Miracle-dz/UniFAR-FTUs huggingface dataset:
Utility of Equations to Estimate Peak Oxygen Uptake and Work Rate From a 6-Minute Walk Test in Patients With COPD in a Clinical Setting

PURPOSE: To determine the utility of equations that use the 6-minute walk test (6MWT) results to estimate peak oxygen uptake ( o2) and peak work rate with chronic obstructive pulmonary disease (COPD) patients in a clinical setting. METHODS: This study included a systematic review to identify published equations estimating peak o2 and peak work rate in watts in COPD patients and a retrospective chart review of data from a hospital-based pulmonary rehabilitation program. The following variables were abstracted from the records of 42 consecutively enrolled COPD patients: measured peak o2 and peak work rate achieved during a cycle ergometer cardiopulmonary exercise test, 6MWT distance, age, sex, weight, height, forced expiratory volume in 1 second, forced vital capacity, and lung diffusion capacity. Estimated peak o2 and peak work rate were estimated from 6MWT distance using published equations. The error associated with using estimated peak o2 or peak work to prescribe aerobic exercise intensities of 60% and 80% was calculated. RESULTS: Eleven equations from 6 studies were identified. Agreement between estimated and measured values was poor to moderate (intraclass correlation coefficients = 0.11-0.63). The error associated with using estimated peak o2 or peak work rate to prescribe exercise intensities of 60% and 80% of measured values ranged from mean differences of 12 to 35 and 16 to 47 percentage points, respectively. CONCLUSIONS: There is poor to moderate agreement between measured peak o2 and peak work rate and estimations from equations that use 6MWT distance, and the use of the estimated values for prescription of aerobic exercise intensity would result in large error. Equations estimating peak o2 and peak work rate are of low utility for prescribing exercise intensity in pulmonary rehabilitation programs.
Graded Exercise Testing Versus Simulated Competition Exercise in Trained Older Males

PURPOSE: Exercise-based rehabilitation is a standard therapy for patients with heart disease. Despite examples of patients who have extended normal rehabilitation exercise into competitive participation, there are no clear-cut guidelines for patients whether they should participate in competitive-level exercise. This study investigated the occurrence of complications, physiologic responses, and exercise patterns during simulated competitive exercise in active, older nonathletes (most with a history of cardiovascular disease) and compared these with responses during maximal incremental exercise. METHODS: Fourteen trained older males, 7 with stable cardiovascular disease, performed an incremental exercise test and time trial of 55 kJ (equivalent to running ∼1 mile) on a semirecumbent stepping ergometer. Variables of gas exchange, hemodynamics, perception, and power output were measured in both tests. RESULTS: Subjects attained a remarkably high physiologic and psychologic strain (respiratory exchange ratio >1.0; average peak rating of perceived exertion >8) in both tests, with no evidence of symptomatic, hemodynamic, or electrocardiographic abnormalities. Peak physiologic responses were not significantly different between simulated competition and incremental exercise. The fixed-work time trial was finished in 8.97 ± 1.85 minutes, mean power output of 100 ± 26 W. Results showed a distinct pacing pattern in the relative power output, consisting of a conservative start, an even-paced middle portion, and an end spurt. CONCLUSIONS: Results suggest that in trained individuals with normal incremental exercise test results, competitive-level efforts may be undertaken with no apparent side effects. This may provide a strategy whereby physicians can advise patients concerning their decision to perform in competitive events.
Temporal and spatial distribution of macrophage phenotype markers in the foreign body response to glutaraldehyde-crosslinked gelatin hydrogels

