A Simple Method to Optimally Select Upper-Limb Joint Angle Trajectories from Two Kinect Sensors during the Twisting Task for Posture Analysis

A trunk-twisting posture is strongly associated with physical discomfort. Measurement of joint kinematics to assess physical exposure to injuries is important. However, using a single Kinect sensor to track the upper-limb joint angle trajectories during twisting tasks in the workplace is challenging due to sensor view occlusions. This study provides and validates a simple method to optimally select the upper-limb joint angle data from two Kinect sensors at different viewing angles during the twisting task, so the errors of trajectory estimation can be improved. Twelve healthy participants performed a rightward twisting task. The tracking errors of the upper-limb joint angle trajectories of two Kinect sensors during the twisting task were estimated based on concurrent data collected using a conventional motion tracking system. The error values were applied to generate the error trendlines of two Kinect sensors using third-order polynomial regressions. The intersections between two error trendlines were used to define the optimal data selection points for data integration. The finding indicates that integrating the outputs from two Kinect sensor datasets using the proposed method can be more robust than using a single sensor for upper-limb joint angle trajectory estimations during the twisting task.

Simple benchmarking method for determining the accuracy of depth cameras in body landmark location estimation: Static upright posture as a measurement example

To evaluate the postures in ergonomics applications, studies have proposed the use of low-cost, marker-less, and portable depth camera-based motion tracking systems (DCMTSs) as a potential alternative to conventional marker-based motion tracking systems (MMTSs). However, a simple but systematic method for examining the estimation errors of various DCMTSs is lacking. This paper proposes a benchmarking method for assessing the estimation accuracy of depth cameras for full-body landmark location estimation. A novel alignment board was fabricated to align the coordinate systems of the DCMTSs and MMTSs. The data from an MMTS were used as a reference to quantify the error of using a DCMTS to identify target locations in a 3-D space. To demonstrate the proposed method, the full-body landmark location tracking errors were evaluated for a static upright posture using two different DCMTSs. For each landmark, we compared each DCMTS (Kinect system and RealSense system) with an MMTS by calculating the Euclidean distances between symmetrical landmarks. The evaluation trials were performed twice. The agreement between the tracking errors of the two evaluation trials was assessed using intraclass correlation coefficient (ICC). The results indicate that the proposed method can effectively assess the tracking performance of DCMTSs. The average errors (standard deviation) for the Kinect system and RealSense system were 2.80 (1.03) cm and 5.14 (1.49) cm, respectively. The highest average error values were observed in the depth orientation for both DCMTSs. The proposed method achieved high reliability with ICCs of 0.97 and 0.92 for the Kinect system and RealSense system, respectively.

Dairy cattle with bovine leukaemia virus RNA show significantly increased leukocyte counts

Infection with bovine leukaemia virus (BLV), a retrovirus, causes dysfunction of the immune system and can have a marked economic impact on dairy industries due to decreased milk production and reduced lifespan in affected dairy cattle. The presence of proviral DNA has been the major diagnostic indicator of BLV infection. However in the course of BLV infection, the viral genome can be dormant, without detectable gene expression, resulting in limited impact on infected animals. At present, there is limited knowledge regarding haematological indices in dairy cattle that could indicate activation of the BLV genome and suggest reactivated BLV infection. In this study, BLV infection and BLV genome reactivation were evaluated based on the presence of BLV DNA and BLV env gene transcripts, respectively. BLV RNA transcription was confirmed. Among 93 whole blood samples obtained from asymptomatic dairy cattle, the prevalence of BLV proviral DNA and transcripts was 93.5% (n = 87/93) and 83.9% (n = 78/93), respectively. Between groups with and without BLV, the mean counts of white blood cells and lymphocytes in whole blood were significantly associated with the presence of BLV RNA (P < 0.05), but not with BLV proviral DNA. These results shed light on the activation status of the BLV genome and should be taken into account when evaluating the possible impact of BLV on cattle.

Cryptococcus neoformans var grubii meningoencephalitis in a patient on fingolimod for relapsing-remitting multiple sclerosis: Case report and review of published cases

INTRODUCTION

Fingolimod, a sphingosine-1-phosphate modulator used in the treatment of relapsing-remitting multiple sclerosis, has been associated with several cases of cryptococcosis.

CASE REPORT

We present a case of Cryptococcal meningoencephalitis attributable to Cryptococcus neoformans var. grubii, in a 58-year-old bird-keeper from Australia, after 7 years of fingolimod therapy. We discuss this in the context of previously reported cases, our understanding of fingolimod immune modulation, and known Cryptococcus pathobiology.

CONCLUSION

We suggest consideration of harm minimisation behaviours in patients requiring fingolimod, particularly in those with profound CD4 lymphopenia. Furthermore, we echo the call for improved post-marketing surveillance systems to determine the epidemiology of atypical infections with novel immunomodulatory treatments.

Unique Access to u-Channel Physics: Exclusive Backward-Angle Omega Meson Electroproduction

Backward-angle meson electroproduction above the resonance region, which was previously ignored, is anticipated to offer unique access to the three quark plus sea component of the nucleon wave function. In this Letter, we present the first complete separation of the four electromagnetic structure functions above the resonance region in exclusive ω electroproduction off the proton, ep→e^{'}pω, at central Q^{2} values of 1.60, 2.45  GeV^{2}, at W=2.21  GeV. The results of our pioneering -u≈-u_{min} study demonstrate the existence of a unanticipated backward-angle cross section peak and the feasibility of full L/T/LT/TT separations in this never explored kinematic territory. At Q^{2}=2.45  GeV^{2}, the observed dominance of σ_{T} over σ_{L}, is qualitatively consistent with the collinear QCD description in the near-backward regime, in which the scattering amplitude factorizes into a hard subprocess amplitude and baryon to meson transition distribution amplitudes: universal nonperturbative objects only accessible through backward-angle kinematics.

P2817Efficacy and safety of ticagrelor monotherapy in patients with complex percutaneous coronary intervention: insights from the Global Leaders trial

Background/Introduction

Purpose

Methods

The Global Leaders trial recruited 15,991 patients treated by default with a biolimus A9-eluting stent, and randomised in a 1:1 ratio either to the experimental strategy (1-month dual antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) or to the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy). Complex PCI includes at least one of the following characteristics; left main and/or multivessel PCI, long stenting (defined as total stent length≥46mm), and bifurcation treatment with two stents. The present sub-analysis of the trial evaluated at two years the primary endpoint (composite of all-cause death and new Q-wave myocardial infarction [MI] centrally adjudicated with the Minnesota code). In addition, the patient-oriented composite endpoint (POCE) (composite of all-cause death, any stroke, any MI, and any revascularization) and the net adverse clinical events (NACE) (composite of POCE and Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) were also evaluated at two years.

Results

Of 15,450 patients included in the present analysis, 5,188 (26.7%) patients underwent complex PCI. The experimental strategy, when compared with the reference one, had a significantly lower risk of the primary endpoint (3.56% vs. 5.33%, HR: 0.66; 95% CI: 0.51–0.86; p-value= 0.002; p-value for interaction= 0.019) in patients with complex PCI. Similarly, the experimental treatment was associated with a significantly reduced risk of POCE (14.41% vs. 16.88%, HR: 0.84; 95% CI: 0.74–0.97; p=0.016, p-value for interaction= 0.099) and NACE (15.77% vs. 18.37%, HR: 0.85; 95% CI: 0.74–0.97; p=0.014; p-value for interaction= 0.096). The reduction in ischemic events was predominantly observed in patients with 2 or more characteristics of complex PCI (Figure). In contrast, there was no significant difference in the risk of BARC type 3 or 5 bleeding between the two regimens (2.40% vs. 2.38%, HR: 1.01; 95% CI: 0.71–1.44; p-value=0.956; p-value for interaction= 0.935).

