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Importance: While effective, cardiovascular rehabilitation (CR) as traditionally delivered is not well implemented in lower-resource settings. Objective: To test the noninferiority of hybrid CR compared with traditional CR in terms of cardiovascular events. Design, Setting, and Participants: This pragmatic, multicenter, parallel arm, open-label randomized clinical trial (the Hybrid Cardiac Rehabilitation Trial [HYCARET]) with blinded outcome assessment was conducted at 6 referral centers in Chile. Adults aged 18 years or older who had a cardiovascular event or procedure, no contraindications to exercise, and access to a mobile telephone were eligible and recruited between April 1, 2019, and March 15, 2020, with follow-up until July 29, 2021. Interventions: Participants were randomized 1:1 in permuted blocks to the experimental arm, which received 10 center-based supervised exercise sessions plus counseling in 4 to 6 weeks and then were supported at home via telephone calls and text messages through weeks 8 to 12, or the control arm, which received the standard CR of 18 to 22 sessions with exercises and education in 8 to 12 weeks. Main Outcomes and Measures: The primary outcome was cardiovascular events or mortality. Secondary outcomes were quality of life, return to work, and lifestyle behaviors measured with validated questionnaires; muscle strength and functional capacity, measured through physical tests; and program adherence and exercise-related adverse events, assessed using checklists. Results: A total of 191 participants were included (mean [SD] age, 58.74 [9.80] years; 145 [75.92%] male); 93 were assigned to hybrid CR and 98 to standard CR. At 1 year, events had occurred in 5 unique participants in the hybrid CR group (5.38%) and 9 in the standard CR group (9.18%). In the intention-to-treat analysis, the hybrid CR group had 3.80% (95% CI, -11.13% to 3.52%) fewer cardiovascular events than the standard CR group, and relative risk was 0.59 (95% CI, 0.20-1.68) for the primary outcome. In the per-protocol analysis at different levels of adherence to the intervention, all 95% CIs crossed the noninferiority boundary (eg, 20% adherence: absolute risk difference, -0.35% [95% CI, -7.56% to 6.85%]; 80% adherence: absolute risk difference, 3.30% [95% CI, -3.70% to 10.31%]). No between-group differences were found for secondary outcomes except adherence to supervised CR sessions (79.14% [736 of 930 supervised sessions] in the hybrid CR group vs 61.46% [1201 of 1954 sessions] in the standard CR group). Conclusions and Relevance: The results suggest that a hybrid CR program is noninferior to standard center-based CR in a low-resource setting, primarily in terms of recurrent cardiovascular events and potentially in terms of intermediate outcomes. Hybrid CR may induce superior adherence to supervised exercise. Clinical factors and patient preferences should inform CR model allocation. Trial Registration: ClinicalTrials.gov Identifier: NCT03881150.

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Introducción. Introducción. El uso de humidificadores de burbuja asociados a equipos de oxigenoterapia es una práctica común en los centros hospitalarios de nuestro país. Sin embargo, no se ha evaluado el aporte real de humedad que entregan estos equipos cuando son usados con sistemas de concentración variable a distintas concentraciones de oxígeno. Además, se han descrito problemas de funcionamiento en la entrega de oxígeno cuando se han ocupado este tipo de humidificador. Objetivo. Determinar el aporte real de humedad que entregan los humidificadores de burbuja al ser usados con sistemas de oxigenoterapia de concentración variable. Métodos. Se evaluaron 10 humidificadores de burbuja, marca Hudson RCI®, con válvula liberadora de presión, los cuales se conectaron a un sistema de oxigenoterapia de concentración variable (Marca Hudson RCI®, modelo MULTI-VENT). La medición de la humedad relativa (HR) se realizó en una cámara de acrílico, donde se conectó el inyector del sistema de oxigenoterapia. Para medir H.R. y temperatura se utilizó un higrómetro digital (Veto®, Italia) y un higrómetro análogo (Hygromat®, Alemania). Cada medición requirió un tiempo de 5 minutos para lograr un valor estable. Se realizaron mediciones de la humedad relativa y temperatura entregada por este sistema, con y sin humidificador, a concentraciones de oxígeno de 0.24, 0.26, 0.28, 0.3, 0.35, 0.4 y 0.5. Resultados. Para las la temperatura, no hubo diferencias entre las mediciones realizadas con y sin humidificador de burbuja. Para la humedad relativa, sólo hubo diferencias estadísticamente significativas a concentraciones de oxígeno altas (> 0.35), pero con escaso cambio en la entrega de humedad absoluta. Cuando se utilizó flujos operativos ≥ 6 L/min se activó la válvula liberadora de presión del humidificador. Conclusión. El uso de humidificadores de burbuja asociados a sistemas de oxigenoterapia de concentración variable no genera un aumento significativo de la humedad entregada a concentraciones bajas de oxigeno, por lo cual se podría prescindir de su uso.

