This work was supported by STW (12864, C.C.W.G.B) and the Netherlands Organization for Scientific Research (Rubicon Grant 825.12.016, T.M.H.E).

Los pasos descritos en la siguiente sección están en línea con y aceptados por el comité de ética médica del Centro Médico de la Universidad de Radboud en Nijmegen, Países Bajos. Hasta donde sabemos, 3 sistemas comerciales diferentes de pastillas de temperatura ingeribles están actualmente disponibles para los investigadores. El manual de usuario de las píldoras de temperatura ingeribles es específica de la marca (Tabla de Materiales Específicos), pero todos los sistemas son adecuados para las mediciones durante el ejercicio y en condiciones de reposo. 1. Criterios de exclusión y Asunto Instrucción <ol><li> Pregunta sujetos en forma escrita o verbal de los criterios de exclusión para el uso de la píldora temperatura telemétrico: 1) peso corporal inferior a 36,5 kg, 2) enfermedad gastrointestinal obstructiva, 3) la historia de la cirugía gastrointestinal, 4) un dispositivo médico implantado, y 5 ) un MRI scan programado durante el período experimental. </li><li> Anote el número de serie y la calibración de la píldora de la temperatura. </li&gt; <li> Instruya a los sujetos cómo usar la píldora de la temperatura (véase la sección 2). </li><li> Dar la píldora para el sujeto junto con un manual de instrucciones corta, que contiene la información que se muestra en la sección 2. Si los sujetos reciben la píldora temperatura muy por delante del experimento, recordar el tema del día anterior al experimento de ingerir la píldora temperatura. </li></ol> 2. Instrucciones píldora Temperatura <ol><li> Instruir al sujeto a ingerir la píldora temperatura de al menos 6 horas antes del experimento, para evitar cualquier interacción con la ingesta de fluidos. Siga los pasos posteriores a ingerir la píldora temperatura correctamente. </li><li> Instruya al sujeto para eliminar la banda magnética de la píldora, para activar la batería y permitir medición. </li><li> Instruya al sujeto de ingerir la píldora temperatura preferiblemente con un vaso de agua para mejorar la píldora de la ingestión. </li><li> Pida al sujeto que devolver el material de embalaje de la píldora para el equipo de investigación, para que puedan check números de serie y de calibración antes del comienzo del experimento. </li><li> Indique al sujeto que la píldora temperatura dejará el cuerpo a través de su forma natural (heces) y puede ser lavado a través del inodoro. </li></ol> 3. Experimental Protocolo I: Modo de la sección transversal Nota: En el modo de sección transversal es posible medir hasta 99 temas simultáneamente. <ol><li> Ajuste la grabadora para que los ajustes deseados para la medición de la sección transversal antes de la medición. <ol><li> Encienda la grabadora, conecte la grabadora al ordenador con un cable de transferencia y pulse el botón &#39;F2-PC Link &quot;para que el grabador para conectar con el ordenador. </li><li> Abra el software de Tc en el ordenador, que se puede utilizar para definir los ajustes correctos. Nota: El software es suministrado por la empresa con el fin de la píldora temperatura y grabadora. </li><li> Para ajustar la configuración, haga clic en &#39;ProgramR17; en la pantalla principal del software, y posteriormente utilizar el botón de &#39;PC link abierto &quot;para establecer una conexión con la grabadora y seleccione los ajustes correctos. <ol><li> Seleccione el modo de medición de sección transversal seleccionando &#39;modo Deportes ON&#39;. </li><li> Seleccione la escala de medición de temperatura correcta (Celsius o Fahrenheit). Utilice el &#39;Escribe Config para Grabador&#39; botón para copiar los ajustes de la grabadora. </li><li> Añadir el número de serie y la calibración de todos los sujetos individuales a la grabadora externa, que permite la opción de cambiar de usuario durante el experimento. Pulse el botón &#39;Sensor / código de barras Pantalla&#39; en el software y agregar todos los números de serie y de calibración. Empuje los &#39;Sensores Escribir al Registrador&#39; botón para copiar los datos a la grabadora. </li><li> Compruebe la batería del registrador antes de la medición, para evitar una batería descargada durante la medición y, por tanto, los datos que faltan. Nota: Normalmente, un batteEstado ry de 75% es suficiente para medir durante&gt; 10 h. </li></ol></li></ol></li><li> Una vez que todos los preparativos se