Invasive dynamic electrical impedance myography during 100 s of moderate contraction in rats' gastrocnemius muscle.

GOAL: The present study aimed to investigate the behavior of dynamic electrical impedance myography (dEIM) signals during a 100-s period of the dynamic contraction of Wistar rats' gastrocnemius evoked by electrical stimulation and to link the variations in bioimpedance with muscular energy systems. METHODS: Muscle contraction used 30% of the maximum muscular force and persisted for 100 s, along which dynamic bioimpedance signals were acquired. Based on the bioimpedance signals, two parameters, ΔZc and ΔZpc, were calculated to allow the analysis of their changes with the energy systems that supplied adenosine triphosphate (ATP) to the muscle. ΔZc indicated the variation of impedance of a twitch cycle compared to the values observed during the rest period preceding the cycle, and ΔZpc indicated slow bioimpedance variations compared to the values obtained during the rest period. RESULTS: The results indicated that ΔZc followed the force behavior, achieving a change rate of ∼14%. This parameter was associated with instantaneous impedance changes owing to the occurrence of each twitch. CONCLUSION: Although the findings of this study were linked to energy system processes, future studies are required for improving the understanding of the underlying mechanisms involved in dEIM. SIGNIFICANCE: The results contributed to understanding the relation of energy systems that supply ATP to the muscles with dEIM variations that occurred during muscle activity.

Supervised exercise with or without laser-guided feedback for people with non-specific chronic low back pain. A randomized controlled clinical trial.

BACKGROUND: Among the most effective therapeutic interventions in non-specific chronic low back pain (NSCLBP), clinical practice guidelines highlight exercise therapy and patient education; However, regarding the combined intervention of exercise and Pain Neuroscience Education (PNE), there is no consensus on the most effective form of exercise. OBJETIVE: To find out what changes occurred after the application of two exercise modalities [Supervised Exercise (SE) and Laser-Guided Exercise (LGE)] and PNE on pain, pain pressure thresholds, disability, catastrophizing, kinesiophobia and lumbar proprioception in subjects with NSCLBP. METHODS: Single-blind randomized clinical controlled trial. 60 subjects with NSCLBP. Both groups performed a a total of 16 therapeutic exercise sessions and 8 Pain Neuroscience Education sessions. With the Laser-Guided Exercise Therapy group performing laser-guided exercises. RESULTS: A significant decrease was observed for pain intensity for both groups between baseline and post-intervention and the 3 month follow-up (p < 0.001). There was a significant between-group difference between baseline and post-intervention scores in terms of pain intensity and kinesiophobia in favour of the LGE group. CONCLUSION: Supervised exercise with or without laser feedback, when combined with PNE, reduces pain intensity, disability, pain catastrophizing, kinesiophobia and improves proprioception and PPTs in patients with NSCLBP. At a 3-month follow-up, the combination of LGE plus PNE is most effective for reducing pain intensity.

Iron oxide/hydroxide-nitrogen doped graphene-like visible-light active photocatalytic layers for antibiotics removal from wastewater.

Hybrid layers consisting of Fe oxide, Fe hydroxide, and nitrogen doped graphene-like platelets have been synthesized by an eco-friendly laser-based method for photocatalytic applications. The complex composite layers show high photodecomposition efficiency towards degradation of antibiotic molecules under visible light irradiation. The photodecomposition efficiency was investigated as a function of relative concentrations of base materials, Fe oxide nanoparticles and graphene oxide platelets used for the preparation of target dispersions submitted to laser irradiation. Although reference pure Fe oxide/Fe hydroxide layers have high absorption in the visible spectral region, their photodecomposition efficiency is negligible under the same irradiation conditions. The high photocatalytic decomposition efficiency of the nanohybrid layer, up to 80% of the initial antibiotic molecules was assigned to synergistic effects between the constituent materials, efficient separation of the electron-hole pairs generated by visible light irradiation on the surface of Fe oxide and Fe hydroxide nanoparticles, in the presence of conducting graphene-like platelets. Nitrogen doped graphene-like platelets contribute also to the generation of electron-hole pairs under visible light irradiation, as demonstrated by the photocatalytic activity of pure, reference nitrogen doped graphene-like layers. The results also showed that adsorption processes do not contribute significantly to the removal of antibiotic molecules from the test solutions. The decrease of the antibiotic concentration under visible light irradiation was assigned primarily to photocatalytic decomposition mechanisms.

