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There are various techniques used for tendon lengthening, of which Z-lengthening and sliding-lengthening are the most frequently performed. In patients with cerebral palsy, tendon lengthening may often be necessary at multiple sites. However, they can cause various complications, such as inaccurate extension, overextension, and a lack of tendon continuity. We modified the sliding-lengthening technique with a locking mechanism to address these issues. This technical note aims to describe the surgical technique and pitfalls associated with the modified sliding-lengthening approach and suture locking mechanism. The tendon was exposed and stabilized using sterilized spitz tubes and was then threaded so that each loop length was equivalent to the amount of tendon extension. Symmetrical hemisection of both ends of the tendon was performed, and the tendon was carefully extended to create a tense loop. The modified sliding-lengthening technique with the locking suture mechanism may be an advantageous method that accurately addresses extension volume, prevents hyperextension, and maintains tendon continuity, even when smaller incisions are used.

理学療法評価学では、1年間に3回の実技試験を実施し、学生の理学療法評価技術の習得レベルを確認している。実技試験は3名の担当教員が分担して実施するが、その準備および実施における教員の負担が大きくあった。そこで、新たな実技試験の運用方法を検討し、Microsoft Excelを使用した実技試験採点用アプリケーションを開発した。今回の報告では、アプリケーション開発の経緯と仕様、実際のアプリケーション使用のメリット、今後の課題や展望について報告する。

Objectives Salter osteotomy is widely used to improve acetabular coverage in the treatment of developmental dysplasia of the hip. Herein we describe angulated Salter osteotomy (ASO) as the modified Salter osteotomy, which creates a two-point contact between the proximal and distal fragments and better stabilizes the fixation of the fragments. We reported our results of ASO and compared it with that of Salter osteotomy performed previously by us. Methods We retrospectively reviewed 41 unilateral hips that underwent ASO, with no other accompanying procedures, between 2012 and 2018. We investigated the radiographic measurements included the preoperative values of the acetabular index and center-edge angle (CEA), immediate postoperative values of distance d (lateral displacement of the distal fragment), lateral rotation angle (LRA), the ratio of the obturator height (ROH), pelvic height increase percentage (PHIP) and the values of acetabular index and CEA during the last follow-up. Measurements were compared with 20 unilateral hips that underwent Salter osteotomy. Results The mean age at the time of surgery was 5.4 years, and the mean follow-up duration was 3.3 years. Immediately after surgery, the mean distance d, LRA, ROH and PHIP were 8 mm, 19°, 70 and 1%, respectively. The last follow-up values of acetabular index and CEA significantly improved from the preoperative values by 18° and 21°, respectively. Patients treated with ASO showed significantly larger distance d, more improvement in CEA, and lesser PHIP than those treated with Salter osteotomy. Conclusions The short-term outcomes of ASO are favorable. ASO was as effective as or better than Salter osteotomy in pulling out and stabilizing the distal fragment anterolaterally. ASO prevents elongation of the ilium, which causes pelvic obliquity.

Whether femoral varus derotational osteotomy (VDRO) alone or a combination of femoral and pelvic osteotomies should be performed for hip dislocation in nonambulatory children with cerebral palsy (CP) remains controversial. Few studies have reported radiographical results after the surgical treatment in nonambulatory children with CP. This study aimed to assess the results and determine predictors indicating progressive hip subluxation and redislocation after VDRO without pelvic osteotomy. We retrospectively analyzed 22 hips in 15 nonambulatory children with CP. All patients underwent VDRO without pelvic osteotomy and were followed up for at least 5 years. The mean follow-up period was 7.3 ± 1.9 years. In radiological assessments, we investigated migration percentage (MP), center-edge angle, neck-shaft angle, teardrop distance, break in Shenton's line (SL), sharp's angle, acetabular ridge angle (ARA), and the change ratio of MP (Change MP). We classified patients with an MP of

