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Background Esomeprazole and rabeprazole are metabolised in the liver by means of the CYP2C19 enzyme, which has several functional genetic polymorphisms. Among Caucasians, 70% of the population has a fast metaboliser phenotype, 25-30% an intermediate and 2-5% a slow metaboliser phenotype. It is unknown whether different PPIs are affected to the same extent by these phenotypic differences. Aim To compare the acid-inhibitory effects of esomeprazole 40 mg and rabeprazole 20 mg in relation to CYP2C19 genotype and pharmacokinetics. Methods Eighteen healthy Helicobacter pylori-negative Caucasian subjects with CYP2C19*2-*6 and*17 genotype were included in a randomised investigator-blinded crossover study with esomeprazole 40 mg and rabeprazole 20 mg. Intragastric 24-h pH-monitoring was performed on days 0, 1 and 5 of oral dosing. Results Onset of acid inhibition during the first 4 h after administration did not differ significantly between PPIs. During the upright period, the proportion of time with pH >4 was significantly higher with esomeprazole compared to rabeprazole (52.2 vs. 40.3%, P = 0.003). At day 1 and 5, acid inhibition was significantly greater with esomeprazole than with rabeprazole (median intragastric pH: day 1: 3.7 vs. 3.0, P = 0.008; day 5: 4.7 vs. 3.8, P 4: day 1: 45 vs. 39%, P = 0.054; day 5: 65 vs. 48%, P

PURPOSE: Conventional bioavailability testing of dosage forms based on plasma concentration-time graphs of two products in a two-period, crossover-design, is not applicable to topical treatment of intestinal segments. We introduce an isotope dual-label approach ((13)C- and (15)N(2)-urea) for colon drug delivery systems that can be performed in a one-day, non-invasive study-design.METHODS: Four healthy volunteers took an uncoated or a ColoPulse-capsule containing (13)C-urea and an uncoated capsule containing (15)N(2)-urea. In case of colon-release (13)C-urea is fermented and (13)C detected as breath (13)CO(2). Absorbed (13)C-urea and (15)N-urea are detected in urine.RESULTS: C and (15)N in urine released from uncoated capsules showed a ratio of 1.01 ± 0.06. The (13)C/(15)N-recovery ratio after intake of a ColoPulse-capsule was constant and lower >12 h post-dose (median 0.22, range 0.13-0.48). The (13)C/(15)N-ratio in a single urine sample at t ≥ 12 h predicted the 24 h non-fermented fraction (13)C of 3 h) release and a fermented fraction (13)C >54 %.CONCLUSIONS: Breath and urine (13)C and (15)N data describe the release-profile and local bioavailability of a colon delivery device. This allows non-invasive bioavailability studies for evaluation of colon-specific drug delivery systems without radioactive exposure and with increased power and strongly reduced costs.

Introduction: Driving a car may be negatively affected by driver sleepiness. This is especially seen under monotonous conditions such as prolonged highway driving. This study examined the effects of energy drink (ED) on simulated highway driving. Materials and methods: In a double blind crossover study, N = 21 healthy volunteers performed a 4-hour driving test in the STISIM driving simulator. After 2 hours driving, a 15-minute break was scheduled in two of the three conditions. During the break subjects consumed either 250 ml ED (Red Bull) or a placebo drink (Red Bull without caffeine (80 mg), glucuronolactone, taurine and B-vitamins). Subjects were instructed to drive with a steady lateral position while maintaining a constant speed of 95 km/h. The primary outcome measure was the number of lapses. A lapse is considered to be a short period of inattention and is defined by a deviation from the mean lateral position for >100 cm for 8 seconds or more. Results: No significant differences were observed between the ED, placebo, and continuous driving (9.2, 9.9, 12.5 lapses) in hour 2. In hour 3, significantly fewer lapses were observed after consuming ED versus continued driving (4.3 versus 9.5 lapses, p = 0.020), and having a break and a placebo drink produced a non-significant reduction in the number of lapses (7.4 lapses, p = 0.365). In hour 4 after consuming ED, again significantly fewer lapses were observed when compared with continued driving (6.2 versus 9.4 lapses, p = 0.014). After placebo, the number of lapses in the 4th hour were similar to those observed in the 2nd hour of driving (9.9 versus 9.9 lapses, p = 0.456). In hour 3, the improvement by consuming ED relative to placebo did not reach significance (p = 0.097). In hour 4, consuming ED was significantly more effective in reducing the number of lapses than having a break only (p = 0.034). Conclusion: A 15-minute break in combination with consuming an energy drink significantly reduces the number of lapses during prolonged simulated highway driving.

Biomechanical forces are central in tumor progression and response to treatment. This becomes more important in brain cancers where tumors are surrounded by tissues with different mechanical properties. Existing mathematical models ignore direct mechanical interactions of the tumor with the normal brain. Here, we developed a clinically relevant model, which predicts tumor growth accounting directly for mechanical interactions. A three-dimensional model of the gray and white matter and the cerebrospinal fluid was constructed from magnetic resonance images of a normal brain. Subsequently, a biphasic tissue growth theory for an initial tumor seed was employed, incorporating the effects of radiotherapy. Additionally, three different sets of brain tissue properties taken from the literature were used to investigate their effect on tumor growth. Results show the evolution of solid stress and interstitial fluid pressure within the tumor and the normal brain. Heterogeneous distribution of the solid stress exerted on the tumor resulted in a 35% spatial variation in cancer cell proliferation. Interestingly, the model predicted that distant from the tumor, normal tissues still undergo significant deformations while it was found that intratumoral fluid pressure is elevated. Our predictions relate to clinical symptoms of brain cancers and present useful tools for therapy planning. © 2016 Elsevier Ltd. 49 1524 1531 1524-1531

Alignment of normal, arthritic, and replaced human knees is a much debated subject as is the collateral ligamentous laxity. Traditional quantitative values have been challenged. Methods used to measure these are also not without flaws. Authors review the recent literature and a novel method of measurement of these values has been included. This method includes use of computer navigation technique in clinic setting for assessment of the normal or affected knee before the surgery. Computer navigation has been known for achievement of alignment accuracy during knee surgery. Now its use in clinic setting has added to the inventory of measurement methods. Authors dispel the common myth of straight mechanical axis in normal knees and also look at quantification of amount of collateral knee laxity. Based on the scientific studies, it has been shown that the mean alignment is in varus in normal knees. It changes from lying non-weight-bearing position to standing weight-bearing position in both coronal and the sagittal planes. It also varies with gender and race. The collateral laxity is also different for males and females. Further studies are needed to define the ideal alignment and collateral laxity which the surgeon should aim for individual knees.

