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WOS:000731456300036 PubMed ID:34565133 Background/aim: This study was conducted to compare the effects of conventional physiotherapy and two different 'proprioceptive neuromuscular facilitation' (PNF) techniques on knee muscle strength, knee muscular endurance, and proprioception in knee osteoarthritis (KOA). Materials and methods: The study included 35 patients between the ages of 47 and 62 who were diagnosed with stage 1-2 KOA. The patients were divided into three groups with block randomization method as Repeated Stretching Group (N = 12) With Repeated Stretching Technique, Combined Isotonic Contraction Group (N = 11) With Combined Isotonic Contractions (CIC) Technique, And Conventional Physiotherapy Group (n = 12). PNF was applied to all patterns of the lower extremity in full pattern and patients in all groups were treated for 6 weeks, 3 days a week. Muscle strength, muscle endurance, and proprioception were evaluated with Biodex System Pro3 (Biodex Corp. Shirley NY, USA). Results: Knee extensor muscle strength showed more improvement at CIC group than the other groups, and CIC group showed more improvement compared to the conventional physiotherapy in terms of knee joint position sensation evaluated at 60 degrees (p < 0.05). Conclusion: All methods were effective in patients with early-stage knee osteoarthritis; however, the most effective results were obtained by PNF using CIC technique.

Objectives Acquired coagulopathy may be associated with bleeding risk. Approaches to restore haemostasis include administration of coagulation factor concentrates, but there are concerns regarding potential prothrombotic risk. The present study assessed the prothrombotic potential of four-factor prothrombin complex concentrate (4F-PCC) versus activated PCC (aPCC) and recombinant factor VIIa (rFVIIa), using three preclinical animal models. Methods The first model was a modified Wessler model of venous stasis-induced thrombosis in rabbit, focusing on dilutional coagulopathy; the second model employed the same system but focused on direct oral anticoagulant reversal (i.e. edoxaban). The third model assessed the prothrombotic impact of 4F-PCC, aPCC and rFVIIa in a rat model of ferric chloride-induced arterial thrombosis. Results In the first model, thrombi were observed at aPCC doses ≥10 IU/kg (therapeutic dose 100 IU/kg) and rFVIIa doses ≥50 μg/kg (therapeutic dose 90 μg/kg), but not 4F-PCC 50 IU/kg (therapeutic dose 50 IU/kg). The impact of 4F-PCC (up to 300 IU/kg) on thrombus formation was evident from 10 minutes post-administration, but not at 24 hours post-administration; this did not change with addition of tranexamic acid and/or fibrinogen concentrate. 4F-PCC-induced thrombus formation was lower after haemodilution versus non-haemodilution. In the second model, no prothrombotic effect was confirmed at 4F-PCC 50 IU/kg. The third model showed lower incidence of thrombus formation for 4F-PCC 50 IU/kg versus aPCC (50 U/kg) and rFVIIa (90 μg/kg). Conclusions These results suggest that 4F-PCC has a low thrombotic potential versus aPCC or rFVIIa, supporting the clinical use of 4F-PCC for the treatment of coagulopathy-mediated bleeding.

Purpose This study aimed to compare the post-activation performance enhancement (PAPE) induced by isometric and isotonic exercise on vertical jump performance. Methods 18 healthy trained men (25.8±2.7 years; 78.4±8.2 kg; 175.7±6.1 cm; 25.4±1.8 BMI; 126.72±10.8 kg squat 1-RM) volunteered for this study. They randomly performed two different PAPE protocols: Isotonic squats (ISOTS), which consisted of 2 sets of 3 repetitions at 75% of one-maximum repetition (1-RM); and isometric squats (ISOMS), which consisted of 2 sets of 4 seconds of submaximal (75% of 1-RM) isometric contraction at 90°-knee flexion. Countermovement jump (CMJ) height was tested at baseline and 4 minutes after each conditioning set. Results CMJ height significantly increased after set 1 in both PAPE protocols (ISOMS: p p p = 0.162; ES = 0.11; ISOTS: p = 0.976; ES = 0.06). No significant differences (p>0.05) were found between both isometric and isotonic exercise conditions. Conclusions Despite both protocols showed similar PAPE effects on CMJ height after set 1, none of the protocols demonstrated greater efficacy in increasing subsequent performance in healthy trained men.

R. D. Cook’s Fisher lectureship (Cook, Stat Sci 22:1–26, 2007) opened a new and seminal paradigm in sufficient dimension reduction literature. It suggests a model-based approach, and it enables us to reduce the dimension of categorical and continuous predictors simultaneously. Here, the lectureship is extended for reducing the predictors in semi-supervised data under an isotonic error model, which has been common in many popular science fields such as speech recognition, spam email filtering, artificial intelligence, video surveillance, and so on. Under the isotonic error model, a combined dimension reduction model is proposed for semi-supervised data, and related theories are investigated. Numerical studies and real data example confirm its potential usefulness.

Introduction: Modern amateur sportsmen often spend several hours daily on exercise. Especially those doing cycling, long-distance running or triathlon. Sports drinks are widely used by them on every training routine. Some studies have reported a close relationship between sports drinks and dental erosion. Are there any brands or formulations which can be advantageous and recommended by dental professionals? Methods: 5 “isotonic” sports drinks, an energy drink, orange juice, vitamin water and 2 extempore drinks were chosen for the study. Their pH and osmolality were analyzed. Results: The osmolality of the evaluated drinks varied over a relatively broad range (60-648 mmol/kg). In general, it was increasing with total carbohydrate content. The pH value was in the range of 2.76 to 3.90; what may have an impact on dental erosion. Conclusions: It is always advisable for a sport person to choose a drink with a desired osmolality. This is not an easy issue, because the “isotonic” sports drinks and one of the ex tempore (home-made) drink did not have the optimal osmolality in our opinion. The value of big concern for every dental professional is however and undoubtedly the acidity of all the evaluated beverages. Taking into consideration both parameters, there was no drink in the tested group to be recommended by a sports-oriented dentist.

