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Contemporary Clinical Trials... Jun 2024Enteral nutrition (EN) is preferred when oral feeding is not possible. The use of the Nasogastric Tube (NGT) ensures rapid and low-risk nutrient administration. However,...
BACKGROUND
Enteral nutrition (EN) is preferred when oral feeding is not possible. The use of the Nasogastric Tube (NGT) ensures rapid and low-risk nutrient administration. However, confirming the placement through chest radiography, besides delaying the initiation of nutritional therapy, exposes patients to radiation. The pH test of gastric aspirate provides a quicker check for NGT placement, but its reliability is compromised by challenges related to aspirating gastric secretions.
STUDY OBJECTIVE
The main objective of this study is to assess the high-performance placement of NGTs for nutritional purposes, optimizing the evaluation of correct insertion through pH testing using an electronic pH meter. Additionally, the study aims to evaluate patient tolerance to the intervention.
MATERIALS AND METHODS
This single-center RCT will include 150 EN candidate patients divided into three groups. Each group will use distinct NGTs, evaluating placement through pH testing and chest radiography for safety. Tolerance, complications related to NGT placement, and costs will be assessed, with data collected anonymously through a secure electronic database.
ETHICAL CONSIDERATIONS
authorization no. 3624, Territorial Ethical Committee Lombardy 5, October 20, 2023.
IMPLICATIONS AND PERSPECTIVES
This protocol introduces innovative technologies, such as advanced NGTs and an electronic pH meter, aiming to optimize enteral nutrition management. This RCT focuses on replacing X-rays as the primary method for verifying NGT placement, thereby reducing costs, time, and patient exposure to radiation. Data analysis may provide insights into managing patients on pH-altering medication. Implementing innovative technologies has the potential to reduce errors and improve economic efficiency and process sustainability.
PubMed: 38845620
DOI: 10.1016/j.conctc.2024.101312 -
Journal of Sports Science & Medicine Jun 2024The aim of this study was two-fold: (i) to compare physical fitness adaptations following small-sided games (SSG) and running-based high-intensity interval training... (Randomized Controlled Trial)
Randomized Controlled Trial
Sex Influences the Extent of Physical Performance Adaptations in Response to Small-Sided Games and Running-Based High-Intensity Interval Training: A Parallel Study Design Involving Men and Women Soccer Players.
The aim of this study was two-fold: (i) to compare physical fitness adaptations following small-sided games (SSG) and running-based high-intensity interval training (HIIT), considering sex interactions; and (ii) to describe intra-individual variations of adaptations in both men and women developmental/trained soccer players over an 8-week randomized parallel study design involving 25 women and 27 men. Pre and post-intervention assessments included countermovement jump (CMJ), 10-meter linear sprint test, change-of-direction (COD) deficit, and final velocity at 30-15 Intermittent Fitness Test (VIFT). Significant interactions between time, groups and sex were found in 10-m sprint (F = 6.042; = 0.018; η = 0.112). No significant interactions between time, groups and sex were found in CMJ (F F = 0.609; = 0.439; η = 0.013), COD deficit (F F = 2.718; p = 0.106; η = 0.054) and VIFT (F F = 1.141; = 0.291; η = 0.023). Significant interactions were found between time and sex in CMJ (F F = 29.342; < 0.001; η= 0.379), 10-m sprint (F F = 4.359; = 0.042; η = 0.083), COD deficit (F F = 5.066; = 0.029; η= 0.095) and VIFT (F F = 11.248; = 0.002; η = 0.190). In conclusion, this study suggests similar effects of HIIT in both sexes. However, for women, SSG may entail less efficacy and more inter-individual variability compared to men. Therefore, HIIT could potentially be a better solution for women, whereas both training approaches were equally effective in men.
