Camacho Dueholm (botanylocust88)

BACKGROUND Although supervised exercise therapy (SET) is effective in improving walking distance among adults with symptomatic peripheral artery disease (PAD), some research suggests that individuals with comorbid PAD and type 2 diabetes mellitus (T2DM) may experience a blunted response to SET. It is unknown whether free-living sedentary time changes during SET, and if increases in sedentary time could, in part, explain poor response to SET. OBJECTIVES The purposes of this pilot study were to 1) determine if older adults with PAD (with and without T2DM) engaging in SET change their sedentary behavior; and 2) examine the relationship between changes in sedentary behavior and SET outcomes. We hypothesized that decreased sedentary time during SET would be associated with greater improvements in six-minute walk test (6MWT) total distance and other key SET outcomes. METHODS Participants (n = 44) initiating a 12-week SET program completed the six-minute walk test (6MWT), Short Physical Performance Battery, Walking Impairment Questionnaire, and accelerometer-assessed sedentary behavior at SET initiation, 6 weeks, and 12 weeks. RESULTS Participants' mean age was 72.3 (7.1) years, mean ankle-brachial index was 0.71 (0.25), and 47.7% were female. On average, sedentary time did not change following SET, although there was substantial variability (-40% to +38% change in minutes of sedentary time/day). Participants with T2DM experienced greater improvements in claudication onset distance when compared to participants without T2DM (mean 35 m, p = .044, 95% CI 1.6 to 115.4 meters). Neither changes in sedentary time from baseline to 6 weeks (p = .419) nor T2DM (p = .154) predicted changes in 6MWT total distance from baseline to 12 weeks. CONCLUSIONS As SET availability increases, further examination of factors that may influence SET outcomes will help maximize benefits of this proven therapy. INTRODUCTION The Altura (Alt) endograft is a new design lacking the classic mainbody with the flow divider. Instead, 2 proximal D-shaped endografts form a round circumference in the aortic neck for secure sealing and land in the iliac arteries in across-limb fashion. The aim of this computational study was to compare hemodynamically this model to the classic-bifurcated (Bif) and cross-limb (Cx) endograft designs of equal total length. MATERIALS AND METHODS All 3D endograft models were created using the finite volume analysis application ANSYS CFX (Ansys Inc., Canonsburg, PA, USA). The Alt inlet was constructed as two opposing D-shaped sections. Flow was quantified by time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT) and helicity. The displacement forces were also compared for all models with computational fluid dynamics analysis. RESULTS The Alt design was associated with lower forces (range 4.0-5.9Ν) compared to Bif (4.17-6.15N) and Cx (4.43-6.53N). The 2-piece inlet site of the separated limbs of Alt has higher TAWSS that the uniform inlet segment of the Cx and the Bif model. Most importantly, the mid-and distal segment of the limbs in the Altura design present higher TAWSS in a greater area than the other two models. The inlet of the Alt design showed higher OSI than the other accommodations and similar or comparable OSI values along their mid- and distal limb segments. The range, location and values or RRT were comparable between the three models. Helicity in the iliac limbs is more prominent in the crossed accommodations (Alt, Cx). CONCLUSION Only small differences in the hemodynamic indices and displacement forces were detected between the Alt and classic accommodations. From this point of view, the Alt design could be theoretically considered not inferior to other widely used endograft configurations. BACKGROUND A rapidly expanding pandemic of the new coronavirus has become the focus of global scientific attention. Data are lacking on the impact of the pandemic caused by the severe acute respir