994 resultados para Routine activity


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This study compared for seabream, Sparus aurata exposed to benzo(a)pyrene-B(a)P-, the response of molecular cytochrome P450 1A (CYP1A) and cellular histopathology biomarkers. Male gilthead seabream, Sparus aurata specimens were exposed for 20 days via water to a series of high B(a)P concentrations. CYP1A was assessed by measuring enzymatic activity (EROD) and CYP1A protein content, and cellular responses were evaluated by routine histopathological methods. In addition, biliary metabolites were measured in order to verify that B(a)P was absorbed and metabolised. Histological lesions, both in liver and gills, increased in parallel to B(a)P concentrations, with the majority of changes representing rather non-specific alterations. Hepatic EROD and CYP1A proteins data showed a concentration-dependent induction, while in the gills, EROD activity but not CYP1A proteins showed a non-monotonous dose response, with a maximum induction level at 200 microg B(a)P.L-1 and decreasing levels thereafter. The findings provide evidence that short-term, high dose exposure of fish can result in significant uptake and metabolism of the lipophilic B(a)P, and in pronounced pathological damage of absorptive epithelia and internal organs.

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BACKGROUND: In recent years, the assessment of the plasma aldosterone-to-renin ratio (ARR) has become an established screening method for the diagnosis of primary aldosteronism. Plasma renin activity (PRA) is usually measured to define ARR although, increasingly, renin concentration alone is often measured in clinical routine. OBJECTIVE: To determine the threshold of ARR using active renin concentration to screen for primary aldosteronism. DESIGN AND PARTICIPANTS: To determine the ARR threshold based on plasma immunoreactive renin concentration (irR), we measured plasma aldosterone concentration (PAC), irR and PRA in 36 hypertensive patients, nine thereof with adrenal adenoma, and compared ARRs calculated from irR and PRA, respectively. SETTING: Single-centre, hypertension clinic in a tertiary care hospital. RESULTS: PRA ranged from 0.41-14.9 ng/ml per h and irR from 1.1-72 ng/l. There was an excellent correlation between PRA and irR (r = 0.98, P < 0.0001) and between ARRPRA and ARRirR (r = 0.96, P < 0.0001). An ARRPRA > 750 pmol/l per ng/ml per h was previously found to be highly predictive of primary aldosteronism because 90% of the corresponding patients failed to suppress PAC upon saline infusion or fludrocortisone. The corresponding threshold value for ARRirR was 150 pmol/ng in our patients. Using these cut-offs, nine subjects had both increased ARRPRA and ARRirR while, in three patients, either ARRPRA or ARRirR were increased. The nine patients with increased ARRPRA and ARRirR also had PAC > 650 pmol/l. Only these patients had adrenal adenomas. CONCLUSIONS: The ARR threshold to screen for primary aldosteronism may be based on measurement of irR. An ARRirR > 150 pmol/ng may indicate primary aldosteronism.

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OBJECTIVE To evaluate the correlation between clinical measures of disease activity and a ultrasound (US) scoring system for synovitis applied by many different ultrasonographers in a daily routine care setting within the Swiss registry for RA (SCQM) and further to determine the sensitivity to change of this US Score. METHODS One hundred and eight Swiss rheumatologists were trained in performing the Swiss Sonography in Arthritis and Rheumatism (SONAR) score. US B-mode and Power Doppler (PwD) scores were correlated with DAS28 and compared between the clinical categories in a cross-sectional cohort of patients. In patients with a second US (longitudinal cohort), we investigated if change in US score correlated with change in DAS and evaluated the responsiveness of both methods. RESULTS In the cross-sectional cohort with 536 patients, correlation between the B-mode score and DAS28 was significant but modest (Pearson coefficient r = 0.41, P < 0.0001). The same was true for the PwD score (r = 0.41, P < 0.0001). In the longitudinal cohort with 183 patients we also found a significant correlation between change in B-mode and in PwD score with change in DAS28 (r = 0.54, P < 0.0001 and r = 0.46, P < 0.0001, respectively). Both methods of evaluation (DAS and US) showed similar responsiveness according to standardized response mean (SRM). CONCLUSIONS The SONAR Score is practicable and was applied by many rheumatologists in daily routine care after initial training. It demonstrates significant correlations with the degree of as well as change in disease activity as measured by DAS. On the level of the individual, the US score shows many discrepancies and overlapping results exist.