This study was planned to examine the effect of superimposed, resistance exercise and electrical stimulation of the 3 different training on anthropometric characteristics and endurance of healthy quadriceps femoris muscle in untrained healthy young adults. Forty eight untrained healthy young subject aged between 21-26 (22.43±1.12) participated the study. Subjects were divided into 3 groups: Resistance Training Group (RTG) (n = 17); Electrical Stimulation Group (ESG) (n = 15) and Superimposed Training Group (STG) (n = 16). Dominant leg was determined by the selected tests and training was given three times a week for 6 weeks. Knee circumference, thigh circumference, skinfold measurements, repetition of 10-pound work, step-up, step-down an squatting on one leg test of subjects were taken pre-post training. The results indicated that electrical stimulation was not sufficient alone to strengthen the quadriceps femoris muscle. It is thought that training programs including voluntary muscle contraction must be main component of rehabilitation for muscle hypertrophy. In addition, resistance training has been effective in reducing adipose tissue. © 2012 Science Alert.

Exergaming is a term used for videogame exercise. The aim of this study was to examine the training effect of an exergame that relies on the movements of a dynamic balance board. Nine healthy elderly subjects participated in a six-week intervention in which they played balance games three times a week. before, after and during the intervention phase balance was assessed with the figure-of-eight test, the berg balance Scale (BBS), and the tandem and one-leg stance, both performed with eyes open and closed. Intervention effects were examined using multilevel modeling statistics. predomi- nantly, the dynamic balance performance, measured by the figure-of-eight and the BBS, improved (p

Cadmium is an important toxic environmental heavy metal. Generally, occupational and environmental exposures to cadmium result from heavy metal mining, metallurgy and industrial use and the manufacturing of nickel–cadmium batteries, pigments and plastic stabilizers. Cadmium induces oxidative stress and alters the antioxidant system, resulting in oxidative DNA damage and lipid peroxidation. The effect of naringin, a grapefruit flavonone, on cadmium-induced genomic damage was studied by using an in vitro system to test for chromosomal aberrations and sister chromatid exchanges. Cadmium significantly increased the total chromosomal aberrations in human lymphocytes at concentrations of 20 and 40 μM, and although naringin alone did not induce any chromosomal aberrations, it decreased those induced by cadmium. The mitotic index was not affected by either cadmium or naringin. Cadmium also induced a significant number of sister chromatid exchanges, but naringin alone did not induce sister chromatid exchanges and was unable to decrease the frequency of sister chromatid exchanges induced by cadmium. Replicative index analysis revealed that naringin and cadmium did not significantly alter replicative index frequencies. In this study, we show that plant-based flavonoids, such as naringin, may reduce the genomic damage induced by cadmium and may protect the cellular environments from free radical damage by its possible antioxidative potential.

[EN] We propose to model planar movements between two human segments by means of rolling-without-slipping kinematic pairs. We compute the path traced by the instantaneous center of rotation (ICR) as seen from the proximal and distal segments, thus obtaining the fixed and moving centrodes, respectively. The joint motion is then represented by the rolling-without-slipping of one centrode on the other. The resulting joint kinematic model is based on the real movement and accounts for nonfixed axes of rotation; therefore it could improve current models based on revolute pairs in those cases where joint movement implies displacement of the ICR. Previous authors have used the ICR to characterize human joint motion, but they only considered the fixed centrode. Such an approach is not adequate for reproducing motion because the fixed centrode by itself does not convey information about body position. The combination of the fixed and moving centrodes gathers the kinematic information needed to reproduce the position and velocities of moving bodies. To illustrate our method, we applied it to the flexion-extension movement of the head relative to the thorax. The model provides a good estimation of motion both for position variables (mean R pos=0.995) and for velocities (mean R vel=0.958). This approach is more realistic than other models of neck motion based on revolute pairs, such as the dual-pivot model. The geometry of the centrodes can provide some information about the nature of the movement. For instance, the ascending and descending curves of the fixed centrode suggest a sequential movement of the cervical vertebrae. © 2010 Elsevier Ltd., This work was funded by the Spanish Government and co-financed by EU FEDER funds (Grants DPI2006-14722-C02-01, DPI2006-14722-C02-02, DPI2009-13830-C02-01, DPI2009-13830-C02-02 and Ramon y Cajal contract to JAG).

This study aimed to develop, compare and validate two versions of a video analysis method for assessment of low back moments during occupational lifting tasks since for epidemiological studies and ergonomic practice relatively cheap and easily applicable methods to assess low back loads are needed. Ten healthy subjects participated in a protocol comprising 12 lifting conditions. Low back moments were assessed using two variants of a video analysis method and a lab-based reference method. Repeated measures ANOVAs showed no overall differences in peak moments between the two versions of the video analysis method and the reference method. However, two conditions showed a minor overestimation of one of the video analysis method moments. Standard deviations were considerable suggesting that errors in the video analysis were random. Furthermore, there was a small underestimation of dynamic components and overestimation of the static components of the moments. Intraclass correlations coefficients for peak moments showed high correspondence (>0.85) of the video analyses with the reference method. It is concluded that, when a sufficient number of measurements can be taken, the video analysis method for assessment of low back loads during lifting tasks provides valid estimates of low back moments in ergonomic practice and epidemiological studies for lifts up to a moderate level of asymmetry. © 2011 Elsevier Ltd.

