5 research outputs found
Abdominal Subcutaneous and Visceral Adipose Thickness Are Independently Associated with Insulin Resistance
No full textAbdominal Subcutaneous and Visceral Adipose Thickness Are Independently Associated with Insulin ResistanceView session detail Author Block: SIMONA BERTOLI, ALESSANDRO LEONE, ANGELA SPADAFRANCA, RAMONA DE AMICIS, LAILA VIGNATI, GIORGIO BEDOGNI, ALBERTO BATTEZZATI, Milan, Italy Regional fat distribution rather than overall obesity has been recognized as the link between obesity and diabetes. The measurement of abdominal subcutaneous and visceral adipose thickness (SAT and VAT) by ultrasonography (US) is simple, inexpensive and non-invasive. We have recently shown that both VAT and SAT are associated with metabolic syndrome and its components but their association with insulin resistance (IR) remains unclear. To investigate such association, we carried out a cross-sectional analysis of 4108 Caucasian adults followed as outpatients at the International Center for the Assessment of Nutritional Status (ICANS) in Milan. They were aged 18-87 years, were mostly females (71%) and had a median body mass index (BMI) of 28.7 (25.4 to 32.7). VAT and SAT were assessed by US using a validated protocol. HOMA-IR was used as surrogate index of IR. HOMA-IR was used as surrogate index of IR. 25,1% of the sample was detected to have IR (HOMA-IR > 3,6). The associations of VAT and SAT with IR was examined using multivariable linear regression with fractional polynomials. LogeHOMA was independently associated with VAT (cm), SAT0.5 (cm) and age-2 (years) but not with sex (R2 = 0.452, RMSE = 0.49) (Figure). We conclude that US-VAT and SAT are independently associated with IR in a large sample at different level of BMI
Lopsided Blood-thinning Drug Increases the Risk of Internal Flow Choking and Shock Wave Generation Causing Asymptomatic Stroke
No full textLopsided Blood-thinning Drug Increases the Risk of Internal Flow Choking and Shock Wave Generation Causing Asymptomatic Stroke
Author Block: V R SANAL KUMAR, ISRO; S.K.Choudhary, AIIMS; P.K.Radhakrishnan, GU; Suresh Menon, GT; Vrishank Raghav, AU; K.K.N Namboodiri, Sapna E.Sreedharan, SCTIMST; Bharath R.S, Nichith C, C.Oommen, IISc; V.Sankar, IITK; A.Sukumaran, KCT; Arun K, DHMMC; A.Pal, Tharikaa R.K, AU, Abhirami R, AIMS.
Introduction
Consequence of lopsided blood-thinning-drug, lowering blood-viscosity (BV), is bleeding and very frequently asymptomatic-hemorrhage (AH) and the acute-heart-failure (AHF) happen. V.R.S.Kumar et al. (2020) reported that such asymptomatic episodes are due to the internal flow choking in the cardiovascular system (CVS) at a critical blood-pressure-ratio (BPR), which is regulated by biofluid/blood heat capacity ratio (BHCR).
Methods
The closed-form-analytical-methodology is used for correlating BV, BPR, BHCR, vessel geometry and ejection fraction (EF). In vitro method is used for the BHCR estimation of healthy subjects. In silico method is used for demonstrating the Sanal flow choking.
Results
The analytical models reveal that the relatively high and low BV are risk factors of internal flow choking. In vitro study shows that N2, O2, CO2 & Ar gases are predominant in fresh-blood samples of the healthy subjects at a temperature range of 37-400 C (98.6-1040 F), which increases the risk of flow-choking. In silico results demonstrated the Sanal flow choking followed by the shock wave generation and pressure-overshoot in a simulated artery with the divergent/bifurcation region.
Conclusions
An overdose of blood-thinning drug reduces BV and increases Reynolds number causing high-turbulence leading to the Sanal flow choking. Asymptomatic stroke could be diminished by concurrently lessening the BV and flow turbulence by rising thermal tolerance level in terms of BHCR or by decreasing the BPR. In conclusion, BPR must always be lower than 1.8257 as dictated by the lowest BHCR of the evolved gas for prohibiting asymptomatic stroke
Air force diabetes center of excellence Project ECHO: Successful telemedicine with a global reach
No full text779-P - Air Force Diabetes Center of Excellence Project ECHO: Successful Telemedicine with a Global ReachView session detail Author Block: RICHARD DAVIS, TOM SAUERWEIN, CONNIE MORROW, NINA WATSON, MARK TRUE, San Antonio, TX The U.S. Air Force Medical Service (AFMS) provides primary and specialty care to \u3e 50,000 active duty, retired, and family members worldwide with diabetes. Only nine active duty staff endocrinologists are available to provider specialty support to the primary provider force. Because of the geographic separation of Military Treatment Facilities (MTFs) -including remote locations - and frequent provider reassignment, standardized education and continuity care can be difficult. In 2012, the U.S. Air Force Diabetes Center of Excellence (DCoE) created a continuing telemedicine education venue based on the Project Extension for Community Healthcare Outcomes (ECHO) model. It provides up to date provider education on a variety of diabetes care topics and real time patient case management. Following three years of feedback and a 22% annualized growth rate, our program now reaches 54 independent MTFs in 25 states and several international sites. Using a participant questionnaire based on a Likert scale (0 - strongly disagree, 5 - strongly agree), we assess clinical knowledge and confidence of a given topic pre- and post-presentation. We also use this scale to determine likelihood for practice change, appropriateness of education delivery, and presentation quality. Individual participant feedback Likert scores were averaged following each presentation since program inception. Annualized averaged knowledge and confidence score improvements were consistently greater than 20%, peaking at 34% in 2013. Paired one-tailed hypothesis t-testing showed significance at a p value \u3c 0.00001. Annualized averaged likelihood for practice change scores were consistently \u3e 4.08, appropriateness of delivery \u3e 4.61, and presentation quality \u3e 4.82. Given the limited number of AFMS endocrinologists and routine provider turnover, our implementation of the ECHO model improves the providers’ knowledge and confidence by delivering both live diabetes education and case discussion to a growing global network
