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Cholinergic stimulation of chloride secretion involves the activation of a basolateral membrane potassium conductance, which maintains the electrical gradient favoring apical Cl efflux and allows K to recycle at the basolateral membrane. We have used transepithelial short-circuit current (Isc), fluorescence imaging, and patch clamp studies to identify and characterize the K channel that mediates this response in T84 cells. Carbachol had little effect on Isc when added alone but produced large, transient currents if added to monolayers prestimulated with cAMP. cAMP also enhanced the subsequent Isc response to calcium ionophores. Carbachol (100 microM) transiently elevated intracellular free calcium ([Ca2+]i) by approximately 3-fold in confluent cells cultured on glass coverslips with a time course resembling the Isc response of confluent monolayers that had been grown on porous supports. In parallel patch clamp experiments, carbachol activated an inwardly rectifying potassium channel on the basolateral aspect of polarized monolayers which had been dissected from porous culture supports. The same channel was transiently activated on the surface of subconfluent monolayers during stimulation by carbachol. Activation was more prolonged when cells were exposed to calcium ionophores. The conductance of the inward rectifier in cell-attached patches was 55 pS near the resting membrane potential (-54 mV) with pipette solution containing 150 mM KCl (37 degrees C). This rectification persisted when patches were bathed in symmetrical 150 mM KCl solutions. The selectivity sequence was 1 K > 0.88 Rb > 0.18 Na >> Cs based on permeability ratios under bi-ionic conditions. The channel exhibited fast block by external sodium ions, was weakly inhibited by external TEA, was relatively insensitive to charybdotoxin, kaliotoxin, 4-aminopyridine and quinidine, and was unaffected by external 10 mM barium. It is referred to as the KBIC channel based on its most distinctive properties (Ba-insensitive, inwardly rectifying, Ca-activated). Like single KBIC channels, the carbachol-stimulated Isc was relatively insensitive to several blockers on the basolateral side and was unaffected by barium. These comparisons between the properties of the macroscopic current and single channels suggest that the KBIC channel mediates basolateral membrane K conductance in T84 cell monolayers during stimulation by cholinergic secretagogues. [ABSTRACT FROM AUTHOR]

Agonists that elevate calcium in T84 cells stimulate chloride secretion by activating KBIC, an inwardly rectifying K channel in the basolateral membrane. We have studied the regulation of this channel by calcium, nucleotides and phosphorylation using patch clamp and short-circuit current (ISC) techniques. Open probability (Po) was independent of voltage but declined spontaneously with time after excision. Rundown was slower if patches were excised into a bath solution containing ATP (10 microM-5 mM), ATP (0.1 mM)+protein kinase A (PKA; 180 nM), or isobutylmethylxanthine (IBMX; 1 mM). Analysis of event durations suggested that the channel has at least two open and two closed states, and that rundown under control conditions is mainly due to prolongation of the long closed time. Channel activity was restimulated after rundown by exposure to ATP, the poorly hydrolyzable ATP analogue AMP-PNP, or ADP. Activity was further enhanced when PKA was added in the presence of MgATP, but only if free calcium concentration was elevated (400 nM). Nucleotide stimulation and inward rectification were both observed in nominally Mg-free solutions. cAMP modulation of basolateral potassium conductance in situ was confirmed by measuring currents generated by a transepithelial K gradient after permeabilization of the apical membrane using alpha-toxin. Finally, protein kinase C (PKC) inhibited single KBIC channels when it was added directly to excised patches. These results suggest that nonhydrolytic binding of nucleotides and phosphorylation by PKA and PKC modulate the responsiveness of the inwardly rectifying K channel to Ca-mediated secretagogues. [ABSTRACT FROM AUTHOR]