Abstract Currently, it is not well understood how changes in biomaterial properties affect the foreign body response (FBR) or macrophage behavior. Because failed attempts at biomaterial degradation by macrophages have been linked to frustrated phagocytosis, a defining feature of the FBR, we hypothesized that increased hydrogel crosslinking density (and decreased degradability) would exacerbate the FBR. Gelatin hydrogels were crosslinked with glutaraldehyde (0.05, 0.1, and 0.3%) and implanted subcutaneously in C57BL/6 mice over the course of 3 weeks. Interestingly, changes in hydrogel crosslinking did not affect the thickness of the fibrous capsule surrounding the hydrogels, expression of the pan-macrophage marker F480, expression of three macrophage phenotype markers (iNOS, Arg1, CD163), or expression of the myofibroblast marker aSMA, determined using semi-quantitative immunohistochemical analysis. With respect to temporal changes, the level of expression of the M1 marker (iNOS) remained relatively constant throughout the study, while the M2 markers Arg1 and CD163 increased over time. Expression of these M2 markers was highly correlated with fibrous capsule thickness. Differences in spatial distribution of staining also were noted, with the strongest staining for iNOS at the hydrogel surface and increasing expression of the myofibroblast marker aSMA toward the outer edge of the fibrous capsule. These results confirm previous reports that macrophages in the FBR exhibit characteristics of both M1 and M2 phenotypes. Understanding the effects (or lack of effects) of biomaterial properties on the FBR and macrophage phenotype may aid in the rational design of biomaterials to integrate with surrounding tissue.
Mental Health Workers Negotiating Risk on the Frontline

Abstract Following deinstitutionalisation and the shift to models of community care, mental health practice has become increasingly focused on managing the risks posed by service users. However, the effects of risk management on workers’ professional identities have not been investigated empirically in Australia. Drawing on in-depth interviews with mental health workers from Victoria, Australia, this paper explores the diverse ways in which these workers adapted the formal technologies of risk management (e.g., the completion of risk assessment screens) to their professional identities. Some workers experienced risk management technologies as constraining their interventions with clients, while others saw these technologies as providing opportunities to strengthen and enhance their professional skills. Pondering these differences, the author speculates on the emergence of a new form of professional identity in the broader context of contemporary community mental health care.
Comparison between Essential Vocal Tremor and Dystonic Vocal Tremor Treated with Botulinum Toxin and Propranolol

Objectives: Determine and compare the response to treatment with intramuscular botulinum toxin and oral propranolol on vocal tremors, essential and dystonic. Methods: Randomized clinical trial between January 2012 and September 2013. Fifteen patients with vocal tremor were divided into 2 groups: essential and dystonic vocal tremor. Both groups were treated with botulinum toxin in thyroarytenoid muscle (15 units of Dysport unilaterally) and propranolol (80 to 120 mg daily) at different times. Time to “wash out” after injection of 6 months and after propranolol 2 months. Patients underwent self-assessment of vocal improvement, nasofibroscopy larynx, perceptual, and acoustic analysis of voice before and after each treatment. Data were compared according to the type of tremor and treatment and subjected to statistical analysis (significance level of .05). Results: There was statistically significant improvement in perceptual measure of vocal instability in patients with dystonic tremor after treatment with botulium toxin, compared with propranolol (P = .028). The acoustic measurement variabiity of fundamental frequency was also statistically significant, with a decrease in the treatment of dystonic tremor in connection with the botulinum toxin compared with propranolol (P = .05) and before treatment (P = .011). Conclusions: The dystonic and essential tremors differ in responses to treatment. The dystonic tremor responds positively to the injection of botulinum toxin into the thyroarytenoid muscle, but not to the use of oral propranolol.
Progression of Exercise Training in Early Outpatient Cardiac Rehabilitation: AN OFFICIAL STATEMENT FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION

Aerobic and resistance exercise training is a cornerstone of early outpatient cardiac rehabilitation (CR) and provides impressive benefits for patients. The components of the exercise prescription for patients with cardiovascular diseases are provided in guideline documents from several professional organizations and include frequency (how many sessions per week); intensity (how hard to exercise); time (duration of the exercise training session); type (modalities of exercise training); volume (the total amount or dose of exercise); and progression (the rate of increasing the dose of exercise). The least discussed, least appreciated, and most challenging component of the exercise prescription for CR health care professionals is the rate of progression of the dose of exercise. One reason for this observation is the heterogeneity of patients who participate in CR. All components of the exercise prescription should be developed specifically for each individual patient. This statement provides an overview of the principles of exercise prescription for patients in CR with special emphasis on the rate of progression. General recommendations for progression are given and patient case examples are provided to illustrate the principles of progression in exercise training.
Supervision in Occupational Therapy, Part 2: The Supervisee's Dilemma

