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PubMed2004

The effect of a 5-week wobble-board exercise intervention on ability to discriminate different degrees of ankle inversion, barefoot and wearing shoes: a study in healthy elderly.

OBJECTIVES: There is some evidence of an improvement in falls risk in the elderly after completing a wobble-board training program. This study examined the effects of wobble-board training on ability to discriminate between different extents of ankle inversion movements in a group of older subjects, tested wearing shoes and barefoot. DESIGN: A randomized, controlled, crossover pilot study. SETTING: Canberra region, Australia. PARTICIPANTS: Twenty community-dwelling subjects aged 65 to 85 participated in this study; all were in good health with no known disorder of the musculoskeletal system. MEASUREMENTS: The accuracy with which subjects could identify a set of ankle inversion movements of different extents was measured, with testing conducted in an upright, weightbearing stance. INTERVENTION: The effects of a 5-week training program using a wobble board modified for data logging or a period of normal activity only were assessed. Subjects underwent an ankle movement discrimination test pre- and posttraining, with shoes on and off. RESULTS: Greater improvement in ankle movement discrimination capability was made in subjects who underwent wobble-board training than in subjects who did not train (F(1,18)=11.2, P=.003). Active movements at the ankle were also significantly better discriminated throughout when subjects were wearing shoes than when barefoot (F(1,18)=40.6, P=.001). CONCLUSION: Training with a wobble board provides a simple in-home intervention that improves ability to differentiate between extent of movements into ankle inversion in subjects aged 65 and older. Research on trip and fall frequency after wobble-board use is needed before such training could be widely used.

Accidental Falls↗
PubMed1994

A psychological study of the inverse relationship between perceived risk and perceived benefit.

Judgments of risk and judgments of benefit have been found to be inversely related. Activities or technologies that are judged high in risk tend to be judged low in benefit, and vice versa. In the present study, we examine this inverse relationship in detail, using two measures of relationship between risk and benefit. We find that the inverse relationship is robust and indicative of a confounding of risk and benefit in people's minds. This confounding is linked to a person's overall evaluation of an activity or technology. Theoretical and practical implications of this risk-benefit confounding are discussed.

Adult↗
PubMed1999

Inverse relation of body-surface activation-recovery interval and recovery time to activation time in normal subjects: stronger correlation and more heterogeneous distribution in activation-recovery interval than in recovery time.

The activation-recovery interval (ARI), measured directly from the myocardium, has shown a good correlation with the action potential duration (APD) in experiments. APD has been reported to be inversely related to the activation time (AT). However, no studies have examined the correlation between the body-surface ARI and AT in normal subjects. Fifty normal subjects (25 men and 25 women) were studied to elucidate the relationship between the body-surface ARI and AT. The body-surface AT was defined as the duration between the QRS onset and the minimum dV/dt of the QRS wave, and ARI as the interval between the minimum dV/dt of the QRS wave and the maximum dV/dt of the T wave in each lead of an 87 unipolar lead system. We also measured the recovery time (RT) defined as the duration between the QRS onset and the maximum dV/dt of the T wave. ARI was inversely correlated with AT (r = -0.73). RT was also inversely correlated with AT (r = -0.61), however, RT had a less heterogeneous distribution than ARI (148 ms vs 159 ms). There were no differences between male and female subjects in the relation between ARI and RT or in the body-surface distribution of ARI and RT. These findings suggest that the body-surface ARI may reflect recovery properties over the cardiac surface and that APD may distribute inhomogeneously over the human cardiac surface with a longer RT over an area with a shorter AT. ARI calculated from body-surface ECG may be a useful noninvasive and repeatedly measurable estimate of APD.

Adolescent↗
PubMed2000

FimE-catalyzed off-to-on inversion of the type 1 fimbrial phase switch and insertion sequence recruitment in an Escherichia coli K-12 fimB strain.

