Real-life adaptations in walking patterns in patients with established peripheral arterial disease assessed using a global positioning system in the community: A cohort study

Objective: Lower extremity peripheral arterial disease (PAD) is a chronic condition most commonly presenting with intermittent claudication (IC). IC limits walking ability and may negatively affect health-related quality of life. Treadmill assessment of maximal walking distance (MWD) is the gold standard to assess PAD symptom severity. Despite being a well-established and reproducible tool, it may be inappropriate (due to frailty or fear) for some patients and only describes maximal abilities for a single walk test. Global Positioning Systems (GPS) have been proposed as reliable and reproducible tool to measure total, mean and maximal walking distances in PAD patients, in the community setting. Using GPS our study attempted to explore what happens to the walking ability of patients with IC following no intervention under "real-life" conditions. Design and Methods: Using the GlobalSat DG100 GPS, forty-three patients (69±9yrs; 9 female; no invasive interventions or rehabilitation) undertook two 60-minute walking assessments, 6 months apart. Assessments took place in community spaces that had even terrain, no tall trees or buildings and were free from motorised vehicles. GPS-measured maximum walking distance was the main study outcome measure. Results: Over the 6-month period, patients demonstrated significantly shorter GPS-measured, mean (552m vs 334m; p=0.02) and maximum (714m vs 545m; p=0.04) walking distances, stopping also more frequently (9 v 5 times; p=0.03). Conclusions: Given the reported symptom progression we advocate early intervention (e.g. exercise interventions) combined with frequent patient monitoring in attempts to maintain or improve walking ability. Key Words: peripheral arterial disease; Global Position System; maximum walking distance; intermittent claudication; community assessments

Proximal ischemia is a frequent cause of exercise-induced pain in patients with a normal ankle to brachial index at rest

BACKGROUND: Excluding a vascular origin of exercise-related pain is often difficult in clinical practice. Recent papers have underlined the frequent association of concurrent lumbar spine degenerative disease and peripheral arterial disease. Furthermore, even when suspected, isolated exercise-induced proximal ischemia is difficult to diagnose. Measurement of transcutaneous oxygen pressure (tcpO2) is an interesting and accurate method to differentiate proximal (buttock) from distal (calf) regional blood flow impairment (RBFI) during exercise. OBJECTIVES: We searched for isolated proximal-without-distal RBFI as a possible cause of claudication, in patients with borderline (ABI-b: 0.91 - 0.99) or normal (ABI-n: 1.00 to 1.40) ankle to brachial index at rest. STUDY DESIGN: Retrospective cohort design study. We analyzed patients referred to our laboratory with symptom limiting claudication and an ankle brachial index within normal limits. SETTING: University-based exercise-investigation center. METHODS: Over a 12-year period, we identified 463 patients referred to our laboratory that had their lowest resting ABI between 0.90 and 1.40. The tcpO2 on chest, buttocks, and calves were recorded during treadmill walking tests (3.2 km/h, 10% slope) in 220 ABI-b and 243 ABI-n unique consecutive patients complaining of limiting claudication (each patient\u27s ABI was the lowest of the 2 legs). Limiting claudication was defined as the reported inability to walk 1 kilometer without stopping. A DROP index (limb tcpO2-changes minus chest tcpO2-changes from rest) below -15 mmHg was used to indicate a positive result (i.e. exercise-induced RBFI). RESULTS: Treadmill exercise showed evidence for proximal or distal RBFI, of at least one side, in 128 out of 220 patients (58.2%) and in 86 out of 243 (35.4%) patients with ABI-b and ABI-n, respectively. Isolated proximal-without-distal RBFI was found in 32 out of the 128 (25.0 %) positive tests in ABI-b and 32 out of the 86 (37.2%) positive tests in ABI-n patients. LIMITATIONS: Study limitations include the absence of systematic follow-up of diagnosed patients and absence of systematic search for cardio-respiratory co-morbid conditions. CONCLUSION: Isolated proximal-without distal RBFI is found in approximately one out of 7 patients complaining of symptom limiting claudication with a borderline or normal resting ABI. Exercise-tcpO2 may help to discriminate patients with arterial claudication that could benefit from invasive vascular investigations and procedures

G protein-coupled oestrogen receptor 1, oestrogen receptors and androgen receptor in the sand rat (Psammomys obesus) efferent ducts

