Running economy - a comprehensive review for passive force generation.

Running economy is considered a major determinant of distance running performance. Enhancing the body's ability for passive force generation could have a positive effect on running economy by minimizing the energy cost required for the propulsion of the body. Thus, the purpose of this comprehensive review was to provide a list of modifiable factors that promote this ability. The interest was focused on lower-limb stiffness, as it is a factor of great influence and at the same time can be modified with training and specific biomechanical adjustments. Although it appears that no clear instructions can be provided to athletes and coaches, it should be noted that careful consideration of the runners' anthropometric, physiological, and biomechanical characteristics are necessary for optimal performance results.

The Effects of a Mobile Wellness Intervention with Fitbit Use and Goal Setting for Workers.

Background and Introduction: There is strong evidence that worksite wellness programs can significantly improve the health profile of participating workers. To date, little is known about research on the effects of mobile wellness interventions in worksite settings. Furthermore, no studies have been conducted to evaluate mobile wellness interventions with activity trackers and tailoring strategies for physically inactive workers in manufacturing companies. This study aimed to examine the effects of a mobile wellness intervention with Fitbit and goal setting using brief counseling and text messaging among workers. Materials and Methods: A total of 79 (n = 79) workers from large manufacturing companies were allocated into an experimental group (n = 41) and a control group (n = 38). All participants were asked to wear an activity tracker (Fitbit Charger HR) during all waking hours for 5 weekdays. Participants in the experimental group received Fitbit, daily motivational text messaging, and biweekly counseling with a specifically designed workbook for 12 weeks, whereas Fitbit was only provided to the control group. Results: At the 12-week measurement, there were significant differences between the experimental group and control group on wellness (p < 0.001), physical activity behavior (p < 0.001), daily walking steps (p < 0.001), and physical activity self-efficacy (p < 0.001). Discussion and Conclusions: Although Fitbit facilitates an individual's activities by providing information about daily steps, the tracker itself, without additional goal-setting techniques, may be insufficient to encourage behavior change. These findings indicate that the mobile wellness intervention with Fitbit and goal setting using brief counseling and tailored text messaging is more effective for physically inactive workers.

Clinical and cost-effectiveness of collaborative traditional Korean and Western medicine treatment for low back pain: A protocol for a prospective observational exploratory study.

BACKGROUND: In South Korea, a few patients with low back pain (LBP) are currently being treated with a combination of traditional Korean medicine (KM) and Western medicine (WM). Although a recent research has reported results regarding patient satisfaction and exploratory effectiveness, evidence of comparative effectiveness still needs to be reviewed. The aim of this study is to evaluate the clinical and cost-effectiveness of KM and WM collaborative treatment (CT) compared with that of sole treatment (ST) for patients with LBP in Korea. METHOD/DESIGN: This multisite, prospective observational comparative effectiveness research study is part of a nationwide pilot project for KM and WM collaboration launched by the Korean Ministry of Health and Welfare. The duration of the study is 8 weeks, and the target number of inclusion is 360 patients. Participants receive treatment according to their treatment plan, and a researcher conducts investigations thrice, every 4 weeks. In the final analysis, the merged data from the participants' questionnaire responses, hospital medical records, and administrative data, and Health Insurance Review and Assessment service data will be compared between the CT and ST groups. DISCUSSION: This study will provide clinical and economic information about CT for LBP, which might be a milestone for establishing future polices about this collaboration in Korea. TRIAL REGISTRATION: The study protocol has been registered with the Clinical Research Information Service (KCT0002827).

Epidemiologic Study of Human Epidermal Growth Factor Receptor 2 Expression in Advanced/Metastatic Gastric Cancer: an Assessment of Human Epidermal Growth Factor Receptor 2 Status in Tumor Tissue Samples of Gastric and Gastro-Esophageal Junction Cancer.

PURPOSE: The Trastuzumab for gastric cancer (GC) trial identified human epidermal growth factor receptor 2 (HER2) as a predictor of successful treatment with trastuzumab (HER2 receptor targeting agent) among patients with advanced/metastatic GC. To date, the prevalence of HER2 overexpression in the Korean population is unknown. The present study aimed to assess the incidence of HER2 positivity among GC and gastroesophageal (GE) junction cancer samples and the relationship between HER2 overexpression and clinicopathological characteristics in Korean patients. MATERIALS AND METHODS: Tumor samples collected from 1,695 patients with histologically proven GC or GE junction enrolled at 14 different hospitals in Korea were examined. After gathering clinicopathological data of all patients, HER2 status was assessed by immunohistochemistry (IHC) at each hospital, and IHC 2+ cases were subjected to silver-enhanced in situ hybridization at 3 central laboratories. RESULTS: A total of 182 specimens tested positive for HER2, whereas 1,505 tested negative. Therefore, the overall HER2-positive rate in this study was 10.8% (95% confidence interval=9.3%-12.3%). The HER2-positive rate was higher among intestinal-type cases (17.6%) than among other types, and was higher among patients older than 70 years and 50 years of age, compared to other age groups. CONCLUSIONS: Our evaluation of the HER2 positivity rate (10.8%) among Korean patients with GC and GE junction indicated the necessity of epidemiological data when conducting studies related to HER2 expression in GC and GE junction.

