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BACKGROUND: Anterior cruciate ligament reconstructed (ACLR) athletes show increased hamstrings activation and decreased knee flexion moments (KFMs) during single leg landing tasks at time of return-to-sport (RTS). Although these landing alterations seem protective in the short term, they might become undesirable if they persist after RTS. Therefore, the main aim of this study was to investigate whether those landing alterations persist in the months following RTS. METHODS: Sixteen athletes who had an ACLR performed five unilateral landing tasks at three different time points (at RTS, and at 3 and 6 months after RTS) while KFMs and hamstrings activation were recorded. The following clinical parameters were registered: isokinetic strength of quadriceps and hamstrings, ACL return-to-sport after injury scale (ACL-RSI), Tampa scale of kinesiophobia, self-reported instability and single leg hop distance. A one-way repeated measures analysis of variance (ANOVA) was used to assess whether landing deficits changed over time. Additionally, an explorative analysis was performed to assess whether those athletes whose deficits persisted the most could be identified based on baseline clinical parameters. RESULTS: The ANOVA showed no differences in landing deficits between sessions, indicating persisting reduced KFMs and increased hamstrings activation in the injured leg compared with the contralateral leg. A significant improvement of the quadriceps concentric strength (at 120°/s), ACL-RSI score and jump distance of the single leg hop was found over time. CONCLUSIONS: Landing alterations were not resolved 6 months after RTS. Additional interventions may be needed to normalize landing alterations prior to return to sport. ispartof: The Knee vol:33 pages:305-317 ispartof: location:Netherlands status: Published online

BACKGROUND: Swallowing is a complex physiologic function developing mostly in the first years of life. After 6 years old, if mature deglutition is not achieved, swallowing persists as "atypical swallowing" (AS). OBJECTIVE: The aim of this study was to detect any electromyographical differences in the muscular activation pattern in patients with and without AS. MATERIALS AND METHODS: 38 adolescents and young adults were selected for this study: 20 with atypical swallowing (AS group) and 18 without (C group). Standardised surface electromyographic analysis was performed by the same operator to detect the activity of masseter (MM), temporalis (TA) and submental (SM) muscles. A Student t test for unpaired data was carried out to detect differences between the AS and C groups. A 1-way ANOVA was performed to detect any differences between the three couples of muscles. RESULTS: When compared to controls, AS patients showed a significantly longer duration of activity for each couple of muscles and for the whole duration of swallowing act (P

Positive influences of family members have been associated with a high probability of children’s daily breakfast consumption. Therefore, the aim of this study was to scrutinize the association of breakfast routines between mothers and their children. The baseline data of the Feel4Diabetes-study was obtained in 9760 children (49.05% boys)–mother pairs in six European countries. A parental self-reported questionnaire gauging the frequency of breakfast consumption and of breakfast´ foods and beverages consumption was used. Agreement in routines of mothers and their children’s breakfast consumption was analyzed in sex-specific crosstabs. The relationship of breakfast routine and food groups’ consumption between mothers and their children was assessed with analysis of covariance. The highest proportion of children who always consumed breakfast were those whose mothers always consumed it. Children consuming breakfast regularly had a higher intake of milk or unsweetened dairy products and all kind of cereal products (low fiber and whole-grain) than occasional breakfast consumers (p &lt, 0.05). The strong similarity between mothers and children suggests a transfer of breakfast routine from mothers to their children, as a high proportion of children who usually consume breakfast were from mothers also consuming breakfast. All breakfast foods and beverages consumption frequencies were similar between children and their mothers.

Oliver Van Oekelen,1,* Kristina Vermeersch,1,2,* Stephanie Everaerts,1,2 Bert Vandenberk,3,4 Rik Willems,3,4 Wim Janssens1,2 1Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium; 2Department of Chronic Diseases, Metabolism and Ageing, Laboratory of Respiratory Diseases, KU Leuven, Leuven, Belgium; 3Department of Cardiology, University Hospitals Leuven, Leuven, Belgium; 4Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium *These authors contributed equally to this work Background: A prolonged QT interval is associated with increased risk of Torsade de Pointes and cardiovascular death. The prevalence and clinical relevance of QT prolongation in acute exacerbations of COPD (AECOPD), with high risk for cardiac morbidity and mortality, is currently unclear. Methods: A dual cross-sectional study strategy was therefore designed. A retrospective study evaluated 140 patients with an AECOPD requiring hospitalization, half of which had prolonged QTc on the admission ECG. Univariate and multivariate analyses were conducted to determine associated factors; Kaplan–Meier and Cox regression analyses to assess prognostic significance. A prospective study evaluated 180 pulmonary patients with acute respiratory problems requiring hospitalization, to determine whether a prolonged QTc at admission represents an AECOPD-specific finding and to investigate the change in QTc-duration during hospitalization. Results: Retrospectively, hypokalemia, cardiac troponin T and conductance abnormalities on ECG were significantly and independently associated with QTc prolongation. A prolonged QTc was associated with increased all-cause mortality (HR 2.698 (95% CI 1.032–7.055), p=0.043), however, this association was no longer significant when corrected for age, FEV1 and cardiac troponin T. Prospectively, QTc prolongation was observed in 1/3 of the patients diagnosed with either an AECOPD, lung cancer, pulmonary infection or miscellaneous acute pulmonary disease, and was not more prevalent in AECOPD. The QTc-duration decreased significantly during hospitalization in patients with and without COPD. Conclusion: A prolonged QTc is a marker of underlying cardiovascular disease during an AECOPD. It is not COPD-specific, but a common finding during the acute phase of a pulmonary disease requiring urgent hospital admission. Keywords: COPD, acute exacerbation, cardiovascular morbidity, prolonged QT interval, ECG, Bazett