Central illustration

Conclusion

Together with other well-established clinical risk factors, the extent and complexity of stenting should be taken into account in tailoring antiplatelet regimens for secondary prevention. The 1-month DAPT followed by 23-month ticagrelor monotherapy reduced the ischemic events without increasing the risk of bleeding in patients who underwent complex PCI, when compared with the conventional DAPT.

Acknowledgement/Funding

The Global Leaders trial was supported by the resource from AstraZeneca, Biosensors, and The Medicines Company.

P2695ABSORB bioresorbable scaffold versus Xience metallic stent in acute coronary syndromes with treated with percutaneous coronary intervention. A subanalysis of the COMPARE-ABSORB trial

Background

The safety and efficacy of the ABSORB scaffold in ACS patients remain unclear. The COMPARE-ABSORB trial compares the ABSORB to the Xience stent in lesions and patients at high risk for restenosis Patients with STEMI and urgent PCI for non-STEMI were not excluded.

Methods

Patients included in the COMPARE-ABSORB trial undergoing PCI for ACS were eligible. Predefined implantation techniques for ABSORB was mandatory. Primary endpoint is target lesion failure (TLF) at 1 year, defined as a composite of cardiac death, target vessel myocardial infarction and clinically indicated target lesion revascularization.

Results

Of 1670 patients, 842 were treated for ACS. At 1-year, TLF occurred in 22 patients (5.0%) of the ABSORB group and in 14 patients (3.5%) of the Xience group (HR 1.44%; 95% CI 0.74%-2.82%, P=0.284). Definite device thrombosis occurred in 9 patients (2.0%) of the ABSORB group and in 2 patients (0.5%) of the Xience group (HR 4.10%; 95% CI 0.89%-18.9%, P=0.071).

Baseline characteristics ABSORB (n=442) XIENCE (n=400) Age, years (SD) 60.7 (9.6) 61.3 (9.1) Male 350/442 (79.2%) 313/400 (78.3%) Current smoker 159/439 (36.2%) 126/397 (31.7%) Diabetes mellitus 152/440 (34.5%) 138/399 (34.6%) Hypertension 298/442 (67.4%) 266/400 (66.5%) Hypercholesterolemia 255/442 (57.7%) 232/400 (58.0%) Family history of coronary artery disease 147/442 (33.3%) 103/400 (25.8%) Previous MI 61/442 (13.8%) 67/400 (16.8%) Established Peripheral Vascular Disease 27/442 (6.1%) 15/400 (3.8%) Previous PCI 83/442 (18.8%) 86/400 (21.5%) Previous CABG 1/442 (0.2%) 4/400 (1.0%) Previous stroke 15/442 (3.4%) 21/400 (5.3%) Renal Insufficiency 9/442 (2.0%) 13/400 (3.3%) Clinical presentation   Unstable angina 149/442 (33.7%) 141/400 (35.3%)   Non-ST elevation myocardial infarction 183/442 (41.4%) 156/400 (39.0%)   ST elevation myocardial infarction 110/442 (24.9%) 103/400 (25.7%)

KM plot for target lesion failure

Conclusion

The COMPARE-ABSORB trial showed no difference in the primary endpoint at one year for the ACS subgroup. The signal for increased thrombosis remained, even with the optimized implantation protocol

Acknowledgement/Funding

Maasstad Hospital, Rotterdam, the Netherlands

P2811Impact of ticagrelor monotherapy on two-year clinical outcomes in patients with long stenting: insights from the Global Leaders trial

Background/Introduction

Data on the efficacy and safety of different antiplatelet regimens are limited in patients with increasing total stent length (TSL).

Purpose

To evaluate the impact of the experimental strategy (1-month dual antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) vs. the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy) in patients with increasing TSL.

Methods

The present post-hoc analysis of the Global Leaders trial evaluated the primary endpoint (the composite of the all-cause death and new Q-wave myocardial infarction [MI]) at two years in patients with increasing TSL. In addition, the patient-oriented composite endpoint (POCE) (the composite of all-cause death, any stroke, any MI, and any revascularization) and the net adverse clinical events (NACE) (the composite of POCE and Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) were also assessed.

Results

The cohort of 15,450 patients treated with a biolimus-eluting biodegradable polymer stents were included in this analysis. In the longer TSL group (≥46mm), the experimental strategy significantly reduced the risk of the primary endpoint (3.78% vs. 5.68%, hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.49–0.90, p=0.008, P interaction=0.042) as well as POCE (14.57% vs. 18.11%, HR: 0.79, 95% CI: 0.67–0.92, p=0.003, P interaction=0.010) and NACE (16.07% vs. 19.64%, HR: 0.80, 95% CI: 0.69–0.93, p=0.004, P interaction=0.012) at two years. The risk of BARC type 3 or 5 bleeding at two years was similar between the two antiplatelet regimens.

KM in patients with long stenting

Conclusion

Ticagrelor monotherapy significantly reduced the risk of the primary endpoint, POCE and NACE with a similar risk of BARC type 3 or 5 bleeding at two years in patients with the longer TSL.

Acknowledgement/Funding

The Global Leaders trial was supported by unrestricted grants from AstraZeneca, Biosensors, and The Medicines Company. ECRI (European Cardiovascular R

P2812Ischemic efficacy and bleeding safety of ticagrelor monotherapy in patients with multivessel percutaneous coronary intervention: insights from the Global Leaders trial

Background/Introduction

The optimal duration of DAPT after coronary stent implantation remains a matter of debate and a novel antiplatelet regimen without an increased risk of bleeding while maintaining an anti-ischemic efficacy is of paramount importance in patients at higher risk of ischemia.

Purpose

The aim of the present sub-study of the Global Leaders trial is to evaluate the efficacy and safety of the experimental antiplatelet strategy (1-month dual antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) vs. the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy) in patients with multivessel percutaneous coronary intervention (PCI).

Methods

The Global Leaders trial enrolled 15,991 patients treated by default with a biolimus A-9 eluting stent. The present sub-study of the trial sought to evaluate the impact of the long-term ticagrelor monotherapy on the primary endpoint (composite of all-cause death and new Q-wave myocardial infarction [MI] centrally adjudicated with the Minnesota code) at two years. In addition, the patient-oriented composite endpoint (POCE) (composite of all-cause death, any stroke, any MI, and any revascularization) and the net adverse clinical events (NACE) (composite of POCE and Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) were also evaluated at two years.

Results

A total of 15,845 patients was included in this analysis, of whom 3,576 patients received multivessel PCI. At two years, the experimental strategy significantly reduced a risk of the primary endpoint (the composite of all-cause death and new Q-wave myocardial infarction [MI]) (3.05% vs. 4.85%, HR: 0.62, 95% CI: 0.44–0.88, p=0.006, Pinteraction=0.031) in patients with multivessel PCI. Similarly, the experimental treatment had a significant risk reduction in the patient-oriented composite endpoint (POCE), defined as the composite of all-cause death, any stroke, any MI, and any revascularization (13.37% vs. 16.74%, HR: 0.78, 95% CI: 0.66–0.93, p=0.005, Pinteraction=0.020) and the net adverse clinical events (NACE), defined as the composite of POCE and Bleeding Academic Research Consortium [BARC] defined bleeding type 3 or 5 (14.65% vs. 18.38%, HR: 0.78, 95% CI: 0.66–0.92, p=0.003, Pinteraction=0.014) at two years. There was no significant difference in BARC type 3 or 5 bleeding (2.44% vs. 2.65%, HR: 0.92, 95% CI: 0.61–1.39, p=0.685, Pinteraction=0.754) at two years between the two regimens.