We have investigated the capacity of a well-defined Escherichia coli fimB strain, AAEC350 (a derivative of MG1655), to express type 1 fimbriae under various growth conditions. The expression of type 1 fimbriae is phase-variable due to the inversion of a 314-bp DNA segment. Two tyrosine recombinases, FimB and FimE, mediate the inversion of the phase switch. FimB can carry out recombination in both directions, whereas the current evidence suggests that FimE-catalyzed switching is on-to-off only. We show here that AAEC350 is in fact capable of off-to-on phase switching and type 1 fimbrial expression under aerobic static growth conditions. The phase switching is mediated by FimE, and allows emerging fimbriate AAEC350 to outgrow their non-fimbriate counterparts by pellicle formation. Following inversion of the phase switch, this element can remain phase-locked in the on orientation due to integration of insertion sequence elements, viz. IS1 or IS5, at various positions in either the fimE gene or the phase switch.

Agglutination↗
PubMed2005

Evidence for putting the calculus: caries inverse relationship to work.

OBJECTIVES: To report previously unpublished data from three different types of clinical study to show the strength of the evidence purporting to demonstrate the existence of an inverse relationship between subjects' calculus and caries experience. METHODS: Data have been analysed from: a 3-year caries clinical trial of six toothpastes conducted in Lanarkshire, Scotland that involved 3000 children, Study 1; a caries epidemiological study in the Isle of Lewis that involved 228 children, Study 2; a calculus formation study carried out at Port Sunlight using a wide age range of adults, Study 3. RESULTS: Baseline data taken from Study 1 show that caries prevalence is highly significantly lower in calculus-prone than in calculus-free subjects (P < 0.0001). The inverse relationship is also demonstrated by the 3-year caries increment data for subjects who had used non-zinc toothpastes. Results from Study 2 show that a similar association arose for 8-year olds over a 6-year period, based on their erupting teeth alone. Finally, data from Study 3 show that whilst the extent of caries and calculus experience are both positively linked to age, within specific age groups the relationship between the two dental conditions on an individual subject basis is clearly of an inverse nature. CONCLUSIONS: The present work confirms that calculus status has a direct bearing on both current and future caries experience. Baseline calculus status could be, and has subsequently been demonstrated to be, a useful stratifying factor for caries clinical trials.

Adolescent↗
PubMed2006

Comparison of dynamic treatment regimes via inverse probability weighting.

Appropriate analysis of observational data is our best chance to obtain answers to many questions that involve dynamic treatment regimes. This paper describes a simple method to compare dynamic treatment regimes by artificially censoring subjects and then using inverse probability weighting (IPW) to adjust for any selection bias introduced by the artificial censoring. The basic strategy can be summarized in four steps: 1) define two regimes of interest, 2) artificially censor individuals when they stop following one of the regimes of interest, 3) estimate inverse probability weights to adjust for the potential selection bias introduced by censoring in the previous step, 4) compare the survival of the uncensored individuals under each regime of interest by fitting an inverse probability weighted Cox proportional hazards model with the dichotomous regime indicator and the baseline confounders as covariates. In the absence of model misspecification, the method is valid provided data are available on all time-varying and baseline joint predictors of survival and regime discontinuation. We present an application of the method to compare the AIDS-free survival under two dynamic treatment regimes in a large prospective study of HIV-infected patients. The paper concludes by discussing the relative advantages and disadvantages of censoring/IPW versus g-estimation of nested structural models to compare dynamic regimes.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Plasma vitamins E and A inversely correlated to mortality from ischemic heart disease in cross-cultural epidemiology.

