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1.
Nutr Res ; 125: 27-35, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38460227

RESUMO

In pregnant women, the Energy-adjusted Dietary Inflammatory Index (E-DII) is adopted to measure the inflammatory potential of the diet, but it does not predict the quality of the diet. Our hypothesis is that a more pro-inflammatory diet during pregnancy is also a poorer quality diet. Thus, the objective of this study is to verify the association of the E-DII with the Diet Quality Index Adapted for Pregnancy (DQI-P) and the nutrient intake from the diet in terms of the second and third gestational trimesters. This is a cross-sectional study that took place in Brazil (2018-2019), with eligible adult women up to 72 hours' postpartum and in good health. Socioeconomic, gestational, anthropometric, and food consumption data were collected, enabling the calculation of E-DII, DQI-P, and nutrient intake. The sample (n = 260) had a median E-DII of 0.04 (-1.30 to 1.90) and DQI-P of 68.82 (18.82-98.22). There was no relevant difference between E-DII tertiles by sociodemographic, gestational, and anthropometric characteristics. The E-DII and the DQI-P showed agreement (55.7%) and inverse correlation (r = -0.53; P < .001). Each 1-unit increase in DQI-P, iron, iodine, magnesium, pyridoxine, and vitamin E decreased the E-DII score (P < .05). An increase of 1 unit in protein, saturated fatty acids, and vitamin C increased the E-DII score (P < .05). Thus, the results suggest that the E-DII can predict diet quality during pregnancy, with the added benefit of measuring the inflammatory potential of the diet.


Assuntos
Dieta , Inflamação , Humanos , Feminino , Gravidez , Estudos Transversais , Adulto , Brasil , Adulto Jovem , Ingestão de Energia , Fenômenos Fisiológicos da Nutrição Materna
2.
Data Brief ; 52: 109846, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38146292

RESUMO

Connecting vehicles to the Internet is an emerging challenge of wireless networks. There are two competing methods for achieving this. First, the wireless local area network (WLAN) approach is based on the IEEE 802.11p standard (in its European version called ETSI ITS-G5) created for Cooperative-Intelligent Transportation System applications. Second, the cellular network approach is based on LTE/5G technologies which have been exploited in recent years to support vehicular applications. Advantages such as high bandwidth, high coverage and high reliability make cellular networks a great option for the vehicular environment. This article describes two datasets that support the analysis of WLAN (ETSI ITS-G5) and Cellular (LTE/5G) technologies in a real vehicular and road environment. The two datasets summarize the results obtained in a collection of network performance tests performed in the city of Aveiro, Portugal. In these tests, a set of vehicles (8 On-Board Units) moved randomly around the city, passing near a group of stationary nodes (11 Road-Side Units) uploading data to a server. In the WLAN dataset, data was sent using the ETSI ITS-G5 technology, whereas, in the Cellular dataset, data was sent using LTE/5G technologies. While testing, location, signal quality, and network performance data (achieved throughput, jitter, etc.) were collected. This dataset can support a realistic analysis of WLAN and Cellular performance in an environment that is not only vehicular but also urban, with obstacles and interference.

3.
Nutr Res ; 114: 81-97, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37209507

RESUMO

Based on previous studies, we hypothesized that the dietary inflammatory potential in pregnant women might influence maternal and child health. The objective of this work is to review the literature on the association of Dietary Inflammatory Index (DII) during pregnancy with early and late maternal and child health outcomes. We searched Cochrane, Embase, PubMed, Scopus, Web of Science, and the Virtual Health Library. Observational studies on DII in the gestational period that met the objective of this review were selected. There was a double-blind evaluation of 185 studies, of which 16 were included in narrative synthesis and 9 in meta-analysis. High methodological quality, longitudinal studies (87.5%) and the Food Frequency Questionnaire for DII evaluation (68.8%) prevailed. Outcomes studied were gestational diabetes mellitus (n = 5), gestational age at delivery (n = 7), type of delivery (n = 3), gestational weight gain or pregestational body mass index (n = 11), and anthropometry at birth (n = 8) and of the child up to age 10 years (n = 4). Higher maternal DII was associated with increased risk of small-for-gestational-age babies (odds radio, 1.15; 95% confidence interval, 1.08-1.21; I2, 29%; P = .24) and low birth weight (<2.500 g) (odds ratio, 1.16; 95% confidence interval, 1.06-1.26; I2, 56%; P = .10). The association between higher maternal DII and higher risk of obesity in late childhood is also suggestive. Thus, maternal diet may be a modifiable factor of inflammation in pregnancy associated with health outcomes of the offspring.


