ABSTRACT
Introduction: Low-intensity aerobic training has demonstrated to be beneficial in patients with Duchenne muscular dystrophy (DMD). Aerobic exercise counteracts physical deterioration. Daily exercise (walking to and back from school, playing in the park, etc) is supposed to have a big influence on the muscular state of the patient, but its importance has never been studied before. 6MWT is a primary endpoint for DMD and a strong predictor of decline in ambulation. In Spain, because of the COVID situation, the Spanish population was confined to their home on 14th March 2020. Children could start to go for a walk from April 26th, but they didn't go back to school until September 2020. Patients and methods: DMD children visited in Hospital Sant Joan de Deu with: (1) Previous basal 6MWT (6MWT pre): June 2019;(2) 6MWT pre-confinement (6MWT basal): December 2019;(3) 6MWT post-confinement (6MWT post): June 2020. We analyzed the meters' difference between 6MWT pre and 6 MWT basal, compared with the meter's difference between 6 MWT basal and 6MWT post. Results: 28 DMD children: age: 6-17 years. Meters' difference between 6MWT pre-6MWT basal: average- 1.08, standard deviation 45.97, minimum-157, median 8.50, maximum 93. Meters' Difference between 6MWT basal-6MWT post: average- 34.62, standard deviation 48.26, minimum-124, median- 28.50, maximum 106. The differences are statistically significant (p = 0.006 Wilcoxon test). Conclusion: DMD children presented a bigger deterioration in the 6MWT after confinement. These results support the importance of avoiding a sedentary lifestyle to preserve ambulation and slow down the disease.
ABSTRACT
Despite holding very high expectations regarding installed capacity and planned investments, offshore wind energy is currently facing important challenges to align itself with the levelised cost of energy of other renewable energies such as solar power or onshore wind. In this context, we aim at putting DES optimisation at offshore wind’s disposal and leverage its advantages proved in other areas. To accomplish so, we have performed a DES-based optimisation of the routing strategy and the net income of an offshore wind foundations manufacturing project affected by very important delays due to covid-19 impact and material supply issues. The problem applies to a constraint-based multi-level assembly job shop where we use dispatching rules to model the routing decision. Overall, we have provided the company with an optimised schedule, due dates, expected penalties, expected net income and a detailed ongoing DES model to be used in further stages of the project. Copyright © 2021 Inderscience Enterprises Ltd.