Experimental and clinical attempts at correction of interventricular septal defects.
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Repetitive cyclical motion and intrinsic muscle properties each impose constraints on the nervous systems to produce well-coordinated movements. We suggest that as cycle frequency increases, activation and deactivation dynamics strongly influence the neural control strategy used and may be the governing muscle property that limits performance. Pedaling and animal studies provide supporting data.
Simulation analyses of pedaling demonstrate how individual muscle forces act to accelerate and decelerate the leg segments and the crank to perform external work. The work done by the muscles to accelerate the leg segments ultimately drives the pedals because when the legs decelerate, their mechanical energy is used to overcome the external load.
RATIONALE AND OBJECTIVES: In 1978, Morrow et al published the results of a simple technique for raising radiation oncology patients' levels of awareness about medical options. They reported that providing written information at least 24 hours in advance was an effective tool for increasing the baseline knowledge in this patient group. However, Morrow's cohort consisted exclusively of cancer patients receiving radiation therapy. The authors of this article are concerned with whether the encouraging results reported by Morrow are reproducible when applied to patients awaiting invasive radiologic procedures. METHODS: One hundred sixty consecutive outpatients awaiting contrast were block randomized into one of eight groups based on age, sex, and previous contrast exposure. For each group, half were given their consent form at least 24 hours prior, and the other half at the time of their procedure. All patients were tested at the time of their procedure to evaluate knowledge retention. RESULTS: Comparison between the two study groups showed no overall statistically significant differences either in knowledge (experimental group 4.7 +/- 1.32 versus 4.38 +/- 1.30 control group) or level of satisfaction. Additionally, individuals experienced with contrast failed to outperform those who had never previously been given contrast. There is no significant difference in the performance between the two sexes regardless of group. CONCLUSIONS: The providing of information 24 to 72 hours in advance of an invasive procedure does not have a beneficial effect over just providing the same information at the time of the study.
PURPOSE: The objectives of this study were to: 1) establish a database of kinematic and EMG data during cutting movements, 2) describe normal muscle function and coordination of 12 lower extremity muscles during cutting movements susceptible to ankle sprains, and 3) identify potential muscle coordination deficiencies that may lead to ankle sprain injuries. METHODS: Kinematic, EMG, and GRF data were collected from 10 recreationally active male subjects during both a side-shuffle and v-cut movement. RESULTS: The data showed that muscles functioned similarly during both movements. The primary function of the hip and knee extensors was to decelerate the center-of-mass during landing and to provide propulsion during toe-off. The hip add/abductors functioned primarily to stabilize the hip rather than provide mechanical power. The ankle plantar flexors functioned to provide propulsion during toe-off, and the gastrocnemius had an additional burst of activity to plantarflex the foot before touchdown during the side-shuffle to help absorb the impact. The tibialis anterior functioned differently during each movement: to dorsiflex and supinate the foot after toe-off in preparation for the next step cycle during the side-shuffle and to dorsiflex the foot before impact to provide the heel-down landing and ankle stability in the stance phase during the v-cut. CONCLUSIONS: The muscles crossing the ankle joint, especially the tibialis anterior and peroneus longus, may play an important role to prevent ankle sprain injuries. Both muscles provided stability about the subtalar joint by preventing excessive joint rotations. Future theoretical studies with forward dynamic simulations incorporating individual muscle actuators are needed to quantify the segment accelerations induced by active muscles which may prevent or lead to ankle sprain injuries.
PURPOSE: The goal of this study was to examine the influence of changes in subtalar joint flexibility and compliance on ankle sprain occurrence. METHODS: Muscle model driven simulations of 10 subjects performing the landing phase of a side-shuffle movement were performed. The passive flexibility or compliance of the subtalar joint was varied, and each subject-specific simulation was exposed to a set of perturbed floor conditions. RESULTS: Increases in flexibility and compliance both led to an increase in the occurrence of excessive supination, while changes in flexibility had a greater influence. Changes in flexibility or compliance caused only small changes in the occurrence of excessive supination torques. CONCLUSION: These results suggest that increased mechanical laxity does not directly cause an increase in sprain occurrence during side-shuffle movements.
