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PubMed1985

Statistical analysis of growth limitations in Paracoccus denitrificans: an experiment with a completely randomized two-way factorial design with replications.

Cultivation of microorganisms under growth limitation is a widely used technique in microbiology. The relevant investigations, though seemingly based on straightforward experiments, have generated conflicting results, e.g., concerning molar growth yields. The purpose of this paper is to show that discrepancies in the literature could be solved if more attention were paid to methodology, especially statistics. New experimental results, concerning growth limitations in Paracoccus denitrificans, will exemplify this. They include the following items. Two limitations, one of them being succinate limitation, were established in the present study. Molar growth yields on succinate were 41 g X mol-1 for succinate limitation (95% confidence limits were 38 and 44) and 32 g X mol-1 for the other limitation (95% confidence limits were 29 and 35). The latter result is compatible with sulphate limitation, but the present experimental design does not really permit this conclusion.

Analysis of Variance↗
PubMed2001

Detection of flow limitation in mechanically ventilated patients.

OBJECTIVE: In mechanically ventilated patients flow limitation often goes unrecognised. We compared three methods for detection of flow limitation in mechanically ventilated patients: the resistance method, the negative expiratory pressure (NEP) method, and the interrupter method. DESIGN: Prospective study. SETTING: A medical intensive care unit in a university hospital. PATIENTS: Twenty-six patients (20 COPD, six other pathology), mechanically ventilated under sedation. MEASUREMENTS AND RESULTS: Respiratory mechanics were obtained during application of the three methods. For the resistance method, flow limitation was expressed as percentage of expiratory tidal volume, in which flow did not decrease (FLP-R). For the NEP method, flow limitation was expressed as percentage of expiratory tidal volume in which flow did not increase (FLP-NEP). For the interrupter method, flow limitation was expressed as area of spike-overshoot in flow after interruption. In 18 COPD patients, flow limitation was detected by all methods; mean FLP-R 76% (SD 12%), mean FLP-NEP 90% (SD 11%), mean spike area 21 ml (SD 7 ml). In three patients with other pathology, these values were, respectively, 20% (SD 19%), 48% (SD 21%), and 5 ml (SD 4 ml). The three methods were in close agreement. In nine patients the resistance method increased flow and in six patients the NEP method decreased flow compared to the unimpeded breath. CONCLUSIONS: In mechanically ventilated patients, flow limitation can well be detected by the resistance-, NEP-, and interrupter methods. However, the NEP method can overestimate the flow limited portion, while the resistance method can underestimate the flow limited portion. The interrupter method is found to be less practical.

Adult↗
PubMed2005

Limits to sustained energy intake IX: a review of hypotheses.

Several lines of evidence indicate that animals in the wild may be limited in their maximal rates of energy intake by their intrinsic physiology rather than food availability. Understanding the limits to sustained energy intake is important because this defines an envelope within which animals must trade-off competing activities. In the first part of this review, we consider the initial ideas that propelled this area and experimental evidence connected with them. An early conceptual advance in this field was the idea that energy intake could be centrally limited by aspects of the digestive process, or peripherally limited at the sites of energy utilisation. A model system that has been widely employed to explore these ideas is lactation in small rodents. Initial studies in the late 1980s indicated that energy intake might be centrally limited, but work by Hammond and colleagues in the 1990s suggested that it was more likely that the limits were imposed by capacity of the mammary glands, and other works tended to support this view. This consensus, however, was undermined by studies that showed milk production was higher in mice at low temperatures, suggesting that the capacity of the mammary gland is not a limiting factor. In the second part of the review we consider some additional hypotheses that might explain these conflicting data. These include the heat dissipation limits hypothesis, the seasonal investment hypothesis and the saturated neural control hypothesis. Current evidence with respect to these hypotheses is also reviewed. The limited evidence presently available does not unambiguously support any one of them.

Animals↗
PubMed2006

Relative strengths of benthic algal nutrient and grazer limitation along a lake productivity gradient.