Impact of Fatigue on Maintenance of Upright Posture: Dynamic Assessment of Sagittal Spinal Deformity Parameters After Walking 10 Minutes.

STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: To assess global and regional spinal sagittal radiographic parameters in adults with loss of lumbar lordosis ("flatback") before and after walking 10 minutes. SUMMARY OF BACKGROUND DATA: While routine activities of daily living may exacerbate functional disability of spinal sagittal-plane deformity, there is limited understanding of how sagittal parameters and compensatory mechanisms are affected by activity. METHODS: Consecutive adults with "flatback" at a single institution who previously had full-length standing spinal radiographs before and after walking 10 minutes were reviewed. Changes in spinal deformity sagittal parameters before and after walking were evaluated for two groups: Compensated Sagittal Deformity ("Compensated": sagittal vertical axis [SVA] ≤4 cm and pelvic tilt [PT] >20°) and Decompensated Sagittal Deformity ("Decompensated": SVA>4 cm and PT>20°). Intra-group radiographic comparisons were performed with paired Student t tests. RESULTS: One hundred fifty-seven patients (143 females, 14 males; average age 67.9 ±â€Š5.9 yr) met inclusion criteria. Initial average SVA was 1.7 ±â€Š1.2 cm for "Compensated" and 11.5 ±â€Š6.4 cm for "Decompensated." After walking 10 minutes, significant deteriorations in average SVA were observed for all "Decompensated" patients and 84.6% of "Compensated" patients. For both groups, this was accompanied by significant decreases in PT and LL and increases in PI-LL (P <0.01). Thoracic kyphosis increased after walking for only "Decompensated" (P <0.01). For "Compensated," the change in SVA was determined by decreases in PT and LL, while changes in SVA for "Decompensated" were correlated to worsening of all sagittal parameters. CONCLUSION: After walking, compensatory mechanisms to maintain sagittal balance in adults with spinal deformity are less pronounced than when the patient initially presents. This results in significant sagittal decompensation, irrespective of the initial SVA. As we postulate that loss of compensatory mechanisms is due to fatigue on pelvic and spinal extensor muscles, sagittal parameters can be re-evaluated with radiographs obtained after patients walk 10 minutes to unmask a hidden sagittal imbalance in compensated deformities. LEVEL OF EVIDENCE: 3.

Ecological assessment of coal mine and metal mine drainage in South Korea using Daphnia magna bioassay.

In order to assess the ecological effect of acid mine drainage, metal mine (Dalsung) and coal mine (Samtan) drainage in South Korea were collected. The each mine drainage then investigated by whole effluent toxicity test (WET) and toxicity identification evaluation (TIE). WET results demonstrated that DS leachate and ST mine water is more toxic than other mine drainage due to the presence of cationic metals and acidic pH. TIE results revealed that the acidic pH and copper (Cu) could be the main toxicants in both mine drainage. The strong acidic pH (pH < 3.5) enhanced the metal toxicity by increase of metal activity and bioavailability. The toxicity of most mine drainage revealed that the positive correlation between metal concentration and toxicity unit (TU). The regression data between TU and sum of cumulative criterion unit (CCU) demonstrated the reasonable statistical significance (R = 0.89; p < 0.01), however the excessive iron concentration in mine drainage could be an inhibition factor to estimate the toxicity by the effect of amorphous iron precipitate.

Exposure assessment of epidermal growth factor to various tissues in mice after intravenous and subcutaneous administration.