Knowledge about modifiable determinants of daily physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is crucial to design effective PA interventions. The present study aimed to determine the contribution of quadriceps strength, power and endurance to daily PA in COPD. Additionally, for quadriceps endurance, we also aimed to determine to what extent the association varies according to the mode of movement (isotonic, isometric, or isokinetic). Using a multicentre cross-sectional trial design we determined the contribution of quadriceps function to daily PA (steps, sedentary time and time spent doing moderate-to-very-vigorous physical activity [MVPA]) using bivariate and partial Pearson correlation analysis (r) and multiple linear regression models (ΔR2). Pre-determined controlling factors were sex, age, body mass index (BMI), COPD-assessment test, forced expiratory volume in one second in percent of the predicted value (FEV1pred), and distance walked on the 6-minute walk test. Eighty-one patients with COPD (mean ± SD: age 67 ± 8 years, FEV1pred 57 ± 19%, daily steps 4968 ± 3319, daily sedentary time 1016 ± 305 min, and MVPA time 83 ± 45 min) were included. Small to moderate bivariate correlations (r = .225 to .452, p 2 = .04 [relative improvement 13%] p = .026), daily sedentary time (ΔR2 = .07 [23%], p = .005) and MVPA-minutes (ΔR2 = .08 [20%], p = .001). Isotonic endurance was also independently associated with most PA variables, even when controlling for strength, power or isometric-isokinetic endurance properties of the muscle (r = .246 to .384, p p > .05). To conclude, strength, power, and endurance properties of the quadriceps were low to moderately associated with PA in patients with COPD. Isotonic quadriceps endurance was the only quadriceps property that was independently associated with the different measures of PA after controlling for a basic set of known determinants of PA, quadriceps strength or power, or isometric or isokinetic quadriceps endurance. Future longitudinal studies should investigate its potential as a modifiable determinant of PA.

ilustraciones, diagramas, tablas El objetivo de este trabajo fue aprovechar el permeado obtenido mediante la ultrafiltración del lactosuero para desarrollar dos formulaciones de bebidas isotónicas adicionadas con pulpa de uchuva (Physalis peruviana L.). Se realizaron análisis fisicoquímicos como osmolalidad, acidez titulable, pH y sólidos solubles, bromatológicos y microbiológicos de las bebidas. Se obtuvieron dos bebidas, bebida isotónica con uchuva no hidrolizada (BIUN) y bebida isotónica con uchuva hidrolizada (BIUH). Se evaluó la estabilidad durante 2 meses de almacenamiento a 4°C, y se analizó el perfil sensorial de las bebidas. Los resultados indicaron una alta estabilidad fisicoquímica para las dos bebidas, sólidos solubles entre 6,87±0,12 y 7,1±0,12 °Bx, acidez 0,11±0,01% ácido láctico, y pH entre 5,27±0,01 y 5,20±0,01. La osmolalidad se incrementó de 304,86±0,14 a 324,14±1,16 mOsm/kg para la bebida BIUN y de 330,11±0,52 a 350,54±0,24 mOsm/Kg para la bebida BIUH. El contenido promedio de fenoles totales fue 9,64±0,52 mg-AG/100g y 9,73±0,40 mg-AG/100g, para las bebidas BIUN y BIUH respectivamente. Hubo una reducción significativa (p

12 pags., 10 figs., 2 tabs., Backward elastic electron scattering from odd-A nuclear targets is characterized by magnetic form factors containing precise information on the nuclear structure. We study the sensitivity of the magnetic form factors to structural effects related to the evolution and shape transitions in both isotopic and isotonic chains. Calculations of magnetic form factors are performed in the plane-wave Born approximation. The nuclear structure is obtained from a deformed self-consistent mean-field calculation based on a Skyrme HF+BCS formalism. Collective effects are included in the cranking approximation, whereas nucleon-nucleon correlations are taken into account in the coherent density fluctuation model. The evolution of the magnetic form factors is found to exhibit signatures of shape transitions that show up in selected isotopic and isotonic chains involving both stable and unstable nuclei. Several cases are identified as suitable candidates for showing such fingerprints of shape transitions. A new generation of electron scattering experiments involving electron-radioactive beam colliders will be available in the near future, leading to a renewed interest in this field., This work was supported by Ministerio de Ciencia e Innovación MCI/AEI/FEDER,UE (Spain) under Contracts No. PGC2018-093636-B-I00 and No. RTI2018-098868-BI00. Two of the authors (D.N.K. and A.N.A.) are grateful for support of the Bulgarian Science Fund under Contract No. KP-06-N38/1.

This chapter places the spotlight on the topic of food fraud as it relates to the nonalcoholic ready to drink, or as more commonly known “NARTD,” sector. This category includes soft drinks, juice drinks, juices, energy drinks, water, and functional drinks. The last category is a rapidly growing beverage subsector capturing products with enriched vitamins, minerals, isotonic and sports drinks, wellness, and nutraceutical products. The authors discuss the risks and vulnerabilities to the sector, the important roles that technical knowledge and effective quality assurance and food safety management systems have, and how robust risk and crisis management protocols are critical in the fight against food fraud. The content of this chapter emphasizes that an effective response to the threat of food fraud involves collaboration between industry and government stakeholders.