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Mycobacterium tuberculosis infects more people worldwide each year than any other single organism. The Antigen 85 Complex, a family of fibronectin-binding proteins (Fbps) found in several species of mycobacteria and possibly involved in host interaction, is considered among the putative virulence factors of M. tuberculosis. These proteins are implicated in the production of trehalose dimycolate (TDM) and arabinogalactan-mycolate (AG-M), two prominent components of the mycobacterium cell wall and potent modulators of the immune system during infection. For these reasons, the principal members of the complex, FbpA and FbpB, were the focus of these studies. The genes encoding these proteins, fbpA and fbpB, were each disrupted by insertion of a kanamycin resistance cassette in a pathogenic strain of M. tuberculosis, H37Rv. Neither mutation affected growth in routine broth culture. Thin layer chromatography analysis of TDM and AG-M showed no difference in content between the parent strain H37Rv and the FbpA- and FbpB-deficient mutants grown under two different culture conditions. However, metabolic radiolabeling of the strains showed that the production of TDM (but not its precursor TMM) was delayed in the FbpA- and FbpB-deficient mutants compared to the parent H37Rv. During this same labeling period, FbpA-deficient mutant LAa1 failed to produce AG-M and in the FpbB-deficient mutant LAb1 production was decreased. In macrophage tissue culture assay, LAa1 failed to multiply when bacteria in early log phase were used to infect monolayers while LAb1 grew like the parent strain. The growth deficiency of LAa1 as well as the deficiencies in TDM and AG-M production were restored by complementing LAa1 with a functional fbpA gene. These results suggest that the FbpA and FbpB proteins are involved in synthesis of TDM (but not its precursor TMM) as well as AG-M. Other members of the complex appear to compensate for defects in synthesis caused by mutation of single genes in the complex over time. Mutation of the FbpA gene causes greater in vivo effect than mutation of the FbpB gene despite very similar deficiencies in the rate of production of mycolate containing molecules on the cell surface. ^

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Introduction. There is a need for physical activity interventions based in primary care clinics that take advantage of community resources. The purpose of this randomized controlled trial was to compare the effects of two physical activity interventions: (1) physical activity prescription by a primary care provider plus referral to community physical activity resources and (2) physical activity prescription only. ^ Methods. Sedentary adult patients recruited from a general medicine clinic were randomized to receive a physical activity prescription, delivered by the primary care provider, plus referral to community physical activity resources (n=38) or physical activity prescription only (n=32). Outcomes were use of community resources (exercise facility and personal trainers), physical activity levels (self-report questionnaire and pedometer), and attitudes regarding physical activity assessed at 8 weeks. ^ Results. Three of 38 (7.9%) subjects referred to the community resources and none of the 32 subjects in the prescription only group used the community resources during the 8 week trial. Sixteen of 32 subjects in the prescription plus referral group and 19 of 38 in the prescription group completed the self-report follow-up forms at 8 weeks. For minutes of moderate- or vigorous-intensity physical activity per week, there were no between-group differences at baseline, follow-up, or change from baseline to follow-up. However, for moderate- and vigorous-intensity physical activity, there were significant improvements from baseline to follow-up within each group. For attitudes related to physical activity, there were no between-group differences at baseline, follow-up, or change from baseline to follow-up; neither were there any within-group changes. ^ Discussion. Physical activity prescription delivered by a healthcare provider in the context of a routine primary care visit can improve physical activity levels, with no additional improvement gained by referring to community resources. The intervention was feasible for primary care providers to deliver, but only 50% of subjects returned the self-report physical activity questionnaire at the 8 week assessment. ^

