Role of trunk muscles in generating follower load in the lumbar spine of neutral standing posture

Recently, experimental results have demonstrated that the load carrying capacity of the human spine substantially increases under the follower load condition. Thus, it is essential to prove that a follower load can be generated in vivo by activating the appropriate muscles in order to demonstrate the possibility that the stability of the spinal column could be maintained through a follower load mechanism. The aim of this study was to analyze the coordination of the trunk muscles in order to understand the role of the muscles in generating the follower load. A three-dimensional finite element model of the lumbar spine was developed from T12 to S1 and 117 pairs of trunk muscles (58 pairs of superficial muscles and 59 pairs of deep muscles) were considered. The follower load concept was mathematically represented as an optimization problem. The muscle forces required to generate the follower load were predicted by solving the optimization problem. The corresponding displacements and rotations at all nodes were estimated along with the follower forces, shear forces, and joint moments acting on those nodes. In addition, the muscle forces and the corresponding responses were investigated when the activations of the deep muscles or the superficial muscles were restricted to 75% of the maximum activation, respectively. Significantly larger numbers of deep muscles were involved in the generation of the follower load than the number of superficial muscles, regardless of the restriction on muscle activation. The shear force and the resultant joint moment are more influenced by the change in muscle activation in the superficial muscles. A larger number of deep trunk muscles were activated in order to maintain the spinal posture in the lumbar spine. In addition, the deep muscles have a larger capability to reduce the shear force and the resultant joint moment with respect to the perturbation of the external load or muscle fatigue compared to the superficial muscles.     

Musculature and biomechanics of the trunk in the maintenance of upright posture

Surface perturbation has been used for decades to study balance and postural control; however the behavior of the trunk in these postural responses has been largely overlooked. Thirteen healthy males (18–23 yrs) were exposed to horizontal support surface translations delivered randomly in one of eight different horizontal directions in both sitting and standing. A 4-segment model of the trunk was used to estimate the kinematics and kinetics associated with the postural response, while surface EMG was acquired, bilaterally, from seven trunk muscles and one hip muscle. Multi-segmental movement was observed in the trunk in both test postures. Both the biomechanical and neuromuscular aspects of the trunk response were significantly affected by translation direction and test posture, with an interaction effect between these variables. The response in sitting was closely tied to the movement of the support surface, while the response in standing occurred in two phases: the first related to the dynamic response in the lower limbs, and the second tied to the movement of the support surface. As such, the observed postural responses could be largely explained by the biomechanical constraints of the system, such that the neural control of trunk equilibrium is simplified.     

Foot strike pattern,step rate,and trunk posture combined gait modifications to reduce impact loading during running

Elevated impact loading can be detrimental to runners as it has been linked to the increased risk of tibial stress fracture and plantar fasciitis. The objective of this study was to investigate the combined effects of foot strike pattern, step rate, and anterior trunk lean gait modifications on impact loading in runners. Nineteen healthy runners performed 12 separate gait modification trials involving: three foot strike patterns (rearfoot, midfoot, and forefoot strike), two step rates (natural and 10% increased), and two anterior trunk lean postures (natural and 10-degree increased flexion). Overall, forefoot strike combined with increased step rate led to the lowest impact loading rates, and rearfoot strike combined with anterior trunk lean led to the highest impact loading rates. In addition, there were interaction effects between foot strike pattern and step rate on awkwardness and effort, such that it was both more natural and easier to transition to a combined gait modification involving forefoot strike and increased step rate than to an isolated gait modification involving either forefoot strike or increased step rate. These findings could help to inform gait modifications for runners to reduce impact loading and associated injury risks.     

Reaction to the perturbation of the vertical posture under different conditions of standing and in the case of additional support

The reaction of equilibrium restoration in response to the perturbation of the vertical posture of a subject standing on a stable or unstable support was studied. Perturbation was induced by a sudden forward or backward shift of the support surface. In some of the experiments, the subject was holding onto a handrail suspended on a long soft belt with a fixed upper end. The results of the study showed that the reaction to support movement depended on the direction of the perturbation. The soleus muscle was activated first upon a backward movement, and the anterior tibial muscle was activated first upon a forward movement, with a latency of about 50 ms. Within 30–70 ms, bursts of activity were also detected in the respective antagonist muscles. Sudden movement of the platform caused bursts of impulses in the arm muscles even in the absence of contact with the handrail. These impulse bursts had a longer latency (80–130 ms) and probably played an auxiliary role in the process of the restoration of balance. In the case of standing on an unstable support, the latency of leg muscle activation increased. When a subject was holding onto a handrail, the intensity of impulse bursts decreased in the leg muscles and increased in the arm muscles, while the latent periods of the bursts in the arm muscles decreased. This effect proved to be still more pronounced in the case of balance maintenance on an unstable support. Thus, the change in the response to external perturbations during maintenance of the vertical posture on an unstable support demonstrates that an additional contact of the hand changes the adjustment of the posture control system.     