Assuntos
Diabetes Gestacional , Obesidade , Recém-Nascido , Humanos , Criança , Gravidez , Feminino , Peso ao Nascer , Obesidade/complicações , Dieta , Antropometria , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
Sensors (Basel) ; 22(17)2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36081060

RESUMO

Deep brain stimulation of the Anterior Nucleus of the Thalamus (ANT-DBS) is an effective therapy in epilepsy. Poorer surgical outcomes are related to deviations of the lead from the ANT-target. The target identification relies on the visualization of anatomical structures by medical imaging, which presents some disadvantages. This study aims to research whether ANT-LFPs recorded with the PerceptTM PC neurostimulator can be an asset in the identification of the DBS-target. For this purpose, 17 features were extracted from LFPs recorded from a single patient, who stayed at an Epilepsy Monitoring Unit for a 5-day period. Features were then integrated into two machine learning (ML)-based methodologies, according to different LFP bipolar montages: Pass1 (nonadjacent channels) and Pass2 (adjacent channels). We obtained an accuracy of 76.6% for the Pass1-classifier and 83.33% for the Pass2-classifier in distinguishing locations completely inserted in the target and completely outside. Then, both classifiers were used to predict the target percentage of all combinations, and we found that contacts 3 (left hemisphere) and 2 and 3 (right hemisphere) presented higher signatures of the ANT-target, which agreed with the medical images. This result opens a new window of opportunity for the use of LFPs in the guidance of DBS target identification.


Assuntos
Núcleos Anteriores do Tálamo , Estimulação Encefálica Profunda , Epilepsia , Núcleos Anteriores do Tálamo/fisiologia , Estimulação Encefálica Profunda/métodos , Eletrodos , Epilepsia/terapia , Humanos
5.
Breastfeed Med ; 17(6): 511-518, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35353584

RESUMO

Objectives: Investigating waist circumference (WC) and abdominal circumference (AC) evolution in lactating women, based on macronutrient intake adequacy up to 6 months after childbirth. Materials and Methods: Prospective cohort comprising lactating women recruited at a maternity hospital in Minas Gerais State, Brazil, from June 2018 to June 2019. Selected individuals were healthy adult women who had given birth 72 hours before data collection. Sociodemographic, breastfeeding, and anthropometric data were collected. Food intake was determined through 24 hours dietary recalls. Adequate carbohydrate, protein, and lipid intake was herein defined as 45-65%, 10-35%, and 20-35% of the caloric value consumed by participants, respectively. Wilcoxon test and generalized estimating equations were carried out. This research was approved by the Research Ethics Committee, as well as by the National Research Ethics Committee. Results: There was decrease in weight (-4.45 kg), body mass index (-4.43 kg/m2), WC (-4.70 cm), and AC (-4.70 cm) values from the baseline (n = 260) up to 6 months after childbirth (p < 0.001). The evolution of these measurements has indicated that high carbohydrate and low protein intake were associated with the highest AC values. Low protein and high lipid intake have led to lower WC values (p < 0.05). Conclusions: Macronutrient intake adequacy by the investigated lactating women has influenced their WC and AC evolution. This outcome has evidenced the important role played by nutritional monitoring in puerperium to prevent abdominal fat retention after pregnancy.


Assuntos
Aleitamento Materno , Lactação , Adulto , Índice de Massa Corporal , Peso Corporal , Carboidratos , Dieta , Ingestão de Energia , Feminino , Humanos , Lipídeos , Nutrientes , Gravidez , Estudos Prospectivos , Redução de Peso
6.
Clin Neurol Neurosurg ; 213: 107130, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35066247

