Effect of supervised exercise on physical function and balance in patients with intermittent claudication

Background The aim of the study was to identify whether a standard supervised exercise programme (SEP) for patients with intermittent claudication improved specific measures of functional performance including balance. Methods A prospective observational study was performed at a single tertiary vascular centre. Patients with symptomatic intermittent claudication (Rutherford grades 1–3) were recruited to the study. Participants were assessed at baseline (before SEP) and 3, 6 and 12 months afterwards for markers of lower-limb ischaemia (treadmill walking distance and ankle : brachial pressure index), physical function (6-min walk, Timed Up and Go test, and Short Physical Performance Battery (SPPB) score), balance impairment using computerized dynamic posturography with the Sensory Organization Test (SOT), and quality of life (VascuQoL and Short Form 36). Results Fifty-one participants underwent SEP, which significantly improved initial treadmill walking distance (P = 0·001). Enrolment in a SEP also resulted in improvements in physical function as determined by 6-min maximum walking distance (P = 0·006), SPPB score (P < 0·001), and some domains of both generic (bodily pain, P = 0·025) and disease-specific (social domain, P = 0·039) quality of life. Significant improvements were also noted in balance, as determined by the SOT (P < 0·001). Conclusion Supervised exercise improves both physical function and balance impairment

Electrochemical M2+ recognition by an amidopyridyl-tetrathiafulvalene derivative

A tetrathiafulvalene-based redox-responsive receptor incorporating amide and pyridyl coordinating units exhibits an original multi-wave electrochemical recognition behaviour towards Cd(II)

Modelling and simulation of operation and maintenance strategy for offshore wind farms based on multiagent system

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this record.Maintenance of offshore wind turbines is a complex and costly undertaking which acts as a barrier to the development of this source of energy. Factors such as the size of the turbines, the size of the wind farms, their distance from the coast and meteorological conditions make it difficult for the stakeholders to select the optimal maintenance strategy. With the objective of reducing costs and duration of such operations it is important that new maintenance techniques are investigated. In this paper we propose a hybrid model of maintenance that is based on multi-agent systems; this allows for the modelling of systems with dynamic interactions between multiple parts. A multi-criteria decision algorithm has been developed to allow analysis and selection of different maintenance strategies. A cost model that includes maintenance action cost, energy loss and installation of monitoring system cost has been presented. For the purposes of this research we have developed a simulator using NetLogo software and have provided experimental results. The results show that employing the proposed hybrid maintenance strategy could increase wind farm productivity and reduce maintenance cost.Acknowledgement is made to European Union for the support of this research through the European Program INTERREG IVA France-Channel-UK by funding project entitled MER Innovate

Ruptures Du Tendon d’Achille Une étude rétrospective des ruptures de tendon d’Achille A propos de 137 cas

une étude rétrospective des ruptures de tendond’Achille à propos de 137 casintroduction :Le tendon d’Achille est le plus épais, le plusvolumineux et le plus résistant des tendons del’organisme. Il présente une zone étroite, Si lediagnostic clinique de la lésion est aisé, sontraitement reste sans consensusmateriel et methode :Il s’agit d’une étude rétrospective, concernant137 cas opérés au service de traumatologie orthopédiede centre hospitalo-universitaireFrance fanon entre 2001 et 2017résultats :Sur une période de 16 ans nous avons recensé137 cas de rupture du tendon d’Achille, ce quicorrespond à une fréquence de 8,6 cas par an.L’âge moyen dans notre série était de 38 ansavec sexe ratio H/F de 9 ; Activité sportive : 99cas soit 72.26 %.100patients ont bénéficié d’unsuture sous cutanée ; 33 patients ont bénéficiéd’un laçage, soit 89.1 %. La technique deBosworth a été réalisée dans 4 cas, soit 10.8 %.Elle a été nécessaire vue la faiblesse de la zonesuturée à cause d’un effilochement des deuxbouts.Discussion :La cause la plus fréquente des ruptures dutendon d’Achille est représentée par lesaccidents de sport ce qui a été rapporté danstoutes les séries de la littérature. Prédominancemasculine s’explique par une activité sportiveplus élevée chez les hommes.Dans notre série 37 patients ont bénéficié d’untraitement chirurgical à ciel ouvert utilisantdifférentes techniques : sutures simple avecsurjet de renforcement ou laçage pour lamajorité des cas .et 100 CAS réparationpercutanéeWeber et al et Farizon ont aussi privilégié lasuture et laçage avec un éventuel s’il existe unefragilité tendineuse.L’équipe du service de traumatologieorthopédie de l’hôpital  a utilisé,selon un article publié en 2003 la technique deBosworth .Lecestre, Rouvillain , Boukhrisetbeaucoup d’autres auteurs ont privilégié laténorraphie percutanée selon la technique deDelponte. Lansdaal et Assal , quant à eux ontutilisé la chirurgie mini invasive.Richard et al ont utilisé le traitementfonctionnel.Conclusion :Cretnik et al. , dans une étude comparantchirurgie à ciel ouvert versus ténorraphiepercutanée recommande cette dernière car elleapporte des résultats fonctionnels comparablesà la réparation ouverte, avec un tauxsensiblement inférieur de complications.Justin Lim a conclu que la réparationpercutanée est recommandée sur la base du bastaux de complications et l’aspect cosmétiqueamélioré

Randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease

Background:The aim was to compare percutaneous transluminal angioplasty (PTA), a supervisedexercise programme (SEP) and combined treatment (PTA plus SEP) for intermittent claudication dueto femoropopliteal arterial disease.Methods: Consenting patients with femoropopliteal arterial lesions were randomized to one of threetreatment arms: PTA, SEP, or PTA plus SEP. All patients received optimal medical treatment. Patientswere assessed at baseline and 1, 3, 6 and 12 months after intervention. Clinical (ankle pressures, walkingdistances, symptoms) and quality-of-life (QoL) outcomes (Short Form 36, VascuQol) were analysed.Results: A total of 178 patients (108 men, median age 70 years) were included. All three treatmentgroups demonstrated significant clinical and QoL improvements. One year after PTA (60 patients, 8withdrew), 37 patients (71 per cent) had improved (16 mild, 16 moderate, 5 marked), nine (17 per cent)showed no improvement and six (12 per cent) had deteriorated. After SEP (60 patients, 14 withdrew),32 patients (70 per cent) had improved (19 mild, 10 moderate, 3 marked), six (13 per cent) showed noimprovement and eight (17 per cent) had deteriorated. After PTA plus SEP (58 patients, 11 withdrew),40 patients (85 per cent) had improved (18 mild, 20 moderate, 2 marked), seven (15 per cent) showedno improvement and none had deteriorated. On intergroup analysis, PTA and SEP alone were equallyeffective in improving clinical outcomes, although the effect was short-lived. PTA plus SEP produced amore sustained clinical improvement, but there was no significant QoL advantage.Conclusion: For patients with intermittent claudication due to femoropopliteal disease, PTA, SEP,and PTA plus SEP were all equally effective in improving walking distance and QoL after 12 months.Registration number: NCT00798850 (http://www.clinicaltrials.gov)

Systematic Study of Electron Localization in an Amorphous Semiconductor

We investigate the electronic structure of gap and band tail states in amorphous silicon. Starting with two 216-atom models of amorphous silicon with defect concentration close to the experiments, we systematically study the dependence of electron localization on basis set, density functional and spin polarization using the first principles density functional code Siesta. We briefly compare three different schemes for characterizing localization: information entropy, inverse participation ratio and spatial variance. Our results show that to accurately describe defect structures within self consistent density functional theory, a rich basis set is necessary. Our study revealed that the localization of the wave function associated with the defect states decreases with larger basis sets and there is some enhancement of localization from GGA relative to LDA. Spin localization results obtained via LSDA calculations, are in reasonable agreement with experiment and with previous LSDA calculations on a-Si:H models.Comment: 16 pages, 11 Postscript figures, To appear in Phys. Rev.

Antibody-Directed Lentiviral Gene Transduction for Live-Cell Monitoring and Selection of Human iPS and hES Cells

The identification of stem cells within a mixed population of cells is a major hurdle for stem cell biology–in particular, in the identification of induced pluripotent stem (iPS) cells during the reprogramming process. Based on the selective expression of stem cell surface markers, a method to specifically infect stem cells through antibody-conjugated lentiviral particles has been developed that can deliver both visual markers for live-cell imaging as well as selectable markers to enrich for iPS cells. Antibodies recognizing SSEA4 and CD24 mediated the selective infection of the iPS cells over the parental human fibroblasts, allowing for rapid expansion of these cells by puromycin selection. Adaptation of the vector allows for the selective marking of human embryonic stem (hES) cells for their removal from a population of differentiated cells. This method has the benefit that it not only identifies stem cells, but that specific genes, including positive and negative selection markers, regulatory genes or miRNA can be delivered to the targeted stem cells. The ability to specifically target gene delivery to human pluripotent stem cells has broad applications in tissue engineering and stem cell therapies

Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire

Introduction The introduction of biological and synthetic meshes has revolutionised the practice of implant-based breast reconstruction (IBBR) but evidence for effectiveness is lacking. The iBRA (implant Breast Reconstruction evAluation) study is a national trainee-led project that aims to explore the practice and outcomes of IBBR to inform the design of a future trial. We report the results of the iBRA National Practice Questionnaire (NPQ) which aimed to comprehensively describe the provision and practice of IBBR across the UK. Methods A questionnaire investigating local practice and service provision of IBBR developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Summary data for each survey item were calculated and variation between centres and overall provision of care examined. Results 81 units within 79 NHS-hospitals completed the questionnaire. Units offered a range of reconstructive techniques, with IBBR accounting for 70% (IQR:50–80%) of participating units' immediate procedures. Units on average were staffed by 2.5 breast surgeons (IQR:2.0–3.0) and 2.0 plastic surgeons (IQR:1.0–3.0) performing 35 IBBR cases per year (IQR:20-50). Variation was demonstrated in the provision of novel different techniques for IBBR especially the use of biological (n = 62) and synthetic (n = 25) meshes and in patient selection for these procedures. Conclusions The iBRA-NPQ has demonstrated marked variation in the provision and practice of IBBR in the UK. The prospective audit phase of the iBRA study will determine the safety and effectiveness of different approaches to IBBR and allow evidence-based best practice to be explored