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PubMed1988

Development and first experience with an uncemented press-fit cup.

A new cup with a new concept of cementless fixation and new coating was designed to obtain primary stability by a press-fit mechanism. The press-fit mechanism is achieved by flattening the dome of the hemispheric cup and by using a cup size with an outer diameter 1.5 mm larger than the reamer used last. The coating (Sulmesh) consists of a net shell of four layers of orderly oriented wire meshes with specific pore size and porosity volume. The pure titanium wires are bonded together. The advantages of the press-fit cup are the excellent adaptation with minimal resection and the preservation of the subchondral bone. The preparation of the acetabulum is easy (reaming only), no additional fixation by screws is necessary, and only a few instruments are needed. The results of 81 total hip arthoplasties using the press-fit cup and having an observation period ranging from 12 to 24 months show no clinical or roentgenographic loosening. No intraoperative or postoperative complications because of the press-fit cup were seen.

Acetabulum↗
PubMed1985

Auditory adaptation: notes on power and parabolic curve fitting across intensity: II.

The classic Simultaneous Dichotic Loudness Balance (SDLB) procedure for the study of auditory adaptation was used by Weiler and Hood (1977) in a successful test of a model for predicting adaptation in db at intensities above the initial baseline values, using a linear approximation across levels. When Balzer et al (Brit. J. Audiol., 1984, 18, 49-50) fitted curves for simple baseline adaptation data from four studies based on SDLB data, they reported good fits for the Gompertz technique and for a parabolic formula, but did not test the relative goodness of fit for the linear formula, nor for power approximations as Stevens (1975) might have proposed. The present study makes use of the data used by Balzer et al but examines a linear fit as well as two approximations to Stevens' power law. The present finding that the linear approximation is the least efficient examined would suggest that the Weiler and Hood model should be re-examined to determine the degree to which the model can be improved by use of a curvilinear baseline fit. In addition, it might be noted that the curvilinear formulae, of necessity, involve two or more stages. It is the the current effort of this laboratory to determine whether this reflects a multifactor basis to the classic SDLB adaptation, as well as results from other adaptation techniques.

Adaptation, Physiological↗
PubMed1978

[Problems of hearing aid fitting in elderly adults (author's transl)].

To provide optimum hearing aid fitting in elderly adults, certain factors are necessary which may affect the frequency response curves of the hearing aids. In cases of presbyacusis, an objective fitting of hearing aids can be based on accurate audiometry (via headphone and loudspeaker) with careful interpretation of test results. Importance is placed on directional hearing as it occurs when listening to a speaker against a background of noise. The test methods used in the Department of Audiology, Basel, are described for minitoring the stereophonic fitting of hearing aids. The advantages of this fitting (as opposed to monaural fitting alone) in cases of presbyacusis with symmetrical hearing losses are discussed.

Age Factors↗
PubMed1980

Myoelectric prosthetic fitting in young children.

Fitting myoelectrically controlled hand prostheses to young children has previously been considered unrealistic and even contraindicated. In 1971 the first preschool child was supplied with a myoelectric prosthesis at the Regional Hospital in Orebro, Sweden. A total of 40 young unilateral below-elbow congenital amputee children have thus far been fitted. The youngest children were 16 months of age when fitted. Such prostheses are clearly better integrated and accepted by children than by most adults. However, certain condiderations must be taken into account: the stump parameters ought to be suitable and the fitting done by a skilled team; the training must be properly followed up in close cooperation with the parents, who should be thoroughly and adequately informed; possibilities of prosthetic adjustments and rapid repairs should be mentioned; and psychological factors must be carefully evaluated. Under these conditions a very early myoelectric prosthetic fitting can be expected to greatly benefit the individual.

Age Factors↗
PubMed1994

New ways to look at fitness.