RESUMO

OBJECTIVES: Spontaneous intracerebral hemorrhage (SICH) is a subtype of stroke associated with high mortality and devastating disabilities. Therefore, identifying non-invasive biomarkers for SICH would have a tremendous clinical impact. MicroRNAs (miRNAs) are non-coding single-stranded RNAs containing 21-23 nucleotides that control the activity of various protein-coding genes through post-transcriptional repression. In this systematic review, we report the recent clinical evidence on the role of miRNAs as biomarkers for the prediction, prognosis, early detection, and risk stratification of SICH. METHODS: We conducted a systematic search of PubMed, PubMed Central, MEDLINE, and Embase databases and included only full-text peer-reviewed articles published in English. RESULTS: We included 10 studies comprising seven case-control studies, two cohort studies, and one cross-sectional study, among which we found 27 altered miRNAs, suggesting their role as biomarkers for the early detection of ICH. Additionally, the expression of 34 miRNAs was associated with poor prognosis of ICH; miR-126 and miR-23a-3p expression correlated with relative perihematomal edema (PHE) volume, and using a subset of 10 miRNA signatures had an accuracy of 100% in predicting hematoma in patients with ICH. Moreover, miR-4317 and miR-4325 profiling predicted the development of late seizures. Thirty-nine miRNAs were associated with the incidence of all types of strokes, while 10 miRNAs correlated with the predicted risk of stroke but were not specific to a stroke subtype. The altered miRNA signatures contributed to endothelial dysfunction, hematoma, and PHE through leukocyte activation, oxidative stress response, programmed cell death, smooth muscle cell proliferation, and apoptosis of cerebrovascular endothelial cells. The current data had limitations and gaps, especially the human studies, and there may have been selection bias in the prospective studies. There were also some limitations regarding the methods for obtaining miRNAs and identifying target RNAs specific to SICH pathology. Additionally, there may have been correlations between the outcomes and other factors, such as therapeutic interventions and ICH severity, the circulating miRNA profiles and gene expression profiles, and other pathological conditions and patients' age. Finally, the prediction and risk stratification of SICH could not be calculated separately from ischemic stroke. CONCLUSIONS: Following our literature retrieval, we noted alterations in various miRNA signatures, suggesting their potential role as biomarkers for the early detection and differentiation of SICH. Indeed, miRNA expression was associated with a poor prognosis of SICH and correlated with the predicted risk of stroke but was not specific to a stroke subtype. Further studies are needed, especially on the therapeutic potential of miRNAs and their target RNAs in SICH.


Assuntos
MicroRNAs , Biomarcadores/metabolismo , Hemorragia Cerebral/complicações , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/genética , Estudos Transversais , Células Endoteliais/metabolismo , Células Endoteliais/patologia , Humanos , Estudos Prospectivos , Transcriptoma
7.
Epilepsy Behav ; 126: 108453, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34864377

RESUMO

OBJECTIVE: Heart rate variability (HRV), an index of the autonomic cardiac activity, is decreased in patients with epilepsy, and a low HRV is associated with a higher risk of sudden death. Generalized tonic-clonic seizures are one of the most consistent risk factors for SUDEP, but the influence (and relative risk) of each type of seizure on cardiac function is still unknown. Our objective was to assess the impact of the type of seizure (focal to bilateral tonic-clonic seizure - FBTCS - versus non-FBTCS) on periictal HRV, in a group of patients with refractory epilepsy and both types of seizures. METHODS: We performed a 48-hour Holter recording on 121 patients consecutively admitted to our Epilepsy Monitoring Unit. We only included patients with both FBTCS and non-FBTCS on the Holter recording and selected the first seizure of each type to analyze. To evaluate HRV parameters (AVNN, SDNN, RMSSD, pNN20, LF, HF, and LF/HF), we chose 5-min epochs pre- and postictally. RESULTS: We included 14 patients, with a median age of 36 (min-max, 16-55) years and 64% were female. Thirty-six percent had cardiovascular risk factors, but no previously known cardiac disease. In the preictal period, there were no statistically significant differences in HRV parameters, between FBTCS and non-FBTCS. In the postictal period, AVNN, RMSSD, pNN20, LF, and HF were significantly lower, and LF/HF and HR were significantly higher in FBTCS. From preictal to postictal periods, FBTCS elicited a statistically significant rise in HR and LF/HF, and a statistically significant fall in AVNN, RMSSD, pNN20, and HF. Non-FBTCS only caused statistically significant changes in HR (decrease) and AVNN (increase). SIGNIFICANCE/CONCLUSION: This work emphasizes the greater effect of FBTCS in autonomic cardiac function in patients with refractory epilepsy, compared to other types of seizures, with a significant reduction in vagal tonus, which may be associated with an increased risk of SUDEP.