Background/Aims:Dietary composition has been shown to affect acid-base homeostasis and bone health in humans. We investigated the potential renal acid load (PRAL) and the estimated diet-dependent net acid load (net endogenous acid production, NEAP) in adult vegans and evaluated the relationships between NEAP, food groups and intake of bone health-related nutrients. Methods: The German Vegan Study (GVS) is a cross-sectional study. Data from healthy men (n = 67) and women (n = 87), aged 21–75 years, who fulfilled the study criteria (vegan diet for ≧1 year prior to study start; age ≧18 years, and no pregnancy/childbirth during the last 12 months) were included in the analysis. NEAP values were calculated from diet composition using two models: one based on the protein/potassium quotient and another taking into account an anthropometry-based loss of urinary organic anions. Results:Mean daily intakes of phosphorus, potassium, sodium, magnesium and vitamin C were above, and vitamin D and calcium below Dietary Reference Intake (DRI). Regardless of the model used, the diet in the GVS was characterized by a nearly neutral NEAP. A strong correlation was observed between the NEAP values of the two models (rs = 0.873, p < 0.001). Only the consumption of fruits decreased constantly across the increasing quartiles of NEAP. Conclusions: It can be hypothesized that vegan diets do not affect acid-base homeostasis. With respect to bone health, the significance of this finding needs further investigation.

Introduction: Currently, there is a lot of discussion about whether generic substitution of anti-epileptic drugs (AEDs) with the same active moiety but from different manufacturers can take place safely. Many AEDs are considered to have a narrow therapeutic index, and the consequences of an epileptic attack are severe, in a physical, psychological and social respect. Therefore, there is ample ground to look critically at generic substitution of anti-epileptic medicines. In this context, the Dutch regulatory agency evaluated the exposureof generic AEDs and the occurrence of epilepsy related events. Methods: Reports received by the Dutch Pharmacovigilance Centre Lareb were screened for issues related to generic substitution of AEDs. Public literature dealing with generic substitution of AEDs was reviewed and checked for potential pharmacological issues related to generic substitution of AEDs. Finally, the exposures upon changing between different topiramate and gabapentin generics was evaluated based on internal bioequivalence data. Results: In only 26 of in total 2,103 reports in the Lareb database mentioning an AED as the suspected drug, a possible relationship was indicated with the substitution from a branded AED to a generic one. However, these data should be treated with care, since underreporting is a well-known phenomenon. The majority of publications on generic substitution of AEDs concerned potential instead of actual cases, with many publications based on surveys regarding prescribers' overall experience with switching. Potential issues raised in these publications relate to bioequivalence requirements, use of healthy volunteers instead of patients, variability in exposure, problems with medicine supply, and costs of adverse events. Overall, with very few exceptions, no differences in exposure upon generic substitution of AEDs were actually reported. Generic-generic substitution was also indicated as a potential problem. However, our investigations on topiramate and gabapentin generic-generic substitution indicated that this does not result in significant differences in exposure. Estimated ratios of AUC and Cmax upon substituting generics ranged from 94.1-113.1% and 91.2-103.1% for topiramate and from 95.6-114.9% and 92.5 111.5% for gabapentin, respectively. Conclusion: Overall, no evidence was found for a causal pharmacological relationship between switching to or between generic AEDs and the occurrence of epilepsy-related adverse events. Based on the strict requirements on generics, pharmacological differences between innovator and generic AEDs are considered unlikely, and have indeed hardly been reported. Alternative explanations for increased susceptibility to seizures with generic AEDs may be envisioned, like e.g., new or withdrawn co-medication, compliance, frequent switching, and differences in shape and colour of generics.

Bu çalışma, 05-07 Mayıs 2006 tarihleri arasında İzmir[Türkiye]’da düzenlenen 6. National Congress of Thrombosis, Haemostasis and Angiology’da bildiri olarak sunulmuştur. Objectives: The lack of response of platelets against epinephrine has been discovered with a frequency of 14% to 40% in previous studies. There are studies that have demonstrated the effect of aspirin on platelets may resemble the lack of response to epinephrine. In this study, the extent of the effects of aspirin treatment on aggregation and secretion in healthy males with a lack of response to epinephrine and the frequency of aspirin resistance were investigated. Methods: Blood samples were collected at the beginning and at the end of a 10-day aspirin usage in 52 healthy males. Epinephrine, adenosine diphosphate (ADP), collagen, arachidonic acid (AA) and thrombin aggregations, and adenosine triphosphate (ATP) secretion were studied. Participants were assigned to nonresponder (< 20%), semiresponder (20%-60%), and responder (> 60%) groups, depending on their maximum aggregation responses to epinephrine. Participants who displayed an aggregation to AA at the end of the aspirin treatment were accepted to be aspirin resistant. Results: Of the 52 participants, 4 were found to be nonresponders and 3 of 52 of the participants were found to be semiresponders. Although the lack of response to epinephrine and aspirin treatment displayed similarities in aggregations using epinephrine, ADP, collagen, and thrombin, they differed in aggregations using AA and for ATP secretion. The ratio of aspirin resistance was determined to be 4:52. Conclusions: The observation of AA aggregation in the participants with a lack of response to epinephrine demonstrates that epinephrine nonresponse cannot substitute aspirin treatment. The fact that aspirin resistance is observed in healthy males supports the view that aspirin resistance exists even before the first usage.