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Obesity and physical inactivity are modifiable risk factors that are associated with several health issues; they are major factors in up to 30% of major cancers. Elevated levels of circulating insulin-like growth factor-I (IGF-I) have been associated with high body composition measurements and high cancer risk; exogenous estrogen use is associated with low circulating IGF-I levels and high cancer risk. The relationship between physical activity and circulating IGF levels is complex and findings of previous studies of their relationship remain inconsistent; however, these studies included vague definitions of physical activity. In this study, we used cross-sectional data from the Women's Health Initiative to determine the relationship between specific measures of physical activity (e.g., intensity, duration, and frequency) and circulating IGF-I levels, accounting for exogenous estrogen use and body composition. These data were collected from women enrolled at Women's Health Initiative clinical centers at Baylor College of Medicine and Wake Forest University School of Medicine. Multivariate linear regression analysis showed that circulating IGF-I and IGF-binding protein (BP) 3 levels were positively associated with frequency, duration, and intensity of physical activity. Circulating IGF-I levels and the molar IGF-I:IGF-BP3 ratio were significantly associated with frequency of walking, whereas circulating IGF-BP3 levels were significantly associated with strenuous physical activity, suggesting that different aspects of physical activity and their effects on fitness affect members of the IGF family differently. The results from our study support the recommendation of a regular exercise routine, particularly that of strenuous intensity, for postmenopausal women as a means to prevention of cancer.^

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Introduction: Physical activity is related to health and lifestyle and should be part of the daily routine of all individuals since it brings many benefits to the body. Ains: To study the adolescent population‘s body mass index (BMI). To study the relation between physical activity and gender. Materials and Methods: We performed a quantitative, observational, analytic and cross-sectional study. After the use of exclusion criteria, a sample of 36 individuals was selected from a population of diabetic adolescents. A validated questionnaire was applied to collected physical activity and personal data. SPSS 22.0 was used to treat the data. The chi-square test was applied to study the relation between the level of physical activity and gender; Fisher’s exact test was applied to study the relation between level of physical activity and BMI. Results and discussion: The chi-square test showed a significant relation between the level of physical activity and gender (p-value = 0.018) with moderate intensity (phi = .4), which corroborates other national and worldwide studies. Fisher’s exact test showed no relation between BMI and the level of physical activity (p-value=0,646). Conclusion: 86,1% of the sampled diabetic adolescents are eutrophic, and 66,7% are considered insufficient active. A significant relation was found between gender and the level of physical activity. No relation was found between BMI and level of physical activity.

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Appropriate measures of physical activity are essential for determining the population prevalence of physical activity, for tracking trends over time, and for guiding intervention efforts. Physical activity measurement is characterised by the synthesis of information on the type, frequency, intensity, and duration of activity over a specified period. To date, emphasis in physical activity assessment has been on the measurement of leisure time physical activities. However, some domestic and transport related activities entail energy expenditures equivalent to moderate intensity of 3.0–6.0 METS1 considered to be of sufficient intensity to achieve a health benefit are yet to be included in routine population level physical activity surveillance. This leads to population estimates based only on measures of leisure time physical activities.