In eight study populations in which the medians of total plasma cholesterol did not differ significantly (mean 5.8 mM, p greater than 0.05) and therefore did not correlate with the IHD mortality (r2 = 0.05), the median of absolute plasma level of vitamin E (alpha-tocopherol) was inversely related to the IHD mortality (r2 = 0.55; p = 0.003). Vitamin A behaved similarly (r2 = 0.51; p = 0.046). The absolute levels of vitamins E and A together with cholesterol predicted (by multiple regression analysis) the IHD mortality of these eight populations fairly well (r2 = 0.81; p = 0.06). Considering all 12 study populations analyzed thus far, total plasma cholesterol correlated with the IHD mortality directly as expected (r2 = 0.51; p less than 0.01), but the median of the plasma alpha-tocopherol individually standardized for cholesterol and triglycerides (220 mg/dL + 110 mg/dL, respectively) maintained a strong inverse association with the IHD mortality (r2 = 0.49; p = 0.01). In the partial regression analysis, lipid-standardized vitamin E exhibited an even stronger inverse correlation with IHD mortality (r2 = 0.69; p less than 0.001). Again, vitamin A behaved similarly to vitamin E, that is, after lipid-standardization of individuals (r2 = 0.33; p = 0.07), as well as in the cholesterol-independent partial regression analysis (r2 = 0.74; p less than 0.001). Both vitamins may act singularly, for after lipid-standardization they vary de facto independently (rs = 0.012) in individuals. The combination of vitamins E and A as obtained by multiple partial regression predicted the actual IHD mortality to a large extent (r2 = 0.89; p less than 0.001), whereas the three-variable prediction model, with the median of total cholesterol and of individually lipid-standardized vitamins E and A, fit the actual IHD mortality of these 12 populations almost completely (r2 = 0.94; p less than 0.001). In conclusion, the plasma status of vitamins E and A are important, hitherto underrated risk factors of IHD, which may act independently, but can, if combined, predict at least 53% of the cross-cultural differences of IHD mortality. After inclusion of total cholesterol into a multivariate model, up to 94% of the IHD mortality can be predicted. The present epidemiological data are in agreement with the hypothesis that these vitamins have physiological functions in the protection of lipoproteins against peroxidation and atherogenic apo-B modifications, respectively, but that does not exclude additional beneficial effects of vitamin E and A in the arterial wall.

Adult↗
PubMed2003

A sub-domain inverse finite element characterization of hyperelastic membranes including soft tissues.

Quantification of the mechanical behavior of hyperelastic membranes in their service configuration, particularly biological tissues, is often challenging because of the complicated geometry, material heterogeneity, and nonlinear behavior under finite strains. Parameter estimation thus requires sophisticated techniques like the inverse finite element method. These techniques can also become difficult to apply, however, if the domain and boundary conditions are complex (e.g. a non-axisymmetric aneurysm). Quantification can alternatively be achieved by applying the inverse finite element method over sub-domains rather than the entire domain. The advantage of this technique, which is consistent with standard experimental practice, is that one can assume homogeneity of the material behavior as well as of the local stress and strain fields. In this paper, we develop a sub-domain inverse finite element method for characterizing the material properties of inflated hyperelastic membranes, including soft tissues. We illustrate the performance of this method for three different classes of materials: neo-Hookean, Mooney Rivlin, and Fung-exponential.

Computer Simulation↗
PubMed1999

Prediction of antagonistic muscle forces using inverse dynamic optimization during flexion/extension of the knee.

This paper examined the feasibility of using different optimization criteria in inverse dynamic optimization to predict antagonistic muscle forces and joint reaction forces during isokinetic flexion/extension and isometric extension exercises of the knee. Both quadriceps and hamstrings muscle groups were included in this study. The knee joint motion included flexion/extension, varus/valgus, and internal/external rotations. Four linear, nonlinear, and physiological optimization criteria were utilized in the optimization procedure. All optimization criteria adopted in this paper were shown to be able to predict antagonistic muscle contraction during flexion and extension of the knee. The predicted muscle forces were compared in temporal patterns with EMG activities (averaged data measured from five subjects). Joint reaction forces were predicted to be similar using all optimization criteria. In comparison with previous studies, these results suggested that the kinematic information involved in the inverse dynamic optimization plays an important role in prediction of the recruitment of antagonistic muscles rather than the selection of a particular optimization criterion. Therefore, it might be concluded that a properly formulated inverse dynamic optimization procedure should describe the knee joint rotation in three orthogonal planes.

Algorithms↗
PubMed1990

The dynamics of the subtalar joint in sudden inversion of the foot.

The human subtalar joint was modelled as a quasi-linear second-order underdamped system to simulate sudden inversion motion of the foot relative to the shank. The model was fed with experimental data obtained from six subjects on a specially constructed apparatus. A total of 35 deg inversion was produced on the tested leg rapidly enough (lasting less than 40 ms) in order to ensure that the protective muscles are not activated. The parameters of the joint were evaluated and the following ranges were obtained at 35 deg inversion: elastic stiffness 14-52 Nm rad-1, damping coefficient 1.4-2.9 Nms rad-1, and natural frequency 78-125 Hz. The effects on the test parameters of weight bearing amount, foot dominance, and protective footwear were studied on one subject.

Adult↗
PubMed1993

Comparison of the adjoint and influence coefficient methods for solving the inverse hyperthermia problem.