Many authors have argued that the core of evolutionary biology as represented by the catchphrase 'The fittest survive' is tautological. Concerning the fitness concept of population genetics it is easy to rebut this charge by a proper explication of the term 'survival'. In biology and in the philosophy of biology, various fitness concepts over and above that of population genetics have been elaborated. These concepts, which are called 'supervenient' by some philosophers, have a limited usefulness. On some interpretations they do lead to unacceptable tautologies and circular reasoning. The so-called propensity concept of fitness is problematic in this respect. If interpreted in a proper way, supervenient concepts appear not to allow the formulation of highly general explanations and theories; at best they reveal common patterns among diverse non-general explanations and theories. Philosophers cherishing supervenient fitness concepts are apparently motivated by a mistaken search for general theory. The fitness concept of population genetics may play a role in relatively general theories and explanations. Supervenient concepts cannot play such a role. They should rather help us recognize the value of natural history in biology.

Animals↗
PubMedDate not supplied

Soft toric lenses fitting for the ophthalmic technician.

1. Many ophthalmic technicians are familiar with fitting standard soft lenses that correct hyperopia and myopia. There is less confidence, however, in their proficiency with fitting soft toric lenses that correct astigmatism. 2. Performing accurate keratometry and refraction is an essential first step in fitting soft toric lenses. Familiarity with the different types of toric lenses is integral to an effective fit. 3. Knowledge of front and back surface toric lenses and their indications is of primary concern and allows for an effortless and successful fit.

Allied Health Personnel↗
PubMed1993

Two- to four-year experience with cemented, press-fit, and porous coated applications of the profile total hip system.

The clinical outcome and radiographic results of 90 cemented profile stems, 59 press-fit profile stems and 20 porous-coated profile stems implanted between October, 1987 and December, 1989 were analyzed. All total hip replacements were performed by the same group of surgeons. All used a cementless porous ingrowth acetabular component, and all femoral components were of the same geometrical design. Clinical results were evaluated using the Hip Society/SICOT/AAOS consensus format and were recorded prospectively preoperatively and at 6 months, 1 year, 2 years, 3 years and 4 years postoperatively. Radiographs were evaluated for component migration, subsidence, and cortical and cancellous biologic response as well as zonal analysis of radiolucent lines, using the Muller THR template. The functional results were similar for all three groups with no significant differences at 2 years postoperatively with respect to pain with activity, limp, or support used. However, patient satisfaction tended to be higher for cemented stems than for press-fit or porous-coated stems. Radiographic analysis showed press-fit stems to have a higher incidence (29.5%) of femoral component subsidence (mean 5.7 mm). None of the porous-coated stems subsided. Press-fit and porous-coated stems also demonstrated a higher rate of cortical hypertrophy at mid- and distal stem levels in comparison to cemented components. Press-fit application of the femoral component gives satisfactory clinical results, and the addition of proximal porous coating may confer additional advantages to the technique. Cemented stems enjoy the highest level of patient satisfaction and the most predictable objective clinical results.

Adult↗
PubMed1993

Marginal fit and microleakage of indirect inlay systems.

Three different indirect adhesive inlay systems were investigated for marginal fit and microleakage. MOD cavities were prepared in 67 extracted sound premolar teeth initially with parallel cavity walls. Thirty-four of the premolars had the cavity walls modified to a 10 degrees and 33 to a 15 degrees occlusal divergence. EOS, Isosit and Hi-Ceram porcelain inlays did not fit cavities prepared with parallel walls. All inlays in the Isosit and porcelain groups were able to be seated without modifications in cavities prepared with either a 10 degrees or 15 degrees occlusal divergence. Inlays made by the EOS system required considerable modification of the fitting surface in order for them to fit. Results showed the EOS system to have the largest marginal gaps before cementation (P < 0.001). There was no significant difference in leakage between the three inlay systems after cementation (P < 0.05). The cementum margins leaked more than margins finished on enamel for all inlay systems (P < 0.05). It is concluded from this study that inlay cavities for Isosit and porcelain require at least a 10 degrees occlusal divergence of cavity walls to permit the fitting of inlays without unacceptable modification. The EOS inlays required considerable trimming even when a 15 degrees occlusal divergence of the cavity walls was used.