Purpose The aim of the study was to investigate the electroneurophysiological aspects of volunteers with temporomandibular disorders before and after performing isotonic exercises for pain relief and self-care guidelines. Methods The study was a parallel controlled randomized controlled trial under protocol 1,680,920. The inclusion criteria were age between 18 and 60 years, muscle temporomandibular dysfunction with or without limitation of mouth opening and self-reported pain with scores between 4 and 10. The individuals were randomized into experimental group and control. Twenty-three volunteers participated in the study, most of then were female. Control group had 11 and experimental group 12 individuals. Dropouts occurred in both groups, two in the experimental group and three in the control group. Since there were an intergroup imbalance the power density was analysed just in experimental group. Electroencephalographic recording was performed before and after the interventions, using the 32-channel apparatus, with sample frequency of 600 Hz and impedance of 5 kΩ. The data were processed through the MATLAB computer program. The individual records filtered off-line, using bandpass between 0.5 and 50 Hz. Epochs of 1,710 ms were created and the calculation of the absolute power density calculated by means of the fast Fourier transform. The statistical approach was inferential and quantitative. Results The alpha power density analyzed presented a difference, but not significant, when compared in the two moments. Conclusion According to this study, isotonic exercises performed to reduce pain provided a small increase in alpha power density in the left temporal, parietal and occipital regions. RESUMO Objetivo O objetivo do estudo foi investigar os aspectos eletroneurofisiológicos de voluntários com disfunção temporomandibular antes e após realização de exercícios para redução de dor e orientações de autocuidado. Método Foi realizado ensaio clínico randomizado controlado paralelo, aprovado por um Comitê de Ética. Os critérios de inclusão foram idade de 18 a 60 anos, disfunção temporomandibular muscular, com ou sem limitação de abertura de boca, e dor autorreferida com escores entre 4 e 10. Os indivíduos foram distribuídos, por sorteio, em grupo experimental ou controle. Participaram do estudo 23 voluntários,11 controles e 12 do grupo experimental sendo a maioria do sexo feminino. Desistências ocorreram, sendo duas no grupo experimental e três no controle. Houve desbalanceamento entre grupos e apenas o experimental foi analisado. Foi realizado registro eletroencefalográfico antes e depois das intervenções, por meio de aparelho com 32 canais, frequência amostral de 600 Hz e impedância de 5 kΩ. Os dados foram processados por meio do programa computacional MATLAB. Os registros individuais filtrados off-line, utilizando passa banda entre 0,5 e 50 Hz. Épocas de 1,710 ms foram criadas e o cálculo da densidade de potência absoluta calculada por meio da transformada rápida de Fourier. A abordagem estatística foi inferencial e quantitativa. Resultados A densidade de potência alfa analisada apresentou diferença, porém não significativa, quando comparada nos dois momentos. Conclusão Pode-se concluir que, com base nesse estudo, os exercícios isotônicos realizados para redução de dor proporcionaram pequeno aumento na densidade de potência alfa nas regiões temporal, parietal e occipital esquerdas.

Made available in DSpace on 2021-06-25T10:57:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objectives: To assess the influence of two different implant surfaces on osseointegration in maxillary sinuses of rabbits previously grafted with deproteinized bovine bone (DBB) associated or not with fresh bone marrow (BM). Material and methods: Sixteen New Zealand albino rabbits (males, 3.5/4.5 kg and 9–12 months old) were randomly divided into two groups with 8 rabbits each, according to the type of association of biomaterials used to fill the animals’ maxillary sinuses: DBB (Deproteinized Bovine Bone) and DBB/BM (Deproteinized bovine bone associated with fresh autologous bone marrow). Ninety (90) days following the grafting procedure, the animals received implants in the area with two different microstructures (SA-Sandblasting + acid attack and SA-H-Sandblasting + acid attack + immersion in 0.9% sodium chloride isotonic solution). All rabbits were euthanized 90 days after implant placement. The microtomographic analysis was performed to verify the number of mineralized tissues around the implants throughout their length (%BV/TV), while the histomorphometric analysis was performed to verify the percentage of bone-implant contact around the implants throughout their length (%BIC). Results: We observed no differences in the quantity for %BV/TV (DBB-SA:33.25 ± 19.67; DBB-SA-H:35.15 ± 22.17; DBB/BM-SA:39.71 ± 24.21; DBB/BM-SA-H:36.40 ± 23.07) and %BIC (DBB-SA:58.94 ± 24.37; DBB-SA-H:52.52 ± 24.36; DBB/BM-SA: 61.66 ± 14.60; DBB/BM-SA-H: 64.06 ± 23.30) between the groups assessed. Conclusions: The addition of BM and the type of surface did not influence the osseointegration of implants installed in areas grafted with sintered deproteinized bovine bone at high temperatures in the late period assessed. Department of Diagnosis and Surgery School of Dentistry at Araraquara Univ Est Paulista/UNESP Post Graduation Course in Implantology Instituto Latino-americano de pesquisa odontológica (ILAPEO) Department of Periodontology School of Dentistry at Uberlândia Federal University of Uberlândia Department of Diagnosis and Surgery School of Dentistry at Araraquara Univ Est Paulista/UNESP

Application of intravascular catheterization, a vital task used in minimally invasive vascular surgery, has been hindered by lack of distal force sensor with miniaturized size and millinewton sensing capability. Thus, development of distal sensor for evaluating tool-vessel force interactions during robot-assisted intravascular interventions remains a research area in minimally invasive surgery. In this study, a millinewton force sensor is developed by integrating optical fibers with bragg grating in an isotonic 3D-printed flexure. The miniaturized sensor is calibrated in an experiment for 1D distal force sensing application in PCI procedures, and performance of the sensor is evaluated against that of direct FBG-pasting method. Results from the study shows that the designed sensor shows a higher repeatability and stability with a millinewton resolution in the flexure compartment. Thus, it can be suitably used for distal catheter-tip force sensing during intravascular catheterization.

BACKGROUND Maintenance intravenous fluids (IVFs) are commonly used in the hospital setting. Hypotonic IVFs are commonly used in pediatrics despite concerns about high incidence of hyponatremia. We aimed to increase isotonic maintenance IVF use in children admitted from the emergency department (ED) from a baseline of 20% in 2018 to >80% by December 2019. METHODS We included patients aged 28 days to 18 years receiving maintenance IVFs (rate >10 mL/hour) at the time of admission. Patients with active chronic medical problems were excluded. Interventions included institutional discussions on isotonic IVF based on literature review, education on isotonic IVF use per the American Academy of Pediatrics guideline (isotonic IVF use with appropriate potassium chloride and dextrose), electronic medical record changes to encourage isotonic IVF use, and group practice review with individual physician audit and feedback. Balancing measures were the frequency of serum electrolyte checks within 24 hours of ED admission and occurrence of hypernatremia. Data were analyzed by using statistical process control charts. RESULTS Isotonic maintenance IVF use improved, with special cause observed twice; the 80% goal was met and sustained. No difference was noted in serum electrolyte checks within 24 hours of admission (P > .05). There was no increase in occurrence of hypernatremia among patients who received isotonic IVF compared with those who received hypotonic IVF (P > .05). CONCLUSIONS The application of improvement methods resulted in improved isotonic IVF use in ED patients admitted to the inpatient setting. Institutional readiness for change at the time of the American Academy of Pediatrics guideline release and hardwiring of preferred fluids via electronic medical record changes were critical to success.

