Human walk-to-run transition in the context of the behaviour of complex systems.

This study had two main aims: 1) to investigate if the walk-to-run (WR-) transition occurs when the speed of locomotion is kept constant below the WR-transition speed (speed clamp) and the stride rate is increased monotonously using a metronome and 2) to investigate if diversion of attention and awareness from the locomotion process influences the position of the WR-transition in stride rate, stride length, and locomotion speed (SrSlLs) space. Eighteen healthy individuals (13 men and 5 women) were recruited (age: 23.9 ±â€¯1.5 years, height: 1.77 ±â€¯0.10 m and body mass: 77.3 ±â€¯12.8 kg). Stride-by-stride stride rates, stride lengths, locomotion speeds, and duty factors were determined on a treadmill in 4 different tests: 1) reference WR-transition, 2) preferred walking speed, 3) dual-task test including arithmetic calculations and 4) four speed clamp bouts with different initial velocities. Walk-to-run transitions were elicited in all participants in the speed clamp bouts. When the stride rate ramp was clamped at preferred walking speed the WR-transition stride rate was not significantly different from the WR-transition stride rate during the reference test (t = 2.2, p = 0.312). However, in the SrSlLs space the speed clamp WR-transitions all deviated from the position of the reference WR-transition. Additionally, it was demonstrated that intensive attentional diversion using a dual-task paradigm had very little influence on the position of the WR-transition in the SrSlLs space. It is argued that these observations can be explained in the context of the behavior of complex systems.

Eccentric exercise induces spatial changes in the mechanomyographic activity of the upper trapezius muscle.

In this study, we hypothesized that the recordings of multichannel mechanomyography (MMG) of the upper trapezius muscle would reveal spatially dependent manifestations in the presence of delayed onset muscle soreness occurring 24 hours after eccentric exercise (ECC). Sixteen participants performed high-intensity eccentric exercises (5 sets of 10 eccentric contractions at 100% of max elevation force) targeting the upper trapezius on their dominant side. Twelve accelerometers were attached to record MMG activity during submaximal exercise consisting of static and dynamic arm flexion and abduction. Measurements were taken before and 24 hours after ECC. Average rectified value (ARV), percentage of determinism (% DET), and recurrence (% REC) of the MMG signals were computed to estimate the level of muscular activity and the magnitude of regularity of the MMG. The ARV, % REC, and % DET maps revealed heterogeneous MMG activity of the upper trapezius 24 hours after ECC when compared with before. Increased ARV, % REC, and % DET were found 24 hours after ECC when compared with before. The study provides new key information on how a single muscle responds to ECC. Our findings suggest that multichannel MMG and nonlinear analyses may detect muscular and musculo-tendinous alterations due to ECC.

On voluntary rhythmic leg movement behaviour and control during pedalling.

The overall purpose of the present dissertation was to contribute to the understanding of voluntary human rhythmic leg movement behaviour and control. This was achieved by applying pedalling as a movement model and exposing healthy and recreationally active individuals as well as trained cyclists to for example cardiopulmonary and mechanical loading, fatiguing exercise, and heavy strength training. As a part of the background, the effect of pedalling frequency on diverse relevant biomechanical, physiological, and psychophysiological variables as well as on performance was initially explored. Freely chosen pedalling frequency is considerably higher than the energetically optimal pedalling frequency. This has been shown by others and was confirmed in the present work. As a result, pedal force is relatively low while rates of VO2 and energy turnover are relatively high during freely chosen pedalling as compared to a condition where a lower and more efficient pedalling frequency is imposed. The freely chosen pedalling frequency was in the present work, and by others, found to most likely be less advantageous than the lower energetically optimal pedalling frequency with respect to performance during intensive cycling following prolonged submaximal cycling. This stimulates the motivation to understand the behaviour and control of the freely chosen pedalling frequency during cycling. Freely chosen pedalling frequency was in the present work shown to be highly individual. In addition, the pedalling frequency was shown to be steady in a longitudinal perspective across 12 weeks. Further, it was shown to be unaffected by both fatiguing hip extension exercise and hip flexion exercise as well as by increased loading on the cardiopulmonary system at constant mechanical loading, and vice versa. Based on this, the freely chosen pedalling frequency is considered to be characterised as a highly individual, steady, and robust innate voluntary motor rhythm under primary influence of central pattern generators. The last part of the characterisation is largely based on, and supported by, work of other researchers in the field. Despite the robustness of the freely chosen pedalling frequency, it may be affected by some particular factors. As an example from the present work, freely chosen pedalling frequency during treadmill cycling increased by on average 15 to 17 rpm when power output was increased from a value corresponding to 86% and up to 165% of Wmax . This phenomenon is supported by other studies. As another example from the present work, freely chosen pedalling frequency decreased by on average 9 to 14 rpm following heavy strength training that involved both hip extension and hip flexion. Further, the present work suggested that the latter phenomenon occurred within the first week of training and was caused by in particular the hip extension strength training rather than the hip flexion strength training. The fast response to the strength training indicated that neural adaptations presumably caused the observed changes in movement behaviour. The internal organisation of the central pattern generator is by some other researchers in the field considered to be functionally separated into two components, in which, one is responsible for movement frequency and another is responsible for movement pattern. For the present dissertation, the freely chosen pedalling frequency was considered to reflect the rhythmic movement frequency of the voluntary rhythmic leg movement of pedalling. The tangential pedal force profile was considered to reflect the rhythmic movement pattern. The present work showed that fatiguing hip flexion exercise in healthy and recreationally active individuals modified the tangential pedal force profile during cycling at a pre-set target pedalling frequency in a way that the minimum tangential pedal force became more negative, the maximum tangential pedal force increased, and the phase with negative tangential pedal force increased. In other words, the legs were "actively lifted" to a lesser extent in the upstroke phase. Fatiguing hip extension exercise did not have that effect. And none of the fatiguing exercises affected the freely chosen pedalling frequency. The present work furthermore showed that the primary effect of hip extension strength training was that it decreased the freely chosen pedalling frequency. An interpretation of this could be that the hip extension strength training, in particular, influenced the output from the component of the central pattern generator that may be responsible for rhythmic movement frequency.