KM in patients with multivessel PCI

Conclusion

The present study has demonstrated the experimental antiplatelet strategy, when compared with the reference regimen, could potentially have a favourable balance between ischemic efficacy and bleeding safety in patients who underwent multivessel PCI.

Acknowledgement/Funding

The Global Leaders trial was supported by unrestricted grants from AstraZeneca, Biosensors, and The Medicines Company. ECRI (European Cardiovascular R

Patients with chronic urticaria have a higher risk of psychiatric disorders: a population-based study

BACKGROUND

The prevalence of psychiatric comorbidities in patients with chronic urticaria (CU) in a national population is largely unknown.

OBJECTIVES

To investigate the prevalence of psychiatric disorders and psychiatric medication use in patients with CU in Taiwan.

METHODS

Data were sourced from Taiwan's National Health Insurance Research Database for 2011. Patients who had a primary/secondary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of 708·1, 708·8 or 708·9 during 2011 with at least two outpatient visits and an antihistamine prescription were identified as CU cases. Patients with CU were classified into three disease severity groups according to their medication types. Psychiatric disorders were identified by patients having three outpatient visits with a primary or secondary diagnosis of a given psychiatric disease. Psychiatric medication use was defined by having at least four outpatient visits with prescriptions for anxiolytics, antidepressants or sleeping pills in 2010 or 2011.

RESULTS

Of the 167 132 patients with CU, 82·5% had mild CU, 17·0% had moderate CU and 0·4% had severe CU. Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication prescription than control groups. The relative risk (RR) of psychiatric disorders was 1·43 for patients with mild, 1·50 for patients with moderate and 2·32 for patients with severe CU vs. the controls (P < 0·001). For psychiatric medication prescription, the RRs were 1·95, 2·70 and 2·09, respectively, vs. controls (P < 0·001).

CONCLUSIONS

Patients with CU had a higher prevalence and risk of psychiatric disorders and psychiatric medication prescription than control groups. What's already known about this topic? Previous studies have shown a high prevalence of psychiatric comorbidities in patients with chronic urticaria (CU), with rates ranging from 35% to 60%. Anxiety, depression and somatoform disorders have been reported as the most prevalent mental disorders in patients with CU. What does this study add? Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication use than control groups in the general population. The relative risk (RR) of psychiatric disorders was 1·43 for those with mild CU, 1·50 for those with moderate CU and 2·32 for those with severe CU vs. controls. The RR for psychiatric medication use was 1·95 for those with mild CU, 2·70 for those with moderate CU and 2·09 for those with severe CU vs. controls. Mental health evaluations and management are important elements in CU management.

Skin eruption induced by dieting - an underdiagnosed skin disease in Malaysia

Prurigo pigmentosa is an inflammatory dermatosis characterized by a pruritic, symmetrically distributed erythematous papular or papulo-vesicular eruption on the trunk arranged in a reticulated pattern that resolves with hyperpigmentation. It is typically non-responsive to topical or systemic steroid therapy. The exact etiology is unknown, but it is more commonly described in the Far East countries. Dietary change is one of the predisposing factors. We report on nine young adult patients with prurigo pigmentosa, among whom five were on ketogenic diets prior to the onset of the eruptions. All cases resolved with oral doxycycline with no recurrence. We hope to improve the awareness of this uncommon skin condition among general practitioners and physicians so that disfiguring hyperpigmentation due to delayed diagnosis and treatment can be avoided.

The Gap Between Tools and Best Practice: An Analysis of Safety Prequalification Surveys in the Construction Industry

This study characterizes safety prequalification surveys currently in use in the construction industry to identify approaches that include leading indicators of worker safety performance. We collected prequalification surveys available in the public domain from internet searches, construction company websites, published literature, and construction industry partners. We utilized a conceptual framework, based on safety theory and best practices, to categorize survey questions. Fifty-two prequalification surveys were identified containing 112 unique questions. Most included questions related to lagging indicators (83 percent), safety management leadership (75 percent), and worker training (60 percent). Safety management system elements such as hazard prevention and control, program evaluation and improvement, and coordination and communication were notably absent in 90 percent of the surveys. There was little consistency in the surveys available concerning leading indicators of safety. Only a small number of surveys currently in use incorporate all the elements of best practices associated with robust safety management systems.

Heavy Physics Contributions to Neutrinoless Double Beta Decay from QCD

Observation of neutrinoless double beta decay, a lepton number violating process that has been proposed to clarify the nature of neutrino masses, has spawned an enormous world-wide experimental effort. Relating nuclear decay rates to high-energy, beyond the standard model (BSM) physics requires detailed knowledge of nonperturbative QCD effects. Using lattice QCD, we compute the necessary matrix elements of short-range operators, which arise due to heavy BSM mediators, that contribute to this decay via the leading order π^{-}→π^{+} exchange diagrams. Utilizing our result and taking advantage of effective field theory methods will allow for model-independent calculations of the relevant two-nucleon decay, which may then be used as input for nuclear many-body calculations of the relevant experimental decays. Contributions from short-range operators may prove to be equally important to, or even more important than, those from long-range Majorana neutrino exchange.

Aging may negatively impact movement smoothness during stair negotiation

Stairs represent a barrier to safe locomotion for some older adults, potentially leading to the adoption of a cautious gait strategy that may lack fluidity. This strategy may be characterized as unsmooth; however, stair negotiation smoothness has yet to be quantified. The aims of this study were to assess age- and task-related differences in head and body center of mass (COM) acceleration patterns and smoothness during stair negotiation and to determine if smoothness was associated with the timed "Up and Go" (TUG) test of functional movement. Motion data from nineteen older and twenty young adults performing stair ascent, stair descent, and overground straight walking trials were analyzed and used to compute smoothness based on the log-normalized dimensionless jerk (LDJ) and the velocity spectral arc length (SPARC) metrics. The associations between TUG and smoothness measures were evaluated using Pearson's correlation coefficient (r). Stair tasks increased head and body COM acceleration pattern differences across groups, compared to walking (p < 0.05). LDJ smoothness for the head and body COM decreased in older adults during stair descent, compared to young adults (p ≤ 0.015) and worsened with increasing TUG for all tasks (-0.60 ≤ r ≤ -0.43). SPARC smoothness of the head and body COM increased in older adults, regardless of task (p < 0.001), while correlations showed improved SPARC smoothness with increasing TUG for some tasks (0.33 ≤ r ≤ 0.40). The LDJ outperforms SPARC in identifying age-related stair negotiation adaptations and is associated with performance on a clinical test of gait.

