The effect of muscle fatigue on the last stride before stepping down a curb

The stride before landing may be important during stepping down. The aim of this study was to analyze variability of the kinematics and muscle activity in the final stride before stepping down a curb, with and without ankle and knee muscle fatigue. Ten young participants walked at self-selected speed and stepped down a height difference (10-cm) in ongoing gait. Five trials were performed before and after a muscle fatigue protocol (one day: ankle muscle fatigue, another day: knee muscle fatigue). The analysis focused on the trailing leg during the last but one and the last step on the higher level. Kinematics and muscle activity were recorded. Fatigue increased variability of foot-step horizontal distance in the last step on the higher level of the trailing limb, as well as in the first steps on the lower level for both limbs. This appeared due to an increase in the range of motion of the knee joint after both fatigue protocols. Participants additionally showed an increased ankle and hip ROM and decreased knee ROM. Our results suggest a loss of control under fatigue reflected in a higher variability of trailing and leading limb-step horizontal distances, with compensatory changes to limit fatigue effects, such as a redistribution of movement over joints. © 2012 Elsevier B.V.

Petrologisch-geochemische Charakterisierung quartärer Laven der Eifel als Grundlage zur archäometrischen Herkunftsbestimmung römischer Mühlsteine

Lava aus der quartären Vulkanregion der Eifel wurde in römischer Zeit großmaßstäblich abgebaut, um daraus Mühlsteine hoher Qualität herzustellen, die in großen Mengen in weite Teile des Römischen Reiches exportiert wurden. Somit erweisen sich diese Mühlsteine als ideale Indikatoren für Handelsgebiete und –wege dieser Zeit. Für eine erfolgreiche Herkunftsanalyse von Fundstücken ist eine genaue Charakterisierung der infrage kommenden Rohstoffe die unbedingte Voraussetzung. Aus diesem Grund konzentriert sich diese Arbeit auf die geochemische Definition der 16 bekannten römischen „Basalt“-Abbaustellen in den Vulkanfeldern der Ost- und Westeifel, mit dem vorrangigen Ziel, eine möglichste eindeutige Charakterisierung der einzelnen Abbaustellen zu erreichen. Auf dieser Basis wird eine Vorgehensweise zur folgenden Provenienzanalyse der Mühlsteine entwickelt. Um die geochemische Variabilität der Laven zu erfassen wurden die Abbaustellen großflächig beprobt. Die Proben wurden zunächst petrographisch bestimmt und der Phasenbestand mittels Röntgendiffraktometrie (XRD) untersucht. Die Haupt- und Spurenelement-Zusammensetzung wurde anhand von Röntgenfluoreszenzanalysen und Laser-Massenspektrometrie mit induktiv gekoppeltem Plasma (LA-ICP-MS) ermittelt, die Sr-Nd-Pb-Isotopie ausgewählter Proben mittels Thermo-Ionen-Massenspektrometrie (TIMS). Es zeigte sich, dass auf Grundlage der Haupt- und Spurenelementzusammensetzung, gemessen mit RFA, eine Abgrenzung der Abbaustellen zueinander mittels einer Kombination aus geochemischer Diskriminierung mit Cluster- und Diskriminanzanalysen gelingt. Die anschließende Provenienzanalyse der Mühlsteinfundstücke erfolgt analog zur Charakterisierung der Abbaustellen. Im ersten Schritt wird eine geochemische Zuordnung des Fundstücks vorgenommen, um zu überprüfen, ob eine Eifeler Herkunft überhaupt in Frage kommt. Lässt der geochemische Vergleich mit den Referenzdaten aus dem Gelände eine Eifeler Herkunft zu, kommt im zweiten Schritt die Clusteranalyse zum Einsatz. Hier wird auf multivariater Ebene geprüft, ob das Fundstück einer Eifeler Abbaustelle oder einem Cluster von Eifeler Abbaustellen zugeordnet werden kann. Bei einer positiven Zuordnung wird ergänzend als dritter Schritt die Diskriminanzanalyse angewendet, anhand der das Mühlstein-Fundstück einer Abbaustelle mit einer bestimmten Wahrscheinlichkeit zugewiesen wird. Bei 68 analysierten Mühlsteinen aus verschiedenen Regionen Mitteleuropas konnte so für 49 Fundstücke eine Eifeler Provenienz festgestellt werden. Alle römischen Eifeler Mühlsteine entstammen dem Bellerberg bei Mayen, ein mittelalterliches Stück aus dem Niedermendiger Lavastrom. Die Zuordnung der übrigen 19 Mühlsteine zu anderen möglichen Abbaugebieten erfolgt anhand geochemischer Daten aus der Literatur. Aufgrund der unzureichenden Datenlage sind im Falle dieser Proben jedoch im Gegensatz zur Lavastrom-genauen Zuordnung der Eifeler Mühlen lediglich Vermutungen über die Herkunftsregionen möglich. Damit zeigt sich, dass eine ausführliche Referenzdatenbank der in Frage kommenden Rohstoffe die erforderliche Basis für erfolgreiche Provenienzanalysen ist. Die Möglichkeit der genauen Zuordnungen von Mühlsteinen zu den Eifeler Abbaustellen belegt, dass die Verbindung von geochemischer Auswertung mit Cluster- und Diskriminanzanalysen ein hilfreiches Verfahren zur Provenienzanalyse darstellt.