Dental uniqueness can be proven if no perfect match in pair-wise morphological comparisons of human dentitions is detected. Establishing these comparisons in a worldwide random population is practically unfeasible due to the need for a large and representative sample size. Sample stratification is an option to reduce sample size. The present study investigated the uniqueness of the human dentition in randomly selected subjects (Group 1), orthodontically treated patients (Group 2), twins (Group 3), and orthodontically treated twins (Group 4) in comparison with a threshold control sample of identical dentitions (Group 5). The samples consisted of digital cast files (DCF) obtained through extraoral 3D scanning. A total of 2.013 pair-wise morphological comparisons were performed (Group 1 n = 110, Group 2 n = 1.711, Group 3 n = 172, Group 4 n = 10, Group 5 n = 10) with Geomagic Studio® (3D Systems®, Rock Hill, SC, USA) software package. Comparisons within groups were performed quantifying the morphological differences between DCF in Euclidean distances. Comparisons between groups were established applying One-way ANOVA. To ensure fair comparisons a post-hoc Power Analysis was performed. ROC analysis was applied to distinguish unique from non-unique dentures. Identical DCF were not detected within the experimental groups (from 1 to 4). The most similar DCF had Euclidian distance of 5.19 mm in Group 1, 2.06 mm in Group 2, 2.03 mm in Group 3, and 1.88 mm in Group 4. Groups 2 and 3 were statistically different from Group 5 (p

This study examined mostly lower-middle-income Latino (37%) and African American (33%) adolescents' (N = 90, Mage = 15.90) conceptions of how U.S. wealth is and ought to be distributed, and whether these judgments are related to adolescents' views about societal and legal fairness and their immediate academic plans. Individually administered multipart interviews assessed conceptions regarding (a) actual and ideal U.S. wealth distribution and related "Rawlsian" judgments, (b) social system and legal fairness, and (c) adolescents' near-term life goals. Overall, adolescents underestimated actual levels of U.S. wealth inequality while also preferring a more egalitarian distribution than was believed to exist. Adolescents' wealth-related reasoning was mostly unrelated to other societal or personal judgments, whereas societal and legal fairness judgments were related to personal academic plans. Although adolescents had generally negative views of societal and legal fairness, having more positive fairness conceptions was related to a greater emphasis on academic plans. Compared with their younger peers, older adolescents preferred somewhat more wealth inequality for motivational and economic reasons and preferred living in a society with some inequality. (PsycINFO Database Record

INTRODUCTION: It is crucial to understand the factors that introduce variability before applying metabolomics to clinical and biomarker research.OBJECTIVES: We quantified technical and biological variability of both fasting and postprandial metabolite concentrations measured using 1H NMR spectroscopy in plasma samples.METHODS: In the Netherlands Epidemiology of Obesity study (n = 6,671), 148 metabolite concentrations (101 metabolites belonging to lipoprotein subclasses) were measured under fasting and postprandial states (150 minutes after a mixed liquid meal). Technical variability was evaluated among 265 fasting and 851 postprandial samples, with the identical blood plasma sample being measured twice by the same laboratory protocol. Biological reproducibility was assessed by measuring 165 individuals twice across time for evaluation of short- (3 years) biological variability. Intra-class coefficients (ICCs) were used to assess variability. The ICCs of the fasting metabolites were compared with the postprandial metabolites using two-sided paired Wilcoxon test separately for short- and long-term measurements.RESULTS: Both fasting and postprandial metabolite concentrations showed high technical reproducibility using 1H NMR spectroscopy (median ICC = 0.99). Postprandial metabolite concentrations revealed slightly higher ICC scores than fasting ones in short-term repeat measures (median ICC in postprandial and fasting metabolite concentrations 0.72 versus 0.67, Wilcoxon p-value = 8.0×10-14). Variability did not increase further in a long-term repeat measure, with median ICC in postprandial of 0.64 and in fasting metabolite concentrations 0.66.CONCLUSION: Technical reproducibility is excellent. Biological reproducibility of postprandial metabolite concentrations showed a less or equal variability than fasting metabolite concentrations over time.

In Alzheimer's disease (AD), it is now well established that recollection is impaired from the beginning of the disease, whereas findings are less clear concerning familiarity. One of the most important mechanisms underlying familiarity is the sense of familiarity driven by processing fluency. In this study, we attempted to attenuate recognition memory deficits in AD by maximizing the salience of fluency cues in two conditions of a recognition memory task. In one condition, targets and foils have been created from the same pool of letters (Overlap condition). In a second condition, targets and foils have been derived from two separate pools of letters (No-Overlap condition), promoting the use of letter-driven visual and phonetic fluency. Targets and foils were low-frequency words. The memory tasks were performed by 15 patients with AD and 16 healthy controls. Both groups improved their memory performance in the No-Overlap condition compared to the Overlap condition. Patients with AD were able to use fluency cues during recognition memory as older adults did, but this did not allow to compensate for dysfunction of recognition memory processes.

Purpose To identify factors correlating with poorer quality of life (QoL) in children and adolescents with epilepsy and regarding QoL and depression of their caregivers in Germany. Method A cross-sectional multicenter study on QoL and depression was performed in two representative German states (Hessen and Schleswig-Holstein). Variance analysis, linear regression, and bivariate correlation were used to identify correlating factors for poorer QoL and symptoms of depression. Results Data from 489 children and adolescents (mean age 10.4 ± 4.2 years, range 0.5–17.8; 54.0% male) and their caregivers were collected. We identified missing seizure freedom (p = 0.046), concomitant diseases (p = 0.007), hospitalization (p = 0.049), recent status epilepticus (p = 0.035), living in a nursing home or with foster parents (p = 0.049), and relevant degree of disability (p = 0.007) to correlate with poorer QoL in children and adolescents with epilepsy. Poorer QoL of caregivers was associated with longer disease duration (p = 0.004), non-idiopathic (mainly structural-metabolic) epilepsy (p = 0.003), ongoing seizures (p = 0.003), concomitant diseases (p = 0.003), relevant disability (p = 0.003), or status epilepticus (p = 0.003) as well as with unemployment of the primary caretaker (p = 0.010). Symptoms of depression of caregivers were associated with non-idiopathic epilepsy (p = 0.003), concomitant diseases (p = 0.003), missing seizure freedom (p = 0.007), status epilepticus (p = 0.004), or a relevant disability (p = 0.004) of their ward. A poorer QoL value of the children and adolescents correlated with a poorer QoL value of the caregivers (p Conclusions Epilepsy shows a considerable impact on QoL and symptoms of depression. Early and effective therapy should focus on reduction of seizure frequency and the probability for developing status epilepticus. Furthermore, comprehensive care should pay attention at comorbidities, consequences of disability and dependency on others.