Efectos posturales inmediatos de la amplificación mecanoceptiva en niños con disfunciones neuromotrices, valorados mediante una plataforma de presiones Wii Balance Board. Estudio consecutivo no controlado / Immediate postural effects of mechanoceptive amplification in children with neuromotor dysfunctions, assessed by means of a Wii Balance Board pressure platform. Uncontrolled consecutive study

Introducción: Los trastornos neurológicos son una causa frecuente de discapacidad infantil. Las disfunciones neuromotrices se afrontan clínicamente en la actualidad mediante tratamientos ortopédicos, farmacológicos y fisioterápicos. Las vibraciones terapéuticas son estudiadas para conocer sus efectos tróficos y neuromoduladores. Objetivo: Observar los cambios relacionados con el control postural en casos de disfunción neuromotriz infantil después de la aplicación de estímulos vibratorios ecológicos, medidos con una plataforma de fuerzas. Pacientes y métodos: Estudio consecutivo no controlado. Quince sujetos con discapacidad motora y edad media 9±3,4 años fueron valorados en bipedestación estática mediante la plataforma Wii Balance Board antes y después de una única dosis de amplificación mecanoceptiva (AM). Se analizaron variables del centro de presiones: posición media, excursión media, amplitud y recorrido. Resultados: La posición media conjunta del centro de presiones pre-AM se encontraba más alejada del centro anatómico en el eje frontal que en el sagital de manera estadísticamente significativa (p=0,041) y mostraron recorridos mediolaterales del centro de presiones significativamente más largos (p=0,001) que los anteroposteriores. Post-AM hubo aumentos significativos para la variables excursión media total (p=0,015), amplitud en eje frontal (p=0,010), y recorrido tanto en el total (p=0,005) como en los parciales de ambos ejes frontal (p=0,006) y sagital (p=0,004). A la observación, la posición sagital media conjunta se retrasó mientras que la posición frontal media conjunta se aproximó hacia el centro, con elevada correlación entre reubicación y excursión y entre amplitud y recorrido. Conclusión: Los sujetos obtuvieron un reequilibrio postural tendente hacia la posteriorización y hacia el miembro inferior estimulado después de la AM. (AU)

Introduction: Neurological disorders are a common cause of child disability. Neuromotor dysfunctions are currently being clinically faced through orthopedic, pharmacological and physiotherapeutic treatments. Therapeutic vibrations are studied to know their trophic and neuromodulator effects. Objective: To observe the changes related to postural control in cases of infantile neuromotor dysfunction after the application of ecological vibratory stimuli, measured with a force platform. Patients and methods: Consecutive uncontrolled study. 15 subjects with motor disabilities and a mean age of 9±3.4 years were assessed in static standing using the Wii Balance Board platform before and after a single dose of mechanoceptive amplification (AM). Variables of the center of pressures were analyzed: mean position, mean excursion, amplitude and path length. Results: The pre-MA center of pressures mean position of the ensemble was further from the anatomical center on the frontal axis than on the sagittal axis in a statistically significant way (p=.041) and subjects showed significantly longer mediolateral path lengths of the center of pressures (p=.001) than the anteroposterior path lengths. Post-AM there were significant increases for the total mean excursion variable (p=.015), for the amplitude on the frontal axis (p=.010), and for the path length both in the total (p=.005) as in the partials of axes frontal (p=.006) and sagittal (p=.004). At the observational level, the mean sagittal position of the ensemble was posteriorized while the mean frontal position of the ensemble approached toward the center, with a high correlation between relocation/excursion and amplitude/path length. Conclusion: The subjects obtained a postural rebalancing tending toward posteriorization and toward the stimulated lower limb after MA. (AU)

Portomesenteric vein thrombosis following sleeve gastrectomy: Case report focusing on the role of pathogenetic factors.