Objective:To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes.Methods:MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation.Results:A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively.Conclusion:The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether the universally accepted range of normal patellar height ratios derived from radiography for the Insall-Salvati (IS) and Blackburne-Peel (BP) methods could be similarly applied to both CT and MRI.Materials and Methods: Institutional review board approval was obtained with waiver of informed consent for this HIPPA-compliant study. A total of 45 knees in 42 patients (15 men, 27 women; age range 11 to 75 years, mean age 39 ± 20 years) who underwent tri-modality (radiograph, CT, and MRI) examinations were selected. All patients had knee imaging obtained for a variety of reasons and measurements were performed by two independent readers who were blinded to each other's measurements or the respective measurements derived from each of the methods. Paired t test was used to compare the mean values among the modalities. Inter-observer and inter-method agreements were assessed using intra-class correlation coefficients.Results: Statistically significant, but small quantitative differences are noted between tri-modality patellar height ratios. For comparable results, the small addition of 0.13 and 0.10 are needed for the Insall-Salvati measurements on MRI and CT respectively, compared with radiographs. For the Blackburne-Peel ratio, an additional adjustment of 0.09 is needed between radiographs and MRI, but not between radiographs and CT. These adjustments are independent of gender. The interobserver reproducibility was excellent (ICC ≥ 0.94) for both the Insall-Salvati and Blackburne-Peel methods for all modalities.Conclusion: The results indicate that cut-off values for patella alta and baja derived from radiographs should not be directly transposed to CT and MRI; however, the adjustments are relatively minor. These measurements show excellent reproducibility for all modalities currently used for patellar height measurements. [ABSTRACT FROM AUTHOR]

Study design:Systematic review.Objectives:To identify changes in subjective quality of life (QoL) as one ages with a spinal cord injury (SCI).Setting:Vancouver, Canada.Methods:Electronic databases were searched for studies reporting on age-related QoL changes over time. Data from relevant studies were transcribed into data extraction forms and analyzed by years post injury (YPI) and chronologic age. Each study was assigned a level of evidence based on a modified Sackett scale.Results:In all, 21 studies, each with a low level of evidence, were included for review. The results indicated that regardless of chronologic age, individuals with relatively new SCI have the potential to improve their QoL. Among individuals with advanced YPI, overall QoL is consistently reported as good or excellent over time, however, with variations in different QoL domains.Conclusion:The QoL of individuals aging with a SCI has the potential to improve, and remain high and stable over time. As the identified studies provide low levels of evidence, more longitudinal research with greater methodological and measurement rigor is needed to corroborate the findings and conclusions of this review. [ABSTRACT FROM AUTHOR]

Study design:Systematic review.Objective:To systematically review evidence on aging of the body systems after spinal cord injury (SCI).Setting:Toronto, Ontario and Vancouver, British Columbia, Canada.Methods:Electronic databases (MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO), were searched for studies published between 1980 and 2009. The search was augmented by reviewing the reference lists of relevant papers. Non-intervention studies that were longitudinal or cross-sectional with able-bodied controls that were at minimum matched on chronological age were included for review. Levels of evidence were assigned to the study design using a modified Sackett scale.Results:Of the 74 studies selected for inclusion, 16 were longitudinal in design. The hypothesis that SCI represents a model for premature aging is supported by a large proportion of level 5 evidence for the cardiovascular and endocrine systems, level 2, 4 and 5 evidence for the musculoskeletal system, and limited level 5 evidence for the immune system. Only a few level 4 and 5 studies for the respiratory system were found. The evidence on the genitourinary system, gastrointestinal system, and for skin and subcutaneous tissues provide level 4 and 5 evidence that premature aging may not be occurring. The evidence on the nervous system does not provide evidence of premature aging as a result of SCI.Conclusions:Premature aging appears to occur in some systems after SCI. Additional longitudinal studies are required to confirm these findings.Sponsorship:Rick Hansen Institute; Ontario Neurotrauma Foundation. [ABSTRACT FROM AUTHOR]