han completado y los ajustes predefinidos se comprueban, iniciar el experimento. Para ello, vuelva a la pantalla de inicio de la grabadora y utilizar el botón &#39;F2-Sport&#39; para iniciar la adquisición de datos. </li><li> Al jugador XX aparece en la pantalla, pulse el botón &#39;Leer&#39; para medir la TGI. Utilice el botón &#39;Leer&#39; de nuevo para una medición adicional de la TGI. </li><li> Para cambiar de usuario, haga clic en el número correcto en la grabadora y posteriormente medir el Tc pulsando el botón &#39;Leer&#39;. </li><li> Detener la recopilación de datos pulsando el botón &quot;Stop&quot;. </li><li> Una vez finalizada la medición, apague la grabadora en la forma correcta para evitar la pérdida de datos. Para hacerlo, utilice el botón &#39;Enter&#39; y &#39;Salir&#39; se hace visible en la pantalla principal. Pulse el botón &#39;F1-Exit&#39; y vuelta del rec la grabadora muestra &#39;orden&#39;. Posteriormente, utilice el interruptor de encendido para apagar la grabadora. </li><li> Exportación y almacenar los datos en bruto de la grabadora externa a un ordenador (véase la sección 5, el manejo de datos). </li></ol> 4. Experimental Protocolo II: Modo Continuo Nota: El modo continuo permite medir de forma continua y guardar el Tgi de un sujeto individual en un intervalo de tiempo constante predefinida, por ejemplo, cada 20 seg. En la siguiente sección, la secuencia de pasos utilizados para realizar este tipo de medición se describe. <ol><li> Ajuste la grabadora a la configuración correcta para el modo de medición continua antes de la medición (véase la sección 3, los pasos 3.1.1-3.1.3). </li><li> Seleccione el modo de medición continua mediante la selección de &#39;modo de Deportes OFF&#39;. </li><li> Seleccione una frecuencia de medición mediante el ajuste del &#39;Leer Intervalo&#39; al intervalo de tiempo constante derecha (hh: mm: ss), con un intervalo de muestreo mínimo de 10 seg. </li><li> Seleccione el corescala de medición de temperatura rect (Celsius o Fahrenheit). Utilice el &#39;Escribe Config para Grabador&#39; botón para copiar los ajustes de la grabadora. </li><li> Compruebe la batería del registrador antes de la medición, para evitar una batería descargada durante la medición y, por tanto, los datos que faltan. Nota: Normalmente, un estado de la batería de 75% es suficiente para llevar a cabo una medición de 24 horas. </li><li> Una vez que todos los preparativos se han completado y los ajustes predefinidos se comprueban, iniciar el experimento. Iniciar la adquisición de datos pulsando el botón &quot;Ejecutar&quot; en la pantalla principal de la grabadora. </li><li> Posteriormente, conecte la grabadora en un bolso de la cintura cerca de la zona abdominal del sujeto (máxima 30-40 cm entre la zona abdominal y la grabadora) para evitar errores de medición. Nota: Después de que el comienzo del experimento, cada intervalo de tiempo predefinido se tomará una medida de Tc. Con el botón &quot;Leer&quot; se pueden añadir puntos de muestreo adicionales. </li><li> Detenga el Tc medición pulsando el botón &quot;Stop&quot;. </li><li> Utilice el botón &#39;F1-Exit&#39; para obtener el mensaje de &#39;apagar la unidad&#39; y luego use el interruptor de encendido para apagar la grabadora. </li><li> Exportación y almacenar los datos en bruto de la grabadora externa a un ordenador (véase la sección 5, la extracción de datos). </li></ol> 5. Extracción de datos <ol><li> Conecte la grabadora al ordenador para completar la exportación de datos (artículo 3, paso 3.1.1). </li><li> Abra el software y haga clic en el botón &#39;Descargar&#39; en la pantalla principal del software. </li><li> Introduzca un nombre de archivo y pulse el botón &#39;OK&#39;. Nota: Los datos quedarán almacenados en un archivo .cvt, que se puede abrir utilizando el software de hoja de cálculo. </li><li> Abra el archivo de datos y comprobar visualmente los datos recogidos para los datos y los valores extremos que falta. Nota: Una gran disminución o aumento de la Tgi (≤1 ° C) dentro de un corto intervalo de tiempo (± 1 min) es muy poco realista y puede ser causada por una disturBance de la señal de radio. Como resultado, el punto de datos no realista puede ser retirado para su posterior análisis. </li><li> Interpolar los valores que faltan promediando el valor válido anterior y siguiente. Nota: La interpolación de los datos es posible con un máximo de tres valores perdidos en fila. </li></ol>