INTRODUCTION: Sleeve gastrectomy has currently become the most commonly performed bariatric. procedure worldwide according to the last IFSO survey, overtaking gastric bypass with. a share of more than 50% of all primary bariatric-metabolic surgery. Gastric leak, intraluminal bleeding, bleeding from the staple-line and strictures are the most common complications. Portomesenteric vein thrombosis (PMVT)after sleeve gastrectomy is. another complication that has been increasingly reported in case-series in recent.years, although it remains uncommon. In this case report is described an extended portomesenteric vein thrombosis after. sleeve gastrectomy interesting splenic vein too with a favorable course and an. uneventful follow-up. We try to search in this case for pathogenetic factors involved in. this complication. CASE REPORT: A 42-year old man, with a body mass index (BMI) of 45 kg/m2, with a medical history of Obstructive Sleep Apnea Sindrome (OSAS) underwent laparoscopic sleeve gastrectomy. Early postoperative course was uneventful. Six days after discharge he complained abdominal pain and was admitted at the Emergency Department. A CT scan with intravenous contrast showed an occlusion of the portal vein, of the intrahepatic major branches and an extension to the superior mesenteric vein and the splenic vein. The patient received heparin and oral anticoagulation together with intravenous hydration and proton pump inhibitors. Considering the favourable course the patient was discharged after six days with long-term oral anticoagulation therapy. Anticoagulation with acenocumarol was continued for six months after a CT scan showed resolution of the PMVT without cavernoma. He had no recurrence of symptoms. DISCUSSION: Porto-mesenteric thrombosis after sleeve gastrectomy is a rare complication but it has been increasingly reported over the last 10 years along with the extensive use of sleeve gastrectomy. Because PMVT is closely associated with sleeve gastrectomy in comparison with other bariatric procedures, we need to investigate what pathogenetic factors are involved in sleeve gastrectomy. Thrombophylic state, prolonged duration of surgery, high levels of pneumoperitoneum, thermal injury of the gastroepiploic vessels during greater curvature dissection, high intragastric pressure, inadequate antithrombotic prophylaxis and delayed mobilization of the patient after surgery have been reported as pathogenetic factors of portmesenteric vein thrombosis. Most of the cases presented in the literature such as our clinical case resolve with medical therapy, although portal vein thrombus extends into the superior mesenteric vein and the splenic vein. CONCLUSION: Portomesenteric venous thrombosis is a rare but serious complication of bariatric surgery, especially associated with sleeve gastrectomy. Diagnosis is based on CT examination with intravenous contrast, and initial therapy is anticoagulation. Etiologic factors reported in the literature include a long duration of surgery, a high degree of pneumoperitoneum, high intragastric pressure after sleeve gastrectomy and thermal injury to the short gastric vessels and gastroepiploic arcade. Limited operative time, controlled values of pneumoperitoneum, careful dissection with energy device of gastric greater curvature, appropriate prophylaxis with low molecular weight heparin may be useful tools to prevent and limit this complication. Nonetheless we have to search which factors may condition the evolution of an extended PMVT as that described in this case towards resolution or to a further worsening clinical state. Early diagnosis? Correct treatment? Undiscovered patientrelated factors?

Biomass production, metal and nutrient content in sorghum plants grown on soils amended with sewage sludge.

Sludge generation from wastewater treatment plants in Uruguay has increased in recent years. Agricultural soils may be a final destination. A greenhouse experiment was conducted to quantify the effect of this sludge on 1) plant biomass production and nutrient concentration of sorghum (Sorghum bicolor var. vulgare); 2) the chemical properties of amended soils; and 3) assess whether heavy metal concentrations in sludge are appropriate according to environmental regulations. Two soils (S1 and S2) were amended with pure sludge (PS) and limed sludge (LS), with low dose (LD) of 16.0 and 17.3 Mg ha-1 and high dose (HD) of 32.0 and 34.6 Mg ha-1, respectively. Sludge treatments increased plants' nutrient absorption and dry matter production. The LS treatments incremented plant biomass production, depending on soil pH and nutrient availability. The effect of sludge treatments on elemental concentration in aboveground biomass depended on the element, treatments, and soil type. Mineralized nitrogen (N) and plant available phosphorus (P-Bray 1) values increased with sludge addition without exceeding Uruguay's critical soil level of P-Bray 1 for the sorghum crop. The PS did not increase metal concentration in soils. The LS slightly decreased soil Pb and slightly increased Cr and Zn soil concentration; levels were according to Uruguayan environmental guidelines. Therefore, agriculture soils are a viable final destination for PS and LS. Land applied sludge has acceptable levels of metals and promotes crop development.

Invasive electrical impedance myography at different levels of contraction of gastrocnemius muscle of rat.