Objective: Although recent studies have shown that dynamic stretching may improve individual muscle strength performance, its effects on the functional hamstring/quadriceps (H/Q) strength ratio and thus on injury risk characteristics has not been investigated in depth. The aim of this study was to assess the effects of dynamic stretching on functional H/Q strength ratios for iso-kinetic knee extension and flexion at peak and end range moments in elite women athletes. Material and Methods: A total of twelve healthy elite competitive female athletes (mean age 20 +/- 2 years, mean height 166 6 cm, mean weight 58 +/- 7 kg) volunteered to participate in the study. All subjects completed a non-stretching (control) or a dynamic stretching intervention protocol in a randomized fashion on separate days. The quadriceps and hamstring muscles were stretched during these protocols. Before (pre) and after (post) the intervention, the functional H/Q strength ratio was calculated at 60 degrees.s-1 and 180 degrees.s-1 angular velocities. Results: The strength ratio for knee extension displayed a significant increase and for knee flexion a significant decrease following dynamic stretching during the entire and end range of motion at both angular velocities (p

Immobilization-induced bone loss is usually greater in the epiphyses than in the diaphyses. The larger fraction of trabecular bone in the epiphyses than in the diaphyses offers an intuitive explanation to account for this phenomenon. However, recent evidence contradicts this notion and suggests that immobilization-induced bone loss from the distal tibia epiphysis is mainly from the cortical compartment. The aim of this study was to establish whether this pattern of bone loss was a general rule during immobilization. We monitored various skeletal sites with different tissue composition during 5 weeks of immobilization. Ten healthy male volunteers with mean age of 24.3 years (SD 2.6 years) underwent strict horizontal bed rest. Bone scans were obtained during baseline data collection, at the end of bed rest and after 14 days of recovery by peripheral Quantitative Computed Tomography (pQCT). Sectional images were obtained from the distal tibia epiphysis (at 4% of the tibia's length), from the diaphysis (at 38%), from the proximal metaphysis (at 93%) and from the proximal epiphysis (at 98%), as well as from the distal femur epiphysis (at 4% of the femur's length) and from the patella. Relative bone losses were largest at the patella, where they amounted to − 3.2% (SD 1.8%, p < 0.001) of the baseline values, and smallest at the tibia diaphysis, where they amounted to − 0.7% (SD 1.0%, p = 0.019). The relative losses were generally larger from cortical than from trabecular compartments (p = 0.004), and whilst all skeletal sites depicted such cortical losses, substantial trabecular losses were found only from the proximal tibia epiphysis. Results confirm that the differential losses from the various skeletal sites cannot be explained on the basis of trabecular vs. cortical tissue composition differences, but that endocortical circumference can account for the different amounts of bone loss in the tibia. The present study therefore supports the suggestion of the subendocortical layer as a transitional zone, which can readily be transformed into trabecular bone in response to immobilization. The latter will lead to cortical thinning, a factor that has been associated with the risk of fracture and with osteoarthritis.

The genome is constantly exposed to agents, both exogenous and endogenous, that damage DNA. Consequently, it is very important that determination of this agents and the protective agents. In this work, we evaluated the antigenotoxic/antimutagenic activity of the crude ethanolic extracts of Codium tomentosurn Stackhouse (Chlorophyceae) (CTE), collected from The Coast of South East Marmara Sea, in human lymphocytes culture in vitro against genotoxic/mutagenic agents MMC, EMS and H2O2 by using chromosome aberration (CA), sister chromatid exchange (SCE) and micronuclei (MN) assays as experimental endpoints. Also, in the present study, we determined total phenolic content and total antioxidant capacity (in soluble lipid and water). In addition, total protein, total carbohydrate, vitamins (A. C and E) and pigments (chlorophyll a, chlorophyll b and carotene) contents were also determined. Results of CA, SCE and MN tests show that CTEs have not shown genotoxic effect. In CTE plus MMC-. EMS- or H2O2- treated cultures, CA, SCE and MN frequency which induced by MMC, EMS or H2O2 has been decreased significantly (p < 0.05-0.001). This is the first report on genotoxicity/antigenotoxicity and anti-oxidative capacity of Codium tomentosum. Our results have clearly shown that CTE has strong anti-oxidative and antigenotoxic effect. (C) 2009 Elsevier Ltd. All rights reserved.

The main objective of this study was to investigate the thermal comfort effects of ramie blended seat cover (RBSC) material on drivers. In the experiment, polyester seat covers (PSC) were compared to RBSCs. Both quantitative (measured) and qualitative (perceived) thermal comfort data were collected under normal traffic conditions. Ten volunteer subjects (seven males and three females) who had at least 5 years driving experience and were between 30 and 35 years of age were selected to participate in the study. During trials, temperature was measured at four points that have direct contact between the driver and the seat. Skin wettedness was measured at the back of the subject's torso. During the trials, subjects provided qualitative data by responding to a five question survey administered at 5 min intervals. A significance level of 0.001 inferred that subjects preferred RBSC over PSC seat covers. Relevance to industry This study demonstrates the effects of ramie blended seat cover material (RBSC) and real traffic conditions in thermal comfort. Industries can use our findings to evaluate their ergonomic seat comfort in vehicles and the results of this study can be applied to related industrial applications.

The objective of this study was to compute reference SEMG values for normal subjects of 13 parameters extracted in the time, frequency and bispectrum domain, from the Biceps Brachii (BB) muscle generated under isometric voluntary contraction (IVC). SEMG signals were recorded from 94 subjects for 5 s at 10, 30, 50, 70 and 100% of maximum voluntary contraction (MVC). The Wilcoxon signed rank test was applied to detect significant differences or not at p < 0.05 between force levels for each of the 13 parameters. The main findings of this study can be summarized as follows: (i) The time domain parameters turns per second and number of zero crossings per second increase significantly with force level. (ii) The power spectrum median frequency parameter decreases significantly with force level, whereas maximum power and total power increase significantly with force level. (iii) The bispectrum parameter, maximum amplitude, increases significantly with force level with the exception the transition from 30% to 50% MVC. Although, the tests for Gaussianity and linearity show no significant difference with force level, the SEMG signal exhibits a more Gaussian distribution with increase of force up to 70% MVC. The SEMG linearity test, which is a measure of how constant the bicoherence index is in the bi-frequency domain, shows that the signal's bicoherence index is less constant (hence, the signal is less linear) at 70% of MVC compared to 10, 30, 50 and 100% MVC. (iv) The time domain parameters have good correlation between them as well as, between each one of them and maximum and total power. The median frequency has a good (negative) correlation with the bispectrum peak amplitude. (v) No significant differences exist between values based on gender or age. The findings of this study can further be used for the assessment of subjects suffering with neuromuscular disorders, or in the rehabilitation laboratory for monitoring the elderly or the disabled, or in the occupational medicine laboratory. © 2007 Elsevier Ltd. All rights reserved. 19 1 157 171