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No conflicts of interest declared.

La píldora ingerible temperatura telemétrico tiene la capacidad de proporcionar una medición continua, válida y no invasiva del Tgi. Además, una ventaja de la píldora temperatura es el hecho de que una vez ingeridos, los sujetos no son conscientes de la presencia de la píldora en el cuerpo o que las mediciones se llevan a cabo. Por lo tanto, este método es fácilmente aplicable en condiciones de reposo, así como durante el ejercicio, una carga mínima para los participantes del estudio, y por lo tanto puede ser...

La oxidación de los sustratos durante las contracciones musculares, necesaria para realizar el ejercicio y la actividad física, importante impactos nuestro sistema termorregulador, ya que sólo 20% se utiliza para la potencia muscular 1, mientras que la mayoría de la energía se libera en forma de calor (80%) 2,3. Como consecuencia, la producción de calor metabólico elevado durante la actividad física y ejercicio normalmente excede la capacidad de disipación de calor 4,5, lo que resulta en un aumento en la temperatura corporal central (Tc). En consecuencia, Tc se eleva por encima del punto de ajuste hipotalámico, que se define como la hipertermia 6, e incluso puede resultar en un rendimiento del ejercicio 5,7,8 atenuada y / o el desarrollo de trastornos relacionados con el calor 4,6. Por esta razón, es importante medir con precisión Tc durante el ejercicio prolongado y en particular en condiciones ambientales extenuantes. Literatura describe que un método ideal para medir Tc debe: 1) ser de fácil aplicaciónlicable, 2) no estar sesgados por las condiciones ambientales, 3) tener una alta resolución temporal para controlar rápidamente los cambios en Tc, y 4) tienen la capacidad de detectar pequeños cambios (Δ0.1 ° C) en la temperatura corporal 9,10. Una visión general de los diferentes métodos para medir la Tc fue dado por la Organización Internacional de Normalización (ISO 9886) 11. Se dijo que la temperatura de esófago a nivel de la aurícula izquierda ofrece el acuerdo más cercano con la temperatura central de sangre, mientras que esta medida es capaz de detectar rápidamente los cambios (menores) de la temperatura 12. Aunque las mediciones de temperatura de esófago son generalmente aceptados como el estándar de oro para grabar Tc, su naturaleza invasiva limita el uso práctico de este método. Medidas alternativas para controlar Tc se basan en grabaciones de temperatura de la membrana externa del tímpano, la boca o el recto 12. Estos sitios de medición no son óptimos para medir la Tc, dado su carácter invasivo, METODOLOGÍAdificultades iCal y / o el sesgo potencial por las condiciones ambientales 9,12-14 (Tabla 1). Esto pone de relieve la necesidad de explorar estrategias alternativas para controlar (cambios en) Tc. Estudios previos han descrito el uso de una píldora temperatura telemétrico ingerible como un método de fácil aplicación, fiable y válido para medir la Tgi, que es una estimación representativa de Tc 9,15. Otra, importante, la ventaja de la píldora temperatura es la idoneidad en situaciones sobre el terreno, que es de gran importancia ya elevaciones inducidas por el ejercicio en Tc son generalmente más altos en el campo que en el laboratorio 16. Actualmente, la píldora temperatura es capaz de medir la Tgi cada 10 seg con una precisión de ± 0,1 ° C, lo que hace esta técnica muy adecuada para medir la Tgi durante un evento de ejercicio o un partido importante. Además, en un estudio realizado por Stevens et al 17. Se demuestra quela píldora temperatura de telemetría puede usarse también para controlar la temperatura intragástrica. La píldora temperatura ingerible se describió por primera vez en 1961 18, y desarrollado en la Universidad Johns Hopkins (Baltimore, EE.UU.) en colaboración con el Laboratorio de Física Aplicada de la NASA. El resultado es una cápsula de 20 x 10 mm con un sistema de telemetría, micro batería y un sensor de temperatura de cristal de cuarzo. El sensor de cristal vibra a una frecuencia relativa a la temperatura de la sustancia circundante. Esta señal de radio de temperatura se transmite a través del cuerpo, que puede ser medida por una grabadora externa (Figura 1). Cada píldora de temperatura tiene un número de serie y la calibración única, que puede ser utilizado por la grabadora para convertir la señal de radio y medir la Tgi correspondiente. Una pequeña banda magnética está unida a la parte exterior de la píldora de la temperatura, que desactiva la batería. Cuando se quita esta banda magnética, la píldora es activado inmediatamente y comienza a medir Tc (Figura 2). Casa y colegas, 19 utilizaron seis técnicas distintas (gastrointestinal, rectales, fonético, temporal, axiales y de la frente) para medir Tc, con la temperatura rectal establecer como valor de referencia. Ellos demostraron que la medición gastrointestinal de Tc con la píldora temperatura es la única técnica que muestra buen acuerdo con la referencia Tc. Otros investigaron la relación entre Tgi y la temperatura rectal y han mostrado un pequeño pero significativo sesgo que van desde 0,07 ° C a 0,20 ° C 9,15,20,21. Aunque la dirección y magnitud del sesgo difirieron entre los estudios, los de Bland y Altman 95% los límites de acuerdo fueron ± 0,4 ° C, la cual es aceptable 9,22. Además, en una revisión por Byrne et al. 9 la Tgi se compara con la temperatura rectal y esofágico (patrón oro) como una medida para la Tc. Ellos demuestran que la Tgi mide con el tepíldora mperatura es una medida válida para Tc basado en el buen acuerdo entre la temperatura intestinal y de esófago. Por otra parte, los 95% los límites de Bland y Altman de acuerdo se limitaron a ± 0,4 ° C 22, mientras que hay un sesgo significativo se encontró entre las dos mediciones 9,20,21. Estos resultados sugieren que la Tgi es una medida válida para Tc. Otro aspecto importante de una buena técnica de medición Tc / Tgi es una alta resolución temporal para controlar rápidamente los cambios en Tc. Estudios anteriores han demostrado que la Tgi medido con la píldora de temperatura responde más lentamente sobre los cambios en Tc en comparación con la medición de esófago 15,20,23, que se puede explicar debido a la baja capacidad de calor del esófago y la proximidad al corazón 10 . En la medición de temperatura esofágica, el termistor se coloca a nivel de la aurícula izquierda 10. En este nivel, la arteria pulmonar y el esófago están en contactoy isotérmica 24, que estimula un rápido tiempo de respuesta en los cambios en la temperatura de la medición de esófago. En contraste, los intestinos y el recto son menos perfundidos en comparación con el esófago, lo que resulta en un retraso en la medición de los cambios de temperatura en estas localizaciones anatómicas. Sin embargo, la píldora ingerible temperatura telemétrico tiene una precisión de ± 0,1 ° C y es capaz de medir Tgi cada 10 seg. Un estudio anterior informó de que la temperatura corporal central puede elevarse a un máximo de 1 ° C cada 5 min si no se elimina calor durante el ejercicio 25. Por lo tanto, la resolución temporal de la píldora de temperatura es adecuado para medir cambios en Tgi durante el ejercicio. Sobre la base de estos resultados, se puede concluir que la píldora temperatura es una técnica fiable y válido para medir la TGI. A pesar del uso de la píldora temperatura telemétrica en un gran número de estudios, una descripción clara acerca de cómo utilizar la temperatura de la píldora no se encuentra. Por lo tanto, tl objetivo de este estudio es proporcionar una descripción detallada del protocolo de medición utilizando una píldora temperatura telemétrico ingerible. En segundo lugar, la aplicación de la píldora temperatura de telemetría en dos diferentes protocolos de estudio se describen, en el que se utilizan un diseño de la sección transversal (medida de cada 5 km con una grabadora diferente) y un protocolo que registra continuamente Tgi en los individuos.

