(i) the process must be responsive to stakeholders’ interests, in

(i) the process must be responsive to stakeholders’ interests, in that the turn-around time for assessments must be minimized, transparency must be maximized, the process must be considered fair using universally agreed standards and the process must be modifiable based on stakeholders’ requirements, (ii) the assessment of medical technologies other than drugs may Selleck GS-7977 present different challenges and is managed separately in other HTA organizations, (m) because of the link between

HTA and reimbursement decisions, completion of the HTA process following regulatory approval can delay market access to new technologies,

thus closer integration between regulatory approval and HTA Selleckchem Emricasan processes is being explored internationally, (iv) there is a direct or indirect link to reimbursement in the jurisdictions explored – without this link the role of CER in the US will remain advisory; (v) each jurisdiction reviewed benefits from a single payer that is informed by the process – given the diverse multipayer environment in the US, CER in the US may usefully focus on generating comparative effectiveness evidence; (vi) a common metric for assessing intended and unintended effects of treatment allows comparison across different BAY 63-2521 molecular weight technologies, and (vii) one stated focus of CER is on therapeutic benefit among ‘high-priority populations’, including specific demographic groups (the elderly and children, racial and ethnic minorities) and individuals with disabilities, multiple chronic conditions and specific genomic factors. This will be difficult to achieve because epidemiological evidence of differences in therapeutic benefit among subgroups is detected

through effect modification, or more specifically, statistical evidence of effect measure modification, typically on relative measures of effect. Few randomized trials have enough power to detect effect modification and these have been uncommon in the scientific literature

As consideration is given to the development of a publicly funded CER body in the US, much can be learned from the international experience. Nevertheless, there are some distinctive features of the US healthcare system that must be taken into account when assessing the transferability of these insights”
“Background and Aim: Epidemiological studies have shown that increased serum uric acid (SUA) level is associated with coronary artery disease (CAD). Leukocytes have been shown to play an important role in the atherosclerotic process.

Activation of the beta 2AR in cultured keratinocytes signals the

Activation of the beta 2AR in cultured keratinocytes signals the down-regulation of the AKT pathway, accompanied by a stabilization of the actin cytoskeleton and an increase in focal adhesion formation, resulting in a nonmigratory phenotype. Burn wound injury in excised human skin also rapidly up-regulates MK-8931 clinical trial the intra-epithelial expression of the epinephrine synthesizing enzyme phenylethanolamine-N-methyltransferase, and tissue levels of epinephrine rise dramatically (15-fold) in the burn wounded tissue (values of epinephrine expressed as pg/ug protein +/- standard error of the

mean: unburned control, 0.6 +/- 0.36; immediately postburn, 9.6 +/- 1.58; 2 h postburn, 3.1 +/- 1.08; 24 h post-burn, 6.7 +/- 0.94). Finally, using an animal burn wound model (20% body surface in mice), we found that systemic Fludarabine treatment with beta AR antagonists results in a significant increase (44%, 95% CI 27%-61%, p < 0.00000001) in the rate of burn wound re-epithelialization.

Conclusions This work demonstrates an alternate pathway by which stress can impair healing: by stress-induced elevation of epinephrine levels resulting in activation

of the keratinocyte beta 2AR and the impairment of cell otility and wound re-epithelialization. Furthermore, since the burn wound locally generates epinephrine in response to wounding, epinephrine levels are locally, as well as systemically, elevated, and wound healing is impacted by these dual mechanisms. Treatment with beta adrenergic antagonists significantly Epoxomicin datasheet improves the rate of burn wound re-epithelialization. This work suggests that specific beta 2AR antagonists may be apt, near-term translational therapeutic targets for enhancing burn wound healing, and may provide a novel, low-cost, safe approach to improving skin wound repair in the stressed individual.”
“Background: The absorption of cocoa flavanols in the small intestine is limited, and the majority of the flavanols reach the large intestine where they may be metabolized by resident microbiota.

Objective: We assessed the prebiotic potential of cocoa flavanols in a randomized, double-blind, crossover, controlled intervention study.

Design: Twenty-two

healthy human volunteers were randomly assigned to either a high-cocoa flavanol (HCF) group (494 mg cocoa flavanols/d) or a low-cocoa flavanol (LCF) group (23 mg cocoa flavanols/d) for 4 wk. This was followed by a 4-wk washout period before volunteers crossed to the alternant arm. Fecal samples were recovered before and after each intervention, and bacterial numbers were measured by fluorescence in situ hybridization. A number of other biochemical and physiologic markers were measured.