Blackcurrant contains anthocyanins, known to influence vasorelaxation and peripheral blood flow. We examined the effects of 7 days intake of Sujon New Zealand blackcurrant powder (6g/day) on the lactate curve, maximum oxygen uptake, and cardiovascular responses at rest and during cycling. Thirteen trained triathletes with >3 yrs experience (8 men, age: 38 ± 8 yrs, body mass: 71 ± 9 kg, BF%: 19 ± 5%, mean ± SD) performed two incremental cycling protocols with recording of physiological and cardiovascular responses (Portapres Model 2). Cardiovascular function was also measured in rest. Experimental design was doubleblind, placebo-controlled, randomized and cross-over (wash-out 4 wks). Data were analyzed with two-tailed t tests and 2-way ANOVA and significance accepted at p < .05. Plasma lactate was lower at 40%, 50%, 60% and 70% of maximum power by 27%, 22%, 17% and 13%. Intensity at 4 mmol·L-1 OBLA was 6% higher with blackcurrant without effect on heart rate and oxygen uptake. Maximum values of oxygen uptake, heart rate and power were not affected by blackcurrant, but obtained with 14% lower lactate. In rest, blackcurrant increased stroke volume and cardiac output by 25% and 26%, and decreased total peripheral resistance by 16%, with no changes in blood pressure and heart rate. Cardiovascular responses during exercise at 40%, 50%, 60%, 70% and 80% intensity were not affected. Sujon New Zealand blackcurrant powder affects lactate production and/or clearance during exercise. Sujon New Zealand blackcurrant powder affects physiological and cardiovascular responses in rest and during exercise that may have implications for exercise performance.

Aims Clinical experience indicates that limited or no reverse left ventricular (LV) remodelling may not necessarily imply non-response to cardiac resynchronization therapy (CRT). We investigated the association of the extent of LV remodelling, mechanical dyssynchrony, and survival in patients undergoing CRT. Methods and results In 356 CRT candidates, three blinded readers visually assessed the presence of mechanical dyssynchrony (either apical rocking and/or septal flash) before device implantation and also its correction by CRT 12 +/- 3 months postimplantation. To assess LV reverse remodelling, end-systolic volumes (ESV) were measured at the same time points. Patients were divided into four subgroups: no LV remodelling (ESV change 0 +/- 5%), mild LV reverse remodelling (ESV reduction 5-15%), significant LV reverse remodelling (ESV reduction >= 15%), and LV volume expansion (ESV increase >= 5%). Patients were followed for all-cause mortality during the median follow-up of 36 months. Patients with LV remodelling as in the above defined groups showed 58, 54, and 84% reduction in all-cause mortality compared to patients with volume expansion. In multivariable analysis, LVESV change remained independently associated with survival, with an 8% reduction in mortality for every 10% decrease in LVESV (P = 0.0039), but an optimal cut-off point could not be established. In comparison, patients with corrected mechanical dyssynchrony showed 71% reduction in all-cause mortality (P

Item does not contain fulltext Cardiac magnetic resonance (CMR) imaging is the preferred method to measure right ventricular (RV) volumes and ejection fraction (RVEF). This study aimed to determine the impact of excluding trabeculae and papillary muscles on RV volumes and function in patients with RV pressure and/or volume overload and healthy controls and its reproducibility using semi-automatic software. Eighty patients (pulmonary hypertension, transposition of the great arteries after arterial switch operation and after atrial switch procedure and repaired Tetralogy of Fallot) and 20 controls underwent short-axis multislice cine CMR. End diastolic volume (EDV), end systolic volume (ESV), RV mass and RVEF were measured using 2 methods. First, manual contour tracing of RV endo- and epi-cardial borders was performed. Thereafter, trabeculae were excluded from the RV blood volume using semi-automatic pixel-intensity based software. Both methods were compared using a Student T test and 25 datasets were re-analyzed for reproducibility. Exclusion of trabeculae resulted in significantly decreased EDV; ranging from -5.7 +/- 1.7 ml/m(2) in controls to -29.2 +/- 6.6 ml/m(2) in patients after atrial switch procedure. RVEF significantly increased in all groups, ranging from an absolute increase of 3.4 +/- 0.8 % in healthy controls to 10.1 +/- 2.3 % in patients after atrial switch procedure. Interobserver agreement of method 2 was equal to method 1 for RVEDV, RVESV and RVEF and superior for RV mass. In patients with overloaded RVs exclusion of trabeculae from the blood volume results in a significant change in RV volumes, RVEF and RV mass. Exclusion of trabeculae is highly reproducible when semi-automatic pixel-intensity based software is used.