Topic This article reviews the management of intravenous fluids and the evaluation of volume status in critically ill adults. Clinical Relevance Intravenous fluid administration is one of the most common interventions in the intensive care unit. Critically ill patients have dynamic fluid requirements, making the management of fluid therapy challenging. New literature suggests that balanced salt solutions may be preferred in some patient populations. Purpose of Paper The bedside critical care nurse must understand the properties of various intravenous fluids and their corresponding impact on human physiology. The nurse’s clinical and laboratory assessments of each patient help define the goals of fluid therapy, which will in turn be used to determine the optimal patient-specific selection and dose of fluid for administration. Nurses serve a vital role in monitoring the safety and efficacy of intravenous fluid therapy. Although this intervention can be lifesaving, inappropriate use of fluids has the potential to yield detrimental effects. Content Covered This article discusses fluid physiology and the goals of intravenous fluid therapy, compares the types of intravenous fluids (isotonic crystalloids, including 0.9% sodium chloride and balanced salt solutions; hypotonic and hypertonic crystalloids; and colloids) and their adverse effects and impact on hemodynamics, and describes the critical care nurse’s essential role in selecting and monitoring intravenous fluid therapy.

A 79-year-old man presented to the emergency department with a 1-week history of worsening confusion, falls and hearing impairment. An initial workup for infectious, metabolic and structural causes was unrevealing. However, further history discovered that he had been ingesting one to two bottles of Pepto-Bismol (bismuth subsalicylate) daily for gastro-oesophageal reflux symptoms. On his second day of admission, the plasma salicylate concentration was 2.08 mmol/L (reference range 1.10–2.20 mmol/L), despite no sources of salicylate in hospital. He was diagnosed with chronic salicylate toxicity and Pepto-Bismol use was discontinued. The patient was treated supportively with isotonic intravenous fluids only and plasma salicylate concentration fell to less than 0.36 mmol/L. Concurrently, all his symptoms resolved. This case highlights the potential adverse effects of over-the-counter medications. The diagnosis of chronic salicylate toxicity is challenging, specifically in the elderly and in undifferentiated presentations, as it can be missed if not suspected.

There is little consensus about the type of maintenance fluid therapy and it’s the effect on serum sodium in adults. Thus, this study was conducted to assess the effect of maintenance fluid therapy on serum sodium of hospitalized patients in the intensive care unit. This randomized clinical trial was carried out on 64 patients aged 18-90 years hospitalized in the intensive care unit (ICU) of Imam Sadjad and Shahid Beheshti hospitals, Yasuj, Iran, in 2017. These patients were randomly allocated to take 2500-3000 milliliters of intravenous maintenance isotonic (0.9% saline) or hypotonic (0.45% saline) fluids daily. Blood and urine samples were taken to measure biochemical parameters before and 48 hours after the intervention. Data analyses were done by using SPSS 16 software via descriptive and analytic statistics. Twenty-eight patients in the 0.9% saline group (19 male and 9 female) and 32 patients in 0.45% saline (20 male and 12 female) completed the study. There was no significant difference between two groups in sodium (P=0.94), potassium (P=0.21), sugar (P=0.91), creatinine (P=0.21), Blood Urea Nitrogen (P=0.99), systolic (P=0.81) and diastolic (P=0.73) blood pressure, PH (P=0.27), bicarbonate (P=0.8), and urine specific gravity (P=0.73). Based on the results of this study, it was shown that the administration of maintenance hypotonic fluids has been appropriate for the patients and will not face them with the risk of hyponatremia.

High-intensity unaccustomed eccentric contractions result in weakness and power loss because of fatigue and muscle damage. Through the repeated bout effect (RBE), adaptations occur, then damage and weakness are attenuated following a subsequent bout. However, it is unclear whether the RBE protects peak power output. We investigated the influence of the RBE on power production and estimated fatigue- and damage-induced neuromuscular impairments following repeated high-intensity eccentric contractions. Twelve healthy adult males performed 5 sets of 30 maximal eccentric elbow flexions and repeated an identical bout 4 weeks later. Recovery was tracked over 7 days following both bouts. Reduced maximum voluntary isometric contraction torque, and increased serum creatine kinase and self-reported soreness indirectly inferred muscle damage. Peak isotonic power, time-dependent measures — rate of velocity development (RVD) and rate of torque development (RTD) — and several electrophysiological indices of neuromuscular function were assessed. The RBE protected peak power, with a protective index of 66% 24 h after the second eccentric exercise bout. The protection of power also related to preserved RVD (R2 = 0.61, P < 0.01) and RTD (R2 = 0.39, P < 0.01). Furthermore, the RBE’s protection against muscle damage permitted the estimation of fatigue-associated neuromuscular performance decrements following eccentric exercise. Novelty: The repeated bout effect protects peak isotonic power. Protection of peak power relates to preserved rates of torque and velocity development, but more so rate of velocity development. The repeated bout effect has little influence on indices of neuromuscular fatigue.

Models of muscle contraction are typically based on a measured force-velocity relation embodied as Hill’s contractile element [1]. Adopting a particular force-velocity relation dictates the muscle’s mechanical properties. Dynamic crossbridge based models, such as Huxley’s [2], typically focus on ultrastructural mechanics. This study adapts a dynamic lumped model of cardiac muscle contraction [3] for description of mouse soleus skeletal muscle. This compact, dynamic model exhibits the main features of skeletal muscle contraction with few assumptions. The main differences between cardiac and skeletal muscle dynamics are described. This approach gives one equation and set of parameters capable of modeling isometric and isotonic contractions, skeletal muscle’s force-length relation, variations in contractility, and the force-velocity relation. This new constitutive equation may be useful for modeling striated muscle as part of larger biomechanical models.

