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The reliability of determining effort level of lifting and carrying in a functional capacity evaluation.

OBJECTIVES: To establish inter- and intra-rater reliability of observations in a functional capacity evaluation. BACKGROUND: Functional capacity evaluations are used to assess a person's functional capacity as it relates to work. Lifting and carrying are important aspects of a functional capacity evaluation. An evaluator determines the patient's levels of effort through standardized observations. Questions remain with regards to the reliability of these observations. METHODS: Four healthy subjects were videotaped while performing two lifts and four carries with progressive loads. The videotape was scrambled randomly and viewed twice by 3 physical therapists and 2 occupational therapists. The evaluators determined the amount of effort it required (light, medium, heavy, and maximum). The inter- and intra-rater reliability of the observations was expressed by means of percentage agreement. RESULTS: Inter-rater reliability ranged 87-96%, intra-rater reliability ranged 93-97%. CONCLUSION: The results indicate that by means of standardized observations, therapists can reliably determine effort level during lifting and carrying in healthy subjects, and thus affirm the findings of other studies of similar design.

Adult↗

[Plastic properties of the venous bed of the brain following disengagement of the external jugular veins at different stages of ontogenesis].

The capacity of the venous bed in the brain being great, even inconsiderable changes of the vein lumen can cause severe changes in the blood circulation without an enlargement of the cranial cavity volume. The progressing venous stagnation in the brain is a severe disease of not only the brain but also the whole organism. So, we attempted to study the character of compensatory redistribution of the pial venous system of the cerebrum in occlusion of both exterior jugular veins and to establish its developmental accomodative properties. The work has been performed on 45 dogs. The plasticity of the cerebral pial veins was found to drop with age, their reserving capacity-to grow and their carrying capacity-to decrease. Three successive phases are characteristic of the compensatory-adaptational changes: diffuse dilatation of the venous network, appearance of collaterals and their development against the background of reduction of the surrounding venous network.

Adaptation, Physiological↗

Long-term culture and characterization of the adult ventricular and atrial cardiac muscle cell.

Ventricular and atrial cardiac muscle cells isolated from the adult rat have been cultured and characterized. Once established in culture these myocytes resemble morphologically their in vivo counterparts except that they are flattened on the surface of the culture flask. These cultured cells possess differentiated ultrastructural characteristics including sarcomerically arranged myofilaments, appropriately organized sarcoplasmic reticulum, intercalated discs and a highly organized transverse tubular system. These cells regain the capacity to carry out semiconservative DNA replication; this capacity had previously been thought to have permanently been lost during early neonatal development. Other studies have shown that cultured ventricular myocytes resemble metabolically the in vivo and isolated perfused rat heart and that they possess an adenylate cyclase system which responds appropriately to adrenergic stimulation. These cells also appear electrophysiologically to resemble the intact adult heart. Long-term culture of adult cardiac muscle cells provides a new and unique system which can be used to study the structure and function of the adult mammalian ventricular and atrial cardiac myocyte.

Animals↗

[Comparison of physiological work capacity in lifting and carrying the loads].

Comparative data on the physiologic value of carrying over (along the horizontal surface with the rate of walking of 4.5 km/hr) and load lifting from the floor up to 0.7 m with the rate of 6, 10, 16 per min are given, the magnitude of external load with the weight of 4-300 H being different. Physiologic values of the completed work have been compared because of the significant difference in the work load when lifting and carrying over some objects. It is demonstrated that external load magnitude and physiologic value of muscular work are directly correlated. Physiologic work value during load lifting per work unit is higher than that during its carrying over. The ratio of physiologic value of load carrying over and lifting is different under various magnitudes of external load.

Energy Metabolism↗

Sequential estrogen-progestin replacement therapy in healthy postmenopausal women: effects on cholesterol efflux capacity and key proteins regulating high-density lipoprotein levels.

