Improvement in 6-Minute Walking Distance after Supervised Exercise Training Is Related to Changes in Quality of Life in Patients with Lower Extremity Peripheral Artery Disease.

This study aimed to investigate the relationship between supervised exercise training (SET)-induced changes in treadmill performance and 6 min walking distance, and changes in general (physical and mental) self-perceived health-related quality of life (HRQoL) in symptomatic patients with lower extremity peripheral artery disease (PAD). This is an observational study investigating Fontaine stage II PAD patients participating in 3-month SET. Before and following SET, treadmill performance (pain-free (PFWD) and maximal (MWD)), and 6 min walking distance (6MWD) were assessed. Self-perceived HRQoL was assessed with the Medical Outcomes Study Short-Form 36 (SF-36). Ankle- and toe-brachial indexes were also measured. One-hundred forty-seven patients with PAD were included (64.9 ± 9.6 y, 70% men). After SET, PFWD (+102%, p ≤ 0.001), MWD (+87%, p ≤ 0.001), and 6MWD (+14%, p ≤ 0.001) significantly increased. All eight SF-36 subscale scores significantly improved following SET (p ≤ 0.04). SET significantly improved physical and mental component summaries of the SF-36 (p ≤ 0.001). Larger increases in 6MWD were associated with greater improvements in physical (β = 0.19; p = 0.02) and mental (β = 0.24; p = 0.005) component summaries of the SF-36. No significant relationship was observed between changes in treadmill performance and changes in physical and mental component summaries of the SF-36. These results show that improvements in 6MWD following SET are related to improvements in general self-perceived HRQoL in patients with symptomatic lower extremity PAD. On the contrary, changes in treadmill performance were not related to improvements in HRQoL. These results suggest that the 6 min walking test is an essential outcome measure to assess overall patient functional status following interventions in patients with PAD

Application of long-range weather forecasts to agricultural decision problems in Europe

Agriculture can benefit substantially from long-range weather forecasts, for the month or the season, which can help to optimize farming operations and deal more effectively with the adverse impacts of climate variability, including extreme weather events. In the context of climate change, long-range weather forecasts also represent key elements for the development of adaptation strategies. In spite of an undeniable potential, long-range forecasts issued for instance by the European Centre for Medium-Range Weather Forecasts (ECMWF) have yet to find widespread application in European agriculture. To address partially the question of why this is the case, the performance of the ECMWF monthly ensemble forecasting system was examined. It was noted that predictability is currently limited to about 3 weeks for temperature and 2 weeks for precipitation and solar radiation. This may appear deceptive at first sight, but it was noticed that precipitation forecasts over a month are, overall, at least as valuable as information obtained from observed climatology. Encouraged by this finding, the possibility of using monthly forecasts to predict soil water availability was tested. In an operational context, this could serve as a basis for scheduling irrigation. Positive skills were found for lead times of up to 1 month. It was concluded that more systematic investigations of the possibilities offered by long-range forecasts should be undertaken in the future. However, this will require additional efforts to increase the quality of the forecasts, design appropriate application tools and promote the dissemination of the outcome within the agriculture communit

Prevalence and risk factors for thromboembolic complications in IBD patients

Background: Inflammatory bowel disease (IBD) patients have an increased risk of venous thromboembolic complications (VTEC) such as deep vein thrombosis (DVT) and pulmonary embolism when compared to the non-IBD population. However, studies assessing VTEC prevalence in IBD as well as analyses of VTEC associated risk factors are scarce. We aimed to assess VTEC prevalence in IBD patients and to identify associated risk factors. Methods: Data from patients enrolled in the Swiss IBD Cohort Study (SIBDCS) were analyzed. Since 2006 the SIBDCS collects data on a large sample of IBD patients from hospitals and private practices across Switzerland. Results: A  total of 90/2284 (3.94%) IBD patients suffered from VTEC. Of these, 45/1324 (3.4% overall; 2.42% with DVT, 1.51% with PE) had CD, and 45/960 (4.7% overall; 3.23% with DVT, 2.40% with PE) presented with UC