<table border="0" cellpadding="0" cellspacing="0">
	<tbody>
		<tr>
			<td>CorTemp data recorder</td>
			<td>CorTemp system, HQ Inc., Florida, USA</td>
			<td>Not applicable</td>
			<td>http://www.hqinc.net/cortemp-data-recorder/</td>
		</tr>
		<tr>
			<td>Cortemp ingestible telemetric temperature pill</td>
			<td>CorTemp system, HQ Inc., Florida, USA</td>
			<td>HT150002</td>
			<td>http://www.hqinc.net/cortemp-sensor-2/</td>
		</tr>
		<tr>
			<td>CorTrack II software (Data processing for a PC only)</td>
			<td>CorTemp system, HQ Inc., Florida, USA</td>
			<td>Not applicable</td>
			<td>http://www.hqinc.net/cortrack-ii-data-graphing-software/</td>
		</tr>
	</tbody>
</table>

using an ingestible telemetric temperature pill to assess gastrointestinal temperature during exercise

Exercise results in an increase in core body temperature (Tc), which may reduce exercise performance and eventually can lead to the development of heat-related disorders. Therefore, accurate measurement of Tc during exercise is of great importance, especially in athletes who have to perform in challenging ambient conditions. In the current literature a number of methods have been described to measure the Tc (esophageal, external tympanic membrane, mouth or rectum). However, these methods are suboptimal to measure Tc during exercise since they are invasive, have a slow response or are influenced by environmental conditions. Studies described the use of an ingestible telemetric temperature pill as a reliable and valid method to assess gastrointestinal temperature (Tgi), which is a representative measurement of Tc. Therefore, the goal of this study was to provide a detailed description of the measurement of Tgi using an ingestible telemetric temperature pill. This study addresses important methodological factors that must be taken into account for an accurate measurement. It is recommended to read the instructions carefully in order to ensure that the ingestible telemetric temperature pill is a reliable method to assess Tgi at rest and during exercise.

Los resultados representativos de nuestro trabajo previo que demuestran los métodos se presentan en la siguiente sección, en la que se da un ejemplo de una sección transversal (Figura 3A) y una medición continua (Figura 3B). Medición de la sección transversal de Tgi Un ejemplo de los datos de una medición de la sección transversal se muestra en la Figura 3A. Después de obtener la línea de base Tgi, los ...

Watch this Scientific Journal Video about Using an Ingestible Telemetric Temperature Pill to Assess Gastrointestinal Temperature During Exercise at JoVE.com

Using an Ingestible Telemetric Temperature Pill to Assess Gastrointestinal Temperature During Exercise

This study describes an accurate, reliable and non-invasive technique to continuously measure gastrointestinal temperature during exercise. The ingestible telemetric temperature pill is suitable to measure gastrointestinal temperature in laboratory settings as well as in field based settings.