Circulating urotensin II levels in moderate to severe congestive heart failure: its relations with myocardial function and well established neurohormonal markers

Urotensin II (UII) is a potent vasoactive cyclic peptide thought to play a role in myocardial hypertrophy and remodelling. We therefore determined UII plasma levels in congestive heart failure (CHF) patients and its relationship with the severity of the disease and well-established markers of left ventricular function. UII was significantly higher in CHF patients (n = 57) than in controls (n = 48) [geometric mean (pg/ml), 95% PI: 1.32 (0.67-2.59) versus 0.84 (0.31-1.61), p < 0.0001], was related to the functional class of the disease and correlated negatively with left ventricular ejection fraction (r = -0.316, P = 0.016). Furthermore, UII correlated significantly with Big-ET1 (r = 0.32, p = 0.03), BNP (r = 0.42, p = 0.005) but poorly with Nt-proANP (r = 0.28, p = 0.07). Our results suggest that UII could play a role in worsening the course of congestive heart failure and is associated with established markers of cardiovascular dysfunction.     

Nursing posture is elicited rapidly in maternally naive, haloperidol-treated female and male rats in response to ventral trunk stimulation from active pups

Maternal responsiveness in rats can be induced in virgin females and males, without hormonal priming, following several days of cohabitation with pups. Because antagonism of dopamine (DA) facilitates nursing behavior in lactating rats, the response of nonlactating, maternally naive rats to effective stimulation of the ventral trunk (ventrum) from pups following similar treatment was investigated. Lactating dams, virgin females and males, both intact and gonadectomized, were treated with a catalepsy-inducing dose of haloperidol (5 mg/kg), a DA receptor antagonist, and tested with hungry pups 1 hr later. Subjects were placed over 8 pups and postures assessed every 3 min for 30 min. The nursing posture occurred in most subjects. Lactating and nonlactating females were similar in occurrence of the nursing crouch, though the intensity was somewhat higher in the former; females scored higher than males in terms of likelihood and intensity of crouching; and there was no effect of gonadectomy. The nursing posture was not elicited in intact virgin females if the stimulus pups were anesthetized or if the subjects were treated with saline instead of haloperidol. There were no sex differences in onset or intensity of catalepsy in response to the dose of haloperidol used. These results suggest that the nursing posture occurs reflexively, is not directly dependent upon ovarian hormones, and is diminished by the effects of androgens, prior and current.     

Gut commensal bacteria,Paneth cells and their relations to radiation enteropathy

In steady state, the intestinal epithelium forms an important part of the gut barrier to defend against luminal bacterial attack. However, the intestinal epithelium is compromised by ionizing irradiation due to its inherent self-renewing capacity. In this process, small intestinal bacterial overgrowth is a critical event that reciprocally alters the immune milieu. In other words, intestinal bacterial dysbiosis induces inflammation in response to intestinal injuries, thus influencing the repair process of irradiated lesions. In fact, it is accepted that commensal bacteria can generally enhance the host radiation sensitivity. To address the determination of radiation sensitivity, we hypothesize that Paneth cells press a critical “button” because these cells are central to intestinal health and disease by using their peptides, which are responsible for controlling stem cell development in the small intestine and luminal bacterial diversity. Herein, the most important question is whether Paneth cells alter their secretion profiles in the situation of ionizing irradiation. On this basis, the tolerance of Paneth cells to ionizing radiation and related mechanisms by which radiation affects Paneth cell survival and death will be discussed in this review. We hope that the relevant results will be helpful in developing new approaches against radiation enteropathy.     

Tuning posture to body load: decreases in load produce discrete sensory signals in the legs of freely standing cockroaches

Decreases in load are important cues in the control of posture and walking. We recorded activities of the tibial campaniform sensilla, receptors that monitor forces as strains in the exoskeleton, in the middle legs of freely moving cockroaches. Small magnets were attached to the thorax and body load was changed by applying currents to a coil below the substrate. Body position was monitored by video recording. The tibial sensilla are organized into proximal and distal subgroups that have different response properties and reflex effects: proximal sensilla excite extensor motoneurons while distal receptors inhibit extensor firing. Sudden load decreases elicited bursts from distal sensilla, while increased load excited proximal receptors. The onset of sensory discharges closely approximated the time of peak velocity of body movement in both load decreases and increases. Firing of distal sensilla rapidly adapted to sustained unloading, while proximal sensilla discharged tonically to load increases. Load decreases of small amplitude or at low rates produced only inhibition of proximal activity while decrements of larger size or rate elicited distal firing. These response properties may provide discrete signals that either modulate excitatory extensor drive during small load variations or inhibit support prior to compensatory stepping or initiation of swing.     

