A machine-learning method for classifying and analyzing foot placement: Application to manual material handling.

Foot placement strategy is an essential aspect in the study of movement involving full body displacement. To get beyond a qualitative analysis, this paper provides a foot placement classification and analysis method that can be used in sports, rehabilitation or ergonomics. The method is based on machine learning using a weighted k-nearest neighbors algorithm. The learning phase is performed by an observer who classifies a set of trials. The algorithm then automatically reproduces this classification on subsequent sets. The method also provides detailed analysis of foot placement strategy, such as estimating the average foot placements for each class or visualizing the variability of strategies. An example of applying the method to a manual material handling task demonstrates its usefulness. During the lifting phase, the foot placements were classified into four groups: front, contralateral foot behind, ipsilateral foot behind, and parallel. The accuracy of the classification, assessed with a holdout method, is about 97%. In this example, the classification method makes it possible to observe and analyze the handler's foot placement strategies with regards to the performed task.

[LAST-Q: Adaptation and normalisation in Quebec of the Language Screening Test]. / LAST-Q: adaptation et normalisation franco-québécoises du Language Screening Test.

The goal of the present study was to adapt and to establish normative data for the recently developed Language Screening Test (LAST; Flamand-Roze et al., 2011) in the French-Canadian population according to age and level of education. After an adaptation process, 100 French-Canadian speakers were evaluated with the LAST-Q. As expected, a perfect score of 15/15 was obtained for all high level education participants, and a score of 14/15 was obtained for all participants with a lowest level of education or aged 80 years or more. Thanks to this adaptation, LAST-Q can be used in acute patients in stroke unit in Quebec.

Reducing weight increases postural stability in obese and morbid obese men.

OBJECTIVE: To investigate the effect of weight loss on balance control in obese and morbid obese men. METHODS: In a longitudinal and clinical intervention study, postural stability was measured with a force platform before and after weight loss in men. Weight loss was obtained in obese men (mean body mass index (BMI)=33.0 kg/m(2)) by hypocaloric diet until resistance and in morbid obese men (mean BMI=50.5 kg/m(2)) by bariatric surgery. Morbid obese men were tested before surgery, and 3 and 12 months after surgery when they had lost 20 and nearly 50% of initial body weight, respectively. Normal weight individuals (mean BMI=22.7 kg/m(2)) were tested twice within a 6- to 12-month period to serve as control. Body fatness and fat distribution measures, and posturographic parameters of the center of foot pressure (CP) along the antero-posterior and medio-lateral axes for conditions with and without vision were performed in all subjects. RESULTS: Weight loss averaged 12.3 kg after dieting and 71.3 kg after surgery. Body weight remained unchanged in the control group. After weight loss, nearly all measures of postural stability were improved with and without vision (i.e., CP speed and range in antero-posterior and medio-lateral axes). A strong linear relationship was observed between weight loss and improvement in balance control measured from CP speed (adjusted R (2)=0.65, P<0.001). CONCLUSION: Weight loss improves balance control in obese men and the extent of the improvement is directly related to the amount of weight loss. This should decrease the habitual greater risk of falling observed in obese individuals.

Liver transplantation for cirrhosis in cystic fibrosis.

BACKGROUND: Liver disease is the third most common cause of death in children with cystic fibrosis (CF). Liver transplantation is an effective treatment in children with hepatic failure. AIMS: The objective of the present study was to review the indications and postoperative course of hepatic transplantation in a cystic fibrosis population. PATIENTS: Five children with CF, at a mean age of 16.5 years, underwent liver transplantation. RESULTS: All patients showed cirrhosis, portal hypertension and hepatic failure. The main postoperative complication was ascites refractory to treatment in two patients. No significant deterioration of the pulmonary function was noted. Two patients died, one of Hodgkin lymphoma and the other of progressive pulmonary failure. CONCLUSION: Liver transplantation was indicated in children with CF when hepatic failure and/or severe portal hypertension was present with well-preserved pulmonary function.

Chronic interstitial nephritis due to 5-aminosalicylic acid.