Background. The use of bubble humidifiers associated with oxygen therapy equipment is a common practice in hospitals in our country. However, the real contribution of humidity delivered by these equipments when used with variable concentration systems at different oxygen concentrations has not been evaluated. In addition, operating problems have been described in the delivery of oxygen when this type of humidifier has been used. Objetive. Determine the real contribution of humidity delivered by bubble humidifiers when used with variable concentration oxygen therapy systems. Methods. 10 Hudson RCI® brand bubble humidifiers with a pressure release valve were evaluated, which were connected to a variable concentration oxygen therapy system (Hudson RCI® brand, MULTI-VENT model). The relative humidity (RH) was measured in an acrylic chamber, where the injector of the oxygen therapy system was connected. To measure R.H. and temperature, a digital hygrometer (Veto®, Italy) and an analog hygrometer (Hygromat®, Germany) were used. Each measurement required a time of 5 minutes to achieve a stable value. Measurements of the relative humidity and temperature delivered by this system were made, with and without a humidifier, at oxygen concentrations of 0.24, 0.26, 0.28, 0.3, 0.35, 0.4 and 0.5. Results. For temperature, there were no differences between the measurements made with and without a bubble humidifier. For relative humidity, there were only statistically significant differences at high oxygen concentrations (> 0.35), but with little change in absolute humidity delivery. When operating flows ≥ 6 L/min were used, the humidifier pressure relief valve was activated. Conclusion. The use of bubble humidifiers associated with variable concentration oxygen therapy systems does not generate a significant increase in the humidity delivered at low oxygen concentrations, so their use could be dispensed with.

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H2S is a gaseous compound that contributes to air pollution. In this work, the electrochemical oxidation treatment of gaseous streams polluted with H2S is evaluated using a jet mixer and electrochemical cell device, in which the performance of electrolytic and electro-Fenton assisted absorption processes are compared. Results demonstrate the feasibility of both processes to remove H2S, reaching coulombic efficiencies of nearly 100% in the electrolytic assisted absorption, and 70-80% in the electro-Fenton assisted absorption. Aqueous solutions containing phosphate salts as electrolyte were found to be suitable as absorbents for the process. Efficiency in the cathodic production of H2O2 in these solutions using the experimental device was found to be as high as 32.8% (1.184 mgH2O2/min) at 12 °C and atmospheric pressure. Sequential formation of SO2 and SO3 is obtained by the oxidation of H2S contained in the gas. These species are hydrolysed, and a part remained in the absorbent as SO32- and SO42-, while the rest is dragged in the outlet gas. SO3 production is promoted by electrolytic assisted absorption and polysulphides by the electro-Fenton technology. Low concentrations of elemental sulphur are detected in the solid suspensions formed during the process.

