Intracranial compliance in type 2 diabetes mellitus and its relationship with the cardiovascular autonomic nervous control.

The intracranial compliance in type 2 diabetes mellitus (T2DM) patients and the association with cardiovascular autonomic control have not been fully elucidated. The aim of this study was to assess intracranial compliance using the noninvasive intracranial pressure (niICP) and the monitoring of waveform peaks (P1, P2, and P3) and the relationship with cardiovascular autonomic control in T2DM patients. Thirty-two men aged 40-60 years without cardiovascular autonomic neuropathy (CAN) were studied: T2DMG (n=16) and control group CG (n=16). The niICP was evaluated by a noninvasive extracranial sensor placed on the scalp. Cardiovascular autonomic control was evaluated by indices of the baroreflex sensitivity (BRS), from temporal series of R-R intervals of electrocardiogram and systolic arterial pressure, during supine and orthostatic positions. The participants remained in the supine position for 15 min and then 15 min more in orthostatism. T2DMG presented a decrease of the P2/P1 ratio during the orthostatic position (P<0.001). There was a negative moderate correlation between the P2 peak with cardiovascular coupling (K2HP-SAPLF) in supine (r=-0.612, P=0.011) and orthostatic (r=-0.568, P=0.020) positions in T2DMG. We concluded that T2DM patients without CAN and cardiovascular complications presented intracranial compliance similar to healthy subjects. Despite preserved intracranial adjustments, T2DM patients had a response of greater magnitude in orthostatism. In addition, the decoupling between the heart period and blood pressure signal oscillations in low frequency appeared to be related to the worsening of intracranial compliance due to the increased P2 peak.

Intracranial compliance in type 2 diabetes mellitus and its relationship with the cardiovascular autonomic nervous control

The intracranial compliance in type 2 diabetes mellitus (T2DM) patients and the association with cardiovascular autonomic control have not been fully elucidated. The aim of this study was to assess intracranial compliance using the noninvasive intracranial pressure (niICP) and the monitoring of waveform peaks (P1, P2, and P3) and the relationship with cardiovascular autonomic control in T2DM patients. Thirty-two men aged 40-60 years without cardiovascular autonomic neuropathy (CAN) were studied: T2DMG (n=16) and control group CG (n=16). The niICP was evaluated by a noninvasive extracranial sensor placed on the scalp. Cardiovascular autonomic control was evaluated by indices of the baroreflex sensitivity (BRS), from temporal series of R-R intervals of electrocardiogram and systolic arterial pressure, during supine and orthostatic positions. The participants remained in the supine position for 15 min and then 15 min more in orthostatism. T2DMG presented a decrease of the P2/P1 ratio during the orthostatic position (P<0.001). There was a negative moderate correlation between the P2 peak with cardiovascular coupling (K2HP-SAPLF) in supine (r=-0.612, P=0.011) and orthostatic (r=-0.568, P=0.020) positions in T2DMG. We concluded that T2DM patients without CAN and cardiovascular complications presented intracranial compliance similar to healthy subjects. Despite preserved intracranial adjustments, T2DM patients had a response of greater magnitude in orthostatism. In addition, the decoupling between the heart period and blood pressure signal oscillations in low frequency appeared to be related to the worsening of intracranial compliance due to the increased P2 peak.

Nitrate reduction by electrochemical processes using copper electrode: evaluating operational parameters aiming low nitrite formation.

This work aims to present different electroreduction and electrocatalytic processes configurations to treat nitrate contaminated water. The parameters tested were: current density, cell potential, electrode potential, pH values, cell type and catalyst use. It was found that the nitrite ion is present in all process variations used, being the resulting nitrite concentration higher in an alkaline pH. The increase in current density on galvanostatic operation mode provides a greater reduction of nitrate (64%, 1.4 mA cm-2) if compared to the potentiostatic (20%) and constant cell potential (37%) configurations. In a dual-chamber cell the nitrate reduction with current density of 1.4 mA cm-2 was tested and obtained as a NO3- reduction of 85%. The use of single chamber cell presented 32 ± 3% of nitrate reduction, indicating that in this cell type the nitrate reduction is smaller than in dual-chamber cell (64%). The presence of a Pd catalyst with 3.1% wt. decreased the nitrite (1.0 N-mg L-1) and increased the gaseous compounds (9.4 N-mg L-1) formation. The best configuration showed that, by fixing the current density, the highest nitrate reduction is obtained and the pH presents a significant influence during the tests. The use of the catalyst decreased the nitrite and enhanced the gaseous compounds formation.

Prediction of oxygen uptake dynamics by machine learning analysis of wearable sensors during activities of daily living.