Background There are many reports of Achilles tendon lengthening procedures for equinus deformity of the ankle. We previously modified an Achilles tendon lengthening to prevent overextension with a locking mechanism suture before performing a sliding lengthening. The purpose of this study was to compare the biomechanical properties of the locking mechanism suture with sliding lengthening (L-SL) and Z-lengthening (ZL) using a rabbit model. Methods Thirty-six male Japanese white rabbits were assigned to two groups - half undergoing the L-SL technique and half undergoing the ZL technique on the flexor hallucis longus (FHL) tendon. Six rabbits in each group were sacrificed at one week, three weeks, and six weeks postoperatively and evaluated, while five rabbits underwent radiographical and biomechanical evaluation and one underwent histological evaluation. Results In extension length, L-SL was significantly lower than ZL one week postoperatively. In the L-SL group, elongation one week postoperatively was significantly lower than that three and six weeks postoperatively. In the ultimate failure load, L-SL was significantly higher than ZL one and three weeks after lengthening. In the L-SL group, the ultimate failure load one week postoperatively was significantly lower than that three and six weeks postoperatively. In the ZL group, there were significant differences at all time points. Conclusion L-SL had higher mechanical property in vivo.

In this report, we introduced poly(n-vinylpyridine) (PnVP, n = 2, 4) as an electron-donating stabilizer for small (

We show that the Hilbert series of the projective variety X = P(Omin), corresponding to the minimal nilpotent orbit Omin, is universal in the sense of Vogel: it is written uniformly for all simple Lie algebras in terms of Vogel’s parameters α, β, γ and represents a special case of the generalized hypergeometric function 4F3. A universal formula for the degree of X is then deduced.

We propose an efficient approach to optimize the number of necessary SWAP gates when we perform a quantum circuit on IBM Q system. Our idea is to change the order of quantum gates (if possible) so that each sub-circuit has only gates performing on adjacent qubits. For each sub-circuit, we utilize a SAT solver to find the best qubit placement such that the subcircuit has only gates on adjacent qubits. Each sub-circuit may have a different qubit placement such that we do not need SWAP gates for the sub-circuit. Thus, we insert SWAP gates between two sub-circuits to change the qubit placement which is desirable for the following sub-circuit. To reduce the number of such SWAP gates between two sub-circuits, we utilize A∗ algorithm.

Social communication uses verbal and nonverbal language. We examined the degree of trust and brain activity when verbal and facial expressions are incongruent. Fourteen healthy volunteers viewed photographs of 8 people with pleasant (smile) or unpleasant expressions (disgust) alone or combined with a verbal [positive/negative] expression. As an index for degree of trust, subjects were asked to offer a donation when told that the person in the photograph was troubled financially. Positive emotions and degree of trust were evaluated using the Visual Analogue Scale (VAS). Event-related potentials (ERPs) were obtained at 170–240 ms after viewing the photographs. Brain activity during incongruent conditions was localized using standardized Low Resolution Brain Electromagnetic Tomography (sLORETA). VAS scores for positive × smile condition were significantly higher than those for the other conditions (p<0.05). The donation offered was significantly lower for incongruence between verbal and facial expressions, particularly for negative × smile condition. EEG showed more activity in the parietal lobe with incongruent than with congruent conditions. Incongruence [negative × smile] elicited the least positive emotion, degree of trust, and amount of offer. Our results indicate that incongruent sensory information increased activity in the parietal lobe, which may be a basis of mentalizing.

BACKGROUND: Studies suggest that the observation of others’ actions leads to enhanced motor skill learning. OBJECTIVE: We examined whether others’ or self-action observation is effective for standing balance learning. In addition, we examined cortical activation during action observation using functional near-infrared spectroscopy. METHODS: Thirty-nine healthy young subjects were assigned randomly to the Control, Other-Observation (O-O), and SelfObservation (S-O) groups. The subjects learned to stand on a tilting platform while maintaining a horizontal position. The Control group alternated each trial with a rest period. The O-O and S-O groups were provided with information related to their performance during the rest period: the O-O group observed another person, while the S-O group observed their previous performance. Cortical activation was assessed by changes of hemoglobin oxygenation (oxyHb). RESULTS: A 2-way analysis of variance with repeated measures on balance performance revealed a significant difference in post-training (p < 0.05) and retention (p < 0.01) only in the S-O group. And an increase of oxyHb levels at post-training in the S-O group was observed in the supplementary motor area. CONCLUSION: Self-action observation improved standing balance and brain activity during training and at 24 h after training.