Telemedicine for cardiac surgery candidates

Background: Cardiac surgery is generally well or over-represented in many Western countries. Since the southern part of Switzerland relies on 300 km distance centers for cardiac surgery, we started a project of telemedicine for the distant evaluation of cardiac surgery candidates. We report our experience of the results of the diagnosis made by telemedicine and by direct scrutiny of coronary angiograms. Methods: Coronary angiography was performed at the distant hospital by an invasive cardiology team. Teletransmission of images was performed using three Integrated Service Digital Network (ISDN) lines by direct transmission of recent recording. A total of 98 cases were reviewed (87 aorto-coronary bypass candidates, seven valvular and four congenital heart disease). We further performed a prospective blinded comparison of 47 consecutive cases with severe coronary artery disease (CAD) with respect to localization and number of significant coronary lesions, obtained by direct scrutiny of the original angiograms and the evaluation obtained with the teletransmitted images. Results: In 89 cases of the 98 analyzed (91%) correct diagnosis and surgical approach could be established by distant transmission. In nine cases (9%, all aortocoronary bypass candidates) definitive diagnosis and treatment was feasible only by direct scrutiny of the original angiograms. Five critically ill patients were urgently referred to the surgical care center based on the correct distant diagnosis. The blinded comparison of distant diagnosis and direct scrutiny of angiograms in defining 1-2-3 vessel CAD was good: r=0.87, P≪0.01. Conclusion: Initial experience using non-sophisticated telemedical transmission of angiograms of cardiac surgery candidates seems to be a promising facility for distantly located center

Detection and isolation of circulating tumor cells with single-cell resolution: A successful lab-on-a-chip device

This paper was presented at the 3rd Micro and Nano Flows Conference (MNF2011), which was held at the Makedonia Palace Hotel, Thessaloniki in Greece. The conference was organised by Brunel University and supported by the Italian Union of Thermofluiddynamics, Aristotle University of Thessaloniki, University of Thessaly, IPEM, the Process Intensification Network, the Institution of Mechanical Engineers, the Heat Transfer Society, HEXAG - the Heat Exchange Action Group, and the Energy Institute.This paper presents the unique features of DEPArray™ an automated system enabling image-based cell sorting with single-cell resolution and describes its potential application in the field of oncology

Implications of changes in seasonal mean temperature for agricultural production systems: three case studies

- The performance of dairy cows will suffer from elevated temperatures, reflecting the extent and uncertainty of projected warming in different scenarios, with a marked increase in heat stress for non-intervention scenarios (A1B and A2) toward the end of the century. This calls for the adoption of protective measures in the management of indoor and outdoor animal environments. - A substantial risk of a prolonged pest control season for the codling moth (an apple pest) is projected toward the end of the century for Northern Switzerland sites, and mid-century for the Ticino. Timely preventive programs are anticipated to represent a key ingredient of adaptation to changing risks from agricultural pests. - Results suggest that in the near future viticulture could benefit from increasing temperatures as a wider range of grape varieties could be grown. Toward the end of the century negative impacts from extreme temperatures are nevertheless expected to become important

Tethered balloon measurements of biogenic volatile organic compounds at a Boreal forest site

Measurements of biogenic volatile organic compounds (VOCs) were performed at Hyytiälä, a Boreal forest site in Southern Finland as part of the OSOA (origin and formation of secondary organic aerosol) project in August 2001. At this site, frequent formation of new particles has been observed and the role of biogenic VOCs in this process is still unclear. Tethered balloons served as platforms to collect VOC samples within the planetary boundary layer at heights up to 1.2 km above ground during daytime. Mean mixed layer concentrations of total monoterpenes varied between 10 and 170 pptv, with <font face='Symbol'>a</font>-pinene, limonene and <font face='Symbol'>D</font>³-carene as major compounds, isoprene was detected at levels of 2-35 pptv. A mixed layer gradient technique and a budget approach are applied to derive surface fluxes representative for areas of tens to hundreds of square kilometres. Effects of spatial heterogeneity in surface emissions are examined with a footprint analysis. Depending on the source area considered, mean afternoon emissions of the sum of terpenes range between 180 and 300 <font face='Symbol'>m</font>g m^-2 h^-1 for the period of 2-12 August 2001. Surface fluxes close to Hyytiälä were higher than the regional average, and agree well with mean emissions predicted by a biogenic VOC emission model. Total rates of monoterpene oxidation were calculated with a photochemical model. The rates did not correlate with the occurrence of new particle formation, but the ozone pathway was of more importance on days with particle formation. Condensable vapour production from the oxidation of monoterpenes throughout the mixed layer can only account for a fraction of the increase in aerosol mass observed at the surface