Thirty healthy postmenopausal women were randomized into 2 groups that received a sequential combined hormone-replacement therapy (HRT) (n = 18; conjugated equine estrogen 0.625 mg/d for 28 days and 5 mg of medroxyprogesterone acetate during the last 14 days) or placebo (n = 12). Plasma samples were collected before and during treatment (days 0, 15, 43, 71). High-density lipoprotein (HDL) lipid content, lipoprotein (Lp)A-I and LpA-I:LpA-II concentration, lecithin:cholesterol acyl transferase activity (LCAT), phospholipid transfer protein (PLTP) activity, and the plasma capacity to carry out cholesterol efflux from Fu5AH cells were measured. Most significant changes were found within the first 15 days after HRT. After 71 days of HRT, we found an increase in LpA-I lipoparticles (27%) and the following HDL lipids: phospholipids (21%), triglycerides (45%), and free cholesterol (43%), as well as an increase in cholesterol efflux (12.5%). PLTP activity, on the other hand, decreased 21% after 71 days of treatment. No significant changes in LCAT activity, HDL-cholesterol ester or LpA-I:LpA-II particles were found. Positive correlation between cholesterol efflux and the variables LpA-I and HDL-phospholipids were observed. PLTP was negatively correlated with apolipoprotein (apo) A-I, LpA-I, and LpA-I:LpA-II. In summary, our study, performed during 3 hormonal cycles, shows that HRT not only modifies HDL-cholesterol level, but also its lipid composition and HDL lipoparticle distribution. HRT enhances the plasma capacity to carry out cholesterol efflux from the Fu5AH system and decreases the activity of PLTP, a key protein regulating HDL levels. Considering the protocol sampling, these results represent mainly the estrogenic effect of HRT.

Cholesterol, HDL↗

Microwave solid-state synthesis of LiV(3)O(8) as cathode material for lithium batteries.

A novel and economical microwave route has been developed for the synthesis of electrochemically active LiV(3)O(8) material by using a domestic microwave oven. The heating behavior of the designed reaction system guided the preparation of LiV(3)O(8) at a suitable irradiation power (i.e. heating rate), reaction time, and temperature. At the lowest irradiation power, the conversion fraction of reactants was mainly controlled by reaction temperature. Characterization results of X-ray diffraction (XRD), Fourier transform infrared (FTIR) and Raman spectroscopy, scanning (SEM) and transmission (TEM) electron microscopy, and BET surface areas indicated that the phases of samples prepared by microwave and traditional methods were in good agreement. Nevertheless, the crystallinity, crystallite configuration, and morphology of the samples were different, and were affected by the irradiation time and power. A floppy superposition structure of nanosheets (the size of one nanosheet was about 4.5 microm x 1.2 microm x 3 nm) was preferentially grown at the lowest irradiation power, and this effect on structure was more in evidence as the nanorods formed at the highest irradiation power. Electrochemical studies on ionic conductivity, electrochemical impedance spectroscopy (EIS), and charge-discharge capacity were carried out. It was found that the conductivity, first discharge capacity, and cycle performances of the samples were affected by the crystal size, crystallinity, and crystal configuration and defection concentration. The sample L30 prepared at the lowest irradiation power and the shortest time (30 min) showed the highest discharge capacity (335 mAh/g), but its discharge capacity decreased rapidly. By comparison, the sample L100 had a floppy superposition structure of nanosheets and a high surface area, provided a good two-dimensional channel for the transition of Li(+) ions, and was stable during the intercalation/deintercalation process of Li(+) ions, therefore the high ionic conductivity, high discharge capacity, and good cycle performance were presented. The relationship between the electrochemical properties and the irradiation power was discussed.

Journal Article↗

Functional status and elderly Puerto Ricans.

The ability of the elderly to perform or carry-out a variety of activities that are normal for people in good physical health was measured by 18 questions: ten items about background information and eight questions pertaining to capacity to carry out activities. The capacity range established was 0 and 1. A 0 response revealed that the respondent had no difficulty and a 1 meant that she/he had difficulty at the time of the interview. The tests of significance were those of Kendall's Tau B and C, Cramer's V and Phi. The sub groups of elderly having the most limited functional status were females, urban zone elderly, the oldest old, those of a separated marital status, the never employed, and those with limited education and incomes. These findings are similar to those found in the United States, Europe and Japan.

Activities of Daily Living↗

Evaluating productivity and budgeting staff.

A principal objective of productivity measurement is the manager's desire to match available labor hours (capacity) with available workload (demand) while concurrently minimizing the cost of carrying that capacity. In this article, Mr. Schwartz presents technical labor capacity concepts from a management engineering perspective. Included is assistance in ascertaining the true number of labor hours in a radiology department, and in understanding workload measurement standards.

Efficiency↗

Influence of a recombinant hemoglobin solution on blood rheology.