Effects of tensile prestress level on Charpy impact value (auc) of 50vol% continuous unidirectional 0 degree oriented carbon fiber reinforced epoxy polymer (CFRP) were investigated. Experimental results showed the auc at mid-fracture probability Pf = 0.50 induced by a large prestress of 17.6MPa (109kJm ¹2 ) was increased 30% over that (84kJm ¹2 ) of slight prestress of 0.25MPa. The statistically lowest impact value as at Pf = 0 calculated by 3-parameter Weibull equation was raised 26% from 73 to 92kJm ¹2 showing increased reliability of part strength. Fracture surface observation showed a flat surface extending through the thickness from the impact side generally extends deeper as prestress level was raised. This may be due to the transition depth in the specimen thickness from compression to tension is deeper during impact as prestress level was increased acting to raise the impact values. [doi:10.2320/matertrans.M2013278]

In this article, we describe the trace formulae of composition of several (up to four) adjoint actions of elements of the Lie algebra of a vertex operator algebra by using the Casimir elements. As an application, we give constraints on the central charge and the dimension of the Lie algebra for vertex operator algebras of class $\mathcal{S}^4$. In addition, we classify vertex operator algebras of class $\mathcal{S}^4$ with minimal conformal weight one under some assumptions., 17 pages

ofolate. the methyl donor for methylation of Hcy to methionine. is the most frequent genetic cause of elevated Hcy concentration [3]. An identified C to T substitution at 677 in the MTHFR gene [C677T/MTHFR (A222V)] relatively increases Hcy concentration in subjects with the TT genotype. In this present study. we aim to evaluate the effects of nutritional and genetic factors on plasma Hcy concentration among neonatal girls and their mothers in Japan. Prior to this study ， ethical approval was obtained from a special committee at Nagasaki University (project registration number 100614189). Bl ood samples were obtained the day after delivery from 200 healthy mothers with uncomplicated pregnancies at Nagasaki University Hospital and four clinics/hospital s

Objective: To investigate the feasibility of peripheral sensory nerve stimulation combined with task-oriented training in patients with stroke during inpatient rehabilitation. Design: A pilot randomized crossover trial. Setting: Two rehabilitation hospitals. Subjects: Twenty-two patients with subacute stroke. Interventions: Participants were randomly assigned to two groups and underwent two weeks of training in addition to conventional inpatient rehabilitation. The immediate group underwent peripheral sensory nerve stimulation combined with task-oriented training in the first week, followed by another week with task-oriented training alone. The delayed group underwent the same training in reverse order. Main measures: Outcome measures were the level of fatigue and Wolf Motor Function Test. Patients were assessed at baseline, one and two weeks. Results: All participants completed the study with no adverse events. There was no significant difference in level of fatigue between each treatment. From baseline to one week, the immediate group showed larger improvements than the delayed groups in the Wolf Motor Function Test (decrease in mean time (± SD) from 41.9 ± 16.2 seconds to 30.6 ± 11.4 seconds versus from 46.8 ± 19.4 seconds to 42.9 ± 14.7 seconds, respectively) but the difference did not reach significance after Bonferroni correction ( P = 0.041). Within-group comparison showed significant improvements in the Wolf Motor Function Test mean time after the peripheral sensory nerve stimulation combined with task-oriented training periods in each group ( P < 0.01). Conclusion: Peripheral sensory nerve stimulation is feasible in clinical settings and may enhance the effects of task-oriented training in patients with subacute stroke.

