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Blurred work–home boundaries can hamper teleworkers’ recovery from job demands. In this study, we investigate teleworkers’ temporal, physical, communicative, and technological boundary tactics as predictors of recovery experiences (i.e. psychological detachment and control during leisure time) and recovery outcomes (i.e. exhaustion). We hypothesized that individuals’ work–home segmentation preference as a personal factor and availability demands as a situational factor should moderate the relations between boundary tactics and recovery. Using a web-based survey, we collected data from 274 individuals who mainly worked from home in a lockdown period during the COVID-19 pandemic. Results of hierarchical regression analyses revealed that the use of temporal boundary tactics was positively associated with psychological detachment, control, and lower exhaustion. The use of technological boundary tactics was related to higher psychological detachment. Our moderator hypotheses were partly confirmed: Segmentation preference and availability demands strengthened the relationships between several boundary tactics and psychological detachment, control, and exhaustion. In sum, our study contributes to a better understanding of teleworkers’ recovery processes and provides actionable knowledge for teleworkers on how to enable and sustain their recovery.

Many employees think about their work during off-job time. Scholars have suggested that whether work-related thoughts during off-job time have detrimental or beneficial effects on employees’ well-being and performance depends on the nature of these thoughts. In this study with dual-earner couples we examined whether employees’ positive and negative work reflection during off-job time are associated with their own and with their partners’ work engagement and exhaustion. Furthermore, we investigated whether (a) living with children and (b) being work-linked (i.e. working in the same organisation and/or working in the same profession) moderated these relations. Both partners of 130 German heterosexual dual-earner couples responded to online questionnaires. We estimated multilevel analyses using the actor–partner interdependence model to analyse our dyadic data. We found positive associations between employees’ positive work reflection and both their own and their partners’ work engagement. Employees’ positive work reflection was also associated with their decreased exhaustion. Employees’ negative work reflection was negatively associated with their own work engagement and positively associated with their own exhaustion but unrelated to their partners’ outcomes. Moderator analyses revealed that living with children weakened the link between employees’ positive work reflection and their own work engagement and strengthened the link between their negative work reflection and exhaustion. The presence of couples’ work-linkage did not moderate any of these relations. This study builds on previous research by showing that employees’ positive work-related thinking is not only beneficial to themselves but also to their partners. Furthermore, the results suggest that living with children constitutes an additional demand that reduces the motivational effects of positive work reflection and amplifies the detrimental effects of employees’ negative work reflection.

Abstract. This diary study investigated nurses’ recovery after transitioning to morning shift work (i.e., their short-term adaptation to shift work) by examining the change trajectory of sleep quality over the course of five consecutive morning shifts. Results of latent growth analyses ( N = 132) showed that nurses’ sleep quality started at low levels and increased rapidly in the beginning until it stabilized toward the end of the shift work period. Moreover, work-related rumination moderated the sleep quality trajectory. When rumination was low, nurses’ sleep quality showed a quadratic trajectory, whereas when rumination was high, sleep quality showed a flatter and linear trajectory, suggesting that rumination impedes recovery after the transition and adaptation to morning shift work.

Although previous research on mindfulness predominantly focused on benefits of mindfulness, this study investigates quantitative and emotional demands as contextual antecedents of mindful awareness and acceptance both in the work and home domains. In addition, we examine goal attainment and satisfaction in the work and home domains as consequences of mindful awareness and acceptance. Results of a diary study across 5 workdays with 2 daily measurement occasions among 233 employees revealed that both in the work and home domains, quantitative demands were positively associated with awareness, but not with acceptance, whereas emotional demands were positively associated with acceptance, but not with awareness. Awareness and acceptance were both associated with increased goal attainment and satisfaction in both life domains. We did not find strong evidence for cross-domain relations between demands and mindfulness on the one hand and between mindfulness and goal attainment and satisfaction on the other hand. In sum, this study contributes to a more comprehensive understanding of mindfulness by shedding light on contextualized forms of mindfulness and considering both the awareness and acceptance facets of mindfulness and their contextual predictors and consequences. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