Relationship among several measurements of slipperiness obtained in a laboratory environment

Multiple sensing mechanisms could be used in forming responses to avoid slips, but previous studies, correlating only two parameters, revealed a limited picture of this complex system. In this study, the participants walked as fast as possible without a slip under 15 conditions of different degrees of slipperiness. The relationships among various response parameters, including perceived slipperiness rating, utilized coefficient of friction (UCOF), slipmeter measurement and kinematic parameters, were evaluated. The results showed that the UCOF, perceived rating and heel angle had higher adjusted R² values as dependent variables in the multiple linear regressions with the remaining variables in the final pool as independent variables. Although each variable in the final data pool could reflect some measurement of slipperiness, these three variables are more inclusive than others in representing the other variables and were bigger predictors of other variables, so they could be better candidates for measurements of slipperiness.

Anesthesia for patients with tracheal bronchus

Tracheal bronchus is a congenital anatomical variant of patients with accessory bronchus in the right upper lobe deriving directly from the supracarinal trachea. Pre-operative consultation with the anesthesiologist is important for patient safety and can avoid adverse effects induced by endotracheal intubation. In this report, we described a case of tracheal bronchus in which general anesthesia was performed for video-assisted thoracoscopic surgery. We discussed some of the issues surrounding to complications in tracheal bronchus.

Continuous ambulatory hand force monitoring during manual materials handling using instrumented force shoes and an inertial motion capture suit

Hand forces (HFs) are commonly measured during biomechanical assessment of manual materials handling; however, it is often a challenge to directly measure HFs in field studies. Therefore, in a previous study we proposed a HF estimation method based on ground reaction forces (GRFs) and body segment accelerations and tested it with laboratory equipment: GFRs were measured with force plates (FPs) and segment accelerations were measured using optical motion capture (OMC). In the current study, we evaluated the HF estimation method based on an ambulatory measurement system, consisting of inertial motion capture (IMC) and instrumented force shoes (FSs). Sixteen participants lifted and carried a 10-kg crate from ground level while 3D full-body kinematics were measured using OMC and IMC, and 3D GRFs were measured using FPs and FSs. We estimated 3D hand force vectors based on: (1) FP+OMC, (2) FP+IMC and (3) FS+IMC. We calculated the root-mean-square differences (RMSDs) between the estimated HFs to reference HFs calculated based on crate kinematics and the GRFs of a FP that the crate was lifted from. Averaged over subjects and across 3D force directions, the HF RMSD ranged between 10-15N when using the laboratory equipment (FP + OMC), 11-18N when using the IMC instead of OMC data (FP+IMC), and 17-21N when using the FSs in combination with IMC (FS + IMC). This error is regarded acceptable for the assessment of spinal loading during manual lifting, as it would results in less than 5% error in peak moment estimates.

A critical period for antidepressant-induced acceleration of neuronal maturation in adult dentate gyrus

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used medications for mood and anxiety disorders, and adult neurogenesis in the dentate gyrus has been shown to be involved in the behavioral effects of SSRIs in mice. Studies have shown the varied effects of chronic treatment with SSRIs on adult neurogenesis. One such effect is the acceleration of neuronal maturation, which affects the functional integration of new neurons into existing neuronal circuitry. In this study, we labeled new neurons by using GFP-expressing retroviral vectors in mice and investigated the effect of an SSRI, fluoxetine, on these neurons at different time points after neuronal birth. Chronic treatment with fluoxetine accelerated the dendritic development of the newborn neurons and shifted the timing of the expression of the maturational marker proteins, doublecortin and calbindin. This accelerated maturation was observed even after sub-chronic treatment, only when fluoxetine was administered during the second week of neuronal birth. These results suggest the existence of a 'critical period' for the fluoxetine-induced maturation of new neurons. We propose that the modified functional integration of new neurons in the critical period may underlie the behavioral effects of fluoxetine by regulating anxiety-related decision-making processes.

[Analysis of the correlation between deep medullary veins and clinical prognosis of middle cerebral artery stroke]

Objective: To investigate the relativity between the distribution of deep medullary vein (DMV) in patients with middle cerebral artery stroke and clinical prognosis by using susceptibility-weighted imaging (SWI). Methods: A total of 144 cases of middle cerebral artery stroke patients and 55 healthy volunteers were retrospectively analyzed from January 2015 to October 2015 in order to investigate the symmetrical characteristic and the classification of DMV, then 30 cases were followed up. Kappa test was used to consider the consistency of judging DMV symmetry and type data by two radiologists. Results:Kappa value in DMV symmetry and DMV type were 0.875 and 0.852. Chi-square test analysis revealed a statistically significant difference of DMV symmetry between healthy control and stroke group(χ(2)=31.046, P=0.000). There was correlation between DMV type and NIHSS score in stroke group (r(s)=0.208, P=0.025). There was no statistically significant difference of DMV distribution in the different periods of stroke group (P=0.110). But there was statistically significant difference of DMV distribution between acute and chronic stroke (P=0.018). Among 30 follow-up cases, 18 cases with asymmetry DMV changed into symmetry after stroke therapy. In 8 cases with symmetry DMV, the diameter of DMV became smaller after treatment. In 4 cases, DMV had no changes. Conclusions: DMV in patients of MCA stroke are mostly asymmetry distribution. DMV classification can be used as an imaging standard to predict the prognosis of stroke patients.

[Preliminary study on assessment of lexiscan-induced blood-brain barrier opening and its level by CT perfusion imaging]

Objective: To evaluate the level of lexiscan-induced blood-brain barrier opening of healthy rabbits via CT perfusion weighted imaging (PWI) scan. Methods: Between November 2014 and May 2015, thirty New Zealand white rabbits were randomly assigned into three groups: the experimental group A1 which received one injection of lexiscan(1 ml/kg); the experimental group A2 which received three times injection of lexiscan(total dose: 1.5 ml/kg), finished within 15 minutes; the control group B which was injected the same volume normal saline(1 ml/kg), after 30 minutes, CT PWI scan was performed. Then cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and permeability surface(PS) of the region of interest of each group were acquired and compared statistically. Five cases of each group were injected with 2% Evans blue intravenously posterior to imaging. After one hour of infusion, all the animals were killed. Their brains were examined for the determination of Evans blue distribution. Results: Both the values of CBF and CBV and the staining with Evans blue of the group A1(CBF: (89.88±2.21), (81.42±4.28) ml·(100 g)^-1·min^-1; CBV: (3.97±0.43), (3.66±0.16) ml/g)and group A2 (CBF: (75.16±0.84), (63.66±7.21) ml·(100 g)^-1·min^-1; CBV: (4.07±0.01), (3.75±0.05) ml/g) were higher than those of the group B(CBF: (20.08±5.08), (14.58±8.62) ml·(100 g)^-1·min^-1; CBV: (0.85±0.04), (0.65±0.17) ml/g), the differences were all statistically significant (all P<0.01). While there was no statistically difference between group A1 and group A2(P>0.05). The value of PS of the group A2((22.43±8.09), (20.20±7.01)ml·(100 g)^-1·min^-1 )was higher than that of group A1((13.82±4.44), (10.12±2.44)ml·(100 g)^-1·min^-1) and group B(0.00, 0.00)(the lowest one), the differences were all statistically significant(all P<0.01). The value of MTT of the group A1((2.50±0.82, 2.47±0.10) s) had no statistical difference with group A2 and group B, while the value of group A2((4.50±0.17), (4.72±0.15) s) was higher than that of group B((1.88±0.09), (1.99±0.00) s), the differences were all statistically significant (P<0.05). Conclusion: Changes in hemodynamics of lexiscan-induced blood-brain barrier opening can be monitored by CT PWI scan. When the total dose of lexiscan increasing, the level of the BBB opening is higher with significantly increased CBF, CBV, PS and MTT.

