The Effects of Exercise Therapy Moderated by Sex in Rehabilitation of COVID-19

BackgroundPulmonary rehabilitation serves as a key component in the recovery of COVID-19 and standardized exercise therapy programs in pulmonary rehabilitation have been shown to significantly improve physical performance and lung function parameters in post-acute COVID-19 patients. However, it has not been investigated if these positive effects are equally beneficial for both sexes, especially considering a more severe physical impact of COVID-19 in men when compared to women. Therefore, the purpose of this study was to analyze outcomes of a pulmonary rehabilitation program with respect to sex differences, in order to identify sex-specific pulmonary rehabilitation requirements.MethodsData of 233 patients (40.4% females) were analyzed before and after a three-week standardized pulmonary rehabilitation program. Patients were admitted to rehabilitation due to post-acute COVID-19 illness and staged using the COVID-19 Severity Scale by Huang et al. (2021). Lung function parameters were assessed as part of the clinical routine using spirometry (ICmax, maximal inspiratory capacity) and body plethysmography (FVC, forced vital capacity; FEV1, forced expiratory volume in the first second) and functional exercise capacity was measured by the Six-Minute Walk Test (6MWT). For the comparison of lung function and walking parameters by sex, Welch-ANOVA was used, as results of Levene's test suggested significant heteroscedasticity regarding the investigated parameters (p > 0.05). When comparing post-treatment 6MWT, FEV1 and FCV to corresponding reference values, paired t-tests were used.ResultsAt post-rehabilitation, ICmax, FVC, FEV1 and 6MWT has been improved in both sexes. Females showed a significantly smaller improvement in FEV1 and ICmax (F = 5.86, ω2 = .02; p < 0.05) than males. There was no statistically significant difference in FVC and 6MWT performance improvements between men and women. After the rehabilitation stay, females made greater progress towards reference values of 6MWT (T(231) = -3.04; p < 0.01) and FEV1 (T(231) = 2.83; p < 0.01) than males.ConclusionsSex differences in the improvement of lung function parameters seem to exist when completing a three-week pulmonary rehabilitation program and should be considered when personalizing standardized exercise therapies in pulmonary rehabilitation.Trial registrationthis study was registered in the German Clinical Trials Register (DRKS00026936) on 2021/10/19.

Reference Values and the Z-Score Values of Tricuspid Annular Plane Systolic Excursion in Chinese Children

Objective To establish age-specific and body surface area (BSA)-specific reference values of Tricuspid Annular Plane Systolic Excursion (TAPSE) for children under 15 years old in China. Study design A retrospective study was conducted in Children's Hospital Attached to the Capital Institute of Pediatrics. A total of 702 cases were included in this research to establish reference values of TAPSE. SPSS 25.0 (IBM) was used for data analysis. Lambda-mu-sigma method was used to calculate and construct the age-specific and BSA-specific percentiles and Z-score curves of TAPSE. Results The mean value of TAPSE increased with age and BSA from 0 to 15 years in a nonlinear way and reached the adult level (17mm) until 1 year old. No difference could be observed in genders. Conclusions TAPSE values increased with age and BSA in Chinese children aged between 0-15 years and there was no difference between boys and girls. A multi-center study from different parts of China is supposed to be conducted in the future to reflect the whole spectrum of TAPSE in Chinese children.

Low error estimation of half-cell thermodynamic parameters from whole-cell Li-ion battery experiments: Physics-based model formulation, experimental demonstration, and an open software tool

Low C-rate charge and discharge experiments, plus complementary differential voltage or differential capacity analysis, are among the most common battery characterization methods. Here, we adapt the multi-species, multi-reaction (MSMR) half-cell thermodynamic model to low C-rate cycling of whole-cell Li-ion batteries. MSMR models for the anode and cathode are coupled through whole-cell charge balances and cell-cycling voltage constraint equations, forming the basis for model-based estimation of MSMR half-cell parameters from whole-cell experimental data. Emergent properties of the whole-cell, like slippage of the anode and cathode lithiation windows, are also computed as cells cycle and degrade. A sequential least-square optimization scheme is used for parameter estimation from low-C cycling data of Samsung 18650 NMC|C cells. Low-error fits of the open-circuit cell voltage (e.g., under 5 mV mean absolute error for charge or discharge curves) and differential voltage curves for fresh and aged cells are achieved. We explore the features (and limitations) of using literature reference values for the MSMR half-cell thermodynamic parameters (reducing our whole-cell formulation to a 1-degree-of-freedom fit) and demonstrate the benefits of expanding the degrees of freedom by letting the MSMR parameters be tailored to the cell under test, within a constrained neighborhood of the half-cell reference values. Bootstrap analysis is performed on each dataset to show the robustness of our fitting to experimental noise and data sampling over the course of 600 cell cycles. The results show which specific MSMR insertion reactions are most responsible for capacity loss in each half-cell and the collective interactions that lead to whole-cell slippage and changes in useable capacity. Open-source software is made available to easily extend this model-based analysis to other labs and battery chemistries.

