4-Second Exercise Test: Reference Values for Ages 18–81 Years

Background: Physiological reflexes modulated primarily by the vagus nerve allow the heart to decelerate and accelerate rapidly after a deep inspiration followed by rapid movement of the limbs. This is the physiological and pharmacologically validated basis for the 4-s exercise test (4sET) used to assess the vagal modulation of cardiac chronotropism. Objective: To present reference data for 4sET in healthy adults. Methods: After applying strict clinical inclusion/exclusion criteria, 1,605 healthy adults (61% men) aged between 18 and 81 years subjected to 4sET were evaluated between 1994 and 2014. Using 4sET, the cardiac vagal index (CVI) was obtained by calculating the ratio between the duration of two RR intervals in the electrocardiogram: 1) after a 4-s rapid and deep breath and immediately before pedaling and 2) at the end of a rapid and resistance-free 4-s pedaling exercise. Results: CVI varied inversely with age (r = -0.33, p < 0.01), and the intercepts and slopes of the linear regressions between CVI and age were similar for men and women (p > 0.05). Considering the heteroscedasticity and the asymmetry of the distribution of the CVI values according to age, we chose to express the reference values in percentiles for eight age groups (years): 18–30, 31–40, 41–45, 46–50, 51–55, 56–60, 61–65, and 66+, obtaining progressively lower median CVI values ranging from 1.63 to 1.24. Conclusion: The availability of CVI percentiles for different age groups should promote the clinical use of 4sET, which is a simple and safe procedure for the evaluation of vagal modulation of cardiac chronotropism.

New Exercise-Dipyridamole Combined Test for Nuclear Cardiology in Insufficient Effort: Appropriate Diagnostic Sensitivity Keeping Exercise Prognosis

AbstractBackground:Myocardial perfusion scintigraphy (MPS) in patients not reaching 85% of the maximum predicted heart rate (MPHR) has reduced sensitivity.Objectives:In an attempt to maintain diagnostic sensitivity without losing functional exercise data, a new exercise and dipyridamole combined protocol (EDCP) was developed. Our aim was to evaluate the feasibility and safety of this protocol and to compare its diagnostic sensitivity against standard exercise and dipyridamole protocols.Methods:In patients not reaching a sufficient exercise (SE) test and with no contraindications, 0.56 mg/kg of dipyridamole were IV administered over 1 minute simultaneously with exercise, followed by 99mTc-MIBI injection.Results:Of 155 patients, 41 had MPS with EDCP, 47 had a SE test (≥ 85% MPHR) and 67 underwent the dipyridamole alone test (DIP). They all underwent coronary angiography within 3 months. The three stress methods for diagnosis of coronary lesions had their sensitivity compared. For stenosis ≥ 70%, EDCP yielded 97% sensitivity, SE 90% and DIP 95% (p = 0.43). For lesions ≥ 50%, the sensitivities were 94%, 88% and 95%, respectively (p = 0.35). Side effects of EDCP were present in only 12% of the patients, significantly less than with DIP (p < 0.001).Conclusions:The proposed combined protocol is a valid and safe method that yields adequate diagnostic sensitivity, keeping exercise prognostic information in patients unable to reach target heart rate, with fewer side effects than the DIP.

evaluation framework for software test processes

Magdeburg, Univ., Fak. für Informatik, Diss., 2009

Cardiac Autonomic Adjustments During Baroreflex Test in Obese and Non-Obese Preadolescents

Abstract Background: Recent studies have shown changes in cardiac autonomic control of obese preadolescents. Objective: To assess the heart rate responses and cardiac autonomic modulation of obese preadolescents during constant expiratory effort. Methods: This study assessed 10 obese and 10 non-obese preadolescents aged 9 to 12 years. The body mass index of the obese group was between the 95th and 97th percentiles of the CDC National Center for Health Statistics growth charts, while that of the non-obese group, between the 5th and 85th percentiles. Initially, they underwent anthropometric and clinical assessment, and their maximum expiratory pressures were obtained. Then, the preadolescents underwent a constant expiratory effort of 70% of their maximum expiratory pressure for 20 seconds, with heart rate measurement 5 minutes before, during and 5 minutes after it. Heart rate variability (HRV) and heart rate values were analyzed by use of a software. Results: The HRV did not differ when compared before and after the constant expiratory effort intra- and intergroup. The heart rate values differed (p < 0.05) during the effort, being the total variation in non-obese preadolescents of 18.5 ± 1.5 bpm, and in obese, of 12.2 ± 1.3 bpm. Conclusion: The cardiac autonomic modulation did not differ between the groups when comparing before and after the constant expiratory effort. However, the obese group showed lower cardiovascular response to baroreceptor stimuli during the effort, suggesting lower autonomic baroreflex sensitivity.

