A comprehensive review of 5G NR RF-EMF exposure assessment technologies: fundamentals, advancements, challenges, niches, and implications.

This review offers a detailed examination of the current landscape of radio frequency (RF) electromagnetic field (EMF) assessment tools, ranging from spectrum analyzers and broadband field meters to area monitors and custom-built devices. The discussion encompasses both standardized and non-standardized measurement protocols, shedding light on the various methods employed in this domain. Furthermore, the review highlights the prevalent use of mobile apps for characterizing 5G-NR radio network data. A growing need for low-cost measurement devices is observed, commonly referred to as "sensors" or "sensor nodes," that are capable of enduring diverse environmental conditions. These sensors play a crucial role in both microenvironmental surveys and individual exposures, enabling stationary, mobile, and personal exposure assessments based on body-worn sensors, across wider geographical areas. This review revealed a notable need for cost-effective and long-lasting sensors, whether for individual exposure assessments, mobile (vehicle-integrated) measurements, or incorporation into distributed sensor networks. However, there is a lack of comprehensive information on existing custom-developed RF-EMF measurement tools, especially in terms of measuring uncertainty. Additionally, there is a need for real-time, fast-sampling solutions to understand the highly irregular temporal variations EMF distribution in next-generation networks. Given the diversity of tools and methods, a comprehensive comparison is crucial to determine the necessary statistical tools for aggregating the available measurement data.

Comparison of Low-Cost 5G Electromagnetic Field Sensors.

This paper compares different low-cost sensors that can measure (5G) RF-EMF exposure. The sensors are either commercially available (off-the-shelf Software Defined Radio (SDR) Adalm Pluto) or constructed by a research institution (i.e., imec-WAVES, Ghent University and Smart Sensor Systems research group (S³R), The Hague University of Applied Sciences). Both in-lab (GTEM cell) and in-situ measurements have been performed for this comparison. The in-lab measurements tested the linearity and sensitivity, which can then be used to calibrate the sensors. The in-situ testing confirmed that the low-cost hardware sensors and SDR can be used to assess the RF-EMF radiation. The variability between the sensors was 1.78 dB on average, with a maximum deviation of 5.26 dB. Values between 0.09 V/m and 2.44 V/m were obtained at a distance of about 50 m from the base station. These devices can be used to provide the general public and governments with temporal and spatial 5G electromagnetic field values.

Comparison of the usability of an automatic sleep staging program via portable 1-channel electroencephalograph and manual sleep staging with traditional polysomnography.

Automatic algorithms are a proposed alternative to manual assessment of polysomnography data for analyzing sleep structure; however, none are acceptably accurate for clinical use. We investigated the feasibility of an automated sleep stage scoring system called Sleep Scope, which is intended for use with portable 1-channel electroencephalograph, and compared it with the traditional polysomnography scoring method. Twenty-six outpatients and fourteen healthy volunteers underwent Sleep Scope and polysomnography assessments simultaneously. Polysomnography records were manually scored by three sleep experts. Sleep Scope records were scored using a dedicated auto-staging algorithm. Sleep parameters, including total sleep time, sleep latency, wake after sleep onset, and sleep efficiency, were calculated. The epoch-by-epoch pairwise concordance based on the classification of sleep into five stages (i.e., wake, rapid eye movement, N1, N2, and N3) was also evaluated after validating homogeneity and bias between Sleep Scope and polysomnography. Compared with polysomnography, Sleep Scope seemed to overestimate sleep latency by approximately 3 min, but there was no consistent tendency in bias in other sleep parameters. The Κ values ranged from 0.66 to 0.75 for experts' inter-rater polysomnography scores and from 0.62 to 0.67 for Sleep Scope versus polysomnography scores, which indicated sufficient agreement in the determination of sleep stages based on the Landis and Koch criteria. We observed sufficient concordance between Sleep Scope and polysomnography despite lower concordance in sleep disorder patients. Thus, this auto-staging system might serve as a novel clinical tool for reducing the time and expenses required of medical staff and patients. Supplementary Information: The online version contains supplementary material available at 10.1007/s41105-022-00421-5.

Perioperative Validation of the TensorTip™ MTX Device for Noninvasive Arterial Pressure Measurement: A Method Comparison Study.

Background: The noninvasive TensorTip™ MTX measures blood pressure by interpreting blood diffusion color of the finger skin. In addition to blood pressure, the device is able to measure various vital signs: heart rate, oxygen saturation, stroke volume, and cardiac output. Studies about accuracy and precision thus far available have only been conducted by the manufacturer. The aim of our study was to investigate the accuracy and precision of the TensorTip MTX in comparison to invasive radial artery blood pressure values. Methods: Forty-one patients scheduled for elective surgery were enrolled in this study. Placement of the arterial catheter had to be part of the standard of care. Once hemodynamic stable conditions were achieved, blood pressure was measured. Three measurements with the TensorTip MTX were averaged and compared with one invasive blood pressure measurement using Bland-Altman plot and error grid analysis. Results: Systolic, diastolic, and mean blood pressure had a bias of respectively 6.2, -6.9 and 4.4 mm Hg. Corresponding standard deviation were respectively 30.1, 17.0 and 22.2. Calculated percentage errors were 47.6%, 52.9% and 52.3%. Proportional bias was present in all Bland-Altman analyses. Error grid analysis showed 61.0% of systolic blood pressure measurements, and 46.3% of mean blood pressure measurements were in the clinical acceptable zone. Conclusions: The TensorTip MTX was not able to reliably measure blood pressure compared to blood pressure obtained with an arterial catheter and therefore, the measurement performance is not clinically acceptable. Moreover, a high malfunction rate makes the device unsuitable for use in perioperative period.