Topics: Humans; Soccer; High-Intensity Interval Training; Female; Male; Adaptation, Physiological; Sex Factors; Athletic Performance; Young Adult; Running; Physical Fitness; Exercise Test; Adult
PubMed: 38841647
DOI: 10.52082/jssm.2024.265 -
Journal of Sports Science & Medicine Jun 2024Small-sided games (SSGs) are frequently utilized in training settings to elicit specific stimuli that can promote physical fitness adaptations over time. However,... (Randomized Controlled Trial)
Randomized Controlled Trial
Can The Pitch Dimension Influence the Physical Fitness Adaptations Induced by Small-Sided Training Programs Added to Regular In-Field Training? A Randomized Controlled Study in Youth Soccer Players.
Small-sided games (SSGs) are frequently utilized in training settings to elicit specific stimuli that can promote physical fitness adaptations over time. However, various task constraints, such as pitch dimensions, can significantly influence both the acute external and internal load responses. Thus, understanding the impact of different pitch dimensions on physical fitness adaptations is crucial. This study sought to compare the physical adaptations induced by an SSG-based program utilizing more elongated pitches (SSGlw2; length-to-width ratio: 2.0) versus less elongated pitches (SSGwl1; length-to-width ratio: 1.0) on the Yo-Yo intermittent recovery test level 1 (YYIRT), and 30-meter sprint. This study employed a randomized controlled design. Forty-eight male soccer players (16.4 ± 0.6 years) participated. These players were randomly allocated to two experimental groups (N = 16, SSGlw1; N = 16, SSGlw2) and underwent two weekly additional training sessions over an 8-week period, while a group of 16 players continued with their regular in-field sessions as a control group. Evaluations were conducted before and after the intervention period. Significant interactions time u group were observed in regards YYIRT (F = 15.857; p < 0.001; = 0.413) and 30-m sprint test (p < 0.001). Between-group differences on YYIRT were found in post-intervention (p < 0.001), on which SSGlw2 (p < 0.001) and SSGlw1 (p < 0.001) were significantly greater in comparison to control group. Additionally, between-group differences on 30-m sprint were found in post-intervention (p < 0.001), on which SSGlw2 was significantly better than SSGlw1 (p < 0.001) and control group (p < 0.001). Coaches are advised to prioritize the use of more elongated pitch sizes to promote adaptations in sprint performance, while still acknowledging that aerobic capacity improvements remain significant compared to other pitch shapes.
Topics: Humans; Soccer; Male; Adolescent; Adaptation, Physiological; Physical Fitness; Physical Conditioning, Human; Athletic Performance; Running; Exercise Test
PubMed: 38841646
DOI: 10.52082/jssm.2024.487 -
Journal of Sports Science & Medicine Jun 2024Microdosing can facilitate better accommodation to the training stimulus while aligning with the scheduling needs of teams. In this study, the effectiveness of... (Randomized Controlled Trial)
Randomized Controlled Trial
Microdosing can facilitate better accommodation to the training stimulus while aligning with the scheduling needs of teams. In this study, the effectiveness of microdosing exposure was investigated by comparing the effects of microdosing plyometric jump training (microPJT) with those of regular plyometric jump training (regPJT) and a control group not exposed to plyometric training. The comparison focused on the effects on jumping performance, reactive strength index (RSI), and acceleration over a 10-meter distance. Fifty-two male youth soccer players (16.3 ± 0.6 years old) from under-17 teams participated in a randomized controlled study, with interventions lasting 8 weeks. Assessments were conducted twice, before and after the intervention, measuring squat jump (SJ), countermovement jump (CMJ), RSI during drop jumps, and acceleration in a 10-meter sprint test. The regPJT group completed 34 bilateral jumps and 48 unilateral jumps per week over two weekly sessions, totaling 82 jumps. Conversely, the microPJT group performed 17 bilateral jumps and 24 unilateral jumps weekly over 4 sessions week, totaling 41 jumps. Significant interactions between groups and time were observed concerning SJ (p < 0.001; = 0.282), CMJ (p < 0.001; = 0.368), RSI (p < 0.001; = 0.400) and 10-m sprint time (p < 0.001; = 0.317). Between-group analysis indicated that both the microPJT (p < 0.001) and regPJT (p < 0.001) groups exhibited significant better results compared to the control group in post-intervention evaluation of SJ, CMJ, RSI and 10-m sprint time, while no significant differences were found between experimental groups (p > 0.050). In conclusion, this study has revealed that both microPJT and regPJT are equally effective in enhancing jumping performance and acceleration time in soccer players. This suggests that a smaller training volume, distributed more frequently across the week, can effectively induce improvements in soccer players.