Study design: Randomized-controlled trials (RCTs), prospective cohort, case-control, pre-post studies, and case reports that assessed pharmacological and non-pharmacological intervention for the management of the neurogenic bowel after spinal cord injury (SCI) were included. Objective: To systematically review the evidence for the management of neurogenic bowel in individuals with SCI. Setting: Literature searches were conducted for relevant articles, as well as practice guidelines, using numerous electronic databases. Manual searches of retrieved articles from 1950 to July 2009 were also conducted to identify literature. Methods: Two independent reviewers evaluated each study's quality, using Physiotherapy Evidence Database scale for RCTs and Downs and Black scale for all other studies. The results were tabulated and levels of evidence assigned. Results:A total of 2956 studies were found as a result of the literature search. On review of the titles and abstracts, 57 studies met the inclusion criteria. Multifaceted programs are the first approach to neurogenic bowel and are supported by lower levels of evidence. Of the non-pharmacological (conservative and non-surgical) interventions, transanal irrigation is a promising treatment to reduce constipation and fecal incontinence. When conservative management is not effective, pharmacological interventions (for example prokinetic agents) are supported by strong evidence for the treatment of chronic constipation. When conservative and pharmacological treatments are not effective, surgical interventions may be considered and are supported by lower levels of evidence in reducing complications. Conclusions: Often, more than one procedure is necessary to develop an effective bowel routine. Evidence is low for non-pharmacological approaches and high for pharmacological interventions. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify the determinants of the bone strength index of the distal tibia epiphysis in chronic stroke patients. The results showed that lower cardiovascular fitness, more muscle atrophy, poorer mobility, and more severe spasticity were independently associated with lower tibial bone strength index. To identify the determinants of the bone strength index (BSI) at the distal tibia in chronic stroke patients Sixty-three chronic stroke survivors underwent scanning of the distal tibia at the 4% site on both sides using peripheral quantitative computed tomography. The primary outcomes were trabecular bone mineral density (BMD; milligram per cubic centimeter), total BMD (milligram per cubic centimeter), total bone area (square millimeter), and BSI (square gram per centimeter to the power of four). Cardiovascular fitness, leg lean mass, gait velocity, and spasticity were also measured. Scans from 45 subjects were deemed to have acceptable quality and were included for subsequent analysis. The paretic side had significantly lower trabecular BMD, total BMD, and BSI than the nonparetic side ( p < 0.05). However, the total bone area demonstrated no significant side-to-side difference ( p > 0.05). After adjusting for relevant biological factors, peak oxygen consumption, leg muscle mass, and gait velocity remained positively associated with tibial BSI on both sides ( R2 change = 6.9–14.2%), whereas spasticity of the paretic leg was negatively associated with tibial BSI on the same side ( R2 change = 4.8%). Cardiovascular function, muscle atrophy, mobility, and spasticity are independently associated with BSI of the distal tibia epiphysis among chronic stroke patients. [ABSTRACT FROM AUTHOR]

Osteoporosis beliefs were assessed in immigrant Chinese women in Chinatown, Chicago. Results from a survey utilizing the Osteoporosis Health Belief Scale showed that women expressed concern about osteoporosis but lacked both knowledge of preventive care and health motivation. The objective of this study was to assess osteoporosis beliefs in immigrant Chinese women in Chinatown, Chicago. In a community-based health fair, osteoporosis knowledge and self-efficacy among postmenopausal Chinese immigrants were assessed using the translated Osteoporosis Health Belief Scale. Bone mineral density (BMD) was assessed with calcaneal ultrasound. The study population included 94 women with mean age of 51 ± 9 years, mean length of residence in the United States of 9 ± 7 years, and 73% ( n = 76) of whom were recent immigrants. Women expressed concern about the seriousness of osteoporosis and their relative susceptibility to osteoporosis. In particular, women with a prior fracture reported higher seriousness to osteoporosis. Nonetheless, women exhibited low health motivation and low awareness of the benefits of calcium and exercise. Bone densitometry results corresponded to a T score of −1.2 ± 1.5. Multiple regression analysis revealed that a younger age and longer length of residence in the USA were associated with higher BMD. Chinese immigrant women in Chicago exhibit concern regarding osteoporosis, but are unaware of the benefits of calcium and exercise, and exhibit low health motivation. Chinese women in Chinatown lack necessary knowledge about osteoporosis to develop adequate self-efficacy. Public health initiatives should be undertaken among recent immigrant Chinese women. [ABSTRACT FROM AUTHOR]