Assuntos
Epilepsia , Frequência Cardíaca , Convulsões , Adolescente , Adulto , Eletroencefalografia , Epilepsia/fisiopatologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Convulsões/classificação , Convulsões/fisiopatologia , Morte Súbita Inesperada na Epilepsia/epidemiologia , Adulto Jovem
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 7162-7165, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34892752

RESUMO

Occupational stress is a complex process affecting health and performance. Air Traffic Control is a complex and demanding profession. The current study demonstrates the concept of using a biomonitoring wearable platform (BWP), that combines self-report measures with biomarkers, to track stress among Air Traffic Controllers. A wearable ECG device was used to gather continuously medical-grade ECG data along with a mobile app for daily stress perception, symptoms and events annotation. A total of 256 hours of data from 32 routine work shifts and 5 days-off, from 5 ATCs was recorded with 35 tagged events using Heart Rate Variability metrics- AVNN, RMSSD, pNN50 and LF/HF were computed from ECG data and analyzed during a) shifts vs days off; b) events vs non-events and c) before and after working pauses. ATCs showed low levels of chronic stress using self-reports. Results showed that stress symptomatology slightly increase from the beginning to the end of the shift (Md=1 to Md=2; p<0.05). Statistical significant physiological changes were found between shifts and days off for AVNN and LF/HF (p<0.05), showing higher physiological activation during shifts. A significant reduction of physiological arousal was verified after working pauses, particularly for AVNN and LF/HF (p<0.001). Self-reported data also suggests the same trend (p<0.005). Findings reinforced the discriminatory power of AVNN and LF/HF for short-term stress classification using HRV measurements. Results suggest that the rotating working system, with pause/resting periods included, effective acted as a recovery period.Clinical Relevance-Results provide important clues to the impact of stress on health, particularly cardiac reactivity and the identification of stress quantitative biomarkers as diagnostic indicators, providing a more reliable source for stress monitoring than currently behavioral or subjective measures. Findings will help on the design of stress management programs and prevention actions in order to avoid the negative effects of stress.


Assuntos
Aviação , Saúde Ocupacional , Dispositivos Eletrônicos Vestíveis , Coração , Frequência Cardíaca , Humanos
9.
Epilepsy Res ; 178: 106796, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34763267

RESUMO

OBJECTIVE: Patients with epilepsy, mainly drug-resistant, have reduced heart rate variability (HRV), linked to an increased risk of sudden death in various other diseases. In this context, it could play a role in SUDEP. Generalized convulsive seizures (GCS) are one of the most consensual risk factors for SUDEP. Our objective was to assess the influence of GCS in HRV parameters in patients with drug-resistant epilepsy. METHODS: We prospectively evaluated 121 patients with refractory epilepsy admitted to our Epilepsy Monitoring Unit. All patients underwent a 48-hour Holter recording. Only patients with GCS were included (n = 23), and we selected the first as the index seizure. We evaluated HRV (AVNN, SDNN, RMSSD, pNN50, LF, HF, and LF/HF) in 5-min epochs (diurnal and nocturnal baselines; preictal - 5 min before the seizure; ictal; postictal - 5 min after the seizure; and late postictal - >5 h after the seizure). These data were also compared with normative values from a healthy population (controlling for age and gender). RESULTS: We included 23 patients, with a median age of 36 (min-max, 16-55) years and 65% were female. Thirty percent had cardiovascular risk factors, but no previously known cardiac disease. HRV parameters AVNN, RMSSD, pNN50, and HF were significantly lower in the diurnal than in the nocturnal baseline, whereas the opposite occurred with LF/HF and HR. Diurnal baseline parameters were inferior to the normative population values (which includes only diurnal values). We found significant differences in HRV parameters between the analyzed periods, especially during the postictal period. All parameters but LF/HF suffered a reduction in that period. LF/HF increased in that period but did not reach statistical significance. Visually, there was a tendency for a global reduction in our patients' HRV parameters, namely AVNN, RMSSD, and pNN50, in each period, comparing with those from a normative healthy population. No significant differences were found in HRV between diurnal and nocturnal seizures, between temporal lobe and extra-temporal-lobe seizures, between seizures with and without postictal generalized EEG suppression, or between seizures of patients with and without cardiovascular risk factors. SIGNIFICANCE/CONCLUSION: Our work reinforces the evidence of autonomic cardiac dysfunction in patients with refractory epilepsy, at baseline and mainly in the postictal phase of a GCS. Those changes may have a role in some SUDEP cases. By identifying patients with worse autonomic cardiac function, HRV could fill the gap of a lacking SUDEP risk biomarker.