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Background: Aflifle a growing literature supports the effectiveness of physical activity interventions delivered in the primary care setting, few studies have evaluated efforts to increase physician counseling on physical activity during routine practice (i.e., outside the context of controlled research). This paper reports the results of a dissemination trial of a primary care-based physical activity counseling intervention conducted within the context of a larger, multi-strategy, Australian community-based, physical activity intervention, the 10,000 Steps Rockhampton Project. Methods: All 23 general practices and 66 general practitioners (GPs, the Australian equivalent of family physicians) were invited to participate. Practice visits were made to consenting practices during which instruction in brief physical activity counseling was offered, along with physical activity promotion resources (print materials and pedometers). The evaluation, guided by the RE-AIM framework, included collection of process data, as well as pre-and post-inteivention data from a mailed GP survey, and data from the larger project's random-digit-dialed, community-based, cross-sectional telephone survey that was conducted in Rockhampton and a comparison community, Results: Ninety-one percent of practices were visited by 10,000 Steps staff and agreed to participate, with 58% of GPs present during the visits. General practitioner survey response rates were 67% (n =44/66 at baseline) and 71% (n =37/52, at 14-month follow-up). At follow-up, 62% had displayed the poster, 81% were using the brochures, and 70% had loaned pedometers to patients, although the number loaned was relatively small. No change was seen in GP self-report of the percentage of patients counseled on physical activity. However, data from the telephone surveys showed a 31% increase in the likelihood of recalling GP advice on physical activity in Rockhampton (95% confidence interval [CI]=1.11-1.54) compared to a 16% decrease (95% CI=0.68-1.04) in the comparison community. Conclusions: This dissemination study achieved high rates of GP uptake, reasonable levels of implementation, and a significant increase in the number of community residents counseled on physical activity. These results suggest that evidence-based primary care physical activity counseling protocols can be translated into routine practice, although the initial and ongoing investment of time to develop partnerships with relevant healthcare organizations, and the interest generated by the overall 10,000 Steps program should not be underestimated. ((C) 2004 American journal of Preventive Medicine.

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Agreement on response criteria in rheumatoid arthritis (RA) has allowed better standardization and interpretation of clinical trial reports. With recent advances in therapy, the proportion of patients achieving a satisfactory state of minimal disease activity (MDA) is becoming a more important measure with which to compare different treatment strategies. The threshold for MDA is between high disease activity and remission and, by definition, anyone in remission will also be in MDA. True remission is still rare in RA; in addition, the American College of Rheumatology definition is difficult to apply in the context of trials. Participants at OMERACT 6 in 2002 agreed on a conceptual definition of minimal disease activity (MDA): "that state of disease activity deemed a useful target of treatment by both the patient and the physician, given current treatment possibilities and limitations." To prepare for a preliminary operational definition of MDA for use in clinical trials, we asked rheumatologists to assess 60 patient profiles describing real RA patients seen in routine clinical practice. Based on their responses, several candidate definitions for MDA were designed and discussed at the OMERACT 7 in 2004. Feedback from participants and additional on-site analyses in a cross-sectional database allowed the formulation of 2 preliminary, equivalent definitions of MDA: one based on the Disease Activity Score 28 (DAS28) index, and one based on meeting cutpoints in 5 out the 7 WHO/ILAR core set measures. Researchers applying these definitions first need to choose whether to use the DAS28 or the core set definition, because although each selects a similar proportion in a population, these are not always the same patients. In both MDA definitions, an initial decision node places all patients in MDA who have a tender joint count of 0 and a swollen joint count of 0, and an erythrocyte sedimentation rate (ESR) no greater than 10 mm. If this condition is not met: center dot The DAS28 definition places patients in MDA when DAS28

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Objective: To evaluate the reliability and validity of a brief physical activity assessment tool suitable for doctors to use to identify inactive patients in the primary care setting. Methods: Volunteer family doctors (n = 8) screened consenting patients (n = 75) for physical activity participation using a brief physical activity assessment tool. Inter-rater reliability was assessed within one week (n = 71). Validity was assessed against an objective physical activity monitor (computer science and applications accelerometer; n = 42). Results: The brief physical activity assessment tool produced repeatable estimates of sufficient total physical activity, correctly classifying over 76% of cases (kappa 0.53, 95% confidence interval (CI) 0.33 to 0.72). The validity coefficient was reasonable (kappa 0.40, 95% CI 0.12 to 0.69), with good percentage agreement (71%). Conclusions: The brief physical activity assessment tool is a reliable instrument, with validity similar to that of more detailed self report measures of physical activity. It is a tool that can be used efficiently in routine primary healthcare services to identify insufficiently active patients who may need physical activity advice.