Validez y confiabilidad de dos instrumentos para evaluar la adherencia al tratamiento en pacientes quemados / Validity and reliability of two instruments to assess adherence to treatment in burn patients

RESUMEN Introducción: La adherencia terapéutica constituye uno de los principales problemas de las intervenciones en salud. Una de las poblaciones en las que se evidencian dificultades en la adherencia al tratamiento es en los pacientes quemados. Objetivo: Determinar la validez y confiabilidad de dos instrumentos para la evaluación de la adherencia al tratamiento y sus dimensiones influyentes en pacientes quemados hospitalizados. Métodos: Desde el enfoque cuantitativo se realizó un estudio transversal, en el periodo comprendido de enero de 2017 a diciembre de 2019. Se establecieron como variables de la investigación la adherencia al tratamiento y los factores influyentes en la adherencia al tratamiento. Se utilizó el criterio de expertos, la prueba piloto y por último se aplicaron los dos cuestionarios a 90 pacientes quemados. Resultados: Ambos instrumentos demostraron tener validez de contenido. La fiabilidad test-retest del instrumento para evaluar la adherencia terapéutica fue considerable y significativa, mientras que la consistencia interna fue aceptable. En el instrumento que evalúa las dimensiones influyentes en la adherencia terapéutica la fiabilidad fue muy fuerte y la consistencia buena. Conclusiones: Los dos instrumentos elaborados para la evaluación de la adherencia terapéutica en pacientes quemados hospitalizados, presentaron validez de contenido y confiabilidad.

ABSTRACT Introduction: Therapeutic adherence constitutesone of tema in problems of health interventions. One of the populations in which difficulties in adherence to treatment are evidence disburn patients. Objective: To determine the validity and reliability of two instruments for the evaluation of adherence to treatment and the irinfluential dimensions in hospitalized burn patients. Methods: From the quantitative approach, a cross-sectional study was conducted, in the period from January 2017 to December 2019. Adherence to treatment and influencing adherence to treat ment were established as research variables. Expert judgment wasused, the pilot test and finally the two question naireswere applied to 90 burn patients. Results: Both instruments proved to have content validity. The test-retestreliability of the instrument to evaluate therapeuticad herence was considerable and significant, whilethe internal consistency was acceptable. Reliability was very strong and consistency good in the instrument that evaluates the influencing dimensions in therapeutic adherence. Conclusions: The two instruments developed forthe evaluation of therapeutic adherence in hospitalized burn patients present content validity and reliability.

Necesidad del enfoque de riesgo metrológico en unidades de salud / Need for a metrological risk approach in health units

RESUMEN El empleo de pruebas complementarias en que intervienen equipos biomédicos, que llevan implícitos instrumentos de medición, indicadores para corroborar las hipótesis médicas y lograr diagnósticos certeros se hace más cada vez más común. Un error en las mediciones puede acarrear compromiso para la vida del paciente. De ahí la importancia de considerar el riesgo metrológico en la evaluación del Sistema de Gestión de las mediciones en salud. Este trabajo tiene como propósito contribuir a la visualización de la necesidad del enfoque de riesgo metrológico en las unidades de salud. Como criterios para la selección de las 80 fuentes consultadas se tomaron la declaración explícita de los autores referida al posicionamiento acerca del constructo riesgo y su visión de la importancia de este enfoque en las organizaciones de salud, durante el período del 2009 al 2020, que justifica plenamente el nivel de actualización de la información. Aparecen referenciados 21 textos con el 67 % de actualización. Se concluye que el índice de riesgo metrológico constituye un instrumento valioso al que deben acceder los gestores en salud promoviendo así la incorporación de nuevas técnicas en su gestión, lo que resultaría valioso para la toma de decisiones. El enfoque de riesgo en la evaluación del desempeño metrológico en salud es necesario, lo que evidenciaría un pensamiento avanzado científicamente, profundo y práctico.

ABSTRACT The use of complementary tests in which biomedical teams intervene, which implicitly carries measuring instruments, indicators to corroborate medical hypotheses and achieve accurate diagnoses is becoming more and more common. An error in measurements can compromise the life of the patient. Hence the importance of considering the metrological risk in the evaluation of the Health Measurements Management System. The purpose of this work is to contribute to the visualization of the need for a metrological risk approach in health units. As criteria for the selection of the 80 sources consulted, the explicit declaration of the authors referring to the position regarding the risk construct and their vision of the importance of this approach in health organizations, during the period from 2009 to 2020, which fully justifies the update information level. 21 texts are referenced with the 67% update. It is concluded that the metrological risk index constitutes a valuable instrument that health managers must access, thus promoting the incorporation of new techniques in their management, which would be valuable for decision-making. The risk approach in the evaluation of metrological performance in health is necessary, which would show a scientifically advanced, deep and practical thinking.

Consideraciones acerca del desempeño metrológico en unidades de salud / Statements about the metrological performance in health units

RESUMEN Los métodos utilizados para el sistema de gestión de las mediciones van desde la verificación del equipo hasta la aplicación de técnicas estadísticas en el control del proceso de medición. En el sector salud se desarrolla básicamente la confirmación metrológica. En dicho sector, sirve para verificar que las mediciones de los equipos sean confiables, tanto los de diagnóstico como los de terapia, lo que redunda directamente en la seguridad del paciente. El empleo de metodologías para la construcción y aplicación de un indicador de desempeño con enfoque de gestión es lo más acertado en estos tiempos. El objetivo de este trabajo es explicar cómo la evaluación del desempeño metrológico es esencial para la evaluación de la calidad en las unidades de salud, sustentado en procedimientos actualizados para contribuir a crear una cultura metrológica en las organizaciones de dicho sector.

ABSTRACT The methods used for the measurement management system range from the verification of the equipment to the application of statistical techniques in the control of the measurement process. In the health sector, metrological confirmation is basically developed. In this sector, it serves to verify that the measurements of the equipment are reliable, both those of diagnosis and those of therapy, which directly results in the safety of the patient. The use of methodologies for the construction and application of a performance indicator with a management approach is the most successful in these times. The objective of this work is to explain how the evaluation of metrological performance is essential for the evaluation of quality in health units, based on updated procedures to contribute to create a metrological culture in organizations of this sector.

Measures in organizational behavior: why dont we use big data and analytics? / Medidas do comportamento organizacional: por que não usamos big data e analytics?

Tradeoff analysis, between generalizability, precision, and realism, guides methodological choices in organizational behavior. These methodological choices were systematically reviewed in Brazilian articles and books (1996-2017) to answer the following question: why are there no Brazilian studies on organizational behavior that use big data or analytics? Among 1062 research articles on organizational behavior, published in 19 psychology and business journals, 68% used scales, and only 10% used observation. Observation was often unstructured and supported other methods. The focus was on "saying," instead of "doing". Big data and analytics have the potential to simultaneously reach generalizability, precision, and realism and may pave the way for new conclusions. Additionally, these methods could transform research in organizational behavior.