Study design:Self-report surveyObjective:To ascertain physiatrists' opinions and current practice patterns for bone health management after spinal cord injury (SCI).Participants:Physiatrists who work in teaching rehabilitation centers in Canada.Methods:A 4-page 17-question survey (available in French and English) was sent to working physiatrists in all major Canadian SCI rehabilitation centers.Results:We had an 85% response rate (22 responses). Physiatrists reported that they should be managing bone health issues after SCI in conjunction with family physicians, and most respondents assess and treat for bone health after SCI. However, just over one-third of the physiatrists reported that the current treatment options are not effective for low bone mass; there was more support for pharmacological treatments than there was for rehabilitation modalities.Conclusion:Bone health after SCI is an important health concern that is being managed by physiatrists; however, more discussion and research is needed to ascertain the effectiveness of assessment and treatment options for low bone mass.Spinal Cord (2009) 47, 242–248; doi:10.1038/sc.2008.104; published online 19 August 2008 [ABSTRACT FROM AUTHOR]

Study design:A prospective intervention of functional electrical stimulation leg cycle ergometry (FES-LCE) of four women with spinal cord injury (SCI).Objective:To evaluate the effect of FES-LCE training on arterial compliance in individuals with chronic SCI of traumatic origin.Setting:Tertiary rehabilitation center in Canada.Methods:Large and small artery compliance were measured at the radial artery before and after a 3-month training program using FES-LCE.Results:There was no significant change in large artery compliance after FES-LCE (16.0±4.2 to 16.8±6.1 ml mm Hg−1 × 10, P=NS). There was a marked (63%) increase in small artery compliance after the FES training program (4.2±1.8 to 6.9±3.2 ml mm Hg−1 × 100, P<0.05).Conclusion:It appears that FES-LCE is effective in improving small artery compliance in females with SCI.Spinal Cord (2008) 46, 722–726; doi:10.1038/sc.2008.34; published online 15 April 2008 [ABSTRACT FROM AUTHOR]

Chronic stroke survivors with low hip bone density are particularly prone to fractures. This study shows that fear of falling is independently associated with falls in this population. Thus, fear of falling should not be overlooked in the prevention of fragility fractures in these patients. Chronic stroke survivors with low bone mineral density (BMD) are particularly prone to fragility fractures. The purpose of this study was to identify the determinants of balance, mobility and falls in this sub-group of stroke patients. Thirty-nine chronic stroke survivors with low hip BMD (T-score <−1.0) were studied. Each subject was evaluated for the following: balance, mobility, leg muscle strength, spasticity, and fall-related self-efficacy. Any falls in the past 12 months were also recorded. Multiple regression analysis was used to identify the determinants of balance and mobility performance, whereas logistic regression was used to identify the determinants of falls. Multiple regression analysis revealed that after adjusting for basic demographics, fall-related self-efficacy remained independently associated with balance/mobility performance (R2 = 0.494, P < 0.001). Logistic regression showed that fall-related self-efficacy, but not balance and mobility performance, was a significant determinant of falls (odds ratio: 0.18, P = 0.04). Fall-related self-efficacy, but not mobility and balance performance, was the most important determinant of accidental falls. This psychological factor should not be overlooked in the prevention of fragility fractures among chronic stroke survivors with low hip BMD. [ABSTRACT FROM AUTHOR]

Study design:Systematic review.Objectives:To systematically review the psychometric properties of outcome measures used to assess ambulation in people with spinal cord injury (SCI).Setting:Vancouver, BC, Canada.Methods:A keyword literature search of original articles that evaluated the psychometric properties of ambulation outcome measures in the SCI population was conducted using multiple databases. Multidimensional scales of function were included if specific data were available on ambulation-related subscales. Reliability, validity and responsiveness values were extracted and conclusions drawn about the psychometric quality of each measure.Results:Seven outcome measures were identified and were broadly categorized into timed and categorical measures of ambulation. Timed measures included timed walking tests that showed excellent reliability, construct validity and responsiveness to change. The psychometric properties of the categorical scales were more variable, but those that were developed specifically for the SCI population had excellent reliability and validity. Categorical scales also exhibited some floor or ceiling effects.Conclusion:Excellent tools are available for measuring functional ambulation capacity. Further work is required to develop and evaluate outcome measures to include environmental factors that contribute to the ability to achieve safe, functional ambulation in everyday settings.Sponsorship:Rick Hansen Man-in-Motion Foundation and Ontario Neurotrauma Fund.Spinal Cord (2008) 46, 246–254; doi:10.1038/sj.sc.3102134; published online 9 October 2007 [ABSTRACT FROM AUTHOR]

