Hamstrings and psoas lengths during normal and crouch gait: implications for muscle-tendon surgery

OBJECTIVE: To study the relative contribution of the lung and the chest wall on the total respiratory system mechanics, gas exchange, and work of breathing in sedated-paralyzed normal subjects and morbidly obese patients, in the postoperative period. SETTING: Policlinico Hospital, University of Milan, Italy. METHODS: In ten normal subjects (normal) and ten morbidly obese patients (obese), we partitioned the total respiratory mechanics (rs) into its lung (L) and chest wall (w) components using the esophageal balloon technique together with airway occlusion technique, during constant flow inflation. We measured, after abdominal surgery, static respiratory system compliance (Cst,rs), lung compliance (Cst,L), chest wall compliance (Cst,w), total lung (Rmax,L) and chest wall (Rmax,w) resistance. Rmax,L includes airway (Rmin,L) and "additional" lung resistance (DR,L). DR,L represents the component due to viscoelastic phenomena of the lung tissue and time constant inequalities (pendelluft). Functional residual capacity (FRC) was measured by helium dilution technique. RESULTS: We found that morbidly obese patients compared with normal subjects are characterized by the following: (1) reduced Cst,rs (p < 0.01), due to lower Cst,L (55.3 +/- 15.3 mL x cm H2O-1 vs 106.6 +/- 31.7 mL x cm H2O-1; p < 0.01) and Cst,w (112.4 +/- 47.4 mL x cm H2O-1 vs 190.7 +/- 45.1 mL x cm H2O-1; p < 0.01); (2) increased Rmin,L (4.7 +/- 3.1 mL x cm H2O x L-1 x s; vs 1.0 +/- 0.8 mL x cm H2O x L-1 x s; p < 0.01) and DR,L (4.9 +/- 2.6 mL x cm H2O x L-1 x s; vs 1.5 +/- 0.8 mL x cm H2O x L-1 x s; p < 0.01); (3) reduced FRC (0.665 +/- 0.191 L vs 1.691 +/- 0.325 L; p < 0.01); (4) increased work performed to inflate both the lung (0.91 +/- 0.25 J/L vs 0.34 +/- 0.08 J/L; p < 0.01) and the chest wall (0.39 +/- 0.13 J/L vs 0.18 +/- 0.04 J/L; p < 0.01); and (5) a reduced pulmonary oxygenation index (PaO2/PAO2 ratio). CONCLUSION: Sedated-paralyzed morbidly obese patients, compared with normal subjects, are characterized by marked derangements in lung and chest wall mechanics and reduced lung volume after abdominal surgery. These alterations may account for impaired arterial oxygenation in the postoperative period.     

The whistle and the rattle: the design of sound producing muscles

Vertebrate sound producing muscles often operate at frequencies exceeding 100 Hz, making them the fastest vertebrate muscles. Like other vertebrate muscle, these sonic muscles are "synchronous," necessitating that calcium be released and resequestered by the sarcoplasmic reticulum during each contraction cycle. Thus to operate at such high frequencies, vertebrate sonic muscles require extreme adaptations. We have found that to generate the "boatwhistle" mating call (approximately 200 Hz), the swimbladder muscle fibers of toadfish have evolved (i) a large and very fast calcium transient, (ii) a fast crossbridge detachment rate, and (iii) probably a fast kinetic off-rate of Ca2+ from troponin. The fibers of the shaker muscle of rattlesnakes have independently evolved similar traits, permitting tail rattling at approximately 90 Hz.     

Localization of prothymosin alpha in the nucleus

Age differences in processing resources seem salient to age-related declines in secondary (or "recent") memory. Community-dwelling adults (N = 90, ages 30-80) completed 4 memory tests: Wechsler Memory Scale-Revised (WMS-R) Logical Memory (LM), Cowboy Story (CS), WMS-R Visual Reproductions (VR), and Extended Complex Figure Test (ECFT; Fastenau, in press). Two space-capacity measures (WMS-R Digit Span and Visual Memory Span) and 4 processing speed measures (cancellation and mental-tracking tasks) assessed processing resources. A statistical control procedure was used to isolate retrieval efficiency and measures contributions of age and processing resources to retrieval. A negative relationship between age and retrieval efficiency emerged on all measures (p < .05). The age effect was reduced 60% on LM and CS when processing resources were controlled, eliminated for VR, and unchanged on ECFT. It is possible that visual-spatial retrieval requires fewer processing resources than does verbal retrieval.     