Topics: Humans; Soccer; Plyometric Exercise; Adolescent; Male; Athletic Performance; Acceleration; Muscle Strength
PubMed: 38841635
DOI: 10.52082/jssm.2024.342 -
Advances in Mind-body MedicineAsthma is a chronic disease and its chronicity demands therapy with minimal harm and a good impact on the quality of life of asthmatics. (Randomized Controlled Trial)
Randomized Controlled Trial
Efficacy of a Structured Yoga Intervention Integrated with Routine Care versus Exercise on Pulmonary Function and Quality of Life of Asthma Patients: A Randomized Controlled Trial.
CONTEXT
Asthma is a chronic disease and its chronicity demands therapy with minimal harm and a good impact on the quality of life of asthmatics.
OBJECTIVE
This study evaluates the efficacy of structured yoga intervention integrated with routine care on asthma patients in improving their pulmonary function and quality of life.
DESIGN
The study was a single-blind (outcome assessor) hospital-based randomized controlled trial.
PARTICIPANTS
Adults between 18 to 60 years, diagnosed with mild to moderate asthma as per Global Initiative for Asthma guidelines, with no exacerbation in the past month before screening, were included in the study.
INTERVENTION
A thirty-minute structured yoga intervention was delivered daily by a qualified yoga instructor through a virtual platform.
OUTCOME MEASURES
Questionnaires were utilized to assess the quality of life, and Breath-o-meter equipment was used to measure peak expiratory flow rate (PEFR). It was tested at baseline and then at 15 days, 45 days, and 90 days, whereas the quality of life was evaluated once a month.
STATISTICAL ANALYSIS
Intention to treat analysis was performed to compare the mean outcome between the yoga and control groups using an independent sample t test and repeated measures analysis of variance.
RESULTS
The yoga group significantly improved their PEFR and asthma-related quality of life scores compared to the control group (P < .001). A significant difference (F = 539.72, degree of freedom = 1.1618; P < .001) was detected between PEFR values at several time intervals (baseline, day 15, day 45, day 90) in the intervention group on repeated measures analysis of variance. The difference in quality-of-life scores between yoga and control was also statistically significant (P < .001), with an improvement in the quality-of-life domain of external stimuli.
CONCLUSION
When combined with normal asthma treatment, the findings of this study show that structured yoga intervention integrated with routine care is more beneficial than traditional breathing exercises in increasing PEFR and quality of life.
Topics: Humans; Yoga; Quality of Life; Asthma; Adult; Female; Male; Middle Aged; Single-Blind Method; Young Adult; Adolescent; Exercise Therapy; Exercise; Respiratory Function Tests; Treatment Outcome
PubMed: 38837777
DOI: No ID Found -
International Journal of Chronic... 2024The use of inhaled bronchodilators is the mainstay of treatment for patients with chronic obstructive pulmonary disease (COPD). Although the soft mist inhaler (SMI) was... (Observational Study)
Observational Study
PURPOSE
The use of inhaled bronchodilators is the mainstay of treatment for patients with chronic obstructive pulmonary disease (COPD). Although the soft mist inhaler (SMI) was developed to overcome the disadvantages of pressurized metered dose and drug powder inhalers, misuse during handling has been frequently observed in many studies. However, few studies have focused on SMI misuse among patients with COPD. Thus, we aimed to assess and identify the risk factors associated with SMI misuse among patients with COPD.
PATIENT AND METHODS
In this prospective, observational, cross-sectional study, we enrolled patients with COPD who were undergoing SMI treatment between January 2018 and March 2020. An advanced nurse practitioner assessed the participants' handling of the device by using a check list.