Bone health status of the radius in individuals with chronic stroke was evaluated using peripheral quantitative computed tomography. Bone mineral density and cortical thickness on the affected side were compromised when compared with the unaffected side. Muscle weakness, spasticity, and disuse were identified as contributing factors to such changes. Following a stroke, demineralization and geometric changes occur in bone as a result of disuse and residual impairments, and these can contribute to an increased risk of fragility fractures. This study used peripheral quantitative computed tomography (pQCT) to evaluate volumetric bone mineral density and geometry at the midshaft radius in people living with chronic stroke. Older individuals with chronic stroke were recruited. Each subject underwent a pQCT scan of the midshaft radius at the 30% site on both upper limbs. Muscle strength, motor function, spasticity, and chronic disuse were also evaluated. Data from 47 subjects (19 women) were assessed. A significant difference was found between the two limbs for cortical bone mineral content, cortical bone mineral density, cortical thickness, and polar stress-strain index. There was no significant side-to-side difference in total bone area. Percent side-to-side difference in muscle strength, spasticity, and chronic disuse were significant determinants of percent side-to-side difference in cortical bone mineral content and cortical thickness. The findings suggest that following chronic stroke, endosteal resorption of the midshaft radius occurred with a preservation of total bone area. Muscle weakness, spasticity, chronic disuse significantly contributed to demineralization and geometric changes in the radius following chronic stroke. [ABSTRACT FROM AUTHOR]

Successful treatment of multiple cancer types requires early detection and identification of reliable biomarkers present in specific cancer tissues. To test the feasibility of identifying proteins from archival cancer tissues, we have developed a methodology, termed direct tissue proteomics (DTP), which can be used to identify proteins directly from formalin-fixed paraffin-embedded prostate cancer tissue samples. Using minute prostate biopsy sections, we demonstrate the identification of 428 prostate-expressed proteins using the shotgun method. Because the DTP method is not quantitative, we employed the absolute quantification method and demonstrate picogram level quantification of prostate-specific antigen. In depth bioinformatics analysis of these expressed proteins affords the categorization of metabolic pathways that may be important for distinct stages of prostate carcinogenesis. Furthermore, we validate Wnt-3 as an upregulated protein in cancerous prostate cells by immunohistochemistry. We propose that this general strategy provides a roadmap for successful identification of critical molecular targets of multiple cancer types.Oncogene (2007) 26, 65–76. doi:10.1038/sj.onc.1209755; published online 26 June 2006 [ABSTRACT FROM AUTHOR]

We assessed the impact of a 19-week exercise program on bone health in chronic stroke. Those who underwent the program reported significantly more gain in tibial trabecular bone content and cortical bone thickness on the affected side. Regular exercise is thus beneficial for enhancing bone health in this population. [ABSTRACT FROM AUTHOR]