The relative effects of nutrients and herbivores on primary producers are rarely compared across ecosystems that vary in potential primary productivity. Furthermore, proposed mechanisms to explain such patterns remain understudied. Here, I examine the strength of nutrient and grazer (herbivore) limitation (i.e., the extent to which producers' growth is limited by insufficient nutrient supply or herbivory) of benthic algae across 13 southwest Michigan lakes that vary widely in productivity (i.e., resource supply). I compare the observed patterns of algal limitation and species composition to those predicted by two simple models: one that includes multiple species and species' traits (the food-web model) and one that includes no variation in species or traits (the food-chain model). Species in the food-web model are assumed to display a tradeoff between resource competitive ability and resistance to herbivory (the "keystone predator" tradeoff). Among these lakes, benthic algal nutrient limitation was positive (x=0.083 day-1) and declined significantly along a lake N:P gradient. In contrast, grazer limitation was negative (x=-0.019 day-1) and was not significantly related to any of the measured lake productivity variables. Negative grazer limitation indicated that the removal of grazers caused unexpected declines in algal biomass, which were potentially due to indirect, positive effects (e.g., nutrient recycling) of grazers. Nutrient limitation was significantly stronger than grazer limitation across lakes, which was more consistent with the food-web versus food-chain model. Changes in algal composition were also broadly consistent with predictions of the food-web model in that vulnerable, superior nutrient competitors dominated in low productivity lakes and more grazer-resistant species were observed in high productivity lakes. In general, these results point to the importance of examining limiting factors across systems and the consideration of key species' traits when predicting and interpreting patterns.

Animals↗
PubMed1992

Symptom-limited versus low level exercise testing before hospital discharge after myocardial infarction.

OBJECTIVE: This study was undertaken to compare a low level and a symptom-limited test performed before hospital discharge after an uncomplicated myocardial infarction. BACKGROUND: Exercise testing after myocardial infarction provides useful prognostic information. Usually either a low level test is performed before hospital discharge or a symptom-limited test is performed at 3 weeks. METHODS: The study group comprised 202 patients with an uncomplicated myocardial infarction; 58 patients had a non-Q wave infarction and 115 patients had received thrombolytic therapy. Both a low level and a symptom-limited exercise test were performed in 200 of the 202 study patients in randomized order on consecutive days, a mean of 7.4 +/- 2.3 days after infarction. RESULTS: The symptom-limited test required a considerably greater effort than the low level test: exercise duration was 554 +/- 209 versus 389 +/- 125 s (p less than 0.0001), and peak work load was 5.7 +/- 1.8 versus 4.2 +/- 1.1 METs (p less than 0.0001). The peak heart rate was higher during the symptom-limited test (121 +/- 20 vs. 108 +/- 14 beats/min, p less than 0.0001), as was the rate-pressure product. The number of patients who developed ST segment depression greater than or equal to 1 mm increased from 56 during the low level test to 89 during the symptom-limited test (p less than 0.0001). ST segment depression greater than or equal to 2 mm occurred in 22 patients during the low level test and in 41 patients during the symptom-limited test, an 86% increase (p less than 0.0001). The number of patients with either angina or ST depression greater than or equal to 1 mm increased from 66 to 105 (p less than 0.0001) with the symptom-limited test. Exercise test results were similar for patients with a Q wave or a non-Q wave infarction. Exercise duration was longer and exercise-induced ST depression less frequent in patients who had received thrombolytic therapy. CONCLUSIONS: A symptom-limited exercise test performed before hospital discharge after uncomplicated myocardial infarction provides a significantly greater cardiovascular stress than does a low level test and is associated with an ischemic response nearly twice as frequently. The prognostic significance of a positive response at higher work loads has not been defined.

Angina Pectoris↗
PubMed2004

Joint range of motion limitations in children and young adults with spinal muscular atrophy.

OBJECTIVES: To elicit descriptive data about limited joint range of motion (ROM) in subjects with type II or III spinal muscular atrophy (SMA) and to examine the relation between the number of motions with limited range and both age and functional ability. DESIGN: Descriptive cross-sectional study. SETTING: Neurologic pediatric outpatient clinic at a hospital in Taiwan. PARTICIPANTS: Twenty-seven subjects with SMA type II (mean age, 9.8+/-6.5y) and 17 with SMA type III (mean age, 12.2+/-8.7y). Intervention Measurement with transparent goniometers of joint ROM bilaterally of the shoulder, elbow, wrist, hip, knee, and ankle. MAIN OUTCOME MEASURES: The proportion of participants with each ROM limitation compared with all participants with the same SMA type, age distribution of the participants with each ROM limitation, mean range loss of each motion limitation, and the contracture index (risk index of joint contracture). RESULTS: Eighty-nine percent of the participants with SMA type II experienced knee extension limitation. Approximately 50% of the participants with both types of SMA had ankle dorsiflexion limitation. The motions of knee and hip extension and ankle dorsiflexion also had a relatively high contracture index. The number of motions with limited range positively correlated ( P <.001) with age and upper-extremity functional grade (the higher the functional grade, the poorer the functional ability) for SMA type II. CONCLUSIONS: We found varying degrees of joint ROM limitation. Certain motions were noted to be high risks for the development of contractures. This risk was higher mostly in younger children.