BACKGROUND: Red cell transfusion is a matter of great concern because of viral infections. Recently, a genetically engineered hemoglobin, rHb 1.1, consisting of two alpha chains and one beta chain, has been developed; it has good oxygen-carrying and -unloading capacity and is devoid of renal toxicity. STUDY DESIGN AND METHODS: An in vitro study of the influence of increasing concentrations of rHb 1.1 on plasma and blood viscosity, red cell aggregation and deformability, and neutrophil deformability was performed. RESULTS: The rHb 1.1 (50 g/L in phosphate-buffered saline) had a viscosity of 0.80 +/- 0.02 mPa-sec at 37 degrees C, which was lower than that of normal Hb solution at the same Hb concentration (0.93 +/- 0.01 mPa-sec, p < 0.001) or of albumin, a protein with similar molecular weight (0.93 +/- 0.01, p < 0.0001). The admixture of rHb 1.1 to plasma or to red cell suspensions, at constant Hb concentration, led to a dose-dependent decrease in their viscosities. The simulation of replacement therapy during blood loss revealed rheologic properties of rHb 1.1 that were superior to those of all other fluids. The rHb 1.1 did not affect red cell aggregation or the deformability of red cells or white cells, as measured by the cells' transit time through small pores. CONCLUSION: These data indicate that rHb 1.1 has excellent rheologic properties and should hold promise not only as an oxygen-carrying therapeutic agent, but probably also as a hemodilutional agent that simultaneously decreases blood viscosity and provides oxygen-carrying capacity.

Blood Flow Velocity↗

Adsorption of Bismark Brown dye on activated carbons prepared from rubberwood sawdust (Hevea brasiliensis) using different activation methods.

Hevea brasiliensis or rubberwood tree, as it is commonly known finds limited use once the latex has been tapped. The sawdust of this tree is chosen to ascertain it viability as a precursor for activation. The carbons thus obtained were characterized in terms of iodine, methylene blue number and surface area. The best carbon in each method was utilized to study the adsorption of Bismark Brown, a dye used in the leather industry. Adsorption equilibrium studies were carried out with the synthetic solutions of the dye, at room temperature (298 K). Equilibrium data are fitted with the Langmuir and the Freundlich isotherms models for the system. The effects of contact time, adsorbent dosage and initial dye concentrations on sorption capacity were carried out. Excellent adsorption capacities of 2000 and 1111 mg g(-1) were obtained for steam and chemical followed by steam-activated carbons, respectively. Pilot-plant experimental studies have been performed using packed-bed column with different feed concentrations, flow rates and bed heights, to evaluate sorption of Bismark Brown on steam-activated carbon. Bed depth service time (BDST) design model have been used to analyze the data.

Adsorption↗

Kidney transplantation improves the multidimensional quality of life.

INTRODUCTION: Quality of life is affected during any illness, especially chronic diseases, such as renal failure. OBJECTIVE: To evaluate the quality of life after kidney transplantation. METHODS: One hundred patients were interviewed (60 men, 40 women, mean age 36 +/- 10.4 years, median 35 years) from July to October 2000 using the multidimensional questionnaire WHOQL-Bref. RESULTS: Eighty-eight percent of patients were satisfied/very satisfied with their general health condition. Seventy-seven percent manifested a good capacity to carry out daily activities, and 75% considered themselves satisfied with their work capacity. Quality of life was considered "very good" or "good" among 80%, and "neither good nor bad" in 20%. None considered quality of life in general as "bad" or "very bad." Most (87%) were satisfied with their current condition and with themselves after the kidney transplant. CONCLUSION: Patients perceive kidney transplant as capable of improving their quality of life. The most important finding in this study is that the results of the physical and psychological domains did not show any significant difference. It was possible to conclude that the quality of life for most subjects is related to reduction or disappearance of the symptoms caused by the previous disease.

Adult↗

Are American College of Rheumatology 50% response criteria superior to 20% criteria in distinguishing active aggressive treatment in rheumatoid arthritis clinical trials reported since 1997? A meta-analysis of discriminant capacities.

OBJECTIVE: To carry out a meta-analysis designed to compare the discriminant capacities of American College of Rheumatology 50% (ACR50) with 20% (ACR20) responses in clinical trials on rheumatoid arthritis reported after 1997 and to analyse whether ACR50 can be as informative as ACR20 in distinguishing active from control treatments in more recent trials. METHODS: Clinical trials on rheumatoid arthritis reported since 1997 were identified, which included aggressive combinations of disease-modifying antirheumatic drugs and glucocorticoids, as well as powerful new agents-leflunomide, etanercept, infliximab, anakinra, adalimumab, abatacept, tacrolimus and rituximab. A meta-analysis of ACR20 compared with ACR50 responses for 21 clinical trials was carried out on differences in proportions of responders for active and control treatments and corresponding odds ratios (ORs). RESULTS: In all but one clinical trial on rheumatoid arthritis published since 1997 with data available on ACR20 and ACR50, more than 50% of patients who were ACR20 responders among those randomised to active treatment were also ACR50 responders. This phenomenon was seen for control groups in 38% of trials, many of which included treatment with methotrexate. A meta-analysis of the clinical trials indicated a slight advantage to ACR50 for quantifying treatment comparisons, not significant for differences in proportions but significant for ORs. CONCLUSION: ACR20 and ACR50 seem to be similar in distinguishing active from control treatments in clinical trials on rheumatoid arthritis reported since 1997. As ACR50 represents a considerably stronger clinical response, ACR50 may be a preferred end point for contemporary clinical trials on rheumatoid arthritis.