Aims Audit the type of IV fluid prescribed against NICE recommendations Monitor incidents of hypo– and hyper–natraemia Methods Data were collected from the electronic patient record system (EPR). All fluid prescriptions and electrolyte tests were analysed during three data collection periods: First Audit Period, with promotion of local (NICE–based) guideline Second Period, before introduction of EPR IV fluid prescription ‘power plan’ Third Audit Period, after introduction of EPR power plan We looked at EPR records of patients who had incidents of sodium abnormalities to determine whether they could have been iatrogenic. Results A total of 568 fluid prescriptions were analysed. Data in the first audit cycle showed only 40% of fluid prescriptions were isotonic and the rest were hypotonic. Whilst on IV fluids, there were 12 patients with hyponatraemia, 11 of whom were on hypotonic fluids. These findings were disseminated to general paediatric and paediatric surgical teams, and the local IV fluid guideline was promoted. On the EPR prescription system, a ‘power plan’ was introduced, which makes isotonic maintenance fluids the default option. Data in second audit period, before the fluid prescription power plan had been implemented, showed that 51% of IV maintenance fluids were isotonic. This increased to 88%, after the power plan was introduced. Across both the second and third audit periods, there were 2 infants who developed hyponatraemia after receiving maintenance IV fluids. One was on a mixture of TPN and isotonic fluid, the other was on hypotonic fluids. There was only one incident of hypernatraemia (146), which occurred while on 10% dextrose infusion. Conclusion The prescription of isotonic solutions has increased significantly since the EPR power plan for paediatric fluid prescriptions was introduced. This had a much greater impact than trying to encourage guideline adherence alone. There is little published evidence on the safety of isotonic fluids in young infants. We have not observed any significant hypernatraemia since the increase in isotonic fluid usage.

Muscle models are commonly based on intrinsic properties pooled across a number of individuals, often from a different species, and rarely validated against directly measured muscle forces. Here we use a rich data set of rat medial gastrocnemius muscle forces recorded during in-situ and in-vivo isometric, isotonic, and cyclic contractions to test the accuracy of forces predicted using Hill-type muscle models. We identified force-length and force-velocity parameters for each individual, and used either these subject-specific intrinsic properties, or population-averaged properties within the models. The modeled forces for cyclic in-vivo and in-situ contractions matched with measured muscle-tendon forces with r2 between 0.70 and 0.86, and root-mean square errors (RMSE) of 0.10 to 0.13 (values normalized to the maximum isometric force). The modeled forces were least accurate at the highest movement and cycle frequencies and did not show an improvement in r2 when subject-specific intrinsic properties were used; however, there was a reduction in the RMSE with fewer predictions having higher errors. We additionally recorded and tested muscle models specific to proximal and distal regions of the muscle and compared them to measures and models from the whole muscle belly: there was no improvement in model performance when using data from specific anatomical regions. These results show that Hill-type muscle models can yield very good performance for cyclic contractions typical of locomotion, with small reductions in errors when subject-specific intrinsic properties are used.

We have done a systematic study of the low-energy behavior of the γ-ray strength function with full-configuration shell-model calculations. We have performed calculations in several isotonic and isotopic chains, spanning several mass regions. There are systematic trends: The strength function shows a low-energy enhancement that is more pronounced near shell closures and less so in the mid-shell regions. We predict that the low-energy enhancement is omnipresent, but that for high-mass nuclei it has so far been out of experimental reach due to detector thresholds, except for the case of 151, 153Sm.

The use of complex and advanced analytical techniques for the evaluation of the quality of drug substances and excipients used in parenteral formulations is becoming increasingly feasible. Techniques for the determination of physicochemical properties are summarized under Physical and Chemical Methods. Separation Methods include extraction and chromatography Methods for identification and analysis using spectroscopies are included under Spectroscopic Methods and techniques based on immunological reactions are included under Immunological Methods. The current Food and Drug Administration guidelines for the Inspections of Pharmaceutical Quality Control Laboratories and the Inspections of Microbiological Pharmaceutical Quality Control Laboratories are appended to this chapter. Physical and chemical methods are extensively used in pharmaceutical analyses of sterile products and constitute a variety of techniques that provide information about the structure, purity, and quantitation of active ingredients and excipients. Osmometry determines the tonicity of the injectable solutions—to determine if the solutions are isotonic with blood serum.

The musical motives of a song emerge from the temporal arrangement of discrete tones. These tones normally have few durational values, and are organized in structured groups to create metrical patterns. In the present study we show that the ability to detect the rhythmic structure of a song, while ignoring surface changes, is also present in other species. We familiarized rats (Rattus norvegicus) with an excerpt of the Happy Birthday song. During test, we presented the animals with (i) the same excerpt of the familiarization, (ii) a constant-pitch version of the excerpt that reduced melodic intervals to only one tone (i.e., isotonic) but preserved rhythmic structure, and (iii) a rhythmically scrambled version of the excerpt that preserved the melodic intervals. The animals discriminated the rhythmically scrambled version from the versions that preserved the original rhythm. This demonstrates that rats were sensitive to at least some parts of the rhythmic structure of the tune. Together with previous findings, the present set of results suggests that the emergence of rhythmic musical universals might be based on principles shared with other species. This work was supported by a grant from the BIAL foundation (reference 13/18) and by the Spanish Ministerio de Economía y Competitividad (MEC) FPI grant BES-2014-070547.

Our understanding of Na+ homeostasis has recently been reshaped by the notion of skin as a depot for Na+ accumulation in multiple cardiovascular diseases and risk factors. The proposed water-independent nature of tissue Na+ could induce local pathogenic changes, but lacks firm demonstration. Here, we show that tissue Na+ excess upon high Na+ intake is a systemic, rather than skin-specific, phenomenon reflecting architectural changes, i.e. a shift in the extracellular-to-intracellular compartments, due to a reduction of the intracellular or accumulation of water-paralleled Na+ in the extracellular space. We also demonstrate that this accumulation is unlikely to justify the observed development of experimental hypertension if it were water-independent. Finally, we show that this isotonic skin Na+ excess, reflecting subclinical oedema, occurs in hypertensive patients and in association with aging. The implications of our findings, questioning previous assumptions but also reinforcing the importance of tissue Na+ excess, are both mechanistic and clinical., Na+ has been suggested to accumulate in tissues, particularly skin, in a hypertonic manner and to exert local pathogenic effects. Here, we reappraise this phenomenon which is systemic in nature and reflects isotonic changes in the relative extracellular volume in tissues, e.g. subclinical oedema; as such, it occurs in human hypertension and aging.