Gait adaptation on surfaces with different degrees of slipperiness

Gait adaptation to employ different ways to avoid a potential slip is needed to continue walking safely on a new surface, especially when transitioning to a slippery surface. In this experiment, participants walked back and forth five times (trials) on surfaces with different degrees of slipperiness. The results show that trial 1 was significantly different from other trials for most of the dependent variables, especially for the low and high friction conditions. Kinematics on high and medium friction surfaces were very similar, but more adjustments were needed for low friction surfaces. The data for the first trial reflect gait after walking for 2.4 m on the walkway, not the first step onto the walkway. The current data show that gait adaptation continued beyond the first trial. Since participants in this experiment were aware of the floor conditions, the results could have important safety implications that user awareness alone might be insufficient for safe floor designs.

Risk of infective endocarditis in patients with systemic lupus erythematosus in Taiwan: a nationwide population-based study

Objectives Patients with systemic lupus erythematosus are considered vulnerable to infective endocarditis and prophylactic antibiotics are recommended before an invasive dental procedure. However, the evidence is insufficient. This nationwide population-based study evaluated the risk and related factors of infective endocarditis in systemic lupus erythematosus. Methods We identified 12,102 systemic lupus erythematosus patients from the National Health Insurance research-oriented database, and compared the incidence rate of infective endocarditis with that among 48,408 non-systemic lupus erythematosus controls. A Cox multivariable proportional hazards model was employed to evaluate the risk of infective endocarditis in the systemic lupus erythematosus cohort. Results After a mean follow-up of more than six years, the systemic lupus erythematosus cohort had a significantly higher incidence rate of infective endocarditis (42.58 vs 4.32 per 100,000 person-years, incidence rate ratio = 9.86, p < 0.001) than that of the control cohort. By contrast, the older systemic lupus erythematosus cohort had lower risk (adjusted hazard ratio 11.64) than that of the younger-than-60-years systemic lupus erythematosus cohort (adjusted hazard ratio 15.82). Cox multivariate proportional hazards analysis revealed heart disease (hazard ratio = 5.71, p < 0.001), chronic kidney disease (hazard ratio = 2.98, p = 0.034), receiving a dental procedure within 30 days (hazard ratio = 36.80, p < 0.001), and intravenous steroid therapy within 30 days (hazard ratio = 39.59, p < 0.001) were independent risk factors for infective endocarditis in systemic lupus erythematosus patients. Conclusions A higher risk of infective endocarditis was observed in systemic lupus erythematosus patients. Risk factors for infective endocarditis in the systemic lupus erythematosus cohort included heart disease, chronic kidney disease, steroid pulse therapy within 30 days, and a recent invasive dental procedure within 30 days.

Modelling end-pumped passively Q-switched Nd-doped crystal lasers: manifestation by a Nd:YVO4/Cr4+:YAG system with a concave-convex resonator

A theoretical model for the passively Q-switched (PQS) operation which includes the spatial overlapping between the pump and lasing modes under the thermal lensing effect is developed to give a transcendental equation that can directly determine the critical parameters such as pulse energy, pulse repetition rate, and pulse width for the PQS performance. More importantly, an analytical function which gives the approximate solution for the transcendental equation as well as a specific critical criterion for good PQS operation are derived for practical analyses and design. A Nd:YVO₄/Cr⁴⁺:YAG system with a concave-convex resonator which can achieve fairly stable PQS pulse trains even at a high pump level is further exploited to manifest the proposed spatially dependent model. The good agreement between the experimental results and the theoretical predictions is verified to show the feasibility of the proposed model for designing high-power PQS lasers with high accuracy.

Generation of terahertz optical beating from a simultaneously self-mode-locked Nd:YAG laser at 1064 and 1123 nm

The reflectivity of the output coupler is designed to achieve the synchronously self-mode-locked operation at 1064 and 1123 nm in a diode-end-pumped Nd:YAG laser. Numerical analyses are performed to confirm that the designed output coupler can lead the emission lines to be predominant at 1064 and 1123 nm. Moreover, the crossover of the threshold pump powers for the 1064 and 1123 nm emission lines can be exploited to obtain the single central wavelength of 1064 nm or the single central wavelength of 1123 nm or, simultaneously, dual-central-wavelength self-mode-locked operation by finely adjusting the cavity alignment. For the dual-central-wavelength mode-locked emissions, the pulse repetition rate and the pulse duration are 4.5 GHz and 50.8 ps, respectively. The maximum output power can be up to 2.47 W at a pump power of 7.5 W. The synchronization of the 1064 and 1123 nm mode-locked pulses generates the optical beating pulse trains with repetition rates up to 14.7 THz.

Exploiting concave-convex linear resonators to design end-pumped solid-state lasers with flexible cavity lengths: Application for exploring the self-mode-locked operation

The characteristics of a convex-concave linear resonator under the thermal lensing effect are theoretically analyzed to find an analytical model for designing end-pumped solid-state lasers with flexible cavity lengths. By exploiting the design model, the power scaling for continuous-wave operation under strong thermal lensing can be easily achieved in the proposed resonator with different cavity lengths. Furthermore, the proposed resonator is applied to explore the exclusive influence of cavity length on the self-mode-locked (SML) operation. It is discovered that the lasing longitudinal modes will split into multiple groups in optical spectrum to lead to a multi-pulse mode-locked temporal state when the cavity length increases. Finally, a theoretical model is derived to reconstruct the experimental results of SML operation to deduce a simple relationship between the group number of lasing modes and the cavity length.

Straight ladder inclined angle in a field environment: the relationship among actual angle, method of set-up and knowledge

Ladder inclined angle is a critical factor that could lead to a slip at the base of portable straight ladders, a major cause of falls from heights. Despite several methods established to help workers achieve the recommended 75.5° angle for ladder set-up, it remains unclear if these methods are used in practice. This study explored ladder set-up behaviours in a field environment. Professional installers of a company in the cable and other pay TV industry were observed for ladder set-up at their worksites. The results showed that the actual angles of 265 ladder set-ups by 67 participants averaged 67.3° with a standard deviation of 3.22°. Although all the participants had training on recommended ladder set-up methods, only 3 out of 67 participants applied these methods in their daily work and even they failed to achieve the desired 75.5° angle. Therefore, ladder set-up remains problematic in real-world situations. Practitioner Summary: Professional installers of a cable company were observed for portable straight ladder set-up at their worksites. The ladder inclined angle averaged 67.3° with a standard deviation of 3.22°, while the recommended angle is 75.5°. Only a few participants used the methods that they learned during training in their daily work.

Prospective gait changes as a function of shifting perceptions of slipperiness: effects of visual and somatosensory cues

Forty participants, ages 18-45 years, rated perceived slipperiness before and after walking on five different floors under three different surface conditions. The before-ratings were taken as a proxy for visual cues to slipperiness, while after-ratings were taken as a proxy for somatosensory feedback received while walking on the surface. Before and after ratings of slipperiness were used to predict gait parameters, as a function of trial, during repeated walking. Effects of after-ratings of slipperiness were observed beginning on the second trial, and continued through the fifth trial, while effects of before-ratings of slipperiness were most apparent on the first trial. When perceived slipperiness increased (or decreased) from before to after walking on the surface, gait became more (or less) protective across trials. It is concluded that both visual cues, as well as somatosensory feedback, are used in the prospective control of gait. Practitioner Summary: Effects of visual and somatosensory cues to slipperiness on gait were disentangled using floor surfaces varying in the slipperiness suggested by those cues. Visually based ratings of slipperiness predicted gait parameters on earlier trials, while somatosensory-based ratings predicted gait parameters on subsequent trials. Flooring design should provide reliable information regarding slipperiness.