Results: Compared with the consumption of the LCF drink, the daily consumption of the HCF drink for 4 wk significantly increased the bifidobacterial (P<0.01) and lactobacilli (P<0.001) populations but significantly decreased clostridia counts (P<0.001).

In these films, the Ga content was varied from 0 05 to 7 at % an

In these films, the Ga content was varied from 0.05 to 7 at. % and the Mg content was varied from 5 to 15 at. %. X-ray diffraction showed that the solid solubility limit of Ga in MgxZn1-xO is less than 3 at. %. The absorption

spectra were fitted to examine Ga doping effects on bandgap and band tail characteristics. Distinctive trends in fitted bandgap and band tail characteristics were determined in films with Ga content below 3 at. % and Ga content above 3 at. %. The effects of bandgap engineering on optical transparency were evaluated using transmission spectra. Carrier concentration and Hall mobility data were obtained as functions of Ga content and Mg content. The electrical properties were significantly degraded when the Ga content exceeded 3 at. %. Correlations between conduction mechanisms and this website gallium doping of MgxZn1-xO thin films were described. In addition, the effect of bandgap engineering on the electrical properties of epitaxial single crystal gallium-doped MgxZn1-xO thin ML323 films was discussed.”

Chronic cholestatic pruritus (ChP) is caused by various hepatobiliary disorders. This retrospective study describes the distribution of underlying diseases, clinical characteristics and treatment efficacy in a consecutive collective of patients with ChP.

Patients and methods: Extensive data from 60 patients with ChP (30 women, PARP 抑制剂 30 men; mean age: 58.0 +/- 17.0 years) were retrospectively statistically analyzed concerning demographic data, pruritus characteristics, and response to therapy.

Results: In this study population, 40.0 % of the patients suffered from hepatitis B or C. Regarding the overall population, pruritus started in 50 % of patients after diagnosis of the underlying hepatobiliary disorder. Only in patients with immune-mediated liver diseases did pruritus more often occur before diagnosis (p < 0.05). Only 23.3 % of the patients reported an initial palmoplantar pruritus.

Along with other drugs, anticonvulsants proved to be an effective treatment regime.

Conclusions: In this study, viral pathogenesis was the most common cause of ChP. Other underlying diseases were represented to a lower extent in the total study population. Overall, the collected clinical parameters in each group were comparable. Thus, it was difficult to draw conclusions on the pathogenesis.”
“Purpose: To retrospectively determine the distribution of growth rates across different sizes and subtypes of renal cortical tumors by assessing tumor volume and maximum tumor diameter at serial volumetric computed tomographic (CT) examinations.

Materials and Methods: The institutional review board approved this retrospective, HIPAA-compliant study.

3 mg/lb], IM) as an injection only (6 fish/treatment);

3 mg/lb], IM) as an injection only (6 fish/treatment); check details an injection with anesthesia and surgery (12 fish/treatment); or an injection with anesthesia but without surgery (12 fish/treatment). Physiologic and behavioral data were recorded 12 hours before and at intervals after treatment.

Results-Compared with baseline values, the saline solution-surgery

group had significantly decreased respiratory rates (at 12 to 24 hours), food consumption assessed as a percentage of floating pellets consumed (at 0 to 36 hours), and activity score (at 0 to 48 hours). Respiratory rate decreased in all butorphanol-treated fish; significant decreases were detected at fewer time points following morphine administration. In the butorphanol-surgery group, the value for:food consumption initially decreased but returned to baseline values within 3 hours after treatment; food consumption did not change in the morphine-surgery group. Surgery resulted in decreased activity, regardless of treatment, with the most pronounced effect in the saline solution surgery group. Changes in location in water column, interactive behavior, and hiding behavior were not significantly different among groups. Butorphanol and morphine administration was associated with temporary buoyancy problems and temporary bouts of excessive activity, respectively.