High mobility rates during the period of the "Celtic migrations"? - 87 Sr, 86 Sr and delta 18 O evidence from Early La Tène Europe

Although the period of the historic “Celtic migrations” is archaeologically extensively studied, the long-lasting question whether mass migration or increased individual mobility caused the expansion of the La Tène culture throughout continental Europe persist. Strontium (Sr) and in part oxygen (O) isotope analysis of human remains from the early La Tène cemeteries of Nebringen (Germany), Münsingen-Rain (Switzerland), Monte Bibele (Italy) and the Czech cemeteries of Radovesice I, Radovesice II and Kutná Hora was, therefore, carried out to investigate the importance of residential changes during this time period. These isotope analyses showed that most analysed individuals either came from the area they were buried in or from the surrounding area of the cemetery. An exception was formed by the Czech cemeteries, where almost a quarter of the studied individuals appeared non-local. Together with Nebringen, these cemeteries also had the most varied Sr isotope ratios, which suggest highly mobile communities in which individuals regularly changed their residency. The isotopic ratios of the cemeteries of Münsingen-Rain and Monte Bibele appeared far less varied. In part, these differences might be explained by the community structures of these cemeteries. Morphological kinship analysis in Münsingen-Rain demonstrated biological relatedness among most of the analysed individuals. These related individuals also shared similar isotope signatures, which suggest an origin from the surrounding Aar Valley. In the vicinity of the cemetery of Monte Bibele, an associated settlement site was discovered. The deceased presumably not only shared this settlement, but also cultivated the same land plots. Dispersed settlement structures were suggested for Nebringen, Radovesice and Kutná Hora, as these agriculturally favourable landscapes were densely populated during prehistoric times. Connected to these community structures are the prevailing geological conditions in these areas. Both Münsingen-Rain and Monte Bibele are located in a region where homogeneous geological conditions prevail, whereas the landscapes of Nebringen, Radovesice and Kutná Hora are characterised by complex heterogeneous geological conditions. As the majority of individuals in Nebringen and the Czech cemeteries correspond to the expected isotope values for the studied areas, regularly changing land plots might have contributed to the observed variation. Although mass migration as depicted by the historical sources was not observed individual mobility of a small part of these studied communities certainly played a role. Males appeared, thereby, to have slightly more often a non-local birthplace or moved during childhood. Male mobility was, however, not always associated with burial as a warrior. Females, on the other hand, originated more often from the region. Patrilocal residential patterns, with the exception of the Czech cemeteries, were nevertheless not observed. Objects and ideas also seem to have been exchanged freely, as there are no indications that individuals with particular grave goods came from specific areas. It rather appears that the individuals buried with them were either local or had different places of origin. This can be explained by the fact that the exact origin of grave goods is difficult to establish and the occurrence of similar 87Sr/86Sr values in different areas. This study provided important new insights on the period of the “Celtic migrations” and the way of life of these prehistoric people.