Characterization of tissue scaffolds for time-dependent biotransport criteria - a novel computational procedure

This study aims to establish a new computational framework that allows modeling transient oxygen diffusion in tissue scaffolds more efficiently. It has been well known that the survival of cells strongly relies on continuous oxygen/nutrient supply and metabolite removal. With optimal design in scaffold architecture, its ability to sustain long distance oxygen supply could be improved considerably. In this study, finite element based homogenization procedure is first used to characterize the initial effective biotransport properties in silico. These initial properties are proper indicators to prediction of the on-going performance of tissue scaffolds over time. The transient model by adopting an edge-based smoothed finite element method with combination of mass-redistributed method is then established to more efficiently simulate the transient oxygen transfer process in tissue scaffolds. The proposed new method allows large time steps to model the oxygen diffusion process without losing numerical accuracy, thereby enhancing the computational efficiency significantly, in particular for the design optimization problems which typically require numerous analysis iterations. A number of different scaffold designs are examined either under net diffusion without cell seeding, or under cellular oxygen/nutrient uptake with or without considering cell viability. The association between the homogenized effective diffusivity of net scaffold microstructures and corresponding transient diffusion and time-dependent cellular activities is divulged. This study provides some insights into scaffold design.

Estimating 3D L5/S1 moments and ground reaction forces during trunk bending using a full-body ambulatory inertial motion capture system

Inertial motion capture (IMC) systems have become increasingly popular for ambulatory movement analysis. However, few studies have attempted to use these measurement techniques to estimate kinetic variables, such as joint moments and ground reaction forces (GRFs). Therefore, we investigated the performance of a full-body ambulatory IMC system in estimating 3D L5/S1 moments and GRFs during symmetric, asymmetric and fast trunk bending, performed by nine male participants. Using an ambulatory IMC system (Xsens/MVN), L5/S1 moments were estimated based on the upper-body segment kinematics using a top-down inverse dynamics analysis, and GRFs were estimated based on full-body segment accelerations. As a reference, a laboratory measurement system was utilized: GRFs were measured with Kistler force plates (FPs), and L5/S1 moments were calculated using a bottom-up inverse dynamics model based on FP data and lower-body kinematics measured with an optical motion capture system (OMC). Correspondence between the OMC+FP and IMC systems was quantified by calculating root-mean-square errors (RMSerrors) of moment/force time series and the interclass correlation (ICC) of the absolute peak moments/forces. Averaged over subjects, L5/S1 moment RMSerrors remained below 10Nm (about 5% of the peak extension moment) and 3D GRF RMSerrors remained below 20N (about 2% of the peak vertical force). ICCs were high for the peak L5/S1 extension moment (0.971) and vertical GRF (0.998). Due to lower amplitudes, smaller ICCs were found for the peak asymmetric L5/S1 moments (0.690-0.781) and horizontal GRFs (0.559-0.948). In conclusion, close correspondence was found between the ambulatory IMC-based and laboratory-based estimates of back load.

Pulmonary Cryptococcosis

Inhalation of Cryptococcus into the respiratory system is the main route of acquisition of human infection, yet pulmonary cryptococcosis goes mostly unrecognized by many clinicians. This delay in diagnosis, or misdiagnosis, of lung infections is due in part to frequently subtle clinical manifestations such as a subacute or chronic cough, a broad differential of diagnostic possibilities for associated pulmonary masses (cryptococcomas) and, on occasion, negative respiratory tract cultures. Hematogenous dissemination from the lung can result in protean manifestations, the most severe of which is meningoencephalitis. There are few clinical studies of pulmonary cryptococcosis and its pathogenesis is poorly understood. The main purpose of this review is to describe the epidemiology, clinical presentation, diagnosis, and treatment of pulmonary cryptococcosis to increase clinician's awareness of this diagnostic possibility and to enhance clinical management. Useful pointers to the approach and management of pulmonary cryptococcosis and the implications of disseminated disease are included, together with recommendations for future research.

Introduction to the updated Australian and New Zealand consensus guidelines for the use of antifungal agents in the haematology/oncology setting, 2014

This article introduces the second revision of the Australian and New Zealand consensus guidelines for the use of antifungal agents in the haematology/oncology setting. The current update occurs within the context of a growing population at risk of invasive fungal disease, improved understanding of risk factors, availability of new diagnostic tests, a much-expanded evidence base and changing clinical paradigms. Here, we provide an overview of the history and purpose of the guidelines, including changes in scope since the last clinical update was published in 2008. The process for development, and for enabling review of draft recommendations by end-users and other relevant stakeholders, is described. The approach to assigning levels of evidence and grades of recommendation is also provided, along with a comparison to international grading systems.

Consensus guidelines for the treatment of yeast infections in the haematology, oncology and intensive care setting, 2014

Pathogenic yeast forms are commonly associated with invasive fungal disease in the immunocompromised host, including patients with haematological malignancies and patients of haemopoietic stem cell transplants. Yeasts include the Candida spp., Cryptococcus spp., Pneumocystis jirovecii and some lesser-known pathogens. Candida species remain the most common cause of invasive yeast infections (and the most common human pathogenic fungi). These guidelines present evidence-based recommendations for the antifungal management of established, invasive yeast infections in adult and paediatric patients in the haematology/oncology setting. Consideration is also given to the critically ill patient in intensive care units, including the neonatal intensive care unit. Evidence for 'pre-emptive' or 'diagnostic-driven antifungal therapy' is also discussed. For the purposes of this paper, invasive yeast diseases are categorised under the headings of invasive candidiasis, cryptococcosis and uncommon yeast infections. Specific recommendations for the management of Pneumocystis jirovecii are presented in an accompanying article (see consensus guidelines by Cooley et al. appearing elsewhere in this supplement).

Consensus guidelines for implementation of quality processes to prevent invasive fungal disease and enhanced surveillance measures during hospital building works, 2014

Healthcare-associated fungal outbreaks impose a substantial economic burden on the health system and typically result in high patient morbidity and mortality, particularly in the immunocompromised host. As the population at risk of invasive fungal infection continues to grow due to the increased burden of cancer and related factors, the need for hospitals to employ preventative measures has become increasingly important. These guidelines outline the standard quality processes hospitals need to accommodate into everyday practice and at times of healthcare-associated outbreak, including the role of antifungal stewardship programmes and best practice environmental sampling. Specific recommendations are also provided to help guide the planning and implementation of quality processes and enhanced surveillance before, during and after high-risk activities, such as hospital building works. Areas in which information is still lacking and further research is required are also highlighted.

Intracavity continuous-wave multiple stimulated-Raman-scattering emissions in a KTP crystal pumped by a Nd:YVO(4) laser

Intracavity continuous-wave (CW) multiple stimulated-Raman-scattering emissions have been successfully demonstrated in a KTP crystal pumped by a Nd:YVO(4) 1064-nm laser for the first time. Three different output couplers (OCs) with high-reflection (HR) coating in the range of 1-1.1, 1-1.13, and 1-1.15 μm are employed in the experiment to generate lasing wavelengths at 1095 (the first-Stokes emission of the 266 cm(-1) Raman shift), 1095 + 1128 (the first- and second-Stokes emission of the 266 cm(-1) Raman shift), and 1095 + 1128 + 1149 nm (the first two Stokes emissions of the 266 cm(-1) Raman shift and the first-Stokes emission of the 694 cm(-1) Raman shift), separately. This Raman laser paves a way to produce more-closely spaced set of CW emission in the green-yellow region.