A análise de custo-benefício entre generalidade, precisão e realismo guia escolhas metodológicas em comportamento organizacional. Estas foram sistematicamente revistas em artigos e livros (1996-2017) brasileiros com o objetivo de responder à pergunta: por que não há estudos em comportamento organizacional no Brasil que usem big data ou analytics? Dentre 1.062 artigos com relatos de pesquisa sobre comportamento organizacional publicados em 19 periódicos de Psicologia e Administração, 68% empregaram escalas e apenas 10% a observação. A observação foi muito frequentemente adotada de forma não estruturada e servindo de suporte a outros métodos. O foco foi no "falar" e não no "fazer". Big data e analytics têm o potencial para atingir ao mesmo tempo a generalidade, a precisão e o realismo e podem abrir o caminho para novas conclusões, sendo talvez capaz de transformar a investigação em comportamento organizacional.

Aseguramiento metrológico para la implementación de un sistema de gestión de la calidad / Metrological assurance for the implementation of a quality management system

RESUMEN Fundamento: la implementación de un sistema de gestión de la calidad basado en la norma NC: ISO 9001 conlleva el establecimiento de la metrología como garantía de calidad de la confiabilidad de sus equipos de medición. Objetivo: demostrar la importancia del aseguramiento metrológico para la implementación de un sistema de gestión de la calidad. Métodos: se realizó un estudio descriptivo de corte transversal en el Centro de Inmunología y Productos Biológicos en la Universidad de Ciencias Médicas de Camagüey, en el período enero de 2014 a mayo de 2018. Resultados: en el primer levantamiento metrológico realizado ninguno de los instrumentos estaba verificado, se realizó un subregistro en el 2014, en el 2017 se incrementó el número de instrumentos registrados en la universidad, durante el estudio se actualizó el plan de verificación y se logró la verificación de la mayoría de los instrumentos de medición que posee el centro. Se constató la necesidad de contar con una asignación en el presupuesto para la adquisición de algunos instrumentos en déficit. Conclusiones: el diagnóstico realizado como parte del aseguramiento metrológico permitió conocer la situación real de los instrumentos de medición en el Centro de Inmunología y Productos Biológicos y lograr la verificación de un número importante de los mismos.

ABSTRACT Background: the implementation of a quality management system based on the NC standard: ISO 9001 entails the establishment of metrology as a guarantee of the reliability quality of its measuring equipments. Objective: to demonstrate the importance of metrology assurance for the implementation of a quality management system. Methods: a descriptive cross-sectional study was carried out at the Center of Immunology and Biological Products of the Camagüey University of Medical Sciences, from January 2014 to May 2018. Results: according to the first metrological survey none of the instruments had been verified, there was an underreporting in 2014, in 2017 the number of registered instruments in the university was increased, during the study the verification plan was updated and most of the measuring instruments were verified. It was found that there is a need of a budget allocation for the acquisition of some of the lacking instruments. Conclusions: the diagnosis made as part of the metrology assurance allowed to know the actual situation of the measuring instruments in the Center of Immunology and Biological Products and to verify an important number of them.

Validity of flexicurve for the assessment of spinal flexibility in asymptomatic individuals / Validade do flexicurva na avaliação da flexibilidade da coluna vertebral em indivíduos assintomáticos / Validez del flexicurve en la evaluación de la flexibilidad de la columna vertebral en individuos asimomáticos

Abstract Introduction: Spine problems are common, and assessment of spine flexibility provides relevant information; however, alternative evaluation methods need to be validated. Objective: To evaluate the concurrent validity of the Flexicurve using 3D videogrammetry as a reference value to assess spinal flexion and extension in the lumbar and thoracic regions. Method: The consecutive sample consisted of 39 individuals aged between 18 and 50 years. Two consecutive evaluations were performed by the same rater on the same day and at the same location: (1) Flexicurve and (2) 3D videogrammetry. The assessments were performed with the spine in the neutral position, followed by maximum flexion and extension. The range of motion (ROM) in the maximum flexion and extension positions was calculated in MATLAB® and defined as the difference between the maximum flexion or extension angle and that of the neutral position. Statistical analyses used were the Pearson Product-Moment Correlation coefficient, RMS error and Bland-Altman plot (α < 0.05). Results: The ROM between instruments was similar, with high correlations for thoracic flexion (r = 0.751), extension (r = 0.814) and lumbar flexion (r = 0.853), and RMS errors under 8°. The correlation for lumbar extension was moderate (r = 0.613) and the RMS error was more than 10°. The limits of agreement varied between ± 10º and ± 21º. Conclusion: The Flexicurve is valid for assessing maximum flexion and extension of the thoracic spine, and maximum flexion of the lumbar spine. We suggest caution in evaluating the maximum extension of the lumbar spine.

Resumo Introdução: Problemas na coluna vertebral são frequentes, sendo a avaliação da flexibilidade uma informação relevante a ser considerada pelo profissional. Métodos alternativos para realizar avaliação da flexibilidade da coluna carecem de validação. Objetivo: Avaliar a validade concorrente do Flexicurva utilizando a videogrametria 3D como medida de referência, para a avaliação da flexibilidade em flexão e extensão da coluna vertebral torácica e lombar. Método: A amostra consecutiva contou com 39 indivíduos com idades entre 18 e 50 anos. Duas avaliações consecutivas foram realizadas pelo mesmo avaliador no mesmo dia e local: (1) Flexicurva e (2) videogrametria 3D. As avaliações foram realizadas com a coluna na posição neutra, seguida das posições de flexão e extensão máximas. A ADM nas posições de flexão e extensão máximas foram calculadas no MATLAB®, sendo definida como a diferença entre os ângulos máximos de flexão ou extensão e a angulação da posição neutra. Na análise estatística utilizou-se: Teste de Correlação Produto-Momento de Pearson, Erro RMS e Análise de Bland-Altman. (α < 0,05). Resultados: Os valores de ADM entre os instrumentos foram similares, com correlações altas para a flexão torácica (r = 0,751), extensão torácica (r = 0,814) e para flexão lombar (r = 0,853), com erros RMS inferiores a 8°. Para a extensão lombar a correlação foi moderada (r = 0,613), com erro RMS superior a 10°. Limites de concordância variaram entre ± 10º e ± 21º. Conclusão: O Flexicurva mostrou-se válido para avaliar o movimento flexão máxima e extensão máxima da coluna torácica, e flexão máxima da coluna lombar. Sugerimos cautela na avaliação da extensão máxima da coluna lombar.