Nephrotoxicity has recently been reported with the use of 5-aminosalicylic acid (5-ASA) which has structural similarities to phenacetin and aspirin. The present paper describes 2 cases of interstitial nephritis and 1 case of end-stage failure associated with 5-ASA treatment. The first patient presented with severe renal failure which was partially reversed with 5-ASA discontinuation and steroid therapy. The second had severe renal failure (serum creatinine 469 mmol/l) but renal function stabilized with 5-ASA withdrawal. The third patient had end-stage renal failure and underwent hemodialysis and a successful kidney transplant.

Reduced interferon-gamma production in infants with bronchiolitis and asthma.

Infants are at increased risk of developing asthma after acute bronchiolitis. We assessed the hypothesis that cytokine production is related to the development of asthma after bronchiolitis. The smoking history and the presence of atopy or asthma in parents or siblings were recorded and blood mononuclear cell interferon (IFN)-gamma and interleukin (IL)-4 production in response to IL-2 were assessed in 32 infants hospitalized for bronchiolitis and in a subgroup (n = 19) in which pulmonary function tests were performed approximately 4.9 mo later. The presence of asthma was determined by the Delphi consensus method 2 yr after hospitalization. Infants were classified as follows: asthma absent (A, n = 14), possible (Po, n = 9), or probable (Pr, n = 9). Infants with possible and probable asthma had lower IFN-gamma production at the time of bronchiolitis and a trend to lower IFN-gamma production 4.9 mo later when compared with those who had no asthma. At the time of bronchiolitis, IFN-gamma production was: 123 +/- 31 versus 34 +/- 20 versus 21 +/- 14 pg/ml, A versus Po versus Pr (p = 0.02, ANOVA) and 4.9 mo after bronchiolitis, IFN-gamma production was: 147.3 +/- 45 versus 47.4 +/- 30 versus 22.3 +/- 32 pg/ml, No versus Po versus Pr (p = 0.08 ANOVA). IL-4 production did not differ between groups. Infants who went on to develop asthma had more parent smokers (21.4% versus 55. 6% versus 55.6%, A versus Po versus Pr, p < 0.04), lower VmaxFRC (122 +/- 18 versus 77 +/- 7 versus 67 +/- 8% predicted, A versus Po versus Pr, p < 0.02), lower PC40 histamine (6.4 +/- 3.3 versus 1.2 +/- 0.6 mg/ml, A versus Po+Pr, p < 0.03) but no increase in atopy or asthma in their family. Significant positive correlations were found between IFN-gamma production at the time of bronchiolitis and VmaxFRC (r = 0.606) or PC40 histamine (r = 0.648) 4.9 mo after bronchiolitis. Lower IFN-gamma production at the time of bronchiolitis is an indicator of lower pulmonary function and increased responsiveness to histamine 4.9 mo after bronchiolitis and is related to the development of asthma after bronchiolitis in infants.

Cellular immunity is activated and a TH-2 response is associated with early wheezing in infants after bronchiolitis.

OBJECTIVE: To determine whether abnormalities of cellular immunity are present and linked to early wheezing after bronchiolitis. METHODS: We prospectively studied 26 infants hospitalized for a first episode of bronchiolitis and without any prior immune, cardiac, or respiratory disease. Blood was obtained at the time of enrollment and 5 months later for the assessment of the total cellular and differential counts, CD4+ (helper) and CD8+ (suppressor/cytotoxic) lymphocytes, and the activation markers CD23 (low-affinity immunoglobulin E receptor) and CD25 (interleukin-2 (IL-2) receptor). The cytokines interferon gamma (T-helper (TH) type-1 cytokine) and IL-4 (TH-2) were measured in plasma and in vitro after stimulation with IL-2 or with the house-dust mite (Dermatophagoides farinae) antigen. A daily log of episodes of wheezing was kept by parents after discharge. RESULTS: We found an increase in blood eosinophils, an increased percentage of CD4+, CD25+, and CD23+ lymphocytes in subjects at 5 months compared with the time of bronchiolitis and with healthy subjects of the same age (p < 0.05). Plasma IL-4 levels, although not different from those of healthy subjects, also increased significantly. Peripheral blood lymphocytes from infants who wheezed produced more IL-4 in vitro, 5 months after bronchiolitis, in response to D. farinae antigen. In babies who wheezed, a positive correlation was found between the total number of days that wheezing occurred and the blood eosinophil count. Babies who wheezed more often (> 20 days) had more peripheral blood basophils and eosinophils, and peripheral blood lymphocytes obtained from these subjects at the time of bronchiolitis produced less interferon gamma on stimulation with IL-2. CONCLUSIONS: Bronchiolitis is followed by activation of cellular immunity, and early wheezing in infants is associated with a TH-2 response.