The first paper (Sweeney et al 2001) in this series of three on supervision in occupational therapy reported the views and experiences of occupational therapy supervisors. In contrast to the supervisor experience, where there remains a paucity of evidence in the general literature, the clinician as supervisee has been relatively well explored. However, the literature on the experiences of the occupational therapy supervisee is virtually nonexistent. This paper, the second in the series, describes a grounded theory study which set out to explore the process of first-line supervision from the perspective of the novice occupational therapy supervisee (those employed at basic grade and senior II levels). Data collection took the form of semi-structured, one-to-one interviews with 30 female supervisees, who were drawn from a wide range of clinical specialties within the National Health Service in the South West of England. The findings suggested that there existed a large gap between what many of the supervisees expected from supervision and what they actually received. In addition, there was evidence that the typical supervisee entered the supervision process with the aim of presenting a professional face to her supervisor and to the wider health care team and that she did this to protect her fragile sense of competence. Many supervisees employed a range of covert strategies within the supervision setting in order to facilitate the presentation of a professional face. The use of this approach carried with it a number of risks and benefits for the supervisee. The final paper in the series will discuss the implications of these two studies of supervisor and supervisee experience in order to distil recommendations for the future practice of supervision within the profession.
Construction of a PLGA based, targeted siRNA delivery system for treatment of osteoporosis

Abstract Osteoporosis, a systemic skeletal disorder, occurs when bone turnover balance is disrupted. With the identification of the genes involved in the pathogenesis of the disease, studies on development of new treatments has intensified. Short interfering RNA (siRNA) is used to knockdown disease related gene expressions. Targeting siRNA in vivo is challenging. The maintenance of therapeutic plasma level is hampered by clearance of siRNA from the body. Targeted systems are useful in increasing the drug concentration at the target site and decreasing side effects. Aim of the present study was to develop an injectable siRNA delivery system to protect siRNA during systemic distribution and target the siRNA to bone tissue using a thermoresponsive, genetically engineered, elastin-like recombinamer (ELR), designed to interact with the mineral component of bone. The delivery system consisted of DNAoligo as a siRNA substitute complexed with the cationic polymer, polyethyleneimine (PEI), at N/P ratio of 20. The complex was encapsulated in poly(lactic acid-co-glycolic acid) (PLGA) nanocapsules. PLGA capsules were characterized by SEM, TEM and XPS. FTIR was used to show the preferential attachment of ELR to HAp. Encapsulation efficiency of the complex in PLGA nanocapsules was 48%. The release kinetics of the complex fits the Higuchi release kinetics.
Prevalence of Obstructive Sleep Apnea in a Patient Population Undergoing Cardiac Rehabilitation

OBJECTIVES: The primary objective of this study was to determine the prevalence of undiagnosed or untreated obstructive sleep apnea (OSA) in patients undergoing cardiac rehabilitation. METHODS: A total of 132 consecutive patients were screened by Berlin Questionnaire to determine the presence or absence of OSA. RESULTS: Fourteen patients did not consent to participate. Of the remaining 118 patients, 20 (17%) were found to have a preexisting formal diagnosis of OSA. Of the remaining 98 patients (69 males and 29 females), 43 (44%) were found to have a high probability of OSA as predicted by the Berlin Questionnaire. There was no significant difference in the prevalence (P < .05) between males (29/69, 42%) and females (14/29, 48%) who were predicted to have OSA. Similarly, no significant differences were observed in the ages or body mass index between OSA and non-OSA patients. A significantly greater frequency (P < .05) of coronary artery disease was observed in the OSA group than in the non-OSA group. CONCLUSIONS: Overall, the rate of preexisting and predicted OSA (53%) suggests a high prevalence of OSA in patients with cardiovascular diseases in a cardiac rehabilitation setting. Moreover, the high rate of undiagnosed OSA, as suggested by the Berlin Questionnaire, further adds to the growing literature that a large number of patients with significant cardiovascular disease carry the burden of sleep disordered breathing.
The Independent Effect of Traditional Cardiac Rehabilitation and the LEARN Program on Weight Loss: A COMPARATIVE ANALYSIS