Resumen Introducción: Los problemas en la columna vertebral son frecuentes, siendo la evaluación de la flexibilidad de la columna vertebral una información relevante a ser considerada por el profesional. Los métodos alternativos para realizar la evaluación de la flexibilidad de la columna necesitan validación. Objetivo: Evaluar la validez concurrente del Flexicurva utilizando la videogrametría 3D como medida de referencia para evaluar la flexión y extensión de la columna en las regiones lumbar y torácica. Método: La muestra consecutiva consistió en 39 individuos de edades comprendidas entre 18 y 50 años. El mismo evaluador realizó dos evaluaciones consecutivas en el mismo día y local: (1) Flexicurve (2) Videogrametría 3D. Las evaluaciones se realizaron con la columna en posición neutral seguida de la máxima flexión y extensión. El RDM en la posición máxima de flexión y extensión se calculó en MATLAB®, la flexión máxima y la extensión se definieron como la diferencia entre el ángulo de la posición con respecto al punto neutro. Los análisis estadísticos consistieron en la prueba de correlación de producto-momento de Pearson, error de RMS y los análisis de Bland-Altman (α < 0,05). Resultados: Los valores de RDM entre instrumentos fueron similares, con altas correlaciones para flexión torácica (r = 0.751), extensión torácica (r = 0.814) y flexión lumbar (r = 0.853), y errores RMS por debajo de 8°. Para la extensión lumbar, se moderó la correlación (r = 0,613) y el error RMS fue superior a 10°. Los límites de concordancia variaron entre ± 10º y ± 21º. Conclusión: El Flexicurva se mostró válido para evaluar la flexión máxima y la extensión máxima de la columna torácica, y la flexión máxima de la columna lumbar. Sugerimos precaución al evaluar la extensión máxima de la columna lumbar.

Optimización del desempeño del observador al medir la presión arterial en el consultorio: declaración de posición de la Comisión Lancet de Hipertensión / Optimizing observer performance of clinic blood Pressure measurement: a position statement from the Lancet Commission on Hypertension Group / Otimização do desempenho do observador na medição clínica da pressão arterial: posicionamento do Grupo da Lancet Commission on Hypertension

RESUMEN La hipertensión arterial es una causa modificable muy prevalente de enfermedades cardiovasculares, accidentes cerebrovasculares y muerte. Medir con exactitud la presión arterial es fundamental, dado que un error de medición de 5 mmHg puede ser motivo para clasificar incorrectamente como hipertensas a 84 millones de personas en todo el mundo. En la presente declaración de posición se resumen los procedimientos para optimizar el desempeño del observador al medir la presión arterial en el consultorio, con atención especial a los entornos de ingresos bajos o medianos, donde esta medición se ve complicada por limitaciones de recursos y tiempo, sobrecarga de trabajo y falta de suministro eléctrico. Es posible reducir al mínimo muchos errores de medición con una preparación adecuada de los pacientes y el uso de técnicas estandarizadas. Para simplificar la medición y prevenir errores del observador, deben usarse tensiómetros semiautomáticos o automáticos de manguito validados, en lugar del método por auscultación. Pueden ayudar también la distribución de tareas, la creación de un área específica de medición y el uso de aparatos semiautomáticos o de carga solar. Es fundamental garantizar la capacitación inicial y periódica de los integrantes del equipo de salud. Debe considerarse la implementación de programas de certificación de bajo costo y fácilmente accesibles con el objetivo de mejorar la medición de la presión arterial.(AU)

ABSTRACT High blood pressure (BP) is a highly prevalent modifiable cause of cardiovascular disease, stroke, and death. Accurate BP measurement is critical, given that a 5-mmHg measurement error may lead to incorrect hypertension status classification in 84 million individuals worldwide. This position statement summarizes procedures for optimizing observer performance in clinic BP measurement, with special attention given to low-tomiddle- income settings, where resource limitations, heavy workloads, time constraints, and lack of electrical power make measurement more challenging. Many measurement errors can be minimized by appropriate patient preparation and standardized techniques. Validated semi-automated/automated upper arm cuff devices should be used instead of auscultation to simplify measurement and prevent observer error. Task sharing, creating a dedicated measurement workstation, and using semi-automated or solar-charged devices may help. Ensuring observer training, and periodic re-training, is critical. Low-cost, easily accessible certification programs should be considered to facilitate best BP measurement practice.(AU)

RESUMO A hipertensão é uma causa altamente prevalente de doença cardiovascular, acidente vascular cerebral e morte. A medição precisa da pressão arterial (PA) é um aspecto crítico, uma vez que erros de mensuração da ordem de 5 mmHg podem levar a uma classificação incorreta do status de hipertensão em 84 milhões de pessoas em todo o mundo. O presente posicionamento resume os procedimentos para otimizar o desempenho do observador (o indivíduo responsável pela mensuração da PA) na mensuração clínica da PA, com atenção especial para contextos de baixa a média renda, onde recursos limitados, cargas de trabalho pesadas, restrições de tempo e falta de energia elétrica tornam mais desafiadora a tarefa de medir a PA. Muitos erros de mensuração podem ser minimizados pela preparação adequada do paciente e pelo uso de técnicas padronizadas. Para simplificar a mensuração e evitar erros do observador, devem-se utilizar dispositivos semiautomatizados ou automatizados validados, com manguito para braço, ao invés de auscultação. O compartilhamento de tarefas, a criação de uma estação de trabalho dedicada à mensuração e o uso de dispositivos semiautomatizados ou com carga solar podem ajudar. É essencial que seja assegurado o treinamento e retreinamento periódico do observador. Programas de certificação de baixo custo e de fácil acesso devem ser considerados para facilitar a adoção das melhores práticas na mensuração da PA.(AU)

Communicating vessels volumeter to measure upper extremity lymphedema after breast cancer: reliability and criterion validity compared to the gold standard.