Pain is a multidimensional experience with sensory-discriminative, cognitive-evaluative and affective-motivational components. Emotional factors such as unpleasantness or anxiety are known to have influence on pain in humans. The aim of this single-blinded, cross over study was to evaluate the effects of transcranial direct current stimulation (tDCS) on emotional aspects of pain in pain alleviation. Fifteen subjects (5 females, 10 males) volunteered to participate in this study. In an oddball paradigm, three categories of 20 pictures (unpleasant, neutral, and pleasant) served as rare target pictures from the International Affective Picture System (IAPS). The power of the delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), beta (12–25 Hz), and gamma (30–40 Hz) frequency bands in the three categories were measured using electroencephalography during an oddball paradigm at pre- and post-anodal or sham tDCS above the left dorsolateral prefrontal cortex (DLPFC). Results showed that the beta band power was significantly increased, and the alpha band power was significantly decreased during unpleasant pictures after anodal tDCS compared with sham tDCS. Furthermore, regarding unpleasant pictures, subjective reports of Self Assessment Manikin (SAM) for emotional valence after anodal tDCS showed a significant decrease of unpleasantness. Therefore, emotional aspects of pain may be effectively alleviated by tDCS of the left DLPFC as was shown not only by subjective evaluation, but also by objective observation of cerebral neural activity. This processing may be mediated by facilitation of the descending pain inhibitory system through enhancing neural activity of the left DLPFC.

Objective: To determine whether plantar perception training using a hardness discrimination task efficiently improves stabilization of standing posture balance in the old old as well as the very old.Design: A randomized two-group parallel controlled trial.Setting: Nursing homes.Participants: Forty-six elderly persons 75 years of age or older living in nursing facilities were randomly assigned evenly to either an intervention or a control group.Intervention: The intervention group was given a task to discriminate hardness differences while standing on foam rubber of different levels of hardness, while the control group was given the task to simply remain standing on foam rubber. The tasks were imposed for 10 successive days.Outcome measures: Outcome assessment was made by determinations of centre-of-gravity sway in the standing position and the Functional Reach Test.Results: Planter perception was significantly improved and centre-of-gravity sway in the standing position was also significantly reduced in the intervention group after the intervention. In the control group, however, there were no significant changes in perception or in sway ( P Conclusion: These results suggested that plantar perception exercises might efficiently stabilize standing postural balance in the old old as well as the very old.

〔目的〕在宅脳卒中患者に対する運動介入および栄養指導が動脈硬化指数および運動機能に及ぼす影響を調査した。〔対象〕地域在住の脳卒中患者16名。〔方法〕運動は2時間のプログラムを週2回，3ヶ月間実施し，栄養指導は管理栄養士による定期的な食事調査と栄養指導が行われた。評価項目は心臓足関節血管指数（Cardio Ankle Vascular Index: CAVI），足関節上腕血圧比（Ankle Brachial Index: ABI），歩行速度，握力，Functional reach test（FRT），Timed Up and Go test（TUG），30秒立ち上がりテストとした。〔結果〕麻痺側のCAVI値は介入前に比較して有意に低下した。運動機能面ではFRTおよびTUGのみに有意な改善が認められた。〔結語〕今回の結果から運動介入と栄養指導による学際的介入が運動機能面および動脈機能の面からも有効であることが示唆された。

Crystalline CeO2 films and patterns have been successfully fabricated in a “single-step process” at moderate temperature. In this process, the combination of the ink-jet technique and depositing the precursor on a hot substrate (≤300°C) gave crystalline CeO2 without further heat treatment. X-ray diffraction analysis revealed that the phase formed was crystallized ceria with nanosized (

In order to strengthen carbon fiber reinforced polymer (CFRP), effects of a pre-stressing on Charpy impact value have been investigated. The pre-stressing remarkably enhances the impact value. It probably depends on the residual compressive stress induced by the pre-stressing in CFRP.