The immune system plays an instrumental role in obesity and insulin resistance. Here, we unravel the role of the costimulatory molecule CD40 and its signaling intermediates, TNF receptor-associated factors (TRAFs), in diet-induced obesity (DIO). Although not exhibiting increased weight gain, male CD40(-/-) mice in DIO displayed worsened insulin resistance, compared with wild-type mice. This worsening was associated with excessive inflammation of adipose tissue (AT), characterized by increased accumulation of CD8(+) T cells and M1 macrophages, and enhanced hepatosteatosis. Mice with deficient CD40-TRAF2/3/5 signaling in MHCII+ cells exhibited a similar phenotype in DIO as CD40(-/-) mice. In contrast, mice with deficient CD40-TRAF6 signaling in MHCII+ cells displayed no insulin resistance and showed a reduction in both AT inflammation and hepatosteatosis in DIO. To prove the therapeutic potential of inhibition of CD40-TRAF6 in obesity, DIO mice were treated with a small-molecule inhibitor that we designed to specifically block CD40-TRAF6 interactions; this compound improved insulin sensitivity, reduced AT inflammation, and decreased hepatosteatosis. Our study reveals that the CD40-TRAF2/3/5 signaling pathway in MHCII+ cells protects against AT inflammation and metabolic complications associated with obesity whereas CD40-TRAF6 interactions in MHCII+ cells aggravate these complications. Inhibition of CD40-TRAF6 signaling by our compound may provide a therapeutic option in obesity-associated insulin resistance.

Item does not contain fulltext INTRODUCTION: This prospective study was carried out to investigate if metronome-paced tachypnea (MPT) can serve as an accurate diagnostic tool to identify patients with chronic obstructive pulmonary disease (COPD) who are susceptible to develop dynamic hyperinflation during exercise. Commonly, this is assessed by measuring change in inspiratory capacity (IC) during cardiopulmonary exercise testing (CPET), which, however, is complex and laborious. METHODS: Fifty-three patients with COPD (FEV(1) 58 +/- 22%pred) and 20 age-matched healthy subjects were characterized by lung function testing and performed CPET (reference standard) and MPT. The repeatability coefficient of IC (10.2%) was used as cut-off to classify subjects as hyperinflators during CPET. Subsequently, dynamic hyperinflation was measured after MPT. With receiver operating characteristic analysis, the optimal cut-off for MPT-induced dynamic hyperinflation was determined and sensitivity and specificity of MPT to identify hyperinflators were evaluated. RESULTS: With 10.2% decrease in IC as cut-off for CPET-induced dynamic hyperinflation, the optimal cut-off for MPT was 11.1% decrease in IC. Using these cut-offs, MPT had a sensitivity of 85% and specificity of 85% to identify the subjects who hyperinflated during CPET. CONCLUSIONS: The MPT test shows good overall accuracy to identify subjects who are susceptible to develop dynamic hyperinflation during CPET. Before considering the use of MPT as a screening tool for dynamic hyperinflation in COPD, sensitivity and specificity need further evaluation.

Background: Intradermal immunization is gaining increased attention due to multiple factors: (1) intradermal (ID) vaccination has been shown to induce improved immunogenicity compared to intramuscular (IM) vaccination; (2) ID vaccination has been shown to have a dose-sparing potential over IM leading to a reduced vaccine cost and an increased availability of vaccines worldwide. However, the currently used Mantoux technique for ID injection is difficult to standardize and requires training. The aim of the study was (1) to assess the epidermal and dermal thickness at the proximal ventral and dorsal forearm (PVF & PDF) and deltoid in adults aged 18-65 years (2) to determine the maximum penetration depth and needle characteristics for the development of a platform of medical devices suited for intradermal injection, VAX-ID (TM). Materials and methods: Mean thickness of the PVF, PDF and deltoid were measured using high-frequency ultrasound of healthy adults aged 18-65 years. Correlation with gender, age and BMI was assessed using Mann -Whitney U Test, Spearman correlation and Wilcoxon Signed Ranks Test, respectively. Results: Results showed an overall mean skin thickness of 1.19 mm (0.65-1.55 mm) at the PVF, 1.44 mm (0.78-1.84 mm) at the PDF, and 2.12 mm (1,16-3.19 mm) at the deltoid. Thickness of PVF & PDF and deltoid were significantly different for men vs women (p(mean) < 0.001

Inhibitors of casein kinase 2 (CK2), a regulator of cell proliferation and mediator of the DNA damage response, are being evaluated in clinical trials for the treatment of cancers. Apigenin was capable of inhibiting the activation of CK2 following γ irradiation in LN18 and U87 malignant glioma cells. Apigenin and siRNA-mediated CK2 protein depletion further inhibited NF-κB activation and altered the Tyr68 phosphorylation of Chk2 kinase, a DNA damage response checkpoint kinase, following irradiation. However, CK2 inhibition did not decrease the ability of these glioma cells to repair double-strand DNA breaks, as assessed by COMET assays and γ-H2Ax staining. Likewise, apigenin and siRNA-induced depletion of CK2 failed to sensitize glioma cells to the cytotoxic effect of 2 to 10 G-rays of γ irradiation, as assessed by clonogenic assays. These results contrast with those found in other cancer types, and urge to prudence regarding the inclusion of malignant glioma patients in clinical trials that assess the radiosensitizing role of CK2 inhibitors in solid cancers.

Introduction: In the knee extensors, the time to fatigue for intermittent isometric contractions can be increased by caffeine. Fatigue is muscle length dependent. Aim: We examined the effect of caffeine on fatigue of knee extensors at two joint angles. Methods: Ten male subjects (24±3 yr, 177±5 cm, 75±6 kg) with low caffeine intake (

Item does not contain fulltext Regional heterogeneity in wall architecture and thickness may be present between conduit arteries in the upper and lower limbs in humans. These differences in wall architecture may, in turn, influence vascular responsiveness. Folkow proposed in the 1950s that heterogeneity in wall-to-lumen ratio (W:L) could contribute to differences in vascular responsiveness, but this hypothesis has never been directly confirmed in vivo. Our first aim was to examine wall thickness and W:L across arteries in the lower (common and superficial femoral) and upper limbs (brachial and radial) of healthy men (n=35) using high resolution ultrasound. In a subgroup (n=20) we examined the relationship between W:L of these arteries, physiological (flow-mediated dilation, FMD) and pharmacological vasodilation (glyceryl trinitrate, GTN). Diameter and wall thickness differed significantly across all arteries (ANOVA P