Multivariate probability calibration is the problem of predicting class membership probabilities from classification scores of multiple classifiers. To achieve better performance, the calibrating function is often required to be coordinate-wise non-decreasing; that is, for every classifier, the higher the score, the higher the probability of the class labeling being positive. To this end, we propose a multivariate regression method based on shape-restricted Bernstein polynomials. This method is universally flexible: it can approximate any continuous calibrating function with any specified error, as the polynomial degree increases to infinite. Moreover, it is universally consistent: the estimated calibrating function converges to any continuous calibrating function, as the training size increases to infinity. Our empirical study shows that the proposed method achieves better calibrating performance than benchmark methods.

Background: Obesity is defined as a chronic disease, and is known as a public health problem in developed and developing countries. Several studies have shown the effects of anti-obesity of α-lactalbumin. Aim: This study was designed to investigate the effect of alpha-lipoic acid supplementation and electrical isotonic contraction on anthropometric parameters, body composition and angiogenesis factor, sirtunin-1 and peroxisome proliferator-activated receptor-γ coactivator-1α (PGC1α) in obese people under a weight loss regime. Methods: Obese people who meet the inclusion criteria are included. Participants are randomly divided into four groups (alpha-lipoic (1200 mg) +weight loss regime group; Faradic (three 1 hour sessions) + weight loss regime group; alpha-lipoic (1200 mg) + Faradic (three 1 hour sessions) + weight loss regime group; control group (1200 mg placebo) for 2 months. At the beginning and the end of the study, demographic information, dietary intake, anthropometric parameters, body composition and serum levels of the angiogenesis factor (sirtunin-1, PGC1α and nitric oxide) are measured. Conclusion: Recent studies reported the anti-obesity effects of alpha-lipoic acid. This study is novel, since a similar study has not yet been carried out. This study evaluates the effect of 600 mg of alpha-lipoic acid supplementation or having three sessions of 1 hour per week electrical isotonic contraction induced by Faradic for 2 months alone or in combination in obese people that are undergoing a weight loss regime. Trial registration: Iran Clinical Trials Registry, ID: IRCT20131117015424N2. Registered 2018-04-02

In experimental studies on cardiac tissue, the end-systolic force-length relation (ESFLR) has been shown to depend on the mode of contraction: isometric or isotonic. The isometric ESFLR is derived from isometric contractions spanning a range of muscle lengths while the isotonic ESFLR is derived from shortening contractions across a range of afterloads. The ESFLR of isotonic contractions consistently lies below its isometric counterpart. Despite the passing of over a hundred years since the first insight by Otto Frank, the mechanism(s) underlying this protocol-dependent difference in the ESFLR remain incompletely explained. Here, we investigate the role of mechano-calcium feedback in accounting for the difference between these two ESFLRs. Previous studies have compared the dynamics of isotonic contractions to those of a single isometric contraction at a length that produces maximum force, without considering isometric contractions at shorter muscle lengths. We used a mathematical model of cardiac excitation-contraction to simulate isometric and force-length work-loop contractions (the latter being the 1D equivalent of the whole-heart pressure-volume loop), and compared Ca2+ transients produced under equivalent force conditions. We found that the duration of the simulated Ca2+ transient increases with decreasing sarcomere length for isometric contractions, and increases with decreasing afterload for work-loop contractions. At any given force, the Ca2+ transient for an isometric contraction is wider than that during a work-loop contraction. By driving simulated work-loops with wider Ca2+ transients generated from isometric contractions, we show that the duration of muscle shortening was prolonged, thereby shifting the work-loop ESFLR toward the isometric ESFLR. These observations are explained by an increase in the rate of binding of Ca2+ to troponin-C with increasing force. However, the leftward shift of the work-loop ESFLR does not superimpose on the isometric ESFLR, leading us to conclude that while mechano-calcium feedback does indeed contribute to the difference between the two ESFLRs, it does not completely account for it.

Objective: Hypotonic fluids have been traditionally used in newborns. National Institute for Health and Clinical Excellence-2015 (NICE) fluid therapy guideline recommends the use of isotonic fluids as maintenance fluid therapy in term newborns. However, there is no clear evidence supporting this recommendation. This study aims to compare isotonic (5% dextrose in 0.9% sodium chloride (NaCl)) and hypotonic (5% dextrose in 0.45% NaCl) parenteral fluid therapies in hospitalized term newborns with regard to changes in plasma Na (pNa) and complications related with fluid therapy. Methods: This was a retrospective cohort study performed in a tertiary university hospital NICU between January 2016 and April 2018. Term newborns who were initially isonatremic or mildly dysnatremic (pNa 155 meq/L) and receiving fluid therapy for maintenance or replacement therapy after 48th postnatal hours were eligible for the study. Infants having specific diagnoses requiring extraordinary fluids were excluded. The primary outcome evaluated was the change in mean plasma Na (Delta pNa meq/L/h) at 24 h or at the end of intravenous (i.v.) fluid therapy. Secondary outcomes evaluated were the risk of hyponatremia, hypernatremia, and adverse events attributable to fluid administration. Results: Among the 108 included newborns, 57 received hypotonic fluid (5% dextrose solution in 0.45% NaCl) and the remaining received isotonic fluid (5% dextrose solution in 0.9% NaCl) therapy. The hypotonic fluid group showed a greater Delta pNa compared to the isotonic group (0.48 +/- 0.28 vs. 0.27 +/- 0.21 meq/L/h, p = .001). The risk of experiencing unsafe plasma Na decrease in the hypotonic fluid group (Delta pNa >0.5 meq/L/h) was higher than the isotonic fluid group (odd ratio: 8.46; 95% confidence interval (CI): 2.3-30.06). Six mildly hypernatremic babies between 48 and 72 h of postnatal age showed insufficient Na reduction despite the appropriate amount of fluid. No significant difference was found between the two groups in terms of other outcomes. Conclusion: The results of this study suggested that as maintenance or replacement fluid therapy in the newborn, hypotonic fluids, even 5% dextrose in 0.45% NaCl, can lead to unsafe plasma Na decreases in term newborns, while isotonic fluids are safe when started after the first few days of life. Although the results parallel NICE guidelines, before making recommendations regarding the removal of hypotonic fluids entirely from clinical practice in term newborns following the renal adaptation period; larger randomized controlled studies involving a wide range of babies are needed.