Conclusions and Clinical

Relevance-Butorphanol and morphine appeared to have an analgesic effect in koi, but morphine administration caused fewer deleterious selleck screening library adverse effects. Food consumption appeared to be a reliable indicator of pain in koi.”
“HIV-positive BIRB 796 datasheet adolescents face a number of challenges in dealing with their disease and its treatment. In this qualitative study, twenty-nine HIV-positive adolescents aged 13 to 20 years (22 girls), who live in Switzerland, were asked, in a semi-structured interview (duration of 40-110 minutes), to describe their

perceptions and experiences with the disease itself and with therapeutic adherence. While younger adolescents most often thought of their disease as fate, older adolescents usually knew that they had received it through vertical transmission, although the topic appeared to be particularly difficult to discuss for those living with their HIV-positive mothers. Based on their attending physician’s assessment, 18 subjects were judged highly adherent, 4 fairly and 7 poorly adherent. High adherence appeared linked with adequate psychological adjustment and effective coping mechanisms, as well as with the discussion and adoption of explicit medication-taking strategies. The setting and organisation of health care teams should allow for ongoing discussions with HIV-positive adolescents that focus on their perceptions of their disease, how they cope with it and with the treatment, and how they could improve their adherence.”
“Starting from an existing model by Clem et al.

Since new isotopic evidence from Aramis suggests that it was not<

Since new isotopic evidence from Aramis suggests that it was not

present in Ardipithecus ramidus at 4.4 Ma, we suggest that the origins lie in the period between 3 and 4Myr ago.”
“Study Design. Ten- to 13-year follow-up of a prospective randomized study.

Objective. selleck chemical To compare the 10- to 13-year outcomes of anterior cervical decompression and fusion (ACDF) with a cervical intervertebral fusion cage (CIFC), and the Cloward procedure (CP) using a broad clinical and patient-centered assessment.

Summary of Background Data. There are few prospective studies and none with a follow-up of 10 years or more.

Methods. Patient questionnaires completed 10 years or more after ACDF. Seventy-three patients (77%) responded. Radiographs were obtained NOV120101 at 2 years.

Results. Apart from greater fulfillment of preoperative expectation (P = 0.01) and less headache (P = 0.005) in the CIFC group compared with the CP group,

there were no significant differences in the outcomes of the two surgical methods. Pain intensity improved in comparison with preoperative levels in both the CIFC and CP groups (P < 0.0001), but the Neck Disability Index (NDI) only improved in the CIFC group (P = 0.04). Only those with a healed fusion benefited from an improved NDI (P = 0.02). There was no deterioration in pain intensity or NDI after the 2-year follow-up.

Conclusion. The outcomes of the two surgical methods, with a few exceptions, were equal at 10- to 13-year follow-up, and there was no deterioration in outcome after the 2-year follow-up. Pain intensity improved more than disability, which may indicate that further improvement of physical function requires early more extensive postoperative rehabilitation. Despite persisting disability, repeat surgery was relatively uncommon.”
“Background: An anti-inflammatory effect of light obtained from light-emitting

diodes (LEDs) has been discovered, however, limited ranges find more of wavelengths have been used and the action mechanism has been rarely demonstrated.

Objective: We sought to analyze the immunomodulatory effect of LED on Jurkat T cells and human T cells.

Methods: Jurkat T cells with/without stimulation were irradiated once or five times using seven ranges of LED wavelengths, from 415 nm to 940 nm. Cytotoxic effects were examined by an MIT assay. Changes in T cell-induced cytokines, including IL-2, IL-4, IL-10, IL-12 and IFN-gamma, and their upstream signaling molecules, ZAP-70 and PKC theta, were examined by real-time PCR, ELISA, and Western blot analysis. The effect of the LED wavelength, whose effect was identified on Jurkat T cells, was also examined in human CD3+ T cells with/without stimulation and in Dermatophagoides farinae-induced atopic dermatitis (AD) NC/Nga mice.