Individual-based Creatine Kinase Reference Values in Response to Soccer Match-play

The aim of the present study was to determine the creatine kinase reference limits for professional soccer players based on their own normal post-match response. The creatine kinase concentration was analyzed in response to official matches in 25 players throughout a 3-year period. Samples were obtained between 36–43 hours following 70 professional soccer matches and corresponded to 19.1±12.1 [range: 6–49] samples per player. Absolute reference limits were calculated as 2.5th and 97.5th percentile of the samples collected. Creatine kinase values were also represented as a percentage change from the individual’s season mean and represented by 90th, 95th and 97.5th percentiles. The absolute reference limits for creatine kinase concentration calculated as 97.5th and 2.5th percentiles were 1480 U.L−1 and 115.8 U.L−1, respectively. The percentage change from the individual’s season mean was 97.45±35.92% and players were in the 90th, 95th and 97.5th percentiles when the percentages of these differences were 50.01, 66.7, and 71.34% higher than player’s season mean response, respectively. The data allowed us to determine whether the creatine kinase response is typical or if it is indicative of a higher than normal creatine kinase elevation and could be used as a practical guide for detection of muscle overload, following professional soccer match-play.

Antiviral T-Cell Frequencies in a Healthy Population: Reference Values for Evaluating Antiviral Immune Cell Profiles in Immunocompromised Patients

Viral infections and reactivations are major causes of morbidity and mortality after hematopoietic stem cell (HSCT) and solid organ transplantation (SOT) as well as in patients with immunodeficiencies. Latent herpesviruses (e.g., cytomegalovirus, Epstein-Barr virus, and human herpesvirus 6), lytic viruses (e.g., adenovirus), and polyomaviruses (e.g., BK virus, JC virus) can cause severe complications. Antiviral drugs form the mainstay of treatment for viral infections and reactivations after transplantation, but they have side effects and cannot achieve complete viral clearance without prior reconstitution of functional antiviral T-cell immunity. The aim of this study was to establish normal ranges for virus-specific T-cell (VST) frequencies in healthy donors. Such data are needed for better interpretation of VST frequencies observed in immunocompromised patients. Therefore, we measured the frequencies of VSTs against 23 viral protein-derived peptide pools from 11 clinically relevant human viruses in blood from healthy donors (n = 151). Specifically, we determined the VST frequencies by interferon-gamma enzyme-linked immunospot assay and classified their distribution according to age and gender to allow for a more specific evaluation and prediction of antiviral immune responses. The reference values established here provide an invaluable tool for immune response evaluation, intensity of therapeutic drugs and treatment decision-making in immunosuppressed patients. This data should make an important contribution to improving the assessment of immune responses in immunocompromised patients.

Cord-blood derived chemistry reference values in preterm infants for sodium, chloride, potassium, glucose, and creatinine

Objectives: Guidelines recommend preterm infants be supported to maintain their serum electrolytes within “normal” ranges. In term babies, cord blood values differed in pathological pregnancies from healthy ones. Study design: We examined cord blood sodium, chloride, potassium, glucose, and creatinine to derive maturity-related reference intervals. We examined associations with gestational age, delivery mode, singleton versus multiple, and prenatal maternal adverse conditions. We compared preterm cord values to term, and to adult reference ranges. Results: There were 591 infants, 537 preterm and 54 term. Preterm cord glucose levels were steady (3.7+/-1.1mmol/l), while sodium, chloride and creatinine increased over GA by 0.17, 0.14 and 1.07 micromol/week respectively (p<0.003). Average preterm cord potassium and chloride were higher than term (p<0.05). Compared to adult reference intervals, cord preterm reference intervals were higher for chloride (100-111 vs 98-106 mmol/l), lower for creatinine (29-84 vs 62-115 micromol/l), more variable for potassium (2.7-7.9 vs. 3.5-5.0 mmol/l) and sodium (130-141 vs. 136-145 mmol/l). Cesarean section was associated with higher potassium and lower glucose; multiple births with higher chloride and creatinine and lower glucose; SGA with lower glucose. Conclusions: Cord blood values vary across the GA range with increases in sodium, chloride and creatinine while glucose remained steady. Average preterm reference values were higher than term values for potassium and chloride. Preterm reference values differed from published adults’ reference values. The varies across GA and by delivery mode, SGA, and being a multiple, which may have direct implications for neonatal care and fluid management.