Electrical impedance myography (EIM) is as an experimental technique that associates muscle impedance with muscular activity. Changes in muscle impedance during contraction occur mainly due to changes in the morphological and physiological characteristics of muscles that lead to different impeditivities in comparison with the resting condition. There is no consensus on the details of muscular impedance during muscle activity. EIM measurements on humans are also influenced by factors such as the electrode-skin interface, layers of skin and fat, and the connective tissue that can generate undesirable effects in the impedance signal. These effects can be avoided if EIM measurements are carried out directly on the muscle by using the models of animals. This study investigates changes in the EIM signal in the gastrocnemius muscles of Wistar rats during different levels of muscular contraction. In vivo experiments were conducted on 19 male rats. The muscle was exposed, fixed on a load cell, and electrically stimulated to evoke different levels of muscle contraction. Signals of the components of impedance were analyzed against the muscular force signal. The results show moderate correlations (p < 0.05) among the impedance-related parameters of resistance (r = -0.76), reactance (r = 0.57), and phase (r = 0.53). In addition to providing an experimental protocol for the invasive collection of data on electrical impedance to minimize problems associated with surface electrodes, this study shows that of the components of impedance, resistance is most affected by the intensity of muscular contractions and that morphological changes influence impedance mainly at low intensities.

New fabrication method for producing reduced graphene oxide flexible electrodes by using a low-power visible laser diode engraving system.

The fabrication of bendable electronic devices is a scientific-technological area of very rapid advance in which new materials and fabrication techniques are being continuously developed. In these kinds of devices, the fabrication of flexible conductive electrodes adherent to the substrate is a key factor. Further, eco-friendliness, low cost and fast production are essential requirements for the successful progress of new technologies. In this work, a novel method for obtaining graphene-based flexible electrodes is presented. Conductive films were obtained by means of the visible laser irradiation of graphene oxide layers deposited on polyethylene terephthalate substrates and self-standing membranes sandwiched between glass slides. Despite the low power of the laser system, the numerical simulations indicate the development of temperatures over 1000 K throughout the irradiated material. The laser-induced spatially confined heating leads to the reduction of the graphene oxide material, whereas the glass-based sandwich assembly avoids reoxidation from the surrounding air. By scanning and pixelated modes, reduced graphene oxide electrodes, up to 100 µm in thickness, and with a resistivity as low as 6 × 10-4 Ωm, were obtained in an easy and versatile way. Proof-of-concept microsupercapacitors and electrochemical sensors were fabricated with this technique, showing promising performance.

Efectos de una amplificación mecanoceptiva mediante microvibraciones funcionales sobre la distribución de los apoyos en bipedestación en un niño con parálisis cerebral. Estudio de caso / Effects of a mecanoceptive amplification using functional micro-vibrations on the distribution of standing supports in a child with cerebral palsy. Case study

INTRODUCCIÓN: La causa más prevalente de discapacidad infantil es la parálisis cerebral. Se ha demostrado que la terapia vibratoria tiene efectos beneficiosos sobre el control postural, siendo una de las limitaciones en la parálisis cerebral infantil. Su valoración nos permite así orientar las intervenciones terapéuticas. El objetivo de este estudio fue determinar la eficacia terapéutica de las microvibraciones funcionales sobre la estabilidad y los apoyos en bipedestación. MATERIAL Y MÉTODO: Aplicación durante 3 meses, a un niño de 6 años con tetraparesia distónica, de un protocolo de intervención mediante un dispositivo Mecanoamplificador un día a la semana mientras caminaba 15 min. Se realizó una valoración postural pre- y postintervención mediante una plataforma de fuerzas portátil Wii Balance Board. RESULTADOS: Se observaron modificaciones en indicadores de estabilidad postural que sugieren mejoras inmediatas y acumuladas. CONCLUSIÓN: La amplificación mecanoceptiva podría incorporarse como una terapia eficaz sobre el control postural deficitario en la parálisis cerebral

INTRODUCTION: Cerebral palsy is the most prevalent cause of disability in childhood. It has been shown that vibration therapy has beneficial effects on postural control, being one of the limitations in cerebral palsy. Its assessment can help to guide therapeutic interventions. The aim of this study is to determine the therapeutic efficacy of functional micro-vibrations on the stability and on the supports in the standing position. MATERIAL AND METHOD: An intervention protocol was applied for three months to a 6-year-old boy with dystonic tetraparesis, by means of a Mechano-amplifier device one day a week while walking for 15 min. A pre- and post-intervention postural assessment was carried out using a portable Wii Balance Board platform. RESULTS: Changes were observed in indicators of postural stability that suggested immediate and accumulated improvements. CONCLUSIÓN: Mecanoceptive amplification could be incorporated as an effective therapy on postural deficit control in cerebral palsy

Smoking and diabetes: dangerous liaisons and confusing relationships.