Aim: The aim of this study was to establish a third molar developmental database to model dental age of Polish youngsters, to investigate the rating level of the scores when dividing a year interval into a quarter of a year and to examine sex differences, left-right and upper-lower jaw asymmetry. Material and methods: A cross-sectional sample of 1048 orthopantomograms of 644 females and 404 males aged between 12 and 26 years was investigated using the scoring system of Gleiser and Hunt modified by Kohler. Reference tables according to age were split in a whole year and in quarters of a year using descriptive statistics. The various developmental stages between males and females were analyzed with a paired t-test and the cusum method. Differences in mineralization between the quadrants were analyzed with a two-factor ANOVA and the Duncan post hoc test. The single quadratic and support vector regression were performed to describe the relationship between score and age. Results: Dividing age classes in quarters of a year discriminated better between individuals provided that there is a sufficient sampling size for all age classes. The mineralization tempo occurred significantly at a faster rate in males. The maturational events in the upper arch developed significantly at earlier ages for both genders. Obtained chronological age had nearly the same standard error of estimate when calculated with both regression methods. Discussion and conclusion: Comparing the results of the present study with those of other population groups suggests that there are differences in the ageing process of the wisdom tooth. This is the first database of Polish youngsters (15-24 years) with their respective regression equations to yield age estimations.

Background People with diabetes or diabetic polyneuropathy often experience limitations in mobility and gait. These limitations are believed to be related to disturbed muscle function and sensory information. In previous studies on diabetic gait, results were confounded by a lower, preferred walking speed in people with diabetes or diabetic polyneuropathy. This study aimed to identify gait-velocity independent effects of diabetes and diabetic polyneuropathy on lower extremity kinematics and muscle activation patterns. Methods Eight people with diabetic polyneuropathy, 10 diabetic controls without polyneuropathy and ten healthy, age-matched controls walked at their preferred velocity and a standard velocity of 1.4 ms −1 . Muscle activation patterns of gluteus maximus, biceps femoris, rectus femoris, vastus medialis, gastrocnemius medialis, soleus, and tibialis anterior , and spatiotemporal and joint angles characteristics were analysed. Findings Independent of walking speed, muscle activation differed between groups. In diabetic polyneuropathy participants activation of ankle-joint dorsal flexors was prolonged by 5–10% of the stride cycle. Activity of monoarticular knee-joint extensors lasted about 10% longer in both diabetic groups compared to healthy elderly. Initiation of muscle activity did not differ between groups. If gait velocity was controlled, spatiotemporal characteristics were similar between groups. Interpretation The study showed that independent of the preferred lower gait velocity, people with diabetes or diabetic polyneuropathy adjust the timing of muscle activity. Contrarily, the concurrent changes in spatiotemporal characteristics occurred to be the result of changed velocity only. The delayed cessation of muscle activity suggested a reduced rate of force development underlying the adjusted timing of muscle activation.

Contains fulltext : 73167.pdf (Publisher’s version ) (Open Access) Understanding language always occurs within a situational context and, therefore, often implies combining streams of information from different domains and modalities. One such combination is that of spoken language and visual information, which are perceived together in a variety of ways during everyday communication. Here we investigate whether and how words and pictures differ in terms of their neural correlates when they are integrated into a previously built-up sentence context. This is assessed in two experiments looking at the time course (measuring event-related potentials, ERPs) and the locus (using functional magnetic resonance imaging, fMRI) of this integration process. We manipulated the ease of semantic integration of word and/or picture to a previous sentence context to increase the semantic load of processing. In the ERP study, an increased semantic load led to an N400 effect which was similar for pictures and words in terms of latency and amplitude. In the fMRI study, we found overlapping activations to both picture and word integration in the left inferior frontal cortex. Specific activations for the integration of a word were observed in the left superior temporal cortex. We conclude that despite obvious differences in representational format, semantic information coming from pictures and words is integrated into a sentence context in similar ways in the brain. This study adds to the growing insight that the language system incorporates ( semantic) information coming from linguistic and extralinguistic domains with the same neural time course and by recruitment of overlapping brain areas.

ObjectivesThis study sought to evaluate the impact of obesity on patient radiation dose during atrial fibrillation (AF) ablation procedures under fluoroscopic guidance.BackgroundObesity is a risk factor for AF and its recurrence after ablation. It increases patient radiation dose during fluoroscopic imaging, but this effect has not been quantified for AF ablation procedures.MethodsEffective radiation dose and lifetime attributable cancer risk were calculated from dose-area product (DAP) measurements in 85 patients undergoing AF ablation guided by biplane low-frequency pulsed fluoroscopy (3 frames/s). Three dose calculation methods were used (Monte Carlo simulation, dose conversion coefficients, and depth-profile dose curves).ResultsMedian DAP for all patients was 119.6 Gy·cm2(range 13.9 to 446.3 Gy·cm2) for procedures with a median duration of 4 h and 83 ± 26 min of fluoroscopy. Body mass index was a more important determinant of DAP than total fluoroscopy time (r = 0.74 vs. 0.37, p < 0.001), with mean DAP values per hour of fluoroscopy of 58 ± 40 Gy·cm2, 110 ± 43 Gy·cm2, and 184 ± 79 Gy·cm2in normal, overweight, and obese patients, respectively. The corresponding effective radiation doses for AF ablation procedures were 15.2 ± 7.8 mSv, 26.7 ± 11.6 mSv, and 39.0 ± 15.2 mSv, respectively (Monte Carlo). Use of conversion coefficients resulted in higher effective dose estimates than other methods, particularly in obese patients. Mean attributable lifetime risk of all-cancer mortality was 0.060%, 0.100%, and 0.149%, depending on weight class.ConclusionsObese patients receive more than twice the effective radiation dose of normal-weight patients during AF ablation procedures. Obesity needs to be considered in the risk-benefit ratio of AF ablation and should prompt further measures to reduce radiation exposure.