Acrylic Resins↗
PubMedDate not supplied

Influence of finish-line geometry on the fit of crowns.

Previous studies on the fit of complete crowns have neglected to assess the internal adaptation of castings prior to cementation. Theoretical arguments and laboratory studies have failed to clarify which is the most desirable finish-line configuration in terms of marginal fit. This study evaluated axial and marginal fit of crowns made for three tooth preparations that had different labial finish-line configurations: shoulder, shoulder-bevel, and chamfer. The crowns were not cemented, but were sectioned and examined on their respective dies. There were no significant differences (P < or = .05) among groups for marginal or axial gaps. Crown fit was not influenced by any of the three finish lines tested, and castings with well-fitting margins exhibited measurable axial wall space.

Analysis of Variance↗
PubMed1998

Goodness-of-fit tests for GEE modeling with binary responses.

Analysis of data with repeated measures is often accomplished through the use of generalized estimating equations (GEE) methodology. Although methods exist for assessing the adequacy of the fitted models for uncorrelated data with likelihood methods, it is not appropriate to use these methods for models fitted with GEE methodology. We propose model-based and robust (empirically corrected) goodness-of-fit tests for GEE modeling with binary responses based on partitioning the space of covariates into distinct regions and forming score statistics that are asymptotically distributed as chi-square random variables with the appropriate degrees of freedom. The null distribution and the statistical power of the proposed goodness-of-fit tests were assessed using simulated data. The proposed goodness-of-fit tests are illustrated by two examples using data from clinical studies.

Antidepressive Agents↗
PubMed2026

Aerobic Fitness and Health-Related Phenotypes: A Two-Stage Phenome-Wide Mendelian Randomization Study.

PURPOSE: We investigated potentially causal associations between genetically predicted aerobic fitness and multiple health phenotypes using a two-stage phenome-wide Mendelian randomization (MR) study. METHODS: Genetically determined aerobic fitness, as operationalized by Cai et al., served as the exposure instrument. We screened 712 health-related phenotypes as outcomes using publicly available European-ancestry genome-wide association studies (GWAS) summary statistics from OpenGWAS (Discovery GWAS n > 5000), prioritizing non-UK Biobank/non-FinnGen datasets for Discovery when available and selecting an independent GWAS for validation. Associations were estimated using the MR-Robust Adjusted Profile Score method, controlled for multiple testing (5% false discovery rate) and unaffected by violations of MR assumptions (directional concordance between discovery and validation; no evidence of horizontal pleiotropy across inverse-variance weighted, MR-Egger, weighted-median, and weighted-mode methods; negative control analysis on hair color). RESULTS: We identified 108 discovery associations, of which 34 remained valid and statistically significant after validation. Higher genetically determined aerobic fitness was associated with lower lacunar stroke risk, lower arterial stiffness, higher heart rate variability, lower diastolic blood pressure, more favorable anthropometric measures, lower use of antidiabetic drugs, lower asthma risk, lower C-reactive protein, higher bone mineral density, favorable liver function biomarkers, favorable platelet-related traits, multiple blood count-derived hematological cell indices and counts, as well as higher years of schooling. Adverse associations were confined to atrial fibrillation, valvular heart disease, and systolic blood pressure. CONCLUSIONS: Genetically determined aerobic fitness is linked to a broad pattern of favorable cardiometabolic, inflammatory, musculoskeletal, respiratory, hepatic, and hematological phenotypes, alongside a narrow set of potential cardiovascular hazards.

Humans↗
PubMed2001

Cardiovascular fitness as a predictor of mortality in men.