BACKGROUND: The traditional overflow method for measuring limb volume remains the gold standard, but many disadvantages still inhibit its routine use in clinical practice. OBJECTIVE: To assess the intra-rater and inter-rater reliability and criterion validity of the 'communicating vessels volumeter' (CVV) for volume measurement of lymphedematous upper extremities (LUE) by using the overflow volumeter (OV) as the reference standard. METHODS: Twelve LUE of 12 women undergoing mastectomy for breast cancer were measured three times each by three raters using both methods, totaling 216 volume measurements. Criterion validity was estimated by 33 volume measurements of one cylinder of known volume by three raters using both methods, totaling 198 measurements. RESULTS: Measurement time was short with both CVV and OV. The intraclass correlation coefficient3,1 was high for both CVV and OV in intra-rater (0.99 vs 0.99) and inter-rater (0.99 vs 0.99) analyses. The bias between methods was low (7.50mL; 0.40%) and the limits of agreement were narrow (-5.80 to 6.50%). The volumes were statistically equal with a strong correlation (R2=0.98) between methods. CVV was more accurate than OV (0.00 vs 0.02%) in cylinder measurements. CONCLUSION: The high intra-rater and inter-rater reliability rates of CVV were comparable to those of OV, and the volumes resulting from LUE measurements were statistically equal in the two methods. Criterion validity rates indicated that CVV measurements were closer to the actual value of the cylinder than those obtained with the OV.

Escalas de avaliação de risco para queda: revisão integrativa da literatura / Escalas de evaluación de riesgo de caídas: revisión integrativa de la literatura / Fall risk evaluation scales: an integrative literature review

Objetivo caracterizar e qualificar escalas de avaliação de risco de quedas validadas para emprego entre pacientes adultos hospitalizados. Método revisão integrativa da literatura que incluiu investigações desenvolvidas entre pacientes hospitalizados com idade igual ou superior a 18 anos, consultadas as bases de dados LILACS, PubMed, CINAHL e Embase. Resultados localizaram-se 319 artigos, dos quais 9 foram incluídos nesta revisão. A maioria das escalas foi criada entre os anos de 1989 e 1999, para avaliação de riscos entre adultos e idosos. Os domínios mobilidade (88,8%), história de queda (88,8%), estado mental (66,6%), incontinência (77,7%), uso de medicamentos (66,6%) e déficit sensorial (55,5%) foram mais frequentemente empregados. Quatro escalas (44,4%) apresentaram resultados de testes para avaliação de propriedades psicométricas. Conclusão as escalas encontradas na literatura científica não apresentaram consenso entre os domínios para predição de quedas e a maioria não foi submetida à avaliação das propriedades psicométricas recomendadas.

Objetivo caracterizar y calificar escalas de evaluación de riesgo de caídas validadas para su aplicación en pacientes adultos hospitalizados. Método Revisión integrativa de la literatura que incluyó estudios desarrollados entre pacientes hospitalizados con edad igual o mayor a 18 años, consultadas en las bases LILACS, PubMed, CINAHL y Embase. Resultados Se obtuvieron 319 artículos, 9 de los cuales fueron incluidos en la revisión. La mayoría de las escalas fueron creadas entre 1989 y 1999, para evaluación de riesgos entre adultos y ancianos. Los dominios movilidad (88,8%), historial de caídas (88,8%), estado mental (66,6%), incontinencia (77,7%), uso de medicamentos (66,6%) y déficit sensorial (55,5%) fueron los más habitualmente empleados. Cuatro escalas (44,4%) presentaron resultados de tests para evaluación de propiedades psicométricas. Conclusión Las escalas encontradas en la literatura científica no expresaron consenso entre los dominios para la predicción de caídas. La mayoría no fue sometida a evaluación de propiedades psicométricas recomendadas.

Objective to characterize and qualify fall risk evaluation scales validated for application in hospitalized adult patients. Method an integrative literature review that included investigations developed with hospitalized patients 18 years old or older after consulting the LILACS, PubMed, CINAHL, and Embase databases. Results 319 papers were found, among which nine were included in the present review. Most scales were developed between 1989 and 1999 and oriented to assess fall risk in adults and elderly people. The domains mobility (88.8%), fall history (88.8%), mental state (66.6%), incontinence (77.7%), use of medications (66.6%), and sensory deficit (55.5%) were used most often. Four scales (44.4%) showed test results for the evaluation of psychometric properties. Conclusion the scales found in the scientific literature did not present a consensus on the domains for fall prediction and most were not submitted to evaluation of the recommended psychometric properties.

Effects of 1% cyclopentolate hydrochloride on anterior segment parameters obtained with Pentacam in young adults / Efeitos do cloridrato ciclopentolato 1% sobre os parâmetros do segmento anterior obtidos com Pentacam em adultos jovens

Purpose: To investigate the effects of topically applied 1% cyclopentolate hydrochloride on anterior segment parameters obtained with a Pentacam rotating Scheimpflug camera in healthy young adults. Methods: Anterior segment analyses of 25 eyes from 25 young adults (Group 1), before and after 45 min of 1% cyclopentolate hydrochloride application, were performed. For a control group (cycloplegia-free, Group 2), 24 eyes of 24 age- and sex-matched healthy cases were evaluated twice at 45 min intervals. The results obtained from the groups were compared statistically. Results: The mean ages of the groups were 23.04 ± 3.42 (range, 18-29) and 22.4 ± 2.05 (range, 18-27) years for Groups 1 and 2, respectively (p=0.259). In Group 1, measurements between the two analyses were significantly different for the values of anterior chamber depth (ACD), anterior chamber angle (ACA), and anterior chamber volume (ACV) (p<0.05), whereas no statistical difference was found for the central corneal thickness (CCT) and keratometry (K1, K2) measurements. In Group 2, none of these parameters were statistically different between the two analyses. Conclusions: Topically applied 1% cyclopentolate hydrochloride caused an increase in the ACD and ACV values, and a decrease in the ACA value. However, it had no significant effect on the CCT and keratometry measurements. It is important to consider these effects when using the Pentacam device on young adults with cycloplegia and when applying it for various reasons. .