Dose-related effects of atrial overdrive pacing (AOP) on sleep-related breathing disorder (SRBD) were studied. Fourteen patients with pacemakers with moderate to severe SRBD (mean screening apnea-hypopnea index [AHI] 35.2 +/- 21.9 events/hour) were randomized to 3 levels of pacing (50, 10, and 20 beats/min greater than the mean nocturnal heart rate) and studied by polysomnography, observing for changes in AHI. At the 2 AOP levels, no significant change was observed in the primary end point of reduction in AHI. Additionally, there was no observed impact on secondary end points of the study. Cyclic variation of heart rate was progressively abolished with higher levels of AOP without affecting AHI. Large variations were observed between the screening and control studies in SRBD indexes in a number of patients. In conclusion, AOP demonstrated no benefit to predominantly obstructive SRBD disorder of at least moderate severity.

Accumulation of atrial adipose tissue is associated with atrial fibrillation (AF). However, the underlying mechanisms remain poorly understood. We examined the relationship between the characteristics of fatty infiltrates of the atrial myocardium and the history of AF.Atrial samples, collected in 92 patients during cardiac surgery and in a sheep model of persistent AF, were subjected to a detailed histological analysis. In sections of human right atrial samples, subepicardial fatty infiltrations were commonly observed in the majority of patients. A clear difference in the appearance and fibrotic content of these fatty infiltrations was observed. Fibro-fatty infiltrates predominated in patients with permanent AF (no AF: 37 ± 24% vs. paroxysmal AF: 50 ± 21% vs. permanent AF: 64 ± 23%, P0.001). An inverse correlation between fibrotic remodelling and the amount of subepicardial adipose tissue suggested the progressive fibrosis of fatty infiltrates with permanent AF. This hypothesis was tested in a sheep model of AF. In AF sheep, an increased accumulation of peri-atrial fat depot was observed on cardiac magnetic resonance imaging and dense fibro-fatty infiltrations predominated in the left atria of AF sheep. Cellular inflammation, mainly consisting of functional cytotoxic T lymphocytes, was observed together with adipocyte cell death in human atria.Atrial fibrillation is associated with the fibrosis of subepicardial fatty infiltrates, a process in which cytotoxic lymphocytes might be involved. This remodelling of the atrial subepicardium could contribute to structural remodelling forming a substrate for AF.

A high proportion of patients develops atrial fibrillation (AF) after ablation for atrial flutter (AFL). Radiofrequency ablation for AFL therefore would only be useful if it leads to a better quality of life despite this high incidence of AF post-ablation.All patients who underwent AFL ablation in our centre before March 2002 (n=203) were contacted by letter a median of 2.3 years after their ablation. Sixty-eight percent answered the questionnaire polling the perceived benefits of the procedure. The results were stratified according to the presenting arrhythmia before the ablation: only AFL, predominantly AFL, predominantly AF or class Ic-III AFL.Despite a 60% incidence of AF, 84% considered the procedure to be beneficial during the 1st year and 77% during the 2nd year post-ablation. Patients with predominantly AF before the procedure showed significantly less overall improvement than the 3 other groups (50% and 33% after I year and 2 years, p0.01) and a smaller reduction in palpitations (50% and 29% after I year and 2 years, p0.01). The benefit of an ablation was also significantly less in patients who developed AF post-ablation than in patients who were completely arrhythmia free (75% versus 98% 1st year, 58% versus 91% 2nd year; p 0.01); nevertheless 75% of these patients reported fewer palpitations and 56% tolerated symptoms better than before.Despite a high incidence of AF after AFL ablation, the majority of patients considered the intervention beneficial. Only in patients with predominantly AF before ablation the procedure does not seem beneficial.

SUMMARYThe effect of an increase in gravity on the mechanics of running has been studied by using a force platform fixed to the floor of an aircraft undergoing flight profiles, resulting in a simulated gravity of 1.3 g. The power spent to maintain the motion of the centre of mass of the body is ∼1.3 times greater than on Earth, due to a similar increase of both the power spent against gravity and to sustain the forward speed changes. This indicates that the average vertical displacement per unit distance and the average direction of the push are unchanged. The increase in power is mainly due to an increase in step frequency rather than to an increase in the work done at each step. The increase in step frequency in turn is mainly due to a decreased duration of the effective aerial phase (when the vertical force is less than body weight), rather than an increase in the stiffness of the bouncing system. The maximal speed where step frequency can match the resonant frequency of the bouncing system is increased by ∼5 km h–1 at 1.3 g. These results suggest a similar running mechanics at higher gravity, maintained at the expense of greater energy expenditure.

The purpose of this study was to establish a representative reference dataset for temporal characteristics of foot roll-over during barefoot jogging, based on plantar pressure data collected from 220 healthy young adults. The subjects ran at 3.3 ms-1 over a 16.5 m long running track, having a built-in pressure platform mounted on a force platform. The initial contact, final contact, time to peak pressure and the duration of contact at the lateral and medial heel, metatarsal heads I to V and the hallux were measured. Temporal plantar pressure variables were found to be reliable (93% of ICC coefficients above 0.75) and both gender and asymmetry influences could be neglected. Foot roll-over during jogging started with heel contact followed by a latero-medial contact of the metatarsals and finally the hallux. After heel off, the forefoot started to push off at the lateral metatarsals, followed by a more central push off over the second metatarsal and finally over the hallux. Based on the plantar pressure data, the stance phase during running was divided into four distinct phases: initial contact (8.2%), forefoot contact (11.3%), foot flat (25.3%) and forefoot push off (55.1%). These findings provide a reliable and representative reference dataset for temporal characteristics of foot roll-over during jogging of young adults that may also be relevant in the evaluation of running patterns.

