Alterations in step frequency and muscle activities using body weight support influence the ventilatory response to sinusoidal walking in humans.

The use of body weight support (BWS) can reveal important insights into the relationship between lower-limb muscle activities and the ventilatory response during sinusoidal walking. Here, healthy participants (n = 15) walked on a treadmill while 0%, 30%, and 50% of their body weight was supported with BWS. The walking speed was varied sinusoidally between 3 and 6 km h-1, and three different frequencies, and periods ranging from 2 to 10 min were used. Breath-by-breath ventilation ([Formula: see text]) and CO2 output ([Formula: see text]) were measured. The tibialis anterior (TA) muscle activity was measured by electromyography throughout the walking. The amplitude (Amp), normalized Amp [Amp ratio (%)], and phase shift (PS) of the sinusoidal variations in measurement variables were calculated using a Fourier analysis. The results revealed that the Amp ratio in [Formula: see text] increased with the increase in BWS. A steeper slope of the [Formula: see text]-[Formula: see text] relationship and greater [Formula: see text]/[Formula: see text] values were observed under reduced body weight conditions. The Amp ratio in TA muscle was significantly positively associated with the Amp ratio in the [Formula: see text] (p < 0.001). These findings indicate that the greater amplitude in the TA muscle under BWS may have been a potent stimulus for the greater response of ventilation during sinusoidal walking.

[Differences Between Visiting Nurses and Patients/Families in the Perception of the Difficulties in Intervening Immediately After Hospital Discharge].

The implementation of medical home care requires the fulfillment of discharge coordination and planning, but some hospital nurses face difficulties due to differences in perception between nurses and patients/families. Visiting nurses involved immediately after hospital discharge also have difficulties in providing at-home care and struggle with differences in perception. This study clarifies the differences between visiting nurses and patients/families in their perception of discharge immediately after hospital discharge and suggests a way to resolve those differences. We also examine an ideal approach to discharge coordination and planning. We conducted a survey of 100 visiting nurses, and the results from 81 responses (validity rate: 81.0%) showed that the differences in perception were "different for all: visiting nurses, patients, and family members," with "need for care content" and "perception of prognosis" being the most frequent responses. Methods of resolving differences were categorized as "respect for intentions," "explanation," "intervention during hospitalization," "coordination with patients/families," and "service coordination". To resolve the differences in perception among nurses, it is important to start interventions by visiting nurses during hospitalization through collaboration between hospital and visiting nurses. Seamless support until after discharge, respecting the wishes of patients/families, careful explanation of the patient's condition, including prognosis, and the step-by-step planning of discharge coordination by the team are also important.

Reconstruction of an Extensive Full-Layer Defect of the Upper Eyelid.

What are the zones of the eyelid and the characteristics of this defect?What are the eyelid defect reconstruction options?What are the major potential complications of the eyelid defect reconstruction?How can the complications be avoided?

Influence of Step Frequency on the Dynamic Characteristics of Ventilation and Gas Exchange During Sinusoidal Walking in humans.

We tested the hypothesis that restricting either step frequency (SF) or stride length (SL) causes a decrease in ventilatory response with limited breath frequency during sinusoidal walking. In this study, 13 healthy male and female volunteers (mean ± SD; age: 21.5 ± 1.8 years, height: 168 ± 7 cm, weight: 61.5 ± 8.3 kg) participated. The walking speed was sinusoidally changed between 50 and 100 m⋅min-1 with periods from 10 to 1 min. Using a customized sound system, we fixed the SF at 120 steps⋅min-1 with SL variation (0.83-0.41 m) (SF fix ) or fixed the SL at 0.7 m with SF variation (143-71 steps⋅min-1) (SL fix ) during the subjects' sinusoidal walking. Both the subjects' preferred locomotion pattern without a sound system (Free) and the unprompted spontaneous locomotor pattern for each subject (Free) served as the control condition. We measured breath-by-breath ventilation [tidal volume (VT) and breathing frequency (Bf)] and gas exchange [CO2 output ( V . CO2), O2 uptake ( V . O2)]. The amplitude (Amp) and the phase shift (PS) of the fundamental component of the ventilatory and gas exchange variables were calculated. The results revealed that the SF fix condition decreased the Amp of the Bf response compared with SL fix and Free conditions. Notably, the Amp of the Bf response under SF fix was reduced by less than one breath at the periods of 5 and 10 min. In contrast, the SL fix condition resulted in larger Amps of Bf and V . E responses as well as Free. We thus speculate that the steeper slope of the V . E - V . CO2 relationship observed under the SL fix might be attributable to the central feed-forward command or upward information from afferent neural activity by sinusoidal locomotive cadence. The PSs of the V . E , V . O2, and V . CO2 responses were unaffected by any locomotion patterns. Such a sinusoidal wave manipulation of locomotion variables may offer new insights into the dynamics of exercise hyperpnea.

Anaerobic performance after 3-day consecutive CO2-rich cold-water immersion in physically active males.

Background Objective: We investigated the effects of a 3-day consecutive CO2-rich cold (20 °C) water immersion (CCWI) following a high-intensity intermittent test (HIIT) on subjects' sublingual temperature (Tsub), blood lactate ([La]b), and heart rate (HR) compared to cold (20 °C) tap-water immersion (CWI) or passive recovery (PAS). Methods: Thirty-two subjects were randomly allocated into three groups (CCWI, CWI, and PAS), each of which completed 4 consecutive days of cycling experiments. HR, Tsub, and [La]b were recorded on each day of exercise testing (immersion from Day 1 to Day 3 and Day 4). HIIT consisted of 8 sets of 20-sec maximum exercise at an intensity of 120% of VO2max with 10-sec passive rest. The mean and peak power, and peak pedal repetitions (PPR) within HIIT were averaged and the decline in PPR (ΔPPR) from Day 1 to Day 4 was measured. Results: In CCWI and CWI, HR declined significantly following each immersion, with CCWI showing the larger reduction (p < 0.001). At Day 2, CCWI showed a significantly lower [La]b compared to PAS (p < 0.01). The changes in mean and peak power from Day 1 to Day 4 did not differ among the groups (p = 0.302). ΔPPR of HIIT was significantly correlated with the HR and [La]b values after immersions (ΔPPR-HR: r2 = 0.938, p < 0.001, ΔPPR-[La]b: r2 = 0.999, p < 0.001). Conclusions: These findings indicate that CCWI is a promising intervention for maintaining peak performance in high-intensity intermittent exercise, which is associated with a reduction in [La]b and HR.