INTRODUCTION: Despite its numerous other benefits, cardiac rehabilitation (CR) has not consistently proven to be an effective, although much needed, intervention for weight loss in the cardiovascular disease (CVD) population. Comparatively, the LEARN (Lifestyle, Exercise, Attitudes, Relationships, Nutrition) program appears to be an effective intervention for weight loss. The purpose of the present investigation was to compare changes in body weight in a CVD cohort consecutively participating in traditional CR and the LEARN program. METHODS: Forty-four patients diagnosed with CVD (22 men/22 women) participated in a 12-week multidisciplinary CR program. All patients successfully completed the LEARN program following CR. Body mass index (BMI) and body weight were recorded immediately prior to and following both CR and LEARN. RESULTS: The peak metabolic equivalents were significantly higher following CR (7.3 ± 1.6 vs 8.5 ±1.6, P < .001), while body weight (203.5 ± 32.6 vs 201.8 ± 32.5 lbs, P > .10) and BMI (32.1 ±4.0 vs 31.8 ±3.9 kg/m2, P > .05) were unchanged. All subjects then successfully completed the LEARN program, participating in an average of 10 sessions. There was a significant reduction in body weight (203.3 ± 30.7 vs 190.1 ± 30.4 lbs, P < .001) and BMI (32.0 ± 3.9 vs 29.5 ±3.8 kg/m2, P < .001) following the LEARN program. DISCUSSION: Our results support the independent value of the LEARN program in eliciting weight loss for CR patients. Clinicians delivering CR services should consider integrating a focused weight loss program, such as LEARN, into their usual CR programs.
Design of dual-mode dual-band bandpass filters with controllable frequencies for multimode wireless communication applications

A flexible approach for designing dual-mode dual-band bandpass filters with controllable passband frequencies is presented. Two dual-mode dual-band bandpass filters are proposed for experimental verification. The first filter, whose two passbands are centered at 3.4 and 5.5 GHz with the corresponding fractional bandwidth of 19 and 13%, respectively, is suitable for the applications of worldwide interoperability for microwave access (WiMAX) and wireless local area network. The second filter, whose two passbands are centered at 4 and 7.4 GHz with the corresponding fractional bandwidth of 25 and 13%, respectively, is suitable for the downlink of C-band and X-band satellite communication systems. Both filters have been designed, fabricated, and measured. The measured results show good agreements with those of the simulation.
Long-term Results of a 12-Week Comprehensive Ambulatory Cardiac Rehabilitation Program

PURPOSE: To evaluate the long-term outcome of a 12-week outpatient cardiac rehabilitation (CR) program. METHODS: In a prospective single-center interventional cohort study, 201 consecutive patients (133 patients after acute coronary syndrome, 32 patients after heart surgery, and 36 patients with heart failure) attending a 12-week comprehensive outpatient CR program were evaluated for exercise capacity, cardiovascular risk factors (CvRFs), and quality of life at entry, end, and 1.4 years after completion of the program (followup). RESULTS: Physical exercise capacity improved significantly from program entry to program end and remained at this level at followup (P ⩽ .006). CvRFs at followup were significantly reduced with regard to smoking prevalence and blood lipids (P < .001). At program end and followup, MacNew heart disease–specific emotional, physical, and social quality of life were improved significantly compared with those at program entry (P < .001). Use of cardioprotective medication remained equally high over the entire study period. However, significantly fewer patients reached blood pressure (<140/90 mm Hg, P = .034) and body mass index (<30 kg/m2, P = .017) goals at followup than at program end. CONCLUSION: The 12-week comprehensive outpatient CR program was successful at reducing important CvRFs long-term.
Pulmonary Rehabilitation Exercise Prescription in Chronic Obstructive Lung Disease: US SURVEY AND REVIEW OF GUIDELINES AND CLINICAL PRACTICES