Exercise-induced oxyhemoglobin desaturation and pulmonary diffusing capacity during high-intensity exercise.

The purpose of this investigation was to examine if exercise-induced arterial oxyhemoglobin desaturation selectively observed in highly trained endurance athletes could be related to differences in the pulmonary diffusing capacity (DL) measured during exercise. The DL of 24 male endurance athletes was measured using a 3-s breath-hold carbon monoxide procedure (to give DLCO) at rest as well as during cycling at 60% and 90% of these previously determined VO2max. Oxyhemoglobin saturation (SaO2%) was monitored throughout both exercise protocols using an Ohmeda Biox II oximeter. Exercise-induced oxyhemoglobin desaturation (DS) (SaO2% < 91% at VO2max) was observed in 13 subjects [88.2 (0.6)%] but not in the other 11 nondesaturation subjects [NDS: 92.9 (0.4)%] (P < or = 0.05), although VO2max was not significantly different between the groups [DS: 4.34 (0.65) l/min vs NDS: 4.1 (0.49) l/min]. At rest, no differences in either DLCO [ml CO.mmHg-1.min-1: 41.7 (1.7) (DS) vs 41.1 (1.8) (NDS)], DLCO/VA [8.2 (0.4) (DS) vs 7.3 (0.9) (NDS)], MVV [l/min: 196.0 (10.4) (DS) vs 182.0 (9.9) (NDS)] or FEV1/FVC [86.3 (2.2) (DS) vs 82.9 (4.7) (NDS)] were found between groups (P > or = 0.05). However, VE/VO2 at VO2max was lower in the DS group [33.0 (1.1)] compared to the NDS group [36.8 (1.5)] (P < or = 0.05). Exercise DLCO (ml CO.mmHg-1.min-1) was not different between groups at either 60% VO2max [DS: 55.1 (1.4) vs NDS: 57.2 (2.1)] or at 90% VO2max [DS: 61.0 (1.8) vs NDS: 61.4 (2.9)]. A significant relationship (r = 0.698) was calculated to occur between SaO2% and VE/VO2 during maximal exercise. The present findings indicate that the exercise-induced oxyhemoglobin desaturation seen during submaximal and near-maximal exercise is not related to differences in DL, although during maximal exercise SaO2 may be limited by a relatively lower exercise ventilation.

Dose-response relationships for edrophonium antagonism of mivacurium-induced neuromuscular block during N2O-enflurane-alfentanil anaesthesia.

The purpose of this study was to determine the dose-response relationships for edrophonium antagonism of mivacurium-induced neuromuscular block. Seventy-five ASA I or II adults were given mivarcurium 0.15 mg x kg(-1) followed by an infusion (7 micrograms x kg(-1) x min(-1) during alfentanil-propofol-N2O-enflurane anaesthesia. Train-of-four stimulation (TOF) was applied to the ulnar nerve every 20 sec and the response of the adductor policis was recorded (Relaxograph NMT-100, Datex, Helsinki, Finland). Mivacurium infusion was modified at five-minute intervals in order to keep the height of the first twitch in TOF(T1) at 5% of its control value. At the end of surgery, edrophonium (0.0, 0.125, 0.25, 0.5, or 1.0 mg x kg(-1) combined glycopyrrolate (0.0, 0.0012, 0.0025, 0.005, or 0.01 mg x kg(-1) were administered by random allocation. Edrophonium doses of 0.25, 0.5 and 1.0 mg x kg(-1) were different from placebo with regard to time to attain a TOF ratio (fourth twitch in TOF/T1) = 0.7 (13.8 +/- 4.5, 11.1 +/- 3.5, 11.4 +/- 3.0 vs 19.7 +/- 4.7 min P< 0.05). Doses of 0.5 and 1.0 mg x kg(-1) permitted faster recovery time of T1 from 10 to 95% (T10-95) than did placebo (7.5 +/- 3.8, 8.9 +/- 3.5 vs 14.5 +/- 5.0 min P<0.05). Edrophonium 0.5 mg x kg(-1) was different from placebo with regard to recovery time of T1 from 25 to 75% (T25-75) (3.3 +/- 2.0 vs 6.7 +/- 2.0 min P<0.05). Only edrophonium 0.5 mg x kg(-1) provided faster recovery than placebo with regard to all three indices. It is concluded that edrophonium 0.5 + glycopyrrolate 0.005 mg x kg(-1) allow the fastest recovery from a mivacurium-induced block during enflurane-N2O anaesthesia.

