Gait analysis using three-dimensional motion and ground reaction force systems in patients with hemiplegia treated with botulinum toxin type A in ankle plantar flexors.

Objective: The efficacy of botulinum toxin type A (BoNT-A) injection on spasticity has usually been measured using the range of motion (ROM) of joints and Modified Ashworth Scale (MAS); however, they only evaluate muscle tone at rest. We objectively analyzed the gait of three patients with hemiplegia using three-dimensional motion analysis and ground reaction force (GRF) systems to evaluate muscle tone during gait. Materials and Methods: We measured passive ankle dorsiflexion ROM with knee extension and the MAS score for clinical evaluation, and gait speed, stride length, single-leg support phase during the gait cycle, joint angle, joint moment, and GRFs for kinematic evaluation before and one month after BoNT-A injection. Results: All patients showed an increase in ankle dorsiflexion ROM, improvement in MAS score, and increase in stride length. Case 1 showed an increase in gait speed, prolongation of the single-leg support phase, increase in hip extension angle and moment, and improvement in the vertical and anterior-posterior components of the GRFs. Case 2 showed an increase in gait speed, improvement in double knee action, increase in ankle plantar flexion moment, and improvement in propulsion in the progressive component of the GRFs. Case 3 exhibited a laterally directed force in the GRFs. Conclusion: We evaluated the effects of BoNT-A injections in three patients with hemiplegia using three-dimensional motion analysis and GRFs. The results of the gait analysis clarified the improvements and problems in hemiplegic gait and enabled objective explanations for patients.

Sense of Coherence as a Mediator in the Association Between Empathy and Moods in Healthcare Professionals: The Moderating Effect of Age.

While empathy is considered a critical determinant of the quality of medical care, growing evidence suggests it may be associated with both one's own positive and negative moods among healthcare professionals. Meanwhile, sense of coherence (SOC) plays an essential role in the improvement of both psychological and physical health. Reportedly, individual SOC reaches full stability after around age 30. The aim of this study was first to evaluate the mediatory role of SOC on the association between empathy and individual moods among 114 healthcare professionals in a general hospital, and then to examine the moderating effect of age on this association. Participants completed a range of self-report demographic questionnaires, Empathy Process Scale (EPS), the 13-item Antonovsky's SOC, and Profile of Mood States (POMS). Findings showed that SOC mediated the relations between empathy (EPS) and both POMS-Vigor (POMS-V: self-vigor mood) and POMS-Depression (POMS-D: self-depression mood). Notably, moderated mediation analysis revealed that there was a significant interaction (age × SOC) on self-vigor mood (POMS-V) in healthcare professionals. The indirect effect of empathy (EPS) on self-vigor mood (POMS-V) through SOC was significant at over mean age "32.83." Although there was no significant interaction with age regarding the indirect effect of empathy (EPS) on self-depression mood (POMS-D), in the sub-category level analysis of empathy (EPS), we found a significant interaction item [age × empathy for other's negative affect (EPS-N)] on SOC. This indirect effect was also significant at over mean age "32.83." Taken, together, the current study highlighted the significant mediator of SOC on that empathy amplifies self-vigor mood and attenuates self-depression mood as a protective factor among the Japanese healthcare professionals. Some components of these processes may depend on the moderating role of age, indicating that we may need to consider the SOC development with age for more effective empathy performance interventions among healthcare professionals.

Development and present status of seismic evaluation and seismic retrofit of existing reinforced concrete buildings in Japan.

This paper describes the development and present status of seismic evaluation and seismic retrofit of existing buildings mainly for low-rise and medium-rise reinforced concrete buildings in Japan. First, since the seismic evaluation of existing buildings has close relationships with the seismic design of new buildings, a brief history of the development of seismic design, seismic evaluation, and seismic retrofit is provided in terms of major earthquake disasters mostly in Japan and associated with some major events in the U.S. Then, the development of seismic evaluation and retrofit is reviewed, focusing on the items in which the author has been deeply involved. This provides insight into previous earthquake damage, methodologies for seismic evaluation, the basic concept of the Standard for Seismic Evaluation of Existing Reinforced Concrete Buildings, studies on the demand criteria for seismic safety, and the present status of seismic evaluation and retrofit. Finally, the typical methods of seismic retrofit and some examples of retrofitted buildings in Japan are explained.

Codes we don't want to crack-How seismic design and building codes have helped reduce the damage caused by earthquakes

The Great Hanshin eathquake on January 17 was a major seismic event, measuring 7.2 on the Richter scale of magnitude, 7 on the Japanese scale of intensity, and XI on the MM (Modified Mercalli) scale used in the US. Not only was the Gret Hanshin earthquake an inland type earthquake but it occured on an unmonitored fault located directly beneath a major metropolis (Kobe) of 1.5 million inhabitants. Consequently, loss of life and property was enormous. Over 160,000 buildings and houses were damaged in the Kobe earthquake. Of these, 1.000 to 2.000 reinforced concrete buildings and steel-structure buildings were severely damaged or collapsed completely. More than 50.000 wooden houses were completely destroyed. 90

of the approximately 5.500 people killed in the quake were crushed to death in fallen buildings. Two key features of the destruction were the fires caudesd by collapsing wooden buildings and the extent of damage to reinforced concrete and steel-structure buildings built 20 to 30 years ago, before implementation of the current Seismic Design Code. Also striking were the collapse of the first floor of buildings with weak first-story structures, the collapse of the middle stories of multi-story buildings, and damage related to weld breaks in steel-structure buildings. (AU)

The effect of vertical excitation on structural response seismic characteristics

Under an eathquake, structures might vibrate not only horizontally but also vertically due to a vertical excitation. Now the effect of the vertical excitation, however is not considered directly or with scientific justification. The effect of vertical excitation mus be studiesd to improve the seismic capacity of structures under real eathquakes. In this paper, the characteristics of vertical excitations are discussed comparing with horizontal excitations using 12 ground acceleration records including 1995 Hyogoken-nambu earthquake records as the first step. As the results, these can be said that the maximum vertical ground acceleration is generally smaller than the horizontal, the vertical input energy due to earthquake is less than the horizontal, but the response acceleraton is larger than the horizontal and vertical maximum response acceleration should accur at the same time. (AU)

Needs to evaluate real seismic perfomance of buildings-lessons from the 1995 Hyogoken-nambu eathquake-

The lessons for buildings from the damage due to the Hyogoken-nambu earthquake are necessity to develop more rational seismic design codes based upon a perfomance-based design concept, and to evaluate seismic performance of existing buildings. In this paper, the lessons for buildings from the Hyogoken-nambu earthquake, the building damage due to the earthquake, the reasons why the seismic retrofit has not been implemented much, the responses to the lessons from the earthquake, the Network Committe for promotion of seismic retrofit of buildings,the Law for promotion of seismic retrofit of buildings and the implementation of seismic retrofit in Japan are described. (AU)

Potential seismic risk assessment of urban cities based on macro-zonation concept

This paper describes a potential seismic risk of a city or a group of cities based on the "macro-zonation concept" in which regional macro information such as topography, number of active faults and historical earthquakes, population, accessibility from neighboring cities etc. is considered. In this study, typical cities in Japan are selected and their potential seismic risk is estimated based on statistical data related to macro information. Also the relationship between the estimated potential seismic risk and damage observed in Kobe districts damaged by 1995 Hyogoken-nambu earthquake are investigated. (AU)