Antirheumatic Agents↗

Test-retest reliability of lifting and carrying in a 2-day functional capacity evaluation.

The objectives of this study were to establish test-retest reliability of lifting and carrying of a functional capacity evaluation (FCE) on two consecutive days and to verify the need for a 2-day protocol. A cohort of 50 patients (39 men, 11 women) with nonspecific low back pain were evaluated using a 2-day FCE protocol. Intraclass correlation coefficients (ICC) were calculated for weight lifted and carried. Predictive relationships between test and retest were explored by means of a regression analysis. The results of ICC were lifting low 0.87, lifting overhead 0.87, and carrying 0.77. Performances on day 2 were on an average 6-9% higher. Other than the amount of weight handled on day 1, no variable was found to predict performance on day 2. It was concluded that test-retest reliability of lifting and carrying was good, and the need for a 2-day protocol could not be confirmed.

Adult↗

Frameshift mutagenesis by nitracrine analogues in wild-type, uvrB, polA and recA strains of Salmonella typhimurium, with and without plasmid pKM101.

The mutagenic potential of 9-[(3-dimethylaminopropyl)amino]-acridine and its 1-, 2-, 3- and 4-nitro derivatives was studied in several strains of Salmonella typhimurium carrying the frameshift marker hisC3076. The strains all carried deep rough (rfa) mutations, and were either wild-type with respect to DNA repair capacity or carried recA, uvrB, polA1 or polA3 (amber) mutations. Derivatives with and without plasmid pKM101 were also studied. The des-nitro compound resembled 9 aminoacridine and other simple intercalating compounds. Both toxicity and mutagenesis were apparently unaffected by the uvrB and recA mutations or by the presence of plasmid pKM101. However, mutagenicity was reduced by the polA1 mutation, and virtually eliminated by the polA3 mutation. The drug was substantially more toxic in the latter, slightly more toxic in the former, of these polA- strains. Plasmid pKM101 enhanced mutagenesis and protected from toxicity in both polA1- and polA3- strains, although it did not restore either of these parameters to the level in the wild-type strain. The 2-nitro compound was generally similar to the des-nitro compound, except that it was considerably more toxic and apparently non-mutagenic in the recA-bearing strain. By contrast, mutagenicity of the 3- and 4-nitro compounds was enhanced by the uvrB mutation and by the presence of the plasmid. These compounds were highly toxic but non-mutagenic in the recA- strain, and showed some increased toxicity in polA1- and polA3- strains. The 1-nitro compound has been previously found to cross-link DNA. Unlike well-characterised cross-linkers such as mitomycin C it was highly mutagenic in the uvrB- strain, and this mutagenesis was enhanced by plasmid pKM101, but eliminated by the recA mutation. At high doses, where the drug was completely toxic towards uvrB- or recA-carrying strains, it became mutagenic in the DNA-repair-proficient strains. This 'high-dose' mutagenesis was enhanced by plasmid pKM101, but reduced by the polA1 mutation and almost eliminated by the polA3 mutation. Although there are several possible interpretations of these data, they are compatible with the suggestion that the lesion induced by high doses (but not by low doses) of nitracrine is a cross-link, but that this is not the major mutagenic lesion.

Aminoacridines↗

The influence of in vitro caffeine treatment on human sperm morphology and fertilizing capacity.

After publication in the literature that in vitro caffeine treatment causes damage of the normal shape of the sperm head and thereby decreases fertilizing capacity, we carried out a clinical and electron microscopic study to determine the influence of caffeine on the fertilizing capacity and sperm cell morphology. Sixty women (with infertile husbands) underwent artificial insemination by donor with frozen/thawed semen over a period of 12 months, using randomized addition of caffeine in alternate months. Fourteen women became pregnant during the 6 months they received caffeine-treated semen, whereas only 7 pregnancies occurred during the 6 months the women received semen without caffeine. Scanning electron microscopic examinations of fresh proven donor semen showed no morphologic changes caused by the in vitro caffeine treatment. However, quantitative morphologic analysis of the frozen/thawed semen was unsatisfactory because of the freezing technique and the masking effect of the protective medium. It is concluded that in vitro caffeine treatment of fertile donor semen does not damage the spermatozoa; furthermore, it seems to improve the fertilizing capacity.

Adult↗