Adolescent↗
PubMedDate not supplied

Correlates of functional limitations in older Chinese patients with chronic obstructive pulmonary disease in Hong Kong.

BACKGROUND: Few studies have examined functional limitations in Chinese elders with chronic obstructive pulmonary disease (COPD). OBJECTIVES: The objective was to describe the functional limitations, respiratory status, and psychologic status of Chinese elders with COPD; to examine the relationships between functional limitations and selected variables including age, gender, duration of COPD, and hospital readmission history; and to identify the variables that predict functional limitations in Chinese elders with COPD. METHOD: A correlational predictive study was performed with a sample of 97 Chinese elders with COPD. The subjects were 65 years or older and recruited from two hospitals in Hong Kong. Data were individually collected on the day the individual was to be discharged from the hospital, by using the Barthel Index for functional limitations, forced expiratory volume in 1 second percent predicted for respiratory status, and General Health Questionnaire (28 items) for psychologic status. Information on age, gender, duration of COPD, and hospital readmission history were also identified from the medical record. RESULTS: Functional limitations in Chinese elders with COPD were significantly correlated with poorer respiratory status and more depressive symptoms. Multiple regression analysis indicated that depressive symptoms were a significant predictor of functional limitations after controlling for the effect of respiratory status. DISCUSSION: The results of this study demonstrate that depressive symptoms to some extent predict functional limitations in Chinese elders with COPD. Investigation of the effect of appropriate screening and interventions for depressive symptoms on preventing, delaying, or reducing functional limitations in this patient group is suggested.

Activities of Daily Living↗
PubMed2004

Impact of mandatory resident work hour limitations on medical students' interest in surgery.

BACKGROUND: The number of US medical students applying for general surgery residency has been declining. Recent studies have shown that the issue of "controllable lifestyle" has become a critical factor in medical students' decision-making process. We postulate that widespread implementation of resident work hour limitations would bolster medical students' interest in pursuing surgical careers. STUDY DESIGN: Students from New York University School of Medicine were surveyed about their attitudes toward work hour limitations and its effect on their interest in pursuing a surgical residency. One hundred thirty-two students participated. RESULTS: Nearly 95% of respondents believed that work hour limitations were a positive change and, if all other factors were equal, they would choose a training program that used work hour limitations over one that did not. The most common reasons cited in favor of limits were improvements in resident lifestyle (42%) and patient safety (34%). Fifty-three percent of respondents indicated that presence of work hour limitations alone would increase their interest in considering a surgical residency and only 2% of medical students indicated that it would lessen their interest in surgery. Not surprisingly, intellectual interest in a specialty was the most important factor in choosing a residency for 86% of students. Nevertheless, work hour limitations were designated a higher priority than future salary by 55% of medical students. CONCLUSIONS: The presence of work hour limitations has a positive impact on medical students' interest in surgery. Widespread implementation of work hour limitations may bolster the number of applications for surgical residency.

Adult↗
PubMed2006

Change in impairments in the first two treatments predicts outcome in impairments, but not in activity limitations, in subacute neck pain: an observational study.

QUESTION: Does change in impairments within and between the first two manual therapy treatments predict change in activity limitations by the end of treatment in patients with subacute neck symptoms? DESIGN: Longitudinal, observational study. PARTICIPANTS: 29 people with neck pain for more than two weeks who subsequently received >or= three treatments. OUTCOME MEASURES: Impairments measured were active neck ROM in six directions (total ROM), most limited direction of ROM (limited ROM), pain intensity, and pain location. Activity limitations were measured using the Neck Disability Index and the Patient Specific Functional Scale. Patients' perceptions of change were measured using the Global Perceived Effect Scale. Impairments and patients' perceptions were measured before and after the first two treatments and before the final treatment whereas activity limitations were measured only before the first and last treatments. RESULTS: All measures improved by the end of treatment.Between-treatment change in limited ROM predicted change in limited ROM (rs2 = 0.53 and 0.57) and total ROM (rs2 = 0.26) by the end of treatment. Within- and between-treatment change in pain location predicted change in pain location (rs2 = 0.24, 0.27,0.28, and 0.57) by the end of treatment. No significant relationships were found between change in any impairments in the first two treatments and change in activity limitations by the end of treatment. CONCLUSIONS: Change in impairments predicts change in the same impairment by the end of treatment, but not in other impairments or activity limitations. It is recommended that there assessments used to guide and refine treatment be individualised and related to the specific goals for that patient.

