Standard and alternative methods of stretcher carriage: performance, human factors, and cardiorespiratory responses

Transporting a casualty on a stretcher is a common task for medical and military personnel. Stretchers are usually carried by hand, but distributing the load to other parts of the body may have advantages. To examine alternative carriage methods, 11 soldiers walked on a treadmill at 4.8 km/h while performing two-person carries of a stretcher containing an 80-kg manikin. In separate trials, soldiers carried the stretcher using: (1) hand carriage, (2) shoulder straps, (3) a specially designed harness that allowed load shifting between the hips and shoulders (hip-shoulder system), and (4) a clip that fitted on the belt of standard military load carrying equipment (LCE) and placed the stretcher mass mainly on the hips. With each system, subjects walked until volitional fatigue or 30 min. While walking, expired gases and heart rates were obtained and subjects rated their perceived exertion (Borg Scale). At the conclusion of all four trials, subjects rated each system on a number of subjective measures. Results showed that average (+/- SD) carriage times were 2.7+/-1.4, 14.5+/-8.3, 25.4+/-8.1, and 21.7+/-9.9 min with the hand, shoulder, hip-shoulder and LCE systems respectively (p<0.01). Hand carriage resulted in considerably more cardiorespiratory stress (higher heart rate and minute ventilation, p<0.05) than the other three systems, but there were few consistent differences among the other three systems. Perceived exertion in the upper body was less with the hip-shoulder and LCE systems than with the other two systems (p<0.05). Subjects preferred the hip-shoulder and LCE systems overall and for specific subjective characteristics such as comfort, ease of use and stability (p<0.01). These data indicate that moving the stretcher load from the hands and placing that load on the shoulders and/or hips results in improved performance, reduced cardiorespiratory stress and favourable subjective evaluations. Further developmental work should focus on the hip-shoulder and LCE systems.     

Qualitative models of seat discomfort including static and dynamic factors

Judgements of overall seating comfort in dynamic conditions sometimes correlate better with the static characteristics of a seat than with measures of the dynamic environment. This study developed qualitative models of overall seat discomfort to include both static and dynamic seat characteristics. A dynamic factor that reflected how vibration discomfort increased as vibration magnitude increased was combined with a static seat factor which reflected seating comfort without vibration. The ability of the model to predict the relative and overall importance of dynamic and static seat characteristics on comfort was tested in two experiments. A paired comparison experiment, using four polyurethane foam cushions (50, 70, 100, 120 mm thick), provided different static and dynamic comfort when 12 subjects were exposed to one-third octave band random vertical vibration with centre frequencies of 2.5 and 5.5 Hz, at magnitudes of 0.00, 0.25 and 0.50 m x s(-2) rms measured beneath the foam samples. Subject judgements of the relative discomfort of the different conditions depended on both static and dynamic characteristics in a manner consistent with the model. The effect of static and dynamic seat factors on overall seat discomfort was investigated by magnitude estimation using three foam cushions (of different hardness) and a rigid wooden seat at six vibration magnitudes with 20 subjects. Static seat factors (i.e. cushion stiffness) affected the manner in which vibration influenced the overall discomfort: cushions with lower stiffness were more comfortable and more sensitive to changes in vibration magnitude than those with higher stiffness. The experiments confirm that judgements of overall seat discomfort can be affected by both the static and dynamic characteristics of a seat, with the effect depending on vibration magnitude: when vibration magnitude was low, discomfort was dominated by static seat factors; as the vibration magnitude increased, discomfort became dominated by dynamic factors.     

Quantitative prediction of overall seat discomfort

Static seat characteristics (seat stiffness) and dynamic seat characteristics (vibration magnitude) can both influence judgements of seat comfort. It is proposed that seat comfort can be predicted on the basis of Steven's psychophysical law: psi = kphi(n), where psi is a sensation magnitude, phi is the stimulus magnitude and k is a constant. The law is modified to: psi = a + bphis[n(s)] + cphiv[n(v)], where phis and phiv represent seat stiffness and vibration magnitude, n(s) and n(v) are exponents determined by the rate of increase in discomfort associated with the stiffness and vibration magnitude, and a, b and c are constants. The stiffness of foam loaded to 490 N may indicate static seat comfort, while the vibration dose value (VDV) on the seat surface may indicate vibration discomfort. Two experiments with 20 subjects investigated this approach. The first experiment with five magnitudes of vibration, three foams and a rigid wooden flat seat yielded 0.929 for the exponent, n(v), for VDV. In the second experiment subjects judged the overall seat discomfort while exposed six vibration magnitudes with the same four seating conditions. This experiment yielded 1.18 for the exponent, n(s), for seat stiffness. The overall prediction of seat discomfort was given by: psi = -50.3 + 2.68phis1.18 + 101phiv0.929. The prediction equation provided more accurate estimates of subject discomfort than models using either the VDV alone or the stiffness alone, especially when the vibration magnitude was low or the seats were similar. An interaction variable between the VDV and the stiffness slightly improved the prediction. The equivalence of the two stimuli was given by log10 (stiffness) = 0.787 log10 (VDV) + 1.34, or log10 (VDV) = 1.27 log10 (stiffness) - 1.70.     