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Current Ambient Intelligence and Intelligent Environment research focuses on the interpretation of a subject’s behaviour at the activity level by logging the Activity of Daily Living (ADL) such as eating, cooking, etc. In general, the sensors employed (e.g. PIR sensors, contact sensors) provide low resolution information. Meanwhile, the expansion of ubiquitous computing allows researchers to gather additional information from different types of sensor which is possible to improve activity analysis. Based on the previous research about sitting posture detection, this research attempts to further analyses human sitting activity. The aim of this research is to use non-intrusive low cost pressure sensor embedded chair system to recognize a subject’s activity by using their detected postures. There are three steps for this research, the first step is to find a hardware solution for low cost sitting posture detection, second step is to find a suitable strategy of sitting posture detection and the last step is to correlate the time-ordered sitting posture sequences with sitting activity. The author initiated a prototype type of sensing system called IntelliChair for sitting posture detection. Two experiments are proceeded in order to determine the hardware architecture of IntelliChair system. The prototype looks at the sensor selection and integration of various sensor and indicates the best for a low cost, non-intrusive system. Subsequently, this research implements signal process theory to explore the frequency feature of sitting posture, for the purpose of determining a suitable sampling rate for IntelliChair system. For second and third step, ten subjects are recruited for the sitting posture data and sitting activity data collection. The former dataset is collected byasking subjects to perform certain pre-defined sitting postures on IntelliChair and it is used for posture recognition experiment. The latter dataset is collected by asking the subjects to perform their normal sitting activity routine on IntelliChair for four hours, and the dataset is used for activity modelling and recognition experiment. For the posture recognition experiment, two Support Vector Machine (SVM) based classifiers are trained (one for spine postures and the other one for leg postures), and their performance evaluated. Hidden Markov Model is utilized for sitting activity modelling and recognition in order to establish the selected sitting activities from sitting posture sequences.2. After experimenting with possible sensors, Force Sensing Resistor (FSR) is selected as the pressure sensing unit for IntelliChair. Eight FSRs are mounted on the seat and back of a chair to gather haptic (i.e., touch-based) posture information. Furthermore, the research explores the possibility of using alternative non-intrusive sensing technology (i.e. vision based Kinect Sensor from Microsoft) and find out the Kinect sensor is not reliable for sitting posture detection due to the joint drifting problem. A suitable sampling rate for IntelliChair is determined according to the experiment result which is 6 Hz. The posture classification performance shows that the SVM based classifier is robust to “familiar” subject data (accuracy is 99.8% with spine postures and 99.9% with leg postures). When dealing with “unfamiliar” subject data, the accuracy is 80.7% for spine posture classification and 42.3% for leg posture classification. The result of activity recognition achieves 41.27% accuracy among four selected activities (i.e. relax, play game, working with PC and watching video). The result of this thesis shows that different individual body characteristics and sitting habits influence both sitting posture and sitting activity recognition. In this case, it suggests that IntelliChair is suitable for individual usage but a training stage is required.

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This paper is part of the Project “Adaptive thinking and flexible computation: Critical issues”. In this paper we discuss different perspectives of flexibility and adaptive thinking in literature. We also discuss the idea of proceptual thinking and how this idea is important in our perspective of adaptive thinking. The paper analyses a situation developed with a first grade classroom and its teacher named the day number. It is a daily activity at the beginning of the school day. It consists on to look for the date number and to think about different ways of writing it using the four arithmetic operations. The analyzed activity was developed on March 19, so the challenge was to write 19 in several ways. The data show the pupils’ enthusiasm and their efforts to find different ways of writing the number. Some used large numbers and division, which they were just starting to learn. The pupils presented symbolic expressions of 19, decomposing and recomposing it in a flexible manner.