Effects of Foot Orthoses on Skeletal Motion During Running

Objective. To quantify the effects of medial foot orthoses on skeletal movements of the calcaneus and tibia during the stance phase in running. Design. Kinematic effects of medial foot orthoses (anterior, posterior, no support) were tested using skeletal (and shoe) markers at the calcaneus and tibia. Background. Previous studies using shoe and skin markers concluded that medially placed orthoses control/reduce foot eversion and tibial rotation. However, it is currently unknown if such orthoses also affect skeletal motion at the lower extremities. Methods. Intracortical Hofman pins with reflective marker triads were inserted under standard local anesthetic into the calcaneus and tibia of five healthy male subjects. The three-dimensional tibiocalcaneal rotations were determined using a joint coordinate system approach. Eversion (skeletal and shoe) and tibial rotation were calculated to study the foot orthoses effects. Results. Orthotic effects on eversion and tibial rotations were found to be small and unsystematic over all subjects. Differences between the subjects were significantly larger (pp\u3c0.05). Conclusions. This in vivo study showed that medially placed foot orthoses did not change tibiocalcaneal movement patterns substantially during the stance phase of running. Relevance Orthoses may have only small kinematic effects on the calcaneus and tibia (measured with bone pins) as well as on the shoes (measured with shoe markers) during running of normal subjects. Present results showed that orthotic effects were subject specific and unsystematic across conditions. It is speculated that orthotic effects during the stance phase of running may be mechanical as well as proprioceptive

Non-linear analysis of two-layer timber beams considering interlayer slip and uplift

A new mathematical model and its finite element formulation for the non-linear analysis of mechanical behaviour of a two-layer timber planar beam is presented. A modified principle of virtual work is employed in formulating the finite element method. The basic unknowns are strains. The following assumptions are adopted in the mathematical model: materials are taken to be non-linear and can differ from layer to layer; interacting shear and normal contact tractions between layers are derived from the non-linear shear contact traction-slip and the non-linear normal contact traction-uplift characteristics of the connectors; the geometrically linear and materially non-linear Bernoulli's beam theory is assumed for each layer. The formulation is found to be accurate, reliable and computationally effective. The suitability of the theory is validated by the comparison of the numerical solution and the experimental results of full-scale laboratory tests on a simply supported beam. An excellent agreement between measured and calculated results is observed for all load levels. The further objective of the paper is the analysis of the effect of different normal contact traction-uplift constitutive relationships on the kinematic and static quantities in a statically determined and undetermined structure. While the shear contact traction-slip constitutive relationship dictates the deformability of the composite beam and has a substantial influence on most of the static and kinematic quantities of the composite beam, a variable normal contact traction-uplift constitutive relationship is in most cases negligible

Autoimmunhämolytische Anämien

Die Autoimmunhämolytischen Anämien (AIHA) sind seltene aber potentiell lebensbedrohliche Erkrankungen, die einer raschen Abklärung und Therapie bedürfen. Die Diagnose wird durch den gleichzeitigen Nachweis einer Hämolyse und von antierythrozytären Autoantikörpern gestellt. Der wichtigste diagnostische Test in der Abklärung einer AIHA ist der direkte Antiglobulin Test (DAT, direkter Coombs-Test). AIHA können gemäß der optimalen Wirktemperatur der antierythrozytären Autoantikörper in AIHA vom Wärme- respektive vom Kältetyp und aufgrund ihrer Ätiologie in primäre oder sekundäre AIHA unterteilt werden. Da die AIHA nicht selten mit einer Grundkrankheit assoziiert ist, muss gezielt nach dieser gesucht werden, bevor von einer primären AIHA gesprochen werden kann. Die Therapie unterscheidet sich je nach Typ der AIHA. Bei den häufigeren Wärme-Antikörpern besteht die Erstlinientherapie neben der Behandlung der Grundkrankheit in der Gabe von systemischen Kortikosteroiden und in zweiter Linie in der Verabreichung des anti-CD20-Antikörpers Rituximab, der Gabe anderer Immunsuppressiva oder der Splenektomie. Die AIHA vom Kälte-Typ ist seltener und bedarf meist nur supportiver Maßnahmen (Vermeidung von Kälteexposition und Transfusion von Erythrozytenkonzentraten). Die paroxysmale Kältehämoglobinurie (PCH) ist heutzutage hauptsächlich eine infektgetriggerte Ursache kindlicher Hämolysen, während Medikamente weitere wichtige Auslöser autoimmunhämolytischer Anämien auch im Erwachsenenalter sind. Abstract: Autoimmune hemolytic Anemia (AIHA) is a uncommon but potentially lethal disorder requiring prompt diagnosis and treatment. Diagnosis is based on clinical and laboratory signs of hemolysis and a positive direct antiglobulin test (DAT). AIHA is classified according to the clinical context (primary or secondary) and the characteristics of the auto-antibody (warm vs. cold antibodies). Most AIHA are caused by warm antibodies and in about fifty percent of these patients an underlying disease such as a lymphoproliferative or an autoimmune disorder can be detected. Warm antibodies usually belong to the IgG type and cause hemolysis mainly by Fc-mediated phagocytosis of the IgG-coated red blood cells (RBC) in the spleen. First-line treatment is still based on systemic corticosteroids whereas second-line treatment options include the anti-CD20-antibody rituximab, splenectomy and various immunosuppressive drugs. Cold-agglutinines are less common and usually associated with an underlying disease such as infections (acute) or again lymphoproliferative and autoimmune disorders (chronic). Cold antibodies generally belong to the IgM type and are strong activators of the classical complement pathway which leads to intravascular hemolysis. Treatment options are usually supportive (warming) and RBC transfusions. Paroxysmal cold hemoglobinuria (bithermic IgG antibody) is an important cause of hemolysis in infants and occurs secondary to acute infections