Assuntos
Epilepsia Resistente a Medicamentos , Epilepsia Reflexa , Adolescente , Adulto , Eletroencefalografia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Pessoa de Meia-Idade , Convulsões , Adulto Jovem
10.
Cad. Ibero-Am. Direito Sanit. (Online) ; 10(4): 176-196, out.-dez.2021.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1344352

RESUMO

Objetivo: descrever as principais causas e consequências do aumento exponencial da judicialização do direito à saúde no Brasil. Metodologia: revisão integrativa de literatura sobre a judicialização do Sistema Único de Saúde (SUS). A busca dos estudos se deu no banco de dados da Biblioteca Virtual em Saúde (BVS) e foram selecionados artigos científicos publicados a partir de 1988 até 2020 em língua portuguesa, que analisaram o contexto brasileiro e se encontravam disponíveis gratuitamente no formato online. Resultados: o principal motivo das demandas de saúde ao Poder Judiciário foi o acesso a medicamentos. A repercussão da judicialização da saúde no orçamento e financiamento do SUS pode comprometer as políticas públicas de saúde. Conclusão: há necessidade de maior articulação dos diversos setores, no sentido de equilibrar as necessidades dos usuários do SUS e a disponibilidade de recursos do Estado, visando o bem-estar coletivo.


Objective: describe the main causes and consequences of the exponential increase in the judicialization of the right to health in Brazil. Methodology: integrative literature review on the judicialization of the Unified Health System (SUS, in Portuguese). The search for the studies took place in the database of the Virtual Health Library (VHL) and it was selected scientific articles published from 1988 to 2020 in Portuguese, which analyzed the Brazilian context and were available for free in the online format. Results: the main reason for health demands in the judiciary is the access to drugs, the impact of the Medical Judicialization in the budget and financing of SUS may compromise public health policies. Conclusion: there is a need for greater articulation of the various sectors, in the sense of balance as a need for SUS users and the availability of State resources, specifically the collective well-being.


Objetivo: describir Las principales causas y consecuencias del aumento exponencial en la judicialización del derecho a la salud en Brasil. Metodología: revisión integradora de la literatura sobre la judicialización del Sistema Único de Salud (SUS). La búsqueda de los estudios se realizó en la base de datos de la Biblioteca Virtual en Salud (BVS) y se seleccionaron artículos científicos publicados desde 1988 hasta 2020 en portugués, que analizaban el contexto brasileño y estaban disponibles de forma gratuita en formato online. Resultados: la razón principal de las demandas de salud en el poder judicial fue el acceso a los medicamentos. La repercusión de la judicialización de la salud en el presupuesto y el financiamiento del SUS puede comprometer las políticas de salud pública. Conclusión: existe una necesidad de una mayor articulación entre los diversos sectores, a fin de equilibrar las necesidades de los usuarios del SUS y la disponibilidad de recursos del Estado, con el objetivo de lograr el bienestar colectivo.

11.
PLoS Negl Trop Dis ; 15(4): e0009290, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33861753

RESUMO

Since introduction into Brazil in 2014, chikungunya virus (CHIKV) has presented sustained transmission, although much is unknown about its circulation in the midwestern states. Here, we analyze 24 novel partial and near complete CHIKV genomes from Cuiaba, an urban metropolis located in the Brazilian midwestern state of Mato Grosso (MT). Nanopore technology was used for sequencing CHIKV complete genomes. Phylogenetic and epidemiological approaches were used to explore the recent spatio-temporal evolution and spread of the CHIKV-ECSA genotype in Midwest Brazil as well as in the Americas. Epidemiological data revealed a reduction in the number of reported cases over 2018-2020, likely as a consequence of a gradual accumulation of herd-immunity. Phylogeographic reconstructions revealed that at least two independent introductions of the ECSA lineage occurred in MT from a dispersion event originating in the northeastern region and suggest that the midwestern Brazilian region appears to have acted as a source of virus transmission towards Paraguay, a bordering South American country. Our results show a complex dynamic of transmission between epidemic seasons and suggest a possible role of Brazil as a source for international dispersion of the CHIKV-ECSA genotype to other countries in the Americas.