While previous research has indicated that segmenting work and home is beneficial to employees’ recovery, this study, which includes 130 dual-earner couples, investigates if and when integrating work and home by receiving work-related support from one’s partner fosters employees’ recovery experiences (i.e., psychological detachment, relaxation, mastery). Moreover, we examine couples’ work-linkage (i.e., both partners working in the same organization and/or the same occupation) as a moderator. Additionally, we consider the consequences of offering work-related support for the supporting partner’s recovery experiences. We used the actor-partner interdependence model to account for the dependent structure of dyadic data. Results of multiple group analyses comparing work-linked with non-work-linked couples showed that receiving work-related support from a partner was associated with increased relaxation and mastery experiences, at least among work-linked couples. Work-related support was not associated with employees’ detachment. Providing work-related support was positively related to employees’ mastery experiences in non-work-linked couples only, whereas it was unrelated to psychological detachment and relaxation both in couples with and without work-linkage. Drawing on conservation of resources theory and on boundary theory, the findings of this study shed light on work-related spousal support as an enabler of recovery experiences in work-linked couples, extending the limited view that segmenting work and home is the only beneficial approach for recovery during leisure time.

This study aims at resolving the inconsistent findings regarding the effects of time pressure on work engagement and personal resources by considering time pressure’s qualitative sources. Specifically, using the notion of statistical suppression, we argue that qualitative challenge and hindrance demands operate as suppressor variables and thus determine whether time pressure itself exerts a challenging or hindering potential. To test our assumptions, we conducted a daily diary study over the course of one workweek in a sample of 396 employees. We tested our hypotheses at the day-level. Results of multilevel structural equation modeling revealed that when controlling for qualitative challenge demands, time pressure positively related to exhaustion, but negatively related to work engagement and self-esteem. Suppression was significant. In contrast, when controlling for qualitative hindrance demands, time pressure was unrelated to work engagement, negatively related to self-esteem, and positively related to exhaustion, whereby qualitative hindrance demands did not act as a suppressor variable at the day-level. Additional analyses revealed that qualitative challenge and hindrance demands operated as suppressor variables at the person-level. In summary, when qualitative challenge demands were controlled for, time pressure operated as a hindrance demand. Yet, when qualitative hindrance demands were controlled for, time pressure operated as a challenge demand at the person-level. Our findings outline the need to account for the quality of work when assessing time pressure’s effects and further highlight the relevance of suppressor variables within the field of occupational health psychology.

This study investigated interindividual differences in employees' trajectory of sleep quality over a 5-day workweek. We hypothesized that sleep quality is entrained to the rhythm of the workweek showing a linear increase from Monday to Friday. Moreover, we proposed that employees' chronic job demands (time pressure and social stress) and their negative work reflection on Sunday night moderated the sleep quality trajectory. In this study, 132 employees completed a baseline questionnaire assessing chronic job demands and age, and daily morning surveys from Monday to Friday assessing sleep quality and negative work reflection on Sunday. On average, sleep quality did not significantly change from Monday to Friday. However, negative work reflection moderated the sleep quality trajectory: When negative work reflection was high, the start level of sleep quality on Monday was lower and sleep quality displayed a linear increase over the workweek. When negative work reflection was low, employees' sleep quality remained stable throughout the week. Chronic social stress, but not time pressure, indirectly affected employees' sleep quality trajectory via negative work reflection on Sunday. Further, results revealed age differences in the effects of social stress on employees' sleep quality trajectory: The start level of sleep quality was lower and its increase over the workweek was stronger for older employees high on social stress. This study contributes to research on the dynamics of employee sleep and extends findings on age-differential effects of workplace characteristics. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Psychological detachment from work during off-job time is crucial to sustaining employee health and well-being. However, this can be difficult to achieve, particularly when job stress is high and recovery is most needed. Boosting detachment from work is therefore of interest to many employees and organizations, and over the last decade numerous interventions have been developed and evaluated. The aim of this meta-analysis was to review and statistically synthesize the state of research on interventions designed to improve detachment both at work and outside of it. After a systematic search (covering the period 1998-2020) of the published and unpublished literature, 30 studies with 34 interventions (N = 3,725) were included. Data were analyzed using a random-effects model. Interventions showed a significant positive effect on detachment from work (d = 0.36) on average. Moderator analyses revealed that it did not matter how the different studies conceptualized detachment but that the context in which detachment was measured (outside or at work) significantly influenced intervention effectiveness. Furthermore, using the stressor-detachment model as the organizing framework, we found that while interventions addressing job stressors or altering primary and secondary appraisal were all effective, only the interventions that addressed primary appraisal were more effective than those that did not. Additionally, while the delivery format did not moderate intervention effectiveness, interventions with longer durations and higher dosages were more effective than shorter and lower dosage interventions. Finally, interventions were more effective among older participants and participants with initial health or recovery-related impairments. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