Hiroshi Maeoka, Makoto Hiyamizu, Atsushi Matsuo, Shu MoriokaDepartment of Physical Therapy, Faculty of Health Science, Kio University, Koryo-cho, Kitakatsuragi-gun, Nara, Japan Purpose: Pain is a multidimensional experience with sensory-discriminative, cognitive-evaluative, and affective-motivational components. Emotional factors, such as unpleasantness or anxiety, are known to have influence on pain in humans. Repeated painful stimulation has been reported to reduce subjective pain intensity. Nevertheless, there is little evidence of the influence of such stimulation on the emotional factors of pain. The aim of this study was to evaluate the influence of repeated painful stimulation on the experience of unpleasantness and anxiety. Materials and methods: Eight subjects (six females, two males) volunteered to participate in this study. Subjects received repeated painful stimulation for 3 consecutive days each instance lasting 6 seconds, 60 times per day, on the medial side of the forearm of the nondominant hand. We examined the following items to evaluate changes of responses to painful stimulation: pain thresholds, pain tolerance levels, pain intensities, unpleasantness, and anxiety. Furthermore, pain thresholds and pain tolerance levels were compared between different sites on the ipsilateral and contralateral forearms. Results: No immediate or chronological changes in pain thresholds or pain tolerance levels were observed. Pain intensities were reduced significantly over the 3-day experimental period (P

Solution processing based on Ink-jet and spray technologies is one of low cost on-site ceramic patterns/films fabrication methods at moderate temperatures from precursor solutions. In the present study, we have used ink-jet and spray technologies to fabricate ceramic films of titania directly on glass substrates at 300–400∘C. The precursor solution was prepared by dissolving Titanium tetraisopropoxide in appropriate solvents (water/ethanol and acetylacetone). A cleaned glass substrate was kept on a hot plate and heated it up to a predetermined temperature. Droplets of the precursor solution produced through a spray gun were traveled towards heated substrate with a atmospheric pressure. When the droplets hit on the heated substrate, precursor started to decompose, nucleate and grow into the TiO2 film. The anatase pattern was directly obtained by ink-jet method at moderate temperatures.

The aim of this study was to examine patients with post-stroke hemiplegia for space estimation disorder during visual reaching for a target. Six patients with post-stroke hemiplegia with no parietal damage were studied, as well as 6 healthy older adults and 6 healthy younger adults as a control group. A target was placed on the table in front of the subject, and then the subject was asked to verbally indicate the farthest reachable point while the target was gradually being moved further away from the subject. The difference was then obtained by measuring the distance from the subject to the indicated point. There was no significant difference in the errors between the estimated and actual values in the healthy older and younger adults. No significant difference was also observed between dominant and non-dominant hands. There were significant differences between the paretic and non-paretic side in the hemiplegic patients, as well as between the paretic side of hemiplegic patients and the dominant hand in the healthy older adults. Compared with healthy subjects, the hemiplegic patients showed a greater difference between the estimated and actual values for both the non-paretic and paretic sides, which indicates an estimation disorder during visual reaching in patients with post-stroke hemiplegia. These results are discussed based on a conversion of the visual coordinates into movement coordinates during visual reaching.

非利き手での書字課題に対する鏡治療の影響を評価した。健常成人10名を対象とし，鏡治療前後での非利き手での実際の課題実行時間と心的イメージ時間を測定した。非利き手で“理学療法”の4文字を実際に書字し，またそれを心的イメージすることを課題とした。鏡治療にはミラーボックスを作成し，利き手の鏡映像のみが視覚入力され，それを見ながら書字練習を10分間実施した。実際の課題実行時間は，鏡治療後に有意に減少した（p=0.003）。また心的イメージ時間でも，鏡治療後に有意な減少を示した（p=0.003）。本結果から，実際の運動反復練習を実施することなしに，明確な運動イメージを形成させることのみでも，パフォーマンス時間の変化が期待できる可能性が示唆された。