Changes in bilateral coupling between the index fingers from posture to voluntary movement
No full textAUTHOR BLOCK: M. G. TUCKER1, *S. MORRISON2, R. S. BARRETT1; 1Physiotherapy and Exercise Sci., Griffith Univ., Gold Coast, Australia; 2Sch. Physical Therapy, Old Dominion Univ., Norfolk, VA Abstract: The ability to coordinate the limbs in a purposeful manner during voluntary action is a fundamental property of the motor system. The question of "how" individuals coordinate their limbs across different actions and what is the neurophysiological underpinnings for the coordination process formed the basis for this study. Specifically, the aim was to examine what changes occur in bilateral coupling as individuals perform three fundamentally different classes of movements (e.g., postural, isometric, isotonic). Twelve young adult individuals participated in this study. Each bilateral action was performed using the index fingers. The specific movements involved; a) maintaining a steady state postural position (postural tremor), b) producing isometric force output to match a target force (20%, 40% MVC), and c) performing an alternating isotonic flexion/extension action (in-phase and out-of-phase). Specific kinematic (finger acceleration), kinetic (isometric force output) measures were collected from each participant during each specific task. Surface EMG activity from extensor digitorum and flexor digitorum were also collected. The results of the cross correlation analysis produced a positive incremental trend in the coupling strength between the index fingers from postural to isotonic actions. Coupling was lowest during the postural tremor task (r=0.03), increased during the isometric tasks (r=0.55-0.65) and was highest (r=0.93-0.97) for the voluntary finger flexion/extension (isotonic) tasks. Changes in the level of coupling between limb actions were also reflected by differences in the inter- and intra-muscle relations. For the postural tasks, no significant coupling was seen between contralateral muscle pairs. In comparison, a higher degree of coupling between muscles was observed during the isotonic and isometric actions. The degree of regularity within any given motor output across tasks was also examined using Approximate Entropy (ApEn) analysis. The postural tremor output was the most complex (high ApEn) whereas the isotonic and isometric movement signals was more regular (low ApEn). Overall, the results illustrate that coupling between the index fingers increases from posture to voluntary movement, and that these coordination changes were mediated by coupling changes between homologous muscle pairs. Increased coupling was also associated with increased regularity of the resultant motor output. Together these findings support the general premise that any alteration of the strength of the coupling relations between system elements is a contributing factor in the complex nature of any given systems physiological output. Theme and Topic (Complete): D.17.a. Kinematics and muscle activity ; D.16.d. Kinematics and Muscle Activity Keywords (Complete): Coordination ; Neurophysiology ; Complexity ; Coupling ; Bilateral Presentation Preference (Complete): Poster Only Support (Complete): Support: NoNo Full Tex
Cardiovascular and Autonomic Responses to Acute Exposure to Mild Hypercapnic Conditions: A pilot study
No full textTitle: Cardiovascular and Autonomic Responses to Acute Exposure to Mild Hypercapnic Conditions: A pilot study
Author Block: Andres Benitez-Albiter1, Michael F. Allen1, Cody P. Anderson1, Matthew J. Jones1, Minhyeok Jang1, Kollyn Weimer1, Muhammed Enes Erol1, Gwenael Layec1, and Song-Young Park1,2
1School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, United States of America
2Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, United States of America
Introduction: Prolonged sitting (PS), defined as sitting for 2+ hours at a time, has been identified as an independent risk factor for cardiovascular disease (CVD). We previously reported that an acute bout of PS can attenuate macrovascular function in healthy young adults. Additionally, we reported that PS in mild hypercapnic environments (elevated CO2 concentrations) can further exacerbate these impairments in healthy young adults, and these impairments can be partially prevented by intermittent bouts of passive and active leg movements. However, the effects of prolonged sitting with a mild hypercapnic environment in the elderly population have not been studied. Therefore, the purpose of this study was to examine the impact of prolonged sitting with a mild-hypercapnic condition on macrovascular endothelial function in the popliteal and brachial arteries of healthy elderly adults. Additionally, we have further examined the effects of passive and active movements to negate the negative effects of prolonged sitting in elderly adults.
Hypothesis: We hypothesized that 1) PS will attenuate local and systemic macrovascular endothelial function, 2) passive and active leg movements will preserve macrovascular endothelial function.
Methods: Healthy elderly adults (n=1, 1 male, 71) participated in three experimental visits consisting of 2.5h of prolonged sitting in a mild-hypercapnic condition (CO2 = 1500ppm): control (CON, no movement), passive (PASS, passive leg movement), and active (ACT, active leg movement). Popliteal and brachial artery endothelial function was measured using flow-mediated dilation (FMD). All measurements were taken pre- and post-sitting.
Results: Popliteal FMD was reduced in the CON condition compared to both the PASS and ACT (D -3.54 vs D -2.621 vs D 0.267, respectively). Brachial FMD was attenuated in the CON condition compared to both the PASS and ACT (D -3.197 vs D -1.863 vs D 0.75, respectively).
Conclusion: This preliminary data shows that uninterrupted prolonged sitting induces impairments in both local and systemic macrovascular endothelial function. Additionally, intermittent bouts of passive and active movements can partially preserve macrovascular function during PS