Objetivo: Pesquisar os efeitos do cloridrato de ciclopentolato a 1%, aplicado topicamente, em parâmetros do segmento anterior medidos com a câmera de Scheimpflug Pentacam em adultos jovens e saudáveis. Métodos: A análise do segmento anterior, de 25 olhos de 25 jovens adultos (Grupo 1), antes e após 45 minutos da aplicação de cloridrato ciclopentolato a 1%, foram realizados. Como grupo controle (sem cicloplegia, Grupo 2), 24 olhos de 24 pacientes saudáveis pareados por idade e sexo, foram avaliados duas vezes em intervalos de 45 minutos. Os resultados obtidos com os grupos foram comparados estatisticamente. Resultados: A média de idade dos grupos foram 23,04 ± 3,42 (18-29 anos) e 22,4 ± 2,05 (18-27) anos, respectivamente (p=0,259). No Grupo 1, as medidas entre os dois exames foram significativamente diferentes para os valores de profundidade da câmara anterior (ACD), ângulo da câmara anterior (ACA), e do volume da câmara anterior (ACV) (p<0,05 para todos), enquanto que não foram diferentes para a espessura corneana central (CCT) e ceratometria valores (K1, K2). No Grupo 2, nenhum destes parâmetros foi diferente entre os dois exames. Conclusões: Aplicação tópica de cloridrato de ciclopentolato a 1% causou um aumento nos valores de ACD e ACV e uma diminuição nos valores da ACA. No entanto, ele não teve nenhum efeito significativo sobre as medidas de CCT e ceratometria. É importante considerar esses efeitos sobre as medidas tomadas com Pentacam em adultos jovens com cicloplegia quando aplicá-las em diferentes situações. .

Changes in anterior chamber eye during accommodation as assessed using a Dual Scheimpflug system / Mudanças na câmara anterior do olho durante a acomodação avaliadas por meio de sistema de Scheimpflug duplo

Purpose: To study the changes in anterior chamber depth (ACD), anterior chamber angle (ACA), and pupil diameter (PD) during accommodation. Methods: Eighty eyes of 80 subjects, aged 22 to 40 years, were included. The rotating Dual Scheimpflug and a Placido disc system (Galilei G4, Ziemer Ophthalmic Systems AG, Switzerland) was used to measure the changes in ACD, ACA, and PD during accommodation. ACD measurement was taken for the central zone and for 4 more positions, each in different orientation (nasal, superior, temporal and inferior), 4 mm away from the centre. ACA was measured for the whole eye as well for the nasal, superior, temporal, and inferior quadrants. These metrics were obtained for various accommodation stimuli, ranging from +1 D to -4 D in 1-D steps. Results: For a given position, the ACD did not vary significantly with accommodation. For the central ACD, the percentage of relative change between far and near vision was -4.11%. The ACA was significantly lower at the inferior, temporal, and superior positions. There was no change in the ACA of the whole eye and that of the nasal orientation. These two eye metrics were significantly lower in the superior-nasal than in the inferior-temporal region. At each vergence studied, the PD decreased significantly with accommodation. The relative change after the -4 D stimulus was -8.13%. Conclusion: ACA and PD varied significantly with accommodation, whereas no such variation of ACD was observed. Further, the anterior chamber was found to be asymmetrical, with the nasal-superior area becoming significantly shallower than the inferior temporal region. .

Objetivo: Estudar as mudanças na profundidade da câmara anterior (ACD), ângulo da câmara anterior (ACA) e diâmetro da pupila (PD) durante a acomodação. Métodos: Foram incluídos 80 olhos de 80 indivíduos com idades entre 22 e 40 anos. Um sistema rotacional de Scheimpflug duplo acoplado a um sistema de disco de Placido (Galilei G4, Ziemer Ophthalmic Systems AG, Suíça) foi usado para medir as mudanças na ACD, ACA e PD, durante a acomodação. As medidas da ACD foram consideradas na zona central e em mais 4 posições, cada uma em orientação diferente (nasal, superior, temporal e inferior), a 4 milímetros de distância do centro. O ACA do olho inteiro, assim como nos quadrantes nasal, superior, temporal e inferior foram medidos. Todos estes indicadores foram obtidos por vários estímulos acomodativos, que variaram de +1 D a -4 D em intervalos de 1 D. Resultados: A ACD não variou significativamente com acomodação para qualquer determinada orientação, sendo a percentagem de variação relativa entre longe e visão de perto -4,11% para a ACD central (onde sinal negativo representa uma diminuição na ACD). Em relação ao ACA, este diminuiu significativamente em posições inferiores, temporais e superiores. O ACA total de olho e o ACA nasal não se alterou. Estas duas métricas oculares foram significativamente menores no par nasal-superior do que no temporal-inferior. Finalmente, PD diminuiu significativamente com a acomodação em cada vergência estudada, a mudança relativa após o estímulo de -4 D foi -8,13%. Conclusão: ACA e PD variaram significativamente com a acomodação, enquanto ACD não. Além disso, a câmara anterior se mostrou alterar assimetricamente, com a área nasal-superior se tornando ...

Development of a new evaluation method for gelatin film sheets.

Gelatin film sheets are often used to form the shell in soft capsules prepared using the rotary die method. Examination of the film sheet properties is extremely important when materials other than gelatin are used. We examined the relationship between the width and the tensile strength of the gelatin film sheet in order to establish the required indexes of the gelatin film sheets. The coefficients of correlation (R) of the linear regressions 4 and 15 min after preparation of the gelatin film sheets were 0.9858 and 0.9167, respectively. These results suggest that the tensile strength decreased when the width of the gelatin film sheet increased. Subsequently, we examined the relationship between time and the tensile strength. We observed new phenomenon: the tensile strength of the gelatin sheets increased with time, following two phases. The first phase corresponded to over phase transition point at 4, 8, and 15 min and the second phase corresponded to under transition point at 15, 30, and 60 min. The R values were 0.9952 (4, 8, 15 min) and 0.9494 (15, 30, 60 min).