(C) 2009 Wiley Periodicals, Inc J Appl Polym Sci 113:3725-3731,

(C) 2009 Wiley Periodicals, Inc. J Appl Polym Sci 113:3725-3731, 2009″
“The implementation of cigarette smoking abstinence reinforcement programs may be hindered by the time intensive burden placed on patients and treatment providers. The use of remote monitoring and reinforcement of smoking abstinence may enhance the accessibility and acceptability of this intervention, particularly in rural

areas where transportation can be unreliable and treatment providers distant. This study determined the effectiveness of an Internet-based abstinence reinforcement intervention in initiating and maintaining smoking abstinence in rural smokers. Sixty-eight smokers were enrolled to evaluate the efficacy of an Internet-based smoking cessation program. During the 6-week intervention period, all participants were asked to record 2 videos Vistusertib in vitro of breath carbon monoxide (CO) samples daily. Participants also typed the value of their CO readings into web-based software that provided feedback and reinforcement based on their smoking status. Participants (n=35) in the Abstinence

Contingent (AC) group received monetary incentives contingent on recent smoking abstinence (i.e., CO of 4 parts per million or below). Participants (n=33) in the Yoked Control (YC) group received monetary incentives independent of smoking status. Participants in the AC group were significantly check details more likely than the YC group to post negative

CO samples on the study website (OR=4.56; 95% CI=2.18-9.52). Participants assigned to AC were also significantly more likely to achieve some level of continuous abstinence over the 6-week intervention compared to those assigned to YC. These results demonstrate the feasibility and short-term efficacy of delivering reinforcement for smoking abstinence over the Internet to rural populations. (C) 2009 Elsevier Ireland Ltd. All rights reserved.”
“A simple reverse-phase (RP) high performance liquid chromatography (HPLC) method was developed and validated, according to the International Harmonisation Guidelines (ICH), for the determination of risperidone (RISP) from solid lipid nanoparticles (SLN). Chromatographic runs were performed on a RP-C18 column, using an isocratic mobile phase of methanol, acetate BX-795 inhibitor buffer (0.05 M; pH 4.6) and triethylamine (60: 40: 0.02, v/v/v). The flow rate was 1 ml/min, the run time was 10 min and the RISP absorbance was measured at 280 nm, using UV detection. A linear response was obtained for a RISP concentration range of 0.25 – 10.00 mu g/ml (R-2 = 0.9996), with a detection and quantification limits of 0.011 and 0.034 mu g/ml, respectively. The method was shown to be specific, precise at the intra-day (RSD < 0.796%) and inter-day (RSD < 0.331%) levels, and accurate with recoveries between 86.

Men and women show a rapid antidepressant response following scop

Men and women show a rapid antidepressant response following scopolamine, but the magnitude of response is larger in women than in men. Neuropsychopharmacology (2010) 35, 2479-2488; doi: 10.1038/npp.2010.131; published online 25 August 2010″
“Non-neonatal hypoxic-ischemic encephalopathy is a clinical condition often related to cardiopulmonary arrest that demands critical management and treatment decisions. Management depends

mainly on the degree of neurological impairment and prognostic considerations. Computed tomography (CT) is often used to exclude associated or mimicking pathology. If any, only check details nonspecific signs such as cerebral edema, sulci effacement, and decreased gray matter (GM)/white matter (WM) differentiation are evident. Pseudosubarachnoid hemorrhage, a GM/WM attenuation ratio < 1.18, and inverted GM attenuation are associated with a poor prognosis. Magnetic resonance

(MR) imaging is more sensitive than CT in assessing brain damage in hypoxic-ischemic encephalopathy. Some MR findings have similarities to those seen pathologically, based on spatial distribution and time scale, such as lesions distributed in watershed regions and selective injury to GM structures. In the acute phase, lesions are better depicted using diffusion-weighted imaging (DWI) because of the presence of cytotoxic edema, which, on T2-weighted images, only become apparent later in the early subacute phase. In the late subacute phase, postanoxic leukoencephalopathy BAY 1895344 molecular weight and contrast enhancement could be observed. In the chronic phase, atrophic changes predominate over tissue signal changes. MR can be useful for estimating prognosis when other tests are inconclusive. Some findings, such as the extent of lesions on DWI and presence of a lactate peak and depleted N-acetyl aspartate peak on MR spectroscopy, seem to have prognostic value.”
“Proton (H-1) magnetic resonance spectroscopy (MRS) changes are noted in Wilson’s disease (WD). However, see more there are no studies regarding membrane phospholipid abnormality using P-31

MRS in these patients. We aimed to analyze the striatal spectroscopic abnormalities using P-31 and H-1 MRS in WD.

Forty patients of WD (treated, 29; untreated,11) and 30 controls underwent routine MR image sequences and in vivo 2-D P-31 and H-1 MRS of basal ganglia using an image-selected technique on a 1.5-T MRI scanner. Statistical analysis was done using Student’s t test.