PURPOSE: Based on the resistance-rpm relationship for cycling, which is not unlike the force-velocity relationship of muscle, it is hypothesized that the cadence which requires the minimal muscle activation will be progressively higher as power output increases. METHODS: To test this hypothesis, subjects were instrumented with surface electrodes placed over seven muscles that were considered to be important during cycling. Measurements were made while subjects cycled at 100, 200, 300, and 400 W at each cadence: 50, 60, 80, 100, and 120 rpm. These power outputs represented effort which was up to 32% of peak power output for these subjects. RESULTS: When all seven muscles were averaged together, there was a proportional increase in EMG amplitude each cadence as power increased. A second-order polynomial equation fit the EMG:cadence results very well (r2 = 0.87- 0.996) for each power output. Optimal cadence (cadence with lowest amplitude of EMG for a given power output) increased with increases in power output: 57 +/- 3.1, 70 +/- 3.7, 86 +/- 7.6, and 99 +/- 4.0 rpm for 100, 200, 300, and 400 W, respectively. CONCLUSION: The results confirm that the level of muscle activation varies with cadence at a given power output. The minimum EMG amplitude occurs at a progressively higher cadence as power output increases. These results have implications for the sense of effort and preferential use of higher cadences as power output is increased.
A cross sectional study was designed to measure DDT residues and its metabolites in breast milk samples collected randomly from Saudi lactating mothers living in Al-Ehssa region; which was under leishmania control until 1995, and compare them to samples from mothers living in Riyadh region where no spraying activities was involved. p,p'-DDE, p,p'-DDD and p,p'-DDT residues were measured in 878 breast milk samples by Gas Chromatography/Electron Capture Detector (GC/ECD) and confirmed by Gas Chromatography/Mass Spectrometer Detector (GC/MSD). Variation in the DDT and its metabolites levels were investigated with respect to regional distribution. Wilcoxon rank sum tests showed that the average ranks of p,p'-DDE, p,p'-DDD, p,p'-DDT and sigma p,p'-DDT in lactating mothers from Al-Ehssa region were significantly higher than those living in Riyadh region. These differences supported our hypothesis that the implications of the spraying activities to control vector borne diseases in Al-Ehssa region are obvious. We estimated that 99.2% of infants of lactating mothers living in Al-Ehssa region had sigma p,p'-DDT daily intakes that exceeded 20 micrograms/Kg-day of body weight, the WHO/UNEP Acceptable Daily Intakes for a 5-Kg infant. Exposure of infants to these chemicals through breast-feeding is clearly a public health concern. Because the bulk of literature highlights the adverse health effects of DDT and its metabolites on children and infants, public health polices should enforce the ban of DDT use and advise pregnant and lactating women to avoid DDT containing food or any other type of exposure.
Selective laser sintering (SLS) is a powerful manufacturing technology that does not require part-specific tooling or significant human intervention and provides the ability to easily generate parts with complex geometric designs. The present work focuses on developing a manufacturing framework using this technology to produce subject-specific transtibial amputee prosthetic sockets made of Duraform PA, which is a nylon-based material. The framework includes establishing an overall socket design (using the patellar-tendon bearing approach), performing a structural analysis using the finite element method (FEM) to ensure structural reliability during patient use, and validating the results by comparing the model output with experimental data. The validation included quantifying the failure conditions for the socket through a series of bending moment and compression tests. In the case study performed, the FEM results were within 3% of the experimental failure loads for the socket and were considered satisfactory.