Inter-subject variability of muscle synergies during bench press in power lifters and untrained individuals.

The purpose of the study was to elucidate the role of expertise on muscle synergies involved in bench press. Ten expert power lifters (EXP) and nine untrained participants (UNT) completed three sets of eight repetitions at 60% of three repetition maximum in bench press. Muscle synergies were extracted from surface electromyography data of 21 bench press cycles using non-negative matrix factorization algorithm. The synergy activation coefficient represents the relative contribution of the muscle synergy to the overall muscle activity pattern, while the muscle synergy vector represents the relative weighting of each muscle within each synergy. Describing more than 90% of the variability, two muscle synergies reflected the eccentric and concentric phase. The cross-correlations (ρ(max)) for synergy activation coefficient 2 (concentric phase) were 0.83 [0.71;0.88] and 0.59 [0.49;0.77] [Median ρ(max) (25th;75th percentile)] (P = 0.001) in UNT and EXP, respectively. Median correlation coefficient (ρ) for muscle synergy vector 2 was 0.15 [-0.08;0.46] and 0.48 [0.02;0.70] (P = 0.03) in UNT and EXP, respectively. Thus, EXP showed larger inter-subject variability than UNT in the synergy activation coefficient during the concentric phase, while the muscle synergy vectors were less variable in EXP. This points at the importance of a specialized neural strategy in elite bench press performance.

Frequency and pattern of voluntary pedalling is influenced after one week of heavy strength training.

Changes in voluntary rhythmic leg movement characteristics of freely chosen cadence (reflecting movement frequency) and tangential pedal force profile (reflecting movement pattern) were investigated during 4weeks of (i) heavy hip extension strength training (HET, n=9), (ii) heavy hip flexion strength training (HFT, n=9), and (iii) no intervention (CON, n=9). Training consisted of three 5RM-10RM sets per session, with two sessions/week. Submaximal ergometer cycling was performed before the training period (pretest) and after every week of training (test A1, A2, A3, and posttest). Strength increased by on average 25% in HET and 33% in HFT. Freely chosen cadence was only changed in HET, occurring already after 1week of training. Thus, percentage reductions of cadence in HET at test A1, A2, A3, and posttest, with respect to the pretest value, amounted for maximally on average 17%, or 14rpm, and were larger than the corresponding changes in CON (p=.037). Percentage increases in minimum tangential pedal force in HET at test A1, A2, A3, and posttest, with respect to the pretest value, were larger than the corresponding changes in CON (p=.024). Heavy hip flexion strength training did not cause such alterations.

Application of transport phenomena analysis technique to cerebrospinal fluid.

The study of hydrocephalus and the modeling of cerebrospinal fluid flow have proceeded in the past using mathematical analysis that was very capable of prediction phenomenonologically but not well in physiologic parameters. In this paper, the basis of fluid dynamics at the physiologic state is explained using first established equations of transport phenomenon. Then, microscopic and molecular level techniques of modeling are described using porous media theory and chemical kinetic theory and then applied to cerebrospinal fluid (CSF) dynamics. Using techniques of transport analysis allows the field of cerebrospinal fluid dynamics to approach the level of sophistication of urine and blood transport. Concepts such as intracellular and intercellular pathways, compartmentalization, and tortuosity are associated with quantifiable parameters that are relevant to the anatomy and physiology of cerebrospinal fluid transport. The engineering field of transport phenomenon is rich and steeped in architectural, aeronautical, nautical, and more recently biological history. This paper summarizes and reviews the approaches that have been taken in the field of engineering and applies it to CSF flow.