The mean durations of illness and treatment were 6.2 +/- 7.4 and 4.8 +/- 5.9 years, respectively. MRI images were abnormal in all the patients. H-1 MRS revealed statistically significant reduction of N-acetyl aspartate (NAA)/choline (Cho) and NAA/creatine ratios in striatum (H-1 MRS) of treated patients compared to controls. The mean values of phosphomonoesters (PME) (p < 0.0001), phosphodiesters (PDE) (p < 0.0001), and total phosphorus (TPh) (p < 0.0001) were elevated in patients compared to controls.

Leukemia (2010) 24, 2048-2055;doi:10 1038/leu 2010 211; published

Leukemia (2010) 24, 2048-2055;doi:10.1038/leu.2010.211; published online 23 September 2010″
“Fragile X syndrome is caused by the loss of expression of the fragile X mental retardation protein (FMRP). As a RNA binding protein, FMRP functions in translational regulation, localization, and stability of its neuronal target transcripts. The Drosophila homologue, dFMR1, is well conserved in sequence and function with respect to human FMRP. Although dFMR1 is known to express two main isoforms, the mechanism behind production of the second, more slowly migrating isoform has remained elusive. Furthermore, it remains unknown whether the two isoforms may

also contribute differentially to dFMR1 function. We have found that this Nutlin-3 in vitro second dFMR1 isoform is generated through an alternative

translational start site in the dfmr1 5′UTR. This 5′UTR coding sequence is well conserved in the melanogaster group. Translation this website of the predominant, smaller form of dFMR1 (dFMR1-S(N)) begins at a canonical start codon (ATG), whereas translation of the minor, larger form (dFMR1-L(N)) begins upstream at a non-canonical start codon (CTG). To assess the contribution of the N-terminal extension toward dFMR1 activity, we generated transgenic flies that exclusively express either dFMR1-S(N) or dFMR1-L(N). Expression analyses throughout development revealed that dFMR1-S(N) is required for normal dFMR1-L(N) expression levels in adult brains. In situ expression analyses showed that either dFMR1-S(N) or dFMR1-L(N) is individually sufficient for proper dFMR1 localization in the nervous system. Functional studies demonstrated that both dFMR1-S(N)

and dFMR1-LN can function independently to rescue dfmr1 null defects in synaptogenesis and axon guidance. Thus, dfmr1 encodes two functional isoforms with respect to expression and activity throughout neuronal development. (C) 2011 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Fludarabine combination chemotherapy achieves high response rates in chronic lymphocytic leukemia (CLL) and indolent lymphoma. The aim of this study was to investigate the incidence and characteristics of treatment-related myelodysplasia and acute myeloid leukemia (t-MDS/AML) after treatment with fludarabine in combination A-769662 datasheet for lymphoproliferative disorders and identify risk factors for its development. In all, 176 patients treated with fludarabine combination were followed for a median of 41 months (range 6-125 months). In all, 19 cases of t-MDS/AML have been identified for an overall rate of 10.8%. Median overall survival post-t-MDS/AML diagnosis was 11 months. Patients developing t-MDS/AML included 11/54 with follicular lymphoma (FL) (crude rate 20.4%), 5/82 with CLL (6.1%) and 3/24 with Waldenstrom macroglobulinemia or marginal zone lymphoma (12.5%).

Agents that block the induction or slow the spread of CSD may be

Agents that block the induction or slow the spread of CSD may be of utility in treating migraine. Here we examined the ability of propofol hemisuccinate (PHS), a water-soluble prodrug of propofol, to affect CSD

in mice. For comparison, we examinined dizocilpine, an NMDA receptor antagonist, that is well recognized to inhibit CSD. When administered ATM inhibitor 15 min prior to activation of CSD by KCI application to the cortex, intraperitoneal PHS at doses of 120 and 200 mg/kg decreased the number of CSD deflections without an effect on CSD amplitude, and at 200 mg/kg caused a 77% reduction in CSD velocity. The minimally-effective dose of PHS (120 mg/kg) did not cause sedation or motor impairment and while some animals receiving 200 mg/kg did demonstrate motor impariment

none exhibited loss-of-righting reflex (anesthesia). Dizocilpine produced comparable inhibition of CSD at doses of 0.5 and 2.5 mg/kg. We conclude that acute PHS treatment inhibits CSD. Our results indicate that propofol, or its prodrug PHS, are worthy of further investigation as a treatment for migraine. (C) 2012 Elsevier Ireland Ltd. All rights selleck products reserved.”
“Purpose: Transitioning care of patients with spina bifida to adult centers poses a challenge. We sought patient and parent perspectives on the transition process at our center and correlated these perspectives with medical outcomes.