In Vivo Evaluation of the Phenox CRC Mechanical Thrombectomy Device in a Swine Model of Acute Vessel Occlusion

Mechanical thrombectomy in ischemic stroke is of increasing interest as it is a promising strategy for fast and efficient recanalization. Several thrombectomy devices have been introduced to the armentarium of mechanical thrombectomy. Currently, new devices are under development and are continuously added to the neurointerventional tool box. Each device advocated so far has a different design and mechanical properties in terms of thrombus-device interaction. Therefore, a systematic evaluation under standardized conditions in vivo of these new devices is needed. The purpose of this study was to evaluate the efficiency, thrombus-device interaction, and potential complications of the novel Phenox CRC for distal mechanical thrombectomy in vivo. The device was evaluated in an established animal model in the swine. Recanalization rate, thromboembolic events, vasospasm, and complications were assessed. Radiopaque thrombi (2 cm length) were used for the visualization of thrombus-device interaction during retrieval. The Phenox CRC (4 mm diameter) was assessed in 15 vessel occlusions. For every occlusion a maximum of 3 retrieval attempts were performed. Complete recanalization (TICI 3/TIMI 3) was achieved in 86.7% of vessel occlusions. In 66.7% (10/15), the first retrieval attempt was successful, and in 20% (3/15), the second attempt led to complete recanalization of the parent artery. In 2 cases (13.3%) thrombus retrieval was not successful (TICI 0/TIMI 0). In 1 case (6.7%) a minor embolic event occurred in a small side branch. No distal thromboembolic event was observed during the study. Thrombus-device interaction illustrated the entrapment of the thrombus by the microfilaments and the proximal cage of the device. No significant thrombus compression was observed. No vessel perforation, dissection, or fracture of the device occurred. In this small animal study, the Phenox CRC was a safe and effective device for mechanical thrombectomy. The unique design with a combination of microfilaments and proximal cage reduces thrombus compression with a consequently high recanalization and low complication rate.

Budesonide is effective in adolescent and adult patients with active eosinophilic esophagitis

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus characterized by dense tissue eosinophilia; it is refractory to proton pump inhibitor therapy. EoE affects all age groups but most frequently individuals between 20 and 50 years of age. Topical corticosteroids are effective in pediatric patients with EoE, but no controlled studies of corticosteroids have been reported in adult patients.

Phase I/IIa study of cilengitide and temozolomide with concomitant radiotherapy followed by cilengitide and temozolomide maintenance therapy in patients with newly diagnosed glioblastoma

Invasion and migration are key processes of glioblastoma and are tightly linked to tumor recurrence. Integrin inhibition using cilengitide has shown synergy with chemotherapy and radiotherapy in vitro and promising activity in recurrent glioblastoma. This multicenter, phase I/IIa study investigated the efficacy and safety of cilengitide in combination with standard chemoradiotherapy in newly diagnosed glioblastoma.

The role of reinfection and partner notification in the efficacy of Chlamydia screening programs

Repeated Chlamydia trachomatis infections after treatment are common. One reason is reinfection from untreated partners in ongoing sexual partnerships. Mathematical models that are used to predict the impact of screening on reducing chlamydia prevalence often do not incorporate reinfection and might overestimate the expected impact. We describe a pair compartmental model that explicitly incorporates sexual partnership duration and reinfection. The pair model predicts a weaker impact of screening when compared directly with a model that does not accommodate partnerships. Effective management of sex partners to prevent reinfection might need to be strengthened in chlamydia control programs.