Lumbar erector spinae oxygenation during prolonged contractions: implications for prolonged work

Owing to the recent interest in torso stabilization exercises together with many questions regarding the duration of prolonged isometric holds in occupational settings, the authors attempted to assess the level of back muscle oxygenation during prolonged isometric contractions. Specifically, this study recorded relative oxygen saturation of haemoglobin/myoglobin using Near Infrared Spectroscopy (NIRS) in the L3 erector mass during prolonged isometric contractions at intensities from 2 to 30% of maximum voluntary contraction (MVC). It was hypothesized that available oxygen to these muscles is severely compromised even at moderate levels of activation observed in occupational work. Eight volunteers without a history of lower back pain or injury participated in this study. The exercise task involved isometric contraction of the lower erector spinae at five different levels of each subject's maximal voluntary contraction: 2, 5, 10, 20 and 30% MVC, presented in random order. Subjects were placed in a sitting position, with a curved plastic plate secured horizontally to the pelvis to minimize movement at the hip joint. During extensor exertions, they were restrained with a harness that was attached at chest level to a load cell. Each isometric contraction was performed for 30 s followed by 1 min of rest. All levels of contraction demonstrated reduction in oxygen. Given the concern for motion artefact on the NIRS signal, sham trials were conducted where the subjects went through the procedure of attaching the pulling cable but no active pull was performed. These trials showed no change in the NIRS signal. At this time NIRS appears to be the only non-invasive instrumentation available to indicate total available muscle oxygen during low level, prolonged work. Although the specific tissue volume sampled by NIRS cannot be positively identified, it appears that tissue oxygenation in the lumbar extensor musculature is reduced as a function of contraction intensity, even at levels as low as 2% of MVC. These data have implications for prolonged work where postures requiring isometric contractions are sometimes held for hours, and where musculoskeletal illness has been linked to prolonged contraction levels above 2%MVC--these data suggest a possible biological pathway.     

LFP: A PC-program for ligand-field analysis of 3d(n) ions in Oh and lower symmetries

A modular and efficient version of PC program for calculating ligand-field parameters, i.e. crystal-field model (CFM) and angular overlap model (AOM) is presented. The LFP program is designed to calculate the ligand-field parameters of low symmetry transition metal complexes. It is based on the general method for the analysis of central ion states distortion using group theory. The program has not closed form. It will be extended, according to spectroscopic studies in our laboratory. It is written in FORTRAN language.     

Detailed differential coefficients of anomalous dispersion terms to derivatives in least-squares refinement for X-ray crystallography

In X-ray crystallographic analysis, correct trial structures are refined by least-squares method. The detailed differential coefficients for the parameters of the calculated structure factor Fc(h) can not be found in any papers, textbooks, nor user's manual of several crystallographic computer systems. We describe, firstly, the basic expression of the structure factors, Fo(h) and Fc(h), anomalous dispersion terms of the structure factor, and then least-squares refining of magnitude of Fo(h) and Fo(h)2 for use in teaching, education and computer programming. Secondly we derive the differential terms of the structure factors, solve the normal equation by diagonal, block and full-matrix approximations, and apply these to the revised computer program LSBF in DS*SYSTEM. Several practical tests are performed for these differentiations.     

Automation of the use of fluorescent microspheres for the determination of blood flow

Fluorescent-labeled microspheres (FM) are a new tool for the determination of organ blood flow. However, the FM-method is labor intensive, because of the necessity to recover the microspheres from the tissue samples. The aim of this study was to automate the FM-method. A Zymate-Robotic System (Zymark, Idstein, Germany) was modified to handle a novel filtration device. The robot is surrounded by 12 different stations which are necessary to process the samples. It performs the sequential steps which are needed to recover the microspheres from the samples. The dyes are finally released from the FM with a solvent and their fluorescent intensity is measured online using a spectrophotometer (Perkin Elmer, Uberlingen, Germany). The robotic system is able to recover the FM through digestion and filtration of the tissue samples using the new filter, to dissolve the FM and to release the dyes so that their fluorescent intensities can be measured for the calculation of organ blood flow.     

Adaptive method of realizing natural gradient learning for multilayer perceptrons

The natural gradient learning method is known to have ideal performances for on-line training of multilayer perceptrons. It avoids plateaus, which give rise to slow convergence of the backpropagation method. It is Fisher efficient, whereas the conventional method is not. However, for implementing the method, it is necessary to calculate the Fisher information matrix and its inverse, which is practically very difficult. This article proposes an adaptive method of directly obtaining the inverse of the Fisher information matrix. It generalizes the adaptive Gauss-Newton algorithms and provides a solid theoretical justification of them. Simulations show that the proposed adaptive method works very well for realizing natural gradient learning.