The combined harmful effects of cigarette smoking and hyperglycemia can accelerate vascular damage in patients with diabetes who smoke, as is well known. Can smoking cause diabetes? What are the effects of smoking on macro and microvascular complications? Now growing evidence indicates that regular smokers are at risk of developing incident diabetes. Since the prevalence rates of smoking in patients with diabetes are relatively similar to those of the general population, it is essential to address the main modifiable risk factor of smoking to prevent the onset of diabetes and delay the development of its complications. Quitting smoking shows clear benefits in terms of reducing or slowing the risk of cardiovascular morbidity and mortality in people with diabetes. Does quitting smoking decrease the incidence of diabetes and its progression? What are the effects of quitting smoking on complications? The current evidence does not seem to unequivocally suggest a positive role for quitting in patients with diabetes. Quitting smoking has also been shown to have a negative impact on body weight, glycemic control and subsequent increased risk of new-onset diabetes. Moreover, its role on microvascular complications of the disease is unclear. What are the current smoking cessation treatments, and which ones are better for patients with diabetes? Stopping smoking may be of value for diabetes prevention and management of the disease and its macrovascular and microvascular complications. Unfortunately, achieving long-lasting abstinence is not easy and novel approaches for managing these patients are needed. This narrative review examines the evidence on the impact of smoking and smoking cessation in patients with diabetes and particularly in type 2 diabetes mellitus and its complications. In addition, management options and potential future directions will be discussed.

Reeducación postural global en lesiones de hombro. Estudio piloto / Global postural re-education in shoulder injury. Pilot study

Introducción: La reeducación postural global (RPG) implica una serie de movimientos con la participación activa del paciente y se basa en la idea integral del sistema muscular. Debido a la relación del complejo articular con diferentes estructuras se plantea un abordaje de tratamiento con este método. Objetivo: Evaluar los resultados de un tratamiento con el método RPG en lesiones localizadas a nivel del complejo articular del hombro. Metodología: Veinte sujetos fueron divididos en 2 grupos: grupo 1 con sujetos sanos y grupo 2 con pacientes con enfermedad de hombro. Se realizaron 2 valoraciones (pre y postratamiento) y 3 sesiones semanales de 30 min. En cada sesión se realizaron 3 posturas. Resultados: En el grupo 1 se observó una mejora significativa (p < 0,05) en los valores de flexión y rotación externa, en la prueba dedos-suelo y en el test de Schober; el resto de los resultados no mostraron indicios de significación (p > 0,05). En el grupo 2 se obtuvo un aumento de la movilidad del complejo articular del hombro y de movilidad a nivel del raquis dorsal y lumbar, así como una disminución del dolor. Conclusiones: El método RPG podría ser útil para el tratamiento de lesiones localizadas a nivel del complejo articular del hombro, siendo una terapia válida para introducirse dentro del programa de intervención terapéutico en sujetos susceptibles a tratamiento fisioterápico en lesiones de dicho complejo articular y como terapia de prevención y mantenimiento de sujetos sanos

Introduction: Global Postural Re-education (GPR) involves a series of movements with the active participation of the patient and is based on the integral concept of the muscular system. Due to the relationship of the joint complex with different structures, a treatment approach is established using this approach. Objective: To evaluate the results of a treatment of injuries located at the level of the shoulder joint complex using the RPG method. Methodology: A controlled clinical trial was conducted on 20 subjects divided into 2 groups, with Group 1 consisting of healthy subjects, and group 2 with patients who had a shoulder injury. Two evaluations (pre- and post-treatment) were performed, with 3 weekly sessions of 30minutes. Three positions were examined in each session. Results: There was a significant improvement in Group 1 (P < .05) in the values of flexion and external rotation, the finger-floor test, and Schober test. There was no evidence of significance in the other results (P > .05). An increase in shoulder joint complex mobility was obtained in Group 2, with progress in dorsal and lumbar spine, as well as a decrease in pain. Conclusions: The GPR method could be useful to treat injuries that are located at shoulder joint complex level. It seems to be a valid therapy to be introduced into the therapeutic intervention program in susceptible individuals to physical therapy treatment in joint complex injuries, as well as a prevention and maintenance therapy of healthy subjects

Assessment of Alimentación Normal con Ajuste de Insulina (ANAIS), a Spanish version of the DAFNE programme, in people with Type 1 diabetes: a randomized controlled parallel trial.