Validity of the Creasy risk appraisal instrument for prediction of preterm labor.

The study objectives were twofold: (a) retrospective evaluation of the predictive validity of the Creasy in a cross-cultural urban and rural population based on the outcome data of publicly served prenatal patients, and (b) examination of the universality of the Creasy through comparison of the predictive validity found in the study population with other published results. Subjects were 433 white and African American women who entered prenatal services through 1 urban and 12 rural health department sites and received care in a regionalized system in East Central Georgia. The Creasy instrument was administered once to all prenatal women in their initial clinical encounters. The instrument identified 30.47% of the women who experienced preterm deliveries. Only 44.3% of the time did a score indicating high risk for preterm delivery accurately predict preterm delivery. Predictive validity for rural and urban subjects was not significantly different. As predictive validity for the Creasy was low, it was determined that it has limited clinical usefulness with a single administration. Usefulness may be improved with further risk-factor specification and frequent measurement throughout pregnancy.

Chromosomal location of genes controlling short-term and long-term somatic embryogenesis in wheat revealed by immature embryo culture of aneuploid lines.

The expression of essential genes during somatic embryogenesis can be analysed by inducing aneuploid cells to undergo embryogenesis during immature embryo culture and then determining whether defects occur. Triticum aestivum disomic and aneuploid stocks, including 36 ditelosomics and 7 nullitetrasomic 'Chinese Spring' wheats, were compared for their ability to undergo somatic embryogenesis after 2 months of in vitro immature embryo culture. Their regeneration capacity was observed after 4 and 14 months of in vitro culture to determine which chromosome arms influence the process. The large range of variation found among the tested aneuploids suggested that genetic control of the somatic tissue culture ability is polygenic. Our results indicate that genes affecting somatic embryo-genesis and regeneration are located in all of the homoeologous chromosome groups. The lack of chromosome arms 1AL (DT 1AS) and 3DL (DT 3DS) practically suppresses somatic embryogenesis, demonstrating that major genes on wheat chromosome arms 1AL and 3DL control regeneration capacity. Results suggest that plants were mainly produced from somatic embryo development. Although the control of somatic embryogenesis and regeneration is polygenic, the genes located on the long arms of homoeologous group 3 chromosomes have a major effect. We also have evidence of chromosome arms that determine the time required for regeneration.

Nuclear gametophytic genes from chromosome arm 1RS improve regeneration of wheat microspore-derived embryos.

The effect of the 1RS chromosome arm from rye on plant regeneration from microspore-derived embryos was studied using anther culture technology with genotypes carrying the 1BL-1RS translocated chromosomes, the normal wheat chromosome 1BL-1BS, and ditelosomic lines DT 1BS and DT 1BL. A significant difference was observed in microspore-derived green plants between chromosome structure concerned with 1RS and 1BS arms. An analysis of the inheritance of the 1B-1R translocation was performed on the basis of the frequency of male gametes 1BL-1RS in the microspore-derived green plants and that of the 1B-1R translocation inherited through the pollen or the egg cell from structurally heterozygous hybrids 1BL-1BS/1BL-1RS. Both the normal 1B and the translocated 1BL-1RS chromosomes were sexually transmitted through the pollen grains with the same frequency. The 1BL-1RS chromosome is only transmitted through 45% of the egg cells. On the contrary, two-thirds of the microspore-derived green plants regenerated from the anther culture experiments possess the translocated chromosome. The involvement of the rye chromosome arm 1RS from 'Aurora' on regeneration capacity of the microspore-derived embryos has been proposed through the effect of a "gametophytic gene."

Childhood primary pulmonary neoplasms.