Materials and Methods: Patients who attended the adult spina bifida clinic at our institution were invited to complete SF-36(R), the Ambulatory

Care Experience Survey and a Transition of Care Survey. Urological and neurosurgical medical outcomes were correlated with health status, clinic experience and perspectives on the transition process. Statistical analysis was done using SPSS(R), version 16.0.

Results: Of 105 patients with spina bifida 24 participated in the study. SF-36 results to showed that the physical health domain correlated with lack of employment (p = 0.006). Patients whose parents completed the surveys on their behalf were more likely to have physical limitations than the patients who completed surveys (p = 0.011). Urological and neurosurgical outcomes did not significantly affect SF-36, Ambulatory Care Experience Survey or Transition of Care Survey scores in this patient population. Patients and caregivers identified similar key elements and barriers in the transition process. Satisfaction with care at the pediatric center was higher than at the adult center.

Conclusions: Transitioning care of patients with spina bifida from pediatric to adult care poses challenges for the health care system. Medical outcomes do not impact the patient perspective of the transition process. To optimize the transition of care we must address the barriers identified by patients and their caregivers.”
“Quinine specifically blocks connexin 36 (Cx36), one of the proteins that form gap junction channels.

A subset of patients

have progressive, drug-refractory di

A subset of patients

have progressive, drug-refractory diastolic heart failure with severely limiting symptoms caused by low cardiac output. Heart transplantation has been the only therapeutic option available for such patients. This study analyzes clinical and hemodynamic outcomes of a novel surgical technique to improve diastolic filling by means of left ventricular cavity enlargement.

Methods: Forty-four symptomatic patients underwent apical myectomy to augment left ventricular end-diastolic volume. Myectomy was performed through an apical incision, and hypertrophic muscle was excised at the apex and midventricle. Information from a prospective database was supplemented by surveys, patient contact, and medical records.

Results: The mean age of P5091 cell line the patients was 50 +/- 17 years, and 66% were women. All patients were severely limited with dyspnea, www.selleckchem.com/products/SB-431542.html 61% had angina, and 59% had syncope/presyncope. Ninety-one percent of patients were in New York Heart Association class III or IV. A mean of 16 +/- 7 g of muscle was removed. Preoperative and postoperative hemodynamic catheterization (n = 14) showed a decrease in left ventricular end-diastolic

pressure from 28 +/- 9 to 24 +/- 7 mmHg (P-.002) and an increase in end-diastolic volume index from 55 +/- 17 to 68 +/- 18 mL/m(2) (P=.003). Invasive measurements of stroke volume increased from 56 +/- 17 to 63 +/- 19 mL (P=.007). Of the 42 patients who survived to hospital discharge, 41 had improvement in symptoms. Mean peak maximum oxygen consumption with exercise (n 5) increased from 13.5 +/- 4.4 to 15.8 +/- 4.6

mL/kg per minute. Survival at 1, 3, and 5 years was 95%, 81%, and 81%, respectively. At follow-up of 2.6 +/- 3.1 years, 23 (74%) patients were in New York Heart Association class I or II. One patient underwent heart transplantation 5 years after apical myectomy.

Conclusions: Apical myectomy improves functional status by decreasing left ventricular end-diastolic pressure, improving operative compliance, and increasing stroke volume. This procedure might be of value in other patients with hypertrophic cardiomyopathy who have severe hypertrophy and small left ventricular end-diastolic volume. (J Thorac Cardiovasc Surg 2010;139:634-40)”
“Action observation influences action execution; Bcl-w this strong coupling is underlined by an overlap of cortical areas activated during observation and execution of action, and is dependent of specific motor experience. The goal of the present study was to verify if action observation can be used for rehabilitation of elderly people. We tested this question with a protocol of observational practice of 2 frequently used movements: walking and sit-to-stand/back-to-sit. Both tasks were performed at normal and maximal speed before and after training, by 8 elderly subjects.