Is the vegetation inside Carex sempervirens tussocks highly specific or an image of the surrounding vegetation?

Questions: How do species diversity, frequency and composition in tussocks differ from those in similar sized plots outside tussocks? Does the extent of the differences depend on community types or environmental conditions? Location: A sub-alpine grassland in the Swiss National Park. Methods: In each of the two communities (short grass and tall graminoid) differing in species composition, grazing intensity and soil nutrient availability, relevés were made in 40 pairs of small circular plots, with one plot located inside a randomly selected Carex sempervirens tussock and the other outside. Results: We found 92 vascular species, of which 46 had a frequency higher than 5%. Species richness (S), pooled cover, Shannon’s diversity (H) and cumulative species number (CS) were higher outside than inside the C. sempervirens tussocks, but evenness (J) was lower. S, H and CS differed more in the tall graminoid community than in the short grass community. However, dissimilarity between the paired relevés inside and outside tussocks did not differ between the two communities. Of the 46 most frequent species, 12 were statistically more and only one less frequent outside than inside the tussocks. Vegetation inside and outside tussocks could be clearly distinguished in the ordination space. Conclusion: Vegetation inside C. sempervirens tussocks is different from that in the surrounding area and represents an impoverished but homogenized version of the surrounding vegetation. Although tussocks of C. sempervirens were systematically avoided by grazers, there is little evidence that tussocks facilitate the species growing inside them

Equivalence of pegfilgrastim and filgrastim in lymphoma patients treated with BEAM followed by autologous stem cell transplantation

Objective: To evaluate the impact of pegfilgrastim on engraftment, hospital stay and resources in patients with Hodgkin's and non-Hodgkin's lymphoma after conditioning with high-dose BEAM followed by autologous peripheral blood stem cell transplantation (APBSCT) compared with filgrastim. Methods: We reviewed patient charts and our prospective transplantation database for clinical data from the post-transplant period. An integrated cost analysis, including the use of blood products and length of hospital stay, was also performed. Results: Fourteen (26%) patients with Hodgkin's lymphoma and 40 (74%) patients with non-Hodgkin's lymphoma were analyzed. Thirty-four (68%) patients received single-dose pegfilgrastim (6 mg), and 20 (32%) patients received daily filgrastim (5 μg/kg) after APBSCT. No differences were observed regarding duration of neutropenia grade 4 (pegfilgrastim median 7 days/filgrastim median 8 days; p = 0.13), thrombocytopenia grade 4 (7/9.5 days, respectively; p = 0.21), fever (4.5/2 days; p = 0.057), intravenous antibiotic treatment (11/10 days; p = 0.75) or length of hospital stay (16.5/16 days; p = 0.27) between the groups. The use of pegfilgrastim resulted in 12% higher treatment-related costs when compared to filgrastim, without reaching statistical significance (p = 0.38). Conclusion: Pegfilgrastim appears to be equivalent to filgrastim after high-dose BEAM followed by APBSCT in the treatment of lymphoma patients