Accuracy of the Microsoft Kinect for measuring gait parameters during treadmill walking

The measurement of gait parameters normally requires motion tracking systems combined with force plates, which limits the measurement to laboratory settings. In some recent studies, the possibility of using the portable, low cost, and marker-less Microsoft Kinect sensor to measure gait parameters on over-ground walking has been examined. The current study further examined the accuracy level of the Kinect sensor for assessment of various gait parameters during treadmill walking under different walking speeds. Twenty healthy participants walked on the treadmill and their full body kinematics data were measured by a Kinect sensor and a motion tracking system, concurrently. Spatiotemporal gait parameters and knee and hip joint angles were extracted from the two devices and were compared. The results showed that the accuracy levels when using the Kinect sensor varied across the gait parameters. Average heel strike frame errors were 0.18 and 0.30 frames for the right and left foot, respectively, while average toe off frame errors were -2.25 and -2.61 frames, respectively, across all participants and all walking speeds. The temporal gait parameters based purely on heel strike have less error than the temporal gait parameters based on toe off. The Kinect sensor can follow the trend of the joint trajectories for the knee and hip joints, though there was substantial error in magnitudes. The walking speed was also found to significantly affect the identified timing of toe off. The results of the study suggest that the Kinect sensor may be used as an alternative device to measure some gait parameters for treadmill walking, depending on the desired accuracy level.

Age-related differences in inter-joint coordination during stair walking transitions

Stair negotiation is one of the most difficult and hazardous locomotor tasks for older adults with fall-related accidences reported frequently. Since knowledge about inter-joint coordination during stair walking provides insights to age-related changes in neuromuscular control of gait that can inform prevention or intervention strategies, the current study investigated the effect of age on the pattern and variability of inter-joint coordination during stair-floor transitions during gait. Gait and motion analyses of the lower extremities of 20 young and 20 older adults during floor to stair (F-S) and stair to floor (S-F) walking transitions provided continuous measures of relative phase (CRP) that assessed inter-joint coordination of the hip, knee, and angle joints. The mean absolute relative phase (MARP) and deviation phase (DP) provided descriptive metrics for CRP pattern and variability respectively. For hip-knee CRP pattern, older adults demonstrated significantly smaller MARP than young adults in stance and most swing phases during F-S and S-F. For knee-ankle, older adults showed a significant smaller MARP of the trailing limb during S-F than young adults. In most stance and swing phases, the hip-knee DP values of older adults were significantly lower than that of young adults. Significant lower knee-ankle DP values of older adults were only detected in swing phase during S-F. The findings suggest that normal aging adults have less independent control of adjacent joints compared to younger adults suggesting they have less flexibility to modulate inter-joints coordination appropriately during stair walking transitions.

Using horizontal heel displacement to identify heel strike instants in normal gait

Heel strike instants are an important component of gait analyses, yet accurate detection can be difficult without a force plate. This paper presents two novel techniques for kinematic heel strike instant (kHSI) detection which examined maximal resultant horizontal heel displacement (HHD). Each of these HHD techniques calculates HHD from a selected reference location of either the stance ankle or stance heel to the swing heel. The proposed techniques, along with other previously established techniques, were validated against a 10N force plate threshold. Fifty-four healthy adults walked overground at both normal and fast speeds while wearing athletic shoes. The reported true and absolute errors were as low as 3.2 (4.4) and 5.7 (3.4)ms, respectively, across 8678kHSI when using the stance ankle as a reference, which significantly outperformed (p<0.0001) the established techniques. Gait speed was shown to have a significant effect (p<0.0001) on HHD-determined kHSI, as well as the three other techniques evaluated, highlighting the need for condition-specific identification of kHSI.

Cryogenically monolithic self-Raman lasers: observation of single-longitudinal-mode operation

A cryogenically monolithic Nd:YVO4 self-Raman laser is experimentally explored and theoretically analyzed. The variation of the stimulated Raman scattering (SRS) threshold on the temperature is found to be nonlinear because the reduction of thermal lensing enlarges the cavity mode size. In spite of the nonlinear variation of the SRS threshold on the temperature, the overall SRS output power can be efficiently increased from 0.78 to 1.36 W for temperature decreasing from 285 to 80 K at an absorbed power of 17.2 W. More interestingly, the single-longitudinal-mode operation is experimentally achieved when temperature is lower than 125 K.

24-W cryogenically cooled Nd:YAG monolithic 946-nm laser with a slope efficiency >70

A high-power efficient monolithic Nd:YAG 946-nm laser is demonstrated at the cryogenic temperature. By exploring the absorption and the fluorescence spectra of the Nd:YAG crystal, it reveals the fact that the absorption bandwidth at 808 nm is narrowing and the fluorescence intensity at 1061 nm is significant enhanced when the temperature is decreased. The temperature dependence of the lasing threshold at 946 nm is found to display a minimum value near a temperature of 170 K. At an incident pump power of 34.5 W, the local heating leads the optimum temperature to be approximately 120 K and the maximum output power can reach 24.4 W with the conversion efficiency of 71% as well as the slope efficiency up to 75%.

Using mutual information to capture major concerns of postural control in a tossing activity

Human body motion for load-tossing activity was partitioned into three phases using four critical events based on the load position viz. lift-off, closest to body, peak and release. For each phase, three objective functions values, viz. mobilization, stabilization and muscular torque utilization, used to control the motion patterns, were then calculated. We hypothesize that the relationships between different objective functions can be extracted using information theory. The kinematic data obtained with 36 treatment combinations (2 tossing distances, 2 tossing heights, 3 weights, and 3 target clearances) was used to estimate the mutual information between each pair of objective functions and construct Chow-Liu trees. Results from this research indicate that there was no dominant concern in the first two phases of the activity; however, torque utilization and mobilization were found to be important factors in the third phase of the load tossing activity.

Investigating gait adjustments and body sway while walking across wooden scaffold boards

The flexible wooden boards are still being used on the scaffolds at some construction worksites in China. We examined if the board dimension, acclimation phase and construction work experience influence workers' walking strategies on these boards. Among the 40 construction workers recruited, half of them had more than 1 year of construction work experience. The participants' body sway and the gait adjustments were captured and analysed. Our analysis showed the width and thickness of the boards had significant effects on walking speed. There is a significant interaction between construction experience and board width on stride width, whereas the interaction between construction experience and acclimation phase affects step length and walking speed. The body sway at the C6/C7 and L5/S1 locations are significantly affected by most of the factors. We also found that once the participants acclimated to the board condition, the sway variability increased. Practitioner Summary: This study investigated gait and postural adjustments of workers with different construction experience while walking over wooden scaffold boards, which is one of the activities highly associated with falling accidents in China.