OBJECTIVE: To examine the relations of cardiorespiratory fitness, as measured by maximal oxygen uptake and exercise test duration at the initiation of the study, with overall, cardiovascular disease (CVD)-related, and non-CVD-related mortality. METHODS: A population-based cohort study of 1294 men with no CVD, pulmonary disease, or cancer at baseline in Kuopio and surrounding communities in eastern Finland. During an average follow-up of 10.7 years, there were 124 overall, 42 CVD-related, and 82 non-CVD-related deaths. RESULTS: The relative risk of overall death in unfit men (maximal oxygen uptake <27.6 mL/kg per minute) was 2.76 (95% confidence interval, 1.43-5.33) (P =.002), and the relative risk of CVD-related death was 3.09 (95% confidence interval, 1.10-9.56) (P =.05), compared with fit men (maximal oxygen uptake >37.1 mL/kg per minute) after adjusting for age, examination years, smoking, and alcohol consumption. The relative risk of non-CVD-related death in unfit men was almost the same magnitude as for overall death. Furthermore, adjustment for serum lipid levels, blood pressure, plasma fibrinogen level, diabetes, and fasting serum insulin level did not weaken these associations significantly. Exercise test duration also had a strong inverse relation to overall, CVD-related, and non-CVD-related mortality. Poor cardiorespiratory fitness was comparable with elevated systolic blood pressure, smoking, obesity, and diabetes in importance as a risk factor for mortality. CONCLUSIONS: Cardiorespiratory fitness had a strong, graded, inverse association with overall, CVD-related, and non-CVD-related mortality. Maximal oxygen uptake and exercise test duration represent the strongest predictors of mortality.

Adult↗
PubMed1999

One-mile run performance and cardiovascular fitness in children.

BACKGROUND: Endurance run tests are administered in schools to assess cardiovascular fitness, defined in the laboratory as maximum oxygen consumption. OBJECTIVE: To examine the validity of this concept, assessing the influences of body fat and maximum values of oxygen consumption per unit time, stroke volume, heart rate, and arteriovenous oxygen difference on 1-mile (1.6-km) run time in healthy sixth-grade boys. STUDY DESIGN: Subjects were 36 boys with a mean (SD) age of 12.2 (0.5) years. The relationship was examined between body fat content (estimated by skinfold measurements) and maximum oxygen consumption per kilogram and cardiac variables (during maximum cycle testing) with 1-mile run velocity. RESULTS: Body fat content and maximum oxygen consumption per kilogram (independent of body fat) accounted for 31% and 28% of the variance in run velocity, respectively. Stroke volume was the only component of maximum oxygen consumption that related to run performance. CONCLUSIONS: These findings suggest that cardiovascular fitness and body fat content contribute equally to 1-mile run time in healthy boys and together account for only 60% of the variance in performance on this endurance fitness test. Consequently, 1-mile run performance in children may not serve as a strong indicator of cardiovascular fitness.

Adipose Tissue↗
PubMed2004

Differences in endocrine function with varying fitness capacity in postpubertal females across the weight spectrum.

OBJECTIVE: To relate endocrine and nutritional correlates of fitness in postpubertal physically active females across the normal weight spectrum to identify markers and how these might serve as associations of exercise-related endocrine disruption. DESIGN: Cross-sectional study analyzed by repeated-measures analysis of variance for frequent blood sampling. SETTING: A general clinical research center. SUBJECTS: Twenty-two healthy postpubertal female subjects recruited 2 years or more after menarche. MAIN OUTCOME MEASURES: Maximum oxygen consumption was determined as an index of fitness and daily caloric intake was calculated from a 3-day food diary. During the follicular phase of the cycle, luteinizing hormone was sampled every 10 minutes during a 24-hour period, while follicle-stimulating hormone and cortisol were sampled hourly. RESULTS: For every 1-unit increase in maximum oxygen consumption, cortisol concentration increased by 2% (P =.005; 95% confidence interval, 1%-3%). However, there was no association between mean gonadotropin concentrations and fitness. Hormone concentrations were not significantly associated with body mass index or percentage of body fat. Higher mean caloric intake from a 3-day summary was inversely related to mean luteinizing hormone concentration, which decreased by 5.5% for every 100-kcal increase (P =.03; 95% confidence interval, 1%-10%). With every 1-year increase in age at menarche, follicle-stimulating hormone concentration decreased by 12% (P =.01; 95% confidence interval, 4%-19%) and cortisol concentration increased by 7% (P =.03; 95% confidence interval, 1%-12%). CONCLUSIONS: In active adolescents, increased cortisol concentration may represent an adaptive change to exercise that may precede gonadotropin changes seen with higher levels of fitness.