Validity and reliability of the International Physical Activity Questionnaire among adults in Mexico / Validez y fiabilidad del Cuestionario Internacional de Actividad Física en adultos de México

OBJECTIVE: To determine the test-retest reliability and validity of the Spanish version of the short-form International Physical Activity Questionnaire (IPAQ) among adults in Mexico. METHODS: This was a cross-sectional study of a convenience sample of 267 adult factory workers in Mexico City. Participants were 19 - 68 years of age; 48% were female. Participants wore an accelerometer for 9 consecutive days and were administered the Spanish version of the short form IPAQ on two occasions (IPAQ1 and IPAQ2, separated by 9 days). The relation and differences between moderate-to-vigorous physical activity (MVPA) measures obtained from IPAQ1, IPAQ2, and the accelerometer were determined using correlations, linear regression, and paired t-tests. RESULTS: IPAQ1 and IPAQ2 measures of MVPA were significantly correlated to each other (r = 0.55, P < 0.01). However, MVPA was 44 ± 408 minutes/week lower in IPAQ1 than in IPAQ2, although this difference did not reach statistical significance (P = 0.08). The (min/week) measures from IPAQ1 and IPAQ2 were only modestly correlated with the accelerometer measures (r = 0.26 and r = 0.31, P < 0.01), and by comparison to accelerometer measures, MVPA values were higher when based on IPAQ1 (174 ± 357 min/week, P < 0.01) than for IPAQ2 (135 ± 360 min/week, P < 0.01). The percentage of participants who were classified as physically inactive according to the World Health Organization guidelines was 18.0% in IPAQ1, 25.1% in IPAQ2, and 28.2% based on the accelerometer. CONCLUSIONS: Similar to what has been observed in other populations, the short form IPAQ has a modest reliability and poor validity for assessing MVPA among Mexican adults.

OBJETIVO: Determinar la fiabilidad en aplicaciones repetidas (test-retest) y la validez de la versión abreviada en español del Cuestionario Internacional de Actividad Física (CIAF) en adultos de México. MÉTODOS: Se llevó a cabo un estudio transversal de una muestra de conveniencia de 267 adultos que trabajaban en una fábrica de la ciudad de México. Los participantes tenían de 19 a 68 años de edad; 48% eran mujeres. Los participantes llevaron un acelerómetro durante nueve días consecutivos y se les administró la versión abreviada en español del CIAF en dos ocasiones (CIAF1 y CIAF2, con un intervalo de nueve días). Se determinó la relación y las diferencias entre las mediciones de la actividad física de moderada a vigorosa (AFMV) obtenidas mediante el CIAF1, el CIAF2 y el acelerómetro usando análisis de correlación y regresión lineal, y pruebas de la t para datos emparejados. RESULTADOS: Las mediciones de la AFMV mediante el CIAF1 y el CIAF2 se correlacionaron significativamente entre sí (r = 0,55, P < 0,01). Sin embargo, en el CIAF1 se obtuvo una AFMV inferior a la del CIAF2 en 44 ± 408 minutos/semana, aunque esta diferencia no alcanzó significación estadística (P = 0,08). Las mediciones en minutos/semana del CIAF1 y el CIAF2 solo se correlacionaron moderadamente con las mediciones del acelerómetro (r = 0,26 y r = 0,31, P < 0,01) y, en comparación con las mediciones del acelerómetro, los valores de la AFMV fueron mayores cuando se basaron en el CIAF1 (174 ± 357min/semana, P < 0,01) que en el CIAF2 (135 ± 360 min/semana, P < 0.01). El porcentaje de participantes que se clasificaron como físicamente inactivos según las directrices de la Organización Mundial de la Salud fue de 18,0% mediante el CIAF1, de 25,1% mediante el CIAF2 y de 28,2% mediante el acelerómetro. CONCLUSIONES: De manera análoga a lo observado en otras poblaciones, la versión abreviada del CIAF presenta una fiabilidad moderada y una validez deficiente para evaluar la AFMV en adultos mexicanos.

Assessment of changes in left ventricular systolic function with oesophageal Doppler.

BACKGROUND: We tested the ability of mean acceleration (Acc) and peak velocity (V peak) of the aortic velocity signal measured by oesophageal Doppler to reflect left ventricular (LV) systolic performance. METHODS: We included critically ill patients in whom a fluid challenge (n=25) or the introduction of dobutamine, 5 µg kg(-1) min(-1) (n=25), was planned by the attending physician. Before and after therapeutic interventions, we measured Acc and V peak (CardioQ device) and LV ejection fraction (LVEF) using echocardiography. RESULTS: For all pairs of measurements, the absolute values of Acc and V peak correlated with LVEF (r=0.36 and 0.57, respectively). The correlation was significantly higher for V peak than for Acc. Volume expansion did not significantly change LVEF and Acc, but significantly increased V peak by 7 (8)%. Dobutamine increased LVEF by 30 (15)%, Acc by 33 (25)%, and V peak by 20 (10)%. Considering the pooled effects of volume expansion and dobutamine, changes in Acc and V peak and those of LVEF were correlated (r=0.53 and 0.67, respectively). When excluding changes <18% (i.e. the least significant change for LVEF), the concordance rate was 96% for Acc and 100% for V peak. CONCLUSIONS: V peak and, to a lesser extent, Acc measured by oesophageal Doppler behaved as markers of LV systolic performance as they were almost insensitive to fluid administration and changed to a much larger extent with dobutamine. These indices could be used to estimate LV systolic performance and to assess the effects of inotropic therapy.

Consistência entre medidas antropométricas em inquéritos nacionais / Consistency between anthropometric measures in national surveys / Consistencia entre medidas antropométricas en pesquisas nacionales

OBJETIVO: Analisar a consistência entre valores de altura e peso obtidos por mensuração direta e por relato em inquéritos nacionais contemporâneos. MÉTODOS: Selecionamos o grupo de 20 a 39 anos na Pesquisa de Orçamentos Familiares (POF) e do sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) de 2008 e 2009. Os inquéritos foram pareados por sexo e idade. A inferência sobre a comparação entre valores de altura e peso medidos padronizadamente (POF) e autodeclarados (Vigitel) foi feita com teste t de student e pelo estimador Spearman (ρ). A consistência entre índices e indicadores antropométricos nos dois inquéritos foi estimada pelos estimadores de Lin (Φ) e Pearson (r). RESULTADOS: Peso e altura referidos foram maiores que os medidos de forma padronizada. A correlação dos valores médios de altura nos dois inquéritos foi de ρ = 0,31 em mulheres e ρ = 0,62 em homens. A associação foi de ρ = 0,86 e ρ = 0,88, respectivamente, para peso. O índice de massa corporal mostrou forte correlação e concordância com aproximadamente 0,90 para os dois estimadores em ambos os sexos. A concordância entre diagnóstico de obesidade a partir de valores dos dois inquéritos medidos e autodeclarados foi Φ = 0,89 em homens e Φ = 0,91 em mulheres. CONCLUSÕES: Altura e peso declarados seguem o mesmo viés em relação àqueles mensurados padronizadamente e eliminam distorções nos índices e indicadores estimados nos dois inquéritos. Os valores declarados da antropometria mostram boas perspectivas de uso em outras análises envolvendo determinantes de saúde e nutrição.