STUDY DESIGN::Prospective, correlational. OBJECTIVES::(1) Describe how pain changes over recovery from admission to spinal cord injury (SCI) rehabilitation, discharge and after 6 months of community living and (2) examine the relationship between pain and community integration at 6 months of community living. SETTING::Tertiary rehabilitation centre, SCI unit, Vancouver, Canada. METHODS::Subjects from 66 consecutive admissions to the SCI Program of a tertiary rehabilitation centre for the treatment of a traumatic SCI during the years 2000-2002 were followed using data from the National Rehabilitation Reporting System (NRS). Information was obtained from NRRS standardized assessments performed on admission, discharge and 6 months of community living. Early community living was defined as 6 months postdischarge. Community reintegration was assessed by the Reintegration to Normal Living Index (RNL). Pain presence, pain impact and pain intensity were assessed using single item Likhert-type scales. RESULTS::In all, 86%of individuals with a SCI reported pain at 6 months postdischarge, with 27%of these individuals reporting pain that impacted on many or most activities. Pain impact and pain intensity were related to the community reintegration (r=-0.39 and-0.55, P<0.001), with pain intensity accounting for 25%of the variance in RNL scores. CONCLUSIONS::Pain is a major consequence of a SCI, impacting on an individual's activities and perception of how well they are integrated into the community. The results of this study highlight the need to address pain during both the rehabilitation phase of treatment and the early transition into the community.Spinal Cord (2005) 43, 278-282. doi:10.1038/sj.sc.3101702 Published online 30 November 2004 [ABSTRACT FROM AUTHOR]

Background: We retrospectively compared the accuracy of somatostatin receptor scintigraphy (SRS) with that of helical computed tomography (CT) in the detection and localization of primary and metastatic neuroendocrine tumors. Methods: A medical record search identified 27 patients with known or clinically suspected neuroendocrine tumors who underwent helical CT and SRS within 3 months of one another at our institution. CT images were evaluated retrospectively by two blinded radiologists who used consensus reading. Images were evaluated for the presence or absence of primary tumor and hepatic and extrahepatic metastases. CT results were compared with the SRS report as interpreted by the nuclear medicine physicians. The results of the surgical, clinical follow-up, and pathologic findings were considered as the gold standard. Sensitivity, specificity, and accuracy were calculated for both imaging techniques. In addition, McNemar analysis was performed to determine statistically significant differences between CT and SRS. Results: Helical CT was more sensitive than SRS in the detection of extrahepatic metastases, and the difference between the two imaging modalities was statistically significant (p = 0.0312) as determined by the McNemar chi-square test. However, the difference between CT and SRS in detecting primary neuroendocrine tumors, hepatic metastasis, and combined hepatic and extrahepatic metastasis was not statistically significant (p = 0.625, 1.000, and 1.000, respectively). Conclusion: Helical CT and SRS have similar sensitivity, specificity, and accuracy in detecting primary neuroendocrine tumor and hepatic metastasis. However, helical CT appears to be more sensitive in detecting extrahepatic metastasis from primary neuroendocrine tumors. [ABSTRACT FROM AUTHOR]

Study design: Retrospective analysis. Objectives: (1) Describe the self-care, productivity and leisure problems identified by individuals with a spinal cord injury (SCI) during rehabilitation, (2) describe the perceived level of satisfaction and performance with self-care, productivity and leisure activities following an SCI, (3) quantify the relationship between the Canadian occupational performance measure (COPM), a client-centred, individualized measure of function, and the functional independence measure (FIM). Setting: Tertiary rehabilitation centre, spinal cord injury unit, GF Strong Rehabilitation Centre, Vancouver, Canada. Methods: Health records from 41 individuals with an SCI admitted between 2000 and 2002 were reviewed. Information was obtained from assessments performed on admission and discharge. Self-care, productivity and leisure problems identified by individuals with an SCI were described and their perceived level of performance and satisfaction was calculated. The relationship between the COPM and the FIM was measured by the Pearson product correlation. Results: Self-care goals were identified most frequently (79%) followed by productivity (12%) and leisure (9%) goals. The top three problems identified by individuals with an SCI were functional mobility (including transfers and wheelchair use), dressing and grooming. A fair relationship was found between the COPM and the FIM (r between 0.35 1 and 0.5 14, P<0.05). Conclusions: The results highlight the importance of including a client-centred outcome measure in the assessment of individuals with an SCI. Initial support is provided for use of the COPM in individuals with an SCI. [ABSTRACT FROM AUTHOR]