Activities of Daily Living↗
PubMed1997

Activation of Peptide ions by blackbody radiation: factors that lead to dissociation kinetics in the rapid energy exchange limit.

Unimolecular rate constants for blackbody infrared radiative dissociation (BIRD) were calculated for the model protonated peptide (AlaGly)(n) (n = 2-32) using a variety of dissociation parameters. Combinations of dissociation threshold energies ranging from 0.8 to 1.7 eV and transition entropies corresponding to Arrhenius preexponential factors ranging from very "tight" (A(infinity) = 10(9.9) s(-1)) to "loose" (A(infinity) = 10(16.8) s(-1)) were selected to represent dissociation parameters within the experimental temperature range (300-520 K) and kinetic window (k(uni) = 0.001-0.20 s(-1)) typically used in the BIRD experiment. Arrhenius parameters were determined from the temperature dependence of these values and compared to those in the rapid energy exchange (REX) limit. In this limit, the internal energy of a population of ions is given by a Boltzmann distribution, and kinetics are the same as those in the traditional high-pressure limit. For a dissociation process to be in this limit, the rate of photon exchange between an ion and the vacuum chamber walls must be significantly greater than the dissociation rate. Kinetics rapidly approach the REX limit either as the molecular size or threshold dissociation energy increases or as the transition-state entropy or experimental temperature decreases. Under typical experimental conditions, peptide ions larger than 1.6 kDa should be in the REX limit. Smaller ions may also be in the REX limit depending on the value of the threshold dissociation energy and transition-state entropy. Either modeling or information about the dissociation mechanism must be known in order to confirm REX limit kinetics for these smaller ions. Three principal factors that lead to the size dependence of REX limit kinetics are identified. With increasing molecular size, rates of radiative absorption and emission increase, internal energy distributions become relatively narrower, and the microcanonical dissociation rate constants increase more slowly over the energy distribution of ions. Guidelines established here should make BIRD an even more reliable method to obtain information about dissociation energetics and mechanisms for intermediate size molecules.

Journal Article↗
PubMed1971

Effect of sulphate-limited growth on mitochondrial electron transfer and energy conservation between reduced nicotinamide-adenine dinucleotide and the cytochromes in Torulopsis utilis.

1. Conditions have been established for the sulphate-limited growth of Torulopsis utilis in continuous culture. 2. Mitochondria prepared from sulphate-limited cells lack both piericidin A sensitivity and the first energy-conservation site (site 1). Sensitivity to antimycin A or cyanide and the second and third energy-conservation sites were apparently unaffected by sulphate-limited growth. 3. Aerobic incubation for 8h of sulphate-limited cells with a low concentration of sulphate (50mum or less) resulted in the recovery of mitochondrial piericidin A sensitivity and site 1. The use of higher concentrations of sulphate (250mum or more) still resulted in the recovery of mitochondrial piericidin A sensitivity and site 1, but also resulted in the appearance of a non-phosphorylating oxidase, which mediated oxidation of the respiratory chain at about the level of cytochrome b in an antimycin A- and cyanide-insensitive manner. Both this alternative route and the conventional normal route of respiration were shown to coexist and to intercommunicate at the level of cytochrome b. 4. Low-temperature spectroscopy failed to identify any new respiratory component to explain the alternative route. 5. The apparent affinity of the alternative route for oxygen was similar to that for the conventional route through cytochrome oxidase, namely half-maximal activity at 0.1mum-oxygen or less. 6. The non-haem iron concentration of submitochondrial particles was unaffected by sulphate limitation, whereas the acid-labile sulphide concentration was lowered tenfold. Marked increases (between four- and 30-fold) in the acid-labile sulphide concentration of submitochondrial particles were observed in sulphate-limited cells after aerobic incubation with various concentrations of sulphate. The lowest increase (fourfold) was observed without added sulphate, the highest (30-fold) with 1.0mm added sulphate. 7. The ratio of non-haem iron to acid-labile sulphide in submitochondrial particles varied with different growth conditions from a maximum of 15.0 to a minimum of 0.72. It is suggested that analytical measurements of non-haem iron are an inadequate guide to the concentration of iron-sulphur protein in complex systems. 8. The effects of sulphate-limited growth on site 1 and piericidin sensitivity are interpreted to indicate a role for iron-sulphur protein in these properties. 9. The aerobic incubation of sulphate-limited cells with cycloheximide resulted in the recovery by mitochondria of site 1 but not of piericidin sensitivity. 10. The appearance of the alternative route for cyanide- and antimycin-A (but not piericidin A-) insensitive respiration on incubating sulphate-limited cells with sulphate concentrations higher than 250mum indicates that the alternative route involves an iron-sulphur protein.