This day-level study examined the role of perceived organizational support (POS) in the context of employees’ negative work reflection during off-job time. We hypothesized that negative work reflec...

Blurred work–home boundaries can hamper teleworkers’ recovery from job demands. We investigate teleworkers’ temporal, physical, communicative, and technological boundary tactics as predictors of re...

The actions that individuals take to proactively craft their jobs are important to help create more meaningful and personally enriching work experiences. But do these proactive behaviors have implications beyond working life? Inspired by the suggestion that individuals aim for a meaningful life we examine whether on days when individuals craft their jobs, they are more likely to craft non-work activities. It also seems likely that characteristics of the home environment moderate these cross-domain relationships. We suggest that crafting crosses domains particularly when individuals gain resources through high autonomy and high workload at home. We partly supported our model through a daily diary study, in which 139 service sector employees from six European countries (Belgium, Denmark, Germany, Netherlands, Spain, UK) reported their experiences twice a day for five consecutive workdays. Home autonomy and home workload strengthened the positive relationship between seeking resources at work and at home. Moreover, home autonomy strengthened the positive association between seeking challenges at work and at home, and the negative relation between reducing demands at work and at home. These findings suggest that the beneficial implications of job crafting transcend life boundaries thereby providing advice for how individuals can experience greater meaning in their lives.

Building on the pioneering work of Kreiner, Hollensbe and Sheep (2009) this study examines five specific boundary management tactics: a) Setting nonwork times and b) banking work times as two tempo...

Self-determination theory suggests that satisfaction of an individual's basic psychological needs (for competence, autonomy, and relatedness) is a key for well-being. This has gained empirical support in multiple life domains, but little is known about the way that need satisfaction interacts between work and home. Drawing from ideas of work–home compensation, we expect that the benefits of need satisfaction in the home domain are reduced when needs are satisfied in the work domain. We tested this hypothesis with a daily diary study involving 91 workers. Results showed that individuals particularly benefit from satisfaction of their need for competence in the home domain when it is not satisfied during the working day. No such interactions were found between the needs for autonomy or relatedness. Our study highlights that the interaction of need satisfaction across domains represents a boundary condition for the beneficial effects of need satisfaction.Practitioner points* The study examines the interplay between daily need satisfaction at work and at home and its relation to employee well-being at bedtime.* Employees particularly benefit from competence need satisfaction at home (e.g., doing a hobby which challenges them) on days when they do not get a sense of competence from their job (e.g., if the tasks are not particularly challenging, or they are underperforming).

Nitrogen oxide (NOx) pollution is emerging as a primary environmental concern across Europe. While some large European metropolitan areas are already in breach of EU safety limits for NO2, this phenomenon does not seem to be only restricted to large industrialized areas anymore. Many smaller scale populated agglomerations including their surrounding rural areas are seeing frequent NO2 concentration violations. The question of a quantitative understanding of different NOx emission sources is therefore of immanent relevance for climate and air chemistry models as well as air pollution management and health. Here we report simultaneous eddy covariance flux measurements of NOx, CO2, CO and non methane volatile organic compound tracers in a city that might be considered representative for Central Europe and the greater Alpine region. Our data show that NOx fluxes are largely at variance with modelled emission projections, suggesting an appreciable underestimation of the traffic related atmospheric NOx input in Europe, comparable to the weekend-weekday effect, which locally changes ozone production rates by 40%.