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The ability of an organism to voluntarily control the stimuli onset modulates perceptual and attentional functions. Since stimulus encoding is an essential component of working memory (WM), we conjectured that controlling the initiation of the perceptual process would positively modulate WM. To corroborate this proposition, we tested twenty-five healthy subjects in a modified-Sternberg WM task under three stimuli presentation conditions: an automatic presentation of the stimuli, a self-initiated presentation of the stimuli (through a button press), and a self-initiated presentation with random-delay stimuli onset. Concurrently, we recorded the subjects' electroencephalographic signals during WM encoding. We found that the self-initiated condition was associated with better WM accuracy, and earlier latencies of N1, P2 and P3 evoked potential components representing visual, attentional and mental review of the stimuli processes, respectively. Our work demonstrates that self-initiated stimuli enhance WM performance and accelerate early visual and attentional processes deployed during WM encoding. We also found that self-initiated stimuli correlate with an increased attentional state compared to the other two conditions, suggesting a role for temporal stimuli predictability. Our study remarks on the relevance of self-control of the stimuli onset in sensory, attentional and memory updating processing for WM.

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Industry 4.0 involves various areas of engineering such as advanced robotics, Internet of Things, simulation, and augmented reality, which are focused on the development of smart factories. The present work presents the design and application of the methodology for the development of augmented reality applications (MeDARA) using a concrete, pictorial, and abstract approach with the intention of promoting the knowledge, skills, and attitudes of the students within the conceptual framework of educational mechatronics (EMCF). The flight of a drone is presented as a case study, where the concrete level involves the manipulation of the drone in a simulation; the graphic level requires the elaboration of an experiential storyboard that shows the scenes of the student's interaction with the drone in the concrete level; and finally, the abstract level involves the planning of user stories and acceptance criteria, the computer design of the drone, the mock-ups of the application, the coding in Unity and Android Studio, and its integration to perform unit and acceptance tests. Finally, evidence of the tests is shown to demonstrate the results of the application of the MeDARA.

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Within Industry 4.0, drones appear as intelligent devices that have brought a new range of innovative applications to the industrial sector. The required knowledge and skills to manage and appropriate these technological devices are not being developed in most universities. This paper presents an unmanned aerial vehicle (UAV)-based smart educational mechatronics system that makes use of a motion capture (MoCap) laboratory and hardware-in-the-loop (HIL) to teach UAV knowledge and skills, within the Educational Mechatronics Conceptual Framework (EMCF). The macro-process learning construction of the EMCF includes concrete, graphic, and abstract levels. The system comprises a DJI Phantom 4, a MoCap laboratory giving the drone location, a Simulink drone model, and an embedded system for performing the HIL simulation. The smart educational mechatronics system strengthens the assimilation of the UAV waypoint navigation concept and the capacity for drone flight since it permits the validation of the physical drone model and testing of the trajectory tracking control. Moreover, it opens up a new range of possibilities in terms of knowledge construction through best practices, activities, and tasks, enriching the university courses.

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Coronary heart disease is the most common cause of death worldwide. Standard cardiac rehabilitation (face-to-face sessions) has shown benefits in increasing muscle strength and functional exercise capacity in adults and older people. However, it is unknown whether hybrid cardiac rehabilitation (a first face-to-face phase + a second remote monitoring phase) will have similar benefits in adults versus older subjects. The aim of this study was to compare the effects of a hybrid exercise-based cardiac rehabilitation program on muscle strength and functional exercise capacity in "adult" versus "older" people with coronary artery disease. We hypothesized that a hybrid exercise-based cardiac rehabilitation program would improve muscle strength and functional exercise capacity, but the impact would be smaller in the older group than the adult individuals. This study is part of a larger project (The Hybrid Cardiac Rehabilitation Trial-HYCARET). We subjected 22 adult (<60 y) females and males (ADULT; n = 5/17 (f/m); 52 ± 5 y; 28.9 ± 3.4 kg·m-2) and 20 older (≥60 y) females and males (OLDER; n = 6/14 (f/m); 66 ± 4 y; 27.4 ± 3.9 kg·m-2) with coronary artery disease to 12 weeks of hybrid exercise-based cardiac rehabilitation program. Prior to and after 12 weeks of a hybrid exercise-based cardiac rehabilitation program, grip strength (handgrip), leg strength (chair stand test), and functional exercise capacity (6-minute walk test, 6MWT) were assessed. The hybrid exercise-based cardiac rehabilitation program resulted in a 9.4 ± 14.6% and a 6.2 ± 12.1% grip strength increase, a 14.4 ± 39.4% and a 28.9 ± 48.1% legs strength increase, and a 14.6 ± 26.4% and a 6.8 ± 14.0% functional exercise capacity improvement in ADULT and OLDER, respectively (p < 0.05) with no differences between groups. In conclusion, a hybrid exercise-based cardiac rehabilitation program could increase muscle strength and improve functional exercise capacity in adults and older people with coronary artery disease. More future studies comparing effectiveness among these age groups are needed to strengthen this conclusion.