Antimycin A↗
PubMed2000

Perfusion, diffusion and their heterogeneities limiting blood-tissue O2 transfer in muscle.

The relative roles of blood flow (perfusion) and diffusion in O2 supply to exercising muscle can be estimated using a simple model consisting of an O2-consuming tissue block in contact with blood (perfusion Q, slope of O2 equilibirum curve beta) through a resistance to O2 diffusion (O2-diffusing capacity D). The decisive variable is the 'equilibration index' Y=D/(Qbeta). With decreasing Y, diffusion limitation increases and perfusion limitation decreases (Y > 3 indicates predominant perfusion limitation; 3 > Y > 0.1, combined perfusion and diffusion limitation, Y < 0.1, prevailing diffusion limitation). On the basis of literature data on humans at maximum O2 uptake, O2 supply to muscle is shown to be always limited by both perfusion and diffusion. In nomoxia, perfusion limitation is prevalent, but in hypoxia diffusion limitation becomes predominant. The underlying model assumes perfect homogeneity of muscles with respect to O2 requirement, diffusion conditions and blood flow. In numerous studies on isolated and in situ muscles a pronounced heterogeneity of blood flow has been found, also during exercise and at maximal O2 uptake. It is shown that with unequal distribution of blood flow and/or O2-diffusing capacity the efficiency of O2 transfer is reduced with reference to the homogeneous model. Therefore, the diffusing capacity value calculated on the basis of the homogeneous model is an underestimate of the true diffusing capacity and diffusion limitation is overestimated.

Diffusion↗
PubMed2002

Linearly scaled, rate-invariant normal limits for QT interval: eight decades of incorrect application of power functions.

INTRODUCTION: Normal limits for QT traditionally are derived as mean +/- 2*SD, with rate adjustment done by dividing QT values by power functions such as RR 1/2 (proportional scaling). METHODS AND RESULTS: We evaluated procedures for deriving normal limits by comparing adjusted QT distributions versus heart rate using ECG data of 11,739 normal men and women aged > or = 40 years. QT decreased as predicted by many power functions with heart rate but its SD remained relatively unchanged. Consequently, proportional scaling induced rate-dependent distortion of normal limits. Furthermore, QT distributions by heart rate were variably skewed and non-normal. Therefore, normal limits expressed as mean +/- 2*SD were misleading. Omission of regression intercept was an additional reason for failure of Bazett's and Fridericia's formulas. Regularized normal limits for adjusted QT (Qta) were obtained with linear instead of proportional scaling of type QTa = QT + k1*(1 - RR(k2)), for instance, with k2 = 0.5, k1 = 0.360 for males and 0.353 for females, or with k2 = 0.42, k1 = 0.414 for males and 0.420 for females. With linear scaling, QTa = 460 msec was established as the upper 2% normal limit, with 32 msec as the limit for a significant QTa increase from reference ECG in serial comparison. CONCLUSION: Traditional procedures for establishment of normal limits failed because of proportional scaling, assumption of normal QT distribution, or omission of regression intercept. Percentile distributions of linearly scaled adjusted QT produced regularized rate invariant normal limits within normal sinus rates.

Adult↗
PubMed2000

Normal limits of high-resolution signal-averaged ECG parameters of Japanese adult men and women.