Contains fulltext : 54749.pdf (Publisher’s version ) (Closed access) We examined the expression and function of group-II metabotropic glutamate (mGlu) receptors in an animal model of absence seizures using genetically epileptic WAG/Rij rats, which develop spontaneous non-convulsive seizures after 2-3 months of age. Six-month-old WAG/Rij rats showed an increased expression of mGlu2/3 receptors in the ventrolateral regions of the somatosensory cortex, ventrobasal thalamic nuclei, and hippocampus, but not in the reticular thalamic nucleus and in the corpus striatum, as assessed by immunohistochemistry and Western blotting. In contrast, mGlu2/3 receptor signalling was reduced in slices prepared from the somatosensory cortex of 6-month-old WAG/Rij rats, as assessed by the ability of the agonist, LY379268, to inhibit forskolin-stimulated cAMP formation. None of these changes was found in "pre-symptomatic" 2-month-old WAG/Rij rats. To examine whether pharmacological activation or inhibition of mGlu2/3 receptors affects absence seizures, we recorded spontaneous spike-wave discharges (SWDs) in 6-month-old WAG/Rij rats systemically injected with saline, the mGlu2/3 receptor agonist LY379268 (0.33 or 1 mg/kg, i.p.), or with the preferential mGlu2/3 receptor antagonist, LY341495 (0.33, 1 or 5 mg/kg, i.p.). Injection of 1 mg/kg of LY379268 (1 mg/kg, i.p.) increased the number of SWDs during 3-7 h post-treatment, whereas injection with LY341495 reduced the number of seizures in a dose-dependent manner. It can be concluded that mGlu2/3 receptors are involved in the generation of SWDs and that an upregulation of these receptors in the somatosensory cortex might be involved in the pathogenesis of absence epilepsy.

The aim of this study was to evaluate the frictional behaviour of 15 different archwires and 16 different brackets using small oscillating displacements when opposed to a standard stainless steel bracket or a standard stainless steel wire. Tests were run according to a pilot study at a frequency of 1 Hz and with a reciprocating tangential displacement of 200 microm, while the wire remained centred in the bracket slot under a load of 2 N. The results indicated a significant difference between the evaluated wires and brackets. The mean coefficient of friction (COF) of the wires varied from 0.16 for Imagination NiTi tooth-coloured wire to 0.69 for the True Chrome Resilient Purple wire, while for the brackets it ranged from 0.39 for Ultratrimm to 0.72 for the Master Series. The fact that in this study, a large number of different commercially available archwires and brackets were evaluated with the same apparatus according to the same protocol, allows a direct comparison of the different archwire and bracket combinations, and can assist in the choice of the optimal bracket-wire combination with regard to friction.

Objective: To determine the influence of ageing on lean muscle area and isometric and concentric and eccentric muscle strength in the upper and lower extremity in a cross-sectional study design. Subjects and methods: Lean muscle area and maximal muscle strength (isometric and isokinetic, 60degrees and 120degrees/s) of both upper and lower extremity were assessed of 45 men and 56 women (20 to 89 years). Results: One-way variance analysis and regression analyses revealed a parallel decline with age in both sexes for maximal muscle strength. The decline in maximal muscle strength from age 60 was 34 to 45% in men and 11 to 32% in women in the arms and 40 to 47% in men and 37 to 45% in women in the legs. Isometric, concentric and eccentric contractions showed a similar decline in ageing in both sexes. There was a better maintenance with age of the strength in the arms than in the legs (p < 0.01) and at 120degrees/s than at 60degrees/s (p < 0.05). Conclusions: The present findings suggest a parallel decline in lean muscle area and strength and similar losses in isometric, concentric and eccentric strength with increasing age.

The objective of the pilot study is to measure the changes in health-related quality of life (HRQOL, general and prostate specific) 3 months after the disease has been diagnosed in men with prostate cancer. The results are compared with benign prostate hyperplasia (BPH) patients. Also the influence of psychosocial factors (distress, coping and social support) on the experienced changes in health-related quality of life is studied for both patient groups. The sample consists of 61 patients who filled in the questionnaire before the diagnosis was know to them and after 3 months (38 benign prostate hyperplasia and 23 prostate cancer patients). The measures consist of: quality of life, micturation symptoms, sexual functioning, coping style, psychological distress, life events, social support, social desirability, and health behavior. The results show a decrease in quality of life for prostate cancer patient after three moments, while the quality of life measure for BPH patients are stable over time. For both patient groups, the psychosocial factors do not change after 3 months. The psychosocial factors contribute only marginal to the changes in quality of life. Conclusions are drawn concerning the need and the content of psychosocial support and education for prostate cancer patients.

An earlier study (Dols et al. 2000) suggested that cue-induced urge to smoke depends on the expectation of smoking. The present study tried to replicate the findings under stringently controlled conditions. DESIGN: A 2 (context) x 2 (cues) x 6 (trial) within-subject design. Each smoker entered two different contexts; one context predicted the future occurrence of smoking (i.e. one puff of a cigarette) and one context predicted the non-occurrence of smoking. In each context smokers were exposed to smoking cues (i.e. cigarettes and lighter) or not. SETTING: Laboratory at Maastricht University. PARTICIPANTS: Thirty-two daily smokers, smoking at least five cigarettes a day for at least 2 years. MEASUREMENTS: Participants reported their urge to smoke in each context in the presence and absence of smoking cues using a computerized visual analogue scale (VAS). FINDINGS: The results revealed that the urge to smoke was higher in a context in which smoking was expected relative to a context in which it was not expected. As in the previous study the urge-inducing effect of smoking cues was larger in the smoking context than in the non-smoking context. Moreover, smoking cues did not have a significant effect in the non-smoking context. CONCLUSIONS: It was shown that smoking cues elicit craving due mainly to a generated expectation of the occurrence of smoking and less due to salience or long history of associative learning. Theoretical and practical implications of the results are discussed.