Background: The efferent ducts are mainly involved in the reabsorption of the seminiferous tubular fluid. Testosterone and oestrogens regulate efferent ducts functions via their receptors.Materials and methods: This paper presents an experimental investigation on the location of the P450 aromatase, the 17-b oestradiol (E2), the androgen receptor (AR), the oestrogen receptor 1 (ESR1), the oestrogen receptor 2 (ESR2) and the G protein-coupled oestrogen receptor 1 (GPER1) in the efferent ducts using Psammomys obesus as an animal model to highlight the effect of the season on the histology and the distribution of these receptors.Results: We observed a proliferation of the connective tissue, decreasing in the height of the epithelium during the resting season compared to the breeding season. Ciliated cells expressed P450 aromatase, AR, E2, ESR1, ESR2 and GPER1 during both seasons. Basal cells showed a positive staining for the ESR1 and the GPER1 during both season, the AR and E2 during the breeding season and ESR2 during the resting season.Conclusions: Our result shows that the expression of androgen receptor and oestrogen receptors in the efferent ducts vary by season witch suggest that they are largely involved in the regulation of the efferent ducts functions

Pre-breakup magmatism on the Vøring margin: Insight from new sub-basalt imaging and results from Ocean Drilling program hole 642E

Highlights • Sub-basalt imaging improvement on the Vøring Margin • Definition of a new seismic facies unit: the Lower Series Flows • Significant organic carbon content within the melting crustal segment • Apectodinium augustum marker for the PETM is reworked into the Lower Series Flows • The Lower Series Flows, early Eocene in age, predate the Vøring Margin breakup Abstract Improvements in sub-basalt imaging combined with petrological and geochemical observations from the Ocean Drilling Program (ODP) Hole 642E core provide new constraints on the initial breakup processes at the Vøring Margin. New and reprocessed high quality seismic data allow us to identify a new seismic facies unit which we define as the Lower Series Flows. This facies unit is seismically characterized by wavy to continuous subparallel reflections with an internal disrupted and hummocky shape. Drilled lithologies, which we correlate to this facies unit, have been interpreted as subaqueous flows extruding and intruding into wet sediments. Locally, the top boundary of this facies unit is defined as a negative in polarity reflection, and referred as the K-Reflection. This reflection can be correlated with the spatial extent of pyroclastic deposits, emplaced during transitional shallow marine to subaerial volcanic activities during the rift to drift transition. The drilled Lower Series Flows consist of peraluminous, cordierite bearing peperitic basaltic andesitic to dacitic flows interbedded with thick volcano-sedimentary deposits and intruded sills. The peraluminous geochemistry combined with available C (from calcite which fills vesicles and fractures), Sr, Nd, and Pb isotopes data point towards upper crustal rock-mantle magma interactions with a significant contribution of organic carbon rich pelagic sedimentary material during crustal anatexis. From biostratigraphic analyses, Apectodinium augustum was found in the The Lower Series Flows. This species is a marker for the Paleocene – Eocene Thermal Maximum (PETM). However, the absence of very low carbon isotope values (from bulk organic matter), that characterize the PETM, imply that A.augustum was reworked into the early Eocene sediments of this facies unit which predate the breakup time of the Vøring Margin. Finally, a plausible conceptual emplacement model for the Lower Series Flows facies unit is proposed. This model comprises several stages: (1) the emplacement of subaqueous peperitic basaltic andesitic flows intruding and/or extruding wet sediments; (2) a subaerial to shallow marine volcanism and extrusion of dacitic flows; (3) a proto-breakup phase with intense shallow marine to subaerial explosive volcanism responsible for pyroclastic flow deposits which can be correlated with the seismic K-Reflection and (4) the main breakup stage with intense transitional tholeiitic MORB-type volcanism and large subsidence concomitant with the buildup of the Seaward Dipping Reflector wedge

Crustal and basin evolution of the southwestern Barents Sea: from Caledonian orogeny to continental breakup

A new generation of aeromagnetic data documents the post-Caledonide rift evolution of the southwestern Barents Sea (SWBS) from the Norwegian mainland up to the continent-ocean transition. We propose a geological and tectonic scenario of the SWBS in which the Caledonian nappes and thrust sheets, well-constrained onshore, swing from a NE-SW trend onshore Norway to NW-SE/NNW-SSE across the SWBS platform area. On the Finnmark and Bjarmeland platforms, the dominant inherited magnetic basement pattern may also reflect the regional and post-Caledonian development of the late Paleozoic basins. Farther west, the pre-breakup rift system is characterized by the Loppa and Stappen Highs, which are interpreted as a series of rigid continental blocks (ribbons) poorly thinned as compared to the adjacent grabens and sag basins. As part of the complex western rift system, the Bjørnøya Basin is interpreted as a propagating system of highly thinned crust, which aborted in late Mesozoic time. This thick Cretaceous sag basin is underlain by a deep-seated high-density body, interpreted as exhumed high-grade metamorphic lower crust. The abortion of this propagating basin coincides with a migration and complete reorganization of the crustal extension toward a second necking zone defined at the level of the western volcanic sheared margin and proto-breakup axis. The abortion of the Bjørnøya Basin may be partly explained by its trend oblique to the regional, inherited, structural grain, revealed by the new aeromagnetic compilation, and by the onset of further weakening later sustained by the onset of magmatism to the west