High-resolution signal-averaged electrocardiography (Hi-Res ECG) has been found useful in measuring ventricular late potentials for identifying patients prone to life-threatening ventricular arrhythmias. Several studies have reported cut-off values (normal limits) of Hi-Res ECG parameters, including sex-specific limits, for adult population. However, there are no such studies reporting such limits in the Japanese population. Hi-Res ECGs were recorded from 482 normal healthy patients (204 men; 278 women) with no cardiac disease and normal electrocardiogram. Three Hi-Res ECG parameters filtered QRS duration (FQRSD), low amplitude signal duration under 40 microV of terminal QRS (LASD), and root mean square voltage in the terminal 40 milliseconds (RMSV) were analyzed. FQRSD was longer in men than in women (P < .0001). RMSV was larger in men than in women (P < .0001). There was no significant difference in LASD between men and women. The upper limit (90th percentile) of FQRSD was 116 milliseconds for women. The upper limit of LASD was 42 milliseconds for both men and women. The lower limit (10th percentile) of the RMSV was 14 microV for both men and women. There was no significant difference in the distributions of the Hi-Res ECG parameters between our study and an earlier study on mostly whites from the United States and Europe. The upper limits (90th percentile) of FQRSD and LASD in the Japanese normal patients were nearly the same as for whites. But, the lower limit (10th percentile) of RMSV in our Japanese normals was significantly smaller than that for whites. Therefore, it may be necessary to use race-specific normal limits for late potential analysis. Criteria for abnormal late potentials (defined as abnormal values in at least 2 of the 3 Hi-Res ECG parameters) were met in 18 of 482 (3.7%) normal healthy patients. Further studies are needed to evaluate the role of these criteria in identifying cardiac patients with life-threatening arrhythmias in the Japanese population.

Adolescent↗
PubMed2006

Estimated MP2 and CCSD(T) interaction energies of n-alkane dimers at the basis set limit: comparison of the methods of Helgaker et al. and Feller.

The MP2 (the second-order Møller-Plesset calculation) and CCSD(T) (coupled cluster calculation with single and double substitutions with noniterative triple excitations) interaction energies of all-trans n-alkane dimers were calculated using Dunning's [J. Chem. Phys. 90, 1007 (1989)] correlation consistent basis sets. The estimated MP2 interaction energies of methane, ethane, and propane dimers at the basis set limit [EMP2(limit)] by the method of Helgaker et al. [J. Chem. Phys. 106, 9639 (1997)] from the MP2/aug-cc-pVXZ (X=D and T) level interaction energies are very close to those estimated from the MP2/aug-cc-pVXZ (X=T and Q) level interaction energies. The estimated EMP2(limit) values of n-butane to n-heptane dimers from the MP2/cc-pVXZ (X=D and T) level interaction energies are very close to those from the MP2/aug-cc-pVXZ (X=D and T) ones. The EMP2(limit) values estimated by Feller's [J. Chem. Phys. 96, 6104 (1992)] method from the MP2/cc-pVXZ (X=D, T, and Q) level interaction energies are close to those estimated by the method of Helgaker et al. from the MP2/cc-pVXZ (X=T and Q) ones. The estimated EMP2(limit) values by the method of Helgaker et al. using the aug-cc-pVXZ (X=D and T) are close to these values. The estimated EMP2(limit) of the methane, ethane, propane, n-butane, n-pentane, n-hexane, n-heptane, n-octane, n-nonane, and n-decane dimers by the method of Helgaker et al. are -0.48, -1.35, -2.08, -2.97, -3.92, -4.91, -5.96, -6.68, -7.75, and -8.75 kcal/mol, respectively. Effects of electron correlation beyond MP2 are not large. The estimated CCSD(T) interaction energies of the methane, ethane, propane, and n-butane dimers at the basis set limit by the method of Helgaker et al. (-0.41, -1.22, -1.87, and -2.74 kcal/mol, respectively) from the CCSD(T)/cc-pVXZ (X=D and T) level interaction energies are close to the EMP2(limit) obtained using the same basis sets. The estimated EMP2(limit) values of the ten dimers were fitted to the form m0+m1X (X is 1 for methane, 2 for ethane, etc.). The obtained m0 and m1 (0.595 and -0.926 kcal/mol) show that the interactions between long n-alkane chains are significant. Analysis of basis set effects shows that cc-pVXZ (X=T, Q, or 5), aug-cc-pVXZ (X=D, T, Q, or 5) basis set, or 6-311G** basis set augmented with diffuse polarization function is necessary for quantitative evaluation of the interaction energies between n-alkane chains.