INTRODUCTION AND OBJECTIVE:The manufacturer recommends filling the pressure-regulating balloon (PRB) with 22 cc of isotonic solution at the time of implantation, whilst the occlusive cuff (OC) is e...

INTRODUCTION AND OBJECTIVE:Artificial urinary sphincter (AUS) is the gold standard for treatment of male stress urinary incontinence. The device can be filled with normal saline (NS) or isotonic co...

The present paper deals with nonlinear, non-monotonic data regression. This paper introduces an efficient algorithm to perform data transformation from non-monotonic to monotonic to be paired with a statistical bivariate regression method. The proposed algorithm is applied to a number of synthetic and real-world non-monotonic data sets to test its effectiveness. The proposed novel non-isotonic regression algorithm is also applied to a collection of data about strontium isotope stratigraphy and compared to a LOWESS regression tool.

The aim of this study was to gain a greater understanding of the detection, treatment, and monitoring of hypovolemic shock (HVS) in dogs by general practitioners in the United Kingdom (UK). An online survey was devised and distributed by email to first opinion practices in the UK. All veterinarians working in first opinion practice treating small animals were eligible to complete the survey. Most respondents (n = 164, 93%) were confident with HVS diagnosis. Isotonic crystalloid fluids were the most common fluid type for first-line treatment and administered as a 10-30 mL/kg bolus over 10-30 minutes by 57% respondents. Initial intravenous isotonic crystalloid fluid rates for HVS management ranged from maintenance fluid requirements to 90 mL/kg/hr for an undefined time period. A synthetic colloid was the most popular second-line fluid choice, typically considered after a total administered volume of 60-90 mL/kg of isotonic crystalloid fluids. Only 72 respondents (40.7%) were able to measure blood lactate in-house, which was used routinely by 36 respondents (20.3%) for initial treatment decision making. Respondents treating HVS most frequently were more likely to use lactate for initial decision making (P = .008). This study highlighted variabilities in the initial approach, fluid management strategies and monitoring instituted by UK general practitioners when faced with canine patients in HVS. This suggests that there is a discrepancy in what is determined to be the most optimal diagnostic and treatment plan for canine HVS patients.

Effective single-particle potentials obtained from the established nonrelativistic nuclear energy density functional approach are incorporated into the microscopic-macroscopic method to calculate the ground-state shell corrections, mass excesses, and ${Q}_{\ensuremath{\alpha}}$ values for heaviest nuclei. The low-lying one-quasiparticle states are studied in the isotonic chains with neutron numbers $N=175$, 176, and 177. The isomeric states are discussed in the odd isotopes. The possible $\ensuremath{\alpha}$-decay chains of nuclei $^{295}119$ and $^{295,297}120$ are analyzed and compared with the available experimental data. The termination of the $\ensuremath{\alpha}$-decay chains by spontaneous fission is analyzed. The production cross sections are calculated for superheavy nuclei with $112\ensuremath{\le}Z\ensuremath{\le}120$ in the actinide-based complete fusion reactions with projectiles $^{48}\mathrm{Ca}, ^{48,50}\mathrm{Ti}, ^{54}\mathrm{Cr}, ^{58}\mathrm{Fe}$, and $^{64}\mathrm{Ni}$.

Patients with severe hyponatremia and renal failure who require continuous renal replacement therapy (CRRT) are at risk for overcorrection of their sodium level due to preformulated isotonic replacement or dialysate fluids. Rapid correction of hyponatremia can lead to serious neurologic complications including osmotic demyelination syndrome (ODS). There is limited data available in preventing overcorrection of severe hyponatremia with CRRT. It has been proposed to use reduced effluent volume to avoid overcorrection. However, there are instances where the CRRT prescription cannot be reduced due to other metabolic derangements. Herein, we present four cases using a calculated amount of dextrose 5% solution (D5W) prefilter as preblood pump to prevent overcorrection of hyponatremia while delivering recommended effluent volume of at least 20-25 mL/kg/hr in majority of cases. In each case, the rate of sodium correction did not exceed 8 mEq/day using D5W prefilter. Even in patients whose hyponatremia was initially overcorrected, adding calculated amount of amounts of D5W prefilter decreased the sodium level back down to prevent the risk of ODS. We also review a simplified equation to determine the D5W rate depending on the prescribed effluent volume.

Background: The anti-obesity effects of Alpha-lipoic acid (α-LA) and isotonic contraction has been reported. However, the underlying mechanism is not fully understood. This study aimed to investigate the effect of α-LA supplementation and Faradic (an electrical stimulating system) on anthropometric parameters, body composition, VEGF, Sirtunin-1, nitric oxide (NO), and PGC1-α in obese people undergoing a weight loss regime.Methods: This randomized clinical trial was carried out on 100 obese adults. The subjects were randomly assigned to four groups of 25 subjects including Faradic, α-LA, -α-LA+Faradic, and control. A Bio Impedance Analyzer (BIA) was used to estimate anthropometric measurements including weight, body mass index (BMI), fat mass, and fat free mass. The serum levels of Sirtunin-1, PGC1-α, VEGF, and NO levels were measured. All measurements were done at baseline and after 8 weeks of intervention.Results: A significant weight reduction was observed in all four groups compared to baseline (p=Name of the registry: Iranian Registry of Clinical TrialsTrial registration number: IRCT20131117015424N2Date of registration: https://www.irct.ir/search/result?query=IRCT20131117015424N2URL of trial registry record: 04/04/2018

Chewing exercises have been applied in clinical settings to improve the occlusal force and function of the masseter muscle in elderly individuals. However, the clinical relevance and effects of chewing exercises are unclear. This study aimed to investigate the effects of bilateral chewing exercises on the occlusal force and masseter muscle thickness in community-dwelling Koreans aged 65 years. Forty community-dwelling healthy elderly individuals were enrolled in this study. They were assigned to the experimental or the control group. The experimental group performed chewing exercises using medical equipment developed to facilitate such exercises. The chewing exercises were divided into isometric and isotonic types and were performed for 20 min/d, 5 days/wk, for 6 weeks. The control group did not perform any chewing exercises. The outcome measures were occlusal force and masseter muscle thickness, which were evaluated using an occlusometer and ultrasound device, respectively. A paired t test and an independent t test were used to evaluate the training effects. Within-group comparisons showed that occlusal force and masseter muscle thickness improved significantly in the experimental group (P < .001 for both), while the control group showed no significant improvements (P = .098 and .130). Between-group comparisons showed that the experimental group had a greater increase in occlusal force and masseter muscle thickness (P < .05 for both) compared to the control group. These results suggest that chewing exercises are effective in improving occlusal force and masseter muscle thickness in healthy elderly individuals.