Chronic obstructive pulmonary disease is a common, progressive disorder associated with disabling symptoms, skeletal muscle dysfunction, and substantial morbidity and mortality. Current national guidelines recommend pulmonary rehabilitation (PR) to improve dyspnea, functional capacity, and quality of life. Many PR exercise programs are based on guidelines from the American College of Sports Medicine. Recommendations have also been published by the American Association of Cardiovascular and Pulmonary Rehabilitation and the American Thoracic Society. Translating exercise science into effective training and clinical care requires interpretation and the use of diverse national PR guidelines and recommendations. Pulmonary rehabilitation clinicians often vary in their education and background, with most nurses and respiratory care practitioners lacking formal training in exercise physiology. Patients often have comorbidities that may further complicate exercise provision and prescription. This article describes the results of an informal, nonscientific survey of the American Association of Cardiovascular and Pulmonary Rehabilitation members exploring current PR exercise prescription practices as a basis for discussion and reviews current national exercise recommendations for chronic obstructive pulmonary disease. Further, it describes areas of uncertainty regarding exercise prescription in PR and suggests strategies for providing effective exercise training, given the diversity of guidelines, clinician preparedness, and patient complexity.
Submissão às recomendações do BI-RADS™ por médicos e pacientes: análise preliminar de 3.000 exames realizados em uma clínica particular

The Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology is a system designed to standardize mammography reports, to reduce breast imaging misinterpretations and to facilitate monitoring of the outcome. OBJECTIVE: To identify the compliance of women and physicians with BI-RADS recommendations in Goiânia, GO, Brazil. MATERIALS AND METHODS: 3,000 women submitted to mammography examinations in a private clinic in Goiânia (January to December, 2002) were evaluated. The mammograms were reported according to BI-RADS classification. Women classified as categories 0, 3, 4 and 5 were followed up by telephone. RESULTS: Women who refused to follow the recommendation: category 0 (11.5%), 3 (13.8%), 4 (28%), 5 (0%). Physician failure to advise the patient to follow the recommendation: category 0 (18.2%), 3 (17%), 4 (20%). Women who complied with BI-RADS recommendation: category 0 (1.8%), 3 (5.7%), 4 (40%), 5 (100%). Contact lost during the follow-up: category 0 (68.5%), 3 (39%), 4 (12%). CONCLUSION: The level of compliance with BI-RADS recommendations was low in categories 0 and 3, and moderate in category 4. About 30% of women classified as category 0 did not undergo additional imaging evaluations either because of their refusal or lack of adequate physician advice.
Núcleos de Apoio à Saúde da Família: desafios e potencialidades na visão dos profissionais da Atenção Primária do Município de São Paulo, Brasil

Family Health Support Centers (NASF) were created in Brazil to increase the case-resolution capacity of primary healthcare. Prior to their implementation in the West Side of the city of Sao Paulo, Brazil, a series of workshops were held for primary healthcare professionals to prepare a proposal for such centers. Hermeneutic analysis was used to study the transcribed material. The thematic categories were: role, constitution, and functioning of the NASF, relationship with family health teams, and interdisciplinarity. The participants' expected the NASF to be an empowering device for comprehensiveness of care, intervening in an existing culture of unnecessary referrals while fostering linkage with other levels of care. The participants also expected the NASF to contribute to the discussion on health professionals' training and stimulating reflection with policymakers on health indicators based exclusively on the number of consultations. These indicators fail to reflect the impact on the services' activities and the quality of care offered to the population in the coverage area.