Background Transcranial magnetic stimulation (TMS) is an attractive research and possibly therapeutic tool for non-invasive central nervous system stimulation. However, relatively little is known about the direction, magnitude and distribution of induced electric field and current flows in tissue, and optimal setup characteristics as well as appropriate sham stimulation conditions remain largely undetermined, hampering reproducibility. Methods We reconstruct the conductive phenomena induced by TMS by implementing digitized coil geometry and realistic stimulator parameters and solving the electromagnetic problem over an MRI-based, realistic head model of 1 mm resolution. Findings are validated by recording motor evoked potentials from the right abductor pollicis brevis muscle from healthy subjects stimulated in a stereotaxic framework. Results Several commonly used sham stimulation configurations elicit conductive patterns which achieve up to 40% of the strength of real stimulation. Also, variations in coil position of the order of a 7° tilt, which are expected to occur in non-stereotaxic stimulation, can alter the stimulation intensity by up to 25%. Conclusions In accordance with our findings, several clinical studies observe measurable effects during sham stimulation or no significant difference between sham and real stimulation, and the sensitivity of stimulation intensity to tiny coil rotations affords a partial explanation for the poor reproducibility and partial disagreements observed across clinical TMS studies. Knowledge of coil and stimulator specifications alone is hence not sufficient to control stimulation conditions, and a stereotaxic setup coupled with individually adjusted field solvers appear essential in performing reliable TMS studies.

Statistical shape analysis, a relatively a new method for biological research, compares body forms by using specific landmarks determined by anatomical prominences. In this study, we aimed to identify normal facial asymmetry between the right and the left sides of the face. Facial landmark data were collected from two-dimensional digital images of 321 young healthy subjects (150 males and 171 females). These data were analysed using Euclidean distance matrix analysis. The number of significantly asymmetric linear distances between the two halves of the face was greater in females than in males. We found that the left side of the face was most commonly dominant in both males and females. Such data may be useful in establishing a database for future similar studies.

Aim: To investigate the influence of tendinous and synaptic changes induced by unilateral lower limb suspension (ULLS) on the tendon tap reflex. Methods: Eight young men underwent a 23-day period of ULLS. Muscle cross-sectional area (CSA), torque and electromyographic (EMG) activity of the plantar flexor muscles (normalized to the M wave), Achilles tendon–aponeurosis mechanical properties, soleus (SOL) H and T reflexes and associated peak twitch torques were measured at baseline, after 14 and 23 days of ULLS, and 1 week after resuming ambulatory activity. Results: Significant decreases in muscle CSA (−9%), in maximal voluntary torque (−10%) and in the associated SOL EMG activity (−16%) were found after ULLS (P < 0.05). In addition to a 36% (P < 0.01) decrease in tendon–aponeurosis stiffness, normalized H reflex increased by 35% (P < 0.05). An increase in the slope (28%, P < 0.05) and intercept (85%, P < 0.05) of the T reflex recruitment curve pointed to an increase in the gain and to a decrease in the sensitivity of this reflex, possibly resulting from the decrease in the tendon–aponeurosis stiffness at low forces. Following ULLS, changes in tendinous stiffness correlated with changes in neuromuscular efficiency (peak twitch torque to reflex ratio) at higher tendon tap forces. Conclusion: These findings point out the dual and antagonistic influences of spinal and tendinous adaptations upon the tendon tap reflex in humans under conditions of chronic unloading. These observations have potential implications for the sensitivity of the short-latency Ia stretch response involved in rapid compensatory contractions to unexpected postural perturbations.

Introduction Aging and the decline of ovarian hormonal secretion during menopause may alter libido, and sexual response and functioning. The effects of hormone replacement therapy (HRT) on the genital vascular hemodynamics have been widely studied. However, there is a lack of knowledge about the effect of HRT on basal clitoral blood flow. Aim The aims of this study were to measure clitoral artery blood flow and to determine whether HRT has a significant effect in clitoral artery blood flow in postmenopausal women. Methods Doppler sonography of clitoral arteries was performed in 25 postmenopausal women aged 51.3 ± 4.5 years who had been using a continuous combined HRT (0.625 mg of conjugated equine estrogens plus 2.5 mg medroxyprogesterone acetate, in 1 tablet daily) for 2.0 ± 1.1 years, and the clitoral artery peak systolic velocity, resistance index (RI), and pulsatility index (PI) were measured. Thirty‐five postmenopausal women aged 50.0 ± 4.2 years who had not used HRT served as a control group. Main Outcome Measures Assessment of clitoral blood flow with color Doppler ultrasonography by measuring the peak systolic velocity, RI, and PI. Results Clitoral artery circulation was easily detectable by the color Doppler sonography. The clitoral artery peak systolic velocities were significantly higher in postmenopausal women taking HRT compared with the control group (11.8 ± 5.2 cm/second vs. 15.0 ± 5.4 cm/second, P = 0.025). Conclusion HRT improves blood flow to the clitoris. A clitoral blood flow evaluation may be proposed as a potential tool to assess the impact of HRT on the genital tissues and to investigate female sexual response disorders in postmenopausal women. Alatas E, Yagci B, Oztekin O, and Sabir N. Effect of hormone replacement therapy on clitoral artery blood flow in healthy postmenopausal women. J Sex Med 2008;5:2367–2373.