Assuntos
Febre de Chikungunya/epidemiologia , Febre de Chikungunya/transmissão , Vírus Chikungunya/genética , Genoma Viral/genética , Adolescente , Adulto , Teorema de Bayes , Brasil/epidemiologia , Febre de Chikungunya/diagnóstico , Vírus Chikungunya/isolamento & purificação , Monitoramento Epidemiológico , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia , Análise Espaço-Temporal , Sequenciamento Completo do Genoma , Adulto Jovem
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4559-4562, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019008

RESUMO

Wearable devices have been showing promising results in a large range of applications: since industry, to entertainment and, in particular, healthcare. In the scope of movement disorders, wearable devices are being widely implemented for motor symptoms objective assessment. Currently, clinicians evaluate patients' motor symptoms resorting to subjective scales and visual perception, such as in Parkinson's Disease. The possibility to make use of wearable devices to quantify this disorder motor symptoms would bring an accurate follow-up on the disease progression, leading to more efficient treatments.Here we present a novel textile embedded low-power wearable device capable to be used in any scenario of movement disorders assessment due to its seamless, comfort and versatility. Regarding our research, it has already improved the setup of a wrist rigidity quantification system for Parkinson's Disease patients: the iHandU system. The wearable comprises a hardware sensing unit integrated in a textile band with an innovative design assuring higher comfort and easiness-to-use in movement disorders assessment. It enables to collect inertial data (9-axis) and has the possibility to integrate two analog sensors. A web platform was developed for data reading, visualization and recording. To ensure inertial data reliability, validation tests for the accelerometer and gyroscope sensors were conducted by comparison with its theoretical behavior, obtaining very good results.


Assuntos
Doença de Parkinson , Dispositivos Eletrônicos Vestíveis , Humanos , Doença de Parkinson/terapia , Reprodutibilidade dos Testes , Têxteis , Articulação do Punho
13.
Sensors (Basel) ; 20(14)2020 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-32664479

RESUMO

The development of wearable health systems has been the focus of many researchers who aim to find solutions in healthcare. Additionally, the large potential of textiles to integrate electronics, together with the comfort and usability they provide, has contributed to the development of smart garments in this area. In the field of neurological disorders with motor impairment, clinicians look for wearable devices that may provide quantification of movement symptoms. Neurological disorders affect different motion abilities thus requiring different needs in movement quantification. With this background we designed and developed an inertial textile-embedded wearable device that is adaptable to different movement-disorders quantification requirements. This adaptative device is composed of a low-power 9-axis inertial unit, a customised textile band and a web and Android cross application used for data collection, debug and calibration. The textile band comprises a snap buttons system that allows the attachment of the inertial unit, as well as its connection with the analog sensors through conductive textile. The resulting system is easily adaptable for quantification of multiple motor symptoms in different parts of the body, such as rigidity, tremor and bradykinesia assessments, gait analysis, among others. In our project, the system was applied for a specific use-case of wrist rigidity quantification during Deep Brain Stimulation surgeries, showing its high versatility and receiving very positive feedback from patients and doctors.


Assuntos
Movimento , Doenças do Sistema Nervoso/diagnóstico , Têxteis , Dispositivos Eletrônicos Vestíveis , Estimulação Encefálica Profunda , Humanos , Articulação do Punho
14.
Preprint em Inglês | SciELO Preprints | ID: pps-717

RESUMO

Objective: To determine whether the SEIR model, associated to mobility changes parameters, can determine the likelihood of establishing control over an epidemic in a city, state or country. Study design and setting: The critical step in the prediction of COVID-19 by a SEIR model are the values of the basic reproduction number (R0) and the infectious period, in days. R0 and the infectious periods were calculated by mathematical constrained optimization, and used to determine the numerically minimum SEIR model errors in a country, based on COVID-19 data until April 11th. The Community Mobility Reports from Google Maps (<https://www.google.com/covid19/mobility>) provided mobility changes on April 5th compared to the baseline (Jan 3th to Feb 6th). The data was used to measure the non-pharmacological intervention adherence. The impact of each mobility component was calculated by logistic regression models. COVID-19 control was defined by SEIR model R0<1.0 in a country. Results: The ECDC has registered 1,653,204 COVID-19 worldwide on April 11th. Sixteen countries presented 78% of all cases. Of the six Google Maps mobility parameters, the "Stay at home" parameter was the strongest one to control COVID-19 in a country: an increase of 50% in mobility trends for places of residence has a 99% chance of outbreak control. Conclusions: Residential mobility restriction presented itself as the most effective measure. The SEIR model associated with mobility parameters proved to be a useful tool in determining the chance of COVID-19 outbreak control.