Despite growing recovery research, little is known about couple-dyadic processes of recovery from work. Given that dual-earner couples experience most of their recovery opportunities during nonwork times when they are together, partners in a couple relationship may substantially affect recovery and work engagement. In this study, we propose a couple-dyadic model in which weekend partner recovery support (reported by the recipient partner) is positively related to the recipient partner's state of recovery after the weekend which, in turn, increases the recipient's work engagement the following week (actor-actor mediation effect). We also test the effect of one's state of recovery on the partner's subsequent work engagement (partner effect). Additionally, work-linked relationship status is tested as a moderator of the partner effect. Actor-partner interdependence mediation modeling is used to analyze the data from 167 dual-earner couples who answered surveys on 4 measurement occasions. The results support the indirect effect of partner recovery support on work engagement through the postweekend state of recovery. Multigroup analysis results reveal that the partner effect of state of recovery on work engagement is significant for work-linked couples only and is absent for non-work-linked couples. Theoretical and practical implications, limitations, and future research directions are discussed. (PsycINFO Database Record

BACKGROUND Hospital costs are expected to correlate with clinical complexity. Do costs for congenital heart surgery correlate with Aristotle complexity scores? METHODS 442 inpatient stays in 2008 were evaluated. Aristotle scores and levels were determined. Costs were estimated according to the German Institute for Hospital Reimbursement system. Pearson and Spearman R correlation coefficients and corresponding goodness-of-fit regression coefficients R2 were calculated. RESULTS Mean basic and comprehensive Aristotle scores were 7.60 +/- 2.74 and 9.23 +/- 2.94 points, respectively. Mean expenses per hospital stay amounted to 29,369 +/- 30,823 Euros. Aristotle basic and comprehensive scores and levels were positively correlated with hospital costs. With a Spearman R of 1 and related R2 of 0.9436, scores of the 6 Aristotle comprehensive levels correlated best. Mean hospital reimbursement was 26,412 +/- 17,962 Euros. Compensation was higher than expenses for patients in comprehensive levels 1 to 3, but much lower for those in levels 4 to 6. CONCLUSIONS Aristotle comprehensive complexity scores were highly correlated with hospital costs. The Aristotle score could be used as a scale to establish the correct reimbursement after congenital heart surgery.

BACKGROUND Stage I palliation of hypoplastic left heart syndrome (HLHS) and its variants is usually performed by a Norwood operation. The management of pulmonary blood flow during this procedure remains controversial. The RV-to-PA conduit (RVPAC) has been proposed as the better alternative compared to a systemic-to-pulmonary shunt (SPS). METHODS A retrospective single center chart review of consecutive patients who underwent a Norwood I procedure between 01/1997 and 09/2006 was performed. All patients were operated in deep hypothermia, with or without circulatory arrest, using different shunt modifications according to surgeon's preference. Patients were divided into two groups depending on surgical management for pulmonary blood flow (modified BT shunt [BT] and non-valved RVPAC [Sano]). RESULTS Fifty-four patients were included in the study (BT: 31 patients vs. Sano: 23 patients). Diastolic blood pressure during the first 24 hours postoperatively was significantly lower in the BT group (BT: 38.6 +/- 6.9 mmHg vs. Sano: 42.4 +/- 7.2 mmHg; P < 0.01) with a trend towards a higher systolic blood pressure (BT: 74.1 +/- 13.5 mmHg vs. Sano: 69.8 +/- 12.1 mmHg; P = 0.08). Mean circulatory arrest time in the BT group was significantly longer compared to the Sano patients (BT: 41 +/- 21 min vs. Sano: 25 +/- 23 min; P < 0.01). The mean hospital stay was 18.5 days for BT patients and 20 days for Sano patients ( P = 0.45). Early mortality for the total cohort was 14.8 % (n = 8) (BT 19.4 % [n = 6] vs. Sano 8.7 % [n = 2]; P = 0.12). There was no significant difference in inter-stage mortality between the two groups (BT: 18.2 % vs. Sano: 21.1 %; P = 0.47). CONCLUSION The results for both established surgical methods (BT and Sano) for the palliation of HLHS and its variants have improved over time and are reaching acceptable early mortality rates. There was a trend towards a favorable early outcome for Sano patients, which did not reach statistical significance in this study due to the low patient numbers.