The characterization of arachnoid cell transport II: paracellular transport and blood-cerebrospinal fluid barrier formation.

We used an immortalized arachnoid cell line to test the arachnoid barrier properties and paracellular transport. The permeabilities of urea, mannitol, and inulin through monolayers were 2.9 ± 1.1 × 10(-6), 0.8 ± .18 × 10(-6), 1.0 ± .29 × 10(-6)cm/s. Size differential permeability testing with dextran clarified the arachnoidal blood-cerebrospinal fluid (CSF) barrier limit and established a rate of transcellular transport to be about two orders of magnitude slower than paracellular transport in a polyester membrane diffusion chamber. The theoretical pore size for paracellular space is 11Å and the occupancy to length ratio is 0.8 and 0.72 cm(-1) for urea and mannitol respectively. The permeability of the monolayer was not significantly different from apical to basal and vice versa. Gap junctions may have a role in contributing to barrier formation. Although the upregulation of claudin by dexamethasone did not significantly alter paracellular transport, increasing intracellular cAMP decreased mannitol permeability. Calcium modulated paracellular transport, but only selectively with the ion chelator, EDTA, and with disruption of intracellular stores. The blood-CSF barrier at the arachnoid is anatomically and physiologically different from the vascular-based blood-brain barrier, but is similarly subject to modulation. We describe the basic paracellular transport characteristics of this CSF "sink" of the brain which will allow for a better description of mass and constitutive balance within the intracranial compartment.

Strength training improves 5-min all-out performance following 185 min of cycling.

To investigate the effects of heavy strength training on the mean power output in a 5-min all-out trial following 185 min of submaximal cycling at 44% of maximal aerobic power output in well-trained cyclists. Twenty well-trained cyclists were assigned to either usual endurance training combined with heavy strength training [E+S; n=11 (♂=11)] or to usual endurance training only [E; n=9 (♂=7, ♀=2)]. The strength training performed by E+S consisted of four lower body exercises [3 × 4-10 repetition maximum (RM)], which were performed twice a week for 12 weeks. E+S increased 1 RM in half-squat (P≤0.001), while no change occurred in E. E+S led to greater reductions than E in oxygen consumption, heart rate, blood lactate concentration, and rate of perceived exertion (P<0.05) during the last hour of the prolonged cycling. Further, E+S increased the mean power output during the 5-min all-out trial (from 371 ± 9 to 400 ± 13 W, P<0.05), while no change occurred in E. In conclusion, adding strength training to usual endurance training improves leg strength and 5-min all-out performance following 185 min of cycling in well-trained cyclists.

Relationship between efficiency and pedal rate in cycling: significance of internal power and muscle fiber type composition.

Cycling was performed to test the following two hypotheses: (1) muscular efficiency is unrelated to pedal rate (61, 88, and 115 r.p.m.) for a group of subjects with a wide range of slow twitch (ST) fibers in spite of decreasing whole-body efficiency and (2) muscular efficiency correlates positively with % ST muscle fibers, and this correlation is more pronounced at low pedal rates than at high pedal rates. Whole-body gross efficiency decreased from 20-22% at 61 r.p.m. to 15-18% at 115 r.p.m. Mean muscular efficiency for all subjects (n=16) was approximately 26%, with delta efficiency being constant and muscular efficiency (taking internal power into account) slightly increasing with pedal rate. Muscular efficiency correlated positively (R(2)=0.25) with % ST fibers (21-97% ST in m. vastus lateralis) at 115 r.p.m. while not at 61 and 88 r.p.m. In conclusion, the decrease in whole-body gross efficiency with increasing pedal rate was not explained by a decrease in muscular efficiency, and supported increase in internal power to account for the increase in metabolic power with increasing pedal rate. Furthermore, differences between individuals in muscle fiber type composition affected muscular efficiency, which correlated positively with % ST muscle fibers during fast pedalling.

Muscle fibre type, efficiency, and mechanical optima affect freely chosen pedal rate during cycling.