AIM: To evaluate the effects of Alimentación Normal con Ajuste de Insulina (ANAIS), a group-based, therapeutic education programme for Type 1 diabetes based on a flexible insulin regimen adjusted to the individual's food intake. METHODS: Participants with Type 1 diabetes and HbA1c levels of 53-86 mmol/mol (7-10%) were recruited from outpatient clinics at a tertiary care centre. They were randomized (using opaque, sealed envelopes, with a 2:1 treatment allocation ratio) to attend the training course immediately (immediate ANAIS; intervention group) or a year later (delayed ANAIS; control group). The main outcome was HbA1c level at 1 year. Secondary outcomes included lipid levels, weight, hypoglycaemic events, insulin dose, treatment satisfaction, self-perceived dietary freedom, quality of life and participant-defined goals. RESULTS: A total of 48 participants were assigned to the intervention group and 32 to the control group. Twelve months after completing the training, adjusted HbA1c was not significantly different in the intervention group [64 ± 1.3 vs 68 ± 1.6 mmol/mol (8.0 ±0.1% vs 8.4 ±0.1%); P=0.081]. Treatment satisfaction was significantly higher in the intervention group, but no differences were found in hypoglycaemic events, weight, insulin dose or changes in dietary freedom. At 1 year after the intervention, 72% of the participants (vs 33% in the control group; P=0.046) reported exceeding their expectations regarding achievement of their main personal goal. CONCLUSION: Promoting dietary freedom and empowering people with Type 1 diabetes through structured education programmes, such as ANAIS, improves treatment satisfaction and self-defined goals. No significant improvement in HbA1c level was achieved.

Abordaje fisioterapéutico de la intervención de Latarjet abierta en luxación recidivante anterior de hombro. A propósito de un caso / Physiotherapy approach of the open Latarjet surgery in recurrent anterior shoulder dislocation. A case report

Introducción: Las luxaciones recidivantes de hombro están muy presentes en la población actual. La acción quirúrgica de elección se divide entre la intervención de Bankart o de Latarjet. Objetivo: Describir pautas terapéuticas fisioterápicas de tratamiento en la luxación recidivante de hombro intervenida con la técnica de Latarjet. Material y método: Estudio de caso de un paciente, varón de 38 años, intervenido mediante técnica de Latarjet tras luxación anterior recidivante de hombro, al que se le aplica fisioterapia antiálgica, terapia manual y reeducación muscular. Resultados: El paciente experimentó mejoría en el balance articular (rotación externa 90°/rotación interna 70°) y muscular (5 + men la escala Lovett-Daniels), así como una disminución del dolor (0 en escala EVA) y una mejora en la respuesta miedo/evitación al movimiento. Conclusión: Tras el periodo de recuperación el paciente lleva una evolución favorable, tanto en la actuación rehabilitadora desarrollada como en la estabilidad glenohumeral propuesta por intervención

Introduction: Recurrent shoulder dislocations are very common in the current population. The surgery of choice is divided between the intervention of Bankart or Latarjet. Objective: To describe the physiotherapeutic treatment regimens on the shoulder operated with the Latarjet technique. Material and method: A case study is presented on a 38-year-old male patient, who underwent Latarjet technique after a recurrent anterior dislocation of the shoulder to which antalgic therapy, manual therapy, and muscle re-education were applied. Results: The equilibrium of the joint improved (External rotation 90°/ Internal rotation 70°) and muscle (5 + on the Lovett-Daniels scale) equilibrium. There was also a decrease in pain (0 on the visual analogue scale), and an improvement in the response fear / avoidance to movement. Conclusion: After the recovery period, the patient progressed favourably with the rehabilitation methods, as well as in the glenohumeral stability proposed by intervention

Effects of artificial light on flowering of foredune vegetation.

The impact of ecological light pollution involves alteration of periods of natural light, a fact that has proven effects on ecosystems. Few studies have focused on the impact of this pollution on wild plant species, and none on coastal dune plants. Many coastal dunes and their plants are adjacent to tourist areas, and these might be affected by light pollution. Such is the case of the Natural Reserve Dunas de Maspalomas (Gran Canaria), where some individuals of the plant species Traganum moquinii, located in the El Inglés beach foredune zone, are affected by light pollution. This study examines the effect of light pollution on the flowering process and, by extension, the reproductive cycle of these plants. Plants located closer to high artificial illumination sources receive ~2,120 h/yr of intense light more than plants located furthest from those artificial lighting sources. Parts of the plants of Traganum moquinii exposed directly to the artificial light show a significant decrease in the production of flowers, compared to the parts in plants in shade, and to the plants more distant from artificial lights. In consequence, plants exposed more directly to artificial light have a lower potential for seed reproduction. The spectrum of artificial light also affects the plants, and light between 600 and 700 nm primarily affects the reproductive cycle of the Traganum moquinii species. The implications for the ecological and geomorphological functioning of the dune system are discussed, because this species plays a decisive role in the formation of foredune zones and nebkhas in arid dune systems.