El uso de una temperatura píldora ingerible telemétrico para evaluar la temperatura gastrointestinal durante el ejercicio

Exercise results in an increase in core body temperature (Tc), which may reduce exercise performance and eventually can lead to the development of ...

using-an-ingestible-telemetric-temperature-pill-to-assess

Research

Education

JoVE Core

JoVE Journal

Nursing

Medicine

Unit 1

Vital Signs: Temperature

SCIENTISTS IN ACTION

10.3K vistas.  Radboud University Medical Center. This study describes an accurate, reliable and non-invasive technique to continuously measure gastrointestinal temperature during exercise. The ingestible telemetric temperature pill is suitable to measure gastrointestinal temperature in laboratory settings as well as in field based settings. 

Video: Using an Ingestible Telemetric Temperature Pill to Assess Gastrointestinal Temperature During Exercise

Using Learning Outcome Measures to assess Doctoral Nursing Education

Education programs at all levels must be able to demonstrate successful program outcomes. Grades alone do not represent a comprehensive measurement methodology for assessing student learning outcomes at either the course or program level. The development and application of assessment rubrics provides an unequivocal measurement methodology to ensure a quality learning experience by providing a foundation for improvement based on qualitative and quantitatively measurable, aggregate course and program outcomes.  Learning outcomes are the embodiment of the total learning experience and should incorporate assessment of both qualitative and quantitative program outcomes. The assessment of qualitative measures represents a challenge for educators in any level of a learning program. Nursing provides a unique challenge and opportunity as it is the application of science through the art of caring. Quantification of desired student learning outcomes may be enhanced through the development of assessment rubrics designed to measure quantitative and qualitative aspects of the nursing education and learning process. They provide a mechanism for uniform assessment by nursing faculty of concepts and constructs that are otherwise difficult to describe and measure. A protocol is presented and applied to a doctoral nursing education program with recommendations for application and transformation of the assessment rubric to other education programs. Through application of these specially designed rubrics, all aspects of an education program can be adequately assessed to provide information for program assessment that facilitates the closure of the gap between desired and actual student learning outcomes for any desired educational competency.

The structure and process for measuring student learning outcomes through customizable assessment rubrics is discussed and applied to a doctoral nursing education program.

Resultado del aprendizaje utilizando las medidas para evaluar la educación de Doctorado en Enfermería

Education programs at all levels must be able to demonstrate successful program outcomes. Grades alone do not represent a comprehensive measurement ...

Investigación

Medicina

Using Quantitative Real-time PCR to Determine Donor Cell Engraftment in a Competitive Murine Bone Marrow Transplantation Model

Murine bone marrow transplantation models provide an important tool in measuring hematopoietic stem cell (HSC) functions and determining genes/molecules that regulate HSCs. In these transplant model systems, the function of HSCs is determined by the ability of these cells to engraft and reconstitute lethally irradiated recipient mice. Commonly, the donor cell contribution/engraftment is measured by antibodies to donor- specific cell surface proteins using flow cytometry. However, this method heavily depends on the specificity and the ability of the cell surface marker to differentiate donor-derived cells from recipient-originated cells, which may not be available for all mouse strains. Considering the various backgrounds of genetically modified mouse strains in the market, this cell surface/ flow cytometry-based method has significant limitations especially in mouse strains that lack well-defined surface markers to separate donor cells from congenic recipient cells. Here, we reported a PCR-based technique to determine donor cell engraftment/contribution in transplant recipient mice. We transplanted male donor bone marrow HSCs to lethally irradiated congenic female mice. Peripheral blood samples were collected at different time points post transplantation. Bone marrow samples were obtained at the end of the experiments. Genomic DNA was isolated and the Y chromosome specific gene, Zfy1, was amplified using quantitative Real time PCR. The engraftment of male donor-derived cells in the female recipient mice was calculated against standard curve with known percentage of male vs. female DNAs. Bcl2 was used as a reference gene to normalize the total DNA amount. Our data suggested that this approach reliably determines donor cell engraftment and provides a useful, yet simple method in measuring hematopoietic cell reconstitution in murine bone marrow transplantation models. Our method can be routinely performed in most laboratories because no costly equipment such as flow cytometry is required.

Determining donor cell engraftment presents a challenge in mouse bone marrow transplant models that lack well-defined phenotypical markers. We described a methodology to quantify male donor cell engraftment in female transplant recipient mice. This method can be used in all mouse strains for the study of HSC functions.

Usando cuantitativa en tiempo real PCR para determinar quimerismo de células donantes en un modelo competitivo Trasplante de médula ósea murina

Murine bone marrow transplantation models provide an important tool in measuring hematopoietic stem cell (HSC) functions and determining genes/molecules ...

Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation

Pulmonary rehabilitation (PR) is an important component in the management of respiratory diseases. The effectiveness of PR is dependent upon adherence to exercise training recommendations. The study of exercise adherence is thus a key step towards the optimization of PR programs. To date, mostly indirect measures, such as rates of participation, completion, and attendance, have been used to determine adherence to PR. The purpose of the present protocol is to describe how continuous data tracking technology can be used to measure adherence to a prescribed aerobic training intensity on a second-by-second basis.
In our investigations, adherence has been defined as the percent time spent within a specified target heart rate range. As such, using a combination of hardware and software, heart rate is measured, tracked, and recorded during cycling second-by-second for each participant, for each exercise session. Using statistical software, the data is subsequently extracted and analyzed. The same protocol can be applied to determine adherence to other measures of exercise intensity, such as time spent at a specified wattage, level, or speed on the cycle ergometer. Furthermore, the hardware and software is also available to measure adherence to other modes of training, such as the treadmill, elliptical, stepper, and arm ergometer. The present protocol, therefore, has a vast applicability to directly measure adherence to aerobic exercise.

Pulmonary rehabilitation is widely recognized in the management of respiratory diseases. A key component to successful pulmonary rehabilitation is adherence to the recommended exercise training. The purpose of the present protocol is to describe how continuous data tracking technology can be used to precisely measure adherence to a prescribed aerobic training intensity.

El uso de la tecnología de seguimiento de datos continua para Estudiar Ejercicio Adherencia en Rehabilitación Pulmonar

Pulmonary rehabilitation (PR) is an important component in the management of respiratory diseases. The effectiveness of PR is dependent upon adherence to ...

Ex Vivo Intestinal Sacs to Assess Mucosal Permeability in Models of Gastrointestinal Disease

The epithelial barrier is the first innate defense of the gastrointestinal tract and selectively regulates transport from the lumen to the underlying tissue compartments, restricting the transport of smaller molecules across the epithelium and almost completely prohibiting epithelial macromolecular transport. This selectivity is determined by the mucous gel layer, which limits the transport of lipophilic molecules and both the apical receptors and tight junctional protein complexes of the epithelium. In vitro cell culture models of the epithelium are convenient, but as a model, they lack the complexity of interactions between the microbiota, mucous-gel, epithelium and immune system. On the other hand, in vivo assessment of intestinal absorption or permeability may be performed, but these assays measure overall gastrointestinal absorption, with no indication of site specificity. Ex vivo permeability assays using &#34;intestinal sacs&#34; are a rapid and sensitive method of measuring either overall intestinal integrity or comparative transport of a specific molecule, with the added advantage of intestinal site specificity. Here we describe the preparation of intestinal sacs for permeability studies and the calculation of the apparent permeability (Papp) of a molecule across the intestinal barrier. This technique may be used as a method of assessing drug absorption, or to examine regional epithelial barrier dysfunction in animal models of gastrointestinal disease.

Ex Vivo Intestinal Sacs to Assess Mucosal Permeability in Models of Gastrointestinal Disease

This protocol describes the use of excised intestinal tissue preparations or "intestinal sacs" as an ex vivo model of intestinal barrier function. This model may be used to assess integrity of both the epithelial barrier and the mucous gel layer at specific intestinal sites in animal models of digestive disease.

Ex Vivo intestinal Sacs para evaluar la permeabilidad de la mucosa en modelos de enfermedad gastrointestinal

The epithelial barrier is the first innate defense of the gastrointestinal tract and selectively regulates transport from the lumen to the underlying ...

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise

Exercise is a stress to the pulmonary vasculature. With incremental exercise, the pulmonary diffusing capacity (DLCO) must increase to meet the increased oxygen demand; otherwise, a diffusion limitation may occur. The increase in DLCO with exercise is due to increased capillary blood volume (Vc) and membrane diffusing capacity (Dm). Vc and Dm increase secondary to the recruitment and distension of pulmonary capillaries, increasing the surface area for gas exchange and decreasing pulmonary vascular resistance, thereby attenuating the increase in pulmonary arterial pressure. At the same time, the recruitment of intrapulmonary arteriovenous anastomoses (IPAVA) during exercise may contribute to gas exchange impairment and/or prevent large increases in pulmonary artery pressure.
We describe two techniques to evaluate pulmonary diffusion and circulation at rest and during exercise. The first technique uses multiple-fraction of inspired oxygen (FIO2) DLCO breath holds to determine Vc and Dm at rest and during exercise. Additionally, echocardiography with intravenous agitated saline contrast is used to assess IPAVAs recruitment.
Representative data showed that the DLCO, Vc, and Dm increased with exercise intensity. Echocardiographic data showed no IPAVA recruitment at rest, while contrast bubbles were seen in the left ventricle with exercise, suggesting exercise-induced IPAVA recruitment.
The evaluation of pulmonary capillary blood volume, membrane diffusing capacity, and IPAVA recruitment using echocardiographic methods is useful to characterize the ability of the lung vasculature to adapt to the stress of exercise in health as well as in diseased groups, such as those with pulmonary arterial hypertension and chronic obstructive pulmonary disease.