International audience; Background: Muscular strength should be one of the main parameters to assess the interest or not of surgery after proximal hamstring rupture. Yet, this parameter is difficult to compare between the different studies because of the heterogeneous assessment methods.Methods: We realized a critical review of strength assessment methods used to evaluate treatments performed after proximal hamstring rupture. The studies were selected from several medical databases with the keywords: "proximal hamstring rupture" OR "proximal hamstring avulsion" AND "strength" OR "isokinetic".Findings: 24 articles evaluated muscular strength after proximal hamstring rupture. 7 have been excluded because the method was not described. 6 types of dynamometric evaluation were used: 2 with an isometric method, 3 with a pneumatic isotonic method and 13 with an isokinetic method. Muscular strengths after non-surgical treatment could not be compared because of the low number of studies and different methods of assessment. After surgery, only isokinetic results measured at the angular speed of 60°/s could have been weighted. A 15% strength deficit was shown at >12 months after surgery.Interpretation: Muscular strength assessment methods currently used to evaluate the strength after proximal hamstring rupture are too disparate to clearly define the strength deficit after rupture and surgery. Strength evaluation should be more rigorous in order to prove the real interest of the surgical management.

This paper presents implantable antenna systems which are miniaturized and it is proposed for biomedical applications, particularly for scalp administration. The advanced prototypes reveal the broad band features on the industrial, scientific, and medical (ISM) bands. Every structure is concatenated with the microelectronic constituents and a battery. The methodology and the operation are discussed briefly in this paper. The results of scalp implantable antenna produces a band from 0.9GHz to 0.92GHz. The measurements are fulfilled in an isotonic solution of sodium chloride for validation. The antenna proposes a fine accordance between the simulated and firmed results and to examine the range of the data transmission, a link budget is calculated.

Objective: The present study aimed to compare the clinical characteristics of volunteers with temporomandibular dysfunction before and after performing exercises with those of volunteers who only followed self-care guidelines.Methods: A parallel randomized controlled trial was performed. Individuals included underwent the intervention twice a week for one month, while the control group only followed self-care guidelines.Results: Twenty-three volunteers participated; however, during the study, four dropped out. At the end of the study, the degree of depression decreased in the volunteers in the intervention group.Conclusion: The level of pain decreased, but the improvement was not statistically significant and, therefore, could not be attributed to the intervention. It can be concluded that the strategies used to reduce pain in this study were not sufficient for clinical improvement in volunteers with temporomandibular dysfunction.

Este artículo se encuentra disponible en la siguiente URL: https://www.nutricionhospitalaria.org/articles/03095/show Introducción: la erosión dental es la pérdida patológica, crónica, localizada e indolora de los tejidos dentarios, producida por la acción química de ácidos y sin la intervención de la acción de microorganismos. En los últimos años se ha observado un incremento significativo de la prevalencia de esta patología, especialmente en niños y adolescentes. Objetivos: determinar la prevalencia de la erosión dental en la dentición temporal mediante el índice Basic Erosive Wear Examination (BEWE) en niños de entre 5 y 12 años, y determinar los hábitos de alimentación que pueden favorecer en ellos el desarrollo de lesiones. Métodos: se llevó a cabo un estudio transversal en una muestra de 391 niños. Se realizó una encuesta donde se analizaron los hábitos de alimentación, y se realizó una exploración clínica de los dientes temporales empleando el índice BEWE. Resultados: la prevalencia de la erosión dental en la muestra estudiada fue del 19,7 %, presentándose con mayor frecuencia lesiones iniciales. Conclusiones: el 30,62 % de la población estudiada presentaba riesgo bajo de erosión dental, observándose un aumento del riesgo a medida que aumentaba el consumo de bebidas ácidas (bebidas gaseosas, bebidas isotónicas y zumos de frutas) y frutas ácidas, como naranjas, uvas y manzanas. / Introduction: dental erosion is the pathological, chronic, localized and painless loss of dental tissues, produced by the chemical action of acids, where the action of microorganisms is not involved. In recent years, a significant increase in the prevalence of this pathology has been observed, especially in children and adolescents. Objectives: to determine the prevalence of dental erosion in temporary dentition using the Basic Erosive Wear Examination Index (BEWE) in children between 5 and 12 years of age, and to determine the eating habits that may favor the development of these lesions. Methods: a cross-sectional study was carried out on a sample of 391 children. A survey was conducted where eating habits were analyzed and a clinical examination of the temporary teeth was performed using the BEWE index. Results: the prevalence of dental erosion in the studied sample was 19.7 %, with mild lesions being most common. Conclusions: in all, 30.62 % of the studied population had a low risk of dental erosion, and risk was seen to increase with consumption of acidic beverages (soft drinks, isotonic drinks and fruit juices) and acidic fruits such as oranges, grapes and apples.

Lower limb rehabilitation as assisted by physiotherapists plays an important role for post-stroke recovery to help patient to regain body movement, gait and speech capabilities in which the rehabilitation process is performed at the hospital or rehabilitation centre. However, transporting the patients to such places for scheduled appointments would increase the overall cost and become unfavourable. Therefore, a prototype of portable home-based lower limb rehabilitation equipment is developed in this paper that is able to analyse the human muscle contraction during rehabilitation session and interpret the patient's progress in terms of animation performance scoring. Specifically, the developed rehabilitation equipment consists of an actuator for lower limb flexion and extension activities in which three electromyogram (EMG) electrodes are patched on the rectus femoris muscle for muscle contraction signal reading during the rehabilitation procedure. This project used Arduino as the microcontroller to collect the muscle contraction signal and interpret them in terms of animation to visualize the patient's progress. The assimilation test performed to a normal individual showed that the developed rehabilitation equipment has successfully collected vigorous muscle contraction during rehabilitation procedure of lower limb and visualized the performance-based index of the muscle progress via animation.