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A very attractive advantage of manufacturing prosthetic sockets using solid freeform fabrication is the freedom to introduce design solutions that would be difficult to implement using traditional manufacturing techniques. Such is the case with compliant features embedded in amputee prosthetic sockets to relieve contact pressure at the residual limb-socket interface. The purpose of this study was to present a framework for designing compliant features to be incorporated into transtibial sockets and manufacturing prototypes using selective laser sintering (SLS) and Duraform material. The design process included identifying optimal compliant features using topology optimization algorithms and integrating these features within the geometry of the socket model. Using this process, a compliant feature consisting of spiral beams and a supporting external structure was identified. To assess its effectiveness in reducing residual limb-socket interface pressure, a case study was conducted using SLS manufactured prototypes to quantify the difference in interface pressure while a patient walked at his self-selected pace with one noncompliant and two different compliant sockets. The pressure measurements were performed using thin pressure transducers located at the distal tibia and fibula head. The measurements revealed that the socket with the greatest compliance reduced the average and peak pressure by 22% and 45% at the anterior side distal tibia, respectively, and 19% and 23% at the lateral side of the fibula head, respectively. These results indicate that the integration of compliant features within the socket structure is an effective way to reduce potentially harmful contact pressure and increase patient comfort.
The objective of this study was to evaluate the performance of different multivariate optimization algorithms by solving a "tracking" problem using a forward dynamic model of pedaling. The tracking problem was defined as solving for the muscle controls (muscle stimulation onset, offset, and magnitude) that minimized the error between experimentally collected kinetic and kinematic data and the simulation results of pedaling at 90 rpm and 250 W. Three different algorithms were evaluated: a downhill simplex method, a gradient-based sequential quadratic programming algorithm, and a simulated annealing global optimization routine. The results showed that the simulated annealing algorithm performed for superior to the conventional routines by converging more rapidly and avoiding local minima.
The target article presents a framework for coordination of one- and two-joint muscles in a variety of tasks. Static optimization analyses were performed that minimize muscle fatigue, and it is claimed that the predicted muscle forces account for essential features of EMG activity qualitatively well. However, static optimization analyses use the observed joint moments, which implicitly assumes that they minimize the total muscle fatigue of the task. We use a forward dynamics (i.e., relationship between muscle forces and the kinematics and kinetics of task performance) modeling approach to show that this assumption does not appear to be true in cycling (which was used as an example task in the target article). Our results challenge the hypothesized coordination framework and the underlying concept that general coordination principles for dynamic tasks can be elucidated using inverse-dynamics-based analyses.
Rheological experiments on fine-grained water ice II at low strain rates reveal a creep mechanism that dominates at conditions of low stress. Using cryogenic scanning electron microscopy, we observed that a change in stress exponent from 5 to 2.5 correlates strongly with a decrease in grain size from about 40 to 6 micrometers. The grain size-sensitive creep of ice II demonstrated here plausibly dominates plastic strain at the low-stress conditions in the interior of medium- to large-sized icy moons of the outer solar system.
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Aortic aneurysm and dissection are manifestations of Marfan syndrome (MFS), a disorder caused by mutations in the gene that encodes fibrillin-1. Selected manifestations of MFS reflect excessive signaling by the transforming growth factor-beta (TGF-beta) family of cytokines. We show that aortic aneurysm in a mouse model of MFS is associated with increased TGF-beta signaling and can be prevented by TGF-beta antagonists such as TGF-beta-neutralizing antibody or the angiotensin II type 1 receptor (AT1) blocker, losartan. AT1 antagonism also partially reversed noncardiovascular manifestations of MFS, including impaired alveolar septation. These data suggest that losartan, a drug already in clinical use for hypertension, merits investigation as a therapeutic strategy for patients with MFS and has the potential to prevent the major life-threatening manifestation of this disorder.
The surface of Triton is very bright but shows subtle yellow to peach hues which probably arise from the production of colored organic compounds from CH4 + N2 and other simple species. In order to investigate possible relationships between chemical processes and the observed surface distribution of chromophores, we classify the surface units according to color/albedo properties, estimate the rates of production of organic chromophores by the action of ultraviolet light and high-energy charged particles, and compare rates, spectral properties, and expected seasonal redistribution processes to suggest possible origins of the colors seen on Triton's surface.