Hematological condition of breeding bulls after a long winter period of operation in the conditions of the Udmurt Republic

Purpose: to study hematological parameters of blood in bulls-producers of dairy breeds on the day of semen collection in the Udmurt Republic after a long winter period of operation, depending on the breeds, age and place of selection.Materials and methods. The work was performed at the Federal Research Center for Animal Husbandry named after Academy Member L. K. Ernst on the basis of AO "Udmurtplem" of the Udmurt Republic in the period from 2020 to 2021 on dairy bulls (n=20) aged 15-69 months, including a purebred Holstein breed of domestic selection (n=6), a Holstein black-and-white breed of European selection (the Netherlands, n=6), a black-and-white breed with blood transfusion on Holsteins on at the level of 94-98% (n=8). The content of white blood cells, red blood cells, hemoglobin and hematocrit, depending on age and breed, was studied on the ABC VET hematological analyzer on the day of taking the seed.Results. It was found that on average, in 20 bulls aged 15-69 months, the level of white blood cells was at the level of reference values of 8.8±0.25 x 109/l, red blood cells 10.3 x 1012/l, which is 50% more than the reference values. The concentration of hemoglobin is 128.0±2.92 g/l, hematocrit is on average 54.3%, with a norm of 24-46%. Breeding bulls at a reliable level, differing in age, showed that some animals had high indicators for red blood cells of 10.3±0.26 x 102, for hematocrit of 54.3% against 24-46% of reference values. Also, according to hematological indicators, there was a tendency to increase the concentration of hemoglobin and hematocrit in European-bred bulls.Conclusion. The study of the variability in hematological parameters depending on the selection showed that there is no significant difference in leukocytes and all indicators are at the level of reference values, and in erythrocytes more than 50% than the highest indicators. The highest hemoglobin values were at the level of 141-156 g/l instead of 128 g/l according to the highest reference values. Hematocrit also showed high max values in all groups in comparison with the reference values of 59-66% versus 46% in the norm. It is necessary when analyzing hematological blood parameters in addition to the average statistical indicators (M+m) also, monitor the variability (min-max) in order to obtain more objective information.

Normal sex and age-specific parameters in a multi-ethnic population: a cardiovascular magnetic resonance study of the Canadian Alliance for Healthy Hearts and Minds cohort

Background Despite the growing utility of cardiovascular magnetic resonance (CMR) for cardiac morphology and function, sex and age-specific normal reference values derived from large, multi-ethnic data sets are lacking. Furthermore, most available studies use a simplified tracing methodology. Using a large cohort of participants without history of cardiovascular disease (CVD) or risk factors from the Canadian Alliance for Healthy Heart and Minds, we sought to establish a robust set of reference values for ventricular and atrial parameters using an anatomically correct contouring method, and to determine the influence of age and sex on ventricular parameters. Methods and results Participants (n = 3206, 65% females; age 55.2 ± 8.4 years for females and 55.1 ± 8.8 years for men) underwent CMR using standard methods for quantitative measurements of cardiac parameters. Normal ventricular and atrial reference values are provided: (1) for males and females, (2) stratified by four age categories, and (3) for different races/ethnicities. Values are reported as absolute, indexed to body surface area, or height. Ventricular volumes and mass were significantly larger for males than females (p < 0.001). Ventricular ejection fraction was significantly diminished in males as compared to females (p < 0.001). Indexed left ventricular (LV) end-systolic, end-diastolic volumes, mass and right ventricular (RV) parameters significantly decreased as age increased for both sexes (p < 0.001). For females, but not men, mean LV and RVEF significantly increased with age (p < 0.001). Conclusion Using anatomically correct contouring methodology, we provide accurate sex and age-specific normal reference values for CMR parameters derived from the largest, multi-ethnic population free of CVD to date. Clinical trial registration ClinicalTrials.gov, NCT02220582. Registered 20 August 2014—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02220582.

Revised D-A-CH reference values for the intake of biotin

Purpose The reference values for biotin intake for Germany, Austria and Switzerland lead back to a report in 2000. Following a timely update process, they were revised in 2020. Methods For infants aged 0 to < 4 months, adequate biotin supply via human milk was assumed and in consequence the reference value reflects the amount of biotin delivered by human milk. For infants aged 4 to < 12 months, biotin intake was extrapolated from the reference value for younger infants. Due to missing data on average requirement, the reference values for biotin intake for children, adolescents and adults were derived based on observed intake levels. The reference value for lactating women considered in addition biotin losses via human milk. Results The reference value for biotin intake for infants aged 0 to < 4 months was set at 4 µg/day and for infants aged 4 to < 12 months at 6 µg/day. In children and adolescents, the reference values for biotin intake ranged from 20 µg/day in children 1 to < 4 years to 40 µg/day in youths 15 to < 19 years. For adults including pregnant women, 40 µg/day was derived as reference value for biotin intake. For lactating women, this value was set at 45 µg/day. Conclusions As deficiency symptoms of biotin do not occur with a usual mixed diet and the average requirement cannot be determined, reference values for an adequate biotin intake for populations from Germany, Austria and Switzerland were derived from biotin intake levels assessed in population-based nutrition surveys.