The aim of this study was to analyze the midterm results following the Ross-Konno procedure in children. Between 1999 and 2008, 29 patients with complex left ventricular outflow tract obstruction underwent the Ross-Konno procedure. There were 12 (41%) infants (group A) and 17 (59%) older patients (group B). The median age at operation was 3.3 years (range, 6 days to 16 years). At 7 years of follow-up, survival was 96% (1 late death), with no differences between groups A and B. Freedom from aortic regurgitation ≥ mild was 81%, with no differences between groups A and B. No residual gradient was noted in the left ventricular outflow tract in either group. Freedom from mitral regurgitation ≥ mild was 100% in group B and 41% in group A ( P = .0029). The mitral regurgitation was associated with morphological abnormalities of the mitral valve and with development of endocardial fibroelastosis after failed intervention during the newborn period. Freedom from reoperation was 73% in group B and 24% in group A ( P = .0093). All patients are now in sinus rhythm, and 43% are without medication. With the technical aspects of this procedure well accomplished, mortality is low, and the functional outcome is encouraging. At midterm follow-up, there was no residual or recurrent outflow tract obstruction and an excellent function of the neoaortic valve. The higher incidence of mitral regurgitation in infants, which was associated with morphological abnormalities of mitral valve and development of endocardial fibroelastosis, is worrisome.

Oncogenic Potential of Inhaled Hydrazine in the Nose of Rats and Hamsters after 1 or 10 1-hr Exposures. Latendresse, J. R., Marit, G. B., Vernot, E. H., Haun, C. C., and Flemming, C. D. (1995). Fundam. Appl. Toxicol. 27, 33-48. Hydrazine (N2H4) is used as a fuel for missiles and standby power systems of operational military aircraft. Maintenance of missiles and aircraft may result in accidental human exposure to high concentrations for brief periods of time. The purposes of this study were to assess the oncogenic potential of N2H4 in rats and male hamsters exposed to a high concentration of N2H4 for repeated short exposures and to investigate the relationships of acute and subchronic effects of N2H4 to nasal tumorigenesis. In Phase 1 (acute and subchronic) and Phase 2 (lifetime) experiments, groups of male and female Fischer 344 rats and male Syrian golden hamsters were exposed by inhalation to 0, 75 (Phase 2 only), or 750 ppm N2H4 for 1 (acute) or 10 (subchronic) 1-hr weekly exposures. Rodents were euthanized 24 hr after exposures 1 and 10 and 24 to 30 months poststudy initiation. Significant reductions in body weight were observed in N2H4-treated rodents compared to controls during the exposure interval. No hydrazine-induced mortality was detected. Histopathologic examination after the acute and subchronic exposures revealed degeneration and necrosis of transitional, respiratory, and olfactory epithelia in the anterior nose and, in rats exposed subchronically, squamous metaplasia of the transitional epithelium. Minimal to mild rhinitis resulted from N2H4 exposures. Apoptosis was observed in olfactory and squamous metaplastic transitional epithelium. Lesions occurred at sites reportedly having high air-flow and generally appeared to be more severe in the anterior portion of the nose. By 24 months, the squamous metaplastic transitional epithelium reverted back to normal-appearing transitional epithelium. By 24+ months, low incidences (sexes combined) of hyperplasia ( 5 194 , 2.6%) and neoplasia ( 11 194 , 5.7%) were detected, principally in the transitional epithelium of the 750 ppm N2H4-treated rats. A similar incidence of hyperplasia ( 2 94 , 2%) and neoplasia ( 5 94 , 5.3%) was detected in the high-exposure group of hamsters. The location and type of N2H4-induced proliferative lesions were similar to those reported in a chronic N2H4-exposure study (5.0 ppm × 6 hr/day × 5 days/week for 1 year) conducted in our laboratory, but the chronic study had much higher incidences (rats, sexes combined: hyperplasia 15.5% vs 2.6% and polypoid adenoma 44.6% vs 5.2%). The product (CD) of concentration × time was the same (7500 ppm hours) for the high-dose groups for both studies, but the duration of exposure was 150× longer and the concentration was 150× lower in the chronic study. These comparisons suggest that the duration of exposure is a more significant factor than concentration in N2H4-induced nasal tumorigenesis.