Two studies investigated the effect of a food's viscosity on bite size, bite effort and food intake using a standardized protocol in which subjects sipped through a straw every 20 s for a period of 15 min from one of two products, a chocolate-flavored dairy drink and a chocolate-flavored dairy semi-solid, matched for energy density. In the first study, subjects consumed 47% more from the liquid than from the semi-solid to reach the same degree of satiation, with larger bite sizes for the liquid throughout the 15 minute period (8.7 ± 0.45 g) compared to the semi-solid (5.8 ± 0.3 g, p < 0.01). In the second study bite effort was eliminated by using a peristaltic pump to present the products every 20 s. Oral processing time before swallowing was set at 5 s (both products) or 8 s (semi-solid). With the elimination of bite effort and a standardized oral processing time, subjects consumed as much from the semi-solid as from the liquid to reach the same degree of satiation. Bite size for liquids started relatively small and grew gradually over successive bites, whereas the bite size for the semi-solid food started relatively large and became gradually smaller. The latter effect was even more pronounced when the oral processing time was increased from 5 to 8 s. In conclusion, semi-solids resulted in smaller bite sizes and lower intake than liquids, but these differences disappeared when differences in bite effort were eliminated. © 2008 Elsevier Inc. All rights reserved.

Objective To examine the acute physiologic effects of acute whole-body vibration (WBV) exercise in young and older people. Design Every participant performed 9 conditions in a static squat position, consisting of no vibration and WBV at 30Hz and 3 loads corresponding to (1) no load (0% body mass), (2) load of 20% body mass, and (3) load of 40% body mass. A Jendrassik voluntary contraction was also performed with no vibration and WBV at 30Hz with no load and 20% body mass. Setting Laboratory facilities at a university in the United Kingdom. Participants Healthy young people (n=12; 6 men, 6 women; mean age, 21.5y) and 12 healthy older people (6 men, 6 women; mean age, 69.2y) from the local community. Interventions Not applicable. Main Outcome Measures The Physical Activity Questionnaire, anthropometric measures, counter-movement jump, and isometric maximal voluntary contraction with the Jendrassik maneuver were assessed in both groups. Oxygen uptake (V̇o2), blood pressure, heart rate, and rating of perceived exertion (RPE) were recorded during WBV and load conditions as the outcome of the study. Results Both vibration and load were associated with an increase (P

The aim of this study was to assess whether the in vivo specific force and architectural characteristics of the lateral gastrocnemius (GL) muscle of early pubescent boys ( n = 11, age = 10.9 ± 0.3 yr, Tanner stage 2) differed from those of adult men ( n = 12, age = 25.3 ± 4.4 yr). Plantarflexor torque was 55% lower in the boys (77.4 ± 21.4 N·m) compared with the adults (175.6 ± 31.7 N·m, P < 0.01). Physiological cross-sectional area (PCSA), determined in vivo using ultrasonography and MRI, was 52% smaller in the boys ( P < 0.01). No difference was found in pennation angle, or in the ratio of fascicle length ( Lf) to muscle length between the boys and men. Moment arm length was 25% smaller in the boys ( P < 0.01). Antagonist coactivation, assessed using surface EMG on the dorsiflexors, was not different between the boys and men (11.8 ± 6.7% and 13.5 ± 5.8%, respectively). Surprisingly, GL force normalized to PCSA (specific force) was significantly higher (21%) in the boys than in the men (13.1 ± 2.0 vs. 15.9 ± 2.7 N/cm2, P < 0.05). This finding could not be explained by differences in moment arm length, muscle activation, or architecture, and other factors, such as tendinous characteristics and/or changes in moment arm length with contraction, may be held responsible. These observations warrant further investigation.

This study investigated the effects of ship motion on peak spinal loading during lifting. All measurements were done on a ship at sea. In 1-min trials, which were repeated over a wide range of sailing conditions, subjects lifted an 18 kg box five times. Ship motion, whole body kinematics, ground reaction forces and electromyography were measured and the effect of ship motion on peak spinal moments and compression forces was investigated. To investigate whether people time their lifts in order to reduce the effect of ship motion on back loading, trials were performed at a free and at a constrained (lifting every 10s) work pace. With increase of the (local) vertical ship acceleration, increased moments and compression forces were found. Furthermore, lifting at a free work pace did not result in smaller effects of ship motion on spinal moments and compression forces than working at a constrained work pace.

Different time-frequency techniques may be used to investigate the relation between latency and frequency of transient-evoked otoacoustic emissions. In this work, the optimization of these techniques and the interpretation of the experimental result are discussed. Time-frequency analysis of click-evoked otoacoustic emissions of 42 normal-hearing young subjects has been performed, using both wavelet and matching pursuit algorithms. Wavelet techniques are very effective to provide fast and reliable evaluation of the average latency of large samples of subjects. A major advantage of the matching pursuit technique, as observed by Jedrzejczak et al. [J. Acoust. Soc. Am. 115, 2148-2158 (2004)], is to provide detailed information about the time evolution of the response of single ears at selected frequencies. A hybrid matching pursuit algorithm that includes Fourier spectral information was developed, capable of speeding-up computation times and of identifying "spurious" atoms, whose latency-frequency relation is apparently anomalous. These atoms could be associated with several known phenomena, either intrinsic, such as intermodulation distortion, spontaneous emissions and multiple internal reflections, or extrinsic, such as instrumental noise, linear ringing and the acquisition window onset. A correct interpretation of these phenomena is important to get accurate estimates of the otoacoustic emission latency.