OBJECTIVES: This study was conducted to examine the tissue distribution of human recombinant epidermal growth factor (EGF) after multiple intravenous and subcutaneous injections in mice. METHODS: Male BALB/c mice were divided into (1) EGF 1 mg/kg intravenous dose, (2) EGF 5 mg/kg intravenous dose, (3) drug-free intravenous control, (4) EGF 1 mg/kg subcutaneous dose, (5) EGF 5 mg/kg subcutaneous dose and (6) drug-free subcutaneous control groups. EGF and drug-free dosing solutions were injected by intravenous and subcutaneous injections once a day for 3 days. EGF concentrations in serum and tissues of kidney, liver, lung, small intestine and tongue were determined by ELISA. KEY FINDINGS: As the intravenous and subcutaneous doses were increased from 1 to 5 mg/kg, serum Cmax and area under the concentration-time curve (AUC) values were increased dose-proportionally. In lung, tongue and small intestine, increases in AUC were dose-proportional after intravenous injections, but greater than dose-proportional after subcutaneous injections. The fold-increases in Cmax and AUC values were lowest in liver and highest in kidney. CONCLUSION: Based on Cmax and AUC data, the systemic exposure achieved by subcutaneous injections was comparable with that achieved by intravenous injections.

Imaging for assessment of treatment response in hepatocellular carcinoma: Current update.

Morphologic methods such as the Response Evaluation Criteria in Solid Tumors (RECIST) are considered as the gold standard for response assessment in the management of cancer. However, with the increasing clinical use of antineoplastic cytostatic agents and locoregional interventional therapies in hepatocellular carcinoma (HCC), conventional morphologic methods are confronting limitations in response assessment. Thus, there is an increasing interest in new imaging methods for response assessment, which can evaluate tumor biology such as vascular physiology, fibrosis, necrosis, and metabolism. In this review, we discuss various novel imaging methods for response assessment and compare them with the conventional ones in HCC.

Assessment of mOMV adjuvant efficacy in the pathogenic H1N1 influenza virus vaccine.

PURPOSE: Since the pandemic (H1N1) 2009 virus has been a seasonal flu which still poses great human health concerns worldwide, vaccination would be considered as the most effective strategy to control the influenza virus spreading. Here, we assessed adjuvant efficacy of modified outer membrane vesicle (mOMV) towards the pandemic H1N1 split antigen. MATERIALS AND METHODS: For this study, mice were vaccinated twice with various amount of antigen (0.05, 0.1, and 0.5 µg/dose hemagglutinin [HA]) that were mixed with mOMV, aluminum hydroxide (alum), and MF59, as well as the combined adjuvant comprising the mOMV plus alum. RESULTS: We found that all the adjuvanted vaccines of A/California/04/09 (CA04, H1N1) containing HA antigen more than 0.1 µg/dose protected effectively from lethal challenge (maCA04, H1N1) virus, compared to the antigen only group. Furthermore, vaccinated mice received as low as 0.05 µg/dose of the split vaccine containing the combined adjuvant (10 µg of mOMV plus alum) showed a full protection against lethal challenge with H1N1 virus. Taken together, these results suggest that mOMV can exert not only the self-adjuvanticity but also a synergy effect for the vaccine efficacy when combined with alum. CONCLUSION: Our results indicate that mOMV could be a promising vaccine adjuvant by itself and it could be used as a vaccine platform for development of various vaccine formulations to prepare future influenza pandemic.

Evaluation of the effect of PVA tape supplemented with 2.26% fluoride on enamel demineralization using microhardness assessment and scanning electron microscopy: in vitro study.

OBJECTIVE: This in vitro study was designed to evaluate the effectiveness of experimental 2.26% fluoride-polyvinyl alcohol (F-PVA) tape in inhibition of enamel demineralization using enamel surface microhardness (SMH) analysis and scanning electron microscopy (SEM) examination. DESIGN: Enamel specimens (n=60) prepared from bovine incisor teeth with microhardness ranging from 260 to 370Knoop hardness number (KHN) were pooled and randomly assigned to four groups: control group, F-PVA tape group, F-varnish group, and CPP-ACFP group. After topical application of agents in each group, pH-cycling was processed. Then, SMH was measured and the percentage loss of surface microhardness (%SML) was calculated. For the SEM examination, five sample specimens in each group were treated and the morphologic character was evaluated. RESULTS: After pH-cycling, the SMH values of the enamel specimens of F-PVA tape and F-varnish group were significantly higher than that of CPP-ACFP group, there was no significant difference between F-PVA tape and F-varnish group. With SEM examination, enamel surface in the F-PVA tape group showed mild irregularity in general and numerous spherical and ovoid crystals formed on the enamel surface were also observed. The density of crystals was higher than that of both control group and CPP-ACFP group. CONCLUSION: F-PVA tape is effective in inhibition of enamel demineralization. The inhibition potential of enamel demineralization of F-PVA tape is comparable with that of fluoride varnish and greater than that of CPP-ACFP. With the significant advantages of excellent physical properties, ease of application, and improved safety, F-PVA tape can be used not only for professional treatment, but also in a home-use delivery system.