Aims: Despite sophisticated perioperative management, some patients (pts.) need cardiopulmonary support (ECMO) after Norwood procedure (NP). We instituted a rapid deployement of (rECMO) within half an hour of circulatory instability. Methods: Data of 68 consecutive neonates undergoing NP between 1/2007–12/2009 were retrospectively analyzed. Impact of rECMO support on survival until Glenn OP (SG) was evaluated, with pts. having an Aristoteles comprehensive score

Background This study analyzed the long-term outcome after operations for open aortic valvotomy, specifically looking at the preservation of the native aortic valve. Methods Between 1983 and 2011, 34 neonates with critical aortic stenosis underwent open valvotomy. The mean age at operation was 15 days (range, 1 to 28 days). Follow-up was 100% complete. Results Three patients died early. The probability of survival was 91.2%, with a mean follow-up of 11 years (range, 10 months to 21 years). Event-free survival was 77%, 68%, 68%, and 57% at 5, 10, 15, and 20 years, respectively, and freedom from aortic valve replacement was 93%, 83%, 68%, and 57%. Tricuspid valve morphology revealed the best outcome, with event-free survival of 90% (p = 0.006) and 100% freedom from aortic valve replacement (p = 0.0012) at 20 years of follow-up. All but 4 patients were in New York Heart Association class I; 77 % of all patients were without medication. Conclusions In neonates, predictable and consistent long-term results can be accomplished by open valvotomy in any type of valve morphology, even in an asymmetric arrangement. Operative repair not only offers a 90% survival benefit in the long-term but also preserves the native aortic valve in most patients. Clearly superior results were achieved in tricuspid valve morphology, in which there was no need for aortic valve replacement at 20 years of follow-up.

BACKGROUND: The Aristotle score quantifies the complexity involved in congenital heart surgery. It defines surgical performance as complexity score times hospital survival. We studied how expected and observed surgical performance evolved over time. METHODS: 2312 main procedures carried out between 2006 and 2010 were analyzed. The Aristotle basic score, corresponding hospital survival and related observed surgical performance were estimated. Expected survival was based on the mortality risks published by O'Brien and coauthors. Observed performance divided by expected performance was called the standardized ratio of performance. This should trend towards a figure above 100 %. Survival rates and performance are given with 95 % confidence intervals. RESULTS: The mean Aristotle basic score was 7.88 ± 2.68. 51 patients died: observed hospital survival was 97.8 % (97.1 % – 98.3 %). 115 deaths were anticipated: expected survival was 95.2 % (93.5 % – 96.3 %). Observed and expected surgical performance reached 7.71 (7.65–7.75) and 7.49 (7.37–7.59), respectively. Therefore the overall standardized ratio of performance was 102.94 %. The ratio increased from 2006 (ratio = 101.60 %) to 2009 (103.92 %) and was 103.42 % in 2010. Performance was high for the repair of congenital corrected transposition of the great arteries and ventricular septal defect (VSD) by atrial switch and Rastelli procedure, the Norwood procedure, repair of truncus arteriosus, aortic arch repair and VSD closure, and the Ross-Konno procedure, with corresponding standardized ratios of 123.30 %, 116.83 %, 112.99 %, 110.86 % and 110.38 %, respectively. With a ratio of 82.87 %, performance was low for repair of Ebstein's anomaly. CONCLUSION: The standardized ratio of surgical performance integrates three factors into a single value: procedure complexity, postoperative observed survival, and comparison with expected survival. It constitutes an excellent instrument for quality monitoring of congenital heart surgery programs over time. It allows an accurate comparison of surgical performance across institutions with different case mixes.

Controversy persists regarding the management of patients suffering from tetralogy of Fallot with absent pulmonary valve syndrome. Airway obstruction caused by the dilated pulmonary arteries is the determining factor in the mortality of symptomatic newborns and infants. A number of surgical techniques for the reduction of bronchial obstruction have been proposed, producing variable results. All strategies have focused on plication and reduction of the anterior or posterior wall of the normally positioned pulmonary arteries, with or without pulmonary valve replacement. An alternative approach is to bring the pulmonary arteries anterior to the aorta and away from the trachea and bronchial tree. This technique has the potential to reduce or eliminate bronchial compression by the central pulmonary arteries. Failure of the treatment could be expected in symptomatic patients, where the pathology of the airways extends beyond the proximal pulmonary arteries.