A theoretical framework and research agenda for studying team attributions in sport

The attributions made for group outcomes have attracted a great deal of interest in recent years. In this article we bring together much of the current research on attribution theory in sport and outline a new conceptual framework and research agenda for investigating the attributions of team members. The proposed framework draws on multiple conceptual approaches including models of attribution, group dynamics and stress responses to provide a detailed hypothetical description of athletes' physiological, cognitive and affective responses to group competition. In describing this model we outline important antecedents of team attributions before hypothesising how attributions can impact hormonal and cardiovascular responses of athletes, together with cognitive (goals, choices, expectations), affective (self-esteem, emotions), and behavioural (approach-avoidance actions) responses of groups and group members. We conclude by outlining important methodological considerations and implications for structured context specific attribution-based interventions

Middle Neolithic farming of open-air sites in SE France: new insights from archaeobotanical investigations of three wells found at Les Bagnoles (L'Isle-sur-la-Sorgue, Dépt. Vaucluse, France)

Previous reviews of Middle Neolithic agricultural practice (4400–3500 cal bc) in southern France have highlighted a change in crop assemblages after 4000 cal bc, with a reduction of naked wheat and an increase of emmer and partly of einkorn. The recent investigation of three wells from the site of Les Bagnoles (4250–3800 cal bc) in the periphery of the southern Rhône valley yielded an unprecedented amount of waterlogged uncharred and charred plant macro remains that offer new insights into crop diversity and its changes over time. The results from the wells at Les Bagnoles were compared with other dated sunken features from open-air sites (in contrast to caves and rock shelters), with the aim of identifying patterns sug-gesting changes in the crop spectra between the early (MN1) and late (MN2) Middle Neolithic phases from taphonomically comparable contexts. The results from Les Bagnoles demonstrate that oil crops and pulses are underrepresented in dry sites and that they were a significant part of Middle Neolithic agriculture. They also indicate an increase in the representation of einkorn (instead of emmer) during MN2 that is also visible in other open-air sites. The comparison of the archaeobotani-cal results with silo storage capacity values as a proxy for average production capacity per household leads us to propose a possible drop in naked wheat productivity and opens new questions in factors affecting crop choice at the beginning of the 4th millennium cal bc

Accounting for success and failure: a discursive psychological approach to sport talk

YesIn recent years, constructionist methodologies such as discursive psychology (Edwards & Potter, 1992) have begun to be used in sport research. This paper provides a practical guide to applying a discursive psychological approach to sport data. It discusses the assumptions and principles of discursive psychology and outlines the stages of a discursive study from choice of data through to transcription and analysis. Finally, the paper demonstrates a discursive psychological analysis on sport data where athletes are accounting for success and failure in competition. The analysis demonstrates that for both success and failure, there is an apparent dilution of personal agency, to either maintain their modesty in the case of success or to manage blame when talking about failure. It is concluded that discursive psychology has much to offer sport research as it provides a methodology for in-depth studies of supporting interactions

Physicochemical characterization of Mozzarella cheese wheys and stretchwaters in comparison with several other sweet wheys

To better understand the origins of the problems occurring during Mozzarella cheese whey concentration, lactose crystallization, and spray-drying steps, a physicochemical characterization was achieved. For this purpose, Mozzarella cheese wheys were sampled and their content in different compounds such as total nitrogen, noncasein nitrogen, nonprotein nitrogen, lactate, citrate, chloride, sulfate, phosphate anions, calcium, magnesium, potassium, sodium cations, and the sugars glucose and galactose were measured. In a second step, the results were compared with the corresponding content in Cheddar cheese wheys, Raclette cheese wheys, soft cheese wheys, and Swiss-type cheese wheys. At the end of this survey, it was shown that Mozzarella cheese wheys were more concentrated in lactate and in minerals-especially phosphate, calcium, and magnesium-than the other cheese wheys and that they contained galactose. These constituents are known to be hygroscopic. Complementary surveys are now necessary to compare the hygroscopicity of galactose and lactate and discover whether the amounts of these compounds found in Mozzarella cheese wheys are a factor in the problems encountered during the concentration, lactose crystallization, and spray-drying steps

Applicabilité du GPS dans l’évaluation des limitations à la marche des claudications artérielles

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