recognized compared to supervised settings. The activities were recognized by using a hybrid classifier combining a tree structure containing a priori knowledge and artificial neural networks, and also by using three reference classifiers. Activity data were collected for 68 h from 12 subjects, out of which the activity was supervised for 21 h and unsupervised for 47 h. Activities were recognized based on signal features from 3-D accelerometers on hip and wrist and GPS information. The activities included lying down, sitting and standing, walking, running, cycling with an exercise bike, rowing with a rowing machine, playing football, Nordic walking, and cycling with a regular bike. The total accuracy of the activity recognition using both supervised and unsupervised data was 89% that was only 1% unit lower than the accuracy of activity recognition using only supervised data. However, the accuracy decreased by 17% unit when only supervised data were used for training and only unsupervised data for validation, which emphasizes the need for out-of-laboratory data in the development of activity-recognition systems. The results support a vision of recognizing a wider spectrum, and more complex activities in real life settings.

Estimating intensity of physical activity: a comparison of wearable accelerometer and gyro sensors and 3 sensor locations.

Automatic estimation of physical activity using wearable sensors can be used for promotion of a healthier lifestyle. In this study, accelerometers and gyroscopes attached to ankle, wrist and hip were used to estimate intensity of physical activity. The estimates are compared to metabolic equivalent (MET) obtained from a portable cardiopulmonary exercise testing system. Data from common everyday tasks and exercise were collected with 11 subjects. The tasks include, e.g., ironing, vacuuming, walking, running and cycling on exercise bicycle (ergometer). The strongest linear correlation with metabolic equivalent was obtained with the tri-axial accelerometer attached to the ankle (r=0.86).

Accuracy of a novel real-time microprocessor QRS detector for heart rate variability assessment.

Assessment of heart rate variability from 24-h recordings requires a high-quality Holter, expensive equipment and multistage processing of recordings. We compared a new personal computer-based digital QRS detector system with a Holter recorder, and found the two methods to be equally accurate in time and frequency domain measures of heart rate variability.