Yearly stepwise increments of the growth hormone dose results in a better growth response after four years in girls with Turner syndrome. Dutch Working Group on Growth Hormone

To optimize the growth promoting effect of growth hormone (GH), 65 previously untreated girls with Turner syndrome (TS), chronological age (CA) 2-11 yr, were randomized into 3 dosage regimen groups: A, B, and C, with a daily recombinant-human GH dose during 4 study years of 4-4-4-4, 4-6-6-6, and 4-6-8-8 IU/m2 b.s. The first GH dosage increase in groups B and C resulted in a significantly higher mean height velocity (HV) compared with constant dose group A. During the third year, when the dose was raised again only in group C, mean HV was significantly higher in groups B and C than in group A, and in group C compared with group B. In year 4 only group C mean HV remained significantly higher than group A. The pattern of change in HSDSCA (Dutch-Swedish-Danish Turner references) was identical; however, in year 4 mean delta HSDSCA in group B also remained significantly higher than group A. After 4 yr GH treatment, the following was determined. 1) The mean delta HSDSCA was significantly higher for groups B and C compared with group A, but not significantly different between groups B and C. 2) Although significantly higher compared with estimated values for untreated Dutch girls with TS, bone maturation of the GH treated girls was not significantly different between groups. 3) It was positively related with the degree of bone age (BA) retardation at start of study and negatively with baseline CA. 4) Both the modified Index of Potential Height (mIPHRUS) and a recently developed Turner-specific final height (FH) prediction method (PTSRUS), based on regression coefficients for H, CA, and bone age, showed significant increases in mean FH prediction, without significant differences between groups. PTSRUS values were markedly higher than the mIPHRUS values. Dose dependency could be shown for the area under the curve (AUC) for GH, but delta HSDSCA was not linearly related with AUC. Baseline GH binding protein (BP) levels were in 84% of the cases within the normal age range; the decrease in mean levels after 6 months GH was not significant. Mean insulin-like growth factor I (IGF-I) and IGFBP-3 plasma levels increased significantly, without significant differences between groups. delta HSDSCA during GH was dependent on IGF-I plasma levels at baseline and during the study period, beta-0.002 and beta-0.0004. Thus, a stepwise GH-dosing approach reduced the "waning" effect of the growth response after 4 yr treatment without undue bone maturation. FH prediction was not significantly different between treatment groups. Irrespective of the GH dose used, initiation of GH treatment at a younger age was beneficial after 4 yr GH when expressed as actual cm gained or as gain in FH prediction, but was not statistically significant when expressed as delta HSDSCA over the study period.     

Community resources for clients with mobility problems

Clients are leaving the hospital "quicker and sicker," and they frequently have acute care needs that must be met by resources outside the hospital setting. Community resources are diverse, vary widely from place to place, and have no central administration. Thus, using them can be challenging for both the nurse, client, and family. Reimbursement mechanisms underlie a person's ability to use resources and receive health care. By presenting two actual case scenarios where clients have mobility problems commonly seen by orthopaedic nurses, the authors discuss the community resources available, avenues of access to them, and their reimbursement mechanisms.     

A PDE method for patchwise approximation of large polygon meshes

Three-dimensional (3D) representations of complex geometric shapes, especially when they are reconstructed from magnetic resonance imaging (MRI) and computed tomography (CT) data, often result in large polygon meshes which require substantial storage for their handling, and normally have only one fixed level of detail (LOD). This can often be an obstacle for efficient data exchange and interactive work with such objects. We propose to replace such large polygon meshes with a relatively small set of coefficients of the patchwise partial differential equation (PDE) function representation. With this model, the approximations of the original shapes can be rendered with any desired resolution at interactive rates. Our approach can directly work with any common 3D reconstruction pipeline, which we demonstrate by applying it to a large reconstructed medical data set with irregular geometry.     

Loss and gain functions for CBR retrieval

The method described in this article evaluates case similarity in the retrieval stage of case-based reasoning (CBR). It thus plays a key role in deciding which case to select, and therefore, in deciding which solution will be eventually applied. In CBR, there are many retrieval techniques. One feature shared by most is that case retrieval is based on attribute similarity and importance. However, there are other crucial factors that should be considered, such as the possible consequences of a given solution, in other words its potential loss and gain. As their name clearly implies, these concepts are defined as functions measuring loss and gain when a given retrieval case solution is applied. Moreover, these functions help the user to choose the best solution so that when a mistake is made the resulting loss is minimal. In this way, the highest benefit is always obtained.     

Applications of ontologies in requirements engineering: a systematic review of the literature

There is an increase use of ontology-driven approaches to support requirements engineering (RE) activities, such as elicitation, analysis, specification, validation and management of requirements. However, the RE community still lacks a comprehensive understanding of how ontologies are used in RE process. Thus, the main objective of this work is to investigate and better understand how ontologies support RE as well as identify to what extent they have been applied to this field. In order to meet our goal, we conducted a systematic literature review (SLR) to identify the primary studies on the use of ontologies in RE, following a predefined review protocol. We then identified the main RE phases addressed, the requirements modelling styles that have been used in conjunction with ontologies, the types of requirements that have been supported by the use of ontologies and the ontology languages that have been adopted. We also examined the types of contributions reported and looked for evidences of the benefits of ontology-driven RE. In summary, the main findings of this work are: (1) there are empirical evidences of the benefits of using ontologies in RE activities both in industry and academy, specially for reducing ambiguity, inconsistency and incompleteness of requirements; (2) the majority of studies only partially address the RE process; (3) there is a great diversity of RE modelling styles supported by ontologies; (4) most studies addressed only functional requirements; (5) several studies describe the use/development of tools to support different types of ontology-driven RE approaches; (6) about half of the studies followed W3C recommendations on ontology-related languages; and (7) a great variety of RE ontologies were identified; nevertheless, none of them has been broadly adopted by the community. Finally, we conclude this work by showing several promising research opportunities that are quite important and interesting but underexplored in current research and practice.