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The educational sector has made extraordinary efforts to neutralize the impact of the pandemic caused by COVID-19, forcing teachers, scholars, and academic personnel to change the way education is delivered by developing creative and technological solutions to improve the landscape for education. The Internet of Things (IoT) is crucial for the educational transition to digital and virtual environments. This paper presents the integration of IoT technology in the Two-Dimensional Cartesian Coordinate System Educational Toolkit (2D-CACSET), to transform it into MEIoT 2D-CACSET; which includes educational mechatronics and the IoT. The Educational Mechatronics Conceptual Framework (EMCF) is extended to consider the virtual environment, enabling knowledge construction in virtual concrete, virtual graphic, and virtual abstract levels. Hence, the students acquire this knowledge from a remote location to apply it further down their career path. Three instructional designs are designed for this work using the MEIoT 2D-CACSET to learn about coordinate axes, quadrants, and a point in the 2D Coordinate Cartesian System. This work is intended to provide an IoT educational technology to offer an adequate response to the educational system's current context.

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The 2-Minute Step Test (2MST) has been presented as an alternative to the 6-Minute Walk Test (6MWT) based on the association between the two tests in older adults; however, some authors propose that it should not be a substitute but rather a complement to the latter in the fitness evaluation. Specifically, in coronary disease, despite the potential and clinical utility of 2MST, the relationship of both tests in this population is unknown. This study aimed to determine the relationship between 6MWT and 2MST and to explore the relationship of biodemographic factors for both tests in subjects with treated coronary artery disease. For this, the 6MWT and the 2MST were applied to patients with coronary artery disease treated in 6 hospitals in Chile between May 2019 and February 2020. Additionally, lower limb strength was assessed by a chair-stand test, grip strength was assessed by a dynamometer, and physical measurements were applied. In total, 163 participants underwent both tests (average age = 58.7 ± 9.8 years; 73.6% men; 64.4% revascularized by angioplasty; 28.2% revascularized by surgery, and 7.4% treated by drugs or thrombolysis). Heart rate was higher at the end of the 6MWT, while the perception of effort was greater at the end of the 2MST. There was a weak positive correlation between the 6MWT and the 2MST in subjects with treated coronary disease (r = 0.28, p = 0.0003). While age (r = -0.27), weight (r = 0.25), height (r = 0.49), and strength of both lower limbs (r = 0.41) and grip strength (r = 0.53) correlated weakly or moderately to the covered distance in 6MWT, the number of steps by the 2MST correlated only weakly to height (r = 0.23), lower limb strength (r = 0.34), and grip strength (r = 0.34). Age, weight, height, lower limb strength, and grip strength would explain better the meters walked in the 6MWT than the steps achieved in the 2MST. With these findings, we can conclude that, in patients with treated coronary artery disease, it does not seem advisable to replace 6MWT with 2MST when it is possible to do so. Additionally, the 2MST may provide additional information in the fitness evaluation. However, the usefulness of 2MST in this population needs to be further studied.