Currently, oxygen uptake () is the most precise means of investigating aerobic fitness and level of physical activity; however, can only be directly measured in supervised conditions. With the advancement of new wearable sensor technologies and data processing approaches, it is possible to accurately infer work rate and predict during activities of daily living (ADL). The main objective of this study was to develop and verify the methods required to predict and investigate the dynamics during ADL. The variables derived from the wearable sensors were used to create a predictor based on a random forest method. The temporal dynamics were assessed by the mean normalized gain amplitude (MNG) obtained from frequency domain analysis. The MNG provides a means to assess aerobic fitness. The predicted during ADL was strongly correlated (r = 0.87, P < 0.001) with the measured and the prediction bias was 0.2 ml·min-1·kg-1. The MNG calculated based on predicted was strongly correlated (r = 0.71, P < 0.001) with MNG calculated based on measured data. This new technology provides an important advance in ambulatory and continuous assessment of aerobic fitness with potential for future applications such as the early detection of deterioration of physical health.

Linear and non-linear contributions to oxygen transport and utilization during moderate random exercise in humans.

NEW FINDINGS: What is the central question of this study? The pulmonary oxygen uptake (pV̇O2) data used to study the muscle aerobic system dynamics during moderate-exercise transitions is classically described as a mono-exponential function controlled by a complex interaction of the oxygen delivery-utilization balance. This elevated complexity complicates the acquisition of relevant information regarding aerobic system dynamics based on pV̇O2 data during a varying exercise stimulus. What is the main finding and its importance? The elevated complexity of pV̇O2 dynamics is a consequence of a multiple-order interaction between muscle oxygen uptake and circulatory distortion. Our findings challenge the use of a first-order function to study the influences of the oxygen delivery-utilization balance over the pV̇O2 dynamics. The assumption of aerobic system linearity implies that the pulmonary oxygen uptake (pV̇O2) dynamics during exercise transitions present a first-order characteristic. The main objective of this study was to test the linearity of the oxygen delivery-utilization balance during random moderate exercise. The cardiac output (Q̇) and deoxygenated haemoglobin concentration ([HHb]) were measured to infer the central and local O2 availability, respectively. Thirteen healthy men performed two consecutive pseudorandom binary sequence cycling exercises followed by an incremental protocol. The system input and the outputs pV̇O2, [HHb] and Q̇ were submitted to frequency-domain analysis. The linearity of the variables was tested by computing the ability of the response at a specific frequency to predict the response at another frequency. The predictability levels were assessed by the coefficient of determination. In a first-order system, a participant who presents faster dynamics at a specific frequency should also present faster dynamics at any other frequency. All experimentally obtained variables (pV̇O2, [HHb] and Q̇) presented a certainly degree of non-linearity. The local O2 availability, evaluated by the ratio pV̇O2/[HHb], presented the most irregular behaviour. The overall [HHb] kinetics were faster than pV̇O2 and Q̇ kinetics. In conclusion, the oxygen delivery-utilization balance behaved as a non-linear phenomenon. Therefore, the elevated complexity of the pulmonary oxygen uptake dynamics is governed by a complex multiple-order interaction between the oxygen delivery and utilization systems.

Urban and rural Indian drinking patterns: the special case of the Lumbee.

This paper reports the results of a study of 460 adult male Lumbee Indians in a rural and urban setting. The study sought to determine what factors would explain the differences in drinking patterns between the rural and urban settings. The major variables considered were: (1) quantity, frequency, and variability of drinking; (2) occupational prestige; (3) commitment to work; (4) status satisfaction; and (5) job satisfaction. The urban Lumbee show a mean drinking pattern that is heavier than that of the rural group. In general, low achievement, as measured by occupational prestige and status satisfaction, and low satisfaction, as measured by job satisfaction and commitment to work, predict more excessive drinking patterns. Implications of the findings for treatment and future research are discussed.

Meeting the special needs of Appalachian alcoholics.

The Appalachian Regional Comprehensive Alcoholism Program in Beckley, West Virginia, was established in 1972 to meet the needs of a four-county catchment area. In designing the program, planners took into account the special cultural and economic characteristics of the population to be served--individualism, isolation, religiosity, conservatism, distrust of newcomers, and economic deprivation--and set up a program they believe respects local norms. For instance, the program has been staffed mainly by local professionals. Individual therapy, family therapy, and crisis intervention are used much more frequently than group psychotherapy, and clients have a strong voice in treatment decisions. Local ministerial associations are involved whenever possible, and outreach efforts include home visits as well as the use of the media to disseminate information.