Publications by authors named "Rafael Arias"

Perceptual training enhances the ability to anticipate crucial information for decision-making, for example, a soccer goalkeeper predicting penalty kick direction. However, it remains unclear whether perceptual practice alone (implicit method) is sufficient for optimal decision-making improvement, or whether emphasising pertinent details during practice (explicit method) could yield better results. This study compared implicit and explicit methods of learning ball direction prediction during soccer penalties, involving both goalkeepers and non-soccer players (novices).

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Pulmonary vascular dysfunction in the absence of pulmonary hypertension (PH) has been observed in patients with idiopathic pulmonary fibrosis (IPF). We describe the prevalence and etiology of elevated pulmonary vascular resistance (PVR) without PH among patients with IPF. Hemodynamic, echocardiographic, and functional respiratory imaging (FRI) data was compared between patients with IPF without PH with normal (<3 wood units) and elevated PVR (≥3 wood units).

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Although atrial fibrillation (AF) is strongly associated with stroke, previous studies have shown suboptimal use of anticoagulation (AC). In particular, there is a lack of data on the long-term use of AC after AF catheter ablation. We followed up patients 1 to 5 years out from catheter ablation at the Johns Hopkins Hospital (JHH) to assess their long-term use of AC.

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Identification of mosquito species is necessary for determining the entomological components of malaria transmission, but it can be difficult in morphologically similar species. DNA sequences are largely used as an additional tool for species recognition, including those that belong to species complexes. mosquitoes are vectors of human and simian malaria in the Neotropical Region, but there are few DNA sequences of species in public databases.

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At high altitude, hypoxia amplifies oxyhemoglobin saturation (SO) swings with changes in respiratory mechanics. Our objective was to examine the effects of posture on SO and determine predictors of postural SO changes in highlanders. 50 native highlanders from Puno, Peru (3825 m) assumed supine and upright-seated postures, in rotating sequence, while undergoing continuous pulse-oximetry.

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Invasive procedures were previously developed for measuring pharyngeal collapsibility in rodents during expiration, when declining neuromuscular activity makes the airway unstable. We developed a non-invasive approach for streamlining collapsibility measurements by characterizing responses in physiologic markers of dynamic expiratory airflow obstruction to negative nasal pressure challenges. Anesthetized mice were instrumented to monitor upper airway pressure-flow relationships with head-out plethysmography while nasal pressure was ramped down from ~ +5 to -20 cm HO over several breaths.

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Associations between sleep disordered breathing (SDB) and cardiometabolic outcomes have not been examined in highlanders.We performed nocturnal polygraphy in Peruvian highlanders (3825 m). Multivariable linear regression models examined associations between SDB metrics and haemoglobin, glucose tolerance (haemoglobin A1c (HbA1c)), fasting glucose, homeostatic model-based assessments of insulin resistance and β-cell function (HOMA-IR and HOMA-β, respectively), blood pressure, and lipids, while adjusting for age, sex, body mass index (BMI) and wake oxygenation.

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Study Objectives: To assess effects of low-level continuous positive airway pressure (CPAP) on snoring in habitual snorers without obstructive sleep apnea (OSA).

Methods: A multicenter prospective in-laboratory reversal crossover intervention trial was conducted between September 2013 and August 2014. Habitual snorers were included if they snored (inspiratory sound pressure level ≥ 40 dBA) for ≥ 30% all sleep breaths on a baseline sleep study (Night 1), and if significant OSA and daytime somnolence were absent.

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Background: Obesity causes multiorgan dysfunction, specifically metabolic abnormalities in the liver. Obese patients are opioid-sensitive and have high rates of respiratory complications after surgery. Obesity also has been shown to cause resistance to leptin, an adipose-derived hormone that is key in regulating hunger, metabolism, and respiratory stimulation.

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The database of patients who underwent laparoscopic gastric bypass at our institution from 2002 to 2008 was reviewed. Five patients with kidney transplants were found. The impact of the laparoscopic gastric bypass on their comorbidities and the grafts and patients' survival were studied.

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Background: There is inconclusive data on whether critically ill individuals with severe secondary peritonitis requiring multiple staged laparotomies may became eligible candidates for deferred primary anastomoses (DPA). We sought to compare a protocol for DPA against a protocol for diversion in severely ill critical patients with intra-abdominal sepsis.

Methods: A retrospective cohort study was performed examining 112 patients admitted through an ICU between 2002 and 2006, with diagnosis of secondary peritonitis and managed with staged laparotomies whom required small- or large-bowel segment resections.

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