Effect of liraglutide on physical performance in type 2 diabetes: Results of a randomized, double-blind, controlled trial (LIPER2).

AIMS: To assess the effect of the GLP-1 analogue liraglutide on measures of cardiac function and physical performance in patients with type 2 diabetes (T2D). METHODS: In this phase-IV randomized double-blind placebo-controlled parallel-group clinical trial at a tertiary hospital, T2D patients with HbA1c levels of 7-10% with oral agents and/or intermediate-/long-acting insulin were allocated (computer-generated randomization, ratio 1:1) to either liraglutide 1.8 mg/day or a placebo for 6 months. The primary endpoint was maximum oxygen consumption (VO2max) during cycle ergometry, while other procedures included a 6-min walk test, echocardiography, anthropometry and blood tests. Safety endpoints were also monitored, and an intention-to-treat analysis was performed. RESULTS: A total of 24 patients (15 women) aged 52 (11.7) years, with diabetes duration of 8.7 (5.8) years, BMI 34.98 (6.2) kg/m2 and HbA1c 8.2% (0.68%), were randomized to liraglutide 1.8 mg daily or placebo. There were no differences in VO2max [17.98 (4.8) vs. 15.90 (4.96) mL/kg/min; P > 0.10], VE/VCO2 slope [30.18 (4.8) vs. 32 (4.49)], left ventricular ejection fraction or 6-min walk test [530.7 (86) vs. 503.9 (84) m] at 6 months. HbA1c was lower (6.7% vs. 7.7%; P = 0.005), with a trend towards lower maximum systolic blood pressure during ergometry [171.7 (24.4) vs. 192.5 (25.6); P = 0.052] in the liraglutide group at the end of the study. There were no severe adverse events. CONCLUSION: In this trial, liraglutide improved glycaemic control in T2D, but had no significant effects on either physical performance or myocardial function.

Medición del gasto energético en pruebas submáximas de valoración funcional mediante acelerometría / Measurement of energy expenditure in submaximal functional assessment tests through accelerometry

Introducción: La valoración funcional del paciente es un elemento relevante en la práctica clínica prestando atención a la desadaptación al ejercicio como consecuencia del proceso patológico. El grado de desadaptación podemos valorarlo mediante pruebas de campo, como las pruebas ISWT y 6MWT. La acelerometría puede ser una herramienta de utilidad para valorar la actividad física y el consumo energético. El objetivo de este estudio es determinar el gasto energético entre las pruebas de valoración funcional ISWT y 6MWT; analizar las diferencias y el grado de correlación existente entre ellas, teniendo en cuenta el nivel de actividad física de los sujetos. Métodos: Veintiséis sujetos jóvenes sanos realizaron las pruebas ISWT y 6MWT con la colocación de un acelerómetro triaxial en la muñeca que registraba el movimiento. Resultados: Las pruebas ISWT y 6MWT mostraron un consumo distinto para todos los sujetos (p<0,001) y un alto grado de correlación entre ellas (p<0,001) basado en el coeficiente tanto de Pearson como de Spearman. Conclusión: La acelerometría es útil para la medición del gasto energético en pruebas submáximas de valoración funcional, permitiéndonos así relacionar el consumo energético con el nivel de actividad física

Introduction: Functional assessment of patients is a key element of clinical practice because it focuses on impaired adjustment to exercise as a consequence of the pathological process. The degree of impairment can be assessed by field tests such as the incremental shuttle walk test (ISWT) and the 6minute walk test (6MWT). Accelerometry might be a useful tool to evaluate physical activity and energy expenditure. The aim of this study was to determine energy expenditure through the use of ISWT and 6MWT and to analyse the differences and correlation between them, bearing in mind the participants' level of physical activity. Methods: A total of 26 healthy young participants performed the ISWT and 6MWT functional assessment tests while wearing a triaxial accelerometer on their wrists that recorded their movements. Results: The ISWT and 6MWT showed different expenditure levels for each participant (P<.001) and a high correlation between them (P<.001) based on both Pearson and Spearman coefficients. Conclusion: Accelerometry is useful for measuring energy expenditure in submaximal functional assessment tests, allowing us to relate energy consumption to physical activity

Inflammation and ventricular-vascular coupling in hypertensive patients with metabolic syndrome.