Journal Article↗
PubMed2002

Limited surgery for cancer of the larynx and hypopharynx: options and consequences.

We reviewed surgical options for laryngeal preservation (limited surgery) in laryngeal and hypopharyngeal cancers and the consequences of the options. Of 44 patients with laryngeal cancer, 11 (25%) received limited surgery and 33 (75%) received total laryngectomy. The survival rates were 91% for the limited surgery group and 73% for the total (radical) surgery group. Of 31 patients with hypopharyngeal cancer, 7 (23%) received limited surgery and 24 (77%) received total laryngopharyngectomy. The survival rates were 53% for the limited surgery group and 40% for the total (radical) surgery group. The survival rates associated with limited surgery were thus better than those for total (radical) surgery for cancers of both the larynx and hypopharynx. This was attributed to the limited surgery group comprising well-selected patients with confined lesions. Organ preservation surgery should be technically simple, reliable in terms of its functional impact and, above all, should not jeopardize the patient's survival. Supracricoid subtotal laryngectomy with cricohyoidoepiglottopexy or cricohyoido-pexy has great potential for laryngeal preservation and will become the major limited surgery modality for treating cancer of the larynx. Limited surgery, however, needs to be performed with great care and is indicated only for very well-selected patients with cancer of the hypopharynx.

Adult↗
PubMed2004

Activity limitation, coping efficacy and self-perceived physical independence in people with disability.

OBJECTIVE: This study examines whether the relationships between activity limitations and independence are mediated by coping efficacy. METHOD: Data come from a cross-sectional survey of 286 adults, aged 55 or older, with osteoarthritis (OA) and/or osteoporosis (OP). Physical independence was assessed by asking to what extent respondents' OA/OP had affected their independence on a 5-point scale from 'not at all' to 'a great deal'. Activity limitations were examined in three domains: personal care, community mobility, and household activity. A coping efficacy scale was derived from three items scored on a 5-point Likert-type scale from strongly disagree to strongly agree. Structural equation modelling was used to test the model. RESULTS: Activity limitation in household activities was directly associated with perceptions of independence, with a statistically significant standardized path coefficients of -0.32. The effect of activity limitation in personal care was partially mediated by coping efficacy with a direct effect of -0.41 which was partially offset by coping efficacy to give a net effect of -0.308. The effect of community mobility on independence was completely mediated through coping efficacy with significant standardized path coefficients of -0.85 (community mobility to coping efficacy) and -0.14 (coping efficacy to independence). The overall model's goodness of fit was excellent (R =0.59, ch-square/df=1.4, CFI=0.97, and NNFI=0.97). CONCLUSION: Activity limitation had a detrimental effect on the level of self-perceived independence. Coping efficacy showed a significant mediating effect between activity limitation and self-perceived independence for the domains of personal care and community mobility, but not household tasks. This study suggests that how activity limitation affects perceptions of independence varies across activity limitation domains, and indicates the importance of incorporating activity limitation domains in future studies.

Activities of Daily Living↗
PubMed2005

Comparing self-report, clinical examination and functional testing in the assessment of work-related limitations in patients with chronic low back pain.

PURPOSE: To compare the work-related limitations assessed using self-report, clinical examination and functional testing in patients with chronic low back pain (CLBP). METHODS: Work-related limitations of 92 patients were assessed using self-report, clinical examination and functional testing. To obtain the assessed limitations the patient (self-report), the physician (clinical examination) and a trained evaluator (functional testing) completed a scorings form about the work-related limitations of the patient. The Isernhagen Work Systems Functional Capacity Evaluation (IWS FCE) was used to obtain the functional testing results. A kappa value of more than 0.60, absolute agreement of more than 80% and ICC of more than 0.75 were considered as acceptable. RESULTS: Little agreement and correlation among self-report, clinical examination and functional testing were found for the assessment of work-related limitations. Self-reported limitations were considerably higher than from those derived from clinical examination or functional testing. Additionally, the limitations derived from the clinical examination were higher than those derived from the IWS FCE. CONCLUSION: Comparing self-report, clinical examination and functional testing for assessing work-related limitations in CLBP patients showed large considerable differences in limitations. Professional health care workers should be aware of these differences when using them in daily practice.

Adult↗