15.
Sensors (Basel) ; 20(2)2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31936023

RESUMO

Deep brain stimulation (DBS) surgery is the gold standard therapeutic intervention in Parkinson's disease (PD) with motor complications, notwithstanding drug therapy. In the intraoperative evaluation of DBS's efficacy, neurologists impose a passive wrist flexion movement and qualitatively describe the perceived decrease in rigidity under different stimulation parameters and electrode positions. To tackle this subjectivity, we designed a wearable device to quantitatively evaluate the wrist rigidity changes during the neurosurgery procedure, supporting physicians in decision-making when setting the stimulation parameters and reducing surgery time. This system comprises a gyroscope sensor embedded in a textile band for patient's hand, communicating to a smartphone via Bluetooth and has been evaluated on three datasets, showing an average accuracy of 80%. In this work, we present a system that has seen four iterations since 2015, improving on accuracy, usability and reliability. We aim to review the work done so far, outlining the iHandU system evolution, as well as the main challenges, lessons learned, and future steps to improve it. We also introduce the last version (iHandU 4.0), currently used in DBS surgeries at São João Hospital in Portugal.


Assuntos
Estimulação Encefálica Profunda , Procedimentos Neurocirúrgicos , Software , Punho/fisiologia , Humanos , Movimento (Física) , Processamento de Sinais Assistido por Computador , Dispositivos Eletrônicos Vestíveis
16.
Free Radic Biol Med ; 147: 167-174, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31874251

RESUMO

Previous studies have shown that reactive oxygen species (ROS) such as superoxide or hydrogen peroxide generated at low levels can exert a tumor-promoting role via a redox-signaling mechanism. Reports also suggest that both tumorigenesis and tumor growth are associated with enhanced ROS formation. However, whether ROS levels or ROS-derived oxidative marker levels increase during tumor growth remains unknown. In this study, in vivo bioluminescence imaging with a boronate-based pro-luciferin probe was used to assess ROS formation. Additionally, probe-free cryogenic electron paramagnetic resonance was used to quantify a characteristic aconitase [3Fe4S]+ center that arises in the tumor tissue of mouse xenografts from the reaction of the native [4Fe4S]2+ cluster with superoxide. Results indicated that tumor growth is accompanied by increased ROS formation, and revealed differences in oxidant formation in the inner and outer sections of tumor tissue, respectively, demonstrating redox heterogeneity. Studies using luciferin and pro-luciferin probes enabled the assessment of tumor size, ROS formation, and bioenergetic status (e.g., ATP) in luciferase-transfected mice tumor xenografts. Probe-free ex vivo low-temperature electron paramagnetic resonance can also be translated to clinical studies.


Assuntos
Neoplasias , Animais , Espectroscopia de Ressonância de Spin Eletrônica , Camundongos , Oxirredução , Espécies Reativas de Oxigênio , Temperatura
17.
PeerJ ; 6: e5967, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30581658

RESUMO

BACKGROUND: Stress at work has been broadly acknowledged as a worldwide problem and has been the focus of concern for many researchers. Firefighting, in particular, is frequently reported as a highly stressful occupation. In order to investigate firefighters' occupational health in terms of stress events, perceptions, symptoms, and physiological reactions under real-world conditions, an ambulatory assessment protocol was developed. METHODS: Seventeen firefighters' cardiac signal was continuously monitored during an average of three shifts within a working week with medical clinically certified equipment (VitalJacket®), which allows for continuous electrocardiogram (ECG) and actigraphy measurement. Psychological data were collected with a software application running on smartphones, collecting potential stressful events, stress symptoms, and stress appraisal. RESULTS: A total of 450.56 h of medical-quality ECG were collected, and heart rate variability (HRV) analysis was performed. Findings suggest that although 'fire' situations are more common, 'accidents' are more stressful. Additionally, firefighters showed high levels of physiological stress (based on AVNN and LF/HF HRV metrics) when compared to normative healthy population values that may not be diagnosed using merely self-reports. DISCUSSION: The proposed ambulatory study seems to be useful for the monitoring of stress levels and its potential impact on health of first responders. Additionally, it could also be an important tool for the design and implementation of efficient interventions and informed management resolutions in real time. Potential applications of this research include the development of quantified occupational health (qOHealth) devices for real life monitoring of emergency personnel stress reactions.