To assess the pulmonary diffusion and vasculature responses to exercise, we describe the multiple-inspired oxygen diffusion capacity technique to determine capillary blood volume and membrane diffusing capacity, as well as agitated saline contrast echocardiography to assess the recruitment of intrapulmonary arteriovenous anastomoses.

Evaluación del volumen de sangre capilar pulmonar, la membrana Capacidad de Difusión y intrapulmonar arteriovenosa anastomosis durante el ejercicio

Exercise is a stress to the pulmonary vasculature. With incremental exercise, the pulmonary diffusing capacity (DLCO) must increase to meet the increased ...

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time. There are many reported approaches for temperature management, including improvised methods that repurpose standard supplies (e.g., ice, chilled saline, fans, blankets) but more sophisticated technologies designed for temperature management are typically more successful in delivering an optimized protocol. Over the last decade, advanced technologies have developed around two heat transfer methods: surface devices (water blankets, forced-air warmers) or intravascular devices (sterile catheters requiring vascular placement). Recently, a novel device became available that is placed in the esophagus, analogous to a standard orogastric tube, that provides efficient heat transfer through the patient&#39;s core. The device connects to existing heat exchange units to allow automatic patient temperature management via a servo mechanism, using patient temperature from standard temperature sensors (rectal, Foley, or other core temperature sensors) as the input variable. This approach eliminates vascular placement complications (deep venous thrombosis, central line associated bloodstream infection), reduces obstruction to patient access, and causes less shivering when compared to surface approaches. Published data have also shown a high degree of accuracy and maintenance of target temperature using the esophageal approach to temperature management. Therefore, the purpose of this method is to provide a low-risk alternative method for controlling patient temperature in critical care settings.

This study presents a novel method to provide efficient patient temperature control for cooling or warming patients. A single use, triple lumen device is placed into the esophagus, analogous to a standard orogastric tube, and connects to existing heat exchange units to perform automatic patient temperature management.

Transferencia de calor del esófago para el Control de temperatura del paciente y gestión de la temperatura objetivo

Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often ...

An Optimized Evans Blue Protocol to Assess Vascular Leak in the Mouse

Vascular leak, or plasma extravasation, has a number of causes, and may be a serious consequence or symptom of an inflammatory response. This study may ultimately lead to new knowledge concerning the causes of or new ways to inhibit or treat plasma extravasation. It is important that researchers have the proper tools, including the best methods available, for studying plasma extravasation. In this article, we describe a protocol, using the Evans blue dye method, for assessing plasma extravasation in the organs of FVBN mice. This protocol is intentionally simple, to as great a degree as possible, but provides high quality data. Evans blue dye has been chosen primarily because it is easy for the average laboratory to use. We have used this protocol to provide evidence and support for the hypothesis that the enzyme neprilysin may protect the vasculature against plasma extravasation. However, this protocol may be experimentally used and easily adapted for use in other strains of mice or in other species, in many different organs or tissues, for studies which may involve other factors that are important in understanding, preventing, or treating plasma extravasation. This protocol has been extensively optimized and modified from existing protocols, and combines reliability, ease of use, economy, and general availability of materials and equipment, making this protocol superior for the average laboratory to use in quantifying plasma extravasation from organs.

In this article, an economical, optimized, and simple protocol is described which uses the Evans blue dye method for assessing plasma extravasation in the organs of FVBN mice that can be adapted for use in other strains, species, and other organs or tissues.

Un optimizado Evans azul protocolo para evaluar la fuga Vascular en el ratón

Vascular leak, or plasma extravasation, has a number of causes, and may be a serious consequence or symptom of an inflammatory response. This study may ...

Conducting Maximal and Submaximal Endurance Exercise Testing to Measure Physiological and Biological Responses to Acute Exercise in Humans

Regular physical activity has a positive effect on human health, but the mechanisms controlling these effects remain unclear. The physiologic and biologic responses to acute exercise are predominantly influenced by the duration and intensity of the exercise regimen. As exercise is increasingly thought of as a therapeutic treatment and/or diagnostic tool, it is important that standardizable methodologies be utilized to understand the variability and to increase the reproducibility of exercise outputs and measurements of responses to such regimens. To that end, we describe two different cycling exercise regimens that yield different physiologic outputs. In a maximal exercise test, exercise intensity is continually increased with a greater workload resulting in an increasing cardiopulmonary and metabolic response (heart rate, stroke volume, ventilation, oxygen consumption and carbon dioxide production). In contrast, during endurance exercise tests, the demand is increased from that at rest, but is raised to a fixed submaximal exercise intensity resulting in a cardiopulmonary and metabolic response that typically plateaus. Along with the protocols, we provide suggestions on measuring physiologic outputs that include, but are not limited to, heart rate, slow and forced vital capacity, gas exchange metrics, and blood pressure to enable the comparison of exercise outputs between studies. Biospecimens can then be sampled to assess cellular, protein, and/or gene expression responses. Overall, this approach can be easily adapted into both short- and long-term effects of two distinct exercise regimens.