BACKGROUND AND AIMS: Metabolic syndrome (MetS) is currently considered to raise the risk for type 2 diabetes and cardiovascular events. It has been suggested that part of this risk excess may be due to a cluster of additional factors associated with MetS. We aimed to investigate the role of inflammation on the ventricular-vascular coupling in patients with MetS. METHODS AND RESULTS: We enrolled a total of 227 hypertensive patients (106 with MetS and 121 without MetS) matched for age and gender. Aortic pulse wave velocity (aPWV), intima-media thickness (IMT) and high sensitivity C-reactive protein (CRP) increased according to the number of MetS components. Patients with MetS showed increased aPWV (11.5 ± 3.7 vs. 10.3 ± 2.5 m/s, P = 0.03) compared with controls. In a model adjusted for age, sex, heart rate and mean blood pressure, aPWV resulted increased in patients with CKD (beta 1.29 m/s, 95%CI 0.61-1.96 m/s, P < 0.001) and MetS (beta 0.89 m/s, 95%CI 0.28-1.51 m/s, P = 0.005). After additional adjustment for CRP and IMT, the slope of aPWV was respectively reduced by 16% and 62%, suggesting that inflammation and intima-media thickening could contribute to aortic stiffening in patients with MetS. In these patients, aPWV was also associated with left-ventricular mass index (beta 0.79 g/m2.7, 95%CI 0.05-1.52 g/m2.7, P = 0.05). CONCLUSION: MetS is characterized by an inflammation-dependent acceleration in cardiovascular ageing. This pattern of pathophysiological abnormalities may contribute to amplify the burden of cardiovascular risk in patients with MetS.

Determination of mercury in hair of children.

Although high or repeated exposure to different forms of Hg can have serious health consequences, the most important toxicity risk for humans is as methylmercury (MeHg) which exposure is mainly through consumption of fish. Generally, more than the 80% of Hg in hair is as MeHg, which is taken up by hair follicles as MeHg-cysteine complexes. In this context, hair samples were collected from 200 children (7 years) living in a coastal site in the North-East (A) of Italy and from 299 children (6-11 years) living in a urban area of South of Italy (B) to determine the levels of MeHg. Considering the neurotoxicity of MeHg, children were subjected to cognitive and neuropsychological tests. The hair values of Hg in the children population groups were comparable with data reported in other international surveys. On the other hand, combining results of the neurological tests with Hg levels, a possible relationship between Hg and an increase of the errors average reported in some neurological tests has been noted. Although the Hg levels were not elevated, a possible neurological influence in children, a population more susceptible than adults, might not be excluded, but the influence on neurological performances of the children could be also due to the family environment (socio economic status, educational level, etc.).

Obstetrical providers' preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study.

OBJECTIVE: To describe obstetrical providers' delivery preferences and attitudes towards caesarean section without medical indication, including on maternal request, and to examine the association between provider characteristics and preferences/attitudes. DESIGN: Cross-sectional study. SETTING: Two public and two private hospitals in Argentina. POPULATION: Obstetrician-gynaecologists and midwives who provide prenatal care and/or labour/delivery services. METHODS: Providers in hospitals with at least 1000 births per year completed a self-administered, anonymous survey. MAIN OUTCOME MEASURES: Provider delivery preference for low-risk women, perception of women's preferred delivery method, support for a woman's right to choose her delivery method and willingness to perform caesarean section on maternal request. RESULTS: 168 providers participated (89.8% coverage rate). Providers (93.2%) preferred a vaginal delivery for their patients in the absence of a medical indication for caesarean section. Whereas 74.4% of providers supported their patient's right to choose a delivery method in the absence of a medical indication for caesarean section and 66.7% would perform a caesarean section upon maternal request, only 30.4% would consider a non-medically indicated caesarean section for their own personal delivery or that of their partner. In multivariate adjusted analysis, providers in the private sector [odds ratio (OR) 4.70, 95% CI 1.19-18.62] and obstetrician-gynaecologists (OR 4.37, 95% CI 1.58-12.09) were more willing than either providers working in the public/both settings or midwives to perform a caesarean section on maternal request. CONCLUSIONS: Despite the ethical debate surrounding non-medically indicated caesarean sections, we observe very high levels of support, especially by providers in the private sector and obstetrician-gynaecologists, as aligned with the high caesarean section rates in Argentina. TWEETABLE ABSTRACT: Non-medically indicated c-section? 74% of sampled Argentine OB providers support women's right to choose.