Serial High-Sensitivity Troponin T in Post-Primary Angioplasty Exercise Test

Abstract Background: The kinetics of high-sensitivity troponin T (hscTnT) release should be studied in different situations, including functional tests with transient ischemic abnormalities. Objective: To evaluate the release of hscTnT by serial measurements after exercise testing (ET), and to correlate hscTnT elevations with abnormalities suggestive of ischemia. Methods: Patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty were referred for ET 3 months after infarction. Blood samples were collected to measure basal hscTnT immediately before (TnT0h), 2 (TnT2h), 5 (TnT5h), and 8 hours (TnT8h) after ET. The outcomes were peak hscTnT, TnT5h/TnT0h ratio, and the area under the blood concentration-time curve (AUC) for hscTnT levels. Log-transformation was performed on hscTnT values, and comparisons were assessed with the geometric mean ratio, along with their 95% confidence intervals. Statistical significance was assessed by analysis of covariance with no adjustment, and then, adjusted for TnT0h, age and sex, followed by additional variables (metabolic equivalents, maximum heart rate achieved, anterior wall STEMI, and creatinine clearance). Results: This study included 95 patients. The highest geometric means were observed at 5 hours (TnT5h). After adjustments, peak hscTnT, TnT5h/TnT0h and AUC were 59% (p = 0.002), 59% (p = 0.003) and 45% (p = 0.003) higher, respectively, in patients with an abnormal ET as compared to those with normal tests. Conclusion: Higher elevations of hscTnT may occur after an abnormal ET as compared to a normal ET in patients with STEMI.

A Wireless Mesh Network NS-3 Simulation Model: Implementation and Performance Comparison With a Real Test-Bed

Wireless mesh networks present an attractive communication solution for various research and industrial projects. However, in many cases, the appropriate preliminary calculations which allow predicting the network behavior have to be made before the actual deployment. For such purposes, network simulation environments emulating the real network operation are often used. Within this paper, a behavior comparison of real wireless mesh network (based on 802.11s amendment) and the simulated one has been performed. The main objective of this work is to measure performance parameters of a real 802.11s wireless mesh network (average UDP throughput and average one-way delay) and compare the derived results with characteristics of a simulated wireless mesh network created with the NS-3 network simulation tool. Then, the results from both networks are compared and the corresponding conclusion is made. The corresponding results were derived from simulation model and real-worldtest-bed, showing that the behavior of both networks is similar. It confirms that the NS-3 simulation model is accurate and can be used in further research studies.

O depoimento da criança no processo civil e sua valoração probatória

O presente trabalho tem por objetivo examinar um dos meios de prova oral do processo civil, que é o depoimento da criança. Diante da existência de uma certa resistência quanto à utilização e validade deste meio de prova, foram destacados argumentos de direito probatório favoráveis à tomada do depoimento infantil, como o direito à prova no sistema da prova livre e na vertente do direito de ação e defesa, além da necessária comparação com o processo penal e o destaque aos princípios da proteção integral e do superior interesse da criança, os quais foram reforçados por outros de natureza médico-psicológica, que visaram a destacar a capacidade cognitiva da criança em recordar fatos e relatá-los. Após a desconstrução do modelo de exclusão prévia do depoimento infantil, a dissertação abordou os modelos de proteção para a audição judicial da criança, para se evitar a vitimização secundária da criança e exposição desnecessária às partes, advogados e juízes. Neste particular, foram revisados os modelos inglês do closed-circuit television - CCTV e argentino da Câmara de Gesell como paradigmas para vários outros países, inclusive o Brasil que tem incentivado o depoimento sem dano. Em derradeiro, foi examinada a valoração desse depoimento da criança, tomando-se por base a justificação lógico-racional da prova consubstanciada nos módulos de constatação, ocasião em que foi possível sublinhar que a utilização dos modelos e métodos de inquirição protetivos culminam em maior credibilidade ao depoimento da criança no processo civil e proporcionam a descoberta de falsidade voluntária ou não. Também no tópico da valoração da prova, o conteúdo do depoimento infantil vai trazer maior confiança quando conjugado com elementos intrínsecos, como a coerência do discurso e a ausência de contradições, e extrínsecos, realizado na modalidade protetiva.