In the current study, the relationship between objective measurements and subjective experienced comfort and discomfort in using handsaws was examined. Twelve carpenters evaluated five different handsaws. Objective measures of contact pressure (average pressure, pressure area and pressure-time (P-t) integral) in static and dynamic conditions, muscle activity (electromyography) of five muscles of the upper extremity, and productivity were obtained during a sawing task. Subjective comfort and discomfort were assessed using the comfort questionnaire for hand tools and a scale for local perceived discomfort (LPD). We did not find any relationship between muscle activity and comfort or discomfort. The P-t integral during the static measurement (beta=-0.24, p

Ojectives To assess quality of life among Turkish immigrants in Sweden by using the WHOQOL-100 scale and to evaluate the domains' contribution to explain the variance in the quality of life of the immigrants. Our hypothesis was QOL among Turkish immigrants in Sweden are better than Turkish people who are living in their home country. Materials and methods This study was performed in the districts of Stockholm where Turkish immigrants have mostly settled. With the help and guidance of the Turkish Association, a sample of 520 participants was selected. We collected the demographic data by printed questionnaires, and to measure the quality of life, we used the WHOQOL-100 scale Turkish version. For analysis, we used the SPSS V.13.0 and R package programs, variance analyses, and Bayesian regression. Results The quality of life among the sample of Turkish immigrants was found to be moderate, but higher than the sample of the Turkish population. The quality of life of male immigrants was found to be higher than for females. Swedish-born Turks had better quality of life perceptions. Conclusions Turkish immigrants' quality of life perceptions were better than those of the Turkish sample. The best scores were received from the third generation. The first generation and female immigrants need attention in order to receive higher quality of life perceptions.

This study was undertaken to determine the relationship between physical factors and vertical axial rotation through the tibial shaft caused by passive knee and subtalar joint rotation in healthy subjects. The data collected were analyzed in detail to determine the relationship between various physical parameters, such as age, body mass, height, and sex, and tibial rotation. A total of 484 healthy subjects were examined with the measuring the vertical axial rotation through tibial shaft (MVARTS) system. Evaluators passively measured internal and external tibial rotation. The effects of any 2 simultaneous variables and outcomes with a single variable were analyzed; the results were documented graphically. Data were also examined through multiple regression analysis (stepwise regression). Agreement between right and left internal tibial rotations was observed to be strong, as was agreement between right and left external rotations. Female patients exhibited a greater amount of internal/external rotation than did male patients. Differences between female and male patients were noted to be significant. A highly significant and inverse relationship between physical parameters and tibial rotations was noted. Findings suggest that as age, body mass, and height increase, tibial motion is reduced. ©2007 Health Communications Inc.

Objective: We evaluated the effects of a new combined hormonal contraceptive vaginal ring (CVR) delivering the nonandrogenic progestin Nestorone® (NES) and ethinyl estradiol (EE) on several key estrogen-sensitive hepatic proteins that may be markers for the risk of arterial or venous disease events and on blood pressure (BP). Because the pharmacologic androgenicity of the progestin in these formulations influences the hepatic impact of EE, we selected an oral contraceptive (OC) delivering the androgenic progestin levonorgestrel (LNG) and EE as the comparator. We also investigated the effect of delivery route, which is known to modify the hepatic effects of estradiol, but has not been widely studied with EE. Study Methods: Women, aged 18-34 years, with no contraindications to the use of combined OCs, were randomized to three cycles of treatment with a CVR delivering NES/EE (150/15 μg/day) or a combined OC providing LNG and EE (150/30 μg per tablet). Each cycle consisted of 21 days of active treatment, followed by 7 days without treatment. During the last weeks of the pretreatment and third treatment cycles, blood samples were obtained for determinations of plasma concentrations of angiotensinogen, an estrogen-sensitive hepatic protein, and serum concentrations of sex hormone-binding globulin (SHBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and estrogen- and androgen-sensitive proteins. BP was also measured. Results: Of 47 women randomized, 45 completed the study (CVR: 23; OC: 22). Within-group comparisons over time by repeated-measure analysis of variance demonstrated statistically significant changes over time with both treatments for all hepatic proteins (p

This study investigated the contribution of muscle architecture to the differences in the torque-velocity and power-velocity relationships between older (OM n = 9, aged 69-82 years) and younger men (YM n = 15, aged 19-35 years). Plantarflexors' (PF) maximal isometric and concentric torques were recorded at 0.87, 1.75, 2.62, 3.49 and 4.36 rad s(-1). Physiological cross-sectional area (PCSA) was calculated as the ratio of muscle volume (determined by magnetic resonance imaging) to muscle fascicle length (Lf, measured by ultrasonography). GM PCSA and Lf of the OM were, respectively, 14.3% (P < 0.05) and 19.3% (P < 0.05) smaller than of the YM. In the OM, GM maximum isometric torque and maximum contraction velocity (Vmax), estimated from Hill's equation were, respectively, 48.5 and 38.2% lower (P < 0.001) than in the YM. At all contraction velocities, the OM produced less torque than the YM (46.3% of YM at 0.87 rad s(-1) to 14.7% at 4.36 rad s(-1), P < 0.001). Peak power (PP) of the OM was 80% lower than that of the YM and normalisation of PP to muscle volume only reduced this difference by 10%. Normalisation of torque to PCSA reduced, but did not eliminate, differences in torque between YM and OM (9.6%) and differences in torque/PCSA increased with contraction velocity (P < 0.05). After normalisation of velocity to Lf, the difference in Vmax between the OM and the YM was reduced to 15.9%. Thus, although muscle architecture contributes significantly to the differences in the torque- and power-velocity properties of OM and YM, other contractile factors, intrinsic to the muscle, seem to play a role. It is noteworthy that the deficit in PP between OM and YM is far greater than that of muscle torque, even after normalisation of PP to muscle volume. This finding likely plays an important role in the loss of mobility in old age.

A questionnaire measuring cognitive and affective representations of terror risk was developed and tested in Turkey and Israel. Participants in the study were university students from the two countries (n = 351). Four equivalent factors explained terror risk cognitions in each sample: costs, vulnerability, trust, and control. A single negative emotionality factor explained the affective component of terror risk representations in both samples. All factors except control could be measured reliably. Results supported the validity of the questionnaire by showing expected associations between cognitions and emotions, as well as indicating gender differences and cultural variations. Current findings are discussed in relation to previous results, theoretical approaches, and practical implications.