An adjoint formulation is derived and used to determine the elements in the Jacobian matrix associated with the inverse problem of estimating the blood perfusion and temperature fields during hyperthermia cancer treatments. This method and a previously developed influence coefficient method for obtaining that matrix are comparatively evaluated by solving a set of numerically simulated inverse hyperthermia problems. The adjoint method has the advantage of requiring fewer solutions of the bioheat transfer equation to estimate the Jacobian than does the influence coefficient method when the number of measurement sensors is significantly smaller than the number of unknown parameters. Thus, it could be a preferable method to use in hyperthermia applications where the number of sensors is strictly limited by patient considerations. However, the adjoint method requires that CPU time intensive convolutions be numerically evaluated. Comparisons of the performance of the adjoint formulation and the influence coefficient method show that, first, there is a critical ratio of the number of measurement sensors to the number of unknown parameters at which the CPU time per iteration required to calculate the Jacobian matrix is the same for both methods. The adjoint method is faster than the influence coefficient method only when the value of the ratio is less than that critical value. For the hyperthermia problems investigated in the present study, this only occurs for cases with a very small number of measurement sensors. This presents a potential problem for clinical applications because the fewer measurement sensors used, the less information that can be gathered to correctly solve the inverse problem.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed2003

Fuzzy logic guided inverse treatment planning.

A fuzzy logic technique was applied to optimize the weighting factors in the objective function of an inverse treatment planning system for intensity-modulated radiation therapy (IMRT). Based on this technique, the optimization of weighting factors is guided by the fuzzy rules while the intensity spectrum is optimized by a fast-monotonic-descent method. The resultant fuzzy logic guided inverse planning system is capable of finding the optimal combination of weighting factors for different anatomical structures involved in treatment planning. This system was tested using one simulated (but clinically relevant) case and one clinical case. The results indicate that the optimal balance between the target dose and the critical organ dose is achieved by a refined combination of weighting factors. With the help of fuzzy inference, the efficiency and effectiveness of inverse planning for IMRT are substantially improved.

Algorithms↗
PubMed2005

Regularization of inverse planning for intensity-modulated radiotherapy.

The performance of a variational regularization technique to improve robustness of inverse treatment planning for intensity modulated radiotherapy is analyzed and tested. Inverse treatment planning is based on the numerical solutions to the Fredholm integral equation of the first kind which is ill-posed. Therefore, a fundamental problem with inverse treatment planning is that it may exhibit instabilities manifested in nonphysical oscillations in the beam intensity functions. To control the instabilities, we consider a variational regularization technique which can be applied for the methods which minimize a quadratic objective function. In this technique, the quadratic objective function is modified by adding of a stabilizing functional that allows for arbitrary order regularization. An optimal form of stabilizing functional is selected which allows for both regularization and good approximation of beam intensity functions. The regularized optimization algorithm is shown, by comparison for a typical case of a head-and-neck cancer treatment, to be significantly more accurate and robust than the standard approach, particularly for the smaller beamlet sizes.

Algorithms↗
PubMedDate not supplied

Rapid measurement of T1 with spatially selective pre-inversion pulses.

A method is described for rapidly obtaining a multipoint estimate of T1 from a sample that is homogeneous over a few millimeters. An image of the longitudinal recovery curve is produced through the application of successive "pre-inversion" slices that are perpendicular to the imaging slice. These pre-inversion pulses are analogous to pre-saturation pulses, but they are much thinner and the tip angle is 180 degrees. The baseline for the recovery is measured from sections of the sample that have not been perturbed by the slice selective pre-inversion pulses. The existence of the baseline value and the lack of slice profile effects allows a quick T1 estimate (QT1) to be made with a simple linear regression algorithm. The QT1 values are found to correlate very well with T1 values measured with the scanner in "spectrometer' mode, for volumes as small as 5 x 5 x 5 mm. Possible applications are T1 estimates in homogeneous samples and tissues, and scouting the T1 range of a tissue to be measured with higher resolution volume localization techniques.

Algorithms↗
PubMed1998

A continuous penalty function method for inverse treatment planning.