One hundred fascia-sparing myocutaneous rectus abdominis flaps: An update

Major efforts have been undertaken to reduce donor-site morbidity after abdominal flaps, which eventually culminated in the introduction of the deep inferior epigastric perforator (DIEP) flap. However, due to anatomical variations (absence of dominant perforators) and the risk of ischaemic complications, the selection of patients qualifying for a DIEP flap is limited. Furthermore, DIEP flaps can only be used as free flaps. We present our long-term experience with a dissection technique of rectus abdominis myocutaneous (RAM) flaps that was developed to circumvent these drawbacks. The dissection is characterised by preventing to sacrifice any perforators nourishing the flap and by fully preserving the anterior rectus sheath, but not the muscle. The study comprises a consecutive series of prospectively assessed patients, treated between February 2000 and April 2008. A total of 100 fascia-sparing RAM flaps were operated on 97 patients (age 22-84 years, median 64 years). Free flaps were mainly used for breast reconstruction (47 flaps/24 patients), and cranially (34) or caudally (19) pedicled flaps for soft-tissue coverage after sternectomy, urogenital tumour resection or rectum amputation. Eighty patients had a total of 213 risk factors, such as cardiovascular diseases, obesity, hyperlipidaemia, diabetes mellitus, smoking or steroid medication. Partial tissue loss (skin or fat necrosis) occurred in 13 flaps, out of which seven required surgical revision. The ischaemic complications were evenly distributed between the patient subsets. At a follow-up of 2-89 months (median 20 months), one patient showed a flap harvest-related abdominal bulge after bilateral-free transverse rectus abdominis myocutaneous (TRAM) flap. We conclude that the present dissection technique provides maximal perforator-related perfusion and minimal donor-site morbidity even in pedicled flaps and high-risk patients. In free flaps, it may, therefore, be recommended as an alternative to the DIEP flap.

Microbiologic findings 1 year after partial- and full-mouth scaling in the treatment of moderate chronic periodontitis

To investigate the impact on microbiologic variables of full-mouth scaling (FMS) and conventional scaling and root planing (cSRP) after 12 months.

IRF4 regulates IL-17A promoter activity and controls ROR?t-dependent Th17 colitis in vivo

The transcription factor IRF4 is involved in several T-cell-dependent chronic inflammatory diseases. To elucidate the mechanisms for pathological cytokine production in colitis, we addressed the role of the IRF transcription factors in human inflammatory bowel disease (IBD) and experimental colitis.

CX3CR1 defines functionally distinct intestinal mononuclear phagocyte subsets which maintain their respective functions during homeostatic and inflammatory conditions

Intestinal mononuclear phagocytes (iMNP) are critically involved in mucosal immunity and tissue homeostasis. Two major non-overlapping populations of iMNP have been identified in mice. CD103(+) iMNP represent a migratory population capable of inducing tolerogenic responses, whereas CX3CR1(+) iMNP are resident cells with disease-promoting potential. CX3CR1(+) iMNP can further be subdivided based on differential expression of CX3CR1. Using CX3CR1(GFP/+) ×RAG2(-/-) mice, we demonstrate that CX3CR1(hi) and CX3CR1(lo) iMNP clearly differ with respect to their morphological and functional properties. Compared with CX3CR1(hi) iMNP, CX3CR1(lo) iMNP are polarised towards pro-inflammatory responses already under homeostatic conditions. During a CD4(+) T-cell-induced colitis, CX3CR1(lo) cells accumulate in the inflamed mucosa and upregulate the expression of pro-inflammatory cytokines and triggering receptor expressed on myeloid cells-1 (TREM-1). In contrast, CX3CR1(hi) iMNP retain their non-inflammatory profile even during intestinal inflammation. These findings identify two functionally distinct iMNP subsets based on differential expression of CX3CR1 and indicate an unanticipated stability of iMNP.

Quantifying transmission of norovirus during an outbreak

Healthcare workers are thought to play a role in nosocomial transmission of norovirus, but the level and direction of norovirus transmission between patients and healthcare workers in sustaining transmission during an outbreak have not been quantified.

Transmission of Chlamydia trachomatis through sexual partnerships: a comparison between three individual-based models and empirical data

Chlamydia trachomatis is the most common bacterial sexually transmitted infection (STI) in many developed countries. The highest prevalence rates are found among young adults who have frequent partner change rates. Three published individual-based models have incorporated a detailed description of age-specific sexual behaviour in order to quantify the transmission of C. trachomatis in the population and to assess the impact of screening interventions. Owing to varying assumptions about sexual partnership formation and dissolution and the great uncertainty about critical parameters, such models show conflicting results about the impact of preventive interventions. Here, we perform a detailed evaluation of these models by comparing the partnership formation and dissolution dynamics with data from Natsal 2000, a population-based probability sample survey of sexual attitudes and lifestyles in Britain. The data also allow us to describe the dispersion of C. trachomatis infections as a function of sexual behaviour, using the Gini coefficient. We suggest that the Gini coefficient is a useful measure for calibrating infectious disease models that include risk structure and highlight the need to estimate this measure for other STIs.