Butterfly wing morphology variation in the British Isles: the influence of climate, behavioural posture and the hostplant-habitat

Gradients (isophenes) in modifications of butterfly wing morphology (colour, pattern, size) to the north and west of Britain are shown to correlate closely with contemporary environmental gradients, whereas their alleged formation as infra-specific units in Devensian refugia off western Britain is unsubstantiated. A model is described which explains the transformation in phenotypes in relationship to climate, especially ambient temperatures and radiation levels. In cooler, less predictable summer conditions to the north and west, selection has favoured modifications in adult phenotypes that maintain efficiency in thermoregulation, mate advertisement and predator escape. The form that wing modifications take depends mainly on basking posture (lateral, dorsal-absorption and reflectance), which determines the allocation and interaction of functions on different wing surfaces. It is also dependent on hostplant-habitat structure, which influences thermal stability and the milieu of predators and conspecifics, and other behavioural norms (mate-locating behaviour) and biological attributes (size, robustness, speed and mode of flight, chemical defences) which affect their relationships with predators and conspecifics. The significance of Quaternary palaeoenvironments to phenetic transformations is discussed as is the relevance of the model to the development of phenotypes in arctic endemic butterflies. Differences in phenotypes of butterflies which occupy arctic and temperate montane environments are also predicted by the model.     

Variability in nectar production and standing crop, and their relation to pollinator visits in a Mediterranean shrub

Nectar standing crops in flowers within an individual plant are often highly variable. This variability may be a by-product of the foraging activity of insect pollinators. Alternatively, plants may be selected to produce highly variable rewards to reduce consecutive visitation by risk-averse pollinators, thus diminishing within-plant pollen transfer. This study evaluated the roles of pollinator control vs. plant control over nectar variability in the bee-pollinated shrub Rosmarinus officinalis L. (Lamiaceae). We sampled nectar production, standing crop and pollinator visits in three shrubs of one population over 17 days during one blooming season. Nectar production rates were highly variable (CV = 1.48), and increased after rainy days. Nectar standing crops were even more variable (CV = 2.16), decreased with increasing temperatures, and increased with time since the last rain. Pollinator visit rates decreased with variability in nectar standing crops, increased with flower number per shrub, and were unaffected by variability in nectar production rates. Repeated sampling of marked flowers revealed no correlation between their nectar standing crops and production rates. These findings support the role of reward variance in reducing pollinator visits, but suggest that plants are not in complete control of this variability. Rather, plant-generated variability can be modified by intensive foraging activity of pollinators. Such pollinator control over nectar variability is likely to reduce the selective advantage of plant-generated reward variation. Handling Editor: Neal Williams.     

Safety and tolerability of donepezil 23 mg in moderate to severe Alzheimer's disease

Background  

Donepezil 23 mg/d, recently approved in the United States for treatment of moderate to severe Alzheimer's disease (AD), was developed to address the need for an additional treatment option for patients with advanced AD. This report, based on a pivotal phase 3 study, presents a detailed analysis of the safety and tolerability of increasing donepezil to 23 mg/d compared with continuing 10 mg/d.     

Combination of a model-deformation method and a positional MRI to quantify the effects of posture on the anatomical structures of the trunk

Understanding the postural effects on organs and skeleton could be crucial for several applications. This paper reports on a methodology to quantify the three-dimensional effects of postures on deformable anatomical structures. A positional MRI scanner was used to image the full trunk in four postures: supine, standing, seated and forward-flexed. The MRI stacks were processed with a custom toolbox, implemented using open source software. The semi-automated segmentation was based on the deformation of generic models of the pelvis, sternum, femoral heads, spine, liver, kidneys, spleen, skin, thoracic and abdominal cavities. The toolbox was designed to be easily extended by additional image filters, deformation schemes, or new generic models. Results obtained on one subject demonstrate that the method can be used to quantify the effects of postures on skeleton and organs. The spinal curvature, the pelvic parameters and the volume of the thoracic cavity were affected by the four postures. The volumes of the kidneys, spleen, liver and abdominal object were mostly unaffected. The movement of organs was coherent with the effect of gravity. The deformation of organs between postures was expressed using geometrical transformations. Investigations should be pursued on a larger population to confirm the patterns observed on the first subject.