Printing of sub-100-nm metal nanodot arrays by carbon nanopost stamps.

This work reports an efficient method to fabricate hexagonally patterned metal nanodot arrays at the sub-100-nm scale, which is based on contact printing via novel nanometer-scaled stamps. Vertically aligned carbon nanoposts, supported by hexagonally ordered nanochannels of anodic aluminum oxide templates, are employed as the stamping platform to directly transfer controlled metal nanodot arrays. Using the fabrication platform, a number of patterned metal nanodot arrays made of Au, Cu, Ni, Ag, Pt, Al, and Ti can be contact-printed over large substrate areas in ambient conditions. The size, density, and interdistance of the printed nanodots are controllable with a tight correspondence to the mother stamp geometries, which can be precisely tuned by modifying the pore dimensions of the alumina matrixes. An advanced example of contact printing of metal nanoparticles is successfully demonstrated by the controlled formation of nanodot arrays in a specific area.

Effectiveness of steroid injection in treating patients with moderate and severe degree of carpal tunnel syndrome measured by clinical and electrodiagnostic assessment.

OBJECTIVES: This study is to assess the effectiveness of steroid injections to improve the clinical and electrodiagnostic (EDX) parameters associated with moderate and severe carpal tunnel syndrome (CTS). The study will also evaluate the correlation between EDX and clinical assessment scores. METHODS: Patients with moderate or severe CTS identified by EDX were recruited. A visual analog scale, the Boston Carpal Tunnel Syndrome Questionnaire, and EDX procedures were all used during patients' pretreatment. These tests were repeated at 4 and 8 weeks after patients received a 20 mg injection of triamcinolone in the carpal tunnel to evaluate the changes and the correlation between the clinical and EDX parameters. RESULTS: Although moderate and severe CTS showed significant improvement in clinical parameters at 4 weeks and 2 months, EDX parameters of moderate CTS were significantly improved at 4 weeks, but diminished at 8 weeks. Those with severe CTS were not significantly improved at either 4 or 8 weeks. There was no correlation between clinical and EDX results for both groups. DISCUSSION: Steroid injection is an effective method to improve clinical scales but has limited ability to restore nerve conduction in moderate or severe CTS. Because there is no correlation between clinical and EDX parameters, we should consider both clinical and neurophysiologic tests to assess CTS.

Comparative radiologic evaluation of percutaneous endoscopic lumbar discectomy and open microdiscectomy: a matched cohort analysis.

BACKGROUND: Only a few studies comparing percutaneous endoscopic discectomy and open discectomy have been reported in the literature. The purpose of this study was to compare the radiographic changes in patients treated with percutaneous endoscopic lumbar discectomy (PELD) with those of patients treated with open lumbar microdiscectomy (OLM). METHODS: A total of 30 patients who underwent PELD with a minimum three years of follow-up were randomly selected. To compare with the PELD group, 30 patients who underwent OLM during the same period were also randomly selected according to sex, age, and disc level. The clinical outcomes were evaluated by the Macnab criteria. Statistical analysis was performed using independent sample t-test, paired sample t-test, chi-square test, Fisher's exact test, and analysis of variance (ANOVA). RESULTS: The successful clinical outcomes were 96.7% in the PELD group and 93.3% in the OLM group. Among the various radiological parameters, changes of disc height (1.41 +/- 1.19 mm in the PELD group and 2.29 +/- 2.12 mm in the OLM group, p=0.024) and foraminal height (1.26 +/- 0.91 mm in the PELD group and 1.85 +/- 0.92 mm in the OLM group, p=0.017) were significantly different between the two groups. CONCLUSIONS: Although the clinical outcomes were similarly satisfactory in both groups, PELD is a less invasive procedure than open microdiscectomy in s elected cases.

Migration of medical image data archived using mini-PACS to full-PACS.

This study evaluated the migration to full-PACS of medical image data archived using mini-PACS at two hospitals of the Yonsei University Medical Center, Seoul, Korea. A major concern in the migration of medical data is to match the image data from the mini-PACS with the hospital OCS (Ordered Communication System). Prior to carrying out the actual migration process, the principles, methods, and anticipated results for the migration with respect to both cost and effectiveness were evaluated. Migration gateway workstations were established and a migration software tool was developed. The actual migration process was performed based on the results of several migration simulations. Our conclusions were that a migration plan should be carefully prepared and tailored to the individual hospital environment because the server system, archive media, network, OCS, and policy for data management may be unique.