18.
Annu Int Conf IEEE Eng Med Biol Soc ; 2018: 4335-4338, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30441313

RESUMO

Firefighting is a hazardous profession commonly exposed to high stress that can interfere with firefighter's health and performance. Nevertheless, on-duty stress levels quantitative evaluations are very rare in the literature. In order to investigate firefighters' occupational health in terms of stress perceptions, symptoms, and quantified physiological reactions under real-world conditions, an ambulatory assessment protocol was developed. Therefore, cardiac signal from firefighters ($N =6$) was continuously monitored during two shifts within a working week with a medical clinically certified equipment (VitalJacket®), allowing continuous electrocardiogram (ECG) and actigraphy measurement. Psychological data were collected with an android application, collecting potential stressful events, stress symptoms, and stress appraisal. A total of 130 hours of medical-quality ECG were collected, from which heart rate variability (HRV) metrics were extracted and analyzed. Statistical significant differences were found in some HRV metrics - AVNN, RMSSD, pNN50 and LF/HF - between events and non-events, showing higher levels of physiological stress during events (p<0.05). Stress symptoms increase from the beginning to the end of the shift (from 1.54 ± 0.52 to 2.01 ± 0.73), however the mean stress self-perception of events was very low (3.22 ± 2.38 in a scale ranging from 0 to 10). Negative and strong correlations were also found between stress symptoms and some time-domain ECG measures (AVNN, SDNN and pNN50). It can be concluded that stress may not always be detected when using merely self-reports. These results enhance the importance of combining both self-report and ambulatory high-quality physiological stress measures in occupational health settings. Future studies should investigate not only what causes stress but also its impact on health and well-being of these professionals, in order to contribute to the design of efficient stress-management interventions.


Assuntos
Bombeiros , Eletrocardiografia , Frequência Cardíaca , Humanos , Monitorização Fisiológica , Psicofisiologia
19.
Sensors (Basel) ; 18(8)2018 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-30044415

RESUMO

Wearable Health Devices (WHDs) are increasingly helping people to better monitor their health status both at an activity/fitness level for self-health tracking and at a medical level providing more data to clinicians with a potential for earlier diagnostic and guidance of treatment. The technology revolution in the miniaturization of electronic devices is enabling to design more reliable and adaptable wearables, contributing for a world-wide change in the health monitoring approach. In this paper we review important aspects in the WHDs area, listing the state-of-the-art of wearable vital signs sensing technologies plus their system architectures and specifications. A focus on vital signs acquired by WHDs is made: first a discussion about the most important vital signs for health assessment using WHDs is presented and then for each vital sign a description is made concerning its origin and effect on heath, monitoring needs, acquisition methods and WHDs and recent scientific developments on the area (electrocardiogram, heart rate, blood pressure, respiration rate, blood oxygen saturation, blood glucose, skin perspiration, capnography, body temperature, motion evaluation, cardiac implantable devices and ambient parameters). A general WHDs system architecture is presented based on the state-of-the-art. After a global review of WHDs, we zoom in into cardiovascular WHDs, analysing commercial devices and their applicability versus quality, extending this subject to smart t-shirts for medical purposes. Furthermore we present a resumed evolution of these devices based on the prototypes developed along the years. Finally we discuss likely market trends and future challenges for the emerging WHDs area.

20.
J Neuropathol Exp Neurol ; 77(8): 665-672, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29850869

RESUMO

Mitochondrial diseases (MDs) result from alteration of the mitochondrial respiratory chain (MRC) function. Despite the prevalence of MDs in the population, the paucity of animal models available limits the understanding of these disorders. Mutations in SDHA, a gene that codes for the alpha subunit of succinate dehydrogenase (SDH), can cause some forms of MD. SDHA is a crucial contributor to MRC function. In order to expand the range of MD animal models available, we attempted to generate a Sdha knockout rat. Since homozygous Sdha-/- rats could neither be identified in newborn litters, nor as early as embryonic day 14, we evaluated wild-type (WT) and heterozygous Sdha+/- genotypes. No differences in behavioral, biochemical, or molecular evaluations were observed between WT and Sdha+/- rats at 6 weeks or 6 months of age. However, 30% of Sdha+/- rats displayed mild muscle fiber atrophy with rare fibers negative for cytochrome oxidase and SDH on histochemical staining. Collectively, our data provide additional evidence that modeling SDH mutations in rodents may be challenging due to animal viability, and heterozygous rats are insufficiently symptomatic at a phenotypic and molecular level to be of significant use in the study of SDH deficiency.


Assuntos
Complexo II de Transporte de Elétrons/genética , Complexo II de Transporte de Elétrons/metabolismo , Força da Mão/fisiologia , Músculo Esquelético/metabolismo , Músculo Esquelético/patologia , Animais , DNA Mitocondrial/genética , DNA Mitocondrial/metabolismo , Complexo II de Transporte de Elétrons/análise , Técnicas de Inativação de Genes/métodos , Masculino , Músculo Esquelético/química , Ratos , Ratos Transgênicos
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