OBJECTIVE: To analyze the consistency between height and weight values obtained by direct measurement and reporting in contemporary national surveys. METHODS: A group of 20 to 39 year olds were selected in the Household Budget Survey (POF) and Surveillance System Risk and Protective Factors for Chronic Diseases Survey Telephone (Vigitel), 2008 and 2009. The surveys were matched by sex and age. For inference about the comparison between standardized (POF) and self-declared (Vigitel) height and weight values used the Student t test and the Spearman estimator (ρ). The consistency between anthropometric indexes and indicators in the two surveys was estimated by the estimators of Lin (Φ) and Pearson (r). RESULTS: Weight and height results were higher than those measured in a standardized way. The correlation of average height in the two surveys was ρ = 0.31 in women and ρ = 0.62 in men. The association was ρ = 0.86 and 0.88 respectively, for weight. Body mass index showed a strong correlation and agreement of approximately 0.90 for the two estimators in both sexes. The agreement between the diagnosis of obesity from the values of the measured and self-declared surveys was Φ = 0.89 in men and Φ = 0.91 in women. CONCLUSIONS: Reported height and weight follow the same bias as those measured standardly and eliminates distortion in estimated indices and indicators in both surveys. The declared anthropometric values show good prospects for use in other analyses involving determinants of health and nutrition.

OBJETIVO: Analizar la consistencia entre valores de altura y peso obtenidos por medición directa y por relato en pesquisas nacionales contemporáneas. MÉTODOS: Seleccionamos el grupo de 20 a 39 años en la Investigación de Presupuestos Familiares y del sistema de Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas por Indagación Telefónica (Vigitel) de 2008 y 2009. Las pesquisas fueron pareadas por sexo y edad. La inferencia sobre la comparación entre valores de altura y peso medidos estandarizadamente (POF) y auto declarados (Vigitel) fue hecha con la prueba t de Student y por el estimador Spearman (ρ). La consistencia entre índices e indicadores antropométricos en las dos pesquisas fue estimada por los estimadores de Lin (Φ) y Pearson (r). RESULTADOS: peso y altura referidos fueron mayores que los medidos de forma estandarizada. La correlación de los valores promedios de altura en dos pesquisas fue de ρ = 0,31 en mujeres y ρ = 0,62 en hombres. La asociación fue de ρ = 0,86 y ρ = 0,88 respectivamente, para peso. El índice de masa corporal mostró fuerte correlación y concordancia con aproximadamente 0,90 para los dos estimadores en ambos sexos. La correspondencia entre diagnóstico de obesidad a partir de valores de las dos pesquisas medidas y auto declaradas fue Φ = 0,89 en hombres y Φ = 0,91 e mujeres. CONCLUSIONES: Altura y peso declarados siguen el mismo sesgo con relación a aquellos medidos estandarizadamente y elimina distorsiones en los índices e indicadores estimados en las dos pesquisas. Los valores declarados de antropometría muestran buenas perspectivas de uso en otros análisis involucrando determinantes de salud y nutrición.

Use of accelerometry to measure physical activity in adults and the elderly / Actividade física em adultos e idosos avaliados por acelerometria

OBJECTIVE: To review the use of accelerometry as an objective measure of physical activity in adults and elderly people. METHODS: A systematic review of studies on the use of accelerometty as an objective measure to assess physical activity in adults were examined in PubMed Central, Web of Knowledge, EBSCO and Medline databases from March 29 to April 15, 2010. The following keywords were used: "accelerometry," "accelerometer," "physical activity," "PA," "patterns," "levels," "adults," "older adults," and "elderly," either alone or in combination using "AND" or "OR." The reference lists of the articles retrieved were examined to capture any other potentially relevant article. Of 899 studies initially identified, only 18 were fully reviewed, and their outcome measures abstracted and analyzed. RESULTS: Eleven studies were conducted in North America (United States), five in Europe, one in Africa (Cameroon) and one in Australia. Very few enrolled older people, and only one study reported the season or time of year when data was collected. The articles selected had different methods, analyses, and results, which prevented comparison between studies. CONCLUSIONS: There is a need to standardize study methods for data reporting to allow comparisons of results across studies and monitor changes in populations. These data can help design more adequate strategies for monitoring and promotion of physical activity.

OBJETIVO: Analisar o uso da acelerometria como medida objetiva da atividade física em adultos e idosos. MÉTODOS: Revisão sistemática nas bases PubMed, Web of Knowledge, EBSCO e Medline, de 29 de março a 15 de abril de 2010. As palavras-chave utilizadas na busca foram: "accelerometry", "accelerometer", "physical activity", "PA", "patterns", "levels", "adults", "older adults" e "elderly", isoladamente ou combinadas usando "and" ou "or". As listas de referências dos artigos recuperados foram examinadas para captar artigos potenciais. Dos 899 estudos localizados, 18 foram revistos integralmente, com seus dados extraídos e analisados. RESULTADOS: Onze estudos foram realizados nos Estados Unidos, cinco na Europa, um em Camarões e outro na Austrália. Poucos envolveram idosos, e apenas um referiu a estação ou período do ano em que decorreu a coleta de dados. Os métodos, análises e resultados divergiram entre os estudos, impossibilitando uma análise mais aprofundada. CONCLUSÕES: Deve-se promover a padronização de procedimentos que permitam comparar resultados entre estudos e monitorizar alterações numa população. Esses dados contribuem para a adequação das estratégias de monitoramento e promoção da atividade física.