STUDY DESIGN:: Prospective analysis of relationships. OBJECTIVES:: (1) To quantify the relationship between individual lower extremity muscle strength and functional walking measures and (2) to determine whether a multiple regression model incorporating lower extremity muscle strength could predict the performance of functional walking measures in persons with incomplete spinal cord injury (ISCI) living in the community. SETTING:: Tertiary rehabilitation center, Vancouver, Canada. METHODS:: In all, 22 subjects with ISCI participated. The relationship between functional walking measures (gait speed, 6-min-walk distance, and ambulatory capacity) and muscle strength (manual tests of hip flexors/extensors/abductors, knee flexors/extensors, ankle dorsiflexors/plantarflexors, and great toe extensors) were measured by Pearson's correlation and regression procedures. RESULTS:: For both the more and less affected sides, hip flexors, hip extensors, and hip abductors produced the highest correlations with the three functional measures. The less affected hip flexor strength explained more than 50% of the variance in gait speed and 6-min-walk distance while the less affected hip extensor strength explained up to 64% of the variance in ambulatory capacity. For all three functional measures, the strength of the less affected limb was more important than that of the more affected limb. CONCLUSIONS:: Lower extremity muscle strength, in particular that of hip flexors, hip extensors, and hip abductors, is an important determinant of functional walking performance.Spinal Cord (2004) 42, 156-162. doi:10.1038/sj.sc.3101569 [ABSTRACT FROM AUTHOR]

: To determine whether the presence of back pain and its related disabilities are determinants of balance and functional mobility in a group of women with osteoporosis, we carried out a cross-sectional analysis of 93 community-dwelling women with osteoporosis between the ages of 65 and 75 years old. We assessed health history, anthropometrics, self-report of current physical activity level and self-report of back pain (intensity and pain-related disabilities). Balance was measured by computerized dynamic posturography and functional mobility was assessed by timed figure-of-eight test. The prevalence of back pain was high (75%) in this cohort of older women with osteoporosis. Age was the major determinant of both balance and functional mobility and accounted for 9% and 14% of the variance, respectively. After accounting for age, back pain explained an additional 9% of the variance in balance and 13% of the variance in functional mobility. The high prevalence of back pain demonstrates the importance of pain management in the treatment of osteoporosis. Furthermore, the finding of self-reported back pain as a determinant of both balance and functional mobility suggests that this measure may deserve attention when screening women with osteoporosis for fracture risk. Prospective studies are needed to determine whether pain management will improve balance and functional mobility. [ABSTRACT FROM AUTHOR]

This paper presents a mathematical model for changing mortality in functional form. This model may be used to obtain cohort forces of mortality and cohort survivorship functions from a period force of mortality and a period life table under conditions of gradually changing mortality if an estimate of the amount of change in mortality is available. An example is given to show how the cohort functions are derived from the period functions. [ABSTRACT FROM AUTHOR]

We have investigated the surface reactivities of Ni/Pt(111) bimetallic model catalysts using ethylene and cyclohexene as probing molecules. The bimetallic surfaces were generated by evaporating Ni onto a Pt(111) single- crystal surface held at 600 K. The surface chemistry was investigated using high-resolution electron energy loss spectroscopy (HREELS), Auger electron spectroscopy (AES), temperature-programmed desorption (TPD) and low-energy electron diffraction (LEED). The reactivities of the bimetallic surfaces were compared with those of the clean Pt(111) surface and a thick Ni(111) film on the Pt(111) substrate. Formation of the bimetallic surface led to a significantly reduced reactivity towards the decomposition of ethylene when compared to either Pt(111) or Ni(111)/Pt(111) surfaces. Furthermore, although the surface reactivity towards cyclohexene was retained for the bimetallic surface, the decomposition mechanism was distinctly altered from that of either Pt(111) or Ni(111)/Pt(111) surfaces. [ABSTRACT FROM AUTHOR]

Respiratory syncytial virus (RSV) is a frequent cause of bronchiolitis leading to acute admission to hospital in the winter months. A wide range of findings accompanies this disease and the appearances are seldom completely diagnostic. Associated bacterial co-infections are common and we have shown an association with atelectasis among patients with pathogenic bacteria in the nasopharynx. [ABSTRACT FROM AUTHOR]