Conventional inverse treatment planning attempts to calculate dose distributions that may not be feasible given the specified dose levels to various anatomical structures. A technique for inverse treatment planning has been developed that uses only target dose levels which are easily selectable to be feasible. A nonlinear constrained minimization problem is formulated to reflect the goal of sparing critical organs as much as possible while delivering a certain target dose within specified uniformity. The objective function is the squared dose delivered to critical organs. The constraints require the delivery of certain target dose within specified uniformity and non-negative pencil beam weights. A continuous penalty function method is introduced as a method for solving the large-scale constrained minimization problem. The performance of the continuous penalty function method is optimized by numerical investigation of few numerical integration schemes and a pair of weighting functions which influence the utility of the method. Clinical examples are presented that illustrate several features of the technique. The properties of the continuous penalty function method suggest that it may be a viable alternative to conventional inverse treatment planning.

Biophysical Phenomena↗
PubMed1998

Inverse radiosurgery treatment planning through deconvolution and constrained optimization.

An inverse radiosurgery treatment planning approach is presented which calculates conformal dose distributions for small, irregularly shaped targets. Two general approaches have been suggested for solution of the inverse radiotherapy problem: explicit and implicit. Explicit methods are typically fast, but generally require geometric and/or dosimetric simplifications. Implicit methods have also been used, but are computationally expensive because they require iterative manipulation of each beam's individual elements. The method presented here incorporates an integrated approach in order to efficiently solve the inverse problem without requiring simplifications which may affect the accuracy of the final result. A deconvolution algorithm (explicit approach) is utilized to determine the intensity modulation function for multiple user-selected beam's eye views of the desired dose distribution. A simulated annealing algorithm (implicit approach) then optimizes each beam's macroscopic weight. Additionally, this method is fully three-dimensional and accurately models phantom scatter by incorporating Monte Carlo generated energy deposition kernels into the dosimetry process. Several small target structure examples are presented and applicability of this methodology to larger targets for general radiotherapy cases is addressed.

Algorithms↗
PubMed1998

Fast iterative algorithms for three-dimensional inverse treatment planning.

Three types of iterative algorithms, algebraic inverse treatment planning (AITP), simultaneous iterative inverse treatment planning (SIITP), and iterative least-square inverse treatment planning (ILSITP), differentiated according to their updating sequences, were generalized to three dimension with true beam geometry and dose model. A rapid ray-tracing approach was developed to optimize the primary beam components. Instead of recalculating the dose matrix at each iteration, the dose distribution was generated by scaling up or down the dose matrix elements of the previous iteration. This significantly increased the calculation speed. The iterative algorithms started with an initial intensity profile for each beam, specified by a two-dimensional pixel beam map of M elements. The calculation volume was divided into N voxels, and the calculation was done by repeatedly comparing the calculated and desired doses and adjusting the values of the beam map elements to minimize an objective function. In AITP, the iteration is performed voxel by voxel. For each voxel, the dose discrepancy was evaluated and the contributing pencil beams were updated. In ILSITP and SIITP, the iteration proceeded pencil beam by pencil beam instead of voxel by voxel. In all cases, the iteration procedure was repeated until the best possible dose distribution was achieved. The algorithms were applied to two examples and the results showed that the iterative techniques were able to produce superior isodose distributions.

Algorithms↗
PubMed2000

Optimization of inverse treatment planning using a fuzzy weight function.

A fuzzy approach has been applied to inverse treatment planning optimization in radiation therapy. The proposed inverse-planning algorithm optimizes both the intensity-modulated beam (IMB) and the normal tissue prescription. In the IMB optimization, we developed a fast-monotonic-descent (FMD) method that has the property of fast and monotonic convergence to the minimum for a constrained quadratic objective function. In addition, a fuzzy weight function is employed to express the vague knowledge about the importance of matching the calculated dose to the prescribed dose in the normal tissue. Then, a validity function is established to optimize the normal tissue prescription. The performance of this new fuzzy prescription algorithm has been compared to that based on hard prescription methods for two treatment geometries. The FMD method presented here both provides a full-analytical solution to the optimization of intensity-modulated beams, and guarantees fast and monotonic convergence to the minimum. It has been shown that the fuzzy inverse planning technique is capable of achieving an optimal balance between the objective of matching the calculated dose to the prescribed dose for the target volume and the objective of minimizing the normal tissue dose.

Algorithms↗