Contains fulltext : 127510.pdf (Publisher’s version ) (Closed access) The involvement of neural motor and sensory systems in the processing of language has so far mainly been studied in native (L1) speakers. In an fMRI experiment, we investigated whether non-native (12) semantic representations are rich enough to allow for activation in motor and somatosensory brain areas. German learners of Dutch and a control group of Dutch native speakers made lexical decisions about visually presented Dutch motor and non-motor verbs. Region-of-interest (ROI) and whole-brain analyses indicated that 12 speakers, like L1 speakers, showed significantly increased activation for simple motor compared to non-motor verbs in motor and somatosensory regions. This effect was not restricted to Dutch-German cognate verbs, but was also present for non-cognate verbs. These results indicate that L2 semantic representations are rich enough for motor-related activations to develop in motor and somatosensory areas. 16 p.

The aim of this retrospective study was to determine the outcome of orthodontic treatment carried out on patients by postgraduate students at the Katholieke Universiteit Leuven, Belgium. The treatment outcome of 292 ’final examination’ patients and of 287 ’control’ patients was compared by means of the Peer Assessment Rating (PAR) index. The sample consisted of dental casts representing a wide range of malocclusions at the start of treatment and post-treatment. All patients received non-surgical treatment between 1987 and 1996 by one of 18 different postgraduate students. The data were analysed with a variant of the analysis of covariance. A significantly higher (P

OBJECTIVE: To compare the prevalence of "syndrome X"-related parameters in parents of type 1 diabetic patients with diabetic nephropathy (DNP) to those in parents of diabetic patients without DNP. RESEARCH DESIGN AND METHODS: In this cross-sectional study, we included 50 parents of type 1 diabetic patients with DNP and 50 parents of diabetic patients without DNP. All parents were investigated in a fasting state for serum lipids including nonesterified fatty acids (NEFAs), glucose, HbA1c, plasma uric acid, fasting insulin levels, and albuminuria. Blood pressure was recorded in the supine position using an automatic device; ankle/brachial index was measured with Doppler ultrasound. Presence of cardiovascular disease was determined by a standardized questionnaire and electrocardiogram registration. Subjects without known diabetes underwent a 2-h oral glucose tolerance test. Anthropometric parameters such as BMI, waist-to-hip ratio, and percentage of body fat were measured. In addition to univariate analysis, a syndrome X score (SXS) was formulated, comprising a number of syndrome X-related biochemical, physiological, and/or anthropometric parameters. RESULTS: Univariate analysis revealed no significant differences in syndrome X parameters between parents of type 1 diabetic patients with or without DNP. Also, the composite SXS was similar in both groups. CONCLUSIONS: In this study, no differences were found in the prevalence of syndrome X features between parents of type 1 diabetic patients with DNP and parents of patients without DNP.

One hundred skeletally mature healthy volunteers underwent standardized bilateral posteroanterior radiographs in unloaded (static) and loaded (dynamic) conditions to determine the symmetry of ulnar variance. The mean age was 32 +/- 9 years (range, 19-61 years), with 58 women and 42 men. Ulnar variance was measured to the closest 0.5 mm using the method of perpendiculars. Three separate measurements were made of each radiograph in a blinded fashion by the same investigator. An intraobserver standard deviation of 0.21 was used to calculate a 95% tolerance interval of 0.7 mm (rounded up to 1 mm) as a measure of significance. The average static ulnar variance was -0.13 +/- 1.5 mm on the left and -0.29 +/- 1.6 mm on the right. The average dynamic ulnar variance was 0.93 +/- 1.5 mm on the left and 0.82 +/- 1.5 mm on the right. When compared individually, there was a greater than or equal to 1 mm side to side difference in 37% of volunteers under static and 38% under dynamic conditions. There were no significant correlations between ulnar variance measurements and patient age, gender, race, or handedness. Use of the normal wrist radiograph as a baseline for static radial length measurements is valid in only 63% of cases.

Objectives: The adhesive capacity of 17 different bracket types was evaluated in an in vitro peel/shear test. Methods: Silane-treated metal bars were used as substrates with all bonding being performed using the orthodontic adhesive Concise. The effect of aluminium oxide air abrasion on the bonding performance of recycled metal bracket bases was evaluated. Morphological examination of the bracket bases was carried out under scanning electron microscopy. Statistics analysis included one-way ANOVA with Tukey's Studentized Range Test, two-way ANOVA and Weibull analysis. Results: Mean peel/shear bond strength values range from 13.9 MPa for Allure Accu Arch, a ceramic bracket type, to 1.6 MPa for the plastic bracket CeramaFlex Advant Edge. Allure Accu Arch performed the best of all the ceramic brackets. However, bracket wing fracture was observed. The metal brackets Mini masters and Omni Arch showed no significant difference in bond strength compared with the ceramic bracket Allure Accu Arch (P Conclusion: The type of the bracket base determines its adhesive capacity. Sandblasting the base of recycled metal brackets had no uniform effect.

The purpose of this study was to evaluate the in vitro peel/shear bond strength of a selection of orthodontic bracket adhesives to human premolar teeth.Twenty-two commercially available bracket adhesives were used to bond the same bracket type (Miniature Twin, 3M Unitek, Monrovia, CA. USA) on 264 intact human premolar teeth and then adhesively tested to failure. Peel/shear bond strength values were calculated in newtons and megapascals. The site of bond failure was scored according to the Adhesive Remnant Index. Statistics included one-way analysis of variance and Tukey's Studentized Range test together with Weibull analysis. The latter is a survival analysis able to describe the performance of a material.The mean bond strengths varied from 9.9 MPa for Concise to 4.1 MPa for Heliosit Orthodontic. The overall F-test showed a significant difference (P0.0001). No significant differences in bond strength were found between Concise, AccuBond, Imperva Dual, Transbond XT, Kurasper and Spectrum.Concise and AccuBond are among the materials of choice for bonding fixed orthodontic appliances to teeth. These materials combine high bond strength with a reliable bond that is easily and quickly debonded.