A biomechanical musculo-skeletal model of functional electrical stimulation (FES)-induced rat ankle motion was implemented and tested in rat experiments. The muscle model is a new Hill-based model which includes established physiological relations of force–velocity and force–length–frequency. However, the series-elastic component and the activation component of previous Hill-based models are replaced by a new component which accounts for dynamic time delays and recruitment that occur in real muscle force generation during limb movements. The skeletal model includes gravity and dynamic forces that occur in real rat ankle motions. In computer simulations, various FES patterns were applied to the tibialis anterior (TA) and soleus (SO) model muscles to produce walk-like ankle motions. In lab experiments, the same stimulation patterns were applied by epimysial electrodes implanted in the TA and SO muscles of live rats cordotomized at level T7. The resulting rat motions were recorded by video camera. Video data was converted to ankle angle-vs-time files for comparison with corresponding model angle-vs-time files. Over a physiologically significant range of ankle motions, model parameters were adjustable to yield model motions that agreed with rat motions to within 2° (root mean square differences of rat and model ankle angles). This is shown in plots of model and rat motions presented here for representative cases of FES. The accuracy of our model in reproducing real ankle motions supports the hypothesis that our new muscle model generates correct muscle forces over a useful range of limb motions. It suggests that the model may be useful in the design of FES neural prostheses.

In einer Studie an 2 kinderchirurgischen Einrichtungen uber die Versorgung von Milzrupturen spiegelt sich der Trend zur Organerhaltung deutlich wider. Ultraschalldiagnostik, Farbdoppler-Sonographie, m

Thirty people with classical or definite rheumatoid arthritis received laser exposure to a Q-switch neodymium laser that operated at 1.06 micrometer with an output of 15 joules/cm2 for 30 nsec. One hand was lased at the proximal interphalangeal (PIP) and metacarpal phalangeal (MCP) joints, whereas the other hand was sham lased. The patient, physician, and occupational therapy evaluators did not know which hand was being lased. Twenty-one patients noted improvement of both their MCP and PIP joints of both hands during laser therapy. Twenty-seven noted improvement of their PIP joints and 26 noted improvement of the MCP joints during therapy. Heat, erythema, pain, swelling, and tenderness all improved with time in both hands, but the lased hand had more significant improvement in erythema and pain. There was also significant improvement in grasp and tip pressure on the lased side. The level of circulating immune complexes as measured by platelet aggregation decreased during lasing. The improvement may be related to laser exposure. The exact role that laser radiation has upon rheumatoid arthritis and its mechanism of action remain to be elucidated.

In 21 patients with nonresected stomachs and symptoms of delayed gastric emptying, obstruction was excluded by upper gastrointestinal series and upper endoscopy; all had abnormal results of barium test meal (BTM) study. Each had repeat BTM after the administration of 10 mg of metoclopramide. Each patient also had two gamma camera studies after a technetium Tc 99m sulfur colloid labeled meal; normal saline or metoclopramide was administered before each test in a blinded and random manner. Half-time (T1/2) and percentage of isotope remaining at six hours (GC6) were recorded. Ten asymptomatic controls had a gamma camera scanning study, and seven of these had a BTM. Nine of 19 patients had a T1/2 in the normal range, and in 12 of 19 patients the GC6 was in the normal range. The magnitude of retention of barium at six hours on the BTM did not correlate with the T1/2 (r . 0.076) or the GC6 (r. 0.296). Thus, these tests were not comparable in this study. By regression analysis, a significant reduction was shown in the amount of retained food and barium (P less than .01), the T1/2 (P less than .01), and the GC6 (P less than .01) after intramuscular administrationmore » of metoclopramide, indicating that both tests were able to evaluate the effects of this drug.« less

The posteromedial aspect of the distal end of the femur in the area of insertion of the adductor magnus is the site of occurrence of a developmental defect that may have the roentgenographic characteristics of a malignant bone tumor. As it is asymptomatic, this common defect is almost always an incidental finding, but it has been confused with osteosarcoma. The lesion is thought to be due to trauma or the avulsion of small bits of bone at the site of insertion of the adductor magnus muscle. Histologically the lesion has been mistaken for osteosarcoma because of the immature reactive bone and fibrous tissue presnet. It is usually possible to identify these defects roentgenographically and avoid biopsy.