To assess the influence of exercise intensity on physiologic and biologic responses, two different exercise testing protocols were utilized. Methods outlining exercise testing on a cycle ergometer as an incremental maximal oxygen consumption test and endurance, steady state submaximal endurance test are described.

Realización de ejercicio máximo y submáximo resistencia pruebas para medir las respuestas fisiológicas y biológicas al ejercicio agudo en seres humanos

Regular physical activity has a positive effect on human health, but the mechanisms controlling these effects remain unclear. The physiologic and biologic ...

Providing Visual Biofeedback Using Brightness Mode Ultrasound During a Golf Swing

Using ultrasound biofeedback in conjunction with verbal cueing can increase muscle thickness more than verbal cueing alone and may augment traditional rehabilitation techniques in an athletic, physically active population. Brightness mode (B-mode) ultrasound can be applied using frame-by-frame analysis synchronized with video to understand muscle thickness changes during these dynamic tasks. Visual biofeedback with ultrasound has been established in static positions for the muscles of the lateral abdominal wall. However, by securing the transducer to the abdomen using an elastic belt and foam block, biofeedback can be applied during more specific tasks prevalent in lifetime sports, such as golf. To analyze muscle activity during a golf swing, muscle thickness changes can be compared. The thickness must increase throughout the task, indicating that the muscle is more active. This methodology allows clinicians to immediately replay ultrasound videos for patients as a visual tool to instruct proper activity of the muscles of interest. For example, ultrasound can be used to target the external and internal obliques, which play an important role in swinging a golf club or any other rotational sport or activity. This methodology aims to increase oblique muscle thickness during the golf swing. Additionally, the timing of muscle contraction can be targeted by instructing the patient to contract the abdominal muscles at specific time points, such as the beginning of the downswing, with the goal of improving muscle firing patterns during tasks.

Brightness mode ultrasound can be used to provide visual biofeedback of the muscles of the lateral abdominal wall during a golf swing. Post-swing visual and verbal instruction can increase the muscle activation and timing of the external and internal obliques.

Proporcionar biorretroalimentación visual mediante ultrasonido de modo brillo durante un swing de golf

Using ultrasound biofeedback in conjunction with verbal cueing can increase muscle thickness more than verbal cueing alone and may augment traditional ...

Muscle Function Obtained with Motion Mode Ultrasound and Surface Electromyography during Core Endurance Exercise

Motion mode (M-mode) ultrasound allows researchers and clinicians to measure the change of muscle thickness across time. Muscle thickness can be measured between fascial borders at a given time point during an exercise. This selected time point produces a one-dimensional image resulting in real-time, live observation of anatomy. Ultrasound used during functional movement can be referred to as dynamic ultrasound; this is feasible and reliable with the use of a linear transducer, elastic belt, and foam block to secure consistent transducer placement. The lateral abdominal wall is commonly investigated using ultrasound due to the overlapping nature of the muscles. Surface electromyography (sEMG) can complement M-mode ultrasound imaging because it measures the electrical representation of muscle activation. There is minimal evidence using M-mode ultrasound and sEMG simultaneously during core exercise. Exercises that challenge the core musculature involve both isometric holds (e.g., side plank), as well as oscillatory extremity movements (e.g., dead bug). In this study, both instruments will be used simultaneously to measure core muscle function during exercise. Ultrasound measurements will be obtained using a linear transducer and ultrasound unit, and sEMG measurements will be acquired from a wireless sEMG system. To make comparisons between participants and exercises, normalization methods using static, exercise starting positions for both instruments will be used. An activation ratio will be used for ultrasound and calculated by dividing the contracted thickness (thickness during a time point of exercise) by the rested (starting position) thickness. Muscle thickness will be measured in centimeters from the superior inferior fascial border to inferior superior fascial border. These methods aim to offer an innovative and practical measurement of muscle function with M-mode ultrasound and sEMG during core endurance exercises.

This protocol uses motion mode ultrasound and surface electromyography simultaneously to measure muscle function of the core. Muscle thickness and activation of the local stabilizers (e.g., transverse abdominis, internal oblique) and global movers (e.g., external oblique) is achievable during specific time points of the side plank and dead bug exercises.

Función muscular obtenida con ultrasonido de modo de movimiento y electromiografía de superficie durante el ejercicio de resistencia central

Motion mode (M-mode) ultrasound allows researchers and clinicians to measure the change of muscle thickness across time. Muscle thickness can be measured ...