Nine children (6 boys, 3 girls) were diagnosed with a primary endobronchial or pulmonary parenchymal neoplasm. The average age at diagnosis was 9 years. Presenting complaints included cough (7), fever (5), pulmonary infection (3), respiratory distress (3), weight loss (2), pain (2), and hemoptysis (1). Pulmonary x-rays showed persistent atelectasis, pneumonic infiltrates or mass lesions. A computed tomography scan was performed in 8. Five of six endobronchial tumors were diagnosed with bronchoscopy and biopsy. Treatment consisted of thoracotomy and pulmonary resection in 7 cases and laser resection in 2. The pathologic diagnoses were bronchial carcinoid (3), bronchial mucoepidermoid carcinoma (1), inflammatory pseudotumor (plasma cell granuloma) of the bronchus (2) and of the lung parenchyma (1), fibrosarcoma (1), and rhabdomyosarcoma (1). Postoperative chemotherapy was given only to the patient with pulmonary rhabdomyosarcoma; this child died. One child has developed a local recurrence while 7 children are alive and free of disease at an average of 2.4 years postresection. Pulmonary neoplasms are unusual in the pediatric age group and represent a wide spectrum of pathology. Including the present series, 383 tumors have been described. Seventy-six percent were malignant. Early investigation and surgical intervention are essential in children with persistent pulmonary symptoms or x-ray abnormalities. In most cases, the prognosis is excellent with complete surgical resection; however, malignancies other than bronchial adenoma are associated with significantly mortality.

Personal characteristics and spells without health insurance.

People without health insurance differ not only in their personal characteristics and reasons for being without health insurance but also in the length of time they spend in uninsured spells. A hazard model of spell durations is used to estimate the relative effects of a person's characteristics in the month just before an uninsured spell begins on the duration of the spell. Using the Survey of Income and Program Participation, our analyses indicate that monthly family income, educational attainment, and industry of employment in the month prior to losing health insurance are the characteristics that have the greatest impact on the exit rate from being without health insurance. Because low-income people could end an uninsured spell with either private health insurance or Medicaid, findings from an exploratory competing risks model are also reported.

Spells without health insurance: the distribution of durations when left-censored spells are included.

In a previous paper (1990), we estimated the distribution of durations of uninsured spells for which the beginning could be observed. We raised the concern that uninsured spells that were in progress when the Survey of Income and Program Participation began might not be proportionally represented in a sample of uninsured spells restricted to spells with observed beginnings. This paper includes spells in progress when SIPP began. Including left-censored spells, and correcting for length bias inherent in such spells, does not fundamentally change our previous estimate of the distribution.

A test for the measurement of pulmonary diffusion capacity during high-intensity exercise.

The most commonly used technique for the measurement of pulmonary diffusing capacity (DL) is the single-breath hold technique requiring a 10-s breath-hold after the maximal inspiration of carbon monoxide (0.3% CO) and helium (10% He). To measure pulmonary diffusing capacity in our experiments, we had the added advantage of the use of the Gould Pulmonary Function Laboratory that automates the collection and recording of data and the calibration of equipment for each test. However, this technique, DL(CO), is difficult to use during exercise of moderate or elevated intensity because of the lengthy breath-hold. Thus, the purpose of the present study was to compare DL(CO) with 3-s and 5-s breath-holds to a 10-s breath-hold at rest and during moderate and intense exercise in 14 subjects. As expected, an increase in the DL(CO) was observed during moderate and intense exercise when compared to resting values (45.7 +/- 10.0 and 53.0 +/- 7.6 vs 32.1 +/- 7.7 ml CO min-1 mmHg-1). No difference was observed between values for DL(CO) measured at varying breath-hold times at rest (3 s: 32.9 +/- 7.4; 5 s: 32.0 +/- 7.5; 10 s: 31.4 +/- 8.2 ml CO min-1 mmHg-1) or during moderate exercise (3 s: 45.9 +/- 10.1; 5 s: 45.9 +/- 10.6; 10 s: 45.2 +/- 10.4 ml CO min-1 mmHg-1) or intense exercise (3 s: 52.1 +/- 8.3; 5 s: 54.3 +/- 9.3; 10 s: 52.6 +/- 5.2 ml CO min-1 mmHg-1). Reliability coefficients indicated that the use of a 3-s breath-hold was appropriate.(ABSTRACT TRUNCATED AT 250 WORDS)