Adolescent↗
PubMed1983

Effects of weight loss on fitness in obese children.

The relationship between weight and fitness change was established in 113 obese preadolescents participating in a six-month behavioral weight control program. Results showed significant improvements for both weight and fitness. Program success was strongly related to changes in exercise heart rate. Children who were most successful in the program decreased their maximal and recovery heart rates by 10.1 and 17.8 beats per minute, children with medium success had decreases of 4.9 and 11.8 beats per minute, and least successful children had decreases of 3.9 and 6.4 beats per minute. Analyses revealed that the combination of effective weight loss and an initially moderate degree of overweight (40% to 50%) combined to produce the greatest fitness changes. Children who entered treatment more than moderately overweight achieved comparable fitness improvements only if their weight loss was dramatic.

Behavior Therapy↗
PubMed1988

Determination of fitness in children with asthma. Use of standardized tests for functional endurance, body fat composition, flexibility, and abdominal strength.

Children with asthma frequently have exercise-induced disease that can limit their participation in both organized sports and vigorous free play. We measured fitness in a group of children with moderately severe to severe asthma with an instrument that is used widely and is available to clinicians for assessment of the physical capability of their patients. Abnormalities in physical fitness were present primarily in the area of endurance, with performance in the nine-minute run frequently found to be low. Increased skin-fold thickness was also present more frequently than in the normal population. Abdominal strength and flexibility were normal. Abnormalities in fitness were not well explained by measures indicating the presence of poorly controlled disease. All children with significant asthma probably should be tested to document the level of fitness so that appropriate intervention can be initiated.

Adolescent↗
PubMed1992

Parental behavior in relation to physical activity and fitness in 9-year-old children.

OBJECTIVE: To examine the relationship between parental behaviors and physical activity and fitness in elementary school-aged children. DESIGN: Cross-sectional survey of students and parents. SETTING: Seven public elementary schools in a suburban southern California city. PARTICIPANTS: One hundred forty-eight fourth-grade girls and 149 fourth-grade boys and their parents. Eighty-four percent were white. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Children's physical activity was indicated by self-report, data obtained from a monitor (accelerometer), and results of the mile run/walk. Multiple regression analysis, controlling for ethnicity and body mass index, was conducted separately for girls and boys to explain variation in child activity and fitness. Parents' reported physical activity was not associated with child activity or fitness. However, availability of transportation by parents to sport and fitness activities was significant (or nearly so) in two regressions for boys and in one regression for girls. Parents who played with their children had more active boys, based on self-report, but verbal encouragement to be active was not significant in any model. CONCLUSION: The parental role as gatekeeper of access to activity and sport facilities deserves further study.

Behavior↗
PubMed1993

Habitual physical activity and health-related physical fitness in fourth-grade children.

OBJECTIVE: To examine the relationship between habitual physical activity and components of health-related physical fitness in children. DESIGN: Cross-sectional survey with correlational analysis. SETTING: Seven public elementary schools in a suburban southern California city. PARTICIPANTS: Five hundred twenty-eight healthy fourth-grade children (274 boys and 254 girls), 85% of whom were non-Hispanic whites. Ninety-eight percent of eligible students participated. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Results of six measures of physical activity in children (monitoring by accelerometer, parent report, and child self-reports of weekday activity, weekend activity, and summer involvement in activity classes and youth sports) were combined in a physical activity index. This index of habitual physical activity was examined in relation to measures of five components of health-related fitness: the mile run, skin-fold tests, pull-ups, sit-ups, and the sit-and-reach test. The physical activity index was significantly associated with all five fitness components. The canonical correlation was .29. CONCLUSION: Active children appear to engage in a sufficient variety of activities to enhance multiple components of health-related fitness.

California↗