Contribution of gait parameters and available coefficient of friction to perceptions of slipperiness

Perceived slipperiness rating (PSR) has been widely used to assess walkway safety. In this experiment, 29 participants were exposed to 5 floor types under dry, wet and glycerol conditions. The relationship between their PSR and objective measurements, including utilized coefficient of friction (UCOF), gait kinematics and available coefficient of friction (ACOF), was explored with a regression analysis using step-wise backward elimination. The results showed that UCOF and ACOF, as well as their difference, were the major predictors of the PSR under wet and glycerol conditions. Under wet conditions, the participants appeared to rely on the potential for foot slip to form their PSR. Under glycerol conditions, some kinematic variables also became major predictors of PSR. The results show how different proprioceptive responses and ACOF contributed to the prediction of PSR under different surface conditions.

Assessment of autonomic nervous system by using empirical mode decomposition-based reflection wave analysis during non-stationary conditions

Arterial blood pressure (ABP) is an important indicator of cardiovascular circulation and presents various intrinsic regulations. It has been found that the intrinsic characteristics of blood vessels can be assessed quantitatively by ABP analysis (called reflection wave analysis (RWA)), but conventional RWA is insufficient for assessment during non-stationary conditions, such as the Valsalva maneuver. Recently, a novel adaptive method called empirical mode decomposition (EMD) was proposed for non-stationary data analysis. This study proposed a RWA algorithm based on EMD (EMD-RWA). A total of 51 subjects participated in this study, including 39 healthy subjects and 12 patients with autonomic nervous system (ANS) dysfunction. The results showed that EMD-RWA provided a reliable estimation of reflection time in baseline and head-up tilt (HUT). Moreover, the estimated reflection time is able to assess the ANS function non-invasively, both in normal, healthy subjects and in the patients with ANS dysfunction. EMD-RWA provides a new approach for reflection time estimation in non-stationary conditions, and also helps with non-invasive ANS assessment.

Separated response function ratios in exclusive, forward π(±) electroproduction

The study of exclusive π(±) electroproduction on the nucleon, including separation of the various structure functions, is of interest for a number of reasons. The ratio RL=σL(π-)/σL(π+) is sensitive to isoscalar contamination to the dominant isovector pion exchange amplitude, which is the basis for the determination of the charged pion form factor from electroproduction data. A change in the value of RT=σT(π-)/σT(π+) from unity at small -t, to 1/4 at large -t, would suggest a transition from coupling to a (virtual) pion to coupling to individual quarks. Furthermore, the mentioned ratios may show an earlier approach to perturbative QCD than the individual cross sections. We have performed the first complete separation of the four unpolarized electromagnetic structure functions above the dominant resonances in forward, exclusive π(±) electroproduction on the deuteron at central Q(2) values of 0.6, 1.0, 1.6  GeV(2) at W=1.95  GeV, and Q(2)=2.45  GeV(2) at W=2.22  GeV. Here, we present the L and T cross sections, with emphasis on RL and RT, and compare them with theoretical calculations. Results for the separated ratio RL indicate dominance of the pion-pole diagram at low -t, while results for RT are consistent with a transition between pion knockout and quark knockout mechanisms.

The stochastic distribution of available coefficient of friction for human locomotion of five different floor surfaces

The maximum coefficient of friction that can be supported at the shoe and floor interface without a slip is usually called the available coefficient of friction (ACOF) for human locomotion. The probability of a slip could be estimated using a statistical model by comparing the ACOF with the required coefficient of friction (RCOF), assuming that both coefficients have stochastic distributions. An investigation of the stochastic distributions of the ACOF of five different floor surfaces under dry, water and glycerol conditions is presented in this paper. One hundred friction measurements were performed on each floor surface under each surface condition. The Kolmogorov-Smirnov goodness-of-fit test was used to determine if the distribution of the ACOF was a good fit with the normal, log-normal and Weibull distributions. The results indicated that the ACOF distributions had a slightly better match with the normal and log-normal distributions than with the Weibull in only three out of 15 cases with a statistical significance. The results are far more complex than what had heretofore been published and different scenarios could emerge. Since the ACOF is compared with the RCOF for the estimate of slip probability, the distribution of the ACOF in seven cases could be considered a constant for this purpose when the ACOF is much lower or higher than the RCOF. A few cases could be represented by a normal distribution for practical reasons based on their skewness and kurtosis values without a statistical significance. No representation could be found in three cases out of 15.

Postoperative adverse outcomes after non-hepatic surgery in patients with liver cirrhosis

BACKGROUND

Postoperative adverse outcomes in patients with liver cirrhosis are not completely understood. This study evaluated the association between liver cirrhosis and adverse outcomes after non-hepatic surgery.

METHODS

Reimbursement claims were used to identify patients with preoperative liver cirrhosis who underwent non-hepatic surgery from 2004 to 2007. Control patients without cirrhosis were matched by age, sex, type of surgery and anaesthesia. The adjusted odds ratios (ORs) and 95 per cent confidence intervals (c.i.) of postoperative adverse events associated with liver cirrhosis were analysed by multivariable logistic regression.

RESULTS

Thirty-day mortality rates among 24 282 patients with cirrhosis and 97 128 control patients were 1·2 per cent (299 deaths) and 0·7 per cent (635 deaths) respectively. Liver cirrhosis was associated with postoperative 30-day mortality (OR 1·88, 95 per cent c.i. 1·63 to 2·16), acute renal failure (OR 1·52, 1·34 to 1·74), septicaemia (OR 1·42, 1·33 to 1·51) and intensive care unit admission (OR 1·39, 1·33 to 1·45). Postoperative mortality increased in patients who had liver cirrhosis with viral hepatitis (OR 2·87, 1·55 to 5·30), alcohol dependence syndrome (OR 3·74, 2·64 to 5·31), jaundice (OR 5·47, 3·77 to 7·93), ascites (OR 5·85, 4·62 to 7·41), gastrointestinal haemorrhage (OR 3·01, 2·33 to 3·90) and hepatic coma (OR 5·11, 3·79 to 6·87).

CONCLUSION

Patients with liver cirrhosis had increased mortality and complications after non-hepatic surgery, particularly those with cirrhosis-related clinical indicators.

PPARα-mediated responses in human adult liver stem cells: In vivo/in vitro and cross-species comparisons

The peroxisome proliferator-activated receptor α (PPARα) is a ligand-activated transcription factor that regulates a variety of biological processes including lipid metabolism and energy homeostasis. Peroxisome proliferators (PPs) are carcinogens in rodents, while humans are resistant to peroxisome proliferation and carcinogenesis. In this study, we examined the differential gene expression elicited by clofibrate (CLO) and WY-14,643 (WY) in C57BL/6 mouse liver compared to responses in human HepG2 hepatoma and HL1-1 adult stem cells. Mice were gavaged with sesame oil, 300mg/kg CLO or WY for 2, 4, 8, 12, 18 or 24h, or daily for 4 or 14 days. Although no significant changes in body weight gain were observed, WY induced relative liver weight at 4 and 14 days. Genome-wide hepatic gene expression analysis identified 719 and 1443 differentially expressed unique genes elicited by CLO and WY, respectively (|fold change|>1.5, P1(t)>0.99). Functional analysis associated the gene expression changes with lipid metabolism, transport, cell cycle and immune response. Most differentially expressed genes were in common to both treatments and clustered together only at early time points (2-8h). Complementary QRT-PCR studies in human HL1-1 and HepG2 cells treated with 50μM WY or DMSO for 1, 2, 4, 8, 12, 24 or 48h identified a minimal number of conserved orthologous responses (e.g., Pdk4, Adfp and Angptl4) while some genes (i.e., Bmf, a tumor suppressor) exhibited induction in human cells but repression in mice. These data suggest that PPs elicit species-specific PPARα-mediated gene expression.