RESULTS
Among 159 participants, 136 (85.5%) reported inhaler misuse. Duration of COPD and COPD assessment test (CAT) scores were positively associated with inhaler misuse; adherence and education level were negatively associated with inhaler misuse. In the multivariable analysis, a low educational level (less than high school), high CAT score (≥ 10), and short duration of COPD (≤ 2 years) were identified as risk factors for SMI misuse.
CONCLUSION
SMI misuse remains common among patients with COPD. Therefore, clinicians should pay close attention to their patients using SMIs, especially in the early period after the diagnosis of COPD.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Male; Female; Cross-Sectional Studies; Risk Factors; Aged; Prospective Studies; Middle Aged; Bronchodilator Agents; Administration, Inhalation; Nebulizers and Vaporizers; Medication Adherence; Equipment Design; Risk Assessment; Educational Status; Lung
PubMed: 38835808
DOI: 10.2147/COPD.S458200 -
Organic & Biomolecular Chemistry Jun 2024We have devised a supported-amine-catalyzed efficient synthesis of spiro-thiazolone-tetrahydrothiophenes a sulfa-Michael/aldol cascade approach. The catalyst...
We have devised a supported-amine-catalyzed efficient synthesis of spiro-thiazolone-tetrahydrothiophenes a sulfa-Michael/aldol cascade approach. The catalyst demonstrated sustained efficacy over 21 cycles. These derivatives were found to exhibit excellent binding abilities with purified human serum albumin as indicated by both and -based experiments.
Topics: Humans; Catalysis; Thiophenes; Amines; Serum Albumin, Human; Protein Binding; Spiro Compounds; Molecular Structure; Thiazoles; Molecular Docking Simulation
PubMed: 38835316
DOI: 10.1039/d4ob00619d -
Aging Cell Jun 2024With aging skeletal muscle fibers undergo repeating cycles of denervation and reinnervation. In approximately the 8th decade of life reinnervation no longer keeps pace,...
With aging skeletal muscle fibers undergo repeating cycles of denervation and reinnervation. In approximately the 8th decade of life reinnervation no longer keeps pace, resulting in the accumulation of persistently denervated muscle fibers that in turn cause an acceleration of muscle dysfunction. The significance of denervation in important clinical outcomes with aging is poorly studied. The Study of Muscle, Mobility, and Aging (SOMMA) is a large cohort study with the primary objective to assess how aging muscle biology impacts clinically important traits. Using transcriptomics data from vastus lateralis muscle biopsies in 575 participants we have selected 49 denervation-responsive genes to provide insights to the burden of denervation in SOMMA, to test the hypothesis that greater expression of denervation-responsive genes negatively associates with SOMMA participant traits that included time to walk 400 meters, fitness (VO), maximal mitochondrial respiration, muscle mass and volume, and leg muscle strength and power. Consistent with our hypothesis, increased transcript levels of: a calciumdependent intercellular adhesion glycoprotein (CDH15), acetylcholine receptor subunits (CHRNA1, CHRND, CHRNE), a glycoprotein promoting reinnervation (NCAM1), a transcription factor regulating aspects of muscle organization (RUNX1), and a sodium channel (SCN5A) were each negatively associated with at least 3 of these traits. VO and maximal respiration had the strongest negative associations with 15 and 19 denervation-responsive genes, respectively. In conclusion, the abundance of denervationresponsive gene transcripts is a significant determinant of muscle and mobility outcomes in aging humans, supporting the imperative to identify new treatment strategies to restore innervation in advanced age.
Topics: Humans; Aging; Male; Muscle, Skeletal; Aged; Female; Middle Aged; Cohort Studies; Adult
PubMed: 38831622
DOI: 10.1111/acel.14115 -
PloS One 2024This study examined functional trajectories of subjects during the transition phase between ambulatory and non-ambulatory Duchenne muscular dystrophy (DMD) to inform...