A Motor Learning Oriented, Compliant and Mobile Gait Orthosis

People affected by Cerebral Palsy suffer from physical disabilities due to irreversible neural impairment since the very beginning of their life. Difficulties in motor control and coordination often relegate these patients to the use of a wheelchair and to the unavoidable upcoming of disuse syndromes. As pointed out in recent literature Damiano [7] physical exercise, especially in young ages, can have a deep impact on the patient health and quality of life. For training purposes is very important to keep an upright position, although in some severe cases this is not trivial. Many commercial mobile orthoses are designed to facilitate the standing, but not all the patients are able to deploy them. ARGO, the Active Reciprocated Gait Orthosis we developed, is a device that overcomes some of the limitations of these devices. It is an active device that is realized starting from a commercial reciprocated Gait Orthosis applying sensors and actuators to it. With ARGO we aim to develop a device for helping limbs in a non-coercive way accordingly to user’s intention. In this way patients can drive the orthosis by themselves, deploying augmented biofeedback over movements. In fact Cerebral Palsy patients usually have weak biofeedback mechanisms and consequently are hardly inclined to learn movements. To achieve this behavior ARGO deploys a torque planning algorithm and a force control system. Data collected from a single case of study shows benefits of the orthosis. We will show that our test patient reaches complete autonomous walking after few hour of training with prototype

Dynamic simulation of management events for assessing impacts of climate change on pre-alpine grassland productivity

The productivity of permanent temperate cut grasslands is mainly driven by weather, soil characteristics, botanical composition and management. To adapt management to climate change, adjusting the cutting dates to reflect earlier onset of growth and expansion of the vegetation period is particularly important. Simulations of cut grassland productivity under climate change scenarios demands management settings to be dynamically derived from actual plant development rather than using static values derived from current management operations. This is even more important in the alpine region, where the predicted temperature increase is twice as high as compared to the global or Northern Hemispheric average. For this purpose, we developed a dynamic management module that provides timing of cutting and manuring events when running the biogeochemical model LandscapeDNDC. We derived the dynamic management rules from long-term harvest measurements and monitoring data collected at pre-alpine grassland sites located in S Germany and belonging to the TERENO monitoring network. We applied the management module for simulations of two grassland sites covering the period 2011–2100 and driven by scenarios that reflect the two representative concentration pathways (RCP) 4.5 and 8.5 and evaluated yield developments of different management regimes. The management module was able to represent timing of current management operations in high agreement with several years of field observations (r2 > 0.88). Even more, the shift of the first cutting dates scaled to a +1 ◦C temperature increase simulated with the climate change scenarios (− 9.1 to − 17.1 days) compared well to the shift recorded by the German Weather Service (DWD) in the study area from 1991− 2016 (− 9.4 to − 14.0 days). In total, the shift in cutting dates and expansion of the growing season resulted in 1− 2 additional cuts per year until 2100. Thereby, climate change increased yields of up to 6 % and 15 % in the RCP 4.5 and 8.5 scenarios with highest increases mainly found for dynamically adapted grassland management going along with increasing fertilization rates. In contrast, no or only minor yield increases were associated with simulations restricted to fertilization rates of 170 kg N ha− 1 yr− 1 as required by national legislations. Our study also shows that yields significantly decreased in drought years, when soil moisture is limiting plant growth but due to comparable high precipitation and water holding capacity of soils, this was observed mainly in the RCP 8.5 scenario in the last decades of the century

An Affordable Upper-Limb Exoskeleton Concept for Rehabilitation Applications

In recent decades, many researchers have focused on the design and development of exoskeletons. Several strategies have been proposed to develop increasingly more efficient and biomimetic mechanisms. However, existing exoskeletons tend to be expensive and only available for a few people. This paper introduces a new gravity-balanced upper-limb exoskeleton suited for rehabilitation applications and designed with the main objective of reducing the cost of the components and materials. Regarding mechanics, the proposed design significantly reduces the motor torque requirements, because a high cost is usually associated with high-torque actuation. Regarding the electronics, we aim to exploit the microprocessor peripherals to obtain parallel and real-time execution of communication and control tasks without relying on expensive RTOSs. Regarding sensing, we avoid the use of expensive force sensors. Advanced control and rehabilitation features are implemented, and an intuitive user interface is developed. To experimentally validate the functionality of the proposed exoskeleton, a rehabilitation exercise in the form of a pick-and-place task is considered. Experimentally, peak torques are reduced by 89% for the shoulder and by 84% for the elbow