Factor V Leiden causing activated protein C resistance is the most common inherited form of thrombophilia leading to thrombosis. Its frequency shows great ethnic and geographic variations. The aim of this study was to determine the frequency of FV Leiden and coinheritance of FV Leiden with two other frequent hereditary thrombophilia causes, namely, prothrombin G20210A and methylene-tetrahydrofolate reductase (MTHFR) C677T mutation in the Aegean region of Turkey. The study population consisted of 1030 (500 men and 530 women) apparently healthy subjects. Functional resistance to activated protein C (APC) was measured by using the test kit STA staclot APC-R ((Diagnostica Stago, Asnieres, France, Cat. No. 00721). In subjects with APC resistance, molecular analyses of FV Leiden and of prothrombin G20210A and MTHFR C677T mutation were performed by using FV-PTH-MTHFR StripA (Vienna Lab, Labordiagnostika GmbH, Austria) kit, which was based on hybridization of polymerase chain reaction (PCR) amplified DNA products with mutation-specific oligonucleotide probes. Functional APC resistance was present in 93 subjects (9%). FV Leiden mutation was found in 87 of 93 subjects with APC resistance by PCR method. The FV Leiden carrier frequency was found to be 8.4% (87/1030). Seventy-six individuals were heterozygous (7.3%), and 11 were homozygous (1.06%). Among the 87 subjects with FV Leiden mutation, 45 subjects had MTHFR C677T gene mutation (7 homozygous, 38 heterozygous) and 4 subjects had heterozygote prothrombin G20210A gene mutation. A combination of FV Leiden and prothrombin G20210A and MTHFR C677T gene mutation was detected in 3 subjects. The results indicate that FV Leiden prevalence is quite high and coexistence of FV Leiden with other hereditary causes of thrombosis such as prothrombin G20210A mutation and MTHFR enzyme defect is not rare in healthy population of Aegean region of Turkey. © 2007 Sage Publications.

Oral glucose intake inhibits hypothalamic neuronal activity more effectively than glucose infusion. Am J Physiol Endocrinol Metab 293: E754-E758, 2007. First published June 12, 2007; doi:10.1152/ajpendo.00231.2007. - We previously showed that hypothalamic neuronal activity, as measured by the blood oxygen level-dependent ( BOLD) functional MRI signal, declines in response to oral glucose intake. To further explore the mechanism driving changes in hypothalamic neuronal activity in response to an oral glucose load, we here compare hypothalamic BOLD signal changes subsequent to an oral vs. an intravenous (iv) glucose challenge in healthy humans. Seven healthy, normal-weight men received four interventions in random order after an overnight fast: 1) ingestion of glucose solution ( 75 g in 300 ml) or 2) water ( 300 ml), and 3) iv infusion of 40% glucose solution (0.5 g/kg body wt, maximum 35 g) or 4) infusion of saline (0.9% NaCl, equal volume). The BOLD signal was recorded as of 8 min prior to intervention ( baseline) until 30 min after. Glucose infusion was associated with a modest and transient signal decline in the hypothalamus. In contrast, glucose ingestion was followed by a profound and persistent signal decrease despite the fact that plasma glucose levels were almost threefold lower than in response to iv administration. Accordingly, glucose ingestion tended to suppress hunger more than iv infusion ( P

Background: Red blood cells (RBCs) represent a storage pool for folate. In contrast to plasma, RBC folate can appear in different biochemical isoforms. So far, only the methylenetetrahydrofolate reductase (MTHFR) 677 TT genotype has been identified as a determinant of RBC folate vitamer distribution. Objective: The purpose of this study is to identify clinical and biochemical determinants of RBC folate vitamer distribution in healthy subjects. Design: In an observational study, 109 subjects, aged 18 to 65 years, were studied. Red blood cell folate vitamers were analyzed using a liquid chromatography-tandem mass spectrometry method. Other variables recorded included vitamin B2, B6 and B12 status, homocysteine, plasma and RBC S-adenosylhomocysteine and S-adenosylmethionine, renal function and the MTHFR C677T polymorphism. Results: The MTHFR C677T genotype was the dominant determinant of nonmethylfolate accumulation. The median (range) nonmethylfolate/total folate ratio was 0.58% (0-12.2%) in the MTHFR CC group (n=55), 0.99% (0-14.3%) in the CT group (n=39) and 30.3% (5.7-73.3%) in the TT genotype group (n=15), P

Contains fulltext : 51497.pdf (Publisher’s version ) (Closed access) The aim of this study was to assess exposure to pesticides for a longitudinal epidemiological study on adverse reproduction effects among greenhouse workers. Detailed information on pesticide use among greenhouse workers was obtained on a monthly basis through self-administered questionnaires and subsequent workplace surveys. Questionnaires were filled in for a whole year. Dermal exposure rankings were developed for each task using the observational method Dermal Exposure Assessment Method (DREAM). Exposure scores were calculated for each worker for each month during the year, taking into account frequency, duration and exposure intensity for each task. A total number of 116 different active ingredients were used in the population, whereas a mean number of 15 active ingredients were applied per greenhouse. DREAM observations provided insight into the exposure intensity of 12 application techniques and three mixing and loading activities. Relatively high DREAM scores were obtained for scattering, fogging, dusting, and mixing and loading of powders. Observations with DREAM indicated that application with a horizontal ground-boom, motor driven boom, and bulb shower resulted in low dermal exposure. Exposure scores showed substantial variation between workers and over the year. It can be concluded that exposure variation between- and within greenhouses is very large, both in terms of chemical composition and exposure intensity. This may be a significant contributor to the inconsistent results of studies evaluating health effects of pesticide exposure.