This study examined functional trajectories of subjects during the transition phase between ambulatory and non-ambulatory Duchenne muscular dystrophy (DMD) to inform clinical trial designs for new therapeutics. Ambulatory, pulmonary, and upper limb function leading up to loss of ambulation (LoA) and non-ambulatory measures following LoA were quantified; time ordering of pulmonary and upper limb milestones relative to LoA were determined; and the 10-second time threshold for 10-meter walk/run (10MWR) as a marker of approaching LOA was explored. Included in this analysis were 51 subjects aged between 7 and 18 years who experienced LoA during follow-up in the PRO-DMD-01 natural history study. Mean age at LoA was 12.7 (7.1-18.6) years. Mean annual rates of decline in forced vital capacity (FVC) <80%-predicted and performance of upper limb (PUL) 1.2 total score were smaller before than after LoA, but not significantly (FVC %-predicted: 5.6% vs. 10.1%, p = 0.21; PUL 1.2 total score: 2.3 vs. 3.8 units, p = 0.20). More than half of patients experienced clinically significant deficits in FVC %-predicted and PUL 1.2 before experiencing LoA. Among subjects with baseline 10MWR >10 s, those with <1 year to LoA had similar mean ages but significantly worse mean ambulatory function at baseline compared to those with ≥1 year to LoA. Enriching DMD clinical trials for patients with declining pulmonary or upper limb function is achievable without restricting enrollment to non-ambulatory patients. The sequencing of LoA and initial deficits in pulmonary and upper limb function varied across patients and highlights the potential for composite outcomes or multi-outcome trial designs to assess disease-modifying therapies more comprehensively.
Topics: Humans; Muscular Dystrophy, Duchenne; Child; Adolescent; Male; Walking; Clinical Trials as Topic; Vital Capacity; Upper Extremity; Disease Progression
PubMed: 38829874
DOI: 10.1371/journal.pone.0304099 -
Journal of Vascular Nursing : Official... Jun 2024The six-minute walk test (6MWT) is extensively employed to evaluate gait impairment in patients with symptomatic peripheral artery disease (PAD) and has been associated...
PURPOSE
The six-minute walk test (6MWT) is extensively employed to evaluate gait impairment in patients with symptomatic peripheral artery disease (PAD) and has been associated with different health outcomes. However, various approaches exist for calculating and interpreting the six-minute test in order to address the needs of patients more effectively. Therefore, we investigated how these different approaches correlate with functional capacity and cardiovascular health in patients with symptomatic PAD.
METHODS
In total, 227 PAD patients [65.2% men and 67 (13) y.o.] were included in this cross-sectional study. The 6MWT was performed along a 30-meter corridor and the distance was expressed in three ways: absolute (described as the meters walked during the test), relativized (based on the results of the 6MWT in healthy individuals), and DW (multiplying the body weight in kilograms by the absolute distance in the 6MWT). A functional capacity z-score was calculated using the results of the handgrip strength test, 4-meter walking test, and sit-and-stand test. A cardiovascular parameter z-score was calculated with data on brachial and central blood pressure, the low-frequency component/high-frequency component ratio, and carotid-femoral pulse wave velocity.
RESULTS
The absolute (b = 0.30, 95%CI: 18-0.43, R² = 0.11, p < 0.001) and DW (b = 0.40, 95%CI: 27-0.53, R² = 0.17, p < 0.001) measures were related to functional capacity, independently of sex, age, and the ankle-arm index of the patients. Neither absolute nor DW were related to cardiovascular health. The relativized measure was not associated with either functional capacity or cardiovascular health.
CONCLUSION
In patients with symptomatic PAD, absolute and DW measures are related to functional capacity, but not cardiovascular function.
Topics: Humans; Peripheral Arterial Disease; Male; Female; Cross-Sectional Studies; Aged; Walking; Walk Test; Body Weight; Pulse Wave Analysis; Hand Strength; Middle Aged; Blood Pressure; Ankle Brachial Index
PubMed: 38823969
DOI: 10.1016/j.jvn.2024.02.002