Factory Acceptance Test des Prozessleitsystems PCS 7 und Anlagenfeld Simulation mit WinMOD

Das Prozessleitsystem PCS 7 beinhaltet softwaretechnische Lösungen für alle Hierarchieebenen der industriellen Automatisierung von der Unternehmensleitebene bis zur Anlagenfeldebene. Mit der Simulationssoftware WinMOD können Komponenten,Signale und Prozesse einer Industrieanlage nachgebildet werden. Zudem bietet WinMOD Schnittstellenlösungen für gängige Speicherprogrammierbare Steuerungen und eignet sich somit für den Factory Acceptance Test (FAT) von Prozessleitsystemen. Die FATs sollen sich hauptsächlich auf die Überprüfung von Signaladressierungen und von Ursache und Wirkung konzentrieren. Im Rahmen der vorliegenden Arbeit wurden ausgewählte PCS 7–Projekte untersucht und auf deren Grundlage Aussagen getroffen wie zukünftig Simulationen effektiv erstellt werden können. Hierzu wurden mithilfe von WinMOD Simulationsmodule angelegt - welche reale Komponenten des Anlagenfeldes ersetzen – , ihr Aufbau beschrieben und in einer Bibliothek zusammengefasst. Im Anschluss wird auf die Verwendung der Bibliothek für verschiedene Anwendungsfälle eingegangen und eine Lösung präsentiert, welche das Erstellen einer Simulation für spezifische Projekte optimiert. Das Ergebnis zeigt auf, dass WinMOD sowohl neue Möglichkeiten der Durchführung für einen FAT liefert, wobei die Simulationserstellung nur einen geringen Mehraufwand bedeutet und sich die Durchführung der Simulation ergonomischer und kürzer gestaltet.

Diversity and stability of fishes (Teleostei) in a temporary river of the Brazilian semiarid region

The effects of hydrological disturbances by flooding and drought on the diversity and stability in a temporary river fish community in the Brazilian semiarid region were analyzed over the 1996 hydrological cycle. Twelve collections of fishes were made during the wet and dry phases, and 789 individuals of 16 species were collected. Diversity was measured using Simpson's Index (S) and community stability was analyzed by the variation in abundance using Kendall's W concordance test. Fish diversity in the Taperoá river was subjected to hydrological disturbances by flooding and drought. During the wet phase the diversity was higher (S = 0.855) than during the dry phase (S = 0.771). The community was considered stable during the whole annual hydrological cycle (W = 0.418 p < 0.001), but a higher stability in the community was found during the dry phase. During the dry phase the number of dominant species was smaller than during the wet phase.

Spatial and trophic interactions in wet and dry seasons between gambusia luma and Gambusia sexradiata (Pisces: Poecilidae) in Belize, Central America / David W. Greenfield, Chester F. Rakocinski, Teresa A. Greenfield.

n.s. no.14(1983)

Seasonal abundance of the shipworm Neoteredo reynei (Bivalvia, Teredinidae) in mangrove driftwood from a northern Brazilian beach

Shipworms are important decomposers of wood, especially in mangrove forests where productivity is high. However, little emphasis has been given to the activity of shipworms in relation to the export of nutrients from mangroves to adjacent coastal areas. As a first step to obtaining such information, the frequency of colonized mangrove driftwood as well as shipworm density and length were studied by collecting washed up logs during a year at Ajuruteua beach, state of Pará, northern Brazil. A single species, Neoteredo reynei (Bartsch, 1920), was found colonizing driftwood. Although large colonized logs were most common on the beach, shipworm density was higher in small logs, especially during the dry season. In general, however, density was higher during the wet season (January to April) and lowest in July. Overall shipworm mean length was 9.66cm. In large logs, mean length increased between the wet and dry seasons. However, there was no difference in length among log size categories. Mean shipworm length was similar throughout most of the year but tended to be greater in July. Although salinity varied between 10.9 and 40 during the year, no relationship was found between salinity and density or length. The results suggest that shipworm activity in driftwood logs is relatively constant throughout the year. Increased air humidity and rainfall may promote survival during the wet season. Large logs may take longer to colonize and thus have lower densities than small ones which are scarce probably because they are destroyed rapidly by shipworm activity. However, data on the disintegration of logs would be necessary to test this hypothesis. Larger size of shipworms in the dry season may be related to growth after an earlier recruitment period. Shipworms in large logs during the dry season may be better protected from dessication and high temperatures by the insulating properties of the larger volume of wood.

A topological proof that surface relators are test words

Vegeu el resum a l'inici del document del fitxer adjunt.