UNLABELLED: This study investigated the variation in freely chosen pedal rate between subjects and its possible dependence on percentage myosin heavy chain I (%MHC I) in m. vastus lateralis, maximum leg strength and power, as well as efficiency. Additionally, the hypothesis was tested that a positive correlation exists between percentage MHC I and efficiency at pre-set pedal rates but not at freely chosen pedal rate. Twenty males performed cycling at low and high submaximal power output ( approximately 40 and 70% of the power output at which maximum oxygen uptake (VO(2max)) was attained at 80 r.p.m.) with freely chosen and pre-set pedal rates (61, 88, and 115 r.p.m.). Percentage MHC I as well as leg strength and power were determined. Freely chosen pedal rate varied considerably between subjects: 56-88 r.p.m. at low and 61-102 r.p.m. at high submaximal power output. This variation was only partly explained by percentage MHC I (21-97%) as well as by leg strength and power. Interestingly, %MHC I correlated significantly with the pedal rate at which maximum peak crank power occurred (r = -0.81). As hypothesized, %MHC I and efficiency were unrelated at freely chosen pedal rate, which was in contrast to a significant correlation found at pre-set pedal rates (r = 0.61 and r = 0.57 at low and high power output, respectively). CONCLUSIONS: Subjects with high percentage MHC I chose high pedal rates close to the pedal rates at which maximum peak crank power occurred, while subjects with low percentage MHC I tended to choose lower pedal rates, favouring high efficiency. Nevertheless, the considerable variation in freely chosen pedal rate between subjects was neither fully accounted for by percentage MHC I nor by leg strength and power. Previously recognized relationships between percentage Type I ( approximately %MHC I) and efficiency as well as between pedal rate and efficiency were confirmed for pre-set pedal rates, but for freely chosen pedal rate, these variables were unrelated.

Chorioretinitis sclopetaria from BB ex memoria.

Chorioretinitis sclopetaria presents a characteristic pattern of choroidal and retinal changes caused by a high velocity projectile passing into the orbit, in close proximity to the globe. While it is unlikely that a patient should completely forget the trauma causing such damage, preserved or compensated visual function may blur the patient's memory of these events over time. Characteristic physical findings help to clarify the antecedent history. Despite the lack of an acknowledged history of ocular trauma or surgery, in our case, the characteristic ocular findings discovered at presentation allowed for recognition of the underlying etiology. Because of good visual function, the patient had completely forgotten about the trauma that occurred 12 years earlier. Strabismus surgery was performed for treatment of the presenting symptomatic diplopia. The pathognomonic findings in chorioretinitis sclopetaria are invaluable in correctly diagnosing this condition, especially when a history of ocular trauma is unavailable.

Escherichia coli chest-wall hemorrhagic cellulitis associated with central-line placement.

Cellulitis is a common clinical entity. Hemorrhagic cellulitis is distinctly unusual and is most frequent in compromised hosts. In normal or near normal hosts, hemorrhagic cellulitis may rarely complicate gram-negative sepsis. Usually, hemorrhagic cellulitis occurs below the waist. The differential diagnosis includes invasive streptococcal infection, mixed aerobic and anaerobic infection, gram-negative sepsis, and gross gangrene. We present the first-known case of Escherichia coli chest-wall hemorrhagic cellulitis associated with a central line in a patient with renal failure.

Linear free energy relationships implicate three modes of binding for fluoroaromatic inhibitors to a mutant of carbonic anhydrase II.

[figure: see text] Linear free energy relationships between binding affinity and hydrophobicity for a library of fluoroaromatic inhibitors of F131V carbonic anhydrase II (CA) implicate three modes of interaction. X-ray crystal structures suggest that F131 interacts with fluoroaromatic inhibitors, while P202, on the opposite side of the active site cleft, serves as the site of the hydrophobic contact in the case of the F131V mutant. 2-Fluorinated compounds bind more tightly, perhaps due to the field effect of the nearby fluorine on the acidity of the amide proton.

Monocanalicular intubation for dacryostenosis in oculo-auriculo-vertebral dysplasia (hemifacial microsomia) with congenital corneal anesthesia.

PURPOSE: To present a case of oculo-auriculo-vertebral dysplasia associated with corneal anesthesia and ipsilateral dacryostenosis that was successfully treated with monocanalicular lacrimal intubation. METHODS: Case report. RESULTS: Previous neurotrophic corneal ulcers in a child with hemifacial microsomia had become secondarily infected from a stagnant tear lake, resulting in significant corneal scarring and visual loss. A single monocanalicular stent maintained nasolacrimal patency without causing further corneal trauma, despite constant medial gaze because of wide lateral tarsorrhaphy and contralateral occlusion therapy for amblyopia. CONCLUSIONS: Monocanalicular stents may aid the treatment of dacryostenosis in the face of compromised corneal sensation.

Ocular anesthesia for cataract surgery: a direct sub-Tenon's approach.

We describe a new technique in which ocular anesthesia is obtained by dissection of the superior quadrants, as in strabismus or retinal surgery, followed by direct infusion of the retrobulbar space with local anesthetic agent, using a blunt 19-gauge cannula. In 112 cases of cataract surgery in which we used this direct sub-Tenon's approach, we found it to be a safe, simple, and effective method of achieving rapid ocular anesthesia.